The effect of different cuspal angulation in a lingualized occlusion on a masticatory performance and patient satisfaction in edentulous patients

Abstract

The Purpose of the Study: Edentulism effects 25% of the global population over age of 65, reaching 35% in middle- and high-income countries. Complete dentures are the most common form of prosthodontic treatment but they are constructed with different occlusions. Lingualized occlusion has become an increasingly established method for constructing complete dentures but there is no evidence that explores the effect of cuspal angles of the posterior teeth on patient reported outcomes. Materials and Methods: This study uses questionnaires and objective methods to test for differences in patient satisfaction and masticatory performance between 17 edentulous patients in 2 groups who were provided with lingualized occlusion complete dentures with posterior maxillary teeth that had either 20 or 30-degree cuspal angles. At the time of insertion, and 2-4 weeks later, all patients were asked to completes questionnaires on oral health and denture satisfaction, and then participate in two separate tests of masticatory performance (carrots & sieves, and masticatory chewing gum). Results: No significant differences between the two groups were reported for OHIP for visit 1 (P=0.63) or visit 2 (P=0.73), and sub scores for functional and psychological domains in both visits. Results for the Dental Satisfaction Questionnaire indicated generally a high level of satisfaction, with significant difference between the groups after 2-4 weeks (P=0.004), and maxillary satisfaction during visit 1 (P=0.005) and mandibular performance in visit 2 (P=0.003). Both tests of objective masticatory performance indicated that patients with 30- degree cuspal angles achieved higher masticatory performance than patients with 20-degree cuspal angles: carrots test (P=0.004) and chewing gum (P=0.00015). Conclusions: This pilot study results suggest that satisfaction and performance of lingualized occlusion is high, but these measures can be improved with testing different cuspal angles. It also suggests that the masticatory chewing gum, can be used as an alternative methodology when testing for masticatory performance. Given small sample sizes, more work is needed to establish the reliability of these preliminary results.