Frequency of Complete and Removable Partial Denture Treatment in the Primary Health Centres in Three Different Regions of Kosovo from 2002 to 2013.

INTRODUCTION: Edentulism and prosthodontic care are very common, especially in the elderly. The study investigated the treatment with complete dentures (CDs) and acrylic removable partial dentures (ARPDs) among people receiving new prosthodontic treatment in the Primary Health Centres of the three regions in Kosovo from 2002 to 2013. METHODS: The data on ARPDs delivery and CDs delivery was obtained from the archives of primary health centres from three Kosovo regions (Prizren, Peje, Ferizaj) from 2002 to 2013. The data was analysed concerning year of treatment, type of dentures, jaw, age, gender and urban or rural origin of the patients. The trend of treatment was determined, and the binomial logistic regression model was used for predicting odds of ARPD versus CD treatment by year of treatment and patient characteristics. RESULTS: From 2002 to 2013, 9,478 patients received 11,655 CDs and 4,401 ARPDs. Delivery of CDs significantly increased by 57.45 dentures per year (R2=0.609) and delivery of ARPDs by 30.39 dentures per year (R2=0.569). Each year the odds for ARPD versus CD increased by 4.2% (95% CI: 3.0%-5.4%). Younger patients have higher odds for ARPD rather than CD and odds for ARPD are decreasing as the age of patients rises. The gender, residence, and jaw all had a significant impact on prosthodontic treatment too. CONCLUSIONS: In Primary Health Centres of Kosovo, there is a trend for higher frequencies of both dentures (more obvious for ARPD), and the frequency is highly dependent on the age of patients.

Bone and soft tissue changes associated with a removable partial denture. A novel method with a fusion of CBCT and optical 3D images.

BACKGROUND: The purpose of this study was to propose a novel method for 3D evaluation of bone and mucosal changes in removable partial denture (RPD) foundation area using a fusion of cone beam computed tomography (CBCT) and optical 3D images. METHOD: Two CBCT scans and three impressions, taken at insertion and after ten months of wearing the RPD, were acquired from five patients. 3D models of bone and surface were created from CBCT images and gypsum casts, respectively, spatially aligned and saved in Standard Tessellation Language file format. Visual and numerical analysis of differences between the models allows evaluation of surface, mucosal and bone changes in regions of interest (ROI) defined as narrow ROI (nROI), denture foundation area ROI (dROI) and wide ROI (wROI). Site-specific analysis was performed in mesiodistal and buccolingual direction. RESULTS: Visual evaluation of 3D color-coded deviation maps showed irregular distribution of bone and surface changes. The differences between mandibles and also between left and right sides were found. Mean volume of bone change in dROI was -135.86 (range = -456.18 to 21.20) mm3. The average bone change thickness in dROI was -0.26 (range = -0.96 to 0.07) mm. The mean volume changes in nROI were -38.31 (range = -118.26 to 45.87) mm3, -51.96 (range = -182.54 to 5.6) mm3 and 13.66 (range = -80.62 to 79.46) mm3 for surface, bone and mucosa, respectively. CONCLUSIONS: The proposed method facilitates separate visual and numerical evaluation of surface, mucosa and bone changes. It opens possibilities for a better understanding of denture-supporting tissues remodeling, objective evaluation and comparison of different treatment options.

Implant-prosthetic rehabilitation after radiation treatment in head and neck cancer patients: a case-series report of outcome.

BACKGROUND: Slovenia has a high burden of head and neck cancer. Patients are mostly treated with surgery followed by radiation therapy. Advanced surgical and prosthodontic techniques have expanded the rehabilitation options. The aim of the study was to review the outcome of implant-prosthetic treatment after radiation therapy. PATIENTS AND METHODS: Twenty irradiated head and neck cancer patients who received a removable implant-supported denture at the University Medical Centre Ljubljana were included in the study. Kaplan-Meier survival analysis, Cox proportional hazard models and logistic regression were used to assess the implant survival and success rate. RESULTS: Twenty patients had 100 implants inserted. The estimated implant survival rate was 96% after 1 year and 87% after 5 years. Failures were mostly observed before loading (91.2%). Implants inserted in the transplanted bone were significantly more likely to fail. Out of 89 implants supporting the dentures, 79 implants (88.7%) were successful, meaning that they were functionally loaded and exhibited no pain, radiolucency or progressive bone loss. Prosthetic treatment was significantly less successful in older patients. The attachment system and the number of implants did not have a statistically significant influence on the success rate. CONCLUSIONS: Implant-supported dentures have been shown to be a reliable treatment modality after head and neck cancer surgery and radiation therapy. Possible early failures should be communicated with the patients.

Effects of polishing techniques on the surface roughness of acrylic denture base resins.

STATEMENT OF PROBLEM: Rough surfaces of denture bases promote adhesion of microorganisms and plaque formation. It is therefore important to know how different polishing systems affect surface roughness of denture base acrylic resins. PURPOSE: The objective of this study was to compare the effects of 4 chairside polishing kits and 2 conventional laboratory techniques used for polishing 3 different acrylic denture base resins. MATERIAL AND METHODS: Using contact profilometric measurement, the surface texture of 54 specimens (15x30x3 mm) per acrylic material (autopolymerized ProBase Cold, heat-polymerized ProBase Hot, and injection heat-polymerized SR Ivocap plus) was studied before and after cutting with a tungsten carbide bur, and during and after chairside polishing with 4 polishing kits (Exa Technique, Acrylic Polisher HP blue, AcryPoint, Becht Polishing Cream), and after conventional polishing with 2 polishing systems (Universal Polishing Paste for Resins and Metals, Lesk Polishing Liquid). There were 9 specimens for each acrylic resin material and polishing method combination. Conventional lathe polishing with polishing paste served as the control. Mean average surface roughness (Ra) values of each specimen group were analyzed using a 2-way analysis of variance, the Scheffé post-hoc test, and paired t test (alpha=.05) with the Bonferroni adjustment. After testing the polished acrylic resin surfaces were evaluated under a scanning electron microscope. RESULTS: The highest mean average surface roughness (Ra=2.86+/-0.8 microm to 3.99+/-1.31 microm) was measured for surfaces finished with a tungsten carbide bur. The lowest surface roughness values (Ra=0.02+/-0.01 microm) were determined for acrylic resin specimens polished with a lathe and polishing paste. The Ra values of resin specimens after polishing with chairside silicone polishing kits ranged from 0.05+/-0.0 microm to 0.35+/-0.05 microm. Mean average Ra values of specimens polished with a polishing cream alone (Ra=1.01+/-0.17 microm to 1.68+/-0.47 microm) were significantly higher (P<.05) than those obtained with other polishing systems tested, which was confirmed by scanning electron microscope images of acrylic resin surfaces. Significant differences in mean average surface roughness were found between autopolymerizing and injected heat-polymerizing resin specimens. In addition, scanning electron microscopy revealed increased porosity of autopolymerizing resin specimens. CONCLUSIONS: Conventional laboratory polishing was found to produce the smoothest surface of denture base acrylic resin. Chairside silicone polishing kits produced a significantly smoother surface of acrylic resin than specimens polished with a tungsten carbide bur. The presence of large pores was characteristic for the autopolymerizing resin material.