Clinical study on the correlation between psychogenic dental prosthesis incompatibility, oral stereognosis, and the psychologic diagnostic tools SCL-90-R and CES-D.

PURPOSE: The objective of this study was to use an oral stereognosis test to evaluate possible intraoral/sensorimotor causes in patients with a psychologic diagnosis of psychogenic prosthesis incompatibility, and to evaluate possible correlations between oral stereognosis and the psychologic diagnostic tools Symptom Checklist-90-R (SCL-90-R) and Center of Epidemiological Studies Depression Scale (CES-D). MATERIALS AND METHODS: The study cohort comprised 83 patients with complete dentures fabricated according to a standardized protocol. Twelve patients diagnosed with psychogenic prosthesis incompatibility (11 women, 1 man) using the SCL-90-R and CES-D scales in a previous study and a group of 24 randomly selected control subjects (14 women, 10 men) underwent an oral stereognosis test with 10 neutral-tasting plastic test specimens with a maximum edge length of 8 mm in 2 test cycles. RESULTS: The results revealed no significant differences in oral stereognostic ability between patients with diagnosed psychogenic dental prosthesis incompatibility and the control patients. The patients in the test group expressed clear dissatisfaction with their dentures. No correlation was found between oral stereognostic ability and the SCL-90-R or CES-D values. CONCLUSIONS: This study is the first to use oral stereognosis tests for patients with psychologically diagnosed psychogenic dental prosthesis incompatibility. The diagnosis of psychogenic prosthesis incompatibility by the SCL-90-R and CES-D scales is affirmed by the lack of correlations between the functional/anatomic aspects of oral stereognostic ability, psychologic diagnostic tools, and the clinical picture of psychogenic prosthesis incompatibility. Thus, psychogenic prosthesis incompatibility can be classified more explicitly as a psychosomatic disorder.

Radiographic findings, ridge resorption, and subjective complaints of complete denture patients.

To evaluate the relationship between the complaints of complete denture wearers and alveolar bone resorption as well as the location of mental foramina, 96 patients were interviewed. All subjects had received new dentures at the University of Iowa between August 1985 and July 1990. Panoramic radiographs had been made for all the subjects before dentures were fabricated. The amount of estimated ridge resorption correlated significantly with the number of years females had been edentulous, but no correlation was found in males. The location of the mental foramen in relationship to the crest of residual ridge correlated negatively with the number of years both genders were edentulous. Subjective need for dental treatment, as expressed by "sore gums" or poor or fair chewing ability, were the most frequent complaints among the subjects. These complaints were more often recorded with the subjects who had lost more than 50% of their estimated original ridge height than with those with less than 50% resorption, but this difference was not significant.

Etiologic factors in denture sore mouth syndrome.

A total of 24 patients, 19 women and 5 men, complaining of denture sore mouth was studied. In part I the following investigations were performed: (1) Mechanical factors were evaluated. (2) Temperature was measured beneath the prosthetic denture. (3) Yeast cultures were made. (4) Patch tests with possible allergens were performed on the buccal mucosa and on the skin of the back. In all these investigations there were no significant differences from the results obtained in a control group. In part II the connection between psychological factors and denture sore mouth was explored. Test results of the denture sore mouth group and a matched control group were compared. The obtained data suggest that complaining behavior concerning somatic symptoms in general, on a neurotic base, is a psychological characteristic of denture sore mouth patients.