A New Full Digital Workflow for Fixed Prosthetic Rehabilitation of Full-Arch Edentulism Using the All-on-4 Concept.

(1) Background: Recent digital workflows are being developed for full-arch rehabilitations supported by implants with immediate function. The purpose of this case series is to describe a new digital workflow for the All-on-4 concept. (2) Methods: The patients were rehabilitated using the All-on-4 concept with a digital workflow including computerized tomography scanning, intra-oral scanning, and CAD-CAM production of the temporary prosthesis, with the 3D printing of stackable guides (base guide, implant guide, and prosthetic guide). The passive fit of the prostheses and the time to perform the rehabilitations were evaluated. (3) Results: The digital workflow allowed for predictable bone reduction, the insertion of implants with immediate function, and the connection of an implant-supported prosthesis with immediate loading. The time registered to perform the full-arch rehabilitations (implant insertion, abutment connection, prosthesis connection) was below 2 hours and 30 min. No passive fit issues were noted. (4) Conclusions: within the limitation of this case series, the digital workflow applied to the All-on-4 concept using stackable base-, implant-, and prosthetic guides constitutes a potential alternative with decreased time for the procedure without prejudice of the outcome.

Ultrasound analysis of the masseter and anterior temporalis muscles in edentulous patients rehabilitated with full-arch fixed implant-supported prostheses.

OBJECTIVES: Total tooth loss is common in the aging population resulting in insufficient chewing function with subsequent weakening of the masticatory muscles. The study aims to evaluate the changes in thicknesses of the masseter and anterior temporal muscle in edentulous patients following the reconstruction of implant-supported fixed prostheses and compare them with the dentate individuals. MATERIALS AND METHODS: The study was designed as a prospective, single-center, controlled clinical trial. A total of 60 participants were included in the present study. The patients were divided into two groups; Group I (Test Group): 30 edentulous patients who received implant-supported fixed prostheses, Group II (Control Group): 30 dentate individuals of an age and sex-matched group. Ultrasonography was used to measure the cross-sectional thickness of the left and right musculus masseter and anterior temporalis immediately after the cementation of the prosthetic rehabilitation (T1), on the 1st (T2) and 6th (T3) months after rehabilitation and at a single time point in the control group. RESULTS: The results showed that there were significant comparison differences in muscle thickness at the baseline measurements between groups while at the end of the 6th month, these differences were not significant. The muscle thicknesses of both the masseter and anterior temporalis muscles increased significantly at T2 and T3 compared to T1 in the test group. The asymmetry index between the left and right muscles in the test group and the asymmetry differences between groups also decreased significantly at the end of the 6th month. CONCLUSION: The implant-supported fixed prostheses significantly increase the thicknesses of the masseter and anterior temporal muscle together with a decrease in the asymmetry between the left and right muscles. At six months, implant-treated patients showed similar muscle thicknesses compared to dentate individuals. CLINICAL RELEVANCE: The findings suggest that implant-supported fixed prostheses can improve the masticatory function and facial symmetry of edentulous patients.

Evaluation of Masticatory Function, Satisfaction, and Quality of Life Among Users of Complete Dentures Relined with Resilient Materials: A Systematic Review.

PURPOSE: To evaluate whether complete dentures (CDs) relined with long-term resilient liners (LTRLs) favor better masticatory function, satisfaction, and quality of life among completely edentulous patients compared to conventional CDs. MATERIALS AND METHODS: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and was registered in PROSPERO (the International Prospective Register of Systematic Reviews; CRD42021258700). The population, intervention, comparison, and outcome (PICO) purpose was to determine whether CDs relined with LTRLs favor better masticatory function, satisfaction, and quality of life among completely edentulous patients when compared to CDs. Searches were performed in the PubMed/MEDLINE, Embase, Scopus, Lilacs, BBO, and OpenGrey databases. Manual searches were also performed to identify additional primary studies. RESULTS: Overall, 3,953 articles were found. After removing duplicates, reading the articles, and applying the inclusion and exclusion criteria, 15 articles were selected for qualitative analysis, totaling 422 patients with follow-up periods ranging from 1 week to 3 years. Among these, 8 studies assessed masticatory function using different methods, 2 assessed satisfaction, 1 assessed quality of life, and 4 assessed more than one outcome. Through qualitative analysis, LTRLs showed satisfactory results in most studies when compared to CDs in relation to masticatory function, satisfaction, and quality of life. CONCLUSIONS: LTRLs favor better masticatory function, satisfaction, and quality of life among completely edentulous patients compared to CDs.

Masticatory function in edentulous patients wearing implant overdentures after graftless maxillary sinus membrane elevation.

BACKGROUND: Graftless sinus floor augmentation shows good results in bone gain, radiology and implant survival. Clinically, this technique can be recommended as an alternative to conventional procedures using augmentation materials. OBJECTIVES: This study aims to assess masticatory performance, masticatory ability and patient satisfaction after graftless sinus floor augmentation. METHODS: The study group consisted of patients who had received a graftless sinus lift procedure in a split-mouth design and was compared to patients with maxillary implant-supported overdentures without augmentation and a natural dentition group. To assess objective masticatory performance, the mixing ability test was performed. Three questionnaires were used to assess patient reported outcomes related to mastication and patient satisfaction. RESULTS: Each group included ten patients. Both the graftless sinus lift group and the edentulous control group had a worse masticatory performance compared to the natural dentition group. Masticatory ability, measured by patient reported outcomes, was not different between the graftless sinus floor augmentation group and implant-retained overdentures group without augmentation, but the natural dentition group showed better results. Thereby, the better the masticatory performance in patients with a graftless sinus membrane elevation the better the patient satisfaction for 'prosthesis', 'appearance of prostheses', 'speech' and 'mastication and eating'. CONCLUSIONS: Patients with implant-supported overdentures show inferior masticatory function compared to those with natural dentition. There were no significant differences in masticatory performance between patients with implant-retained overdentures, with or without graftless augmentation. The decision on the preferred procedure should consider additional factors such as anatomical, surgical-technical aspects and patient's preferences.

Expediting the Rehabilitation of Severely Resorbed Ridges Using a Combination of CAD-CAM and Analog Techniques: A Case Report.

With the life expectancy increasing, there is a growing need for prosthetic dental treatments to restore the oral health, function, and quality of life of edentulous patients. Presently, only a few articles are available describing the oral rehabilitation of patients with severely resorbed ridges with milled complete dentures. This clinical case report provides a straightforward protocol consisting of a combination of analog and digital techniques for the rehabilitation of edentulous patients with severely resorbed ridges with milled fixed and removable complete dentures. This technique permits the minimization of the number of appointments, improves patient comfort, allows for the digital archiving of important clinical data, and permits the manufacture of prostheses with improved mechanical properties. These favorable outcomes were achieved by using the patient's existing PMMA complete denture as a custom tray for a final impression with light-bodied Polyvinylsiloxane. Subsequently, the resulting models were digitized, and a digital complete denture was designed and manufactured in an expedited manner using CAD-CAM techniques. Therefore, this case report highlights the potential of CAD/CAM technology to predictably restabilize oral functions and improve patients' quality of life.

Fabrication of complete dentures for an older patient with mobility impairment in three appointments: A dental technique.

OBJECTIVE: To describe the clinical procedures of complete denture set fabrication in three appointments. BACKGROUND: Simplified approaches have proven not to be inferior to conventional ones in terms of quality, patient satisfaction and masticatory ability. MATERIALS AND METHODS: The patient was a 77-year-old edentulous adult with mobility impairment seeking dental rehabilitation in a small number of appointments due to commuting difficulties. RESULTS: A set of complete dentures was delivered within three appointments. The second appointment was dedicated to set-up trial due to the patient's aesthetic demands. CONCLUSION: Under certain circumstances and after a thorough study of each case, dental clinicians may propose the fabrication of complete dentures in a three-appointment protocol incorporating a set-up trial session.

Influence of wearing complete denture on the glycemic control, serum lipid, and proteins in patients with diabetes.

Aims: The aim of this study was to assess the impact of prosthodontic rehabilitation on glycemic and lipid control in functionally and completely edentulous patients with diabetes. Setting and Design: An in vivo study conducted with the intention of studying the potential link between edentulism and impaired masticatory efficiency with the nutritional status in diabetic patients. Materials and Methods: A total of 20 diabetic patients based on the inclusion criteria were selected. They were rehabilitated using a removable prosthesis, and observations were made across three parameters - glycosylated hemoglobin (HbA1C), serum cholesterol (S col), and serum protein (SP) at three stages - baseline, 3 months, and 6 months posttreatment. This was done to gauge the impact of the prosthetic rehabilitation on their health due to an increased masticatory efficiency potentially causing changes in dietary patterns. Statistical Analysis Used: •Inter group comparison (>2 groups) was done using one way ANOVA followed by pair wise comparison using post hoc test. •Intra group comparison was done using repeated measures ANOVA (for>2 observations) followed by post Hoc test. For all the statistical tests, P < 0.05 was considered to be statistically significant, keeping α error at 5% and ß error ati20%, thus giving a power to the study as 80%. Results: Hba1c at the baseline had a mean value of 8.04%, which reduced to 7.87% at the 3-month stage and 7.38% at the 6-month stage. S col at the baseline had a mean of 151.6 mg/dL; at the 3-month follow-up, it was 166.5 mg/dL, and at the 6-month follow-up, it was 173.95 mg/dL. SP had a mean baseline value of 6.38 mg/dL, which progressed to 6.67 mg/dL at the 3-month stage and 6.97 at the 6-month stage. Conclusion: Within the limitations of this study, it can be concluded that after 6 months of prosthetic rehabilitation in edentulous/functionally edentulous patients: There was a reduction in HbA1c (8.04%-7.38%); however, it was found to be statistically insignificant at that stage There was an increase in S col (151.6 mg/dL-173.95 mg/dL); it was found to be statistically significant There was an increase in SP (6.38 mg/dL-6.97 mg/dL); however, it was found to be statistically insignificant at that stage.

The effect of prosthetic rehabilitation with or without dietary advice on nutritional status in elderly patients: a systematic review.

BACKGROUND: Elderly people frequently report tooth loss, affecting their nutritional status. There is a gap in the scientific evidence about the influence of prosthodontic rehabilitation on nutritional status. OBJECTIVE: To investigate the influence of prosthodontic rehabilitation combinates or not with dietary advice on nutritional status in elderly patients. METHODS: A systematic literature search was conducted in three electronic databases to identify randomized clinical trials that evaluated the effect of prosthetic rehabilitation on nutritional status in subjects aged 60 years or older, with a follow-up of at least 1 month after prosthesis rehabilitation. RESULTS: Of the 1517 articles identified in the initial search, 12 were selected for the final review. No significant difference between the types of prosthesis were found regarding the chewing by the elderly population. Although patients who received prosthetic treatment had significant improvement in chewing ability, a consistent pattern of improvement in nutritional status was not observed when they did not receive dietary advice. In addition, the association between the condition of the dentition, the masticatory performance and nutritional change of elderly patients has been found. Studies that evaluated simultaneous complete denture treatment and simple dietary advice showed an improvement of nutrient intake in elderly patients. CONCLUSIONS: Isolated prosthetic rehabilitation may not have the effect of exerting a change in nutritional status of edentulous elderly patients. In general, simultaneous dietary consulting and prosthetic treatment in combination may improve dietary habits, since masticatory capacity and efficiency are not the only factors that influence the nutritional status of a patient.

Muscle activity between dentate and edentulous patients rehabilitated with dental prostheses: A systematic review.

BACKGROUND: Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing movements needed to break, crush and grind food. OBJECTIVE: To compare muscle activity using electromyography (EMG) while clenching or chewing soft and/or hard foods among individuals with natural dentition (ND) and edentulous patients rehabilitated with dental prostheses. METHODS: This review was conducted until March, 2023, and the research question was "Is the muscle activity of edentulous patients rehabilitated with dental prostheses similar to that of dentate individuals?" A search strategy was conducted in PubMed/MEDLINE, The Cochrane Library, Web of Science, Lilacs, Embase and manual journal searches. RESULTS: Ten studies were included in the analysis. Most of them reported that individuals with ND had significant higher muscle activity (clenching or chewing) than complete dentures (CD) users. However, no difference was observed between patients with full mouth implant-supported fixed dental prosthesis (ISFDP) and ND. Additionally, two studies compared patients with mandibular ISFDP with maxillary CD and individuals with ND and found no differences; however, one study concluded that patients with ISFDP with CD (maxillary or mandibular) had lower muscle activity than individuals with ND. Only one study reported a higher muscle activity in patients with full-mouth ISFDP than in individuals with ND. CONCLUSIONS: Bimaxillary CD users had lower muscle activity than individuals with ND. During rehabilitation, the muscle activity of patients with full-mouth ISFDP and mandibular ISFDP with maxillary CD is similar to individuals with ND.

A study on relationship between dynamic postural balance and masticatory efficiency in the elderly population with complete dentures: An in vivo study.

Aim: Mastication is an important consideration for patients seeking prosthodontic treatment. Individuals with mastication problems have increased risk of systemic diseases which can negatively affect a person's postural balance control, which in turn increases the risk of falls. This study aims to correlate masticatory efficiency and dynamic postural balance in complete denture patients at 3 and 6 months after denture insertion. Settings and Design: In vivo - observational study. Materials and Methods: Fifty edentulous healthy patients were rehabilitated with conventional complete dentures. The dynamic postural balance was evaluated using the timed up-and-go test. The masticatory efficiency was evaluated using a color-changing chewing-gum and a color scale. The values for both were recorded 3 and 6 months after denture insertion. Statistical Analysis Used: Spearman's correlation. Results: The correlation between the values of dynamic postural balance and the values of masticatory efficiency was negative (values are inversely proportional) at 3 months (-0.379) and at 6 months (-0.246). Conclusions: This study showed that there is a correlation between dynamic postural balance and masticatory efficiency. Prosthodontic rehabilitation of edentulous patients is important for improving postural balance by generating adequate postural reflex through mandibular stability for the prevention of falls in the elderly population and improving masticatory efficiency.

Electromyographic Evaluation of Muscle Activity in Patients Rehabilitated with Full Arch Fixed Implant-Supported Prostheses.

Background and Objectives: Implant rehabilitation of complete edentulous arches has become more and more popular because of the increased access of the population to this type of treatment. Furthermore, the development of new rehabilitation procedures can be applied in most clinical cases, including in those with severe atrophy. Hence, this study aimed to assess the functional changes that can occur in the stomatognathic system after implant rehabilitation procedures. Materials and Methods: A total of 63 patients were accepted in the study. They were divided into a first control (dentate) group (CG) and a second study group (edentulous, SG). For the latter, 30 patients received 204 two-stage implants immediately loaded with provisional prostheses. Surface electromyography (EMG) was assessed at the time of prostheses fixation, while for some patients it was applied six months after the fixation of the fixed prostheses, as well. These supplemental investigated patients formed a third, follow-up study group (FSG). All assessments were performed during the processes of clenching and mastication. The obtained data of the two study groups, SG and FSG, were compared with those of the control group, CG. Results: No statistical differences were found in the electrical muscular activity between the study and control groups during both clenching and mastication (p > 0.05). In addition, there were no differences within the same study group, both initially and after 6 months. The only changes were noticed between static and dynamic values for the right masseter muscle in the follow-up group FSG (p = 0.008). Deviations of the overlapping coefficients were similar for all groups (p = 0.086): for CG, 20.5%, median 11.1 (min. 0, max. 104); for SG, 21.4%, median 12.2 (min. 0, max. 103); for FSG, 36.1%, median 26.9 (min. 0, max. 160). This revealed no neuromuscular adaption to the prostheses. Conclusions: Implant-prosthetic rehabilitation led to an EMG activity that was similar to that of dentate patients immediately after the placement of the fixed implant-supported prostheses. Moreover, the measured values did not change after six months of functioning for all evaluated parameters. This may point to an immediate restoration of the muscle contraction capacity, without the necessity of adaptation over time. The study serves as an argument for the application and reliability of the immediate fixed implant-supported prostheses from the perspective of muscle adaptation and functioning.

Dynamic and static computer-assisted implant surgery for completely edentulous patients. A proof of a concept.

OBJECTIVES: To assess the accuracy and patient reported outcome measures (PROMs) of the computer-guided "double factor" technique for treating fully edentulous patients. METHODS: A proof of concept prospective study was designed. Ten consecutive patients requiring full arch dental implant supported rehabilitation in a private practice were enrolled between October 2021 and March 2022. All patients were treated by means of an All-on-four®, and implants were planned and placed according to the "double factor" technique. This technique merges the static and dynamic computer-guided surgical approach in the same surgery. The primary outcome was the accuracy of implant placement, measured by overlapping post- and pre-operative cone-beam computerized tomography with the implant planning. Additionally, PROMs and patient quality of life after surgery were evaluated using different questionnaires. Descriptive and bivariate data analyses were performed. Statistical significance was considered for p < 0.05. RESULTS: A total of 48 implants were placed using the "double factor" technique, and 12 full-arch immediate loading prostheses were delivered. The mean angular deviation was 3.74° (standard deviation [SD]: 2). The total linear deviation at the apex and platform of the implant was 1.25 mm (SD: 0.55) and 1.42 mm (SD: 0.64), respectively. No statistically significant differences were found between tilted and axial implants, the upper and lower jaw, or the right and left side. High self-reported satisfaction was registered, and the Oral Health Impact Profile-14 (OHIP-14) score improved postoperatively (p = 0.002). CONCLUSIONS: The "double factor" technique is a valid and accurate treatment approach for fully edentulous patients. CLINICAL SIGNIFICANCE: The double factor technique merges the advantages of both the dynamic and static computer assisted surgery approaches, affording accurate and predictable results when treating fully edentulous patients in a minimally invasive manner.

A simplified technique for fabricating complete dentures for patients with Parkinson's disease: a case report / Técnica simplificada como alternativa para confecção de próteses totais para paciente com Doença de Parkinson: relato de caso

BACKGROUND AND OBJECTIVE: Parkinson's disease is a neurological disorder that affects 1% of individuals aged 60 years and older. The associated symptoms can impose limitations on the available dental treatment options. CASE DESCRIPTION: This case report follows the CARE guidelines and presents an adapted and simplified technique to fabricate complete dentures for a 74-year-old male edentulous patient with Parkinson's disease. This modified technique enabled the fabrication of complete dentures in 4 clinical sessions of approximately 40 minutes. The first session involved manufacturing a preliminary impression with fast-setting alginate. The base plates and occlusal rims were then adjusted for artificial teeth arrangement during the second session. The final prosthesis was completed in the third session, which involved a teeth try-in and fabrication of a functional impression with low-melting thermoplastic material and polyether. Finally, denture installation was performed in the fourth session and follow-up consisted of 3 weekly sessions. DISCUSSION: Considering that the treatment provided satisfactory aesthetics and function, mastication and socialization benefits, and improved the self-esteem and well-being of the older patient with Parkinson's disease, the authors suggest this adapted and simplified technique for fabricating complete dentures. (AU)

JUSTIFICATIVA E OBJETIVO: A doença de Parkinson é uma desordem neurológica que afeta 1% dos indivíduos com 60 anos ou mais. Os sintomas associados podem impor limitações nas opções de tratamento odontológico disponíveis. DESCRIÇÃO DO CASO: Este relato de caso segue o protocolo CARE e apresenta uma adaptação da técnica simplificada para confecção de novas próteses totais, para um paciente edêntulo, do sexo masculino, de 74 anos com doença de Parkinson. Essa técnica modificada possibilita a confecção de próteses totais em quatro sessões clínicas de aproximadamente 40 minutos. A primeira sessão envolveu uma moldagem preliminar com alginato de presa rápida. As placas articulares com rodetes de cera foram ajustadas para montagem dos dentes artificiais durante a segunda sessão. A prótese definitiva foi concluída na terceira sessão, que envolveu a prova dos dentes e moldagem funcional com material termoplástico de baixa fusão e poliéter. Por fim, a instalação da prótese foi realizada na quarta sessão e o acompanhamento consistiu em três sessões semanais. DISCUSSÃO: Considerando que o tratamento proporcionou estética e função satisfatórias, benefícios mastigatórios e de socialização, melhora da autoestima e bem-estar do idoso com doença de Parkinson, os autores sugerem o uso da adaptação da técnica simplificada para confecção de prótese total. (AU)

Benefits of Contemporary Rehabilitation of Edentulism: A Statement.

The purpose of this study was to review the impact of loss of teeth and the current state of treatment options available for oral rehabilitation of edentulism. Function with complete dental prostheses varies based on a patient's ability to adapt to removable prostheses and their psychologic acceptance of the treatment. There is varying dissatisfaction with removable prostheses, particularly in Western economies. This is driven in part by the availability of oral implants, which have transformed the treatment options for oral rehabilitation in general and for edentulous rehabilitation in particular. Quality-of-life studies have confirmed the advantages of implants for the retention and support of dental prostheses, as they improve function and esthetic measures to nearly those of the dentate state. Osseoperception, the concept of feedback to the sensorimotor system from tissues surrounding osseointegrated implants, contributes to enhanced function with implant treatment. It is recognized that tooth loss resulting in the loss of periodontal mechanoreceptors has a detrimental effect on jaw motor control even after implant treatment. However, despite this limitation, oral rehabilitation with or without implants, which improves function and esthetics, helps maintain psychosocial and cognitive health.

Assessment of quality of life in total edentulous patients rehabilitated with implants and fixed prosthesis

Aim: Tooth loss is very prevalent in Brazil, reflecting high demand for dental services, especially those related to oral rehabilitation. This study aimed to assess the quality of life in total edentulous patients rehabilitated with implants and fixed prosthesis. Methods: Thirty-two patients were evaluated before and after rehabilitation with dental implants and fixed prosthesis using the OHIP-14 questionnaire and the Visual Analogue Scale (VAS) after 6 months follow-up. Results:OHIP-14 revealed a significant improvement after treatment in all seven parameters and in the global score (P < 0.001). VAS presented positive results related to patient satisfaction regarding oral rehabilitation, except for the hygiene of the fixed dentures. Conclusion: At the end of this study, OHIP-14 scores decreased by 50% in most of the questions raised, and VAS presented positive results, except for hygiene of the fixed dentures, presenting an improvement in the quality of life of total edentulous patients after rehabilitation with implants and fixed prosthesis

Oral health-related quality of life (OHRQoL) after rehabilitation with removable partial dentures (RPDs): A systematic review and meta-analysis.

OBJECTIVES: To summarise evidence on the change in oral health-related quality of life (OHRQoL) before and after rehabilitation with removable partial dentures (RPDs) amongst partially edentulous adults. DATA: Studies assessing OHRQoL amongst patients aged ≥18 years, before and after rehabilitation with RPDs of any type and design, were included. The quality of included studies was evaluated using the Cochrane risk of bias tools. Meta-analysis was conducted using a random-effect model. SOURCES: MEDLINE, EMBASE and CENTRAL, up to March 29, 2022. STUDY SELECTION AND RESULTS: Thirteen studies were eligible and eight were included in the meta-analysis. The studies had moderate to serious risk of bias. There was a very low level of certainty that OHRQoL, as measured using OHIP-14, improved 3 months after RPDs were fitted (222 participants, MD: -12.0, 95% CI: -16.1, -7.9, p<0.001) and after 6 months (101 participants, MD: -10.5, 95% CI: -16.4, -4.6, p<0.001). At 12 months post-treatment, RPD rehabilitation did not result in statistically significant improvement in OHIP-14 scores (62 participants, MD: -12.7, 95% CI: -26.1, 0.6, p = 0.06). However, the assessment using OHIP-49 at 12 months showed significant improvement (87 participants, MD: -34.8, 95% CI: -41.9, -27.7, p<0.001), with low certainty of evidence. CONCLUSIONS: Based on the limited evidence available, this review found that RPD rehabilitation appear to improve OHRQoL in the short term up to 6 months, with a very low level of certainty. The long-term effect of RPD treatment on OHRQoL after 12 months is inconclusive. There is currently insufficient evidence on the effect of RPD treatment on OHRQoL. This review highlights the need for more and better quality studies. CLINICAL SIGNIFICANCE: Data on RPD outcomes are summarised, aiding clinicians in providing evidence-based patient-centred care that matches patients' needs and expectations. Recommendations for future research were also highlighted. REGISTRATION: PROSPERO CRD42022328606.

Electromyographic Activity of Masseter Muscles After Complete Denture Rehabilitation in Edentulous Participants.

PURPOSE: To evaluate the electromyographic (EMG) activity of masseter muscles (MMs) after the provision of new complete dentures (CDs) and to assess the possible correlations between clinical behavior and the EMG findings. MATERIALS AND METHODS: The sample included 78 edentulous participants (56 women, 22 men; mean age: 65.59 ± 10.47 years). Prior to provision of the new CDs, surface EMG activity of the masseter muscles was recorded during rest, maximum voluntary contraction, and mastication (MAST) using a wax artifact (WA). The tests were repeated using the new CDs, followed by the WA, at 7 days, 14 days, 21 days, and 10 months. At each assessment after placement of the CDs, the participants were questioned regarding five parameters (comfort, esthetics, retention, mastication, and speech). RESULTS: There was an initial decline in the EMG activity of the masseter muscles after the provision of new CDs during MAST, followed by a gradual increase in this activity over time (P > .05). There was a significant improvement in MAST reported by participants at 10 months (3.59 ± 1.141) compared to 7 days (2.50 ± 1.058) (P = .011). There was no significant correlation between the EMG findings and the clinical parameters (P > .05). CONCLUSION: Although there was no significant difference in EMG activity of the MMs over time, an improvement in MAST reported by the participants was observed.

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.

Denture-related problems of patients in acute geriatric care.

BACKGROUND: With increasing frailty and complaint-oriented utilization of dental care, the prevalence of oral diseases also increases. AIM: To clarify whether there is a need for dental prosthodontic treatment during residential acute geriatric rehabilitation. METHODS: Within 3 weeks in a hospital for acute geriatric patients, 79 out of 157 newly admitted patients were interviewed as study participants (age: median 79.0 years, range 66-96 years, female 51.9%), dental findings were recorded, treatment needs were determined but X­rays were not taken. RESULTS: Of the participants 31.1% had not seen a dentist for more than 1 year and 18.2% were edentulous. The median number of teeth in dentate participants was 16 (range 1-28 teeth); based on all participants, there was a median of 12.0 teeth (range 0-28 teeth). Of the 52 denture wearers (45 upper jaw and 43 lower jaw), 5 each of the maxillary and mandibular dentures could not be assessed because they were not available at the hospital. Moderate denture deficiencies were present in 62.5% of participants wearing upper dentures (mandibular 55.3%). CONCLUSION: Dental treatment is needed in this vulnerable patient group. Therefore, the oral cavity should be assessed as part of the geriatric assessment. The available data confirm that the use of validated assessment instruments, such as the mini dental assessment as part of the comprehensive geriatric assessment would be useful. In addition to an oral examination, simple dental treatment should be provided to reduce infections and improve chewing ability. The geriatrician should be informed of the urgency of treatment. The overall rehabilitative approach of acute geriatric treatment would be complete if oral health would not be excluded.

Effect of isometric exercises on the masseter muscle in older adults with missing dentition: a randomized controlled trial.

Maintaining oral function in older individuals with missing teeth is important for leading a healthy and independent life. This study aimed to evaluate whether simple isometric exercises can maintain and improve the oral function [maximum occlusal force (MOF) and masticatory ability (MA)] and the masticatory muscle properties [masseter muscle thickness (MMT) and echo intensity (MMEI)] in older adults during the maintenance phase of removable prosthetic treatment. Participants were randomly categorized into the intervention and control groups. The mouthpieces were distributed, and participants were instructed to use them for exercising. The intervention group was instructed to perform maximum clenching for 10 s, whereas the control group was instructed to tap the teeth at an arbitrary speed for 10 s. Both were repeated five times at an interval of 5 s between each activity and twice daily for 4 weeks. The outcomes were measured after a month of exercise. The intervention group showed a significant improvement in the MOF, MMT during contraction, MMT at rest and MMEI during contraction. There were no significant differences in the MA and MMEI at rest. In the control group, no improvement was observed in any of the parameters. When the isometric exercises were performed using a mouthpiece, there was an improvement in the oral function and masseter muscle properties in older individuals with Eichner B status who used dentures.