Guido Heydecke

The Effects of Mandibular Two-implant Overdentures on Nutrition in Elderly Edentulous Individuals

It is unclear whether mandibular implant overdentures improve the nutritional state of edentulous patients better than conventional dentures. In a randomized clinical trial, we tested for post-treatment differences in nutritional status between patients with mandibular two-implant retained overdentures and those with conventional complete dentures. Edentulous subjects (ages 65–75 yrs) received two-implant mandibular overdentures (IOD, n = 30) or conventional dentures (CD, n = 30). Measures of nutritional state were gathered before and 6 mos after treatment. Significant improvements in anthropometric parameters were detected in the IOD but not in the CD group, for percent body fat (p = 0.011) and skin-fold thickness at the biceps, subscapularis, and abdomen (p < 0.05), with significant decreases in waist circumference (p < 0.0001) and waist-hip ratio (p = 0.001). Significant increases were seen in concentrations of serum albumin (p = 0.015), hemoglobin (p = 0.01), and B12 (p = 0.01). No significant between-group differences were found. These results suggest that low-cost IOD treatment may improve the nutritional state of edentulous people.

The effectiveness of 2-implant overdentures – a pragmatic international multicentre study

The purpose of this multicentre observational study was to determine patient satisfaction with either conventional dentures or mandibular 2-implant overdentures in a real world setting. Two hundred and three edentulous patients (mean age 68·8 ± 10·4 years) were recruited at eight centres located in North America, South America and Europe. The patients were provided with new mandibular conventional dentures or implant overdentures supported by two implants and ball attachments. At baseline and at 6 months post-treatment, they rated their satisfaction with their mandibular prostheses on 100-mm visual analogue scale questionnaires. One hundred and two (50·2%) participants had valid baseline and 6-month satisfaction data. Although both groups reported improvements, the implant overdenture group reported significantly higher ratings of overall satisfaction, comfort, stability, ability to speak and ability to chew. These results suggest that edentulous patients who choose mandibular implant overdentures have significantly greater improvements in satisfaction, despite their relatively higher cost, than those who choose new conventional dentures.

The color of human gingiva and mucosa: visual measurement and description of distribution

No soft tissue shade guide is available for matching the color of denture resins to human intraoral soft tissues. To determine the color of both the gingiva and the alveolar mucosa, intraoral soft tissue colors of 150 men and women were assessed under standardized lighting conditions. Colors of the papilla, attached gingiva, and alveolar mucosa in the central incisor region of the maxilla and mandible were examined using Munsell color tabs and their corresponding notations (value, hue, chroma). Statistical evaluation was performed by using frequency tables and multiple regression (level of significance p=0.05). Color ratings for the maxillary interincisal papilla lay in the yellow hue spectrum. A high incidence of ratings was found between 7/6 2.5R and 7/4 5R (Munsell color notations). Two further peaks were identified for the colors 3/6 2.5 R and 8/4 10R. Five peaks with the highest frequency of ratings were present with regard to the color of the mucosa in the maxillary incisal region: 6/6 2.5R, 7/6 2.5R, 6/8 5R, 5/8 7.5RP, and 5/6 10RP. In the mandible, a similar pattern was found. Using the results from visual matching tests, five color frequency peaks were identified. They could be used to construct an intraoral soft tissue shade guide.