Search Results (60)

Background/Objectives: Halitosis in geriatric patients is multifactorial, but the joint contribution of prosthetic rehabilitation type and polypharmacy after routine dental procedures has rarely been quantified. We investigated how prosthesis type, polypharmacy, and salivary function were associated with volatile sulfur compound (VSC) burden and self-perceived halitosis in elderly dental patients. Methods: This cross-sectional study enrolled 88 patients aged ≥65 years, four weeks after completing routine dental procedures. Participants were stratified into three groups: complete denture wearers (n = 30), partial removable denture wearers (n = 28), and fixed prostheses/implants (n = 30). We measured unstimulated salivary flow rate (uSFR), tongue coating index (TCI), denture biofilm index, total VSCs (Halimeter^®), organoleptic score (0–5), and self-perceived halitosis. Polypharmacy, comorbidities, and the Geriatric Oral Health Assessment Index (GOHAI) were recorded. Analyses included one- and two-way ANOVA, Spearman correlations, theory-informed multivariable linear and logistic regression, exploratory mediation analysis, and ROC curves. Results: Forty-two participants (47.7%) reported halitosis. Mean VSC differed across groups (complete dentures 278.2 ± 38.6 ppb; partial 211.2 ± 46.3 ppb; fixed 164.4 ± 43.9 ppb; ANOVA p < 0.001). uSFR correlated inversely with VSC (ρ = −0.61, p < 0.001) and TCI correlated positively (ρ = 0.56, p < 0.001). A significant prosthesis × polypharmacy interaction was observed (F = 3.74, p = 0.029, η²_p = 0.082): polypharmacy was associated with higher VSC most clearly among partial and fixed prostheses wearers, whereas complete denture wearers showed high VSC levels regardless of polypharmacy status. Exploratory mediation findings were consistent with partial indirect association, with 45.9% of the polypharmacy–VSC association statistically explained by reduced uSFR; however, the cross-sectional design precludes causal or temporal interpretation. The full multivariable model showed apparent discrimination for self-perceived halitosis (AUC = 0.92), while the simplified four-item chairside composite model showed AUC = 0.89; neither estimate was optimism-corrected or externally validated. Conclusions: In elderly post-procedure patients, complete denture wearing, polypharmacy, and salivary hypofunction were independently and jointly associated with higher halitosis burden. Reduced salivary flow was consistent with a partial indirect statistical pathway in the polypharmacy–VSC association, supporting hydration counseling and meticulous prosthesis hygiene as low-cost geriatric interventions. Sensitivity analyses excluding implant-supported restorations, participants with MMSE scores of 24–26, and expanded mediation models including TCI and biofilm/plaque did not materially change the main inference. Full article

Objectives: This study aimed to identify the oral health conditions of homeless individuals in Rome, the most frequently required dental treatments, and to describe a standardized, replicable clinical protocol tailored to the specific needs and access barriers of this vulnerable population. Methods: Five hundred homeless individuals received comprehensive dental examinations at the Primary Care Services of the Dicastery for the Charity Services (Vatican City) between September 2023 and January 2026. Clinical assessments included oral hygiene status, periodontal health, caries prevalence, and degree of edentulism. Treatment interventions were programmed by scheduling subsequent appointments. For patients requiring prosthetic rehabilitation, treatment was sequenced into distinct steps: preparatory treatments (hygiene, extractions, conservative procedures), impression taking, prosthesis try-in, and delivery. Results: Oral health assessment revealed poor or absent hygiene (85.4%), high DMFT scores (63.0%), and root residues (22.4%). Periodontal disease affected 94.0% of participants (gingivitis 73.0%, periodontitis 21.0%). Tooth loss patterns included partial edentulism (12.0%) and complete edentulism (24.0%). A total of 440 appointments were scheduled, with an attendance rate of 78.4%. Prosthetic rehabilitation was completed in 150 patients: 50 received partial dentures (33.3%) and 100 complete dentures (66.7%). Conclusions: The examined homeless individuals experienced severe oral health deterioration characterized by extensive tooth loss and advanced periodontal disease. A substantial prosthetic rehabilitation was needed in this sample. The proposed sequential treatment protocol demonstrated high feasibility and patient adherence in this vulnerable population. Comprehensive dental services that address both immediate emergency needs and long-term rehabilitative care are crucial for improving oral health-related quality of life and facilitating social reintegration. Patient-reported outcomes indicated meaningful improvements in digestive function, aesthetic satisfaction, and employment opportunities following prosthetic rehabilitation. Full article

Background/Aim: This study aims to assess the prevalence of self-reported oral ulcers and their associated factors among patients with type 2 diabetes mellitus (T2DM) in Bangladesh. Materials and Methods: A hospital-based cross-sectional study was conducted among 260 patients with T2DM attending outpatient dental services at three tertiary hospitals in Dhaka. Data were collected using a semi-structured questionnaire covering sociodemographic characteristics, behavioral and dietary factors, medical history, and self-reported oral mucosal conditions. Associations between oral ulcers and potential risk factors were analyzed using Chi-square and Fisher’s exact tests. Results: Most participants were middle-aged (50–59 years), female, of low educational status and married, with a high prevalence of regular tooth-brushing but low use of oral hygiene aids such as mouthwash. Traumatic ulcers (21.5%) and oral lichen planus (19.6%) were the most frequently observed oral mucosal lesions followed by recurrent aphthous ulcers, oral lichenoid reactions, and oral candidiasis. Traumatic ulcers and oral lichenoid reactions showed associations with sharp teeth, dentures or braces, and amalgam restorations, while lichen planus and aphthous ulcers were significantly associated with smoking, systemic conditions such as hypertension, and coexisting oral lesions such as oral candidiasis. Multivariable logistic regression showed that sharp teeth, denture or brace use, amalgam restorations, and tobacco-related habits were associated with oral lesions. Conclusions: Oral ulcers and related mucosal lesions were found to be common among patients with T2DM in Bangladesh, with traumatic ulcers being most frequent and several local and behavioral factors showing significant associations. Full article

Surface roughness and mechanical performance are critical determinants of the clinical behavior, hygiene, and longevity of denture base materials. This study investigated the influence of two extrusion temperatures—280 °C and 300 °C—on both the surface roughness and compressive strength of ThermoSens thermoplastic polymer specimens over a 7-day immersion period. Surface roughness was evaluated at baseline, 24 h, and 7 days using a contact profilometer, while compressive strength was measured after 7 days following ISO 604 guidelines. Samples processed at 300 °C exhibited a significantly greater reduction in surface roughness over time (28.3%) compared with those processed at 280 °C (18.3%). However, although specimens processed at 300 °C showed a greater percentage reduction, their absolute roughness values remained higher than those processed at 280 °C. Compression testing demonstrated higher strength and modulus values in the 300 °C group (91.6 ± 1.8 MPa; 1887.9 ± 42.3 MPa) compared to the 280 °C group (82.3 ± 2.1 MPa; 1755.4 ± 38.7 MPa). These findings indicate a trade-off between improved mechanical performance at higher processing temperatures and lower surface roughness at lower temperatures, highlighting the need for the careful optimization of processing conditions. Full article

Objective: This study aimed to quantitatively evaluate five opportunistic respiratory pathogens among individuals, with or without dentures, who have either healthy or diseased periodontal conditions. Methods: Saliva samples were obtained from 24 older adults. DNA extraction was performed, followed by a quantitative Polymerase Chain Reaction targeting five opportunistic respiratory pathogens, namely Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pyogenes, Klebsiella pneumoniae, and Streptococcus agalactiae. The abundance of opportunistic pathogens among the four groups [denture-wearing with active periodontal disease (DAP), non-denture-wearing with active periodontal disease (NDAP), denture-wearing with stable periodontal health (DSP), and non-denture-wearing with stable periodontal health (NDSP)] were compared. Results: Saliva samples of all participants (100%) carried at least one opportunistic respiratory pathogen. Of the five pathogens, S. aureus, P. aeruginosa, K. pneumoniae, and S. agalactiae were present in more than 50% of the samples. A significant difference in the bacterial load of K. pneumoniae and P. aeruginosa was observed (p < 0.05). The quantity of P. aeruginosa in the NDAP group was significantly lower than the DSP group. However, for K. pneumoniae, no significant differences between the groups were detected. Conclusions: In this small pilot cohort, a relatively high prevalence and substantial microbial load of opportunistic respiratory pathogens were identified in the saliva of older adults. On the basis of these preliminary findings, optimal oral and denture hygiene care is suggested as a potential approach to reduce the presence and burden of respiratory pathogens in this population, although larger studies are required to confirm these associations and determine their clinical significance. Full article

Background/Objectives: Fixed partial dentures (FPD) are intended to restore the impaired functions of the dento-maxillary system (DMS) following the onset of partial edentulism. The objectives of this study were to determine the association of risk factors represented by caries predisposition (DMFT index - decayed (D), missing (M), and filled (F) teeth), oral hygiene, bruxism and smoking with FPD complications. Methods: This retrospective cross-sectional study was conducted on a sample of 428 patients who presented to the Department of Prosthetic Dentistry at the University of Medicine and Pharmacy of Craiova for various complications related to FPD. Biological, technical, and aesthetic complications were identified in terms of their frequency and their association with risk factors, including caries predisposition quantified by the DMFT index, oral hygiene, bruxism, and smoking status. Associations were assessed using Pearson’s chi-square tests and Mann–Whitney U tests (two-sided, α = 0.05), performed in IBM SPSS Statistics, version 26 (IBM Corp., Armonk, NY, USA). Results: The DMFT index showed elevated values, 16.41 ± 4.43 in subjects aged ≤45 years and 18.39 ± 4.89 in subjects aged >45 years. Oral hygiene was satisfactory in a percentage of 75.82%, bruxism was present in 38%, and 40.52% were smokers. Regarding FPD complications, 94.77% were biological, 86.27% were technical, and 85.62% were aesthetic. Conclusions: Caries predisposition, assessed by the DMFT index, and smoking were associated with a higher frequency of biological complications. Bruxism and smoking were associated with technical complications, while unsatisfactory oral hygiene and smoking were associated with aesthetic complications. Full article

Introduction: Oral candidiasis is a common opportunistic fungal infection of the oral mucosa, most frequently caused by Candida albicans. Its development is influenced by local factors, such as denture use and oral hygiene, as well as systemic conditions including diabetes, nutritional deficiencies, and chronic inflammatory diseases. Accurate diagnosis requires both clinical evaluation and mycological testing. The aim of this retrospective study was to analyze demographic characteristics, predisposing factors, and the species distribution of Candida isolates in patients diagnosed with oral candidiasis. Materials and Methods: A retrospective review of medical documentation was conducted to evaluate patient demographics, risk factors, comorbidities, denture use, and results of mycological examinations confirming oral candidiasis. Results: A total of 71 patients (49 women and 22 men), aged 21–85 years (mean 59.6 ± 16 years), were included in the study. Fungal etiology was confirmed in all cases, with Candida albicans identified most frequently (81.69%). Among comorbidities, cardiovascular diseases were most common (30.99%), followed by diabetes (14.08%), and chronic periodontitis, respiratory, and gastrointestinal diseases (each 11.27%). Removable dentures were used by 18.30% of patients, and nicotine addiction was reported in 9.86%. All strains were susceptible to the tested antifungals, except for species with known intrinsic resistance. Conclusions: Oral candidiasis in this cohort predominantly affected women and older adults, with Candida albicans remaining the most common etiological agent. Denture use emerged as an important local predisposing factor and was associated with a higher proportion of infections caused by non-albicans species. These findings underscore the importance of comprehensive clinical evaluation and routine mycological testing to guide targeted antifungal therapy, especially in patients with risk factors such as denture use or systemic comorbidities. Full article

Background/Objectives: Pathological tooth loss resulting from poor oral hygiene or systemic diseases can lead to partial edentulism, affecting patients both psychologically and physically. These consequences include facial height reduction, temporomandibular dysfunction, and impaired phonetics and mastication. Immediate complete dentures are often an effective provisional solution during the transition to full edentulism; however, establishing the occlusal plane can be challenging when remaining teeth prevent a conventional wax try-in. This clinical case aims to present a qualitative clinical case study of a single patient, illustrating the use of the Broadrick Occlusal Plane Analyzer (BOPA) for the establishment of an occlusal plane in harmony with the anterior and condylar guidance. Methods: A 51-year-old male patient presented to the Department of Prosthodontics at the School of Dentistry, Autonomous University of Guadalajara, with partial edentulism, periodontal disease, and generalized Grade III tooth mobility. Immediate maxillary and mandibular complete dentures were selected as the treatment of choice. Due to the presence of remaining teeth that hindered clinical determination of the occlusal plane, the BOPA was used during the denture design process. Results: Anatomical landmarks were combined with BOPA tracing to establish an occlusal plane harmonious with anterior and condylar guidance. The center of the curve was modified to accommodate anatomic variability in anteroposterior reference points. Conclusions: The use of the Broadrick Occlusal Plane Analyzer facilitated the accurate determination of the occlusal plane for the fabrication of immediate complete dentures in a patient where clinical assessment was limited. This modification allowed the establishment of a bilateral balanced occlusal scheme, contributing to functional and acceptable provisional oral rehabilitation during postoperative alveolar healing. Full article

Ceramic dental implants, particularly one-piece zirconia, offer a biocompatible and aesthetic alternative to titanium, with high strength and improved oral hygiene. By eliminating the implant–abutment micro-gap, they reduce bacterial accumulation because of their low plaque affinity and enhance stability. However, challenges remain, including alignment precision, limited retrievability, and sensitivity to mechanical stress. Misalignment can affect occlusal and functional outcomes, and zirconia’s rigidity complicates crown removal and modification. This case report explores the use of PEEK (polyether ether ketone) primary telescopic crowns to overcome these limitations, improving force distribution, enabling minor adjustments, and enhancing prosthetic retrievability in full-mouth zirconia restorations. A 62-year-old male patient seeking a fixed solution to replace removable dentures received 16 one-piece zirconia implants (eight per jaw). PEEK telescopic crowns were used over implant abutment copings, finalized with aesthetic zirconia bridges. The report details surgical and prosthetic procedures, along with a brief literature review on zirconia implants and PEEK applications. PEEK integration in telescopic prosthetic designs marks a notable advancement in prosthodontics. Its shock-absorbing, biocompatible, and stress-modulating properties make it valuable for implant-supported and hybrid restorations. As digital workflows advance, PEEK-based telescopic restorations may increasingly replace traditional metal-based solutions, improving long-term clinical outcomes. Further clinical research on a larger sample is needed. Full article

Denture hygiene is crucial for preventing oral infections, with Candida albicans being a common fungal pathogen that can colonize denture surfaces. This in vitro study evaluated the adherence of C. albicans on two denture base materials—polyamide and polymethyl methacrylate (PMMA)—and assessed the antifungal efficacy of various chemical and natural cleansers. A total of 100 polished specimens were inoculated with C. albicans and treated with chemical agents (Listerine at 2%, 20%, 50%; Corega^®, Block Drug Company, Jersey City, NJ, USA); Protefix^®, Queisser Pharma, Flensburg, Germany and natural products (15% apple vinegar, 2% tea tree oil, 2% peppermint oil) for different durations (5, 15, 30, 480 min). Chlorhexidine (2%) and untreated samples served as positive and negative controls, respectively. Corega^® and 15% vinegar eliminated C. albicans within 5 min on both materials. 50% Listerine was effective after 5 min on PMMA but required 480 min on polyamide. Protefix^® showed full efficacy in 5 min on PMMA and 30 min on polyamide. Tea tree oil required 30–480 min for activity, while peppermint oil showed minimal effect throughout. Under the tested conditions, Corega^® appeared most effective. Natural cleansers, particularly vinegar and tea tree oil, also showed considerable anticandidal potential, suggesting they may serve as alternative agents for denture hygiene applications. Full article

Background/Objectives: As the aging population is growing globally, oral health has become integral to ensuring healthy aging and quality of life. This study assessed the oral health status of older adults in a Malaysian long-term care facility and explored caregiver-reported challenges in providing oral care. Methods: A convergent mixed-methods design was applied, involving 115 residents aged ≥60 years and 16 caregivers in a public facility. The residents’ oral health was assessed using interviewer-assisted questionnaires (demography, dependency level, Oral Frailty Five-item Checklist), clinical examinations (dental caries status, number of remaining teeth, oral and denture hygiene), and the Decayed, Missing, and Filled Teeth (DMFT) index. Focus group discussions with caregivers were conducted, transcribed, and thematically analyzed. Quantitative data were descriptively analyzed using SPSS version 29.0. Results: Over one-third of the residents (39%) were moderately to highly dependent on caregivers. All had experienced dental caries, with most having fewer than 20 teeth (92.9%) and requiring dentures (81.7%). Overall, both oral and denture hygiene were poor. Assessment of oral frailty indicated that the majority of residents (94.8%) were at risk of impaired oral function. A thematic analysis identified four key themes influencing oral health: (1) health and oral health conditions of residents; (2) variety in oral care practices; (3) older adults’ attitudes and behaviors; and (4) system factors. These themes were mapped in a conceptual framework demonstrating multilevel influences on oral care. Conclusions: Despite the single-center design, these findings provide actionable insights for improving geriatric oral health policies in Malaysia. Practical recommendations include integrating oral health into aged-care standards, expanding mobile dental services, and establishing oral care champions within facilities. Addressing these challenges is critical to improving quality of life and aligning long-term care practices with the WHO’s healthy aging priorities. Full article

Background: Oral candidiasis is a prevalent opportunistic infection, predominantly caused by Candida albicans (CA), though non-albicans Candida (NAC) species are increasing worldwide. This study aimed to characterize the prevalence of Candida species, evaluate antifungal susceptibility, and identify predisposing risk factors in patients with oral mucosal candidiasis. Methods: A retrospective review of 1286 electronic patient medical records (788 women, 498 men) from 2018 to 2022 was conducted at the Department of Periodontal and Oral Mucosa Diseases, Medical University of Silesia. Swabs from the oral cavity were processed to identify Candida strains by mass spectrometry, followed by drug susceptibility testing for amphotericin B, nystatin, flucytosine, econazole, ketoconazole, miconazole, and fluconazole. Relevant local and systemic predisposing factors were recorded and analyzed statistically. Results: Among 958 patients with positive fungal cultures, CA accounted for 66.79% of isolates, while NAC constituted 33.21%. Multi-strain infections were detected in 8.46% of patients. CA showed lower resistance (<10%) to amphotericin B, nystatin, and flucytosine, but up to 30% resistance to azoles. NAC strains demonstrated elevated resistance rates (>40% for most azoles), with C. krusei exhibiting the highest resistance to the previously mentioned antifungal agents. Key risk factors included wearing removable dentures (p = 0.042) and uncontrolled diabetes mellitus (p = 0.0431). Additional factors, including poor oral hygiene, reduced salivary flow, and immunosuppressive conditions, further increased infection risk. Patients presenting with multiple risk factors were more likely to have multi-strain infections and more severe disease courses. Conclusions: This retrospective analysis highlights the growing prevalence of NAC, rising antifungal resistance (particularly to azoles), and the importance of identifying risk factors, especially denture use and poor glycemic control. Enhanced preventive strategies, robust diagnostic approaches, and optimized antifungal regimens are essential to address this evolving clinical challenge. Full article

Inhaled corticosteroids (ICSs) are widely used to manage chronic respiratory conditions such as asthma, chronic obstructive pulmonary disease (COPD), and human immunodeficiency virus (HIV). However, prolonged use of ICS is associated with the development of oropharyngeal candidiasis, a fungal infection primarily caused by Candida albicans, due to local immunosuppression in the oral cavity. The incidence of oropharyngeal candidiasis varies depending on geographic region, patient age, and comorbidities, with immunocompromised individuals, those with diabetes, and the elderly being particularly vulnerable. Key risk factors include high ICS doses, poor oral hygiene, and improper use of inhalers. Prevention is the cornerstone of managing oropharyngeal candidiasis associated with the chronic use of inhaled corticosteroids. Patient education on proper inhaler technique and oral hygiene is essential to reduce the risk of fungal overgrowth in the oral cavity. Additional preventive strategies include the use of spacers, mouth rinsing after inhalation, and proper denture care. In cases where these measures fail to prevent the infection, prompt detection and early intervention are crucial to prevent progression or recurrence. This narrative review aims to analyze the most effective prophylactic measures to prevent oropharyngeal candidiasis associated with the chronic use of inhaled corticosteroids, emphasizing patient education, oral hygiene, and proper use of inhalation devices. Full article

Background/Objectives: Denture hygiene is essential for the prevention of oral candidiasis, a condition frequently associated with Candida albicans colonization on denture surfaces. Cetylpyridinium chloride (CPC)-loaded montmorillonite (CPC-Mont) has demonstrated antimicrobial efficacy in tissue conditioners and demonstrates potential for use in antimicrobial coatings. In this study, we aimed to develop and characterize CPC-Mont-containing coating films for dentures, focusing on their physicochemical behaviors and antifungal efficacies. Methods: CPC was intercalated into sodium-type montmorillonite to prepare CPC-Mont; thereafter, films containing CPC-Mont were fabricated using emulsions of different polymer types (nonionic, cationic, and anionic). CPC loading, release, and recharging behaviors were assessed at various temperatures, and activation energies were calculated using Arrhenius plots. Antimicrobial efficacy against Candida albicans was evaluated for each film using standard microbial assays. Results: X-ray diffraction analysis confirmed the expansion of montmorillonite interlayer spacing by approximately 3 nm upon CPC loading. CPC-Mont showed temperature-dependent release and recharging behavior, with higher temperatures enhancing its performance. The activation energy for CPC release was 38 kJ/mol, while that for recharging was 26 kJ/mol. Nonionic emulsions supported uniform CPC-Mont dispersion and successful film formation, while cationic and anionic emulsions did not. CPC-Mont-containing coatings maintained antimicrobial activity against Candida albicans on dentures. Conclusions: CPC-Mont can be effectively incorporated into nonionic emulsion-based films to create antimicrobial coatings for denture applications. The films exhibited temperature-responsive, reversible CPC release and recharging behaviors, while maintaining antifungal efficacy, findings which suggest the potential utility of CPC-Mont-containing films as a practical strategy to prevent denture-related candidiasis. Full article