The effect of attachment type and implant number on satisfaction and quality of life of mandibular implant-retained overdenture wearers

doi: 10.1111/j.1741‐2358.2011.00531.x The effect of attachment type and implant number on satisfaction and quality of life of mandibular implant‐retained overdenture wearers Objective: The aim of this study was to compare the quality of life and patient satisfaction outcomes of two attachment systems in mandibular overdentures with different numbers of supporting implants. Materials and methods: Sixty‐two edentulous patients with either splinted or single attachments in mandibular implant overdentures with different numbers of supporting interforaminal implants were investigated for patient satisfaction and quality of life in this retrospective study. Comparisons between groups were perceived by the Mann–Whitney U test. Relations among the parameters were investigated by Spearman’s rho correlation analysis. The results were evaluated statistically at a significance level of p < 0.05. Results: No statistically significant association is found between visual analogue scales scores and attachment type as well as implant number (p > 0.05), whereas Oral Health Impact Profile (OHIP)‐14 total scores for patients with 4‐implant‐supported bars were significantly lower than all the other attachment types (p < 0.05). Additionally, a negative (rate = 32.2%), statistically significant association between period of edentulism and total OHIP‐14 scores was detected (p < 0.05). Conclusions: A mandibular implant‐retained overdenture supported with four implants and bar attachments shows the highest ‘quality of life’ score and patient satisfaction is not influenced by the number of implants or attachment type.     

The influence of mandibular implant-retained overdentures in masticatory efficiency

doi: 10.1111/j.1741‐2358.2011.00539.x The influence of mandibular implant‐retained overdentures in masticatory efficiency Objective: To evaluate the masticatory efficiency of patients rehabilitated with conventional dentures (CDs) or implant‐retained mandibular overdentures. Background: Despite the evident benefits of implants on mastication as assessed by subjective patient‐based outcomes, the extent of implant overdenture treatment effect on food comminution is not well established. Materials and methods: A randomised clinical trial was carried out with 29 completely edentulous patients divided into two groups. The first group was rehabilitated with a mandibular overdenture retained by two splinted implants with bar‐clip system, while the second group was rehabilitated with a mandibular CD. Both groups also were rehabilitated with maxillary CDs. Masticatory efficiency and patient satisfaction were assessed 3 months after denture insertion. Masticatory efficiency was evaluated through the colorimetric method with the beads as the artificial test‐food. Comparisons for masticatory efficiency and patient satisfaction were performed using Student’s t‐test (α = 0.05). Results: No significant statistical difference was found for masticatory efficiency (p = 0.198). Patient overall satisfaction was significantly higher for the mandibular overdenture (p < 0.001). In addition, mandibular overdenture patients were significantly more satisfied with chewing experience (p < 0.05) and retention of the lower denture (p < 0.005). Conclusion: The results of this study suggest that mandibular overdenture significantly improves chewing experience, although limited effect on masticatory efficiency has been observed.     

Outcome of implant-supported overdenture treatment--a survey of 58 patients

Gerondontology 2012; doi: 10.1111/j.1741‐2358.2011.00524.x
Outcome of implant‐supported overdenture treatment – a survey of 58 patients Objective: The aim of this follow‐up study was to evaluate the long‐term outcome of implant‐supported or implant‐retained mandibular overdenture treatment. Material and methods: Altogether 112 patients treated with implant‐supported overdentures between 1985 and 2004 were invited to the follow‐up and 58 attended the clinical examination. The total amount of implants examined and still in use was 197. The average number of implants installed was three (range 2–4), and the mean length of the implants was 12 mm (range 8–21 mm). There were altogether 48 overdentures with a bar connection and 10 with a ball connection. Results: The most frequent prosthetic complications were technical: loosening of the retentive mechanism (39.7%) and breakage of the matrices (5.2%). The most common peri‐implant soft‐tissue findings were bleeding and slight hyperplasia. The implant‐supported overdentures of 19 patients (32.8%) had been renewed, while 39 patients (67.2%) still used their original overdentures, of which the oldest was 20 years old. Conclusion: The results of this long‐term follow‐up study show that the outcome of implant‐supported mandibular overdenture treatment was excellent. The patients were satisfied with the treatment, regardless of the attachment type used. Removable overdentures are more easy to clean and can be cleaned outside the patient’s mouth, whereas fixed‐implant full‐arch dentures in the edentulous mandible require much more time‐consuming hygiene. This kind of overdenture treatment is suitable also in the elderly, even though their ability to practice appropriate oral hygiene might be decreased.     

Understanding the ‘epidemic’ of complete tooth loss among older New Zealanders

doi:10.1111/j.1741‐2358.2009.00306.x
Understanding the ‘epidemic’ of complete tooth loss among older New Zealanders Objective: The aim of this study was to obtain a deeper understanding of the social factors driving New Zealand’s historic ‘epidemic of edentulism’ and how they operated. Method: In‐depth, semi‐structured interviews with 31 older New Zealanders were analysed using applied grounded theory. Results: Universal factors present in the data were: (a) the way in which New Zealand society accepted and indeed encouraged edentulism without stigma for those who had a ‘sub‐optimal’ natural dentition; (b) how the predominant patterns of dental care utilisation (symptomatic and extraction‐based) were often strongly influenced by economic and social disadvantage; and (c) the way in which lay and professional worldviews relating to ‘calcium theory’ and dental caries were fundamental in decisions relating to the transition to edentulism. Major influences were rural isolation, the importance of professional authority and how patient‐initiated transitions to edentulism were ultimately facilitated by an accommodating profession. Conclusion: The combined effects of geography, economics, the dental care system and the professional culture of the day, in the context of contemporary (flawed) understandings of oral disease, appear to have been the key drivers. These were supported (in turn) by a widespread acceptance by the profession and society alike of the extraction/denture philosophy in dealing with oral disease.     

Validation of a real‐time PCR for Haemophilus parasuis

Aims: To validate a real‐time PCR test for the diagnosis of Glässer’s disease, a major pig disease caused by Haemophilus parasuis. Methods and Results: The specificity of a real‐time PCR amplifying the inf B gene was validated with 68 H. parasuis isolates and 36 strains of closely related species. As well, 239 samples of DNA from tissues and fluids of 16 experimentally challenged animals were tested with the real‐time PCR, and the results were compared with culture and a conventional PCR. The real‐time PCR produced significantly more positive results than the conventional PCR (165 vs 86). Conclusions: The sensitivity of the real‐time PCR combined with high specificity makes it a very valuable tool for the diagnosis of Glässer’s disease. Significance and Impact of Study: This new method will improve the ability of laboratories to diagnose Glässer’s disease, especially in laboratories where the culture method for H. parasuis is not optimal.     

Resonance frequency analysis of overdenture retainer implants with immediate loading

doi: 10.1111/j.1741‐2358.2011.00488.x
Resonance frequency analysis of overdenture retainer implants with immediate loading Objective: To evaluate 16 patients of both sexes with lower overdenture and upper complete dentures, by analysing the resonance frequency of the initial and late stability of implants used to retain the overdenture under immediate loading. Background: Oral rehabilitation treatment with complete dentures using implants has been increasingly more common among the specialists in the oral rehabilitation area. This is an alternative for obtaining retention and stability in treatments involving conventional complete dentures, where two implants are enough to retain the overdenture satisfactorily. Materials and methods: The Osstell? Mentor device was used for the analysis in the initial period (primary stability), 3 and 15 months after the installation of the lower overdenture (secondary stability). The statistical analysis was performed with the repeated measures model (p < 0.01). Results: The implant stability quotients were observed to increase after 15 months of the rehabilitating treatment. Conclusion: The use of overdentures over two lower implants should become the treatment of choice for individuals who have a fully edentulous mandible.     

Oral implants in dependent elderly persons: blessing or burden?

doi:10.1111/j.1741‐2358.2009.00314.x
Oral implants in dependent elderly persons: blessing or burden? Background: Implant‐supported (partial) dentures may raise problems in patients who have become dependent on others for daily oral health care. Dental hygienists and general dental practitioners, as well as care providers, volunteer aiders and even health care insurance companies, should anticipate the growing demand for specific oral health care for patients provided with implant‐supported (partial) dentures. Objective: To report three cases of dependent patients and to present recommendations to prevent or resolve implant‐related oral problems. Materials and methods: The three case reports are demonstrating that implant insertion in (dependent) elderly people needs careful consideration. Discussion: When considering implant treatment, some questions should be raised: (1) Is the treatment appropriate in contributing to the patient’s well‐being and quality of life? (2) Is the treatment the most suitable treatment? (3) Does the treatment integrate with the patient’s oral health care plan? (4) Is the patient sufficiently cooperative? (5) Is the patient supported by a well‐functioning oral (self) care assisting network? (6) Is it possible for the patient to regular see an oral health care professional and is oral health care easily accessible in cases of an emergency? Conclusion: Dependent elderly people can benefit from oral implants, providing that adequate oral health care and aftercare can be provided. When indicated, removal of the anchorage structure is easily performed by putting the implants to sleep. All implant patients should be provided with an ‘implant passport’. Regular information and instruction for care providers about the oral condition of the patient are essential.     

Construction and evaluation of self‐cloning bottom‐fermenting yeast with high SSU1 expression

Aim: To construct a self‐cloning brewer’s yeast that can minimize the unfavourable flavours caused by oxidation and certain kinds of sulfur compounds. Methods and Results: DNA fragments of a high‐expression promoter from the TDH3 gene originating from Saccharomyces cerevisiae were integrated into the promoter regions of the S. cerevisiae‐type and Saccharomyces bayanus‐type SSU1 genes of bottom‐fermenting brewer’s yeast. PCR and sequencing confirmed the TDH3 promoter was correctly introduced into the SSU1 regions of the constructed yeasts, and no foreign DNA sequences were found. Using the constructed yeasts, the concentration of sulfite in fermenting wort was higher when compared with the parent strain. In addition, the concentrations of hydrogen sulfide, 3‐methyl‐2‐buten‐1‐thiol (MBT) and 2‐mercapto‐3‐methyl‐1‐butanol (2M3MB) were lower when compared with the parent strain. Conclusion: We successfully constructed a self‐cloning brewer’s yeast with high SSU1 expression that enhanced the sulfite‐excreting ability and diminished the production ability of hydrogen sulfide, MBT and 2M3MB. Significance and Impact of the Study: The self‐cloning brewer’s yeast with high SSU1 expression would contribute to the production of superior quality beer with a high concentration of sulfite and low concentrations of hydrogen sulfide, MBT and 2M3MB.     

Isolation and identification of Acanthamoeba species related to amoebic encephalitis and nonpathogenic free‐living amoeba species from the rice field

Aims: Isolation and characterization of the clinically relevant amphizoic amoebas in vegetated farmlands, which may present a risk to farmers’ health. Methods and Results: Acanthamoeba species was isolated and characterized via morphological and molecular means in the rice field where the patient was exposed to rice paddy water which most probably was the point of infection. An Acanthamoeba sp. abundant in the rice field was identified. Genotyping showed the strain to be genotype T4, which was identical to the amoebic parasite found in patient’s cerebrospinal fluid. During the course of the study, three nonpathogenic free‐living amoeba species were also isolated and characterized for the first time in Taiwan. Conclusions: This study successfully located a possible source of granulomatous amoebic encephalitis in a patient and provided the first evidence that Acanthamoeba genotype T4 may be a potential pathogen in Taiwan. Significance and Impact of the Study: The integration of field survey, clinical data and morphological and genetic examination represents a sound strategy for investigation of the possible role of free‐living amoebae in causing human diseases. Future work should include investigating the potential contributory role of other nonpathogenic free‐living protozoa in disease of livestock or even human.     

Hyperbaric oxygen therapy treatment for the fixation of implant prosthesis in oncology patients irradiated

doi: 10.1111/j.1741‐2358.2012.00636.x Hyperbaric oxygen therapy treatment for the fixation of implant prosthesis in oncology patients irradiated Objectives: This study aimed to present a clinical report of an irradiated oncologic patient who underwent hyperbaric oxygen therapy to be rehabilitated with implant‐supported prosthesis. Materials and Methods: A 67‐year‐old man was admitted at Oral Oncology Center (FOA‐UNESP) presenting a lesion on the mouth floor. After clinical evaluation, incisional biopsy and histopathological exam, a grade II squamous cell carcinoma was diagnosed. The patient was subjected to surgery to remove the lesion and partial glossectomy. Afterwards, the radiotherapy, in the left/right cervicofacial area of the supraclavicular fossa, was conducted. After 3 years of the surgery, the patient was submitted to hyperbaric oxygen therapy. Then, four implants were installed in patient’s mandible. Five months later, an upper conventional complete denture and lower full‐arch implant‐supported prosthesis were fabricated. Conclusion: The treatment resulted in several benefits such as improving his chewing efficiency, swallowing and speech, less denture trauma on the mucosa and improving his self‐esteem.     

‘Cylindrocarpon’ and Ilyonectria Species Causing Root and Crown Rot Disease of Potted Laurustinus Plants in Italy

During the 2012 and 2013 growing seasons, a disease was detected on potted laurustinus (Viburnum tinus) plants in two nurseries located in the Catania province (eastern Sicily, Italy). ‘Cylindrocarpon’‐like species were consistently recovered from crown rot and stem rot tissues. Based on morphological characteristics, DNA sequencing and phylogenetic analysis of β‐tubulin (TUB), histone H3 (HIS3) and translation elongation factor‐1α (TEF‐1 α) gene sequences, the fungi associated with symptomatic tissues were identified as ‘Cylindrocarpon’ pauciseptatum, Ilyonectria novozelandica and I. torresensis. Koch's postulates were fulfilled by pathogenicity tests carried out on potted V. tinus cuttings. To our knowledge, this is the first report worldwide of ‘C.’ pauciseptatum, I. novozelandica and I. torresensis causing disease on V. tinus.     

A comparison of patient satisfaction between treatment with conventional complete dentures and overdentures in the elderly: a literature review

doi:10.1111/j.1741‐2358.2009.00299.x
A comparison of patient satisfaction between treatment with conventional complete dentures and overdentures in the elderly: a literature review Background: It has been stated that mandibular overdentures are more satisfactory than conventional dentures, but problems relating to the use of retrospective ratings, lack of control group and sequential provision of treatment may compromise the findings. Objective: To establish a comparison between treatment with conventional complete dentures and implant‐retained overdentures in elderly patients by conducting a literature review. Materials and methods: A search of English language peer‐review literature was completed using Medline up to 2008 focusing on evidence‐based research. Randomised clinical trials (RCTs) and longitudinal prospective studies were favoured in the review, using a general hierarchical classification. Articles that did not focus exclusively on the comparison of patient satisfaction between complete dentures and overdentures were excluded from further evaluation. The last search was conducted in February 2008. Key terms included quality of life, patient satisfaction, edentulism, complete denture and overdenture. Results: Among the 90 articles found in the initial search, 27 met the inclusion criteria. This included 18 RCTs and eight prospective and one cohort study. Most of the articles stated superiority of the mandibular implant‐retained overdenture therapy over the conventional complete denture regarding patient satisfaction and quality of life. Conclusion: Even with implant treatment presenting higher patient satisfaction and improvement of quality of life, it was not possible to establish a direct comparison between the studies due to differences in adopted methodologies.     

Cytology of the ‘penile’ neovagina in transsexual women

S. Weyers, K. Lambein, Y. Sturtewagen, H. Verstraelen, J. Gerris and M. Praet
Cytology of the ‘penile’ neovagina in transsexual women Objective: The primary objective was to describe the neovaginal cytology in transsexual patients (n = 50) treated with the inverted penile skin technique. Secondary objectives were to compare our cytological findings with patient characteristics including use of oestrogens, sexual orientation and penetrative intercourse. Methods: The medical and surgical history, sexual orientation and whether there was a current relationship were ascertained. A speculum examination was followed by microscopy of a Pap smear of the neovaginal vault. Results: Well‐preserved nucleated squamous cells were found in 72%. The correlation between their presence and sexual orientation was highly significant (P = 0.016), with those not sexually interested and homosexually oriented all having nucleated cells on the Pap smear. However, the correlation between these cells and penetrative intercourse failed to reach significance. Four samples showed atypical squamous cells of undetermined significance, all were negative for high‐risk human papillomavirus (HR‐HPV) types. One patient showed a low‐grade squamous intraepithelial lesion that was HR‐HPV positive. There was a significant correlation between the presence of cytological lesions and sexual orientation (P = 0.006). Four percentage of the specimens showed Döderlein bacilli. Inflammation was found in 30.6% of samples with squamous cells. Conclusions: The penile skin‐lined neovagina of transsexual women can reflect the cytological findings present in biological women. However ‘normal’ cervical cytology, with superficial, intermediate and parabasal cells as well as Döderlein bacilli, was found in only 4% of transsexual women. Although one patient’s Pap test showed koilocytes and was HR‐HPV positive, no high‐grade squamous intraepithelial lesions were identified.     

A cixiid survey for natural potential vectors of ‘Candidatus Phytoplasma phoenicium’ in Lebanon and preliminary transmission trials

Almond witches'‐broom (AlmWB) disease, associated with ‘Candidatus Phytoplasma phoenicium’, is an emerging threat with real risk of introduction in Euro‐Mediterranean Countries. Its rapid spread over large geographical areas suggests the presence of efficient insect vector(s). In the present work, a survey on cixiids was carried out in Lebanon in the years 2010–2013 in AlmWB‐infested almond and nectarine orchards. Insects were collected by means of different methods, identified with a stereo microscope, and analysed for phytoplasma identification through 16S rDNA PCR‐based amplification and nucleotide sequence analyses. Preliminary transmission trials were performed with the most abundant species. A list of the cixiid genera and species present in the studied area is given as well as some information about their biology. ‘Ca. Phytoplasma phoenicium’ strains were detected in the genera Cixius, Tachycixius, Eumecurus and Hyalesthes. Preliminary trials revealed that Tachycixius specimens were able to transmit the detected strains to healthy peach potted seedlings. Further studies are required to better clarify the taxonomic status and the bio‐ethology of collected planthoppers and deeply study their role as phytoplasma vectors.     

Multiple gene analyses reveal extensive genetic diversity among ‘Candidatus Phytoplasma mali’ populations

This study focused on evaluating the genetic diversity among ‘Candidatus Phytoplasma mali’ (‘Ca. P. mali’) populations in orchards of north‐western Italy, where apple proliferation (AP) disease is widespread and induces severe economic losses. ‘Ca. P. mali’ was detected through restriction fragment length polymorphism (RFLP) analysis of PCR‐amplified 16S rDNA in 101 of 114 samples examined. Collective RFLP patterns, obtained by restriction analyses of four amplified genomic segments (16S/23S rDNA, PR‐1, PR‐2 and PR‐3 non‐ribosomal region, ribosomal protein genes rplV‐rpsC and secY gene), revealed the presence of 12 distinct genetic lineages among 60 selected representative ‘Ca. P. mali’ isolates, underscoring an unexpected high degree of genetic heterogeneity among AP phytoplasma populations in north‐western Italy. Prevalence of distinct genetic lineages in diverse geographic regions opens new interesting avenues for studying the epidemiology of AP disease. Furthermore, lineage‐specific molecular markers identified in this work could be useful for investigating the biological life cycle of ‘Ca. P. mali’.     

Radiographic changes in alveolar bone height on overdenture abutments: a longitudinal study

Objective: Stabilisation of partial dentures is an important part of prosthodontic treatment, particularly in patients with an excessive reduction in alveolar bone supporting their abutment teeth. In these cases, overdenture prostheses are one possible treatment choice. Background: The aim of this study was to evaluate the effects of overdentures on the condition of alveolar bone of the remaining teeth, and to evaluate the overdenture concept in the prosthetic treatment of partially edentulous patients. Materials and methods: The investigation was conducted on 22 patients during observation periods of 6 and 10 years. After preparation, all abutment teeth were provided with either amalgam restorations or gold copings. An overdenture in the lower jaw was fabricated for every patient. A special film holder was used to repeat the X‐ray procedure in every patient in the same manner. The radiographs were evaluated using the grid scale. The alveolar bone level of all remaining teeth was evaluated on dental films by measuring the distance between the root apex and coronal border of the alveolar bone. Results: A statistically significant difference (p < 0.01) was calculated 6 years after delivery stage between distal alveolar bone levels of experimental abutments under overdentures and the remaining teeth of the control group. Alveolar bone of abutment teeth was considerably preserved, particularly in seven patients observed 10 years after provision of their dentures. Conclusion: Within the limitation of this study, the validity of the overdenture treatment in partially edentulous patients is concluded. Good oral hygiene was crucial for the success of treatment with overdentures.     

Evaluation of Hydrangea macrophylla for Resistance to Leaf‐Spot Diseases

Garden hydrangea (Hydrangea macrophylla) is a popular ornamental plant that can be devastated by leaf‐spot diseases. Information is needed to determine susceptibility of commercial cultivars to leaf‐spot diseases. To address this need, 88 cultivars of H. macrophylla were evaluated for their resistance to leaf‐spot diseases in full‐shade (2007–2008), full‐sun (2007–2008) and partial‐shade (2009–2010) environments in McMinnville, TN, USA. Ten cultivars [‘Ami Pasquier’, ‘Ayesha’, ‘Blue Bird’, ‘Forever Pink’, ‘Fuji Waterfall’ (‘Fujinotaki’), ‘Miyama‐yae‐Murasaki’, ‘Seafoam’, ‘Taube’, ‘Tricolor’ and ‘Veitchii’] were rated resistant (R) or moderately resistant to leaf spot under each of the three environments. In 2007–2008, approximately 51% of the cultivars were rated R in full shade, but only 5% were R in full sun. In 2009–2010, only 1% of the cultivars were rated R in partial shade. Although environmental parameters including temperature and rainfall influence disease severity and host reaction, a shaded environment was least favourable for leaf‐spot disease development, which demonstrates that establishing hydrangea in shaded environment can be an effective tool along with cultivar selection for managing leaf‐spot diseases on hydrangea. Six pathogens, Corynespora cassiicola, Cercospora spp., Myrothecium roridum, Glomerella cingulata (Anamorph: Colletotrichum gloeosporioides), Phoma exigua and Botrytis cinerea, were associated with leaf‐spot diseases of garden hydrangea. Of the leaf‐spot pathogens, C. cassiicola was most frequently isolated (55% of all isolates), followed by Cercospora spp. (20%) and other pathogens (25%). Because symptoms attributed to each leaf‐spot pathogen were similar, cultivars were selected for resistance to multiple leaf‐spot pathogens.