Nonadaptation to New Mandibular Complete Dentures: A Survival Analysis and Interpretation of the Time to Adaptation.

PURPOSE: To determine the average time for patients to adapt to mandibular complete dentures (CDs) and the factors associated with this critical period. MATERIALS AND METHODS: In total, 108 completely edentulous patients were rehabilitated using CDs. Adaptation was evaluated based on the following criteria: mastication, comfort, speech, and swallowing with dentures. The Kaplan-Meier method was used to estimate the average time to adaptation. The logrank test was used to assess the adaptation period and associated factors. RESULTS: Of the 108 rehabilitated patients, 89 had adapted to mandibular CDs at the 6-month follow-up. The mean time to adaptation estimated from the Kaplan-Meier curve was 78.54 days (95% confidence interval [CI] 71.04 to 86.04). The factors associated with the adaptation period were previous experience with a mandibular denture (P = .032), the professional who made the previous CDs (P = .034), frequency of appearance of traumatic lesions after 15 days of rehabilitation (P = .023), posterior mandibular ridge height (P = .005), and regular use of the new dentures (P = .002). CONCLUSIONS: Most patients adapted to mandibular dentures after 2.6 months. Lack of prior experience with mandibular dentures, use of old dentures made by a dental technician, occurrence of traumatic injuries 15 days after CD delivery, presence of a resorbed posterior mandibular ridge, and nonregular wear were associated with longer adaptation time to new mandibular CDs.

Incidence and risk factors for non-adaptation of new mandibular complete dentures: a clinical trial.

OBJECTIVE: To investigate the incidence and risk factors for non-adaptation of the conventional mandibular complete denture (CMCD). MATERIALS AND METHODS: A total of 108 edentulous patients were rehabilitated with complete dentures (CDs) and followed up at 3- and 6-month intervals. Adaptation was confirmed based on chewing, phonetics, and comfortable swallowing with the CDs. The risk factors among sociodemographic and patient-centered factors were analyzed. Statistical analyses included the chi-square test and then a multivariate analysis. RESULTS: After 3 months, 38.0% of patients showed non-adaptation to CMCDs. Non-adaptation was significantly associated with the absence of previous mandibular denture experience (p = 0.042), ulcerations after 15 days of rehabilitation (p < 0.001), and a reduced posterior mandibular ridge (p = 0.035). After 6 months, this incidence decreased to 14.1%. The factors associated with non-adaptation were ulcerative lesions after 15 (p < 0.001) and 30 (p < 0.001) days of the delivery of CDs and the non-regular use of mandibular CDs (p < 0.001). CONCLUSION: The incidence of non-adaptation was higher after 3 months, with reduction after 6 months. Sociodemographic variables did not influence the adaptation. After 3 months, the absence of previous experience, traumatic ulcers, and reduced mandibular ridges hindered the adaptation of patients to mandibular CDs. After 6 months, only the occurrence of ulcerative lesions and non-regular wear of dentures were risk factors for non-adaptation. CLINICAL RELEVANCE: A considerable number of patients have difficulties in adapting to the mandibular dentures. Identifying the factors of non-adaptation of the dentures will contribute to increasing the predictability of this critical adaptation period.

Impact of artificial teeth occlusal morphology on bimaxillary denture treatment in elderly: a clinical trial.

PURPOSE: To evaluate the performance of complete dentures (CD) with anatomical and nonanatomical teeth in completely edentulous elderly individuals regarding oral health-related quality of life (OHRQoL), satisfaction, masticatory performance (MP), need for adjustment after CD placement, and patient preference for occlusal type. MATERIALS AND METHODS: A randomized crossover clinical trial comprising 50 edentulous elderly individuals was conducted. The participants were divided into two groups: AT-NT (rehabilitated initially with anatomical teeth and 3 months later with nonanatomical teeth) and NT-AT (rehabilitated initially with nonanatomical teeth and 3 months later with anatomical teeth). OHRQoL was analyzed using the OHIP-EDENT; a satisfaction questionnaire was applied; MP was evaluated by the median particle size (×50) after chewing an artificial test food; and the number of adjustments of the prosthesis base was assessed quantitatively. RESULTS: Overall, 34 elderly individuals (mean age: 69 years) were analyzed. No significant difference was observed between CD users with anatomical and nonanatomical teeth for OHRQoL (P = .674), satisfaction (P = .725), MP (P = .849), or number of adjustments (P = .135). Most subjects (52.9%) did not express a preference for any occlusal surface type. However, among those with a preference, the majority (32.4%) opted for nonanatomical teeth. CONCLUSION: Both posterior tooth types are eligible for oral rehabilitation in elderly users of conventional CDs, as the variables were not influenced by occlusal morphology. However, further studies are warranted in highly resorbed mandibular edges or in cases of adaptation difficulties, as the results may differ.

Masticatory efficiency, quality of life, comfort, retention and satisfaction on digital denture: case report / Eficiência masticatória, qualidade de vida, conforto, retenção e satisfação com prótese total digital: caso clínico

ABSTRACT The aim of this study was to describe a clinical protocol for fabrication of maxillary and mandibular dentures using CAD/CAM technology. Further, digital and conventional dentures fabricated for the same patient were compared. The comparison was based on patient's satisfaction, comfort, retention, number of follow-up sessions, masticatory performance and quality of life. No laboratorial step was needed for CAD/CAM fabrication and less sessions were required up to denture insertion. Compared to the conventional dentures, digital dentures provided better satisfaction, comfort and retention and required less follow-up sessions. Both dentures presented similar results about masticatory performance and quality of life. As a conclusion, digital denture is a viable treatment alternative for edentulous patients. However, controlled and randomized clinical trials are required to reveal the real benefits of this treatment alternative compared to the conventional denture.

RESUMO O objetivo deste estudo foi descrever um protocolo clínico para a fabricação de próteses superiores e inferiores usando a tecnologia CAD/CAM. Além disso, as próteses digitais e convencionais fabricadas para o mesmo paciente foram comparadas. A comparação foi baseada na satisfação, conforto, retenção, número de sessões de acompanhamento, desempenho mastigatório e qualidade de vida do paciente. Nenhuma etapa laboratorial foi necessária para a fabricação de CAD/CAM e menos sessões foram necessárias até a inserção da prótese. Comparadas às próteses convencionais, as próteses digitais proporcionavam melhor satisfação, conforto e retenção e exigiam menos sessões de acompanhamento. Ambas as próteses apresentaram resultados semelhantes sobre desempenho mastigatório e qualidade de vida. Como conclusão, a prótese digital é uma alternativa viável para o tratamento de pacientes desdentados. No entanto, ensaios clínicos controlados e randomizados são necessários para revelar os benefícios reais dessa alternativa de tratamento em comparação com a prótese convencional.

Impacto da morfologia oclusal de dentes posteriores na qualidade de vida, satisfação e performance mastigatória de usuários de próteses totais bimaxilares / Impact of the occlusal morphology of posterior teeth on the quality of life, satisfaction and chewing performance of users of bimaxillary complete dentures

Objetivo: Objetivou-se avaliar o desempenho de próteses totais (PT) com dentes anatômicos e não anatômicos em pacientes idosos desdentados totais, quanto ao impacto na qualidade de vida relacionada à saúde bucal (OHQoL), satisfação, performance mastigatória (PM), necessidade de ajuste após a instalação das PTs e preferência do paciente quanto ao tipo oclusal. Materiais e métodos: Em um ensaio clínico randomizado do tipo crossover, 50 idosos desdentados totais foram divididos em duas sequências de tratamento: DA-DN (reabilitados inicialmente com dentes anatômicos e, após, 3 meses, com dentes não anatômicos) e DN-DA (reabilitados inicialmente com dentes não anatômicos e, após 3 meses, com dentes anatômicos). O OHQoL foi analisado através do OHIP-EDENT e um questionário de satisfação foi aplicado. A PM foi por análise granulométrica, após a mastigação de um alimento artificial. O alimento-teste triturado foi submetido a um sistema de tamises e o peso das partículas em cada peneira foi utilizado para determinar o tamanho mediano das partículas (X50). A quantidade de ajustes na base da prótese foi avaliada quantativamente. Para a análise dos dados, foram utilizados os testes não-paramétricos de Mann-Whitney e correlação de Spearman. Resultados: A amostra final foi composta por 34 idosos, com idade média de 69 anos. Não houve diferença entre usuários de prótese total com dentes anatômicos e não anatômicos, tanto para o OHIP-EDENT (p=0,674) e satisfação (0,725) como para a PM (p = 0,849) e nem com relação ao número de ajustes na base das próteses totais após a instalação (p=0,135). Conclusão: Dentes com superfícies oclusais planas, quando comparados a dentes anatômicos não mostraram-se vantajosos no que concerne ao impacto da saúde oral na qualidade de vida, a satisfação do usuário, a performance mastigatória, ao números de ajustes após a instalação da prótese e a preferência em relação ao tipo de superfície oclusal (AU).

Objective: The objective of this study was to remove pressure (PT) with anatomical and nonanatomical teeth in edentulous elderly patients, with impact on oral health related quality of life (OHQoL), satisfaction, masticatory performance (PM) the installation of hands and preference of the patient to the occlusal type. Materials and methods: In a crossover randomized clinical trial, 50 edentulous elderly patients were divided into two treatment stages: AD-ND (rehabilitated in the past with anatomical teeth and, after 3 months, with nonanatomical teeth) and DN-DA (initially rehabilitated with non-anatomical teeth and, after 3 months, with anatomical teeth). The OHQoL was analyzed through OHIP-EDENT and for satisfaction through a questionnaire. PM was evaluated by the granulometric analysis method, after mastication of an artificial food. The shredded test food was subjected to a sieve system and the weight of the particles in each sieve was used to determine the mean particle size (X 50). The amount of data at the base of the prosthesis was evaluated numerically. Data analysis, on the other hand, was not tested by Mann-Whitney and Spearman. Results: A final sample was made by 34 elderly, with a mean age of 69 years. OHIP-EDENT (p = 0.674) and satisfaction (p=0.725) as well as PM (p = 0.849), and for the number of total prosthesis care after installation (total dentures) with anatomical and non-anatomical teeth. p = 0.135). Conclusion: The occlusal alterations of the plane, when compared with the anatomical teeth, did not prove to be advantageous with respect to the impact of oral health on quality of life, user satisfaction, masticatory performance and conditioning graphics after the installation of prosthesis (AU).

Impact of mandibular conventional denture and overdenture on quality of life and masticatory efficiency.

The aim of this non-randomized controlled clinical trial was to evaluate the oral health-related quality of life and masticatory efficiency of patients rehabilitated with mandibular two-implant overdentures with immediate loading or conventional dentures. Fifty completely edentulous patients wearing bimaxillary conventional dentures, for at least one year, were recruited. The patients were then assigned to either two treatment groups: mandibular overdentures supported by two implants with bar-clip system and a maxillary conventional denture (n = 25), and new maxillary and mandibular conventional complete dentures (n = 25). Masticatory efficiency and oral health-related quality of life were assessed before and 3 months after denture insertion. The Brazilian version of OHIP-Edent questionnaire was used to assess the oral health-related quality of life. Masticatory efficiency was evaluated with chewing capsules through a colorimetric method. The results revealed fewer oral health-related quality of life problems in patients wearing mandibular two-implant overdentures compared to the conventional dentures group. In addition, the implant overdenture group presented statistically significant improvement in masticatory efficiency (p = 0.001). There was no correlation between masticatory efficiency and OHIP in the implant group (p > 0.05), however a correlation was found in the conventional denture group (p < 0.05). Therefore, these short-term results suggest that mandibular overdenture retained by 2 implants with immediate loading combined with maxillary conventional dentures provide better masticatory efficiency and oral health-related quality of life than mandibular conventional dentures.

Impact of mandibular conventional denture and overdenture on quality of life and masticatory efficiency

Abstract The aim of this non-randomized controlled clinical trial was to evaluate the oral health-related quality of life and masticatory efficiency of patients rehabilitated with mandibular two-implant overdentures with immediate loading or conventional dentures. Fifty completely edentulous patients wearing bimaxillary conventional dentures, for at least one year, were recruited. The patients were then assigned to either two treatment groups: mandibular overdentures supported by two implants with bar-clip system and a maxillary conventional denture (n = 25), and new maxillary and mandibular conventional complete dentures (n = 25). Masticatory efficiency and oral health-related quality of life were assessed before and 3 months after denture insertion. The Brazilian version of OHIP-Edent questionnaire was used to assess the oral health-related quality of life. Masticatory efficiency was evaluated with chewing capsules through a colorimetric method. The results revealed fewer oral health-related quality of life problems in patients wearing mandibular two-implant overdentures compared to the conventional dentures group. In addition, the implant overdenture group presented statistically significant improvement in masticatory efficiency (p = 0.001). There was no correlation between masticatory efficiency and OHIP in the implant group (p > 0.05), however a correlation was found in the conventional denture group (p < 0.05). Therefore, these short-term results suggest that mandibular overdenture retained by 2 implants with immediate loading combined with maxillary conventional dentures provide better masticatory efficiency and oral health-related quality of life than mandibular conventional dentures.

Neoplasias de glândulas salivares menores: estudo retrospectivo de 83 casos / Minor salivary gland neoplasms: retrospective study of 83 cases

Objetivo: Analisar os achados clínicos e histopatológicos de neoplasias de glândulas salivares menores arquivadas no Serviço de Anatomia Patológica da Disciplina de Patologia Oral do Departamento de Odontologia da Universidade Federal do Rio Grande do Norte. Métodos: Dados referentes à idade e gênero dos pacientes e localização anatômica das neoplasias de glândulas salivares menores, diagnosticadas no período de janeiro de 1970 a dezembro de 2007, foram obtidos em fichas de requisição de biópsia. Para o estudo histopatológico, cortes histológicos corados em hematoxilina e eosina foram avaliados sob microscopia de luz. Resultados: Foram identificados 83 casos. Destes, 69,9% acometeram o gênero feminino. Pacientes com neoplasias malignas apresentaram maior média de idade (47,6 anos) que pacientes com neoplasias benignas (40,7 anos). Os sítios anatômicos mais acometidos foram: palato (43,4%), mucosa jugal (10,8%), lábio superior (10,8%) e rebordo alveolar (10,8%). Os três tipos histológicos mais frequentes foram: adenoma pleomórfico (38,6%), carcinoma mucoepidermóide (18,1%) e carcinoma adenóide cístico (13,3%). Conclusão: Neoplasias de glândulas salivares menores afetaram com maior frequência o gênero feminino. Pacientes com neoplasias malignas apresentaram maior média de idade ao diagnóstico da condição. O subtipo histológico mais comum foi o adenoma pleomórfico, seguido do carcinoma mucoepidermóide e do carcinoma adenóide cístico. Em conjunto, estas três neoplasias perfizeram 70,0% de todos os tumores diagnosticados.

Objective: The aim of this study was to evaluate the clinical and histopathological findings of minor salivary gland neoplasms recorded in the files of the Anatomic Pathology Service of the Discipline of Oral Pathology of the Department of Dentistry of the Federal University of Rio Grande do Norte. Methods: Data regarding age and gender of the patients and location of the minor salivary gland tumors diagnosed between January 1970 and December 2007 were taken from biopsy request forms. The histopathological study consisted of tissue sections stained with hematoxylin and eosin assessed under a light microscope. Results: Eighty-three cases were identified, of which 69.9% were females. The mean age of patients with malignant neoplasms (47.6 years) was higher than that of patients with benign neoplasms (40.7 years). The most common sites were: palate (43.4%), buccal mucosa (10.8%), upper lip (10.8%) and alveolar ridge (10.8%). The three most common histological types were: pleomorphic adenoma (38.6%), mucoepidermoid carcinoma (18.1%) and adenoid cystic carcinoma (13.3%). Conclusion: Minor salivary gland tumors are more common in females. Patients with malignant neoplasms presented higher mean age at diagnosis. The most common histological type was pleomorphic adenoma, followed by mucoepidermoid carcinoma and adenoid cystic carcinoma. Together, these three neoplasms accounted for 70% of all diagnosed tumors.