Influence of visual acuity, manual dexterity and handgrip strength on oral and denture hygiene ability of non-frail older people: Development of the Gerostomatological Assessment Battery.

BACKGROUND: Due to the heterogeneity of older people, it is difficult to identify reliable factors influencing oral health. OBJECTIVE: The aim was to illustrate the influence of visual acuity, manual dexterity, and handgrip strength on the oral and denture hygiene ability of older non-frail people. METHODS: In a cross-sectional study, conducted at a specialized dental clinic, at baseline, all participants received professional prophylaxis and instruction on daily oral and denture hygiene regimes for a 6-week intervention period. Data on the Quigley and Hein modified plaque index (QHI), respectively, the Denture Hygiene Index (DHI), visual acuity, manual dexterity and handgrip strength in non-frail participants (≥ 65 years) were collected. Recruitment was done within the clinic's patient clientele and within the staff (control cohort). RESULTS: Women showed significantly better manual dexterity than men (Mann-Whitney U, p = .01), while women's mean handgrip strength was significantly lower (Mann-Whitney U, p < .01). Manual dexterity (Mann-Whitney U, p = .003) and handgrip strength (Mann-Whitney U, p = .052) were associated with age. However, visual acuity, manual dexterity and handgrip strength had no influence on oral or denture hygiene. CONCLUSION: Visual acuity, manual dexterity and handgrip strength have no influence on oral and denture hygiene ability in older non-frail people. Further studies should investigate whether these factors also have no influence on oral and denture hygiene in vulnerable older patients. Therefore, an assessment tool for the evaluation of potential influencing factors of oral and denture hygiene is proposed in a dental context. This Gerostomatological Assessment Battery (G-AB) can be used as a helpful tool to check the individual cognitive function and comprehension, dental therapy approaches and their individual adaption.

Effect of complete denture wearing on tongue motor biomechanics during swallowing in edentulous older adults.

AIM: Contact of the tongue against the hard palate plays an important role in swallowing. Therefore, age-related decline in tongue function has received much attention. The purpose of the present study was to investigate the effect of complete denture wearing on tongue motor biomechanics during swallowing in healthy edentulous older adults. METHODS: A total of 19 edentulous patients (6 males and 13 females, mean age 76.2 ± 7.2 years) without any history of neuromuscular disease or dysphagia were selected. All patients were wearing complete dentures in both the upper and lower jaws. Tongue pressure against the hard palate during swallowing saliva was recorded using an original T-shaped sensor sheet with five measuring points. Measurements were carried out both with and without the prostheses. For evaluating swallowing ability, the frequency of swallowing saliva in 30 s was recorded (Repetitive Saliva Swallowing Test). RESULTS: With the prostheses, the maximal magnitude and duration of tongue pressure was larger at Ch. 1 (anterior-median part of the hard palate) and Ch. 2 (mid-median part) right and left circumferential parts than without the prostheses. As for the integral of tongue pressure, that with prostheses was larger at all 5 channels than that without prostheses. There was significant improvement in the Repetitive Saliva Swallowing Test value while wearing prostheses. CONCLUSIONS: These results suggested that swallowing function deteriorated as a result of the decline in tongue-palate contact on removing complete dentures in edentulous older adults. CLINICAL RELEVANCE: The present study showed the effect of wearing prostheses on swallowing in edentulous older adults.

Technical complications of implant-supported fixed partial dentures in partially edentulous cases after an average observation period of 5 years.

OBJECTIVES: The purpose of this prospective long-term study was to evaluate the incidence of the most common technical problems, namely screw loosening, screw fracture, fracturing of veneering porcelain and framework fracture in implant-supported fixed partial dentures (FPDs), and assess the survival and success rate (event-free survival) after 5 years of function. MATERIALS AND METHODS: In 76 partially edentulous patients, a total of 205 3i-implants (machined surface) were placed and restored with 112 implant-supported FPDs (46 single crowns, 81 splinted crowns, seven FPD bridges and 23 FPDs with cantilevers). The survival rate of FPDs supported by implants was 94.5% (CI-95: 90.1-98.8) after an average observation period of 5 years. The success rate (event-free survival) of the FPDs was 80% (CI-95: 87.3-72.7). After an observation period of 5 years the cumulative incidence of screw loosening was 6.7% (CI-95: 1.8-11.5), the cumulative incidence for screw fracture was 3.9% (CI-95: 0.1-7.7). Fracture of the veneering porcelain occurred in 5.7% (CI-95: 1.2-10.2) of all FPDs. Fracturing of the suprastructure framework was rare (1%; CI-95: 0-2.9). The overall complication incidence after 5 years was highest in the group of FPDs with cantilever, which showed the lowest success rate 68.6% (CI-95: 50-87.3), followed by single crowns (77.6%; CI-95: 53.3-100) and splinted crowns (86.1%; CI-95: 59.5-100). No complication occurred in FPD bridges. CONCLUSION: Fixed partial dentures supported by 3i-implants showed low technical complications rates, the most common being loosening of the abutment screw. Managing these complications can cause extra amount of chair-side time and patient dissatisfaction.

Zygoma implant-supported prosthetic rehabilitation after partial maxillectomy using surgical navigation: a clinical report.

The rehabilitation of patients with acquired defects of the maxilla is a challenge in terms of reestablishing oronasal separation. In most patients these goals are met by means of prosthetic rehabilitation with an obturator prosthesis. If the remaining dentition does not offer sufficient retention and support, the placement of zygoma implants can enhance the stability of the prosthesis. Due to the anatomic intricacies of the zygomatic bone and the implant length, computer-supported navigated implant placement can be advantageous. In the following clinical report, a diabetic patient with a status of posthemimaxillectomy secondary to aspergillusis infection is presented, in whom a zygoma implant was placed using a CT scan-based navigation system. A special retentive anchoring abutment was used to integrate the zygoma implant into a telescopic crown-retained denture on the residual dentition. This tooth-implant-supported obturator prosthesis restored function and phonetics, as well as esthetics, for this young patient.

Complex dental rehabilitation in a periodontally compromised patient. Part 2: treatment and discussion.

This two-part treatment series discusses the prosthodontic rehabilitation of a female patient with a severe preexisting periodontal condition. In Part 1, the diagnostic and treatment planning strategies were presented. In Part 2, the selected treatment will be revealed and discussed in detail using evidence from the literature. The treatment procedures will be presented in terms of three challenging locations: the anterior maxilla, posterior maxilla, and anterior mandible. At the end of the article, the final outcome is presented and compared with the initial situation.

Complex dental rehabilitation in a periodontally compromised patient. Part 1: diagnosis and treatment planning.

This two-part treatment series discusses the prosthodontic rehabilitation of a female patient with a severe preexisting periodontal condition. In Part 1, the diagnostic and treatment planning strategies are presented, and the advantages and disadvantages of several treatment options are discussed in terms of function, esthetics, and long-term stability. In Part 2, the selected treatment will be revealed and discussed in detail.

Cytotoxic and mutagenic effects of dental composite materials.

Mutagenicity of single compounds of dental resinous materials has been investigated on many occasions before, but the induction of mutagenic effects by extracts of clinically used composites is still unknown. Here, cytotoxic effects and the formation of micronuclei were determined in V79 fibroblasts after exposure to extracts of modern composite filling materials (Solitaire, Solitaire 2, Tetric Ceram, Dyract AP, Definite). For cytotoxicity testing, test specimens were aged for various time periods (0, 24, and 168 h), and V79 cells were then exposed to dilutions of the original extracts for 24, 48, and 72 h. The ranking of the cytotoxic effects of the composites according to EC50 values after a 24-h exposure period was as follows: Solitaire (most toxic)=Solitaire 2