ABSTRACT
PURPOSE: To investigate the influence of different denture-bearing conditions on the masticatory function and patient-reported outcome measures (PROMs) of complete denture wearers. METHODS: Sixty edentulous patients were selected and allocated into two groups according to the American College of Prosthodontics' (ACP) classification: non-atrophic (NAT) (Classes I and II) (n = 24) and atrophic (AT) (Classes III and IV) (n = 36). All patients received new complete dentures (CDs). The objective variables (masticatory performance and swallowing threshold) were assessed as well as the PROMs (oral health-related quality of life (OHIP-EDENT), patient satisfaction) and quality of the prosthesis, at baseline (using the old CD) and after 4 months new prostheses use. Data were analyzed by Mann-Whitney test followed by the Generalized Equations Estimation (GEE), linear regression and Chi-square test. RESULTS: Higher masticatory performance was observed in the NAT group (p < .05) for both time points, baseline and after 4 months. However, compared to baseline, both groups showed significant masticatory improvement after 4 months (p < .05). Satisfaction and overall quality of life improved after 4 months with no difference between groups (p > .05). Regarding the quality of the CD, baseline results were significantly (p < .05) lower in the AT group, but after 4 months, no significant differences were found between groups and in intragroup analysis (p > .05). CONCLUSIONS: The denture-bearing conditions seems to impact masticatory function, but the PROMs are barely affected.
Subject(s)
Denture, Complete , Mastication , Mouth, Edentulous , Patient Reported Outcome Measures , Patient Satisfaction , Quality of Life , Humans , Mastication/physiology , Female , Male , Aged , Mouth, Edentulous/physiopathology , Mouth, Edentulous/rehabilitation , Middle Aged , Deglutition/physiology , Oral HealthABSTRACT
INTRODUCTION: Edentulism is the partial or total loss of teeth, it is irreversible and disabling due to its sequelae in the masticatory, phonetic and aesthetic function that affect the quality of life. OBJECTIVE: To establish the impact of edentulism and sociodemographic factors on the quality of life of the Salvadoran population. MATERIALS AND METHODS: Secondary cross-sectional analysis of data in 3322 users of the Public Health System of El Salvador, aged 15 to > 60 years. The variables under study were sociodemographic, edentulismo and quality of life. Edentulism was determined by clinical examination using the Oral Impact on Daily Performance scale. The statistical analysis was performed using χ2, OR, multiple regression analysis and set the significance threshold at p < 0.05. RESULTS: Partial edentulism in the upper jaw was present in 68.24% people, partial edentulism in the lower jaw was present in 72.42% people and complete edentulism was observed in 2.02% people. There were significant sex differences and a relationship between sex and quality of life (p < 0.004); the self-perception of severe/very severe impacts was greater in women. People without education or with primary or secondary education only were the most affected (p < 0.05). Tooth loss increases with age, affecting quality of life in a severe/very severe manner. Complete edentulism had greater impacts on quality of life in terms of eating (25.64%), speaking (21.15%), and socializing/enjoying contact with people (10.90%). A severe/very severe impact on quality of life of teeth lost was reported mainly by those over 60 years of age, with an average of 11 missing posterior teeth, 6 missing anterior teeth and 13 missing teeth per patient. Those missing up to 6 anterior teeth were times more likely to perceive severe/very severe impacts on quality of life than those without any missing teeth (OR:5.788). Edentulism affected the quality of life of those examined, especially the loss of upper anterior teeth.
Subject(s)
Quality of Life , Humans , Cross-Sectional Studies , Female , Male , Middle Aged , Adult , Adolescent , Young Adult , El Salvador , Sex Factors , Educational Status , Mouth, Edentulous/epidemiology , Mouth, Edentulous/psychology , AgedABSTRACT
RESUMEN Objetivo: Realizar una revisión de la literatura sobre el resultado de las sobredentaduras maxilares según el número de implantes dentales en pacientes edéntulos totales. Materiales y Métodos: Se realizó una búsqueda bibliográfica sistematizada en los motores de búsqueda Pubmed, Scopus y Web of Science y luego de establecer los criterios y filtros de la misma, se utilizaron 6 artículos. De los 6 artículos analizados, 4 fueron estudios de tipo ensayo clínico aleatorizado, 1 estudio prospectivo y 1 estudio retrospectivo. Resultados: Los resultados clínicos de las sobredentaduras maxilares, basados en el número de implantes sobre los cuales fueron soportadas, y comparando los protocolos más difundidos e investigados como los de All-on-4 y All-on-6, fueron similares. Se consideran óptimos, confiables, exitosos y longevos, sin diferencia significativa según el número de implantes dentales colocados. Conclusiones: Las sobredentaduras maxilares soportadas por 4 o 6 implantes fueron técnicas de tratamiento confiables, y ofrecen resultados comparables. Las complicaciones fueron limitadas y los resultados óptimos y duraderos.
ABSTRACT Objective: To review the literature on the outcome of maxillary overdentures according to the number of dental implants in edentulous patients. Materials and Methods: A systematic bibliographic search was carried out in the Pubmed, Scopus and Web of Science search engines and, after appliying the criteria and filters, 6 articles were used. Of the 6 articles analyzed, 4 were randomized clinical trial type studies, 1 prospective study and 1 retrospective study. Results: The results of maxillary overdentures, according to the number of implants used to support them, and comparing the most widespread and researched protocols such as All-on-4 and All-on-6, were similar. They are considered optimal, reliable, successful and long-lived, with no significant difference within the number of dental implants placed. Conclusions: Maxillary overdentures supported by 4 or 6 implants were reliable, and exhibit comparable results. The complications were limited, and the results were optimal and enduring.
Subject(s)
Humans , Dental Implants , Mouth, Edentulous , Dental ImplantationABSTRACT
BACKGROUND: Edentulism remains a major disability worldwide, especially among the elderly population, although the prevalence of complete edentulism has declined over the last decades. In Uganda, the prevalence of edentulism in people aged 20 years and above is 1.8%. The therapy for edentulous patients can be realized through the use of conventional removable complete dentures, implant-supported prostheses, and computer-aided design and computer-aided manufacturing (CADCAM), however, the provision of removable complete dentures continues to be the predominant rehabilitation for edentulous patients. However, no published study has explored the lived experiences with removable complete dentures among the Ugandan population. The aim of the present study was to explore patients' lived experiences on the usage of removable complete dentures among Ugandan edentulous patients attending Makerere University Dental Hospital. METHODS: This was a qualitative study approach using purposive sampling. Fifteen (15) respondents were selected across social demographics. Interviews were recorded and transcribed and themes were generated to draw a deeper meaning to the usage of removable complete dentures. A qualitative statistical package, Atlas Ti software was used to generate themes from the interviews followed by an interpretation of the generated data and the results were presented as text and in a table. RESULTS: The reported key positive experiences due to removable complete denture rehabilitation were the improvement in speech, eating ability, regaining good facial appearance, better oral hygiene management, self-esteem and confidence to smile in public, and a feeling of completeness. However, respondents complained of pain and discomfort due to the looseness of dentures, inability to eat certain foods, and regular cleaning of dentures. The respondents did not go through proper informed consent processes before getting removable complete dentures. CONCLUSION: The study found that patients were satisfied with their removable complete dentures rehabilitation due to the positive experiences registered, such as the ability to eat and talk well, and restoration of self-esteem, all of which improved their quality of life. However, they experience pain and discomfort due to the looseness of dentures.
Subject(s)
Denture, Complete , Mouth, Edentulous , Humans , Uganda , Mouth, Edentulous/psychology , Mouth, Edentulous/rehabilitation , Female , Male , Denture, Complete/psychology , Middle Aged , Aged , Qualitative Research , Adult , Quality of LifeABSTRACT
SUMMARY: Partial or total dental loss (edentulism) is associated with decreased quality of life. Chile has large socioeconomic gaps, which are also recognized in oral health, but it is not known how Edentulism has evolved throughout the country. The aim of this study was to determine the edentulism in people born during the 19th and 20th centuries in Chile, who died in the 20th century, and to compare it with current data from the Chilean Ministry of Health (MINSAL) to observe its evolution in the country. For this purpose, 60 3D models of skulls from the Subactual Osteological Collection of Santiago were analyzed (30 individuals per sex), in which the presence and absence of teeth in antemortem in the maxilla were analyzed. A high percentage of tooth loss was observed, with 65 % partial edentulism, a 30 % total edentulism, and only 5 % had complete dentition in this osteological collection. In addition, a significant decrease over time was found; in 2017, the percentage of complete dentition at the national level was 32.8 %. A higher frequency of edentulism was also found in females from the osteological collection, with a significant probability of twice as much edentulism as in males. However, this sex difference was smaller than those found in the current study. Our study is the first to compare edentulism in Chile in two different time periods, since, in addition to studying it in the 19th and 20th century, it is carried out with data from the present day and in line with previous research, reveals the importance of socioeconomic and sex variables for dental loss.
La pérdida parcial o total de dientes (edentulismo) se asocia a una disminución de la calidad de vida. Chile tiene grandes brechas socioeconómicas, que también se reconocen en la salud oral, pero se desconoce cómo ha evolucionado el edentulismo en el país. El objetivo de este estudio fue determinar el edentulismo en personas nacidas durante los siglos XIX y XX en Chile y fallecidas en el siglo XX, y compararlo con datos actuales del Ministerio de Salud de Chile (MINSAL) para observar su evolución en el país. Para ello, se analizaron 60 modelos 3D de cráneos de la Colección Osteológica Subactual de Santiago (30 individuos por sexo), en los que se analizó la presencia y ausencia de dientes en dentición antemortem en el maxilar. Se observó un alto porcentaje de pérdida dentaria, con un 65 % de edentulismo parcial y un 30 % de edentulismo total, y sólo un 5 % presentaba dentición completa en esta colección osteológica. Además, se encontró una disminución significativa a lo largo del tiempo; en 2017, la dentición completa a nivel país fue del 32,8 %. También se encontró una mayor frecuencia de edentulismo en las mujeres de la colección osteológica, con una probabilidad significativa del doble de edentulismo que en los hombres. Sin embargo, esta diferencia de sexo fue menor que la hallada en datos actuales. Este estudio es el primero que compara el edentulismo en Chile en dos épocas diferentes, ya que además de estudiarlo en los siglos XIX y XX, se realizó con datos de la actualidad y, en línea con investigaciones previas, revela la importancia de las variables socioeconómicas y de sexo en la pérdida dental.
Subject(s)
Humans , Male , Female , Social Class , Tooth Loss/epidemiology , Chile/epidemiology , Prevalence , Mouth, Edentulous/epidemiology , Sex CharacteristicsABSTRACT
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.
Subject(s)
Denture, Complete , Mouth, Edentulous , Humans , Male , Female , Aged , Prospective Studies , Japan/epidemiology , Cross-Sectional Studies , Denture, Complete/statistics & numerical data , Mouth, Edentulous/epidemiology , Frailty/epidemiology , Mastication/physiology , Aged, 80 and over , Patient Satisfaction , Self Report , Longitudinal Studies , East Asian PeopleABSTRACT
PURPOSE: The present study aimed to identify, through a critical review of the literature, the success factors associated with the splinting of fixed prostheses on adjacent implants of the posterior sectors in partially edentulous patients compared with those not splinted. STUDY SELECTION: A MEDLINE strategy was implemented based on a research question to systematically search and extract information from databases (PubMed and Scopus) using MeSH terms/keywords identified for each domain. Systematic reviews, clinical and in vitro studies were selected and classified according to eligibility criteria based on the research question and level of evidence using the PRISMA flowchart. RESULTS: A total of 32 studies were selected for data extraction and analysis according to study design (three systematic reviews, 14 clinical studies, and 15 in vitro studies). Overall, the studies found no significant difference in the association between the survival rate and prosthesis type. In clinical studies, there have been no differences in marginal bone loss between splinted and non-splinted prostheses, and the influence of peri-implant status and restorative materials has been poorly evaluated. The distribution of stress and loads determined in the in vitro studies showed results that could favor splinted prostheses; however, are generally associated with implant design. CONCLUSIONS: The need for splinted or non-splinted adjacent implant-supported prostheses remains controversial. The reviewed evidence indicates that factors such as implant size and its relationship with coronal height could be important in decision-making.
Subject(s)
Dental Implants , Mouth, Edentulous , Humans , Dental Materials , Dental Prosthesis, Implant-Supported/methods , Dental Prosthesis DesignABSTRACT
This study evaluated the stress distribution on an implant-supported zirconia crown of a mandibular first molar subjected to oblique loading by occlusal contact with the natural maxillary first molar by using the 3D finite element method. Two virtual models were made to simulate the following situations: (1) occlusion between maxillary and mandibular natural first molars; (2) occlusion between zirconia implant-supported ceramic crown on a mandibular first molar and maxillary natural first molar. The models were designed virtually in a modeling program or CAD (Computer Aided Design) (Rhinoceros). An oblique load of 100 N was uniformly applied to the zirconia framework of the crown. The results were obtained by the Von Mises criterion of stress distribution. Replacement of the mandibular tooth by an implant caused a slight increase in stress on portions of the maxillary tooth roots. The crown of the maxillary model in occlusion with natural antagonist tooth showed 12% less stress when compared with the maxillary (model in occlusion with the) implant-supported crown. The mandibular crown of the implant show 35% more stress when compared with the mandibular antagonist crown on the natural tooth. The presence of the implant to replace the mandibular tooth increased the stresses on the maxillary tooth, especially in the region of the mesial and distal buccal roots.
Subject(s)
Molar , Mouth, Edentulous , Humans , Finite Element Analysis , Zirconium , Crowns , Stress, Mechanical , Dental Stress Analysis , Dental Prosthesis, Implant-SupportedABSTRACT
INTRODUCTION: The application of occlusal concepts in prosthodontics is still under debate.This study assessed the impact of compensating curves on the comminution of complete denture wearers. METHODS: Seven edentulous subjects, aged 64.6 ± 2.0 years, were rehabilitated with new muco-supported complete dentures and tested in two occlusal plane settings: with and without compensating curves. A randomised triple-blind clinical trial was conducted, considering one-week and one-month as adaptation periods for dentures. After each trial, the subjects were crossed over to their respective groups. One-week was also chosen as the washout period, and after that, the subjects were re-examined. The masticatory performance and swallowing threshold were determined while chewing Optocal test food. The multiple sieve method was used for fractionation and granulometry. RESULTS: During the masticatory performance and swallowing threshold estimates, no differences were found between the median particle sizes obtained with the both occlusal plane conditions (P ⟩ 0.05). However, the swallowing threshold improved after one month, resulting in smaller particle sizes. Moreover, the chewing rates for the both test foods were also increased (P ⟨ 0.05). CONCLUSIONS: These findings suggest that the compensating curves did not have an impact on the masticatory function of subjects wearing complete dentures.
Subject(s)
Mastication , Mouth, Edentulous , Humans , Denture, Complete , Dental OcclusionABSTRACT
BACKGROUND: The impact of treatments on completely edentulous individuals on masticatory performance (MP), oral health-related quality of life (OHRQoL), nutritional status (NS) and socio-economic profile (SP) is unclear in the literature. OBJECTIVE: To compare the MP, OHRQoL, NS and SP of totally edentulous elderly users of bimaxillary complete dentures (CD) and users of lower implant-supported fixed complete dentures (IFCD). METHODS: Forty participants were allocated into groups according to rehabilitation treatment (n = 20): bimaxillary CD (G1) and lower IFCD, and upper CD (G2). The evaluation of MP used almonds by the method of sieves. Four questionnaires (Geriatric Oral Health Assessment Index-GOHAI and Oral Health Impact Profile Edent-OHIP-Edent, Brazilian Economic Classification Criteria-ABEP and Mini Nutritional Assessment-MNA) were applied to assess the OHRQoL, SP and NS of the elderly, respectively. After evaluating the statistical assumptions, the Mann-Whitney (α = .05) test was applied to compare the groups regarding MP, OHRQoL, NS and SP. Spearman's correlation (α = .05) was performed to verify the correlation between the MP, the OHRQoL and the NS of the participants. RESULTS: G2 showed better MP (p < .05) in all masticatory cycles, OHRQoL (p < .05) and NS than the G1. However, the participants' self-perception of oral health did not differ between groups (p < .05). A moderate negative correlation was found between MP and OHRQoL for 40 masticatory cycles (r2 = -0.513; p = .001). CONCLUSION: Individuals rehabilitated with IFCD had a higher average monthly family income and achieved superior behaviour in MP and OHRQoL, in addition to lower risks of malnutrition when compared to individuals using bimaxillary CD.
Subject(s)
Mouth, Edentulous , Nutritional Status , Aged , Humans , Cross-Sectional Studies , Oral Health , Quality of LifeABSTRACT
BACKGROUND: While edentulism remains a serious public health problem for older adults in Colombia, few analyses have been conducted from the framework of active aging as a part of the positive discourse of aging. This study analyzed complete edentulism and its relationship with determinants including personal, behavioral, and health systems and social services. METHODS: This study included a total of 19,004 older adults. We used univariate, bivariate, and multivariate logistic regression type scores to investigate the relationships between the variables. The personal determinants included basic (Barthel scale) and instrumental activities of daily living (Lawton scale), public transportation, functional limitations, self-perceived health, and health problems. The behavioral factors included alcohol and tobacco use, mini nutritional tests, and physical activity. The last determinant was the healthcare system, while social services access included dental services. The analysis also included sociodemographic variables. RESULTS: The results revealed significant associations for the variables of the three determinants, including the risk of malnutrition (odds ratio [OR]=1.15), functional limitation (OR=1.15), moderate physical activity (OR=1.08), and access to dental services (OR=2.31). Sex, years of education, and race were also risk factors, among other variables. Personal determinants, behavior, and use and access to health services were related to edentulism in older adults. CONCLUSION: These findings support the need to include different analyses of edentulism from multicausality and to understand the oral cavity and the living conditions of aging adults.
Subject(s)
Activities of Daily Living , Humans , Female , Male , Colombia/epidemiology , Aged , Aged, 80 and over , Mouth, Edentulous/epidemiology , Risk Factors , Aging/physiology , Middle Aged , Exercise , Health Services Accessibility/statistics & numerical data , Cross-Sectional Studies , Logistic ModelsABSTRACT
This study aimed to compare the accuracy of full-arch digital implant impressions using seven different scanbodies and four intraoral scanners. A 3D-printed maxillary model with six implants and their respective multi-unit abutments was used for this study. Seven scanbodies (SB1, SB2, SB3, SB4, SB5, SB6, and SB7) and four intraoral scanners (Primescan®, Omnican®, Trios 3®, and Trios 4®) were assessed. Each combination group was scanned ten times and a dental lab scanner (D2000, 3Shape) was used as a reference. All scans were exported as STL files, imported into Convince software (3Shape) for alignment, and later into Blender software, where their 3D positions were analyzed using a Python script. The 3D deviation, angular deviation, and linear distance between implants #3 and #14 were also measured. Accuracy was measured in terms of "trueness" (scanbody 3D deviation between intraoral scan and desktop scan). Kruskal-Wallis followed by the Bonferroni correction was used to analyze the data (⺠= .05). The study found statistically significant differences in digital impression accuracy among the scanners and scanbodies (p<0.001). When comparing different intraoral scanners, the Primescan system showed the smallest 3D deviation (median 110.59 µm) and differed statistically from the others, while Trios 4 (median 122.35 µm) and Trios 3 (median 130.62 µm) did not differ from each other (p = .284). No differences were found in the linear distance between implants #3 and #14 between Trios 4, Primescan, and Trios 3 systems. When comparing different scanbodies, the lowest median values for 3D deviation were obtained by SB2 (72.27µm) and SB7 (93.31µm), and they did not differ from each other (p = .116). The implant scanbody and intraoral scanner influenced the accuracy of digital impressions on completely edentulous arches.
Subject(s)
Dental Implants , Mouth, Edentulous , Humans , Imaging, Three-Dimensional , Computer-Aided Design , Models, Dental , Prostheses and Implants , Dental Impression Technique , Dental Arch/diagnostic imaging , Dental Arch/surgeryABSTRACT
BACKGROUND: The maintenance of marginal bone integrity around dental implants continues to be a clinical challenge. It is still unclear whether loading multiple implant-supported prostheses that have different implant connections influences bone resorption. OBJECTIVES: The aim of this in vitro study was to compare stress distribution around residual edentulous ridges supported by external hexagon (EH) and Morse taper (MT) implants with screw-retained frameworks obtained with the use of different methods. MATERIAL AND METHODS: Three-element implant-supported prostheses with distal cantilevers were manufactured according to different techniques of obtaining the framework: LAS - framework sectioned and welded with a laser; TIG - framework sectioned and welded with tungsten inert gas (TIG); and CCS - framework obtained using a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Occlusal and punctual loading (150 N) was applied to the cantilevers. In the photoelastic stress analysis, the fringe orders (n) were quanitified using the Tardy method, which calculates the maximum shear stress value (τ) at each selected point. RESULTS: High stress around the implants and tightening were observed in the TIG group, mainly in the crestal bone region for the EH and MT implant connections. The LAS and CCS frameworks exhibited lower stress for the MT connection under occlusal and punctual loading. CONCLUSIONS: The comparative analysis of the models showed that the MT connection type associated with the laser-welded or CAD/CAM frameworks resulted in lower stress values in the crestal bone area, suggesting the preservation of bone tissue in this region.
Subject(s)
Dental Implants , Mouth, Edentulous , Humans , Computer-Aided Design , Stress, MechanicalABSTRACT
Objective: to evaluate the responsiveness of the Brazilian version of OHIP-EDENT instrument to applications of patient-centered approaches in dental clinical practice and research. Materials and Methods: one hundred edentulous patients up to 50 years old attending a public university clinic were enrolled in this non- randomized clinical study. All subjects received a new CD and answered an oral health-related quality of life (OHRQoL) instrument before treatment (BT) and 3 months after treatment (AT). The responsiveness was analyzed by dividing the mean score ranging from BT to AT by the standard deviation of change scores considering 0.2, 0.5, and 0.8 represent small, moderate, and large clinical changes, respectively. Results: There was a decrease in AT and DT in total scores and in all subscales (p<0.001). The OHIP-EDENT responsiveness scores dropped 14.46 points after treatment, demonstrating a positive reduction as well as an improvement in the patient OHRQoL after new CD. The SRM scored as 1.74, representing satisfactory responsiveness. Conclusion: the OHIP-EDENT (Brazilian version) presents capacity to detect changes in edentulous patients. This instrument can help weigh risks and benefits, assess the cost effectiveness of treatments, and influence recommendations on health policies adopting a more holistic approach to healthcare.
Objetivo: avaliar a capacidade de resposta da versão brasileira do instrumento OHIP-EDENT para aplicações de abordagens centradas no paciente na prática clínica e pesquisa odontológica. Materiais e Métodos: cem pacientes edêntulos de até 50 anos atendidos em uma clínica universitária pública foram incluídos neste estudo clínico não randomizado. Todos os indivíduos receberam uma nova prótese total (PT) e responderam a um instrumento de qualidade de vida relacionado à saúde bucal (QVRSB) antes do tratamento (AT) e 3 meses após o tratamento (DT). A capacidade de resposta foi analisada dividindo-se a pontuação média variando de AT a DT pelo desvio padrão dos escores de mudança, considerando que 0,2, 0,5 e 0,8 representam alterações clínicas pequenas, moderadas e grandes, respectivamente. Resultados: observou-se diminuição AT e DT das pontuações totais e de todas as subescalas (p<0,001). Os escores de responsividade do OHIP-EDENT caíram 14,46 pontos após o tratamento, demonstrando uma redução positiva das médias, bem como uma melhora na QVRSB do paciente após a nova PT. A capacidade de resposta foi 1,74, representando uma grande responsividade. Conclusão: o OHIP-EDENT (versão brasileira) apresenta capacidade de detectar a resposta em pacientes edêntulos. Este instrumento pode ajudar a pesar riscos e benefícios, avaliar a relação custo- eficácia dos tratamentos e influenciar recomendações sobre políticas de saúde que adotem uma abordagem mais holística dos cuidados de saúde.
Subject(s)
Adult , Middle Aged , Quality of Life , Oral Health , Mouth, Edentulous , Denture, CompleteABSTRACT
BACKGROUND: Elderly people frequently report tooth loss, affecting their nutritional status. There is a gap in the scientific evidence about the influence of prosthodontic rehabilitation on nutritional status. OBJECTIVE: To investigate the influence of prosthodontic rehabilitation combinates or not with dietary advice on nutritional status in elderly patients. METHODS: A systematic literature search was conducted in three electronic databases to identify randomized clinical trials that evaluated the effect of prosthetic rehabilitation on nutritional status in subjects aged 60 years or older, with a follow-up of at least 1 month after prosthesis rehabilitation. RESULTS: Of the 1517 articles identified in the initial search, 12 were selected for the final review. No significant difference between the types of prosthesis were found regarding the chewing by the elderly population. Although patients who received prosthetic treatment had significant improvement in chewing ability, a consistent pattern of improvement in nutritional status was not observed when they did not receive dietary advice. In addition, the association between the condition of the dentition, the masticatory performance and nutritional change of elderly patients has been found. Studies that evaluated simultaneous complete denture treatment and simple dietary advice showed an improvement of nutrient intake in elderly patients. CONCLUSIONS: Isolated prosthetic rehabilitation may not have the effect of exerting a change in nutritional status of edentulous elderly patients. In general, simultaneous dietary consulting and prosthetic treatment in combination may improve dietary habits, since masticatory capacity and efficiency are not the only factors that influence the nutritional status of a patient.
Subject(s)
Mouth, Edentulous , Nutritional Status , Humans , Aged , Mouth, Edentulous/rehabilitation , Denture, Complete , Diet , CounselingABSTRACT
Aim: The aim of this study was to evaluate the accuracy of models of partially edentulous arches obtained by three-dimensional (3D) printing. Settings and Design: This was an in vitro study. Materials and Methods: Fifteen partially edentulous models were evaluated, using two methods of measuring dimensions: virtual, using the Standard Tessellation Language files of the models and software (control group), and physical, through printing the models and digital caliper (test group). For both methods, measurements were made regarding the dimensions of the teeth (width and length - buccal/lingual or palatal/occlusal) and distances between the teeth. Statistical Analysis Used: For the variable of linear measurements (width and length) and distances between teeth of the same hemiarch, the Wilcoxon test was used, while for the variable between opposite hemiarches, the paired t-test was used. Results: In the evaluation of the linear measurements, a significant difference was observed only when the width of the molar tooth was analyzed (P = 0.014). When the buccal length was measured, all teeth had linear measurements provided by the virtual method that was lower than the physical (P = 0.000), as well as the lingual/palatal length in incisors (P = 0.003) and molars (P = 0.009) and in total (P = 0.001). As for the analyses between teeth, no difference was identified between the measurements provided by the virtual method compared to the physical one. Conclusions: The 3D printer used to print partially edentulous models provided linear distortions in the teeth but without changes in the distances between teeth of the same hemiarch and between teeth of opposite hemiarches.
Subject(s)
Imaging, Three-Dimensional , Mouth, Edentulous , Humans , Imaging, Three-Dimensional/methods , Models, Dental , Printing, Three-Dimensional , IncisorABSTRACT
OBJECTIVES: Previous studies have established an association between tooth loss and depression. However, longitudinal evidence is scarce and needs to be verified in other populations. The aim of this study was to examine the longitudinal association between the number of remaining teeth and incident depression at 2- and 4-years follow-up in individuals enrolled in the Maule cohort (MAUCO) in Chile. METHODS: This prospective study used the information of individuals, aged 38 to 74 years, excluding those with depression at baseline. The number of remaining teeth at baseline was determined in four groups: "20 or more teeth", "10 to 19 teeth", "1 to 9 teeth" and "no natural teeth". Depression was measured through the PHQ-9. Logistic regression was performed to calculate the odds ratios (OR) for incidence depression at both periods of follow-ups, adjusting for age, sex, educational attainment, diabetes mellitus II, and stressful events at follow-up. Also, we performed adjusted multinomial logistic models to analysis the association between the number of remaining teeth and depression severity. RESULTS: In total individuals (n = 3335 at follow 1, n = 2461 at follow 2), all groups have ORs for incident depression above 1 considering 20 or more teeth as reference. In men, those with 10-19 teeth have 2.44 times higher odds of incident depression than those with 20 or more teeth (OR 2.44, CI 95% 1.33-4.50). Edentulous subjects at 4 years follow-up had 2.24 times higher odds of depression than those with more than 20 teeth (OR 2.24 CI 95%1.35-3.72). In women, the ORs (CI 95%) of incident depression were 2.56 (1.50-4.39), 1.56 (1.02-2.40) and 1.27 (0.90-1.81) for "none", "1-9", "10-19" respectively in comparison to the reference group. In edentulous individuals at baseline, the odds for each of the comparisons "mild vs no", "moderate vs no", "moderately severe vs no" and "severe vs no" were above 1, at both follow-ups. CONCLUSION: Individuals with less than 20 teeth in the mouth could had higher odds of incident depression at 2- and 4-years follow-up, with differences between men and women. Also, in our study, edentulism was associated with increased odds of incident depression at 4-years follow-up in women, and with higher levels of severity of depressive symptoms.
Subject(s)
Depression , Mouth, Edentulous , Male , Female , Humans , Chile/epidemiology , Depression/epidemiology , Prospective Studies , Face , Mouth, Edentulous/epidemiologyABSTRACT
BACKGROUND: Adequate muscle activity is important for the success of oral rehabilitation: it maintains the integrity of the stomatognathic system and is responsible for chewing movements needed to break, crush and grind food. OBJECTIVE: To compare muscle activity using electromyography (EMG) while clenching or chewing soft and/or hard foods among individuals with natural dentition (ND) and edentulous patients rehabilitated with dental prostheses. METHODS: This review was conducted until March, 2023, and the research question was "Is the muscle activity of edentulous patients rehabilitated with dental prostheses similar to that of dentate individuals?" A search strategy was conducted in PubMed/MEDLINE, The Cochrane Library, Web of Science, Lilacs, Embase and manual journal searches. RESULTS: Ten studies were included in the analysis. Most of them reported that individuals with ND had significant higher muscle activity (clenching or chewing) than complete dentures (CD) users. However, no difference was observed between patients with full mouth implant-supported fixed dental prosthesis (ISFDP) and ND. Additionally, two studies compared patients with mandibular ISFDP with maxillary CD and individuals with ND and found no differences; however, one study concluded that patients with ISFDP with CD (maxillary or mandibular) had lower muscle activity than individuals with ND. Only one study reported a higher muscle activity in patients with full-mouth ISFDP than in individuals with ND. CONCLUSIONS: Bimaxillary CD users had lower muscle activity than individuals with ND. During rehabilitation, the muscle activity of patients with full-mouth ISFDP and mandibular ISFDP with maxillary CD is similar to individuals with ND.
Subject(s)
Dental Implants , Mouth, Edentulous , Humans , Dental Prosthesis, Implant-Supported , Mouth, Edentulous/rehabilitation , Denture, Complete , Mastication/physiology , Muscles , Denture, OverlayABSTRACT
Quantifying in edentulous patients the facial collapse and whether complete conventional denture (CCD) and implant-supported fixed complete denture (ISFCD) can restore the facial proportions to match those of a dentate patient (CG) is relevant for clinical dentists. One hundred and four participants were enrolled and divided into edentulous (n=56) and CG (n=48). The edentulous participants were rehabilitated with CCD (n=28) or ISFCD (n=28) in both arches. Anthropometric landmarks in the face were marked and captured by stereophotogrammetry. Linear, angular, and surface measurements were analyzed and compared among groups. The statistical analysis was performed by an independent t-test, the one-way ANOVA, and Tukey's test. The significance level was set at 0.05. The facial collapse was quantified as a significant shortening of the lower third of the face affecting facial aesthetics in all parameters evaluated and the same was observed in comparison among CCD, ISFCD, and CG. The CCD presented statistical differences with the CG group in the lower third of the face and labial surface, and the ISFCD showed no statistical differences with the CG and CCD. The facial collapse in edentulous patients could be restored through oral rehabilitation with an ISFCD similar to those of dentate patients.
Subject(s)
Dental Implants , Jaw, Edentulous , Mouth, Edentulous , Humans , Adult , Jaw, Edentulous/rehabilitation , Denture, Complete , Dental Prosthesis, Implant-SupportedABSTRACT
This study aimed to evaluate the pathways that explain the association between race/skin color and edentulism in elderly Brazilians. This was a cross-sectional study using data from participants aged 60 years or older from the 2019 Brazilian National Health Survey, a nationally representative population-based sample. Data were obtained by a structured interview and participants were classified as edentulous if they reported having lost all natural teeth. Information on race, socioeconomic level, behavioral aspects, psychosocial aspects, and access to dental care was collected by interviewers using a questionnaire. The pathways between race/skin color and edentulism were analyzed using structural equation modeling. The final sample of the study included 22,357 participants. Most participants were white (51.5%; 95% confidence interval [CI]: 50.3-52.6), and 36.8% (95%CI: 35.7-37.9) were edentulous. Race/skin color was indirectly associated with edentulism via enabling factors. These findings suggest that socioeconomic inequalities are key in explaining racial inequalities in edentulism among Brazilian older adults.