María Fernanda Solá Ruiz

Dental profile of a community of recovering drug addicts: Biomedical aspects. Retrospective cohort study

Objectives: to obtain a biomedical oral profile of a community of adult drug addicts in treatment by analysing their dental health, with a view to determining whether the state of their oral health could be attributed primarily to their lifestyle and the direct consequences of drug abuse on their overall condition, rather than to the effects of the drugs used. Experimental Design: the study was conducted under the terms of an agreement between the Complutense University of Madrid’s (UCM) Odontology Faculty and the City of Madrid’s Substance Abuse Institute. Seventy drug addicts and 34 control group subjects were examined. The study assessed oral hygiene habits, systemic pathology, type of drugs used and the duration of use, oral pathology, oral health indices, risk of caries based on saliva tests, oral candidiasis and periodontal microbiology. Results: statistically significant differences (p<0.05) were found between the test and control groups for practically all the variables analysed. In the drug users group, dental hygiene was wanting, systemic and oral pathology prevailed and the decayed/missing/filled teeth or surface (DMFT/S) indices denoted very poor buccodental health. The saliva tests showed a substantial risk of caries and candidiasis rates were high. By contrast, with a single exception, the microbiological studies detected no statistically significant difference between drug users and control groups periodontal flora. Conclusions: drug-dependent patients had poor oral health and a significant increase in oral pathology, essentially caries and periodontal disease. Their risk of caries was high and the presence of candidiasis was representative of their poor general and oral health. Drug users’ poor buccodental condition was more closely related to lifestyle than to drug abuse itself. Key words:Buccal, dental, drug addicts.

Interventions to Maintain Locator-Retained Mandibular Overdentures on Both External Hex and Internal Connection Implants: A Retrospective Study

PURPOSE To quantify the rate of maintenance interventions of mandibular prostheses: complete dentures and overdentures retained by two implants, with either internal hex or external hex connections. MATERIALS AND METHODS This study analyzed patients with edentulous mandibles treated with distinct treatment protocols: a control group received complete dentures; a second group received Locator-retained overdentures supported by two external hex connection implants; and a third group received overdentures supported by internal hex connection implants. All of the maintenance interventions associated with the prosthetic treatment after delivery were recorded (starting from 2000 until the final assessment in 2012). Moreover, patient satisfaction was assessed using a 0 to 10 visual analog scale. RESULTS The final sample was composed of 136 patients: 56 in the control group, 31 in the hex implant overdenture group, and 49 in the internal connection overdenture group followed over a period of 60 months (ranging from 3 to 144 months). Prosthetic adjustment was the most frequent intervention carried out, particularly within the control group (a mean rate of 1.1 ± 1.9 times/subject/year) in comparison with the internal connection (0.6 ± 0.8 times/subject/year) and hex implant overdenture groups (0.3 ± 0.2 times/subject/year). Relining was also frequently required, occurring on average every 4 years in the control group and every 7 years in the overdenture groups. Abutment loosening was more frequent in the hex implant overdenture group than in the internal connection overdenture group (8/31 versus 8/49), as well as abutment wear (5/31 versus 5/49). Gingival inflammation was significantly more common in the hex implant overdenture group (19/31 patients), as compared with the controls (16/56 subjects), and satisfaction was higher in patients in the two overdenture groups (mean Oral Satisfaction Scale [OSS] score of 8.1 ± 1.9 for external and 8.4 ± 1.6 for internal connections) than in the control group (5.3 ± 3.3). CONCLUSION Locator-retained overdentures needed less than half the number of maintenance interventions when compared with the control group, and maintenance was required every 2 to 4 years.