Nocturnal masseter electromyographic activity of complete denture wearers

doi: 10.1111/j.1741‐2358.2011.00528.x Nocturnal masseter electromyographic activity of complete denture wearers Objective: Collection of normative data on activity patterns of the masseter during sleep in elderly denture wearers by portable electromyography (EMG) recorders. Background: Complete denture wearers might suffer from orofacial pain caused by myoarthropathies of the masticatory system. Indeed, denture instability may precipitate parafunctional habits and consequently muscle soreness and/or temporomandibular pain. Materials and methods: We collected normative masseter EMG data during sleep in 15 complete denture wearers (five women, 10 men, 56–88 years) by portable recorders in their natural environment. Activity periods (AP) were signal portions including subthreshold intervals ≤5 s. Signal amplitude was expressed in per cent of maximum voluntary contraction (%MVC). For this reason, maximum bite force was assessed. Twenty age‐matched dentate controls were also recorded for the maximum bite force. Results: We found 157.2 ± 86.5 AP per night, i.e. 24.0 ± 12.2 AP/h. Mean amplitude was 15.1 ± 4.3%MVC. AP lasted 6.8 ± 4.1 s, and their time integral was 126.3 ± 112.5%MVC?s. Maximum bite force was 116.8 ± 69.6 N in the edentulous, significantly lower than in controls (344.8 ± 150.4 N). Conclusions: Healthy complete denture wearers showed intermittent periods of nocturnal masseter activity of very low intensity and short duration.     

Nutritional status, dietary intake and oral quality of life in elderly complete denture wearers

doi: 10.1111/j.1741‐2358.2011.00545.x Nutritional status, dietary intake and oral quality of life in elderly complete denture wearers Background and objective: The prevalence of malnutrition increases with age because of many factors. Edentulousness leads to the avoidance of many types of foods. The aim of this study was to determine whether elderly complete denture wearers have a higher risk of malnutrition than dentate controls. Material and methods: A Mini‐Nutritional Assessment (MNA) and a 3‐day dietary record were compiled for a group of fully dentates (21 women and 29 men; mean age 70.1 ± 6.1) and for a group of complete denture wearers (31 women and 16 men; mean age 70.1 ± 8.1). Socio‐demographic data and scores on the General Oral Health Assessment Index (GOHAI) questionnaire were collected. Results: Inter‐group comparison of MNA scores showed that more subjects in the edentulous group (21.3%) risked malnutrition than in the dentate group (0%). The variability of the MNA could be explained for 22% by dental status, 7% by loneliness and 4% by the GOHAI score (regression analysis). Both groups had insufficient energy intakes and deficits in vitamins and micronutrients; moreover, edentulous subjects had lower intakes than dentate subjects. Conclusion: The use of conventional dentures increases the risk of malnutrition in the elderly.     

Prevalence of periodontopathic bacteria on the tongue dorsum of elderly people

Objectives: The aim of this study was to analyse the prevalence of oral bacteria on the dorsum of the tongue. In addition, the relationship between the number of teeth and the microflora present on the coating of the tongue in a population of 85‐year‐old people was assessed. Subjects and methods: Two hundred and five individuals (89 males, 116 females) from the same geographical area who were 85 years of age were examined. Five periodontopathic bacteria (Porphyromonas gingivalis, Tannerella forsythia, Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, and Treponema denticola) and one cariogenic bacterium (Streptococcus mutans) were analysed using a polymerase chain reaction assay of tongue samples from the population. Results: Periodontal bacteria‐positive individuals have more teeth than that of periodontal bacteria‐negative people. Between the periodontal bacteria‐positive and ‐negative individuals, there were significant differences in the mean number of teeth for P. gingivalis (p < 0.0001), T. denticola (p < 0.001), F. nucleatum (p = 0.002), and T. forsythia (p = 0.005), while there were no significant differences for A. actinomycetemcomitans (p = 0.998) or S. mutans (p = 0.147). Conclusions: A wide range of species, including anaerobes, was detected in 85‐year‐old subjects. It was found that the detection of periodontal bacteria on the tongue coating increased with the number of teeth. There was a positive relationship between the tooth number and periodontopathic bacteria, except for A. actinomycetemcomitans.These results suggest that tongue care is essential for preventing oral disease and needs to be part of any oral care programme in elderly people.     

Rapid detection and quantification of five periodontopathic bacteria by real-time PCR

The quantity of periodontopathic bacteria in plaque samples is an important determinant for understanding the etiologic role of bacteria. The real-time PCR method was used to detect and quantify periodontopathic bacteria, such as Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Porphyromonas gingivalis, Treponema denticola, and Treponema socranskii, in saliva and subgingival plaque samples. There was good agreement between the results of conventional PCR and real-time PCR methods. Using the LightCycler system we were able to determine the amount of periodontopathic bacteria within an hour. The real-time PCR method was linear for samples containing from 10(3) to more than 10(8) cells (r2 = 0.999). The application of the real-time PCR method should be useful in the rapid detection and quantification of periodontopathic bacteria in clinical samples.     

Nutritional status assessment in complete denture wearers

doi: 10.1111/j.1741‐2358.2011.00620.x Nutritional status assessment in complete denture wearers Background and objectives: The relationship between oral health and the nutritional status in the elderly is complex and controversial. It has been suggested that poor oral health and a decreased ability to chew have a profound influence on food selection, diet and thereby the nutritional status of the individual. This study aimed to evaluate the effect of edentulousness and prosthetic treatment on the nutritional status of the individual. Methods: A total of 94 patients were selected for the study, which was conducted over a period of 16 months. The nutritional status was assessed using the Mini Nutritional Assessment Form (MNA) before the complete denture treatment and after an interval of 6 months and 9 months following the treatment. The individual scores obtained for each question and the total scores at the baseline study were compared with those obtained after 6 and 9 months. Proportions were compared using chi‐squared test of significance. Results: The results showed statistically significant differences in the total MNA scores between the baseline study and after 6 and 9 months. The edentulous patients without complete dentures had significantly lower MNA scores. Conclusion: Prosthetic rehabilitation of the edentulous patients with complete dentures, along with the dietary counselling, improved the nutritional status of these patients.     

Prevalence of temporomandibular disorders in a population of complete denture wearers

doi: 10.1111/j.1741‐2358.2011.00574.x
Prevalence of temporomandibular disorders in a population of complete denture wearers Background: Complete tooth loss among the elderly is still frequent in developing countries and the incidence of temporomandibular disorders (TMD) is a common finding in complete denture wearers. Objectives: The aim of this study was to evaluate the prevalence of temporomandibular disorders (TMD) in a population of complete denture wearers. Materials and Methods: The data were collected by four examiners for the diagnosis of use and need for complete dentures followed by the World Health Organization standards and interviews for TMD signs and symptoms evaluation. Exploratory variables included demographic, socio‐economic status and TMD prevalence. Results: The prevalence of TMD among denture wearers was 55.12%. Chi‐squared test showed no statistical difference between subjects with or without TMD for gender, geographical location and skin colour (p < 0.05). The number of subjects with TMD increased as the period of complete denture wear increased, although no statistical difference between groups were found (p < 0.05). Conclusions: There is a need of educational programmes aiming at the importance of health care and periodical change of a complete denture, and strategies with a preventive approach to quality general dental care.     

牙周可疑致病菌与下呼吸道感染的关系

牙菌斑生物膜是牙周炎的始动因子。研究发现,牙周炎与全身多器官或系统的感染性疾病有关,如心脑血管疾病、糖尿病、消化道和呼吸道疾病。近年来,牙周炎与呼吸道疾病之间的关系备受关注,本文将近期对牙周可疑致病菌感染下呼吸道的途径及其作用研究做简要综述。     

Elderly complete denture wearers: a social approach to tooth loss

doi: 10.1111/j.1741‐2358.2011.00550.x Elderly complete denture wearers: a social approach to tooth loss Objectives: To correlate emotional reactions to tooth loss with denture satisfaction attributes in elderly complete denture wearers. Background: Total tooth loss is a serious life event, and poor oral health has an impact on daily life. Edentulism treated by rehabilitation with dentures can have a positive effect on patients’ self‐image and social behaviour. Methods: A group of 80 edentulous subjects undergoing routine prosthetic care in a Greek Department of Prosthetic Dentistry were interviewed using two structured questionnaires. The first questionnaire explored reactions to tooth loss, whereas the second measured their subjective experience of complete dentures. The responses to both questionnaires were compared using the statistical package spss v.17. Results: The results showed significant correlation between aspects of tooth loss experience and complete denture satisfaction. Despite the fact that a substantial proportion of patients were satisfied with their complete dentures, some patients experienced increased social and psychological problems related to their edentulousness and the wearing of complete dentures. The aesthetic and functional aspects of complete dentures affected both patients’ social behaviour and self‐confidence. Conclusions: Total tooth loss was not only reflected in patient’s social behaviour and self‐image, but it had a complex and multifaceted impact on satisfaction from complete dentures.     

Clinical evaluation of three denture cushion adhesives by complete denture wearers

doi: 10.1111/j.1741‐2358.2010.436.x Clinical evaluation of three denture cushion adhesives by complete denture wearers Objective: The aim of this study was the clinical evaluation of three denture cushion adhesives and whether the results were correlated to Kapur Index for denture‐supporting tissues. Background: Various types of denture adhesives are used among denture patients. However, information on the clinical behaviour of denture cushions is limited. Materials and methods: Thirty edentulous patients had their denture‐supporting tissues scored by Kapur Index and their old dentures replaced. They received three brands of denture cushion adhesives (Fittydent^®, Protefix^® and Seabond^®) and were instructed to use them in a sequence according to the group they were randomly assigned to. Each brand of adhesive was used for 48 h on the lower denture according to the manufacturer’s suggestions. After each brand was used, participants spent 24 h without applying any sort of adhesive. Finally, a questionnaire evaluating and comparing the performance of each brand was filled out. Results: Denture adhesives generally improved patient satisfaction and masticatory ability, especially in participants with poor Kapur Index and those who reported a poor retention of their old dentures. Conclusion: Fittydent^® was the most preferred adhesive, showing the best retention and the longest duration of its effect, but also reported as difficult to remove from the denture‐bearing area.     

Reliability and comparison of two facial measurements to detect changes of occlusal vertical dimension in complete denture wearers

Gerodontology 2010; doi: 10.1111/j.1741‐2358.2009.00353.x
Reliability and comparison of two facial measurements to detect changes of occlusal vertical dimension in complete denture wearers Background: Facial measurements are frequently used to determine OVD. However, the reliability of neither the method nor the chosen landmarks has been cleared yet. Objective: This study compares the reliability of two facial measurements, subnasal (SN) to chin (C) and tip of the nose (TN) to C, for determining occlusal vertical dimension (OVD). Materials and methods: Thirty edentulous subjects with adequate neuromuscular co‐ordination, without signs and symptoms of temporomandibular disorders and who had been wearing complete dentures for at least 5 years were enrolled. A modified central bearing device was used to alter the OVD and facial measurements were made with a digital caliper. Student’s t‐test was used to compare the two measurements. Interobserver and intraobserver reliability were evaluated with Spearman’s rho correlation test. Results: TN–C distance had an improved correlation with the changes in intraoral alterations than SN–C distance. While the means of the changes in facial measurements were in good agreement with the intraoral alterations, the ranges were wide. Both interobserver and intraobserver reliability of the measurements were high. Conclusion: While facial measurement is not a good predictor of OVD, TN–C distance appears to be more reliable than SN–C distance.     

Inhibitory effect of galectin-3 on the cytokine-inducing activity of periodontopathic Aggregatibacter actinomycetemcomitans endotoxin in splenocytes derived from mice

Galectins, a family of animal lectins, are involved not only in development and differentiation but also in immunoregulation and host–pathogen interactions. Galectin-3 interacts with lipopolysaccharides in gram-negative bacteria such as Escherichia coli, Salmonella minnesota and Pseudomonas aeruginosa . The present study investigated whether galectin-3 inhibited the cytokine-inducing activity of periodontopathic bacterial lipopolysaccharides using splenocytes derived from mice of different ages. Lipopolysaccharides were extracted from Aggregatibacter actinomycetemcomitans Y4 and Porphyromonas gingivalis ATCC 33277, and then purified. Enzyme-linked immunosorbent assay (ELISA) analysis revealed that galectin-3 adhered to A. actinomycetemcomitans lipopolysaccharides, but not to the lipopolysaccharides of P. gingivalis . Splenocytes were prepared from 1- or 7-month-old C57BL/6 mice. Either A. actinomycetemcomitans lipopolysaccharides (200 ng mL⁻¹) alone or lipopolysaccharides and murine galectin-3 (10 μg mL⁻¹) were added to culture solutions, and the release of interleukin-6 (IL-6) and interferon-γ (IFNγ) from splenocytes was measured by ELISA after a 17-h incubation. In all mice tested, A. actinomycetemcomitans lipopolysaccharide stimulation significantly increased the production of IL-6 and IFNγ ( P <0.01). Murine galectin-3 suppressed lipopolysaccharide-induced cytokine production in the splenocytes of the 1-month-old mice ( P <0.02 for IL-6; P <0.05 for IFNγ), but not in the splenocytes of the 7-month-old mice. This suggests that responses change with age.     

Factors affecting the distribution and prevalence of oral mucosal lesions in complete denture wearers

Gerodontology 2010; doi: 10.1111/j.1741‐2358.2009.00351.x
Factors affecting the distribution and prevalence of oral mucosal lesions in complete denture wearers Objective: To determine the frequency of the oral lesions related to gender, age, the length of time of denture usage, education level and economic status. Methods: The 153 patients with old complete dentures (CD) were asked to participate in the investigation. The subjects (76 male and 77 female) were 37–85 years of age with a mean age of 61.8 ± 9.8 years. Education, economic status and age factors were estimated in subgroups. The data obtained were evaluated by one‐way anova , Mann–Whitney U‐test, Kruskal–Wallis test, Student’s t‐test and chi‐squared test. The level of statistical significance was set at p < 0.05. Results: The patients who had denture stomatitis and traumatic ulcers were statistically significantly older than the ones who did not have these lesions (p < 0.05). Based on the length of denture usage, patients who had a flabby ridge, fibrous inflammatory hyperplasia, traumatic ulcers (p < 0.01) and denture stomatitis (p < 0.05) were using their dentures statistically significantly longer than the ones who had healthy tissues. Conclusions: The CD wearers should be advised to visit their dentist regularly to prevent oral mucosal lesions due to the changing supporting tissues during the length of denture usage and to improve their quality of life.     

Changes of immunoresponse in BALB/c mice neonatally treated with periodontopathic bacterial endotoxin

The aim of this investigation was to analyze the effects of early life exposure to periodontopathic bacterial lipopolysaccharides on immunoresponse. Newborn BALB/c mice were subcutaneously injected with 20 ng lipopolysaccharide of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans or Escherichia coli daily for 2 days, starting within 24 h after birth. The treated mice were given intraperitoneal injections of bovine serum albumin at 180 and 187 days of age. Seventeen hours after each injection, the mice were bled and sera were separated. Their sera were tested in an enzyme-linked immunosorbent assay system. The mean interleukin-4, interleukin-5, interleukin-6 and immunoglobulin E levels in the sera of mice treated neonatally with P. gingivalis lipopolysaccharide were significantly higher than those of the controls. However, in all cases, no significant difference was noted between mice treated neonatally with A. actinomycetemcomitans- or E. coli lipopolysaccharide and control mice. These data suggest that neonatal exposure to P. gingivalis lipopolysaccharide induces changes in immunological responses when the mice reach maturity.     

Maxillary complete denture movement during chewing in mandibular removable partial denture wearers

Objectives: To evaluate the pattern of maxillary complete denture movement during chewing for free‐end removable partial dentures (RPD) wearers, compared to maxillary and mandibular complete denture wearers. Materials and methods: Eighteen edentulous participants (group I) and 10 volunteers with bilateral posterior edentulous mandibles (group II) comprised the sample. Measures of mean denture movement and its variability were obtained by a kinesiographic instrument K6‐I Diagnostic System, during the mastication of bread and a polysulphide block. Data were analysed using two‐way anova (α = 0.05). Results: Upper movement during chewing was significantly lower for group II, regardless of the test food. The test food did not influence the vertical or lateral position of the denture bases, but more anterior dislocation was found when polysulphide blocks were chewed. Group II presented lower intra‐individual variability for the vertical axis. Vertical displacement was also more precise with bread as a test food. Conclusion: It can be concluded that mandibular free‐end RPD wearers show smaller and more precise movements than mandibular complete denture wearers.     

Assessing expressed need and satisfaction in complete denture wearers

Objectives: The need to assess both lay and professional views of oral health is believed to be at the centre of success when providing dental health care for older patients. Self‐perceived physical (oral) health and perceptions of psychosocial functioning must be included if expressed need is to be assessed. The aim of this work was to construct an expressed need schedule and to assess the ability of this assessment to predict older community‐based patients' satisfaction with complete dentures. Design: Survey of 260 people aged 65 years and over. Setting: Community setting. Main outcome measures: The participants were interviewed using a 55 item modified version of the Oral Health Impact Profile (OHIP) to assess their psychological, social and perceptions of their oral health. All participants were subjected to an oral examination. Results: The results showed that complete denture wearers compared had greater experience of difficulties associated with oral health and psychological functioning. Factor analysis allowed the identification of three dimensions associated with psychological, social and self‐perceived physical (oral) health. When these factors were regressed with normative denture treatment need against satisfaction with complete dentures, satisfaction was characterised by high self‐perceived physical (oral) health, low social health problems and no identifiable normative need. Conclusion: This work supports the inclusion of self‐perceived physical (oral) health and psychosocial health (expressed need) questions in a schedule when predicting satisfaction with complete dentures.     

Attitudes and usage of denture adhesives by complete denture wearers: a survey in Greece and the Netherlands

doi: 10.1111/j.1741‐2358.2011.00566.x
Attitudes and usage of denture adhesives by complete denture wearers: a survey in Greece and the Netherlands Objective: To explore whether there are differences in usage of and attitudes towards denture adhesives among patients in two countries. Background: There are no multi‐country surveys concerning usage of and attitudes towards denture adhesives from complete denture wearers. Materials and methods: The survey took place in Greece and the Netherlands with a sample of 284 and 165 consecutive complete denture wearers, respectively, by using a 9‐item prepared questionnaire. Statistical analysis relied on chi‐square test at α = 0.05. Results: In this survey, 26 and 20% of Greek and Dutch patients, respectively, had tried denture adhesive, but only 27% of them in Greece as well as in the Netherlands currently used it; 49% of the Greek and 45% of the Dutch participants rated the overall performance of adhesives as good. Between the two populations, no differences were identified in a majority of the research variables, except where 27% of Greeks answered that they did not know the existence of denture adhesives compared to none of the Dutch patients and when 90% of the Dutch contrary to 70% of Greeks reported that they did not need denture adhesives as they could manage their dentures well. Conclusion: The usage of and attitudes towards denture adhesives between the Greek and Dutch sample were similar with only two exceptions concerning the knowledge of existence and the need of using denture adhesives.     

Comparison of different assays for the aggregation of oral bacteria by human whole saliva

For comparison, human whole saliva-induced aggregation was studied by phase-contrast microscopy, spectrophotometry combined with macroscopic observations, and in microtiterplate assay under identical experimental conditions for Actinomyces viscosus HG 85 (T14-V) and HG 380 (T14-AV), Bacteroides gingivalis HG 66 (W 83), Streptococcus rattus HG 59 (BHT), and Streptococcus sanguis I HG 169. The entire process of formation, extension, and sedimentation of aggregates could merely be observed by the combination of these assays. The very first stages of aggregation could only be detected and quantitated by phase-contrast microscopy. Within 2 1/2 min. 50% of the A. viscosus, S. rattus, and S. sanguis cells were aggregated, denoted as T₅₀. In microtiterplates, however, aggregates were observed in general only after sedimentation at 30–45 min of incubation, expressed as T_A. For interpretation of the spectrophotometric curves, additional microscopic and macroscopic data were a prerequisite. The small decline in absorbance during the first 30–45 min (phase 1) corresponded to the formation and extension of non-sedimenting aggregates, whereas the subsequent pronounced fall in absorbance (phase 2) was caused by the massive sedimentation of aggregates. The moment of inflexion between both phases, T_I, marked the onset of sedimentation of aggregates and corresponded very well with T_A, at which time already 92–98% of the cells were aggregated as quantitated by microscopy. In conclusion, only by microscopy the formation and extension of aggregates could be observed within a few minutes and quantitated in terms of aggregation rate. From 30–45 min, merely the sedimentation of aggregates was visualized in microtiterplates, whereas the time course of the overall process was recorded indirectly by spectrophotometry.