Survival analysis of mandibular complete dentures with acrylic-based resilient liners.

OBJECTIVE: The purpose of this long-term randomised controlled trial was to compare the longevity of dentures constructed using a conventional acrylic resin (CAR) to that of dentures constructed using an acrylic-based resilient liner (ARL). MATERIALS AND METHODS: The follow-up study was essentially carried out by annual telephone calls to each of the 67 participants. The Kaplan-Meier method and life-table analysis were used for univariate analyses. The Cox proportional-hazards test was used as a final model for statistically adjusting predictor variables such as sex, clinician type, mandibular denture type and age at denture delivery. RESULTS: The denture type was likely to affect the survival time of the dentures, while the sex and clinician type were not. The group using acrylic-based resilient denture liners had twice the risk of having shorter denture-survival times than those using conventional acrylic resin dentures. Younger participants were likely to have a reduced risk of having shorter denture-survival times than older participants. CONCLUSION: We conclude that mandibular complete dentures constructed using ARL are twice as likely as dentures constructed using CAR to have shorter denture survival times, mainly because of material deterioration.

Multivariate analysis reveals oral health-related quality of life of complete denture wearers with denture adhesives: a multicenter randomized controlled trial.

Purpose To investigate the difference in improvement of oral health-related quality of life (OHR-QoL) depending on the oral and denture conditions of a complete denture wearer when using a cream or powder type denture adhesive in a 10-center parallel randomized clinical trial.Methods Two hundred edentulous subjects who wore complete dentures were allocated to each of the three groups according to denture adhesive type: cream, powder, and control (saline solution). The materials were applied to the mucosal surface of the dentures for 4 days, and baseline data and data after the intervention were collected. OHR-QoL was assessed using the Japanese version of the modified Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT-J) scale for outcome. Multivariate analysis was used to investigate improvements in OHR-QoL according to participant characteristics among complete denture wearers using these materials.Results OHIP-EDENT-J scores were significantly decreased in all groups after the intervention (p < 0.05); however, there were no statistically significant differences among the groups. Multiple logistic regression analysis revealed a significant association between the vertical height of the maxillary and mandibular alveolar ridge and OHIP-EDENT-J scores in the cream-type denture adhesive group. In contrast, there were no significant association between participant characteristics and OHIP-EDENT-J scores in the powder-type adhesive and control groups.Conclusions The use of denture adhesives could improve OHR-QoL for complete denture wearers. The cream-type denture adhesives may be expected to improve OHR-QoL in patients with poor residual ridge conditions compared with patients with good residual ridge conditions.

Effect of denture adhesives on oral moisture: A multicenter randomized controlled trial.

PURPOSE: The purpose of this study was to investigate the effect of denture adhesives on oral moisture in a 10-center parallel randomized clinical trial. METHODS: Two hundred edentulous subjects wearing complete dentures were allocated into three groups: cream-type adhesive, powder-type adhesive and control groups. The adhesives (and saline solution in the control group) were applied to the mucosal surface of the dentures for 4 days, and baseline data and data after the intervention for eight meals over 4 days were obtained. For the main outcome, oral moisture was measured with a moisture checking device. Secondary outcomes were denture satisfaction, masticatory performance, denture retention, and occlusal force. In addition to between-group and within-group comparisons of oral moisture, investigations for secondary outcomes were undertaken in subgroups classified according to the degree of oral moisture at baseline (normal subgroup and dry mouth subgroup). Intention-to-treat analysis was also performed. RESULTS: Between-group and within-group comparisons of oral moisture showed no significant differences. The cream-type and powder-type denture adhesives were significantly effective in the dry mouth group for denture satisfaction ratings of ability to masticate, stability, retention, and comfort of mandibular dentures (p<0.05). The masticatory performance and retentive force of the dry mouth denture adhesive using groups were significantly improved after intervention (p<0.05). CONCLUSIONS: The oral moisture of complete denture wearers was not influenced by the use of denture adhesives. Our findings showed that denture adhesives improved subjective denture satisfaction, masticatory performance, and retention for complete denture patients with oral dryness.

Effects of resilient denture liner in mandibular complete denture on the satisfaction ratings of patients at the first appointment following denture delivery.

PURPOSE: The purpose of this study was to investigate whether edentulous patients with a permanent acrylic resilient liner denture (RLD) in mandibles exhibit significant improvements in their satisfaction ratings at the first appointment following the delivery of RLD dentures when compared to those with conventional heat-activated acrylic resin dentures (ARD) in mandibles. METHODS: Seventy-four subjects were randomly allocated into RLD and ARD groups by a random permuted block within the strata method after written informed consent. A parallel-randomized controlled clinical trial at two centers was conducted from April 2004 to July 2006. The outcomes were satisfaction ratings with a 100 mm visual analog scale (VAS) involving general satisfaction as well as satisfaction related to chewing, speaking, cleaning, stability, retention, comfort, and esthetics. The pain rating was also measured by the VAS. The outcomes were analyzed by Student t-test and Pearson's correlation coefficient. RESULTS: A significant difference between the RLD and ARD group in the maxillary denture was only obtained in the satisfaction rating of speaking. A significant difference between the RLD and ARD groups for the mandibular dentures was obtained in every satisfaction rating. The pain rating of the RLD group was significantly lower than that of the ARD group. The satisfaction ratings of mandibular denture functions significantly correlated with ratings of comfort and pain. CONCLUSION: Despite the limitation of a short-term observation, the mandibular satisfaction ratings were dramatically higher in RLD wearers than in ARD wearers.

Study protocol for a multi-center, randomized controlled trial to develop Japanese denture adhesive guidelines for patients with complete dentures: the Denture Adhesive Guideline trial: study protocol for a randomized controlled trial.

BACKGROUND: Denture adhesives, characterized as medical products in 1935 by the American Dental Association, have been considered useful adjuncts for improving denture retention and stability. However, many dentists in Japan are hesitant to acknowledge denture adhesives in daily practice because of the stereotype that dentures should be inherently stable, without the aid of adhesives. The aim of this study is to verify the efficacy of denture adhesives to establish guidelines for Japanese users. The null hypothesis is that the application of denture adhesives, including the cream and powder types, or a control (isotonic sodium chloride solution) would not produce different outcomes nor would they differentially improve the set outcomes between baseline and day 4 post-application. METHODS: This ten-center, randomized controlled trial with parallel groups is ongoing. Three hundred edentulous patients with complete dentures will be allocated to three groups (cream-type adhesive, powder-type adhesive, and control groups). The participants will wear their dentures with the denture adhesive for 4 days, including during eight meals (three breakfasts, two lunches, and three dinners). The baseline measurements and final measurements for the denture adhesives will be performed on the first day and after breakfast on the fourth day. The primary outcome is a general satisfaction rating for the denture. The secondary outcomes are denture satisfaction ratings for various denture functions, occlusal bite force, resistance to dislodgement, masticatory performance, perceived chewing ability, and oral health-related quality of life. Between-subjects comparisons among the three groups and within-subjects comparisons of the pre- and post-intervention measurements will be performed. Furthermore, a multiple regression analysis will be performed. The main analyses will be based on the intention-to-treat principle. A sample size of 100 subjects per group, including an assumed dropout rate of 10 %, will be required to achieve 80 % power with a 5 % alpha level. DISCUSSION: This randomized clinical trial will provide information about denture adhesives to complete denture wearers, prosthodontic educators, and dentists in Japan. We believe this new evidence on denture adhesive use from Japan will aid dentists in their daily practice even in other countries. TRIAL REGISTRATION: ClinicalTrials.gov NCT01712802 . Registered on 17 October 2012.

Randomized controlled trial investigating the effect of an acrylic-based resilient liner on perceived chewing ability in edentulous patients wearing mandibular complete dentures.

PURPOSE: The aim of this study was to investigate the effect of an acrylic-based resilient liner (ARL) on perceived chewing ability in patients using mandibular complete dentures compared with that of patients using mandibular complete dentures with a conventional acrylic resin (CAR). MATERIALS AND METHODS: This randomized controlled trial was conducted at two centers from April 2004 to July 2006. Seventy-four subjects were randomly allocated to either the ARL or CAR group using a random permuted block method after obtaining written informed consent. A valid questionnaire listing 35 foods was used to evaluate the subjects' perceived chewing ability of each item, assessed according to the following scale: 0=cannot eat, 1=can eat with difficulty, and 2=can eat easily. If subjects did not eat the food because they disliked it or had not eaten it since first wearing dentures, they filled in a triangle or square, respectively. These figures were treated as a 0 during analysis. RESULTS: No significant differences were observed between the ARL and CAR groups. The perceived chewing ability of subjects with new complete dentures was significantly higher than that of those with their old complete dentures. The duration of edentulism was positively associated with perceived chewing ability. CONCLUSIONS: An ARL applied to mandibular complete dentures has no significant impact on the perceived chewing ability of edentulous patients in comparison to a CAR.

The use of existing denture-satisfaction ratings for a diagnostic test to indicate prognosis with newly delivered complete dentures.

PURPOSE: The study investigated the relation between subjective satisfaction ratings of existing dentures and outcomes of newly delivered dentures, and the ability of the diagnostic test, using existing ratings, to indicate prognosis with newly delivered dentures. METHODS: Consecutive 165 edentulous patients were recruited from November 2001 to August 2006 at a university-affiliated hospital. Dentures were fabricated with an acrylic base with full-balanced occlusion using hard resin artificial teeth by multiple prosthodontists. At the baseline and 3-month after delivery, patients rate their overall, maxillary, and mandibular satisfaction for existing and replaced dentures on a 100-mm visual analogue scale (VAS). The association between baseline ratings and newly delivered dentures was analyzed by regression analysis. The test's performance was measured by constructing a two-by-two table; patients with the following cutoff values on the VAS (overall:

Investigation on how renewal of complete dentures impact on dietary and nutrient adequacy in edentulous patients.

PURPOSE: The aim of this study is to investigate changes of diet and nutrient adequacy between complete denture wearers with their existing dentures and those with new dentures. METHODS: After obtained their written informed consent 30 patients who visited Nihon University School of Dentistry at Matsudo Affiliated Hospital from March 2004 to November 2005 were asked to record their 3 consecutive day's meals and to take a picture of them. Furthermore, foods which they can eat with their dentures were examined the questionnaire developed by Hirai. Referring to the obtained records and pictures, one dietitian interviewed to confirm the exact intakes of meals. In addition, the masticatory ability was calculated using the questionnaire. The nutrient adequacy and masticatory score determined at the time of the first and second survey were examined by repeated-measures ANOVA. A p-value less than 0.05 was considered statistically significant. RESULT: The total intake of energy and nutrients was almost over 100% in both the groups. However, no statistically significant difference was obtained. The masticatory score with the existing and new denture were 66.1+/-18.5 and 58.3+/-19.9, respectively. The score increased significantly in the new denture group when compared with that of the existing denture group. CONCLUSION: The self-evaluation of the masticatory function improved after the switch from the old to new dentures.

Prospective clinical trial comparing lingualized occlusion to bilateral balanced occlusion in complete dentures: a pilot study.

PURPOSE: The aim of this prospective comparative trial was to evaluate whether patients treated with complete dentures with lingualized occlusion (LO) exhibited more positive results than patients treated with complete dentures with bilaterally balanced occlusion (BBO). MATERIALS AND METHODS: Twenty-eight completely edentulous patients, ranging in age from 60 to 82 years (mean age 70.9), consented in writing to be participants in this trial. The first 14 patients enrolled in the study protocol were treated with complete dentures with LO, and the next 14 patients were treated with complete dentures with BBO. Baseline characteristics were measured prior to the trial. Main outcome variables involved subjective outcomes of general satisfaction, ability to masticate, and stability and retention of the prostheses; these were quantified with a 100-mm visual analog scale. Objective outcomes were masticatory performance and the number of adjustments. Statistical assessments of the 2 groups were compared using multiple linear regression analysis. The baseline characteristics were analyzed by Student t test and chi-square test. RESULTS: There were no significant differences between the groups at baseline. The height of the alveolar ridge exhibited significant correlations with masticatory performance (P = .02). The occlusal scheme exhibited a significant correlation with only the patient's retention satisfaction rating (P = .03). CONCLUSION: Despite limitations of this study attributed to the small sample size and lack of randomization, this pilot study found that edentulous patients fitted with complete dentures with LO experienced and expressed greater satisfaction with their denture retention. In addition, it was observed that a higher alveolar ridge resulted in greater masticatory performance.