Functional salivary reservoir in maxillary complete denture - technique redefined.
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ABSTRACT:
SUBMITTER: Joseph AM
PROVIDER: S-EPMC5134153 | biostudies-other | 2016 Dec
REPOSITORIES: biostudies-other
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Project description:Bone preservation is an essential issue in the context of last teeth extraction and complete edentulism. The intended treatment, whether a complete denture or an implant placement, is facilitated with a voluminous residual ridge. Bone resorption after multiple extractions has not been as well studied as the bone resorption that occurs after the extraction of a single tooth. Recent advances in bone substitute materials have revived this issue. The purpose of this study is to evaluate the interest in using bone substitute material to fill the socket after last teeth extraction in a maxillary immediate complete denture procedure compared with the conventional protocol without socket filling.A randomized, controlled, clinical trial was designed. The 34 participants eligible for maxillary immediate complete denture were divided into two groups. Complete dentures were prepared despite persistence of the last anterior teeth. The control group received a conventional treatment including denture placement immediately after extractions. In the experimental group, in addition to the immediate denture placement, a xenograft bone-substitute material (Bio-Oss Collagen®) was placed in the fresh sockets. The primary outcome of the study is to compare mean bone ridge height loss 1 year after maxillary immediate complete denture placement, with or without bone-substitute material, in incisor and canine sockets. The secondary outcomes are to compare the average bone ridge height and width loss for each extraction site. An original quantitative evaluation method using cone beam computed tomography was designed for reproducible measurements, with a radio-opaque denture duplicate. Two independent operators perform the radiologic measurements.The immediate complete denture technique limits bone resorption in multiple extraction situations and thus allows better denture retention and better options for implant placement. To compare the benefit of using any bone socket-filling material, we proposed a quantitative evaluation protocol of resorption in the specific case of the last anterior maxillary teeth extraction with immediate denture placement.ClinicalTrials.gov, NCT02120053 . Registered on 18 April 2014.
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Project description:Symptoms of oral discomfort such as dry mouth are common in older people wearing dentures. Such symptoms are mainly treated symptomatically. Many of these symptoms are related to saliva, and associations with salivary volume have been reported. Although denture treatment improves symptoms by increasing the amount of saliva, the effects on salivary components remain unclear. This study aimed to investigate the effects of denture treatment on salivary metabolite changes based on salivary metabolome analyses. We enrolled 21 patients requiring denture treatment. At the first visit, and after completion of denture treatment, saliva outflow was measured under resting and stimulated conditions, samples for salivary metabolite analysis were collected, and masticatory efficiency was tested. In all participants, masticatory efficiency increased after denture treatment. Moreover, the amounts of resting and stimulated saliva were increased. Using salivary metabolome analysis, 61 salivary metabolites were detected. Substantial concentration changes were observed for 4 and 21 metabolites in resting and stimulated saliva, respectively. The four metabolites common to both saliva tests had significantly lower concentrations after treatment. These results suggest that the improvement in masticatory function by dentures is related not only to salivary secretion volume, but also to salivary metabolite composition.
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Project description:Denture stomatitis, inflammation and redness beneath a denture, affects nearly half of all denture wearers. Candidal organisms, the presence of a denture, saliva, and host immunity are the key etiological factors for the condition. The role of salivary proteins in denture stomatitis is not clear. In this study 30 edentulous subjects wearing a maxillary complete denture were recruited. Unstimulated whole saliva from each subject was collected and pooled into two groups (n = 15 each), healthy and stomatitis (Newton classification II and III). Label-free multidimensional liquid chromatography/tandem mass spectrometry (2D-LC-MS/MS) proteomics on two mass spectrometry platforms were used to determine peptide mass differences between control and stomatitis groups. Cluster analysis and principal component analysis were used to determine the differential expression among the groups. The two proteomic platforms identified 97 and 176 proteins (ANOVA; p < 0.01) differentially expressed among the healthy, type 2 and 3 stomatitis groups. Three proteins including carbonic anhydrase 6, cystatin C, and cystatin SN were found to be the same as previous study. Salivary proteomic profiles of patients with denture stomatitis were found to be uniquely different from controls. Analysis of protein components suggests that certain salivary proteins may predispose some patients to denture stomatitis while others are believed to be involved in the reaction to fungal infection. Analysis of candidal proteins suggests that multiple species of candidal organisms play a role in denture stomatitis.
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Project description:The conventional technique for the fabrication of complete dentures is complex, with a long fabrication process and difficult-to-control restoration quality. In recent years, digital complete denture design has become a research focus. Digital complete denture tooth arrangement is a challenging issue that is difficult to efficiently implement under the constraints of complex tooth arrangement rules and the patient's individualized functional aesthetics. The present study proposes a complete denture automatic tooth arrangement method driven by a reconfigurable rule; it uses four typical operators, including a position operator, a scaling operator, a posture operator, and a contact operator, to establish the constraint mapping association between the teeth and the constraint set of the individual patient. By using the process reorganization of different constraint operators, this method can flexibly implement different clinical tooth arrangement rules. When combined with a virtual occlusion algorithm based on progressive iterative Laplacian deformation, the proposed method can achieve automatic and individual tooth arrangement. Finally, the experimental results verify that the proposed method is flexible and efficient.
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Project description:ObjectivesThe aim of this study was to assess two patient-based outcomes of complete denture (CD) wearers who continued or discontinued using denture adhesive (DA) after one-month run-in period of DA use.MethodsThis quasi-experimental study comprised 76 CD wearers. The two patient-based outcomes were oral health-related quality of life and masticatory performance, determined by the Thai-version of oral impacts on daily performances index and multiple sieve method of 20-stroke peanut mastication. Denture retention and stability were evaluated using the CU-modified Kapur criteria to classify the CD into acceptable or unacceptable quality. The outcomes were collected at 3 time points: 1) at baseline (T0), 2) after a 1-month run-in period of DA use (T1), at which time the participants decided whether to continue using DA, and 3) 1-month after continuing or discontinuing using DA (T2). Changes in the percentages of having an oral impact from T0 to T2 were evaluated using the McNemar's test. The effect of denture quality and the decision to use DA on peanut particle size across time points were assessed using repeated measures ANOVA. The peanut particle size changes in each group between time points were evaluated using the one-way repeated measures ANOVA and Tukey post-hoc comparison test.ResultsThe participants who continued using DA at T2 had greater oral impact reduction after the 1-month run-in period of DA use, whereas cleaning and emotional impacts emerged in those who discontinued using DA. At T1 and T2, the peanut particle size of the participants who continued and discontinued using DA was not significantly changed from T0, except for the acceptable CD wearers who discontinued using DA at T2, whose peanut particle size decreased from T0 to T2.ConclusionsBaseline oral impacts and their change influenced CD wearers' decision whether to continue using DA. However, masticatory performance did not affect the patients' decision.
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