Protezlerin Neden Olduğu Oral Mukoza Değişiklikleri
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Oral infections occur due to contact between biofilm rich in Candida albicans formed on the inner surface of complete dentures and the mucosa. This study investigated historical advances in the prevention and treatment of oral mucosal infection and identified gaps in the literature. Bibliographic research was conducted, looking at PubMed, Embase, Web of Science, and Scopus, where 935 articles were found. After removing duplicates and excluding articles by reading the title and abstract, 131 articles were selected for full reading and 104 articles were included. Another 38 articles were added from the gray literature. This review followed the PRISMA-ScR guidelines. The historical period described ranges from 1969 to 2023, in which, during the 21st century, in vitro and in vivo studies became more common and, from 2010 to 2023, the number of randomized controlled trials increased. Among the various approaches tested are the incorporation of antimicrobial products into prosthetic materials, the improvement of oral and denture hygiene protocols, the development of synthetic and natural products for the chemical control of microorganisms, and intervention with local or systemic antimicrobial agents. Studies report good results with brushing combined with sodium hypochlorite, and new disinfectant solutions and products incorporated into prosthetic materials are promising.
Background/purpose
Decubital lesions or traumatic ulcers caused by dentures usually appear one or two day(s) after new dentures placement due to mismatch of the microrelief of the tissue and the microrelief of the gingival surface of the prosthesis. The study aimed to analyze factors that could influence the healing of ulcers during a one-week period after the placement of new partial and complete dentures.
Materials and methods
The prospective cohort study included 60 patients with new denture-induced traumatic ulcers. Traumatic ulcers were treated with denture adjustment, or combination of adjustment with 0.2% or 0.3% hyaluronic acid gels respectively for seven days. Healing of ulcers were observed through measurement of perimeter, area, maximum and minimum diameters on digital photographs. Multivariate logistic regression was used to predict other factors that could affect healing process.
Results
Perimeter, area, maximum and minimum diameters of denture-related ulcers were significant decreased after application of gels on the fifth and seventh day. The fifth day ulcers were not healed if dentures were only adjusted, while healed lesion was 40% for the other two groups. On the seventh day, the percent of healed lesion in the group with dentures adjustment was 20%, while it was increased to 75% healed lesions for combination of denture adjustment and hyaluronic acid gels. Anticoagulant/anti-aggregation drugs also had positive impact on ulcer healing; antihypertensives that included diuretics slowed ulcer healing, other monitored factors in the study did not show a significant impact.
Conclusion
Hyaluronic acid in combination with the dentures adjustment for seven days leads to higher healing rate, and reduction in size of ulcers that did not heal until this time point.
One of the most common oral diseases affecting people wearing dentures is chronic atrophic candidiasis or denture stomatitis (DS). The aim of the paper is to provide an update on the patho-genesis, presentation, and management of DS in general dental practice settings. A comprehensive review of the literature published in the last ten years was undertaken using multiple databases, including PubMed via MEDLINE, EMBASE, and Scopus. The eligible articles were analyzed to identify evidence-based strategies for the management of DS. Despite its multifactorial nature, the leading cause of DS is the development of oral Candida albicans biofilm, which is facilitated by poor oral and denture hygiene, long-term denture wear, ill-fitting dentures, and the porosity of the acrylic resin in the dentures. DS affects between 17 and 75% of the population wearing dentures, with a slight predominance in elderly females. The mucosal denture surfaces and posterior tongue are the common sites of DS, and the affected areas exhibit erythema, the swelling of the palatal mucosa and edema. Oral and denture hygiene protocols, adjusting or re-fabricating poorly adapting dentures, smoking cessation, avoiding nocturnal denture wear, and the administration of topical or systemic antifungals are the mainstay of management. Alternate treatments such as microwave disinfection, phytomedicine, photodynamic therapy, and incorporation of antifungals and nanoparticles into denture resins are being evaluated for the treatment of DS but require further evidence before routine use in clinical practice. In summary, DS is the most common oral inflammatory lesion experienced by denture wearers. Most patients with DS can be managed in general dental practice settings. Effective management by general dental practitioners may be supported by a thorough understanding of the pathogenesis, the recognition of the clinical presentation, and an awareness of contemporary treatment strategies.
The main purpose of the study was to highlight the incidence of various changes in the oral mucosa associated with wearing removable acrylic dentures. Materials and method. The study was performed on a total of 45 subjects who presented at the Prosthodontics Clinic and the Oral Rehabilitation Clinic of Craiova Faculty of Dental Medicine during January 2018-May 2020. Results. Of the 45 subjects that were wearing at least one acrylic denture 31,11% presented oral mucosa changes or lesions. The most common mucosal lesion was type 1 according to Newton's classification.
Introduction:
the prevalence of denture related mucosa lesions (DRML) varies across different countries and a recent study reported an increasing trend in its prevalence. The objective of this study was to determine the prevalence of DRML and factors related to the lesions among denture wearers seen in a Nigerian teaching hospital.
Methods:
interviewer's administered questionnaire was used to obtain information from consecutive patients that had used removable denture for at least six months and consented to participate. Data related to gender, age, types of denture and presence of denture induced oral lesions were obtained, entered into a computer and analyzed using IBM SPSS Version 20. Descriptive statistics were expressed as frequency and percentages. Fisher's exact test was performed for discrete variables. A P-value less than 0.05 was regarded as statistically significant.
Results:
a total of 104 respondents participated in the study and 14 had DRML giving a prevalence of 13.5%. The majority, 11 out of the 14 (78.57%) presented with mucosa ulceration, while 8 (57.14%) out of the 14 cases of DRML were caused by over extension of the denture flanges. There was no statistically significant relationship between daily removal of denture fore going to bed to sleep at night and DRML (p=0.776).
Conclusion:
the prevalence of denture related mucosal lesion was 13.3% and the major cause was over extension of denture flange. There is need to emphasize adherence to review appointments for early detection and correction of denture instability and over extension of denture flange to prevent DRML.
Introduction: The fissured epulis is a reactive tissue growth that develops underneath a dental prosthesis. Its etiology is related to removable of partial or total dentures and other irritative or traumatic factors. Oral cancer (CAB) is a malignant neoplasm of aggressive behavior, and it has become one of the most serious health problems worldwide. Currently, squamous cell carcinoma is considered a disease with a high mortality rate. This article aims to describe the clinical management of a squamous cell carcinoma, as a result of a fissured epulis in upper total edentulous patient. Case Report: A female patient, 58 years of age, with no systemic or family history, went for a lower removable prosthesis. The clinical examination in the maxilla presented an enlargement of soft tissue in the bottom of the vestibule on the left side, asymptomatic, compatible with a fissured epulis. Two surgical procedures were performed to remove the pathology and a sample was taken to perform a biopsy, which resulted in a squamous cell carcinoma. The patient was referred to a center specialized in cancer treatments (Society for the Fight Against Cancer) where she currently is receiving the attention of the case. Conclusions: The lack of knowledge of this injury on the part of the patient, and the lack of symptomatology, absence of periodic controls, maladjustment, and incorrect prosthetic design were the risk factors that triggered the injury.
Background
To evaluate the frequency of maxillary dentures-related lesions and the possible associated risk factors.
Material and Methods
Ninety-seven participants were selected, and a complete anamnesis, physical examination and tests of occlusion vertical dimension (OVD), retention and stability of the denture, biofilm quantification, cytopathology, sialometry, pH analysis and buffer capacity of the saliva were performed. Statistical analyses were performed with the Pearson’s chi-square, Mann-Whitney tests, and Pearson’s coefficient (p<0.05).
Results
In 78% of the participants at least one denture-related lesion was found. Denture-associated stomatitis (63%), inflammatory fibrous hyperplasia (19%) and traumatic ulceration (11%) were the 3 most frequent lesions. The habit of night use of the denture was considered an independent risk factor for the development of oral lesions [OR=3.0 (95% CI 1.09-8.56); p<0.05]. Furthermore, the longest period of use of the same denture and biofilm also had statistically significant relation to oral lesions. The biofilm seems to be more related to the prevalence of oral lesions according to the multiple logistic regression [OR=1.3 (95% CI: 1.01-1.83) p<0.05]. The lack of a dentures’ cleaning solution and detrition of the prothesis were independent risk factors for denture-associated stomatitis. Male gender, loss of OVD and bad buffer capacity were risk factors for angular cheilitis. Fractures of the base and repair of broken dentures were risk factors for traumatic ulcers.
Conclusions
These results show a high frequency of denture-related lesions. Besides, participants hygiene habits and poor quality of the dentures were the main factors for the development of these lesions.
Key words:Complete denture, oral health, oral hygiene, oral lesion, saliva.
Background
Denture‐induced oral Lesions (DIOLs) often manifests shortly after the placement or adjustment of new or realigned dentures, frequently resulting in severe pain and discomfort.
Objectives
This study aimed to classify DIOLs placing a particular emphasis on assessing the associated pain.
Methods
A prospective case study was conducted involving 126 patients who were fitted with a total of 193 dentures of various types at the Hadassah School of Dental Medicine. All patients underwent comprehensive intra‐oral examinations within 1–8 weeks following denture delivery, completed symptom questionnaires and had their medical records reviewed. Key variables documented included age, gender, overall health status, denture type, and a detailed description of the DIOLs. The description encompassed factors such as lesion location, shape, colour, size, border characteristics, ulcerative appearance, membrane coverage, 3D morphology (elevated, immersed and flat) and patient‐reported Verbal Pain Score (VPS) when touching the DIOLs, when wearing the denture, and when not wearing the denture.
Results
Notably, 25.4% of denture wearers required no adjustments, while 14.4% necessitated more than three revisions. A majority (71.8%) of DIOLs cases were associated with mandibular complete dentures, primarily situated on the alveolar ridge. The mean VPS indicated a pain intensity of 7 ± 2.1, with temporary dentures in both jaws causing the most discomfort. Implant‐supported overdentures were particularly painful when placed in the mandible. Additionally, VPS scores were higher among older individuals and those with prior prosthetic experiences. A significant correlation was observed between pain intensity and presence of chronic health condition (0.036).
Conclusions
This study revealed distinct characteristics of DIOLs and highlighted the multifactorial nature of pain experienced following the development of DIOLs. Insights into the influence of patient and denture characteristics on DIOLs and pain intensity can guide healthcare professionals in optimising patient comfort and satisfaction.
Dental prosthesis have the main goal of rehabilitation of edentulous spaces present in oral cavity. Due to their prolonged use and poor oral hygiene it paves way for inflammatory and traumatic lesions and makes chewing inefficient thereby reduces the nutritional capacity of the patient. These lesions are more common among elderly and immune compromised patients, this article is a review about the oral lesions caused by the long term use of dentures both removable and complete dentures.