The purpose of this review is to investigate the relationship between oral health status and oropharyngeal dysphagia (OD) in older people and to collect a list of oral health indicators that can enable carers and health professionals to screen for risk of dysphagia in older people during oral examinations. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P 2015) guidelines. The analysis methods and inclusion criteria were documented in a protocol published in the Prospective International Register of Systematic Reviews (PROSPERO) under the registration number CRD42020140458. A total of 19 articles published between 2002 and 2020 were retained by the search criteria for the qualitative synthesis. Eighteen studies demonstrated at least one positive association between an oral health component (dental, salivary and/or muscular) and dysphagia. This review highlights that oral health and OD are associated but was not able to determine causality. The lack of scientific evidence could be explained by the observational approach of the majority of the studies and the irrelevant choice of oral health indicators. A relationship may exist between oral health and dysphagia, but this review highlights the lack of valid and standardized oral health indicators that would be needed to assess the impact of oral health on the overall health status of individuals.

Both conventional and digital impressions aim to record the spatial position of implants in the dental arches. However, there is still a lack of data to justify the use of intraoral scanning over conventional impressions for full-arch implant-supported prostheses. The objective of the in vitro study was to compare the trueness and precision of conventional and digital impressions obtained with four intra-oral scanners: Trios 4 from 3Shape^®, Primescan from Dentsply Sirona^®, CS3600 from Carestream^® and i500 from Medit^®. This study focused on the impression of an edentulous maxilla in which five implants were placed for implant-supported complete prosthesis. The digital models were superimposed on a digital reference model using dimensional control and metrology software. Angular and distance deviations from the digital reference model were calculated to assess trueness. Dispersion of the values around their mean for each impression was also calculated for precision. The mean distance deviation in absolute value and the direction of the distance deviation were smaller for conventional impressions (p-value < 0.001). The I-500 had the best results regarding angular measurements, followed by Trios 4 and CS3600 (p < 0.001). The conventional and I-500 digital impressions showed the lowest dispersion of values around the mean (p-value < 0.001). Within the limitations of our study, our results revealed that the conventional impression was more accurate than the digital impression, but further clinical studies are needed to confirm these findings.

To evaluate the accuracy of conventional polyether impressions (Impregum™ Penta™ Soft from 3M®) and digital scans produced by five intra-oral scanners (IOSs): Trios 3 (3Shape®), Trios 4 (3Shape®), Primescan (Dentsply Sirona®), CS3600 (Carestream®) and I500 (Medit®) scanners in maxillary free-ended partial edentulism for long-span implant-supported prostheses in partially edentulous arch. This in vitro study involved the impression of a maxillary working model with free-end partial edentulism, in which six implants were placed before digitization using a desktop scanner to generate a digital reference model. Conventional impressions and digital scans with five IOSs were obtained. Conventional impressions were digitized using the same desktop scanner. Each digital STL file of conventional or digital impressions was superimposed over the reference STL file to enable comparison. Trueness was assessed by calculating angles and distance deviations. For precision, dispersions of values around their means were also measured. The mean distance deviation was significantly higher for conventional impressions (454.24±334.70 µm) than for IOSs (ranging from 160.98±204.48 µm to 255.56±395.89 µm) (p<0.001). The mean angular deviation was high with conventional impressions (1.82±1.51°), intermediate with CS3600 (1.38±1.42°), Primescan (1.37±2.54°) and Trios 4 (1.30±0.64°) scanners, and lower with I500 (0.97±0.75°) and Trios 3 (1.01±0.85°) scanners (p<0.001). The dispersion of distance values around their means was lowest with Trios 3 and I500, followed by CS3600, Primescan, and Trios 4 scanners respectively, and higher for conventional impressions (p<0.001). The dispersion of angular values was smallest with I-500, Trios 3, and Trios 4 compared with other groups and was highest with Primescan (p<0.001). Within the limits of the current study, Trios 3 scanner exhibited the highest accuracy, followed by I500, Trios 4, CS3600, Primescan, and conventional impressions respectively. IOSs might be reliable for the fabrication of an implant-supported prosthesis. In vivo studies are required to confirm these findings. Passive adaptation of the implant-supported framework is a challenge when rehabilitating patients with maxillary free-end partial edentulism. While conventional impressions remain a reliable and clinically validated technique in implantology, the Trios 3, I500, Trios 4, CS3600, and Primescan scanners could potentially reduce mechanical complications, given their demonstrated higher accuracy compared to conventional impressions for long-span implant-supported prostheses in partially edentulous arch.

Oral health indicators are usually collected to alert for the presence of infectious diseases, but the impact of poor oral health on the nutritional status of older people with dementia is often neglected. This study aims to explore the relationship between the number of posterior dental functional units (PFUs) and the anthropometric measure of malnutrition, the mid-upper arm circumference (MUAC), in older people with dementia while controlling for other variables, and to analyze whether the number of PFUs is considered when adjusting the texture of the food provided at mealtimes. A total of 103 individuals who were 70 years or older with dementia were recruited from seven institutions. Cognitive impairment was assessed using the Mini Mental State Examination. Data were collected from medical records (sociodemographic characteristics, presence of chronic diseases, prescribed medications, results of serum albumin level), as well as questionnaires (type of feeding routes, type of food texture, supplements intake, Activity of Daily Living index), clinical examinations (MUAC), and oral health parameters (PFUs, oral dryness, oral hygiene). MUAC was the dependent outcome variable. MUAC was associated with the number of PFUs (p = 0.032); participants with PFU ≤ 4 were 7.5 times more likely to have MUAC < 21 cm than others. Other associations were found between MUAC and albumin level (OR = 12.5; p = 0.001), modified food texture (OR = 4.2; p = 0.035), and length of institutional stay (OR = 5.2; p = 0.033); however, the type of oral feeding was not significantly related to the number of PFUs (p = 0.487) so there is an inadequate correlation between food texture and oral health status. Similar to MUAC, the number of PFUs could be an oral anthropometric criterion that is recorded during routine hygiene care to alert for the risk of malnutrition and the inappropriate choice of food texture in older individuals with dementia.

With the advancement in ceramic restorations bonded to the tooth structure, the treatment has become a practicable and conservative option to restore teeth with shape alteration owing to the high demand for aesthetics, with minimum tooth preparation. This article describes the case of a 25-year-old man who was dissatisfied with his smile. After an assessment of the clinical situation, a decision was made to place a full-mouth prosthodontic rehabilitation (monolithic lithium disilicate glass-ceramic, IPS E-max CAD) with minimal tooth preparation, which figures as a conservative full-coverage approach. The restoration of an aesthetic smile resulted in the patient’s satisfaction. Bonding of all monolithic veenerlay and crowns onto minimally prepared teeth figures as conservative treatment in cases of hypodontia.