Residual ridge atrophy in complete denture wearers and relationship with densitometric values of a cervical spine: a hierarchical regression analysis

doi: 10.1111/j.1741‐2358.2011.00589.x Residual ridge atrophy in complete denture wearers and relationship with densitometric values of a cervical spine: a hierarchical regression analysis Background: The rate of residual ridge atrophy (RRR) and its association with mineral density of other bones have not yet been fully explained. Objective: To measure RRR over a 5‐year period in complete denture wearers and relate it to the density of a cervical spine (CSBD). Materials and methods: Sixty‐two patients (different gender, age, body mass index, duration of edentulousness (DE) and different denture‐wearing habits) participated. A copper stepwedge was attached to the cassette, and 50 lateral radiograms met the criteria to be included. Results: A significant decrease in vertical height was observed in all measured sites. The amount of RRR was highest in frontal areas of both jaws and decreased gradually towards lateral regions. Hierarchical regression analysis revealed that the amount of RRR in the maxillary frontal area could be explained up to 48.4% by the variable DE and only up to 6.1% by the CSBD, while gender had almost no influence (1%). Similar results were obtained for the lateral maxillary RRR (33.9%; 7%; 2%), frontal mandibular RRR (40; 8.4; 0.4%) and lateral mandibular RRR (31.5%; 3.4%; 7.7%). Conclusion: Skeletal bone density, reflecting systemic and hereditary factors, is weakly related to RRR (3.4–8.4%).     

Correlation between residual ridge resorption and radiomorphometric indices

doi: 10.1111/j.1741‐2358.2011.00514.x Correlation between residual ridge resorption and radiomorphometric indices Objectives: The study evaluated the relationship between residual ridge resorption (RRR) and radiomorphometric indices, including mandibular cortical index (MCI), mandibular cortical width (MCW) and panoramic mandibular index (PMI), along with demographic factors. Material and methods: Panoramic radiographs of 1863 patients over 20 years of age were assessed. Gender, age and dental status of each patient were recorded. Relationships between RRR and demographic factors and radiomorphometric indices were evaluated using chi‐square and Fisher’s exact tests with level of significance of p = 0.05. Results: Residual ridge resorption was not affected by gender (p > 0.05), but was more frequently seen in patients over the age of 50 compared with those below 49 years of age (p < 0.001). RRR was significantly associated with edentulism (p < 0.001) and with severe erosions of endosteal margin of mandible (p < 0.05). RRR was more frequently seen in patients with PMI below 0.30 (p < 0.001) and with MCW below 3 mm in 50‐ to 69‐year‐old age group (p < 0.001). Conclusions: Patients younger than 50 years of age who demonstrate severe erosions of endosteal margin of mandible and have MCW < 3 mm and PMI < 0.30 appear to be suitable candidates for early implant placement or for maintaining roots or natural teeth to preserve bone, regardless of gender.     

The effect of osteoporosis on residual ridge resorption and masticatory performance in denture wearers

doi: 10.1111/j.1741‐2358.2011.00610.x The effect of osteoporosis on residual ridge resorption and masticatory performance in denture wearers Aim: To compare masticatory performance, masticatory efficiency and residual ridge resorption (RRR) in osteoporotic and non‐osteoporotic edentulous subjects after rehabilitation with complete dentures. Method: Thirty subjects fulfilling the inclusion criteria were enrolled from the patients visiting the Department of Prosthodontics for complete denture fabrication. Two groups consisting of control subjects (group I; N = 15) and osteoporotic subjects (group II; N = 15) were formed. Complete dentures satisfying certain criteria were fabricated for both groups. Masticatory performance and efficiency were measured 6 months after denture insertion. Areal measurements were taken on lateral cephalograms before and 6 months after denture fabrication. The data were then computed to analyse differences between groups I and II using SPSS statistical software version 15.0. Results: Six months after denture fabrication, the masticatory performance and efficiency were significantly higher (p < 0.001) for group I, with a significant decrease in maxillary and mandibular sagittal area seen in both groups. The rate of bone loss was more in group II compared with group I. Conclusion: Greater masticatory function was demonstrated by the non‐osteoporotic group, and the rate of RRR was more in the osteoporotic group compared with the normal group. In this pilot study, osteoporosis leads to greater RRR, decreased masticatory performance and efficiency in edentulous subjects 6 months after denture insertion. Screening for osteoporosis is suggested as a routine procedure for all edentulous subjects undergoing rehabilitation. Recall check‐ups for osteoporotic patients should be more frequent, and these patients may require more frequent denture remakes.     

Two novel SNPs in genes involved in immune response and their association with mandibular residual ridge resorption

“Residual ridge resorption” (RRR) is a multifactorial condition involving bone resorption of the residual ridge. We investigated 10 single nucleotide polymorphisms (SNPs) in seven genes with the aim of identifying the genetic factors associated with RRR susceptibility. The study group included 96 RRR patients and 96 controls. Age at first edentulism, duration of edentulism, and bone height were recorded. Saliva was collected from the subjects for DNA extraction. Genotype analysis was performed on the ‘SequenomMassARRAYiPLEX’. The genotype and allele frequencies calculated in patients and controls were compared. We found that rs1800896 in the IL10 gene and rs5743289 in NOD2 gene showed significant association with RRR. Within the RRR group, genotypes for each SNP were separated, and we observed that the age at first edentulism and bone height showed variations in the different genotypes of the ten studied SNPs. This study showed an association between SNPs in IL10 and NOD2 genes. It also revealed that the genotypes of the different SNPs influence bone resorption and health. Additionally, age at first edentulism and bone height were much lower in some genotypes. This study demonstrates the need for larger multicenter trials to confirm these findings. Finally, we suggest that the results of this study may be utilized for developing novel genetic diagnostic tests and for identifying Saudi individuals who may be more susceptible to RRR development following dental extraction.     

Denture-related stomatitis managed with tissue conditioner and hard autopolymerising reline material

doi: 10.1111/j.1741–2358.2010.00398.x
Denture related stomatitis managed with tissue conditioner and hard autopolymerising reline material. Objective: To compare the response of denture‐related stomatitis (DS) under management with a tissue conditioner (TC) and autopolymerising hard reline material (AHRM). Background data: Denture‐related stomatitis affects up to 75% of denture wearers; not wearing the denture at night, using TC or prescribing topical or systemic antifungal agents could reduce its incidence. Materials and methods: This was a double‐blind study consisting of 44 participants with DS who wear denture; they were randomly divided into two unmatched groups according to the material used for the management of DS. The TC was replaced weekly, and the AHRM was placed at the beginning of the study and was not changed for 4 weeks. A dentist performed an initial and a weekly clinical diagnosis for DS; the clinical situation was recorded by means of photographs for each week. Results: Both TC and AHRM were effective in the management of DS. Significant differences were found in the DS resolution time (p < 0.001), taking longer for the TC. Conclusions: Both the tissue conditioner and AHRM are effective for the management of DS, but AHRM requires less time for recovery and as a result fewer appointments are required for the patient.     

Influence of body mass index and the time of edentulousness on the residual alveolar ridge resorption in complete denture wearers

Alveolar bone loss (RRR) is a continuous process following tooth extraction, more pronounced during the first few months after the tooth extraction than later. The RRR in the mandible is twice that of the maxilla during a 1-year period and the mandibular: maxillary resorption ratio increases further to 4:1. So far, the etiology of RRR has not been elucidated. It has been speculated that both systemic and local factors contribute. The aim of this study was to analyse the rate of RRR in five different regions of both jaws on lateral cephalograms of 100 complete denture wearers during a one-year period and to compare the rate of RRR between patients being edentulous over a different period of time and between patients with different body mass index. The height of residual ridges was measured on 5 different sites at the delivery of the dentures and a year later using a calibrated grid. The results revealed significant RRR in a one year period. Body mass index had no significant influence on the rate of RRR on any of the five examined sites of the maxilla or the mandible (p > 0.05), while the period of edentulousness had a significantly higher rate of resorption in first 3 sites of measurement (anteriorly) in patients being edentulous less than 1 year than in patients being edentulous for 1-10 years or for over 10 years (ANOVA, p < 0.05).     

下颌起排法全口排牙临床效果研究

目的:研究通过比较不同的排牙方式制作的全口义齿对咀嚼次数、咀嚼效率以及患者的主观感受的影响。方法:78例无牙颌患者按照牙槽嵴高度分为正常组和低平组,正常组有患者32例,低平组有患者46例,每组分别戴用上颌起排法和下颌起排法制作的全口义齿,比较咀嚼次数、咀嚼效率和满意度的差别。结果:在戴用上颌起排法制作的全口义齿时,正常组的咀嚼次数高于低平组,差异具有统计学意义(t=3.60,P0.05);戴用下颌起排法制作的全口义齿后,低平组的咀嚼次数高于采用上颌起排法的全口义齿,差异具有统计学意义(t=4.41,P0.05);在戴用上颌起排法制作的全口义齿中,正常组的咀嚼效率高于低平组,差异具有统计学意义(t=5.72,P0.05);而在戴用下颌起排法制作的全口义齿后,低平组的咀嚼效率高于采用上颌起排法的全口义齿,差异具有统计学意义(t=7.16,P0.05)。正常组认为使用下颌起排法制作全口义齿咀嚼能力、稳固感好于上颌起排法,差异均具有统计学意义(P0.05);低平组认为使用下颌起排法制作全口义齿咀嚼能力、稳固感和舒适感好于上颌起排法,差异均具有统计学意义(P0.05)。结论:对于牙槽嵴低平无牙颌患者使用下颌起排法制作的全口义齿,能够有效地增强咀嚼效率,提高义齿的稳定性。     

Clinical and microbiological efficacy of three different treatment methods in the management of denture stomatitis

Gerodontology 2010; doi: 10.1111/j.1741‐2358.2009.00354.x
Clinical and microbiological efficacy of three different treatment methods in the management of denture stomatitis Objective: This study evaluated. the effect of mouthrinses and tissue conditioner on the clinical findings and microbial flora of 60 patients with Newton’s type II denture stomatitis (N2DS) Background: Denture stomatitis is a common problem in complete denture wearers. Materials and methods: Sixty patients with N2DS were included in this study and divided into three groups. Two groups of patients were instructed to rinse their mouth with the designated mouthrinses DioxiDent and Corsodyl twice daily for 1 min and to soak their dentures overnight in these solutions for 15 days. For the third group, tissue conditioner was placed in each of 20 patients’ existing maxillary dentures. Patients were evaluated both clinically and microbiologically at baseline and after 15 days. Palatal swabs and smears were taken from each patient before and after treatment and these samples were examined mycologically. The difference between Candida colonisation before and after treatment and the differences between pre‐treatment and post‐treatment clinical findings were assessed. Results: DioxiDent and Corsodyl showed an improvement in palatal inflammation and a decrease in Candida colonisation compared to Visco‐gel. Conclusions: The effectiveness of topical chlorine dioxide and chlorhexidine gluconate in the management of N2DS was demonstrated.     

The prevalence of denture stomatitis and its predisposing conditions in an older Greek population

doi:10.1111/j.1741‐2358.2009.00359.x
The prevalence of denture stomatitis and its predisposing conditions in an older Greek population Background: Pathology related to complete denture‐wearing will remain an important issue because of an increase in the ageing population. Objective: To investigate the prevalence and the risk factors for denture‐related stomatitis in the edentulous maxilla of older patients with a maxillary complete denture. Material and methods: One hundred and six patients treated in the Department of Prosthodontics of the Athens Dental School were interviewed and clinically examined. The results were analysed using chi‐square tests and multiple logistic regression. Results: Denture stomatitis was recorded in 39.6% of the sample (pinpoint hyperaemia: 17%, diffuse erythema: 16%, papillary hyperplasia: 6.6%). Chi‐square tests recorded significant associations between denture stomatitis and the continuous use of dentures (particularly the diffuse erythema type), the increased duration of denture experience and the poor retention of the maxillary denture. Other significant associations were recorded between the increased age of the current denture and pinpoint hyperaemia, and the reduced frequency of denture cleaning and papillary hyperplasia. Multiple logistic analysis revealed that the most important risk factor for denture stomatitis was the continuous use of the denture. Conclusion: The prevalence of denture stomatitis was high in denture users. Although many predisposing conditions were recorded, the most important risk factor was the continuous use of the denture. Therefore, appropriate advice on denture maintenance should be provided.     

Oral health status,C-reactive protein and mortality--a 10 year follow-up study

Background: Epidemiological studies have reported a strong association between C‐reactive protein (CRP) and cardiovascular diseases (CVD). Elevated CRP levels have been observed both in dentate individuals with chronic dental infections like periodontal disease and in those edentulous. The mechanisms behind these observations, especially the reasons for the elevation of CRP in the edentulous, are poorly understood. The comparative data on the importance of these inflammatory conditions in the oral cavity as causes of elevated CRP levels and CVD risk factors are also limited. Objective: To determine if edentulism is associated with increased levels of CRP and investigate the possible mechanism for this association; and to study the influence of periodontal disease and edentulism on 10‐year mortality. Subjects: Of the 364 subjects aged 76,81, and 86 years in 1990,196 were dentate and 168 edentulous. By December 1999, 179 had died, almost half (n=87) of them due to cardiovascular disease. Results: Significantly more of the edentulous subjects had elevated (>3 mg/L) CRP levels as compared to those with at least 20 teeth (p<0.01). They also had high salivary microbial counts (p<0.05), and more mucosal lesions (p<0.0001) than those with at least 20 teeth. In multivariate analysis, high microbial counts (OR 2.3, CI 1.06‐5.05) and mucosal lesions (OR 2.18, CI 1.03‐4.61) were significantly associated with elevated CRP levels. The risk for all‐cause mortality was non‐significantly elevated among the edentulous (RR 1.48, CI 0.95 – 2.31) and dentate with periodontal disease (RR 1.58, CI 0.96 – 2.61). CVD mortality was significantly higher among the dentate with periodontal disease (RR 1.97, CI 1.01 – 3.85) when compared with dentate without periodontal disease. Conclusion: Among the edentulous, chronic infections like denture‐related mucosal lesions are important determinants of elevated CRP, comparable to periodontal disease in the dentate. Elevated CRP per se and edentulism were not significantly associated with increased mortality. Periodontal disease was, however, still associated with a two‐fold CVD mortality in this very old population.     

Cytogenetical damage in exfoliated oral mucosa cells in elderly people suffering denture stomatitis

doi:10.1111/j.1741‐2358.2009.00315.x
Cytogenetical damage in exfoliated oral mucosa cells in elderly people suffering denture stomatitis Objectives: The aim of this study was to evaluate comparatively the DNA damage (micronucleus) and cellular death (pyknosis, karyolysis and karyorrhexis) in exfoliated oral mucosa cells from chronic denture stomatitis patients and healthy controls. Background: Over the course of ageing, individuals may develop many diseases such as denture stomatitis. Material and methods: A total of 23 chronic denture stomatitis patients and 23 controls presenting good oral conditions were included in this study. Individuals had epithelial cells mechanically exfoliated, placed in fixative and placed on clean slides, which were checked for nuclear phenotypes. Results: The results indicated no statistically significant differences (p > 0.05) of micronucleated oral mucosa cells from chronic denture stomatitis patients when compared to healthy controls. Nevertheless, chronic denture stomatitis was able to increase other nuclear alterations closely related to cytotoxicity such as karyorrhexis, pyknosis and karyolysis as depicted by significant differences (p < 0.05) between groups. No interaction was observed between smoking and chronic denture stomatitis. Conclusion: In summary, these data indicated that chronic denture stomatitis was able to induce cytotoxic effects as assessed by a micronucleus test.     

Salivary immunity in elderly individuals presented with Candida-related denture stomatitis

doi: 10.1111/j.1741‐2358.2011.00476.x
Salivary immunity in elderly individuals presented with Candida‐related denture stomatitis Objectives: Elderly individuals with Candida‐related denture stomatitis (DS) present with a reduced defence against Candida albicans. This study evaluated levels of antimicrobial mediators in the elderly DS saliva and salivary neutrophils’ activation characteristics compared with elderly and young without DS. Methods: Salivary peroxidases (SPO) and elastase activities (ELA), nitric oxide (NO), transforming growth factor beta (TGF‐β), IL‐6 and CCL3 production were determined in saliva from elderly with or without DS, and young control individuals. TLR4, CXCR1, CD11b, CD16 and CD32 expression on salivary neutrophils were evaluated. Correlations between number and apoptosis rate of salivary neutrophils, enzymatic activities and cytokine levels were determined. Results: Elderly DS individuals exhibited the lowest SPO and ELA activities. Also, the activity of both enzymes was low in elderly without DS. Although both elderly groups showed higher salivary NO and TGF‐β levels compared to young control groups, elderly DS presented the highest salivary NO, TGF‐β, IL‐6 and CCL3 levels. Decreased percentages of salivary TLR4⁺ and CD16⁺ neutrophils were detected in both elderly groups. Although these damages could influence the establishment and persistence of DS, the highest levels of salivary IL‐6 and CCL3 in elderly DS could be preventing more serious complications.     

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.     

Treatment protocol for denture stomatitis,prior to anatomical molding

doi: 10.1111/j.1741‐2358.2012.00661.x Treatment protocol for denture stomatitis, prior to anatomical molding Background: Microorganisms of the genus Candida have been recovered from complete dentures made of acrylic resin, with high numbers of colony forming units and species diversity, which can act as infectious agents causing chronic atrophic candidiasis (denture stomatitis). Objective: The objective of this paper is present a treatment protocol for chronic atrophic candidiasis (denture stomatitis). Materials and Methods: The work describes three cases of totally edentulous patients presenting palate stomatitis who were submitted for treatment associating denture rebasing with chemically‐activated acrylic resin, night immersion in 2.5% sodium hypochlorite and use of topical antifungals for two weeks. Results: In all cases, remission of the inflammatory process occurred. Conclusion: The proposed treatment protocol proved to be to be effective.     

Two-step impression for atrophic mandibular ridge

BACKGROUND: The clinical difficulties encountered while treating edentulous patients with atrophic mandibular ridges are legion. Capturing tissue details while making an impression of a resorbed mandibular ridge poses a great clinical challenge. Extending the denture bases adequately to cover all of the available supporting tissues is one of the prime requisite. Surgical approach is necessary only when the patient is incapable of wearing a conventional denture. This article describes a technique of making an impression of an atrophic mandibular ridge by the use of monophase and light-bodied impression material where surgical options such as implants, vestibuloplasty or ridge augmentation may not be feasible. This procedure results in improved stability and retention of the denture base.     

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.     

Associated factors for falls among the community-dwelling older people assessed by annual geriatric health examinations

Background

Falls are very common among the older people. Nearly one-third older people living in a community fall each year. However, few studies have examined factors associated with falls in a community-dwelling population of older Taiwanese adults.

Objectives

To identify the associated factors for falls during the previous 12 months among the community-dwelling Taiwanese older people receiving annual geriatric health examinations.

Participants

People aged sixty-five years or older, living in the community, assessed by annual geriatric health examinations

Methods

1377 community-dwellers aged ≥65 years who received annual geriatric health examinations at one hospital in northern Taiwan between March and November of 2008. They were asked about their history of falls during the year prior to their most recent health examination.

Results

The average age of the 1377 participants was 74.9±6.8 years, 48.9% of which were women. Three-hundred and thirteen of the participants (22.7%) had at least one fall during the previous year. Multivariate analysis showed that odds ratio for the risk of falling was 1.94 (95% CI 1.36-2.76) when the female gender group is compared with the male gender group. The adjusted odds ratios of age and waist circumference were 1.03 (95% CI 1.00–1.06) and 1.03 (95% CI 1.01–1.05) respectively. The adjusted odds ratios of visual acuity, Karnofsky scale, and serum albumin level were 0.34 (95% CI 0.15–0.76), 0.94 (95% CI 0.89–0.98), and 0.37 (95% CI 0.18–0.76) respectively. Larger waist circumference, older age, female gender, poorer visual acuity, lower score on the Karnofsky Performance Scale, and lower serum albumin level were the independent associated factors for falls.

Conclusion

In addition to other associated factors, waist circumference should be included as a novel risk factor for falls.     

Use of a mandibular advancement device in patients with congestive heart failure and sleep apnoea

Objective: To evaluate the practical use of the mandibular advancement device (MAD) for treatment of sleep apnoea (SA) in patients with congestive heart failure (CHF) over 1 year. Subjects: Twenty‐five patients aged 66 ± 8 years (mean ± SD) met the inclusion criteria and were included in the study. Design: In a prospective, clinical trial, the apnoea‐hypopnoea index (AHI), a measure of SA, was determined with a portable device. Failure to enter treatment and compliance, adverse events and signs and symptoms of temporomandibular disorders (TMD) were examined before intervention and 4–6 weeks, 6 months, and 1 year after intervention. Results: Six patients had removable dentures of whom four had complete dentures. Before treatment, eight patients reported minor symptoms of TMD. The AHI fell from 19.3 ± 12.1 to 11.8 ± 9.5 (p = 0.004) with use of the device. In most patients, use of the MAD had no severe effects on the signs and symptoms of TMD. Adverse events such as pain in the temporomandibular joints, soreness in the teeth, and tiredness in the jaws were reported by 10 patients. Dental complications were observed in two patients. Sixty‐four per cent of the patients were still using the MAD at the 1‐year follow‐up. Conclusions: Both the general and oral health of CHF patients were important in treatment with a MAD. The MAD therapy had no severe effect on the masticatory system and edentulous patients could be treated.     

Relationship between symptoms of temporomandibular disorders and dental status, general health and psychosomatic factors in two cohorts of 70-year-old subjects

Objective: To study the prevalence of symptoms of temporomandibular disorders (TMD) in two cohorts of 70‐year‐old subjects examined 8 years apart and analyse the relationship between such symptoms and dental status, general health and various background factors. Materials and methods: Two cohorts of 70‐year‐old subjects, born in 1922 (n = 422) and 1930 (n = 491) respectively, were examined with an interval of 8 years. A TMD symptom index (0–5) was established on answers to five questions related to TMD symptoms. Results: There were no statistically significant differences between the two cohorts for prevalence of TMD symptoms and TMD index, neither for headache, neck ache, bruxism and chewing ability. TMJ sounds was the most prevalent symptom, 14%, whereas other TMD symptoms had low prevalence. The distribution of the TMD symptom index showed that 81% reported no symptoms, 15% one symptom, 3% two symptoms and 1% three to five symptoms. Single TMD symptoms and the TMD index exhibited significant associations (p < 0.001) with bruxism, headache, neck pain and several general health and psychosomatic factors, but with dental status only in women. Logistic regression showed that bruxism, neck pain, mouth dryness and a number of psychosomatic factors were associated with the TMD index. Conclusions: Besides TMJ sounds (14%), other TMD symptoms were rarely reported by the 70‐year‐old subjects. The TMD index was significantly associated with bruxism and several general health and psychosomatic complaints but with dental status only in women.     

Palatal and mandibular tori in a Romanian removable denture-wearing population

doi:10.1111/j.1741‐2358.2009.00318.x
Palatal and mandibular tori in a Romanian removable denture‐wearing population Objective: To establish the prevalence of palatal tori (TP) and mandibular tori (TM) in a Romanian denture‐wearing population in order to see how or if tori influenced the denture design or the treatment planning. Background data: There are no available data regarding tori in an elderly Romanian population and its implication for treatment planning. It could be considered a local factor influencing the quality of prosthetic treatment. Material and method: Tori prevalence was investigated in 251 patients, with an average age of 62 years. A statistical analysis was made, using odds ratio (OR) for the distribution related to gender and the Chi‐squared test for the differences in prevalence related to age groups. Treatment planning difficulties because of presence of tori were recorded. Results: Frequency of TP was significantly higher in both genders (OR = 2.0661 and p = 0.0446) and non‐significant frequency for distribution between genders for TM (OR = 0.9421 and p = 0.8273). The differences in age groups showed both tori types have a variable prevalence related to age. The most frequent location for TP was found in the posterior one‐third and two‐thirds of the palate and for TM in the canine and first premolar area presenting with different sizes. Conclusions: Tori prevalence in our study group is high and is significantly related to age (p < 0.05) having a peak at over 60 years. The preferential site of TP in the posterior palatal area and this location has an impact on decision making in treatment planning for the upper denture.