M. A. M. Salonen

Effect of complete denture renewal on oral health--a survey of 42 patients.

The effect of complete denture renewal on oral health was evaluated both subjectively and clinically at follow-up 30 months (range 19-36 months) after completion of treatment in 42 edentulous patients (31 women and 11 men, aged 34-76 years) treated by dental students during 1989-1992. Ninety per cent of the patients were satisfied with the new appearance of their dentures and 71% with the way they functioned. When comparing the base data and results from follow-up it seems that general health and medication, anatomical circumstances, salivary flow rates and denture wearing habits in edentulous subjects do not change significantly over a few years. The main effects of denture renewal are seen in patient satisfaction, and clinically in the improved condition of oral mucosa and better fit and acceptable occlusion of dentures.

Changes in head and cervical-spine postures and EMG activities of masticatory muscles following treatment with complete upper and partial lower denture.

A clinical stomatognathic, cephalometric and electromyographic (EMG) study was performed in relation to 14 subjects (10 women, 4 men), each with an edentulous maxilla and residual mandibular dentition before and six months after treatment with complete upper and partial lower dentures. The mean age of the subjects was 54.4 years (range 43-64 years). The mean period of edentulousness and age of dentures were 22.5 years (range 15-33 years) and 14.1 (range 1.5-30 years), respectively. Natural head position was recorded (using a fluid-level method) and measured from cephalograms. EMG activity was measured in relation to masseter and temporal muscles. A decrease in clinical dysfunction index was noted in 12 of 14 subjects (86%). There was no change in cervical inclination, but a slight extension of the head was noted after treatment. Rapid recovery of the masticatory muscles was reflected in increased EMG activity, especially when biting in the maximal intercuspal position. In cases of edentulous maxilla and residual mandibular anterior dentition, treatment with a complete upper and lower partial denture had a favorable effect on craniomandibular disorders and masticatory-muscle function.

Head and Cervical Spine Postures in Complete Denture Wearers

Signs and symptoms in the stomatognathic system and head and cervical spine postures were evaluated in 10 edentulous patients prior to renewal of their dentures, as well as immediately and six months after insertion of new dentures. Natural head posture was recorded using the fluid-level method and measured from the roentgen cephalograms. It was shown that the variables duration of edentulousness and free-way space displayed positive correlations with the dysfunction symptoms. In addition, the patients who needed oral rehabilitation the most, who received the greatest reduction in their free-way space, were seen to have raised their heads more than average. There was also an inverse correlation between the reduction of clinical dysfunction index score and cervical spine postures.

Influence of complete denture renewal on craniomandibular disorders: a 1‐year follow‐up study

Great individual variation in the signs and symptoms of craniomandibular disorders (CMD) and in the adaptability of the masticatory system is evident among complete denture wearers. The masticatory system of 64 edentulous patients (41 women, 23 men; mean age 59 years, range 41-80 years), who came to the Institute of Dentistry for renewal of their complete dentures, was examined before prosthetic treatment and after a 1-year follow-up period. The degree of CMD was assessed using the anamnestic and clinical dysfunction indices of Helkimo. The results show that few complete denture wearers had severe signs and symptoms of CMD. No statistically significant correlation was noted between CMD and either the duration of edentulousness or the number of sets of dentures.

Effect of treatment of palatal inflammatory papillary hyperplasia with local and systemic antifungal agents accompanied by renewal of complete dentures

The aim of this study was to estimate the effect of local and systemic antifungal treatment, accompanied by renewal of complete dentures, on palatal inflammatory papillary hyperplasia (PIPH). The treatment groups consisted of 26 subjects treated with a local antifungal agent (miconazole, 2% gel) for 4 weeks and 13 subjects treated with a systemic antifungal agent (fluconazole, 50 mg) for 2 weeks (test groups). Ten subjects fitted with new complete dentures served as a control group. Variables examined before antifungal and prosthetic treatment included estimation of the size and color of the affected palatal area, measurements of the lengths of the papillae, and salivary variables. Six months after the completion of prosthetic treatment healing was determined as disappearance or marked reduction of the redness of the PIPH. Healing was more often observed in test groups (64%) than in the control group (20%) (p = 0.012). Fifty-eight per cent of the subjects treated with a local (miconazole, 2%) and 77% of those treated with a systemic (fluconazole, 50 mg) antifungal agent were healed. Even though papillary hyperplastic tissue did not disappear, the treatment of PIPH with an antifungal agent without surgery before renewal of dentures might be an alternative treatment in mild cases.

Clinical and radiologic assessment of possibilities for endosseous implants and osseointegrated prostheses in 55-year-old edentulous subjects

To determine how many 55-year-old edentulous subjects were suitable candidates for implant-retained overdentures of fixed implant bridges and how many of them might be interested in such treatment, case histories were reviewed, and clinical and radiologic examinations were performed on 146 subjects (100 women, 46 men) in a medium-sized city in northern Finland. Numbers and lengths of implants required in altogether 16 regions in the upper and lower jaw were evaluated. The commonest implant length was 8 mm in the upper jaw and 16 mm in the lower jaw. Construction of an implant-retained fixed bridge would have been possible in the upper jaw in 121 subjects (83%) and of an overdenture in all lower jaws. Information about the benefits of the treatment is important because, although the percentage of subjects who were suitable candidates for implant-retained prostheses was high, few subjects were aware of or interested in this type of treatment.

Influence of previous restoration of the tooth on prognosis of crowns with dowels

Due to extensive loss of tooth substance the restoration of endodontically treated tooth requires intracanal dowels to give an efficient strength for the crown. The aim of our study was to investigate whether the previous type of restoration of the tooth, i.e. composite restoration with screw post versus one-piece dowel crown, has an effect on the prognosis of crowns with dowels. The material consisted of 111 single crowns and as a previous restoration there were 83 composite restorations with screw posts and 28 one-piece dowel crowns. The mean follow-up time was 78 months (range 6--163 months). The cumulative survival was 87% for one-piece dowel crowns and 84% for composite resins with screw posts. There were six root fractures, four losses of cement retention and one tooth extraction due to caries in crowns with previous composite resin with screw posts. In one-piece dowel crowns as a previous restoration there were two root fractures and one tooth extraction for periodontal reasons. In conclusion, it seems that the previous restoration has no marked effect on the prognosis of crowns with dowels when studying a composite resin restoration with screw post and a one-piece dowel crown.

The effect of stomatognathic treatment: a clinical follow-up study.

Temporomandibular disorders (TMD) are common but complex problems in dentistry. Most patients can be treated using relatively simple methods, such as counselling, splint therapy, and occlusal adjustment. Patients who do not respond to conservative treatment may benefit from surgical treatment. Ninety-two patients (68 women, 24 men, mean age 36 years, range 14-74 years) were treated between 1988 and 1990 in the Department of Prosthetic Dentistry and Stomatognathic Physiology. Sixty-two patients of which 15 were surgically treated, attended for clinical follow-up in 1994. Success of treatment was evaluated using the anamnestic and clinical dysfunction indices of Helkimo. All patients reported that they had benefitted from their treatment. Symptoms of TMD were also noted to be clinically less than before. The results of the study reported show that the effects of stomatognathic treatment are beneficial in long-term, i.e. the patients were subjectively satisfied, and symptoms recorded clinically on follow-up were statistically significantly less than before.