Differences in Lip Support with and without Labial Flanges in a Maxillary Edentulous Population. Part 2: Blinded Subjective Analysis

Manzotti, Anna; Wu, Rong

doi:10.1111/jopr.12621

Cited by 7 publications

(5 citation statements)

References 24 publications

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“…This study was approved by the University Institutional Review Board (IRB‐12‐200‐2), and a detailed explanation of the materials and methods for recruitment of all patients, fabrication of flangeless dentures, and digital photography methods are described in part 1 of this study . A random sample of 20 maxillary edentulous patients, described in part 2 of the study, was used for analysis . Therefore, a total of 80 images (2 frontal and 2 profile images per subject) were used to present to the judges for VAS analysis.…”

Section: Methodsmentioning

confidence: 99%

“…Measurement of subjective outcomes such as lip support and facial esthetics is challenging because a qualitative assessment should be converted to a quantitative and measurable outcome. The visual analog scale (VAS) as explained in part 2 of the study is a well‐validated method of assessment . However, the VAS method does not lend itself to discriminatory analysis testing, when a side‐by‐side comparison of variables is necessary.…”

mentioning

confidence: 99%

“…Regarding lip support and facial esthetics, the former is a surrogate outcome, and the latter is a true outcome. Part 2 of the study showed there are clinically insignificant differences in facial esthetics ratings (true outcome) between flange and flangeless dentures . The judges were blinded to the purpose of the study to eliminate any bias in facial esthetic ratings.…”

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confidence: 99%

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Differences in Lip Support with and without Labial Flanges in a Maxillary Edentulous Population – Part 3: Unblinded and Discriminatory Subjective Analysis

Nguyen

Manzotti

Kuo

2017

Journal of Prosthodontics

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Purpose: To study the subjective differences in direct lip support assessments and to determine if dentists and laypeople are able to discern and correctly identify direct changes in lip support between flange and flangeless dentures. Materials and Methods:A random sample of 20 maxillary edentulous patients described in part 2 of the study was used for analysis. A total of 60 judges comprising 15 general dentists, 15 prosthodontists, and 30 laypeople, the majority of who were distinct from part 2 of the study, were recruited. All images used in this study were cropped at the infraorbital level and converted to black and white tone, to encourage the judges to focus on lip support. The judges were un-blinded to the study objectives and told what to look for, and were asked to rate the lip support of each of the 80 images on a 100 mm visual analog scale (VAS). The judges then took a discriminatory sensory analysis test (triangle test) where they were required to correctly identify the image with a flangeless denture out of a set of 3 images. Both the VAS and triangle test ratings were conducted twice in a random order, and mean ratings were used for all analyses. Results: The overall VAS ratings of lip support for images with flangeless dentures were slightly lower compared to images with labial flanges, and this difference was statistically significant (p < 0.0001). This was true for both profile and frontal images. However, the magnitude of these differences was too small (no greater than 5 mm on a 100-mm scale) to be clinically significant or meaningful. The differences in VAS ratings were not significant between the judges. For the triangle test, judges overall correctly identified the flangeless denture image in 55% of frontal image sets and 60% of profile image sets. The difference in correct identification rate between frontal and profile images was statistically significant (p < 0.0001). For frontal and profile images, prosthodontists had the highest correct identification rate (61% and 69%), followed by general dentists (53% and 68%) and by laypeople (53% and 50%). The difference in correct identification rate was statistically significant between various judges (p = 0.012). For all judges, the likelihood of correctly identifying images with flangeless dentures was significantly greater than 1/3, which was the minimum chance for correct identification (p < 0.0001). Conclusions: Removal of a labial flange in a maxillary denture resulted in slightly lower ratings of lip support compared to images with a labial flange, but the differences were clinically insignificant. When judges were forced to look for differences, flangeless dentures were detected more often in profile images. Prosthodontists detected the flangeless dentures more often than general dentists and laypeople.It is generally understood that a labial flange is necessary in complete dentures to provide lip support, complete the contours of the denture, and provide a border seal; however, a recent article on flangeless maxillary dentures c...

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Differences in Lip Support with and without Labial Flanges in a Maxillary Edentulous Population – Part 3: Unblinded and Discriminatory Subjective Analysis

Nguyen

Manzotti

Kuo

2017

Journal of Prosthodontics

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“…Measurement of esthetic outcomes in dentistry has undergone significant changes in the past few decades, due to the importance of dental appearance in modern society . As presented in part 2 of this study, previous literature has shown that dentists and patients do not share the same esthetic threshold when assessing dental and facial esthetics . An important aspect in the evaluation of esthetic outcome of dental treatment is the subjectivity of each evaluator .…”

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confidence: 89%

Differences in Lip Support with and without Labial Flanges in a Maxillary Edentulous Population. Part 4: Patient‐Centered Analysis

Touloumi

2017

Journal of Prosthodontics

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Purpose: To study the subjective differences in facial esthetics evaluations and the ability to distinguish facial changes due to changes in lip support, when evaluated by patients themselves. An additional objective was to study the differences between patients' self-evaluation versus evaluation of other patients. Materials and Methods: A total of 22 maxillary edentulous patients from the original sample of 31 patients described in Part 1 of the study, returned to participate in this part of the study. The 22 patients acted as judges for all images in this study, and were therefore un-blinded to the objectives and details of the study. Patients first completed evaluation of facial esthetics on a visual analog scale (VAS). Four digital images per patient (total of 88 images) were evaluated in a random order, twice by all 22 patients. The mean scores from all judgments were used as the outcomes to be analyzed. All patients then took a discriminatory sensory analysis test (triangle test) where they were required to correctly identify the image with a flangeless denture out of a set of 3 images. Both the VAS and triangle test ratings were conducted twice in a random order, and mean ratings were used for all analyses. Results: For VAS analysis, there were no statistically significant or clinically significant differences in facial esthetics ratings between flange and flangeless dentures (p < 0.05). This was true for both profile and frontal images, irrespective of selfevaluation versus evaluation of other patients, years of patient edentulism, and judge (patient) gender. For the triangle test, frontal images had a correct identification rate of 50.2% and profile images of 50.4%, and the difference was not significant. There were no significant differences in triangle test results with respect to self-evaluation versus evaluation of other patients and judge (patient) gender. For all patients, the likelihood of correctly identifying images with flangeless dentures was significantly greater than 1/3, which was the minimum chance for correct identification (p < 0.0001). Conclusions: Flangeless dentures resulted in no differences in facial esthetics ratings for frontal and profile images, when evaluated by patients. When patients were forced to look for differences, flangeless dentures were detected in half of the image sets. These findings were similar for self-evaluation versus evaluation of other patients and for both patient genders.In restoring edentulous maxillae, clinicians can choose various options based on patients' desires, finances, and available bone volume.

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“…Bone structures resorption undeniably leads to an increase in prosthetic height. In the horizontal direction, the antero-posterior shift of bone structures complicates the restoration of aesthetics and function [ 23 , 24 ].…”

Section: Prosthetic Solutions In Response To Aging In Completely Eden...mentioning

confidence: 99%

Benefit of Hyaluronic Acid to Treat Facial Aging in Completely Edentulous Patients

Aubry

Collart-Dutilleul

Renaud

et al. 2022

JCM

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Hyaluronic acid (HA) is widely used in aesthetic medicine for its moisturizing and anti-aging action. This molecule, which is naturally present in the body, has an interesting response to aging, accentuated in totally edentulous patients. While its aesthetic benefits for facial rejuvenation are well-documented, there is a lack of description and investigation on its therapeutic usefulness for edentulous patients. The management of completely edentulous patients is a daily reality in dental practice and requires specific attention. The aesthetic and functional challenge is considerable. The displacement of the bone base, which is often marked, and lack of soft tissue support are sometimes difficult to correct with prosthetic reconstruction. This review aims to present the physiological processes appearing in completely edentulous patients and prosthetic solutions available to recreate oral functions and counteract facial aging. As prosthetic rehabilitations are not fully satisfying for counterbalancing the impression of excessive facial aging, we investigated the applications of HA injection in the perioral area, in order to improve edentulism treatment, and discussed the advantages and disadvantages, compared to other dermal fillers and rejuvenation therapies. Considering the specific situations of edentulous patients, dermal HA injections help to correct uncompensated bone losses and mucous volume losses and appear to be a therapeutically beneficial for treating completely edentulous patients, without the requirement to full rejuvenation therapy.

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Differences in Lip Support with and without Labial Flanges in a Maxillary Edentulous Population. Part 2: Blinded Subjective Analysis

Cited by 7 publications

References 24 publications

Differences in Lip Support with and without Labial Flanges in a Maxillary Edentulous Population – Part 3: Unblinded and Discriminatory Subjective Analysis

Differences in Lip Support with and without Labial Flanges in a Maxillary Edentulous Population – Part 3: Unblinded and Discriminatory Subjective Analysis

Differences in Lip Support with and without Labial Flanges in a Maxillary Edentulous Population. Part 4: Patient‐Centered Analysis

Benefit of Hyaluronic Acid to Treat Facial Aging in Completely Edentulous Patients

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