A case control study to investigate the effects of denture wear on residual alveolar ridge resorption in edentulous patients.

OBJECTIVES: To investigate the effect of complete denture wearing on residual ridge resorption in edentulous patient compared with edentulous patient who never wore dentures. METHODS: Patients who had been edentulous for at least five year who had never worn dentures successfully were matched to edentulous denture wearing control patients. To control for factors possibly associated with alveolar ridge resorption patients who had been rendered edentulous in one arch before the other, smokers, those taking steroids, bisphosphonates, with histories of autoimmune diseases, diabetes mellitus or osteoporosis at any time during their period of edentulousness were excluded. Case and control groups were matched for age, sex and time since being rendered edentulous. Statistical analyses were undertaken using Person's Chi squared (X2) test and Fisher's exact test. RESULTS: 30 edentulous patients who had not worn dentures for at least five years were identified and matched with 30 controls. All control patients were the same age ± 2 years and had been edentulous for the same number of years ± 2 years of their respective controls. There was no significant difference between age and time since being rendered edentulous between case and control. Denture wearers had significantly more maxillary and mandibular residual alveolar ridge resorption than did non denture wearers. Severe ridge resorption was mostly confined to the denture wearing group. CONCLUSION: Patients wearing complete dentures for more than 5 years had significantly more residual alveolar ridge resorption than was found in non-denture wearing edentulous patients.

Dimensional stability of complete denture permanent acrylic resin denture bases; A comparison of dimensions before and after a second curing cycle.

The purpose of this study was to measure deformation of mandibular complete denture permanent bases after secondary curing. A cast of a flat mandibular edentulous ridge was duplicated ten times. A wax base was laid on the original cast, two wax sprues were attached and an overcast was made. The overcast was used to produce wax bases similar in outline and thickness on the duplicate casts. These were invested and following manufacturer's instructions ten similar acrylic resin bases were produced. The fitting surface of each denture base was scanned on a contacting scanner with an axis resolution of 1 microm and accurate to 25 microm. Denture teeth were waxed up on the base on the original master cast, an overcast was made to produce wax ups and tooth positions that were similar in outline and thickness to the original. These were processed, removed from the flasks and excess acrylic resin was removed. The denture bases were rescanned in an identical fashion to the first scanning procedure. Using commercially developed metrology software calibrated colour maps were generated for each denture base that illustrates measurements of differences between pairs of surfaces. Histograms showing distributions of distances between points were constructed. 50% of the points were separated by a mean 50 microm or less and that 90% of the points were separated by 160 microm or less. The maximum separation was of 380 microm. Complete denture permanent bases were not found to distort significantly as a result of being subjected to a second heat curing cycle as part of final processing of dentures.

An investigation of factors influencing patients' satisfaction with new complete dentures using structural equation modelling.

OBJECTIVE: To investigate possible relationships between patient and clinical factors and patient satisfaction with new complete dentures. METHODS: Patients attending King's College London Dental Institute, Guy's Hospital, London, for new complete dentures were recruited. Relevant history was recorded and the edentulous mouth and existing dentures, where present, were examined at the beginning of treatment. The edentulous mouth, the previous and new dentures were re-examined at the first post-insertion visit. Three months after this visit, patients were sent a postal questionnaire to assess patient satisfaction. Data were analysed using structural equation modelling techniques. RESULTS: 723 patients were recruited. Significant relationships were found between quality of complete dentures, quality of residual alveolar, adaptability factors and patients' satisfaction with complete dentures. CONCLUSIONS: Quality of the mandibular residual alveolar ridges, retention and stability of the mandibular dentures, accuracy of reproduction of retruded jaw relationship and patient adaptability were powerful determinants of patients' satisfaction with new complete dentures.

The influence of personality on patients' satisfaction with existing and new complete dentures.

OBJECTIVE: To investigate the influence of patient personality on satisfaction with and use of complete dentures. METHODS: Patients attending a dental school for replacement of existing complete dentures completed a Personality Questionnaire and quality of existing complete dentures was assessed. After the first post-insertion visit quality of new dentures was assessed. Patients' satisfaction with the new dentures was elicited using a structured interview. Three months and 2 years after insertion of new dentures self completed denture satisfaction questionnaires were mailed to all participants. RESULTS: Three hundred and eight patients participated and 217 completed all stages of the study. Use of dentures was not associated with personality. In the old dentures patient rating of the three aspects of satisfaction with the mandibular denture, of appearance and general satisfaction were significantly associated with neuroticism. In the case of the new dentures at first review, no aspects of satisfaction rated by patients were significantly associated with personality. Significant negative associations between Neuroticism and all aspects of satisfaction with new dentures were found at 3 months. At 2 years after the dentures were placed significant negative associations between Neuroticism and all aspects of satisfaction with new dentures except rating of appearance and maxillary denture chewing ability were found. CONCLUSIONS: Neurotic patients were significantly less satisfied with complete dentures. Personality traits did not influence patients' use of dentures.

Investigation of new complete denture quality and patients' satisfaction with and use of dentures after two years.

OBJECTIVES: To investigate if clinical quality of new complete dentures predicts patient satisfaction with and usage of those dentures two years after insertion in the same way that it did initially and three months after insertion. METHODS: Four hundred and seventeen patients recruited to a denture outcome study two years previously were surveyed. In each case aspects of denture quality had previously been rated according to a validated method at the first post-insertion visit and patients had completed a postal questionnaire three months after denture insertion. When the dentures were two years old, patients were sent another postal questionnaire to assess denture usage and satisfaction with the dentures. RESULTS: The response rate to the postal survey was 87%. Data were analysed using structural equation modelling and Bayesian belief networks. No significant associations were found between aspects of new denture quality and patient satisfaction with and use of complete dentures after two years. These results contrast with the three month returns from the same patients that demonstrated significant associations between new denture quality and satisfaction with and use of new complete dentures. CONCLUSIONS: The authors conclude that initial clinical quality of new complete dentures is not a significant factor in determining patients' satisfaction with and use of these complete dentures two years after insertion.