Prolonged use of old dentures: A qualitative study with Brazilian older adults.

OBJECTIVE: To explore older adults' perceptions, motivations and reasons for using and not replacing old and worn complete dentures over prolonged periods. MATERIALS AND METHODS: In-depth, semi-structured interviews were conducted with Brazilian edentulous older adults who were wearing complete dentures which were at least 20 years old. A purposive sampling method was used to recruit participants from an existing waiting list of those referred to a hospital clinic for new dentures. The interviews were video-recorded, transcribed verbatim and analysed using thematic analysis. RESULTS: Sixty-two individuals were assessed and nine were included in the study, aged from 61 to 77 years (mean = 65.4), with seven (77.8%) of them women. The reported time using their current dentures ranged from 22 to 45 years (mean = 28). Content analysis revealed three main themes: the perception of the current dentures' condition after prolonged use; reasons for the prolonged use and non-replacement; and unsuccessful attempts to replace the dentures. Overall, participants acknowledged the poor condition of their dentures and did recognise the need for replacement. Several factors had prompted them to delay or temporarily forego replacement, with financial constraints being the main barrier. Some reported failed attempts to replace the dentures in the past years or months; however, challenging adaptation to the new prostheses led to them reverting back to their old dentures as a fallback solution. CONCLUSION: Factors influencing prolonged denture use in older adults include a complex interplay of financial aspects, treatment awareness, access and personal factors. Dental professionals can play a pivotal role in promoting timely denture adjustment or replacement by addressing these factors through patient education and personalised care.

Postoperative local interventions for the palate as a gingival graft donor area: a scoping review.

OBJECTIVE: This scoping review aimed to systematically identify evidence-based interventions to stimulate healing or protect the harvested palate of patients undergoing gingival grafting. MATERIAL AND METHODS: The study followed guidelines from the Joanna Briggs Institute and PRISMA-ScR (protocol available at osf.io/zhafn). PubMed, Embase, and seven other databases were searched on November 2022, with additional monitoring until April 2023. The inclusion criteria focused on studies evaluating outcomes related to the donor area (palate) and interventions for healing or protecting it, regardless of publication year and language. Data from the included publications was extracted and presented through narrative text, tables, and figures. RESULTS: Eighty-one studies (including 64 clinical trials, four case series, five theses, and eight systematic reviews) and 37 clinical trial records were included. The number of studies on this topic has significantly increased, reflecting a growing interest in the field. Thirty-six interventions with published results and 12 interventions with unpublished results from clinical trial registers were identified. Some promising interventions that showed potential for improving patient-reported outcomes include cyanoacrylate adhesive, platelet-rich fibrin (PRF), and the combination of palatal stents and healing agents. CONCLUSIONS: Thirty-six interventions with published results were identified for postoperative use on the harvested palate, showing varying levels of evidence and conflicting effectiveness for specific outcomes. CLINICAL RELEVANCE: Postoperative discomfort and pain in the palate are commonly experienced by patients undergoing grafting procedures using this region as the donor area. Awareness of the available options and their levels of evidence is crucial for informed decision-making.

One-year prospective study on single short (7-mm) implant overdentures in patients with severely resorbed mandibles.

OBJECTIVE: This prospective study aimed to assess the effectiveness of using a single short implant to retain a single-implant mandibular overdenture (SIMO) in participants with severely atrophic edentulous mandibles. MATERIAL AND METHODS: The study sample included 18 edentulous participants with severely resorbed mandibular ridges and limited bone height in the symphyseal region sufficient for the insertion of a 7.0-mm-height implant. First, patients received new conventional dentures or had their dentures relined, followed by the insertion of a 3.75 x 7 mm morse-taper implant, and the incorporation of a stud-type attachment and a nylon retentive insert after a 3-month healing period. Implant stability quotient (ISQ) was measured at baseline and after 3 and 12 months. Patient-reported outcomes (satisfaction with the dentures and oral health-related quality of life) were assessed before implant placement and at the 3-, 6-, and 12-month follow-ups. Clinical-radiographic outcomes and the incidence of prosthodontic events were assessed throughout the follow-up period. RESULTS: The implant survival rate was 100%. ISQ increased from baseline (72.7 ± 6.6) to the 3-month (82.0 ± 3.3) and 1-year (85.4 ± 2.9) follow-ups (p < .001). After 1 year, satisfaction with the mandibular prosthesis increased significantly, and the overall OHIP-Edent score decreased by 79.2%. No effects were found for the maxillary denture (p = .420). Due to dissatisfaction with treatment, two participants (11.1%) required additional implants after the 1-year follow-up and were considered as prosthodontic failures. CONCLUSION: Single-implant mandibular overdenture retained by a short implant showed favorable outcomes after 1 year. Further studies with larger samples and longer follow-up periods are needed to confirm the findings of this single-group prospective study. The present study was registered at the Brazilian Clinical Trials Registry (REBEC), identifier RBR-7p2xmg. The trial registry occurred during the study execution, and its final approval was delayed because of several formatting adequacies required by the platform REBEC.

Single-implant mandibular overdentures: Clinical, radiographic, and patient-reported outcomes after a 5-year follow-up.

STATEMENT OF PROBLEM: Previous studies on single-implant mandibular overdentures have reported favorable results for clinical and patient-reported outcomes. However, information from longer term clinical studies is lacking. PURPOSE: The purpose of this clinical study was to assess clinical, radiographic, and patient-reported outcomes of edentulous individuals rehabilitated with single-implant mandibular overdentures after a 5-year follow-up. MATERIAL AND METHODS: A prospective clinical study was performed including completely edentulous individuals who received new conventional complete dentures and then an external hexagon implant in the mandibular midline region, followed by the incorporation of a retention system (O-ring/ball attachment; Neodent). Data collection occurred at baseline and 3, 6, 12, 24, and 60 months after implant loading. Assessed outcomes included implant stability, peri-implant soft tissue condition, peri-implant marginal bone level, satisfaction with the prostheses, and oral health-related quality of life (OHRQoL). Clinical maintenance events were also recorded. Descriptive statistics, incidence rates, Wilcoxon Signed Ranks test, and Generalized Estimating Equation regression were used for data analysis (α=.05). RESULTS: Thirty of 34 eligible participants attended the 5-year follow-up visit, mean ±standard deviation age was 68.1 ±7.8 years, and 70% were women. The overall implant survival rate was 88.9%. After 5 years, the OHRQoL showed statistically significant improvement for all evaluation periods compared with baseline (P<.001). Regarding satisfaction with the mandibular denture, a significant increase was found between all evaluation periods compared with baseline in terms of comfort, stability, and ability to masticate (P<.001). Implant stability significantly increased (P=.003), and a mean bone loss of 1.46 mm was observed compared with baseline measures. The most frequent maintenance event was replacement of the O-ring matrix (n=80). Twenty-one midline fractures of the overdenture occurred in 14 study participants. No significant changes in peri-implant soft tissue conditions were observed. CONCLUSIONS: A single-implant mandibular overdenture effectively maintained the positive effect of the intervention on oral health-related quality of life and patient satisfaction, stable peri-implant condition, and acceptable rates of prosthetic events.

Cost-effectiveness randomized clinical trial on the effect of photobiomodulation therapy for prevention of radiotherapy-induced severe oral mucositis in a Brazilian cancer hospital setting.

OBJECTIVES: This study aimed to assess the cost-effectiveness of photobiomodulation therapy (PBMT) in association with a Preventive Oral Care Program (POCP) compared with POCP alone in the treatment of radiotherapy (RT)-induced oral mucositis (OM). METHODS: The cost-effectiveness was evaluated from the health provider perspective and conducted alongside a randomized, double-blind clinical trial. Participants were randomly assigned to either PBMT (n = 25) or control (n = 23) group. The PBMT group participants received PBMT associated with POCP. In the control group, patients were submitted to POCP alone. Costs were identified, quantified, and valued through observation and consultation of the hospital's financial sector database and estimated in Brazilian real and converted to international dollars using the purchasing power parity exchange rate. The incremental cost-effectiveness ratio (ICER) was estimated by considering the prevention of severe OM, interruption of RT, and oral health-related quality of life (OHRQoL) scores, measured by the OHIP-14 and patient-reported OM symptoms scale (PROMS). RESULTS: The incremental cost of PBMT was $857.35, and the cost per session was $25.69. The ICER was $ 2867.39 to avoid one case of severe OM and $ 2756.75 to prevent one interruption in RT due to OM. ICER to reduce 1 point in OHIP-14 and PROMS scores were $170.79 and $31.75, respectively. CONCLUSION: PBMT is more cost-effective than POCP alone in preventing severe OM, worsening of the OHRQoL, and RT interruptions. PBMT is a promising therapy, especially to avoid interruptions in oncological treatment. TRIAL REGISTRATION: ReBEC-RBR-5h4y4n.

Photobiomodulation reduces the impact of radiotherapy on oral health-related quality of life due to mucositis-related symptoms in head and neck cancer patients.

To assess the effectiveness of photobiomodulation therapy (PBMT) in the oral health-related quality of life (OHRQoL) of patients with head and neck cancer undergoing radiotherapy (RT), using the Oral Health Impact Profile-14 (OHIP-14) and the Patient-Reported Oral Mucositis (OM) Symptoms Scale (PROMS), and to correlate OM degree with the PROMS and OHIP-14 scores. Forty-eight patients undergoing RT for head and neck cancer were randomly assigned into two groups: PBMT group (n = 25)-daily PBMT associated with a preventive oral care program (POCP); and control group (n = 23)-receiving POCP exclusively. OHRQoL was assessed using the PROMS and OHIP-14 questionnaires. OM degrees were classified according to the World Health Organization and the National Cancer Institute scales. Assessments were performed at the 1st, 7th, 14th, 21st, and 30th RT sessions. PBMT was effective in preventing and treating severe OM. Both groups showed increased OHRQoL impacts throughout the RT sessions; however, higher impacts were observed in the control group, mainly at the final stage of treatment (21st and 30th RT sessions). Significant correlations were found between the severity of OM and PROMS scores in the total sample and the control group at all RT periods. PROMS and OM scores were positive correlated at 14th, 21st, and 30th RT sessions in the control group, suggesting that this instrument is useful in classifying OM. PBMT was effective in treating and preventing severe OM and OM-related symptoms, and with consequent positive impacts in OHRQoL in head and neck patients undergoing RT. The PROMS scale was helpful instrument for assessment of the severity of OM. Brazilian Clinical Trials database (ReBEC - RBR-5h4y4n), registered in Aug, 24th 2017.

Perceptions and experiences of patients following treatment with single-implant mandibular overdentures: A qualitative study.

OBJECTIVE: This study aimed to explore the perceptions and long-term experiences of edentulous patients rehabilitated with single-implant mandibular overdentures (SIMO). METHODS: Thirteen participants, mean age 65.7 years, 69.2% women, who had had their treatment completed for at least 1 year, were invited and included in the study. Focus groups including four to five participants each were conducted, audio and video recorded and transcribed verbatim. Subsequently, the transcripts were analysed according to the principles of thematic analysis. RESULTS: Four major themes emerged as follows: before decision to undergo treatment with SIMO, implant surgery experience, perception of treatment outcomes and impressions about the care received. Lack of information, cost, comorbidities, older age and fear were initial barriers to the decision for treatment. Dissatisfaction with previous treatment and a sense of opportunity motivated the decision. There were ambivalent reports of absence of pain during surgery and discomfort during anaesthesia. Post-surgical recovery exceeded the pre-surgical negative expectations in most cases. There was a tendency for a positive impact of SIMO on the patients' quality of life, comprising improved ability to chew and communicate, dietary diversification, greater comfort and safety, increased self-confidence and social interaction. Few minor inconveniences were reported such as the feeling of insecurity after an episode of denture fracture and the need to use adhesive paste. Satisfaction with the care received and the trust in the dentist and dental team were evident. CONCLUSION: In general, participants presented positive perceptions and rewarding experiences after rehabilitation with SIMO.

Individual factors associated with masticatory performance of complete denture wearers: A cross-sectional study.

AIM: The aim of this study was to assess whether differences in inter-individual clinical and prosthodontic variables affect masticatory performance (MP) of edentulous subjects who received new complete dentures. MATERIALS AND METHODS: There were 204 edentulous participants who received new maxillary and mandibular complete dentures between October 2014 and March 2018 at a university clinic. MP was measured by a mixing ability test with a two-coloured chewing gum for 20 and 50 chewing cycles. The outcome variable was the degree of colour mixing of the chewed gum, expressed by the variation of hue (VOH) and measured by electronic colourimetric analysis. Explanatory variables included gender and age, quality of the dentures, classification of edentulous ridges and prognostic features, time since the insertion of the new dentures and patient-reported outcomes related to complete denture treatment. Bivariate correlation tests, multiple linear regression and a linear mixed model were used for data analysis. RESULTS: Mean VOH values were 0.57 (±0.13) and 0.43 (±0.16) for 20 and 50 chewing cycles, respectively. Mixing ability was higher in females than in males for 20 (P = 0.036) and 50 (P = 0.006) chewing cycles. No effects on the patient-reported outcome measures were observed. The time since denture delivery, gender, age and Prosthodontic Diagnostic Index (PDI) score were independently associated with masticatory performance at 20 and/or 50 chewing cycles. Overall masticatory performance tested by the linear mixed-effect model confirmed that VOH value was negatively influenced by male gender, older age and shorter time since denture delivery. CONCLUSION: Masticatory performance seems to be improved with the continuous use of newly inserted dentures and negatively influenced by advanced age.

A 2-year prospective study of single-implant mandibular overdentures: Patient-reported outcomes and prosthodontic events.

OBJECTIVE: This prospective clinical trial aimed to assess clinical and patient-reported outcomes of the single-implant mandibular overdenture treatment (SIMO) after a 2-year follow-up period. MATERIALS AND METHODS: An external hexagon implant was inserted in the mandibular midline of 45 complete denture wearers. Participants had a mean age of 63.4 (SD = 8.3), and 75.6% were female. Based on the primary stability of the implant, immediate loading was performed in 38 patients (84.4%). O'ring/ball attachments were used for retention. Outcome assessment included the participants' satisfaction with the dentures and oral health-related quality of life (OHRQoL) impacts at the 3-, 6-, 12-, and 24-month follow-up visits after implant loading. Moreover, all prosthodontic events were recorded during this period. RESULTS: The post-loading implant survival rate was 95.3%. There was a significant increase in satisfaction with the mandibular overdenture (p < .001) and a decrease in the overall OHRQoL impacts (p < .001) in the 3-month follow-up. No significant changes were observed between the 3- and 24-month follow-ups. The incidence of prosthodontic events was relatively high, including the need for matrix replacement and repair of the overdenture fracture. Most prosthodontic complications were minor and properly managed in periodic recall visits. CONCLUSIONS: Single-implant mandibular overdenture is a feasible alternative for subjects poorly adapted to the mandibular denture and resulted in significant improvement in patient satisfaction and quality of life measures. A careful selection of patients based on their demanding needs and expectations is essential to indicate this alternative. The incidence of maintenance events in the long term reinforces the need for periodical clinical monitoring.

Photoelastic Stress Distribution Produced by Different Retention Systems for a Single-Implant Mandibular Overdenture.

PURPOSE: For patients poorly adapted to conventional dentures, the single-implant mandibular overdenture has been proposed as a simplified alternative for the two-implant treatment, together with the use of immediate loading of the implant. The aim of this in vitro study was to compare the photoelastic characteristics of stress transfer around the implant in a single-implant mandibular overdenture using different types of attachments. MATERIALS AND METHODS: A photoelastic model of an edentulous mandible with a resilient edentulous ridge and a unique implant located at the symphyseal region was obtained to reproduce a single implant-retained mandibular overdenture. Six 2.0 mm height attachments were selected and inserted in the same photoelastic model in a random order. A universal testing machine was used to induce axial vertical loads of 70 Ncm applied at the central incisor and at the central region of the first right molar without contact on the contralateral side. The photoelastic analysis was performed using a polariscope integrated into the testing machine. Standard separate views were photographed, using only one model per system. A visual qualitative analysis of stress-induced fringes was performed to comparatively rank the different attachment systems. RESULTS: All attachments showed a similar tension distribution concentrated in the apical third, and the highest stress concentration was at the apical level. There was a low stress concentration at the coronal third of the implant, with no discernible stress in the first threads of the implants, except for Dalla Bona, which showed low stress at the coronal part of the implant (1 fringe). No identifiable fringes were observed when the load was applied in the molar region, which resulted from the low amount of stress transmitted by the implant for all attachments. CONCLUSION: The load transferred to a single mandibular implant was evenly distributed around the implant with low stress concentration, irrespective of the type of retention system.

Effect of Dancing Interventions on Depression and Anxiety Symptoms in Older Adults: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis (PROSPERO CRD42023428105) investigated the effect of dancing on depression and anxiety symptoms in older adults. Conducted up to October 2023, the search across seven databases and gray literature yielded 5020 records. Only randomized trials that analyzed dance interventions for depression and/or anxiety in older adults were included. Nineteen randomized trials, involving 508 participants in dance classes lasting 5 weeks to 18 months, were included and 16 were subjected to meta-analysis. Risk of bias was assessed using the Cochrane tool. The meta-analysis showed a statistically significant reduction in depression among older adults participating in dance interventions (p < 0.01). A decrease in depressive symptoms was significant compared to that in those involved in no other intervention (p = 0.02) but not compared to that achieved with other interventions in control groups (p = 0.96). Subgroup analysis showed no significant differences in depression scores for those with mild cognitive impairment (p = 0.47). These conclusions are associated with moderate bias and very low certainty. Due to heterogeneity and the small number of studies, conclusions for anxiety outcomes could not be drawn. These results underscore the potential clinical relevance of integrating dance into mental health interventions for older adults, thereby highlighting a promising avenue for enhancing the mental well-being of this demographic.

A 1-Year Parallel-Group Randomized Clinical Trial Comparing the Effectiveness of a Mandibular Complete Denture vs an Early Loaded Single-Implant Overdenture.

PURPOSE: To assess the effectiveness of converting a conventional mandibular denture (CMD) into a single-implant mandibular overdenture (SIMO). MATERIALS AND METHODS: Edentulous patients received a new CMD and were randomly assigned to the CMD or SIMO group. For SIMO patients, a midline early-loaded implant was inserted and incorporated into the CMD after 3 weeks. Patient satisfaction and oral health-related quality of life were assessed at baseline and up to 1 year. Regression models were constructed using Generalized Estimating Equation (GEE). RESULTS: After 12 months, 32 patients were assessed (CMD: n = 17; SIMO: n = 15). Significant improvement was observed for the SIMO group compared to baseline measures. CONCLUSIONS: SIMO may be considered an effective alternative for patients unsatisfied with their CMDs.

A 1-year parallel-group randomized clinical trial comparing effectiveness of mandibular complete denture versus early loaded single-implant overdenture.

PURPOSE: To assess the effectiveness of converting a conventional mandibular denture (CMD) into a single-implant mandibular overdenture (SIMO). MATERIALS AND METHODS: Edentulous subjects received a new set of CMDs and were randomly assigned to CMD or SIMO groups. For SIMO patients, a midline, early loaded implant was placed and incorporated into the CMD after 3 weeks. Patient satisfaction and oral health-related quality of life were assessed at baseline and up to 1 year. Regression models were constructed using generalized estimating equations. RESULTS: After 12 months, 32 patients were assessed (CMD: n = 17; SIMO: n = 15). Significant improvement was observed for the SIMO group when compared to baseline measures. CONCLUSION: SIMO may be considered an effective alternative for patients unsatisfied with their CMDs.

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.

A prospective cohort on the incidence of fractures in single-implant mandibular overdentures.

OBJECTIVE: Denture fracture is one of the most common complications in prosthodontics and implant overdentures are reported to be at higher risk of fractures. Therefore, the aim of this study was to assess the incidence and factors associated with the occurrence of fractures in patients treated with a single implant mandibular overdenture (SIMO) opposed by a conventional maxillary complete denture. METHODS: A cohort of 152 patients, 65.1% female and 34.9% male, mean age 65.4 ± 8.5 years, were prospectively followed-up for a minimum of 1 year and up to 6.7 years. Patients received a single midline mandibular implant with a retention system incorporated in the overdenture: Straumann ball abutment and gold elliptical matrix (n = 37), Neodent ball/nylon matrix (n = 83), or Neodent Equator/nylon matrix (n = 32). Fracture was defined as a complete separation of denture parts and classified as midline fracture (over the implant region), or elsewhere. No metal reinforcement was incorporated into the overdenture. Incidence rates, life table analysis, Kaplan-Meier, and Cox regression were used for data analysis. RESULTS: Overdenture fractures occurred in 49 patients (32.2% incidence), with repeated fractures in 16 patients. The majority of fractures were associated with function (42.6%) or due to the overdenture being dropped (36.8%). Overall incidence density was 0.14 fracture/patient/year. The risk of fracture was associated with the duration of the overdenture use (HR = 0.84; 95%CI = 0.71-0.99). CONCLUSION: Midline denture fracture was a common complication in patients receiving SIMO treatment regardless of the implant / retention system. The use of metal reinforcement may be considered to reduce the risk of recurrent fractures. CLINICAL SIGNIFICANCE: This clinical prospective study showed that single-implant mandibular overdentures are at high risk of midline fractures. Proper post-insertion monitoring and the identification and management of patient's individual risk factors are essential for the successful treatment in the long-term.

Effect of photobiomodulation on the severity of oral mucositis and molecular changes in head and neck cancer patients undergoing radiotherapy: a study protocol for a cost-effectiveness randomized clinical trial.

BACKGROUND: Oral mucositis (OM) is the most frequent and debilitating acute side effect associated with head and neck cancer (HNC) treatment. When present, severe OM negatively impacts the quality of life of patients undergoing HNC treatment. Photobiomodulation is a well-consolidated and effective therapy for the treatment and prevention of severe OM, and is associated with a cost reduction of the cancer treatment. Although an increase in the quality of life and a reduction in the severity of OM are well described, there is no study on cost-effectiveness for this approach considering the quality of life as a primary outcome. In addition, little is known about the photobiomodulation effects on salivary inflammatory mediators. Thus, this study aimed to assess the cost-effectiveness of the photobiomodulation therapy for the prevention and control of severe OM and its influence on the salivary inflammatory mediators. METHODS/DESIGN: This randomized, double-blind clinical trial will include 50 HNC patients undergoing radiotherapy or chemoradiotherapy. The participants will be randomized into two groups: intervention group (photobiomodulation) and control group (preventive oral care protocol). OM (clinical assessment), saliva (assessment of collected samples) and quality of life (Oral Health Impact Profile-14 and Patient-Reported Oral Mucositis Symptoms questionnaires) will be assessed at the 1st, 7th, 14th, 21st and 30th radiotherapy sessions. Oxidative stress and inflammatory cytokine levels will be measured in the saliva samples of all participants. The costs are identified, measured and evaluated considering the radiotherapy time interval. The incremental cost-effectiveness ratio will be estimated. The study will be conducted according to the Brazilian public health system perspective. DISCUSSION: Photobiomodulation is an effective therapy that reduces the cost associated with OM treatment. However, little is known about its cost-effectiveness, mainly when quality of life is the effectiveness measure. Additionally, this therapy is not supported by the Brazilian public health system. Therefore, this study widens the knowledge about the safety of and strengthens evidence for the use of photobiomodulation therapy, providing information for public policy-makers and also for dental care professionals. This study is strongly encouraged due to its clinical relevance and the possibility of incorporating new technology into public health systems. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials-ReBEC, RBR-5h4y4n . Registered on 13 June 2017.

Effectiveness of immediately loaded single-implant mandibular overdentures versus mandibular complete dentures: A 1-year follow-up of a randomized clinical trial.

OBJECTIVE: This randomized clinical trial (RCT) aimed to assess the 1-year effectiveness of single-implant mandibular overdentures (SIMO) compared to conventional complete dentures (CCD). METHODS: In the first phase of the study, participants received new maxillary and mandibular CCDs. Then, they were randomly allocated to one of the study groups (CCD or SIMO). Participants in SIMO group received an external hexagon implant in the mandibular midline, with the immediate connection of an O-Ring/ball attachment. Oral health-related quality of life (OHIP-EDENT) and patient satisfaction in both groups were assessed before allocation and at 6- and 12-month follow-up visits. Both intention-to-treat (ITT) and per-protocol approaches were used for analyses. Statistical analyses were performed using the Wilcoxon Signed Ranks test and the Generalized Estimating Equations. RESULTS: Eighty-four participants (CCD n = 42; SIMO n = 42) were included, out of which 70 completed the 12-month follow-up (CCD n = 34; SIMO n = 36). ITT analysis showed no changes for the CCD group in the longitudinal assessment compared to baseline. Participants in SIMO group had a significant improvement in OHIP-EDENT scores and satisfaction with the mandibular denture. No changes for the maxillary denture were observed in either groups. Similar results were found when per-protocol analysis was performed. CONCLUSIONS: SIMO treatment resulted in a significant improvement in patient perceived outcomes compared to the CCD. SIMO may be considered as an alternative treatment modality for patients with poorly adapted and/or unstable mandibular dentures (ClinicalTrials.gov NCT03463174). CLINICAL RELEVANCE: The immediately loaded single-implant mandibular overdenture markedly improved patient satisfaction and oral health-related quality of life of conventional denture wearers after a 12-month follow-up.

A survey of retracted articles in dentistry.

BACKGROUND: Publication retraction is a mechanism to preserve the scientific literature against publications that contain seriously flawed or erroneous data, redundant publication, plagiarism, unethical research, and other features that compromise the integrity of science. An increase in the occurrence of retractions in recent years has been reported. Nevertheless, there is scarce information on this topic concerning publications in dentistry and related specialties. Thus, this study aimed to investigate retracted papers published in dental journals. METHODS: Data collection included an exploratory search in PubMed and a specific search in SCImago Journal Rank indexed journals, complemented by the cases reported on the Retraction Watch website and in PubMed. All 167 dental journals included in SCImago were searched for identification of retracted articles up to March 2016. The selected retracted articles and their corresponding retraction notices were recorded and assessed for classification according to the reason for retraction and other additional information. RESULTS: Forty of the 167 journals scrutinised at SCImago (23.9%) had at least one retracted article, and four additional journals were identified from the Retraction Watch website. A total of 72 retracted found were retracted for the reasons: redundant publication (20.8%), plagiarism (18.1%), misconduct (13.8%), overlap (13.6%) and honest error (9.7%). Higher number of retractions were reported in those journals with cites/doc <2.0-n = 49 (74.2%). The types of studies were mainly laboratory studies (34.7%), case reports (22.2%) and review articles (13.9%). CONCLUSIONS: The approach to ethical problems in papers published in dental scientific journals is still incipient; retractions were mostly due to the authors' malpractice and were more frequently related to journals with less impact.

The economic burden of opioid prescription by dentists: A 12-month survey of consumer expenditure in Brazil.

OBJECTIVES: To describe consumer expenditure on opioids prescribed by dentists in Brazil during a 12-month period. METHODS: We surveyed individual dispensed prescriptions of opioids in private pharmacies from October 2012 to September 2013. A descriptive analysis of costs included a calculation of the overall and mean maximum price to consumers. Monetary costs were converted from local currency units (Brazilian Real - BRL) to international dollars using purchasing power parity (PPP) exchanging rates. RESULTS: 129,708 prescriptions were retrieved from the database. The overall expenditure on opioids was R$4,316,383.46 BRL or $2,721,315.82 (PPP). The mean cost of an individual prescription was R$33.27 BRL ($20.98 PPP), ranging from 14.19 to 3,255.60 BRL. Codeine was frequently prescribed (87.2 percent). CONCLUSIONS: The expenditure on opioids is a significant cost to Brazilian patients, especially given that the Brazilian Public Health System should dispense these drugs free of charge. Codeine was the most prescribed opioid.