ABSTRACT
Resumen: La estabilidad de una prótesis convencional (PC) inferior se ve afectada por una excesiva resorción mandibular; el incremento de peso de una prótesis gravitacional (PG) por su combinación metal (interno) y acrílico (externo) puede aumentarla. Objetivo: Comparar la estabilidad, desempeño masticatorio (DM), peso y percepción del paciente con reborde atrófico mandibular de PC contra PG. Material y métodos: Se solicitó el consentimiento informado en seis adultos mayores desdentados. La altura del reborde residual inferior fue medida en mm. A cada paciente se le elaboró una PC y una PG (idénticas). Se utilizó primero una y luego la otra; cada una en periodos de tiempos iguales. Al término del uso de cada prótesis se le realizó una encuesta tipo Likert y una escala visual análoga (EVA), midiendo la estabilidad clínica (escala de Woelfel), DM (tamaño medio de partícula con el alimento prueba artificial) y el peso de las prótesis (g). Se utilizó la prueba de rangos de Wilcoxon y la evaluación de correlaciones de Spearman (p = 0.05). Resultados: La prueba clínica de estabilidad resultó con diferencia significativa (p = 0.046) a favor de la PG. El análisis de las correlaciones entre variables indica que a menor movimiento mayor facilidad en el habla y la reducción del alimento. En el DM no se obtuvo diferencia estadísticamente significativa (p = 0.893). Conclusiones: A pesar de la limitación del tamaño de la muestra los resultados indican que las PG son más estables y pueden ser buena alternativa de tratamiento para pacientes con limitaciones económicas o no candidatos a cirugía.
Abstract: Stability of conventional lower prostheses (CP) is affected by excessive mandibular resorption, the greater weight of a gravitational prosthesis (GP) caused by its combination of metal (internal) and acrylic (external) can increase said stability. Objective: In patients with mandibular atrophic ridge, to compare stability, masticatory performance, weight and perception of CP in comparison with GP. Material and methods: Informed consent of six adult edentulous patients was requested. Residual lower ridge height was measured in mm. Identical CP and GP were manufactured for each patient: firstly, one was used, and then the other, each one for same periods of time. At the end of prostheses use, a Likert type survey was conducted, as well as analogous visual scale (AVS) measuring clinical stability (Woelfel scale), MP (particle mean size with artificial test foodstuff) as well as prostheses weight in grams. Wilcoxon ranking test was used as well as Spearman's correlations (p = 0.05). Results: Significant differences were found in the clinical stability test (p = 0.046) favoring GP. Correlation among variables analysis indicates that to lesser movement, greater ease for speech and food processing was found. No statistically significant difference was found in MP (p = 0.893). Conclusions: In spite of limitations imposed by sample size, results indicated that GP were more stable and could represent a suitable treatment alternative for patients who are not candidates for surgery or suffer financial limitations.
ABSTRACT
BACKGROUND: Denture stomatitis is associated to Candida albicans, different bacteria and other co-factors such as an acid pH, a carbohydrate ingestion increase, different systemic illnesses and pharmacological treatments. OBJECTIVE: The aim of this study was to determine Candida albicans, Staphylococcus aureus and Streptococcus mutans prevalence in the mucous membrane and prosthesis of patients with and without atrophic denture stomatitis and its relationship with other potential clinical co-factors. STUDY DESIGN: Saliva was collected from 105 patients (62 female and 43 male) wearing dental prosthesis in order to measure their pH. Oral samples of the mucous membrane and the internal surface of dental prosthesis were taken with sterile cotton to proceed with the microbiological study. The identification of the isolated microorganisms was performed using conventional microbiological methods. RESULTS: Diabetes and Hypertension were the most frequent systemic illnesses. High carbohydrate ingestion was observed in numerous patients. Atrophic denture stomatitis was reported in 50 patients and the pH average in saliva was of 5.2. The presence of C albicans, S. aureus and S. mutans in the mucous membrane and prosthesis was of 51.4%, 52.4% and 67.6%, respectively. C. albicans was isolated in 66.7% from the prosthesis, whereas S. aureus and S. mutans were isolated in 49.5% of those same prosthesis. C. albicans was isolated in 86% of the patients with atrophic denture stomatitis and S. aureus was isolated in a similar percentage (84% of patients). The isolation of S. mutans was less frequent, and it was observed in 16% of the oral samples of these patients. CONCLUSIONS: C. albicans, S. aureus and S. mutans frequently colonize the oral mucous of patients wearing dental prosthesis. This illness-bearing condition is more frequent in patients with denture stomatitis, even though dental prosthesis colonization is lower than in the oral mucous.
