The effect of using denture adhesives on patient satisfaction with complete dentures; a randomized clinical trial.

BACKGROUND: Denture adhesives can be useful in improving patients' satisfaction with complete dentures. However, comparison clinical trials are lacking. The purpose of this randomized clinical trial was to assess the satisfaction of edentulous patients and their oral health impact profile when provided with 3 types of denture adhesives. METHODS: Sixty-four completely edentulous patients seeking complete dentures for their first time were randomly divided into 3 groups. Each group received a set of complete dentures, which were adjusted at review appointments until participants reported no complaints. After 1 month of using the dentures, participants rated their overall satisfaction and their satisfaction regarding comfort, retention, stability, and efficiency of mastication and speech on a 100-mm visual analog scale (VAS). Participants also filled out the oral health impact profile for edentulous patients (OHIP-EDENT) questionnaire. Each group was then given 1 type of denture adhesive to use. Group C received Corega Ultra denture fixative cream (GlaxoSmithKline), Group O received Olivafix (Bonyf), and Group S received Sea. Bond adhesive strips (Sea.Bond). Mann-Whitney U test was used to analyze the differences in VAS scores before and after using the adhesive within each group and Wilcoxon-signed rank test was used to compare OHIP scores and total OHIP values before and after using the adhesive within each group (p = 0.05). Furthermore, Kruskal Wallis test was used to compare the differences before and after using the adhesives in VAS and OHIP values between the 3 groups. RESULTS: Significantly higher VAS values were detected in all groups and significantly lower values for many OHIP items in addition to total OHIP values were detected in all groups after using the adhesives (P < 0.05), except for the ease of cleaning for Group O and Group S (P > 0.05). No significant differences were found in VAS and OHIP values between the 3 groups (P > 0.05), except for the ease of cleaning which was significantly different between Group C and Group S (p = 0.005). CONCLUSIONS: Using denture adhesives for completely edentulous patients resulted in higher patient satisfaction as indicated by higher VAS scores as well as improved quality of life as indicated by lower OHIP-EDENT scores after using the adhesives. These improvements were not dependent on the type of adhesive, except for ease of cleaning as adhesive strips were easier to clean than paste type adhesives. TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov (ID: NCT05496283) on 11/08/2022.

Simplified versus conventional complete dentures: A randomized crossover clinical trial.

STATEMENT OF PROBLEM: A simplified approach to complete denture treatment, omitting the border molding and definitive impression appointment, was suggested as an alternative to the conventional approach. However, comparison clinical trials are lacking. PURPOSE: The purpose of this randomized crossover clinical trial was to assess the satisfaction of edentulous patients and their oral health impact profile when provided with complete dentures fabricated through the simplified or the conventional approach. MATERIAL AND METHODS: Forty completely edentulous patients seeking complete dentures were randomly divided into 2 groups (n=20). Each group received 2 sets of dentures. The first group received conventionally fabricated complete dentures, and the second group received complete dentures fabricated through the simplified approach. After 2 months, participants rated their overall satisfaction and their satisfaction regarding comfort, retention, stability, and efficiency of mastication and speech on a 100-mm visual analog scale (VAS). Participants also filled out the oral health impact profile for edentulous patients (OHIP-EDENT) questionnaire. Each group was then given the alternate set of dentures and reviewed again after 2 months. The results were analyzed by using the Mann-Whitney U and Wilcoxon-signed rank tests (α=.05). RESULTS: The simplified complete dentures had significantly higher VAS scores for general satisfaction with maxillary dentures (P=.036), satisfaction with retention of maxillary dentures (P=.002), satisfaction with stability of maxillary dentures (P=.003), and satisfaction with speaking (P=.002). No statistically significant differences were found between the 2 groups regarding the other VAS items or OHIP-EDENT scores (P>.05). CONCLUSIONS: The simplified denture fabrication approach required fewer appointments and resulted in higher patient satisfaction and similar OHIP-EDENT scores compared with the conventional approach. The simplified approach can be recommended over the conventional approach.

Predictability of dental students' performance in clinical courses based on their performance in pre-clinical and academic courses.

OBJECTIVES: Some dental schools depend on the students' academic performance for admission purposes. This research aimed at investigating the correlations between dental students' performance in specific academic courses and their pre-clinical and clinical counterparts and the correlations between students' performance in the pre-clinical practical courses and the clinical courses. METHODS: Academic and practical pre-clinical and clinical grades were retrieved for 811 students who graduated from the School of Dentistry, the University of Jordan, between 2016 and 2018. Ten courses (five academic and five practical) were selected. Pearson's rho test was used to calculate the correlations between the courses. RESULTS: Statistically significant weak-to-moderate positive correlations were found between each academic course and its pre-clinical or clinical counterparts and between pre-clinical and clinical courses. A statistically significant positive moderate correlation (p < .001) was found between students' performance in fourth and fifth year restorative clinics. CONCLUSION: The results of this study suggest that the academic performance could partially predict the practical performance in both the pre-clinical and clinical courses and that the clinical performance could partially be predicted from the pre-clinical practical performance. Moreover, students who can successfully perform the required clinical procedures in fourth year will successfully perform the required clinical procedures in fifth year. However, other confounding factors should be taken into consideration such as manual dexterity and artistic skills even though their intellectual abilities are average.

The predictive value of high school grade point average to academic achievement and career satisfaction of dental graduates.

BACKGROUND: In a country where admission to dental schools is based solely on the cognitive abilities of students, the aim of the study was to investigate the correlation between high school grade point average and graduating academic achievement for dental students; moreover, determine whether a correlation exists between dental students' graduating academic achievement and their career choices and job satisfaction. METHODS: A five-year retrospective cohort study was conducted at the University of Jordan, involving (828) dental graduates first enrolled between 2010 and 2014. Correlations comparing high school grade point average and graduating academic achievement were done for the total sample composed of (736) students. A short survey was constructed to assess the career choices and job satisfaction for recently graduated dentists and correlate them with their graduating academic achievement. RESULTS: Statistically significant but weak positive correlation (0.3) was found between high school grade point average and graduating academic achievement for dental students (p ≤ 0.05). Statistically significant correlations were found between graduating academic achievement and career choices and job satisfaction. CONCLUSION: The significant positive correlation between the high school grade point average and graduating academic achievement of our dental students indicate that our school admission system depending on high school grade point average is a valid system. There was a significant negative correlation between the graduating academic achievement and both the career choices and job satisfaction among fresh graduate dentists in Jordan. This information is required to update the dental school admissions procedures in response to the changing dental educational landscape.

Biocompatibility and Durability of Diazonium Adhesives on Dental Alloys.

PURPOSE: A new type of diazonium-based adhesive has been recently developed by our team to bind dental alloys (Titanium, stainless steel, and cobalt chromium) to dental polymers. Here, we explored the endurance of the resulting adhesive after thermal-cycling and autoclave aging. MATERIALS AND METHODS: Polished samples of titanium (Ti), stainless steel (SS) and cobalt chromium (Co-Cr) were coated with a diazonium-based adhesive. Untreated samples served as controls (n = 12 per each condition). X-ray photoelectron spectroscopy (XPS) was performed to characterize the elemental compositions of the different surfaces. Biocompatibility of the coated alloys was assessed with human gingival fibroblasts (HGF). Inductively coupled plasma (ICP) and total organic carbon (TOC) analyses were used to quantify the ions and organic matters released from the diazonium coated alloys. Endurance of the adhesives was assessed by exposing the samples to autoclaving and thermal-cycling. The tensile strength of the poly(methylmethacrylate) (PMMA)-alloy bond was also tested. RESULTS: Results of mechanical testing demonstrated a higher endurance of the coated CoCr, Ti, and SS compared to the uncoated alloys. The human fibroblasts cultured on the substrates remained alive and metabolically active, and the coatings did not release significant amounts of toxic chemicals in solutions. CONCLUSIONS: The results further support the use of diazonium-based adhesives as new coupling agents for dental applications.

Clinical evaluation of reasons for replacement of amalgam vs composite posterior restorations.

Background: The aim of the present study is to evaluate the most common reasons for replacing posterior amalgam and resin composite restorations in patients attending the university dental restorative clinics. Methods: A total of 318 restorations which needed to be replaced were clinically and radiographically evaluated in a period of nine months. The frequencies of reasons for replacing posterior amalgam and resin composite restorations were calculated; secondary caries, restoration/tooth fracture, marginal discoloration/ditching, proximal overhang/open margin, loss of anatomy, pain/sensitivity, and esthetics. Results: The sample population comprised of 191 females and 106 males. The majority of the sample population fell in the age group of 40-50 years (n = 110). 318 restorations (n = 318) were examined in this study. 82% of examined teeth were restored with amalgam (n = 261), while posterior composite restorations comprised 18% of the examined teeth (n = 57). Among all restorations demanded to be replaced by the patients (n = 318), aesthetic need was the most common reason (n = 98), followed by Ditching or discoloration (n = 64), secondary caries (n = 57), and fracture (n = 44). Loss of anatomy was the least common cause to replace both amalgam and resin composite restorations (n = 5). The different reasons of failure were all significant between amalgam and resin composite restorations as shown in (Fig. 1) (p < 0.005). The most common reason for amalgam replacement was aesthetic. The most common reason for composite replacement was secondary caries and marginal ditching. Conclusion: Both amalgam and composite had different reasons for replacement. Amalgam had lesser risk of developing secondary caries and higher longevity than composite.

Factors Affecting Patient Satisfaction with Complete Dentures.

Background: Rehabilitation of the edentulous patients has always been a challenge. The success of conventional complete denture therapy might be affected by several factors such as patients' age, personality, previous denture wearing experience, expectations, aesthetics, residual ridge form and anatomy, denture quality, the method of its construction, dentist experience, and dentist-patient relations. Objectives: The aim of this study was to compare patient satisfaction with complete dentures provided by fourth and fifth year dental students and prosthodontists with a minimum of 5 years' experience at the University of Jordan Hospital 8 weeks after insertion. Methods: Questionnaires were distributed to a total of 60 completely edentulous patients who received complete maxillary and mandibular dentures. Besides demographic questions, the questionnaire included questions that probed the patient's satisfaction with his maxillary and mandibular dentures in general using two types of scales. Results: Results indicated that dentist experience does not affect patients' satisfaction with their complete dentures. Our results also indicated that patients who had previous dentures could adapt more easily and were generally more satisfied with their newly inserted dentures especially with regard to their chewing ability and comfort with their mandibular dentures. Gender also influenced patient satisfaction with complete dentures especially the part related to psychological and social disability. Conclusions: Results of this study will help in further understanding factors influencing patient satisfaction with their complete dentures.

Disclosing Agent for Resin Composite Based on Adsorption Surface Treatment.

A composite disclosing agent can help dentists distinguish resin boundaries from the tooth structure and facilitate its complete removal while avoiding damage to the surrounding sound tooth structures. In this study we characterized the interaction of composite resin with various organic molecules with functional groups comparable to composite monomers which resulted in the development of a composite disclosing agent. The adhesion of these molecules to composite and tooth enamel and the ability to selectively stain composite were verified using spectrophotometry and other techniques. The optimal staining conditions were confirmed clinically in a pilot study on orthodontic patients. Our results indicated that a molecule with phenyl groups resembling composite monomers, such as methyl salicylate, was able to adsorb to composite resin through Van Der Waals forces and not tooth enamel and serve as a primer for a disclosing agent.

Metal-composite adhesion based on diazonium chemistry.

OBJECTIVE: Composite resins do not adhere well to dental alloys. This weak bond can result in failure at the composite-metal interface in fixed dental prostheses and orthodontic brackets. The aim of this study was to develop a new adhesive, based on diazonium chemistry, to facilitate chemical bonding between dental alloys and composite resin. METHODS: Samples of two types of dental alloys, stainless steel and cobalt chromium were primed with a diazonium layer in order to create a surface coating favorable for composite adhesion. Untreated metal samples served as controls. The surface chemical composition of the treated and untreated samples was analyzed by X-ray photoelectron spectroscopy (XPS) and the tensile strength of the bond with composite resin was measured. The diazonium adhesive was also tested for shear bond strength between stainless steel orthodontic brackets and teeth. RESULTS: XPS confirmed the presence of a diazonium coating on the treated metals. The coating significantly increased the tensile and shear bond strengths by three and four folds respectively between the treated alloys and composite resin. CONCLUSION: diazonium chemistry can be used to develop composite adhesives for dental alloys. SIGNIFICANCE: Diazonium adhesion can effectively achieve a strong chemical bond between dental alloys and composite resin. This technology can be used for composite repair of fractured crowns, for crown cementation with resin based cements, and for bracket bonding.

Fracture of fiber-reinforced composites analyzed via acoustic emission.

This study investigated the fracture resistance of composite resins using a three-point bending test and acoustic emission (AE) analysis. Three groups of specimens (n=15) were prepared: non-reinforced BelleGlass HP composite (NRC), unidirectional (UFRC) and multidirectional (MFRC) fiber-reinforced groups which respectively incorporated unidirectional Stick and multidirectional StickNet fibers. Specimens were loaded to failure in a universal testing machine while an AE system was used to detect audible signals. Initial fracture strengths and AE amplitudes were significantly lower than those at final fracture in all groups (p<0.05). Initial fracture strength of UFRC (170.0 MPa) was significantly higher than MFRC (124.6 MPa) and NRC (87.9 MPa). Final fracture strength of UFRC (198.1 MPa) was also significantly higher than MFRC (151.0 MPa) and NRC (109.2 MPa). Initial and final fracture strengths were significantly correlated (r=0.971). It was concluded that fiber reinforcement improved the fracture resistance of composite resin materials and the monitoring of acoustic signals revealed significant information regarding the fracture process.

Self-directed study and carving tooth models for learning tooth morphology: perceptions of students at the University of Aberdeen, Scotland.

Tooth morphology has been taught at the University of Aberdeen Dental School, United Kingdom, through self-directed workshops, using online handouts and tooth models. Tooth carving sessions were recently added to introduce manual skills training through learning tooth morphology at an early stage of the dental course. The aim of this study was to assess students' perception of both teaching modalities to evaluate their usefulness and to allow further course development. The subjects of this study were first-year dental students. Students' opinions were sought upon completion of the tooth morphology sessions using a structured questionnaire that investigated their views about the effectiveness of both learning methods. The results suggest that self-directed workshops represent an effective way of learning tooth morphology; however, the students recommended further development of the course to make it more focused. Although students questioned the value of the carving sessions, they agreed that it helped to develop their manual dexterity, which was one of the main objectives of the exercise. Further review and development of the course is required in addition to follow-up of the students' performance in clinical skills to further elucidate any advantages of tooth carving to advocate it as a mode of learning.

Students' opinions and attitudes after performing a dental OSCE for the first time: a Jordanian experience.

This study at the Faculty of Dentistry, University of Jordan investigated and evaluated students' attitudes and opinions after attempting a dental objective structured clinical examination (OSCE) for the first time. The OSCE consisted of sixty-seven stations for fourth-year dental students. After the exam, students were asked to voluntarily complete a questionnaire designed to evaluate their attitudes and opinions about the exam. Of the 134 students who participated in the OSCE, 93.2 percent completed the questionnaire; 43.4 percent said they found the exam difficult and 56.6 percent found it easy (p=0.147). Seventy percent reported that the exam was objective, while 30 percent did not (p<0.001); 65.5 percent indicated that it was a better test than traditional patient-based tests, whereas 34.5 percent did not (p<0.001). Sixty-eight percent stated that there were too many stations, while 30.9 percent stated the number of stations was appropriate and 0.8 percent stated there were too few (p<0.001). Of these respondents, 75.6 percent reported the exam was organized, whereas 21.1 percent said the exam was not very well organized and 3.3 percent said the exam was not organized at all (p<0.001). Overall, the students responded that the OSCE was able to test their clinical judgment and skills and it was a better method for evaluating their clinical skills; most preferred to have such tests in the future. Although the students reported the exam had too many stations, they perceived that it was well organized and that the time allocated for each station was appropriate. These dental students perceived that the OSCE was a suitable method to test operative dentistry clinical judgment and skills.