Assessment of occlusion changes during laboratory phase of relining: An in vitro study.

AIM: Assessment of occlusion changes during laboratory phase of relining is essential to evaluate the occlusal discrepancies that could get incorporated in the denture with the use of different relining materials. Since the long term stability and functional success of the denture is heavily influenced by occlusion, an In-vitro study to assess these changes after relining is warranted. The aim of the study is to evaluate the changes in occlusion during laboratory phase of relining procedure. SETTINGS AND DESIGN: This is an in vitro study with a total of 30 specimen. MATERIALS AND METHODOLOGY: A total of 30 maxillary standardized dentures were fabricated after mounting on a semi adjustable articulator. These samples will be divided into three groups based on the relining material used (Autopolymerizing resin, Heat-cure resin, Tissue conditioner). The vertical dimension, Centric contact points and eccentric contact points were measured before and after relining. STATISTICAL ANALYSIS USED: The variables were tested to see if they had a normal distribution using the Shapiro-Wilk test. Parametric distribution was seen for ECP leading to further comparison using one way analysis of variance (ANOVA). Non-parametric distribution was found while testing the VD, CCP leading to adoption of Kruskal-wallis test for comparison of groups. Dunn Bonferroni test was done for VD since results were significant. RESULTS: The results of this in-vitro study showed statistically significant difference with respect to change in vertical dimension in all groups pre and post relining (P = 0.005). The centric contact points showed lesser variation in position when comparing the pre to the post relining phase with the use of autopolymerising resins, whereas heat cure resins and tissue conditioners showed statistically significant difference in the centric point contacts post relining. No statistically significant changes were seen in eccentric occlusion post relining in all groups. Tissue conditioners showed minimum mean changes in eccentric contacts. CONCLUSION: Within the limitations of this study, the use of autopolymerising resins depicted the most stable results with respect to occlusion, for relining of dentures.

Retention loss and wear assessment of three attachment systems for implant retained-mandibular overdentures: An in vitro study.

BACKGROUND: The stud-shaped attachment systems (AS) with different shape designs (ball, cylindrical, conical) and materials (metallic, plastic, or a combination of both) are commonly used to provide better retention and stability in implant-retained mandibular overdentures (IRMO). PURPOSE: The purpose of the present study was to evaluate and compare the retention loss and the wear (patterns, location, material loss) of three resilient unsplinted AS: a well-established ball attachment system (BAS) and two more recent cylindrical attachment systems (CAS), Locator R-Tx® and Novaloc®. MATERIALS AND METHODS: The implants, their corresponding abutments, the color-coded or position-coded retention devices (RD), the matrix metal housing were incorporated within CAD/CAM resin blocks and cyclically loaded with 19.6 N along the implant axis in a chewing machine to simulate 10,000 insertion-removal cycles (IRC). At cycle 10, 100, 1,000, 5,000, and 10,000, the retention force was measured using a universal testing machine. The wear was qualitatively examined using a binocular magnifier for both systems, and quantitatively assessed from micro-computed tomography acquisitions for CAS. Material loss exceeding 50 µm was considered significant. RESULTS: The three AS showed different retentive behavior along time. All the Locator R-Tx® RD lost more than 50 % of their retention after 10,000 IRC. The retention of the Ball System slightly varied over time, the final retention loss in Bmed and Bmax groups being lower than 25 % of the initial retention. Wear was located at the tip of their gold RD and at the equator area of their ball abutment. For Locator R-Tx®, the more retentive the plastic RD, the greater its wear and retention loss. Only Novaloc® maintained a stable retention with even a slight tendency to increase and showed a negligible wear. Implant abutments of the CAS showed no significant wear. CONCLUSION: After 10,000 IRC, corresponding to approximately 5-years clinical use, almost all RD provided retention force over 5 N, which could be sufficient to maintain satisfaction in most of the patients. The retention loss observed most prominently for the Locator R-Tx®, then for the Ball System, seemed to correlate with the wear observed on their RD. The practitioner may expect less RD maintenance with the Novaloc® stable retention overtime.

Quantitative and qualitative assessment of the wear pattern of two attachment systems of dissimilar materials for mandibular implant-retained overdentures: an in-vitro study.

BACKGROUND: Attachment material is one of the contributing factors to the degree of wear of the attachment components in mandibular implant-retained overdentures. The purpose of this in vitro study was to compare the wear behavior of 2 different attachment systems of dissimilar materials in mandibular implant-retained overdentures by qualitative and quantitative methods. METHODS: Two attachment systems of different materials were utilized (n = 16); Titach (Dental Evolutions Inc, Beverly Hills, CA, USA) with a titanium-to-titanium interface and Locator R-Tx (Zest Anchors Inc, Escondido, CA, USA) with a titanium-to-nylon interface. One thousand cycles of overdenture insertion and removal simulating 1-year clinical use were performed. All matrices were removed from the overdentures and all patrices were unscrewed from the implants for wear assessment quantitively using a stereomicroscope and qualitatively using a scanning electron microscope. Data were analyzed by using an independent sample t test. RESULTS: After cyclic loading, stereomicroscopic findings showed that the Titach group had statistically significant higher wear value than the Locator R-Tx group (p < 0.001). Moreover, scanning electron microscopy images showed noticeable abrasion in Titach patrix at the area of highest convexity. However, the Locator R-Tx matrix displayed an apparent tear of rubber inserts. CONCLUSIONS: Titach attachment with the titanium-to-titanium interface revealed more wear than Locator R-Tx attachment with the titanium-to-nylon interface. Thus, the type of attachment material influences the degree of wear of the attachment components.

Cost/effectiveness analysis of treatment options for the rehabilitation of the total edentulous mandible.

BACKGROUND: Several solutions are available for the rehabilitation of edentulous jaws. Each treatment option is characterised by specific advantages and drawbacks. OBJECTIVE: The aim of this research was to perform a cost-effectiveness (CE) analysis of the main rehabilitative solutions of totally edentulous mandibles. METHODS: Decision tree models were built using TreeAge Pro Healthcare 2021 software to compare the following strategies: Conventional Denture (CD), Overdenture retained by two implants (OD-2), Overdenture retained by a bar on two implants (ODbar), Overdenture retained by 4 mini-implants (ODmini) and Fixed denture supported by 4 implants (FD). Costs were estimated using data from public rate tables. Effectiveness measures were obtained from a meta-analysis of literature data, normalising the different scales in 0-1 range. A value of 30 000€ per 1 normalised utility points was set as threshold of willingness to pay (WTP). Probabilistic sensitivity analysis (PSA) with 1000 Monte Carlo Simulations was performed to characterise uncertainty. RESULTS: Total costs ranged between 1804,40€ for CD and 10 008,80€ for FD rehabilitations, with an effectiveness of 0,69 and 0,95 normalised points (0-1 scale) for the two solutions. The ODbar resulted to be the most CE strategy at the established WTP value, with the highest Net Monetary Benefit (22 001,20€), followed by the OD-2 rehabilitation (21 866,80€). PSA analysis confirmed the dominance of OD-2 and ODbar strategies, confirming a net separation from the other alternatives. CONCLUSION: OD stabilised by 2 implants could represent a good rehabilitative solution for patients with edentulous mandible, being a good trade-off in terms of costs and effectiveness. Nevertheless, a standardised measure of oral health-related quality of life is needed to obtain more reliable results.

Cost and complications associated with implant-supported overdentures with a resilient-attachment system: A retrospective study.

STATEMENT OF PROBLEM: Implant-supported overdentures with a splinted or nonsplinted attachment system have been a successful treatment option for edentulous mandibles with excessive hard tissue resorption. Currently, the 2 most common treatment approaches for an implant overdenture uses either a bar attachment system (splinted) or resilient (LOCATOR)-attachment system (nonsplinted). The LOCATOR-attachment system is often chosen for the lower initial cost. However, whether the ongoing maintenance costs of the LOCATOR-attachment system increase the overall cost of this system is unclear. PURPOSE: The purpose of this retrospective study was to investigate the frequency of maintenance procedures, complications, and costs associated with the LOCATOR-supported overdenture treatment. MATERIAL AND METHODS: The retrospective data of 75 patients who had received implant-supported overdentures with LOCATOR-attachments at the University of Colorado School of Dental Medicine in the previous 10 years were collected and screened to evaluate the number of maintenance visits, type of complications, and cost (actual fees for the service) of the maintenance visits. The data were analyzed, and the mean values calculated. RESULTS: The average number of maintenance visits was 7.7 in the mean observation time of 5.2 years. Replacement of the attachment was the most frequent complication (63%). The average maintenance cost charged to the patient for maintenance was 56.2% ($795) of the initial cost over the average 5.2 years of follow-up. The average total maintenance cost (actual fees for the service) was 95.4% ($1349) of the initial cost over the average of 5.2 years of follow-up. The average maintenance cost adjusted or lost over the 5.2 years follow-up was 39.2%. CONCLUSIONS: The 5-year costs for the maintenance of mandibular overdentures with a LOCATOR-attachment system were equal to or higher than the initial cost of the treatment. The number of maintenance visits and the cost were higher for patients who were older than 75 years.

Comparison of general satisfaction, oral health-related quality of life, and patient's self-assessment between mandibular single-implant overdentures and experimental removable complete dentures: A randomized crossover clinical trial.

Objective Patient satisfaction with single-implant overdentures (1-IODs) is unclear. This randomized crossover trial aimed to compare the general satisfaction, oral health-related quality of life, and patients' self-assessment between mandibular 1-IODs and experimental removable complete dentures (eRCDs). Methods New mandibular RCDs were fabricated for 22 patients with edentulous mandibles. After adapting to the RCDs, one implant was inserted in the mandibular midline. The participants were then randomly classified into groups 1 and 2. Group 1 received IODs for the first 2 months, while group 2 used eRCDs with a non-loaded implant in the midline. After 2 months, the treatment was switched. Four validated, patient-reported dental outcome measures were assessed: general satisfaction, Japanese version of the Oral Health Impact Profile for edentulous subjects (OHIP EDENT-J), General Oral Health Assessment Index (GOHAI), and Patient's Denture Assessment (PDA). The assessments were performed at the end of the IOD- and eRCD- use periods. Results General satisfaction was significantly higher during the IOD period (p = 0.002). Significant differences were observed in all domains of the OHIP, except orofacial pain (p = 0.084). Further, the total score (p<0.001) and the scores of the physical (p<0.001) and psychosocial functioning (p = 0.001) domains of the GOHAI differed significantly. The total PDA score (p = 0.001) and the scores of the function (p = 0.004), lower denture (p = 0.002), esthetics and speech (p = 0.026), and importance (p = 0.009) domains were significantly higher during the IOD period than during the eRCD period. Conclusion General satisfaction, oral health-related quality of life, and patient self-assessment scores were significantly higher for 1-IODs than for eRCDs. Clinical significance Within the limitations of this study, we found that mandibular single-implant overdentures may be an efficient alternative to mandibular experimental removable complete dentures due to higher general satisfaction, oral health-related quality of life, and patient self-assessment scores of dentures.

In vitro assessment of polyetheretherketone for an attachment component for an implant-retained overdenture.

STATEMENT OF PROBLEM: Frequent maintenance because of the limited lifetime of overdenture attachments with O-rings has led to the development of materials that might improve their functionality and longevity. However, testing of newly developed attachment materials is lacking. PURPOSE: The purpose of this in vitro study was to evaluate a newly developed attachment made of polyetheretherketone (PEEK) for an implant-retained overdenture. MATERIAL AND METHODS: Specimens of PEEK, polyacetal, and Teflon O-ring materials were prepared for analysis of roughness, surface hardness, and compressive strength. For the fatigue resistance test, new specimens based on acrylic resin were subjected to 2880 insertion and removal cycles. Compression and roughness data were compared with the Kruskal-Wallis and Dunn post hoc test; hardness data with ANOVA and t test; and fatigue and stereomicroscopy with ANOVA with repeated measures, t test, and Bonferroni adjustment (α=.05). RESULTS: Polyacetal had the lowest surface roughness (P=.038). There was a significant difference in hardness among the materials (P<.05). PEEK presented the highest compressive strength among the materials (P<.001). For the fatigue resistance, only polyacetal showed a difference between the initial time-point (P<.05) and subsequent time-points. Polyacetal had a higher fatigue resistance than Teflon (P<.001) and PEEK (P<.05). Regarding the internal deformation of the attachments, a significant difference was observed among the materials (P<.05). CONCLUSIONS: PEEK showed promising results regarding the physicomechanical properties necessary for use as an overdenture attachment when compared with other evaluated materials. In addition, the PEEK attachment showed results comparable to those in the control group (O-rings) in terms of retention.

Immediately loaded single-implant mandibular overdentures compared to conventional complete dentures: A cost-effectiveness analysis.

BACKGROUND: In recent years, the single-implant mandibular overdenture (SIMO) has been proposed as an alternative to more complex overdenture designs as a simplified implant intervention for edentulous patients. OBJECTIVE: The aim of this study was to run a cost-effectiveness analysis alongside a randomized clinical trial comparing the SIMO and the conventional complete denture (CCD) treatment. Imediately loaded external hexagon implant and ball attachment were used for the overdenture goup. Direct costs related to therapies were identified and valuated throughout a 1-year period after delivery, in Brazilian currency (R$) and converted into international dollars (I$) using purchase power parity exchange rates. Treatment effectiveness was measured using the OHIP-Edent and satisfaction scores for calculation of incremental cost-effectiveness ratios (ICER). RESULTS: Outcomes were assessed at the 1-year follow-up for 65 patients (CCD=34; SIMO=31). Overall OHIP-Edent and satisfaction scores improved significantly in the SIMO group, while remained unchanged in the CCD group. The mean overall costs were R$1,179.04 (I$590.99) for the CCD group and R$2,127.91 (I$1,068.20) for the SIMO group - 80.7% incremental cost for SIMO. The ICER calculation for SIMO treatment showed a mean cost of I$48.20 for 1-point reduction in OHIP-Edent scores, and I$12.56 for 1-point increase in satisfaction score. CONCLUSIONS: Findings support the effectiveness of this simplified and low-cost implant intervention for edentulous patients. SIMO also seems a cost-effective alternative to the CCD and the relatively low incremental cost may potentially increase the utilization of dental implants among older subjects, especially those with limited financial resources. CLINICAL SIGNIFICANCE: The immediately loaded single-implant mandibular overdenture was superior to the conventional complete denture in terms of patient-reported outcome measures at a low incremental cost.

[Satisfaction and clinical assessment of 56 adult patients with biofunctional complete denture].

PURPOSE: The purpose of this study was to investigate the patient satisfaction and the clinical effect of biofunctional complete denture via questionnaire survey. METHODS: Fifty-six patients(26 males and 30 females) with biofunctional complete denture were asked to fill in a questionnaire about satisfaction and the type-variety of food after repair for 1 week, 1 month and 3 months during regular follow-up visits or telephone visits. SPSS 26.0 software package was used to analyze the data. RESULTS: After 3 months of wearing bio-functional complete denture, the average score of the five indicators of aesthetic degree, speech function, chewing function, retention function and comfort level of the patients were >6, reaching the level of "satisfactory" or "fair"; among which the aesthetic degree was the highest (7.71±1.46). The food type score reached 33.96±1.21 at the third month. Repeated measures ANOVA showed that each group of indexes changed significantly over time (P<0.05). Except that the mean value of aesthetics score was equal at 3 months and 6 months, the other indexes all increased along time. Among 56 patients, two had 5 or more times of modification due to pain, accounting for 3.57%. CONCLUSIONS: Bio-functional complete denture can achieve good clinical effect in the early stage of denture repair in patients with dentition loss.

[Do the additional costs of mandibular implant-retained overdentures even out the improved quality of life?] / Wegen de meerkosten van een implantaatgedragen mandibulaire gebitsprothese op tegen de verbeterde kwaliteit van leven?

In publications, implant retained overdentures have frequently been suggested to be a cost-efficient treatment alternative to conventional dentures. But whether the additional health benefits of implant retained overdentures even out the higher costs is not answered unequivocally. The qualification of the improved quality of life and the valuation of costs are strongly determined by the decision maker (insurance and/or patient). Future research must be encouraged to further elucidate patient willingness to pay for implant retained overdentures and the societal return on investment herein more generally.

Assessment of the changes in retention and surface topography of attachments for maxillary 4-implant-retained overdentures.

STATEMENT OF PROBLEM: Restoring the edentulous maxilla with an implant-retained overdenture (IRO) can present a challenge because of increased implant divergence and the added wear of the implant abutments and attachments. However, knowledge pertaining to the degree of implant divergence and its effects on the wear pattern of the implant attachments is lacking. PURPOSE: The purpose of this in vitro study was to investigate the change in the retention and wear characteristics of unsplinted abutments and attachments when used to retain a maxillary 4-implant palateless complete removable overdenture with different implant angulations. MATERIAL AND METHODS: Three groups of specimens of 0-, 15-, and 30-degree implant angulations were evaluated, each with 7 specimens. The retention of specimens was recorded after aging cycles equivalent to 1, 2.5, and 6 years of use. The surface of the attachments was examined with light and scanning electron microscope (SEM). RESULTS: Increasing the interimplant divergence improved the initial retention. After 1 year of use, retention of the 15- and 30-degree groups was significantly higher than that of the 0-degree group (P<.05). No significant difference in retention was found between the 15- and 30-degree groups (P>.05). After 2.5 and 6 years of use, no significant difference in retention was noted between groups (P>.05). Under light and SEM examination, the wear of the abutments and attachments was related to the interimplant divergence. CONCLUSIONS: The initial retention of single attachments increased significantly as the implant divergence increased. The retention of the 15- and 30-degree groups was significantly higher than that of the 0-degree group after 1 year of use. No significant difference in retention was found after 2.5 and 6 years, regardless of implant angulation.

Assessment of Retention of CAD-CAM Milled PEKK vs PEEK Double Crown-retained Removable Partial Dentures: A Randomized Clinical Trial.

AIM AND OBJECTIVE: To assess and compare the dislodging force of double crown-retained removable partial dentures (RPDs) made from polyetherketoneketone (PEKK) and polyetheretherketone (PEEK) at insertion (baseline) and one year after clinical functional use. MATERIALS AND METHODS: A total of 18 patients with maxillary symmetrical Kennedy class I with the second premolars being the last standing abutment were selected. The patients were randomly assigned into two groups according to the materials used for the construction of the double crown-retained RPD. Group I: Double crown-retained RPDs were made from PEKK. Group II: Double crown-retained RPDs were made from PEEK. For both groups, the primary copings were made from zirconia (ZrO2). The dislodging force was measured using a digital force gauge at baseline and one year after clinical functional use. An independent t-test was used for intergroup comparisons and a paired t-test for intragroup comparisons. RESULTS: when comparing both groups at baseline, there was no significant difference between the two groups, but after one year, Group I had a significantly higher dislodging force value than Group II. Individually, there was an increase in dislodging force in both groups one year after clinical functional use, which was statistically significant for Group I. CONCLUSION: After clinical functional use, double crown-retained RPDs made from PEEK in combination with ZrO2 primary copings demonstrate a minimal increase in dislodging force, while those made of PEKK demonstrate a significant increase in dislodging force. CLINICAL SIGNIFICANCE: All patients were satisfied with the retention and esthetics of their dentures. Polyetherketoneketone double crown-retained RPDs demonstrate better retention one year after clinical functional use.

Assessment of Undercuts Relative to Abutment Teeth and Edentulous Area: A Retrospective Cross-sectional Study.

AIM: Undercuts on abutment teeth (AT) should be identified and quantified to establish the exact location of the active tip of the retentive arm of the direct retainer. The aim of this study was to locate and evaluate tissue and tooth undercut areas in various Kennedy's classes and to assess the correlation, if any, between Kennedy's classes and the location and depth of undercuts. MATERIALS AND METHODS: One hundred and seven patients' casts, with designated AT and edentulous areas (EAs), were surveyed. The undercuts on AT and EAs were measured using undercut gauges. Statistical analysis was performed. RESULTS: The median depth of the undercut was maximum on distal the surface of mandibular AT in a Kennedy's class III edentulous situation. No significant difference was found between the amount of tissue undercuts measured on the EA in each of the Kennedy's classes in the maxillary and mandibular arches. CONCLUSION: No significant difference was found between the amounts of undercut measured on AT and the EA in each of the Kennedy's classes in the maxillary and mandibular arches. No correlation was found between Kennedy's classes and the location and depth of undercuts. CLINICAL SIGNIFICANCE: The results of our study reinforce that the diagnosis and selection of ideal abutments should be stressed while planning for a removable dental prosthesis (RDP). In the majority of the cases, the anticipated design of the direct retainer can be applied, though one cannot overlook the need for proper diagnosis and survey.

Cost-effectiveness analysis of two attachment systems for mandibular overdenture.

OBJECTIVES: This study analysed the cost-effectiveness of two different attachments for the 2-implant overdenture (2IOD) in edentulous mandibles. MATERIALS AND METHODS: When considering alternative treatments, cost-effectiveness analysis is an important factor for stakeholders (patient, clinician, social security, insurance company, etc.). A general practice population (n = 116) was treated between 2003 and 2013 with a mandibular 2IOD with 2 different ball/stud attachment systems, one spherical (Group D) and one cylindrical (Group L). Patient well-being was assessed with OHIP-14-Total (OHIP-14-T), at intake and annually up to 5 years, to calculate the health effect. Initial and maintenance costs of both treatments were inventoried. The cost-effectiveness was compared. Annual discount rates of 4% and 1.5% were applied to future costs and health outcomes, following Dutch guidelines. Prices were adjusted to the year 2003. To offset the uncertainty in relevant input parameters, a sensitivity analysis was performed using bootstrap analysis. Significance was set at p < .05. RESULTS: The health effect was 6.36 (SD 5.32) for Group D and 8.54 (SD 5.63) for Group L. The sum of the discounted costs up to 5 years was EUR 4,210.98 (SD 634.75) for the D and EUR 3,840.62 (SD 302.63) for the Group L (p = .005). The bootstrapping reports that L abutment clearly dominates the D abutment in terms of cost-effectiveness. CONCLUSIONS: The 2IOD on the L abutment is dominant compared to the 2IOD on D abutment, in a 5-year perspective.

Assessment of the trueness and tissue surface adaptation of CAD-CAM maxillary denture bases manufactured using digital light processing.

STATEMENT OF PROBLEM: Limited information is available evaluating the trueness and tissue surface adaptation of computer-aided design and computer-aided manufacturing (CAD-CAM) maxillary denture bases fabricated using digital light processing (DLP). PURPOSE: The purpose of this in vitro study was to evaluate the trueness of DLP-fabricated denture bases and to compare the tissue surface adaptation of DLP with milling (MIL) and pack and press (PAP). MATERIAL AND METHODS: The maxillary denture bases were virtually designed on the reference cast and were fabricated using DLP and MIL. Their intaglio surfaces were scanned and superimposed on the reference computer-aided design denture base to evaluate the trueness. A total of 20 denture bases (10 per technique) were also fabricated on the duplicated master casts using DLP and MIL. Ten denture bases were additionally made using PAP. The intaglio surfaces of the dentures were scanned and superimposed on the corresponding casts to compare the degree of tissue surface adaptation among the 3 techniques. The Mann-Whitney test and Kruskal-Wallis ANOVA were used for statistical analyses (α=.05). RESULTS: The trueness of the DLP denture base was significantly better than that of the MIL denture base (P<.001). Statistically significant differences were detected with respect to tissue surface adaptation of the denture base among the groups (P<.001). The DLP denture base showed the best denture base fit among the 3 techniques with a small interquartile range. CONCLUSIONS: Within the limitations of this in vitro study, the DLP maxillary denture base showed better trueness and tissue surface adaptation of ≤100 µm of the 3-dimensional surface deviation than the MIL and PAP denture bases.

Do traditional techniques produce better conventional complete dentures than simplified techniques? A 10-year follow-up of a randomized clinical trial.

OBJECTIVES: The use of a simplified method (S) of fabricating complete dentures has been shown to be more cost-efficient than the traditional method (T), and there are no negative consequences that detract from the cost savings in the short term. However, it is not clear whether this remains constant over a decade. The objective of this study was to clarify patients' perspectives and determine any differences between the dentures fabricated with these two different techniques after a decade of use. MATERIAL AND METHODS: Edentate individuals participated in a randomized controlled clinical trial and completed a 6-month follow-up from 2001 to 2003 (T group n = 50; S group n = 54). For this 10-year follow-up, they were interviewed by telephone. The assessment included whether the denture was still in use or replaced, the condition of the dentures, patient satisfaction and oral health-related quality of life (OHRQoL). Between and within-group differences and the factors that cause deterioration of oral health-related quality of life (OHRQoL) were determined. RESULTS: Among 54 responders (25 T and 29 S), 14T and 21S kept the original dentures. Both groups were similar in ratings of satisfaction and OHRQoL (maxilla T: 80.0 S: 86.0, p = 0.36; mandibular; T: 66.1 S: 72.3, p = 0.48; OHRQoL T: 111.1 S: 108.5, p = 0.46). Irrespective of fabrication method, discomfort, chewing difficulty and esthetics were the factors that deteriorate OHRQoL (adjusted r = 0.76, p < 0.001). CONCLUSION: The results indicate that the simplified method remains more cost-efficient than the traditional method over a 10-year period. (IRB approval: A09-E71-12 B McGill University, trial registry: ClinicalTrial.org; NCT02289443).

Randomised clinical trial of patient satisfaction with traditional and simplified complete dentures.

To clinically evaluate the patient satisfaction and associated costs of dentures made using a simplified procedure that eliminates assembly on the articulator and dentures made with the conventional technique. Single-blind randomised clinical trial. Forty edentulous patients were randomly divided into 2 groups. One group received dentures made using the conventional method (CG), and the other using a simplified technique (SG) that omits the use of functional impressions (with modelling compound and ZOE impression paste) and an articulator to assemble the models. Overall patient satisfaction was assessed at 3 and 6 months by means of a Numerical Rating Scale (NRS). The comparisons were made using a repeated measures ANOVA (P = .05). No significant differences were found in terms of the satisfaction stated by the patients or the quality of the prosthesis evaluated by a professional among the dentures made using the traditional (n = 17) and simplified (n = 21) techniques. The rehabilitation of an edentulous patient with a simplified technique for the preparation of a total prosthesis is a feasible, more economical alternative and accepted by most patients.

Immediate Vacuum Formed Overdenture for a Pediatric Patient with Ectodermal Dysplasia.

Restoring the dental and facial esthetics in a growing patient with ectodermal dysplasia (ED) is fundamental to improve psychosocial issues, esthetics, and function. The purpose of this clinical report was to present a simple, fast, and cost-effective technique to re-establish a pleasant smile of an eight-year-old male patient with hypohydrotic ED. A vacuum-formed overdenture prosthesis is described, which is recommended as an immediate interim restorative treatment in the maxillary arch with excellent stability and retention.

Modified retention and stability criteria for complete denture wearers: A risk assessment tool for impaired masticatory ability and oral health-related quality of life.

STATEMENT OF PROBLEM: Some complete denture wearers report difficulty with daily activities, especially activities related to denture retention and stability. However, no standard criteria are available for professionally based assessment of complete denture quality. PURPOSE: The purpose of this clinical study was to determine the association between professionally based assessment of complete denture quality, evaluated by conventional and Chulalongkorn University (CU)-modified Kapur criteria and multiple patient-based outcomes: oral health-related quality of life (OHRQoL), eating satisfaction, and masticatory performance. The sensitivity and specificity of these criteria in estimating the outcomes were investigated. MATERIAL AND METHODS: The participants were 126 individuals with removable acrylic resin complete dentures. Denture retention and stability were scored based on the Kapur method, with excellent intraobserver reliability indicated by a Kappa score of 0.91 to 0.99. The clinical quality of the complete denture was classified according to conventional and CU-modified Kapur criteria. The participants were interviewed for OHRQoL by using the Thai version of the Oral Impacts on Daily Performances (OIDP) index and responses were reported as the absence or presence of oral impacts. Participants' satisfaction eating with their dentures was determined by using a 5-point Likert scale and dichotomized into satisfied and dissatisfied categories. Masticatory performance was evaluated by the multiple sieve method of peanut mastication. After adjusting for covariates, the associations between denture quality and overall and condition-specific (CS) impacts on eating and on eating satisfaction were analyzed by using binary logistic regression, while its association with masticatory performance was determined using linear regression. Goodness-of-fit post estimation was conducted to determine the sensitivity and specificity of each denture quality criterion in estimating patient-based outcomes. RESULTS: Complete denture retention and stability, evaluated by conventional and CU-modified Kapur criteria, were associated with multiple patient-based outcomes. However, denture stability showed a stronger association than retention. The CU-modified criteria assessed the quality of maxillary and mandibular dentures individually and revealed a higher sensitivity in estimating all patient-based outcomes. CONCLUSIONS: Retention and stability were important indicators in estimating the masticatory ability and OHRQoL of complete denture wearers. The CU-modified Kapur criteria can identify impaired masticatory ability and OHRQoL in complete denture wearers better than conventional criteria.

Prognoses of new complete dentures from the patient's denture assessment of existing dentures.

OBJECTIVES: The aim was to determine prognostic factors affecting frequent post-delivery adjustments of new complete dentures using patients' assessments of existing complete dentures. MATERIALS AND METHODS: A total of 125 edentulous participants (56 men, 69 women; mean age, 76.4 years) who required new complete dentures evaluated existing dentures using the patient's denture assessment (PDA), a questionnaire regarding the self-assessment of dentures composed of 22 question items and containing six subscales: "function," "lower denture," "upper denture," "expectation," "esthetics and speech," and "importance." Moreover, the numbers of post-delivery adjustments of new dentures were recorded. A multiple logistic regression analysis was performed to identify significant factors for frequent adjustments of new dentures with five subscales of the PDA (excluding "importance"), level of mandibular ridge resorption, and age as independent variables. RESULTS: The analysis showed that "function," "esthetics and speech," and level of mandibular ridge resorption were significant variables for a frequent number of post-delivery adjustments of new complete dentures. CONCLUSIONS: The results suggested that patients' assessments of existing dentures using the PDA might allow a prediction of prognosis for complete denture treatments. Additionally, low "function" scores and high "esthetics and speech" scores for existing dentures and high levels of mandibular ridge resorption were significant prognostic factors affecting frequent post-delivery adjustments of new complete dentures. CLINICAL RELEVANCE: It may be difficult for edentulous persons to adapt to new complete dentures, especially those who have complaints about mastication and swallowing with existing dentures and poor mandibular ridges, but are satisfied with esthetics and speech.