Changes in Oral Health Related Quality of Life (OHRQoL) and Satisfaction with Conventional Complete Dentures Among Elderly People.

PURPOSE: To assess the changes in oral health-related quality of life (OHRQoL) and satisfaction among older adults after receiving new complete dentures, and the association of age, gender, education, medical history, past prosthetic history (number of previous complete dentures and time since current complete dentures) and quality of existing complete dentures with patients' ratings of satisfaction with their complete dentures. MATERIALS AND METHODS: The study comprised 114 community-dwelling adults ≥ 65 year of age, all wearing complete dentures in both jaws. The sample was selected from four senior day centres. Data were collected using clinical oral examinations and a self-administered questionnaire. Dentures were clinically evaluated for retention, stability, occlusion, articulation and vertical dimension. The questionnaire recorded data on sociodemographic information, previous denture history, oral satisfaction scale (OSS), and OHRQoL through the Oral Impacts on Daily Performance (OIDP) scale. RESULTS: There was a significant improvement in OHRQoL after treatment (mean OIDP score: 2.7) compared to before treatment (mean OIDP score: 6.6). The largest changes were in relation to impacts on eating (33.3% to 15.9%) and smiling (17.5% to 4.5%). Six months after placement of the dentures, patient satisfaction improved compared to before treatment (p < 0.001). The results of this study demonstrated that satisfaction was correlated with age, gender, and past prosthetic history in the patients rehabilitated with complete dentures. CONCLUSIONS: The provision of new dentures among older adults resulted in significantly better satisfaction and OHRQoL than wearing existing dentures. There was no significant correlation between the clinical assessment of the dentures and patients' satisfaction with them.

Prevalence and Clinical Effects of Certain Therapy Concepts among Partially Edentulous Serbian Elderly.

PURPOSE: This study was conducted to identify the prevalence of partially edentulous individuals in Serbia and to identify prosthodontic treatment used for their rehabilitation as well as to compare prosthodontic treatment concepts among Serbian elderly participants who answered closed-format questionnaires. MATERIALS AND METHODS: The study was conducted at the Clinic for Dental Prosthetics, University of Belgrade, Military Medical Academy and the Department of Prosthodontics of Home Centre Belgrade; the study consisted of 120 participants. A questionnaire with closed-format questions regarding the influence of applied therapy concepts for participants with Kennedy Class I partial edentulism was created. Statistical software SPSS 11.5 was used for data analysis. Chi-square tests were performed, and p-values were calculated for each parameter. RESULTS: A total of 1081 people were examined; 730 participants were partially edentulous in at least one jaw. Five hundred forty-one participants wore Kennedy Class I maxillary or mandibular removable partial dentures (RPDs). Ninety percent of the patients were restored with RPDs; 60% of participants were unrestored, had shortened dental arches, and requested alternative therapeutic solutions. Significantly lower needs for new treatments were identified in participants with fixed dental prostheses (7.5%). CONCLUSIONS: Kennedy Class I was the most common type of partial edentulism among Serbian elderly, usually treated with RPDs. Elderly participants with the applied shortened dental arch and RPD therapy concepts requested alternative therapeutic solutions more often than those rehabilitated with fixed partial dentures.

Treatment of obstructive sleep apnea patients using oral appliances--our experiences.

BACKGROUND/AIM: Obstructive sleep apnea (OSA) is one of the most prevalent sleep disorders. It is recognized as a serious risk factor for car and workplace accidents due to daytime sleepiness, and factor for coronary heart diseases and stroke. The aim of this study was to examine the effectiveness of oral appliances for mandibular advance in treating mild to moderate OSA. METHODS: A total of 15 patients were included in this study, all diagnosed with mild or moderate OSA. Oral appliances were custom made for each patient in protrusive position at 50% of maximum mandibular advancement. The patients were given instructions not to sleep on their backs and avoid alcohol consumption during the study as these are the factors that can contribute to symptoms progression. RESULTS: Complete and partial treatment success was achieve in 14 of the patients. Apnea-hypopnea index values were significantly lower (p < 0.05) at the end of a 6-month observation period compared to those at the treatment beginning. A great improvement in symptoms was observed, with daytime sleepiness index values significantly reduced already within the first month of the treatment. CONCLUSION: Treatment of obstructive sleep apnea with oral appliances has proven successful. Patients were comfortable using oral appliances and were ready to wear them for prolonged period of time. Use of oral appliances is very common in the world and should not be discarded. They are also very comfortable, practical and affordable comparing to continuous positive airway pressure (CPAP) apparatus, not to mention surgery. Use of oral appliances is safe and very well tolerated, and ought to be offered to patients with OSA.

Finite element analysis of compressive stress and strain of different implant forms during vertical loading.

This study analyzed the influence of platform switching on the stress/strain distribution of vertically loaded implants. Employing finite element analysis, the aim of this study was to determine the distribution of stresses and strains generated by a simulated vertical load on different implant models positioned in the molar region with respect to changes of implant design and biomechanics. Two different implant designs, one with and one without platform switching, with the same length (11.5 mm) and diameter of (3.80 mm) were analyzed. Both virtual implant-bone models were subjected to a load of 500 N. The results showed that the maximum stress/strain in implant-bone samples was located in the area of the implant neck, with stress/strain values decreasing in the apical direction. It was found that the implant design with platform switching developed lower stresses and strains than the implant design without platform switching.

Frequency and quality of root canal fillings in an adult Serbian population.

INTRODUCTION: Estimation of frequency and quality of root canal fillings is the way to evaluate endodontic treatment needs and success/failure rates of performed endodontic procedures. OBJECTIVE: The aim of this study was to determine the frequency and quality of root canal fillings and the frequency of apical periodontitis on endodontically treated teeth in a group of adult patients from Serbia. METHODS: In order to analyze the presence and quality of root canal fillings and the frequency of periapical radiolucencies on endodontically treated teeth, 3526 teeth were examined on orthopantomograms of 153 adult patients. RESULTS: Overall, 12.5% of examined teeth were root filled, and 51.8% of them had radiographic signs of apical periodontitis. The analysis of root fillings quality revealed the presence of more inadequate ones (55.9%). The frequency of apical periodontitis was significantly higher in teeth with inadequate than in those having adequate root canal obturation (72.2% and 25.9%, respectively). CONCLUSION: The frequency of apical periodontitis on root-filled teeth in this group of patients was high, indicating a low success rate of performed endodotic procedures and high endodontic retreatment needs.

Finite element analysis in defining the optimal shape and safety factor of retentive clasp arms of a removable partial denture.

BACKGROUND/AIM: Retentive force of removable partial denture (RPD) directly depends on elastic force of stretched retentive clasp arms (RCAs). During deflection RCA must have even stress distribution. Safety factor is the concept which can be applied in estimating durability and functionality of RCAs. This study was based on analyzing properties of clasps designed by conventional clasp wax profiles and defining the optimal shapes of RCAs for stress distribution and safety factor aspects. METHODS: Computer-aided-design (CAD) models of RCAs with simulated properties of materials used for fabrication of RPD cobalt-chromium-molybdenum (CoCrMo) alloy, commercially pure titanium (CPTi) and polyacetale were analzed. RESULTS: The research showed that geometrics of Rapidflex profiles from the BIOS concept are defined for designing and modeling RCAs from CoCrMo alloys. I-Bar and Bonihard clasps made from CPTi might have the same design as Co-CoCrMo clasp only by safety factor aspect, but it is obvious that CPTi are much more flexible, so their shape must be more massive. Polyacetale clasps should not be fabricated by BIOS concept for CoCrMo alloy. A proof for that is the low value of safety factor. CONCLUSION: The BIOS concept should be used only for RCAs made of CoCrMo alloy and different wax profiles should be used for fabricating clasps of other investigated materials. The contribution of this study may be the improve ment of present systems for defining the clasps shapes made from (CoCrMo alloys. The more significant application is the possibility of creating new concepts in defining shapes of RCA made from CPTi and polyacetale.

Prevalence, severity, and clinical determinants of oral impacts in older people in Bosnia and Herzegovina.

This study aimed to assess the prevalence and the severity of oral impacts and the relationships between oral health-related quality of life (OHRQoL) and clinical measures of oral function in a sample of older adults in Bosnia. The sample comprised 261 community-dwelling adults of ≥65 yr of age. Participants were randomly drawn from three senior day-centres for elderly people. Data were collected using clinical examination and a questionnaire. The OHRQoL was assessed through the Oral Impacts on Daily Performances (OIDP) measure, in terms of the prevalence, intensity, and extent of oral impacts. Overall, 55.2% reported at least one oral impact in the last 6 months. Difficulty eating (43.3%) and difficulty speaking (34.1%) were the most common impacts. These were also the most severely affected performances, while 'going out' and 'enjoying the contact of other people' were the least severe. A higher number of natural teeth, natural occluding pairs, and anterior and posterior occluding pairs were all significantly associated with a lower prevalence of oral impacts and correlated with the OIDP score, even after adjusting for sociodemographic factors. The prevalence of oral impacts was high and there was a strong and consistent association between OHRQoL and clinical dental indicators of function.

Optical aspect of deformation analysis in the bone-denture complex.

The aim of this study was to register and measure any deformation of mandible models under load. The method for full field measurement of strain is done by using the ARAMIS three-dimensional image correlation system. The system uses two digital cameras that provide a synchronized stereo view of the specimen and the results show the complete strain field during the tests. The biggest deformation values were just under the working force of the biggest intensity 500 N, and for the region of the lower second premolar the deformation is 625 microm. The following study is presented that highlight the use of stereometric measuring system for modern research. It is shown that this measuring methodology can capture the trends of the experiments.

[Applicability of a Serbian version of the "Oral Impacts on Daily Performance (OIDP)" index--assessment of oral health-related quality of life].

BACKGROUND/AIM: The Oral Impacts on Daily Performance (OIDP) is a well-known psychometric test used internationally to assess the oral health-related quality of life. The interview and self-administrated questionnaire both assess the degree to which oral health problems have affected the life of the participants over the previous 6 months. The aim of this study was to translate the OIDP index into Serbian and to assess its reliability in practice as its initial verification in the Serbian speaking area. METHODS: Following an internationally established methods, the OIDP scale was translated using standardized methodology that consisted of forward translation, pilot study and backward translation. RESULTS: A pilot study was carried out with 44 respondents (24 males i 20 females) using a preliminar Serbian version of the OIDP index. All patients were aged over 65 years. A total of 68.2% of the participants replied that they had at least one OIDP impact on daily life in the past 6 months. These troubles were most prominent during eating (47.7%) and speaking (36.4%), but there is a little impact of troubles in the domain of psychosocial sphere. The corrected item-total correlation coefficients for all items were above the minimum recommended level of 0.20 for including an item in a scale. The standardized Cronbach's alpha coefficient was 0.75. CONCLUSION: Based on these results, we can conclude that this index is suitable for use in everyday practice in Serbian speaking area providing useful information required to assess oral health-related quality of life.

Analysis of the compressive strain below the removable and fixed prosthesis in the posterior mandible using a digital image correlation method.

It was the purpose of this study to determine and analyse strains in the bone of posterior mandible below the removable and fixed partial dentures using Digital Image Correlation Method. Dried mandible with shortened dental arch (Kennedy Class 1) was used in the experiment. The mandible model was prepared for accepting two types of restorations for bilaterally missing molars conventional therapy, and removable and fixed partial dentures were manufactured following standard prosthetic protocol. The models with prosthetic restorations placed in situ were subjected to loading of 50-300 N, and photographed using two digital cameras as part of the digital image correlation method equipment. Afterwards, the obtained data for strains within restored mandible during loading ciclus were analysed in the software Aramis and graphically presented. Percentage size of the mandible strains within the line section are from 0.14 to 0.19% for the removable partial denture experimental model and 0-0.14% for the fixed partial denture experimental model. The study has demonstrated that Digital Image Correlation method can be used to measure strain on the mandible surface and replacements during loading and that from biomechanical perspective both therapeutic modalities can be equally useful for the restoration of the mandible with bilaterally distal edentulous spaces.

Biomechanical behavior of restored and unrestored mandible with shortened dental arch under vertical loading condition.

The aim of this in vitro study was to investigate the strain distribution of the compressed mandible bone under the applied restoration- removable partial denture and to compare with the same but unrestored mandible under vertical (occlusal) load and to find out whether removable partial denture-restored or unrestored mandible causes greater strain effect on supporting tissue. Four mandible models were tested during loading for the purpose of strain measuring. Digital image correlation system (GOM - German Optical Measuring, Braunschweig, Germany), used for measuring strain consists of two digital cameras and software ARAMIS (6.2.0, Braunschweig, Germany). Remaining teeth suffer from greater strain in the mandible model without removable partial denture (7.5-10%). On the contrary, mandible with removable partial denture shows the maximum strain below the denture saddle (3.5%). However, it can be noticed that the marginal bone of the second lower praemolar in both experimental models is deformed whether the mandible model has (2.8%) or has not (10%) replacement. Within the limitations of this study the higher strain is observed in mandible model without replacement and the strain is limited locally, in the bone region that surrounds remaining teeth and mental foramen.

[Dedicated composite fillings--inlays]. / Namenski kompozitni ispuni--"inleji".

BACKGROUND: The aim of the study was to evaluate the quality and persistence of esthetics of dedicated inlay by clinical methods. METHODS: The paper reviews the clinical significance and technique of preparing particular composite inlays before and after the construction of the metallic framework partial denture. On the basis of indications the total of 30 inlays were placed into cavities under relatively dry working conditions. Six, twelve, eighteen and twenty-four months after the placement of filling, control check-up was carried out by Ryge criteria. RESULTS: After two years marginal discoloration as well as the change of the colour occurred in 3.3% of inlays. There was neither detectable secondary caries, nor the symptoms of pulpal damage. The requirements to be fulfilled concerning the composite materials, in order that they can be implemented for this purpose, were also discussed. CONCLUSION: From the clinical point of view, purpose inlays from Herculite XRV lab C8B in combination with Opti Bond System and composite cement Porcelite Dual Cure showed high functional and esthetic values in the observational period of two years.