Tanta Dental Journal

SYSTEMATIC REVIEW
Year
: 2019  |  Volume : 16  |  Issue : 2  |  Page : 55--67

Patient expectations and satisfaction with conventional complete dentures: a systematic review


Swati Singh1, Sunil K Mishra2, Ramesh Chowdhary1,  
1 Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
2 Department of Prosthodontics, Peoples College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India

Correspondence Address:
Ramesh Chowdhary
Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka
India

Abstract

Background Patient's satisfaction with dentures depends only on the treatment modality is quite questionable. The aim of the study was to find out various factors affecting the expectations and satisfaction of the patient with conventional complete dentures (CCDs). Materials and methods An electronic search was performed using Medline, PubMed, Ebscohost, Web of Science, and Cochrane databases. Manual search of Gerodontology and Prosthodontics journal was also done. Articles in English or whose abstract was available in English were included. The search was focused on various factors affecting the expectations and satisfaction of the patient with CCDs. After screening of titles and abstracts literature that fulfilled the inclusion criteria were selected for full-text reading. Results The initial literature search resulted in 377 articles out of which 319 articles were excluded. Three additional articles were included by hand searching, resulting in total 61 articles for systemic review. Conclusion Patient's expectation with CCDs is always more than patient's satisfaction. Stable mandibular denture is most important determinant of patient satisfaction. Patients are usually more satisfied with their maxillary CCDs compared to the mandibular CCDs. Satisfaction with denture also depends on the psychological status of patient.



How to cite this article:
Singh S, Mishra SK, Chowdhary R. Patient expectations and satisfaction with conventional complete dentures: a systematic review.Tanta Dent J 2019;16:55-67


How to cite this URL:
Singh S, Mishra SK, Chowdhary R. Patient expectations and satisfaction with conventional complete dentures: a systematic review. Tanta Dent J [serial online] 2019 [cited 2020 Mar 28 ];16:55-67
Available from: http://www.tmj.eg.net/text.asp?2019/16/2/55/267562


Full Text



 Introduction



Mastication, phonetics and esthetics are the important functions performed by the stomatognathic system and once there is complete loss of natural teeth, resorption of the alveolar bone occurs and hampers the oral health and function. This incidence often causes the psychological and negative social effects on the patients [1]. A decrease in the prevalence of complete edentulism in many countries has been reported but still patient requiring rehabilitation with complete dentures is still much more in many countries [2],[3],[4],[5],[6]. The rehabilitation of the edentulous patients in such conditions is by the conventional complete dentures (CCDs) which is a very common treatment modalities followed throughout the world [2],[7]. Higher occurrence of edentulism is found in individuals with poor socioeconomic conditions and there is increased need to decrease the cost of rehabilitation with dentures, so that this poor patients can be given a good treatment in an affordable cost [8].

Very little attention has been given towards the various reason and psychological factors related to the success or failure of prostheses, although there was increased in advancements to rehabilitate the patient with complete dentures with improved technique and materials. Psychological factors can provide valuable information about the patient's expectation and satisfaction with CCDs and help the dentist to give a successful and well functional prosthesis to their patients [9].

This systemic review was done to find out various factors affecting the expectations and satisfaction of the patient with CCDs.

 Materials and Methods



Search strategies

The present review was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A structured electronic systematic search without time or language restrictions was undertaken in January 2017 in the following databases: PubMed/Medline, Web of Science, Cochrane and Ebscohost databases.

The following terms were used in the search strategy with the filter 'article types' selected with the item 'abstract'.

{Subject AND adjective}

{Subject: (complete denture OR conventional denture)}

{object: (patient satisfaction OR patients expectations)}

A manual search of complete denture journals including Journal of Prosthodontic, Journal of Prosthetic Dentistry, International Journal of Prosthodontics along with Gerodontology was also performed.

Inclusion and exclusion criteria

Eligibility criteria included clinical trials either randomized or not on CCDs. Case reports, technical reports, finite element analysis, biomechanical studies, animal studies, other in-vitro studies were excluded. Articles not in English language were excluded.

Study selection

Three reviewers independently read the titles and abstracts of all articles obtained through the electronic searches and any disagreement among them regarding the inclusion or exclusion criteria was resolved by a discussion between them.

Data extraction

From the studies included in the final analysis, the following data were extracted (when available): author, year of publication, purpose of study, number of patients, age, follow-up, study summary, outcome and inference.

 Results



The study selection process is summarized in [Figure 1]. Initial search of articles with the given key words resulted in 377 articles on expectations and satisfaction with CCDs. Three hundred and nineteen articles were excluded for not meeting the inclusion criteria, resulting in 58 studies. Additional hand-searching yielded in three articles Thus, a total of 61 articles were included in the review. Detailed data of the 61 included studies are listed in [Table 1] [2],[10],[11],[12],[13],[14],[15],[16],[17],[18],[19],[20],[21],[22],[23],[24],[25],[26],[27],[28],[29],[30],[31],[32],[33],[34],[35],[36],[37],[38],[39],[40],[41],[42],[43],[44],[45],[46],[47],[48],[49],[50],[51],[52],[53],[54],[55],[56],[57],[58],[59],[60],[61],[62],[63],[64],[65],[66],[67],[68],[69] with articles on patients expectation and satisfaction with CCDs. Results found that patients expectation is usually higher than their satisfaction with CCDs. Patients who are more satisfied with their lives will also have an impact on complete denture; they were more satisfied than neurotic patients. Usually mandibular dentures have less retention as compared to maxillary conventional dentures.{Figure 1}{Table 1}

 Discussion



Patient's satisfaction with their dentures is fundamental to improving oral health-related quality of life among edentulous individuals. Various in-vivo studies [17],[25],[26],[27],[28],[35],[40],[53] were done assessing patient satisfaction regarding speech, mastication, chewing efficiency, postinsertion appointments required, with CCDs. Effects of different factors like age, sex, psychological status of patient, dentist's experience, technique used, communication with patient on success of complete denture were studied [15],[19],[22],[23],[29],[30],[32],[34],[39],[42],[47],[49],[51],[62],[64],[69]. Male patients were more esthetically satisfied when compared to females, as observed in a group of studies [10],[39],[46], whereas another study [52] showed females were more satisfied with esthetics. Patient-dentist communication [14], patient's confidence rather than quality of prosthesis [16] are very important for the success of dentures. The most important determinant for patient's satisfaction with dentures are the clinically stable mandibular denture [18].

It was observed that there is no difference in patient's perception of treatment outcome when different techniques (traditional and simplified) [15],[27],[54], different border molding techniques [32],[42], omitting selected laboratory steps following standard clinical protocol [34] are used for denture fabrication. Application of denture adhesives improves greatly the patient's satisfaction with dentures [21]. It was observed that satisfaction, stability and esthetics was better when anatomic teeth were used and canine, premolar guidance were used [49]. Patient satisfaction with lingualised occlusion were higher than those for bilaterally balanced occlusion as lingualized occlusion showed the greatest muscle activity and maximum voluntary contraction in both anterior temporalis and masseter muscles. Mean chewing time decreased with lingualised occlusion [35]. There is no correlation between age of the patient and denture satisfaction [46].

Shigli et al. [47] showed remount procedures and occlusal corrections significantly reduced the number of postinsertion visits. Psychological status of patient also affects patient's denture satisfaction. Neurotic patients are less satisfied [51],[62]. Patients who are well satisfied with their daily life are also satisfied with their dentures [60] and negative affects like irritability, boredom, anger, loneliness, helplessness cause denture intolerance and positive affects like joy, peace, usefulness cause denture acceptance [65].

Psychological counselling of the patients can be done along with good CCDs so that the performance of dentures can be improved further and meets expectations and satisfaction of the patients which can improve in their quality of life.

 Conclusion



This review article illustrates satisfaction of patient with complete denture. Many factors are responsible for it, like psychological factors (neurotic patients are less satisfied, female patients are more aesthetically concerned, while males more functionally concerned), clinical experience (more the experienced dentist, more satisfied the patient will be) and patient confidence in dentist, denture quality. Stable mandibular denture is most important determinant of patient satisfaction. Use of denture adhesive, soft liner also improves patient satisfaction with CCD, by improving adhesion of denture.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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