It has been hypothesized that depression can be both a risk factor and a consequence of oral diseases. Tooth loss leads to discomfort, pain, and functional limitations which could lead to disability and, subsequently, to handicap. However, the association between depression and edentulism has not been established yet. Data from the Canadian Community Health Survey (CCHS) Cycle 2.1 were used to examine the association between edentulism and depression in community-dwelling Canadians 45 years of age and older. Separate logistic regression models were developed for dentate and edentulous groups as well. Different regression selection methods were implemented and the area under the ROC curve was used to select models with the highest predictability. Analysis showed that edentulism was not associated with depression. For the edentulous group, oral/facial pain was the only oral health factor predicting depression, whereas avoiding smiling or laughing, dry mouth, oral/facial pain predicted depression in the dentate individuals.

It has been hypothesized that depression can be both a risk factor and a consequence of oral diseases. Tooth loss leads to discomfort, pain, and functional limitations which could lead to disability and, subsequently, to handicap. However, the association between depression and edentulism has not been established yet. Data from the Canadian Community Health Survey (CCHS) Cycle 2.1 were used to examine the association between edentulism and depression in community-dwelling Canadians 45 years of age and older. Separate logistic regression models were developed for dentate and edentulous groups as well. Different regression selection methods were implemented and the area under the ROC curve was used to select models with the highest predictability. Analysis showed that edentulism was not associated with depression. For the edentulous group, oral/facial pain was the only oral health factor predicting depression, whereas avoiding smiling or laughing, dry mouth, oral/facial pain predicted depression in the dentate individuals.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / IntroduÃÃo: a diabetes à um dos principais fatores de risco relacionados à progressÃo da periodontite. Por outro lado, o tratamento periodontal ou a remoÃÃo de dentes comprometidos pode melhorar o controle glicÃmico dos diabÃticos. Objetivo: comparar por meio de dados de prontuÃrios os nÃveis de glicemia de jejum (GJ) de idosos diabÃticos do tipo 2, desdentados totais e dentados e, especificamente nestes, avaliar o efeito da doenÃa periodontal sobre o seu controle glicÃmico. Material e mÃtodo: idosos diabÃticos do tipo 2 totalmente desdentados (DESD - n=124), assim como dentados (DENT - n=65), foram selecionados segundo as seguintes caracterÃsticas: idade igual ou superior a 60 anos, nÃo fumantes e utilizaÃÃo de algum hipoglicemiante. Resultado: observou-se diferenÃa (p<0,05) para mÃdia de GJ entre os grupos DESD (144,9  66,9 mg/dL) e DENT (120,4  38,0 mg/dL). Quando o grupo DENT foi subdividido dentre os que apresentavam periodontite (DENT-P; GJ=126,7  44,6 mg/dL) ou nÃo (DENT-A; GJ= 117,4  34,2 mg/dL), foi observada diferenÃa apenas entre os grupos DESD e DENT-A. TambÃm foi observado que o grupo DESD demonstrou maior risco para hiperglicemia do que o grupo DENT. Para o corte de GJ &#8805; 126 mg/dL foi observado Odds ratio - OR = 2,01 (IC 95%=1,08 - 3,73). Para o corte de GJ &#8805; 170 mg/dL, OR = 2,47 (IC 95%=1,07 - 5,76). ConclusÃo: idosos desdentados diabÃticos do tipo 2 possuem um risco maior para expressar hiperglicemia do que indivÃduos dentados. Nestes, entretanto, a presenÃa de doenÃa periodontal parece influenciar o seu controle glicÃmico. / Introduction: Some studies had shown that the periodontal treatment can interfere with the glycemic control of diabetes patients. Thus, it can be hypothesized that in the absence of a periodontal infection, as in an edentulous or healthy periodontal patient, the glycemic control of type 2 diabetes patients can be improved. Objectives: The aim of this cross-sectional study was to compare the glycemic control of type 2 diabetes edentulous and dentate patients presenting or not periodontal diseases. Methods: There were selected type 2 diabetics according to the following criteria: they must be non-smokers, aging 60 years or more and being under therapy with hypoglycemics. Subjects were assigned to two groups based on their respective dental condition: edentulous (DESD, n=124) and dentate (DENT, n=65) The glycemic control was analyzed by fasting serum glucose (FSG). Results: It was found significant differences (p<0.05*) for mean GJ between groups DESD (144,9  66,9 mg/dL) and DENT (120,4  38,0 mg/dL). But when the DENT group was divided according to the presence of periodontitis (DENT-P; GJ=126,7  44,6 mg/dL) or not (DENT-A; GJ= 117,4  34,2 mg/dL), this difference was observed only between DESD and DENT-A. It was also observed that DESD group showed higher risk to present hyperglycemia when analyzed through two GJ cutoffs: GJ &#8805; 126 mg/dL, Odds ratio (OR) = 2,01 (CI 95%=1,08 - 3,73) and GJ &#8805; 170 mg/dL, OR = 2,47 (CI 95%=1,07 - 5,76). Conclusions: Edentulous type 2 diabetes patients presented higher glycemic levels than dentate ones. But, in these patients, the presence of periodontal diseases, along with other non-investigated factors could interfere with their glycemic control.

>Magister Scientiae - MSc / Edentulism negatively impacts patients􀂶 quality of life. A fixed complete-arch implant-supported prosthesis is proven to restore function and aesthetics and is associated with high patient satisfaction. An immediate loading protocol can provide patient satisfaction in a shorter period, as the time between surgical implant placement and connection of a prosthesis is lessened. The many considerations involved in this type of treatment are either based on available evidence or the preferences of the clinicians themselves.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2014-09-02T11:26:28Z No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertação Joao Francisco Machado do Nascimento.pdf: 721039 bytes, checksum: 2a145e907cf0cfc7e15f26459ae30aff (MD5) / Made available in DSpace on 2014-09-02T11:26:28Z (GMT). No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertação Joao Francisco Machado do Nascimento.pdf: 721039 bytes, checksum: 2a145e907cf0cfc7e15f26459ae30aff (MD5) Previous issue date: 2013-08-14 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / For patients poorly adapted to conventional dentures, the single-implant mandibular overdenture has been proposed as a simplified alternative for the two-implant treatment, together with the use of immediate loading of the implant. The aim of this in vitro study was to compare the photoelastic characteristics of stress transfer to the implant in a single-implant mandibular overdenture using different types of attachments. A photoelastic model of an edentulous mandible with a resilient edentulous ridge and a unique implant located at the symphyseal region was obtained to reproduce a single implant-retained mandibular overdenture. Six 2.0 mm height attachments were selected and inserted in the same photoelastic model in a random order. A universal material testing machine was used to induce axial vertical loads of 70 N applied in the central incisor and in the central region of the first right molar without contact on the contralateral side. The photoelastic analysis was performed using a polariscope integrated into the testing machine. Standard separate views were photographed and evaluated visually for stress-induced fringes, to comparatively rank the different attachment systems. All attachments showed a similar tension distribution concentrated in the apical third, and the highest stress concentration at the apical level. There was a low stress concentration at the coronal third of the implant, with no discernible stress in the first threads of the implants, except for Dalla Bona which showed low stress at the coronal part of the implant (one fringe). No identifiable fringes were observed when the load was applied in the molar region, which resulted from the low amount of stress transmitted by the implant for all attachments. It was concluded that the load transferred to a single mandibular implant is low and within the limits of functional loading, irrespective of the type of retention system. / Implantes osseointegrados vêm sendo utilizados com sucesso para restaurar a função e a estética de pacientes desdentados totais e parciais. No entanto há necessidade de tornar o tratamento de pessoas com necessidade de overdenture retida com implante menos oneroso e mais eficiente. O objetivo deste trabalho foi verificar pela técnica fotoelástica (Qualitativa) as tensões geradas ao redor do implante pela aplicação de carga sobre overdenture mandibular retida por um implante unitário na sínfise da mandibular. Foi confeccionado um modelo de resina fotoelástica Araldite, reproduzido de uma mandibular anatômica, onde foi fixado na região sínfise um implante 3.75x11mm (Titamax Ti Cortical, Neodent, Curitiba, Brasil). Com um modelo foi confeccionada uma prótese total e gingival artificial. Todos os pilares foram posicionados sobre o implante e apertado com 10 Ncm, a fêmea foi capturada de forma direta à prótese, com a réplica da mucosa em posição. Todos foram sucessivamente capturados e levados ‘à máquina de ensaio universal. Com uma carga axial de 70 Ncm na fossa central do 46 e incisal do 41. Foram fotografados em um polariscópio as franjas resultantes das tensões. Foram feitas análises qualitativa dos resultados das tensões sobre o attachment. De acordo com os resultados obtidos pode-se concluir que a carga transferida para o implante, é baixo, independente do sistema de retenção.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Magister Scientiae Dentium - MSc(Dent) / Background: Most edentulous patients have expectations regarding complete dentures that are not only dependant on past experiences but also the information they received from others. These expectations may impact on the level of satisfaction the patient would have when receiving their complete dentures. When determining levels of satisfaction, factors such as comfort, speech, aesthetics, mastication, retention, fit / stability and occurrence of pain should be assessed. The dental student should be able to clinically apply theoretical knowledge to provide the patient with a stable and retentive denture that fulfils their expectations on function and aesthetics. Not much has been written regarding this link between patients' expectations and satisfaction with complete dentures at the University of the Western Cape, thus it warranted further investigation. Aim: The aim of this study was to determine whether patients' expectations influence their satisfaction with new complete dentures constructed by undergraduate dental students. Objectives:- 1. To determine the expectations of the edentulous patients prior to receiving new complete dentures. 2. To determine if patients’ expectations influences satisfaction with new complete dentures. 3. To investigate the influence of socio-demographic factors on patients' satisfaction wearing complete dentures. 4. To determine if the level of experience of the undergraduate student influences patient satisfaction. Methodology: This was an observational study using two questionnaires for data collection namely the Patient Expectation Questionnaire and the Oral Health Impact Profile- 20. Socio-demographic data was collected as part of the first questionnaire. Each participant was given an individual case number that corresponded on both questionnaires. This facilitated correlation between the expectations and satisfaction results of individual patients. Results: The age range for the majority of the patients was between 56-65 years. Females made up 72% of the sample with 85% of the sample of coloured ethnicity. Statistical analysis included reliability testing of the Patient Expectation Questionnaire and the Cronbach's Alpha of .773 was recorded, which indicates good reliability. Results following analysis of the Oral Health Impact Profile-20 showed high levels of satisfaction in most domains. The correlation between patients' expectations and satisfaction with new complete dentures was not proven using Pearson correlation. However, the comparison between the expectations questionnaire and Oral Health Impact Profile-20 frequency distribution showed positive results and most expectations of the patient were met or even exceeded for certain domains. Conclusion: Once analysis of both questionnaires was completed high levels of expectations were recorded and these expectations were met in most domains. Even though the statistical relationship between patient expectations and satisfaction was not proven, analysis of the questionnaires yielded positive results. No association was found between pre-treatment expectation and patient satisfaction with complete dentures. Some socio-demographic factors influenced patient satisfaction with complete dentures. High levels of patient satisfaction were recorded regardless of the clinical experience of the undergraduate dental student.

Objectives To provide contemporary, national population-based estimates of complete tooth loss of older adults by English language proficiency. Methods We conducted a cross-sectional analysis of the 2017 Medical Expenditure Panel Survey among participants ≥50 years of age (n=10,452, weighted=111,895,290). Results The prevalence of complete tooth loss was higher among those with limited English proficiency (Spanish speaking: 13.7%; Other languages: 16.9%) than those proficient in English (Spanish speaking: 5.0%; Other languages: 6.0%). After adjusting for education, complete tooth loss was less common among participants for whom Spanish was their primary, with limited English proficiency relative to English only (adjusted odds ratio: 0.56; 95% confidence interval: 0.42-0.76). Among those without complete tooth loss, dental visit in the past year were less common among participants with primary languages other than English as compared to those who only speak English. Discussion Research is needed to examine the relationship of aging, oral health, and access to care.

A população idosa possui alta prevalência de edentulismo e, conseqüentemente, é afetada pelos problemas a ele associados. A perda da dimensão vertical de oclusão (DVO) é um destes problemas que compromete, entre outros fatores, o desempenho do sistema estomatognático. Logo, doenças relacionadas ao colapso da musculatura da via aérea superior (VAS), como a síndrome da apnéia obstrutiva do sono (SAOS), tornam-se enfermidades relevantes para pacientes nesta faixa etária. Sendo assim, medidas terapêuticas eficazes e de baixo custo, como a utilização de aparelhos intraorais (AIOs) para liberação do fluxo aéreo, podem ser empregadas contribuindo para a qualidade do sono destes pacientes. O objetivo deste estudo foi avaliar parâmetros subjetivos e objetivos do sono, em 10 pacientes idosos portadores de Próteses totais (PTs) bimaxilares, após a utilização de novas PTs confeccionadas no Programa Envelhecer Sorrindo e após o uso de dois AIOs: um dispositivo intraoral (DIO), especialmente desenvolvido para aumentar a DVO sem provocar avanço mandibular, e um aparelho de avanço mandibular (AAM). Para isso, questionários de rastreamento da qualidade do sono e polissonografias (PSGs) foram realizados, em quatro momentos distintos: sem as PTs, com as PTs, com o DIO e com o AAM. Foram realizadas, também, telerradiografias em norma lateral (TNL) dos pacientes com as PTs, com o DIO e com o AAM a fim de avaliar alterações no diâmetro da VAS e o posicionamento mandibular nesses três momentos. Concluiu-se que, o AAM testado promove maior porcentagem de sono no estágio 1, podendo contribuir para a melhora na qualidade subjetiva do sono dos pacientes, uma vez que ajudou a diminuir o tempo necessário para iniciar o sono, além de facilitar a manutenção do estado de vigília. / There is a high prevalence of edentulism and problems associated to it in the elderly population. A decrease in vertical dimension of occlusion (VDO) is one of these problems that may compromise the stomatognathic system. Therefore, it is important to investigate diseases related to upper airway (UA) musculature collapse, such as the syndrome of obstructive sleep apnea (OSAS). Therapeutic measures of low cost and high efficacy, such as intraoral appliances (IAs) to release the air flow may be employed, contributing to patients sleep quality. The aim of this study was to evaluate subjective and objective sleep parameters in 10 elderly patients who wore maxilar and mandibular complete dentures (CD). The analyses were performed after the use of a new pair of CD and after using two IAs: an intraoral device (ID), especially developed to increase the VDO without causing mandibular advance, and a mandibular advance device (MAD). For this purpose, questionnaires and polysomnography (PSG) were performed in four distinct stages: patients not wearing CD, wearing CD, wearing ID and wearing MAD. In addition, lateral cephalograms (LC) of patients wearing FD, wearing ID and wearing MAD were performed to assess changes in UAs diameter and in the mandibular positioning. It was concluded that the MAD tested promotes higher percentage of stage 1 sleep and and may contribute to the improvement in patients subjective sleep quality, as it helped to decrease the time needed to fall asleep, and facilitate the maintenance of wakefulness.