Can Denture Wearing Increase the Nutritional Status in Pre-Elderly and Elderly Patients?

Abstract Objective: To investigate the relationships among tooth loss, denture wearing, nutrition intake, and nutritional status. Material and Methods: This observational cohort study was conducted on 26 patients (≥ 45 years old) at the Faculty of Dentistry, Universitas Indonesia. Tooth loss was classified according to the Eichner Index. The Semi-quantitative Food Frequency Questionnaire was used to measure nutritional intake (kcal). Mini Nutritional Assessment Short Form (MNA-SF) and Handgrip Strength (HGS) assessments were employed to measure the nutritional status at baseline (before denture insertion), 1, 2, 3, 6, 9, and 12 months after denture use. Results: Significant differences in nutritional intake (p<0.05) between the Eichner B and C groups were noted at 3, 6, 9, and 12 months after using dentures. Significant increases in nutritional intake were noted after wearing the dentures (p<0.05) when compared with the baseline values. The nutritional status was considered normal in 65.4% of the patients at 12 months and 38.5% at baseline. Furthermore, the nutritional status 1, 2, 3, 6, 9, and 12 months after wearing denture was significantly improved compared with the baseline values (p<0.05). Significant differences in HGS (p<0.05) were observed between the Eichner B and C groups at 6, 9, and 12 months after using the denture. However, no significant differences in HGS were noted before and after wearing the denture (p<0.05). Conclusion: Denture wearing can improve the nutritional intake and status of pre-elderly and elderly patients.

Relationships Between Tooth Loss and Masticatory Performance, Nutrition Intake, and Nutritional Status in the Elderly

Abstract Objective: To analyze the associations between posterior tooth loss and masticatory performance, nutrition intake, and nutritional status in the elderly. Material and Methods: A total of 158 subjects aged 60 years and older from Depok, West Java, Indonesia were enrolled in this cross-sectional study. Posterior teeth contacts were assessed and the subjects were divided into two groups based on Eichner Index; group A2-B3 and group B4-C3. The masticatory performance test was conducted using color-changeable chewing gum. A semi-quantitative food-frequency questionnaire was used to measure nutritional intake in the form of total calories, and the Mini-Nutritional Assessment-Short Form was used to measure nutritional status. Mann Whitney U test was used to determine differences in masticatory performance, nutrition intake, and nutritional status between the two groups Results: Seventy-four percent of participants were female, and 26% were male. A significant difference in the mean masticatory performance score (p<0.001) was noted between Eichner group A2-B3 (5.66 ± 1.80) and B4-C3 (3.20 ± 1.25). However, no statistically significant difference in nutritional status and calorie intake were found between the two groups (p>0.05) Conclusion: Despite the adequacy of nutrition intake and nutrition status in this population, tooth replacement is necessary to improve masticatory performance in both groups.

Relationships Between Infant Birth Weight and Maternal Mastication Ability, Caloric Intake and Prepregnancy Body Mass Index of Women with Posterior Tooth Loss

Abstract Objective: To analyze the relationships between infant birth weight and maternal mastication ability, caloric intake, and body mass index (BMI) of women with posterior tooth loss. Material and Methods: A cross-sectional study was conducted in 52 females aged 20-35 years who gave birth recently and had one or more unreplaced missing posterior teeth. The number and locations of the missing teeth were grouped on the basis of the Eichner Index. Prepregnancy BMI, caloric intake, and subjective mastication ability were recorded Results: A significant difference was observed in the mean infant birth weights between the subjects with good and poor mastication in Eichner A2 (p<0.001), B1 (p=0.039), and B2 groups (p=0.039), that mean infant birth weight was lower in the group of women with poor mastication. The Pearson correlation test revealed a significant relationship between maternal caloric intake and infant birth weight (p<0.001). Mean infant birth weights differed between BMI categories, i.e., underweight, normal and overweight women subjects (2.59 ± 0.18 Kg, 2.99 ± 0.15 Kg, 3.58 ± 0.30 Kg) (p<0.001). The Kruskal-Wallis test revealed significant differences between the prepregnancy BMIs of pregnant women with posterior tooth loss and infant birth weights (p<0.001) Conclusion: We found that decreased subjective mastication ability in pregnant women who lost posterior teeth was associated with decreased infant birth weight, whereas higher mean caloric intake and higher prepregnancy BMI in pregnant mothers who lost posterior teeth were associated with increased infant birth weight.

Maxillofacial prosthodontics practice profile: a survey of non-United States prosthodontists.

BACKGROUND: This study surveyed non-United States maxillofacial prosthodontists (MFP) to determine their practice profile and rationale for pursuing an MFP career. METHODS: Email addresses for the MFP were obtained from the International Society for Maxillofacial Rehabilitation, American Academy of Maxillofacial Prosthetics, and International Academy for Oral Facial Rehabilitation. Emails with a link to the electronic survey program were sent to each participant. Chi-square and Mann-Whitney-U tests were used to investigate the influence of formal MFP training on professional activities and type of treatments provided. RESULTS: One hundred twelve respondents (response rate 39%) from 33 nationalities returned the survey. The top three reasons for pursuing an MFP career were personal satisfaction, prosthodontics residency exposure, and mentorship. The predominant employment setting was affiliation with a university (77%). There were significant differences between respondents with and without formal MFP training regarding provision of surgical treatments (P = 0.021) and dental oncology (P = 0.017). Most treatments were done together with otolaryngology, oral surgery (68%) and head and neck surgery (61%). Practitioners not affiliated with a university spent significantly more time in clinical practice (P = 0.002), whereas respondents affiliated with universities spent significantly more time in teaching/training (P = 0.008) and funded research (P = 0.015). CONCLUSIONS: Personal satisfaction is the most important factor in a decision to choose an MFP career. Most of the MFPs work at a university and within a multidisciplinary setting. There were differences regarding type of treatments provided by respondents with and without formal MFP training.

Efficacy of cleansing agents in killing microorganisms in mixed species biofilms present on silicone facial prostheses--an in vitro study.

OBJECTIVES: The purpose of this study was to assess the efficacy of different cleansing agents in killing mixed species biofilms on silicone facial prostheses. MATERIALS AND METHODS: Two bacterial and three yeast strains, isolated from silicone facial prostheses, were selected for the mixed species biofilms. A variety of agents used to clean facial prostheses were employed, viz., antibacterial soap, essential-oil-containing mouth rinse, ethanol 27 %, chlorhexidine mouth rinse, and buttermilk. Colony forming units (CFUs) and live/dead staining were analyzed to assess the efficacy of these cleansing agents against 24-h and 2-week biofilms and regrown biofilms on silicone samples. RESULTS: Chlorhexidine was the most effective cleansing agent. Chlorhexidine killed 8 log unit CFUs (>99.99 % killing) in a 24-h biofilm and 5 log unit CFUs (>99.99 % killing) in 2-week biofilms. Also, after regrowth and repeated treatment of the biofilm, chlorhexidine was the most effective cleansing agent showing no detectable CFUs. The essential-oil-containing mouth rinse (containing 26.9 % ethanol) showed a similar efficacy as ethanol (27 %) alone. Antibacterial soap and buttermilk were the least effective agents tested. CONCLUSIONS: Chlorhexidine showed the highest reduction in CFUs in 24-h, 2-week, and regrown mixed species biofilm of microorganisms isolated from silicone facial prostheses. CLINICAL RELEVANCE: Chlorhexidine mouth rinse (easy obtainable and relatively cheap) is very effective in killing bacteria and yeast present in biofilms on silicone facial prostheses. When applied on a regular basis, cleansing a facial prosthesis with chlorhexidine will presumably increase its lifetime and reduce skin irritations.

Current state of craniofacial prosthetic rehabilitation.

PURPOSE: This study aimed to review the current state of the techniques and materials used to rehabilitate maxillofacial defects. MATERIALS AND METHODS: The MEDLINE and EMBASE databases were searched for articles pertinent to maxillofacial prostheses published from January 1990 to July 2011. The main clinical stages were the subject of analysis. RESULTS: A multidisciplinary approach is preferred when rehabilitating maxillofacial defects. Surgical reconstruction can be used for smaller defects, but larger defects require a prosthesis to achieve an esthetic rehabilitation. Implant retained prostheses are preferred over adhesive prostheses. Silicone elastomer is currently the best material available for maxillofacial prostheses; however, longevity and discoloration, which are greatly influenced by ultraviolet radiation, microorganisms, and environmental factors, remain significant problems. In the near future, the widespread availability and cost effectiveness of digital systems may improve the workflow and outcomes of facial prostheses. Patients report high satisfaction with their prostheses despite some areas that still need improvement. CONCLUSIONS: Maxillofacial prostheses are a reliable treatment option to restore maxillofacial defects and improve quality of life. Significant progress has been made in the application of implants for retention and digital technology for designing surgical guides, suprastructures, and craniofacial prostheses. Further improvements are necessary to enhance longevity of prostheses.

Indonesian undergraduate dental students' perceptions toward implant treatment and education.

OBJECTIVE: Indonesia foresees high demand in providing dental implant therapy and need to prepare competent graduating dentists. No information about undergraduate dental implant education in Indonesia has been reported in the literature. The objective of this study was to investigate dental students' perceptions towards implant treatment and education in one Indonesian dental school. METHODS: A survey was distributed to 166 fourth- and fifth-year students of Faculty of Dentistry, University of Indonesia (FD-UI). The survey consisted of 14 questions on students' perceptions on implant treatment, current undergraduate implant curriculum, and their future plans. RESULTS: One hundred and forty-one students (85%) returned the survey. Dental implant was considered as a treatment of choice for restoring missing mandibular first molar and maxillary anterior tooth, but not edentulous mandible. The majority of students rated that the topic of implant dentistry was insufficiently covered during undergraduate education, were interested in learning more, and planned to include implant as part of their future practice. CONCLUSION: Dental students of FD-UI are aware of implant treatment as a restorative option in replacing a single missing tooth. There is a need for a nationwide discussion for introducing a comprehensive implant dentistry curriculum in undergraduate dental education in Indonesia.

Microbial biofilms on facial prostheses.

The composition of microbial biofilms on silicone rubber facial prostheses was investigated and compared with the microbial flora on healthy and prosthesis-covered skin. Scanning electron microscopy showed the presence of mixed bacterial and yeast biofilms on and deterioration of the surface of the prostheses. Microbial culturing confirmed the presence of yeasts and bacteria. Microbial colonization was significantly increased on prosthesis-covered skin compared to healthy skin. Candida spp. were exclusively isolated from prosthesis-covered skin and from prostheses. Biofilms from prostheses showed the least diverse band-profile in denaturing gradient gel electrophoresis (DGGE) whereas prosthesis-covered skin showed the most diverse band-profile. Bacterial diversity exceeded yeast diversity in all samples. It is concluded that occlusion of the skin by prostheses creates a favorable niche for opportunistic pathogens such as Candida spp. and Staphylococcus aureus. Biofilms on healthy skin, skin underneath the prosthesis and on the prosthesis had a comparable composition, but the numbers present differed according to the microorganism.