Patient satisfaction with occlusal scheme of conventional complete dentures: A randomised clinical trial (part I)

Abstract

Summary Background Occlusal scheme can affect denture retention, stability, occlusal force distribution, aesthetics, masticatory function, patient comfort and general patient satisfaction with dentures. Objectives This study aimed to compare the patient satisfaction with 3 types of complete denture occlusion including fully bilateral balanced occlusion (FBBO), newly presented buccalised occlusion (BO) and lingualised occlusion (LO). Methods In this parallel randomised clinical trial, new conventional complete dentures were fabricated for 86 volunteers. Participants were randomly allocated to 3 groups with 3 different occlusal schemes. All patients were recalled at 1 and 3 months after delivery for data collection. The 19‐item version of Oral Health Impact Profile for Edentulous Patients questionnaire was used in this study. The visual analogue scale (VAS) was used for assessment of the prosthodontist's attitude towards denture quality, patient's attitude towards different occlusal schemes and evaluation of patient satisfaction. Data were analysed using the Wilcoxon signed rank test, the Kruskal‐Wallis test and the post hoc Dunn test via SPSS version 18.0 (P ≤ .05). Results Eighty‐six patients completed the study, and their data were analysed (mean age ± standard deviation = 57.78 ± 9.98 years). The only significant difference when comparing the 3 groups was physical pain, which was significantly higher in FBBO group. No significant differences were found for the VAS scores of patient and prosthodontist satisfaction or the domain scores among the 3 occlusal schemes either at 1 or at 3 months post‐delivery. The VAS score of patient satisfaction and prosthodontist satisfaction increased at third compared to first month after delivery. Conclusion The results of this randomised clinical trial provided evidence that BO is as effective as LO for the fabrication of complete dentures.

Bilateral balanced occlusion compared to other occlusal schemes in complete dentures: A systematic review

“…All of the studies reported the BBO occlusion scheme; of these, 7 studies compared BBO with CG, 9 compared BBO with LO, and 3 compared BBO with ZD . Most of studies were considered crossover design, while 6 other studies were not considered crossover design . In crossover design, the most of studies made a new set of dentures to evaluated occlusion effect .…”

“…Five studies found positive effect in terms of satisfaction or quality of life for LO, perhaps because enables more efficient bolus penetration than BBO, or because LO presents less occlusal interference and surface contacts between the maxillary and mandibular teeth and, consequently, fewer mandibular denture loadings and dislodging during lateroprotrusion movements . Furthermore, LO should be considered a favorable occlusal scheme because present lower physical pain compared to BBO, especially for patients with a severely reabsorbed mandibular alveolar ridge (<20 mm), because it provides better mandibular denture retention and a lower chance of pain than BBO . However, in this study, the authors used porcelain teeth in their BBO scheme and hard resin teeth in their LO scheme; this may have influenced the results, as porcelain shows a higher modulus of elasticity than resin and thus contributes to a pressure increase in the residual ridge …”

“…This is an important finding, because it is more complex and time‐consuming for dentists and dental technicians to construct dentures using BBO compared to CG and LO occlusal scheme. These other occlusal schemes can be completed in less time and with less difficulty with simple occlusal adjustments …”

“…However, a period of 3 months after the insertion of new dentures is recommended for the re‐establishment of masticatory efficiency and satisfaction (chewing ability, taste, speech, aesthetics, retention and comfort) . So, for a correct decision in terms the effect of occlusion scheme on patient satisfaction, an evaluation at least 3 months after the occlusal adjustment session is recommended …”

Patient satisfaction with occlusal scheme of conventional complete dentures

“…Studies on balanced occlusal schemes have reported variable results. Some such studies indicated the superiority of lingualised occlusion (LO) compared with fully bilateral balanced occlusion (FBBO) . On the other hand, a few studies found similar results for LO and FBBO .…”