Determinants of dissatisfaction with dentures: a multiple regression analysis

The purpose of this study was to investigate the relationship between satisfaction with complete dentures and several causal factors. One hundred thirty patients who received new dentures were investigated during their treatment. The results showed that 33% of the variance in satisfaction with dentures could be clarified by (1) the attitude toward dentures, (2) the quality of the dentures, (3), the oral conditions (opposite of what was expected), and (4) the number of previous dentures worn. Thus the patient's attitude toward dentures, measured by a questionnaire administered prior to his or her receiving new dentures, and the number of previous dentures worn, are prospective indicators for satisfaction with new dentures. The oral condition and the patient's personality seem to be unimportant factors, as measured by a neurotic lability scale and by a "health locus of control scale." Only 33% of the variance in satisfaction could be clarified by means of the variables used in the study. Thus satisfaction with dentures for most patients is individually determined and, for dentist and patient, is often unpredictable.     

Myodynamic and conventional construction of complete dentures: a comparative study of comfort and function

Function and comfort during wearing of myodynamically and conventionally constructed dentures were evaluated in 30 patients. All patients were fitted with one set of myodynamic and one set of conventional dentures. The neutral zone was recorded with a Xantopren blue impression. Twenty-three of the patients preferred the myodynamic dentures, two preferred the conventional dentures, two experienced no difference and three patients used a combination of the conventional and the myodynamic sets. There were also less post-insertion problems with the myodynamic dentures compared to the conventional ones.     

Characteristics of the repeat prosthesis of patients who have worn dentures for a long time

To study the peculiarities of installing new dentures in patients after a long-lasting use of full removable dentures, 77 patients were investigated aged 44 to 86 years which had previously used the dentures for 3 to 24 years. With respect to the character of plastic dentures abrasion and related changes in occlusion 2 groups of patients were singled out. The new dentures were constructed with due consideration of the changes in jaw respective positions with their limits extended and, on indications, porcelain dentures installed.     

Cantilevered fixed partial dentures in a geriatric population: preliminary report

This study has shown that treatment with distally extending cantilever fixed partial dentures is a favorable alternative to treatment with removable partial dentures in elderly patients with reduced dentition. In patients with anterior teeth and one or two premolar teeth remaining in the mandible, sufficient occlusal stabilization for a maxillary complete denture was provided by a two- or three-unit cantilever fixed partial denture. A pronounced improvement in chewing function and stability of the maxillary denture was expressed, even by patients who were previously well adapted to wearing removable partial dentures.     

The effectiveness of palate-less versus complete palatal coverage dentures (a pilot study)

The aim of this pilot study was to evaluate the effectiveness of palate-less dentures as a substitute for conventional complete palatal coverage. Ten edentulous patients who had recently received maxillary and mandibular complete dentures were included in the study. The patients' maxillary conventional dentures were duplicated to construct 'U' shape palate-less dentures. A strain gauge biting fork was used to compare the maximum biting force and chewing tests using almond were performed. They failed to show significant differences. Eight patients were more comfortable with the palate-less dentures than the complete palatal coverage. It was concluded that Palate-less dentures could be as effective as dentures with complete palatal coverage.     

Implants in conjunction with removable partial dentures: a literature review

Although the benefits of implant-borne removable prostheses are readily apparent for the fully edentulous patient and have been well documented, there is a paucity of studies concerning the combination of implants with removable partial dentures in partially edentulous patients. The aim of this article is to review the literature regarding implants with removable partial dentures and evaluate the evidence for this clinical approach. A MEDLINE/PubMed search from 1990 to 2006, focusing on the use of implants with removable partial dentures and related features, was supplemented with a hand search to identify relevant peer-reviewed English articles published in dental journals and textbooks on removable partial dentures.     

Fabrication of complete dentures in three visits using existing prosthesis—a simplified technique for geriatric patients

Complete edentulism often limits patients’ ability to masticate and perform other oral functions, resulting in a reduction of oral‐health‐related quality of life. Although the two‐implant mandibular overdenture may be considered as a minimum standard of treatment of complete edentulism, patients often prefer conventional complete dentures due to cost and surgical procedures related to implant supported dentures. Many complete denture patients may have limited access to dental care due to socioeconomic or health issues, hence there is a need in simplification of complete denture fabrication. Researchers have proposed “simplified” techniques to fabricate complete dentures by eliminating two stage impression procedures facebow transfer, and articulator programming, with impressive initial results. However, long‐term clinical data of these techniques is unavailable. A novel technique for fabricating simplified complete dentures in three visits, using patient's existing dentures is presented here. Unlike previously described techniques on “simplified” dentures, this technique does not eliminate vital steps such as border‐molded impressions, facebow transfer, verification of centric relations during try‐in, programming of the articulator, and balancing procedures.     

Strategic use of a new dental magnet system to retain partial and complete overdentures

Dental management of older adults is becoming increasingly complex. For many, denture wearing difficulties will become a norm, and implant retained prostheses may be beyond their financial resources or unacceptable for other reasons. Patients with limited or no denture wearing experience may not tolerate conventional dentures for functional or psychosocial reasons. Incorporation of Dental Magnets into dentures may be useful for patients with limited ability to tolerate or control removable dentures. This paper reports on the use of the Magfit (Aichi Steel, Nagoya, Japan) system in three patients with differing clinical problems.     

Dissertations 25 years after date 25. Dentures: a question of grinning and bearing it

'Dentures: A question of grinning and bearing it' is not just the title of a 25-year-old thesis, but it also reflects the content well. Dissatisfaction with complete dentures is not only determined by the quality of the dentures and the oral conditions, but also and just as much by the patient's capacity to adapt to and accept the dentures. In order to treat an edentulous patient adequately, an oral healthcare provider should pay special attention to these aspects. After 25 years of further scientific study, this conclusion is still true. The current care standard for edentulous patients with atrophy of the residual mandibular alveolar ridge is an overdenture supported by 2 implants. For edentulous patients with a solid residual mandibular alveolar ridge, conventional complete dentures are the first choice of treatment. Only in cases of obvious remaining complaints, should an implant-supported overdenture be considered.     

Expectations and satisfaction of denture patients in a university clinic

These results indicate that patients' expectations of dentures before treatment were unrealistically high and that informational videotapes did not significantly affect these expectations. Satisfaction with current dentures was surprisingly high before treatment and increased significantly from pretreatment to postreatment for both groups in the study. While it is likely that this increase in satisfaction reflects a change from poor to excellent denture status, this finding may also be attributed to cognitive dissonance theory; that is, high satisfaction may represent the means by which patients justify the expenses of their denture treatment. Although the videotape presentations did not alter the expectations of patients and their satisfaction with dentures, the tapes represent a potential source of accurate, standardized information for both patient and student dentist.     

Denture mobility and bolus position during mastication in patients wearing conventional and pelotte-retained full upper dentures: a cineradiographic study

With cineradiographic technique an assessment was made of the denture mobility of conventional and pelotte dentures in the upper jaw and of the position of the bolus during chewing of meat and bread. Five randomly selected edentulous patients with moderate alveolar ridge resorption rehabilitated with dentures of conventional design, and another five with dentures furnished with subnasal retentive pelottes, were incorporated in the study. Cineradiographic registrations were made in lateral and frontal projections with a picture frame speed of 38/s. Analysis of the cineradiographic films revealed only small differences for the denture mobility for the two patient groups. This indicated in the patients with severe ridge resorption, an obvious reduction of denture displacement through the use of the nasal pelotte or prong. The displacement was of similar magnitude as for those dentures where an alveolar ridge creates effective retention and limitation of horizontal movements. The analyses of the bolus position during chewing gave the information that in all individuals wearing pelotte dentures, the bolus was positioned more distally, than for patients with conventional dentures. Presumably this was in order to reduce discomfort in the frontal region, i.e. the region of the pelottes. Patients with conventional dentures showed a more even distribution of the bolus to all regions.     

Comparison of the effectiveness of several denture sanitizing systems: a clinical study

The purpose of this clinical study was to test the effectiveness of three methods of decontamination on complete dentures. Dentures worn by patients for varying lengths of time were handled aseptically and treated with three different treatment modalities. The dentures were touched and sectioned and then retouched to a variety of microbiological media. The quantity of microbial growth was recorded and predominating microorganisms were identified using standard microbiological techniques. System A was found to consistently decontaminate and sanitize dentures worn by patients. System B and System C showed variable reduction of microorganisms. An unexpected spectrum of both pathogenic and opportunistic microorganisms was found in the dentures examined, including a wide range of gram-negative bacteria, gram-positive bacteria, and yeasts. A wide range of microorganisms must be considered when treating either oral or systemic diseases in denture wearers. Denture hygiene and decontamination are critical to the prevention of oral and systemic disease transmission. The dentures of ill patients must be considered as possible sources of pathogenic microorganisms.     

Evaluation of the use of and attitudes towards a face-bow in complete denture fabrication: a pilot questionnaire investigation in Chinese prosthodontists

Summary  The aim of this study was to assess the use of and attitudes towards a face-bow among Chinese prosthodontists in complete denture fabrication. Thirty-six prosthodontists in two dental hospitals affiliated separately to two of the top four dental schools in China were included. A questionnaire was sent to them with 18 questions covering the following four aspects: (i) the education and experience background of the prosthodontists, (ii) their impression of the quality of the dentures, (iii) the use of and attitudes towards a face-bow in complete denture fabrication and (iv) their understanding of jaw relationship and occlusal adjustment in complete denture fabrication. Most (97%) experienced Chinese prosthodontists seldom used a face-bow in complete denture fabrication. Although they (92%) believed that more than 90% of their edentulous patients were satisfied with the complete dentures, 39% of them thought that not using a face-bow might lower the quality of complete dentures and 94% believed that there was a difference between the quality of dentures fabricated with an adjustable articulator and those made with a simple articulator. Among the 36 prosthodontists, 75% often and 8% occasionally did the occlusal adjustment when giving the newly made dentures to their patients. The great majority of prosthodontists in two of top four Chinese dental hospitals, who believed most of their patients satisfied with their complete dentures, seldom used a face-bow. Occlusal adjustment may be helpful to eliminate the possible errors caused by not using a face-bow.     

Clinical outcome of glass-fiber-reinforced crowns and fixed partial dentures: a three-year retrospective study.

OBJECTIVE: Glass-fiber-reinforced resin composites for the fabrication of esthetic single crowns and fixed partial dentures have been developed recently. However, little data on the clinical outcome of such restorations have been published. The purpose of this retrospective study was to evaluate the clinical outcome of crowns and fixed partial dentures made from the glass-fiber-reinforced resin composite material Targis/Vectris. METHOD AND MATERIALS: Between 1995 and 1997, 39 patients were treated with 67 single crowns and 83 fixed partial dentures. Twenty-five crowns and 28 fixed partial dentures were cemented with temporary cement, while 42 crowns and 55 fixed partial dentures were cemented with either zinc-phosphate cement or glass-ionomer cement. RESULTS: In September 2001, 57 restorations in 17 patients were still in function. The three-year survival rate calculated according to the Kaplan-Meier method was 58.8% for all restorations. However, after this time, it was 37.5% for crowns and 59.9% for fixed partial dentures cemented with temporary cement, and 55.1% for crowns and 67.9% for fixed partial dentures cemented with zinc phosphate or glass ionomer. The differences between the restoration groups were not statistically significant. CONCLUSION: Glass-fiber-reinforced crowns and fixed partial dentures made with the glass-fiber-reinforced resin composite material Targis/Vectris showed a lower survival rate than that published for metal-ceramic crowns and fixed partial dentures. Therefore, the use of this material for the fabrication of single crowns or fixed partial dentures as permanent restorations cannot be recommended.     

Dentist and patient appraisal of complete dentures in a Dutch elderly population

The majority of the Dutch elderly population wears full dentures. According to clinical standards these dentures are often of a poor quality. The treatment demand, however, is small. The purpose of the present study is to describe the quality of dentures by means of clinical criteria on the one hand and judgments of the patients on the other. 131 denture-wearing individuals, with a mean age of 71, participated. A "denture quality" scale was constructed, consisting of five clinical parameters. The judgments of the respondents were recorded in terms of complaints and satisfaction with the dentures. The results show weak or nonsignificant correlations between the denture quality and the subjective measures. After dichotomizing the denture quality score (treatment need vs no treatment need), however, the poorer dentures appeared to be related to more complaints. It was concluded that for planning purposes it seems valid to use clinical figures. On the individual level the prediction of the subjective appraisal of full dentures on the basis of a clinical appreciation appears not to be adequate.     

Prosthodontic management of worn dentition in pediatric patient with complete overlay dentures: a case report

Overlay complete dentures are simple, reversible and economical treatment modality for patients with congenital or acquired disorders that severely affect the tooth development. It satisfies both the esthetic and functional demands where the extraction of teeth is not generally indicated. In pediatric patients, the overlay dentures establish a relatively stable occlusion that improves patient''s tolerance to the future treatment procedures for worn dentition. This clinical report highlights the imperative need of appropriate treatment strategy and application of maxillary and mandibular overlay dentures in a pediatric patient who suffered from congenitally mutilated and worn dentition.     

The late results of using fixed dentures made of stainless steel with a titanium nitride-based finish coating

Forty-four patients fitted with fixed dentures made of stainless steel with TiN-based decorative coating were followed up for 2 years. Abrasion of the decorative coating at the site of the crown contact with the basis and clammers of plate dentures and at the site of cutting edges of frontal teeth was recorded in 11 (25 percent) subjects. Measurements of the electric potentials have revealed their essential increase in the patients fitted with dentures with TiN-based coating vs. those with dentures made of gold and steel.     

Oral stereognosis in stroke and Parkinson's disease: a comparison of partially dentate and edentulous individuals

Oral stereognosis was measured in partially dentate and edentulous patients with stroke, Parkinson's disease, and an age and gender-matched control group. Stereognostic tests involving conventional free intra-oral manipulation of test objects were undertaken in the partially dentate and edentulous with and without complete dentures. Comparisons were made using the unpaired t-test and ANOVA. Edentulous stroke patients without dentures had significantly greater error scores and fewer correct identifications compared with partially dentate stroke patients. Stereognostic measures were similar in the partially dentate and edentulous with dentures, within experimental groups. In the partially dentate, there were no differences in stereognostic measures between the three groups. Stereognostic measures were poorer in edentulous stroke patients with and without dentures compared with the edentulous control group. Partially dentate stroke patients are less likely to have impaired oral stereognosis than edentulous stroke patients.     

The use of existing denture-satisfaction ratings for a diagnostic test to indicate prognosis with newly delivered complete dentures

PurposeThe study investigated the relation between subjective satisfaction ratings of existing dentures and outcomes of newly delivered dentures, and the ability of the diagnostic test, using existing ratings, to indicate prognosis with newly delivered dentures.MethodsConsecutive 165 edentulous patients were recruited from November 2001 to August 2006 at a university-affiliated hospital. Dentures were fabricated with an acrylic base with full-balanced occlusion using hard resin artificial teeth by multiple prosthodontists. At the baseline and 3-month after delivery, patients rate their overall, maxillary, and mandibular satisfaction for existing and replaced dentures on a 100-mm visual analogue scale (VAS). The association between baseline ratings and newly delivered dentures was analyzed by regression analysis. The test's performance was measured by constructing a two-by-two table; patients with the following cutoff values on the VAS (overall: ≤31; maxillary: ≤47; mandibular: ≤36) were considered unsatisfied with existing or new dentures. Relative validity of the diagnostic tests was assessed by means of sensitivity, specificity, and likelihood ratios.ResultsMandibular dentures showed a significant association between baseline and new dentures (coefficient = 0.27, p = 0.01). Results of test measures for overall, maxillary, and mandibular existing dentures were 71%, 38%, and 87% (sensitivity); 62%, 66%, and 49% (specificity); and 1.1, 1.9, and 1.7 (positive likelihood), and 0.5, 1.0, and 0.2 (negative likelihood).ConclusionsTest performance indicates that the negative (satisfied) result for mandibular existing dentures may be useful to rule out the unsatisfied patients with new mandibular dentures.     

Oral health-related quality of life and satisfaction before and after treatment with complete dentures in a Dental School in Brazil

Purpose: The aim of this study was to evaluate the impact of treatment with new complete dentures on oral health-related quality of life and satisfaction of edentulous patients attending the Prosthodontic Department in a Dental School in Brazil. Methods: A total of 70 edentulous subjects (37–86 years) treated by undergradute students at the Araçatuba Dental School, University of State of São Paulo, were accessed. A specific questionnaire for edentulous patients (EDENT) based on the Oral Health Impact Profile (OHIP-EDENT) was applied to collect information on patient oral health-related quality of life. Questions related to the personal satisfaction of the edentulous patients with their complete dentures were also included. The patients were accessed before the treatment, and 3 months after receiving the new dentures. Results: After rehabilitation with new complete dentures, all domains of OHIP-EDENT showed significant improvements. There was also a significant improvement in patient satisfaction after placement of new complete dentures. Furthermore, it was possible to observe association between upper denture satisfaction and age. Conclusion: Conventional complete dentures may have a positive impact on oral health-related quality of life and satisfaction of edentulous patients.