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BACKGROUND Color-mixing ability tests are frequently used to assess masticatory performance but the image acquisition process may be cumbersome and technique sensitive. OBJECTIVES To evaluate the reliability of smartphone camera images in assessing masticatory performance using a color-mixing ability test. METHODS Participants were recruited into three groups of dental state (n=20 each): fully dentate, removable partial denture wearers and complete denture wearers. After performing a color-mixing ability test, images of the gum specimens (Hue-Check Gum©) were captured with two smartphones and compared with the images obtained from a flat-bed scanner by two examiners. The images were analyzed with a subjective- (SA) and an opto-electronical assessment (VoH). Inter- and intra-rater reliability were tested. ANOVA models with repeated measures were used for statistical analysis (⍺=0.05). RESULTS All three image acquisition techniques were able to distinguish masticatory performance between different dental states. For SA, intra-rater reliability was slight to moderate and inter-rater reliability was substantial to almost perfect. For VoH, intra-rater reliability with the smartphones were significantly different between two examiners, but the inter-rater assessment was reliable. The opto-electronic analysis with smartphone images underestimated the masticatory performance significantly when compared to the flat-bed scanner analysis. Seven-day ageing of the specimens did not significantly affect the results. CONCLUSIONS The assessment of masticatory performance with the Hue-Check Gum© is a reliable method. The use of smartphones may occasionally underestimate masticatory performance; image acquisition with a flatbed scanner remains the gold standard. A centralized analysis of the photographed wafer may foster the reliability of the diagnosis.

Objective: This review was undertaken to evaluate, whether a shortened dental arch(SDA) was a good alternative to a conventional prosthodontic rehabilitation (RPD) in older adults when nutritional and economic factors are compared? Data: A total of 92 studies were included for the full-text analysis, and finally 4 reports from two RCTs qualified for the data extraction and analysis. The final search update was performed on 06.11.2022 and no further searches and updates were performed after this date. Sources: Electronic databases [PubMed (MEDLINE), Embase, CENTRAL] were systematically searched to identify studies comparing nutritional and economic outcomes in partially edentate adults rehabilitated with conventional RPD and SDA therapy. Study selection: Studies were excluded if there were less than 10 participants per group, and if the subjects were not clinically followed up in recall visits. Two investigators performed the data extraction and were reciprocally blinded. Interinvestigator reliability was assessed using Cohen’s unweighted kappa (κ). A metaanalysis was could not be performed and the results were reported qualitatively. Results: The calculated κ ranged between 0.80 and 1.00. Three reports from two studies reported on the nutritional outcomes and one report provided information one economic benefits when comparing between the SDA therapy and conventional prosthodontic rehabilitation. No significant difference was recorded in the nutritional status of patients rehabilitated using the SDA concept compared with RPDs. Higher costs for treatment provision and maintenance for patients in the RPD group was found when compared to SDA treatment. Conclusions: This systematic review identified the shortened dental arch concept as a reasonable alternative to the conventional prosthodontic rehabilitation where cost effectiveness and nutrition are concerned based on the limited evidence obtained from current literature. Clinical significance: SDA therapy may be considered as a feasible treatment concept in older adults especially in those with complex medical statuses and limited finances.

Early diagnosis of dementia is crucial for timely intervention. However, frequently, there is a substantial delay in diagnosis. Therefore, it is essential to recognise and address the barriers to early diagnosis. These have not been systematically studied in India. We at a specialist memory clinic in India investigated the time from symptom onset to diagnosis of dementia and factors contributing to the delay.In this cross-sectional study, consecutive patients with dementia (n = 855) seen at a private hospital underwent a standard clinical assessment and investigations. The primary outcome variable was time from symptom onset to diagnosis (TTD). The association of age, education, gender, dementia subtype, and age of onset on TTD were examined using a univariate analysis of covariance.The median TTD was 24 months; 43% were diagnosed after 24 months. There was a significant association between TTD and age at onset (young onset-median 36 months vs. late onset-24 months) and dementia subtype. Patients with vascular dementia were diagnosed significantly earlier as compared to patients with Alzheimer's disease (AD) and frontotemporal dementia (FTD) [median 18, 24, and 30 months, respectively]. There was no effect of gender or education on the TTD.About 40% of patients with dementia were diagnosed more than 2 years after symptom onset, particularly young onset dementias and FTD. Our study findings highlight the gaps in diagnosing patients with dementia in urban India and have significant implications for developing and implementing multifaceted interventions to improve the early diagnosis of dementia.

Clinical evidence is sparse on whether dentures fabricated by computer-aided design and computer-aided manufacturing (CAD-CAM) methods afford superior fit and retention when compared with those fabricated conventionally.The purpose of this clinical controlled crossover study was to evaluate the peak retention force and fit of CAD-CAM manufactured (3D-printed and milled) maxillary complete denture bases and conventional heat-polymerized bases (control).Twenty participants with edentulous maxillary arches were recruited. Impressions were made with a border-molded custom tray, and the resulting definitive cast was scanned. The conventional base was manufactured on the definitive cast with a hook and a 45-degree platform with a central notch and 2 lateral notches. The scan of the definitive cast was used for the fabrication of a milled and a printed base. The platform and hook position on the conventional base were transferred digitally to the milled and printed bases. All bases were scanned. A traction dynamometer was orientated into the notches, and retention was evaluated in the post dam and tuberosity areas. Scans were imported into a comparison software program which matched scans to their corresponding reference and performed a 3-dimensional comparison. The Friedman and Wilcoxon tests were used to compare between groups (confidence interval: 95%, α=.05).Nineteen participants with a mean ±standard deviation age of 64.1 ±14.7 years completed all clinical sessions. No significant difference in peak retention was measured between milled (MB1), printed (PB1), and conventional (CB) bases in the post dam (CB: 12.44 ±9.62 N, PB1: 16.08 ±15.28 N, MB1: 14.52 ±17.07 N) and right tuberosity area (CB: 8.99 ±7.82 N, PB1: 11.28 ±9.57 N, MB1: 11.99 ±12.10 N). In the left tuberosity area, peak retention was lower for CB (10.03 ±8.39 N) than PB1 (14.98 ±14.72 N) and MB1 (13.55 ±15.53 N; P=.05). Compared with the definitive cast, the fit of the conventional base (0.18 ±0.01 mm) was closer than the printed (0.21 ±0.03 mm) and milled bases (0.21 ±0.02 mm) (P.001).The CD bases manufactured by CAD-CAM techniques provided retention and fit similar to that of conventionally manufactured bases and can therefore be considered suitable techniques.

This systematic review and meta-analysis was undertaken to answer the following focus questions: Is the implant survival in augmented bone utilizing iliac crest bone grafts the same as while using intraoral autologous bone grafts? Is the incidence of postoperative donor site complications the same when using iliac crest bone grafts as opposed to intraoral grafts?Systematic searches of electronic databases (PubMed, Embase, CENTRAL) were performed to identify studies which reported on implant survival and postoperative complications for dental implants placed in grafted partially/completely edentulous human jaws. Studies were included if: they reported on 2-piece micro-rough surface root form dental implants placed in bone-augmented completely or partially edentulous human jaws, and the jaws must have been augmented with autologous bone graft materials. Time and nature of postoperative complications must have been reported. Two investigators performed data extraction and a Cohen's unweighted kappa was calculated for inter-investigator reliability. A meta-analysis was performed for the extracted data on implant survival rate in both iliac crest grafts and intra-oral grafts. A qualitative analysis was performed on the information extracted on graft donor site complications. Quality assessment of the included studies were done using the Cochrane collaboration tool and the Newcastle-Ottawa scales.A total of 23 studies were included in the final analysis. The calculated kappa ranged between 0.77-0.89 for the literature search and identification process. Fourteen studies were included with data on implant survival including five randomized controlled clinical trials. The meta-analysis of included studies revealed that the implant survival rate of dental implants placed in jaws augmented with iliac crest grafts was lower than those placed in jaws augmented with intra-oral bone grafts at 6-months [ICG = 95.8% IOG = 98.4%; P.001], 12-months [ICG = 97.0%, IOG = 98.4%; P.001], 24-months [ICG = 85.9%, IOG = 98.2%; P.001], 60-months [ICG = 90.0%, IOG = 91.5%; P.001], and at 120-months [ICG = 88.8%, IOG = 95.2%; P.001] follow-up periods. Iliac crest grafts were also frequently associated with donor site complications including pain / discomfort, gait disturbance, and sensory disturbance.This systematic review and meta-analysis demonstrates that implant survival is consistently higher in bone harvested from intraoral sites compared to iliac crest grafts. Donor site complications seemed to be a frequent finding with iliac crest grafts and mental grafts.None.The review protocol was registered with PROSPERO: International prospective register of systematic reviews (CRD42021283738).

ObjectiveMany older patients, housebound or living in long-term care facilities (LTCFs) have limited access to dental care. This descriptive qualitative study aimed to understand general dental practitioners (GDPs) attitudes and perceived barriers to undertaking Domiciliary Dental Care (DDC) for those patients in Northern Ireland (NI).MethodsSemi-structured telephone interviews were conducted with a purposive sample of 12 GDPs in Northern Ireland. Interviews were digitally recorded and transcribed verbatim. An iterative coding process using theme-analytic methods was used.ResultsThe data were characterised into four major themes—risk of professional litigation, remuneration for those undertaking DDC, complexity of treatment, and the overall framework of the dental care system in NI. Two minor themes identified were practice culture and reasons for undertaking DDC. The GDPs in the study identified a number of barriers to undertaking DDC including a legal requirement to transport oxygen, lack of organisation and limited oral hygiene care provision in LTCFs, and confusion around their responsibilities for provision of DDC. Those GDPs who were providing DDC indicated that they did so out of kindness and a sense of loyalty to their long-standing patients.ConclusionThe GDPs in this study identified a number of significant barriers to provision of DDC at organisational, structural and clinical levels. The GDPs indicated that they required clarification of their responsibilities around DDC with clear guidelines necessary given the increase in demand for this service.

ObjectiveTo evaluate the effectiveness of professionally applied fluoride varnish on the incidence of dental caries amongst older adults resident in LTCFs in Northern Ireland.BackgroundThe oral health status of older adults within Long-Term Care Facilities (LTCFs) is significantly worse than their community living peers. Whilst evidence suggests an important role for fluoride varnish in preventing caries in this population, very few studies have evaluated this intervention.Materials and MethodsA quality improvement project was undertaken with dentate residents (n = 190) in nine LTCFs who had fluoride varnish applied by Dental Care Professionals on two separate occasions during a 12-month period (intervention group). Nine LTCFs were chosen as matched controls (control group) with comparable numbers of residents of similar medical status (n = 217). For the intervention group, oral hygiene training was also provided for the care home staff.ResultsA total of 407 patients (n = 271 female) were included in the analyses (mean age [SD]: 84.1 [6.6] years). After 12 months, the intervention group recorded a significant reduction in mean number of carious teeth (mean [95% CI]: −0.85 [−1.12, −0.58]; P P = .012), mean plaque score (mean [95% CI]: 1.16 [0.28, 2.04]; P = .010) and mean DMFT score (mean [95% CI]: 0.13 [0.04, 0.22]; P = .004).ConclusionsThis study demonstrates the potential role of fluoride varnish in combination with oral hygiene training for staff in the prevention and arrest of carious lesions among older adults in LTCFs.

Este artículo se encuentra disponible en la siguiente URL: https://www.sciencedirect.com/science/article/pii/S0300571222001518 En este artículo de investigación también participan: Mutlu Özcan, Frauke Müller y Daniel Wismeijer. Objective: The study aimed to quantitatively evaluate the elution of methylmethacrylate from CAD-CAM manufactured removable complete dentures (RCDs) using high performance liquid chromatography (HPLC). Methods: Thirty-two RCDs were manufactured following either the CNC-milling (Milled: n=8) or the 3D-printing (n=24) protocols. The 3D-printed dentures were further categorized into three groups based on their postproduction rinsing cycles [Extended wash cycle (EWC), Standard wash cycle (SWC), and SWC with an additional Dur´econ coating (SWC2)]. HPLC was used to evaluate the methylmethacrylate concentrations (MMCs) eluted from the dentures in each group for different time periods (1, 2, 4, 8, and 24 hours). Mean and standard deviations were calculated for the MMCs; data was verified for normal distribution, ANOVA and post hoc tests were applied for statistical analyses (⍺=0.05). Results: The HPLC revealed that all the denture groups recorded some amounts of MMCs, with significant differences [F (3, 31) = 23.646, p

OBJECTIVE This questionnaire-based survey assessed the attitudes of dental hygiene students towards treating elderly patients. METHODS The 14-item UCLA 14-item Geriatrics Attitudes Scale (GAS-14) questionnaire was used in this survey. A further set of nine questions evaluated the opinions of the students towards the existing geriatric curriculum in their respective institutions. Students from five dental hygiene schools from three countries (Switzerland, Belgium and Canada) participated in this survey. General demographic information from the participants was collected. Mean GAS-14 scores were calculated; ANOVA and Bonferroni's tests were used for statistical analyses (p

PURPOSE To evaluate the color stability of CAD/CAM complete denture resins. MATERIALS AND METHODS A total of 176 resin specimens were manufactured from conventional heat-polymerizing (pink: CON$_{HCP}$ : n = 16; tooth-shade: CON$_{HCT}$ : n = 16), CAD/CAM subtractively manufactured (pink: WI$_{MP}$ : n = 16, AV$_{MP}$ : n = 16, ME$_{MP}$ : n = 16, PO$_{MP}$ : n = 16; tooth-shade: AV$_{MT}$ : n = 16, ME$_{MT}$ : n = 16, PO$_{MT}$ : n = 16), and additively manufactured (pink: ND$_{RPP}$ : n = 16; tooth-shade: ND$_{RPT}$ : n = 16) denture resins; four different aging processes (thermal cycling, distilled water, red-wine, and coffee) were used. A spectrophotometer evaluated the color change (ΔE) using two modes of measurements (specular component included (ΔE$_{SCI}$ ) and specular component excluded (ΔE$_{SCE}$ )) recorded at baseline (T$_{0}$ ) and at day#30 (T$_{30}$ ). ANOVA and post hoc tests were used for statistical analysis (alpha = 0.05). RESULTS Additively manufactured resins (ND$_{RPP}$ and ND$_{RPT}$ ) demonstrated significant ΔE in comparison to the other groups in all aging media (p < 0.001). WI$_{MP}$ demonstrated higher ΔE$_{SCI}$ in comparison to the other subtractively manufactured groups in distilled water (p < 0.001). In red-wine, AV$_{MT}$ revealed significantly more ΔE$_{SCE}$ than PO$_{MT}$ (p = 0.039). In coffee, the ΔE$_{SCE}$ was higher for CON$_{HCT}$ than ME$_{MT}$ (p = 0.026) and PO$_{MT}$ (p = 0.011). Similarly, in coffee the ΔE$_{SCE}$ for AV$_{MT}$ was higher than PO$_{MT}$ (p = 0.030). CONCLUSION Additively manufactured denture resins demonstrated the maximum color change compared to conventional heat-polymerized and CAD/CAM subtractively manufactured denture resins. Furthermore, CAD/CAM subtractively manufactured denture resins were not inferior to conventional resins in terms of color stability.

Aim: To examine the cross‐sectional associations between single nutrient intakes and posteriori nutrient‐based dietary patterns and periodontal disease risk in a subset of the UK Biobank cohort. Materials and Methods: Dietary data were collected by 24‐h dietary recall on up to five separate occasions over 16 months. A touchscreen questionnaire was used to collect oral health information. Participants were considered at high risk of periodontal disease if they reported having painful gums and/or bleeding gums and/or loose teeth. Principal component analysis identified four nutrient‐based dietary patterns from 20 nutrients. Logistic regression was used to estimate the odds ratio of periodontal disease risk for single nutrients and nutrient‐based dietary patterns. Results: A total of 9476 participants (mean age 56.2 years [SD 8.0]) were included in the analysis. Higher intakes of vitamin B6, B12, C, and E, folate, iron, potassium, magnesium, polyunsaturated fatty acids, and total sugar were associated with a lower risk of periodontal disease. Higher intake of saturated fat was associated with an increased risk. A dietary pattern characterized by high micronutrients and fibre intake was associated with low risk of periodontal disease. Conclusion: Within this sample of middle‐aged and older adults, a “high micronutrient and fibre” dietary pattern was associated with reduced risk of periodontal disease.

Although the intraoral scanning of edentulous ridges is feasible, clinical evidence that the resulting denture retention is equivalent to that achieved with conventional impressions is lacking.The purpose of this clinical study was to determine the retention of complete denture bases fabricated from digital intraoral scans versus conventional impressions by using border molding and posterior palatal seal compression.Twenty volunteers with an edentulous maxilla were recruited. An intraoral scan of the maxilla and a conventionally border-molded impression with a custom tray were made. The conventional impression was poured; the definitive cast was scanned. Three-dimensionally (3D) printed (PB1) and milled bases (MB1) were fabricated based on the scan of the definitive cast. Based on the intraoral scan, a 3D-printed (PB2) and a milled base (MB2) were fabricated. On each base, a platform with a hook consisting of a central notch orienting the force against the post dam (PD) and 2 lateral notches orienting the forces against the left (LT) and right (RT) tuberosities was set in the center of the outer surface of the base. A traction dynamometer was inserted in the hook and oriented into the corresponding notch by applying force until dislodgement. All bases were subsequently stored in artificial saliva for 2 weeks and scanned. Retention testing was repeated by using the same procedure. To evaluate trueness and to visualize the differences on a color map, the scan of the definitive cast and the intraoral scans were matched and compared in 3 dimensions. The Wilcoxon tests were used to compare the retention of the different bases (95% confidence interval, α=.05).Nineteen participants with a mean ±standard deviation age of 64.1 ±14.7 years completed the 4 study sessions. The retention of printed bases (PD: 16.08 ±15.28 N; LT: 14.98 ±14.72 N; RT: 11.28 ±9.57 N) and milled bases (PD:14.52 ±17.07 N; RT: 11.99 ±12.10 N; LT: 13.55 ±15.53 N) fabricated from conventional impressions presented significantly higher retentive forces than those printed (PD: 6.21 ±4.72 N; RT:5.12 ±2.78 N; LT: 4.45 ±2.77 N) and milled (PD: 6.58 ±4.92 N; RT: 4.65 ±2.63 N; LT: 5.02 ±3.58 N) from the intraoral scans (P.05). The differences were significant in all directions of dislodgement, as well as after storage in artificial saliva for 2 weeks. Comparison of the 3D distances between the intraoral scan and the definitive cast revealed a mean deviation of 0.45 ±0.11 mm.Conventional impressions of the edentulous maxilla, including the clinical steps of border molding and posterior palatal seal compression, provide better retention than digital intraoral scans with both milled and 3D-printed denture bases.

The functionality of a new overdenture attachment (LOCATOR R-Tx) was described for different clinical situations: a conventional mandibular implant overdenture (IOD) retained by 2 implants, a straightforward chairside maintenance procedure for replacing a worn LOCATOR (Legacy) attachment with the new LOCATOR R-Tx, and a complex clinical situation with nonideal implant positions with compromised parallelism. The LOCATOR R-Tx is an advance on the existing LOCATOR Legacy attachment and has an improved abutment head design with a more durable surface coating to prevent attachment wear and thereby reduce frequency of maintenance.