RESUMO
STATEMENT OF PROBLEM: The influence of different denture adhesive forms on retention, stability, denture movement, and masticatory efficiency have been studied. However, studies that investigated their effect on patient-based outcomes are scarce. PURPOSE: The purpose of this crossover randomized controlled trial was to investigate the influence of 3 different denture adhesive forms on patient satisfaction and oral health-related quality of life (OHRQoL) in edentulous individuals. MATERIAL AND METHODS: A total of 30 edentulous participants were enrolled. They initially received conventional dentures, which they used for 3 months. They were then instructed to use 3 forms of denture adhesives (cushion, paste, and powder) for 3 months each. Patient satisfaction was assessed by using a visual analog scale (VAS), and OHRQoL was assessed by using the oral health impact profile in the edentulous adults instrument. Assessments were done 3 months after wearing the conventional dentures, then after by using each denture adhesive form for 3 months, with a 1-month washout period. The average retention duration for each form and participant preference were also evaluated. Statistical analysis was conducted by using the repeated measures ANOVA test followed by the Scheffé test for VAS scores and retention duration. The Friedman test followed by the Wilcoxon signed-rank test was used for OHRQoL scores (α=.05). RESULTS: Irrespective of their forms, denture adhesives significantly improved patient satisfaction in most aspects (P<.001) and significantly improved OHRQoL (P<.001). VAS scores for the cushion form were significantly higher than those for the other 2 forms regarding general satisfaction, comfort, and ease of cleaning dentures and tissues. For stability and masticatory ability, the cushion and paste forms were significantly better (P<.05) than the powder form. OHRQoL scores were significantly higher (worse) for the powder form compared with the other 2 forms for the functional limitation, physical pain, and physical disability domains, with insignificant differences between the cushion and paste forms (P>.05). The powder form found the shortest retention duration and the least preference. CONCLUSIONS: Denture adhesives significantly improved OHRQoL and almost all aspects of patient satisfaction. The cushion form provided higher satisfaction levels for most aspects, followed by paste and then powder. OHRQoL outcomes were comparable for all forms, except for the functional limitation, physical pain, and physical disability domains, which were significantly better with the cushion and paste forms. The cushion and paste forms were more retentive and more preferred by the participants than the powder form.
RESUMO
STATEMENT OF PROBLEM: Placing removable partial denture (RPD) rests on composite resin restorations has long been a debatable issue. Despite developments in composite resins such as nanotechnology and bulk-filling techniques, studies investigating the performance of composite resin restorations when used to support occlusal rests remain scarce. PURPOSE: The purpose of this in vitro study was to investigate the performance of bulk-fill versus incremental (conventional) nanocomposite resin restorations when they are used to support RPD rests under functional loading. MATERIAL AND METHODS: Thirty-five caries-free intact maxillary molars of similar coronal size were collected and divided into 5 equal groups (n=7): Enamel (Control) group: rest seats prepared entirely in enamel; Class I Incremental group: Class I cavities restored with incrementally placed nanohybrid resin composite resin (Tetric N-Ceram); Class II Incremental group: Mesio-occlusal (MO) Class II cavities restored with Tetric N-Ceram; Class I Bulk-fill group: Class I cavities restored with high-viscosity bulk-fill hybrid resin composite (Tetric N-Ceram Bulk-Fill); and Class II Bulk-fill group: MO Class II cavities restored with Tetric N-Ceram Bulk-Fill. Occlusal rest seats were prepared mesially in all groups, and clasp assemblies were fabricated and cast in cobalt chromium alloy. Specimens with their clasp assemblies were subjected to thermomechanical cycling using a mechanical cycling machine (250000 masticatory cycles) and 5000 thermal cycles (5 °C to 50 °C). Surface roughness (Ra) was measured with a contact profilometer before and after cycling. Fracture analysis was done using stereomicroscopy, and margin analysis was done with a scanning electron microscope (SEM) before and after cycling. Statistical analysis of Ra was conducted using ANOVA followed by the Scheffé test for between-group comparison and paired t test for within-group comparison. The Fisher exact probability test was used for fracture analysis. The Mann-Whitney test was used for between-group comparison and Wilcoxon signed rank test for within-group comparison for the SEM images (α=.05). RESULTS: Mean Ra increased significantly after cycling in all groups. Significant differences in Ra were found between enamel and all 4 resin groups (P<.001), with no significant differences between incremental and bulk-fill resin groups for both Class I and II specimens (P>.05). No significant differences were found between the 2 resin groups with regard to fracture and margin analysis (P>.05). CONCLUSIONS: The surface roughness of enamel was significantly lower than that of both incremental and bulk-fill nanocomposite resins before and after functional loading. Incremental and bulk-fill nanocomposite resins showed comparable performance in terms of surface roughness, fracture behavior, and marginal adaptation.