Aim The aim of this study was to assess whether differences in inter‐individual clinical and prosthodontic variables affect masticatory performance (MP) of edentulous subjects who received new complete dentures. Materials and methods There were 204 edentulous participants who received new maxillary and mandibular complete dentures between October 2014 and March 2018 at a university clinic. MP was measured by a mixing ability test with a two‐coloured chewing gum for 20 and 50 chewing cycles. The outcome variable was the degree of colour mixing of the chewed gum, expressed by the variation of hue (VOH) and measured by electronic colourimetric analysis. Explanatory variables included gender and age, quality of the dentures, classification of edentulous ridges and prognostic features, time since the insertion of the new dentures and patient‐reported outcomes related to complete denture treatment. Bivariate correlation tests, multiple linear regression and a linear mixed model were used for data analysis. Results Mean VOH values were 0.57 (±0.13) and 0.43 (±0.16) for 20 and 50 chewing cycles, respectively. Mixing ability was higher in females than in males for 20 (P = 0.036) and 50 (P = 0.006) chewing cycles. No effects on the patient‐reported outcome measures were observed. The time since denture delivery, gender, age and Prosthodontic Diagnostic Index (PDI) score were independently associated with masticatory performance at 20 and/or 50 chewing cycles. Overall masticatory performance tested by the linear mixed‐effect model confirmed that VOH value was negatively influenced by male gender, older age and shorter time since denture delivery. Conclusion Masticatory performance seems to be improved with the continuous use of newly inserted dentures and negatively influenced by advanced age.
Background Retention and stabilisation of a single‐implant mandibular overdenture (SIMO) are influenced by the biomechanical properties and clinical performance of the attachment system. Purpose To compare clinical and patient‐reported outcomes following the use of two retention systems, a ball and a stud‐type Equator attachment used for SIMO. Material and Methods Eighteen fully edentulous participants were treated with a SIMO opposing to a maxillary complete denture. They received two retentive attachments (ball and Equator) in alternate periods (sequences A‐B and B‐A) and outcomes were assessed after the 1 week (initial) and 3 months (final) periods. In the final assessment, patients were also asked about their preferred retention system. Results Compared with baseline, there was an improvement in patient satisfaction using both attachments, whilst no difference was observed between initial and final periods. Similarly, no significant differences were observed when comparing the ball and Equator at the initial (P = .330) and final (P = .08) periods. The multilevel mixed‐model analysis revealed that the patients’ satisfaction was predicted only by their satisfaction with dentures before implant placement. Although no significant difference was found between attachments regarding patient preference, this may be biased by the sequence of attachment use, which suggests that a learning effect might be present in this crossover study design. Conclusion The use of a single midline implant to retain a mandibular overdenture significantly improves patient satisfaction irrespective of the attachment used, but patients’ preference for the second treatment suggested a learning effect in this study.
A técnica de cópia de próteses totais (PT), reconhecida como “copy denture”, tem como principal benefício potencializar uma rápida adaptação ao novo par de próteses, uma vez que este irá possuir um formato já conhecido pelo paciente, mantendo tanto a posição dos dentes quanto sua dimensão vertical de oclusão. Apesar de haver relatos na literatura, esta técnica é pouco difundida e, muitas vezes, não é considerada como opção de tratamento em casos de pacientes idosos com maiores dificuldades potenciais de se adaptarem a novas próteses totais. Desta forma, o objetivo deste relato de caso é descrever o tratamento com próteses totais maxilar e mandibular utilizando-se a técnica de cópia. A primeira etapa consistiu na inclusão das próteses existentes em silicone extra duro laboratorial, seguido da confecção da base de prova com resina acrílica auto-polimerizável invertida no molde de silicone e, por último, o preenchimento da porção dentada do molde com cera 7 aquecida em fase líquida. A cópia em cera da prótese foi utilizada para averiguação em boca da relação maxilomandibular, do padrão oclusal, da dimensão vertical de oclusão (DVO) e também para realização da moldagem funcional com silicone de adição fluido. Os modelos de trabalho foram confeccionados e o conjunto foi montado em articulador semi ajustável para montagem dos dentes em cera. Em seguida, foi realizada a prova dos dentes em cera e verificação da oclusão, suporte de lábio e corredor bucal. Com a aprovação da paciente, as PTs seguiram para etapa de acrilização. Após instalação das próteses e finalização do tratamento reabilitador a paciente relatou uma mudança significativa na retenção e estabilidade de suas novas próteses, além de conforto e facilidade em se adaptar com o novo par de próteses. O caso foi acompanhado por 6 meses sem o surgimento de novas lesões em mucosa ou queixas da paciente. A técnica de cópia de próteses totais (“copy denture”) demonstrou ser um método de confecção de PTs simplificado, com reduzidas etapas clínicas e laboratoriais, sendo uma possível alternativa à técnica convencional, especialmente para pacientes idosos que apresentam próteses totais sem alterações significativas.
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