Evaluation of dynamic impression lining material effects on masticatory function and the oral health-related quality of life of complete denture wearers: A six-month randomized controlled trial.

PURPOSE: To determine the effect of a dynamic impression lining material (DIL) on the retention and stability of mandibular complete dentures (LCD), masticatory performance, and the oral health-related quality of life (OHRQoL) of the patients wearing complete denture (CD) compared with those wearing a denture with conventional hard denture liner (HL). METHODS: Twenty-five patients who wore CD with an ill-fitting LCD were randomly assigned to two groups: LCD relined with DIL (Dynamic impression lining material) or HL (Tokuyama® Rebase II (fast)). Three objective measures (denture retention, stability, and masticatory performance) were measured. The OHRQoL was also measured using the Thai version of oral impacts on daily performance. Outcomes were measured at six time points: baseline, 3 days, 1 week, 1 month, 3 months, and 6 months after relining. Outcome changes were analyzed using a generalized estimating equation, and all models were adjusted for age, mandibular ridge form, and CD age at a 5% significance level. RESULTS: After LCD relining, the frequency and severity of adverse oral impacts significantly decreased. In the DIL group, denture pain occurred on and off over six months, and an ill-fitting denture impacted at one month. In the HL group, denture pain continuously decreased over time. At 3 months, changes in the clinical properties of DIL were observed, including perceived odor. The material also peel-off from the denture base, and plaque accumulation was observed. In contrast, the HL properties remained stable for over 6 months. CONCLUSIONS: Although DIL improves denture retention and stability, masticatory performance, and the OHRQoL of the patients who wear CD, oral adverse effects were not eliminated. The clinical properties of DILs changed at 3 months, while the HL remained relatively stable for up to 6 months.(The clinical trial registration number: Thai Clinical Trials Registry (TCTR) number TCTR20210625005.).

Decision to use denture adhesive in complete denture wearers after one-month run-in period: A quasi-experimental study.

OBJECTIVES: The aim of this study was to assess two patient-based outcomes of complete denture (CD) wearers who continued or discontinued using denture adhesive (DA) after one-month run-in period of DA use. METHODS: This quasi-experimental study comprised 76 CD wearers. The two patient-based outcomes were oral health-related quality of life and masticatory performance, determined by the Thai-version of oral impacts on daily performances index and multiple sieve method of 20-stroke peanut mastication. Denture retention and stability were evaluated using the CU-modified Kapur criteria to classify the CD into acceptable or unacceptable quality. The outcomes were collected at 3 time points: 1) at baseline (T0), 2) after a 1-month run-in period of DA use (T1), at which time the participants decided whether to continue using DA, and 3) 1-month after continuing or discontinuing using DA (T2). Changes in the percentages of having an oral impact from T0 to T2 were evaluated using the McNemar's test. The effect of denture quality and the decision to use DA on peanut particle size across time points were assessed using repeated measures ANOVA. The peanut particle size changes in each group between time points were evaluated using the one-way repeated measures ANOVA and Tukey post-hoc comparison test. RESULTS: The participants who continued using DA at T2 had greater oral impact reduction after the 1-month run-in period of DA use, whereas cleaning and emotional impacts emerged in those who discontinued using DA. At T1 and T2, the peanut particle size of the participants who continued and discontinued using DA was not significantly changed from T0, except for the acceptable CD wearers who discontinued using DA at T2, whose peanut particle size decreased from T0 to T2. CONCLUSIONS: Baseline oral impacts and their change influenced CD wearers' decision whether to continue using DA. However, masticatory performance did not affect the patients' decision.

The impact of poor dental status and removable dental prosthesis quality on body composition, masticatory performance and oral health-related quality of life: a cross-sectional study in older adults.

BACKGROUND: To determine the impact of dental status, types, and quality of dental prostheses on body composition, masticatory performance and oral health-related quality of life (OHRQoL). Potential associations between body composition, masticatory performance and OHRQoL were also investigated. METHODS: This cross-sectional study included 110 older adults who received prosthodontic treatment at the Dental Faculty Clinics at Chulalongkorn University. Participants were categorized according to their dental prostheses: complete denture (CD), removable partial denture (RPD) and fixed partial denture (FPD). Retention and stability of the RPD and CD were evaluated using the CU-modified Kapur and the modified NHANES III criteria to classify denture quality into acceptable and unacceptable. Dental status including posterior occluding pairs and number of remaining natural teeth were assessed intraorally. Dependent variables were body composition, masticatory performance and OHRQoL. Body composition, including muscle mass (kg), bone mass (kg), basal metabolic rate (kcal) and visceral fat (%) were determined through a bioelectrical impedance analysis. Masticatory performance was assessed using a multiple sieve method of peanut mastication. OHRQoL was assessed using the validated Thai version of Oral Impacts on Daily Performances (Thai-OIDP) index. After adjusting for covariates, including age and sex, the associations between oral and dental prosthesis status and body composition, masticatory performance as well as OIDP score were analyzed using multivariable linear and negative binomial regression analyses. Spearman's correlation was used to determine the potential associations between body composition, masticatory performance and OHRQoL. RESULTS: The presence of fewer natural teeth or wearing an unacceptable removable denture were factors associated with lower bone mass, muscle mass and basal metabolic rate, and with a higher visceral fat. Similar dental and removable denture status were also associated with larger peanut particle size and higher OIDP score. Masticatory performance and OHRQoL variables were moderately correlated (Spearman's rho = 0.44). However, body composition was not correlated with masticatory performance or OHRQoL. CONCLUSIONS: In individuals wearing dental prostheses, factors such as severity of tooth loss, types, and quality of dental prostheses, particularly retention and stability, negatively impacted not only masticatory function and OHRQoL, but also their overall body composition and health.

Masticatory index for patients wearing dental prosthesis as alternative to conventional masticatory ability measures.

OBJECTIVES: The study objectives were: 1) to develop a masticatory index for evaluating masticatory ability in patients wearing a dental prosthesis, including complete dentures (CD), removable partial denture (RPD), and fixed partial denture (FPD), 2) to test the reliability and validity of the index, and 3) to determine whether the index better reflected patients' masticatory ability compared with conventional subjective and objective measures. METHODS: The present cross-sectional study consisted of 2 phases: 1) developing the Chulalongkorn University masticatory index (CUMI) consisting of 20 food items in 5 masticatory difficulty grades using a 3-point Likert scale, and 2) application of the CUMI in 110 patients wearing a dental prosthesis, including CD, RPD, and FPD (control group). The CUMI test-retest reliability was reevaluated 2 weeks later. The convergent validity was compared with objective masticatory performance evaluated with a standard peanut chewing test, and subjective eating impacts evaluated by the Oral Impacts on Daily Performances Index. Oral and denture status were determined clinically. The associations between CUMI score, peanut particle size, and eating impact score was identified using Spearman's correlation coefficient. To evaluate discriminant validity, the associations between masticatory ability measurements and oral and denture status were analyzed using regression analyses. RESULTS: The CUMI's Cronbach's alpha and intraclass correlation coefficient values were 0.89 and 0.95, respectively. The convergent validity was shown by significant associations between the increased CUMI score, smaller peanut particle size and decreased eating impact score. Multivariable analyses found that the CUMI score, peanut particle size, and percentage of having an eating impact were significantly associated with the number of remaining teeth and posterior occluding pairs, and type and quality of dental prosthesis. However, the CUMI demonstrated better discriminant validity because significant dose-response relationships were found only between the decreased CUMI score and increased tooth loss severity, and unacceptable denture quality. Adjusted R2 values of the CUMI models were the highest, followed by those of peanut particle size and eating impact. CONCLUSION: CUMI is a reliable and valid tool to evaluate masticatory ability of patients wearing a dental prosthesis, including CD, RPD, and FPD. Due to a better discriminant validity, the CUMI better reflects masticatory ability of patients compared with conventional subjective and objective masticatory ability measures.

Effect of complete denture occlusal schemes on masticatory performance and maximum occlusal force.

STATEMENT OF PURPOSE: Masticatory performance and maximum occlusal force may be different, depending on the occlusal schemes of the complete dentures used. PURPOSE: The purpose of this study was to evaluate the effect of 2 complete denture occlusal schemes on masticatory performance and maximum occlusal force. MATERIAL AND METHODS: Two complete denture occlusal schemes, bilateral balanced occlusion and neutrocentric occlusion, were delivered to 10 participants who were completely edentulous (6 men and 4 women; mean age, 67.3 years). Masticatory performance was evaluated with the multiple sieve method and maximum occlusal force with pressure-sensitive films. The 2 occlusal schemes were interchanged on the participants' denture bases. Two-way repeated-measures ANOVA was used to examine the differences between the occlusal schemes and chewing strokes and their interactions. The paired t test was used to compare the maximum occlusal force of the 2 occlusal schemes (α=.05). RESULTS: No difference was found in masticatory performance (P=.07) or maximum occlusal force (P=.31) between the occlusal schemes. For both schemes, a significant difference was found in masticatory performance (P<.001) with increased numbers of chewing strokes. CONCLUSIONS: Complete dentures with bilateral balanced occlusion and neutrocentric occlusion found no significant differences in masticatory performance and maximum occlusal force. However, more chewing strokes resulted in better masticatory performance.

Factors associated with masticatory performance in unilateral distal extension removable partial denture patients.

PURPOSE: Masticatory performance of denture patients is an outcome of the intricate inter-relationship between patient characteristics and denture construction. This study aimed to identify both patient- and denture-related factors associated with masticatory performance in unilateral distal extension removable partial denture patients (RPDs). MATERIALS AND METHODS: Seventy-two patients (25 male and 47 female, mean age 63.4 +/- 6.7 years) with unilateral distal extension RPDs were included in the study. The Mixing Ability Index (MAI) obtained from a chewing test using standard two-colored wax cubes, determined masticatory performance. The effect of each evaluated factor on masticatory performance was first determined by an independent t-test or one-way analysis of variance. The statistically significant factors were entered in a model of multivariate linear regression analysis to estimate the independent effect on MAI. RESULTS: The MAI ranged from -3.06 to 0.80 (Mean -0.71 +/- 0.86). Univariate analyses identified male gender, high maximum bite force, more functional tooth units, and natural dentition opposing RPDs as patient factors increasing the MAI. Multivariate analysis (adjusted R(2)= 0.346) revealed that gender (p < 0.001), maximum bite force (p= 0.02), and number of functional tooth units (p= 0.03) were independent predictors for masticatory performance. None of the denture-related factors had a significant influence on MAI. CONCLUSION: Gender, maximum bite force, and number of functional tooth units were the main factors influencing masticatory performance of unilateral distal extension RPD patients.

Masticatory function after unilateral distal extension removable partial denture treatment: intra-individual comparison with opposite dentulous side.

Due to large individual differences of masticatory function, an inter-individual comparison between denture patients and complete dentate people would be insufficient. This cross-sectional study aimed to evaluate patients' masticatory performance (determined by Mixing Ability Index, MAI) and bite force (determined by maximum bite force, MBF) after removable partial denture (RPD) treatment by comparing those of the RPD replaced side with those of their own opposite dentulous side, and to evaluate influence of bite force on masticatory performance in different dentitions. Subjects included patients with unilateral distal extension RPDs (n=28). Apart from the RPD replaced area on one-side, all subjects had intact dentitions. Both masticatory parameters were evaluated separately on each chewing side. MAls and MBFs obtained from the RPD replaced side (0.65 +/- 0.50 and 220 +/- 155 N, mean +/- SD) were significantly lower than those from the dentulous side (1.06 +/- 0.64 and 450 +/- 268 N; Wilcoxon signed-ranks, P < 0.001). MBF significantly influenced MAI in both RPD replaced (Univariate linear regression; R2 = 0.17, P < -0.001) and dentulous sides (R2 = 0.51, P < 0.001). After RPD treatment, masticatory performance and bite force of RPD replaced side were lower than those of their own dentulous side. The influence of the bite force on masticatory performance in RPD replaced side was less significant than that in the dentulous side.