Prosthetic complications and quality of life among wearers of mandibular overdenture with the Facility-Equator system

Abstract This longitudinal study aimed to assess the performance of the Facility-Equator system as mandibular overdenture (MO) retainers from a prosthetic perspective during 2 years of loading and to investigate the oral health-related quality of life (OHRQoL) and whether prosthetic events can affect the OHRQoL. Twenty-four patients (68.1 ± 7.51 years) reported their OHRQoL through the Geriatric Oral Health Assessment Index (GOHAI) and Oral Health Impact Profile (OHIP-EDENT) questionnaires before MO loading and after 1 and 2 years of usage. Prosthetic occurrences were recorded during this period. Data were analyzed using the Wilcoxon test, Mann-Whitney test, and Spearman correlation coefficients. Of the 127 prosthetic events that occurred in the first year, the most frequent events were prosthesis adjustments (16.5%), dislodgement of the Equator attachment (14.17%), and O-ring replacement (11.8%). Eighty-seven prosthetic events were recorded in the second year, the most frequent events being prosthesis adjustments (27.6%), O-ring replacement (20.7%), and recapturing the female matrix (11.5%). All domains of the GOHAI and OHIP-EDENT questionnaires exhibited a significant difference (p < 0.05) between the baseline and 1- and 2-year evaluations, except in the Social Disability and Psychological Discomfort domains (p > 0.05) of OHIP-EDENT after 1 year. Complications related to prosthetic maintenance, such as fracturing of the prosthesis, Equator dislodgement, prosthesis rebasing, and new overdenture confection, affect the OHRQoL (p < 0.05), primarily the Physical Pain and Discomfort domains, especially in the first year of MO loading.

Evaluation of bite force and masticatory performance: complete denture vs mandibular overdenture users

Abstract: This cross-sectional observational study with 24 patients evaluated differences in bite force (BF) and masticatory performance (MP) between conventional complete denture (CCD) and implant mandibular overdenture (IMO) users and the correlation between these variables. The BF test was performed bilaterally with an occlusal force device. During the MP test, patients were asked to chew Optocal particles for 40 cycles. The Shapiro Wilk test was employed to verify the normality of the data, the student t test to identify differences between groups, and Pearson's correlation to investigate interrelationships between variables. A multiple linear regression was subsequently performed via the stepwise method. P values ≤0.05 were considered statistically significant. Unlike IMO users, CCD users presented a significant difference (25.6%) in BF between the dominant and non-dominant chewing side (p=0.04). IMO users presented significantly higher BF (p=0.01) without presenting a dominant side (p=0.38), and also performed significantly better for the following MP parameters: MPX50 values decreased by 27.25% in IMO users (p=0.01), MPB decreased by 48.38% (p=0.01), and ME 5.6 decreased by 53.25% (p=0.02), while ME2.8 increased by 151.57% (p=0.01). The BF and MPX50 in the IMO wearers group were negatively correlated (-0.57; p=0.05); this correlation coefficient was the only parameter included in the multivariate regression model. IMO users have higher BF and better masticatory performance than CCD users, especially in terms of chewed particles size reduction. MP is correlated with a higher BF in IMO users through better particle trituration.

Resumo Este estudo observacional transversal com 24 participantes teve como objetivo avaliar as diferenças na força de mordida (FM) e na PM (performance mastigatória) entre usuários de prótese total convencional (PTC) e de overdenture mandibular (OM) e a correlação entre essas variáveis. O teste de FM foi realizado bilateralmente com um dispositivo de força oclusal. Durante o teste de PM, os pacientes foram solicitados a mastigar uma porção padronizada de Optocal por 40 ciclos mastigatórios. O teste de Shapiro Wilk foi empregado para verificar a normalidade dos dados, o teste T de Student para identificar diferenças entre os grupos e os coeficientes de correlação de Pearson para investigar inter-relações entre variáveis. Uma regressão linear múltipla foi realizada pelo método stepwise. Valores de p≤0,05 foram considerados estatisticamente significantes. Diferentemente dos usuários de OM, os usuários de PTC apresentaram uma diferença significativa (34%) na FM entre o lado dominante e o não dominante (p=0,04). Os usuários de OM apresentaram FM significativamente maior (p=0,01) sem apresentar um lado dominante (p=0,38) e obtiveram PM significativamente melhor nos seguintes parâmetros: os valores de PMX50 diminuíram 27,25% (p=0,01), PMB diminuiu em 48,38% (p=0,01), e EM 5.6 diminuiu 53,25% (p=0,02), enquanto EM2.8 aumentou 151,57% (p=0,01). A FM e PMX50 no grupo de usuários da IMO foram negativamente correlacionados (-0,57;p=0,05); esse coeficiente de correlação foi o único parâmetro incluído no modelo de regressão multivariada. Os usuários da OM possuem maior FM e melhor performance mastigatória do que os usuários de PTC, observados principalmente na redução do tamanho das partículas mastigadas. A PM está correlacionada com um maior FM nos usuários da OM através de uma melhor trituração de partículas.

Prevalence of risk factors for denture stomatitis in complete denture wearers

Aim: The prevalence of denture stomatitis and the relationship with its risk factors was evaluated via secondary data from 62 complete denture (CD) wearers, between 2015 and 2017. Methods: The data was stored in an Excel database and was analyzed using the statistics software STATA/SE 12.0. A descriptive analysis was performed taking into account a categorization of the clinical variables according to risk factor in 4 domains: CD usage, systemic health, hygiene habits, and usage habits. The association amongst the denture stomatitis and risk factors variables was tested by the Chi-square test and the results were statistically significant at p-values <0.05. Results: The CD wearers participants were composed by a majority of elderly (80.64%) and women (72.78%); with 45.16% having been using the current denture for more than 10 years and another 74.19% related a continuous usage. Diabetes and hypertension were related by 83.87% and 67.74%, respectively, with 87.10% using medication. Although 75.80% reported cleaning their dentures 3 times per day or more, and 59.68% considered their oral hygiene very good, 50% of the complete dentures showed dirtiness and clinical signs of Denture Stomatitis were present in 30.64% of the patients. Despite of the evaluated sample shows many risk factors for the development of the disease, an association between the variables was not observed. Conclusion: Considering the high prevalence of the disease in the studied sample, preventive and educational measures on denture usage and hygiene must be reinforced in order to maintain the oral health of the edentulous patients

Exploratory and confirmatory factorial analysis of the OHIP-Edent instrument

Abstract Several instruments have been used to measure oral health-related quality of life (OHRQoL). The Oral Health Impact Profile (OHIP) questionnaire was based on the concept that sequential events related to oral diseases can cause discomfort, functional limitations and consequently, result in dysfunctions and even disabilities. There are few studies in the literature that structurally analyze the instruments to verify whether they measure the requirements to which they were designed to. The objective of the study was to evaluate the internal structure of the OHIP-Edent questionnaire. The OHIP-Edent was administered to 54 edentulous patients' wearers of conventional complete dentures. For structural analysis, an exploratory factorial analysis (EFA) was carried out. After determining the internal consistency of the model (Cronbach's alpha = 0.88), the fit was checked using the root mean square error approach (value 0.04), the comparative fit index (value 0.982) and the Tucker-Lewis index (value 0.976). After analysis of the 19 questions and the seven domains proposed in the OHIP-Edent questionnaire, the hypothetical factorial model showed three dimensions denominated "Physical Impact", "Psychological Impact" and "Social Impact". In this sample of conventional complete denture wearers, the OHIP-Edent seems adequate to measure the "Physical Impact", "Psychological Impact", and "Social Impact" of the OHRQoL. The confirmatory factorial analysis confirmed the model and, through adjustment indexes, it was verified that the three dimensions have convergence and consistence adequate in order to characterize the OHRQoL construct with validity.

Simplified micrometric surface characterization of different implant surfaces available on the Brazilian market

Aim: This study characterized the implant surfaces available on the Brazilian market in terms of topography, chemical composition, and roughness. Methods: The following brands were selected according to their surfaces: Kopp (Ko), Signo Vinces (Sv), Neodent (Ne), Osseotite (Os) NanoTite (Nt), SIN (Si), Titanium Fix (Tf), conventional Straumann (Str), Active SLA (SLA). The morphological analysis and the alloy impurities and implant surface contaminants were analyzed by SEM-EDS. Surface roughness parameters and 3-D reconstructions were obtained by laser microscopy (20x). Two distinct areas were evaluated: i) the cervical portion (no surface treatment), and ii) the middle third (treated surface). Results: The characterization of the implant surfaces by SEM showed morphological differences between the thread geometries and surface morphology at 800x and 2000x magnification. The EDS elemental analysis showed a predominance of titanium (Ti) for all implants. The SLA surface showed only peaks of Ti while other implants brands showed traces of impurities and contaminants including Al, C, PR, F, Mg, Na, Ni, O, P, and SR. The implant surface roughness in the cervical portion did not exceed Ra 0.5­1.0 µm, constituting a minimally rough surface and obtaining acceptable standards for this region. Only Nt, Str, and SLA presented Ra above 2 µm in the middle third area showing a rough surface favorable for osseointegration. Conclusion: This study concluded that there is no established standard for morphology, chemical composition and implant surface roughness that allows a safe comparison between the available dental implant surfaces. National implant brands generally contain more impurities and surface contaminants than their international counterparts and were consequently more sensitive to the surface treatment techniques

Atitudes e conhecimento dos pais quanto ao uso de dentifrícios fluoretados em crianças de um a 65 meses de idade / Attitudes and knowledge of parents regarding the use of fluoride dentifrices in children aged one to sixty-five months

Objetivo: analisar o conhecimento dos pais sobre o flúor, os dentifrícios, seu uso e o motivo da escolha. Sujeitos e método: estudo transversal com dados coletados em entrevistas com pais de crianças de um a 65 meses de idade, sobre questões socioeconômicas, conhecimento sobre flúor, motivo pela escolha do dentifrício, quantidade utilizada e hábitos de higiene bucal da criança. Os dados foram analisados por meio de estatística descritiva. Resultados: foram entrevistados 202 pais. A média de idade das crianças participantes do estudo foi de 35,6 meses (±15,06). Os pais citaram os seguintes critérios para a compra do dentifrício: ausência de flúor (20,3%), preço (6,9%), sabor (11,4%), marca (10,9%), e 20,8% dos pais responderam não haver critério. Com relação ao início da administração do dentifrício fluoretado para as crianças, 43,1% dos paisrelataram que ocorreu até um ano, 21,8% mais de um ano, e 35,1% não lembravam. Sobre a quantidade utilizada de dentifrício, 32,2% dos pais apontaram usar a técnica longitudinal, 41,1% a transversal, 26,2% a dogrão de arroz, e 5% não responderam. Com relação à higiene bucal ser realizada sozinha ou com ajuda, em 12,2% ela é realizada somente pela criança, em 47,7% dos casos é a criança com a ajuda de um adulto, e em40,1% é feita somente pelo adulto. Conclusão: Os pais têm conhecimentos sobre o flúor e sua finalidade, porém não utilizam a dose recomendada para a idade e não há uma conscientização quanto à motivação para a escolha do dentifrício. Assim, há necessidade de investir em educação a respeito dos dentifrícios para a escolha consciente e o uso adequado.