Prevalence of Partial Edentulousness in a Population Based On Age and Gender: An Epidemiological Study

To find out the prevalence of partial edentulousness in a given age group among the population attending the Non communicable disease opd in Tirunelveli Medical College and Hospital from September 2018 to February 2019. To evaluate the gender ratio among the partially edentulous patients. Methods: A total of 623 patients were randomly selected from the Non communicable disease opd attending the Tirunelveli medical college and hospital. The patients were divided into 6 groups based on age group 20-30, 31-40, 41-50, 51-60, 61-70, 71-80. They were divided into two groups based on gender as male and female. The partial edentulous condition was divided into 2 groups whether it is in maxilla or mandible. The type of partial edentulousness based on Kennedy’s Classification was tabulated in customized clinical forms. Results: Class III Kennedy’s edentulous condition was the most prevalent (33.1%) followed by class I edentulousness (16.2%). The age group of 51-60 (36%) had the maximum number of partially edentulous patients. There was no gender based distribution of partial edentulousness based on Kennedy’s Classification. There was equal distribution of partial edentulousness in the maxilla and mandible. Conclusion: As prevention is better than cure, the importance of dental health care awareness becomes evident. The possible mode of treatment modality for the particular stage of partial edentulousness must be explained to the patient.

Microorganismos en lengua y saliva de pacientes edéntulos y con periodontitis crónica y su posible conexión con la Proteína C reactiva / Microorganisms in the Tongue and Saliva of Edentulous and Chronic Periodontal Disease Patients and the Possible Relation to the C-Reactive Protein

Antecedentes: Existe evidencia clínica y experimental que la proteína C reactiva (PCR) es un marcador de inflamación sistêmica asociado a periodontitis crónica. Esta enfermedad es la principal causa de cdcntulismo y ambas condiciones presentan, en algunos casos, los mismos microorganismos. Objetivo : Identificar microorganismos periodontopatógenos presentes en pacientes cdéntulos y en pacientes con periodontitis moderada/avanzada y establecer su relación con la PCR ultrasensible (PCR-us). Métodos: Se realizó un estudio de corte transversal en 61 pacientes mayores de 30 años de edad, divididos en dos grupos: con periodontitis crónica y cdcntulos. A cada paciente se le tomó una muestra de saliva y del dorso de la lengua, para identificación microbiológica de microorganismos, y muestra sérica, para evaluación de PCR-us. Se analizó la asociación entre microorganismos, PCR-us y por grupo de pacientes. Resultados: La PCR-us mostró un valor máximo de 1,12 mg/1 en el grupo de cdéntulos sin mostrar diferencia estadísticamente significativa con el grupo de periodontitis crónica (p = 0,29). Sin embargo, valores mayores de PCR-us se observaron en pacientes con microorganismos como Candida albicans, Porphiromona gingival is, Actinomyces nacslundii (A. nacslundii), Capnocytophaga sp., Streptococcus intermedius (S. intermedius) y Bactcroidcs thctaiotaomicron. Conclusión: De acuerdo con los resultados de este estudio, no hay diferencia en PCR-us entre pacientes cdéntulos y aquellos con enfermedad periodontal. Se encontraron periodontopatógenos en cdéntulos principalmente Capnocytophaga sp., A. nacslundii y S. intermedius, tanto en lengua como en saliva.

Background: Ihcrc is clinical and experimental evidence that C-Rcactivc Protein (CRP) is a systemic inflammation marker associated to the chronic periodontal disease. This disease is the main cause of cdcntulousncss and, in some eases, both conditions involve the same microorganisms. Objective: To identify the pcriodontopathic microorganisms appearing in both edentulous patients and patients with moderate/advanced periodontal disease and to determine how they relate to the ultrasensible CRP (US-CRP). Methods: A cross-sectional study was carried out in 61 patients with ages above 30 years divided into two groups: patients with chronic periodontal disease and edentulous patients. Each patient was taken a saliva sample from the tongue dorsum for microbiologic identification of microorganisms, and scrum samples for US-CRP evaluation. The relation between microorganisms and US-CRP was analyzed and described per group. Results: Ihc US-CRP showed a maximum value of 112 mg/L in the edentulous group without any statistically significant difference as compared to the periodontal chronic disease group (p = 029). However, higher values of US-CRP were observed in patients with microorganisms such as Candida albicans, Porphiromona gingivalis, Actinomyces nacslundii (A. nacslundii), Capnocytophaga sp., Streptococcus intermedius (S. intermedius) and Bactcroidcs thctaiotaomicron. Conclusion: Based on the results herein, no difference is observed for che US-CRP between edentulous patients and chronic periodontal disease patients. 'Ihc main periodontal pathogens found in the edentulous subjects include Capnocytophaga sp., A. nacslundii and S. intermedius, both in the tongue and the saliva.

Association of edentulousness and removable prosthesis rehabilitation with severity of signs and symptoms of temporomandibular disorders.

Context: There are very few studies concerning the role of denture status in temporomandibular disorders (TMDs) and those show conflicting results. Aim: To evaluate the association of edentulousness and removable prosthesis rehabilitation with severity of TMD signs and symptoms. Settings and Design: Data were collected from 2000 subjects reporting for dental treatment, above 30 years of age. Subjects and Methods: The subjects were interviewed with a questionnaire and clinically examined for TMD on basis of Helkimo’s index. The number of existing teeth, wearing of removable dentures, need for denture repair, and age of dentures was recorded. Statistical Analysis: The association between the TMD findings and recorded variable outcomes was analyzed by means of Chi‑square test. Results: Completely edentulous individuals associated more with TMD related findings in incidence and intensity than partially/fully dentate subjects. Complete denture wearers were more associated with TMD symptoms, limited mandibular mobility, muscle tenderness, and pain on mandibular movement. Partial denture wearers were more associated with severely impaired temporomandibular joint function and joint pain. Signs and symptoms of TMD were more prevalent and severe in patients who needed to get their dentures repaired, those wearing dentures more than 5‑year‑old, and in patients who had not got their dentures repaired during the past 5 years. Conclusions: Edentulousness, complete/partial denture wearing and poor condition of the dentures associate with greater incidence and intensity of TMD associated signs and symptoms.

Oral health status and treatment need among institutionalized elderly in India.

Aim: To assess the oral health status and treatment needs among elderly people aged 60 years and above residing as inmates in the old age homes of Hyderabad and Secunderabad, Andhra Pradesh, India. Settings and Design: A cross‑sectional study was performed to determine the oral health status and treatment needs among elderly people. Materials and Methods: In order to assess the oral health status and treatment needs, the clinical assessment of oral mucosa, community periodontal index, loss of attachment, dentition status and treatment need, prosthetic status and prosthetic need was recorded based on a modified World Health Organization 1997 proforma. Statistical Analysis Used: Multi‑group analysis was done using analysis of variance. P < 0.05 was considered statistically significant. Results: Of the 812 inmates, 431 (64.0%) of the study participants had oral mucosal lesions. In terms of periodontal status, all sextants were excluded (Code “X”) in 324 (39.9%) subjects. Out of dentate population, a majority of the inmates (219; 27.0%) presented with deep pockets (Code “4”) followed by shallow pockets (Code “3” ‑ 183; 22.5%). The majority of the subjects had no prosthesis in the upper arch (85.0%) and lower arch (86.6%). Conclusion: The study demonstrated poor oral health among institutionalized elderly inmates. Oral mucosal lesions were found to be higher and periodontal status was also poor amongst the study population.

Clinical assessment of masticatory efficiency in the rehabilitation of edentulous patients

Rehabilitation of edentulous patients has been a constant concern in dentistry. Several studies have reported a reduction in the masticatory function in these patients. Osseointegrated implants have been used in order to obtain better masticatory efficiency, but more studies are needed to confirm these results. Aim: To evaluate the masticatory function of patients with conventional dentures and implant-supported dentures. Methods: A double-blinded controlled clinical study was conducted. The sample was composed of 60 patients divided into three groups: G1 with 20 patients with conventional upper (maxillary) and lower (mandibular) complete dentures, G2 with 20 patients with mandibular overdentures and upper (maxillary) complete dentures, and G3 with 20 patients with lower fixed implant-supported complete dentures (protocol). Objective data were collected through the masticatory efficiency test performed by the colorimetric method with the beads, in which capsules of a synthetic material enclosing fuchsine-containing granules were used. Results: A statistically significant difference was found for masticatory efficiency between groups G1 and G2 (pd"0.05) and between G1 and G3 (pd"0.05), and there was no statistically significant difference between G2 and G3 (pe"0.05). Conclusions: The results suggest that placement of osseointegrated implants in complete denture wearers improves their masticatory efficiency.

Masticatory afficiency in denture wearers with bilateral balanced occlusion and canine guidance

The maintenance of masticatory function is especially important for patients wearing complete dentures due to their limitations. Thus, the bilateral balanced occlusal concept is used to achieve greater masticatory efficiency. However, a critical review of the literature reveals that there is not sufficient scientific evidence to support bilateral balanced occlusion as the most appropriate occlusal concept in complete dentures. Therefore, the aim of this study was to evaluate the masticatory efficiency in complete dentures wearers with bilateral balanced occlusion and canine guidance. A double-blinded controlled crossover clinical trial was conducted. The sample was composed by 24 edentulous patients who wore sets of complete dentures with both occlusal concepts during equal periods of 3 months. Objective data were collected through the masticatory efficiency test performed by the colorimetric method with the beads, in which capsules of a synthetic material enclosing fuchsine-containing granules were used. Subjective data were recorded by patient's ratings of their chewing function. No significant statistical difference was found for masticatory efficiency (p=0.095) between the two occlusal concepts studied. The results suggest that bilateral balanced occlusion does not improve the masticatory efficiency in complete denture wearers.

A manutenção da função mastigatória tem importância especial em pacientes portadores de prótese total devido às limitações inerentes a esse tipo de prótese. Nesse contexto, a oclusão balanceada bilateral (OBB) é empregada com o intuito de obter-se uma maior eficiência mastigatória. Entretanto, analisando-se a literatura criticamente, observa-se que não existem evidências científicas suficientes que suportem a aplicação da OBB como conceito oclusal ideal em prótese total (PT). Assim, o presente trabalho teve o objetivo de verificar se pacientes portadores de PT dupla com OBB apresentam maior eficiência e capacidade mastigatória que aqueles com desoclusão com guia canino (DGC). Com esse intuito, realizou-se um ensaio clínico controlado duplo-cego do tipo crossover. A amostra foi composta de 24 pacientes portadores de prótese total dupla, onde todos fizeram uso de ambos os conceitos oclusais por períodos iguais de 3 meses. A avaliação da eficiência mastigatória foi realizada através do método colorimétrico com o uso de cápsulas mastigatórias. Não se encontrou diferença estatística significativa para a eficiência (p=0,0952) entre os dois conceitos oclusais estudados. Dessa forma, pode-se concluir que usuários de PT dupla com OBB não apresentam maior eficiência mastigatória que aqueles com DGC.