Effectiveness of silicone-based resilient denture liners on the patient-reported chewing ability: A randomized controlled trial.

PURPOSE: This randomized controlled trial (RCT) aimed to elucidate the effectiveness of silicone-based resilient denture liners on perceived chewing ability. METHODS: The RCT included completely edentulous patients on both the maxilla and mandible, who were willing to fabricate a new set of complete dentures. A random permuted block method (block size: 4) was used to assign groups to receive maxilla conventional complete denture and mandibular with either a conventional complete denture (CD) or complete demure relined with silicone-based resilient denture liner (RD). The patient-reported chewing ability of six foods, soybean curd, fish sausage, soybean sprout, cubic rice cracker, hard rice cracker, and dry squid, on a 100-mm visual analog scale was measured and reported at the final adjustment and three months after the final adjustment. Mann-Whitney U test was used to analyze the differences between the CD and RD (p < 0.05). RESULTS: Edentulous patients wearing mandibular complete denture with RD had a higher patient-reported chewing ability than those wearing a CD, but the fish sausage did not in the RD three months after the final adjustment. It also took three months for the patient-reported masticatory ability to improve for cubic rice crackers, hard rice crackers, and dry squid and to show a difference between the RD and CD groups. CONCLUSION: Although limited to some food types, mandibular complete dentures relined with silicone-based liners improved patient-reported chewing ability.

Effectiveness of silicone-based resilient denture liners on masticatory function: A randomised controlled trial.

OBJECTIVES: This randomised controlled trial aimed to compare the masticatory function between the silicone-based resilient denture liner and conventional denture among edentulous patients. METHODS: The trial included edentulous patients who were willing to have a new set of complete dentures. Participants were randomly assigned to receive mandibular complete dentures with either a 1) conventional denture base (CD group) or (2) silicone-based resilient denture liner (RD group). Masticatory performance (evaluated with gummy jelly) and the maximum occlusal force were measured at baseline, on final adjustment, and at 3 months after the final adjustment. The outcomes were analyzed using two-way mixed analysis of variance and a paired t-test. The statistical significance was set at p < 0.05. RESULTS: The masticatory performance was lower in the RD group than in the CD group; it increased significantly over time in the CD group, but not in the RD group. The maximum occlusal force in the RD group was significantly higher than that in the CD group; it increased significantly over time in the RD group, but not in the CD group. CONCLUSIONS: Silicone-based RD liners applied to mandibular complete dentures are effective in improving the maximum occlusal force but not the masticatory performance, as measured with gummy jelly. CLINICAL SIGNIFICANCE: Prior evidence has suggested that mandibular complete dentures with resilient denture liners improve masticatory function. However, the results of this study indicate that difficulties may remain with the mastication of foods with a certain texture (e.g., gummy jelly).

The effects of silicone-based resilient denture liners on pain: A randomized controlled trial.

PURPOSE: This randomized controlled trial aimed to study the effects of lining mandibular complete dentures with silicone-based resilient denture liners, especially with respect to sensation. METHODS: The trial included completely edentulous patients who were willing to fabricate new set of complete denture. A random permuted block method (block size: 4) was used to assign participants to one of the following groups: mandibular conventional denture (CD) group or mandibular denture with resilient denture liner (RD) group. The outcomes were evaluated using both, objective measures (current perception threshold (CPT) and pain threshold (PT)) for external stimuli measured using the Neurometer CPT® and subjective measures (physical pain and psychological discomfort measured using the Japanese version of Oral Health Impact Profile for Edentulous patients-OHIP-EDENT-J). The outcomes were measured twice, at immediately after completion of denture adjustments (first measurement), and 3 months after the completion of denture adjustments (second measurement). All outcomes were analyzed using the Student t-test. A p-value of <0.05 was considered statistically significant. RESULTS: CPT was significantly higher with RD than CD only at second measurement with frequency level of 2000 Hz and 5 Hz. The pain thresholds were significantly higher in the RD group than the CD group. The physical pain and psychological discomfort scores were significantly lower in the RD group than in the CD group. CONCLUSION: This study concludes that edentulous patients wearing mandibular complete dentures with silicone-based resilient denture liners dull perception mandibular ridge mucosa and felt less pain than those without the liners.

Receptivity of the mandible versus the maxilla to external stimuli in patients with complete dentures.

PURPOSE: This study aimed to investigate whether the mandible is more receptive to external stimuli than the maxilla in patients with complete dentures by comparing regional current perception thresholds (CPTs) and pain threshold (PTs). METHODS: A single operator obtained measurements from maxillae at the incisor foramen and the left side of the greater palatine foramen region and the mandible at the left side of the mental foramen region, using the Neurometer CPT/C device, CPT and PT values from the oral mucosa of 20 edentulous individuals wearing complete dentures were analyzed. Participant characteristics such as mucosal thickness, occlusal force, age, and sex. Mucosal thickness over target regions and occlusal force were measured by the same operator using Krupp SDM and Occlusal Force-Meter GM10s devices. Differences in CPT and PT among the three measurement regions were tested with an analysis of covariance, and post hoc t-tests with the Bonferroni correction. RESULTS: There were no significant differences between the mental foramen, incisor papilla, and greater palatine regions CPT values. PTs obtained at all current frequencies (2000Hz, 250Hz, and 5Hz) were lowest in the mental foramen region and highest in the greater palatine region. Covariates including sex, mucosal thickness, and occlusal force had no significant influence on CPT or PT values at all frequencies. CONCLUSIONS: The mandible exhibits higher receptivity to external pain stimuli than the maxilla.

Verification of the reliability of current perception threshold and pain threshold testing by application of an electrical current stimulus to mandibular mucosa in young adults.

BACKGROUND: There is little evidence regarding the reliability of CPT and PT measurements to gauge mandibular perception. Thus, this study aimed to evaluate the test-retest reliability of CPT and PT values obtained from the mandibular oral mucosa and to test the bilateral differences in CPT and PT values obtained from the mental foramen region and buccal shelf region by a single operator. METHODS: CPT and PT values were obtained from the mental foramen and buccal shelf regions of 20 volunteers (10 males and 10 females; average age: 26.4 ± 2.6 years) by using the Neurometer CPT/C® device to deliver electrical stimulation. RESULTS: Relative and absolute reliabilities were confirmed over two measurements of CPT and PT over a 7- to 10-day measurement interval. Intra-class correlation coefficients (ICCs) for CPT and PT table obtained from the mental foramen region were >0.8, while most ICC for the buccal shelf region were <0.8. Standard error of measurement, minimal detectable change and Bland-Altman analyses showed that the CPT and PT measurements had no systematic error and could serve as useful methods. At all frequencies, the bilateral difference in CPT and PT values at the mental foramen and buccal shelf region was not significant. CONCLUSION: CPT and PT measurements using a custom-made device that applied an electrical current to the mental foramen region have appropriate reliability to assess intra-oral sensitivity to electrical stimulation in young adults.

Measurement reliability of current perception threshold and pain threshold in parallel with blood sampling.

The irritation and pain associated with oral blood sampling necessary to monitor glycemic control can alter oral sensation, but no studies have measured the reliability of oral sensation testing when performed concurrently with blood sampling. The primary and secondary aims of this study were to verify the measurement reliability of current perception threshold (CPT) and pain threshold (PT) tests performed before and after blood sampling and to investigate the differences in CPTs/PTs obtained from the oral cavity, hand, and foot, respectively. CPT/PT measurements were obtained from the oral mucosa and the tips of fingers and toes of 18 volunteers (10 males and 8 females, average age = 26.3 years) using electrical stimulation at frequencies of 5, 250, and 2,000 Hz. Participants also provided blood samples by pricking their own index fingers with a small needle. All subjects completed the following 3 conditions at once-weekly intervals as follows: (a) sensory measurements followed by blood sampling (SB block); (b) blood sampling followed by sensory measurements (BS block); (c) sensory measurements without blood sampling (CO control block). Cronbach's α coefficients were over 0.78 for the SB, BS, and CO blocks, and are considered to be acceptable for assuring measurement reliability. The oral cavity had significantly lower CPT/PTs than both hands and feet, such that the threshold increased in the order oral cavity < hand < foot. CPT and PT measurements performed concurrently with blood sampling are both reliable and region specific, and for which the oral cavity is the most sensitive testing region.

The influence of patient characteristics on acrylic-based resilient denture liners embedded in maxillary complete dentures.

PURPOSE: A major complication associated with the use of resilient denture liners (RDLs) is a change in hardness over time. In vivo studies on the deterioration of RDLs over time are needed. We aimed to investigate the influence of patient characteristics on the hardness of acrylic-based RDLs (ARDLs) embedded in complete maxillary dentures. We hypothesized that 1 month after application of the ARDLs, the hardness would be influenced by age, saliva condition, occlusal force, smoking, drinking, denture wearing during sleeping, denture cleanser usage, and denture type. METHODS: Thirty complete maxillary denture wearers were recruited after obtaining informed consent. One investigator measured the Shore D hardness of the commercially available ARDLs, Soften (SFT), FD Soft (FDS), and Bio Liner (BIO) using a Vesmeter(®). The salivary flow rates and pH values and the occlusal force were measured for all patients before initiation of the study. T-tests and Pearson's correlation coefficients were used for the statistical analyses. A p-value of <0.05 was considered statistically significant. RESULTS: Smoking, wearing dentures while sleeping, use of denture cleansers, and denture type were associated with an increase in the hardness of the RDLs. The resting saliva pH only influenced the hardness of the SFT ARDLs. CONCLUSIONS: Smoking, denture wearing while sleeping, denture cleanser usage, denture type, and resting saliva pH are important predictors of the deterioration of ARDLs over time.

Characteristics of the pain tolerance threshold induced by electrical stimulation of the alveolar ridge.

The purpose of this study was to determine the characteristics of the pain tolerance threshold (PTT) induced by electrical stimulation of the alveolar ridge. A total of 100 healthy volunteers studying or working at Nihon University School of Dentistry at Matsudo and patients from Nihon University School of Dentistry at Matsudo Affiliated Hospital, including 51 men (58.7 ± 17.6 years old) and 49 women (60.7 ± 17.1 years old), participated in this study. The volunteers were enrolled after obtaining written informed consent. PTT measurements were obtained using a Neurometer CPT/C® device to deliver electrical stimulation around the left greater palatine foramen at frequencies of 5 and 250 Hz. When the stimulus could no longer be tolerated, the participant released a button to automatically discontinue the stimulus. After the distribution of the PTT values was analyzed, the influence of gender, age, and Eichner index on PTT was analyzed. The Eichner index values were divided into three categories: group A (four supporting zones), group B (less than four supporting zones but with anterior tooth contact), and group C (no occlusal contact). The PTT values did not show a normal distribution. There were no significant differences in PTT between men and women. PTT was significantly associated with age (P = 0.017) at 5 Hz in men. There were no significant differences in PTT among the Eichner index groups. The characteristics of the PTT of the alveolar ridge are as follows: (1) age and PTT at 5 Hz are significantly associated with men but not with women, and (2) the Eichner index has no influence on the PTT.