Discriminating Masticatory Performance and OHRQoL According to Facial Morphology in Complete Denture Wearers: A Single-Center Controlled Study.

PURPOSE: To evaluate the influence of facial type and anteroposterior skeletal discrepancy of complete denture wearers on residual ridge height, masticatory performance, oral health-related quality of life (OHRQoL), and satisfaction levels. MATERIALS AND METHODS: A total of 56 edentulous patients (mean age of 67.1 years) were radiographically evaluated prior to rehabilitation to determine residual ridge height in the maxilla and mandible, facial type, and anteroposterior skeletal discrepancy. Masticatory performance tests with 40 chewing cycles were applied. The Dental Impact on Daily Living questionnaire was used to measure OHRQoL and satisfaction. Data were analyzed with Kruskal-Wallis test and logistic regression. RESULTS: Dolichofacial participants presented with significantly higher bone height than mesofacial and brachyfacial types in the anterior region of the maxilla and mandible and had more mandibular bone than mesofacial types in the premolar region. Class II patients presented significantly higher bone height than Class I participants in the anterior maxilla. Dolichofacial patients performed significantly better than brachyfacial patients in the masticatory performance test. Class I patients achieved more homogenous artificial food trituration than Class III patients (P < .05). High OHRQoL scores were reported in appearance and general performance irrespective of facial type or anteroposterior skeletal discrepancy. CONCLUSION: Dolichofacial patients had superior masticatory performance compared to brachyfacial patients. Class III patients showed a reduced capacity to homogenize the food bolus. Mesofacial, dolichofacial, and Class III patients reported the best perceptions of their OHRQoL. Anteroposterior skeletal discrepancy seems to be the main factor contributing to mastication impairments in totally edentulous patients.

Influence of Age and Time Since Edentulism on Masticatory Function and Quality of Life in Implant-Retained Mandibular Overdenture Wearers: 1-year Results from a Paired Clinical Study.

PURPOSE: To investigate the influence of age and time since edentulism on masticatory function and quality of life related to oral health (OHRQoL) in totally edentulous patients after implant-retained mandibular overdenture (IMO) loading. MATERIALS AND METHODS: The sample consisted of 33 patients categorized in two age groups (≤ 65 and > 65 years, respectively), and two time since edentulism groups (< 25 and ≥ 25 years). The masticatory function was evaluated through the masticatory performance and swallowing threshold tests before IMO loading, and 1, 3, 6, and 12 months after IMO loading. The OHRQoL was evaluated by applying the Oral Health Impact Profile (OHIP-EDENT) and Geriatric Oral Health Assessment Index (GOHAI) questionnaires, before loading and after 3, 6, and 12 months. Data were subjected to the Mann-Whitney test and Wilcoxon signed-rank test for paired samples. RESULTS: The masticatory performance and swallowing threshold were not influenced by the age nor by time since edentulism, except 6 months after IMO loading when patients ≤ 65 years of age performed the swallowing threshold test in a significantly shorter time with a reduced number of masticatory cycles (P < .05). The masticatory performance and swallowing threshold outcomes showed a gradual improvement up to 12 months, irrespective of the patient categorization. The GOHAI questionnaire scores showed that the OHRQoL was influenced by age in complete denture wearers with a difference between groups in the psychosocial and global domains. The time since edentulism was not affected by the GOHAI scores of complete denture wearers (P < .05). The OHIP-EDENT questionnaire only indicated significant differences as a function of age or time since edentulism between complete denture wearers. Age was associated with significant differences in the physical pain domain outcome, while time since edentulism did not affect only the psychologic discomfort, psychologic inability, and handicap domains. CONCLUSION: Neither the age nor the time since edentulism influenced the masticatory function of IMO-wearing patients. However, IMO significantly improved the masticatory function in totally edentulous patients, and this is more evident for younger patients (≤ 65 years) with a shorter time since mandibular edentulism (< 25 years). The OHRQoL is only influenced by age and time since edentulism in complete denture wearers; IMO treatment eliminates these differences.