Translation, cross-cultural adaptation, and validation of the Liverpool Oral Rehabilitation Questionnaire (LORQ) into the Dutch language.

STATEMENT OF PROBLEM: The Liverpool Oral Rehabilitation Questionnaire (LORQ) is a health-related quality of life instrument assessing the impact of oral rehabilitation on patients' health-related quality of life. Because a validated Dutch version of the LORQ is not available, the questionnaire cannot be used in the Netherlands. PURPOSE: The purpose of this study was to translate and adapt the LORQv3 into a Dutch-language version and to evaluate the internal consistency, reliability, and validity of the resulting LORQv3-NL. MATERIAL AND METHODS: The original English-language LORQv3 was translated into Dutch via the forward-backward approach. The reliability and construct validity of the LORQv3-NL was tested on a sample of 158 participants. The participants were enrolled at the dental faculty of Radboudumc, at the Centre for Special Oral Care of the Radboudumc and Maastricht UMC+, and in general practices. Internal consistency was assessed by calculating the Cronbach α, and the test-retest reliability (n=34; 2-week interval) was assessed by weighted kappa coefficient. Furthermore, convergent validity was measured by comparing the outcomes with those of the Dutch version of the Oral Health Impact Profile 14-item (OHIP-NL14) (n=17), and patients with head and neck cancer (n=25) were added to test discriminative validity. RESULTS: Internal consistency and test-retest reliability were satisfactory (Cronbach α=0.75-0.89; intraclass correlation coefficient=0.89). In addition, all associations were in the expected direction. CONCLUSIONS: The LORQv3-NL appears to be a good tool for assessing denture complaints and denture incompatibility.

Clinical studies of fiber-reinforced resin-bonded fixed partial dentures: a systematic review.

In the past decade, follow-up studies on fiber-reinforced composite fixed partial dentures (FRC FPDs) have been described. Combining the results of these studies to draw conclusions about the effectiveness of FRC FPDs is challenging. The objective of this systematic review was to obtain survival rates of FRC FPDs and to explore the relationships between reported survival rates and risk factors. In a literature-selection procedure on the clinical performance of FRC FPDs, 15 studies, reporting on 13 sets of patients, were analyzed. The Kaplan-Meier estimate of the overall survival, based on the data from all sets of patients (n = 435) was 73.4% (69.4-77.4%) at 4.5 yr. Converted survival rates at 2 yr of follow-up showed substantial heterogeneity between studies. It was not possible to build a reliable regression model that indicated risk factors. The technical problems most commonly described were fracture of the FPD and delamination of the veneering composite.

Fiber-reinforced dental composites in beam testing.

OBJECTIVES: The purpose of this study was to systematically review current literature on in vitro tests of fiber-reinforced composite (FRC) beams, with regard to studies that followed criteria described in an International Standard. The reported reinforcing effects of various fibers on the flexural strength and elastic modulus of composite resin beams were analyzed. SOURCES: Original, peer reviewed papers, selected using Medline from 1950 to 2007, on in vitro testing of FRC beams in comparison to non-reinforced composite beams. Also information from conference abstracts (IADR) was included. DATA: With the keywords (fiber or fibre) and (resin or composite) and (fixed partial denture or FPD), the literature search revealed 1427 titles. Using this strategy a broad view of the clinical and non-clinical literature on fiber-reinforced FPDs was obtained. Restricting to three-point bending tests, 7 articles and 1 abstract (out of 126) were included. Finally, the data of 363 composite beams were analyzed. The differences in mean flexural strength and/or modulus between reinforced and unreinforced beams were set out in a forest plot. Meta-regression analyses were performed (single and multiple regression models). CONCLUSIONS: Under specific conditions we have been able to show that fibers do reinforce resin composite beams. The flexural modulus not always seems to increase with polyethylene-reinforcement, even when fibers are located at the tensile side. Besides, fiber architecture (woven vs. unidirectional) seems to be more important than the type of fiber for flexural strength and flexural modulus.

Further delineation of the KBG syndrome phenotype caused by ANKRD11 aberrations.

Loss-of-function variants in ANKRD11 were identified as the cause of KBG syndrome, an autosomal dominant syndrome with specific dental, neurobehavioural, craniofacial and skeletal anomalies. We present the largest cohort of KBG syndrome cases confirmed by ANKRD11 variants reported so far, consisting of 20 patients from 13 families. Sixteen patients were molecularly diagnosed by Sanger sequencing of ANKRD11, one familial case and three sporadic patients were diagnosed through whole-exome sequencing and one patient was identified through genomewide array analysis. All patients were evaluated by a clinical geneticist. Detailed orofacial phenotyping, including orthodontic evaluation, intra-oral photographs and orthopantomograms, was performed in 10 patients and revealed besides the hallmark feature of macrodontia of central upper incisors, several additional dental anomalies as oligodontia, talon cusps and macrodontia of other teeth. Three-dimensional (3D) stereophotogrammetry was performed in 14 patients and 3D analysis of patients compared with controls showed consistent facial dysmorphisms comprising a bulbous nasal tip, upturned nose with a broad base and a round or triangular face. Many patients exhibited neurobehavioural problems, such as autism spectrum disorder or hyperactivity. One-third of patients presented with (conductive) hearing loss. Congenital heart defects, velopharyngeal insufficiency and hip anomalies were less frequent. On the basis of our observations, we recommend cardiac assessment in children and regular hearing tests in all individuals with a molecular diagnosis of KBG syndrome. As ANKRD11 is a relatively common gene in which sequence variants have been identified in individuals with neurodevelopmental disorders, it seems an important contributor to the aetiology of both sporadic and familial cases.

Intraoral-extraoral combination prosthesis: improving retention using interconnecting magnets.

Osseointegrated implants have been well documented for retaining an obturator prosthesis as well as a facial prosthesis. However, when the defect extends to both the facial area and the maxilla, it is difficult to rehabilitate those defects to the satisfaction of the patient, especially in cases where implants cannot be placed on both sites. This case report describes the use of magnets to connect two prostheses, thereby increasing retention and patient comfort.

Variability in dentofacial phenotypes in four families with WNT10A mutations.

This article describes the inter- and intra-familial phenotypic variability in four families with WNT10A mutations. Clinical characteristics of the patients range from mild to severe isolated tooth agenesis, over mild symptoms of ectodermal dysplasia, to more severe syndromic forms like odonto-onycho-dermal dysplasia (OODD) and Schöpf-Schulz-Passarge syndrome (SSPS). Recurrent WNT10A mutations were identified in all affected family members and the associated symptoms are presented with emphasis on the dentofacial phenotypes obtained with inter alia three-dimensional facial stereophotogrammetry. A comprehensive overview of the literature regarding WNT10A mutations, associated conditions and developmental defects is presented. We conclude that OODD and SSPS should be considered as variable expressions of the same WNT10A genotype. In all affected individuals, a dished-in facial appearance was observed which might be helpful in the clinical setting as a clue to the underlying genetic etiology.

Five-year survival of 3-unit fiber-reinforced composite fixed partial dentures in the posterior area.

OBJECTIVES: The purpose of this clinical study was to evaluate the long-term outcome of three-unit posterior fixed partial dentures (FPDs) made of fiber-reinforced resin composite (FRC), and to identify design factors influencing the survival rate. METHODS: 77 patients (52 females, 25 males) received 96 indirectly made FRC FPDs, using pre-impregnated unidirectional glass-fibers, requiring manual wetting, as framework material. FPDs were surface (n=31) inlay (n=45) or hybrid (n=20) retained and mainly located in the upper jaw. Hybrid FPDs consisted of a wing retainer at canine and an inlay retainer at distal abutment tooth. Surface FPDs consisted of uplay and wing combinations. Follow-up period was at minimum 4.5 years, with checkups at every 1-2 years. The study was carried out by six operators in three centers in the Netherlands, Finland and Sweden. Survival rates, including reparable defects of FPDs, and success rates were determined. RESULTS: Kaplan-Meier survival rate at 5 years was 71.2% (SE 4.8%) for success and 77.5% (SE 4.4%) for survival. Differences were not significantly different. Main failure modes were delamination and fracture of the FPD. Only FPDs with surface retainers showed debonding. CONCLUSIONS: A success rate of 71% and a survival rate of 78% after 5 years was found. Survival rates of inlay, hybrid and surface retained FPDs did not significantly differ.

Five-year survival of 3-unit fiber-reinforced composite fixed partial dentures in the anterior area.

OBJECTIVES: The purpose of this clinical study was to evaluate the long-term outcome of 3-unit anterior fixed partial dentures (FPDs) made of fiber-reinforced resin composite (FRC), and to identify design factors influencing the survival rate. METHODS: 52 patients (26 females, 26 males) received 60 indirectly made FRC FPDs, using pre-impregnated unidirectional glass fibers, requiring manual wetting, as framework material. FPDs were surface (n=48) or hybrid (n=12) retained and mainly located in the upper jaw. Hybrid FPDs had a combination of retainers; i.e. crown at one and surface retention at the other abutment tooth. Surface FPDs were either purely adhesively retained (n=29) or with additional mechanical retention (n=19). Follow-up period was at minimum 5 years, with check-ups every 1-2 years. Six operators were involved, in three centers in the Netherlands, Finland and Sweden. Survival rates, including repairable defects of FPDs, and success rates were determined. RESULTS: Kaplan-Meier survival rate at 5 years was 64% (SE 7%). For the level of success, values were 45% (SE 7%) and the estimated median survival time 58 (SE 10.1) months. For surface FPDs, additional mechanical retention did not improve survival significantly. There was a trend towards better survival of surface FPDs over hybrid FPDs, but differences were not significant. Main failure modes were fracture of the FPD and delamination of veneering composite. SIGNIFICANCE: A success rate of 45% and a survival rate of 64% after 5 years was found. Fracture of the framework and delamination are the most prevalent failure modes, especially for surface FPDs.