Patient and Clinical Evaluation of Traditional Metal and Polyamide Removable Partial Dentures in an Elderly Cohort.

PURPOSE: To evaluate several clinical and functional parameters by administration of specific questionnaires to an elderly patient's cohort wearing three different types of removable partial denture (RPD): VALPLAST-RPD (Polyamide VALPLAST), CoCr-RPD (cobalt-chromium alloy), and PMMA-RPD (heat polymerized polymethyl methacrylate). MATERIALS AND METHODS: One hundred twenty patients (mean age 73 years) were included in this study. All patients were treated with a removable partial denture for the maxillary arch. After 1 year of use, patients and clinicians were asked to compile specific questionnaire on patient satisfaction, including aesthetic, functional, and clinical outcomes. It was also evaluated whether the localization of the missing teeth according to Kennedy classification may affect these parameters. Categorical data obtained from the questionnaires were analyzed by chi-squared test. RESULTS: VALPLAST-RPD was the most satisfactory aesthetically. Nevertheless, patients of VALPLAST-RPD group reported increased difficulty in cleaning the prosthesis, roughness perceived by the tongue, and increased retention loss (p < 0.001). Patients with PMMA-RPD claimed a higher level of encumbrance (p < 0.001) and increased speech difficulties (p = 0.002). Clinically, patients of VALPLAST-RPD and PMMA-RPD groups displayed redness of the mucosa area around abutment teeth (p < 0.001). Patients of VALPLAST-RPD group had four cases of artificial teeth loss and two cases of discoloration. The position of missing teeth did not significantly influence any parameter. CONCLUSIONS: Each RPD material utilized may present advantages and disadvantages in an elderly population. VALPLAST-RPD may be recommended to older patients with non-extensive edentulous areas supported by anterior and posterior teeth, and not subjected to strong chewing loads. The main advantages are aesthetic satisfaction and easiness to insert and remove it.

Management of a fractured, nonremovable implant: a clinical report with a 12-month follow-up.

Implant failures could be due to biological or mechanical factors, which also include fracture of the fixture. The present report presents a case of a single fractured implant placed in the left mandibular molar region. Since the residual portion of the fixture was perfectly osseointegrated with no signs of peri-implantitis, and in direct contact with the roof of the inferior alveolar nerve canal, it was decided to treat the patient with a short implant positioned on top of the fractured, and not removing the fractured implant. Clinical and radiographical follow-up was performed for 12 months after loading. Periimplant soft tissues healing and implant osseointegration were achieved 6 months after implant placement; at the end of the follow-up a periimplant bone remodeling of 0.3 mm was observed. In conclusion, short implants could be taken into consideration as a treatment option in cases of nonremovable implants and sufficient residual bone height.

Bite Force in Elderly with Full Natural Dentition and Different Rehabilitation Prosthesis.

(1) Background: This study aimed to investigate maximum bite force (MBF) in elderly patients with natural full dentition (FD), patients rehabilitated with Traditional Complete Dentures (CD), with overdentures (IRO) and edentulous patients (ED). We also tested whether MBF changes are associated with gender, age of the patients and body mass index (BMI) as result of altered food; (2) Methods: Three hundred and sixty-eight geriatric patients were included. We studied two types of prostheses: (a) IRO with telescopic attachments. (b) CD (heat polymerized polymethyl methacrylate resin). The MBF was measured using a digital dynamometer with a bite fork; (3) Results: We found that MBF is higher in males than females, regardless of teeth presence or absence (p < 0.01). In patients with CD or IRO, there are no differences between males and females; prostheses improve MBF compared to edentulous patients (p < 0.0001) and this effect is greater with IRO prostheses (p < 0.0001); the chewing force of FD subjects remains greater (p < 0.0001); there are no differences among chewing strength based on different BMI categories, although FD subjects have a reduced incidence of obesity; there is a significant negative correlation between MBF and age (p = 0.038; R = 0.145), and no correlation between MBF and BMI; (4) Conclusions: This study showed that MBF improves more in patients using IRO prostheses, although not reaching the MBF of FD subjects. MBF does not correlate with BMI, although we found increased percentages of obesity in edentulous subjects or those with prostheses. Thus, old people wearing prostheses require special attention by a nutritionist to avoid risk of malnutrition.

Masticatory Force in Relation with Age in Subjects with Full Permanent Dentition: A Cross-Sectional Study.

Masticatory performance is directly correlated with masticatory muscle work to grind and cut the food. Chewing efficacy is decisive to eating a variety of foods needed maintain general health status at all ages. Older people have oral problems that get worse with age. Elders have more pathologies such as periodontal diseases, caries, tooth loss and inadequate dental prostheses than younger subjects. OBJECTIVES: to investigate the correlation between masticatory bite force (MBF) and body mass index (BMI) vs. aging and sex. METHODS: This study was performed on 426 subjects (213 females plus 213 male) assigned into five different groups by age. Group "A" aged from 20 to 35 years; group "B" aged 45-59 years; group "C" aged 60-69 years; group "D" aged 70-79 years; and group "E" aged more than 79 years. RESULTS: There were not statistically significant differences in right-side MBF versus left-side MBF. The differences between sex were statistically significant with a stronger bite in males than females (p < 0.05). At the same time, younger subjects had a stronger bite than elders (p < 0.05). In group "E", more corpulent subjects (BMI > 25) had an MBF higher than less corpulent subjects (BMI < 25, p < 0.05). The analysis of mean MBF showed a statistically significant difference within all groups stratified by BMI with mean values inversely proportional with age (p < 0.001). CONCLUSION: The results in our study confirm data from many scientific papers. The importance of the present paper was to correlate data between and within a large sample with a wide range of ages. Our sample subjects had a 31%-33% decrease in MBF from group "A" to group "E" group, but they all had full permanent dentation and they preserved a valid MBF.

The Effects of Wearing a Removable-Partial-Denture on the Bite Forces: A Cross-Sectional Study.

BACKGROUND: Removable partial dentures are a frequently used prosthetic treatment in the elderly population, but different types or RPDs might guarantee different chewing capabilities. In many studies, the relationship between chewing and aging has been reported and it has been shown that efficient chewing can improve the overall quality of life. OBJECTIVES: In the present study, the relationship between maximum bite force (MBF) and RPDs was studied. A relationship between the body mass index (BMI) and the type of prosthesis was also analyzed. METHODS: 240 elderly patients, 120 males and 120 females, with bilateral posterior edentulism (class 1 of Kennedy classification) who had been wearing an RPD for at least a year, were recruited. Patients were divided into two groups: Group 1: male (n = 60) and female (n = 60) patients with bilateral edentulous areas located posterior to the remaining natural teeth and natural teeth in the opposite dental arch. Group 2: male (n = 60) and female (n = 60) patients with maxillary and mandibular bilateral edentulous areas located posterior to the remaining natural teeth. Their Body Mass Index (BMI) and Maximum bite force (MBF) were measured and compared according to the material and design of their RPD. RESULTS: In both Groups, patients wearing cobalt-chrome alloy RPDs (Co-Cr-RPD) (Group 1: 20.25 ± 6.7 MBF, p < 0.001; Group 2: 16.0 ± 5.7 MBF, p < 0.001) had an increased MBF when compared to polymethylmethacrylate RPD (PMMA-RPD) (Group 1: 12.9 ± 3.36 MBF; Group 2: 10.4 + 2.8 MBF), and Valplast RPD (V-RPD) (Group 1: 14.3 ± 4.7 MBF; Group 2: 11.3 ± 3.4 MBF) users. There were no significant differences in bite force between patients wearing PMMA-RPD and V- RPD in both Groups. Patients in Group 2 showed a lower MBF than those in Group 1 (Group 1: 16.05 ± 6.13 MBF; Group 2: 12.6 ± 4.84 MBF; p < 0.001). CONCLUSIONS: A reduction in chewing force can lead to choosing softer foods for nutrition, which can lead to an increase in BMI. Our results show that only CoCr-RPD wearers were able to chew consistent food, whereas PMMA- RPD and V-RPD, due to the properties of the materials, their instability, and the possibility of causing pain during mastication, determined a limitation in the choice of food for many of the participants.

A case report of a TPS dental implant rigidly connected to a natural tooth: 19-year follow-up.

AIM: A partial edentulous area was restored with a tooth to implant fixed partial denture and a rigid connection between the two elements. Maintenance recalls were performed over a 19-year period of observation on a yearly basis. METHODS: THE FOLLOWING PARAMETERS WERE COLLECTED DURING EACH EXAMINATION OVER THE ENTIRE PERIOD OF OBSERVATION: PD around the implant and natural tooth abutment, gingival index, modified gingival index, plaque index, modified plaque index, occlusal assessment, marginal bone loss. Radiographic assessment of peri-implant bone remodeling was performed in a retrospective way. The following reference points were assessed on each image: fixture-abutment junction, threads, first contact of the crestal bone with the implant on both mesial and distal side. This made possible, with the known values for implant diameter and length, to make linear measurements of remaining peri-implant bone measured from the mesial and distal marginal bone levels and the fixture-abutment junction. The amount of bone change over the baseline to a 19 years follow-up observation time was calculated for both the implant and the natural tooth. RESULTS: Clinical parameters showed healthy values over the entire period of observation with slight isolated positive bleeding on probing. Bone remodeling values were constant over the entire period with slight higher values around the tooth. Peri-apical radiographs did not show any intrusion of the tooth. CONCLUSIONS: The present case report showed the complete functionality and stability of a tooth to implant rigidly connected FPD over a period of 19 years.