A novel prosthesis presentation test to screen for cognitive and functional decline.

OBJECTIVES AND BACKGROUND: To validate a novel screening test for cognitive and functional decline in older patients rehabilitated with complete removable dental prostheses (CRDPs). MATERIALS AND METHODS: Edentate old in-patients rehabilitated with CRDPs were included in this study. Participants were requested to remove their prostheses before their intraoral examinations. The prostheses were then presented in an inverted orientation. Participants had to correct the orientation of the prostheses and insert them in the appropriate jaws. The test was repeated after the intraoral exam. Appropriate statistical models were used (⍺ = .05) to associate the test results with the participants' mini-mental state examination (MMSE) score, functional independence measure (FIM), age and sex. RESULTS: Among the 86 participants (mean-age: 85.4 ± 6.4 years; mean MMSE: 19.8 ± 5.5; mean FIM: 77.9 ± 20.8), 21 (24.4%) failed to correctly insert the prosthesis. The prosthesis presentation test (PPT) was associated with the FIM but not the MMSE. Regression models further confirmed an association with age (P = .043), but not sex. Additional analyses revealed the PPT test is associated with the FIM's cognitive sub-sets of memory, problem solving and social interaction. CONCLUSION: The PPT is a novel, simple and quick screening tool that can help detect functional difficulties in older people. It can easily be performed during an oral examination. Future studies are needed to determine whether the PPT can be used to detect deficits in executive function, as a complement to the MMSE and also as a first assessment of a patient's ability to manage dentures independently.

Prevalence of oral hygiene tools amongst hospitalised elders: A cross-sectional survey.

OBJECTIVE: This study aimed to evaluate the prevalence of various oral hygiene tools amongst hospitalised elders and to associate their cognitive status with the prevalence of tools and oral hygiene status. MATERIALS AND METHOD: Elderly hospitalised participants were included in the study and underwent a brief clinical intra-oral examination. A semi-structured questionnaire evaluated the awareness and personal possession of the various oral hygiene tools. Participants' personal information and various clinical parameters including DMF (T) index, plaque index, CPITN index, denture plaque and calculus index were collected. Mini-Mental State Examination (MMSE) scores were retrieved from the medical records. Linear regression models were applied for statistical analyses (P < 0.05). RESULTS: A total of 100 hospitalised elders (age = 84.5 ± 6.9 years; ♀ = 72, age = 84.9 ± 7.2 years; ♂ = 28, age = 83.3 ± 5.8 years) participated in this study. Awareness was high for manual toothbrush (100%), electric toothbrush (86%), dental floss (79%), interdental brush (44%), interdental stick (55%) and mouthwash (75%), but was low for tongue scraper (9%), while the prevalence of use was 93%, 17%, 27%, 21%, 29%, 39% and 4%, respectively. Linear regression models revealed plaque scores were lower when more hygiene tools were used by the participants (P = 0.0059). Participants with high MMSE scores had lower plaque scores (P = 0.0004) and possessed more oral hygiene tools (P = 0.0203). CONCLUSION: Poor oral hygiene is often noticed in institutionalised elders and might be related to a lack of knowledge about existing oral hygiene tools. These may help optimising oral hygiene, especially in cognitively impaired elders. Oral hygiene tools should be prescribed according to the patient's need, functional and cognitive status.

Myocentric relation in an additive esthetic rehabilitation within a fully digital workflow.

In recent years, tooth wear has been a growing concern in dentistry as it has become increasingly prevalent among the population. At the same time, the development of adhesive techniques has enabled minimally invasive treatment protocols, with the goal of preserving and protecting teeth for as long as possible. This clinical report presents the case of a full-mouth rehabilitation patient with tooth wear who was treated using minimally invasive techniques. Esthetic and functional outcomes were designed and monitored using digital tools such as digital impressions, 3D facial scans, a digital tooth library, transcutaneous electrical nerve stimulation (TENS), MRI, and kinesiographic (KS) analysis throughout the treatment. To increase the vertical dimension of occlusion, instead of using traditional centric relation (CR) methods, a myocentric relation (MCR) technique was employed. This approach allowed the clinician to maintain the occlusal Class I situation, avoiding more invasive orthodontic treatment or maxillofacial surgery and resulting in reduced morbidity, treatment time, and cost for the patient. At the 1-year follow-up, good patient adaptation was shown, suggesting that the MCR concept is a viable alternative to conventional CR methods in appropriate cases.