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      Comparison of Three Prosthodontic Treatment Modalities for Patients with Periodontally Compromised Anterior Mandibular Teeth: A 2-year follow-up study

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          Abstract

          Objectives

          To prospectively assess self-perceived chewing function (CF) and oral health-related quality of life (OHRQoL) in geriatric patients after receiving three different treatment modalities in the mandible: removable partial denture (CD-RPD), complete denture (CDs), or complete overdenture supported by mini dental implants (CD-MDI). At baseline, all patients had mobile anterior teeth (1 mm or >) and missing posterior teeth in the mandible. Patients were completely edentulous in the maxilla. After treatment, patients were recalled at the 3-month and the 2-year post-treatment period.

          Materials and Methods

          A total of 176 patients participated (CD group, n=68; CD-RPD group, n=58; CD-MDI group, n=50). Self-reported CF was assessed using the Chewing Function questionnaire (CFQ), The OHRQoL was evaluated using the OHIP14 questionnaire, which the patients completed 1. before treatment, 2. three months after treatment, and 3. at the 2-year post-treatment stage.

          Results

          The OHRQoL and the self-perceived CF significantly improved in all groups after treatment (p<0.01). The highest improvement of a CF was recorded in the CD-MDI group. The OHRQoL was significantly higher in the CD-MDI group in comparison to the CDs group after treatment (p<0.01). At the 2-year post-treatment stage, self-perceived CF significantly further improved in the CD-MDI group, while it worsened in the CD and the CD-RPD groups (p<0.01). The same pattern was recorded for the OHIP14 summary scores. The highest amount of denture repairs and adjustments was recorded in the CD-RPD group, although maintenance was also demanding in the CD-MDI group.

          Conclusion

          Within the limitations of this study, rehabilitation with mandibular MDI retained overdenture can be considered as preferred treatment with the constant improvement of OHRQoL and a chewing function in comparison to mandibular CD or mandibular RPD option in patients with mobile anterior mandibular teeth.

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          Most cited references60

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          A classification of marginal tissue recession.

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            Confirmatory factor analysis of the Oral Health Impact Profile.

            Previous exploratory analyses suggest that the Oral Health Impact Profile (OHIP) consists of four correlated dimensions and that individual differences in OHIP total scores reflect an underlying higher-order factor. The aim of this report is to corroborate these findings in the Dimensions of Oral Health-Related Quality of Life (DOQ) Project, an international study of general population subjects and prosthodontic patients. Using the project's Validation Sample (n = 5022), we conducted confirmatory factor analyses in a sample of 4993 subjects with sufficiently complete data. In particular, we compared the psychometric performance of three models: a unidimensional model, a four-factor model and a bifactor model that included one general factor and four group factors. Using model-fit criteria and factor interpretability as guides, the four-factor model was deemed best in terms of strong item loadings, model fit (RMSEA = 0·05, CFI = 0·99) and interpretability. These results corroborate our previous findings that four highly correlated factors - which we have named Oral Function, Oro-facial Pain, Oro-facial Appearance and Psychosocial Impact - can be reliably extracted from the OHIP item pool. However, the good fit of the unidimensional model and the high interfactor correlations in the four-factor solution suggest that OHRQoL can also be sufficiently described with one score.
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              A modified short version of the oral health impact profile for assessing health-related quality of life in edentulous adults.

              The aim of this study was to develop a shortened version of the Oral Health Impact Profile (OHIP) appropriate for use in edentulous patients and to evaluate its measurement properties. Data were collected from the Ontario Study of Older Adults and a longitudinal clinical trial of implant-retained prostheses undertaken in Newcastle Dental Hospital, UK. All subjects completed an OHIP at baseline, and UK subjects also completed an OHIP posttreatment. Using an item impact reduction method, a shortened version of the OHIP (called OHIP-EDENT) was derived from both datasets. Discriminant validity and responsiveness properties of this modified version were compared with OHIP-14 and OHIP-49. Using an item impact method of reducing the 49 OHIP items produced very similar subsets in both Canadian and British populations; the modified version had little overlap with the current short version (OHIP-14). Discriminant validity properties of OHIP-EDENT were similar to OHIP-14 and OHIP-49. Using effect sizes to assess sensitivity to change, OHIP-EDENT exhibited less susceptibility to floor effects than OHIP-14 and appeared to measure change as effectively as OHIP-49. The modified shortened version of the OHIP derived in this study has measurement properties comparable with the full 49-item version. This modified shortened version may be more appropriate for use in edentulous patients than the current short version.
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                Author and article information

                Journal
                Acta Stomatol Croat
                Acta Stomatol Croat
                ASC
                Acta Stomatologica Croatica
                University of Zagreb School of Dental Medicine, and Croatian Dental Society - Croatian Medical Association
                0001-7019
                1846-0410
                March 2019
                March 2019
                : 53
                : 1
                : 4-16
                Affiliations
                [1 ]Department of Prosthodontics, School of Dental Medicine & Clinical Hospital Centre Zagreb, University of Zagreb , Zagreb, Croatia,
                [2 ]Department of Prosthodontics, School of Dental Medicine, University of Zagreb , Zagreb, Croatia
                [3 ]Private Dental Office , Zagreb, Croatia,
                [4 ]Department of Prosthodontics, Division of Dental Medicine, Faculty of Medicine, University of Ljubljana & University Medical Center, University Dental Clinics , Ljubljana, Slovenia
                Author notes
                Address for correspondence:
Professor Asja Čelebi
University of Zagreb School of Dental Medicine
Department of Removable Prosthodontics
Gundulićeva 5, Zagreb HR-10 000 Croatia
Tel: 01 4802 111
 celebic@ 123456sfzg.hr
                Article
                ASC_53(1)_4-16
                10.15644/asc53/1/1
                6508933
                31118528
                4d6ddf6d-31b6-4e04-9e0f-e206211fa4ce
                Copyright @ 2019

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND) 4.0 License.

                History
                : 10 November 2018
                : 01 February 2019
                Categories
                Original Scientific Papers

                geriatric dentistry,dental prosthesis,mandible,patient satisfaction,mastication,diagnostic self evaluation

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