University J Dent Scie 2018; Vol.

4, Issue 2
University
Journal of
Dental Sciences

“A COMPARATIVE STUDY TO EVALUATE THE ROLE OF

COMPLETE DENTURES IN IMPROVING THE NUTRITIONAL
STATUS OF EDENTULOUS PATIENTS” Research
Article
Kaushik Kumar Pandey1, Abhishek Gaur2, A K Verma3, Mariyam Ali4, Pratibha Katiyar5, Amrit Rai6
1
Assistant Professor At Career Institute of Dental Sciences and Hospital, Lucknow
2
Associate Professor At Career Institute of Dental Sciences and Hospital, Lucknow
3
Prosfessor At Career Institute of Dental Sciences and Hospital, Lucknow
4
Prosfessor & Head Career Institute of Dental Sciences and Hospital, Lucknow
5
Associate Professor At Career Institute of Dental Sciences and Hospital, Lucknow
6
Private Practitioner At Seva Dental Clinic Lucknow

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) Keywords: -
Immediately after insertion of dentures 2) After three weeks of usage 3) After six weeks of usage. Material And Nutrition, edentulous,
Method :-Armamentarium and materials used in this study are 5ml disposable syringe, EDTA vials – collection denture,
of blood sample for Hb estimation. Plain vials – collection of blood sample for calcium, protein, phosphorus nutritional elements,
estimation. VITROS 250 machine – for estimation of blood calcium, phosphorus and protein. Photoelectric geriatric health
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 Conflict of interest: Nil
blood haemoglobin, serum calcium level, protein, phosphorus levels at the day of balenced complete denture No conflicts of interest : Nil
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.

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

University Journal of Dental Sciences, An Official Publication of Aligarh Muslim University, Aligarh. India 34
University J Dent Scie 2018; Vol. 4, Issue 2
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
University Journal of Dental Sciences, An Official Publication of Aligarh Muslim University, Aligarh. India
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
35
University J Dent Scie 2018; Vol. 4, Issue 2

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

F=2.432, p=0.09

Fig. 5 Patients blood sample collection

Bar Diagram 2: The Total Serum Ca Level At Different

Follow Up
Fig. 6 Collected blood samples: vial with EDTA (Hb) & Plain Table 3 shows the total Phosphorus at different follow-up.
vial(Ca, P, Protein) The changes in Phosphorus over different follow up is
Ethical clearance was taken from the ethical committee of statistically significant (F=4.663, p=.01). (Bar Diagram 3)
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 F=4.663, p=.01
significant (F=1.266,p=0.29).(Bar Diagram 1)

F=1.266,p=0.29

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)

Bar Diagram 1: Total Protein estimation at different follow

–up
Table 2 shows the total Serum Ca at different follow-up. The F=1.524,p=0.22
changes in Serum Ca over different follow up is not

University Journal of Dental Sciences, An Official Publication of Aligarh Muslim University, Aligarh. India 36
University J Dent Scie 2018; Vol. 4, Issue 2
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
University Journal of Dental Sciences, An Official Publication of Aligarh Muslim University, Aligarh. India
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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University Journal of Dental Sciences, An Official Publication of Aligarh Muslim University, Aligarh. India 38