Comparación de prótesis removibles parciales y totales entregadas según sus características clínicas en el servicio de odontología del hospital nacional de geriatría y gerontología, en el período de tiempo comprendido del 1 de enero 2005 al 31 de diciembre del 2008 / Comparison of partial and total removable prosthesis delivered according to their clinical characteristics in the dentistry service of the national hospital of geriatry and gerontology, in the period under january 1 of 2005 to december 31 of 2008

RESUMEN Objetivo: Comparar la cantidad y características de las prótesis dentales removibles parciales y totales, en el servicio de odontología del Hospital Nacional de Geriatría y Gerontología, en el periodo de tiempo comprendido del 1 de enero 2005 al 31 de diciembre 2008, equivalentes a 326 expedientes. Se tomó la base de datos del servicio de odontología de consulta externa especializada de los pacientes atendidos de los años 2005 al 2008, en los cuales se entregaron un total de 2786 prótesis dentales removibles. Materiales y métodos: Con base en el dato anterior se seleccionó la muestra no aleatoria a conveniencia hasta alcanzar el tamaño de 599 prótesis entregadas, examinando 326 expedientes del periodo de enero del 2005 a diciembre del 2008, con un nivel de confianza de 99% y un error de muestreo de 0.0466. La recolección de datos se realizó por medio del programa Microsoft Excel donde se utilizó una tabla en la que se anotó el número de expediente, fecha de inicio y conclusión de prótesis, tipo de prótesis, cantidad y color de prótesis, edad, género y domicilio del paciente por distrito, cantón y provincia. El procesamiento se realizó por medio de estadística descriptiva utilizando cuadros y gráficos. Resultados: Se determinó que el mayor porcentaje de rango de edad de personas que solicitaron prótesis removibles fue de 62 a 65 años, independiente si eran prótesis totales o parciales, los pacientes que requirieron dos prótesis fueron 273 de 326, en su mayoría los pacientes solicitaron prótesis totales para un total de 372 de 599 prótesis entregadas. De la guía de color utilizada en el HRBC los colores más requeridos fueron los tonos claros blanco amarillentos que corresponde al número 62 y 65; de los expedientes analizados la mayoría de los pacientes residían en San José con un total de 200 pacientes. Se concluye que el mayor porcentaje de edentulismo que se presento es el edentulismo total con un 62%, la prótesis más utilizada es la prótesis total superior removible y en su mayoría los pacientes requieren dos prótesis, con respecto al color no es concluyente para este estudio debido a los datos no disponibles en los expedientes analizados.

ABSTRACT Objective: Compare the quantity and characteristics of partial and total removable dental prostheses, in the dentistry service of the National Hospital of Geriatrics and Gerontology, in the period from January 1, 2005 to December 31, 2008. The database of the specialized outpatient dentistry service of the patients treated from 2005 to 2008 was taken, in which a total of 2786 removable dentures were delivered. Materials and methods: Based on the previous data, the non-random sample was selected for convenience until reaching the size of 599 protheses of 326 files, with a confidence level of 99% and a sampling error of 0.0466. Data collection was carried out through the Microsoft Excel program where a table was used in which the file number, date of start and conclusion of the prosthesis, type of prosthesis, amount and color of prosthesis, age, gender and address were used of the patient by district, canton and province. The processing was carried out by means of descriptive statistics using tables and graphs. Results: It was determined that the highest percentage of the age range of people who requested removable prostheses was 62 to 65 years, the patients that required two prostheses were 273 of 326. In their majority, the patients requested total prostheses for a total of 372 of 599 prostheses delivered. Of the color guide used in the HRBC, the most requested colors were the light yellowish-white tones corresponding to the number 62 and 65; of the files analyzed, most of the patients resided in San José with a total of 200 patients. Conclusion: It is concluded that the highest percentage of edentulism that is presented is total edentulism with 62%, the most commonly used prosthesis is the removable upper total prosthesis and for the most part patients require two prostheses, with respect to color it is inconclusive for this study due to data not available in the analyzed files.

Factors associated with the need for a complete denture in one arch or both arches among the elderly population

Abstract: This study aimed to identify factors associated with the need for complete dentures in one dental arch or both, among the elderly population. The cross-sectional household study was conducted with a representative sample of elderly people (65 years or older) in the state of São Paulo, Brazil, in 2015. The dependent variable was the need for complete dentures (in one arch or both), and independent variables were socioeconomic and demographic conditions, social capital, self-perception of oral health and access to dental services. Simple and multinomial logistic regression models tested effect measures (p < 0.05). A total of 5,948 elderly people participated. Results indicated that those with greater chances of needing a complete denture in one arch were male (OR = 1.54; CI95%:1.04-2.29), with fewer household goods (OR = 2.25; CI95%:1.50-3.38), lower monthly household income: R$501-1500 (OR = 3.44; CI95%:1.27-9.35), R$1501-2500 (OR = 4.11; CI95%:1.50-11.27), R$2501-4500 (OR = 2.76; CI95%:1.10-6.95), self-reported need for a complete denture (OR = 4.75; CI95%:3.08-7.35), ≥3 years since last dental appointment (OR = 1.80; CI95%:1.06-3.05), and dissatisfaction with last dental appointment (OR = 1.80; CI95%:1.06-3.05). There were more chances of the need for complete dentures in both arches among older elders (OR = 1.44; CI95%:1.06-1.88), with lower monthly household income: R$ < 501 (OR = 4.45; CI95%:1.71-11.60), R$501-1500 (OR = 4.01; CI95%:2.14-7.51), R$1501-2500 (OR = 2.95; CI95%:1.64-5.32), < 3 years of education (OR = 1.45; CI95%:1.13-1.85), feeling unhappy (OR = 2.74; CI95%:1.35-5.57), self-reported need for a complete denture (OR = 8.48; CI95%:5.75-12.50), dissatisfaction with their mouth (OR = 2.38; CI95%:1.64-3.46), ≥3 years since last dental appointment (OR = 4.28; CI95%:2.85-6.43), and dissatisfaction with last dental appointment (OR = 4.28; CI95%:2.85-6.43). The several dimensions of the determinants of the need for a complete denture reflect the influence of both demographic and socioeconomic aspects, social capital, self-perception of oral health and access to dental services.

Uso de prótese total e síndrome da fragilidade em idosos institucionalizados / Total prosthesis use and frailty syndrome in institutionalized elderly

Introdução: Perda dentária constitui indicador prévio de envelhecimento acelerado, em particular nos idosos institucionalizados, sendo preferencialmente tratada com reabilitações protéticas. Uma das manifestações patológicas do envelhecer que compartilha características com perdas dentárias é a síndrome da fragilidade. Objetivo: Avaliar relação entre uso de prótese total e síndrome da fragilidade em idosos institucionalizados. Métodos: Estudo transversal, com 69 idosos institucionalizados, realizado em João Pessoa-PB, Brasil. Foram utilizados formulário para avaliar saúde bucal, condição protética e testes específicos para variáveis do fenótipo de fragilidade. Na análise estatística foram aplicados testes t-Student e Qui-Quadrado. Resultados: A amostra caracterizou-se pelo predomínio de frágeis (49,3%) e usuários de prótese total (50,7%). Os pré-frágeis e frágeis apresentaram maior prevalência de edentulismo e de uso de prótese total (56,3% e 39,4%, respectivamente). Contudo, não foram encontradas diferenças significativas entre os grupos (p = 0,05). Conclusão: É sugerido que o uso de prótese total não influencia a fragilidade em idosos institucionalizados. (AU)

Background: Tooth loss is an early indicator of accelerated aging, in institutionalized elderly in particular, being preferentially treated with prosthetics rehabilitation. One of the pathological displays of to age, that share characteristics with tooth loss, is the frailty syndrome. Objective: Evaluate relationship between total prosthesis use, and frailty syndrome in institutionalized elderly. Methods: Cross-sectional study of 69 institutionalized elderly in the city of João Pessoa, Brazil. A form to assess oral, and dental health data, and specific tests for frailty phenotype variables were used t Student's and chi-square test was applied in statistical analysis. Results: The sample was characterized as predominantly denture complete use (50,7%), and frail (49,3%). Pre-frail, and frail exhibited highest prevalence of edentulous, and complete denture use (56,3% e 39,4%, respectively). However, no significant differences were found between groups (p = 0,05). Conclusion: It is suggested that complete denture use wasn't related to frailty in institutionalized elderly. (AU)

Prótesis total con reservorio salival en un paciente con síndrome de Sjögren / Complete Denture with Salivary Reservoir in a Patient with Sjogren's Syndrome

Antecedentes: El síndrome de Sjögren es una enfermedad autoinmune que empieza a manifestarse hacia los 45 años de edad y cuya incidencia aumenta con la edad. La sintomatología en la cavidad oral se caracteriza por boca seca o xerostomía. Gran cantidad de pacientes que la padecen son portadores de prótesis totales debido a la pérdida dental en edades avanzadas. Objetivo: Describir el caso de un paciente con síndrome de Sjögren a quien se le elaboró una prótesis con reservorio salival para disminuir síntomas orales. Métodos: Se realizaron ensayos de laboratorio para elaborar los reservorios buscando resistencia estructural de la prótesis; facilidad de colocación y retiro de las tapas de los reservorios para permitir la limpieza de los depósitos; estética y que contuvieran la mayor cantidad posible de saliva artificial. Los diseños se probaron en el paciente. Resultados: Después de realizar ensayos de prueba de la prótesis en ambos maxilares, el paciente comentó sobre la facilidad de retiro de las tapas, ausencia de nauseas, fonética normal, higiene adecuada, comodidad, solución parcial al problema de xerostomía y duración aproximada de tres horas una vez llenos los reservorios. Conclusión: Los prototipos finales proporcionaron mejores condiciones de los reservorios y aumentaron la cantidad de saliva. Se recomienda realizar estudios clínicos controlados para confirmar los hallazgos de este caso.

Background: Sjögren's syndrome is an autoimmune disease that manifests after the age of 45 years and whose incidence increases with age. Symptoms in the oral cavity includes dry mouth or xerostomia. Large number of Sjögren's patients wear complete dentures due to tooth loss at advanced ages. Objective: To describe the case of a Sjögren's patient for whom dentures with salivary reservoirs were made to reduce oral symptoms. Methods: Lab tests were conducted to find an optimum denture design with reservoirs. Requirements included: structural resistance, easy placement and removal of reservoir caps to allow cleaning, good esthetics, and containing the greatest amount of artificial saliva. Models were tried in the patient. Results: Several models were tried for both jaws. At the end, the patient reported about easiness to remove caps, absence of nausea, normal phonetics, adequate hygiene, comfort, and partial solution to the problem of xerostomia with an approximate duration of three hours once the reservoir was full. Conclusion: Final prototypes provided the best characteristics of reservoirs and stored the highest amounts of saliva. It is important to conduct clinical controlled trials to confirm the findings of this case.

Geriatria ­ atualização em pistas deslizantes / Geriatria ­ sliding plates atualization

No artigo é proposta a substituição da resina lisa na região posterior das pistas deslizantes por dentes cúspide zero, respeitando o plano de orientação obtido através do desgaste de Paterson, na reabilitação do paciente edentado e sugerido um esquema de montagem dos dentes anteriores visando o equilíbrio articular.

The authors propose replacing the smooth resin in the posterior region of the sliding tracks by zero cusp teeth, respecting the guidance plan obtained by Paterson wear in the rehabilitation of the edentulous patient and suggest an arrangement of the anterior teeth in order to articulate the balance.

Self-report of gingival problems and periodontitis in indigenous and non-indigenous populations in Chiapas, Mexico.

OBJECTIVE: To estimate the prevalence of self-reported gingival and periodontal conditions and their association with smoking, oral hygiene, indigenous origin, diabetes and location (urban or rural) in indigenous and non-indigenous adults in Chiapas, Mexico. METHODS: A cross-sectional study of 1,749 persons, ≥20 years of age, living in four rural and four urban marginal localities in Comitán (Chiapas, México). The variables investigated were: age; sex; indigenous origin; oral hygiene; halitosis; chewing ability; gingival conditions; periodontitis; smoking; alcoholism; diabetes; and location. Bivariate analysis and a logistic regression model were used to identify the association of periodontitis with the independent variables. RESULTS: In total, 762 (43.6%) indigenous and 987 (56.4%) non-indigenous persons were interviewed. Their mean age was 41 ± 14 years, 66.7% were women and 43.8% lived in rural locations. Gingival problems were reported by 68.5% and periodontitis by 8.7%. In total, 17.9% had used dental services during the previous year, 28.7% wore a removable partial or a complete dental prosthesis, 63.7% had lost at least one tooth, the prevalence of diabetes was 9.2% and the prevalence of smoking was 12.2%. The logistic regression model showed that age, diabetes and the interaction between rural location and indigenous origin were associated with the presence of periodontitis. CONCLUSIONS: Indigenous people living in rural areas are more likely to have periodontitis. It is necessary to promote oral health practices in indigenous and marginalised populations with a focus on community-oriented primary care.

Avaliação da atividade proliferativa celular das lesões bucais causadas pelo uso de próteses totais através da impregnação tecidual pela prata / Proliferative cellular activity evaluation of lesions caused by dentures through tissue silver impregnation

Introdução: As próteses totais visam conservar a função do sistema estomatognático do paciente totalmente edêntulo. Porém, na mucosa bucal podem aparecer manifestações cuja principal causa são as próteses totais mal adaptadas. Objetivo: o presente estudo objetiva investigar a proliferação tecidual das lesões causadas por próteses totais removíveis através do método de impregnação pela prata (AgNOR), com isso facilitando o tratamento e a determinação do prognóstico das lesões a serem estudadas. Metodologia: foram selecionados todos os casos das lesões bucais mais comumente associadas à utilização de próteses totais registradas no Serviço de Diagnóstico Histopatológico do ICB­UPF nos anos de 2012 e 2013, tendo sido encontrados 5 casos de granuloma piogênico, 5 casos de hiperplasia de fundo de sulco, 5 casos de fibroma de irritação e 2 casos de fibroma ossificante periférico. Os cortes histopatológicos das lesões foram impregnados pela prata (método AgNOR), tendo sido obtido, com auxílio do programa Image Tool®, o número de NORs de 100 células de cada caso, resultando numa média de NORs em cada grupo de lesões. Resultados: os resultados obtidos foram tabulados em planilha eletrônica e a comparação do número médio de NORs de cada grupo foi realizado por meio do teste estatístico ANOVA, 5% de significância. Resultados: o grupo das hiperplasias de fundo de sulco mostrou média de 2,41 NORs por núcleo, o grupo dos granulo mas piogênicos mostrou 2,44, o fibroma de irritação 2,22, e o fibroma ossificante periférico mostrou média de 1,89 NORs por núcleo celular, diferindo estatisticamente esta lesão das anteriormente mencionadas (p = 0,002). Conclusão: o fibroma ossificante periférico mostrou ser a lesão causada por prótese total removível com a menor atividade proliferativa celular. Tal estudo precisa ser complementado por futuros estudos clínicos.

Introduction: the total dentures are aimed at preserving the function of the stomatognathic system of the fully edentulous patient. However, in the oral mucosa may appear manifestations whose main cause are the totally unsuitable dentures. Objective: this study aims to investigate the proliferation of tissue lesions caused by removable dentures by impregnation method for silver (AgNOR), thereby facilitating the treatment and determining the prognosis of the lesions to be studied. Methodology: we selected all cases of oral lesions most commonly associated with the use of dentures recorded in Histopathological Diagnostic Service ICB-UPF in the years 2012 and 2013, having been found 5 cases of pyogenic granuloma, 5 cases of hyperplasia, 5 cases of irritation fibroma and 2 cases of peripheral ossifying fibroma. Histopathological lesions cuts were impregnated by silver (AgNOR method), having been obtained with the aid of the program Image Tool®, the number of NOR cells 100 in each case, resulting in an average NORs in every group of lesions. Results: the results were tabulated in a spreadsheet and comparing the average number of NORs of each group was conducted through ANOVA, 5% significance level. Results: The group of hyperplasias showed average of 2.41 NORs per nucleus, the group of pyogenic granulomas showed 2.44, the irritation fibroma 2.22, and peripheral ossifying fibroma showed average of 1.89 NORs for cell nucleus, differing significantly from that of the aforementioned lesions (p = 0.002). Conclusion: the peripheral ossifying fibroma proved the injury caused by removable dentures with lower cell proliferative activity. This study needs to be complemented by future clinical studies.

Provision of specific dental procedures by general dentists in the National Dental Practice-Based Research Network: questionnaire findings.

BACKGROUND: Objectives were to: (1) determine whether and how often general dentists (GDs) provide specific dental procedures; and (2) test the hypothesis that provision is associated with key dentist, practice, and patient characteristics. METHODS: GDs (n = 2,367) in the United States National Dental Practice-Based Research Network completed an Enrollment Questionnaire that included: (1) dentist; (2) practice; and (3) patient characteristics, and how commonly they provide each of 10 dental procedures. We determined how commonly procedures were provided and tested the hypothesis that provision was substantively related to the three sets of characteristics. RESULTS: Two procedure categories were classified as "uncommon" (orthodontics, periodontal surgery), three were "common" (molar endodontics; implants; non-surgical periodontics), and five were "very common" (restorative; esthetic procedures; extractions; removable prosthetics; non-molar endodontics). Dentist, practice, and patient characteristics were substantively related to procedure provision; several characteristics seemed to have pervasive effects, such as dentist gender, training after dental school, full-time/part-time status, private practice vs. institutional practice, presence of a specialist in the same practice, and insurance status of patients. CONCLUSIONS: As a group, GDs provide a comprehensive range of procedures. However, provision by individual dentists is substantively related to certain dentist, practice, and patient characteristics. A large number and broad range of factors seem to influence which procedures GDs provide. This may have implications for how GDs respond to the ever-changing landscape of dental care utilization, patient population demography, scope of practice, delivery models and GDs' evolving role in primary care.

The influence of mandibular ridge anatomy on treatment outcome with conventional complete dentures

Since prognostic indicators are likely to take on increasingimportance as a diagnostic tool for selection of patients forimplant provision, this study investigated the influence of theshape and resiliency of the mandibular alveolar ridge on theretention and stability of conventional complete dentures. Ninety-three edentulous patients wearing both maxillary andmandibular conventional complete dentures composed the sample.Data were collected regarding shape and resiliencyof themandibular residual ridge. Dentures were assessed for retentionand stability using an objective and reproducible tool.The associationsbetween the clinical characteristics of the mandibularalveolar ridge and denture retention and stability were analyzedusing chi-square and Fisher exact tests (α = 0.05). A significantassociation between ridge shape and denture stability (p < 0.05)was found, while ridge resiliency was significantly associated todenture retention (p < 0.001). Based on the results, mandibularridge shape and resiliency influenced the retention and stabilityof conventional complete dentures...

Comparison of systemic health conditions between African American and Caucasian complete denture patients.

PURPOSE: To compare prevalence of systemic health conditions (SHC) between African American and Caucasian edentulous patients presenting for complete dentures (CD) at an urban dental school. METHODS: The study included patients presenting for CD 1/1-12/31/2010, ages 20 to 64 years, and either African American or Caucasian. Covariates included: age group, gender, employment status, Medicaid status, smoking history, and alcohol consumption. SHC included at least one of the following: arthritis, asthma, cancer, diabetes, emphysema, heart attack, heart murmur, heart surgery, hypertension, or stroke. RESULTS: The group (n = 88) was 44.3% African American, 65.9% ≥50, 45.5% male, 22.7% employed, and 67.0% with at least one SHC. African Americans were older (p = 0.001) and more likely to have one or more SHC (p = 0.011). Patients with at least one SHC were older (p = 0.018) and more likely female (p = 0.012). The total sample logistic regression model assessing SHC yielded only gender as statistically significant (males < OR 0.32, 95% CI 0.11 to 0.92). Caucasian males were less likely to have SHC (OR 0.17, 95% CI 0.04 to 0.77), and Caucasians ≥50 were more likely (OR 5.36, 95% CI 1.19 to 24.08). African Americans yielded no significant associations. CONCLUSIONS: Among selected completely edentulous denture patients at an urban dental school, two out of three patients had at least one SHC. This exploratory study suggests there may be health status differences between African American and Caucasian patients in this setting, calling for further study.

Tooth loss strongly associates with malnutrition in chronic kidney disease.

BACKGROUND: In chronic kidney disease (CKD), inadequate nutritional intake, inflammation, and increased oxidative stress have been the major contributing factors in malnutrition pathogenesis. However, there is still a paucity of evidence assessing the magnitude of the effect of tooth loss on malnutrition in CKD populations. The authors hypothesize that among patients with CKD, tooth loss may affect nutritional status, using the National Health and Nutrition Examination Survey 1988 to 1994 (NHANES III). METHODS: Glomerular filtration rate (GFR) was estimated based on cystatin C levels using the relevant equation. Urinary albumin-to-creatinine ratio (albuminuria) was calculated in milligrams per gram with a cutoff point of 30 mg/g. CKD was defined based on estimated GFR <60 mL/minute/1.73m(2) and albuminuria ≥30 mg/g. The cutoff point for serum albumin was set at 3.7 g/dL. Tooth loss categories were based on the number of missing and replaced teeth. RESULTS: A total of 2,749 patients was included and stratified based on their oral health status. There was a statistically significant correlation between tooth loss and the proportion of patients with low protein and caloric intake (P = 0.02 and 0.01, respectively). Serum albumin reached a frequency peak in the fully edentulous group without dentures (group 4, 19.2%). In the same group, individuals had lower protein (30.1%) and caloric intake (30.2%) (P = 0.01 and 0.02, respectively). Furthermore, logistic regression analysis confirmed the significant role of tooth loss on serum albumin and protein and energy intake in this population even after adjusting for confounding variables. CONCLUSION: Tooth loss independently predicts low energy and protein intake, as well as serum albumin levels, biomarkers of malnutrition in CKD.

Xerostomia in complete denture wearers: prevalence, clinical findings and impact on oral functions.

OBJECTIVES: To investigate the prevalence of dry mouth in a select sample of edentulous Jordanian older population wearing complete dentures and to evaluate its impact on oral functions. BACKGROUND: The prevalence and impact of Xerostomia as a cofactor in causing denture problems in Jordanians have not been previously investigated. MATERIALS AND METHODS: This study included 455 participants (253 men and 202 women). Perception of dry mouth was measured by a pilot-tested questionnaire. Xerostomic status was confirmed clinically. Complete denture function was also assessed. RESULTS: One hundred and thirty six subjects (29.9%) had reported a subjective feeling of dry mouth with a prevalence of 24.9% in men (n = 63) and 36.1% in women (n = 73) (p < 0.01). 136 of the 145 subjects with satisfactory dentures showed one or more signs suggestive of Xerostomia. The majority of xerostomic participants with different sets of complete dentures were dissatisfied with oral functions (p < 0.05). There was a significant association between dry mouth and increasing age, female gender and smoking status (p < 0.05). CONCLUSION: Among complete denture wearers, Xerostomia is significantly more prevalent in women and associated with increased age and smoking. Xerostomia adversely affects oral functions and overall satisfaction with dentures.

Maximum bite force idn elderly indigenous and non-indigenous denture wearers

El objetivo de este estudio fue comparar las medidas de fuerza máxima de mordida (MBF) en pacientes desdentados adultos mayores indígenas (Mapuches) y no indígenas, en el momento de recibir sus prótesis totales y un mes posterior a la inserción.Una muestra de 100 sujetos adultos mayores fue dividida en dos grupos: 50 indígenas y 50 no indígenas, cada uno de ellos con 25 pacientes de sexo femenino y 25 masculino. Todos los individuos estudiados eran completamente edéntulos, quienesrecibieron prótesis removibles totales nuevas tanto superior como inferior. Las medidas fueron realizadas en el momento de la inserción de ambas prótesis y posterior a un mes de uso. Seles solicitó a los sujetos que realizaran un esfuerzo máximo con tres mordidas por lado en máxima intercuspidación, con un tiempo de descanso de 2 minutos entre cada medición. El análisisestadístico fue realizado por medio del test t-Student´s. Los valores de fuerza máxima observados en los sujetos indígenas fueron significativamente mayores que en los individuos no indígenas. Además, los valores de fuerza posterior al mes de uso dela prótesis nueva fueron significativamente mas altos que losobtenidos al momento de la inserción de la prótesis. Por otro lado, no se identificaron diferencias significativas en los valores entre los lados izquierdo y derecho. Así, los pacientes indígenasmostraron valores mayores de fuerza masticatoria máxima. También, se pudo observar que los pacientes sufrieron un proceso de adaptación a las prótesis nuevas, en los cuales la fuerza máximamasticatoria posterior a un mes aumentó considerablemente...

Removable dental prostheses and cardiovascular survival: a 15-year follow-up study.

OBJECTIVES: In previous studies, increasing number of teeth predicted better survival and the acute needs for dental treatment predicted mortality. We sought to investigate whether restored dentitions by various removable dental prostheses impact cardiovascular (CVD) longevity. METHODS: Kuopio Oral Health and Heart study was initiated as a cross-sectional investigation with 256 subjects with diagnosed coronary artery disease [CAD] and 250 age- and sex-matched controls without CAD in 1995-1996. The mean age of both groups was 61, 30% were females. We appended mortality follow-up records to the baseline data and formulated this 15-year follow-up study. We examined the relationship between various types of dental prostheses and cardiovascular mortality by proportional hazard regression analyses. We also explored their correlation to oral and systemic inflammatory markers such as asymptotic dental score and C-reactive protein. RESULTS: In a model adjusted for age, sex and smoking, groups having only natural teeth (NT), removable partial denture(s) [PD] and NT, a PD and a full denture [FD], and FD/FD or FD/NT demonstrated the following hazard ratios for mortality (95% confidence interval). NT both arches: 1.00 [reference]; PD and NT: 0.75 [0.22-2.56]; PD and FD: 1.99 [1.05-3.81]; and FD opposed by FD or NT: 1.71 [0.93-3.13], respectively [p for trend=0.05]. Although statistically not significant, those with PD and NT with mean a number of teeth [Nteeth] of 15.4 had better survival compared with those who had all NT [Nteeth=22.5]; while those who had FD and PD [Nteeth=6.5] had shorter longevity than those with FD/FD or FD/NT [Nteeth=3.5]. CONCLUSIONS: Although not all subgroups of dental prostheses reached significant relationship with CVD mortality, our study suggests that not only the number [quantity] of remaining teeth but their maintenance [quality] removing potential inflammatory foci, such as pericoronitis or retained root tips, may positively impact on cardiovascular survival.

A study to evaluate the frequency and association of various mucosal conditions among geriatric patients.

UNLABELLED: Geriatric dentistry or gerodontics is the delivery of dental care to older adults involving the diagnosis, prevention and treatment of problems associated with normal aging and age-related diseases as part of an interdisciplinary team with other health care professionals. AIM: To evaluate the oral mucosal status in the elderly population of different age group and fnd out the association of age, gender and denture with oral mucosal disorders. MATERIALS AND METHODS: The study sample consisted of 570 geriatric persons concentrating mainly on the oral mucosal changes or lesions occurring in the geriatric population. Individuals those are aged above 60 years were selected, and all the examined geriatric persons were categorized into 3 age groups to fnd out the association of oral mucosal lesions in each group. Group I-60 to 65 years, Group II-66 to 70 years, Group III-71 and above years. RESULTS: The sample of 570 elderly patients included 279 (48.95%) men and 291 (51.05%) women in three age groups: 61 to 65 years (40.35%), 66 to 70 years (31.05%), and 71 years and older (28.60%). The sample included 254 (44.56%) dentate patients, 205 (35.96%) denture wearers (partial and complete denture wearers) and 111 (19.47%) edentulous persons who lacked dentures in both the jaws. Almost half of the patients examined (48%) had one or more oral mucosal lesions. The 48% of the patients who presented with oral mucosal lesions, twenty fve different oral mucosal conditions were identifed and the three most common fndings were lingual varices (13.68%), denture induced infammatory fbrous hyperplasia (4.21%), squamous cell carcinoma (4.21%). There was some differences in the distribution of oral mucosal condition among the sexes. Leukoplakia and dysplasia were signifcantly associated with men (p < 0.001) whereas the association of fbroma and lichen planus with women were signifcant (p < 0.001). CONCLUSION: In our study it was found that patients in groups II and III had more prevalence of oral mucosal disorders. Lingual varices, oral squamous cell carcinoma, fbroma and denture induced infammatory fbrous hyperplasia were more commonly associated with the geriatric patients. The oral lesions (fbroma and lichen planus) were strongly associated with women while leukoplakia was strongly associated with men. Ageing is an important factor that can infuence the occurrence of mucosal lesions and with age the oral mucosa becomes more permeable to noxious substances and more vulnerable to external carcinogens.

Hypohidrotic ectodermal dysplasia: a multidisciplinary approach.

Hypohidrotic ectodermal dysplasia (HED; Christ-Siemens-Touraine syndrome) is a genetic disorder characterized by sparse hair, oligodontia with peg-shaped teeth, reduced sweating, and defects in a number of other ectodermal organs. A partial or complete absence of eccrine glands can lead to recurrent severe overheating that may cause seizures and neurological deficits. This clinical report presents a 14-year-old male patient with hypohidrotic ectodermal dysplasia, including the clinical and radiographic findings, and multidisciplinary treatment. The Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version (K-SADS-PL) was administered to patient along with mother to assess for any psychiatric disorders. The screening and rating scales completed by mother and two teachers to evaluate the severity of attention deficit hyperactivity disorder (ADHD) symptoms, and other behavioral problems. Patient's academic performance, adaptive functioning, and problem behavior was evaluated using. The Teacher Report Form. Mental capacity was assessed with the Wechsler Intelligence Scale for Children (WISC-R). Illness Perception Questionnaire Revised was used to systematically assess illness representation attributes and emotional representations of illness. On the psychiatric diagnosis assessment using K-SADS-PL sub-threshold attention deficits and anxiety symptoms were determined. In this case we established a multidisciplinary approach in his treatment with pediatric, dermatological, and dental examinations, beside his psychiatric evaluation. The prosthetic rehabilitation included restoring upper teeth with copings and fabrication of upper and lower complete dentures. Metal framework was not incorporated in the partial denture design allowing modifications as the oral and maxillofacial development continued. Removable complete or partial dentures without metal framework is a treatment of choice until the completion of facial growth at which definitive treatment is considered.

Relationship between squamous cell carcinoma of the anterior two thirds of the tongue and removable denture use: a pioneer study in a Portuguese population.

The aim of the study was to determine whether there is any relationship between the presence of removable dentures and squamous cell carcinoma of the anterior two thirds of the tongue in a Portuguese population. A retrospective cross-sectional study was conducted on patients with a biopsy-proven diagnosis of squamous cell carcinoma of the tongue, who were seen and treated at the Department of Head and Neck Surgery of the Portuguese Institute of Oncology 'Francisco Gentil', Lisbon, Portugal, during a 3-year period. Several factors were examined: gender, use of removable dentures, age, location of the lesion, and alcohol and tobacco consumption. One hundred and six cases were selected from the initial 151 cases, with a male:female ratio of 3:1 and the lateral borders being the most commonly affected site. The prevalence in both genders was between the sixth and seventh decade of life. Men were more likely to consume alcohol and tobacco than women, and no relationship was observed between denture use and presence of carcinoma of the tongue. In light of the data obtained, it may be considered that female use of a denture plays an important role, but it cannot be identified as a remarkable etiologic factor.

Palatal and mandibular tori in a Romanian removable denture-wearing population.

OBJECTIVE: To establish the prevalence of palatal tori (TP) and mandibular tori (TM) in a Romanian denture-wearing population in order to see how or if tori influenced the denture design or the treatment planning. BACKGROUND DATA: There are no available data regarding tori in an elderly Romanian population and its implication for treatment planning. It could be considered a local factor influencing the quality of prosthetic treatment. MATERIAL AND METHOD: Tori prevalence was investigated in 251 patients, with an average age of 62years. A statistical analysis was made, using odds ratio (OR) for the distribution related to gender and the Chi-squared test for the differences in prevalence related to age groups. Treatment planning difficulties because of presence of tori were recorded. RESULTS: Frequency of TP was significantly higher in both genders (OR=2.0661 and p=0.0446) and non-significant frequency for distribution between genders for TM (OR=0.9421 and p=0.8273). The differences in age groups showed both tori types have a variable prevalence related to age. The most frequent location for TP was found in the posterior one-third and two-thirds of the palate and for TM in the canine and first premolar area presenting with different sizes. CONCLUSIONS: Tori prevalence in our study group is high and is significantly related to age (p<0.05) having a peak at over 60 years. The preferential site of TP in the posterior palatal area and this location has an impact on decision making in treatment planning for the upper denture.

Factors influencing edentulous patients' preferences for prosthodontic treatment.

The aim of this study was to identify factors influencing edentulous patients' preferences for treatment using conventional or implant dentures (ID). A consecutive sample of 112 patients was selected in a university facility. All patients responded to a questionnaire concerning preferences about treatment and factors influencing preferences for conventional complete dentures (CD), implant-retained overdentures (IRO) and fixed implant-supported prostheses (FISP). Subsequently, a set of 21 questions was presented, and patients were requested to rate the importance of various potential reasons influencing their choice of treatment. Preference for CD was more prevalent for maxilla (52·7%) and mandible (41·1%). Fixed implant-supported prostheses and IRO were preferred for the mandible (FISP=37·5%; IRO=21·4%) rather than maxilla (FISP=27·7%; IRO=19·6%). The most preferred treatment option among the subjects when evaluating both arches was the implant-supported fixed or removable prosthesis (FISP/IRO). A preference for combined upper and lower CD was also commonly reported (39·3%). Factor analysis identified six components that accounted for 72·2% of the total variance: (i) psychosocial benefits, (ii) functional performance, (iii) technical and financial concerns, (iv) post-insertion complaints, (v) removability and (vi) longevity. Technical and financial concerns (cost, complexity, surgery risks and duration of treatment) were more relevant for those who preferred ID (P<0·001). With the exception of post-insertion complaints, all mean scores of component factor loadings were positive for ID. Conventional complete dentures are associated with lower expected outcomes by patients, and cost-related issues are the major factors associated with the preferences for implant treatment of edentulous patients.

Relationship between squamous cell carcinoma of the anterior two thirds of the tongue and removable denture use: a pioneer study in a Portuguese population

The aim of the study was to determine whether there is any relationship between the presence of removable dentures and squamous cell carcinoma of the anterior two thirds of the tongue in a Portuguese population. A retrospective cross-sectional study was conducted on patients with a biopsy-proven diagnosis of squamous cell carcinoma of the tongue, who were seen and treated at the Department of Head and Neck Surgery of the Portuguese Institute of Oncology 'Francisco Gentil', Lisbon, Portugal, during a 3-year period. Several factors were examined: gender, use of removable dentures, age, location of the lesion, and alcohol and tobacco consumption. One hundred and six cases were selected from the initial 151 cases, with a male:female ratio of 3:1 and the lateral borders being the most commonly affected site. The prevalence in both genders was between the sixth and seventh decade of life. Men were more likely to consume alcohol and tobacco than women, and no relationship was observed between denture use and presence of carcinoma of the tongue. In light of the data obtained, it may be considered that female use of a denture plays an important role, but it cannot be identified as a remarkable etiologic factor.

O objetivo deste estudo foi determinar se existe alguma relação entre o uso de prótese removível e o carcinoma escamoso dos dois terços anteriores na população portuguesa estudada. Um estudo retrospectivo foi conduzido em paciente com diagnóstico anatomopatologico de carcinoma escamoso dos dois terços anteriores, diagnosticados no Instituto Português de Oncologia, Francisco Gentil, Lisboa desde 1 de Janeiro de 2001 até 31 de Dezembro de 2003. Diferentes fatores foram analisados: o gênero, uso de prótese removível, idade, localização, álcool e tabaco. Dos 151 casos iniciais de carcinoma, foram selecionados 106 casos mostrando numa proporção de 3:1 (masculino/feminino). Os bordos laterais foram a localização mais comum e a prevalência em ambos os sexos sitou-se entre a sexta e a sétima década. A presença de álcool e tabaco foi significativamente mais comum nos homens não se observando relação entre o uso de prótese e a presença do carcinoma na língua. Não se observou relação estatística entre o uso de prótese removível e o carcinoma escomoso dos dois terços anteriores da língua. Face aos resultados, o uso de prótese no sexo feminino desempenha um papel importante ainda que não possa ser considerado um fator etiológico significativo.