Clinical outcomes of milled, 3D-printed, and conventional complete dentures in edentulous patients: A systematic review and meta-analysis.

PURPOSE: This systematic review aims to compare clinical outcomes of digital dentures with conventional dentures. MATERIALS AND METHODS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in Prospero. The formulated population, intervention, comparison, outcome (PICO) question was "What is the clinical outcome of digital versus conventional complete dentures (CDs) in edentulous patients?". The search strategy used three main electronic databases and an additional manual search was completed in August 2023 by following an established search strategy. Initial inclusion was based on titles and abstracts, followed by a detailed review of selected studies, and clinical studies that evaluated the clinical outcome of digital (milled or 3D-printed) versus conventional CDs were included. A qualitative analysis for clinical studies was used to assess the risk of bias. The certainty of the evidence was assessed according to the grading of recommendations, assessment, development, and evaluations (GRADE) system. In addition, a single-arm meta-analysis was performed to evaluate the retention between digital versus conventional CDs. RESULTS: The initial search yielded a total of 947 articles, out of which 19 were selected for a comprehensive review, and six met the eligibility criteria to be included in this systematic review. The computer-aided design and computer-aided manufacturing (CAD-CAM) CDs showed increased retention, no relevant differences in oral health-related quality of life (OHRQoL), and shorter working time compared to conventional dentures. Two studies were eligible for meta-analysis; retention was significantly better among CAD-CAM fabricated dentures (standardized mean difference [SMD] 0.501) than conventional dentures. The heterogeneity between studies was high (95% CI: 0.049-0.952). CONCLUSIONS: Clinically, both the milled and the 3D-printed CD fared better than conventional dentures in terms of retention, reduction in the number of appointments, improved patient comfort, and improved predictable maintenance of the denture. Patients' perceptions and satisfaction were independent of the digital and conventional fabricated dentures.

Complete dentures associated with frailty among edentulous older Japanese people: A prospective analysis.

OBJECTIVE: This study aimed to explore the cross-sectional and prospective associations between self-reported functionality of complete dentures (FCD), satisfaction with complete dentures (SCD) and the ability to chew hard food (ACHF) on the one hand and the frailty index (FI) on the other hand among edentulous community-dwelling older Japanese people. METHODS: The study examined 770 edentulous participants of the Nihon University Japanese Longitudinal Study of Aging. The self-reported FCD, SCD and ability to chew six groups of food (from hardest to softest) with complete dentures were the independent variables at the baseline. The FI was computed including 40 deficits as the dependent variable at the baseline and 4 years later. Cross-sectional and prospective generalized linear regression models were fitted controlling for age, gender, marital status, education, working status and area of residence. RESULTS: The use of non-functional complete dentures and dissatisfaction with complete dentures were both associated with a higher FI cross-sectionally (3.9% [95% CI 2.2-5.6] and 3.2% [95% CI 1.5-4.9], respectively) and prospectively (3.9% [95% CI 2.0-6.0] and 3.3% [95% CI 1.3-5.3], respectively). Regarding the ability to chew, a higher FI at baseline was observed among those able to chew food of Group 2 (1.9%, [95% CI 0.1-3.7]) and Groups 4-6 (1.9%, [95% CI 0.1-3.7]), and a progressive increment in the FI, as the participants reported being able to chew softer groups of food at the follow-up (Group 2: 2.2% [95% CI 0.05-4.3]; Group 3: 3.6% [95% CI 1.2-6.0]; and Groups 4-6: 3.4 [95% CI 0.7-6.1]). CONCLUSION: Self-reported use of non-functional complete dentures, dissatisfaction with dentures and a reduced ACHF with complete dentures were associated with a higher FI both cross-sectionally and prospectively.

Evaluation and comparison of patient satisfaction with VertexThermosens and conventional acrylic complete dentures.

OBJECTIVES: Patient perception and satisfaction with dentures are important indicators in prosthodontic treatment. This study aimed to compare patients' satisfaction with VertexThermosens dentures versus conventional acrylic dentures during a 12-month study period. MATERIAL AND METHODS: This randomized study involved 60 participants aged between 45 and 80 with representation of both sexes. The patients were divided into two groups: The first group (experimental group), which had complete dentures from VertexThermosens base material included 30 participants. The second group (control group), which had complete dentures from convectional rigid acrylic base material, included 30 participants. Patient satisfaction with the dentures was assessed in each of the two Vertex/Acrylic groups through a specially created questionnaire of five questions with a five-point Likert scale of possible answers (0 = never; 1 = rarely; 2 = occasionally; 3 = often; and 4 = very often). RESULTS: After 12 months, intergroup comparison with Mann-Whitney U Test related to Q2 (p = 0.193), Q3 (p = 0.960), Q4 (p = 0.317), Q5 (p = 1.000) patient satisfactions indicated that there was no significant difference between the two groups (Vertex/Acrylic), except  Q1 (p = 0.010) question, Vertex group was more satisfied. The results regarding the patients of both groups (Vertex/Acrylic) showed that after 12 months of wearing the denture, the satisfaction level regarding to all questions increased, except Q5-question for Vertex group, where the difference was not significant due to the already achieved maximum satisfaction at zero time. CONCLUSION: Based on the findings of this clinical study, it can be concluded that higher satisfaction is seen in patients rehabilitated with VertexThermosens dentures than with conventional rigid acrylic dentures.

Association of Salivary Cortisol With Anxiety in Type 2 Diabetes Mellitus Patients Before and After Complete Denture Rehabilitation: An In-Vivo Analysis.

Background Complete edentulism negatively impacts emotional, physical, social, and psychological well-being, leading to a decline in quality of life and heightened stress and anxiety. Stressful situations associated with edentulism can elevate cortisol levels, potentially increasing the risk of diabetes. Rehabilitation with complete dentures needs careful evaluation for its impact on general health, considering stress points and systemic effects. This study aimed to assess salivary cortisol levels in type 2 diabetes mellitus patients before and after complete denture rehabilitation, highlighting the intricate relationship between diabetes, cortisol, and the stress response. Methods This is a cross-sectional study centered on individuals with diabetes who were completely edentulous and undergoing evaluation by the outpatient prosthodontic department. Glycated hemoglobin, anxiety levels, and the fabrication of complete dentures were all accomplished with the participants' consent. Patients underwent evaluations before and one month after receiving complete denture rehabilitation. Results An absolute correlation between salivary cortisol levels and anxiety may be established because anxiety levels dramatically decreased during complete denture rehabilitation. Conclusion By learning how the patient's general health is related to their new set of complete dentures and how to correlate that information with dental rehabilitation, professionals can help patients better adapt to their new set of dentures.

Tooth-Supported Overdentures Revisited.

The goal of prosthodontics is to provide a functional prosthesis to restore aesthetics, functions, and masticatory efficiencies. Tooth-supported overdentures are one of the treatment options for removable dentures. This article aims to discuss the advantages and disadvantages of tooth-supported overdentures and the principles of using various overdenture attachments, including non-attachment overdentures. The common treatment options in preparing the overdenture abutment are either with or without abutment coping with or without attachment systems, which were discussed and illustrated. A range of tooth-supported overdenture systems were addressed, from low to high financial implications and treatment complexities. The clinician can choose a system that best fits the patient's condition and expectations. This allows clinicians to decide and consider tooth-supported overdentures as a treatment option before full edentulism. A well-executed tooth-supported overdenture ensures the preservation of alveolar bone, optimizes patient satisfaction in denture treatment, and eventually improves the patient's adaptation when transitioning to complete dentures.

Fabrication of complete dentures for an older patient with mobility impairment in three appointments: A dental technique.

OBJECTIVE: To describe the clinical procedures of complete denture set fabrication in three appointments. BACKGROUND: Simplified approaches have proven not to be inferior to conventional ones in terms of quality, patient satisfaction and masticatory ability. MATERIALS AND METHODS: The patient was a 77-year-old edentulous adult with mobility impairment seeking dental rehabilitation in a small number of appointments due to commuting difficulties. RESULTS: A set of complete dentures was delivered within three appointments. The second appointment was dedicated to set-up trial due to the patient's aesthetic demands. CONCLUSION: Under certain circumstances and after a thorough study of each case, dental clinicians may propose the fabrication of complete dentures in a three-appointment protocol incorporating a set-up trial session.

Effect of Duplication Techniques on the Fitting Accuracy of CAD-CAM Milled, 3D-Printed, and Injection-Molded Mandibular Complete Denture Bases.

BACKGROUND: Digital technology has been introduced in prosthodontics, and it has been widely used in denture duplication instead of a conventional denture duplication technique. However, research comparing different denture duplication techniques and how they affect the fitting accuracy of the denture base is scarce. OBJECTIVES: The aim was to assess the impact of duplication techniques on the accuracy of the fitting surface of computer-aided design and manufacturing (CAD-CAM) milled, 3D-printed, and injection-molded complete denture bases (CDBs). METHODOLOGY: This study involved fabricating a mandibular complete denture base with three marked dimples as reference marks (A, B, and C at the incisive papilla, right molar, and left molar areas) using a conventional compression molded technique. This denture was then scanned to generate a standard tessellation language (STL) file; after that, it was duplicated using three different techniques (milling, 3D printing, and injection molding) and five denture base resin materials-two milled CAD-CAM materials (AvaDent and IvoBase), two 3D-printed materials (NextDent and HARZ Labs), and one injection-molded material (iFlextm). Based on the denture base type, the study divided them into five groups (each with n = 10). An evaluation of duplication accuracy was conducted on the fitting surface of each complete denture base (CDB) using two assessment methods. The first method was a two-dimensional evaluation, which entailed linear measurements of the distances (A-B, A-C, and B-C) between reference points on both the scanned reference mandibular denture and the duplicated dentures. Additionally, a three-dimensional superimposition technique was employed, involving the overlay of the STL files of the dentures onto the reference denture's STL file. The collected data underwent statistical analysis using a one-way analysis of variance and Tukey's pairwise post hoc tests. RESULTS: Both evaluation techniques showed significant differences in fitting surface accuracy between the tested CDBs (p ˂ 0.001), as indicated by one-way ANOVA. In addition, the milled CDBs (AvaDent and IvoBase) had significantly higher fitting surface accuracy than the other groups (p ˂ 0.001) and were followed by 3D-printed CDBs (NextDent and HARZ Labs), while the injection-molded (iFlextm) CDBs had the lowest accuracy (p ˂ 0.001). CONCLUSIONS: The duplication technique of complete dentures using a CAD-CAM milling system produced superior fitting surface accuracy compared to the 3D-printing and injection-molded techniques.

A comparative evaluation of physical properties of CAD/CAM complete denture resins- an in vitro study.

BACKGROUND: In dentistry, there is a growing preference for computer-aided design and computer-aided manufacturing (CAD/CAM) systems over traditional laboratory procedures. However, there is not much literature comparing various CAD/CAM materials. Thus, this study aimed to assess and compare the color stability and hardness of gingival and tooth colored milled and 3D-printed acrylic resins. MATERIALS AND METHODS: Four types of CAD/CAM materials were prepared: 3D-printed pink shade (PP), milled polymenthymethacrylate (PMMA) pink shade (MP), 3D-printed tooth shade (PT) and milled PMMA tooth shade (MT) (n = 6). For hardness, disc shaped samples of 15 mm × 2 mm and for color stability, bar shaped samples of 65mmx10mmx2.5 mm were prepared and polished. Vickers hardness test was performed in a microhardness tester. Color stability test was done by immersing in coffee solution and coca cola for 7 days. Day 0 and day 7 measurements were recorded using a digital spectrophotometer and the change in color was calculated. For statistical analysis, one-way ANOVA and Tukey's post hoc tests were done. RESULTS: For color stability, milled PMMA was superior to 3D-printed resin samples. Milled pink and tooth shade samples had similar color stability, whereas 3D-printed tooth shade samples were more color stable as compared to pink shade 3D-printed samples. For hardness, milled tooth shade PMMA was the most superior one, followed by 3D-printed tooth shade, whereas pink shade milled PMMA and 3D-printed resin samples had similar hardness values and were inferior to the tooth shade CAD/CAM materials. CONCLUSION: Color stability of milled PMMA is superior to that of 3D-printed resins. Hardness of tooth shade milled and 3D-printed resins is more than that of pink shade milled and 3D-printed resins.

Denture care and oral health-related quality of life among complete denture wearers in Eastern Province of Saudi Arabia.

INTRODUCTION: This study aimed to evaluate denture care and hygiene and oral health-related quality of life (OHRQoL) among complete denture (CD) wearers in the Eastern Province of Saudi Arabia. METHODOLOGY: This cross-sectional study was conducted on CD wearers in the Eastern Province of Saudi Arabia. A pre-tested questionnaire was administered among study participants. Questionnaire was divided in three sections: (1) patients' demographic data, (2) awareness and maintenance of CD and (3) OHRQoL. Independent sample t-test and one-way ANOVA test were performed. RESULTS: The study included data of 300 participants with 71% of males and 28% of females. Majority of participants (82.7%) cleaned CD daily, removed CD while sleeping (88.0%) and knew that unhygienic dentures can cause oral infection (92.7%). Only 19.3% used denture cleansing tables, 41% used toothpaste, and 60.7% rinsed CD with water. Regarding OHIP-DENT domains, highest score was for functional limitation domain (2.20 ± 1.67) and the lowest for handicap domain (0.94 ± 1.09). The mean OHIP-DENT score of the sample was 12.02 ± 8.52. Females (p = 0.006), participants below 65 years of age (p = 0.029), non-Saudis (p = 0.042), those with university education (p = 0.030) and low monthly income (p = 0.045) and participants who visited dentist due to problem with CD (p = 0.041) demonstrated significantly higher mean OHIP-DENT score. CONCLUSION: Majority of participants demonstrated appropriate denture care behaviours because they were aware of the importance of denture care and hygiene. Female gender, age below 65 years, non-Saudi nationality, university education, low monthly income and visiting dentist due to problem were related to poor OHRQoL.

Retention and Patient Satisfaction of Conventional Over Simplified Non-Balanced Maxillary Removable Complete Dentures.

AIM: Insufficient evidence is available in quantifying the retention between simplified and conventional non-balanced dentures. The aim of the study was to quantify and compare the maxillary denture retention and patient satisfaction between conventional and simplified removable non-balanced complete dentures. METHOD: This randomized clinical trial recruited 44 patients (n=22) with definitive criteria. Simplified and conventional non-balanced complete dentures were fabricated for the intervention groups. The denture retention of maxillary complete dentures was assessed with a dynamometer and patient satisfaction with a visual analogue scale. The mean retention of maxillary denture and satisfaction were recorded at 0-,3-, and 6 - month intervals. The data were statistically analyzed. (α=.05). RESULTS: The mean ±SD of retention for conventional denture at 0, 3, and 6 months by dynamometer ranged from 122 ± 1.64 N to 121 ± 1.57 N and 111 ±1.45N to 110±1.97 N for the simplified denture. The mean ±SD of visual analogue score varied between 9.45±0.35 to 7.19± 0.69 for conventional dentures and 8.00 ±1.39 to 6.81±0.82 for simplified dentures. The repeated ANOVA, t-test and post-hoc Bonferroni revealed statistically significant differences between the two types of denture. (P⟨.05) Conclusion: Numerical retention and satisfaction were higher in conventional non-balanced dentures than simplified dentures.

Current Trends In Complete Denture Education In Undergraduate Dental Colleges Of Pakistan.

Objective: To determine the current trends in complete denture education in undergraduate dental colleges. METHODS: The survey-based study was conducted in April and May 2020 at undergraduate dental colleges of Pakistan, and comprised heads of the Prosthodontics Department at all dental colleges across Pakistan having at least one batch of final year dental students. Data was collected using an online predesigned questionnaire that explored theoretical and practical teaching patterns of complete denture prosthodontics in the undergraduate years, and the materials and practices of students when constructing complete dentures in the clinics. The participants were given the option of choosing more than one option where needed. Data was analysed using SPSS 23. RESULTS: Of the 49 subjects approached, 40(81.6%) returned the forms duly filled; 11(27.5%) from public-sector institutions and 29(72.5%) from the private sector. There were 26(65%) institutions which required that their undergraduate students fabricate 2-4 conventional complete dentures. In all 40(100%) colleges, faculty gave live clinical demonstrations before students fabricated conventional complete dentures in the outpatient departments. Teaching strategy included small group discussions in 25(62.5%) institutions. Green stick 40(100%), zinc oxide eugenol 40(100%) and impression compound 39(97.2%) were the materials of choice for various steps of impression making. In all the 40(100%) institutions, students fabricated conventional complete dentures during their prosthodontics rotation. Immediate, copy and overdentures were constructed by students in 8(20%), 3(7.5%) and 8(20%) institutions, respectively. Conclusion: Majority of the dental schools used similar impression materials and techniques for fabricating conventional complete dentures. Didactic teaching of conventional and unconventional complete dentures was being carried out at a huge majority of the dental institutions studied.

Comparative Evaluation of Hardness and Energy Absorption of Some Commercially Available Chairside Silicone-Based Soft Denture Liners and a Heat-Cured Soft Denture Liner.

Aim: To investigate the hardness and energy absorption of four commercially available chairside types of silicone materials and compare their properties with heat-cured silicone material. Materials: The chairside materials investigated were GC reline soft, mucopren soft, sofreliner soft and elite soft relining. The heat-cured polymer silicone material was Molloplast B. All soft lining materials were processed according to manufacturers' instructions. Two properties were investigated. Ten specimens for each test were prepared for each soft liner except for the water absorption and solubility test, for which only five specimens were prepared. The specimens of energy absorption (10 × 10 × 3 mm) were tested using a Lloyd instruments testing machine. Hardness specimens (38 × 38 × 3) were tested using a shore A durometer and were divided into two subgroups; dry and wet storage. Results: The specimens of energy absorption (10 × 10 × 3 mm) were tested using a Lloyd instruments testing machine. Sofreliner soft was significantly softer than Molloplast B. GC reline soft was significantly harder than molloplast B. At high loads, sofreliner soft and elite soft relining was significantly more resilient than molloplast B. Mucopren soft was significantly stiffer than Molloplast B. At low loads, all materials showed similarities in stiffness and resilience; the difference between them was insignificant. After one month of immersion, GC reline and mucopren significantly increased hardness values. Conclusion: In all conditions and at all four-time points, the hardness values for GC Reline soft were the greatest, and hardness values for Sofreliner Soft were the least. Some chairside soft denture lining materials could have similar significant properties to molloplast-B, such as sofreliner soft and elite.

A randomized controlled trial assessing denture adhesive efficacy on denture retention across 13 hour.

PURPOSE: To compare the effects of two denture adhesive formulations on the bite force required to dislodge a maxillary denture in adult participants during a 13-h test period. MATERIALS AND METHODS: Twenty-two participants with a fair-to-poor fitting maxillary denture opposed by natural dentition or a stable mandibular denture were enrolled in this single-center, randomized, double-blind, two-treatment, 4-period crossover study. Participants were randomly assigned a product usage sequence so that each participant used each product twice during the 4-day test period. The test product was a denture cream adhesive formulated with an optimized calcium/zinc partial salt of polyvinyl methyl ether/maleic acid (Fixodent Ultra technology); the control product was a cream adhesive formulated with a calcium/zinc partial salt of polyvinyl methyl ether/maleic acid (Fixodent Original technology). On each study day, bite force at dislodgement was measured with a gnathodynamometer at baseline, representing the "no adhesive" score. Then, after standardized product application to the participant's existing maxillary denture by site staff, bite force measurements were retaken at 1, 3, 5, 7, 9, 11, and 13 h. The change from baseline and the 13-h area under the bite-force-change-from-baseline curve were analyzed via an analysis of variance. RESULTS: Twenty-one participants completed all test periods; one additional participant completed three test periods so 22 participants were included in the analysis. There were 15 females and 7 males with a mean age of 70 years. The mean 13-h area under the bite-force-change-from-baseline curve was 8% greater (p = 0.010) for the test adhesive (114.3 lb) than for the control adhesive (105.9 lb). Both adhesives showed a statistically significant increase in bite force (p < 0.001) at each time point compared to no adhesive. CONCLUSIONS: The optimized calcium/zinc partial salt of polyvinyl methyl ether/maleic acid test adhesive provided superior maxillary denture retention relative to that of the control adhesive across 13 h. Both adhesives increased bite force at dislodgement compared to no adhesive.

Flexural Strength Analysis of Different Complete Denture Resin-Based Materials Obtained by Conventional and Digital Manufacturing.

PMMA (Polymethylmethacrylate) is the material of choice to fabricate denture bases. Recently, with the introduction of CAD-CAM and 3D printers in dentistry, new materials have been proposed for complete denture manufacturing. AIM: This study compared the flexural strength of different resins fabricated using different technologies (conventional, CAD-CAM-milled, and 3D-printed) and polymerization techniques. METHODS: A total of 11 different resins were tested: six PMMA conventional (Acrypol R, Acrypol LL, Acrypol HI, Acrypol Fast, Acryself and Acryslef P), two milled obtained from UDMA PMMA disks (Ivotion disk and Aadva disk, control groups), two 3D-printed PMMA resins (NextDent Denture 3D+, and SprintRayEU Denture Base), and one 3D-printed composite resin (GC Temp Print). Flexural strength was measured using a universal testing machine. One-way ANOVA and Bonferroni post hoc tests were performed; the p-value was set at 0.05 to consider statistically significant differences among the groups. Spearman test was used to evaluate the correlation between polymerization technique and the flexural strength of 3D-printed resins. RESULTS: CAD-CAM-milled specimens showed the highest flexural strength (107.87 MPa for UDMA) followed by 3D-printed composite resins (102.96 MPa). Furthermore, 3D-printed resins polymerized for 40 min with the BB cure unit showed no statistically significant differences with conventional resin groups. Moreover, in all the 3D-printed specimens, a high correlation between polymerization technique and flexural strength was found. CONCLUSIONS: In terms of flexural strength, the polymerization technique is a determinant for both acrylic and composite resins. Temp Print can be a potential alternative to fabricating removable dentures and showed promising results when used in combination with pink color resin powder.

Evaluation of the Denture Impact on the Palatal Rugae: An Original Research.

Introduction: The palatal rugae may alter their shape based on the various physical pressures that they had to endure. This study's objective is to assess the various alterations in the palatal rugae parameters among the complete denture wearers. Materials and Procedures: Forty subjects in all were chosen for the study. The control group interventional groups had an equal number of participants who were further equally distributed based on gender. For all of the participants, mucostatic maxillary alginate imprints were taken, and gypsum castings were created. They were called at the scheduled intervals of 2, 6, and 12 months following the treatment. The models used during those recalls and all of the palatal rugae were examined under a microscope for quantity, length, form, orientation, and unifications. The unpaired t-test was used to statistically examine palatal rugae alterations. Results: Following the wear of the dentures, the experimental group's primary, secondary, and fragmented rugae all gradually shrank in length. In terms of statistics, the alteration solely affected primary rugae and was significant (P < 0.001). After a year of wearing dentures, a minimal change in rugae's form was noticed in the denture groups, but it was statistically not substantial (P > 0.05). Conclusion: Due to the prolonged mechanical stress the dentures placed on the palatal rugae, complete denture users saw a significant reduction in the length of their primary rugae. Rugae number, orientation, and unification were among the other criteria that did not change during the course of the study. Analysis of the palatal rugae may not be useful in identifying people wearing full dentures. However, in forensic investigations, rugae may act as an adjunct to other methods like fingerprints and DNA analysis.

Esthetic and Functional Rehabilitation of a Child with Complete Anodontia in Primary and Mixed Dentition Stage: A Case Report with 4-year Follow-up.

Background: Pediatric dentists face significant challenges when treating a child with anodontia. Early intervention is essential to ensure the normal physiological and psychological development while also promoting normal jaw development. Case Report: This report describes a 4-year follow-up case of a child with complete anodontia. Prosthetic rehabilitation during the primary and mixed dentition period improved the facial esthetics, self-esteem, speech, and masticatory function of the child. Conclusion: This case report summarizes the treatment procedure, challenges faced in clinical management and the various prosthetic options with its advantages and disadvantages for a child with anodontia. How to cite this article: Kaikure MK, Shetty K, Menezes R, et al. Esthetic and Functional Rehabilitation of a Child with Complete Anodontia in Primary and Mixed Dentition Stage: A Case Report with 4-year Follow-up. Int J Clin Pediatr Dent 2023;16(4):649-655.

Comparison of Oral Health-Related Quality of Life in Partial and Complete Denture Wearers: A Propensity Score Analysis.

Background: Dentures, both partial and complete, have been shown to have the same impact on one's quality of life. Due to the impossibility of randomization in these studies, they are prone to selection bias. This study aimed to compare the effect of partial and complete dentures on oral health-related quality of life (OHRQoL) by propensity score to overcome selection bias. Methods: This is a cross-sectional descriptive-analytic study. A total of 1376 people participated in this study. Age, sex, marital status, education level, smoking, smoking opium and its derivatives, and dental visit was collected by a checklist. OHRQoL was measured by the OHIP-14 questionnaire. The generalized boosted model was used to estimate the propensity score. Missing data were imputed using multiple imputations with mixed models. The assumptions of multivariable regression analysis and propensity score method were first examined, and then the quality of life related to oral health was compared between the two groups. Results: The regression model's assumptions were not verified due to high skewness and collinearity. The results of the normality test (P < 0.001) and goodness fit test (P < 0.001) revealed that the regression model did not fit the data. The propensity score method reduced at least 76% of the bias resulting from the distribution difference between the confounding variables and was used for analysis. In the regression and propensity score method, the results showed that the total OHIP-14 score of the complete prosthesis group was higher than the partial prosthesis group at 3.92 (95% CI = (2.18,5.65)) and 3.64 (95% CI = (1.93,4.53)), respectively. This difference was clinically and statistically significant (P < 0.001). In addition, there is a significant difference in the two groups based on propensity in all seven areas (P < 0.001). But there is no significant difference in the regression adjustment of the Functional limitation of the two groups (P = 0.035). Conclusion: The propensity score has fewer assumptions than the regression method and may be more reliable for OHIP scores. The propensity score analysis revealed that despite the costs and repair issues associated with partial dentures, complete denture wearers have lower OHRQoL than partial denture wearers.

Effect of New Complete Dentures and Simple Dietary Advice on Cognitive Screening Test among Edentulous Older Adults: A Randomized Controlled Trial.

Mild cognitive impairment (MCI), including memory loss, has been attracting attention in Japan. This study assessed the effect of new complete dentures provision alone and with dietary intervention on cognitive functions assessed using the Japanese version of the Montreal Cognitive Assessment (MoCA-J). A randomized controlled trial was conducted with 70 older adults who required new complete dentures. The participants had new complete dentures fabricated and were randomly classified into the intervention or control group. The intervention group received simple dietary advice, and the control group only received denture care advice. Cognitive function was assessed using the MoCA-J before and at 3 and 6 months after treatment. The between-group comparison and within-group comparison were analyzed. No significant differences were reported for comparisons between the intervention and control groups. A significant increase was revealed in the within-group comparisons for the total scores between the 3- and 6-month assessments (p = 0.002) and between the baseline and 6-month assessments (p = 0.012) in the intervention group. In the control group, a significant increase in the total scores was not revealed between any of evaluation period. Complete denture replacement combined with simple dietary intervention may help improve MoCA-J scores in edentulous older adults.

Adhesion of Conventional, 3D-Printed and Milled Artificial Teeth to Resin Substrates for Complete Dentures: A Narrative Review.

BACKGROUND: One type of failure in complete or partial dentures is the detachment of resin teeth from denture base resin (DBR). This common complication is also observed in the new generation of digitally fabricated dentures. The purpose of this review was to provide an update on the adhesion of artificial teeth to denture resin substrates fabricated by conventional and digital methods. METHODS: A search strategy was applied to retrieve relevant studies in PubMed and Scopus. RESULTS: Chemical (monomers, ethyl acetone, conditioning liquids, adhesive agents, etc.) and mechanical (grinding, laser, sandblasting, etc.) treatments are commonly used by technicians to improve denture teeth retention with controversial benefits. Better performance in conventional dentures is realized for certain combinations of DBR materials and denture teeth after mechanical or chemical treatment. CONCLUSIONS: The incompatibility of certain materials and lack of copolymerization are the main reasons for failure. Due to the emerging field of new techniques for denture fabrication, different materials have been developed, and further research is needed to elaborate the best combination of teeth and DBRs. Lower bond strength and suboptimal failure modes have been related to 3D-printed combinations of teeth and DBRs, while milled and conventional combinations seem to be a safer choice until further improvements in printing technologies are developed.

The impact of residual ridge morphology on the masticatory performance of complete denture wearers.

Statement of the problem: Morphology of the residual ridge (RR) is expected to influence the masticatory performance (MP) of complete denture (CD) patients, but considerable details of this relationship are unknown. Purpose: We aimed to investigate the association between the objective MP and RR morphology of CD wearers and other contributory factors affecting their MP. Materials and methods: Sixty-five patients with well-fitting upper and lower CDs with no complaints of pain were enrolled. The objective MP was measured using test gummy jelly and a fully automated measuring device. The RR form was divided into U-type, V-type, I-intermediate, and F-Flat, then combinations of upper and lower RR forms (combined RR) were classified. The height was measured using CD's denture basal surface replicas, while occlusal contact of CDs was assessed using a tooth contact analysis system. The relationship between surveyed factors and MP was evaluated using Spearman's rank correlation, Kruskal-Wallis test, generalized linear regression, and analysis of covariance. Results: Participants with F-F and V-F combined RR forms had the lowest MP, while those with U-U and U-I forms had the highest MP, regardless of RR height. Participants with low RR height had the lowest MP, and those with high RR height had the highest MP, regardless of RR form. The analysis of covariance revealed that mandibular RR height, combined RR forms, and total occlusal contact area significantly affected the MP. Conclusions: Our findings confirmed that the mandibular RR height, RR form combinations, and occlusal contact influence the MP of CD wearers.ClinicalImplications:The MP of CD wearers varied, depending on the height and form of the RR, as well as the occlusal contact area of the CDs. The results of this manuscript show that the morphology of the denture bearing area and the occlusion of the CDs are essential factors in predicting the treatment outcome of CD wearers. This allows the clinician to fabricate a complete denture with the denture basal surfaces adjusted and occlusion provided according to the patient. CD patients can be educated on how to chew to improve MP based on their own RR morphology.