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Clinical Analysis of Complete Denture Satisfaction Factors: Dentist and Patient Perspective

Authors:
  • Avicenna Dental College

Abstract and Figures

Background: The dilemma of patient satisfaction vs. non-satisfaction with dentures is another never-ending debate in dentistry. The fabrication of optimal dentures is possible with appropriate prosthetic laboratory techniques along with patients’ anatomic and physiologic requirements assessed by a dentist. Objective: The purpose of this study was to evaluate the patient’s priority and mean satisfaction scores of the patient and dentist during complete denture therapy. Material and methods: After selecting the subjects based on decided inclusion and exclusion criteria, the patients were asked to fill the proforma with VAS. The proforma contained a questionnaire divided into 3 parts which need to be filled by both the patients and the dentist, independently. The patients rated their dentures using a scale ranging from 1-5 (5=very satisfied; 4=satisfied; 3=neither satisfied, nor dissatisfied; 2=dissatisfied; 1=very dissatisfied), and a dentist rated the quality of the denture and the denture-bearing area. Results: According to the patient’s priority the majority of the patients preferred mastication (47%). The highest mean dentist satisfaction score was concerned with the extension of a denture (0.97 ± 0.28). There was no statistically significant difference with age and gender for mean denture assessment, aesthetic, phonetics, mastication and comfort satisfaction score (p>0.05). However, the employed patients have aesthetic, phonetics and mastication satisfaction score higher than unemployed patients and the relationship was statistically significant (p<0.05). The educated patients have mean phonetics satisfaction score higher as compared to uneducated patients and the relationship was statistically significant (p<0.05). Conclusion: Majority of the patients was concerned with better chewing function with their dentures. Age and gender do not affect patient satisfaction. However, employed patients were less satisfied with their dentures as compare to unemployed patients. In addition, patients who were educated had better phonetics with their dentures as compare to uneducated patients. Strong dentist-patient communication is necessary to be able to satisfy a patient. Keywords: Complete denture, Satisfaction, Patient communication
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International Journal of Medical Research &
Health Sciences, 2019, 8(8): 128-134
128
ISSN No: 2319-5886
ABSTRACT
Background: The dilemma of patient satisfaction vs. non-satisfaction with dentures is another never-ending debate in
dentistry. The fabrication of optimal dentures is possible with appropriate prosthetic laboratory techniques along with
patients’ anatomic and physiologic requirements assessed by a dentist. Objective: The purpose of this study was to
evaluate the patient’s priority and mean satisfaction scores of the patient and dentist during complete denture therapy.
Material and methods: After selecting the subjects based on decided inclusion and exclusion criteria, the patients
were asked to ll the proforma with VAS. The proforma contained a questionnaire divided into 3 parts which need to
be lled by both the patients and the dentist, independently. The patients rated their dentures using a scale ranging
from 1-5 (5=very satised; 4=satised; 3=neither satised, nor dissatised; 2=dissatised; 1=very dissatised), and
a dentist rated the quality of the denture and the denture-bearing area. Results: According to the patient’s priority
the majority of the patients preferred mastication (47%). The highest mean dentist satisfaction score was concerned
with the extension of a denture (0.97 ± 0.28). There was no statistically signicant difference with age and gender for
mean denture assessment, aesthetic, phonetics, mastication and comfort satisfaction score (p>0.05). However, the
employed patients have aesthetic, phonetics and mastication satisfaction score higher than unemployed patients and
the relationship was statistically signicant (p<0.05). The educated patients have mean phonetics satisfaction score
higher as compared to uneducated patients and the relationship was statistically signicant (p<0.05). Conclusion:
Majority of the patients was concerned with better chewing function with their dentures. Age and gender do not affect
patient satisfaction. However, employed patients were less satised with their dentures as compare to unemployed
patients. In addition, patients who were educated had better phonetics with their dentures as compare to uneducated
patients. Strong dentist-patient communication is necessary to be able to satisfy a patient.
Keywords: Complete denture, Satisfaction, Patient communication
Clinical Analysis of Complete Denture Satisfaction Factors: Dentist
and Patient Perspective
Abdul Razzaq Ahmed1, Muhammad Usman Muneer 2*,
Saurabh Chaturvedi , Muhammad Farhan Khan and Sadiq Amin Ahmed Rana
3
Muhammad Waqar Hussain ,
3
14
1 King Khalid University, Abha, Saudi Arabia
2 Avicenna Medical and Dental College, Lahore, Pakistan
3 Bakhtawar Amin Medical and Dental College, Multan, Pakistan
4 Baqai Medical University, Karachi, Pakistan
*Corresponding e-mail: usmuner@hotmail.com
INTRODUCTION
According to surveys by WHO, the age group of people more than 50 years is increasing worldwide. A number of
agencies are also working on increasing the life expectancy of the population in many countries. In 2014 surveys
by the UN, reported that the age group of people above 65 years is increasing day by day in Arab [1]. For a dentist
point of view tooth loss is considered as mortality, in other words, it is the ultimate death of a tooth or an end of oral
disease in a patient. Worldwide elderly patients are more often presented with a complaint of complete edentulism. In
Canada, 17% of the population was edentulous in 1990 and currently is 9.7% in the US among the age group greater
than 18 years [2]. The study reported a dramatic increase in edentulism, 33.1% of the population aged 65years or
above was suffering from the condition [2]. Study in Riyadh in 2014 among a sample of 279 female reported that
231 (82.8%) of subjects were completely edentulous in both arches and rest of the patients were having missing teeth
in a single arch [3]. In spite of various advances in dentistry and in the era of dental implants complete dentures has
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Kadhim, et al.
its own signicance in Geriatric dentistry. The dilemma of patient satisfaction vs non-satisfaction with dentures is
another never-ending debate in dentistry. The fabrication of optimal dentures is possible with appropriate prosthetic
laboratory techniques along with patients’ anatomic and physiologic requirements assessed by a dentist [4]. The
study evaluating patient feedback regarding satisfaction of their dentures found that a large number of patient are
completely satised with an average denture while in spite of appropriate denture fabrication according to prosthetic
criteria, many patients are still not satised with functions of their denture [5,6].
Literature review suggests that successful rehabilitation with a complete denture does not only depend on factors
modulated by dentist and lab fabrication, patient-dependent factors are also a major concern [7].
Consistency of saliva, anatomical stability of alveolar ridge and overlying soft tissue, depths of sulci and limitations
of the neutral zone are the important factors which affect the stability of the denture [8]. Ultimately effects patient’s
satisfaction negatively. A survey by Bhat VS9 in India evaluated the clinical factors affecting the patient’s level of
satisfaction with their complete dentures. This questionnaire-based survey grades the patient as very happy, happy and
average satisfaction. It is found that 21% of patients were very happy with the retention of upper dentures while 23%
were very happy with the retention of lower dentures. Similarly, Fenlon MR, also found that retention and stability
are dependent on the condition of the mandibular alveolar ridge and its reproducibility thus supposed to be the major
determinant for patient’s adaptability and satisfaction with new dentures [9,10]. Facial aesthetics and phonetics are
also considered as major determinants of satisfaction considered in the current study and previous literature as well.
The same Indian study found that 53% were very happy with a physical change in the face and only 13% were
unsatised. However, 25% were very happy with adaptation in speech while 35% were not able to attain optimal
phonetics with their dentures. Another factor which is considered as an essential requirement for patient satisfaction
is proper mastication needs. About 22% were happy with their masticatory needs while 3% were not happy with
mastication with new complete dentures [9].
As discussed earlier various psychosocial, psychological and socio-cultural factors are also implemented in assessment
of the success of complete denture treatment. Ali, HI, also in a study indicated that literacy rate, individual’s perception,
mental status and socioeconomic status of the patient also negatively or positively affect the patient’s satisfaction
with a denture [8]. A study in Saudi Arabia investigated the prevalence of edentulism among females of varying
socioeconomic status and demand for prosthetic rehabilitation [3]. It found that 59.1% of the population that belongs
to low socioeconomic status are susceptible to tooth loss and demands complete and partial dentures. Moreover in
such cases, long term tooth loss and compromised dental hygiene are the factors responsible for anatomical changes
in the oral cavity and ultimately lack of satisfaction with prosthetic rehabilitation. For a healthcare provider, it is
important to consider that the patient is the one who already suffered the burden of disease and any complications and
dissatisfaction increasing the trouble for him [3].
The ultimate goal of any treatment is to provide maximum benet to the patient. Therefore studies have been done
to improve the quality of complete denture by investigating the patient’s feedback. The purpose of the current study
is to evaluate the satisfactory parameters for both patient and dentist and assess the patient’s priority during denture
provision. Thus the aim of the study was to enhance the health care quality of patient and ultimately the quality of life
after prosthetic replacement of teeth.
MATERIALS AND METHODS
The study was conducted in the Department of Prosthodontics at Avicenna Dental College, Lahore, from the period
of September 2017 to April 2019. The sample size was estimated using the WHO sample size calculator taking
statistics for patient satisfaction score as 3.98 ± 1.12 [11], the margin of error as 0.205 and 95% condence level.
The calculated sample size came out as 115. Patients were recruited through non-probability sampling technique
post-ethical approval and implied consent was obtained. Edentulous patients requiring complete dentures from age
48-65 years of either gender having no systemic disease were included in the study. The patients who were mentally
incapacitated and did not provide consent were excluded from the study.
The data was collected through a validated questionnaire having Cronbach’s-α validity of 85%. The proforma
was divided into socio-demographic, patient’s priority, dentist satisfaction through denture assessment and patient
satisfaction. This proforma was to be lled by both the patients and the dentist independently. The patients and dentist
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Kadhim, et al.
rated their satisfaction for dentures using Likert-Scale ranging from 1-5 (5=very satised; 4=satised; 3=neither
satised nor dissatised; 2=dissatised; 1=very dissatised).
SPSS version 23 was used to analyze data. Mean and SD was calculated for quantitative variables like age whereas
frequencies and percentages were calculated for qualitative variables like gender, employment status, and education.
Descriptive analysis for the dentist and patient satisfaction score was also done. The independent t-test was used
to compare denture assessment, aesthetic, phonetics, mastication and comfort parameters with age, gender, and
employment and education status. The p ≤ 0.05 was taken as statistically signicant.
RESULTS
Total of 115 participants was included in the study. The mean age of the patients was 58.28 ± 7.02 years. The majority
of the patients were males (52.2%) whereas 47.8% were females. Most of them were unemployed (73%) and had
primary schooling (74.8%) (Table 1).
Table 1 Baseline characteristics of participants
Quantitative Variables Mean SD
Age (Years) 58.28 7.02
Qualitative variables n %
Gender
Male 60 52.2%
Female 55 47.8%
Employment Status
Unemployed 84 73.0%
Employed 22 19.1%
Self-employed 9 7.8%
Educational status
Uneducated 6 5.2%
Primary schooling 86 74.8%
Postgraduate 23 20.0%
According to the patient’s priority, the majority of the patients preferred mastication (47%) followed by aesthetics
(28.7%), phonetics (13.9%), and comfort (10.4%) (Figure 1).
Figure 1 Patient’s priority
The highest mean dentist satisfaction score was concerned with the extension of a denture (0.97 ± 0.28), while the
lowest mean score was calculated for occlusion (0.79 ± 0.41). The mean satisfaction score for a facial appearance
with dentures is high in aesthetic parameters and reported as 4.50 ± 1.09. The mean satisfaction score for the feeling
of condence when speaking with denture was reported as high in phonetics parameters (4.32 ± 1.05). The mean
satisfaction score for dentures helpful in eating food is reported as high in mastication parameters (4.30 ± 1.35). The
mean satisfaction score for the absence of sore spots due to a denture is reported as high in comfort parameters (4.91
± 0.41) (Table 2).
Table 2 Descriptive analysis of satisfaction of dentist and patients
Part A
Denture Assessment Mean SD
Quality Of Fit (Retention) 0.93 0.26
Extension 0.97 0.18
Vertical Relation 0.91 0.28
Occlusion 0.79 0.41
Part B
Aesthetic
Have missing teeth made an impact on your prole? 0.76 0.43
Do you avoid laughing or smiling with missing teeth? 0.23 0.43
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Do you avoid conversation with others due to missing teeth? 0.24 0.43
Are you afraid to visit an occasion without your teeth? 0.39 0.49
Are you satised with your facial appearance with dentures? 4.50 1.09
Are you satised with the size, shape, and color of the teeth? 4.46 1.12
Phonetics
Do you have a speech problem due to missing teeth? 0.56 0.5
Does air blow out during speech? 0.41 0.49
Do you often avoid people due to a speech problem? 0.26 0.44
Has a speech problem affected your profession? 0.45 0.5
Are you satised with your speech with dentures? 4.13 1.1
Do you feel condent when you speak with a denture? 4.34 1.05
Mastication
Has your chewing capability been compromised without teeth? 0.97 0.18
Have your ability to engulf food been affected? 0.74 0.44
Has your diet selection changed? 0.62 0.49
Do you avoid eating with others? 0.20 0.40
Has a loss of teeth affected your digestion and general health? 0.43 0.50
Are your dentures helpful in eating food? 4.30 1.35
Do your upper denture falling down while opening the mouth? 0.19 0.40
Do your lower denture getting displaced on tongue movements? 0.46 0.50
Comfort
Do you have pain while opening or closing the mouth with dentures? 0.08 0.27
Do you have even contact of teeth on both sides while closing the mouth? 0.78 0.41
Have you had sore spots due to dentures? 4.91 0.41
Have felt that your denture has not been tting properly? 0.39 0.49
The stratication of the dentist and patient’s satisfaction score was done with age, gender, employment status, and
education status. There was no statistically signicant difference was observed between the age group <60 years
and ≥ 60 years (p>0.05) for mean denture assessment, aesthetic, phonetics, mastication and comfort satisfaction
score. Similarly, there was no statistical signicance observed between males and females (p>0.05) for mean denture
assessment, aesthetic, phonetics, mastication and comfort satisfaction score. The employed patients have aesthetic,
phonetics and mastication satisfaction score higher than unemployed patients and the relationship was statistically
signicant (p<0.05). The educated patients have mean phonetics satisfaction score higher as compared to uneducated
patients and the relationship was statistically signicant (p<0.05) (Table 3).
Table 3 Comparison of dentist and patient’s satisfaction score with age and gender
Age Groups <60 years (n=77) ≥ 60 years (n=38) p-value
Mean SD Mean SD
Denture assessment 3.64 0.74 3.53 0.76 0.46
Aesthetic 10.32 2.19 11.11 2.29 0.08
Phonetics 10.19 2.5 10.05 2.32 0.77
Mastication 8.06 1.95 7.61 2.25 0.26
Comfort 6.12 6.26 0.78 0.69 0.33
Gender Male (n=60) Female (n=55) p-value
Mean SD Mean SD
Denture assessment 3.57 0.77 3.64 0.73 0.620
Aesthetic 10.60 2.22 10.56 2.29 0.930
Phonetics 10.23 2.40 10.05 2.49 0.690
Mastication 7.95 2.09 7.87 2.04 0.840
Comfort 6.13 0.77 6.20 0.73 0.640
Employment
Status
Employed (n=31) Unemployed (n=84) p-value
Mean SD Mean SD
Denture assessment 3.68 0.75 3.57 0.75 0.502
Aesthetic 9.68 2.55 10.92 2.04 0.008
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Phonetics 9.35 2.46 10.44 2.38 0.033
Mastication 7.29 2.18 8.14 1.97 0.048
Comfort 6.16 0.93 6.17 0.67 0.973
Education status Educated (n=98) Uneducated (n=17) P-value
Mean SD Mean SD
Denture assessment 3.59 0.77 3.65 0.61 0.780
Aesthetic 10.5 2.38 11.06 1.14 0.345
Phonetics 10.42 2.42 8.59 1.97 0.004
Mastication 7.86 2.15 8.24 1.39 0.486
Comfort 6.16 0.74 6.18 0.81 0.947
DISCUSSION
The study aims to evaluate the patient’s priority in the fabrication of a denture and also assess how much satised
were patients when they receive their denture in terms of aesthetic, phonetics, mastication and comfort. The study
also determined satisfaction parameters of a successful denture. Berg E stated that a healthy, constructive, open and
practical discussion between the dentist and his patient reects successful denture provision [12]. Ever since the
edentulism has become a legendary tradition of older age, the need for prosthetic rehabilitation is always in demand. It
is extremely imperative for a dentist to consider his patient’s priorities with regards to denture fabrication. Edentulism
and older age add up to increase the level of irritability in the patient’s behavior. In accordance with current study
results, there were 47% of patients that prioritize to incorporate such features in their denture that could enhance their
chewing abilities. This explains that denture provision is one way to improve the overall quality of life as edentulism
has a negative impact on the patient’s well-being [13,14]. The other parameter in this aspect is aesthetics. It shows that
28.7% of patents chose to have aesthetically pleasing denture over proper mastication and comfort. This is thought-
provoking that social embarrassment might play an important role in edentulous patients [15,16]. The other two
parameters phonetics and comfort were least noticeable. Only 13.9% of patients needed to have proper phonetics with
their dentures. Indeed speech is one of the main factors affected by edentulism however results are self-explanatory
and fortunately it is the least reported problem according to most of the patients [17].
With respect to patient’s socio-demographic status, the mean age of the patients was 58.28 ± 7.02 years wherein
52.2% were males and 47.8% were females. About 73% of patients were unemployed (73%) whereas 27% were
unemployed. The importance of socio-demographic in assessing patient’s satisfaction is one the major strength. It
determines whether age, gender or employment status affects the satisfaction of the patient. Satisfaction is variable
parameter and it is subjective to patient’s demographics however it is worth noticing that regardless of what patient’s
age and gender, satisfaction is never affected. Hence age and gender do not seem to be a risk factor for satisfaction
which is also validated in studies conducted [18-22].
According to the patient’s priority criteria, employment is one parameter that affects the patient’s satisfaction. In the
present study, it is justiable that patients who were employed had mean aesthetic mean satisfaction score 9.68 ±
2.55, phonetic mean satisfaction score 9.35 ± 2.46 and mastication mean satisfaction score 7.29 ± 2.18 that is less than
unemployed patients. The result showed a statistically signicant relation of satisfaction with aesthesis, phonetics,
and mastication. Contemplating these results, it is worth noticing that employed patients were less satised with their
aesthetics post denture therapy, this might be because of their social life. The satisfaction levels of employed patients
were higher because they had a higher impact of edentulism in their prole (mean satisfaction score 0.76 ± 0.43);
they had to avoid laughing (mean satisfaction score 0.23 ± 0.43), talking (mean satisfaction score 0.24 ± 0.43) with
their colleagues that causes them in great social dilemma affecting their profession also (mean satisfaction score 0.45
± 0.50). In addition, they had difculty while speaking (mean satisfaction score 0.56 ± 0.50) and blows air out while
speaking (mean satisfaction score 0.41 ± 0.49). The most important factor in these patients that affects mastication
was fear of falling upper denture while opening mouth (mean satisfaction score 0.19 ± 0.40) which is a social trauma
and has a negative impact on patient’s well-being. It is also worth noticing that these patients do not prefer to eat with
anyone (mean satisfaction score 0.20 ± 0.40). The results are in agreement with a study of Santos BF as well as with
many other studies [18,23-25]. In this study, phonetics is one of the factors related to the educational status of the
patient. Patients who were uneducated were not satised with their speech with dentures (p<0.05). This shows that
educated patients had learned phonetics and speech throughout their schooling as compare to uneducated patients.
Therefore, educated patients were able to pronounce alphabets properly. The results of this study regarding the
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Kadhim, et al.
comparison of denture satisfaction with age, gender, employment status, and educational status were not statistically
signicant. However, the dentist had adequate extension in their denture (mean satisfaction score 0.97 ± 0.28) while
there was the least satisfaction with regards to occlusion (mean satisfaction score 0.79 ± 0.41). These results are
contrary to Shirani, et al., study [26].
The study was limited to ascertain mean satisfaction scores of patients and dentist. However, it does not evaluate
whether better communication had higher satisfaction with denture provision.
CONCLUSION
Successful denture delivery is based upon the patient’s satisfaction. In a nutshell, overall patients were satised with
their dentures. Age and gender do not affect patient satisfaction. However, employed patients were less satised with
their dentures as compare to unemployed patients. In addition, patients who were educated had better phonetics with
their dentures as compare to uneducated patients.
Recommendations
A satised patient reects great dental expertise. Patient’s need for their complete dentures should be established.
We recommend initiating strong communication with patients to seek for their priorities. Once priorities are sought,
patient satisfaction is increased. We also recommend conducting more in-depth studies to assess factors leading to
satisfaction.
DECLARATIONS
Conict of Interest
The authors declared no potential conicts of interest with respect to the research, authorship, and/or publication of
this article.
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23, No. 4, 2014, pp. 259-66.
... After 14 days of denture use, a validated questionnaire was used to obtain patients' ratings of the prosthesis on a Likert scale. 21 The questionnaire is based on different domains, including aesthetics, phonetics, mastication, and comfort, while the dentist assessed the denture regarding the quality of fit (retention), extension, vertical relation, and occlusion. ...
... It was chosen as it is a comprehensive selfassessment questionnaire meant to assist dentists in evaluating the final complete denture. 21 Functional complaints about the denture were assessed by questions about phonetics, the presence of any sore spots related to the dentures, denture loosening, or even difficulty eating. Facial aesthetics were also assessed by asking the patients whether they were satisfied with their facial appearance with dentures and whether they were satisfied with the size, shape, and color of the teeth. ...
Article
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Aim: to compare the retention, dentist and patient satisfaction of maxillary 3D-printed dentures fabricated from thermoplastic tray impressions to those made using conventional final impressions. Materials and Methods: Eleven completely edentulous patients were recruited for this double-blind, randomized, crossover clinical trial. Participants were randomly assigned to receive dentures fabricated from either conventional tray final impression or thermoplastic tray final impression for 14 days before switching to the other pair. Outcomes assessed were maxillary denture retention patient and dentist satisfaction with dentures. The outcomes were measured at baseline, and 14 days after denture insertion. After crossover, a similar protocol was implemented. For statistical analysis, a paired sample t-test with α=0.05 was used. Results: The trial was successfully completed by all participants. No significant difference in peak retention values was measured between the two groups at baseline (p = 0.27) and 14 days after denture insertion (p = 0.55). However, after 14 days of denture insertion, there was a statistically significant increase in retention values for both the conventional tray impression (p = 0.016) and the thermoplastic impression (p = 0.022). Regarding patients' satisfaction, there was a statistically significant difference in overall patient satisfaction favoring dentures fabricated from the thermoplastic tray, recording 3.40 ±1.23 (p = 0.021). There was no significant difference in overall dentist satisfaction with the denture in both groups. (p = 0.77) Conclusion: A simplified approach for maxillary denture fabrication using thermoplastic trays could have comparable outcomes with dentures made from conventional trays.
... After 14 days of denture use, a validated questionnaire was used to obtain patients' ratings of the prosthesis on a Likert scale. 21 The questionnaire is based on different domains, including aesthetics, phonetics, mastication, and comfort, while the dentist assessed the denture regarding the quality of fit (retention), extension, vertical relation, and occlusion. ...
... It was chosen as it is a comprehensive selfassessment questionnaire meant to assist dentists in evaluating the final complete denture. 21 Functional complaints about the denture were assessed by questions about phonetics, the presence of any sore spots related to the dentures, denture loosening, or even difficulty eating. Facial aesthetics were also assessed by asking the patients whether they were satisfied with their facial appearance with dentures and whether they were satisfied with the size, shape, and color of the teeth. ...
... The second parameter is "esthetics." In our study, at the insertion visit, we found that esthetics was "good" for females and "very good" for males, and then during the different periods, it will be improved to be "excellent" after 2 months from the insertion of CD for both genders and the probable explanation was that at the insertion visit the muscle in tension due to the presence of the strange thing, which was the CD that has a positive influence on the muscle activity of the patient, and so, a period of adaptation for the muscle fibers to the CD is needed, 24 and this a new CD will allow the reprogramming of neuromuscular that leads to a muscular balance of the masticatory system Goiato et al. 25 This result agreed with Ellis et al., 26 Bhat et al., 13 and there were no significant differences between the genders and this result agrees with Ahmed et al., 27 and disagrees with Bellini et al. 28 The other parameter was comfort levels, which was related to many parameters such as smoothness; in our study, it was good at the insertion time then after 2 months, the satisfaction rate increased to be very good for both genders and this agrees with Bhat et al. 13 and van Waas, 20 there was no significant differences between genders and this agrees with Al-Jammali et al. 3 and Ahmed et al. 27 According to the quality of fitness of the lower dentures, in this study, it was satisfied at the insertion time for both genders, then after 2 months, the satisfaction rate increased to be "good" for females and "very good" for males, and in relation to the quality of fitness of the upper dentures for female, it was "satisfying" at the placement visit while for male, it was "good," but the satisfaction then increased with the increase in the duration of wearing the dentures to be after 2 months became "very good" for both genders. As we know that the quality of CD is closely associated with denture usage, and also related to the condition of underlying hidden variables, including alveolar ridge anatomy and the overlying soft tissue, 12,13 in this study, the satisfaction rate in relation to the quality of fitness of the upper dentures in all periods and in both genders was better than that of the lower CD and this agrees with the results of the study by Berg who found that deterioration in overall satisfaction was mainly a reflection of the patient opinion of the mandibular denture, 23 the probable explanation was that the amount of retention provided by adhesion is proportionate to the area covered by the denture, the surface area covered by the mandibular CD was less than that of covered by upper CD and so the retention was less. ...
... The second parameter is "esthetics." In our study, at the insertion visit, we found that esthetics was "good" for females and "very good" for males, and then during the different periods, it will be improved to be "excellent" after 2 months from the insertion of CD for both genders and the probable explanation was that at the insertion visit the muscle in tension due to the presence of the strange thing, which was the CD that has a positive influence on the muscle activity of the patient, and so, a period of adaptation for the muscle fibers to the CD is needed, 24 and this a new CD will allow the reprogramming of neuromuscular that leads to a muscular balance of the masticatory system Goiato et al. 25 This result agreed with Ellis et al., 26 Bhat et al., 13 and there were no significant differences between the genders and this result agrees with Ahmed et al., 27 and disagrees with Bellini et al. 28 The other parameter was comfort levels, which was related to many parameters such as smoothness; in our study, it was good at the insertion time then after 2 months, the satisfaction rate increased to be very good for both genders and this agrees with Bhat et al. 13 and van Waas, 20 there was no significant differences between genders and this agrees with Al-Jammali et al. 3 and Ahmed et al. 27 According to the quality of fitness of the lower dentures, in this study, it was satisfied at the insertion time for both genders, then after 2 months, the satisfaction rate increased to be "good" for females and "very good" for males, and in relation to the quality of fitness of the upper dentures for female, it was "satisfying" at the placement visit while for male, it was "good," but the satisfaction then increased with the increase in the duration of wearing the dentures to be after 2 months became "very good" for both genders. As we know that the quality of CD is closely associated with denture usage, and also related to the condition of underlying hidden variables, including alveolar ridge anatomy and the overlying soft tissue, 12,13 in this study, the satisfaction rate in relation to the quality of fitness of the upper dentures in all periods and in both genders was better than that of the lower CD and this agrees with the results of the study by Berg who found that deterioration in overall satisfaction was mainly a reflection of the patient opinion of the mandibular denture, 23 the probable explanation was that the amount of retention provided by adhesion is proportionate to the area covered by the denture, the surface area covered by the mandibular CD was less than that of covered by upper CD and so the retention was less. ...
Article
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Objective: A great number of patients are completely satisfied with a regular denture, on the other hand, numerous patients are still not satisfied with their denture functions despite proper denture manufacture in relation to prosthetic standards. Aim: To estimate the parameters of satisfaction for patients to improve the health care quality of patients and evaluate the effect of the adaptation period. Materials and methods: A total of 136 patients who participated in this study were patients with complete dentures (CD), after placement of the CD, the patients were asked some questions (about esthetics, phonetics, comfort, quality of fit, and the masticatory efficiency) and the satisfaction of patients was evaluated by using Likert's scale, then recorded four readings, first at the placement visit, second after 1 month, third after 45 days, and last after 2 months. Results: The female patients' satisfaction related to phonetics was about 37.8% at the placement visit, but about 91.2% after 2 months; the male patients' satisfaction related to phonetics was about 44% at the placement visit, then 94.6% after 2 months; the female patients' satisfaction as related to esthetics was about 56.6% at the placement visit, but was about 89.8% after 2 months; the male patients' satisfaction as related to esthetics was about 68% at the placement visit, but about 89.4% after 2 months. Conclusion: The satisfaction of the patient with their CD is affected by many factors such as phonetics, esthetics, comfort levels, the quality of fitness of the denture, and the mastication. The differences between gender in satisfaction in all parameters were non-significant, that is, p > 0.001. The adaptation period has an effect on the satisfaction rate of the completely edentulous patient with their CD.
... 11,12 A clinical study was conducted to evaluate the patient's priority in the fabrication of complete dentures and the denture satisfaction factors from both the dentist and patient perspectives, although the majority of patients were concerned about better chewing function, congruence between dentist and patient satisfaction scores was evident. 13 Clinical evidence is lacking on whether dentures fabricated by computeraided-design/ computer-aidedmanufacturing along with incorporating the neutral-zone impression technique in the digital workflow can afford superior clinical outcomes when compared with those fabricated conventionally, particularly in patients suffering from ridge resorption. Thus, the current work aims at comparing and correlating the patient and dentistreported outcomes and testing the retention force for; milled neutral-zone and conventional heat-polymerized dentures restoring patients with advanced ridge resorption. ...
... 1,11,12 Similar to this study, some previous studies conducted by Miranda et al. 1 and Turker et al. 13 , involving education level found no significant association between satisfaction and education level. While some studies 2,7,18,22 showed contrasting results. The fact that everyone is equally concerned about their appearance can be used to justify the findings of our study. ...
Article
OBJECTIVE: This study was conducted to determine the influence of education, demographic variables and duration of denture use on satisfaction level among complete denture wearer. METHODOLOGY: A sample of 230 patients, fulfilling the inclusion criteria, were participated in this study. The level of education, demographic details, duration of denture use and patients' satisfaction with complete denture therapy in term of comfort, esthetics, phonetics, chewing, retention and ease of cleaning were recorded by using a questionnaire. Statistical analysis was performed by Statistical Packages for the Social Sciences (SPSS) 20.0. Post-stratification Chi-square test was applied by taking p-value <0.05 as significant. RESULTS: The mean age of the respondents was 60.37±9.055 years, 165(71.74%) were females. Out of 230 respondents, literacy level of 78(33.91%) was matric & above. The average duration of use of denture was 7.09+3.295 months. On the basis of overall satisfaction scores 151(65.5%) patients were satisfied with the denture. There was statistically significant difference in age and patients' satisfaction level with dentures (p< 0.05). CONCLUSION: This study concluded that approximately 65% of the patients are satisfied with complete denture therapy. The demographic variables (except age) and duration of use of denture have no influence on patients' satisfaction level with dentures. KEYWORDS: Edentulism, Complete Denture, Satisfaction
... Nghiên cứu chỉ cho thấy số lượng BN mang PHR nam giới nhiều hơn nữ giới, điều này có thể là do tình trạng vệ sinh răng miệng ở nữ giới tốt hơn ở nam giới, nên tỷ lệ mất răng, phục hình răng ở nữ giới thấp hơn nam giới. Kết quả nghiên cứu của chúng tôi về phân bố đối tượng nghiên cứu về giới cũng tương tự như kết quả nghiên cứu của Ahmed và cộng sự tại Lahore của Pakistan [8]. Phân bố đối tượng nghiên cứu về tuổi: Nhóm tuổi dưới 16 tuổi, tuổi trung bình là 15 tuổi, có 01 BN (chiếm 0,76%), nhóm tuổi từ 16 đến dưới 34 tuổi, tuổi trung bình là 25,72 ± 5,02 tuổi, có 29 BN (chiếm 21,9%), nhóm tuổi từ 34 đến dưới 45 tuổi, tuổi trung bình là 39,61 ± 3,05 tuổi, có 18 BN (chiếm 13,6%), nhóm tuổi từ 45 đến dưới 60 tuổi, tuổi trung bình là 53,25 ± 4,51 tuổi, có 55 BN (chiếm 41,7%), nhóm tuổi từ 60 trở lên, tuổi trung bình là 66,38 ± 5,00 tuổi, có 29 BN (chiếm 22%). ...
Article
Mục tiêu: Nghiên cứu này nhằm đánh giá chất lượng cuộc sống ở người mang phục hình răng dựa trên bộ công cụ WHOQoL-Bref. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang được thực hiện với 132 người mang phục hình răng tại tỉnh Nam Định năm 2019-2021. Chọn mẫu thuận tiện tại 03 vùng miền của tỉnh Nam Định. Thông tin được thu thập bằng bộ câu hỏi, thông qua hình thức hỏi trực tiếp. Kết quả: Nghiên cứu này cho thấy chất lượng cuộc sống trung bình ở người mang phục hình răng là 42,58 và hệ số Cronback's Alpha là 0,89. Kết luận: Bộ công cụ WHOQol-Bref phù hợp với nghiên cứu để đánh giá chất lượng cuộc sống của người mang phục hình răng tại tỉnh Nam Định.
... Yet there are a group of patients who remain dissatisfied despite the clinical perfection of their prostheses (22) . Complaints commonly relate to pain, pressure, looseness, poor function, and appearance (23,24) . In addition, the psychological and personality factors have been implicated in the acceptance of complete dentures. ...
Article
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Objective: This study was conducted to investigate the impact on Oral Health-Related Quality of Life (OHRQoL) among complete denture wearers and to inspect any impact differences between males and females denture wearers. Methods: The study sample involved 100 complete denture wearers' (55 males and 45 females) aged between 40-74 years, who attended the Department of Prosthodontics, College of Dentistry, University of Sulaimani. All of the participants Interviewed directly by the researcher to answer the Oral Health Impact Profile questionnaire (OHIP-EDENT-19) to assess the prevalence of impacts using three answering scales:1= never, 2= sometimes, 3=almost always. Socio-demographic information was gathered. Data were submitted to statistical analysis (chi-square test, P≤0.05). Results: The majority of participants chose score-2 (sometimes) in answering questions regarding functional limitation, physical pain, physical and psychological disability (58%-72%). While score-1 (never) was the answer to social disability questions (69%) and score-3 (almost always) was the response of participants to consider wearing a complete denture is a handicap (46%). There were insignificant differences between both sexes in the majority of responses. However, Females were significantly more anxious than males (P0.05) in answering specific questions regarding self-consciousness, embarrassment, and avoid going out. Conclusions: Conventional complete dentures bring negative impacts in the OHRQoL of elderly patients, mainly concerning physical pain and functional limitation, followed by handicap, physical disability, psychological discomfort. The least negative impact was on social and psychological disabilities. The most encountered problems by females than males were Psychological discomfort, psychological disability, and social disability.
... 10,11 The success of complete dentures is dependent on multiple factors, patient perception is an important factor for successful treatment. 12 Satisfaction towards complete dentures may not only be affected by biologic and technical considerations taken into account during fabrication of complete dentures, other parameters may also play an important role. These include age, gender, literacy level, socioeconomic conditions, marital status, patient/professional relationship and psychological factors. ...
Article
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Objective: To determine the mean satisfaction score for patients with complete dentures and to compare the mean satisfaction score of patients with complete dentures and without past denture experience. Study design and Setting; It was a cross-sectional study conducted at Watim Dental College, Rawalpindi, from March to August 2018. Methodology: A total of 98 patients were selected and were asked regarding previous history of denture usage and their experience with the new set of dentures; in terms of function, comfort, appearance and total satisfaction. As a protocol all patients presenting to outpatient department and those patients who fulfilled the criteria were referred to Prosthodontic department for provision of complete dentures by specialist prosthodontist. Data was analysed using SPSS version 20. Descriptive statistics were calculated for both qualitative and quantitative variables. For qualitative variables like gender frequency and percentages was calculated. For Quantitative variables like age, score of function, comfort, appearance and total satisfaction mean and standard deviation were calculated. Mean± SD was calculated for satisfaction score among patients with and without past experience of denture usage. Independent sample t-test was used to compare quantitative variables. P values of less than 0.05 was considered significant. Results: Mean score of function, comfort, appearance and total satisfaction was greater among the patients with past denture experience as compared to new denture wearers with no past experience of denture wearing. Conclusion: Past denture experience has significant effect on patient satisfaction with their new complete dentures.
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The aim of the study was to assess the edentulism in relation to age, gender, location, level of income and education level of patient. Descriptive cross-sectional study was carried out at Prosthodontics De�partment, Liaquat University Hospital, Hyderabad from October 2017 to September 2018. Diagnosis were made by proper history and examinations. Data were entered regarding patient’s age, gender and level of education, level of income and residence where patient live in proforma. Out of 218 patients, 61.9% were males and 38% females. Minimum age was 50 years while average mean was 59.59 years with standard deviation 9.68 year. 60% of patients were from rural and 40% were from urban areas, 49.5% patients had primary to intermediate education, 40.8% were uneducated, while only 9.6% were graduate patients. About 72% of patients were having income below half million Pakistani Rupees per year, 26.1% earned half to one million and only 1.8% had income more than one million per year. It was concluded that a significant relationship existed between age, educational level and socioeco�nomic status which played vital roles in edentulism. Motivation and ongoing dental education are important for the elderly patients to eliminate the delusion that ‘‘tooth loss’’ is an unavoidable part of the aging process and to identify the availability of prosthetic facilities which helps in reduction of edentuliusm.
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Conventional complete denture therapy is the most extensively used form of treatment for replacement of missing dentition. Patient satisfaction plays a major role in determining the success during treatment procedures. It helps in assessment of certain psychological traits and the impact of complete denture prostheses on daily living. This study was done to evaluate the relationship between patient satisfaction and the newly constructed denture prostheses, as it would indicate the degree of success of the treatment given.
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Objectives: This study aimed to (1) measure the degree of patient satisfaction among the clinical and nonclinical dental services offered at specialty dental centers and (2) investigate the factors associated with the degree of overall satisfaction. Materials and Methods: Four hundred and ninety-seven participants from five dental centers were recruited for this study. Each participant completed a self-administered questionnaire to measure patient satisfaction with clinical and nonclinical dental services. Analysis of variance, t-tests, a general linear model, and stepwise regression analysis was applied. Results: The respondents were generally satisfied, but internal differences were observed. The exhibited highest satisfaction with the dentists’ performance, followed by the dental assistants’ services, and the lowest satisfaction with the center's physical appearance and accessibility. Females, participants with less than a bachelor's degree, and younger individuals were more satisfied with the clinical and nonclinical dental services. The stepwise regression analysis revealed that the coefficient of determination (R2) was 40.4%. The patient satisfaction with the performance of the dentists explained 42.6% of the overall satisfaction, whereas their satisfaction with the clinical setting explained 31.5% of the overall satisfaction. Conclusion: Additional improvements with regard to the accessibility and physical appearance of the dental centers are needed. In addition, interventions regarding accessibility, particularly when booking an appointment, are required.
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Objective: This exploratory study sought to measure current self-reported experiences of older Saudi adults. Method: Self-reported aging perceptions and demographic data from semi-structured questions were obtained from 52 community-dwelling older Saudi adults aged 50 or older. A thematic content analysis was completed around issues of family life/social support, daily/weekly activities, health and health programs, and older adults’ own thoughts about aging and the experience and future of personal aging. Results: Several key themes emerged from the interviews. The majority of respondents in this preliminary study acknowledge a preference for family care. Formal programs in Saudi Arabia are attended with relative infrequency while older adults recognize family support as the preferred method of support. Older Saudi interviewees hold a positive view of aging, but physical functioning, varying financial resources, and other daily obligations are a concern for those in this study. Discussion: Data suggest as the Saudi population ages, more research is needed on the aging experience with particular emphasis on issues relevant to older adults . Future research must work to clarify the aging experience as cultural context changes .
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Difficulties in the acceptance of dentures are multifactorial including psychosocial ones. It is questionable whether the patients' satisfaction depends only on the complete denture therapy characteristics. The aim of the study was to evaluated patients' expectation and satisfaction with complete dentures before and after the treatment concerning phonetics, chewing, comfort of use and aesthetics. Forty complete edentulous patients rated their expectation before and satisfaction after the treatment based on a questionnaire scores. Patient-related variables regarding age, gender and previous experience (whether worn complete denture or not) were also recorded. Patients' rating for expectations were higher than the satisfaction after treatment regarding phonetics, chewing, comfort of use and aesthetics. A negative significant correlation was shown between the items before and after the treatment rating for phonetics, chewing, comfort of use and aesthetics. No statistical correlation was found between all the evaluated aspects' (i.e., phonetics, chewing, comfort of use and aesthetics) of expectation and satisfaction, and age, gender, and previous experience except a weak negative correlation noticed between age and comfort of denture use. Patients' expectations ratings significantly exceeded their satisfactions. Expectations and satisfaction ratings were irrespective of gender and patients previous experience.
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Edentulism is the loss of all permanent teeth due to different biological and non-biological factors. Prevalence of edentulism varies considerably between countries, geographic regions and different patients' backgrounds.
Article
Purpose: Edentulism usually leads to esthetic, functional, and emotional discomfort resulting in a loss of self-esteem and a decrease of the patient's quality of life. Dental implants provide new possibilities to ensure the comfort and efficacy of prosthetic rehabilitation. The aim of this study was to evaluate the satisfaction level of patients rehabilitated using the Brånemark protocol or overdenture implant-supported prostheses. Materials and methods: Fifty-two patients were rehabilitated using the Brånemark protocol and 23 using overdenture prostheses. Then, an adapted oral health-related quality of life questionnaire was administered in addition to a clinical exam to determine the condition of the dental implants and prostheses. The results for treatment expectation, understanding of the type of treatment, phonetic function, chewing comfort, pain, and self-esteem improvement were analyzed with Fisher exact test (P ≤ .05). Results: Both treatments presented satisfaction of above 87%, with no statistical difference between them. Eighty-two percent of patients treated with overdenture prostheses and 80.8% of those treated with the Brånemark protocol had no complaint of pain (P = .087). Conclusion: The treatments analyzed in this study were highly satisfactory with regard to functional and esthetic factors, resulting in an increase in self-esteem and quality of life. The psychological factor is a complex variable in patient satisfaction that directly influences quality of life. Considering the desires of patients in choosing the type of prosthesis is critical to treatment success.
Article
PurposeThe aim of this study was to assess patients' perceptions of benefits and risks concerning complete denture therapy. A secondary objective was to assess the influence of clinical and sociodemographic variables on patients' perceptions. Materials and Methods The sample was composed of 104 volunteers who presented themselves for complete denture treatment at a dental school. The average age of the volunteers was 69.2 years () 9.3. Patient opinions concerning the benefits of complete denture therapy were recorded using a previously reported questionnaire. The answers were evaluated in three domains: (1) benefits (positive perceptions); (2) risks (negative perceptions); and (3) consequences of no treatment. ResultsThe average time of use of the previous dentures was 20 years (SD +/- 12.9). Risk factors (negative perceptions) received lower scores by the patients, while the consequences of no treatment received higher scores. No association was found among evaluations of the previous dentures and educational level, marital status, and gender; however, patients' evaluation about their previous dentures was significantly different depending on age (p= 0.001) and previous dentures' time of use (p= 0.038). Conclusions Patients presented a positive perception of complete denture therapy, and the risk factors (negative perceptions) received the lowest scores. Patient perception regarding complete denture therapy was not influenced by educational level, evaluation of the previous dentures, or marital status.
Article
There is a lack of evidence to recommend a particular type of posterior occlusal form for conventional complete dentures. The type of posterior occlusal scheme can affect complete denture stability, retention, and patient satisfaction. The objective of this study was to compare patient satisfaction to three types of complete denture occlusion using a randomized, crossover controlled trial. Three sets of complete dentures were made for each of 15 patients (mean age = 58.87 ± 15.02 years). They received (1) fully bilateral balanced occlusion (BBO), (2) lingualized occlusion, and (3) buccalized occlusion (BO) denture sets in random order. After wearing each set for 6 weeks, patient satisfaction was assessed using a 19-item version of the Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT). Each question was scored on a 1 to 5 scale for patients' problems with dentures (for these ordinal variables, 1 = "never" and 5 = "very often"). These items were first analyzed by Friedman tests and then by Wilcoxon rank tests for 80% test power at the 0.05-alpha level (d = 0.7). BO resulted in lower avoidance of particular foods and physical disability scores than fully BBO. With the caution of small sample size, the results of this study provide evidence that use of BO can improve food avoidance and physical disability aspects of patient satisfaction with complete dentures.