Oral conditions are associated with salt taste disability among American adults.

AIM: To explore the association between oral conditions and their interaction with salt taste disability among American adults. METHODS: Data from the 2013-2014 NHANES cycle were used (n = 2373). The exposures were periodontitis, defined by the 2017 EFP-AAP classification, dental caries, missing teeth, and edentulism, as per the DMF-T index, and xerostomia. The outcome was salt taste disability, objectively assessed. Covariates included sex, age, educational level, poverty index, obesity, diabetes, smoking, alcohol consumption, and medications related to mouth dryness. Weighted multivariable logistic regression modeling was used to evaluate the relationship between oral conditions and their interaction and salt taste disability. RESULTS: Participants who reported xerostomia were more likely to have salt taste disability (OR 2.42; 95%CI 1.44-4.07), especially those older than 60 years (OR 3.63; 95%CI 1.72-7.63). Among participants aged 40-59, xerostomia increased the chance of salt taste disability; however, the confidence interval included the null value. The interactions between xerostomia and edentulism increased the chance of salt taste disability. CONCLUSION: Oral conditions seem to influence the ability to taste salt. Dental professionals may help identify individuals with taste alterations and raise their awareness of the risk of systemic diseases that require the reduction of salt intake.

Oral frailty among dentate and edentate older adults in long-term care.

BACKGROUND: The objectives of this study were to compare oral frailty (OFr) among edentate and dentate older adults living in long-term care facilities (LTCF) and to clarify how edentulism and oral disease burden (ODB) of dentate older adults are associated with OFr. METHODS: The population of this study comprised 94 edentate and 209 dentate residents in LTCF in Helsinki, Finland, who had previously participated in a nutritional study. The participants underwent a clinical oral examination. The dentate residents were further divided into three ODB groups based on asymptotic dental score. The edentate and different ODB groups were compared with each other regarding demographics and oral and medical findings. OFr was defined as ≥ 2 of following: having a diet of soft/pureed food, residue of food in the oral cavity, inability to keep the mouth open during examination, unclearness of speech, dry mouth. The association between OFr and edentulousness and various levels of ODB was analyzed by a multivariate logistic model. RESULTS: Participants with low ODB had significantly less OFr than their edentate peers (p = 0.009). Furthermore, the edentate and dentate with high ODB had similar odds for OFr. CONCLUSIONS: Edentulousness and high ODB are equally harmful conditions and may predispose to OFr. This study suggests that maintaining healthy natural teeth and good oral health (low ODB) may protect against OFr. TRIAL REGISTRATION: The Ethics Committee of the Hospital District of Helsinki and Uusimaa approved the protocols for the nutritional status and oral healthcare studies and the merging of the data, including patient medical records (Register number HUS/968/2017).

The association between edentulism and progress of multimorbidity over 12 years among older American adults.

OBJECTIVES: To examine the relationship between edentulism and the progress of multimorbidity, and the role of nutritional intake and behaviours among older Americans. METHODS: We used 7 waves (2006-2018) of the Health and Retirement Study, a longitudinal survey of older Americans (number included in analysis 2,224). Edentulism was assessed in 2006 and 2012. Multimorbidity was indicated by 5 self-reported conditions: diabetes, heart conditions, lung diseases, cancer, and stroke. Behavioural factors were smoking, excessive alcohol consumption, physical activity, and body mass index. Nutritional intake was calculated by summing 10 nutrients (Protein, Vitamins C, D, B12, E, Calcium, Zinc, Polyunsaturated fatty acids, Folate and ß- carotene). Multilevel models for analysis of longitudinal data were used to assess the association between change in repeated measures of multimorbidity (between 2006 and 2018) and edentulism (2006) adjusting for nutritional intake, behavioural and socioeconomic factors. RESULTS: Participants who were edentate in 2006 and 2012 had higher rate-ratios (RR) for change in multimorbidity between 2006 to 2018 (RR: 1.29 and 1.28, respectively). After adjusting for socioeconomic factors, total nutrients and behavioural factors, these RR attenuated to 1.12 (95%CI: 1.06, 1.18) and 1.10 (95%CI: 1.05, 1.16), respectively. Total nutrition was negatively associated with progress of multimorbidity, but after adjusting for socioeconomic and behavioural factors the association became insignificant. Total nutrients rates in 2013 were significantly lower among those who were edentate in 2006 and 2012. CONCLUSION: There was a longitudinal association between edentulism and progress of multimorbidity. The relationship appeared to be mediated be behaviours and nutrition.

Allostatic load and oral health later in life among middle-aged and older adults: An analysis of population-based panel data in China.

BACKGROUND: Oral health is a major global public health problem, but its risk factors have not been fully identified. The limited evidence suggests that AL may affect oral health conditions, but most of these studies focus only on middle-aged western populations. OBJECTIVES: To examine whether allostatic load is associated with oral health conditions later in life among middle-aged and older adults in China and there there is a correlation in both middle-aged and older people. MATERIALS AND METHODS: Data were collected from the China Health and Retirement Longitudinal Study 2011-2018 (N = 10 890) and were analysed using logistic regressions for the overall sample and subsamples by age. RESULTS: Results showed that higher inflammation load significantly increased the odds of edentulism (OR = 1.358, 95% CI = 1.020-1.809, p < .05). Higher metabolic load significantly increased the odds of denture use (OR = 1.375, 95% CI = 1.154-1.640, p < 0.001) and difficulty in chewing solid foods (OR = 1.100, 95% CI = 1.035-1.169, p < .01). These associations were manifested in older adults over 60 years of age, while in the middle-aged subsample, the associations were not significant. CONCLUSION: The findings suggested that higher allostatic load was associated with poorer oral health conditions later in life. It is critical to lower allostatic load and improve oral health conditions, especially for older adults over 60 years of age. Prospective studies and intervention trials help to better understand whether allostatic load is causally linked to oral health.

Stereophotometric facial changes in edentulous older adults after rehabilitation with complete dentures.

OBJECTIVES: To evaluate the facial characteristics of edentulous older adults who underwent rehabilitation using complete dentures, and to compare them with dentate individuals. BACKGROUND: Edentulism rehabilitation with complete dentures aims to restore occlusion and facial aesthetics. MATERIALS AND METHODS: The study included 102 edentulous participants needing prosthodontic rehabilitation with complete dentures and 30 with a natural dentition (aged >65). The 3D facial scans were performed using an Artec optical scanner. Superficial facial landmarks were identified, and 16 parameters were calculated. Regional analysis with the superimposition of two scans was used to calculate the average distances and percentage of non-matching surfaces in the 11 regions. Paired and independent t-tests (α = .05) were used to test for group differences, as appropriate. RESULTS: After rehabilitation with complete dentures, facial changes were most noticeable in the perioral region: wider rima oris, longer upper lip, wider upper vermilion, and more protruded profile. The comparison of facial regions without and with dentures showed fuller and curvier cheeks, with no direct influence of dentures. The edentulous faces with dentures appeared shorter and more retruded than those of dentate individuals. A narrower lower vermilion, retruded upper lip, and more flattened facial profile were observed in females with dentures than in their dentate peers. CONCLUSION: Besides the expected positive influence of rehabilitation with complete dentures on facial appearance in the perioral region, there are some unexpected changes, such as fuller cheeks, but there is still deficiency in vertical facial dimensions and a more flattened facial profile.

Functional teeth and cognitive function among the Chinese elderly: The chain mediating effect of depressive symptoms and social participation.

The objective of this study was to investigate the chain mediating effects of depressive symptoms and social participation between functional teeth and cognitive function based on the biopsychosocial model. Data from the 2018 China Health and Retirement Longitudinal Study were analyzed. The findings revealed a favorable connection between the lack of edentulism and cognitive function, persisting even when accounting for the mediating factors of denture usage, depressive symptoms, and social participation. Furthermore, the study identified six indirect pathways in this relationship. The present study has substantiated the correlation between edentulism and cognitive function, thereby proposing that interventions aimed at denture usage, depressive symptoms, and social participation could potentially serve as preventive measures against cognitive decline in elderly individuals afflicted with edentulism. This underscores the significance of addressing these factors to alleviate cognitive decline.

Accuracy of the novel digital non-cross-arch surgical guides with integration of tooth undercut retention and screw-bone support for implant placement in mandibular free-end.

BACKGROUND: Large cross-arch free-end surgical guides can obscure the visual field, compromising surgical accuracy due to insufficient stability at the free-end. This in vitro study aims to evaluate the accuracy of novel digital non-cross-arch surgical guides designed for implant placement at the mandibular free-end, incorporating tooth undercut retention and screw-bone support. MATERIALS AND METHODS: A mandibular dental model lacking left molars was utilized to fabricate unilateral (cross-arch) tooth-supported surgical guides (GT I, n = 20). Subsequently, two additional types of surgical guides were fabricated: GT II (covering two teeth, n = 20) and GT III (covering three teeth, n = 20). These novel surgical guides were designed to utilize the undercut of the supporting teeth for retention and enhance stability with screw-bone support at the guide's free-end. Furthermore, 60 identical guiding blocks were assembled on the three types of surgical guides to facilitate the implants' insertion. On a phantom head, 120 implant replicas were placed at the Federal Dentaire Internationale (FDI) teeth positions #36 and #37 on the dental model, employing a combination of surgical guides and guiding blocks. To assess accuracy, planned and placed implant positions were compared using intraoral optical scanning. Discrepancies in angulation and linear deviations, including the coronal/apical 3D deviations, lateral deviation as well as depth deviation, were measured. Statistical analysis was performed using two-way ANOVA and Bonferroni test (α = 0.05). RESULTS: GT I exhibited significantly largest discrepancies, including angular and linear deviations at the crest and apex at every implant site. Especially in depth, at implant site #36, the mean deviation value of GT I (0.27 ± 0.13 mm) was twice as large as GT III (0.13 ± 0.07 mm), and almost twice as large as GT II (0.14 ± 0.08 mm). However, at implant site #37, this deviation increased to almost a five-fold relationship between GT I (0.63 ± 0.12 mm) and II (0.14 ± 0.09 mm), as well as between GT I and III (0.13 ± 0.09 mm). No significant discrepancies existed between the novel surgical guides at either implant site #36 or #37. CONCLUSION: This study provides a practical protocol for enhancing accuracy of implant placement and reducing the size of free-end surgical guides used at mandibular molar sites.

Global, regional, and national burden and quality of care index (QCI) of oral disorders: a systematic analysis of the global burden of disease study 1990-2017.

BACKGROUND: Oral disorders are still a major global public health challenge, considering their perpetuating and chronic nature. Currently, there is no direct index to measure the quality of care on a population scale. Hence, we aim to propose a new index to measure the quality of care for oral disorders worldwide. METHODS: We generated our database using the data from the Global Burden of Disease (GBD) study 2017. Among different variables such as prevalence, incidence, years lived with disability, and disability-adjusted life years, we utilised principal component analysis (PCA) to determine the component that bears the greatest proportion of information to generate the novel quality of care index (QCI) for oral disorders. RESULTS: Global QCI for oral disorders gradually increased from 1990 to 2017 (from 70.5 to 74.6). No significant gender disparity was observed during this period, and the gender disparity ratio (GDR) was considered optimal in 1990 and 2017. Between 1990 and 2017, the age-standardised QCI for all oral disorders increased in all the SDI regions. The highest QCI for all oral disorders in 2017 belonged to high-middle SDI countries (=80.24), and the lowest YLDs rate was seen in the low SDI quintile. In 1990, the quality of care in European, Central Asian, and Central and South American countries was in the lowest quintiles, whereas the North American, East Asian, Middle Eastern, and some African countries had the highest quality of dental care. Maynmar (=100), Uganda (=92.5), Taiwan (=92.0), China (=92.5), and the United States (=89.2) were the five countries with the highest age-standardised QCI. Nicaragua (=41.3), Belgium (=40.2), Venezuela (=38.4), Sierra Leone (=30.5), and the Gambia (=30.3) were the five countries with the least age-standardised QCI values. CONCLUSION: The quality of care for all oral disorders showed an increasing trend on a global scale from 1990 to 2017. However, the QCI distribution was not homogenous among various regions. To prevent the exacerbation of imminent disparities in this regard, better attention to total tooth loss in high-income countries and prioritising primary healthcare provision in low-income countries are recommended for oral disorders.

[Number of teeth as indicator for individual risk for delirium]. / Zahnzahl als Indikator für individuelles Delirrisiko.

BACKGROUND: Recent research claims some interdependence between oral health and dementia; however, no empirical data could be found regarding the role of oral hygiene in delirium. This study investigated potential risk indicators related to oral hygiene in relation to development of delirium in the care of older patients. METHODS: A dental examination was performed in 120 patients in the context of a case-control study. The ratio of diseased patients with risk factors to diseased patients without risk factors describes the correlation between risk factors and the risk of disease. A binary logistic regression was performed to determine the correlation of the number of teeth to delirium. RESULTS: Every lost tooth enhances the delirium risk by 4.6%. Edentulous patients had a 2.66-fold higher risk to suffer from delirium. Caries experience and periodontitis has no significant impact on delirium prevalence. DISCUSSION: Both edentulousness and the number of lost teeth could be considered as risk indicators for delirium. Periodontitis or caries experience did not have a direct significant impact. The present study examined the merits of edentulousness and tooth loss as a screening parameter.

[Method of comprehensive physiotherapy of dental patients after COVID-19]. / Metod kompleksnoi fizioterapii u stomatologicheskikh patsientov posle COVID-19.

Functional gastrointestinal disorders, which had an impact on the dentofacial system (pain, loose teeth and falling out of them) in patients who have had COVID-19, drew the close attention of specialists of different profiles. The pathogenesis of worsening post-COVID edentulism is insufficiently studied, as many issues of adequate therapy remain unsolved, in which the role of non-drug technologies in the treatment of dental patients who have suffered from COVID-19 is extremely high. OBJECTIVE: To describe the mechanism of action and clinical effectiveness of the developed combined physiotherapy method, including the induced technique of piracetam iontophoresis on the frontooccipital technic and acupuncture laser therapy in dental patients with complaints of edentulism progression after COVID-19 on the basis of the analysis of single studies on the post-COVID loss of teeth treatment. MATERIAL AND METHODS: A number of patients equal 120 who complained of tooth loss after COVID-19 during the past 6 months were examined. The following initial and end points were considered: dental bleeding and inflammation scores, vascular and endothelial dysfunction markers - levels of intercellular adhesion molecules and their receptors (SlCAM-1, SVCAM-1, VEGF-A, ET-1) before and after treatment. RESULTS: Negative correlation between VEGF-A (pg/ml) concentration in peripheral blood serum and sVCAM-1 (ng/ml) level in the examined patients (r=0.4830, p<0.05) and strong inverse correlation between slCAM-1 (ng/ml) level and sVCAM-1 (r=0.7696, p<0.01) have been established. More significant effects after application of the combined induced method on the head's structures and laser acupuncture have been noted than after acupuncture laser exposure and after inducing technique separately, namely in the form of dental inflammation score correction by 1.76 times (p<0.001), decrease of bleeding score by 2.6 (p<0.05), decrease of concentration of SVCAM-1 by 1.7 times and SlCAM-1 by 2 times (p<0.001), increase of endothelin level by 1.7 times as well as the initial low VEGF-A (pg/ml) by 1.5 times (p<0.01). CONCLUSION: The developed physiotherapeutic complex, which includes laser acupuncture physiotherapy and induced technique of 5% piracetam iontophoresis, can potentially be considered as a physioprophylactic and therapeutic model of post-COVID edentulism.

Periodontitis and edentulism as risk indicators for mortality: Results from a prospective cohort study with 20 years of follow-up.

AIM: To investigate the association between periodontitis and edentulism with cardiovascular disease (CVD) and all-cause mortality. METHODS: Baseline data of 506 subjects including 256 angiographically verified coronary artery disease patients and 250 matched participants in cardiovascular health from the Kuopio Oral Health and Heart study were collected from 1995-1996. Mortality data were accrued until May 31, 2015, and related to baseline periodontal health and edentulism, assessed as exposure and collected by means of clinical and radiographic examination by a single examiner. Cox proportional hazards regression models were fit using covariates such as age, gender, smoking, BMI, and education. The final sample size for the periodontitis models ranged from 358 to 376, while the edentate models included 413 to 503 subjects for CVD and all-cause mortality, respectively with no missing values in the predictor, confounders, and outcome. RESULTS: The strongest association was found between edentulism and CVD and all-cause mortality (HR: 1.9 CVD , HR: 1.6all-cause ; p < .01). CONCLUSIONS: Edentulism considered as a poor oral health marker was associated strongly with CVD mortality while periodontitis was not.

The pathways from disadvantaged socioeconomic status in childhood to edentulism in mid-to-late adulthood over the life-course.

BACKGROUND: This study aimed to examine the direct and indirect pathways from childhood socioeconomic status (SES) to the prevalence of edentulism in mid-to-late age Chinese individuals using structural equation modeling (SEM). METHODS: This study analyzed data from 17,032 mid- to-late age Chinese individuals in the 2014 and 2015 China Health and Retirement Longitudinal Study (CHARLS). Childhood SES was determined based on the parents' education and occupation, financial situation of the family, primary residence, food availability, and medical convenience. Adulthood SES was established according to educational achievements of the individuals. Edentulism is defined as the loss of all natural teeth. SEM was used to examine the statistical significance of the association between childhood SES and edentulism, mediated by childhood health, adulthood SES, and adult health. RESULTS: Childhood SES had significant indirect (ß = -0.026, p < 0.01), and total (ß = -0.040, p < 0.01) effects on edentulism. It was determined that 65% of the total effect of childhood SES on edentulism was indirect, and mainly mediated by adult SES. Also, the goodness-of-fit indices of the best-fitting model were acceptable. CONCLUSION: This study revealed that childhood health, adult health and adult SES are mediators that explain the relationship between childhood SES and edentulism. The global attention to alleviate the inequality in edentulism should focus on exploring recommendations and intervention strategies from childhood to adulthood, by considering adult SES, childhood and adult health.

Rehabilitation of full-arch edentulism with fixed or removable dentures retained by root-form dental implants: A systematic review of outcomes and outcome measures used in clinical research in the last 10 years.

AIM: To evaluate outcome measures, methods of assessment, and analysis in clinical studies on the rehabilitation of full-arch edentulism with implant-supported fixed or removable prostheses. MATERIALS AND METHODS: A protocol-oriented search was conducted in MEDLINE via PubMed, EMBASE, and Cochrane Library (PROSPERO registration CRD42021265179) from 1 January 2011 to 27 July 2021 to identify longitudinal studies reporting on the rehabilitation of edentulous patients with implant-supported prostheses. The primary aim of this study was the collection of all objectively reported outcomes in each study. Secondary aims included the description of the methods of assessment and analytical methods. Risk of bias was applied according to the study design (randomized controlled trial, cohort study, or descriptive pre-post study). Individual study data were extracted into an outcomes matrix. Outcomes were grouped into domains and descriptively analysed. A network diagram was generated to establish relationships between domains. The present review follows the PRISMA statement. RESULTS: The screening and selection processes resulted in the identification of 491 publications, corresponding to 421 different studies (cohorts of patients). Only 24% of the studies reported the use of EQUATOR network guidelines. Implant failure/survival was the most reported outcome (270 studies), but the criterion to determine implant failure and/or survival was frequently not described or was ambiguous. Implant success was much less frequently reported (88) and was based on several heterogenous composite definitions. Marginal bone levels (233 studies), technical complications (158), and clinical outcomes (150), including peri-implant soft tissue and implant stability assessment, were also frequently reported. Patient-reported outcome measures (PROMs) (145) and function-based outcomes (40) were predominantly reported in isolation from other outcomes and most frequently in removable restorations. While quality of life was evaluated using valid instruments, patient satisfaction was evaluated based on a common sense concept of satisfaction. Economic outcomes were under-reported (13). CONCLUSIONS: There is great heterogeneity in the criteria to define implant failure or survival and implant success, which prevents the comparison of rates across studies. Even though studies frequently report multiple outcomes, PROMs are usually reported in isolation from other outcomes. It would be valuable to have a set of core outcome variables and standardized methods of measurement for future studies.

Prosthodontic outcomes of mandibular overdenture treatment with one or two implants: 4-year results of a randomized clinical trial.

OBJECTIVE: To assess the incidence of prosthodontic maintenance events and complications during 4 years of follow-up after mandibular overdenture treatment with one or two implants. METHODS: Participants received one or two implants inserted in the midline (1-IOD group) or the lateral incisor-canine area bilaterally (2-IOD group). Implants were loaded with an early loading protocol after 3 weeks. Programmed recall visits were scheduled at the 6-, 12-, 36-, and 48-month follow-ups and nonprogrammed visits in case of prosthodontic complaints. The type of maintenance was registered, and the final treatment outcome was classified as successful, surviving, unknown, dead, repair, or retreatment. RESULTS: Forty-seven participants, mean age 65.4 ± 8.6, 74.5% female, were included (1-IOD = 23; 2-IOD = 24) and 44 completed the 4-year follow-up. A total of 159 prosthodontic maintenance events occurred and 89 in unscheduled visits. The most common event was the need for minor modifications of the denture base due to sore spots in the oral mucosa (n = 56 in 31 patients), matrix activation (n = 54 in 34 patients), and overdenture fracture (n = 25 in 18 patients). A "successful" or "surviving" outcome could be attributed to 57.5% of cases, whereas 38.3% needed repair. No significant differences in the incidence of prosthodontic events or treatment outcomes were found between the two groups. CONCLUSIONS: Findings show that 1-IODs perform similar to 2-IODs when considering the incidence of fractures and the need for prosthodontic maintenance, including adjustments of the overdenture and the attachment system.

Rehabilitation of full-arch edentulism with fixed or removable dentures retained by root-form dental implants: A systematic review of outcomes and outcome measures used in clinical research in the last 10 years.

AIM: To evaluate outcome measures, methods of assessment, and analysis in clinical studies on the rehabilitation of full-arch edentulism with implant-supported fixed or removable prostheses. MATERIALS AND METHODS: A protocol-oriented search was conducted in MEDLINE via PubMed, EMBASE, and Cochrane Library (PROSPERO registration CRD42021265179) from 1 January 2011 to 27 July 2021 to identify longitudinal studies reporting on the rehabilitation of edentulous patients with implant-supported prostheses. The primary aim of this study was the collection of all objectively reported outcomes in each study. Secondary aims included the description of the methods of assessment and analytical methods. Risk of bias was applied according to the study design (randomized controlled trial, cohort study, or descriptive pre-post study). Individual study data were extracted into an outcomes matrix. Outcomes were grouped into domains and descriptively analysed. A network diagram was generated to establish relationships between domains. The present review follows the PRISMA statement. RESULTS: The screening and selection processes resulted in the identification of 491 publications, corresponding to 421 different studies (cohorts of patients). Only 24% of the studies reported the use of EQUATOR network guidelines. Implant failure/survival was the most reported outcome (270 studies), but the criterion to determine implant failure and/or survival was frequently not described or was ambiguous. Implant success was much less frequently reported (88) and was based on several heterogenous composite definitions. Marginal bone levels (233 studies), technical complications (158), and clinical outcomes (150), including peri-implant soft tissue and implant stability assessment, were also frequently reported. Patient-reported outcome measures (PROMs) (145) and function-based outcomes (40) were predominantly reported in isolation from other outcomes and most frequently in removable restorations. While quality of life was evaluated using valid instruments, patient satisfaction was evaluated based on a common sense concept of satisfaction. Economic outcomes were under-reported (13). CONCLUSIONS: There is great heterogeneity in the criteria to define implant failure or survival and implant success, which prevents the comparison of rates across studies. Even though studies frequently report multiple outcomes, PROMs are usually reported in isolation from other outcomes. It would be valuable to have a set of core outcome variables and standardized methods of measurement for future studies.

Scientific rationale for study: Consistent data on the outcomes of treatments for full-arch edentulism are fundamental for establishing high-quality clinical practices with effective impact on patients' lives. Principal findings: Despite the increasing number of studies assessing the rehabilitation of full-arch edentulism with implant-supported prostheses, there has been little adherence to reporting guidelines (EQUATOR network), resulting in high variability regarding the type of outcomes reported. The clinical performance of these restorations has been mostly evaluated using clinician-oriented and patient-reported outcomes. Assessment methods are frequently not described and vary across studies. Practical implications: It would be valuable to have a set of core outcome variables and standardized methods of measurement for future studies.

Narrow diameter titanium-zirconium tissue-level implants supporting multi-unit FDPs in the anterior area: A 5-year prospective study.

BACKGROUND: Narrow diameter implants (NDIs) are used in cases of limited mesio-distal space, or if the alveolar ridge does not allow placement of a standard diameter implant. PURPOSE: The aim of this prospective case series study is to present the 5-year clinical-, radiological-, and patient-reported outcome measures (PROMs) of patients with partial edentulism in the anterior area of the jaws requiring the placement of two narrow diameter implants to support a 3- or 4-unit fixed partial denture (FPD). MATERIALS AND METHODS: Thirty partially edentulous patients missing 3 or 4 adjacent teeth in the anterior area of the jaws were included in the study. Two titanium-zirconium tissue-level NDIs were placed in each patient in healed anterior sites (60 implants). A conventional loading protocol was performed to provide a FPD. Implant survival, success, marginal bone-level changes (MBL), clinical parameters, buccal bone stability with CBCT, adverse events and PROMs were recorded. RESULTS: The survival and success rates for the implants were 100%. The mean MBL (±SD) after prosthesis delivery, and 5-year follow-up (mean 58.8 months; range: 36-60) was 0.12 ± 0.22 and 0.52 ± 0.46 mm, respectively. Decementation and screw loosening were the most frequent prosthetic complications, yielding a prosthetic survival and success rates of 100% and 80%, respectively. Patient satisfaction was high with a mean (±SD) score of 89.6 ± 15.1. CONCLUSIONS: The use of tissue-level titanium-zirconium NDIs supporting splinted multi-unit FPDs in the anterior area seems to be a safe and predictable treatment option after a 5-year follow-up period.

Association of edentulism and all-cause mortality in Chinese older adults: do sex differences exist?

OBJECTIVES: Previous studies revealed that tooth loss or edentulism was related to mortality. However, research in developing countries with large numbers of elderly populations is rare, and whether sex differences exist in this relationship is unknown. This study aimed to investigate the association between edentulism and 7-year all-cause mortality among older adults in China and whether sex differences existed. STUDY DESIGN: This was a prospective cohort study. METHODS: Data were from 2011 to 2018 waves of the China Health and Retirement Longitudinal Study. A total of 6538 participants aged ≥60 years were included. Logistic models were adopted to estimate the risks of mortality according to edentulism. RESULTS: The participants with edentulism at baseline were 20% more likely to die over 7 years after controlling for a set of covariates (odds ratio [OR] = 1.20, 95% confidence interval [CI]: 1.02-1.42). Moreover, edentulism was associated with a 35% higher odds of death among male participants (OR = 1.35, 95% CI: 1.08-1.70), whereas a significant association was not found in female participants. CONCLUSIONS: The findings demonstrated that baseline edentulism predicted all-cause mortality in Chinese older adults, and sex differences existed in this association. This study implied the importance of developing oral health education programs, incorporating dietary recommendations into dental care for edentulous patients, and expanding the coverage of dental services in the health insurance system to prevent edentulism and alleviate its negative outcomes for older adults.

Incident edentulism and number of comorbidities among middle-aged and older Americans.

BACKGROUNDS: Certain chronic non-communicable diseases have been associated with the loss of all natural permanent teeth, referred to as edentulism. It has been suggested that edentulism, a chronic dental state, involving the loss of all teeth and poorer masticatory efficiency, could be associated with multiple chronic conditions as people age. In this study, we describe the association between the number of comorbidities and incident edentulism in a representative sample of older Americans. METHODS: We took data from the Health and Retirement Study (HRS). Dentate participants aged 50 or older at the baseline of 2006 (N = 13 221) and 2012 (N = 13 938) were linked to their dentate and survival status at the follow-up interviews in 2012 and 2018, respectively. The association between the number of comorbidities and incident edentulism was investigated by using multinomial logistic regression models. RESULTS: Over the two observation periods, the number of selected chronic conditions was predictive of edentulism 6 years later. A 10% higher chance of becoming edentulous by 2012 (OR = 1.10, 95% CI = 1.01, 1.20) was found for every additional comorbid condition to those who remained dentate in 2012. A similar association was identified for the 2012-2018 period. CONCLUSION: Among older adults, the number of comorbidities was predictive of incident edentulism, and the same association pattern was found across two longitudinal study periods. Older adults with an increase in the number of comorbidities may experience a higher chance of tooth loss later in time.

Longitudinal association of edentulism with cognitive impairment, sarcopenia and all-cause mortality among older Chinese adults.

BACKGROUND: Tooth loss may be a surrogate for systemic health and aging. However, no previous studies have systematically assessed multiple outcomes relevant to aging trajectory in this area, and many important confounders were not adjusted in most previous studies. This study aims to prospectively evaluate the associations of complete tooth loss (edentulism) with broad markers of sarcopenia, cognitive impairment and mortality. METHODS: Data were derived from the China Health and Retirement Longitudinal Study, a nationally representative household study of the Chinese population aged 45 years and older. Multivariate Weibull proportional hazards regression was used to assess the association between edentulism with sarcopenia and all-cause mortality. Average changes in cognitive function by edentulism was estimated by mixed-effects linear regression models. RESULTS: During the 5-year follow-up, the prevalence of edentulism among adults aged 45 and over was 15.4%. Participants with edentulism had a greater decline in cognitive function compared to those without (ß=-0.70, 95%CI:-1.09, -0.31, P < 0.001). The association of edentulism and all-cause mortality for 45-64 age group (HR = 7.50, 95%CI: 1.99, 28.23, P = 0.003), but not statistically significant for the ≥ 65 age group (HR = 2.37, 95%CI: 0.97, 5.80, P = 0.057). Effects of edentulism on sarcopenia are statistically significant for all age groups (45-64 age group: HR = 2.15, 95%CI: 1.27, 3.66, P = 0.005; ≥65 age group: HR = 2.15, 95%CI: 1.27, 3.66, P = 0.002). CONCLUSIONS: These findings could have important clinical and public health implications, as tooth loss is a quick and reproducible measurement that could be used in clinical practice for identifying persons at risk of accelerated aging and shortened longevity, and who may benefit most from intervention if causality is established.

The effect of using denture adhesives on patient satisfaction with complete dentures; a randomized clinical trial.

BACKGROUND: Denture adhesives can be useful in improving patients' satisfaction with complete dentures. However, comparison clinical trials are lacking. The purpose of this randomized clinical trial was to assess the satisfaction of edentulous patients and their oral health impact profile when provided with 3 types of denture adhesives. METHODS: Sixty-four completely edentulous patients seeking complete dentures for their first time were randomly divided into 3 groups. Each group received a set of complete dentures, which were adjusted at review appointments until participants reported no complaints. After 1 month of using the dentures, participants rated their overall satisfaction and their satisfaction regarding comfort, retention, stability, and efficiency of mastication and speech on a 100-mm visual analog scale (VAS). Participants also filled out the oral health impact profile for edentulous patients (OHIP-EDENT) questionnaire. Each group was then given 1 type of denture adhesive to use. Group C received Corega Ultra denture fixative cream (GlaxoSmithKline), Group O received Olivafix (Bonyf), and Group S received Sea. Bond adhesive strips (Sea.Bond). Mann-Whitney U test was used to analyze the differences in VAS scores before and after using the adhesive within each group and Wilcoxon-signed rank test was used to compare OHIP scores and total OHIP values before and after using the adhesive within each group (p = 0.05). Furthermore, Kruskal Wallis test was used to compare the differences before and after using the adhesives in VAS and OHIP values between the 3 groups. RESULTS: Significantly higher VAS values were detected in all groups and significantly lower values for many OHIP items in addition to total OHIP values were detected in all groups after using the adhesives (P < 0.05), except for the ease of cleaning for Group O and Group S (P > 0.05). No significant differences were found in VAS and OHIP values between the 3 groups (P > 0.05), except for the ease of cleaning which was significantly different between Group C and Group S (p = 0.005). CONCLUSIONS: Using denture adhesives for completely edentulous patients resulted in higher patient satisfaction as indicated by higher VAS scores as well as improved quality of life as indicated by lower OHIP-EDENT scores after using the adhesives. These improvements were not dependent on the type of adhesive, except for ease of cleaning as adhesive strips were easier to clean than paste type adhesives. TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov (ID: NCT05496283) on 11/08/2022.