Long-term impact of implant-supported oral rehabilitation on quality of life: a 5 years prospective study.

BACKGROUND: This study analysed the impact of oral rehabilitation with implant-supported fixed complete dentures (IFCDs) on the oral health-related quality of life (OHRQoL) and its relationship with self-esteem and gratitude. METHODS: 66 patients were interviewed to collect data on OHRQoL (OHIP-14), gratitude and self-esteem, after denture delivery. OHIP-14 scores were analysed over time and contrasted between groups with IFCD complication or not. RESULTS: OHIP-14 changed from 22.1 ± 13.8 at baseline to 1.8 ± 2.3 after rehabilitation. Gratitude and self-esteem mean scores were 38.6 ± 3.0 and 36.9 ± 3.8, respectively. OHIP-14 was statistically different from baseline (22.1 ± 13.8) and 1, 3 and 5 years after rehabilitation (2.3 ± 3.7, 1.9 ± 3.1 and 1.8 ± 2.3). No difference was found between the follow-up times and among OHIP-14 domains. Thirteen out of 66 patients (19.7%) had repairable prosthetic complications, but OHIP-14 did not differ between patients with or without complications. Gratitude and self-esteem showed a moderate association (rs = 0.36; P = 0.003), but no association with OHIP-14. CONCLUSIONS: IFCD treatment has a long-term positive impact on patient's OHRQoL, even among patients who had prosthetic complications. The long-term stability in improved OHRQoL is not associated with self-esteem and gratitude. © 2022 Australian Dental Association.

Early Effect of Implant-Supported Rehabilitation and Nocturnal Bruxism on Maximum Occlusal Force: A Cross-Sectional Study.

This clinical study evaluated the early effect of oral rehabilitation with dental implants and nocturnal bruxism on maximum occlusal force (MOF), before sensorimotor adaptation. A consecutive sample consisted of 127 patients divided into three groups according to their dental state: G1- implant-supported fixed complete denture (IFCD) opposing to a small fixed prosthesis or natural dentition; G2- IFCD opposing to a complete denture; and G3- small fixed prosthesis or natural dentition in both arches. Clinical data were collected after prosthesis installation: systemic and oral health conditions, MOF, self-reported bruxism, and bruxism severity (low, moderate, severe). Data were analysed by ANOVA and Tukey-Krammer tests. Dental state and the interaction sex-bruxism had significant effect on MOF. G1 had higher MOF than G3, but G2 was not significantly different from G1 and G3. Men with bruxism had the highest MOF. The levels of bruxism severity did not have a significant effect on MOF. The results suggest that MOF varies as a function of dental state and the interaction sex-bruxism. However, presence and severity of bruxism alone does not affect MOF.

Influence of the local application of sodium alendronate gel on osseointegration of titanium implants.

The aim of this study was to perform a comparative analysis of aspects of the osseointegration of titanium implants placed with and without the local application of a bisphosphonate agent, after 28 days in vivo. The study involved the placement of 50 commercially pure titanium implants in the middle third of the tibia of 10 rabbits, with the right tibia used as the control and the left as the test site. Sodium alendronate gel was applied locally in the test group and sterile saline solution in the control group. After euthanasia, 10 implants from each group were analyzed for maximum removal torque. The remainder of the sample was processed to obtain non-decalcified slides, approximately 30µm thick, for histomorphological and histomorphometric analyses, including bone-implant contact (%BIC). Data were analyzed at the 5% level of significance. The removal torque values of the test group were, on average, half those obtained in the control group. The test group showed a lower %BIC and notable changes in bone quality. It is concluded that the initial events in the osseointegration of titanium implants are not favoured by the local application of sodium alendronate gel in rabbits.

Changes in hardness and surface topography of tissue conditioners submitted to chemical disinfection.

AIM: The aim of this study was to evaluate the longitudinal effect of chemical disinfection on Shore A hardness, surface roughness (Ra) and morphology of two tissue conditioners (Dura Conditioner [DC] and Softone [SO]). METHODS: Twenty-four specimens (2 mm-thick) were made of each material and randomly divided into three groups (N.=8): control (no disinfection), 10 000 ppm chloride solution (sodium hypochlorite) and Corega Tabs solution (peroxide solution). Soaking was performed daily for 15 min, and Shore A hardness and Ra were measured at baseline and 3, 7, 10, and 14 days. Data were analyzed by repeated measures ANOVA and Bonferroni's test (alfa= 0.05). RESULTS: Chemical disinfection for 14 days with sodium hypochlorite and Corega Tabs affected differently the tested materials. Hardness varied from 8 to 20 for DC and from 8 to 23 for SO with significant interaction (P<0.05) between material and disinfection treatment up to day 7. Ra values (in microm) varied from 1.51 to 4.35 for DC and from 2.08 to 4.15 for SO; there was a significant difference between disinfection treatments (P=0.043) but not between materials (P=0.119). Sodium hypochlorite groups displayed smaller Ra values than the control groups, but did not differ from Corega Tabs groups. Scanning electron microscopy showed different pattern of degradation for each material. CONCLUSIONS: The results suggest that the effect of chemical disinfection on degradation of tissue conditioners is material-specific, but hardness is less affected than surface topography. The overall results support the use of the tested materials for up to three days, independently from the disinfection treatment.

Effect of two microwave disinfection protocols on adaptation of poly (methyl methacrylate) denture bases.

AIM: A few protocols of microwave irradiation have been proposed for disinfection of dental prostheses, but their effect on dimensional alteration still is unknown. This study evaluated the effect of 2 protocols of microwave disinfection on adaptation of resin denture bases polymerised by conventional hot water bath or by microwave energy. METHODS: Thirty-six resin bases were obtained from stone casts duplicated from a metallic master model of an edentulous maxilla and polymerised by either conventional hot water bath or microwave energy. Experimental disinfection treatments were: 1) control (no disinfection); 2) protocol 1 (690 W/6 min); 3) protocol 2 (345 W/6 min). Disinfection procedures were performed 3 times (T1, T2, T3) with a 7-day interval. Adaptation was measured by weighing a vinyl polysiloxane film reproducing the gap between resin base and master model. Data were analysed by ANOVA for repeated measures and Bonferroni test (a=0.05). RESULTS: In T1 and T2, all groups polymerised by microwave energy had higher mean values than the groups polymerised by conventional technique. In T3, denture resin bases polymerised by microwave energy had increased poor adaptation when submitted to microwave disinfection at 690 W for 6 min. No significant changes were found for bases submitted to microwave disinfection at 345 W for 6 min (P>0.05). CONCLUSIONS: Adaptation of denture bases varied as a function of polymerisation technique and protocol of microwave disinfection (power and time) over time. Microwave disinfection at 690 W for 6 min proved harmful to denture bases after repeated disinfection procedures.

Oral function and diet quality in a community-based sample.

Overall diet quality indices, such as the Healthy Eating Index (HEI), are preferred for epidemiological studies, yet studies in dentistry have focused on isolated dietary components. This study investigated the influence of socio-demographic and masticatory variables (masticatory performance, bite force, number of posterior functional tooth units, TMJ disorder, and dentition status) on overall diet quality in a community-based sample (n = 731). Cross-sectional data were derived from clinical examinations, bite force recordings, masticatory performance measurements, and two 24-hour dietary recalls. Females, European-Americans, and older subjects had better HEI scores than males, Mexican-Americans, and younger subjects, respectively. Income, education, and the masticatory variables were not related to diet quality. Analyses according to dentition status (good dentition, compromised dentition, partial denture, and complete dentures) showed no inter-group differences for HEI except for the age groups. The results suggest that the chewing-related factors evaluated in this sample are not predictors of overall diet quality across the socio-demographic groups.

Determinants of masticatory performance in dentate adults.

Masticatory performance results from a complex interplay of direct and indirect effects, yet most studies employ univariate models. This study tested a multivariate model of masticatory performance for dentate subjects. Explanatory variables included number of functional tooth units, bite force, sex, age, masseter cross-sectional area, presence of temporomandibular disorders, and presence of diabetes mellitus. The population-based sample consisted of 631 dentate subjects aged 37-80 years. Covariance structure analysis showed that 68% of the variability in masticatory performance could be explained by the combined effects of the explanatory variables. Age and sex did not show a strong effect on masticatory performance, either directly or indirectly through masseter cross-sectional area, temporomandibular disorders, and bite force. Number of functional tooth units and bite force were confirmed as the key determinants of masticatory performance, which suggests that their maintenance may be of major importance for promoting healthful functional status.

In vitro evaluation of secondary caries development in enamel and root dentin around luted metallic restoration.

Materials that release fluoride have been recommended for patients with high caries risk, but there is no conclusive evidence of their effect on fixed prostheses abutments. This study evaluated the influence of a resin-modified glass-ionomer cement on in vitro caries development in enamel and root dentin around metallic restoration. The cervical portion of 12 human third molars were sectioned in four blocks that were randomly divided into four Groups (n = 12; 1 block from each tooth/group): ZP (restoration + zinc phosphate cement), GI (restoration + resin-modified glass-ionomer cement), C1 (no restoration and no pH cycling), and C2 (no restoration and pH cycling). In ZP and GI, metallic restorations were luted at the crown-root junction. ZP, GI and C2 were submitted to a pH-cycling model. All blocks were sectioned, embedded and polished. Enamel and root dentin demineralization were evaluated through cross-sectional microhardness Knoop measures at 20 to 80 microns of depth (from the outer surface) and at 20 to 220 microns of distance from the cavity margins. Mineral loss values were calculated from Knoop hardness numbers. Data were analyzed by ANOVA, Tukey's test and regression analysis. Groups ZP, GI and C2 showed demineralization in relation to C1, which was more superficial in enamel than in root dentin. In root dentin, mineral loss in ZP and GI was smaller than in C2. Distance from the cavity margins was not significant. There was no difference between resin-modified glass-ionomer cement and zinc phosphate cement regarding artificial secondary caries development in both dental substrates.

Masticatory performance is not associated with diet quality in Class II orthognathic surgery patients.

This study evaluated the association between masticatory function, diet, and digestive system problems in 59 Class II patients 5 years after bilateral sagittal split osteotomy. Dietary intake data were recorded in 4-day diet diaries and analyzed for overall diet quality (Healthy Eating Index) and selected dietary components. Masticatory function was assessed through measurements of masticatory performance, maximum bilateral bite force, and chewing time and number of chewing strokes until the subject felt that the bolus was ready to swallow. Self-reported frequency of digestive system problems was recorded with a 7-point Likert scale questionnaire. Masticatory function was not associated with diet quality or gastrointestinal problems. There was a weak association between intake of foods that require chewing (eg, fiber, protein, meat, and vegetables) and masticatory variables. Fourteen subjects (24%) had a poor diet and 45 subjects (76%) had a diet that needed improvement according to the Healthy Eating Index. Self-reported constipation was the only digestive system problem that was significantly associated with masticatory performance.

[The role of dentistry in the interdisciplinary team: contributing to comprehensive health care for the elderly]. / O papel da odontologia na equipe interdisciplinar: contribuindo para a atenção integral ao idoso.

This literature review focuses on dentistry's role in comprehensive health care for the elderly. The authors discuss the need for an interdisciplinary approach. They begin by analyzing the current situation in geriatric dentistry and related problems in Brazil, relating primarily to the lack of specific studies and human resources with training in geriatrics and gerontology. The authors emphasize interactions between dentistry and other health professions for health promotion, specific prevention, and rehabilitation of elderly patients, with special attention to the importance of communication and information exchange.