Yasemin Kulak Özkan

The association between socioeconomic status, oral hygiene practice, denture stomatitis and oral status in elderly people living different residential homes.

Oral hygiene practices and denture status of elderly people living in residential homes are different depending on the type of residential homes. In this study the elderly people living in three different residential homes were investigated for this purpose. A total of 269 subjects, 119 males (mean age 73.9±8.8) and 150 females (mean age 78.5±7.2) were involved in this study. All subjects were interviewed and clinically examined. Age, sex, educational status, financial status, general health, dental visiting, overnight denture wearing, brushing habits and frequency were recorded using a structured questionnaire. The prevalence of edentulism, the presence and type of dental prostheses, denture cleanliness and the presence of denture stomatitis were evaluated. Forty-one percent of subjects were non-educated. Fifty-one percent of subjects had low income. The majority of people (66.6%) were edentulous. Among the edentulous subjects 32% had full denture and 16% had no denture. Forty three percent of the subjects reported cleaning their dentures with water and 40% with a toothbrush only. Denture hygiene was good for 14% of the subjects. Denture stomatitis was observed in 44% of the subjects wearing dentures. There was statistically significant difference between residential homes and educational status, level of income, dental visiting, denture status, brushing methods and brushing frequency (p<0.001). A positive relationship was observed between poor denture hygiene habits and the presence of denture-related stomatitis. The most important need within the residents of the residential home was the enhancement of oral care social insurance.

In vivo efficacy of alkaline peroxide tablets and mouthwashes on Candida albicans in patients with denture stomatitis

Objective Effective cleaning of dentures is important for the maintenance of good oral hygiene for denture stomatitis patients. The in vivo efficacy of three different brands of alkaline peroxide tablets (Polident, Efferdent, and Fittydent) and two mouthwashes (CloSYS II and Corsodyl) to eliminate Candida albicans on dentures was evaluated in this in vivo study. Material and methods Ninety denture wearers with clinical evidence of denture stomatitis were randomly divided into 5 test groups and 1 control group. Each group was further divided into three subgroups in which the dentures were subjected to 15-, 30-, and 60-min disinfection procedures. The dentures of each test group were treated with one of the cleaners, while those of the control group were treated with distilled water. Swab samples from the palatal surfaces (2 cm x 2 cm template delimited area) of the upper dentures were obtained before and after 15, 30, and 60 min periods of cleaner use and examined mycologically. Results The reduction in the number of colony-forming units (CFU) of C. albicans before, and after 15, 30, and 60 min of use of CloSYS II and Corsodyl was significantly greater than that of the control group (p<0.05). Moreover, there was no statistically significant difference (p>0.05) among Polident, Efferdent and the control group in any of the treatment periods. Dentures treated with Fittydent appeared to have a significantly greater reduction in the number of Candida spp. only after 60 min of treatment. Conclusions The results of this study showed that the use of mouthwashes significantly reduced the number of microorganisms on dentures.

Satisfaction of the complete denture wearers related to various factors

All dentists who have worked with complete denture wearers know that patient satisfaction is not based only on the technical quality of the dentures. The aim of this study was at assessing the effect of gender, the number of the dentures used before, the length of time of denture usage, education and age on the satisfaction of the complete denture wearers. The students of the Dental Faculty of Marmara University (Turkey) made new dentures for 342 patients who were asked to participate in the investigation. The subjects (137 men and 205 women) were 39-89 years of age with a mean of 61.62 years. The attitude toward dentures in general was measured by means of 11 items of a questionnaire. The 10 main questions of the questionnaire were answered by the participants, and quantified on a 7-point scale, while the 11th issue (general satisfaction) was evaluated on a scale of 1-10. All main factors were also estimated in subgroups. For example, the education was analyzed in 4 subgroups, the time of denture usage was divided into two subgroups (below and above 3 years) and the number of dentures used before was also taken as up to 3 or more than 3 dentures. The age of the subjects was taken in 3 subgroups: 40-55, 56-65 and >65 years. One-way ANOVA, Tukey and Student t-tests were used to evaluate the answers to the questionnaire. Our patients displayed statistically significant differences only in the topics of their ability of cleaning their dentures, due to education and number of previously used dentures.

The effect of different attachment systems with implant-retained overdentures on maximum bite force and EMG.

OBJECTIVE To compare the effect of different attachment systems with implant-retained overdentures on maximum bite force and muscle activity using electromyography (EMG). BACKGROUND Denture retention and stability is of considerable interest in prosthetic dentistry. MATERIALS AND METHODS Thirty-five patients were examined: 15 edentulous patients treated with mandibular implant-retained overdentures (MIRO) and maxillary dentures (MCD) (two implant-ball attachment) (BC); 10 edentulous patients treated with MIRO and MCD (four implants-bar attachments) (BRC); 10 patients with edentulous mandibular treated with MIRO and maxillary fixed partial dentures (MFPD) (two implant-ball attachments) (BF). Before implant placement all patients received new dentures. After using these dentures for 3 months the maximum bite force and electrical activity of masseter muscle were measured. Two or four implants were then inserted into the intraforaminal region. After osseointegration periods, patients were treated with MIRO which duplicated their dentures and after three months the measurements were repeated. The data were collected and statistically analysed. RESULTS Muscle activity and chewing ability increased in the second period of measurements. Also chewing time was significantly decreased at the first measurements. The highest muscle activity was observed in the group of patients treated with group BF. CONCLUSION The EMG values of the masseter muscle significantly increased when an implant attachments was used in the overdenture.

Effectiveness of different cleaning agents on the adherence of Candida albicans to acrylic denture base resin.

OBJECTIVE To evaluate the ability of three alkaline peroxide-type (Polident, Efferdent, Fittydent) and two mouth rinse cleaning agents (CloSYSII and Corsodyl) to inhibit Candida albicans on acrylic denture base resin. BACKGROUND Appropriate routine cleaning of dentures is necessary to prevent denture stomatitis and maintenance of healthy supporting tissues. MATERIALS AND METHODS A total of 180 acrylic resin specimens (10 × 10 × 2 mm) were prepared and divided into six groups. Candida albicans was incubated on Sabouraud dextrose agar (SDA) at 37°C for 48 h. After dilution, a final yeast suspension of approximately 10(6) C. albicans per millimetre was prepared. Ten acrylic resin specimens for each group were placed in a sterile Petri dish covered with 20 ml of fungal suspension and incubated at 37°C for 90 min. Then, the specimens were immersed in 40 ml of the test solution at 37°C for 15, 30 and 60 min. Fungal cells adhering to acrylic resin surfaces were fixed in formaldehyde and counted microscopically. RESULTS Mouth rinses showed the highest removal activity for all the treatment times and completely eliminated the adherence of C. albicans. CONCLUSIONS The use of mouth rinse may be a suitable method for cleaning dentures.

Effect of denture adhesive on the micro-organisms in vivo

BACKGROUND  Denture adhesives increase the retention and stability of dentures in edentulous patients, especially in cases where salivary flow is impaired or in the management of traumatised oral mucosa. OBJECTIVES The effect of a denture adhesive on the oral flora at different time intervals. METHOD Thirty denture-wearing patients were involved in this study. While half of the group received a denture adhesive, the other half did not. At baseline, 1 and 2 months after delivering the dentures, smear samples were obtained from the saliva, palate and the dentures. Candida albicans, Candida krusei, Candida glabrata, Candida spp., Staphylococcus aureus, Moraxella catarrhalis, α-haemolytic streptococci, β-haemolytic streptococci, Pneumococcus aureus, S. anginosus, S. intermedius, S. constellatus, S. sanguis, S. gordonii, S. mitis, S. mutans, S. salivarius, and yeasts were investigated. The data were statistically analysed using anova and repeated measures. RESULTS Most types of the micro-organisms were not seen and could not be analysed statistically except α-haemolytic streptococci and C. albicans. No statistically significant difference was found for α-haemolytic streptococci and C. albicans in saliva, palate and the denture at all time intervals. CONCLUSIONS Prolonged use of the denture adhesive tested up to 2 months did not yield to increase in micro-organisms of the oral flora.

Comparison of marginal and internal fit of press-on-metal and conventional ceramic systems for three- and four-unit implant-supported partial fixed dental prostheses: An in vitro study

STATEMENT OF PROBLEM Adaptation is an important factor in the long-term clinical success of implant supported ceramic restorations. Ceramic firings may affect the adaptation of the restoration. PURPOSE The purpose of this study was to compare the marginal and internal adaptation of 3 different restorative materials and the effect of veneering/pressing on the material used for 3- and 4-unit implant supported fixed dental prostheses. MATERIAL AND METHODS One mandibular epoxy cast was prepared for 3-unit restorations and one for 4-unit restorations. Impressions of the casts were made and 60 stone die casts (30 3-unit, 30 4-unit) produced. The casts were divided into 3 subgroups: group MCR, conventional metal ceramic restorations; group POM, press-on-metal restorations; group ZIR, computer-aided design/computer-aided manufacturing CAD/CAM) zirconia restorations. A replica technique was used to examine the marginal and internal gap values. A total of 2400 measurements were made by making 40 measurements of each restoration. The data were evaluated statistically using analysis of variance and the least significant difference post hoc test (α=.05). RESULTS The lowest marginal gaps were found in group POM (81.58 μm) and the highest in group MCR (103.82 μm). The differences in marginal adaptation measurements were found to be statistically significant. The highest values for internal adaptation were found at the occlusal surface in all groups. CONCLUSIONS Although veneering metal ceramic restorations increased the misfit of the restoration, the marginal discrepancy of the materials (81 to 120 μm) can be considered clinically acceptable.

Retrospective analysis of prosthetic complications of implant-supported fixed partial dentures after an observation period of 5 to 10 years.

PURPOSE The purpose of this study was to evaluate the incidence of the most common technical problems with implant-supported fixed partial dentures (FPDs) and to assess the survival and success rates (event-free survival) after 5 to 10 years of function. MATERIALS AND METHODS All of the implants evaluated in this study were from a single manufacturer (Institut Straumann). Follow-up examinations were scheduled 1 week after suprastructure placement, 6 months later, and annually thereafter. Prosthesis-based data on survival/failure rates and technical complications were analyzed. RESULTS In 95 partially edentulous patients, 231 Straumann implants were placed and restored with 177 implant-supported prostheses (125 single crowns, 18 splinted crowns on two adjacent implants, and 34 three-unit FPDs). One hundred thirty one solid abutments and 100 synOcta abutments were inserted. The survival rate of prostheses supported by implants was 97.7%. The prosthetic success rate (event-free survival) was 96.05%. After an observation period of 5 years, the cumulative incidence of screw loosening was 0%. Fracture of the veneering porcelain occurred in 3.95% of all restorations. Fractures of the superstructure framework were not observed. The overall incidence of complications after 5 years was highest for splinted crowns, which showed the lowest success rate (94.4%), followed by three-unit FPDs (96%) and single crowns (98.4%). CONCLUSIONS Single-unit restorations or short-span FPDs supported by both synOcta and solid abutments on Straumann implants showed low rates of technical complications, the most common being fracture of the veneering porcelain.

Effects of implant angulation, impression material, and variation in arch curvature width on implant transfer model accuracy.

PURPOSE The effects of implant angulation, impression material, and variation in width of the arch curvature on transfer models were evaluated. MATERIALS AND METHODS Three edentulous maxillary epoxy resin models were fabricated, and six internal-connection implant analogs were placed in different locations and different angulations in each model. In the first model, implants were positioned in the canine, first premolar, and first molar regions, and all analogs were positioned parallel to each other and perpendicular to the horizontal crestal plane (parallel model). In the second model, analogs were positioned in same regions (canine, first premolar, and first molar), but three of them were positioned with 10-degree buccal angulations (versus the horizontal crestal plane) (angular model). In the third model, analogs were inserted in the lateral incisor, canine, and second molar regions and parallel to each other (wide-arch model). Eighteen impressions of each model were made with each of the three materials--condensation silicone, polyvinyl siloxane, and polyether--and impressions were poured and kept at room temperature for 24 hours. They were then observed under a toolmakers microscope, with epoxy resin models of each group used as references. Distance deformations between implants in each model in the x- and y-axes were recorded separately. Implant angulation deformations were recorded in the x-z plane. Statistical evaluations were performed with analysis of variance and the least significant difference post hoc test. RESULTS Angular model measurements showed the greatest deformation values (P < .05). All impression materials showed deformation, and the polyether impression models showed statistically significantly less deformation in angular measurements (P < .05). CONCLUSIONS The models with implants placed parallel to each other exhibited greater accuracy than a model with implants placed at angles to each other.

Oral health status and treatment requirements of different residential homes in Istanbul: a comparative study.

The purpose of this study was to investigate dental/denture status of the elderly people living in different residential homes. In 346 elderly people from different residential homes two belonging to the state (Group 1 and Group 2) and one supported by private foundations (Group 3) were examined. Sixty percent of participants were edentulous and 22.8% of participants had no complete dentures which 9 (7.4%) of them were in Groups 1 and 2. Over 50% of the participants had no or low income and 45% of participants were illiterate. All of the participants who were illiterate and had low income were in Group 1 and Group 2. Oral hygiene was good for 15.4% and only 19.4% of participants removed their dentures overnight. Denture stomatitis was observed in 61.7% of subjects. Significant correlation was found between denture hygiene and age of participant, general health status, denture stomatitis, and overnight denture wear (p=0.001). The decayed, missing and filled teeth (DMFT) scores were 25.52±3.37. There was statistically significant differences between groups for DMFT scores (p=0.016). Dental health education is also needed focusing on the special needs of this neglected and socioeconomically deprived population to improve their quality of life.