Influence of occlusal appliances on the masticatory muscle function in individuals with sleep bruxism: A systematic review and meta-analysis.

This systematic review answers the question: "Does occlusal appliance use influence masticatory muscle function of dentate individuals with sleep bruxism?". The literature search included six databases, grey literature, and manual search for articles. Randomized and non-randomized clinical trials were included comparing muscle function of sleep bruxers before and after receiving occlusal appliances. Risk of bias was assessed with risk of bias assessment for randomized and non-randomized clinical trials tool. Twelve studies, three represent randomized clinical trials, were included. Risk of bias was considered low, moderate, or serious. Meta-analyses indicated that soft and hard appliances did not influence muscle activity and bite force of bruxers. Qualitative analysis showed that occlusal appliance use did not influence masticatory performance and muscle volume. However, it was effective in reducing tongue force. Certainty of evidence was considered very low for muscle activity when evaluated with hard appliances, and for bite force evaluated with both appliance materials. Low certainty of evidence was observed for muscle activity with soft appliances. Based on the findings of this meta-analysis, occlusal appliances do not affect masticatory muscle function of sleep bruxers. Regardless of appliance material, the activity of masseter and temporal, and bite force of sleep bruxers was not influenced.

Effects of tongue lesions and palatal coverage on oral sensory functions.

STATEMENT OF PROBLEM: Oral stereognosis (OS) plays a significant role in the oral rehabilitation of patients with edentulism, as it influences their adaptation to new prostheses. Because of the essentially tactile characteristic of oral sensory perception, the tongue and palate appear to have a crucial function in OS. However, little is known about the influence of tongue lesions on OS and sensorial function. In addition, controversies remain regarding the role of the palate. PURPOSE: The purpose of this clinical study was to evaluate whether tongue lesions and palatal coverage are disruptive to OS and gustatory function. MATERIAL AND METHODS: Seventy participants (mean age=30.7 ±6.7 years) were divided into a tongue lesion group (experimental; n=35) and a control group (n=35). The tongue lesion group included participants with geographic, fissured, or hairy tongue. OS was evaluated with the oral stereognosis ability (OSA) test. Gustatory function was assessed with exposure to flavored solutions. After completing the above tests, the participants received a palate covering device, and then OS and gustatory function were immediately reevaluated. Data were analyzed with the Mann-Whitney and Wilcoxon tests (α=.05). RESULTS: OSA and gustatory function scores did not differ among the tongue lesion and control groups with and without palatal coverage (all P>.05). After palatal coverage, the tongue lesion group took more time to perform the OSA test than the control group (P<.05). CONCLUSIONS: Neither the presence of tongue lesions nor palatal coverage influenced OS or gustatory function. The OSA test response times were longer for the tongue lesion group after they had received palatal coverage.

Association of sociodemographic characteristics, mental health, and sleep quality with COVID-19 fear in an elderly Brazilian population

Aim: This study determined whether COVID-19 fear is correlated with sociodemographic characteristics, general health, mental health, and sleep quality in an elderly Brazilians. Methods: Elderly people aged ≥ 60 years replied to an online survey containing questions about their sociodemographic characteristics; general health; levels of stress, anxiety, and depression; sleep quality; and COVID fear. Results: Data were statistically analyzed using descriptive statistics (α = 5%). In total, 705 elderly people with mean age of 66 ± 5 years, and most (82.7%) respondents were women, graduated and from southeastern Brazil. COVID-19 fear correlated positively and moderately with sleep quality and symptoms of depression, anxiety, and stress (all p < 0.001). It was associated with females. Elderly people from northern and northeastern Brazil and diabetics had increased COVID-19 fear (all p < 0.05). Conclusion: The fear of COVID-19 exists among Brazilian female old people, diabetics, increases anxiety and stress symptoms, and worsen sleep quality in elderly people

Palatal coverage and oral stereognosis: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Complete denture wearers present with less sensory function than dentate individuals because of the loss of periodontal receptors. However, the role of the palatal receptors on such function is still unclear. PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate the influence of palatal coverage associated with complete dentures or palatal devices on oral stereognosis in edentulous or dentate adults. MATERIAL AND METHODS: Eight major literature databases and the nonpeer-reviewed literature were searched up to December of 2021. Randomized clinical trials and nonrandomized clinical trials comparing oral stereognosis in edentulous or dentate participants using conventional complete dentures or implant-supported prostheses or those using palatal devices were included. Bias was assessed with Cochrane tools (ROBINS-I and RoB 2.0). Meta-analyses were conducted to compare oral stereognosis before and after palatal coverage (α=.05). Certainty of the evidence was verified using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS: Of 14 included studies, the risk of bias was considered low for 9 studies and moderate for 5 studies. Despite the very low certainty of evidence, meta-analyses showed no differences in oral stereognosis immediately after complete denture insertion (standardized mean difference [SMD]=0.302; 95% confidence interval [CI]: -0.124, 0.728; P=.165; I2=92.4%). Oral stereognosis scores improved after ≥1 month of complete denture use compared with initial evaluations without them. Qualitative analysis indicated that oral stereognosis was not influenced by palatal coverage shortly after complete denture installation and that oral stereognosis scores improved over time after prosthesis use. CONCLUSIONS: Oral stereognosis improved with the use of palate-covering prostheses over time. However, because of the very low certainty of evidence, the statement must be interpreted with caution.

Do dual-cure bulk-fill resin composites reduce gaps and improve depth of cure.

This in vitro study aimed to evaluate the gaps length and depth of cure of dual-cure bulk-fill resin composites inserted in box-shaped preparations. Box-shaped preparations (4 mm deep) were made in fifteen human third-molars and divided into three groups according to the resin composites (n=5): Dual-cure bulk-fill BulkEZ (BEZ); Dual-cure bulk-fill HyperFIL (HF); and Tetric Evoceram Bulk-fill (TETRIC), as control. Gaps length (%) was evaluated in tooth-restoration interface with micro-computed tomography (µCT). The restorations were sectioned, and the degree of conversion (DC) and Knoop microhardness were evaluated at five depths (0.3, 1, 2, 3, and 4 mm). Microhardness data were statistically evaluated using absolute values (KHN) and relative values (microhardness percentages in relation to top). Gaps length (%) increased in the following order: BEZ=TETRIC

Do dual-cure bulk-fill resin composites reduce gaps and improve depth of cure

Abstract This in vitro study aimed to evaluate the gaps length and depth of cure of dual-cure bulk-fill resin composites inserted in box-shaped preparations. Box-shaped preparations (4 mm deep) were made in fifteen human third-molars and divided into three groups according to the resin composites (n=5): Dual-cure bulk-fill BulkEZ (BEZ); Dual-cure bulk-fill HyperFIL (HF); and Tetric Evoceram Bulk-fill (TETRIC), as control. Gaps length (%) was evaluated in tooth-restoration interface with micro-computed tomography (µCT). The restorations were sectioned, and the degree of conversion (DC) and Knoop microhardness were evaluated at five depths (0.3, 1, 2, 3, and 4 mm). Microhardness data were statistically evaluated using absolute values (KHN) and relative values (microhardness percentages in relation to top). Gaps length (%) increased in the following order: BEZ=TETRIC<HF. The microhardness percentages in relation to top significantly decreased from 2 mm for TETRIC and 3 mm for HF. BEZ had constant microhardness and DC at all depths, while HF and TETRIC presented a significant decrease on DC at 4 mm. Dual-cure bulk-fill composites did not reduce gaps compared to light-cure bulk-fill, but they can improve depth of cure of bulk-filled restorations.

Resumo O objetivo neste estudo in vitro foi mensurar as fendas e a profundidade de polimerização de compósitos resinosos bulk-fill duais inseridos em preparos em forma de caixa. Os preparos em forma de caixa (4 mm de profundidade) foram realizados em quinze terceiros molares e separados em 3 grupos, de acordo com o compósito resinoso (n = 5): Bulk-fill dual BulkEZ (BEZ); Bulk-fill dual HyperFIL (HF); Tetric Evoceram Bulk-fill (TETRIC). O comprimento das fendas (%) foi avaliado na interface dente-restauração por meio de micro-tomografia computadorizada (µCT). As restaurações foram seccionadas e o grau de conversão (GC) e microdureza Knoop foram avaliados em cinco profundidades (0,3, 1, 2, 3 e 4 mm). Os dados de microdureza foram avaliados estatisticamente por meio de valores absolutos e relativos (porcentagens de microdureza em relação ao topo). O comprimento das fendas (%) aumentou na seguinte ordem: BEZ = TETRIC <HF. O percentual de microdureza em relação ao topo diminuiu significativamente a partir de 2 mm para TETRIC e 3 mm para HF. BEZ apresentou percentuais de microdureza e de GC constantes em todas as profundidades, enquanto HF e TETRIC apresentaram decréscimo significativo no GC em 4 mm. Os compósitos resinosos bulk-fill duais não reduziram as fendas formadas quando comparados a um compósito bulk-fill fotopolimerizável; entretanto, os mesmos podem melhorar a profundidade de polimerização em restaurações de incremento único.

Single implant overdenture reinforced with a metallic framework: A 2-year clinical follow-up.

INTRODUCTION: To prevent single-implant overdenture (SIO) fracture, the inclusion of a framework in the overdenture has been suggested. However, no investigations verified their benefits. OBJECTIVE: To evaluate prosthetic maintenance events, patient satisfaction, and mastication of SIO reinforced by metallic framework users. MATERIAL AND METHODS: Fifteen volunteers had a new set of complete dentures converted into an SIO containing a framework. Maintenance events were recorded, while patient satisfaction was assessed using a visual analog scale. Masticatory performance (MP) was evaluated using the sieving method, maximum bite force (MBF) by pressure sensors, and masseter thickness by ultrasound. Measurements were performed 2, 12, and 24 months after SIO use. Repeated-measures ANOVA and paired Student's t-tests (p < 0.05) were applied. RESULTS: Matrix exchange was the most prevalent maintenance event (83.6%), and no SIO was fractured during the entire follow-up. Satisfaction with the SIO stability decreased (p < 0.01) after 12 months. MP did not change between evaluations (p > 0.05). Conversely, MBF and masseter thickness improved after 12 and 24 months of SIO use (p < 0.05). CONCLUSIONS: Reinforced SIO did not fracture during 2 years but requires maintenance. It improves bite force and muscle thickness, maintaining MP values. Satisfaction with SIO stability decreased in the first year of use.

Rubbing ethanol and time of use: critical factors compromising latex gloves structure / Desinfecção com etanol e tempo de uso: fatores críticos que comprometem a estrutura das luvas de látex

Abstract Introduction Personal protective equipment is mandatory to protect patients and professionals from diseases, especially in the dental environment. The risk of gloves micro-perforations is imminent when using sharp instruments or cleaning them up during lengthy clinical procedures. Objective This study evaluated the integrity of sterile and non-sterile gloves before clinical use and clarified whether friction with disinfectant solution modifies surface morphology and integrity. Material and method Samples of gloves from four different brands were divided into two groups: (1) Sterile surgical gloves (n=260) and (2) Non-sterile gloves (n=260). They were scissored and placed in Ostby's arch so that three solutions - distilled water, ethanol 70°, ethanol 96° - were rubbed with a cotton swab. After 30s, 5, 10, and 15 minutes of solution rubbing, samples were verified by a Scanning Electron Microscope. The pore sizes were measured by Image J software. Result Regardless of the brands, all gloves have been significantly affected by solutions and assessment periods. In general, remarkable changes were evident with ethanol 70° and 96°, and higher pore diameters were observed compared to distilled water. Conclusion Rubbing disinfectant solutions increases gloves' pores sizes, and time negatively influenced its quality.

Resumo Introdução Para proteger pacientes e profissionais de doenças, o uso de equipamentos de proteção individual é obrigatório, principalmente no ambiente odontológico. O risco de microperfurações das luvas é iminente ao usar instrumentos cortantes ou na tentativa de limpar as luvas durante longos procedimentos clínicos. Objetivo Este estudo avaliou a integridade das luvas cirúrgicas e de procedimento antes do uso clínico e esclareceu se o atrito com a solução desinfetante modifica a morfologia e integridade da superfície. Material e método Amostras de luvas de quatro marcas diferentes foram divididas em dois grupos: (1) Luvas cirúrgicas (n = 260) e (2) Luvas descartáveis não estéreis (n = 260). As luvas foram cortadas e colocadas em arco de Ostby, de modo que três soluções - água destilada, etanol 70 °, etanol 96 ° foram esfregadas com um cotonete. Após 30s, 5, 10 e 15 minutos de fricção das soluções, as amostras foram verificadas utilizando um microscópio eletrônico de varredura. Os tamanhos dos poros foram medidos pelo software Image J. Resultado Independentemente das marcas, todas as luvas foram significativamente afetadas por soluções e períodos de avaliação. Em geral, maiores alterações foram evidenciadas com o uso do etanol 70° e 96°, e maiores diâmetros dos poros foram observados quando comparados à água destilada. Conclusão Esfregar soluções desinfetantes aumenta o tamanho dos poros das luvas e o tempo influenciou negativamente sua qualidade.

Does the institutionalization influence elderly's quality of life? A systematic review and meta-analysis.

BACKGROUND: Institutionalization is a global phenomenon and its impact on elderly's quality of life (QoL) is under discussion. This systematic review and meta-analysis evaluated the influence of the institutionalization on elderly's QoL. METHODS: Searches were performed in Medline, Scopus, Web of Science, Lilacs, Cochrane Library and SIGLE by two independent reviewers up to May 2019. The eligibility criteria were based on PECO strategy, considering observational studies in elderly (P), which were (E) or not (C) institutionalized to identify differences in their QoL (O). For qualitative synthesis, data were extracted and risk of bias was evaluated through a validated guideline. Meta-analysis was based on Mean Difference (MD) and Standard Mean Difference (SMD) calculation (p ≤ 0.05). The evidence was quality-tested using Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: The initial search identified 3841 articles. Duplicates were removed, titles and abstracts were read and eligibility criteria were applied, remaining 16 sixteen cross-sectional studies that were included for data extraction and qualitative synthesis. Out of 16 articles, 14 evaluated the Health-Related Quality of Life, using Leipad (n = 2), WHOQOL-BREF and/or OLD (n = 8), SF-36 or RAND-36 (n = 4) questionnaires, and two assessed the Oral Health-Related Quality of Life, through GOHAI questionnaire. One eligible article was considered as low risk of bias. In the meta-analysis, 12 studies were included. Leipad questionnaire did not show differences on elderly's QoL (MD 0.11 [- 0.10, 0.32] I2 = 76%). Differences on elderly's QoL were detected through WHOQOL-BREF (SMD -0.70 [CI95%: - 0.94, - 0.47] I2 = 93%), WHOQOL-OLD (SMD -1.13 [- 1.47, - 0.80] I2 = 91%) and SF-36/RAND-36 (MD -5.97 [CI95%: - 11.29, - 0.64] I2 = 90%). All studies had very low or low certainty of evidence, since the study design influenced evidence classification, and show high heterogeneity. CONCLUSION: Although the institutionalization influences negatively the elderly's QoL, further well-designed studies are needed to confirm this evidence.

Chewing ability and oral health-related quality of life in frail elders after new complete dentures insertion: A paired controlled clinical trial.

AIMS: To compare the effect of new complete dentures (CDs) on self-perceived masticatory ability (MA) and oral health-related quality of life (OHRQoL) in frail and nonfrail elders. METHODS AND RESULTS: Twenty completely edentulous elders were assigned to two groups: frail and nonfrail (n = 10/each). MA was evaluated using a visual analogue scale. OHRQoL was assessed with the Oral Health Impact Profile (OHIP-Edent). Variables were evaluated with volunteers wearing their old and unsatisfactory CDs. Then, a new set of CDs was manufactured and all outcomes were reassessed 2 months after the insertion. Data were analyzed by repeated measures' analyses of variance and Tukey tests. MA for lettuce and peanuts was improved (P < .05) for the frail group after new CD insertion. Psychological discomfort and handicap OHIP-Edent domain improved (P < .05) for both groups after prosthetic treatment. Before treatment, controls reported greater psychological discomfort than the frail group. Meanwhile, the handicap domain score of frail patients improved to a level similar to that of the nonfrail group after treatment. Regardless of frailty, elders showed better MA scores for most food types after treatment and decreased OHIP-Edent domain values. CONCLUSION: Self-reported MA and OHRQoL of frail elderly people were greatly improved after new CD use.

Mastication and oral sensory function in frail edentulous elderly: a case-control study.

OBJECTIVE: To evaluate the maximum bite force (MBF), masticatory performance and oral sensory function (OSF) of frail edentulous elderly. The correlation of MBF with maximum grip strength (MGS) was also assessed. METHODS: Twenty edentulous elderly [10 with and 10 without the frailty phenotype (FP)] were selected to participate in this case-control study. The FP was diagnosed using the criteria of Fried et al., which consider weight loss, exhaustion, physical activity level, weakness and slowness to the evaluation. All volunteers received new complete dentures (CDs) to standardise the occlusal status, and after 2 months of use with no complaint, all variables were assessed. MBF was measured by pressure sensors positioned bilaterally on the first artificial molars. Masticatory performance was assessed using the sieving method and was expressed as the median particle size (X50 ) of Optocal after 40 masticatory cycles. OSF was evaluated using the oral stereognosis test, and MGS was measured using a dynamometer. Groups were compared using one-way analysis of variance. The Pearson coefficient of correlation between MBF and MGS was calculated. RESULTS: Frail elderly people showed reduced MBF (P = 0.0431) and larger X50 values (P = 0.0053) than did non-frail elders, while OSF did not differ between the groups. MBF had a moderate positive correlation with MGS (r = 0.690, P = 0.003). CONCLUSIONS: Frail elderly had reduced MBF and impaired mastication. On the other hand, OSF does not seem to be affected by frailty. MBF was moderately correlated with MGS.

Removable prostheses improve oral health-related quality of life and satisfaction of elderly people with rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease that affects joint tissues and causes severe physical and functional impairments on quality of life due to muscular and articular pain. The involvement of temporomandibular joint in RA interferes with mouth opening and masticatory process. However, no studies addressed the impact of RA on oral health-related quality of life (OHRQoL) and satisfaction with prostheses use in elderly people. Aim: This study assessed the impact of oral rehabilitation with conventional dentures on the OHRQoL and prostheses satisfaction in elderly patients with RA, associated or not with temporomandibular disorder (TMD). Methods: Forty-five elderly were enrolled and divided into three groups: (1) RA and TMD (n=15, experimental), (2) RA without TMD (n=15, experimental), and (3) without RA and without TMD (n=15, control). The OHRQoL and the prostheses satisfaction were evaluated before and after new oral rehabilitation with partial and/or complete dentures. The OHRQoL and prosthesis satisfaction were assessed and verified through OHIP-14 questionnaire and visual analogue scale, respectively. Results: TMD group exhibited the worst mean values (P<0.05) for all OHIP-14 domains before insertion of new dentures. Group 2 showed worst means (P<0.05) compared to controls for functional limitation and physical pain domains of the OHIP-14, but not in the general score. Patients showed better outcomes of satisfaction with prostheses use only after the new rehabilitation. Conclusion: The use of new and well-fitted dentures improves all domains of OHRQoL in patients with RA and TMD and all groups were satisfied with prostheses use after the new rehabilitation with conventional dentures

Bite Force, Masseter Thickness, and Oral Health-Related Quality of Life of Elderly People with a Single-Implant Mandibular Overdenture.

PURPOSE: To compare maximum bite force, masseter thickness, and oral health-related quality of life (OHRQoL) in elderly patients rehabilitated with conventional complete dentures (CDs) and single-implant overdentures (SIOs). MATERIALS AND METHODS: A paired design was conducted, and 12 elderly patients were selected. Initially, a set of new CDs was manufactured and placed. After a 2-month adaptation period, the mandibular CD was transformed into an SIO by inserting one osseointegrated implant into the symphysis region. All variables were evaluated 2 months after both treatments (CD and SIO). Maximum bite force was evaluated using pressure sensors, while masseter thickness was obtained via ultrasound during muscle contraction and relaxation. The Oral Health Impact Profile for edentulous people (OHIP-Edent) was used to measure OHRQoL. Data were analyzed using Student t test and Wilcoxon test. Pearson coefficient of correlation between bite force and masseter thickness was calculated. RESULTS: Values for maximum bite force and masseter thickness during contraction increased significantly after SIO use (P < .001), indicating an improvement in muscle function. Considering OHRQoL, the general score and the domains functional limitation and physical pain were reduced (P < .05), indicating better perception of OHRQoL, with SIO use. Moreover, masseter thickness during contraction was moderately correlated with bite force (r = 0.480; P = .018). CONCLUSION: Using SIO increased the maximum bite force and masseter thickness of elderly patients, leading to an improved OHRQoL.

Prostheses satisfaction and diet of elderly wearing a single implant overdenture: A six-month assessment.

AIMS: To compare prosthesis satisfaction and nutritional intake of edentulous elderly people wearing a conventional complete denture (CD) with those wearing a single implant mandibular overdenture (SIO) after 6 months of use. METHODS AND RESULTS: Completely edentulous elderly patients (n = 22) were divided between a group rehabilitated with CDs in both dental arches and a group receiving a mandibular SIO with a conventional CD in the upper arch (n = 11/group). Patients completed a visual analog scale for degree of satisfaction with their prostheses in seven categories. Nutritional intake of patients (based on patient diaries) was evaluated over a 3-day period. SIO wearers were more satisfied with their prostheses than were CD wearers. Six months after rehabilitation, the SIO group consumed foods higher in vitamins B2 and B6, whereas the CD group consumed more sodium. CONCLUSION: SIO wearers are more satisfied with their prosthesis and consume greater amounts of vitamin B2 and vitamin B6 in their diets than CD wearers. Brazilian Registry of Clinical Trials (#RBR-3kgttj and #RBR-37gdst).

Influence of lower complete denture use on masseter muscles and masticatory function: A longitudinal study.

BACKGROUND: Edentulism can reduce mastication, leading to changes in food pattern, with possible consequences to masticatory muscle thickness. OBJECTIVES: This study verified masticatory function and oral perception in subjects who did not use lower CDs, and whether the insertion of new upper and lower CDs would improve such variables. METHODS: Fifteen edentulous elderly who wore only the upper CD were selected and received new upper and lower CD. Volunteers were evaluated at baseline and after 1, 3 and 6 months of new prosthesis use. Masticatory performance (MP) was assessed by the sieving method (X50 values). Masseter thickness (MT) was evaluated by ultrasonography. Oral sensorial ability (OSA) was assessed by oral stereognosis test and maximum tongue pressure (MTP) was verified by pressure sensors. Data were submitted to repeated measures ANOVA and Tukey-Kramer posthoc tests (α = 0.05). Correlation between OSA and MTP was verified by Person's correlation. RESULTS: X50 and MTP decreased (P < 0.05) after 1 month and remained stable (P > 0.05) for next assessments. After 3 months, MT in rest position was increased (P < 0.05), while during maximum voluntary contraction 1 month was enough to increase MT (P < 0.05). There were no differences for OSA (P > 0.05) and no correlation between OSA and MTP. CONCLUSION: Masticatory performance and masseter thickness of elderly who did not use the lower dentures were improved after 2 months using new upper and lower CDs. However, new CDs in both dental arch decreased MTP. Brazilian Registry of Clinical Trials (ReBEC #RBR-37gdst).

Mandibular single-implant overdenture as an alternative for full arch rehabilitations: a literature review

Oral rehabilitation with mandibular single-implant overdentures (SIO) has been characterized as a solution to improve retention and stability of conventional complete dentures (CD). Among the benefits of this therapy, it can be mentioned minimally invasive surgery, simple prosthetic technique, better retention, and significantly reduced costs. However, the application of this protocol in daily clinic is still not widespread. Aim: Thus, this study aimed to perform a literature review to address the clinical characteristics of this rehabilitation, when compared to two-implant mandibular overdentures and CD. Methods: For this, a search was conducted in the PubMed database, considering articles published in English language, without date limitation. Results: It was found 243 manuscripts, of which 20 were compatible with the aim of this study after title/abstract reading. The selected papers focused on masticatory muscles function, satisfaction levels and self-reported quality of life, as well as surgical and prosthetic outcomes, such as maintenance, repair and implant failure rates. All evaluated manuscripts showed similar masticatory function and patient's satisfaction with SIO and two-implant overdenture, while results for a SIO were greater when compared to rehabilitations with CD. In addition, SIO have proven to do not damage the implant, being implant loss close to zero. However, the prosthesis fracture adjacent to the implant was a recurrent clinical outcome, which requires further studies to solve this impairment. Conclusion: Thus, it can be concluded that SIO represents an alternative treatment for frail elders or low-income patients, leading to higher masticatory function, as well as improved quality of life