Wear, Fatigue and Fracture Resistance of Different Monolithic CAD/CAM Onlays As Abutments for Acetal Resin or Cobalt-Chromium Removable Partial Denture Frameworks.

PURPOSE: To assess wear, fatigue, and fracture resistance of different CAD/CAM onlays, milled from monolithic Zirconia (Zr), hybrid ceramic (EN), and lithium disilicate (LS), when used as abutments for removable partial denture frameworks fabricated from acetal resin (AR) or cobalt-chromium (Co-Cr). METHODS: Standard onlays and RPD framework were designed and milled using CAD/CAM. Onlays were cemented with resin cement to identical teeth models. The RPD's occlusal rest surface and the ceramic onlays' rest seats were both 3D scanned before and after 750,000 mechanical load cycles (50 N) and 8,000 thermal cycles (5-55°C) in a chewing simulator. The volumetric loss was measured using 3D image processing software, and the failure of the samples was detected using a stereomicroscope. The fracture resistance was tested by loading to failure in a universal testing machine. The fatigue failure results were analyzed with Fisher's exact probability test and the wear and fracture resistance data were analyzed using two-way ANOVA and Bonferroni Post-hoc test (P<0.05). RESULTS: A significant difference (p<0.05) was found between the tested experimental groups in wear, fatigue, and fracture resistance. Zr/Co-Cr combinations exhibited the least wear and the highest fatigue and fracture resistance (P<0.05), while the highest wear and least fatigue and fracture resistance were recorded for EN/AR group (p<0.05). CONCLUSIONS: Zr onlays demonstrated a conservative treatment option with superior mechanical behavior when used as an onlay abutment, regardless of the RPD framework material used. The AR framework is not recommended in the posterior region for removable partial dentures.

Effect of Thickness and Bonding Technique on Fatigue and Fracture Resistance of Feldspathic Ultra-Thin Laminate Veneers.

OBJECTIVES: To evaluate the fatigue and fracture resistance of ultra-thin laminate veneers (UTLV) with two different thicknesses and two different bonding protocols. MATERIALS AND METHODS: A total of 64 flat enamel surfaces were assigned to either 0.2 or 0.4 mm UTLV. The UTLV were further subdivided and assigned to one of two bonding techniques: adhesive resin cement(RC( or preheated restorative resin composite (HC) (n = 16). Eight samples were fatigued with 750,000 mechanical cycles and 8,000 thermal cycles between 5 and 55°C in a chewing simulator, and the failure mode was evaluated using a stereomicroscope and SEM. The other eight samples from each group were loaded to failure in a universal testing machine to test the fracture resistance. Fisher's exact Probability test was used to analyze the fatigue test results, and two-way analysis of variance and Bonferroni's test were used to analyze the fracture resistance test results. RESULTS: The difference in fatigue resistance between failure proportions in different groups was statistically different (p < 0.05). The 0.4-mm-thick UTLV had similar results regardless of the bonding technique, while 0.2-mm-thick UTLV only showed comparable results when cemented with preheated HC. No statistically significant difference was found in fracture resistance between the tested groups (p > 0.05). CONCLUSION: The Bonding technique and the thickness of the UTLV had impacted fatigue resistance but had no significant effect on the fracture resistance. bonding of UTLV with preheated composite increases their fatigue resistance. Different testing approaches delivered different results.

2D and 3D Wear Analysis of 3D Printed and Prefabricated Artificial Teeth.

PURPOSE: This study aimed to assess the 3-body wear of prefabricated and 3D-printed artificial denture teeth. MATERIALS AND METHODS: Four groups of artificial teeth were used; 3D-printed polymethylmethacrylate (PMMA) teeth (PR) and 3 prefabricated commercially available denture teeth: PMMA (Gnathostar, GN), PMMA (SR Orthotyp PE, SR), and Nanohybrid composite (SR Phonares NHC, PH). The 3-body wear test was performed using a steatite ceramic antagonist in a chewing simulator with 750,000 cycles, temperature 23 ± 2 ˚C, and force of 50 N. The abrasive medium was composed of ground millet seeds and white rice mixed with distilled water. The teeth were 3D-scanned before and after the wear test. The 3D images were assessed for teeth wear by measuring the volumetric (3D wear) and the vertical (2D wear) substance loss. The one-way analysis of variance followed by Tukey post hoc test was used to statistically obtain the data analysis. RESULTS: Maximum 3D wear was observed in the PR (51.05 ± 4.53 mm³), followed by GN (20.22 ± 6.29 mm³) and SR (12.12 ± 6.29 mm³) artificial teeth. Minimum wear occurred in the PH teeth (6.24 ± 0.87 mm³). The analytical differences amongst the groups were statistically significant (P < .05) except between PH and SR teeth. For 2D wear measurement, the maximum was seen in the GN teeth (6.29 ± 1.64 mm), followed by PR (5.04 ± 0.83 mm) and then SR (4.53 ± 0.87 mm). The PH teeth (3.09 ± 0.68 mm) again showed minimum wear. Statistically, amongst the groups, the major observable differences (P < .05) were between PH and GN, PH and PR, and SR and GN. CONCLUSIONS: Composite resin teeth had a greater wear resistance than acrylic resin teeth and 3D-printed resin teeth, both of which were comparable. Due to the advancement of digital workflows, manufacturers should devote effort to enhancing 3D-printed teeth.

Dental pedagogy in the 'new normal' COVID-19 era: a transition template of teaching protocols.

AIMS: Delivery of clinical dental education, as opposed to clinical medicine, is particularly challenging due to the obligatory aerosol-generating procedures (AGPs) used in dentistry, which are known to facilitate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hence, using AGPs and working in close proximity to patients for extended periods in dental hospital/university settings with multiple teaching clinics have been a formidable prospect for all stake holders. Therefore, several professional and governmental organizations have promulgated variations of infection control guidelines for general practice dentistry in the pandemic era to mitigate SARS-CoV-2 transmission. MATERIALS AND METHODS: In the absence of unified guidelines for modified infection control/clinical procedures for dental education. We implemented a clinical protocol template and modified operating procedures (MOP) for teaching clinical dentistry to fit the infection control requirements during the pandemic/post-pandemic period at the Sharjah University, College of Dentistry, UAE. MOPs ranged from various engineering control measures (e.g., negative-pressure ventilation systems in operatories) to administrative control measures featuring post-procedure fallow periods of treatment-abeyance between patient sessions. RESULTS: The new MOPs for clinical dentistry in the COVID-19 pandemic era, trialled in a UAE dental teaching hospital, have successfully eliminated infection transmission amongst the students, clinicians, ancillary staff, or attending patients, thus far. CONCLUSIONS: The proposed MOPs that complement the standard operating protocols in clinical dentistry were an attempt to mitigate nosocomial infection transmission and protect four different groups of stakeholders, i) the patients, ii) the dental students, iii) the clinical academics, and iv) the para-dental personnel/assistants. Due to the endemicity of the COVID-19 in many regions of the World, the suggested MOPs need periodic review and revision, to fit the emerging data on the disease. Finally, as there are no studies to date comparing the relative efficacy of the MOPs in various dental academic institutions, there is an urgent need for future workers to address this issue.

Oral rehabilitation of maxillofacial trauma using fixed corticobasal implant-supported prostheses: A case series.

INTRODUCTION: Maxillofacial trauma is associated with severe loss of soft and hard tissues that lead to aesthetic and functional disfigurements, adverse psychological impacts on the patient's general and oral health, and decreased quality of life. Therefore, treatment of maxillofacial trauma is challenging. PRESENTATION OF CASE: We present three patients with maxillofacial trauma owing to road traffic accidents that were rehabilitated by immediate use of loaded fixed corticobasal implant-supported prostheses with follow-up periods of 6, 5, and 7 years. All treated patients had a 100 % implant survival rate, healthy peri-implant tissues, stable prosthesis with significant improvement in mastication and phonation, and high patient satisfaction. DISCUSSION: Rehabilitation of patients with intensive maxillofacial trauma requires a multidisciplinary approach to ensure the standard of care during treatment. The described treatment eliminates the need for bone grafting, reduces susceptibility to grafting complications, shortens treatment time, and provides the patient with a fixed prosthesis with predictable success, excellent implant survival, healthy peri-implant tissue, improved prosthetic stability, and high satisfaction rates. CONCLUSION: Corticobasal implant-supported prostheses are a feasible treatment modality to rehabilitate patients with maxillofacial trauma with high success and survival rates and patient satisfaction.

Titanium dioxide dental implants surfaces related oxidative stress in bone remodeling: a systematic review.

Background: Titanium dioxide dental implants have a controversial effect on reactive oxygen species (ROS) production. ROS is necessary for cellular signal transmission and proper metabolism, but also has the ability to cause cell death as well as DNA, RNA, and proteins damage by excessive oxidative stress. This study aimed to systematically review the effect of titanium dioxide dental implant-induced oxidative stress and its role on the osteogenesis-angiogenesis coupling in bone remodeling. Methods: This systematic review was performed conforming to preferred reporting items for systematic review and meta-analysis (PRISMA) model. Four different databases (PubMed, Science Direct, Scopus and Medline databases) as well as manual searching were adopted. Relevant studies from January 2000 till September 2021 were retrieved. Critical Appraisal Skills Programme (CASP) was used to assess the quality of the selected studies. Results: Out of 755 articles, only 14 which met the eligibility criteria were included. Six studies found that titanium dioxide nanotube (TNT) reduced oxidative stress and promoted osteoblastic activity through its effect on Wnt, mitogen-activated protein kinase (MAPK) and forkhead box protein O1 (FoxO1) signaling pathways. On the other hand, three studies confirmed that titanium dioxide nanoparticles (TiO2NPs) induce oxidative stress, reduce ostegenesis and impair antioxidant defense system as a significant negative correlation was found between decreased SIR3 protein level and increased superoxide (O2 •-). Moreover, five studies proved that titanium implant alloy enhances the generation of ROS and induces cytotoxicity of osteoblast cells via its effect on NOX pathway. Conclusion: TiO2NPs stimulate a wide array of oxidative stress related pathways. Scientific evidence are in favor to support the use of TiO2 nanotube-coated titanium implants to reduce oxidative stress and promote osteogenesis in bone remodeling. To validate the cellular and molecular cross talk in bone remodeling of the present review, well-controlled clinical trials with a large sample size are required.

Rehabilitation of Patients with Compromised Ridge Support Using Immediately Loaded Corticobasal Implant-supported Prostheses: A Prospective Observational Study.

AIM: The aim of this prospective study is to evaluate the treatment outcomes and patient satisfaction following the use of fixed immediately loaded corticobasal implant-supported prostheses. MATERIALS AND METHODS: One hundred and seventy-four corticobasal implants (basal cortical screw, BCS implant design) were inserted in 20 consecutive patients with compromised ridge support. Implant survival and success were assessed using the James-Misch implant health quality scale and the Albrektsson criteria for implant success. The peri-implant health was evaluated at 1 week and 3, 6, 9, 12, and 18 months postoperatively. Moreover, the radiographic and prosthetic parameters and patient satisfaction were assessed. RESULTS: The implants showed optimum implant health and a 100% survival rate with none (0%) of the implants failing, mobile, lost, or fractured. Using Wilcoxon signed-rank test, significant decreases in both the modified gingival indexes and the probable pocket depth (PPD) and slight significant increases in the plaque index (PI) at 3, 9, 12, and 18 months and a nonsignificant increase at 6-month follow-up were reported with a range of 0-1. The calculus index (CI) was zero at all follow-up visits. Radiographic evaluations revealed increases in the bone-to-implant contact. Evaluation of the prostheses showed some treatable complications, and all the patients were satisfied. CONCLUSION: The use of corticobasal implant-supported prosthesis meets the patient's demand for an immediate, fixed treatment modality, with high survival and success rates, optimum peri-implant soft tissue health, and high reported satisfaction. CLINICAL SIGNIFICANCE: Corticobasal implants can improve the patient's esthetic, phonetic, mastication, and quality of life with the advantage of eliminating the need of bone grafting procedures.

Oral candidal carriage and its association with dental carious lesions in asymptomatic adults: a cross-sectional study from the UAE.

BACKGROUND: Candida's potential association with dental caries has previously been reported in children. This research aimed at investigating the associations between Candida species in whole saliva and dental and periodontal health indices in a sample of adult patients. METHODS: A cross-sectional study involving 160 patients investigated the associations between Candida species collected by oral rinse technique, and Decayed, Missing, and Filled Surfaces (DMFS), and periodontal health indices. Chi-square and Independent Samples t-test were used to assess the associations between Candida carriage and confounding variables. Binary logistic regression was used to assess association strengths between Candida carriage and DMFS, adjusted for socio-demographic variables, diabetes mellitus and plaque index. RESULTS: Candida colonies were identified in 49 (30.6%) patients with CFUs ranging from 103 to 105 colonies per mL. The quantity of Candida CFUs increased with age (r = 0.200; p < 0.05). Among all dental and periodontal health indices, only DMFS was significantly associated with higher values of Candida carriage (p = 0.034), and this association was independent from sex, age, smoking, diabetes mellitus and plaque index (OR: 1.014; 95% CI 1.0-1.03; p = 0.048). CONCLUSION: The association between Candida species in whole saliva and DMFS reported here supports an etiological role of Candida in dental cariogenesis among adults.

Oral health status and oral health-related quality of life among patients with type 2 diabetes mellitus in the United Arab Emirates: a matched case-control study.

BACKGROUND: Nearly a quarter of the population in the UAE has type 2 diabetes mellitus (T2DM), and this medical condition is associated with poorer oral health. The effects on oral health-related quality of life (OHRQoL), however, have not been examined in this population. Therefore, the objective of this study was to assess the impact of oral health problems, such as caries and periodontitis, on OHRQoL among Arab patients with and without T2DM. METHODS: This matched case-control study included 88 diabetic and 88 non-diabetic participants recruited from University Dental Hospital Sharjah and University Hospital Sharjah, UAE. Participants completed a sociodemographic questionnaire as well as the Oral Health Impact Profile short form (OHIP-14), which measures OHRQoL. Clinical examinations were conducted to assess participants' dental caries status, using the Decayed Missing Filled Teeth (DMFT) Index, and periodontal condition, via clinical attachment loss (CAL) dichotomized to CAL < 3 mm and CAL ≥3 mm. Linear regression models were used to identify the association among OHIP domains, clinical attachment loss, DMFT scores, and diabetes status. RESULTS: The mean age of participants was 43.0 years. A significantly (p = 0.01) higher proportion of diabetic patients (23%) had a CAL ≥3 mm than non-diabetic patients (10%). No significant differences in OHIP scores were observed between diabetic and non-diabetic patients. The results of the linear regression suggested that irrespective of diabetic status, DMFT scores were significantly associated with physical disability, physical pain, psychological discomfort, and psychological disability, as well as total OHIP scores. CAL was significantly associated with the handicap domain. Among non-diabetic patients, OHIP scores were significantly associated with DMFT scores in five OHIP domains (functional limitation, physical disability, physical pain, psychological discomfort, psychological disability), as well as total OHIP scores. Among diabetic patients, CAL was significantly associated with both the social disability and handicap domains, while only the handicap domain reached statistical significance among non-diabetic patients. CONCLUSIONS: Participants who had decayed teeth, irrespective of their diabetic status, reported substantial physical and psychological impacts on OHRQoL. CAL also had a significant impact on OHRQoL, being primarily associated with the OHIP handicap domain in both diabetic and non-diabetic patients.

Rehabilitation of an irradiated marginal mandibulectomy patient using immediately loaded basal implant-supported fixed prostheses and hyperbaric oxygen therapy: A 2-year follow-up.

INTRODUCTION: The prosthetic rehabilitation of mandibular defects owing to tumor resection is challenging, especially when the patient has undergone subsequent radiotherapy. PRESENTATION OF CASE: A 46-year old male presented with a marginal mandibular resection. Following surgery, the patient received adjunctive radiation therapy with a total dose of 70 grays. On clinical examination, the patient presented with severely resorbed edentulous jaws, with an anterior marginal mandibular resection and an obliterated vestibular sulcus. The panoramic radiograph showed a hypocellularity of the maxillary and mandibular bones. A multidisciplinary team was formed, and a treatment plan was formulated which involved the construction of a vestibuloplast stent, and the application of 20 hyperbaric oxygen sessions before implant treatment and 10 more sessions after implant insertion. A total of 16 basal cortical screw implants were inserted to support the fixed prostheses, and a vestibuloplasty was performed to improve esthetics. No complications were observed, and at the 2-year follow-up, the patient presented with excellent peri-implant soft tissue health; increased bone-implant contact; and stable, well-functioning prostheses. DISCUSSION: The construction of a stable, retentive, well-supported removable prosthesis may be complicated in cases of comprehensive mandibular resection. Basal implants can eliminate the need for bone grafting, and reduce the treatment period required for providing a fixed prosthesis. CONCLUSION: To our knowledge this is the first evidence reporting the use of fixed basal implant-supported prostheses in irradiated bone, in conjunction with hyperbaric oxygen therapy. A treatment modality that significantly improves the peri-implant tissue health, and ensures an excellent implant-bone contact.

The Influence of Immediately Loaded Basal Implant Treatment on Patient Satisfaction.

BACKGROUND: Improving patient satisfaction and quality of life is of great importance when considering the different prosthetic treatment options for patients with severely resorbed residual alveolar ridges. We aimed to evaluate and compare patients' satisfaction when changing from fixed, removable, and/or conventional implant prostheses to basal implant-supported prostheses. METHODS: Sixty patients with a history of fixed, removable, and/or conventional implant prostheses who received basal implant-supported prostheses (BCS®, IHDE Implant System) were included in this study. Direct interviews were conducted using a four-section questionnaire that covered sociodemographic data, clinical examination, information on previous prostheses, and new implant information. The obtained data were statistically analysed using a Wilcoxon signed-rank test and chi-squared test. RESULTS: Patients were predominantly female, partially edentulous, and aged between 40 and 59 years. Patients' general satisfaction with basal implants was very high (7.7 out of 8). Patients' satisfaction with comfort, mastication, speech, and aesthetics significantly improved with the new basal implants. Males aged between 40 and 59 years and patients who had previously used both fixed and removable prostheses were generally the most satisfied. Although some patients had complaints, they still had high satisfaction and would choose the same treatment modality again. CONCLUSIONS: Basal implant-supported prostheses have a positive impact on oral health and highly increase patients' satisfaction.

Prosthetic rehabilitation of maxillary and mandibular gunshot defects with fixed basal implant-supported prostheses: A 5-year follow-up case report.

INTRODUCTION: Gunshot injuries to the oral maxillofacial region have serious aesthetic and functional consequences. PRESENTATION OF CASE: A 32-year-old male patient presented with a marginal mandibular resection owing to a gunshot wound. A clinical examination revealed destroyed crowns in teeth 12, 11, and 21; extraction in teeth 13, 22, 24, 31, 32-45; a fracture in tooth 38; and severe pain. Further, he had multiple submental scars and a completely obliterated sulcus. Consequently, a multidisciplinary team was formed who devised the following treatment plan: stage 1, root canal treatment for the maxillary anterior teeth, followed by crown construction and transitional mandibular removable partial denture construction, and stage 2, placement of immediately loaded basal implant definitive prostheses supported by 6 corticobasal screw implants. After 5 years of use, the patient presented with excellent peri-implant soft tissue health, prosthesis stability, and great improvements in aesthetics and function. The patient was highly satisfied with the treatment and restoration of his quality of life. DISCUSSION: Accurate treatment planning is vital for managing complicated cases, including gunshot defect cases, and should involve the selection of the most suitable reconstructive technique with lower susceptible complication rates and high success rates. The described treatment eliminates the need for bone grafting, reduces treatment duration, and involves fixed prosthesis placement. CONCLUSION: To our knowledge, this is the first report on basal implant-based full-mouth rehabilitation in a gunshot mandibular defect patient. The fixed hybrid basal implant-supported prosthesis produced highly acceptable aesthetic and phonetic results and greatly improved the patient's life.

Dentists' Preferences in the Treatment of Congenitally Missing Maxillary Lateral Incisors / Preferências entre os Dentistas no Tratamento da Agenesia de Incisivos Laterais Superiores

Objective: Congenitally missing maxillary lateral incisors present challenges to dentists in terms of treatment planning and can negatively affect aesthetics and function in patients. The aim of the present study was to determine the preferred treatment approach of dentists with different specialties. Material and Methods: We carried out a descriptive, cross-sectional study using a questionnaire that was self-administered to 12 specialists in removable prosthodontics, 18 specialists in restorative dentistry, 14 specialists in orthodontics, and 173 registered general dentists. Results: General practitioners (72.7%), prosthodontists (92.9%) and, restorative dentists (80%) preferred prosthodontic replacement of missing maxillary lateral incisors, while orthodontists (57.1%) preferred canine substitution. Most general practitioners (62.7%), prosthodontists (71.4%), and orthodontists (92.9%), as well as many restorative specialists (40%), preferred implant-retained crowns for prosthetic replacement of missing lateral incisors. The dental specialties differed significantly in terms of their preferred modalities for treating children over the age of 12 years. General practitioners (56%) preferred removable partial dentures (RPDs), while a mere 17.2% preferred to carry out no treatment. All prosthodontists (100%) preferred treatment with RPDs. Restorative dentists preferred RPDs and adhesive bridges in equal number (33.3% in each case). Fifty percent of orthodontists treating children with missing lateral incisors preferred RPDs, followed by (28.6%) who preferred canine substitution. Conclusion: Preference varied for several reasons among dentists' treating both adults and children over 12 years of age (AU)

Objetivo: A agenesia de incisivos laterais superiores apresenta desafios aos cirurgiões-dentistas em termos de planejamento terapêutico e pode afetar negativamente a estética e a função dos pacientes. O objetivo do presente estudo foi determinar a abordagem de tratamento preferencial entre os dentistas de diferentes especialidades. Material e Métodos: Realizouse um estudo descritivo, transversal, utilizando um questionário autoadministrado por 12 especialistas em prótese dentária removível, 18 especialistas em dentística, 14 especialistas em Ortodontia e 173 dentistas clínicos gerais. Resultados: Clínicos gerais (72,7%), protesistas (92,9%) e especialistas em dentística (80%) preferiram a substituição protética dos incisivos laterais superiores ausentes, enquanto os ortodontistas (57,1%) preferiram a substituição canina. A maioria dos clínicos gerais (62,7%), protesistas (71,4%) e ortodontistas (92,9%), bem como muitos especialistas em dentística (40%), preferem coroas implantadas para a substituição protética dos incisivos laterais ausentes. As especialidades odontológicas diferiram significativamente em termos de suas modalidades preferidas para o tratamento de crianças com idade acima de 12 anos. Clínicos gerais (56%) preferiram próteses parciais removíveis (PPRs), enquanto apenas 17,2% preferiram não realizar nenhum tratamento. Todos os protesistas (100%) preferiram o tratamento com PPRs. Especialistas em dentística preferiram PPRs e pontes adesivas em igual número (33,3% em cada caso). Metade dos ortodontistas (50%) que tratam crianças com incisivos laterais ausentes preferiram PPRs, seguido por (28,6%) que preferiram a substituição canina. Conclusão: A preferência variou por várias razões entre os dentistas que tratam adultos e crianças com mais de 12 anos de idade.(AU)

Communication Between Dentists and Dental Technicians During the Fabrication of Removable Partial Dentures in Khartoum State, Sudan.

OBJECTIVES: To investigate the quality of communication between dentists and dental laboratory technicians in private dental laboratories in Khartoum State related to fabrication of removable partial dentures. METHODS: This was a descriptive cross-sectional study, in which dental technicians were interviewed regarding the quality of instructions they received from dentists concerning the construction of removable partial dentures (RPD). Eighty cases were investigated, 69 acrylic (A-RPD) and 11 cobalt chromium (CC-RPD) dentures. RESULTS: Although dentists provided no instructions in 21.7% of A-RPD cases, they gave instructions in all CC-RPD cases. Instructions were primarily given verbally (55.1% in A-RPD, 54.5% in CC-RPD cases), as opposed to written (23.3% in A-RPD, 45.5% in CC-RPD cases). Most design components for A-RPD and CC-RPD cases were not clearly prescribed, and instructions were clear in only 8.7% of A-RPD and 36.4% of CC-RPD cases. Notably, surveying of casts by dentists was only done in 18.2% of CC-RPD cases. Most technicians (84.2%) believed that prosthesis design was the dentists' responsibility. Technicians needed to contact dentists for clarification of design significantly more frequently for CC-RPD (p=0.004) cases. CONCLUSION: Quality of communication between dentists and private laboratory technicians in Khartoum State with regard to removable partial denture construction was largely inadequate.

Translation and validation of the Arabic version of the 5-item Oral health impact profile: OHIP5-Ar.

PURPOSE: The aim of this study was to translate and validate an Arabic version of the 5-item Oral Health Impact Profile (OHIP). METHODS: A total of 320 subjects (aged 18 years and above) were consecutively recruited from dental clinics. The self-administered OHIP5-Ar was distributed and the data were collected and analyzed. The dimensionality of the instrument was investigated using confirmatory factor analyses (CFA). Reliability was assessed as the instruments internal consistency using Cronbach's alpha and test-retest-reliability using intraclass correlation coefficient (ICC). Convergent validity was tested by correlation between perceived global oral and general health questions with the latent factor (OHRQoL) using structural equation modelling analysis and with OHIP5-Ar total score using spearman's correlation coefficient. Known-groups validity was tested among groups with known differences and sensitivity to change was also investigated after dental treatments. RESULTS: The OHIP5-Ar was fitted well in the unidimensional model as indicated by the CFA with fit indices (RMSEA: 0.00, SRMR: 0.010, GFI: 0.998, TLI: 1). Cronbach's alpha was 0.78 and the ICC agreement was 0.88. The validity tests indicated satisfactory validity of the instrument and the sensitivity to change of the instrument revealed significant change in the OHIP5-Ar total score after the provision of dental treatments (effect sizes: 0.55-1.49). CONCLUSION: The OHIP5-Ar showed satisfactory psychometric properties among Arabic-speaking population. This instrument is sensitive to the changes of oral health and can be used to measure the OHRQoL with one total score.

Validation and comparison of the Arabic versions of GOHAI and OHIP-14 in patients with and without denture experience.

BACKGROUND: The assessment of oral heath related quality of life (OHRQoL) for complete denture wearers according to a participant's subjective perception may provide an indication of the adaptive capacity of the individual. The aim of this study was to compare and assess the validation of two quality of life measures, the Oral Health Impact Profile-14 (OHIP-14) and Geriatric Oral Health Assessment Index (GOHAI), in patients with and without previous denture experience. METHODS: A total of 69 elders (36 male and 34 female; mean age, 63 years) from Dental Clinics of the University of Khartoum and the National University in Sudan, with and without previous denture experience, were included in the study. OHRQoL was assessed using two Arabic-translated questionnaires (OHIP-14 and GOHAI) before and after complete denture therapy. Global self-ratings of oral and general health were obtained, and denture satisfaction was assessed using the Denture Satisfaction questionnaire. RESULTS: Both tools had significant correlations with self-rating oral health in patients without denture experience (P < 0.05). However, no significant correlations were found in patients with denture experience. There were significant differences between pre-and post-treatment total scores with both the GOHAI and OHIP-14 (P < 0.001). Responsiveness to treatment using GOHAI and OHIP-14 revealed overall mean effect size higher in patients without (1.49) and (0.83) than those with previous denture experience (0.89) and (0.60), respectively. However, neither tool could detect significant differences between patients with and without denture experience (P > 0.05). CONCLUSION: Greater improvements of OHRQoL after complete denture therapy were observed in participants without than those with previous denture experience. The Arabic-translated versions of GOHAI and OHIP-14 can be regarded as effective measures for assessing treatment outcomes of complete denture therapy.

Comparison between masticatory index and mixing index among complete denture wearers and associated factors: A multivariate analysis.

STATEMENT OF PROBLEM: Masticatory performance is an important and complex multifactorial process in clinical practice. An exploration of the relationships and effects of the associated factors is lacking. PURPOSE: This clinical survey compared masticatory efficiency (mixing index) with perceived masticatory ability (masticatory index) among complete denture wearers and sought to clarify the relationship between these indices and other factors. MATERIAL AND METHODS: The study consisted of 58 complete denture wearers (37 men, 21 women) ranging between 37 and 80 years of age. Participants were interviewed and examined clinically. The perceived masticatory ability of participants regarding 15 types of Sudanese food was evaluated. The degree of mixing of a 2-colored chewing gum was used to measure masticatory efficiency. Multiple regression and structural equation modeling analyses were used to assess the association between both indices and other related factors. RESULTS: Most of the complete denture wearers could eat soft foods easily but found it difficult to eat hard foods and avoided them. No significant differences in masticatory efficiency could be observed regarding sex or age. Values of the mixing index ranged from 13 (well-mixed colors) to 34 (poorly mixed). Perceived masticatory ability was significantly associated with previous denture experience and the duration of denture wearing (P=.01). Masticatory efficiency was significantly associated with denture quality (P=.001) and with perceived masticatory ability (P=.004). CONCLUSIONS: A significant association was noted between denture quality and masticatory performance. A significant association was also observed between perceived masticatory ability and masticatory efficiency, and both can be used to evaluate masticatory performance among complete denture wearers.

Quality of life and problems associated with obturators of patients with maxillectomies.

BACKGROUND: Maxillary defects predispose patients to different undesirable effects. The aim of this study was to assess the quality of life (QoL) of patients with maxillary defects (acquired/congenital) wearing obturators. METHODS: The study comprised 30 patients aged between 16 and 78 years. Interviews were conducted to collect information pertaining to patients; sociodemographic, self-reported function of obturator using Obturator Functioning Scale (OFS), self-evaluation of general health using Visual Analogue Scale (VAS), radiotherapy treatment, salivary gland removal, reconstructive surgery, neck dissection and length of time obturators were worn. Clinical examination included type of maxillectomy, Aramany classification of the defect, and evaluation of obturator function using the Kapur retention and stability scoring system. RESULT: Quality of life was affected significantly by marital status (P = 0.026). Married patients had better quality of life 61.3%, followed by divorced patients 38.8%, widowed 37.3% and the least QoL was detected in single patients 36.5%. Significant association between the type of maxillectomy and QoL was detected (P = 0.002). Retention of obturator prosthesis had a highly significant association with QoL (P < 0.001). Type of maxillectomy had a significant relation with obturator retention (P = 0.005). Stability had a significant correlation with QoL (P = 0.022). Obturator wearers who were treated with radiotherapy had lower QoL than those who were not treated with radiotherapy. CONCLUSION: Rehabilitation of patients with maxillary defects using obturator prosthesis is an appropriate and not invasive treatment modality. Results support that good obturators contribute to a better life quality.

Dimensional Accuracy of Alginate Impressions Using Different Methods of Disinfection With Varying Concentrations.

This study investigated the effect of 1% and 5.25% of sodium hypochlorite (NaOCl) as spray and immersion solutions on the dimensional accuracy of an irreversible hydrocolloid impression material. Impressions of master models were taken using irreversible hydrocolloid impression material, which was then treated with NaOCl 1% or 5.25% solution, either by spaying or immersion, for 5 minutes, or not treated to act as control. The impressions were then poured with stone, and the dimensional accuracy was determined from the mean of six measurements taken between fixed points using a digital caliper. No significant dimensional changes of gypsum casts obtained from irreversible hydrocolloid impression material sprayed with NaOCl solution were observed, whereas significant change in dimensional accuracy occurred when the casts were immersed in NaOCl solution. Based on dimensional stability alone it would be more appropriate to disinfect irreversible hydrocolloid impression material by spraying it with NaOCl solution rather than immersing it.

Does 6 Hours of Contact With Alginate Impression Material Affect Dental Cast Properties?

Alginate impression (irreversible hydrocolloid) material is commonly used in dental practice because it is easy to mix, low in cost, and well tolerated by patients. The material is not dimensionally stable, however; thus, it is necessary to pour the impression immediately after the molding is accomplished, or within 60 minutes if the impression is kept in 100% humidity. Excessive contact of the alginate impression with the cast model over time may affect the model's properties. In this study, the authors tested the effect of contact time between an alginate impression and type III dental stone on cast model properties. Sixty-seven cast models were obtained from a stainless steel cylinder by using irreversible hydrocolloid impression material and type III dental stone. Thirty-seven cast models were separated from the impression after 1 hour (control group) and 30 cast models were separated after 6 hours (study group). The samples were evaluated under light microscope for surface details and measured by digital caliper for dimensional stability. An indentation on the cast was made and the depth of the indentation was then measured with a digital caliper to measure hardness. The dimensional stability of the cast models was not affected when contact time was increased from 1 hour to 6 hours (P = .507). Surface details did not deteriorate when contact time was increased, as all of the samples could reproduce all details after the 1-hour and 6-hour interval periods. However, hardness was greater after 1 hour of contact time (P = .001) than after 6 hours of contact time. In conclusion, contact between alginate impression material and type III dental stone up to 6 hours did not affect the dimensional stability and richness of the surface; hardness, though, was significantly affected.