Patient s satisfaction with removable dentures after relining

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1 ORIGINAL ARTICLE Patient s satisfaction with removable dentures after relining Josip Kranjčić, Maja Kostelić-Stunić 2, Denis Vojvodić, Asja Čelebić, Dragutin Komar, Ketij Mehulić Department of Prosthodontics, School of Dental Medicine, University of Zagreb, 2 Private Dental Clinic; Zagreb, Croatia ABSTRACT Corresponding author: Kranjčić Josip School of Dental Medicine, University of Zagreb Gundulićeva 5, Zagreb, Croatia Phone: ; Fax: ; address: kranjcic@sfzg.hr Original submission: 8 November 2; Revised submission: 4 December 2; Accepted: January 22. Aim To reveal patients satisfaction with their old, usually poorly fitting dentures and the effect of denture relining to the patient s satisfaction. Methods Thirty seven denture wearers participated in study by filling out questionnaires about their satisfaction with dentures before and after relining. In that way the data indicating the subjective patient s experience and satisfaction were collected. Results Relined removable dentures included in study were on average 5.52 years (upper) or 4.86 years old (lower). Most of study participants (57%) were satisfied with their poor fitting dentures. Statistically significant was correlation between chewing discomfort and satisfaction, and the time elapsed from last tooth extraction to denture production. As this period was shorter, chewing discomfort was greater and satisfaction with chewing lower. Majority (5.%) of denture wearers were considerably more satisfied with the chewing ability and felt better regarding the chewing discomfort after denture relining. Minority of the patients (22%) still used an adhesive for fixing the dentures after relining. Conclusion Denture relining affects patient s satisfaction with their dentures. After relining patient s masticatory function was improved, satisfaction with chewing ability and comfort were greater, and denture hygiene better. Denture relining should be performed in order to improve denture fitting to a denture bearing area, thus positively affecting patient s satisfaction with his denture(s). Key words: oral health, mastication, alveolar bone loss, denture rebasing Med Glas Ljek komore Zenicko-doboj kantona 22; 9(2):

2 Kranjčić et al Patient s satisfaction with dentures INTRODUCTION Objective physical indicators of oral morbidity and subjective patient s perception of oral condition contribute to the description of oral health status. Oral health, which is characterized as multidimensional, has always been considered as an important part of patients general health (,2). According to the rapid improvements of oral health, there is a global trend among patients to retain their teeth as long as possible. However, tooth loss is still significant problem in elderly people, and in younger individuals compromised by certain medical conditions (). Multiple tooth loss rises problems that involve agonistic and antagonistic teeth, residual alveolar ridge and the interrelationship between upper and lower jaw. In addition to changes in occlusion and articulation, tooth loss also affects esthetics, physiognomy of the face, temporomandibular joints, phonation, oral function, and patient s social life (4,5). Residual alveolar ridge resorption, as a consequence of tooth extraction, is greater during the first few months after the tooth extraction. Later, the resorption slows down correlating with the time elapsed after tooth extraction (6). Residual alveolar ridge resorption leads to the insufficient support for proper functioning of removable dentures, especially the complete ones (6). Continuous resorption of the residual alveolar ridge leads to poor fitting of the dentures, thus requiring relining with a new resin layer in order to enhance better fitting to the denture bearing area as well as to improve retention and stability of the dentures (7-). Success of a treatment with removable dentures is often judged differently by dentists and patients (). Dentists consider dentures to be successful when they meet certain technical standards, but for some patients overall satisfaction with dentures is related primarily to comfort and the ability to masticate, while in other patients, esthetics and retention seem to be more important (-). Since the patients evaluate the success of therapy as a personal satisfaction, the aim of this study was to reveal patients satisfaction with their old, poorly fitting dentures and to evaluate the effect of denture relining onto the patient s satisfaction. PATIENTS AND METHODS Among patients of Public Health Centers in Zagreb, Croatia, who came to dental surgeries between January 29 and December 2 in order to maintain their poorly fitted removable dentures, 25 were candidates for denture relining diagnosed by specialist of prosthetic dentistry. Unfortunately only 7 patients from 5 to 82 years of age were willing to participate in this study by filling out the questionnaire I (before denture relining) and questionnaire II (after denture relining). Questionnaires I and II were designed by authors of this study in order to gather data that indicate the subjective experience and patients satisfaction with their dentures before and after relining. Questionnaire I included two sets of questions. First group consisted of general questions such as age, gender, type of removable denture (upper or lower), how long they had been wearing dentures (question ) and how old their existing denture was (question 2). Other group comprised questions (in questionnaire I from to 4) about patient s satisfaction with dentures (Table ). Question number 5 (about general satisfaction) had offered 6 answers (completely-, moderately-, sufficiently satisfied; completely-, moderately-, slightly dissatisfied) and question number 6 (day-night denture wearing) offered dichotomous answers. Also, factor analysis with varimax rotation was performed. Analyzing the questionnaire I answers produced five factors. The first factor comprised rarely bad breath, extreme dissatisfaction with dentures, higher age and lack of security with dentures; second factor comprised regular eating with dentures, lack of influence on choice of food and lack of changed taste of food; third factor comprised lack of chewing discomfort and chewing ability satisfaction; fourth factor consisted of cleaning difficulties with cleanliness satisfaction; fifth factor comprised regular use of an adhesive and denture wearing only during the day. Questionnaire II, comprised questions (from to 9) about patients satisfaction with their dentures after relining (Table 2), and questions number (use of adhesives) and (day-night denture wearing) had dichotomous answers. Factor analysis 77

3 Medicinski Glasnik, Volumen 9, Number 2, August 22 with varimax rotation to the questionnaire II answers produced factors. First factor comprised chewing ability, feeling of security and adhesive use after denture relining; second factor consisted of satisfaction with cleaning possibility after denture relining; third factor comprised presence of bad breath and patient s satisfaction with speech after denture relining. The results were statistically analysed using a computer software SPSS 5. (SPSS Inc., Chicago, Illinois, USA) by method of descriptive statistics and the differences in qualitative variables were tested for significance by χ 2 -test. Regression analysis was used to examine correlation of five factors from Questionnaire I with the shortest time that had elapsed from the last tooth extraction to the denture production, and to examine the correlation of three factors from Questionnaire II with the shortest time that had elapsed from the denture production to the denture relining procedure. RESULTS The denture relining was conducted in 25 patients but only 7 (8%) patients filled out both questionnaires. They were aged from 5 to 82 years with average of 6.76 years of age. Twelve (2.4%) patients had only upper complete/partial removable denture, (27%) patients only lower complete/partial removable denture, while 5 (4.6%) patients had upper and lower complete/ partial removable denture. Relined removable upper dentures included in the study were on average 5.52 years old (range from to 5 years) while lower dentures were 4.86 years old (range from to 5 years). Twenty six (7%) patients wore their dentures during the day and night, while (%) patients used their dentures only during the day. With regard to the general satisfaction, (8%) patients were completely satisfied, 7 (9%) patients moderately satisfied, (%) patients sufficiently satisfied, 2 (5%) patients slightly dissatisfied, (27%) patients moderately dissatisfied and 4 (%) patients completely dissatisfied (Table ). Statistically significant (p<.5) was the match that patients who used mostly or frequently their removable dentures (92.9%) felt occasionally or rarely changed taste of food. Patients who occasionally or rarely felt chewing dissatisfaction also percept (occasionally or rarely) food particles under the denture (94.%, p<.5), Table. Distribution of answers for questions -4 from Questionnaire I (before denture relining) No (%) of patients* UD (n=2) LD (n=) UD+LD (n=5) Total (n=7) Questions A B C D A B C D A B C D A B C D (8.%) (8.%) (8.%) (7.%) (.%) (7.%) (26.6%) (75.6%) (2.7%) (2.6%) (4.6%) (25.%) (.%) (4.%) (.%) (2.%) (.%) (.%) (.%) (46.6%) (26.6%) (29.7%) (.5%) (2.4%) (24.%) (.%) (25.%) (8.%) (.%) (.%) (2.%) (.%) (4.%) (26.6%) (26.6%) (4.%) (6.6%) (29.7%) (24.%) (2.6%) (24.%) (4.6%) (8.%) (4.6%) (8.%) (2.%) (.%) (7.%) (.%) (2.%) (.%) (.%) (24.%) (.5%) (27.%) (5.%) a (.%) (6.6%) (25.%) (25.%) (2.%) (.%) (26.6%) (4.%) (25.9%) (4.8%) (25.9%) (.%) b (2.%) (2.%) (.%) (.%) (.%) (4.%) (26.6%) (2.%) (7.%) (.%) (29.%) (25.%) (8.%) (8.%) (8.%) (2.%) (2.%) (6.%) (.%) (.%) (7.%) (.5%) (.5%) (72.9%) (6.6%) (8.%) (8.%) (66.6%) (2.%) (.%) (2.%) (5.%) (2.%) (6.6%) (7.%) (.8%) (.5%) (.8%) (64.8%) (8.%) (4.6%) (5.%) (.%) (2.%) (7.%) (.%) (2.%) (66.6%) (.8%) (27.%) (62.%) (6.6%) (8.%) (75.%) (.%) (4.%) (5.%) (.%) (6.6%) (26.6%) (5.%) (.8%) (8.%) (2.6%) (59.4%) (66.6%) (.%) (.%) (2.%) (4.%) (.%) (46.6%) (6.6%) (6.6%) (4.%) (48.6%) (8.%) (.5%) (29.7%) (6.6%) (25.%) (25.%) (.%) (.%) (9.%) (26.6%) (26.6%) (.%) (.%) (6.2%) (8.9%) (24.%) (4.5%) (6.6%) (8.%) (8.%) (66.6%) (2.%) (.%) (.%) (4.%) (.%) (.%) (7.%) (6.2%) (5.4%) (6.2%) (62.%) *UD, upper denture; LD, lower denture; A, mostly; B, frequently; C, occasionally; D, rarely; Questions:, eating with dentures; 4, any chewing discomfort with dentures; 5, satisfaction with denture chewing ability; 6, choice of food affected by wearing a denture; 7a, food particles under upper denture; 7b, food particles under lower denture; 8, changed taste of food by wearing a denture; 9, speech interferences by wearing a denture;, bad breath;, denture cleaning difficulties; 2, satisfaction with denture cleanliness after denture cleaning;, security with dentures; 4, use of denture adhesives. 78

4 Kranjčić et al Patient s satisfaction with dentures and experience changed taste of food and speech interferences (96.2%, p<.5). Most patients (92.%) who were just occasionally or rarely satisfied with the chewing ability, also felt occasionally or rarely secure with dentures (p<.5). In most cases (95%, p<.5), patients in which dentures affected their choice of food occasionally or rarely perceived the food particles under the denture, as well as changed taste of food (92.9%, p<.5). Occasionally or rarely perceived food particles under the denture were statistically significantly connected with occasionally or rarely bad breath (95.2%, p<.5), and in patients with lower denture with rarely changed taste of food (95%, p<.5). Occasionally or rarely changed taste of food was statistically significant related with occasionally or rarely present bad breath (9.8%, p<.5). Patients with occasionally or rarely present bad breath, had occasionally or rarely cleaning difficulties (9.9%, p<.5). Patients who mostly or frequently had cleaning difficulties with dentures were rarely satisfied with their denture cleanliness (9.9%, p<.5). Those who were satisfied with the denture cleanliness, had been wearing dentures during the day and night (88.9%, p<.5). Patients who mostly or frequently felt secure with their dentures were satisfied with their dentures (p<.5). Also, statistically significant (p<.5) is the fact that 77.4% of patients who used denture adhesives wore their denture during the day and night. Statistically significant (Pearson s coefficient -.682; p<.5) Table 2. Distribution of answers for questions -9 from Questionnaire II (after denture relining) No (%) of patients* Questions UD (n=2) UD+LD (n=5) A B C D E F G A B C D E F G (8.%) (8.%) (.%) (.%) (6.6%) (.%) (6.6%) (2.%) (5.%) (.%) (8.%) (8.%) (8.%) (.%) (.%) (8.%) (6.6%) (5.%) (2.%) (2.%) (8.%) (8.%) (58.%) (6.6%) (8.%) (2.%) (6.6%) (.%) (.%) (6.6%) 4a (6.6%) (25.%) (.%) (25.%) (46.6%) (26.6%) (2.%) (6.6%) 4b (.%) (.%) (26.6%) (26.6%) (4.6%) (6.6%) (4.6%) (66.6%) (2.%) (.%) (58.%) (25.%) (6.6%) (6.%) (26.6%) (6.6%) (6.6%) (.%) (25.%) (.%) (8.%) (.%) (2.%) (26.6%) (.%) (6.6%) (.%) (6.6%) (4.6%) (8.%) (6.6%) (26.6%) (26.6%) (.%) (6.6%) (8.%) (8.%) (8.%) (4.6%) (.%) (6.6%) (6.6%) (6.6%) (6.6%) (46.6%) (26.6%) Questions LD (n=) Total (n=7) A B C D E F G A B C D E F G (.%) (.%) (4.%) (4.%) (2.7%) (8.%) (5.4%) (8.9%) (4.2%) (2.6%) (.%) (.%) (.%) (5.%) (2.7%) (5.4%) (5.4%) (4.2%) (2.4%) (.8%) (.%) (.%) (.%) (4.%) (.%) (2.7%) (.8%) (2.7%) (5.4%) (4.5%) (29.7%) (8.%) 4a 7 7 (7.%) (25.9%) (25.9%) (.%) 4b (.%) (4.%) (2.%) (.%) (5.4%) (6.%) (24.%) (28.%) (2.%) (.%) (4.%) (.%) (45.9%) (2.6%) (29.7%) (2.7%) (8.%) (.%) (.%) (64.8%) (2.6%) (5.4%) (8.%) (8.%) (2.%) (6.2%) (7.8%) (27.%) (.5%) (5.4%) (.%) (5.%) (4.%) (2.7%) (.5%) (29.7%) (5.%) (.5%) (5.4%) (.%) (4.%) (5.%) (5.4%) (2.7%) (5.4%) (8.%) (4.2%) (5.%) *UD, upper denture; LD, lower denture; A, extremely poorer than before; B, considerably poorer than before; C, slightly poorer than before; D, the same as before; E, slightly better than before; F, considerably better than before; G, extremely better than before;, chewing satisfaction with relined dentures; 2, any chewing discomfort with relined dentures;, choice of food affected by wearing a denture; 4a, food particles under the upper denture; 4b, food particles under the lower denture; 5, speech interferences by wearing a denture; 6, bad breath; 7, denture cleaning difficulties; 8, satisfaction with denture cleanliness after denture cleaning; 9, feeling of security with dentures. 79

5 Medicinski Glasnik, Volumen 9, Number 2, August 22 was the correlation of the third factor from questionnaire I to the shortest time that had elapsed since the last tooth extraction to the denture production. As this period was shorter, chewing discomfort was greater and satisfaction with chewing lower (Table ). Only 8 (22%) patients still used adhesive for fixing the dentures after relining while other 29 (78%) patients did not use denture adhesive. Twenty five (68%) patients wore their denture during the day and night. By regression analysis, statistically significant (Beta-standardized coefficient.46, t-value 2.978; p<.) was the correlation of the second factor to the shortest time that had elapsed from denture production to the denture relining procedure. As this period was longer, satisfaction with denture cleaning possibility was greater after denture relining (Table 2). DISCUSSION The present situation in prosthetic dentistry is that dentures (partial or complete) can meet all conceivable technical requirements. Beside the dentists skills and the quality of dentures, patients subjective factors are very important for the final patient s satisfaction with removable dentures (2). In spite of technical perfection, many denture wearers do not seem happy with their dentures (4). Residual ridge resorption is a chronic and continuous process of bone remodelling (6) that weakens retention and stability of the dentures, and is continuous throughout life. It can be also aggravated by certain factors such as denture instability, overloading, etc. Therefore, denture relining is required in order to improve congruence between denture base and a denture bearing area. The frequency of denture relining procedures is variable. Low percentage of denture relining is characteristic for older patients. The reason for that could be an insufficient patient awareness of importance for denture well fitting and maintaining, problems of elderly patients to get to the dentist, or perhaps, dentists do not recall patients frequently. This problem has been reported by many authors (5-9). The average age of removable dentures included in this study was 5.52 years for the upper and 4.86 years for the lower dentures, and in the study of Knezović et al. 4.8% upper and 46.7% lower partial dentures were from to 5 years in use (2). Despite poor dentures condition, most of the study participants (57%) were satisfied with their dentures, which is in accordance with the data from literature (,2). Also, 75.6% of patients in this study used poorly fitting dentures for eating. It appears that most denture wearers learn how to accept functional limitations of dentures and they establish a certain unchanging satisfaction level. The adaptability of the neuromuscular mechanism and individual comfort thresholds may determine satisfaction or dissatisfaction with dentures (). In contrary to our study, Berg found larger number of patients who were generally dissatisfied with dentures (especially with lower ones), and also dissatisfied with the aesthetics and chewing ability (2). Overall satisfaction with dentures and the chewing ability satisfaction (as important oral function) in this study were related with a feeling of security during denture wearing. Chewing discomfort was related with perceived food particles under the denture, changed taste of food and speech interferences, while bad breath was in correlation to cleaning difficulties, food particles under the denture and with changed taste of food. Patients, who had cleaning difficulties, were dissatisfied with dentures cleanliness. Those who were satisfied with dentures cleanliness wore dentures during day and night. Statistically significant relation between feeling of security with dentures and overall satisfaction, as well as with chewing ability, is in accordance with the results of other studies (22,2). Two weeks after the dentures were relined, many of our patients perceived improvement in masticatory function, especially in terms of chewing ability, chewing comfort, and less difficulties while eating hard food. Most patients also reported improvements in speech and feeling of security. These results are in accordance with a belief that patients benefit from well-fitting dentures (24-26). It is possible that each denture wearer achieves a certain level of chewing performance due to denture fit and certain oral sensorymotor functions and physical characteristics (). It seems that this performance level is not markedly affected by the clinical quality of dentures (). Thus, the clinical excellence of dentures in terms of retention, stability, and occlusion cannot explain why some denture wearers can chew almost as well as persons with natural 8

6 Kranjčić et al Patient s satisfaction with dentures REFERENCES. Rener-Sitar K, Čelebić A, Petričević N, Papić M, Sapundzhiev D, Kansky A, Marion Lj, Kopač I, Zaletel-Kragelj L. The slovenian version of the oral health impact profile questionnaire (OHIP-SVN): translation and psychometric properties. Coll Antropol 29; : John MT, Hujoel P, Miglioretti DL, LeResche L, Koepsell TD, Micheelis W. Dimensions of oral-healthrelated quality of life. J Dent Res 24; 8: Leung KCM, Pow EHN. Oral rehabilitation with removable partial dentures in advanced tooth loss situations. Hong Kong Dent J 29; 6: Peltola MK, Raustia AM, Salonen MAM. Effect of complete denture renewal on oral health-a survey of 42 patients. J Oral Rehabil 997; 24: Correa MB, Peres MA, Horta BL, Gigante DP, Demarco FF. Life-course determinants of need for dental prostheses at age 24. J Dent Res 2; 89: Kovačić I, Čelebić A, Knezović-Zlatarić D, Petričević N, Buković D, Bitanga P, Mikelić B, Tadin A, Mehulić K, Ognjenović M. Decreasing of residual alveolar ridge height in complete denture wearers. A five year follow up study. Coll Antropol 2; 4: Jerolimov V, Družetić-Uljanić V, Murphy MW. Tvrdi akrilati za podlaganje u ustima. Hrvat Stomatol Vjesn 99; : Polysois GL, Yannikakis SA, Zissis AJ. Color stability of visible light-cured, hard direct denture reliners: an in vitro investigation. Int J Prosthodont 999; 2:4-6. teeth, whereas others can barely be able to reduce food into small particles (). Denture surfaces tend to collect plaque and stains if not cleaned regularly (27). In our study after dentures relining, less cleaning difficulties were present in 45.9% of patients, and 54.6% of patients were more satisfied with denture cleanliness. Also, none of the patients complained about increased effect of bad breath. It seems that modified, relined dentures with good denture and oral hygiene habits may be responsible for limited hygiene and bad breath problems among these patients (). In conclusion, based on the results of this study, it can be stated that denture relining affects patient s satisfaction with their dentures. After the denture relining, patient s masticatory function was improved, satisfaction with chewing ability and comfort were greater, and denture hygiene better, while use of denture adhesives was reduced. Therefore, denture relining should be performed more often in order to improve denture fitting to a denture bearing area (with all afore mentioned consequences), thus positively affecting patient s satisfaction with his denture(s). Besides, it should be emphasised that very few patients are aware that their poorly fitted removable dentures masticatory function could be improved, especially in terms of chewing ability, chewing comfort, less difficulties while eating hard food, and also that improvements in speech and feeling of security could be made. Although they are not satisfied with their dentures they usually do not seek for improvements. Therefore, more affords should be made in order to educate denture wearers, especially older ones, that considerable improvements could be made to their old, poorly fitted dentures, no matter if they cannot afford the production of new dentures. FUNDING This article supported by the Ministry of Science, Education and Sports of the Republic of Croatia, scientific project Investigation of materials and clinical procedures in prosthetic dentistry (grant No ). TRANSPARENCY DECLARATION Competing interests: none to declare. 9. Christensen GJ. Relining, rebasing partial and complete dentures. J Am Dent Assoc 995; 26:5-6.. Garrett NR, Kapur KK, Perez P. Effects of improvements of poorly fitting dentures and new dentures on patient satisfaction. J Prosthet Dent 996; 76:4-.. Knezović-Zlatarić D, Čelebić A, Valentić-Peruzović M, Ćelić R, Filipović-Zore I, Baučić M. The satisfaction with removable partial denture therapy in the Croatian population. Coll Antropol 2; 24: Knezović-Zlatarić D, Čelebić A, Valentić-Peruzović M, Jerolimov V, Ćelić R, Filipović-Zore I, Alajbeg I. Patient s satisfaction with partial denture therapy. Acta Stomatol Croat 2; 4:7-8.. Knezović-Zlatarić D, Čelebić A. Factors related to patient s general satisfaction with removable partial dentures: a stepwise multiple regression analysis. Int J Prosthodont 28; 2: Kalk W, Baat C. Patient s complaints and satisfaction 5 years after complete denture treatment. Community Dent Oral Epidemiol 99; 8: Willemsen WL, de Baat C, Truin GJ, Burgersdijik RCW, Mulder J, Bronkhorst EM. Changes in dental attitude and behavior among Dutch adults wearing complete dentures. Community Dent Oral Epidemiol 995; 2: Grabowski M, Bertram U. Oral health status and need of dental treatment in the eldery Danish population. Community Dent Oral Epidemiol 975; :8-. 8

7 Medicinski Glasnik, Volumen 9, Number 2, August MacEntee MI. The prevalence of edentulism and diseases related to dentures-a literature review. J Oral Rehabil 985; 2: Hummel SK, Wilson MA, Marker VA, Nunn ME. Quality of removable partial dentures by the adult U.S. population. J Prosthet Dent 22; 88:7-4. Thompson GW, Kreisel PSJ. The impact of the demographics of aging and the edentulous condition on dental care services. J Prosthet Dent 998; 79:56-9. Barenthin I. Dental health status and dental satisfaction. Int J Epidemiol 977; 6:7-9. Berg E. The influence of some anamnestic, demographic, and clinical variables on patient acceptance of new complete dentures. Acta Odontol Scand 984; 42:9-27. Langer A, Michman J, Seifert I. Factors influencing satisfaction with complete dentures. J Prosthet Dent 96; : Yoshizumi DT. An evaluation of factors pertinent to success of complete dentures. J Prosthet Dent 964; 4: Jooste CH, Tomas CJ. The influence of retromylohyoid extension on mandibular complete denture stability. Int J Prosthodont 992; 5:4-8. Lamb DJ, Ellis B, Kent G. Measurements of changes in complete mandibular denture security using visual analogue scales. Int J Prosthodont 994; 7:-4. Van Waas M. The influence of clinical variables on patient s satisfaction with complete dentures. J Prosthet Dent 99; 6:7-. Gornitsky M, Paradis I, Landaverde G, Malo AM, Velly AM. A clinical and microbiological evaluation of denture cleansers for geriatric patients in long-term care institutions. J Can Dent Assoc 22; 68:9-45. Zadovoljstvo pacijenata protezama nakon podlaganja Josip Kranjčić, Maja Kostelić-Stunić 2, Denis Vojvodić, Asja Čelebić, Dragutin Komar, Ketij Mehulić Zavod za stomatološku protetiku, Stomatološki fakultet, Sveučilište u Zagrebu; 2 Privatna stomatološka ordinacija; Zagreb, Hrvatska SAŽETAK Cilj Ispitati zadovoljstvo pacijenata starim, loše priliježućim protezama, te nakon podlaganja proteza. Metode U istraživanju je sudjelovalo 7 nosioca proteza tako što su ispunjavali upitnik o zadovoljstvu protezama, prije i nakon podlaganja. Na taj način prikupljeni su podaci o subjektivnom pacijentovom doživljaju i zadovoljstvu protezama. Rezultati Prosječna starost gornjih proteza, uključenih u istraživanje, bila je 5,52 godine, a donjih 4,86 godina. Većina ispitanika (57%) bila je zadovoljna i svojim loše priliježućim protezama. Statistički značajna povezanost pronađena je između nelagode pri žvakanju i zadovoljstva, kao i vremena proteklog od zadnjeg vađenja zuba do izrade proteze. Što je taj period bio kraći, nelagoda pri žvakanju bila je veća, a zadovoljstvo žvakanjem manje. Nakon podlaganja proteza, većina ispitanika (5,%) bila je znatno zadovoljnija mogućnošću žvakanja, te manje osjećala nelagodu tijekom žvakanja. Tek je manji dio pacijenata (22%), i nakon podlaganja, nastavio koristiti sredstvo za učvrščivanje proteza. Zaključak Podlaganje proteza utječe na zadovoljstvo pacijenata njihovim protezama. Nakon podlaganja žvačna je funkcija bila poboljšana, mogućnost žvakanja i udobnost pri žvakanju bili su veći, a higijena proteza bolja. Podlaganje proteza treba provoditi zbog poboljšanja prilagođenosti proteze ležištu, što pozitivno utječe na zadovoljstvo pacijenta svojom protezom. Ključne riječi: oralno zdravlje, žvakanje, gubitak alveolarne kosti, podlaganje proteza 82