Clinical guide to border moulding and secondary impression in complete dentures

One of the major reason for a successful denture treatment is a good impression and the cast made out of it. It’s a well known fact, that the denture can only be as good as the impressions made. Therefore, attention to every detail and depth of the impressions plays a pivotal role for a successful clinical result, for which border moulding is an essential procedure for the same. Impressions convey operator’s extent of knowledge, understanding and the clinical results that can follow. A combination of a sound knowledge, along with acquired skill, experience, and patience can result in a successful and aesthetic prosthesis with adequate retention, stability and support with minimal post placement corrections. This article gives an insight into the necessary requisites to be followed during border moulding and secondary impression in making of a successful complete dentures.

The Level of utilization and Satisfaction of Complete Denture Treatment Provided in Fiji from 2010-2016

BACKGROUND: Wearing dentures helps rehabilitate the oral health status for the older people. Due to lack of previous data, this objective of this study was to determine the level of utilization and satisfaction of complete denture treatment at dental clinics in Fiji. MATERIALS & METHODS: A cross sectional descriptive study was conducted on 85 edentulous patients and dentures at the Fiji National University (FNU) teaching dental clinic from 2010-2016.Patients who utilized the dentures fabricated at FNU and identified as complete denture patients from 2010-2016 were included in this study. Data was collected using the denture assessment form and Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT) questionnaire. Correlation test was done and p less than 0.05 was considered as level of significance. RESULTS: Participants were between the age range of 40-79 years with majority being male (54%). Greater level of satisfaction noted among 60-69 years male participants and those wearing the dentures for 3-4 years than other groups. Difficulty in chewing (40%) and food catching underneath the denture (33%) were common denture related complains. One thirds of participants reported of uncomfortable dentures while 24% had sore spots due to their dentures. More than two thirds of them, (71%) were unable to eat and enjoy food and for most patients, the vertical dimension (94%), esthetics assessment (94%), tooth selection (91%), boarder extension (78%), posterior seal (99%) and centric relation (99%) were acceptable. Patients with acceptable vertical dimension (46.1±7.6), acceptable esthetics (45.8±7.9) and boarder extension (48.0±7.2) showed greater satisfaction level compared to those with unacceptable denture characteristics. CONCLUSION: This study highlighted that satisfaction among recent denture wearers was low and majority participants portrayed poor understanding regarding denture aftercare and hygiene. It can be recommended for the teaching institutes and dental clinics to evaluate the quality of treatments and help to improve the quality of services being provided to the patients. Further study is needed to determine the in- depth perceptions of denture wearers. It also can be recommended for the patients to take heed of the post operative denture hygiene instructions being given.

Effect of Dentures on Palatal Rugae: An Investigation

Aims: The aim of this study is to evaluate the rugae pattern changes (rugae number, length, shape, direction, and unification) in completely edentulous patients treated with complete denture. Materials and Methods: A total of 100 subjects were selected for the study. The experimental group comprised 60 participants (30 males and 30 females) who had undergone complete denture treatment and the control group comprised 40 participants (20 males and 20 females) who were dentulous and patients with fixed partial denture treatment. Mucostatic maxillary alginate impressions were made for all the subjects, and casts were poured with gypsum. Patients were recalled at the regular intervals of 1, 6, and 18 months after the treatment. During those recalls, the same impression procedure was made, and all the palatal rugaes were observed for number, length, shape, direction, and unifications under magnifying lens. Changes in the palatal rugae were statistically analyzed using the unpaired t‑test. Results: A gradual decrease in the length was observed in primary, secondary, and fragmentary rugae for the experimental group after denture wearing (Group 1). Statistically, the change was significant (P < 0.001) in primary rugae only. A slight change in rugae shape was also observed in the experimental group after 18 months period of denture wearing which is statistically insignificant (P > 0.05). Conclusions: Significant decrease in primary rugae length in complete denture wearers was due to sustained mechanical stress posed by the dentures on palatal rugae. The other parameters such as rugae number, direction, and unification remained constant throughout the study. Palatal rugae analysis may not be helpful for human identification in complete denture wearers. Nevertheless, palatal rugae may serve as an adjuvant to other techniques such as DNA analysis and finger prints in forensic investigations.

The Patient’s Denture Assessment (Thai version) is a valid and reliable tool for evaluating the outcome of treatment with complete denture

Background Complete tooth losses are still being major problems which resulted in lesser quality of life especially for elderly patients. However, there are still lack of questionnaire to evaluate the treatment outcome from the patient’s aspect. The objective of this study is to evaluate the reliability and validity of the Patient’s Denture Assessment-Thai version (PDA-T), then use this questionnaire to assess patient satisfaction with complete denture treatment outcome also investigates the factors involving their satisfaction. Methods The subjects comprised 120 edentulous adult patients (49 men/71 women; average age 70 years-old) from the Prosthodontic and the Geriatric Dentistry and Special Patients Care Clinic at the Faculty of Dentistry, Chulalongkorn University during 2019 March‒2020 March. The patients were divided into two groups: the group experienced (Exper) (n = 54) with wearing complete dentures, and the non-experienced (NonExper) group (n = 66). The patients used the validated PDA-T to self-assess their treatment at different times. The Exper group completed the questionnaire at t0 (during treatment), t0.5 (2‒8-weeks after t0), and t1 (final follow-up). The NonExper group completed the questionnaire only at t1. Results In the Exper group, Cronbach’s α and average inter-item correlation was 0.95 (range 0.76‒0.95) and 0.47 (range 0.57‒0.83), respectively. The intraclass correlation coefficients (n = 18, 95% confidence interval) were 0.98 overall. The paired t-test (p < 0.05) between t0 and t1 indicated a significant difference between t0 and t1 in every PDA-T topic, and the effect size was 1.71. In the NonExper group, the Pearson correlation analysis indicated no significant correlation between the patients' demographics and masticatory function. Conclusion The reliability and validity of the PDA-T indicate it is a valuable tool for evaluating complete denture treatment. Treatment success affected the patients' satisfaction but was not associated with the type of doctors, genders, ages, or educational level.