2种活检方法对156例口腔黏膜恶性黑色素患者预后的影响

目的: 比较2种活检方法在口腔黏膜恶性黑色素瘤（oral mucosal melanoma, OMM）中的预后差异,以期找到OMM最佳的活检模式。方法: 回顾分析2010年1月—2018年1月于上海交通大学医学院附属第九人民医院确诊的OMM病例,比较2种活检方法与预后的关系。主要观察指标为生存期（overall survival, OS）,即病理确诊到死亡日期或随访时间节点（2021年9月1日）。采用SAS 9.3软件包进行统计学分析。结果: 单因素分析显示,T分期、颈淋巴结（CLN）状况、活检类型与OS有统计学相关性。所有3个变量均纳入Cox回归模型中进行多因素分析,结果显示,T分期、颈部淋巴结转移以及活检方法与预后有显著相关性。冷冻活检组颈部淋巴结和远处转移的发生率均显著低于切取活检组 (53%∶74%和22%∶42%,Log-rank=12.955, P<0.01);冷冻活检组的3年和5年OS显著高于切取活检组(65%∶42%,Log-rank=12.570,P<0.01;54%∶20%,Log-rank=7.203,P<0.01)。结论: 冷冻活检组3年及5年OS显著优于切取活检组,冷冻下活检较常规切取活检能显著降低OMM的颈淋巴结及远处转移率。推荐采用冷冻下活检,用以明确OMM的诊断。     

儿童外周血微量营养素与4种口腔黏膜病的关系：217例临床分析

目的: 探讨0~14岁儿童外周血微量营养素水平与4种口腔黏膜病（轻型复发性阿弗他溃疡、口角炎、唇炎和地图舌）的关系。方法: 收集儿童口腔黏膜病(COML)患儿152例和健康儿童（HC）65例,分别记录各组临床资料,测定并比较血清水溶性维生素（维生素B1、B2、B3、B5、B6、B7、B9、B12、C）、血清脂溶性维生素[维生素A、E、K、25(OH)D2、25(OH)D3]、全血锌和血清钙离子水平是否存在差异,采用SPSS 23.0软件包,利用无序多分类logistic回归分析外周血微量营养素水平是否是COML发病的相关危险因素。结果: 外周血微量营养素在患有轻型复发性阿弗他溃疡、唇炎和地图舌的儿童中存在显著差异（P<0.05）。与HC组相比,轻型复发性阿弗他溃疡组儿童维生素B1、B6、B7、C、A、25(OH)D3水平显著降低（P<0.05）,[维生素B6（50.00%∶13.85%）、维生素B7（36.76%∶9.23%）、25(OH)D3（64.71%∶36.92%）]缺乏率、维生素K过量率（8.82%∶0.00%）显著较高（P<0.005）。无序多分类logistic回归分析结果显示,轻型复发性阿弗他溃疡儿童中,维生素B1、维生素C、维生素A缺乏、维生素B5、维生素K过量是其发病的危险因素,且各元素之间相互独立。与HC组相比,唇炎组儿童维生素B7、25(OH)D3水平显著降低（P<0.05）,维生素B7缺乏率较高（P<0.005）。无序多分类logistic回归分析显示,唇炎儿童中,维生素B7、维生素A缺乏是其发病的危险因素,且两者之间相互独立。与HC组相比,地图舌儿童维生素K过量率（7.14%∶0.00%）较高（P<0.005）。无序多分类logistic回归分析显示,地图舌儿童中,维生素C缺乏、维生素K过量是其发病的危险因素,且两者之间相互独立。与其他组相比,外周血微量营养素与口角炎发病无相关性（P>0.05）。结论: COML的发生与外周血微量营养素水平密切相关,提示COML儿童需要监测维生素和矿物质水平,并根据情况补充治疗。     

“新净界漱口水”对放射性口腔黏膜炎的防治效果观察

目的： 前瞻性随机双盲研究“新净界漱口水”对放射性口腔黏膜炎的防治效果。方法：60例拟行放疗的口腔癌患者随机分为试验组和对照组;试验组30例,自放疗第1天起,每天使用“新净界漱口水”含漱4次,每次5 mL,含漱 5 min,直至放疗结束。对照组30例使用生理盐水含漱,方法同试验组。按RTOG口腔黏膜炎分级标准评价2组患者的口腔黏膜炎严重程度,记录疼痛程度,并照相存档。3级口腔黏膜炎视为终止指标,发生者给予其他药物治疗。应用Stata 12.0软件包对数据进行统计分析。结果：2组患者的年龄、性别、放疗技术和剂量无显著差异（P>0.05）。试验组首次观察到黏膜炎的发生时间较对照组晚（照射11.0次∶9.1次,P<0.05）,且试验组在早期出现疼痛的比例较对照组低（36.7%∶70.0%,P<0.05）。另外,试验组3级口腔黏膜炎的出现时间较对照组晚（照射18.9次∶15.9次,P<0.05）,发生率较对照组低（63.3%∶90.0%,P<0.05）。结论：“新净界漱口水”能延缓放疗所致口腔黏膜炎的发生时间,减轻患者的疼痛症状,并能减少3级口腔黏膜炎的发生率,值得临床使用。     

富自体浓缩生长因子纤维蛋白液联合Bio-Oss骨粉对口腔种植引导性骨再生术后黏膜愈合和骨缺损再生的影响

目的 探讨富自体浓缩生长因子纤维蛋白液联合Bio-Oss骨粉对口腔种植引导性骨再生术后黏膜愈合和骨缺损再生的影响。方法 选择2016年10月—2018年12月濮阳市油田总医院口腔科接诊的83例上颌单个前牙缺失伴唇侧骨缺损患者,将其分为2组,实验组（42例）采用富自体浓缩生长因子纤维蛋白液+Bio-Oss骨粉引导骨再生,对照组（41例）采用Bio-Oss骨粉引导骨再生。随访2组患者术后7 d、6周、1年手术区黏膜愈合程度、种植体成功率、骨缺损再生情况、疼痛程度和其他并发症等的发生情况。观察2组种植体成功率和术后并发症,以及术后黏膜颜色、肿胀程度、出血指数、探诊深度、附着丧失、植骨高度、成骨厚度的差异。采用SPSS 25.0软件包对数据进行统计学分析。结果 2组种植体成功率无统计学差异（95.24% ∶ 97.56%,P>0.05）,实验组并发症发生率显著低于对照组（2.38% ∶ 14.63%,P<0.05）,实验组黏膜颜色、肿胀度评分显著低于对照组[（0.65±0.03）分 ∶ （2.01±0.15）分、（1.10±0.37）分 ∶ （2.69±0.54）分,P<0.05],出血指数、探诊深度、附着丧失显著低于对照组[（0.35±0.05） ∶ （0.49±0.09）、（3.39±0.62）mm ∶ （4.41±0.95）mm、（3.02±0.66）mm ∶ （5.31±0.91）mm,P<0.05],植骨高度、成骨高度显著高于对照组[（2.61±0.50）mm ∶ （2.20±0.31）mm、（2.53±0.34）mm ∶ （2.02±0.27）mm,P<0.05],实验组术后疼痛程度显著低于对照组（P<0.05）。结论 富自体浓缩生长因子纤维蛋白液联合Bio-Oss骨粉可有效促进口腔种植引导骨再生术后黏膜愈合和骨缺损再生,减轻术后疼痛和并发症。     

水通道蛋白3在口腔鳞癌中的表达及临床意义

目的: 探讨水通道蛋白3（AQP3）在口腔鳞癌中的表达及临床意义。方法: 收集2014年3月—2017年4月盘锦辽油宝石花医院保存的202例口腔黏膜组织石蜡标本。其中健康者41例（对照组）、口腔黏膜上皮异常增生45例（A组）、口腔鳞癌116例（B组）。利用免疫组织化学方法检测3组口腔黏膜组织中AQP3的表达情况,分析口腔鳞癌口腔黏膜组织中AQP3表达与临床病理因素及预后的关系。采用SPSS 18.0软件包对数据进行统计学分析。结果: B组口腔黏膜组织中AQP3阳性表达率显著高于A组和对照组（P<0.05）,A组口腔黏膜组织中AQP3阳性表达率显著高于对照组（P<0.05）。肿瘤侵袭深度>5 mm、临床T4分期、颈淋巴结转移、低分化患者,口腔黏膜组织中AQP3阳性表达率分别高于肿瘤侵袭深度≤5 mm、临床T2分期、无颈淋巴结转移、中高分化患者（P<0.05）。AQP3阳性表达的口腔鳞癌患者,术后3年生存率（65.85%）显著低于阴性表达患者（90.00%,P<0.05）。Cox回归分析显示,肿瘤临床分期、分化程度、颈淋巴结转移情况、AQP3阳性表达率是影响总生存率的独立预后因素（P<0.05）。结论: 口腔鳞癌患者口腔黏膜组织中AQP3阳性表达率显著高于口腔黏膜上皮异常增生者,AQP3表达与口腔鳞癌患者临床分期、颈淋巴结转移、分化程度、肿瘤侵袭深度及总生存率相关。     

口腔苔藓样损害中淋巴滤泡样结构表征及免疫细胞组成的实验研究

目的:评估口腔苔藓样损害（oral lichenoid lesion,OLL）中是否具有三级淋巴结构（tertiary lymphoid structure,TLS）,并分析其免疫细胞的组成特征。方法:收集正常口腔黏膜组织、口腔扁平苔藓组织（oral lichen planus, OLP）和口腔苔藓样损害组织（oral lichenoid tissue reaction, OLTR）各30例,行苏木精-伊红（H-E）染色,评估各组织中是否存在TLS样结构。利用免疫组织化学染色鉴定TLS相关的B细胞（CD19⁺、CD20⁺）、T细胞（CD3⁺）、滤泡树突状细胞（CD21⁺）、生发中心（Bcl-6⁺）和血管（CD34⁺ PNAd⁺）、淋巴管（CD34⁺ Gp36⁺）结构在各组中的数量和分布特点。在组织病理和分子标志物水平,评价TLS在OLL中的形态学表现。利用GraphPad Prism 7.0软件对数据进行统计学分析。结果:OLP组和OLTR组中,分别有46.7%（14/30）和23.4%（7/30）的病例存在TLS样结构,TLS样结构出现的频率与疾病类型无关（P>0.05）。与对照组相比,OLP组和OLTR组各分子标志物均高表达,其中,CD19、CD20和CD21在OLP组的表达具有TLS的形态结构特点。OLP组和OLTR组中,Bcl-6（平均积分吸光值分别为15 498±15 108 ∶ 1 841±2 276,P<0.000 1）、CD20（13 067±9 049 ∶ 7 695±5 159,P<0.05）、CD21（13 968±14 560 ∶ 2 552±2 584,P<0.000 1）、PNAd（10 328±10 383 ∶ 1 756±1 570,P<0.000 1）和Gp36（12 778±12 390 ∶ 2 313±2 578,P<0.000 1）的表达水平存在显著差异,但表达差异不能作为鉴别疾病类型的依据。结论:OLL中存在TLS,以非经典TLS为主,可见经典TLS;CD20、CD21可作为鉴定OLL损害组织中TLS的标志物,但TLS不能作为鉴别OLP和OLTR的依据。     

B细胞活化因子在系统性红斑狼疮伴牙周炎患者中的表达及相关性分析

目的： 检测B细胞活化因子（B-cell activating factor of the TNF family, BAFF）在牙周炎（periodontitis）和系统性红斑狼疮（systemic lupus erythematosus, SLE）患者血清中的含量,探讨BAFF的表达与牙周炎及SLE的关系。方法： 按纳入标准,选取就诊于中国医科大学附属盛京医院口腔科及风湿免疫科的患者,其中牙周炎组19例（P组）,系统性红斑狼疮组22例（SLE组）,系统性红斑狼疮合并牙周炎组24例（SLE+P组）,健康对照20例（H组）。记录4组受试者一般信息, 牙周探诊深度（periodontal probing depth, PD）、临床附着丧失（clinical attachment loss, CAL）、龈沟出血指数（sulcus bleeding index, SBI）。收集各组患者血清样本,应用酶联免疫吸附试验测定BAFF的含量,对SLE组及SLE+P组受试者的风湿免疫学指标进行测定,并对4组受试者BAFF含量与牙周指标进行相关性分析。采用SPSS 20.0 软件包对数据进行统计学分析。结果： P+SLE组的CAL显著高于P组（P<0.05）;SLE+P组、SLE组及P组的血清BAFF浓度显著高于健康组（P<0.05）;SLE+P组血清BAFF浓度显著高于SLE组（P<0.05）;SLE+P组的ESR、SLEDAI及患病时间显著高于SLE组（P<0.05）;血清BAFF表达水平与CAL及SBI呈显著正相关关系（P<0.01）;血清BAFF表达水平与PD呈正相关关系（P<0.05）;血清BAFF水平与患病时间及激素使用时间呈显著正相关关系（P<0.01）;血清BAFF水平与C3呈正相关关系（P<0.05）。结论： SLE与牙周炎具有一定的相关性,SLE伴牙周炎患者血清BAFF显著升高;BAFF可能在SLE和牙周炎的发生、发展中发挥一定作用。     

82例儿童牙色素沉着危险因素分析

目的: 调查门诊儿童牙黑色素沉着的患病情况,分析儿童牙黑色素沉着的危险因素。方法: 采用病例对照研究,对在上海市口腔病防治院就诊的164名儿童进行饮食习惯、口腔卫生习惯、饮用水来源、患病及用药等相关情况的问卷调查及唾液pH分析,其中82例为有牙黑色素沉着的儿童（病例组）,另82例为同期来院就诊的无牙色素沉着的儿童（对照组）。采用SPSS 21.0软件包对数据进行统计学分析。结果: 单因素分析显示,病例组中将瓶装水作为主要饮用水来源的儿童所占比例较对照组低（18.3% ∶ 35.4%）,服用中草药、多吃蔬菜（≥2次/d）的儿童所占比例较对照组高（23.2% ∶ 9.8%,29.3% ∶ 14.6%）,差异均有统计学意义（P<0.05）。多因素Logistic回归分析显示,服用中草药以及多吃蔬菜（≥2次/d）是牙黑色素沉着的危险因素（P<0.05）,而将瓶装水作为主要饮用水来源是保护因素。结论: 服用中草药以及多吃蔬菜（≥2次/d）是牙色素沉着的危险因素,而多饮瓶装水能降低发生色素沉着的风险。     

血栓弹力图检测在70例口腔颌面部缺损游离皮瓣修复围术期中的效果评价

目的: 探讨血栓弹力图(thromboelastography, TEG)检测在口腔颌面部缺损游离皮瓣修复围术期行抗凝治疗预防游离皮瓣吻合口血栓中的临床应用效果。方法: 回顾分析70例行口腔颌面部缺损游离皮瓣修复患者的临床资料。根据凝血检查方法及抗凝依据不同,分为对照组（常规凝血试验,根据常规凝血指标行抗凝治疗）和试验组（TEG实验和常规凝血实验,根据TEG指标行抗凝治疗）,每组35例,比较2组的凝血状态及皮瓣血栓形成、血肿等并发症。采用SPSS 24.0软件包对数据进行统计学分析。结果: 2组常规凝血试验的活化部分凝血活酶时间(APTT)、凝血酶时间（TT）水平在3个时间点依次降低,纤维蛋白原（FIB）在3个时间点水平上升,差异无统计学意义（P>0.05);国际标准化比率(INR)在3个时间点的差异无统计学意义（P>0.05）。试验组TEG中的Angle、MA、LY30%、EPL在3个时间之间的差异无统计学意义（P>0.05）,R和K值在3个时间点依次减小,差异有统计学意义（P<0.05）;术前和术后24 h,TEG实验的高凝患者阳性检出例数比常规凝血试验多,差异有统计学意义（P<0.05）。2组皮瓣并发症发生率无统计学差异（P>0.05）。结论: 血栓弹力图比常规凝血试验的高凝患者检出率高,血栓弹力图和常规凝血试验结果对抗凝药物的使用均有临床参考价值。     

不同年龄口腔颌面部间隙感染患者的临床特点分析

目的: 分析不同年龄口腔颌面部间隙感染患者的临床特点,为并发症的防治提供理论依据。方法: 回顾分析2007年3月—2017年2月间新疆医科大学第一附属医院颌面肿瘤外科收治的348例口腔颌面部间隙感染手术患者的病例资料,包括一般状况、临床症状、感染来源、治疗效果和并发症。采用SPSS20.0软件包对数据进行统计分析。结果: 348例患者中,高龄患者152例（43.28%）,青年患者196例（56.32%）,高龄患者中,男91例（59.87%）,青年患者中,男117例（59.69%）,两组的性别组成差异无统计学意义（P>0.05）;高龄患者发生并发症112例（73.68%）,青年患者49例（25.00%）,高龄患者更容易发生严重的并发症,本研究还发现,从症状出现到就诊的时间、2组患者实验室检查（白细胞、血糖水平）差异无统计学意义（P>0.05）,青年患者细菌培养阴性101例（51.53%）,青年患者有更高的细菌培养阴性率（P<0.05）,在细菌的组成中,两组患者差异均具有统计学意义（P<0.05）。结论: 在口腔颌面部间隙感染中,高龄患者和青年患者有着许多相同的临床表现,但高龄患者较青年患者更容易发生严重并发症。     

Oral health‐related quality of life of removable partial denture wearers and related factors

This study aims to investigate the oral health‐related quality of life (OHRQoL) in a group of removable partial denture (RPD) wearers in Shiraz (Iran), using the Persian version of the Oral Health Impact Profile (OHIP‐14). Two hundred removable partial denture wearers had completed a questionnaire regarding patients' demographic characteristics and denture‐related factors. In addition, the OHIP‐14 questionnaire was filled out by interviewing the patients. Two measures of interpreting the OHIP‐14 scales were utilised: OHIP‐14 sum and OHIP‐14 prevalence. The relationship of the patients' demographic characteristics and denture‐related factors, with their OHRQoL was investigated. The mean OHIP‐14 sum and OHIP‐14 prevalence of RPD wearers were 13·80 (±10·08) and 44·5%, respectively. The most problematic aspects of OHIP‐14 were physical disability and physical pain. Twenty‐seven percentage and 24% of participants had reported meal interruption and eating discomfort, respectively. OHIP‐14 prevalence and OHIP‐14 sum were found to be significantly associated with factors representing RPD wearer's oral health such as self‐reported oral health and frequency of denture cleaning. Furthermore, OHIP‐14 prevalence and OHIP‐14 sum were significantly associated with factors related to frequency of denture use such as hours of wearing the denture during the day and wearing the denture while eating and sleeping. Therefore, it can be concluded that the OHRQoL of the patients of the study was generally not optimal and found to be strongly associated with oral health.     

Comparison of denture stomatitis prevalence in 2 population groups

PURPOSE: The aim of this cross-sectional study was to profile complete denture wearers in 2 different unmatched and nonrandomized population groups and compare any possible relationships between the prevalence of denture stomatitis and other factors involved in wearing complete dentures. MATERIALS AND METHODS: Denture wearers who attended the clinics of the Dental School and Hospital, University of Bristol, United Kingdom (group A), and the Dental School, University of Athens, Greece (group B), were examined. The examination included a record of gender, age, years wearing a complete denture, number of dentures used, duration of current denture's usage, daily time period of denture wearing, and clinical examination of the maxillary denture-bearing mucosa. Data were analyzed using the chi-square test. RESULTS: Denture wearers of group A were older, more experienced in wearing complete dentures, and had used more sets of dentures. The majority of patients used dentures exhibiting decreased vertical dimension of occlusion and wore their dentures only in the daytime. Denture stomatitis prevalence was statistically significantly different between groups A and B (27% and 39.7%, respectively). In both groups, the denture stomatitis prevalence was greater in women. There was no statistically significant difference between the groups regarding the age of denture wearers, the number of dentures used, or the vertical dimension of occlusion. In group B, the denture stomatitis prevalence was significantly related to the years of denture-wearing experience and the current denture's usage. In both groups, continuous denture wearing was highly related to denture stomatitis prevalence. CONCLUSIONS: This cross-sectional study showed that 2 different population groups of denture wearers presented different complete denture wearing habits and denture stomatitis prevalence. Comparisons indicate that proper denture wearing habits decrease the prevalence of denture stomatitis.     

A comparison of patient's satisfaction between complete and partial removable denture wearers

OBJECTIVES: The aim of this study was to compare satisfaction between complete denture (CD) and Kennedy Class I removable partial denture (RPD) wearers. MATERIALS AND METHODS: A total of 156 CD and 112 RPD wearers took a part in this study. From the primary group of the examined patients, only those whose RPDs and CDs were assessed as excellent or very good by the dentist, took a part in this study. Patients graded satisfaction of their dentures by using an analogue scale from 1 to 5 (1=unsatisfactory; 5=excellent). RESULTS: Both CD and RPD wearers were mostly satisfied with their dentures (the distribution of the scores of the patients' assessments was skewed towards the highest scores; more than half of the patients scored all the examined variables to the best score category). Complete Denture wearers were significantly more satisfied with chewing, speech and retention of maxillary denture than RPD wearers (P<0.05). Removable partial denture wearers were significantly more satisfied with the retention and the comfort of wearing mandibular denture (P<0.05). There was no significant difference between CD and RPD wearers for general satisfaction with their dentures, aesthetics and comfort of wearing maxillary denture (P>0.05; N.S.). CONCLUSIONS: A majority of CD and RPD wearers were satisfied with the dentures. CD wearers were more satisfied with speech, chewing and retention of maxillary denture, while RPD wearers were more satisfied with the retention and the comfort of wearing mandibular denture. Different groups of denture wearers have to make significant, but different adjustments to wear their dentures successfully.     

Prevalence of the 'combination syndrome' among denture patients

The prevalence of symptoms associated with "combination syndrome" were documented in 150 maxillary complete denture wearers. The five alveolar ridge changes that are most consequential to denture wearing and most difficult to correct surgically were found in 7% of the population studied. However, these changes were found in 24% of patients who have natural mandibular anterior teeth opposing complete maxillary dentures. This rate did not differ significantly between patients who do and do not wear a mandibular removable partial denture.     

The effect of orthodontic appliances on the distribution of Candida and plaque in adolescents

The site prevalence and intra-oral density of Candidal organisms may be increased by local factors including prostheses. However, whether significant changes in Candidal carriage occurs with denture wearing is not clearly established. This study employed the imprint culture technique to assess the effects of fixed and removable orthodontic appliances on oral carriage, site prevalence and intra-oral density of Candida in adolescents. Moreover, alterations in plaque distribution were measured. Groups of 12-16 year olds without or wearing fixed and removable appliances were studied. Imprint cultures were taken from six intra-oral sites and colony counts recorded after 48 hours incubation on selective media. Plaque scores were recorded from non-appliance and removable appliance wearers. The prevalence of Candidal carriage in the groups was not significantly different being 46 per cent of non-appliance, 51 per cent of fixed appliance and 52 per cent of removable appliance wearers. However, the prevalence of Candidal recovery at some sites and Candidal densities at all sites were significantly increased in both fixed and removable appliance wearers. Thus orthodontic appliances may predispose to Candidal proliferation in oral carriers. However, the results do not permit the conclusion that appliances may change non-carriers of Candida to carriers. Plaque distribution was significantly altered in removable appliance wearers when compared with non-appliance wearers as a result of increases in palatal plaque scores. These findings again emphasize the particular need for oral hygiene instruction in patients wearing appliances or partial prostheses.     

Prevalence of the ‘combination syndrome’ among denture patients

The prevalence of symptoms associated with “combination syndrome” were documented in 150 maxillary complete denture wearers. The five alveolar ridge changes that are most consequential to denture wearing and most difficult to correct surgically were found in 7% of the population studied. However, these changes were found in 24% of patients who have natural mandibular anterior teeth opposing complete maxillary dentures. This rate did not differ significantly between patients who do and do not wear a mandibular removable partial denture.     

Mandibular bone mineral density changes in complete and removable partial denture wearers: a 6-month follow-up study

PURPOSE: The purpose of the study was to determine the changes in bone mineral density of the mandible in complete and removable free-end saddle denture wearers over a 6-month period. MATERIALS AND METHODS: Twenty removable partial denture patients and 20 complete denture wearers participated. Two dental panoramic radiographs were taken from each patient, the first prior to denture delivery and the second after 6 months of denture wearing. Bone mineral density measurements were performed on panoramic radiographs with a five-step copper stepwedge attached to each film cassette. Bone mineral density values of the measured regions of interest were expressed in equivalents of the stepwedge thickness (mm). RESULTS: The results revealed minor changes in bone mineral density values of the examined regions in the 6-month period. Under the distal end of complete denture saddles, the bone mineral density values decreased, whereas the values under the distal end of removable partial dentures increased. However, the difference between the first and second measurements was not significant. In each of the examined groups, the bone mineral density values at the gonion increased significantly by approximately 20%. This was attributed to the increased strain forces of the masseter muscle at the gonion after denture delivery. CONCLUSION: Significant increase of bone mineral density values was registered 2 mm above the gonion in both complete and removable partial denture wearers. Age and gender were not related to the bone mineral density changes over a 6-month period.     

Oral health impact in patients wearing removable prostheses: relations to somatization, pain sensitivity, and body consciousness

PURPOSE: Previous studies investigating associations between patient personality traits and complaints related to wearing dental prostheses have been inconclusive. From the perspective of cognitive behavioral theory, the current study investigated whether pain sensitivity, body consciousness, and somatization affected the oral health of patients wearing removable dentures. MATERIALS AND METHODS: Eighty-eight patients were supplied with removable partial and complete dentures. The Oral Health Impact Profile (OHIP), with six subscales measuring oral health impairment and disability during daily living, the Pain Sensitivity Index, the Private Body Consciousness scale, and the Somatization Scale of the SCL-90-R, were used. RESULTS: The variables pain sensitivity, body consciousness, and somatization correlated significantly with all six OHIP subscales in removable denture wearers. In multiple hierarchic regression analyses, patient personality accounted for 38.0% of functional limitation and 41.5% of physical pain. CONCLUSION: Pain sensitivity and bodily preoccupation might be important factors in explaining the subjective oral health effects of removable denture wearing.     

Development of a specific indicator of the well-being of wearers of removable dentures

Montero J, Bravo M, López‐Valverde A. Development of a specific indicator of the well‐being of wearers of removable dentures. Community Dent Oral Epidemiol 2011; 39: 515–524. © 2011 John Wiley & Sons A/S Abstract – Objectives: Bearers of removable prostheses have certain particular characteristics that require the inclusion of items able to detect the specific effect on their oral functions (derived from the presence of such prostheses). We aimed to develop and validate a specific indicator for the assessment of oral health–related quality of life in bearers of dentures. Methods: A panel of experts compiled a questionnaire addressing oral health–related quality of life (11 items) to assess the degree of well‐being afforded by removable dentures. After a pilot trial in patients bearing prostheses (n = 36), a consecutive sampling of denture wearers (n = 123) was conducted among patients not requesting odontological treatment and accompanying persons, attending their respective health centres in the City of Granada and its metropolitan area. The subjects were classified as RPP1 (removable partial prosthesis on one of the arches, RPP2 (on both) and complete prosthesis (CP on both arches). Results: The questionnaire was consistent (Cronbach alpha 0.814) and proved to have suitable validity. Factor analysis revealed three factors termed physical, psychological and social well‐being, which coherently supported the interrelationship among the 11 items. The prevalence of impact was significantly higher in the CP individuals (97.1%) and in that of the RPP2 group (92.1%) than in the RPP1 subjects (80.7%). Prosthetic fit, aesthetics and self‐confidence were significantly discrepant among the prosthetic groups, although the total prosthetic quality of life score was not able to differentiate them. The main prosthetic impact in all the prosthesis‐wearing groups was attributed to ‘food impaction’, although all the groups were essentially satisfied with their mouth. Conclusions: The prosthetic quality of life (PQL) questionnaire is a valid and reliable indicator of the specific well‐being of partial or complete denture wearers.     

Frequency and suppliers of removable dentures in Finland in 1983

The frequency of removable dentures and their suppliers were surveyed in March 1983 by interviewing a sample comprising 957 persons drawn to cover the total Finnish population aged 15 yr and over. The interviews revealed that there were 328 denture wearers in this sample (34.3%). The age-standardized rates were 39.7% for denture wearers and 20.4% for those wearing full dentures in both jaws. The rates for complete edentulousness, removable partial dentures of some kind and only partial denture wearing were 21.3%, 10.3% and 6.9%, respectively. Almost all of the removable denture wearers had a denture in the maxilla (97%); 62% had one in the mandible. Dental technicians with a special degree have the right to supply full dentures direct to clients in Finland. Dentists supplied 45% and dental technicians 53% of the full dentures surveyed. The study revealed a contradiction between the legal rights of dental technicians to supply dentures direct to clients and the current practice. The choice of the supplier of a removable denture showed no significant correlation with the education and income of denture wearers. The high frequency of dentures and the misconceptions regarding the supplying of them call for improvement in oral health education.