Patient satisfaction with occlusal scheme of conventional complete dentures: A randomised clinical trial (part I).

BACKGROUND: Occlusal scheme can affect denture retention, stability, occlusal force distribution, aesthetics, masticatory function, patient comfort and general patient satisfaction with dentures. OBJECTIVES: This study aimed to compare the patient satisfaction with 3 types of complete denture occlusion including fully bilateral balanced occlusion (FBBO), newly presented buccalised occlusion (BO) and lingualised occlusion (LO). METHODS: In this parallel randomised clinical trial, new conventional complete dentures were fabricated for 86 volunteers. Participants were randomly allocated to 3 groups with 3 different occlusal schemes. All patients were recalled at 1 and 3 months after delivery for data collection. The 19-item version of Oral Health Impact Profile for Edentulous Patients questionnaire was used in this study. The visual analogue scale (VAS) was used for assessment of the prosthodontist's attitude towards denture quality, patient's attitude towards different occlusal schemes and evaluation of patient satisfaction. Data were analysed using the Wilcoxon signed rank test, the Kruskal-Wallis test and the post hoc Dunn test via SPSS version 18.0 (P ≤ .05). RESULTS: Eighty-six patients completed the study, and their data were analysed (mean age ± standard deviation = 57.78 ± 9.98 years). The only significant difference when comparing the 3 groups was physical pain, which was significantly higher in FBBO group. No significant differences were found for the VAS scores of patient and prosthodontist satisfaction or the domain scores among the 3 occlusal schemes either at 1 or at 3 months post-delivery. The VAS score of patient satisfaction and prosthodontist satisfaction increased at third compared to first month after delivery. CONCLUSION: The results of this randomised clinical trial provided evidence that BO is as effective as LO for the fabrication of complete dentures.

Prenatal metal exposure in the Middle East: imprint of war in deciduous teeth of children.

In war zones, the explosion of bombs, bullets, and other ammunition releases multiple neurotoxicants into the environment. The Middle East is currently the site of heavy environmental disruption by massive bombardments. A very large number of US military bases, which release highly toxic environmental contaminants, have also been erected since 2003. Current knowledge supports the hypothesis that war-created pollution is a major cause of rising birth defects and cancers in Iraq. We created elemental bio-imaging of trace elements in deciduous teeth of children with birth defects from Iraq. Healthy and naturally shed teeth from Lebanon and Iran were also analyzed for trace elements. Lead (Pb) was highest in teeth from children with birth defects who donated their teeth from Basra, Iraq (mean 0.73-16.74 (208)Pb/(43)Ca ppm, n = 3). Pb in healthy Lebanese and Iranian teeth were 0.038-0.382 (208)Pb/(43)Ca ppm (n = 4) and 0.041-0.31 (208)Pb/(43)Ca ppm (n = 2), respectively. Our hypothesis that increased war activity coincides with increased metal levels in deciduous teeth is confirmed by this research. Lead levels were similar in Lebanese and Iranian deciduous teeth. Deciduous teeth from Iraqi children with birth defects had remarkably higher levels of Pb. Two Iraqi teeth had four times more Pb, and one tooth had as much as 50 times more Pb than samples from Lebanon and Iran.

Is tooth loss associated with irritable bowel syndrome?

Although the relationship between number of teeth and gastric disturbances has been recognised, limited data are available linking tooth loss and irritable bowel syndrome (IBS). This study aimed to investigate the relation between dental status and IBS among Iranian adults. In a cross-sectional study on 4669 Iranian adults, dental status was evaluated using a self-administered questionnaire. Participants were categorised into five main groups: those with full dentition (without denture), those with denture, individual who had lost 1-2 teeth, 3-5 teeth and half of one jaw or more. IBS and its subtypes were defined using Rome III criteria. After adjusting for different confounding variables, those who had lost 1-2 and 3-5 teeth had 1·35 and 1·33 times greater odds for IBS than fully dentate subjects, respectively. After controlling for different confounders, individuals who had denture had 103% greater odds to have constipation-predominant IBS than those with full dentition (95% confidence interval: 1·29-3·21). Neither in crude nor in adjusted models were any significant association between dental status and other subtypes of IBS. In addition, we did not find any association between losing half of one jaw or more and IBS. We found that losing 1-2 or 3-5 teeth might significantly be associated with increased risk of IBS. Having denture might be related to constipation-predominant IBS. There should be further prospective studies to confirm these findings.

Effect of different chemical disinfectants on the flexural strength of heat-polymerized acrylic resins.

The purpose of this study was to evaluate the effect of chemical disinfectants on flexural strength of denture base acrylic resins. A total of 176 rectangular specimens (65x10x3 mm) were made from four heat-polymerized acrylic resins (Triplex,QC-20, Meliodent and Acropars) (n=44). The specimens were thermal cycled for 5000 cycles 5-55 degrees C and randomly divided into four groups (n=11). The specimens were immersed in 1% sodium hypochlorite, 2% glutaraldehyde, 10% Micro 10 or water for 30 minutes. The flexural strength was evaluated using a universal testing machine at a crosshead speed of 5 mm/min. Data were subjected to 2-way ANOVA and Tukey HSD (alpha=0.05). The highest flexural strengths of denture base resins were achieved after immersion in water (Triplex=128.9+/-12.8, QC-20=125+/-11.8, Meliodent=96.2+/-11.4 and Acropars=78.1+/-12.3 MPa). Triplex and QC-20 showed the highest flexural strengths in all of the solutions (P<0.05). The flexural strength of denture base acrylic resins was significantly affected by immersion in disinfection solutions but the reduction in flexural strengths of Triplex, QC-20 and Meliodent after disinfection by %1 sodium hypochlorite, %2 glutaraldhyde and Micro 10 were clinically insignificant.

Metal contamination and the epidemic of congenital birth defects in Iraqi cities.

Between October 1994 and October 1995, the number of birth defects per 1,000 live births in Al Basrah Maternity Hospital was 1.37. In 2003, the number of birth defects in Al Basrah Maternity Hospital was 23 per 1,000 live births. Within less than a decade, the occurrence of congenital birth defects increased by an astonishing 17-fold in the same hospital. A yearly account of the occurrence and types of birth defects, between 2003 and 2011, in Al Basrah Maternity Hospital, was reported. Metal levels in hair, toenail, and tooth samples of residents of Al Basrah were also provided. The enamel portion of the deciduous tooth from a child with birth defects from Al Basrah (4.19 µg/g) had nearly three times higher lead than the whole teeth of children living in unimpacted areas. Lead was 1.4 times higher in the tooth enamel of parents of children with birth defects (2,497 ± 1,400 µg/g, mean ± SD) compared to parents of normal children (1,826 ± 1,819 µg/g). Our data suggested that birth defects in the Iraqi cities of Al Basrah (in the south of Iraq) and Fallujah (in central Iraq) are mainly folate-dependent. This knowledge offers possible treatment options and remediation plans for at-risk Iraqi populations.