Initial effects of a treatment by fixed partial dentures supported by mini dental implants from a patient's point of view.

Mini dental implants (MDIs) in dentistry are recommended for cases with adequate bone quality and height, but a lack of alveolar bone width. Some studies well documented successful usage of MDIs for a removable denture support, but studies of MDIs supporting fixed prosthodontic restorations are scarce. We aimed to study the effect of fixed partial dentures (FPD) therapy supported by MDIs or by MDIs and natural teeth, on patients self perceived oral health related quality of life (OHRQoL), self perceived oral aesthetics and self perceived chewing function. A total of 23 patients (10 female and 13 men, age range from 54 to 78 years) were included and 61 MDIs were inserted, 10 in the maxilla and 51 in the mandible. In 14 patients FPDs were constructed only on MDIs and in 9 patients FPDs were constructed on both, MDIs and natural teeth. FPDs on MDIs were replacing mostly mandibular incisors, the second maxillary incisors and the first maxillary premolars. Those FPDs supported by both, MDIs and natural teeth had some MDIs inserted in frontal regions to allow a FPD construction. The three questionnaires: the OHIP-CRO14 for the assessment of OHRQoL, the OES-CRO for assessment of oral aesthetics and the Chewing function questionnaire (CFQ) for assessment of chewing function have been administrated twice:prior to the MDIs insertion and three months after the FPD treatment supported by MDIs had been finished. The CFQ and the OHIP summary scores significantly decreased revealing better OHRQoL and better chewing ability after treatment, and the OES scores significantly increased indicating increased self perceived oral aesthetics (p < 0.01). Clinical examination revealed no periimplant inflammation. Patients' data supplement the initially promising clinical findings. However, further follow ups will be necessary to finally confirm the long term clinical benefit of MDIs.

Development of a new chewing function questionnaire for assessment of a self-perceived chewing function.

OBJECTIVE: To develop a new unidimensional questionnaire for patients' self-assessment of their chewing function (chewing function questionnaire: CFQ) and to test its psychometric properties. METHODS: A focus group of 7 dentists and 15 prosthodontic patients generated a pool of 30 relevant items. A 5-point Likert scale (0-4) was used. A focus group reduced some redundant items, and 21 items remained for pilot testing after which additional four items were eliminated. Then, the 17-item questionnaire was tested on a larger sample (200 participants). Factor analysis was obtained to investigate the dimensionality of the questionnaire. Finally the 10 items remained, and the CFQ was unidimensional. To test the psychometric properties, the CFQ was administrated to 224 individuals: 100 patients were already removable denture wearers (RDWs), 24 patients needed a removable prosthodontic treatment, and 100 individuals had natural teeth (NT group). Discriminative validity was tested between the RDWs and the NT groups. Convergent validity and internal consistency were tested on 200 subjects. The internal consistency was assessed by calculating the Cronbach's alpha coefficient and the average interitem correlation. The test-retest reliability was tested on 60 subjects. Responsiveness was tested on 24 patients who received new removable prosthodontic treatment. RESULTS: The initial factor analysis revealed that the items had been grouped in three different dimensions. By eliminating items with complexities greater than one, additional six questions were eliminated. One more item with the lowest correlation was further eliminated. The final questionnaire included 10 items. Discriminative validity showed significant differences between the NT group and the RDWs, as predicted (P < 0.001). Convergent validity was confirmed by the Spearman's rank correlation. A significant positive association (P < 0.001) was found between the CFQ and one general question about chewing difficulties, as well as between the CFQ and five items from the OHIP49 related to chewing. The test-retest reliability showed high intraclass correlation and no significant differences between the two administrations of the CFQ (P > 0.05). The internal consistency showed satisfactory Cronbach's alpha values (0.916 for all subjects, 0.742 for the NT group, and 0.852 for the RDWs). Responsiveness was confirmed by a significant difference between the baseline and the follow-up score (P < 0.001) and a high effect size (0.95). CONCLUSIONS: The developed CFQ provides an assessment instrument of the hypothetical construct invoked to explain the chewing function. Psychometric properties are satisfactory demonstrating that the instrument is suitable for the assessment of a self-perceived chewing function.

Association of cephalometric changes after 5 years of complete dentures wearing and oral health-related quality-of-life.

OBJECTIVE: The aim was to investigate cephalometric changes after 5 years of wearing complete dentures (CDs) and to asses a possible relationship between changes in cephalometric parameters and patients' oral health-related quality-of-life (OHRQoL). MATERIALS AND METHODS: New complete maxillary and mandibular dentures were fabricated for 30 participants. Two lateral radiographs were obtained from each participant with their CDs in the position of maximal intercuspidation (centric relation): the first radiograph was obtained at the CDs delivery and the second one after 5 years of CDs wearing. A questionnaire (OHIP 14) was given to all participants at the 5-year appointment. RESULTS: Significant differences in most linear and angular cephalometric measurements were found after 5 years of CDs wearing, due to the reduction of the height of the lower third of the face and the forward shifting of the mandible. A significant correlation between the OHIP summary scores and five cephalometric variables was found (ANS-Xi/Xi-Pm angle, FH/N-Pog angle, SN/Go-Gn angle, Go-Gn/ANS-PNS angle and occlusal plane/FH), indicating that more severe cephalometric changes were related with the increase of OHIP scores. CONCLUSION: Changes of cephalometric angles due to lowering of the face and forward shifting of the mandible were related to the decreased OHRQoL (increased OHIP scores).

Changes of the dental service delivered to patients with intellectual disability under general anaesthesia in Dental Polyclinic Split, Croatia, during the years 1985-2009.

People with intellectual disability (ID) usually have a poor quality of oral health, which include poor oral hygiene, untreated caries and high proportion of missing teeth. Due to their fear and repulsive attitude towards medical staff general anesthesia is often a useful method for dental treatment. One thousand and fifty four intellectual disability patients for the period of 1985-2009 who received dental treatment under general anesthesia in Dental Polyclinic Split, were included in the study. Patients were divided into five groups based upon the period when a specific dental treatment had been received. Each period was analyzed for the number of ID patients treated and the type of dental treatment. The results showed that the most services provided were 4006 fillings, followed by 3225 extracted teeth and finally 274 endodontic treatments. Significantly the lowest number of fillings and endodontic treatments were found among patients in group II (1990-1994), with significantly the highest number of extracted teeth. In Conclusion, the types of dental treatment have changed during twenty five years. Number of extracted teeth decreased while the number of fillings and endodontic treatment increased. However, dental status of people with intellectual disability should be improved with more restorative treatments and with better oral health prevention program.