Influence of tooth loss on mandibular morphology : a cone-beam computed tomography study

Tooth loss adversely affects patients? health and psychosocial wellbeing. In addition, it changes mandibular morphology. Objective: To evaluate the effect of tooth loss, age, and gender on mandibular morphology. Cone-beam computed tomographic (CBCT) scans of 101 patients were examined to measure the gonial angle (GA), ramus height (RH) and condylar height (CH). Patients? age, gender, and dental status were recorded. Repeated measures analysis of variance (ANOVA) was used to assess the impact of gender, age, and tooth loss on the GA, RH and CH. The mean measurements of the GA, RH and CH were compared between dentate/edentulous patients after splitting by gender. The GA was larger in edentulous patients compared to dentate ones, in females than in males, and in older than in younger. RH on the right side was significantly longer than on the left side (P< 0.0001), and also longer in males and younger patients. CH was shorter in younger than in older patients and in dentate than in edentulous patients. Tooth loss is associated with changes in mandibular morphology and its prevention would avoid these irreversible changes

The effect of nanodiamonds on candida albicans adhesion and surface characteristics of PMMA denture base material : an in vitro study

Candida albicans&nbsp;is the main causative pathogen of denture stomatitis, which affects many complete denture patients. Objective: To evaluate the effect of different concentrations of nanodiamonds (NDs) added to polymethyl methacrylate (PMMA) denture base material on&nbsp;Candida albicans&nbsp;adhesion as well as on surface roughness and contact angle. Methodology: Acrylic resin specimens sized 10×10×3 mm3&nbsp;were prepared and divided into four groups (n=30) according to ND concentration (0%, 0.5%, 1%, 1.5% by wt). Surface roughness was measured with a profilometer, and the contact angle with a goniometer. The effect of NDs on&nbsp;Candida albicans&nbsp;adhesion was evaluated using two methods: 1) slide count and 2) direct culture test. Analysis of variance (ANOVA) and Tukey's post hoc test were used in the statistical analyses. Results: Addition of NDs decreased the&nbsp;Candida albicans&nbsp;count significantly more than in the control group (p&lt;0.05), with a lowest of 1% NDs. Addition of NDs also significantly decreased the surface roughness (p&lt;0.05), but the contact angle remained the same. Incorporation of NDs into the PMMA denture base material effectively reduced&nbsp;Candida albicans&nbsp;adhesion and decreased surface roughness. Conclusion: PMMA/NDs composites could be valuable in the prevention of denture stomatitis, which is considered one of the most common clinical problems among removable denture wearers

Influence of tooth loss on mandibular morphology: A cone-beam computed tomography study

Background: Tooth loss adversely affects patients’ health and psychosocial wellbeing. In addition, it changes mandibular morphology. Objective: To evaluate the effect of tooth loss, age, and gender on mandibular morphology. Materials and Methods: Cone-beam computed tomographic (CBCT) scans of 101 patients were examined to measure the gonial angle (GA), ramus height (RH) and condylar height (CH). Patients’ age, gender, and dental status were recorded. Repeated measures analysis of variance (ANOVA) was used to assess the impact of gender, age, and tooth loss on the GA, RH and CH. The mean measurements of the GA, RH and CH were compared between dentate/edentulous patients after splitting by gender. Results: The GA was larger in edentulous patients compared to dentate ones, in females than in males, and in older than in younger. RH on the right side was significantly longer than on the left side (P< 0.0001), and also longer in males and younger patients. CH was shorter in younger than in older patients and in dentate than in edentulous patients. Conclusions: Tooth loss is associated with changes in mandibular morphology and its prevention would avoid these irreversible changes.</p

The effect of nanodiamonds on candida albicans adhesion and surface characteristics of PMMA denture base material - an in vitro study

Candida albicans is the main causative pathogen of denture stomatitis, which affects many complete denture patients. Objective: To evaluate the effect of different concentrations of nanodiamonds (NDs) added to polymethyl methacrylate (PMMA) denture base material on Candida albicans adhesion as well as on surface roughness and contact angle. Methodology: Acrylic resin specimens sized 10×10×3 mm3 were prepared and divided into four groups (n=30) according to ND concentration (0%, 0.5%, 1%, 1.5% by wt). Surface roughness was measured with a profilometer, and the contact angle with a goniometer. The effect of NDs on Candida albicans adhesion was evaluated using two methods: 1) slide count and 2) direct culture test. Analysis of variance (ANOVA) and Tukey’s post hoc test were used in the statistical analyses. Results: Addition of NDs decreased the Candida albicans count significantly more than in the control group (p<0.05), with a lowest of 1% NDs. Addition of NDs also significantly decreased the surface roughness (p<0.05), but the contact angle remained the same. Incorporation of NDs into the PMMA denture base material effectively reduced Candida albicans adhesion and decreased surface roughness. Conclusion: PMMA/NDs composites could be valuable in the prevention of denture stomatitis, which is considered one of the most common clinical problems among removable denture wearers.</p

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Studies on tooth loss, mandibular morphology and dental prostheses:clinical, radiological and in vitro examinations

Abstract Tooth loss adversely affects patients’ quality of life and causes inevitable changes in the mandibular morphology. Polymethyl methacrylate (PMMA) is the most frequently used material of removable dentures. Denture stomatitis (DS) is a common clinical finding among denture wearers, particularly patients with debilitating diseases. Several fillers and nanofillers have been used to improve the physical, mechanical, antifungal, and antimicrobial properties of PMMA. The aim of the present retrospective cross-sectional study was to determine the prevalence of tooth loss and the commonly used prosthetic constructions in 479 adult patients at the Department of Substitutive Dental Sciences (SDS), College of Dentistry, University of Dammam, currently Imam Abdulrahman Bin Faisal University, Dammam. The influence of tooth loss on mandibular morphology was studied by using cone-beam computed tomographic (CBCT) scans of 101 patients. The effect of addition of thymoquinone (TQ) and nanodiamonds (NDs) to PMMA on the flexural and surface properties of PPMA and their antifungal influence was tested through in vitro studies. Edentulousness was recorded in 6%, a single edentulous arch in 8%, and partial edentulousness in 74% of the patients. Age and diabetes were significantly associated with edentulousness. Males had a significantly higher number of missing teeth compared to females. Kennedy class III was most common in the upper and lower jaw and was treated more often with fixed partial denture (FPD) than with removable partial denture (RPD). Larger gonial angle (GA) of the mandible was found in edentulous patients, in females and in older compared to dentate patients, males and younger patients. The addition of TQ to PMMA at low concentration did not significantly change the flexural strength, elastic modulus or surface properties of PMMA. The addition of NDs to PMMA significantly reduced surface roughness and the Candida albicans (C. albicans) count. Edentulousness increased in old age and caused changes in mandibular morphology. TQ addition at low concentration did not change the flexural and surface properties of PMMA. NDs decreased the surface roughness of PMMA and Candida albicans adhesion, which could help in the prevention of denture stomatitis.Tiivistelmä Hampaattomuus vaikuttaa potilaiden elämänlaatuun ja aiheuttaa alaleuan muodon muutoksia. Hampaattomuutta ja hammaspuutoksia voidaan hoitaa purennan kuntoutuksella irtoproteeseilla ja kiinteällä protetiikalla. Polymetyylimetakrylaatti (PMMA) on yleisimmin käytetty irtoproteesien materiaali. Suun sieni-infektio, proteesistomatiitti, on yleinen kliininen löydös proteesipotilailla ja erityisesti potilailla, joilla on yleiskuntoa heikentäviä sairauksia. Erilaisia lisämateriaaleja on käytetty parantamaan PMMA:n fysikaalisia, mekaanisia ja antimikrobisia ominaisuuksia. Tämän retrospektiivisen poikittaistutkimuksen tarkoituksena oli kartoittaa hampaattomuuden ja hammaspuutosten esiintyvyys ja toteutetut proteettiset hoidot 479 saudiarabialaisella aikuispotilaalla, jotka oli hoidettu Dammanin yliopiston hammaslääketieteen laitoksella. Hammaspuutosten vaikutusta alaleuan muotoon tutkittiin 101 potilaan kartiokeilatietokonetomografia (KKTT) kuvista. Tymokinonin (thymoquinone, TQ) ja nanotimanttien (ND) lisäyksen vaikutusta PPMA:n taivutuslujuuteen ja pintaominaisuuksiin sekä niiden antimikrobisia ominaisuuksia tutkittiin in vitro kokein. Täydellistä hampaattomuutta oli 6 %:lla, ylä- tai alaleuan hampaattomuutta 8 %:lla ja osittaista hampaattomuutta 74 %:lla potilaista. Hampaattomuutta lisäsivät merkittävästi potilaan ikä sekä yleissairauksista diabetes. Miehillä oli merkittävästi enemmän omia hampaita jäljellä kuin naisilla. Hammaspuutosten sijainnin luokittelussa Kennedyn luokka III oli yleisin sekä ylä- että alaleuassa ja puutos oli useammin hoidettu kiinteällä siltaratkaisulla kuin irrotettavalla osaproteesilla. Alaleuan leukakulma oli hampaattomilla, naisilla ja vanhemmilla potilailla suurempi kuin hampaallisilla, miehillä ja nuoremmilla potilailla. Alhainen TQ-pitoisuus ei merkittävästi muuttanut PMMA:n taivutuslujuutta, kimmomoduulia eikä sen pintaominaisuuksia. Nanotimanttien lisäys vähensi merkittävästi PMMA:n pinnankarheutta ja Candida albicans-kasvustoa. Tutkimus osoitti, että hampaattomuus lisääntyi iän myötä ja aiheutti alaleuan muodon muutoksia. Alhainen TQ-pitoisuus ei muuttanut PMMA:n taivutuslujuutta tai pintaominaisuuksia. Nanotimantit alensivat PMMA:n pinnankarheutta ja Candida albicansin kiinnittymistä siihen, mistä voisi olla apuna proteesistomatiitin ehkäisyssä

Immunization status in childhood cancer survivors: A hidden risk which could be prevented

Background: A limited number of studies have examined the vaccine-specific antibody status of children with cancer. There are disagreements over the guidelines for postcancer immunization strategy. Methods: Our study was an observational, cross-sectional retrospective review of data collected on children who were seen in the outpatient clinic at King Abdullah Medical City, Oncology Center, Jeddah, the Kingdom of Saudi Arabia. Our aim was to evaluate the seropositive status to vaccine-preventable diseases: measles, mumps, rubella, diphtheria, tetanus, polio, and Haemophilus influenzae type B (HIB) in childhood cancer survivors at our center in order to plan future vaccination for these children and establish a simple revaccination schedule. Results: Forty-seven patients (21 boys and 26 girls) were included in the study. Age at the time of cancer diagnosis (mean±standard deviation) was 5.68±3.79 years and age at test sampling was 10.68±3.79 years. Acute leukemia was the most common cancer (49% of patients), followed by lymphoma (28%), brain tumors (13%), and solid tumors (10%). Treatment intensities (according to the Treatment Intensity Rating Scale, version 3.0; ITR-3) were 2, 3, and 4 for 26 patients (55%), 20 patients (43%), and one patient (2.1%), respectively. We found that 93% of our patients were considered seronegative (unprotected) for at least one vaccine-preventable disease. The seronegative rates for measles, mumps, rubella, diphtheria, tetanus, polio, and HIB were 46.8%, 36.2%, 36.2%, 46.8%, 61.7%, 17.1%, and 42.6%, respectively. Criteria including age at diagnosis, age at sampling, type of malignancy, and treatment intensity were not significantly different between seropositive and seronegative patients. Conclusion: Seronegative rates for vaccine-preventable diseases were very high in childhood cancer survivors, which represented a subpopulation of high-risk patients who could benefit from revaccination. We suggest a universal revaccination approach for all childhood cancer survivors, which is easily applicable and of low cost. Key Words: childhood cancer survivors, immunization, vaccin

Effect of Patient’s Personality on Satisfaction with Their Present Complete Denture and after Increasing the Occlusal Vertical Dimension: A Study of Edentulous Egyptian Patients

Complete denture wearers often find it difficult to accept a new denture. Personality traits are among the factors that possibly affect patient satisfaction with a complete denture. Our aim was to investigate the influence of patients’ personality on satisfaction with their present denture and after an increase in the occlusal vertical dimension (OVD). Sixty edentulous patients with complete dentures (22 men and 38 women, mean age 66 years, and range 50–75 years) participated in the study. The age of their complete dentures ranged from 5 to 16 years. Patients’ personalities were evaluated using the Arabic version of the Eysenck Personality Questionnaire. Their satisfaction with their dentures before and after restoration of the OVD and relining of the mandibular denture was evaluated using two questionnaires (I and II), Patients with a high score of neuroticism were less satisfied with their original dentures and after relining and an increase of OVD compared with patients with an average score in that trait. The personality trait of psychoticism was significant to patients’ acceptance of an increase in OVD; that is, patients with a high score were less satisfied with their dentures after increase of OVD than patients with an average score. It is concluded that personality traits affect patients’ acceptance of their complete dentures

Influence of CAD/CAM Milling and 3D-Printing Fabrication Methods on the Mechanical Properties of 3-Unit Interim Fixed Dental Prosthesis after Thermo-Mechanical Aging Process

This study assessed the influence of CAD/CAM milling and 3D-printing fabrication methods on mechanical properties of 3-unit interim fixed dental prosthesis (IFDPs) after thermo-mechanical aging. Forty 3-unit IFDPs were fabricated on a mandibular right second premolar and second molar of a typodont cast. Samples were fabricated from the following materials; auto-polymerized polymethyl methacrylate (conventional resin), CAD/CAM PMMA (milled resin) and two different CAD/CAM 3D-printed composite resins; digital light processing Asiga (DLP AS) and stereolithography NextDent (SLA ND). Mechanical properties were compared between the studied materials using Kruskal–Wallis test, followed by multiple pairwise comparisons using Bonferroni adjusted significance. There was a significant difference in flexural strength and microhardness between the studied materials (p p = 0.02). In conclusion, superior flexural strength, elastic modulus, and hardness were reported for milled IFDPs. SLA ND printed IFDPs showed comparable mechanical properties to milled ones except for the elastic modulus