Unveiling denture-induced oral lesions: A comprehensive study on classification and pain assessment.

BACKGROUND: Denture-induced oral Lesions (DIOLs) often manifests shortly after the placement or adjustment of new or realigned dentures, frequently resulting in severe pain and discomfort. OBJECTIVES: This study aimed to classify DIOLs placing a particular emphasis on assessing the associated pain. METHODS: A prospective case study was conducted involving 126 patients who were fitted with a total of 193 dentures of various types at the Hadassah School of Dental Medicine. All patients underwent comprehensive intra-oral examinations within 1-8 weeks following denture delivery, completed symptom questionnaires and had their medical records reviewed. Key variables documented included age, gender, overall health status, denture type, and a detailed description of the DIOLs. The description encompassed factors such as lesion location, shape, colour, size, border characteristics, ulcerative appearance, membrane coverage, 3D morphology (elevated, immersed and flat) and patient-reported Verbal Pain Score (VPS) when touching the DIOLs, when wearing the denture, and when not wearing the denture. RESULTS: Notably, 25.4% of denture wearers required no adjustments, while 14.4% necessitated more than three revisions. A majority (71.8%) of DIOLs cases were associated with mandibular complete dentures, primarily situated on the alveolar ridge. The mean VPS indicated a pain intensity of 7 ± 2.1, with temporary dentures in both jaws causing the most discomfort. Implant-supported overdentures were particularly painful when placed in the mandible. Additionally, VPS scores were higher among older individuals and those with prior prosthetic experiences. A significant correlation was observed between pain intensity and presence of chronic health condition (0.036). CONCLUSIONS: This study revealed distinct characteristics of DIOLs and highlighted the multifactorial nature of pain experienced following the development of DIOLs. Insights into the influence of patient and denture characteristics on DIOLs and pain intensity can guide healthcare professionals in optimising patient comfort and satisfaction.

[PHYSICAL AND MATHEMATICAL GROUNDS LANDFORMS BASIS PLATE DENTURES WHEN APPLYING THE COMPLEX METHOD OF PREVENTION OF PROSTHETIC STOMATITIS].

Objective - to develop the form of the drug reservoir to hold the vegetable oils under the basis of the prosthesis. The research was conducted on the Bench PMMA samples. The comparison group consisted of smooth plate PMMA. Two study groups were PMMA plates with grooves on one side of a square with sides of 2 mm and depth of channel - 1 mm. The third group consisted of the experimental plate with diamond-shaped notches with the same parameters. The lowest value of the stress in the plate having a rhombic grid, they are 54% less than in the smooth plate and 37% less than in the plate with a square lattice (the best strength characteristics in a rhombic plate with grille). Equivalent move from the plate with a rhombic lattice is less than an order of magnitude than that of a smooth plate and by 5.8% more than at the plate with a square lattice, which indicates good performance design plasticity with rhombic grid. Basis with the rhombic lattice on the surface has the best record on the stress-strain state in comparison with other models considered (smooth plate with a square lattice plate).

The Prevalence of Oral Inflammation Among Denture Wearing Patients with Chronic Obstructive Pulmonary Disease.

Oral inflammation is an important contributor to the etiology of chronic obstructive pulmonary disease, which can impact patient's health status. Previous studies indicate that people with poor oral health are at higher risk for nosocomial pneumonia. Denture wearing is one promoting factor in the development of mucosal infections. Colonization of the denture plaque by Gram-negative bacteria, Candida spp., or other respiratory pathogens, occurring locally, may be aspirated to the lungs. The studies showed that chronic obstructive pulmonary disease (COPD) patients treated with combinations of medicines with corticosteroids more frequently suffer from Candida-associated denture stomatitis. Treatment of oral candidiasis in patients with COPD constitutes a therapeutic problem. Therefore, it is essential to pay attention to the condition of oral mucosal membrane and denture hygiene habits. The guidelines for care and maintenance of dentures for COPD patients are presented in this paper. The majority of patients required improvement of their prosthetic and oral hygiene. Standard oral hygiene procedures in relation to dentures, conducted for prophylaxis of stomatitis complicated by mucosal infection among immunocompromised patients, are essential to maintain healthy oral tissues. The elimination of traumatic denture action in dental office, compliance with oral and denture hygiene, proper use and storage of prosthetic appliances in a dry environment outside the oral cavity can reduce susceptibility to infection. Proper attention to hygiene, including brushing and rinsing the mouth, may also help prevent denture stomatitis in these patients.

Association between Oral Mucosal Lesions and Hygiene Habits in a Population of Removable Prosthesis Wearers.

PURPOSE: This prospective study evaluated the influence of self-reported prosthesis hygiene regimens and prosthesis usage habits on the presence of oral mucosal lesions (OMLs) in complete removable and/or partial removable dental (CRDP/PRDP) prosthesis wearers (PWs). MATERIALS AND METHODS: Between January 2009 and January 2011, the conventional oral mucosa of 400 consecutive PWs (252 women; 148 men), aged between 29 and 86 years, were examined clinically. Information was derived considering the type and age of the prosthesis, hygiene level, frequency and style of prosthesis cleaning, overnight prosthesis use, storage conditions, and systemic diseases. Non-prosthesis- and prosthesis-related OMLs were identified. The data were analyzed using univariate (Chi-square) and multivariate (logistic regression) tests to assess the development of OMLs as a function of the selected variables. Odds ratios (OR) were calculated at 95% confidence intervals (CI; α = 0.05). RESULTS: Of the 400 PWs, 21.5% had CRDP, 52.5% PRDP, and 25.8% CRD/PRD prostheses. Thirty-two percent of the PWs cleaned their prosthesis once a day. Brushing the prosthesis with toothbrush and soap/toothpaste was the most commonly practiced cleaning regimen (85.8%). More than half (64.5%) of the PWs used their prosthesis overnight. Among all PWs, 37.8% had a prosthesis-related OML. Stomatitis Newton Type II (46%) and Type III (38%) were the most common OMLs. OML frequency was higher in PWs having CRDPs than those having PRDPs (p < 0.05). Overnight prosthesis use (p = 0.003, OR: 13.65; 95% CI: 1.7-109.3), denture age ≥11 years (p = 0.017, OR: 1.72; 95% CI: 1.1-2.7), and immersion in water and solution (p = 0.023, OR: 1.13; 95% CI: 0.02-1.02) affected the incidence of OML significantly. Hypertension was the most common systemic disease (31.5%). CONCLUSION: Overnight use, denture age, and storage conditions of CRDP or PRDPs demonstrated a more significant impact on OML incidence than frequency of cleaning. Oral healthcare programs for removable PWs should specifically provide education on prosthesis usage instructions.

Denture stomatitis and salivary vascular endothelial growth factor in immediate complete denture wearers with type 2 diabetes.

STATEMENT OF PROBLEM: Diabetes mellitus type 2 is associated with a variety of oral mucosal changes, including an altered level of salivary vascular endothelial growth factor. However, the authors identified no studies concerning denture stomatitis and salivary vascular endothelial growth factor in immediate denture wearers with diabetes mellitus type 2. PURPOSE: The purpose of this study was to investigate the incidence of and risk factors for denture stomatitis in immediate complete denture wearers with and without diabetes mellitus type 2 and to investigate the relationship between levels of salivary vascular endothelial growth factor and clinical forms of denture stomatitis in both groups. MATERIAL AND METHODS: Individuals without diabetes (n=42) or with diabetes mellitus type 2 (n=36) who were candidates for complete immediate dentures were included in the study. After 1 year of wearing relined immediate dentures, participants were evaluated for denture stomatitis and potential contributing factors. Salivary vascular endothelial growth factor levels were measured with enzyme-linked immunosorbent assays. Data were analyzed with the χ(2) test or the Student t test where appropriate, as well as with binary logistic regression analysis. RESULTS: The incidence of denture stomatitis was 61% in participants with diabetes mellitus type 2 and 38% in those without diabetes. Low denture stability and diabetes mellitus type 2 were risk factors for denture stomatitis. Salivary vascular endothelial growth factor concentrations at the beginning of the study were 557.6 ±94.7 pg/mL in participants with diabetes mellitus type 2 and 103.5 ±21.6 pg/mL in those without diabetes. In Newton Type I and Newton Type II denture stomatitis, vascular endothelial growth factor levels were 460.9 ±55.4 pg/mL and 1445.2 ±422.1 pg/mL in individuals with diabetes and 73.2 ±10.0 pg/mL and 306.5 ±22.6 pg/mL in those without diabetes. CONCLUSIONS: Perceived denture stability and diabetes mellitus type 2 are independent risk factors for the occurrence of denture stomatitis. Altered salivary vascular endothelial growth factor levels and denture stomatitis are more prevalent in denture wearers with diabetes mellitus type 2.

Risk factors for denture-related oral mucosal lesions in a geriatric population.

STATEMENT OF PROBLEM: Denture-related mucosal lesions have been broadly studied. However, no consensus has been reached regarding the risk factors associated with these lesions, and few studies have used multivariable analysis to determine the relative significance of different risks. PURPOSE: The purpose of this study was to determine the relationship between systemic, local, and denture factors on the risk of denture-related oral mucosal lesions in an elderly population by using multivariable analysis. MATERIAL AND METHODS: Eighty-four elderly denture wearers recruited from geriatric residences and day care centers participated in this cross-sectional study. All data were obtained by means of a questionnaire-interview, a physical examination, and complementary tests. Bivariate relationship and multiple logistic regression analyses were performed (α=.05). RESULTS: Angular cheilitis (34%), traumatic ulcers (15%), and denture stomatitis (14%) were the 3 most common lesions, and the prevalence of at least 1 denture-related mucosal lesion was 54%. The presence of denture stomatitis was related to low saliva pH, never having smoked, and regular sugar consumption. Angular cheilitis was associated with age, complete edentulism, the presence of oral Candida, a lack of denture stability, and a reduced occlusal vertical dimension. The presence of traumatic ulcers was related to a resorbed residual alveolar ridge. The presence of at least 1 lesion was associated with poor masticatory efficiency, being resident in a care facility, oral Candida, and a lack of denture stability. CONCLUSIONS: Several systemic, local, and denture-related characteristics are independent risk factors for denture-related mucosal lesions in an elderly population.

Does the presence of anterior mandibular teeth increase the incidence of denture stomatitis?

PURPOSE: To compare the frequency of denture stomatitis (DS) under maxillary complete dentures (CDs) in patients with opposing mandibular distal extension removable partial dentures (RPDs) and CDs. MATERIALS AND METHODS: Participants included 365 maxillary CD wearers (241 women, mean age 70.5 ± 13.2 years; 124 men, mean age 71.5 ± 10.4 years) from 7 rest homes in Istanbul. A total of 268 had mandibular CDs; 97 had mandibular distal extension RPDs. Two independent, calibrated examiners performed oral examinations. Presence of maxillary denture-related stomatitis and the effect of risk factors on DS were evaluated and recorded. RESULTS: The frequency of palatal DS (Newton I-III) was 45.1% (n = 121) in the mandibular CD group and 49.5% (n = 48) in the mandibular distal extension RPD group, a statistically insignificant difference (p= 0.4). Factors significantly associated with palatal DS were maxillary denture age (p= 0.02), reduced occlusal vertical dimension (p= 0.04), and nocturnal denture wear (p= 0.03). CONCLUSION: In this study, DS beneath maxillary CDs did not differ between mandibular distal extension RPD and CD wearers. The presence of mandibular anterior teeth did not influence the occurrence of palatal DS.

Management of Chronic Atrophic Candidiasis (Denture Stomatitis)-A Narrative Review.

One of the most common oral diseases affecting people wearing dentures is chronic atrophic candidiasis or denture stomatitis (DS). The aim of the paper is to provide an update on the pathogenesis, presentation, and management of DS in general dental practice settings. A comprehensive review of the literature published in the last ten years was undertaken using multiple databases, including PubMed via MEDLINE, EMBASE, and Scopus. The eligible articles were analyzed to identify evidence-based strategies for the management of DS. Despite its multifactorial nature, the leading cause of DS is the development of oral Candida albicans biofilm, which is facilitated by poor oral and denture hygiene, long-term denture wear, ill-fitting dentures, and the porosity of the acrylic resin in the dentures. DS affects between 17 and 75% of the population wearing dentures, with a slight predominance in elderly females. The mucosal denture surfaces and posterior tongue are the common sites of DS, and the affected areas exhibit erythema, the swelling of the palatal mucosa and edema. Oral and denture hygiene protocols, adjusting or re-fabricating poorly adapting dentures, smoking cessation, avoiding nocturnal denture wear, and the administration of topical or systemic antifungals are the mainstay of management. Alternate treatments such as microwave disinfection, phytomedicine, photodynamic therapy, and incorporation of antifungals and nanoparticles into denture resins are being evaluated for the treatment of DS but require further evidence before routine use in clinical practice. In summary, DS is the most common oral inflammatory lesion experienced by denture wearers. Most patients with DS can be managed in general dental practice settings. Effective management by general dental practitioners may be supported by a thorough understanding of the pathogenesis, the recognition of the clinical presentation, and an awareness of contemporary treatment strategies.

Complete denture wearing and fractures among edentulous patients treated in university clinics.

OBJECTIVE: The prevalence of wearing and fracture of complete dentures was evaluated among edentulous patients treated in two dental schools in Brazil. BACKGROUND: Acceptance and wearing of complete dentures are related to adaptive behaviour of edentulous patients. However, one reason that could interfere with the wearing dentures is their potential to fracture, which is still a common complication in denture rehabilitation practice. MATERIAL AND METHODS: Two hundred and twenty-four edentulous patients rehabilitated with complete dentures from 2000 to 2005 in Araçatuba and Araraquara Dental School, University of State of São Paulo, were assessed in 2006 and 2007 to answer a questionnaire about wearing and fracture of their dentures. Statistical analysis were performed using Epi Info software and chi-squared test to compare maxillary and mandibular data (α = 0.05). RESULTS: Almost 26% of the patients did not wear their dentures, and among the remainder, the majority wore the maxillary denture. About 30% of the dentures were fractured, with higher prevalence in the maxillary arch (p = 0.003). CONCLUSIONS: Discontinuation of wearing dentures was quite high, especially considering the treatment which was carried out in university clinics. Prevalence of fractures was also high, greater for the maxillary denture, and was one of the main reasons for non-wearing of complete dentures.

The efficacy of a topical gel with triester glycerol oxide in denture-related mucosal injuries.

OBJECTIVE: The efficacy of a topical gel with triester glycerol oxide for treating ulcerations related to new complete dentures was studied and compared with a placebo gel. MATERIALS AND METHODS: Fifty edentulous patients were enrolled in this double-blind clinical study. All subjects received new maxillary and mandibular complete dentures and were recalled 1, 3 and 7 days after denture placement. Twenty-five subjects received topical gel with triester glycerol oxide (TGO), and 25 subjects received topical gel without TGO. At each visit, pain and discomfort with the new dentures was assessed, and at the last visit, healing of ulcerations was also graded by a clinician. Subjects also graded the gel's taste, smell and ease of use. RESULTS: Specifically, there was no statistically significant difference in ulcer healing (p > 0.05), ratings of smell, taste and ease of use (p > 0.05) or pain and discomfort scores (p > 0.05). However, within-group differences were observed in pain and discomfort scores between follow-up sessions (p = 0.01 for all comparisons). CONCLUSION: Clinically, TGO gel is not effective in the treatment of mucosal injuries occurring following placement of complete dentures.

Contemporary denture base resins: Part 2.

UNLABELLED: Provision of partial and complete dentures constructed from resin is commonplace and a satisfactory outcome requires the consideration of the properties of the resin, the oral tissues and prosthodontic principles. This second of a two-part series examines the advantages and disadvantages of flexible nylon denture base resins, which have found popularity for the provision of partial dentures. Adverse effects of denture base resins are examined and the benefits and shortcomings of softliners are explored. Chairside adjustment and polishing, and denture hygiene are also discussed. CLINICAL RELEVANCE: Knowledge of contemporary denture base resin systems will help to achieve optimal outcomes in removable prosthodontics.

Experimental animal models for denture stomatitis: A methodological review.

Denture stomatitis is the most prevalent form of oral candidiasis and the most frequent oral lesion in removable prosthesis wearers. It is characterized by an inflammatory response of the denture-bearing mucosa, especially the palatal mucosa, and its clinical signs include chronic edema and erythema, and papillary hyperplasia. Despite having a multifactorial etiology, its main etiological agent is the infection by Candida albicans. Given its high treatment failure rates, an in vivo model of denture stomatitis should be established to test alternative treatments. The aim of this study is to review the existing denture stomatitis models and to provide an overview of the main methodological differences between them. Over the last 40 years, different animal models were developed in order to study denture stomatitis etiopathogenesis and to assess novel therapies. Many approaches, including the use of antibiotics and immunosuppressors, have to be further investigated in order to establish which protocol is more appropriate and effective for the development of an animal model of denture stomatitis.

In vitro activities of natural products against oral Candida isolates from denture wearers.

BACKGROUND: Candida-associated denture stomatitis is a frequent infectious disease. Treatment of this oral condition is difficult because failures and recurrences are common. The aim of this study was to test the in vitro antifungal activity of pure constituents of essentials oils. METHODS: Eight terpenic derivatives (carvacrol, farnesol, geraniol, linalool, menthol, menthone, terpinen-4-ol, and α-terpineol), a phenylpropanoid (eugenol), a phenethyl alcohol (tyrosol) and fluconazole were evaluated against 38 Candida isolated from denture-wearers and 10 collection Candida strains by the CLSI M27-A3 broth microdilution method. RESULTS: Almost all the tested compounds showed antifungal activity with MIC ranges of 0.03-0.25% for eugenol and linalool, 0.03-0.12% for geraniol, 0.06-0.5% for menthol, α-terpineol and terpinen-4-ol, 0.03-0.5% for carvacrol, and 0.06-4% for menthone. These compounds, with the exception of farnesol, menthone and tyrosol, showed important in vitro activities against the fluconazole-resistant and susceptible-dose dependent Candida isolates. CONCLUSIONS: Carvacrol, eugenol, geraniol, linalool and terpinen-4-ol were very active in vitro against oral Candida isolates. Their fungistatic and fungicidal activities might convert them into promising alternatives for the topic treatment of oral candidiasis and denture stomatitis.

The clinical evaluation of the oral status in Alzheimer-type dementia patients.

BACKGROUND: To evaluate the oral health status in patients with Alzheimer dementia (AD), and the association of the disease severity with the oral findings. METHODS: The study was conducted on the study group (31 AD patients) and the control group (47 healthy volunteers) from the Neurology Department of the Institute. Cognitive status was evaluated with the MMSE scoring system. Oral parameters, such as decaying, missing, filled teeth (DMFT) index and teeth present (PT) were evaluated in the patients. Oral hygiene status, denture status and mucosal lesions, including denture-induced stomatitis were also investigated. RESULTS: The study was conducted on the study group (31 AD patients) and the control group (47 healthy volunteers). Tooth brushing and denture cleaning were irregular in 22 of 31 (70%) patients with AD. The ratio of the subjects who forgot to remove their denture during the night was significantly higher in the study group than in the control group (p < 0.001). In this study, decreased cognitive functions in AD patients have been demonstrated to result in a deterioration of denture care and increased denture-related mucosal lesions. CONCLUSIONS: These findings were considered due to decreased denture care including the non-removal of the denture in the night in the patients with decreased cognitive functions.

Candida-associated denture stomatitis.

Candida albicans is a dimorphic yeast strongly gram positive able to live as normal commensal organism in the oral cavity of healthy people. It is the yeast more frequently isolated in the oral cavity. Under local and systemic factors related to the host conditions, it becomes virulent and responsible of oral diseases known as oral candidiasis. It has been shown that the presence of denture is a predisposing factor to the onset of pathologies related to C. albicans. Clinical studies have shown that C. albicans is not only able to adhere to the mucous surfaces, but also to stick to the acrylic resins of the dental prostheses. Both the plaque accumulated on the denture and the poor oral hygiene contribute to the virulence of Candida, offering the clinical picture of Candida-associated denture stomatitis. The therapeutic strategies currently adopted in the clinical practice to overcome these fungal infections provide for the use of topical and/or systemic antifungal and topical antiseptics and disinfectants, the irradiation with microwaves and the accurate mechanical removal of the bacterial plaque from the denture surfaces and from the underlying mucosa. A correct oral hygiene is important for the control of the bacterial biofilm present on the denture and on the oral mucosa and it is the fundamental base for the prophylaxis and the therapy of the Candida-associated denture stomatitis.

Epidemiology and etiology of denture stomatitis.

Denture stomatitis, a common disorder affecting denture wearers, is characterized as inflammation and erythema of the oral mucosal areas covered by the denture. Despite its commonality, the etiology of denture stomatitis is not completely understood. A search of the literature was conducted in the PubMed electronic database (through November 2009) to identify relevant articles for inclusion in a review updating information on the epidemiology and etiology of denture stomatitis and the potential role of denture materials in this disorder. Epidemiological studies report prevalence of denture stomatitis among denture wearers to range from 15% to over 70%. Studies have been conducted among various population samples, and this appears to influence prevalence rates. In general, where reported, incidence of denture stomatitis is higher among elderly denture users and among women. Etiological factors include poor denture hygiene, continual and nighttime wearing of removable dentures, accumulation of denture plaque, and bacterial and yeast contamination of denture surface. In addition, poor-fitting dentures can increase mucosal trauma. All of these factors appear to increase the ability of Candida albicans to colonize both the denture and oral mucosal surfaces, where it acts as an opportunistic pathogen. Antifungal treatment can eradicate C. albicans contamination and relieve stomatitis symptoms, but unless dentures are decontaminated and their cleanliness maintained, stomatitis will recur when antifungal therapy is discontinued. New developments related to denture materials are focusing on means to reduce development of adherent biofilms. These may have value in reducing bacterial and yeast colonization, and could lead to reductions in denture stomatitis with appropriate denture hygiene.

Denture Hygiene as It Relates to Denture Stomatitis: A Review.

The wear of dentures carries with it the possibility of an inflammatory response by the denture-bearing tissues. Lack of or improper hygiene has been shown to contribute to denture stomatitis (DS). Although essential, denture hygiene is often overlooked by patients or performed improperly. As professional caregivers dentists must instruct patients and ensure that they understand the relevance and importance of denture hygiene. In light of this, the authors conducted a critical review of the literature on protocols and procedures to highlight the importance of denture hygiene and clinically show the effects of lack of denture care. A literature search was done through Google, PubMed, and Google Scholar that focused on publications published in English that dealt with denture hygiene and the disinfection process and on the protocols used. Relevant articles for protocols for denture disinfections were reviewed, and the results of different disinfection techniques were assessed, including manual, chemical, microwave, and a combination of techniques. The authors conclude that dentists must take time to instruct patients on proper denture disinfection procedures and the importance of cleaning the dentures well at least once daily. Denture hygiene and removal prior to sleeping is beneficial in preventing DS and allowing the tissue to achieve a state of homeostasis.

Development and validation of an in vivo Candida albicans biofilm denture model.

The most common form of oral candidiasis, denture-associated stomatitis, involves biofilm growth on an oral prosthetic surface. Cells in this unique environment are equipped to withstand host defenses and survive antifungal therapy. Studies of the biofilm process on dentures have primarily been limited to in vitro models. We developed a rodent acrylic denture model and characterized the Candida albicans and mixed oral bacterial flora biofilm formation, architecture, and drug resistance in vivo, using time course quantitative culture experiments, confocal microscopy, scanning electron microscopy, and antifungal susceptibility assays. We also examined the utility of the model for measurement of C. albicans gene expression and tested the impact of a specific gene product (Bcr1p) on biofilm formation. Finally, we assessed the mucosal host response to the denture biofilm and found the mucosal histopathology to be consistent with that of acute human denture stomatitis, demonstrating fungal invasion and neutrophil infiltration. This current oral denture model mimics human denture stomatitis and should be useful for testing the impact of gene disruption on biofilm formation, studying the impact of anti-infectives, examining the biology of mixed Candida-oral bacterial flora biofilm infections, and characterizing the host immunologic response to this disease process.

Oral mucosa involvement in rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis.

OBJECTIVES: To estimate the frequency and character of oral mucosal lesions in patients with rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis. Furthermore, the relation between oral mucosal involvement and hyposalivation was investigated. DESIGN: Case-control study. SETTING: Rheumatology Clinic, University Hospital "Mother Theresa" in Tirana, Albania. PARTICIPANTS: 124 consecutive hospitalised patients (88 with rheumatoid arthritis, 22 with systemic lupus erythematosus and 14 with systemic sclerosis) and 124 age- and gender- matched healthy controls. METHODS: Oral lesions were clinically examined and classified according to their morphologic aspects and localisation. Examination included also measurement of unstimulated whole salivary flow. MAIN OUTCOME MEASURES: Frequency of oral mucosal lesions and hyposalivation. RESULTS: Oral mucosal lesions were observed in 58.9% of patients, but in only 33.1% of control subjects. Clinical aspects of lesions varied, and palate, buccal and labial mucosa, and tongue were the most affected sites. No significant associations were found between presence of oral lesions and hyposalivation, except oral candidosis which was associated with hyposalivation in controls. CONCLUSIONS: Patients with rheumatoid arthritis, systemic lupus erythematosus and systemic sclerosis have a higher burden of oral mucosa disease than a healthy population. Collaboration of rheumatology and oral medicine units should allow appropriate management of these patients.

[Only a denture sore? Causes of a possible denture sore from a maxillary complete denture]. / Nur eine Prothesendruckstelle? Ursachen einer möglichen Prothesendruckstelle bei Totalprothesen im Oberkiefer.

This case presentation documents the treatment sequence of a 74 years old patient who complained about a sore spot of the palatal mucosa underneath the complete denture. The intraoral examination revealed a dark spot, redness and swelling of the mucosa around this spot and halitosis. The mucosa exhibited a perforation of 3 x 10 mm in diameter. A radiographic 3-D picture showed an impacted canine tooth, which was partly covered by the palatal bone. Firstly the denture base was relieved and the swelling gradually disappeared. Then a biopsy was taken for histological analysis to exclude any malignant process. In local anesthesia the tooth was extracted, which exhibited a deep carious lesion of the entire crown. After surgery a visible collapse of the jaw crest was observed. During a period of two months the denture was relined with a soft material to improve its fit and to enhance the healing process. With a final rebasement, the existing denture could be adapted again and the patient continued to wear it.