Figueredo Olívia Maria Costa de, Gama Lorena Tavares, Câmara-Souza Mariana Barbosa, Marañón-Vásquez Guido Artemio, Magno Marcela Baraúna, Maia Lucianne Cople, Gonçalves Thaís Marques Simek Vega, Rodrigues Garcia Renata Cunha Matheus
Graduate student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil.
Graduate student, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
J Prosthet Dent. 2023 Sep;130(3):351-361. doi: 10.1016/j.prosdent.2021.09.026. Epub 2021 Nov 10.
Denture adhesives improve the mastication of complete denture wearers. However, the impact of denture adhesives with different presentations on mastication remains unclear.
The purpose of this systematic review was to answer the focused question, "Do different presentations of denture adhesives affect the masticatory function of complete denture wearers?".
This review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six databases and the non-peer-reviewed literature were searched up to July 2021. Only clinical studies (randomized clinical trials and nonrandomized clinical trials) comparing the use of different denture adhesive presentations (cream, powder, or strips) were included, without language or follow-up restrictions. The risk of bias was assessed by using the Cochrane tools (RoB 2.0 and ROBINS-I). Masticatory performance, by using single and multiple sieves, masticatory performance with color-changing chewing gum (mixing ability), swallowing threshold (particle size and number of cycles), jaw kinematics, and occlusal force were considered. Meta-analyses were conducted to evaluate masticatory performance (single sieve) and occlusal force outcomes (α=.05), and the certainty of the evidence was determined with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) evaluations.
Nine studies (6 randomized and 3 nonrandomized clinical trials) were included. The risk of bias was considered moderate. Meta-analyses showed no differences between cream and powder denture adhesives for masticatory performance (standard mean difference=0.02; 95% CI=-0.46 to 0.50, P=.93) or between cream and strip denture adhesives for occlusal force (mean difference=14.35; 95% CI=-11.14 to 39.84, P=.27). Similarly, in qualitative analysis, cream and powder denture adhesives' performances were similar regarding masticatory performance with color-changing chewing gum (mixing ability), occlusal force, swallowing threshold (particle size and number of cycles), and jaw kinematics (P>.05). However, for resorbed ridges, cream denture adhesive resulted in a higher masticatory performance than strip (P<.05). When comparing powder to strip denture adhesives, the occlusal force was higher in the powder group (P<.05). The certainty of evidence was very low for all evaluated outcomes.
Different presentations of denture adhesives seem to improve the masticatory function of complete denture wearers in a similar way. However, the qualitative analysis showed that, in patients with a resorbed ridge, a cream denture adhesive may be better than strips to improve mastication, although the certainty of evidence was very low.
义齿粘合剂可改善全口义齿佩戴者的咀嚼功能。然而，不同剂型的义齿粘合剂对咀嚼功能的影响尚不清楚。
本系统评价的目的是回答聚焦问题“不同剂型的义齿粘合剂是否会影响全口义齿佩戴者的咀嚼功能？”
本评价遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。检索了6个数据库以及截至2021年7月的非同行评审文献。仅纳入比较不同剂型（乳膏剂、粉剂或条带剂）义齿粘合剂使用情况的临床研究（随机临床试验和非随机临床试验），无语言或随访限制。采用Cochrane工具（RoB 2.0和ROBINS-I）评估偏倚风险。考虑了咀嚼性能（使用单筛和多筛）、使用变色口香糖的咀嚼性能（混合能力）、吞咽阈值（颗粒大小和循环次数）、颌运动学和咬合力。进行Meta分析以评估咀嚼性能（单筛）和咬合力结果（α = 0.05），并通过推荐分级、评估、制定与评价（GRADE）评估确定证据的确定性。
纳入9项研究（6项随机临床试验和3项非随机临床试验）。偏倚风险被认为是中度。Meta分析显示，乳膏剂和粉剂义齿粘合剂在咀嚼性能方面无差异（标准均差 = 0.02；95%CI = -0.46至0.50，P = 0.93），乳膏剂和条带剂义齿粘合剂在咬合力方面也无差异（均差 = 14.35；95%CI = -11.14至39.84，P = 0.27）。同样，在定性分析中，乳膏剂和粉剂义齿粘合剂在使用变色口香糖的咀嚼性能（混合能力）、咬合力、吞咽阈值（颗粒大小和循环次数）和颌运动学方面表现相似（P > 0.05）。然而，对于吸收性牙槽嵴，乳膏剂义齿粘合剂的咀嚼性能高于条带剂（P < 0.05）。当比较粉剂和条带剂义齿粘合剂时，粉剂组的咬合力更高（P < 0.05）。所有评估结果的证据确定性都非常低。
不同剂型的义齿粘合剂似乎以相似的方式改善全口义齿佩戴者的咀嚼功能。然而，定性分析表明，在牙槽嵴吸收的患者中，乳膏剂义齿粘合剂在改善咀嚼方面可能优于条带剂，尽管证据确定性非常低。
