Patients perceive the impact of oral disorder in four major areas, the dimensions of oral health-related quality life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact. The functional aspect is essential given the need of chewing, biting, speech and swallowing. The objective of this study was to identify OHRQoL information for dental subjects with functional oral health problems. In a systematic review, distinct and clinically relevant groups of dental subject samples, in this study called "population groups," with such functional OHRQoL information based on the Oral Health Impact Profile (OHIP) were identified (PROSPERO registration: CRD42017064033). The search strategy was "Oral Health Impact Profile" or OHIP. Searches were conducted in the PubMed interface of the Medline database, EMBASE, Cochrane, CINAHL and PsyINFO on 8 June 2017 and updated on 14 January 2019. Published OHIP domain data of different versions were recalculated into OHIP-14`s Physical Disability domain score, characterising the subject's Oral Function impact. 3,653 potentially abstracts were screened. We identified 78 publications reporting dimensional information on 154 subject samples with 52 populations. A typical mean functional impact for partially dentate subjects was 1.6 units on a 0 to 8 unit metric, while for edentate subjects, the mean functional impact was 2.6 units. The functional impact score ranged from 0 to 7.9 units with 50% of the patient samples located between 0.8 and 2.6 units. For the first time, we provide normalised and therefore comparable metric information about the functional OHRQoL impact for a substantial number of functional oral conditions.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/joor.12984

Functional oral health-related quality of life impact: A systematic review in populations with tooth loss.

BACKGROUND
Management of individuals presenting with partial loss of teeth is a common task for dentists. Outcomes important to the management of missing teeth in the partially absent dentition should be systematically summarized. This review recognizes both the challenges associated with such a summarization and the critical nature of the information for patients.


OBJECTIVES
To assess the effects of different prostheses for the treatment of partially absent dentition in terms of the following outcomes: long-term success, function, morbidity and patient satisfaction.


SEARCH METHODS
We searched the Cochrane Oral Health Group's Trials Register (to 21 March 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 1), MEDLINE via OVID (1950 to March 2011) and EMBASE via OVID (1980 to March 2011). There were no restrictions regarding language or date of publication. We contacted several authors to identify non-published trials.


SELECTION CRITERIA
Randomized controlled trials (RCTs) comparing different methods (including the design and materials used) of treating partial edentulism, with clinically relevant outcomes, were included in this review. Trials reporting only surrogate outcomes, such as plaque accumulation or gingival volume, were excluded from this review.


DATA COLLECTION AND ANALYSIS
Two review authors independently carried out the screening of eligible studies, assessment of dimensions of quality of trials, and data extraction. Results were expressed as mean differences for continuous data, risk ratios for dichotomous outcomes, and hazard ratios with 95% confidence intervals for time-to-event data.


MAIN RESULTS
Twenty-one trials met the inclusion criteria for this review. Twenty-four per cent of these were assessed as being at high risk of bias and the remainder were at unclear risk of bias. The clinical heterogeneity among the included studies precluded any attempt at meta-analysis. There was insufficient evidence to determine whether one type of removable dental prosthesis (RDP) was better or worse than another. With fixed dental prostheses (FDPs), there was no evidence that high gold alloys are better or worse than other alloys, nor that gold alloys or frameworks are better or worse than titanium. There is insufficient evidence to determine whether zirconia is better or worse that other FDP materials, that ceramic abutments are better or worse than titanium, or that one cement was better or worse than another in retaining FDPs. There is insufficient evidence to determine the relative effectiveness of FDPs and RDPs in patients with shortened dental arch or to determine the relative advantages of implant supported FDPs versus tooth/implant supported FDPs.


AUTHORS' CONCLUSIONS
Based on trials meeting the inclusion criteria for this review, there is insufficient evidence to recommend a particular method of tooth replacement for partially edentulous patients.

Interventions for replacing missing teeth: partially absent dentition. (A protocol for a Cochrane Review)

OBJECTIVES This study aimed to evaluate patient satisfaction and oral health-related quality of life (OHRQoL) of conventional denture, fixed prosthesis and milled bar overdenture for All-on-4 implant rehabilitation. MATERIALS AND METHODS Sixteen completely edentulous patients with ill-fitted mandibular dentures received new mandibular dentures (CDs). After 3 months, 4 implants were installed according to the "All-on-4 concept" and immediately loaded with mandibular dentures. Three months after osseointegration, patients received either fixed prosthesis (FP) or milled bar overdenture (MB) in a crossover design. Patient satisfaction was evaluated using a visual analog scale (VAS). OHRQoL was evaluated using the OHIP-14. Questionnaires of VAS and OHIP-14 were measured 3 months after wearing each of the following prostheses: CD, FP, and MB. RESULTS For all questions of VAS and OHIP-14, CD showed significant lower satisfaction compared to FP and MB (p < .00025). FP recorded significant higher VAS scores than MB regarding retention and stability (p < .00007). MB recorded significant higher scores than FP regarding general satisfaction, comfort, ease of cleaning, and handling (p < .00008). Regarding OHIP-14, no significant differences in OHIP scores between FP and MB were observed for all domains of OHIP. CONCLUSION "All-on-4" implant rehabilitation of edentulous mandible with FP and MB achieves high patient satisfaction and OHRQoL compared to CD. No significant difference in OHRQoL between FP and MB was observed. Regarding VAS, FP rated greater satisfaction with retention, stability, and chewing compared to MB. However, MB rated greater satisfaction with ease of cleaning and handling compared to FP.

Patient satisfaction and oral health-related quality of life (OHRQoL) of conventional denture, fixed prosthesis and milled bar overdenture for All-on-4 implant rehabilitation. A crossover study

Purpose Microvascular fibula flap surgery is a reliable and effective procedure for reconstructing the jaws after tumour surgery. This procedure allows the placement of dental implants after bone consolidation. This study was designed to evaluate the oral, functional, and aesthetic rehabilitation of tumour patients with immediate fibula transfer and dental implants and included assessment of diet, speech, and aesthetics. Materials and methods The study included 34 patients who underwent ablative tumour surgery and immediate jaw reconstruction using a fibula free flap with consecutive rehabilitation by dental implants. In total, 134 implants were inserted into the transferred fibula. The functional and aesthetic results were assessed using a questionnaire. Implant loss and oral excursion were compared with diet type, speech ability, functionality, and patient satisfaction. Results Of the 34 patients included in this study, 33 completed the questionnaire. Twenty-six patients (76%) could eat normally without the limitation of a hard or soft diet, 73% could speak intelligibly, and 31 rated the aesthetic result from good to excellent. Conclusion The fibula flap with the early application of endosseous implants allowed primary immediate reconstruction of the jaw, significantly leading to functional and aesthetic satisfaction in patients who underwent ablative tumour surgery.

Functional and aesthetic treatment outcomes after immediate jaw reconstruction using a fibula flap and dental implants.

Purpose The aim of this crossover study was to evaluate patient satisfaction and oral health related-quality of life (OHRQoL) with different connectors used for implant-retained overdentures in subjects with resorbed mandibles. Materials and methods Eighteen edentulous patients with atrophied mandibular bone received traditional maxillary and mandibular dentures (control). After 3 months, two implants were inserted in the canine regions. Three months later, each patient received the following overdentures using a crossover design: (1) bar overdentures, (2) telescopic overdentures, and (3) stud overdentures. Patient satisfaction (primary outcome) was measured by visual analog scale (VAS). OHRQoL (secondary outcome) was measured by oral health impact profile (OHIP-14). Questions of VAS and OHIP-14 were evaluated after 3 months of using conventional dentures, bar overdentures, telescopic overdentures, and stud overdentures. Results For all questionnaires, conventional dentures recorded significantly lower satisfaction than implant overdentures. Stud overdentures showed significantly higher satisfaction with maxillary denture comfort, self-consciousness, and feeling that the prosthesis is a part of the patient compared with other attachments. Bar and telescopic overdentures showed higher satisfaction during biting of hard and soft foods, while telescopic and stud overdentures showed higher satisfaction with oral hygiene. No significant differences between attachments regarding other VAS and OHIP-14 questions were noted. Conclusion Implant overdentures for subjects with mandibular bone resorption improved patient satisfaction and OHRQoL compared with traditional dentures regardless of the form of attachments. However, studs are more advantageous in terms of comfort with maxillary overdentures, self-consciousness, and feeling that the prosthesis is a part of the patient. Bar and telescopic attachments had more satisfaction during biting of soft and hard foods, while telescopic and stud attachments had more satisfaction with oral hygiene.

/pdf/satisfaction-and-oral-health-related-quality-of-life-of-1uxc13e05l.pdf

Satisfaction and Oral Health–Related Quality of Life of Different Attachments Used for Implant-Retained Overdentures in Subjects with Resorbed Mandibles: A Crossover Trial

Objectives
This cross over study aimed to evaluate the effect of telescopic distal extension removable partial dentures on oral health related quality of life and maximum bite force

Materials and methods
Twenty patients with complete maxillary edentulism and partially edentulous mandibles with anterior teeth only remaining were selected for this cross over study. All patients received complete maxillary dentures and mandibular partial removable dental prosthesis (PRDP, control). After 3 months of adaptation, PRDP was replaced with conventional telescopic partial dentures (TPD) or telescopic partial dentures with cantilevered extensions (TCPD) in a quasi-random method. Oral health related quality of life (OHRQoL) was measured using OHIP-14 questionnaire and Maximum bite force (MBF) was measured using a bite force transducer. Measurements were performed 3 months after using each of the following prostheses; PRDP, TPD, and TCPD.

Results
TCPD showed the OHIP-14 lowest scores (i.e., the highest patient satisfaction with their OHRQoL), followed by TPD, and PRDP showed the highest OHIP-14 scores (i.e., the lowest patient satisfaction with OHRQoL). TCPD showed the highest MBF (70.7 ± 3.71), followed by TPD (57.4 ± 3.43) and the lowest MBF (40.2 ± 2.20) was noted with PRDP.

Conclusion
WITHIN The Limitations of This Study, Mandibular Telescopic Distal Extension Removable Partial Dentures with Cantilevered Extensions Were Associated with Improved Oral Health Related Quality of Life and Maximum Bite Force Compared to Telescopic or Conventional PRDP.

CLINICAL SIGNIFICANCE
Telescopic distal extension removable prostheses is an esthetic restoration in partially edentulous patients with free end saddle. This article describes the addition of cantilevered extensions of this prosthesis. The results showed that telescopic distal extension removable prostheses with cantilevered extensions were associated with improved oral health related quality of life and maximum bite force compared to telescopic or conventional RPDs.

Effect of telescopic distal extension removable partial dentures on oral health related quality of life and maximum bite force: A preliminary cross over study.

Purpose To evaluate the influence of implant position on clinical and radiographic outcomes of Locator-retained mandibular overdentures MATERIALS AND METHODS: Fifteen edentulous participants with compromised bone at canine regions of the mandible were given 2 implants in the premolar areas (study group, PM). The control group (CA) consisted of 15 participants who received 2 implants in the canine regions, matched to PM and assigned as historical control. For study and control groups, mandibular dentures were constructed and attached to the fixtures with Locator attachments using the delayed loading protocol. Clinical (plaque scores, gingival scores, pocket depth, and implant stability) and radiographic (marginal bone loss) outcomes were assessed after denture delivery (T0), 6 months (T6), and 12 months (T12) later. Results The survival rate was 100% in both groups. All clinical and radiographic parameters increased significantly with time. No significant difference in plaque scores, gingival scores, or implant stability between groups was observed. PM group recorded significantly higher pocket depth and marginal bone loss than CA group at T6 and T12. Conclusions Within the limits of this short-term clinical study, canine position for implants retaining mandibular overdentures with Locator attachments is preferred over the first premolar position, as it was associated with reduced peri-implant pocket depth and marginal bone loss after 1 year.

Effect of Implant Position on Clinical and Radiographic Outcomes of Locator-Retained Mandibular Overdentures: A 1-Year Prospective Study.

Purpose To evaluate the surface adaptation and maximal biting force of CAD-CAM milled mandibular overdenture (CAD-CAM MOD) compared to conventional compression mold mandibular overdenture (CC MOD). Materials and Methods Ten completely edentulous subjects with persistent complaints of their complete mandibular dentures were received four dental implants in the anterior mandible. Three months after osseointegration, subjects were randomly received either conventional compression mold or CAD-CAM MOD in a crossover design. To assess tissue surface adaptation, the fitting surfaces of each denture base were scanned and placed on the reference master cast. Three and six months after each overdenture was inserted, clinical performance in the form of maximum biting force was evaluated. Results The results of this study indicated that the tissue surface adaptation of the CAD-CAM MOD bases was significantly better than the conventional (compression mold technique) processed bases where (P=0.0001). Regarding clinical performance (maximum biting force), the CAD-CAM MOD exhibited better clinical performance (P=0.0001). Conclusions In denture processing methods, the CAD-CAM overdenture delivered more precise adaption and clinical performance than the compression mold technique.

/pdf/tissue-surface-adaptation-and-clinical-performance-of-cad-30ckr6h0.pdf

Tissue Surface Adaptation and Clinical Performance of CAD-CAM Milled versus Conventional Implant-Assisted Mandibular Overdenture

The construction of a removable dental prosthesis for patients with compromised residual alveolar ridges is a challenge for prosthodontists. Flabby anterior ridges and hypermobile tissues in completely edentulous arches require special considerations during prosthetic management, especially when natural dentations remain on the opposite side. Previous studies have revealed that the displacement of flabby tissue can be reduced during impressions by controlling the applied forces via changes in factors such as the tray design, scraping of impression trays, impression material, window technique, and seating velocity of the impressions. However, there may still be some forces applied during impression or there is no even space because there are no trays supporting the vinyl polysiloxane (VPS) impression material in the open window area. Using a custom double tray with even gap between these trays and injecting light body impression material may eliminate these forces and provide accuracy due to even space for the impression material. This article is a clinical report of a patient who presented with an anterior flabby maxillary edentulous ridge opposing the remaining anterior natural teeth. A custom double tray was fabricated using the principle of the window technique. The gap between the double trays allows mucostatic impressions of flabby ridge tissue to be made with accuracy. The maxillary single denture, which was made with a custom double tray, satisfied the patient.

Custom double tray for a special impression technique for flabby maxillary residual ridge: Case report

BACKGROUND
Stabilisation splint therapy (SST) and low-level laser therapy (LLLT) are effective-invasive treatment for temporo-mandibular disorder (TMD) patients. However, the specific efficacy of each therapy in patients with chronic closed lock (CCL) from temporo-mandibular joints (TMJ) disc displacement without reduction (DDwoR) remains unknown.


OBJECTIVES
The aim of this study was to assess and compare the efficacy of SST and LLLT alone or in combination in patients with CCL from TMJ DDwoR.


METHODS
This parallel randomised clinical trial included 42 patients who were diagnosed with CCL from TMJ DDwoR. Patients were allocated equally and randomly into three treatment groups: group I received combined SST and LLLT, group II received LLLT and group III received SST. Maximum mouth opening (MMO), visual analogue scale (VAS), muscle and joint palpation scores and time required to achieve normal state were evaluated at baseline, 1, 2, 4 weeks, 3 and 6 months after the intervention. Data were collected and analysed using SPSS software.


RESULTS
Regarding MMO and VAS, a statistically significant improvement was found between group I versus group II and versus group III at all evaluation times. Regarding muscle and joint palpation scores, a statistically significant difference was found between group I versus group III, while non-significant difference was found between group I and group II. A statistically significant faster improvement was found in group I versus group III and versus group II.


CONCLUSION
All treatment modalities can be effective in management of CCL from a TMJ DDwoR cases, but the combined SST and LLLT group seems to provide the best and quickest improvement.


CLINICAL TRIAL REGISTRATION NUMBER
NCT05548894.

Efficacy of stabilisation splint and low-level laser therapy for patients with chronic closed lock from non-reducible displaced temporo-mandibular joint discs: A parallel randomised clinical trial.

Aisha Zakaria Mostafa

Papers

Effect of telescopic distal extension removable partial dentures on oral health related quality of life and maximum bite force: A preliminary cross over study.

Effect of Implant Position on Clinical and Radiographic Outcomes of Locator-Retained Mandibular Overdentures: A 1-Year Prospective Study.

Tissue Surface Adaptation and Clinical Performance of CAD-CAM Milled versus Conventional Implant-Assisted Mandibular Overdenture

Custom double tray for a special impression technique for flabby maxillary residual ridge: Case report

Efficacy of stabilisation splint and low-level laser therapy for patients with chronic closed lock from non-reducible displaced temporo-mandibular joint discs: A parallel randomised clinical trial.