The Impact of Prior Use of Corticosteroid to Dental Extraction on Oral Health-Related Quality-of-Life and Clinical Outcomes: A Randomized Clinical Trial.

PURPOSE: To evaluate the impact of prior use of corticosteroids before dental extractions on oral health-related quality-of-life (OHRQoL). METHODS: A randomized and triple-blind (patient, surgeon, and examiner) clinical trial was designed. The individuals were randomly allocated to 2 groups: test and placebo. In the test group, 2 capsules of 4 mg dexamethasone were administered orally. In the placebo group, subjects received 2 capsules with the same characteristics. In both groups, the administration took place 1 hour before the procedure. OHRQoL was assessed by the Brazilian version of Oral Health Impact Profile 14 (OHIP-14). The OHIP-14 questionnaire and the assessment methods for clinical parameters were collected preoperatively and postoperatively. Multilevel linear regression models fitted the associations between preoperative use of corticosteroids and overall and domain-specific OHIP-14 scores over time. RESULTS: One hundred fourteen patients were selected for the study; however, 21 were excluded for not returning to postoperative control on the seventh day, resulting in 93 patients assessed (test = 44 and placebo = 49). The pain had a negative impact on OHRQoL (P < .01); however, the use of the drug had no statistically significant influence on OHRQoL (P = .62) and the clinical outcomes of pain (P = .63), mouth aperture (P = .05), and edema (P = .69). CONCLUSIONS: The use of the 8 mg dexamethasone administered orally before the procedure was not effective on the improvement of the quality-of-life of patients undergoing dental extraction. However, using the medication seems to result in an improvement in the postoperative period of patients who had impacted teeth. Further research involving the analysis of OHRQoL must be performed, and other dosages and means of administration must be tested.

Impact of excessive gingival display on oral health-related quality of life in a Southern Brazilian young population.

AIM: To compare oral health-related quality of life (OHRQoL) between individuals with and without excessive gingival display (EGD). MATERIALS AND METHODS: A cross-sectional study was conducted in 53 individuals with EGD and 53 controls matched for sex and age. The outcome was OHRQoL, determined using the Oral Health Impact Profile (OHIP-14) and self-perceptions of satisfaction with smile aesthetics. A clinical examination was conducted to evaluate the smile line, colour of the teeth, tooth wear and malocclusion. Poisson regression was used to model the association between excessive gingival display and OHRQoL. RESULTS: Participants with EGD had higher total OHIP-14 score (4.81 ± 4.76) in comparison with the controls (1.85 ± 3.77; p < .001). The percentage of satisfied with smile individuals without and with EGD was 78.9% and 21.1%, respectively (p = .005). In the multivariate analysis, total OHIP-14 scores were 2.10-fold higher individuals with EGD, independently of the other variables analysed. Impacts were evident on the functional limitation, psychological discomfort, psychological disability and social handicap. CONCLUSIONS: The occurrence of EGD exerted a negative impact on OHRQoL independently of confounding variables in this specific population. The present findings justify the planning of treatment for individuals with EGD that impacts quality of life.

Can new dentures decrease Candida levels?

PURPOSE: The aim of this study was to evaluate the influence of time-course changes and various types of removable dentures on the oral levels of Candida species. MATERIALS AND METHODS: In this prospective clinical trial, 72 subjects were divided into three groups according to the type of denture replaced: Kennedy Class I or II removable partial dentures (RPDs), Kennedy Class III or IV RPDs, and complete dentures. Whole saliva and biofilm samples from the palate, tongue, dentures, and inner surface of the cheek were obtained and evaluated for Candida diversity before the delivery of the new prostheses (baseline) and at 1, 6, and 12 months postdelivery. The results were analyzed using a three-way analysis of variance, followed by a post hoc Student-Newman-Keuls test. RESULTS: Candida levels decreased after the insertion of the new dentures; however, after 6 months, Candida levels were similar to baseline, and complete denture wearers presented higher Candida counts than RPD wearers. CONCLUSION: The type of denture does not seem to be a decisive factor in Candida levels. After 6 months, Candida colonization was well established in all types of removable prostheses. Denture replacement alone did not guarantee a decrease in Candida levels for more than 6 months.