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.

Comparative analysis of Candida spp. isolated from complete denture wearers with and without an HIV diagnosis.

STATEMENT OF PROBLEM: Denture-related stomatitis (DRS), an inflammation frequently present in human immunodeficiency virus-positive (HIV+) individuals, can be attributable to colonization by Candida spp., which is considered a main factor. The virulence factors of these species are often modulated by the systemic condition of their hosts. PURPOSE: The purpose of this clinical study was to evaluate the incidence, virulence, and morphology of Candida spp. isolated from biofilms of complete denture wearers with DRS, with and without an HIV diagnosis. In addition, the interaction of the systemic condition with the ability of Candida spp. to colonize was evaluated. MATERIAL AND METHODS: Fifty-five complete denture wearers diagnosed with DRS were divided into 2 groups: experimental (HIV+) and control (human immunodeficiency virus-noninfected participants [HIV-]). Biofilm was collected by a standardized method of ultrasonification of prostheses. The incidence was evaluated by a chromogenic method and polymerase chain reaction (PCR). The virulence factors were assessed by using the capacity for biofilm formation by counting colony-forming units (CFUs/mL), biofilm metabolism by tetrazolium salt metabolization, and proteinase and phospholipase production by using a fluorimetric kit. Morphology was verified by using the hyphae-inducing test, and participants' health data were collected with a form. Data were analyzed by using the Student t, Mann-Whitney U, Spearman, and Fisher tests (α=.05). RESULTS: The results of incidence were related to 55 participants (22 experimental and 33 control); in total, 63 Candida spp. samples were isolated, showing 28 Candida albicans and 36 nonalbicans strains. No significant difference was found between groups in baseline CFU/mL counts, biofilm formation capacity, cell metabolism, and phospholipase production. Proteinase production was higher for C. albicans in the control (P=.031) and for nonalbicans in the experimental (P=.016) groups. Relative to health data, the experimental group showed a moderate negative correlation between the CFU count/mL at baseline for nonalbicans and DRS classification (P=.020). CONCLUSIONS: C. albicans was the most prevalent species. No difference was found in the Candida spp. of complete denture wearers with DRS, with and without an HIV diagnosis, with regard to virulence factors (except for proteinase production) and morphology.

Association between tongue and lip motor functions and mixing ability in complete denture wearers.

BACKGROUND: Masticatory performance of elderly complete denture wearers is low, which may lead to restriction on intakes of several foods such as fresh fruit or raw vegetables. AIM: The aim of this study was to investigate the relationship between tongue motor function, lip motor function, and mixing ability in complete denture wearers. MATERIALS AND METHODS: Participants comprised 54 complete denture wearers with a mean age of 77.1 years. Maximum tongue pressure and oral diadochokinesis were measured to evaluate tongue and lip motor functions. A color-changeable, chewing gum was used to evaluate mixing ability. The relationship between tongue and lip motor functions and mixing ability was assessed using stepwise multiple regression analysis. RESULTS: The stepwise multiple regression analysis identified maximum tongue pressure, the number of repetitions of the syllable "ka", and gender as significant predictors for mixing ability among complete denture wearers. DISCUSSION: The elderly edentulous individuals mainly used tongue motor function in oral motor functions for mixing color-changeable chewing gums, which might be ascribable to wearing complete dentures. CONCLUSIONS: Under the limited conditions of this study, factors relating to tongue motor function, tongue pressure and the number of repetitions of the syllable "/ka"/ significantly contributed to the mixing ability of complete denture wearers. It was suggested that tongue motor function had positive effect on the mixing ability of complete denture wearers.

Management of denture-related traumatic ulcers using ozone.

STATEMENT OF PROBLEM: Management of denture-related traumatic ulcers using ozone may improve tissue healing and reduce patient pain and discomfort. PURPOSE: The purpose of this clinical investigation was to assess the efficacy of ozone in the treatment of denture-related traumatic ulcers. MATERIAL AND METHODS: Seventy-five participants (study group) with denture-related traumatic ulcers were evaluated in this blinded, controlled cohort observational investigation. A control group (n=75) of participants with denture-related traumatic ulcers who matched the study group in sex and age were also recruited. Ulcers were treated with ozone gas for 60 seconds in the study group and with air for 60 seconds in the control group. Pain levels were evaluated by means of a visual analog scale (VAS), and ulcer sizes were measured in each participant at experiment baseline and each day for 15 days. Ulcer duration was established by calculating the period it took to completely heal and disappear. Major outcome measurements were ulcer duration, ulcer size, and levels of pain. RESULTS: Ulcer size decreased from day 2 in the study group (after ozone application) (P≤.01) and from day 4 in the controls (P≤.001). Recorded pain levels decreased from the first day soon after ozone application in the study group (P≤.001) and from day 3 in the controls (P<.001). Ulcer duration, ulcer size from day 3 to day 10, and reported pain levels from day 1 to day 10 decreased more in the study group (P≤.004). CONCLUSIONS: Exposure of denture-related traumatic ulcers to 60 seconds of ozone gas was associated with better ulcer healing and decreased pain levels, ulcer size, and ulcer duration.

Premaxilla Stress Distribution and Bone Resorption Induced by Implant Overdenture and Conventional Denture.

PURPOSE: To relate the principal stress, strain, and total deformation in the premaxilla region beneath a complete denture to the pattern of premaxilla bone resorption when opposed by a conventional complete denture (CD) or by a two-implant-retained overdenture (IOD) using finite element analysis (FEA). MATERIALS AND METHODS: Three-dimensional solid models of the maxilla, mucosa, and denture of a selected edentulous patient were created using Mimics and CATIA software. The FEA model was created and duplicated in ANSYS 16.0 to perform two simulations for the IOD and the CD models. The values of maximum stress and strain and total deformation were obtained and compared to the outcomes of premaxilla resorption from a parallel clinical study. RESULTS: The maximum principal stress in the premaxilla in the IOD model ranged from 0.019 to 0.336 MPa, while it ranged from 0.011 to 0.193 MPa in the CD model. The maximum principal strain in the IOD model was 1.75 times greater than that in the CD model. Total deformation was 1.8 times higher in the IOD model. Greater bone resorption was observed in regions of higher stress, which were on the occlusal and buccal sides of the premaxilla residual ridge. CONCLUSION: Stress, strain, and total deformation values present in the premaxilla area beneath a CD were approximately two times greater in a comparison between an opposing mandibular two-IOD and an opposing mandibular CD. The results were consistent with a parallel clinical study in which the rate of premaxilla bone resorption was almost three times greater in the IOD group.

Risk factors for mandibular bone resorption in complete denture wearers.

This study aimed to evaluate the impact of factors related to the patient (age, sex, bruxism, and general health) or prosthesis (use of old dentures, duration of denture wear, and nocturnal wear) on the mandibular ridge resorption rate (RRR) of complete denture (CD) wearers. This retrospective cohort study was composed of edentulous patients who sought prosthodontic treatment for maxillary and mandibular CDs. The mandibular RRR was estimated based on panoramic radiographs (n = 120) obtained at the time of the clinical examination. The total height of the alveolar process was considered to be 3 times the distance from the inferior border of the mandible to the lower border of the mental foramen. Radiographic measurements were performed by 1 calibrated examiner. Data were collected from dental records related to the patient or prosthesis. Data were evaluated by 1-way analysis of variance or Student t test at a significance level of 5%. Of the factors evaluated, age (P ∼ 0.000), previous use of CDs (P ∼ 0.000), and bruxism history (P = 0.003) were statistically significant for the mandibular RRR. The RRR was greater among patients older than 60 years, those who had been wearing old CDs, and those who reported bruxism. Thus, the study results showed the negative influence of advanced age, use of old dentures, and bruxism on mandibular RRR.

Implant-supported cantilevered fixed dental rehabilitations in fully edentulous patients: Systematic review of the literature. Part II.

AIM: To investigate fully edentulous patients rehabilitated with cantilever-fixed implant-supported restorations and to analyse which complications are reported for this type of treatment. MATERIALS AND METHODS: Two operators screened the literature (MEDLINE, EMBASE) and performed a hand search on the main journals dealing with implantology and prosthetics until 31 December 2017. Only articles that considered cantilever implant-fixed restorations with at least 10 patients and with a mean follow-up of at least 5 years were selected. The outcome variables were survival of implants and prosthesis, mechanical, technical and biological complications, marginal bone loss. The review was performed according to the PRISMA statements. The risk of bias was evaluated for each article. Failure and complication rates were analysed using random effect Poisson regression models to obtain summary estimate of 5- and 10-year survival and complication rates. RESULTS: Fourteen papers for fully edentulous patients were selected. The estimated 5 to 10 years survival rate was calculated to be 99.00% and 96.7% for the implants and the prosthesis, respectively. A total of 299 complications (technical and biological) were reported with a cumulative 5-10 years complication rate of 44.41% and 39.46% for the patients and for the prosthesis, respectively. CONCLUSIONS: There is evidence that cantilever can be successful treatment in fully edentulous patients.

Clinical outcomes of partial and full-arch all-ceramic implant-supported fixed dental prostheses. A systematic review and meta-analysis.

OBJECTIVE: To assess the survival and technical complication rate of partial and full-arch all-ceramic implant-supported fixed dental prostheses (P-FDP/FA-FDP) and supporting implants. MATERIALS AND METHODS: An electronic search through three databases (MEDLINE/Pubmed, Cochrane Library, Embase) was conducted to identify relevant clinical studies with an observation period of at least 12 months, including ≥15 patients. Reconstruction and implant survival rates, technical complications and confounding variables such as processed/installed materials, retention mode and location in the mouth were obtained. Failure and complication rates were analyzed using standard Poisson regression models to calculate 5-year survival and complication estimates. RESULTS: A total of five studies for the P-FDP group and seven studies for the FA-FDP group were included, throughout evaluating veneered zirconia reconstructions. In the P-FDP group, reconstructions were located in posterior regions. Meta-analysis indicated survival estimates on the reconstruction level of 98.3% and 97.7% for P- and FA-FDPs after 5 years. However, chipping of the veneering ceramic was frequent, resulting in estimated 5-year complication rates of 22.8% (P-FDPs) and 34.8% (FA-FDPs). Five-year survival estimates of implants supporting P-FDPs and FA-FDPs of 98.5% and 99.4% were calculated, respectively. Including a total of 540 FDPs, one screw-loosening and 11 de-cementations were reported. Confounding variables were not found to have a significant influence on survival and complication rates. CONCLUSIONS: All-ceramic implant-supported P- and FA-FDPs comprising veneered zirconia frameworks showed high survival but clinically inacceptable fracture rates of the veneering ceramic. Their suitability with regard to this indication and a successful long-term outcome needs to be further evaluated.

Risk factor model of mechanical complications in implant-supported fixed complete dentures: A prospective cohort study.

OBJECTIVES: This prospective cohort study estimated the effect of technical and clinical factors on mechanical complications in implant-supported fixed complete dentures (IFCDs). The patient's perception of the impact of oral rehabilitation on quality of life was assessed. MATERIAL AND METHODS: A non-probabilistic sample consisted of 88 consecutive patients treated with 94 screw-retained, metal-acrylic IFCDs. Data collection included sociodemographic variables, presence and intensity of bruxism, maximal occlusal force, opposing arch, design of the metallic framework, distribution of occlusal contacts, and quality of life (OHIP-14). IFCD-level data were analyzed using Kaplan-Meier survival analysis and Cox regression model. Quality of life data were analyzed by paired Student t test. RESULTS: During a mean follow-up of 35.1 ± 18.3 months, 16/94 IFCDs (17%) had repairable mechanical complications because of loosening/fracture of artificial teeth (n = 15) and screw loosening (n = 1). Framework design (retention pins <4 mm) was a significant risk factor for complications (HR = 11.038; p = 0.027) when adjusted for sex. Mechanical complications were not associated with sex, body mass index, thickness of the acrylic resin veneering, type of opposing arch, distribution of occlusal contacts and force, protrusion interference, presence/intensity of bruxism or maximal occlusal force. OHIP-14 total scores decreased after IFCD treatment for both patients with or without complications. CONCLUSIONS: Within the limitations of this study, the results suggest that clinical success is associated to framework design with retention pins equal or longer than 4 mm. Quality of life improved with IFCD treatment, even in patients with mechanical complications.

Implant survival rates and biologic complications with implant-supported fixed complete dental prostheses: A retrospective study with up to 12-year follow-up.

OBJECTIVES: To assess the rate of biologic complications and implant survival in edentulous patients treated with implant-supported fixed complete dental prostheses (IFCDPs) after a mean observation period of 5.2 years (range: 1-12 years). MATERIALS AND METHODS: A single-visit clinical and radiographic examination was performed to assess types and rates of biologic complications with ceramic IFCDPs (Group 1) and metal-resin IFCDPs (Group 2). RESULTS: Of 457 rough surface dental implants supporting 71 IFCDPs (52 patients), six had failed, yielding an implant survival rate of 98.7% after a mean observation period of 5.2 years after definitive prosthesis insertion. The most frequent minor biologic complication was soft tissue recession (7.7% annual rate), inflammation under the IFCDP (7.4% annual rate), and peri-implant mucositis (6.3% annual rate). The most frequent major biologic complication was peri-implantitis (2.0% annual rate), in 46/457 implants (10.1%) supporting 19 IFCDPs and late implant failure (0.3% annual rate). The frequency of biologic complications was not statistically different between Group 1 and Group 2. The presence of high plaque index had significant effect on bone loss. CONCLUSIONS: After a mean exposure time of 5.2 years postdefinitive prosthesis insertion (range: 1-12 years), implant survival rate of 98.7% was achieved. The six implant failures in three patients occurred after 5 years and affected the prosthesis survival. Soft tissue recession was the most frequent minor biologic complication, whereas peri-implantitis was the most frequent major biologic complication. A 10-year implant-based mucosal recession rate of 77% (95% CI: 68.2-87.9) and a 10-year implant-based peri-implantitis rate of 20% (95% CI: 16.9-24.9) were found.

Biomechanical aspects: Summary and consensus statements of group 4. The 5th EAO Consensus Conference 2018.

OBJECTIVES: The aim of the present publication was to report on the EAO Workshop group-4 discussions and consensus statements on the five reviews previously prepared. These reviews provided the scientific evidence on the effect of crown-to-implant ratio, on reconstructions with cantilevers in fully and partially edentulous patients, on biological and technical complications of tilted in comparison with straight implants, and on the effects of osseointegrated implants functioning in a residual dentition. MATERIAL AND METHODS: The group discussed, evaluated, corrected where deemed appropriate, and made recommendations to the authors regarding the following five reviews submitted: (a) Is there an effect of crown-to-implant ratio on implant treatment outcomes?; (b) Implant-supported cantilevered fixed dental rehabilitations in fully edentulous patients; (c) and in partially edentulous patients; (d) Biological and technical complications of tilted implants in comparison with straight implants supporting fixed dental prostheses; (e) What are the adverse effects of osseointegrated implants functioning among natural teeth of a residual dentition? Based on the five manuscripts and the discussion among the group as well as the plenum members, the major findings were summarized, consensus statements were formulated, clinical recommendations were proposed, and areas of future research were identified. RESULTS: Crown-to-implant ratios ranging from 0.9 to 2.2 did not influence the occurrence of biological or technical complications also in single-tooth restorations. Reconstructions with cantilevers for the rehabilitation of fully and partially edentulous jaws showed high implant and reconstruction survival rates. In contrast, the rate of complications-in particular associated with veneering material-was high during the observation period of 5-10 years. The data reported were primarily derived from studies with high risk of bias. The data for single-implant reconstructions were small. There was no evidence that distally tilted implants were associated with higher failure rates and increased amounts of marginal bone loss. The data supporting these findings, however, were at high risk of bias and frequently incompletely reported. Frequent positional changes occurred between the natural teeth and the implant-supported restorations. These changes were more pronounced in younger individuals, and even though they were reduced with age, they still occurred in adult patients. Even though these changes were frequent, potential implications for the patient are unclear. CONCLUSIONS: The use of single-tooth restorations with crown-to-implant ratio in between 0.9 and 2.2 may be considered a viable treatment option. Multiunit reconstructions with cantilevers are a viable treatment option in fully and partially edentulous patients. Clinicians and patients should be aware, however, that complications are frequent and primarily related to resin material used for veneering. There is some evidence that tilting an implant does affect stability of the implant and the surrounding bone. Treatment options to tilted implants should carefully be considered, as the effect on soft tissues and on prosthesis behavior is poorly reported for tilted implants. Positional changes in the dentition in relation to implant-supported restorations occur frequently. The patient should be informed about the possible need for a treatment related to these changes in the long term.

Survival of 2039 complete arch fixed implant-supported zirconia prostheses: A retrospective study.

STATEMENT OF PROBLEM: Presently, data for the survival of 1-piece complete arch fixed implant-supported zirconia prostheses are limited. PURPOSE: The purpose of this retrospective study was to evaluate the survival outcomes of 1-piece complete arch fixed implant-supported zirconia prostheses fabricated by a single dental laboratory supporting several clinicians. MATERIAL AND METHODS: Outcome data were collected over a 5-year period from a large commercial dental laboratory that fabricated 2039 1-piece complete arch fixed implant-supported monolithic zirconia prostheses. All prostheses were fabricated using the same zirconia system from 1 manufacturer, using standardized protocols. The zirconia prostheses were predominantly monolithic, with veneered porcelain restricted to the gingival region. Because a 5-year warranty against fracture was offered by this dental laboratory, prostheses that were returned to the laboratory for remake because of catastrophic failure (fracture) or technical complications were identified, and data were analyzed using a life table. RESULTS: Of the 2039 zirconia prostheses evaluated, at least 319 prostheses had a minimum of 3 years of clinical service, and 69 prostheses had a minimum of 4 years of clinical service. A total of 6 fractures were reported, resulting in a first-year interval survival rate of 99.8% and a 5-year cumulative survival rate of 99.3%. Six zirconia prostheses were returned to the laboratory during the 5-year period because of technical complications related to the debonding of titanium cylinders, and 3 prostheses were returned because of fracture of the titanium cylinders. No prostheses were returned because of chipping of the veneered gingival porcelain. CONCLUSIONS: Practice-based evidence from this large sample, short-term retrospective study showed that 1-piece complete arch fixed implant-supported zirconia prostheses with veneered porcelain restricted to the gingival region showed a cumulative survival rate of 99.3% in a 5-year period. The technical complication rate related to this type of prosthesis was minimal.

Diagnosis and treatment of orofacial pain in a patient with unserviceable complete dentures: A clinical report.

An ill-fitting complete denture has the potential to create pain and discomfort as well as conceal or confound the diagnosis of other primary sources of orofacial pain such as trigeminal neuralgia. Guidelines of the American Academy of Orofacial Pain offer an evidence-based approach for the assessment, diagnosis, and management of orofacial pain. A complete and accurate differential diagnosis is paramount to the success of treatment as well as to the circumvention of unnecessary therapy. The purpose of this clinical report was to emphasize an evidence-based approach to the diagnosis and treatment of orofacial pain in a patient with edentulism and a history of prolonged denture wear.

Clinical complications and quality assessments with computer-engineered complete dentures: A systematic review.

STATEMENT OF PROBLEM: Computer-engineered complete dentures (CECDs) have significant potential as shown by recent reports of outcomes and specific applications. An understanding of complications and quality assessment factors associated with CECDs from compiled data is lacking in published reports. PURPOSE: The purpose of this systematic review was to determine the clinical complications and quality assessments related to CECDs. MATERIAL AND METHODS: Electronic searches of publications in English from January 1984 to September 2016 were performed in MEDLINE and Cochrane databases, with the results enriched by manual searches and citation mining to address 2 population intervention comparison outcome (PICO) questions: what are the clinical complications associated with CECDs, and what are the quality assessments with CECDs? RESULTS: A review of 5 selected articles (limited data) on CECDs revealed patient dissatisfaction related to overall outcome (25.49%), inadequate retention (20.73%), and esthetic concerns (15.09%) as common complications. Quality assessment factors that were used to report complications were identified. CONCLUSIONS: Patient dissatisfaction, inadequate retention, and inadequate esthetics were the most common complications with CECDs. The addition of a trial placement option for CECDs could result in a better clinical outcome, reducing the incidence of other complications related to occlusal vertical dimension, centric relationship, tooth arrangement, and esthetics, improving patient satisfaction, and reducing remakes. The difficulty in reading the digital preview for an objective assessment before fabrication is a unique but not a common, complication for CECDs.

Do mandibular complete dentures made using a neutral zone technique improve speech?-A pilot study.

OBJECTIVE: The aim of this study was to evaluate speech sound production (SSP) in older edentulous patients provided with two different types of mandibular complete dentures (MCDs; conventional vs neutral zone). BACKGROUND: Regarding the fact that complete dentures (CDs) affect SSP, it is unknown whether the set-up of the artificial teeth resulting from the neutral zone technique leads to a negative impact on SSP. MATERIALS AND METHODS: For 21 participants, a conventional MCD and a MCD using a modified neutral zone technique (neutral zone dentures) were fabricated. The SSP was described using a phonetically balanced text, which was recorded digitally and evaluated. RESULTS: No significant difference in SSP was observed. CONCLUSION: Within the limits of this study, it can be concluded that the application of the neutral zone technique in the mandible has no considerable impact on SSP.

Status of Removable Dentures and Relationship with Oral Candida-Associated Factors in a Geriatric Population in Catalonia.

PURPOSE: Colonization by Candida is related to wearing a denture. How denture type, status, and maintenance play a role in determining Candida colonization remains unknown. This work evaluated removable denture status in an elderly population and explored the association between denture-related factors and oral Candida colonization as determined by systemic and local factors. MATERIALS AND METHODS: Socio-demographic, general health, and behavioral data and oral factors were registered by means of a questionnaire. Oral, dental, and denture-related factors were assessed by clinical examination, and yeasts were isolated from oral and denture specimens. Multiple logistic regression analysis was used to explore the relative relevance of risk factors. RESULTS: Overall, 52.4% of subjects used complete dentures in both lower and upper arches, and 90% of the prostheses were in good condition. Denture plaque index was high in most cases, and 75% of subjects had yeasts in their oral cavities. Oral Candida colonization was significantly associated with low saliva pH, sugar consumption, and the fault of a denture component; however, only sugar consumption was found to be an independent factor related with oral Candida colonization, showing an odds ratio of 3.04 in a multiple logistic regression model. CONCLUSIONS: Elderly people in this study used a complete denture in good condition, with a median age of 15 years. Daily or weekly sugar consumption was found to be highly associated with oral colonization by Candida.

Effects of wearing and removing dentures on oropharyngeal motility during swallowing.

Wearing dentures and dysphagia are common in older individuals; however, it is still unknown how dentures affect oral and pharyngeal swallowing. The purpose of this study was to reveal the effects of wearing and removing dentures on oropharyngeal movements during pharyngeal swallowing in the feeding sequence of solid food. Participants were 25 edentulous volunteers (nine men, 16 women; mean age 76·2 years) who wore complete dentures. The test food was minced agar jelly containing barium sulphate. Subjects were instructed to feed and swallow the test food with or without dentures during observation using videofluorography. We quantitatively evaluated the range, distance and duration of oropharyngeal movements during pharyngeal swallowing. When dentures were absent, the range of mandible and hyoid movements were significantly expanded in the anterosuperior direction, and the range of laryngeal movement was significantly expanded in the anterior direction. Additionally, the posterior pharyngeal wall contraction and upper oesophageal sphincter opening significantly increased. In addition, the distances of the mandible, hyoid and laryngeal movements and the mandibular duration were significantly extended when dentures were absent. No significant differences were observed in the duration of movements of other organs between wearing and removing dentures. The hyoid bone, larynx, posterior pharyngeal wall and upper oesophageal sphincter do not change their duration of movements when dentures were removed but, rather, expand their range of movement. This might be a spatial change of oropharyngeal movement to avoid temporal changes in pharyngeal swallowing when dentures were absent in edentulous older individuals.

Oral squamous cell carcinoma misdiagnosed as a denture-related traumatic ulcer: A clinical report.

A 65-year-old woman presented with an ulcerated lesion in the alveolar ridge mucosa, which appeared after new dentures had been inserted. Despite many treatment attempts, the lesion did not recede, even with the interruption of denture wearing. A biopsy was performed, and histopathologic examination revealed an ulcerated, invasive, poorly differentiated oral squamous cell carcinoma. The time from the patient's first contact with the prosthodontist because of the lesion until the appropriate diagnosis was established was approximately 6 months. This clinical report documents a significant delay in the oral squamous cell carcinoma diagnosis and treatment because of a clinical misdiagnosis of a traumatic ulcer resulting from complete dentures. Prosthodontists should be aware of the importance of early diagnosis of oral cancer among elderly prosthesis wearers.

Clinical performance of CAD-CAM-fabricated complete dentures: A cross-sectional study.

STATEMENT OF PROBLEM: Computer-aided design and computer-aided manufacture (CAD-CAM)-fabricated complete dentures (CD) seek to address the disadvantages associated with conventional CD fabrication. However, few if any randomized clinical trials, cross-sectional, and/or retrospective analyses are available for the clinical performance of CAD-CAM-fabricated CDs. PURPOSE: The purpose of this retrospective study was to evaluate clinician experience with digital CD fabrication attempted in a 2-visit protocol. The actual number of appointments required for insertion and the number of postinsertion adjustment visits, and whether the incidence of treatment complications was related to operator experience were recorded and evaluated. MATERIAL AND METHODS: Patients who had received CAD-CAM-fabricated CDs were identified from a retrospective chart review. The number of appointments needed to insert digital CDs in attempting the 2-visit fabrication protocol marketed by the company, the number of postinsertion adjustments, and the reported complications were counted. There was no control group for comparative purposes used in this study. Whether the experience level of the operator influenced the frequency of a complication, the number of appointments needed to insert the definitive prostheses, and the number of postinsertion visits was determined by using an analysis of variance assessed at the 95% confidence level (α=.05). The frequency of a complication at each of the levels of operator experience was analyzed using the Exact Mantel-Haenszel chi-square test. RESULTS: Of the 48 rehabilitated participants, 24 participants were treated at the predoctoral level and 24 were treated at the graduate prosthodontics resident level. A total of 31 participants satisfied the true 2-visit fabrication protocol, and the remaining 17 participants required additional clinical visits because of complications on the day of insertion. The CD prostheses of 5 participants from the sample population required remaking using the conventional method. The mean number of postinsertion adjustment visits was 2.08. Of the 90 arches completed, 22 prostheses could not be inserted at the second appointment. CONCLUSIONS: The mean number of appointments needed to insert the prostheses in both groups was 2.39 visits--not 2 as claimed by the company. The most common types of complications observed were lack of denture retention, inaccurate occlusal vertical dimension, and incorrect centric relation.

Surgical treatment of denture-induced fibrous hyperplasia with plasma rich in growth factors.

Denture-induced fibrous hyperplasia is a fibrous connective tissue lesion that commonly occurs in oral mucosa in patients showing important alveolar ridge atrophy. In this study, we propose Plasma Rich in Growth Factors (PRGF) to overcome constrains of traditional surgical treatment. Herein, we demonstrated that PRGF represents an autologous source of growth factors able to reduce the healing time of the alveolar mucosa and the discomfort of those patients. These properties are the result of PRGF's precise biological features that result in the following: reduction of duration and intensity of postsurgical pain, acceleration of re-epithelialization of the wound, and reduction of bleeding events and of edema. In conclusion, we showed that using PRGF on patients affected by denture-induced fibrous hyperplasia allows a short healing time, thereby reducing complications and overall improving their quality of life. The aims of this study were to evaluate the influence of PRGF-ENDORET on secondary re-epithelialization in vestibuloplasty after excision of denture irritation fibrous hyperplasia, with an explorative randomized case control trial with 10 patients, 5 patients treated with PRGF and 5 patients with traditional hemostasis, and to analyze differences with simple surgery, considering postoperative rapidity of re-epithelialization, comfort, and discomfort of patients, pain, swelling, and infections.