Wear of resin denture teeth in partial removable dental prostheses

PurposeTo investigate occlusal wear of resin denture teeth in partial removable dental prostheses worn by partially edentulous patients.MethodsThirty patients with partial removable dental prostheses were included in the study. Thirty-two patients with complete dentures served as a reference group. Occlusal wear after two years was evaluated indirectly using gypsum casts and a three-dimensional laser-scanner device. Overall wear of complete occlusal surfaces and maximum wear of occlusal contact areas were measured. Patient and prosthesis data were analyzed using univariate and multiple linear mixed models.ResultsOverall wear of denture teeth in partial removable dental prostheses was 91 (SD 85) μm, and maximum wear of occlusal contact areas was 329 (SD 204) μm (means and standard deviations). Average and maximum wear values for teeth in complete dentures were both lower than those for teeth in partial removable dental prostheses. However, differences between wear of different types of denture did not reach statistical significance after adjustment for gender, type of tooth, dental status of the opposing jaw, and antagonist material. Statistical analysis revealed that wear was greater for denture teeth occluding with ceramic crowns and/or fixed partial dentures as antagonists.ConclusionsResin denture teeth in partial removable and complete dental prostheses are subjected to clinically important occlusal wear that might destabilize occlusion and cause further problems. Patient-related factors and dental status affect wear behavior and should be taken into consideration when treating patients with removable dentures.     

Electromyographic analysis of masticatory and neck muscles in subjects with natural dentition, teeth-supported and implant-supported prostheses

Objectives: To compare the electromyographic (EMG) characteristics of masticatory and neck muscles in patients with natural dentition, teeth‐supported prostheses and implant‐supported prostheses. Materials and methods: Twenty‐five subjects aged 40–80 years were examined. Five patients had maxillary and mandibular implant‐supported fixed prostheses; five patients had mandibular implant‐supported fixed prosthesis and maxillary removable complete denture; seven patients had implant‐supported fixed prosthesis (one arch) and natural dentition or full‐arch tooth‐fixed prosthesis (one arch); and eight control subjects had natural dentition or single tooth‐fixed prostheses. Surface EMG of masseter, temporal and sternocleidomastoid muscles was performed during maximum teeth clenching and unilateral gum chewing. Interarch dental contacts were assessed with shim stocks. Results: All groups had similar interarch dental contacts (P>0.05). During clenching, patients with maxillary and mandibular implant‐supported fixed prostheses had unbalanced standardized masseter and temporalis anterior activities (74%), with significantly larger values found in the other patients and control subjects (all mean values larger than 86%, P=0.017). All patients chewed with significantly larger muscular potentials than control subjects (on average, 1434–2100 μV s vs. 980 μV s, P=0.04), and had altered muscular patterns (left side, P=0.021). The patients with one arch with natural dentition/tooth fixed prostheses had chewing muscular patterns similar to the control subjects. Conclusions: Clenching with the analyzed prostheses was performed with a relative increment of temporalis activity. Neuromuscular coordination during chewing was larger in patients who maintained their teeth or dental roots, independently from the number of dental contacts.     

Dental Implants: A Role in Geriatric Dentistry for the General Practice?

BackgroundIn the general population, the use of dental implants has become a management strategy for replacing missing teeth. As part of the treatment plan for the aging population, general dentists should consider this treatment modality in their practices.OverviewThis study reviews specific issues concerning the aging population and tooth replacement therapies. Older people often desire to replace missing teeth, but they have complex medical, social, economic and resource issues that must be accounted for in their treatment plan. Dentists need to give careful attention to the patient-based assessment, diagnostic criteria and diagnostic steps to help the patient and family understand the strengths and challenges of each type of tooth replacement therapy. The author emphasizes the importance of careful evaluation and assessment of fixed versus removable implant–retained prostheses in the aging population.Conclusions and Clinical ImplicationsFor many general dentists, dental implants have become an increasingly common treatment option for missing dentition. With the population becoming increasingly older worldwide, the general dentist will be confronted with patients who have complex medical and social histories who desire tooth replacement therapy. The rational delivery of this oral health care will assist in providing a high quality of life for these patients.     

Removable dental prostheses and cardiovascular survival: A 15-year follow-up study

ObjectivesIn previous studies, increasing number of teeth predicted better survival and the acute needs for dental treatment predicted mortality. We sought to investigate whether restored dentitions by various removable dental prostheses impact cardiovascular (CVD) longevity.MethodsKuopio Oral Health and Heart study was initiated as a cross-sectional investigation with 256 subjects with diagnosed coronary artery disease [CAD] and 250 age- and sex-matched controls without CAD in 1995–1996. The mean age of both groups was 61, 30% were females. We appended mortality follow-up records to the baseline data and formulated this 15-year follow-up study. We examined the relationship between various types of dental prostheses and cardiovascular mortality by proportional hazard regression analyses. We also explored their correlation to oral and systemic inflammatory markers such as asymptotic dental score and C-reactive protein.ResultsIn a model adjusted for age, sex and smoking, groups having only natural teeth (NT), removable partial denture(s) [PD] and NT, a PD and a full denture [FD], and FD/FD or FD/NT demonstrated the following hazard ratios for mortality (95% confidence interval). NT both arches: 1.00 [reference]; PD and NT: 0.75 [0.22–2.56]; PD and FD: 1.99 [1.05–3.81]; and FD opposed by FD or NT: 1.71 [0.93–3.13], respectively [p for trend = 0.05]. Although statistically not significant, those with PD and NT with mean a number of teeth [N_teeth] of 15.4 had better survival compared with those who had all NT [N_teeth = 22.5]; while those who had FD and PD [N_teeth = 6.5] had shorter longevity than those with FD/FD or FD/NT [N_teeth = 3.5].ConclusionsAlthough not all subgroups of dental prostheses reached significant relationship with CVD mortality, our study suggests that not only the number [quantity] of remaining teeth but their maintenance [quality] removing potential inflammatory foci, such as pericoronitis or retained root tips, may positively impact on cardiovascular survival.     

Practitioner, patient and carious lesion characteristics associated with type of restorative material: findings from The Dental Practice-Based Research Network

BackgroundThe authors conducted a study to identify factors associated with the materials that dentists in The Dental Practice-Based Research Network (DPBRN) use when placing the first restoration on permanent posterior tooth surfaces.MethodsA total of 182 DPBRN practitioner-investigators provided data regarding 5,599 posterior teeth with caries. Practitioner-investigators completed an enrollment questionnaire that included the dentist’s age, sex, practice workload, practice type and number of years since graduation. When patients who had provided informed consent to participate in the investigation sought treatment for a previously unrestored carious surface, the practitioner-investigator recorded patient and tooth characteristics.ResultsPractitioner-investigators used amalgam more often than they used direct resin-based composite (RBC) for posterior carious lesions. Practitioner and practice characteristics (years since graduation and type of practice); patient characteristics (sex, race, age and dental insurance status); and lesion characteristics (tooth location and surface, preoperative and postoperative lesion depth) were associated with the type of restorative material used.ConclusionsSeveral practitioner and practice, patient and lesion characteristics were associated significantly with use of amalgam and RBC: geographical region, years since dentist’s graduation, patient’s dental insurance status, tooth location and surface, and preoperative and postoperative lesion depth.Clinical ImplicationsDespite advances in esthetic dentistry, U.S. dentists still are placing amalgam on posterior teeth with carious lesions. Amalgam was used more often than RBC in older patients, who may have had deeper carious lesions.     

Increased risk for premolar tooth loss in shortened dental arches

ObjectivesTo assess sustainability of shortened dental arches (SDA) by determining time to ‘first restorative intervention’ of teeth and time to ‘tooth loss’ and comparing these outcomes with complete dental arches (CDA) and SDA plus removable dental prostheses (RDP).MethodsData (follow-up time ranged from 27.4 (SD 7.1) to 35.0 (SD 5.6) years; max. follow up: 45.8 years) from patient records of 59 subjects (23 SDA, 23 CDA, and 13 SDA plus RDP) participating in a prospective cohort study on shortened dental arches (SDA) were analysed. Group effects on survival were analysed using Cox regression models; where appropriate Kaplan–Meier analyses were done.ResultsCompared to SDA subjects, CDA subjects had a lower risk to receive a first restorative intervention in anterior teeth (HR = 0.377; 95% CI [0.205–0.695]) and premolars (HR = 0.470; 95% CI [0.226–0.977]). CDA subjects had a lower risk to lose premolars compared to SDA subjects (HR = 0.130; 95% CI [0.053–0.319]). Risk for ‘first restorative intervention’ and for ‘tooth loss’ did not significantly differ between SDA with and without RDP.ConclusionsSDA subjects had an increased risk to lose premolars and to receive a first time restoration in anterior teeth and premolars compared to CDA subjects. SDA subjects with RDP had no increased risk to receive a first restorative intervention or for tooth loss compared to SDA without RDP.Clinical relevanceSubjects with shortened dental arches can be discerned as enduring at-risk patients. It is therefore recommended that shortened dental arch subjects receive intensive and continuous care to prevent further tooth loss.     

The Correlation of Crack Lines and Definitive Restorations with the Survival and Success Rates of Cracked Teeth: A Long-term Retrospective Clinical Study

IntroductionCracked teeth frequently require protective adhesive restorations. This long-term, longitudinal retrospective clinical study aimed to evaluate the factors influencing the success and survival rates of cracked teeth with crack lines (CLs) in different directions when restored early with onlays or full-coverage crowns.MethodsThe dental records of 71 patients with a total of 86 cracked teeth with different pulpal and periapical diagnoses and with follow-ups spanning over 1–11 years were included. Data regarding the demographics; clinical symptoms and signs; bruxism; occlusal interferences; eating habits; pulpal and periapical diagnoses; number, direction, location, and extent of CLs; probing depth; and coronary condition before and after the placement of definitive restorations were collected. Univariate associations between tooth survival and explanatory variables were assessed. The long-term survival rate was estimated using Kaplan-Meier analysis and the log-rank test. A multivariate analysis was performed using Cox regression analysis.ResultsThe overall success rate was 93.0%, and the overall survival estimates of cracked teeth restored early were 98.6%, 94.9%, and 55.9% at the 1-, 5-, and 11-year follow-ups, respectively. The direction of the CLs did not influence the survival of the tooth. No significant association was observed between the type of tooth, probing depth, root canal treatment, and tooth loss (P > .05). The multivariate analysis showed that previously treated cracked teeth (P < .05), the provision of onlay restorations (P < .05), and the placement of posts (P < .05) had higher correlations with tooth loss. Additionally, the placement of full-coverage crowns resulted in lower tooth loss compared with the placement of onlays (P < .05).ConclusionsPrevious endodontic treatment in teeth that subsequently develop CLs has a negative impact on the survival rate of the teeth. Moreover, early placement of full-coverage crowns should be implemented for cracked teeth regardless of the direction or the number of CLs because it is associated with a higher cracked tooth survival rate.     

Dental and periodontal health in a Swiss population-based sample of older adults: a cross-sectional study

In this cross-sectional study, the prevalences of tooth loss, prosthetic dental restorations, and probing pocket depths (PPD) ≥4 mm, and their relationship to sociodemographic factors, were investigated in older Swiss adults. There were up to 1,673 participants aged ≥55 yr in the fourth survey of the Swiss Cohort Study on Air Pollution And Lung And Heart Disease In Adults (SAPALDIA4). Missing teeth, prosthetic dental restorations, and PPD ≥4 mm were recorded in clinical examinations conducted by field workers and compared with self-reported information from questionnaires. Examination data showed that participants were missing five teeth on average, 74.8% had a prosthetic dental restoration, and 21.1% had PPD of ≥4 mm. The mean number of missing teeth and the prevalences of tooth loss, fixed dental prostheses, and removable dental prostheses were associated with age, education level, smoking status, and time since last visit to a dentist. Comparison of data obtained by field workers and that from self-reports show a high level of agreement for the number of missing teeth and the prevalence of removable dental prostheses, but a lower level of agreement for self-reports of fixed dental prostheses and periodontitis.     

Removable prostheses for preschool children: report of two cases.

Dental prostheses are frequently used to avoid psychologic, speech, or swallowing problems in preschool children with considerable tooth loss. Two cases of preschool children are presented, involving multiple loss of primary teeth. The purpose of this study was to promote the correct development of the maxilla and mandible by using removable dental prostheses and to guide the eruption of the permanent molars. Removable acrylic prostheses were provided for two children, with a special metallic s-shaped handle (ansa), which guided the eruption of the first permanent molars. These prostheses were modified as the children grew. By replacing missing teeth, several oral functions were re-established, development of the maxilla and mandible was promoted, and each child could develop socially from a psychologic point of view. The use of removable dental prostheses in preschool-aged children presenting with considerable tooth loss can be a viable and successful treatment option.     

Attachment-retained removable prostheses: Patient satisfaction and quality of life assessment

Statement of problemStudies on the impact of incorporating attachments in removable prostheses on patient-based outcomes are scarce.PurposeThe purpose of this clinical study was to investigate oral health–related quality of life (OHRQoL) and patient satisfaction in partially edentulous participants before and after rehabilitation with mandibular attachment-retained removable prostheses as compared with conventional removable prostheses.Material and methodsThis crossover study included 74 participants (aged 36 to 57). Initially, 56 received conventional clasp-retained removable dental prostheses (RDPs), and 18 received conventional overdentures (ODs) based on their mandibular partially edentulous state. Two months later, of the 56 RDP participants, 24 had received extracoronal attachment-retained RDPs, 17 received telescope-retained RDPs, and 15 received bar-attachment retained RDPs. The 18 OD participants received ball attachment–retained ODs. Assessments included Oral Health Impact Profile-short version-14 for OHRQoL and a visual analog scale (VAS) for patient satisfaction. Assessments were done before treatment and 2 months after wearing each prosthesis with a 1-month washout period. Statistical analysis included the Friedman then the Wilcoxon signed rank test for Oral Health Impact Profile-short version-14 scores and repeated measures ANOVA then the Bonferroni or paired t test for VAS scores (α=.05).ResultsThere were no dropouts. Rehabilitation, irrespective of prosthesis type, significantly improved OHRQoL in all domains and significantly increased overall patient satisfaction (P<.05). When compared with the conventional prostheses, attachment-retained prostheses significantly improved functional limitation, psychological discomfort, and physical limitation domains in all groups (P<.05), as well as the physical pain domain in the OD group (P=.041). General satisfaction, stability, comfort, ability to speak, and ability to masticate significantly increased (P<.05) with attachment-retained prostheses. Conventional prostheses were significantly easier to clean (P<.05) in all groups, except for the telescope-attachment group.ConclusionsBoth conventional and attachment-retained prostheses significantly increased patient satisfaction and improved OHRQoL in all domains as compared with before treatment. However, incorporation of attachments further improved functional limitation, psychological discomfort, and physical limitation domains in all groups, as well as the physical pain domain in the OD group. Participants were more satisfied with their attachment-retained prostheses in most aspects.     

Restoration of noncarious tooth defects by dentists in The Dental Practice-Based Research Network

BackgroundThe authors conducted a study to quantify the reasons for restoring noncarious tooth defects (NCTDs) by dentists in The Dental Practice-Based Research Network (DPBRN) and to assess the tooth, patient and dentist characteristics associated with those reasons.MethodsData were collected by 178 DPBRN dentists regarding the placement of 1,301 consecutive restorations owing to NCTDs. Information gathered included the main clinical reason, other than dental caries, for restoration of previously unrestored permanent tooth surfaces; characteristics of patients who received treatment; dentists’ and dental practices’ characteristics; teeth and surfaces restored; and restorative materials used.ResultsDentists most often placed restorations to treat lesions caused by abrasion, abfraction or erosion (AAE) (46 percent) and tooth fracture (31 percent). Patients 41 years or older received restorations mainly because of AAE (P < .001). Premolars and anterior teeth were restored mostly owing to AAE; molars were restored mostly owing to tooth fracture (P < .001). Dentists used directly placed resin-based composite (RBC) largely to restore AAE lesions and fractured teeth (P < .001).ConclusionsAmong DPBRN practices, AAE and tooth fracture were the main reasons for restoring noncarious tooth surfaces. Pre-molars and anterior teeth of patients 41 years and older are most likely to receive restorations owing to AAE; molars are most likely to receive restorations owing to tooth fracture. Dentists restored both types of NCTDs most often with RBC.     

Variability of dental abnormalities according to the timing of anticancer therapy: A report of two cases

BackgroundCurrent multimodality therapies have increased the survival of patients with childhood cancer. However, these therapies increase the risk of dental complications.Case reportThe first case was a 7-year-old girl who was diagnosed with leukemia at around 8 months of age and received anticancer therapy for about 1 year. The second case was an 8-year-old boy who was diagnosed with leukemia at around the age of 6 and received anticancer therapy for about 2 years. Based on long-term follow-up of two cases, tooth agenesis and microdontia occurs when anticancer therapy is performed at the initial stage of tooth development. However shortening roots of the affected teeth can be found when it is performed at the late stage of tooth development.ConclusionsEarly diagnosis and understanding of dental developmental defects resulting from anticancer therapy are essential for preventing tooth loss and space-related problems in the oral cavity.     

Tooth preservation or implant placement: A systematic review of long-term tooth and implant survival rates

BackgroundFor the past few decades, dental implants have served as reliable replacements for missing teeth. However, there is an increasing trend toward replacing diseased teeth with dental implants.Types of Studies ReviewedThe authors conducted a systematic review of long-term survival rates of teeth and implants. They searched the MEDLINE database for relevant publications up to March 2013. They considered studies in which investigators assessed the long-term effectiveness of dental implants or that of tooth preservation. They included only studies that had follow-up periods of 15 years or longer.ResultsThe authors selected 19 articles for inclusion. Investigators in nine studies assessed the tooth survival rate, whereas investigators in 10 studies assessed the implant survival rate. When comparing the overall long-term (that is, 15 years or more) tooth loss rate with that of implants, the authors observed rates ranging between 3.6 and 13.4 percent and 0 and 33 percent for teeth and implants, respectively. They could not perform a meta-analysis because of the substantial differences between the studies.Practical ImplicationsThe results of this systematic review show that implant survival rates do not exceed those of compromised but adequately treated and maintained teeth, supporting the notion that the decision to extract a tooth and place a dental implant should be made cautiously. Even when a tooth seems to be compromised and requires treatment to be maintained, implant treatment also might require additional surgical procedures that might pose some risks as well. Furthermore, a tooth can be extracted and replaced at any time; however, extraction is a definitive and irreversible treatment.     

Masticatory ability and functional tooth units in Japanese adults

Summary  The purposes of this study were (i) to examine the relationship between the number of natural teeth and the number of functional tooth units in Japanese adults, (ii) to evaluate how functional tooth units relate to subjective masticatory ability and (iii) to determine the minimum number of natural teeth and functional tooth units needed to maintain adequate self-assessed chewing function. A self-administered questionnaire was given and dental examination was conducted for 2164 residents aged 40 to 75 years. Counts were made on the number of functional tooth units of natural teeth (n-functional tooth units), the sum of natural teeth and artificial teeth on implant-supported and fixed prostheses (nif-functional tooth units) and the sum of natural teeth and artificial teeth on implant-supported, fixed and removable prostheses (total-functional tooth units). The average number of natural teeth, n-functional tooth units and nif-functional tooth units decreased with age, but these were often replaced by functional tooth units from artificial teeth on removable prostheses. Total-functional tooth units in 50–59 year old people were slightly lower compared with those in other age groups. Subjects who reported that they could chew every food item on an average had 23·4 total natural teeth, 12·6 posterior natural teeth, 7·6 n-functional tooth units, 8·6 nif-functional tooth units and 10·4 total-functional tooth units, and subjects without chewing difficulties had fewer functional tooth units from removable prostheses. Maintaining 20 and more natural teeth and at least eight nif-functional tooth units is important in reducing the likelihood of self-assessed chewing difficulties.     

The frequency and distribution of caries among the Iron Age population (about 2200 years BP) buried in the Mausoleum of Emperor Qinshihuang

ObjectivesThe purpose of this study was to assess the prevalence, distribution, and intensity of dental caries in the Iron Age population of northern China in order to increase knowledge about the type of food, dietary habit, and social stratification in this Iron Age people.Materials and methodsThe samples analyzed were dental remains of 1548 permanent teeth from 69 male individuals unearthed from the Qin archaeological site of Emperor Qinshihuang's Mausoleum in Lintong (northern China). The sex and the age-at-death of the samples were estimated.ResultsOverall frequency of antemortem tooth loss in the samples was 0.8%. The proportion of individuals with at least one carious tooth was 65.2%, and the frequency of carious lesions was 9.4%, both showing a trend to rise as age increased. Data obtained on dental caries and antemortem tooth loss provided a corrected rate of 9.5% of teeth with caries. The most frequent carious lesions were occlusal lesions (2.6%), followed by interproximal (2.5%) and buccal/lingual lesions (1.0%). Tooth type analysis showed that molars had the highest percentage of caries (18.6%), followed by premolars (4.5%), canines (3.0%), and incisors (3.0%). The total SRCI was 1.6, increasing with age.ConclusionsThese findings indicate that dental caries may be related, at least in part, to the subsistence and diet of this Iron Age population.     

A Systematic Review of the Clinical Performance of Tooth‐Retained and Implant‐Retained Double Crown Prostheses with a Follow‐Up of ≥3 Years

Purpose: The objective of this review was to systematically screen the literature for data related to the survival and complication rates observed with dental or implant double crown abutments and removable prostheses under functional loading for at least 3 years. Materials and Methods: A systematic review of the dental literature from January 1966 to December 2009 was performed in electronic databases (PubMed and Embase) as well as by an extensive hand search to investigate the clinical outcomes of double crown reconstructions. Results: From the total of 2412 titles retrieved from the search, 65 were selected for full‐text review. Subsequently, 17 papers were included for data extraction. An estimation of the cumulative survival and complication rates was not feasible due to the lack of detailed information. Tooth survival rates for telescopic abutment teeth ranged from 82.5% to 96.5% after an observation period of 3.4 to 6 years, and for tooth‐supported double crown retained dentures from 66.7% to 98.6% after an observation period of 6 to 10 years. The survival rates of implants were between 97.9% and 100% and for telescopic‐retained removable dental prostheses with two mandibular implants, 100% after 3.0 and 10.4 years. The major biological complications affecting the tooth abutments were gingival inflammation, periodontal disease, and caries. The most frequent technical complications were loss of cementation and loss of facings. Conclusions: The main findings of this review are: (I) double crown tooth abutments and dentures demonstrated a wide range of survival rates. (II) Implant‐supported mandibular overdentures demonstrated a favorable long‐term prognosis. (III) A greater need for prosthetic maintenance is required for both tooth‐supported and implant‐supported reconstructions. (IV) Future areas of research would involve designing appropriate longitudinal studies for comparisons of survival and complication rates of different reconstruction designs.     

Comparative evaluation of bacterial colonization on removable dental prostheses in patients with COVID-19: A clinical study

Statement of problemIn the outbreak of COVID-19, coinfections and even superinfections in the background of SARS-CoV-2 viral infection have been reported. Such bacterial and fungal strains may be colonized in different tissues and organs, including the oral cavity. Whether infection with COVID-19 could increase colonization of different bacterial strains on removable dental prostheses is unclear.PurposeThe purpose of this clinical study was to compare bacterial colonization on removable dental prostheses in patients with COVID-19, before versus after diagnosis.Material and methodsTwo sex- and age-matched groups of complete-denture-wearing participants (N=60) with and without a positive diagnosis for COVID-19 were enrolled in the study. Swabs were used at 2 different time intervals to sample areas of the dentures, which were then cultured and the colony smears Gram stained. A statistical analysis was conducted by using the Mann-Whitney U test (α=.05).ResultsStreptococcus species (93.3% versus 40.0%, P=.047) and Klebsiella pneumonia (46.7% versus 13.4%, P=.036) were detected more frequently in the COVID-19-positive group.ConclusionsHigher rates of bacterial colonization, especially with Streptococcus species and Klebsiella pneumonia, were detected on removable dental prostheses after COVID-19 infection.     

Patient attitude and habits regarding removable denture home hygiene and correlation with prosthesis cleanliness: A cross-sectional study of elderly Italians

Statement of problemWith the aging population, an increasing number of patients will require removable dental prostheses. Despite the recent public efforts to improve oral healthcare, knowledge of hygiene procedures for removable dental prostheses is sparse.PurposeThe purpose of this cross-sectional study was to determine, through questionnaires, the level of awareness and education of home hygiene procedures among elderly Italian individuals wearing removable dental prostheses and to correlate self-reported hygiene habits and prosthesis cleanliness, as determined by a clinical examination.Material and methodsA cross-sectional study was performed by questionnaires administered by a dental hygienist to patients attending the dental clinics (prosthodontic and periodontology clinical units) at San Paolo Hospital of Milan from January 2014 to October 2015 and who volunteered to participate. The questionnaire included demographic data and oral hygiene habits. Each participant received an intraoral and prosthesis examination performed by the same dental hygienist. The cleanliness of the removable dental prosthesis was classified according to a 3-point scoring system. Categorical variables were expressed as a percentage of study participants and compared by using the χ² test, while, for the statistical correlations between continuous and categorical variables, the point-biserial correlation calculator was used (α=.05).ResultsQuestionnaires were collected from 161 study participants: 92 women (mean ±standard deviation age: 76 ±7.59 years; range: 65-93 years) and 69 men (mean ±standard deviation age: 74 ±6.31 years; range: 65-86 years). A total of 239 prostheses were considered. A significant correlation was found between older participants, older removable dental prostheses, and reduced prosthesis cleanliness, correlating age ranges of participants as well as of removable dental prostheses with the degrees of prosthesis cleanliness (P=.001 and P=.004, respectively). Half the study participants (n=81; 50.3%) reported prosthesis removal during the night, while the others reported sleeping with the prosthesis in place. Some study participants (n=32; 19.9%) reported that they had never received instructions about how to clean the prosthesis. Mechanical brushing with toothbrush and toothpaste was the most common cleaning method (n=47; 29.2%), while the recommended combined cleaning method based on both mechanical brushing and immersion in dental cleanser was applied by 34 (21.1%) study participants. A similar number (n=25; 15.5%) reported at least 1 episode of denture-related stomatitis.ConclusionsIn the analyzed cohort, patient attitude and habits toward home procedures for denture hygiene resulted in poor prosthesis cleanliness. Most individuals used a toothbrush and toothpaste to clean their device, although combining mechanical and chemical cleaning is typically reported to be the optimal method.     

Correlation between diabetes mellitus and number of restored,carious lesions and missing teeth: A retrospective radiographic evaluation

AimThis study aimed to evaluate the prevalence of carious, restored, and missing teeth among diabetic and non-diabetic patients who visited dental clinics in Dammam, Saudi Arabia.MethodThis retrospective study was conducted between April and November 2018. The data collection procedure was conducted in two steps: (1) review of patient records for the demographic variables and (2) screening of digital panoramic radiographs (OPGs). The patients who visited the restorative and prosthetic clinics in the period of 2016–2017 were included in the study.ResultsA total of 1186 patient records and OPGs were reviewed to extract the data. The average age of the patients in the study sample was 40.96 (±16.29). The sample included 751 (63.3%) female and 435 (36.7%) male patients. Among the patients, 192 (16.2%) had diabetes mellitus and 994 (83.8%) were non-diabetic. The average numbers of fixed partial dentures and missing teeth were significantly high among diabetic patients (P < 0.001). Conversely, the average numbers of carious lesions and restored teeth were higher among the non-diabetic patients. Only the number of restored teeth was found to be significant (P < 0.001).ConclusionThe diabetic patients were found to be at high risk of losing teeth compared with the non-diabetic patients. The prevalence of fixed partial dentures was also higher among diabetic patients. The oral health status of dental patients with diabetes needs urgent attention to prevent these patients from having teeth loss, and it can be done by improving their oral health.     

Quantitative analysis of tooth surface loss associated with gastroesophageal reflux disease: a longitudinal clinical study

BackgroundAcid regurgitation resulting from gastroesophageal reflux disease (GERD) causes dissolution of tooth structure. The authors conducted a longitudinal clinical study to measure tooth surface loss associated with GERD.MethodsThe authors made replicas of dental impressions obtained from 12 participants with GERD and six control participants at baseline and six months. Using an optical scanner, they digitized the tooth surfaces of these replicas. They then analyzed the volume of tooth surface loss and characterized it as noncontact erosion or erosion/attrition.ResultsMean (standard deviation) volume loss per tooth in participants with GERD (0.18 [0.12] cubic millimeter) was significantly higher than that in control participants (0.06 [0.03] mm³; t test; P < .013). Nine participants with GERD exhibited tooth surface loss with characteristics of erosion (noncontact erosion in three participants, erosion/attrition in eight participants).ConclusionsTooth surface loss in participants with GERD was significantly greater than that in control participants. The pattern of surface loss was characteristic of erosion in noncontact areas and around contact areas.Clinical ImplicationsAnterior and posterior teeth of participants with GERD were affected by erosive tooth wear. In addition, the amount of erosive tooth wear on occlusal surfaces was twice as high when there was evidence of attrition.