Harald Gjengedal

Denture wearer's perception of ambient care. Part 2. Analyses of data

OBJECTIVE The aim was to investigate to what extent denture wearers were satisfied with the ambient care (care) received. MATERIALS AND METHODS A study sample of 117 completely edentulous and 56 partially edentulous patients, who had received their dentures in the period 1997-2005 at Bergen School of Dentistry, completed a questionnaire containing eight specific items regarding different aspects of care, each with two positive (a and b) and two negative (c and d) categories, and four global items. The care items, including confidence in the dental team, information, waiting time and cost, constitute the Ambient Care Scale; the global items were concerned with overall care, satisfaction with dentures, self-reported oral and general health. RESULTS Between 91-100% of Ambient Care Scale responses were in the two positive categories. The completely edentulous group was significantly more satisfied than the partially edentulous group regarding several Ambient Care Scale items and oral health. Also, ratios between categories b and a showed systematic higher degrees of satisfaction for the completely edentulous group than the partially edentulous group. Fifty-six per cent in the completely edentulous group and 36% in the partially edentulous group were very satisfied, i.e. with ≥ 6 of 8 possible responses in category a. Analysis of the very satisfied showed that the highest degrees of satisfaction for both groups were found regarding students and staff, the lowest regarding cost and waiting times. CONCLUSIONS Patient satisfaction with care was very high. Completely edentulous patients were systematically more satisfied than partially edentulous ones.

CAD/CAM milled complete removable dental prostheses: An in vitro evaluation of biocompatibility, mechanical properties, and surface roughness

This study compared the biocompatibility, mechanical properties, and surface roughness of a pre-polymerized polymethyl methacrylate (PMMA) resin for CAD/CAM complete removable dental prostheses (CRDPs) and a traditional heat-polymerized PMMA resin. Two groups of resin substrates [Control (RC): conventional PMMA; Test (RA): CAD/CAM PMMA] were fabricated. Human primary osteoblasts and mouse embryonic-fibroblasts were cultured for biocompatibility assays. Mechanical properties and surface roughness were compared. ANOVA revealed no difference between the resin groups in the biocompatibility assays. RA demonstrated a higher elastic modulus (p=0.002), youngs modulus (p=0.002), plastic energy (p=0.002), ultimate strength (p=0.0004), yield point (p=0.016), strain at yield point (p=0.037), and toughness (p<0.0001); while RC displayed a higher elastic energy (p<0.0001). Laser profilometry concluded a rougher surface profile (p<0.0001) for RA. This study concluded that the tested CAD/CAM resin was equally biocompatible and presented with improved mechanical properties than the traditional heat-polymerized PMMA resin used in the fabrication of CRDPs.

Denture wearer's perception of ambient care, part 1: validation of a preliminary scale

Abstract Objective. The aim of the present study was to investigate if a preliminary Ambient Care Scale (ACS), intended to measure ambient care in complete denture wearers, had acceptable reliability and validity. Materials and methods. A sample of 117 patients who had received complete dentures in both jaws in the period 1997–2005 at Bergen School of Dentistry completed a questionnaire containing eight items regarding the patients’ relationship with the student and clinical personnel, to what extent they were informed and consulted during treatment, waiting times and cost. In addition, information was gathered regarding demographics, The Psychological General Well-Being index (WHO−5), global ambient care, satisfaction with dentures and how patients viewed their oral health. Results. Cronbachs alpha coefficient was 0.76 for the ACS, indicating acceptable internal consistency. From principle component analysis, three factors were extracted, correlating with ACS with coefficients of 0.72, 0.58 and 0.59, respectively. Acceptable construct validity was indicated by the fact that items were formulated by common agreement among three experienced prosthodontists, the extremely low frequency of missing data (<2%) and that ACS, as expected, was able to discriminate between patients satisfied and dissatisfied with their dentures (p = 0.005) and oral health (p = 0.042), but not between those who had high or low WHO-5 scores (p = 0.77). Conclusions. The ACS appears to have acceptable psychometric properties.

Monolithic zirconia crowns in the aesthetic zone in heavy grinders with severe tooth wear – An observational case-series

OBJECTIVES The aim of this study was to assess the clinical outcomes and patient satisfaction with monolithic zirconia crowns in patients with severe tooth wear (≥1/3 of the tooth crown) in the aesthetic zone. METHODS The historical prospective study sample consisted of 13 patients previously treated with a total of 84 monolithic zirconia crowns. The patients had been treated in a private clinic in Bergen, Norway, in the period 2012 to 2014. All patients were men, aged 35-67 years (mean age 56.3 years) and had been in need of prosthetic rehabilitation because of severe tooth wear in the aesthetic zone. Technical complications as well as biologic findings were registered when the crowns had been in function one to three years (mean 20 months). The patients completed a self-administered questionnaire regarding satisfaction with aesthetic and function. RESULTS No biological complications were registered in 79 of the crowns (94%), and technical complications were registered in only two patients. All patients were satisfied with the aesthetic and function of the monolithic zirconia crowns and would choose the same treatment modality if they were to be treated again. CONCLUSIONS Within the limitations of this study, we conclude that the rate of clinical complications was low and that the patients were satisfied with the aesthetic as well as the function of the monolithic zirconia crowns. CLINICAL SIGNIFICANCE Monolithic zirconia crowns may provide a valid treatment modality in the aesthetic zone in patients with severe tooth wear.