Evaluation of surface roughness of differently manufactured denture base materials.

STATEMENT OF PROBLEM: The popularity of computer-aided design and computer-aided manufacturing (CAD-CAM) dentures has led to the introduction of new denture materials and resins. However, studies on the surface characteristics of these materials and how they compare to dentures fabricated by more traditional methods are lacking. PURPOSE: The purpose of this cross-sectional study was to determine whether the surface roughness (Ra) of denture base materials differed based on manufacturing technique. MATERIAL AND METHODS: Disks of Ø10×2-mm (n=10) were fabricated using 6 different manufacturing techniques, including compression molding (Lucitone 199), injection molding (Ivocap High Impact), Computer Numerical Control (CNC) milling (Ivotion Base), and additive manufacturing on the Carbon M2 (Lucitone Digital Print), the SprintRay Pro55 S (Dentca Denture Base II), and the Envision One (Flexcera Base) systems. An automatic, noncontact laser confocal microscope (VK-X1000 Series; KEYENCE) was used to analyze the Ra surface roughness of each specimen at ×5 magnification. The images were imported into a multifile analyzer, horizontal and vertical roughness profiles were inserted into each scan, and Ra values were calculated and averaged by following the International Organization for Standardization (ISO) 4287 standard. A 1-way analysis of variance (ANOVA) was performed to compare the effect of manufacturing technique on surface roughness, followed by the Tukey multiple comparisons test (α=.05). RESULTS: The additively manufactured Dentca Denture Base II (AM-DB) exhibited a statistically significantly higher Ra when compared with the other test groups (P<.001). The additively manufactured Flexcera Base (AM-FB) showed a higher Ra mean value when compared with injection molding (IM) (P=.036). No statistically significant difference in surface roughness was found among the other tested materials representing the different processing methods (P>.05). CONCLUSIONS: The manufacturing method influences the Ra of denture base materials with varying results. The injection molding method resulted in the smoothest surface compared with additively manufactured and CNC-milled denture base materials.

Leadership education in prosthodontics: Development and impact of the Future Leaders in Prosthodontics (FLIP) workshops.

STATEMENT OF PROBLEM: The effectiveness of leadership education for prosthodontists is unknown. PURPOSE: The purpose of this survey study was to evaluate the self-perceived impact a 2- to 2.5-day leadership education workshop in prosthodontics had on participants' professional, leadership, and management development. MATERIAL AND METHODS: Participants who attended a leadership workshop for future leaders in prosthodontics (FLIP) were surveyed to assess their self-reported improvements in different leadership domains. The survey was administered to 89 participants using an online survey tool, and demographic data about participants were also collected. Results were tabulated for descriptive presentation. Where applicable, the Spearman correlation coefficients were calculated. RESULTS: Seventy-two individuals responded to the invitation for a response rate of 80.9%. Improvement in all 11 leadership capabilities assessed in the survey was noted by over 75% of respondents. Over 90% of respondents reported improvement in overall leadership, career management, team management, self-awareness, problem-solving, and conflict resolution. No significant (P>.13) relationships were found among demographic data such as age, sex, home continent, or primary career focus (academics or private practice). CONCLUSIONS: Within the limitations of this survey study, participants in a leadership workshop noted improvement in a variety of leadership capabilities.

Rehabilitation of Edentulism and Mortality: A Systematic Review.

PURPOSE: It has been shown that tooth loss is associated with an increased risk of early mortality, and that prosthetic rehabilitation of edentulism improves quality of life and reduces morbidity. This review examines association between prosthetic rehabilitation of the edentulous state with a complete denture and mortality. METHODS: A systematic search using combinations of related keywords for "complete denture" and "mortality" was performed on PubMed, Web of Science, and Google Scholar. A reference search of included articles and author contacts was also performed. RESULTS: None of the studies reported results for association between mortality and wearing complete dentures among edentulous individuals; however, based on the published methods and results, a total of 15 studies were found to be eligible for author contacts to obtain relevant data. Overall, 5 eligible studies were included and critically evaluated to summarize their findings. The follow-up period in these studies ranged from 3 to 24 years, and the age group of included samples ranging from 52 to 105 years. The proportion of individuals not wearing dentures ranged from 3.0% to 13.3%. Four of the included studies showed fewer individuals without complete dentures surviving over the follow-up years as compared to the group wearing complete dentures. One of two studies that could adjust for certain confounders found no significant difference in mortality after adjusting, but another study found a 42% reduced risk of dying among those wearing complete dentures, as compared to those not wearing complete dentures after adjusting for age, sex, educational level, smoking, alcohol drinking, body mass index, time spent walking daily, medical history, psychological distress score, energy intake, and protein intake. Due to the small sample size of nondenture wearers, it was not possible to analyze with statistical rigor the comparative risk of dying associated with wearing or not wearing complete dentures. CONCLUSION: Most of the included studies indicated a higher proportion of deceased edentulous patients not using dentures as compared to denture wearers. Nevertheless, small sample size prevents a definite conclusion being drawn regarding a relationship between prosthetic rehabilitation and mortality among edentulous individuals.

Complete Edentulism and Comorbid Diseases: An Update.

The relationship between complete edentulism, which is the terminal outcome of a multifactorial oral disease process and other comorbid diseases, was first reported in 2009. Although the relationship between edentulism and a multitude of systemic diseases was reported, none of the publications studied could determine causality of tooth loss on the incidence of any comorbid disease. Since that publication, there has been a renewed interest in this relationship, and a plethora of new articles have been published. This article will provide an update on articles published since 2008 on the relationship between edentulism and comorbid diseases, and will include the relationship between complete edentulism and such comorbid conditions as malnutrition, obesity, cardiovascular disease, rheumatoid arthritis, pulmonary diseases (including chronic obstructive pulmonary disease), cancer, and even mortality.

Denture adhesive use in complete dentures: clinical recommendations and review of the literature.

This literature review sought to determine the advantages and disadvantages of denture adhesive use among complete denture patients. Manuscripts were obtained by searching the National Library of Medicine's PubMed database, Cochrane Collaboration Library, ADA Center for Evidence-Based Dentistry website, and EMBASE database. A total of 85 abstracts were reviewed, and 38 articles that met the inclusion criteria for this review were selected. The inclusion criteria included clinical trials and case series in which 10 or more patients were treated, as well as Cochrane collaboration reviews and in vitro studies where clinical relevance could be determined. The selected manuscripts were reviewed using a standardized manuscript review matrix. Although denture adhesives improve the retention and function of complete dentures, standardized guidelines are needed for the proper use, application, and removal of denture adhesives. Additionally, long-term studies are warranted on the biologic effects of denture adhesives. There is a need to establish a regular recall program for complete denture patients.