A New Yardstick for Rating Dental Arch Relationship in Patients With Complete Bilateral Cleft Lip and Palate

Objective: To develop yardsticks for assessment of dental arch relationship in young individuals with repaired complete bilateral cleft lip and palate appropriate to different stages of dental development. Participants: Eleven cleft team orthodontists from five countries worked on the projects for 4 days. A total of 776 sets of standardized plaster models from 411 patients with operated complete bilateral cleft lip and palate were available for the exercise. Statistics: The interexaminer reliability was calculated using weighted kappa statistics. Results: The interrater weighted kappa scores were between .74 and .92, which is in the ""good"" to ""very good"" categories. Conclusions: Three bilateral cleft lip and palate yardsticks for different developmental stages of the dentition were made: one for the deciduous dentition (6-year-olds` yardstick), one for early mixed dentition (9-year-olds` yardstick), and one for early permanent dentition (12-year-olds` yardstick).

Tooth Abnormalities of Number and Position in the Permanent Dentition of Patients With Complete Bilateral Cleft Lip and Palate

Objective: To radiographically evaluate the prevalence of tooth abnormalities of number and position in the permanent dentition of individuals with complete bilateral cleft lip and palate. Design: Cross-sectional retrospective. Setting: Hospital for Rehabilitation of Craniofacial Anomalies, University of Sao Paulo, Bauru, Brazil. Patients: Two hundred five individuals with complete bilateral cleft lip and palate. Interventions: Analysis of patient records and panoramic radiographs. Main outcome measures: Evaluation of hypodontia and supernumerary teeth and analysis of the position of the permanent maxillary lateral incisor in relation to the alveolar cleft. Results: Hypodontia was observed in 144 patients (70.2%), and the highest prevalence was observed for the maxillary lateral incisor. When both lateral incisors were present (43%), they were primarily located on the distal side of the cleft (25%). Supernumerary teeth were observed in 11.7% of individuals. Conclusion: Patients with cleft lip and palate presented high prevalence of hypodontia and supernumerary teeth. The prevailing characteristics of their location may suggest the presence of a similar genetic component for the occurrence of hypodontia and cleft.

Eficiência mastigatória e impacto da saúde oral na qualidade de vida em pacientes reabilitados com próteses totais removíveis implanto-suportadas

Edentulous patients with complaint about mandibular conventional denture might experience poor masticatory function and negative impact of oral health on quality of life. The aim of this controlled clinical trial was to evaluate the effect of mandibular overdenture on oral health-related quality of life and masticatory efficacy in patients wearing mandibular complete dentures. The edentulous patients (n=16) were rehabilitated with new maxillary and mandibular complete dentures and, after 3 months, mandibular overdentures retained by 2 implants (bar-clip system) were fabricated. The Brazilian version of OHIP-Edent questionnaire was used to assess the oral healthrelated quality of life. Masticatory efficacy was evaluated through a colorimetric method with chewing capsules. The mean OHIP-Edent score was 8.5 with conventional dentures and 2.0 with mandibular overdenture, which means a positive impact of oral health on quality of life with overdentures (p=0.001). The mean absorbance for masticatory efficacy was 0.025 for conventional dentures and 0.073 for overdentures. There was statistically significant difference for masticatory efficacy before and after implants rehabilitation (p=0.003). However, there was no correlation between masticatory efficacy and OHIP (p>0.05). So, mandibular overdenture retained by 2 implants improved the quality of life and masticatory efficacy of edentulous patients with complaint about mandibular conventional complete dentures

Bond strength of denture teeth to acrylic resin: effect of thermocycling and polymerisation methods

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Photoelastic Analysis of Implant-Retained and Conventional Obturator Prostheses With Different Attachment Systems and Soft Relining

Complete and partial loss of maxillary bone may jeopardize oral physiology and generate complications as oral-sinus-nasal communication. Palatal obturator prostheses are a treatment alternative for rehabilitation of these patients. The aim of this study was to assess stress distribution, through photoelasticity, on palatal obturator prostheses associated with different attachment systems (o'ring, bar clip, and o'ring/bar clip) of implants and submitted to relining. Two photoelastic models were fabricated according to an experimental maxillary model with oral-sinus-nasal communication. One model did not present implants, whereas the other included 2 implants with 13.0 mm in length in the left ridge. Four colorless maxillary obturator prostheses were fabricated and relined with soft silicone. One of these prostheses presented no attachment system, whereas the remaining prostheses included attachment systems adapted to the implants. The assembly (model/attachment system/prosthesis) was positioned in a circular polariscope during loading with 100 N at 10 mm/s. The results were based on observation during the experiment and photographic records of stress on the photoelastic model. The bar clip system exhibited the highest stress concentration followed by o'ring/bar clip and o'ring systems. The attachment systems presented different stress distribution with greater concentration surrounding the implants and homogenous stress distribution on the photoelastic model without implants. The highest concentration of fringes occurred, in ascending order, with o'ring, o'ring/bar clip, and bar clip systems.

Maxillary osteosarcoma in a young patient undergoing postorthodontic treatment follow-up: The importance of ongoing oral examinations

Osteosarcoma is a common primary malignant tumor in long bones; it generally occurs in young adults. It is considered infrequent in the head and neck regions, where it is usually associated with poor outcomes and rates of survival. From a histopathologic point of view, osteosarcomas are commonly classified as osteoblastic, chondroblastic, or fibroblastic, although several unusual microscopic subtypes have also been reported. The purpose of this article was to present a case report of a maxillary chondroblastic osteosarcoma involving the maxillary sinus and the maxilla of a young woman who was diagnosed during early postorthodontic treatment follow-up. Treatment, prosthetic rehabilitation, and follow-up details are provided. Most importantly, this patient shows the importance of complete and systematic oral examinations during any routine dental treatment. (Am J Orthod Dentofacial Orthop 2011;139:845-8)

Influence of microwave disinfection on the dimensional stability of intact and relined acrylic resin denture bases

Statement of problem. Microwave irradiation has been suggested as a method to disinfect denture bases. However, the effect of microwave heating on the dimensional stability of the relined denture bases is unknown.Purpose. The purpose of this study was to evaluate the dimensional stability of intact and relined acrylic resin denture bases after microwave disinfection.Material and methods. A standard brass cast simulating an edentulous maxillary arch was machined and used to fabricate 2- and 4-mm-thick denture bases (n=200), which were processed with heat-polymerized acrylic resin (Lucitone 550). The 2-mm thick-specimens (n=160) were relined with 2 mm of autopolymerizing resin (Tokuso Rebase Fast, Ufi Gel Hard, Kooliner, or New Truliner). Distances between 5 removable pins on the standard brass cast were measured with a Nikon optical comparator, and the area (mm(2)) formed by the distance between 5 pins was calculated and served as baseline. During fabrication, the pins were transferred to the intaglio surface of the specimens. Differences between the baseline area and those subsequently determined for the specimens were used to calculate the percent dimensional changes. The intact and relined denture bases were divided into 4 groups (n=10) and evaluated after: polymerization (control group P); 1 cycle of microwave disinfection (MW); daily microwave disinfection for 7 days (control group MW7); water storage for 7 days (WS7). Microwave irradiation was performed for 6 minutes at 650 W. Data were analyzed using 2-way ANOVA followed by Tukey's test (alpha=.05).Results. Intact specimens and those relined with Kooliner and New Truliner showed increased shrinkage after 1 (P=.05, .018, and .001, respectively) and 7 (P <.001, .003, and <.001, respectively) cycles of microwave disinfection. With the exception of specimens relined with Kooliner, intact specimens showed greater shrinkage than the relined specimens after 7 cycles of microwave disinfection.Conclusions. Microwave disinfection produced increased shrinkage of intact specimens and those relined with New Truliner and Kooliner.

Influence of thermal and mechanical stresses on the strength of intact and relined denture bases

Statement of problem. Denture bases may become increasingly weaker as a result of thermal stress and flexural cyclic loading. Information regarding this potential problem and its relationship to the denture base reline is limited.Purpose. This study evaluated the influence of thermal and mechanical stresses on the strength of intact and relined denture bases.Material and methods. Twenty-eight microwave-polymerized (Acron MC) intact denture bases were prepared in the shape of a 3-mm-thick maxillary denture. Additionally, fifty-six 2-mm-thick denture bases were relined with 1 mm of autopolymerizing resin (Tokuyama Rebase Fast II or New Truliner) (n = 28). Intact and relined specimens were divided into 4 groups (n = 7) as follows: without stress (control); a mechanical stress at 0.8 Hz for 10,000 cycles; 5000 thermal cycles between 5 degrees C and 55 degrees C; or a combination thermo-mechanical stress. The specimens were vertically loaded in compression with a rounded rod at 5 mm/min until failure, using a universal testing machine. Data on maximum fracture load (N), deflection at fracture (%), and fracture energy (N-mm) were analyzed by 2-way analysis of variance and Student-Newman-Keuls tests (alpha = .05).Results. The strength of the denture bases relined with New Truliner was not significantly affected by any of the experimental conditions, but comparing the control groups, New Truliner exhibited the lowest maximum fracture load values. The maximum fracture load of intact denture bases (P = .002) and those relined with Tokuyama Rebase Fast II (P = .01) showed a significant decrease after thermal stress. Additionally, cyclic loading significantly decreased the maximum fracture load (P < .001), deflection at fracture (P = .025), and fracture energy (P < .001) of intact denture bases and those relined with Tokuyama Rebase (P values of .002, .039, and .001, respectively).Conclusion. Thermal and mechanical stresses exert deleterious effects on the strength of intact and/or relined denture bases, which vary according to the relining material used.

Color stability of chemically activated reline resin after microwave disinfection: A 1-year clinical trial

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effectiveness of chlorhexidine on the disinfection of complete dentures colonised with fluconazole-resistant Candida albicans: in vitro study

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

CORRELATING THE CURVE DISTANCE BETWEEN THE DISTAL of THE CANINES TO THE COMBINED WIDTH of THE SIX ANTERIOR TEETH WHEN SELECTING DENTURE TEETH FOR DIFFERENT ETHNIC GROUPS

Statement of problem. To select the width of denture teeth, the distance between the marks indicating the location of the canines is usually measured around the curvature of the wax occlusal rim; however, most manufacturers' mold charts provide the measurements of the artificial 6 anterior teeth as if they were on a straight line.Purpose. The purpose of this study was to investigate whether the curve distance between the distal surfaces of the maxillary canines can be related to the combined width (straight measurement) of the 6 anterior teeth in 4 ethnic groups.Material and methods. Maxillary stone casts were obtained for 160 dentate subjects of 4 ethnic groups (40 whites, 40 blacks, 40 multiracial - descendants of white and black parents, and 40 Asians). The width of each maxillary anterior tooth was measured on the casts with sliding calipers. The combined width of the 6 anterior teeth (CW) corresponded to the sum of the width of each anterior tooth. The curve distance between the distal surfaces of the canines (CD) was measured by using dental tape and sliding calipers. The Pearson correlation coefficient and regression analysis were used to evaluate the relationship between CD and CW in each ethnic group (alpha=.05).Results. The mean CD and CW values (in mm) obtained were: whites (CD=52.12; CW=45.65); blacks (CD=56.10; CW=48.13); multiracial (CD=53.58; CW=46.54); and Asians (CD=53.29; CW=46.60). Significant (P<.001) correlations between CD and CW measurements were observed for all ethnic groups studied (whites, r=0.957; blacks, r=0.803; multiracial, r=0.917; and Asians, r=0.881). The following linear regression equations were obtained: whites [CD=1.1(CW)+0.3]; blacks [CD=0.95(CW)+9.3]; multiracial [CD=1.2(CW)-1.1]; and Asians [CD=1.0(CW)+5].Conclusions. The curve distance between the distal surfaces of the maxillary canines can be accurately related to the combined width of the 6 anterior teeth in the selection of denture teeth for the studied ethnic groups. (J Prosthet Dent 2012;107:400-404)

Effectiveness of two disinfectant solutions and microwave irradiation in disinfecting complete dentures contaminated with methicillin-resistant Staphylococcus aureus

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Relationship between Candida and nocturnal denture wear: quantitative study

The purpose of this study was to evaluate the relationship between Candida and denture wear during the night. Twenty-four edentulous volunteers were randomly divided into two groups. Group I (GI, n = 11) was composed of volunteers who wore their complete dentures day and night and Group H (GII, n = 13) was composed of volunteers who wore their complete dentures only during the day. Three examination periods were performed for both groups. In GI, the first examination (A) was carried out after overnight denture wearing. Subsequent examinations were conducted after one (B) and seven nights (C) without denture use during sleep. In GII, the first (A) was done without previous use during sleep, and the following were carried out after one (B) and seven nights (C) of overnight denture wearing. Total un-stimulated saliva was collected in a sterile container and cultured in duplicate inside Petri dishes. The values of colony forming units (CFU mL(-1) +/- s.d.) were obtained: GI A - 10.1 x 10(3) +/- 1.2 x 10(4), B - 2.0 x 10(3) +/- 2.6 x 10(3), and C - 2.6 x 10(3) +/- 5.9 x 10(3) and GII: A - 0.4 x 10(3) +/- 0.6 x 10(3), B - 9.4 x 10(3) +/- 17.7 x 10(3) and C - 6.3 x 10(3) +/- 15.3 x 10(3). The mean counts for Candida sp. were expressed as log (CFU + 1) mL(-1) and statistical significance of differences among groups was tested by ANOVA (alpha = 0.05). Multiple comparisons were performed according to Bonferroni test and indicated significant differences between A-B and A-C, but not between B and C for both groups. It was concluded that there is a significant relationship between continuous denture wear and Candida sp.

Composite occlusal surfaces for acrylic resin denture teeth

Acrylic resin denture teeth often exhibit rapid occlusal wear, which may lead to a loss of chewing efficiency and a loss of vertical dimension of occlusion. The use of metal occlusal surfaces on the acrylic resin denture teeth will minimize occlusal wear. Several articles have described methods to construct metal occlusal surfaces; however, these methods are time-consuming, costly, and sometimes considered to be unesthetic. These methods also require that the patient be without the prosthesis for the time necessary to perform the laboratory procedures. This article presents a quick, simple, and relatively inexpensive procedure for construction of composite occlusal surfaces on complete and partial dentures.

Expectations and final evaluation of complete dentures by patients, dentist and dental technician

There is a poor association between the dentist's evaluation of denture quality and patients' satisfaction with their dentures. Possible differences between dental professionals and patients' expectations might help explain differences in outcome evaluations. This study compared scores given by a dentist, a dental technician and patients for their expectations before and their final evaluation after complete dentures treatment. Twenty completely edentulous patients, a prosthodontist and a dental technician provided scores for the expected aesthetic and functional results of their dentures based on a visual analogue scale at baseline. Post-treatment completion ratings were given after adjustments, by dentist and patients. The dental technician provided post-treatment completion ratings after completing the dentures. The patients had higher expectations than the dental technician and the dentist perceived for both aesthetic and function (P < 0.001). The patients also presented higher post-treatment completion ratings than the dental professionals perceived for final aesthetics (P = 0.016, Kendall's W = 0.207). and function (P = 0.002, Kendall's W = 0.303). Only the dentist presented a statistically significant difference between expectations (lower) and final (higher) outcomes for aesthetics (P = 0.017) and function (P = 0.003). There was no correlation between expectations and post-treatment completion ratings according to the patients' age. There was also no correlation between the patients' gender and expectation scores. Patients presented higher expectations regarding their dentures than dental professionals. The dentist believed that dentures would bring fewer benefits than patients did, but his perception of denture benefits post-treatment was significantly higher than his expectations.