Oral health-related quality of life and reasons for discontinuing partial removable dental prosthesis usage: a cross-sectional study with one to seven years of follow-up.

BACKGROUND: In partial edentulous individuals, a partial removable dental prosthesis (PRDP) is a common dental replacement option to improve oral function and quality of life. However, some patients discontinue using their denture over time. The aim of this study was to determine the prevalence and characteristics of partial edentulous patients who no longer wear their dentures, explore their reasons, and assess their oral health-related quality of life (OHRQoL). METHODOLOGY: This cross-sectional study, conducted at Chulalongkorn University Dental School from 2013 to 2019, involved patients who received PRDP treatment. They were contacted via phone calls and asked about their denture usage. Eligible participants were patients who had stopped or rarely used their PRDPs. Data on oral status, health insurance, and PRDP variables were collected from hospital records. Telephone interviews were conducted to collect the initial reasons for seeking PRDP treatment, reasons for discontinuation, desire for a new PRDP, and OHRQoL. The Oral Impacts on Daily Performances index was used to assess the OHRQoL. The score was dichotomized into the absence or presence of oral impacts. Chi-square tests and multivariable binary logistic regression were employed to determine the associations between oral impacts and various factors in the participants who discontinued PRDP usage. RESULTS: Among the 975 contacted participants, 175 (17.9%) discontinued using their PRDPs. Most of these individuals had at least 20 remaining natural teeth and/or 4 posterior occluding pairs. The primary initial reason for seeking PRDP treatment was often based on a dentist's suggestion. Although many participants reported no impact on OHRQoL and did not express the need for new PRDPs, those experiencing oral impacts were more likely to seek replacements. CONCLUSIONS: With up to 7 years follow-up duration, individuals with partial edentulism and sufficient remaining functional dentition without oral impacts were more inclined to discontinue PRDP usage. Those with maxillary anterior teeth loss were less likely to discontinue using their PRDP. The primary initial reason for seeking PRDP treatment was often a dentists' suggestion. However, the individuals reporting oral impacts expressed their needs for new denture replacements. This highlights the significance of incorporating patient needs and preferences in prosthodontic decision-making.

Workflows and Laboratory Cost for Removable Digital Complete Denture: Two Case Reports with and without Existing Denture.

The integration of digital dentistry in the fabrication of complete dentures (CDs) has been facilitated through the use of intraoral scanners and computer-aided design and manufacturing (CAD/CAM). However, the financial implications associated with the fabrication of digital CDs have been rarely explored. This study is aimed at presenting two different approaches to CD fabrication, combining conventional with digital techniques, and comparing the total cost of fabrication. The first case involved a 70-year-old woman without existing denture, while the second case involved a 97-year-old woman with inadequate retention and stability of CDs in both jaws. In the first patient, who lacked information about her old denture, the first approach was employed, utilizing milling technology for denture processing. The second patient, who already had an existing denture, underwent the second approach, which employed printing technology for denture processing. CAD/CAM replicas of the existing dentures were used for the final impression, bite registration, and as a guide for tooth arrangement. Two digital protocols and laboratory cost in CD fabrication have been proposed. The relatively high cost of CAD/CAM CDs restricts the widespread of digital technology in CD fabrication.

Clinician evaluation of removable complete denture quality: A systematic review of the criteria and their measurement properties.

STATEMENT OF PROBLEM: Different criteria have been developed and used for the clinician evaluation of removable complete denture (CD) quality. However, the optimal criteria under a specific clinical or research purpose are unclear. PURPOSE: The purpose of this systematic review was to identify the development and clinical parameters of criteria for the clinician evaluation of CD quality and to evaluate the measurement properties of each criterion. MATERIAL AND METHODS: An electronic search was conducted through PubMed, Scopus, and Cochrane Database of Systematic Reviews from database inception to April 2022. A hand search was conducted based on the references in the included studies. The measurement properties of the included CD quality criteria were assessed based on the consensus-based standards for the selection of health measurement instruments (COSMIN) checklist and a previous study. The articles that supported the measurement properties of the original CD quality criteria were also included. RESULTS: Of the 282 abstracts reviewed, 22 clinical studies were included; 17 original articles that developed a new CD quality criterion and 5 articles that additionally supported measurement properties of the original criterion. There were 18 CD quality criteria with 2 to 11 clinical parameters in each criterion, predominantly denture retention and stability, followed by denture occlusion and articulation, and vertical dimension. Sixteen criteria possessed criterion validity shown by its associations with patient performance or patient-reported outcomes. Responsiveness was reported when a CD quality change was detected after delivery of a new CD, denture adhesive use, or during postinsertion follow-up. CONCLUSIONS: Eighteen criteria have been developed for clinician evaluation of CD quality with various clinical parameters, predominantly retention and stability. None of the included criteria met all measurement properties in the 6 assessed domains, but more than half of them had relatively high-quality assessment scores.

The impact of poor dental status and removable dental prosthesis quality on body composition, masticatory performance and oral health-related quality of life: a cross-sectional study in older adults.

BACKGROUND: To determine the impact of dental status, types, and quality of dental prostheses on body composition, masticatory performance and oral health-related quality of life (OHRQoL). Potential associations between body composition, masticatory performance and OHRQoL were also investigated. METHODS: This cross-sectional study included 110 older adults who received prosthodontic treatment at the Dental Faculty Clinics at Chulalongkorn University. Participants were categorized according to their dental prostheses: complete denture (CD), removable partial denture (RPD) and fixed partial denture (FPD). Retention and stability of the RPD and CD were evaluated using the CU-modified Kapur and the modified NHANES III criteria to classify denture quality into acceptable and unacceptable. Dental status including posterior occluding pairs and number of remaining natural teeth were assessed intraorally. Dependent variables were body composition, masticatory performance and OHRQoL. Body composition, including muscle mass (kg), bone mass (kg), basal metabolic rate (kcal) and visceral fat (%) were determined through a bioelectrical impedance analysis. Masticatory performance was assessed using a multiple sieve method of peanut mastication. OHRQoL was assessed using the validated Thai version of Oral Impacts on Daily Performances (Thai-OIDP) index. After adjusting for covariates, including age and sex, the associations between oral and dental prosthesis status and body composition, masticatory performance as well as OIDP score were analyzed using multivariable linear and negative binomial regression analyses. Spearman's correlation was used to determine the potential associations between body composition, masticatory performance and OHRQoL. RESULTS: The presence of fewer natural teeth or wearing an unacceptable removable denture were factors associated with lower bone mass, muscle mass and basal metabolic rate, and with a higher visceral fat. Similar dental and removable denture status were also associated with larger peanut particle size and higher OIDP score. Masticatory performance and OHRQoL variables were moderately correlated (Spearman's rho = 0.44). However, body composition was not correlated with masticatory performance or OHRQoL. CONCLUSIONS: In individuals wearing dental prostheses, factors such as severity of tooth loss, types, and quality of dental prostheses, particularly retention and stability, negatively impacted not only masticatory function and OHRQoL, but also their overall body composition and health.