Masticatory performance of different impression methods for complete denture fabrication: A randomized controlled trial.

OBJECTIVES: To compare the effect of conventional complete dentures fabricated using two different impression methods on masticatory performance and factors relating to masticatory performance in a randomized controlled trial. METHODS: A crossover randomized controlled trial was performed with edentulous patients requiring maxillomandibular complete dentures. Mandibular complete dentures were fabricated using two different methods. The conventional method (C) used a custom tray border molded with an impression compound and a silicone. The simplified method (S) used a stock tray and an alginate. Participants were randomly divided into the two groups. In the C-S group, the conventional method was used first, followed by the simplified method; the order was reversed in the SC group. Adjustments were performed four times. The wash out period was 1 month. Masticatory performance as assessed by the mixing of a color-changeable chewing gum (mixing ability). Maximum occlusal force, occlusal contact area, and perceived chewing ability were assessed for each group. RESULTS: Twenty-seven patients underwent randomization and 24 participants completed the trial. With regard to occlusal contact area, the conventional method showed significantly larger occlusal contact area than the simplified method. No significant differences were observed between the two methods regarding mixing ability, maximum occlusal force, and perceived chewing ability. CONCLUSIONS: This study showed that complete dentures fabricated with the conventional method had a significantly larger occlusal contact area than those made using the simplified method. CLINICAL SIGNIFICANCE: Complete dentures fabricated with the conventional method, comprising a preliminary impression using alginate in a stock tray followed by a final impression using silicone impression material in a border molded custom tray, resulted in fewer post-insertion adjustments than the simplified method, potentially contributing to earlier stability of new dentures.

The effect of new complete denture fabrication and simplified dietary advice on nutrient intake and masticatory function of edentulous elderly: A randomized-controlled trial.

BACKGROUND & AIM: Combination of new complete denture fabrication and tailored dietary counseling is necessary to improve nutrient intake of the edentulous elderly. However, there is no evidence on the effect of simple dietary advice combined with new complete denture fabrication on the nutrient intake of the edentulous elderly. The aim of this study was to clarify the combined effect of new complete denture fabrication and simple dietary advice, using a uniform pamphlet, on the nutrient intake and masticatory function of edentulous elderly. The null hypothesis was that there would be no difference in the nutrient intake and masticatory function between edentulous elderly patients provided with simple dietary advice and new complete dentures and those provided with new dentures alone. METHODS: A double-blind, randomized-controlled, parallel clinical trial was performed on the healthy edentulous elderly who were required to fabricate a new pair of complete denture. The participants were randomly divided into two groups, and each group received different advice: the intervention group received simple dietary advice using a uniform pamphlet, whereas the control group received denture care advice. During the process of new complete denture fabrication, two 20-min one-on-one advice sessions were conducted by a dentist. The primary outcome of this trial was protein intake, which was calculated from the responses in the brief-type self-administered diet history questionnaire (BDHQ). Secondary outcome was masticatory function, which was measured with a color-changeable chewing gum and a test gummy jelly. Outcome assessment was conducted twice, at baseline and at 3 months post-treatment. RESULTS: Among 70 participants who were randomized, 62 completed this trial. Protein intake in the intervention group significantly increased compared with that in the control group. Masticatory function was not significantly different between groups, but significantly increased at 3 months post-treatment compared with the baseline in both groups. CONCLUSION: Simple dietary advice using a uniform pamphlet and a new complete denture fabrication increased nutrient intake and masticatory function of healthy edentulous elderly. CLINICAL TRIAL REGISTRATION NUMBER: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000020716 UMIN000017879.

Cost-effectiveness analysis of two impression methods for the fabrication of mandibular complete dentures.

OBJECTIVES: To compare the cost and to evaluate cost-effectiveness of fabricating mandibular complete dentures (CDs) using two different impression methods. METHODS: A crossover randomized controlled trial including 27 edentulous participants was performed. Mandibular CDs were fabricated using two different impression methods, as follows: (i) conventional method using a custom tray border moulded with impression compound and silicone and (ii) simplified method using a stock tray and alginate. Cost analysis was performed from a clinical practitioner's perspective. The total cost included labor cost, which was calculated using the time spent by dentists and technicians in fabricating CDs and their hourly wages, and the material costs, which were calculated using purchase prices. To evaluate cost-effectiveness, we used general patient satisfaction as an indicator of effectiveness and calculated the incremental cost effectiveness ratio (ICER). ICER represents the cost per one unit of effectiveness. RESULTS: The trial was completed by 24 participants. The total cost was 43,904 Japanese Yen (JPY) (330.91 EUR / 395.78 USD) for the conventional method and 39,792 JPY (299.93 EUR / 358.70 USD) for the simplified method, and this difference was statistically significant (p<0.001). The ICER showed a cost of 633 JPY (4.77 EUR / 5.70 USD) for every one point change in general patient satisfaction. CONCLUSIONS: The results indicated that the total cost of the conventional method was significantly higher than that of the simplified method (p<0.001). CLINICAL SIGNIFICANCE: The conventional impression method for fabricating mandibular CDs, which took additional 633 JPY (4.77 EUR / 5.70 USD) for improvement of general satisfaction, is supposed to be clinically meaningful1.

The effect of prosthetic rehabilitation and simple dietary counseling on food intake and oral health related quality of life among the edentulous individuals: A randomized controlled trial.

OBJECTIVE: To investigate the combined effect of complete denture renewal and simple dietary advice. METHODS: A randomized controlled trial was performed with edentulous patients who required new complete dentures. All participants received complete denture treatment. In addition, the intervention group received dietary advice in a pamphlet form, while the control group received advice pertaining to the care and maintenance of the dentures. The advice was given by dentists for each group. The participants' food intake was assessed at baseline and 3 months after intervention using a diet history questionnaire and an oral health related quality of life assessment measured using the Japanese version of the Oral Health Impact Profile for edentulous people (OHIP-EDENT-J). RESULTS: Among 70 participants who were randomized, 62 participants finished all parts of this trial. At baseline, there was no significant difference in the food intake between the two groups. At the 3-month assessment, the intervention group showed significantly greater intake of chicken (P=0.013), fish with bones (P=0.012), and carrots and pumpkins (P=0.025) compared to the control group. However, at baseline and at the 3-month assessment, there was no significant difference in the OHIP-EDENT-J scores between the groups, but the OHIP-EDENT-J scores significantly improved for both groups at the 3-month assessment. There were more significant improved dimensions of OHIP-EDENT-J in the intervention group than in the control group at the 3-month assessment. CONCLUSIONS: Simple dietary advice combined with complete denture treatment could improve food intake of edentulous patients. CLINICAL SIGNIFICANCE: The present study suggests that brief dietary advice provided by dentists can improve food intake of edentulous elderly. This simply diet advice is much easier compared to customized forms, might enable normal dentists provide patients it. The result of this study broadens possibility of nutritional counseling in daily clinical practice.

Combined effect of new complete dentures and simple dietary advice on nutritional status in edentulous patients: study protocol for a randomized controlled trial.

BACKGROUND: Individuals who are edentulous have a lower intake of fruit, vegetables, fiber, and protein compared with their dentate counterparts because tooth loss is accompanied by a decrease in ability to chew. Whether or not a combination of prosthetic rehabilitation and simple dietary advice produces improvement in dietary intake among edentulous persons is unclear. We aim to investigate the effect of a simultaneous combination of simple dietary advice delivered by dentists and provision of new complete dentures on dietary intake in edentulous individuals who request new dentures. METHODS/DESIGN: Through a double-blinded, parallel, randomized controlled trial in which 70 edentate persons who request new complete dentures will be enrolled, eligible study participants will be randomly allocated to either a dietary intervention group receiving dietary advice or to a control group receiving only advice on the care and maintenance of dentures. Outcome measures include daily intake of nutrients and food items, assessed using a brief self-administered diet history questionnaire; antioxidant capacity, determined using blood and urine samples; nutritional status, assessed with the Mini-Nutritional Assessment-Short Form; oral health-related quality of life, assessed with the Japanese version of the Oral Health Impact Profile-EDENT and the Geriatric Oral Health Assessment Index; subjective chewing ability; masticatory performance, assessed using a color-changeable chewing gum and a gummy jelly; patient self-assessment of dentures; mild cognitive impairment, assessed with the Japanese version of the Montreal Cognitive Assessment; and functional capacity, assessed with the Japan Science and Technology Agency Index of Competence. Outcome measures, except for antioxidant capacity, are to be implemented at three time points: at baseline and at 3 and 6 months following intervention. Antioxidant capacity data are to be collected twice: at baseline and at 3 months following intervention. Differences between the groups at 3 and 6 months and within-group changes are to be compared using the paired t test. DISCUSSION: Simple dietary advice that can be implemented by a dentist would be more practical in clinical practice than tailored dietary counseling. The results of this study will provide beneficial information on dietary intake changes for both edentulous individuals requesting new complete dentures and dentists. TRIAL REGISTRATION: University Hospital Medical Information Network Center Unique Trial Number: UMIN000017879 . Registered on 12 June 2015.

A randomized controlled trial of the different impression methods for the complete denture fabrication: Patient reported outcomes.

OBJECTIVES: To compare the effect of conventional complete dentures (CD) fabricated using two different impression methods on patient-reported outcomes in a randomized controlled trial (RCT). METHODS: A cross-over RCT was performed with edentulous patients, required maxillomandibular CDs. Mandibular CDs were fabricated using two different methods. The conventional method used a custom tray border moulded with impression compound and a silicone. The simplified used a stock tray and an alginate. Participants were randomly divided into two groups. The C-S group had the conventional method used first, followed by the simplified. The S-C group was in the reverse order. Adjustment was performed four times. A wash out period was set for 1 month. The primary outcome was general patient satisfaction, measured using visual analogue scales, and the secondary outcome was oral health-related quality of life, measured using the Japanese version of the Oral Health Impact Profile for edentulous (OHIP-EDENT-J) questionnaire scores. RESULTS: Twenty-four participants completed the trial. With regard to general patient satisfaction, the conventional method was significantly more acceptable than the simplified. No significant differences were observed between the two methods in the OHIP-EDENT-J scores. CONCLUSIONS: This study showed CDs fabricated with a conventional method were significantly more highly rated for general patient satisfaction than a simplified. CLINICAL SIGNIFICANCE: CDs, fabricated with the conventional method that included a preliminary impression made using alginate in a stock tray and subsequently a final impression made using silicone in a border moulded custom tray resulted in higher general patient satisfaction. TRIAL REGISTRATION: UMIN000009875.