Comparing a tablet computer and paper forms for assessing patient-reported outcomes in edentulous patients.

PURPOSE: The aim of this study was to determine whether two methods of documentation, print and electronic forms, for the assessment of patient-reported outcomes (PRO) in complete denture wearers provide comparable results. The study also quantified the time needed for filling the forms by each method. MATERIALS AND METHODS: Thirty participants enrolled in a university clinic answered two forms (a questionnaire for denture satisfaction and OHIP-EDENT). They provided answers with two application methods in a random order, with a one-month interval between them: (1) electronic forms on a tablet computer; and (2) print forms. The methods were compared in terms of mean results, correlation/agreement, internal consistency, and spent time. RESULTS: Mean results for both methods were similar for each denture satisfaction item (100-mm VAS) and OHIP-EDENT summary score. Both questionnaires presented good internal consistency regardless of the application method (Cronbach's α=0.86 or higher). Correlation and agreement between the methods regarding specific items was at least moderate for the majority of cases. Mean time for the electronic and print forms were 9.2 and 8.5 minutes, respectively (paired t test, P=.06, non-significant). CONCLUSION: The electronic method is comparable to print forms for the assessment of important PRO of prosthetic treatment for edentulism, considering the results and time needed. Findings suggest the viability of replacing print forms with a tablet for applying the tested inventories in clinical trials.

Traumatic ulcerative granuloma with stromal eosinophilia around mini dental implants without the protection of a denture base.

This is a report of a case of an unusual oral lesion after the placement of mini implants for the retention of a mandibular overdenture. A patient received four 2-mm-wide dental implants in the anterior mandible and had her mandibular denture relined with a soft material. After 3 months, she was not wearing her mandibular denture, and two nodular ulcerated lesions were observed near the mini implants. The lesions ceased following excision and regular denture wearing. Clinical and microscopic examination led to the diagnosis of traumatic ulcerative granuloma with stromal eosinophilia (TUGSE). TUGSE is rare lesion with a benign course that may occur following injury of the oral mucosa by mini implants under certain circumstances.

Método simplificado versus convencional de confecção de próteses totais: práticas adotadas pelos Cirurgiões-Dentistas / Simplified versus conventional method for the fabrication of complete dentures: procedures adopted by dentists

Introdução: A fim de reduzir custos e tempo clínico envolvidos com o tratamento, Dentistas têm utilizado métodos simplificados, omitindo ou abreviando partes da técnica de confecção das próteses totais. Objetivo: Levantar as práticas utilizadas pelos Cirurgiões-Dentistas para a confecção de próteses totais. Material e método: Os dados foram levantados por meio de um formulário eletrônico contendo perguntas relativas ao perfil e aos procedimentos clínicos utilizados, a fim de quantificar o uso de métodos simplificados e convencionais, bem como para determinar a relação com o perfil desses profissionais. Os resultados foram analisados por meio de análise de Aglomerados. Resultado: As respostas foram dadas, em sua maioria, por homens, tendo a prática clínica como sua principal fonte de renda e clínica privada ou conveniada como ambiente principal de trabalho (n=119). Grande parte dos entrevistados relatou realizar duas moldagens por arcada, utilização de articulador semiajustável com arco facial, determinação de plano oclusal por meio de guias anatômicos, utilização de meios métricos para análise da dimensão vertical de oclusão e determinação direta da relação cêntrica. O próprio Cirurgião-Dentista relatou ser o responsável na fase de seleção de dentes. A estatística identificou dois Aglomerados, com base nas características demográficas e na prática clínica, sendo um grupo formado por generalistas adeptos de perfis mais simplificados e outro formado por profissionais mais especializados em prótese que realizam técnicas convencionais. Conclusão: A adoção de técnicas simplificadas é associada àqueles Dentistas com perfil mais generalista, ...

Introduction: In order to reduce costs and clinical time involved with complete denture treatment, dentists have employed simplified methods based on the reduction or preclusion of certain traditional technical procedures. Purpose: To survey the procedures used by dentists to fabricate complete dentures. Material and method: Data was obtained by an electronic form containing questions about dentists' profile and clinical procedures, in order to quantify traditional and simplified approaches at several moments and to determine them to different professional profiles. Results were evaluated by means of cluster analysis. Result: The majority of respondents were male dentists with clinical practice as their main income source, mainly in private service (n=119). Most participants use to take a pair of impressions from each arch, employ semiadjustable articulators with facebow transfers, shape the occlusal plane with the aid of anatomic references, determine occlusal vertical dimension by metric methods and use mandibular manipulation for centric relation. The dentists performed tooth selection in most cases. Statistical analysis identified two clusters based on demographic characteristics and clinical procedures. General practitioners adopting simplified methods formed the first cluster, whereas prosthodontists used to conventional methods formed the second. Conclusion: General dentists tend to adopt simplified approaches, and prosthodontists tend to work according to traditional academic methods. .

Antimicrobial properties and cytotoxicity of an antimicrobial monomer for application in prosthodontics.

PURPOSE: This study aimed to investigate the antimicrobial properties and cytotoxicity of the monomer methacryloyloxyundecylpyridinium bromide (MUPB), an antiseptic agent capable of copolymerizing with denture base acrylic resins. MATERIALS AND METHODS: The antimicrobial activity of MUPB was tested against the species Candida albicans, Candida dubliniensis, Candida glabrata, Lactobacillus casei, Staphylococcus aureus, and Streptococcus mutans. The minimum inhibitory and fungicidal/bactericidal concentrations (MIC, MFC/MBC) of MUPB were determined by serial dilutions in comparison with cetylpyridinium chloride (CPC). The cytotoxic effects of MUPB at concentrations ranging from 0.01 to 1 g/L were assessed by MTT test on L929 cells and compared with methyl methacrylate (MMA). The antimicrobial activity of copolymerized MUPB was tested by means of acrylic resin specimens containing three concentrations of the monomer (0, 0.3, 0.6% w/w). Activity was quantified by means of a disc diffusion test and a quantification of adhered planktonic cells. Statistical analysis employed the Mann-Whitney test for MIC and MFC/MBC, and ANOVA for the microbial adherence test (α = 0.05). RESULTS: MUBP presented lower MIC values when compared with CPC, although differences were significant for C. dubliniensis and S. mutans only (p= 0.046 and 0.043, respectively). MFC/MBC values were similar for all species except C. albicans; in that case, MUPB presented significantly higher values (p = 0.046). MUPB presented higher cytotoxicity than MMA for all tested concentrations (p < 0.001) except at 0.01 g/L. Irrespective of the concentration incorporated and species, there was no inhibition halo around the specimens. The incorporation of MUPB influenced the adhesion of C. albicans only (p = 0.003), with lower CFU counts for the 0.6% group. CONCLUSIONS: It was concluded that non-polymerized MUPB has an antimicrobial capacity close to that of CPC and high cytotoxicity when compared with MMA. The antimicrobial activity of MUPB after incorporation within a denture base acrylic resin did not depend on its elution, but was shown to be restricted to C. albicans.

Associação entre a higiene de próteses totais e qualidade de vidarelacionada à saúde bucal em pacientes desdentados / Association between denture hygiene and oral health-related quality of life in edentulous patients

Objetivo: Intervenções visando à melhor higiene de próteses totais podem ter maior chance de sucesso caso levem à melhora da qualidade de vida relacionada à saúde bucal (QVSB), assim melhorando a colaboração do paciente. No entanto, não se conhece se há associação entre a higiene precária das próteses e pobre QVSB. Assim, este estudo buscou avaliar a associação entre a área coberta por biofilme sobre próteses totais e a QVSB em uma amostra de pacientes completamente desdentados. Material e método: Uma amostra foi composta por 80 participantes (20 homens e 60 mulheres, média etária de 65,0 ± 9,1 anos) que solicitavam novas próteses totais em uma clínica universitária. A variável usada como medida para a higiene das próteses foi a área coberta por biofilme, quantificada por meio de um método computadorizado. Em seguida, participantes responderam ao instrumento OHIP-EDENT e a questões sobre parâmetros sócio-demográficos. Testes bivariados e regressão múltipla quantificaram a associação entre o biofilme e as demais variáveis (a = 0,05). Resultado: A correlação da área coberta por biofilme com a QVSB, bem como com a maioria das variáveis sócio-demográficas, foi fraca e não significante. A regressão múltipla confirmou essa falta de associação entre o biofilme das próteses e a QVSB. Conclusão: É possível concluir que a higiene de próteses totais é independente da QVSB para o usuário de próteses totais regular.

Objective: Interventions for better denture cleansing would be more successful if they can improve oral health-related quality of life (OHQoL), thus reinforcing patient?s compliance. Nevertheless, it is currently unknown whether precarious denture hygiene is associated with poor OHQoL. This study aimed to assess the association between denture biofilm coverage and OHQoL in a sample of adult edentulous patients wearing complete dentures. Material and method: The sample was composed by 80 participants (20 men and 60 women, mean age of 65.0 ± 9.1 years) who requested new complete dentures in a university clinic. The variable used as a measure of denture hygiene was biofilm coverage area, which was quantified by means of a computerized method. Afterwards, participants answered the OHIP-EDENT instrument and questions about socio-demographic parameters. Bivariate tests and multiple regression quantified the association between denture biofilm and other variables (a = 0.05). Result: Correlation between biofilm coverage area and OHQoL, as well as with most socio-demographic variables, was weak and non significant. Multiple regression confirmed the lack of association between denture biofilm and OHQoL. Conclusion: It can be concluded that denture hygiene is independent of OHQoL for the average complete denture wearers.

Qualidade de vida associada à saúde bucal em portadores de próteses totais convencionais e implantorretidas: relato de dois casos / Oral health-related quality of life in conventional and implant-retained complete denture wearers: two case reports

O termo qualidade de vida associada à saúde bucal (QVSB) tem sido adotado para definir medições de como o paciente percebe as suas próprias condições bucais. O objetivo deste estudo foi relatar a autopercepção da QVSB de dois portadores de próteses totais convencionais ou implantorretidas. Uma entrevista foi conduzida com dois pacientes por meio de um questionário baseado no OHIP-EDENT, com respostas em formato aberto. Um deles portava uma overdenture mandibular com prótese total convencional maxilar e o outro, um par de próteses fixas. Evidenciou-se que as próteses totais sobre implantes restauraram efetivamente o conforto físico e psicossocial. Limitações relativas ao tratamento foram percebidas, como a retenção de alimento sob próteses fixas, apesar de não infuenciarem a QVSB de forma pronunciada. Concluiu-se que, do ponto de vista subjetivo, o uso de prótese total ancorada sobre implantes mostrou-se como uma excelente modalidade de tratamento, apesar de os resultados variarem grandemente em função das necessidades percebidas pelo paciente.

The term oral health-related quality of life (OHRQoL) has been employed for the measurement of subjective parameters of oral conditions. In other words, those parameters are based on self-perception of the patients. The aim of this study was to relate the self-perception by the OHRQoL for conventional and implant-retained complete dentures from two edentulous patients. An interview was conducted by using open format questions similar to those of the OHIP-EDENT inventory. Prosthetic status of the patients comprised (I) a conventional maxillary complete denture and a mandibular overdenture and (II) bimaxillary fixed complete dentures. According to the reports, implant-retained complete dentures restored physical and psycho-social comfort. Functional limitations, i.e. food retention under the denture bases, were perceived but did not infuence the quality of life on a pronounced manner. Although the results have widely changed due to the different perceived needs by the patients, it was concluded that implant-retained prostheses are an excellent modality of treatment for edentulous people.