7 “A COMPARATIVE STUDY COMPARATIVE STUDY.pdfMethod :-Armamentarium and materials used in this study are 5ml disposable syringe, EDTA vials – collection of blood sample for Hb estimation

ABSTRACT : Aim and objectives:- to evaluate and compare nutritional status of newly rehabilitated edentulous

patient with balanced dentures in the defined period of time. Objectives of the study was to Analyze and compare

the improvement in nutritional status by taking blood samples of the patients and checking changes in the level of

Hb, Protein, Calcium and Phosphorus at defined period of time. Data (blood sample) was collected: 1)

Immediately after insertion of dentures 2) After three weeks of usage 3) After six weeks of usage. Material And

Method :-Armamentarium and materials used in this study are 5ml disposable syringe, EDTA vials – collection

of blood sample for Hb estimation. Plain vials – collection of blood sample for calcium, protein, phosphorus

estimation. VITROS 250 machine – for estimation of blood calcium, phosphorus and protein. Photoelectric

colorimeter or spectrophotometers – for estimation of blood hemoglobin. Pipette (Hb pipette .02ml, 5ml

graduated pipette). All 20 selected patients sent to the pathology lab for blood sample collection and estimation of

blood haemoglobin, serum calcium level, protein, phosphorus levels at the day of balenced complete denture

insertion, after 3 weeks and after 6 weeks intervals. Result:- this study proved that three and six week duration

after denture insertion, average serum phosphorus was improved and statistically significant, while serum Hb%,

serum protein showed improvement but statistically insignificant. Serum calcium level was not improved.

1 2 3 4 5 6Kaushik Kumar Pandey , Abhishek Gaur , A K Verma , Mariyam Ali , Pratibha Katiyar , Amrit Rai1Assistant Professor At Career Institute of Dental Sciences and Hospital, Lucknow2Associate Professor At Career Institute of Dental Sciences 3Prosfessor At Career Institute of Dental Sciences 4Prosfessor & Head Career Institute of Dental Sciences 5Associate Professor At Career Institute of Dental Sciences 6Private Practitioner At Seva Dental Clinic Lucknow

and Hospital, Lucknow




INTRODUCTION: Proper nutrition is essential for the

health and comfort of oral tissues as healthy tissues enhance

the possibility of successful prosthodontic treatment in the

elderly. The preservation of a healthy natural dentition is an

important aim of dentistry because the teeth are an essential

prerequisite to commute the food during mastication and to

prepare the ingested food for swallowing and further

processing in the digestive tract.[1,2,3]

Greksa et al. in their study null the hypothesis that there are no

differences in dietary patterns or adequacy between

edentulous patient and individual with nearly complete

dentitions. Although edentulous subjects were more likely

to claim that they had trouble chewing their food and they

were not more likely to select easy to chew foods.[1]

After biochemical analysis in their study Nowjack et al.

observed that intake of tossed salads, carrots and nutritious

food was 2.1 and 1.5 times less in denture wearer as compared

to fully dentate patients. The dietary fiber intake was also 1.2

time less in denture wearers. This lead to lower serum level of

beta carotene, folate and vitamin c in denture wearers.[2 -4[

In India, the extent to which the dental status is associated

with the intake of nutritious foods has been little studied

despite the edentulous reporting chewing problems. Mostly

denture wearers consume whole meal bread and dietary fiber

“A COMPARATIVE STUDY TO EVALUATE THE ROLE OF

COMPLETE DENTURES IN IMPROVING THE NUTRITIONAL

STATUS OF EDENTULOUS PATIENTS”

Journal of Dental Sciences

University

University Journal of Dental Sciences, An Official Publication of Aligarh Muslim University, Aligarh. India 34

University J Dent Scie 2018; Vol. 4, Issue 2

Research Article

Keywords: -

Nutrition, edentulous,

denture,

nutritional elements,

geriatric health

Conflict of interest: Nil

No conflicts of interest : Nil

less often than those who had natural teeth.

Therefore the present study was undertaken with the aim to

appreciate and compare nutritional status of newly

rehabilitated edentulous patient with balanced dentures in the

defined period of time. Objectives of the study was to Analyze

and compare the improvement in nutritional status by taking

blood samples of the patients and checking changes in the

level of Hb, Protein, Calcium and Phosphorus at defined

period of time. Data (blood sample) was collected: 1)

Immediately after insertion of dentures 2) After three weeks

of usage 3) After six weeks of usage.

MATERIALS AND METHOD: Material used for denture

fabrication, 5ml disposable syringe, EDTA vials – collection

of blood sample for Hb estimation. (Fig. 1), Plain vials –

collection of blood sample for calcium, protein, phosphorus

estimation.(Fig. 1), VITROS 250 machine – for estimation of

blood calcium, phosphorus and protein. (Fig. 2),

Photoelectric colorimeter or spectrophotometers – for

estimation of blood hemoglobin. (Fig. 3), Pipette (Hb pipette

.02ml, 5ml graduated pipette).

Fig. 1 Blood sample collection kit

Fig. 2: VITROS 250 Machine – For Estimation of Serum

Calcium, Phosphorus and Protein.

Fig. 3: Photoelectric Colorimeter or Spectrophotometers –

For Estimation of Blood Hemoglobin.

DATA COLLECTION: The study involved a total number

of twenty (20) edentulous subjects between 50-70 years of

age group. The subjects were sub-categorized equally in

group-I(10 male) and group-II(10 female) according to the

gender.

Inclusion criteria were; subjects should be free from any local,

systemic or debilitating disease and not under any medication,

All the subjects were first time denture wearers, All subjects

were given a complete denture with class I and balanced

occlusion using standard dental materials and techniques

prescribed for conventional denture fabrication. Exclusion

criteria were; subjects having any neuro-muscular disorder,

oro-congenital disorder and deleterious habit.

METHODOLOGY: Standardized Balanced Denture

Fabrication:-

For all 20 patients, dentures were fabricated in Post Graduate

clinic with all standard protocol; balanced occlusion given

with the help of Hanau wide view semi adjustable articulator

and facebow (springbow).

CHECKING NUTRITIONAL STATUS: For finding the

improvement in nutritional status the observations were

compared between the first readings which were recorded on

the day of dentures insertion and subsequent the second and

third reading recorded after three and sixth week follow up.

This comparison was done on the basis of a biochemical blood

analysis for serum calcium, protein, phosphorus and blood

hemoglobin levels. 5-6 Blood samples of each subject were

taken in Department of Pathology of Career Institute of

Medical Sciences And Hospital, Lucknow for biochemical

analysis (Fig. 4, 5, 6). All first denture wearer patients were

guided to take a standardized balanced diet chart prescribed

by the dietician so as to get uniformity in nutritional intake7,8.

According to pathology report, readings were tabulated for

statistical analysis and compared for the difference in the

levels of blood for serum calcium, phosphorus, protein and

hemoglobin. The groups were compared using student't-test'

& one way analysis of variance. P-value and F-value were

also calculated.

Ethical clearance was taken from the ethical committee of

institution and the written consent was taken from the subjects

who volunteered for this study.

Fig. 4 patient dentures in centric relation



Fig. 5 Patients blood sample collection

Fig. 6 Collected blood samples: vial with EDTA (Hb) & Plain

vial(Ca, P, Protein)

Ethical clearance was taken from the ethical committee of

institution and the written consent was taken from the subjects

who volunteered for this study.

RESULTS:-

Table 1 shows the total protein at different follow-up. The

changes in protein over different follow up is not statistically

significant (F=1.266,p=0.29).(Bar Diagram 1)

F=1.266,p=0.29

Bar Diagram 1: Total Protein estimation at different follow

–up

Table 2 shows the total Serum Ca at different follow-up. The

changes in Serum Ca over different follow up is not

statistically significant (F=2.432, p=0.09). (Bar Diagram 2)

F=2.432, p=0.09

Bar Diagram 2: The Total Serum Ca Level At Different

Follow Up

Table 3 shows the total Phosphorus at different follow-up.

The changes in Phosphorus over different follow up is

statistically significant (F=4.663, p=.01). (Bar Diagram 3)

F=4.663, p=.01

Bar Diagram 3: The Total Phosphorous Level At Different

Follow up

Table 4 shows the Hb at different follow-up. The changes in

Hb over different follow up is not statistically significant

(F=1.524,p=0.22). (Bar diagram 4)

F=1.524,p=0.22



Bar Diagram 4: Hb Level At Different Followup

DISCUSSION: All the 20 edentulous patients included in

this study were free from any local, systemic or debilitating

disease and were not under any medication so to avoid false

reading of increment or decrement in nutritional elements.

First time denture wearer patients were selected as to get an

accurate check of nutritional elements and Denture were

delivered with class I jaw relationship and balanced occlusion

using standard dental materials and techniques prescribed for

conventional denture fabrication. 5-9 In this study, patients

were not included who had any type neuro-muscular disorder.

Subjects with deleterious habits were also not included as this

will affect the stomatognathic system. 10 All 20 patients were

guided to take a standardized balanced diet chart prescribed

by the dietician so as to get a uniformity in nutritional intake

and fluctuations in nutritional elements like blood Hb%,

serum protein, serum calcium and serum phosphorus were

checked at regular three and six week interval.11-14

The study shows that although there is slight improvement in

total blood hemoglobin and total protein value during third

and six week follow up but the changes in total blood

hemoglobin over different follow up is not statistically

significant. Increased level of blood hemoglobin and total

protein is good finding for this study. This study showed that

total serum calcium level immediately after denture

insertion was not improved during third and six week follow

up and so the changes in total serum Ca over different follow

up was not statistically significant (F=2.432, p=0.09). This

study shows that there is slight improvement in total serum

phosphorus after 3rd week of denture insertion and the

changes in serum Phosphorus over different follow up is

statistically significant (F=4.663, p=.01).

Hence with time limitation, in this study we took only three

and six week duration after denture insertion for evaluation

nutritional elements. There is requirement of more duration

after denture insertion for blood hemoglobin, total protein and

calcium level to be increased in significant amount.

In this study the result showed that there was increase in Hb

%, serum protein, and phosphorus level which indicates the

improvement in nutritional elements in denture wearing

patients and was the positive findings of this study.

CONCLUSION: After the statistical analysis of the study

following conclusion had been drawn:-

1) Total Hb % and total serum protein value analysis,

showed that there was slight improvement in total blood

hemoglobin and total serum protein value during third

and six week follow up after denture insertion. But the

changes in are not statistically significant.

2) Total serum calcium value analysis, 3 week and 6 week

after denture insertion showed no improvement and

statistically insignificant

3) Total serum phosphorus value analysis, 3 week and 6

week after denture insertion showed that there was slight

improvement in total serum phosphorus. The changes in

serum Phosphorus over different follow up is statistically

significant (F=4.663, p=.01).

CONSENT:-

Taken individually from all the patients.

ETHICAL APPROVAL

Ethical approval was taken from institutional ethical research

cell committee.

COMPETING INTERESTS

Authors have declared that no competing interests exist.

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7 “A COMPARATIVE STUDY COMPARATIVE STUDY.pdfMethod :-Armamentarium and materials used in this study are 5ml disposable syringe, EDTA vials – collection of blood sample for Hb estimation