Modified retention and stability criteria for complete denture wearers: A risk assessment tool for impaired masticatory ability and oral health-related quality of life.

STATEMENT OF PROBLEM: Some complete denture wearers report difficulty with daily activities, especially activities related to denture retention and stability. However, no standard criteria are available for professionally based assessment of complete denture quality.

PURPOSE: The purpose of this clinical study was to determine the association between professionally based assessment of complete denture quality, evaluated by conventional and Chulalongkorn University (CU)-modified Kapur criteria and multiple patient-based outcomes: oral health-related quality of life (OHRQoL), eating satisfaction, and masticatory performance. The sensitivity and specificity of these criteria in estimating the outcomes were investigated.

MATERIAL AND METHODS: The participants were 126 individuals with removable acrylic resin complete dentures. Denture retention and stability were scored based on the Kapur method, with excellent intraobserver reliability indicated by a Kappa score of 0.91 to 0.99. The clinical quality of the complete denture was classified according to conventional and CU-modified Kapur criteria. The participants were interviewed for OHRQoL by using the Thai version of the Oral Impacts on Daily Performances (OIDP) index and responses were reported as the absence or presence of oral impacts. Participants' satisfaction eating with their dentures was determined by using a 5-point Likert scale and dichotomized into satisfied and dissatisfied categories. Masticatory performance was evaluated by the multiple sieve method of peanut mastication. After adjusting for covariates, the associations between denture quality and overall and condition-specific (CS) impacts on eating and on eating satisfaction were analyzed by using binary logistic regression, while its association with masticatory performance was determined using linear regression. Goodness-of-fit post estimation was conducted to determine the sensitivity and specificity of each denture quality criterion in estimating patient-based outcomes.

RESULTS: Complete denture retention and stability, evaluated by conventional and CU-modified Kapur criteria, were associated with multiple patient-based outcomes. However, denture stability showed a stronger association than retention. The CU-modified criteria assessed the quality of maxillary and mandibular dentures individually and revealed a higher sensitivity in estimating all patient-based outcomes.

CONCLUSIONS: Retention and stability were important indicators in estimating the masticatory ability and OHRQoL of complete denture wearers. The CU-modified Kapur criteria can identify impaired masticatory ability and OHRQoL in complete denture wearers better than conventional criteria.