Although caries and periodontal diseases, the main causes of tooth loss are preventable the provision of complete dentures is still a commonly accepted treatment. However, because of changes in the oral tissues the fit and stability of complete dentures gradually deteriorates, and denture adhesives may be used to improve retention, stability and avoid food entrapment.
The aim of this review was to investigate the efficacy of denture adhesives (DAs) for complete dentures (CDs), and to provide clinical recommendations for prosthodontists and general practitioners.
Methods
Searches were conducted on the Medline/PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), Google Scholar and clinicaltrials.gov databases. Randomised controlled trials (RCTs) and controlled clinical trials (CCTs) of denture adhesives in patients aged 18 and older wearing single or full set of complete dentures were considered. Primary outcomes were objectively assessed variables directly related to mastication (denture retention, maximum bite force and masticatory efficiency). Secondary outcomes included other objectively assessed variables and patient-reported outcomes. Two reviewers independently screened and selected studies, abstracted data and assessed risk of bias using the Cochrane domains-based tool. The GRADE approach was used to evaluate quality of the evidence and meta-analyses conducted.
Results
- 39 studies (23 RCTs,16 CCTs) were included.
- 17 studies employed a cross-over design.
- No studies were at low risk of bias 17 studies (16 CCTs) were considered to be at high risk of bias and 22 at unclear risk.
- Meta-analysis indicated that
- retention increased for CDs significantly with denture adhesive use SMD = 1.34 (95% CI; 0.89 to 1.79).
- there was an overall increase in bite force in CD wearers SMD = 0.98 (95% CI; 0.50 to 1.47)
- and masticatory performance for CD wearers SMD = 0.72 (95% CI; 0.23 to 1.22)
Conclusions
The authors concluded: –
Denture adhesives can improve denture retention, bite force and masticatory performance of complete denture wearers.
Comments
The reviewers have searched two major databases for RCTs and CCTs assessing the effectiveness of denture adhesives. The findings are similar to 3 other recently published reviews (Lemos et al 2021, Elabbasy et al 2021, Florêncio Costa et al 2020). As the authors highlight the studies only included CD wearers and mostly involved well fitting newly constructed dentures. Almost half of the studies were of a cross-over design so analysis may not adequately take into account within-patient paired differences. None of the included studies were considered to be at low risk of bias and 17 of the included studies were not randomised and may of the studies involved small sample sizes. Future studies should involve larger sample sizes poorer fitting CDs and partial dentures.
Links
Primary Paper
Shu X, Fan Y, Lo ECM, Leung KCM. A systematic review and meta-analysis to evaluate the efficacy of denture adhesives. J Dent. 2021 Mar 13;108:103638. doi: 10.1016/j.jdent.2021.103638. Epub ahead of print. PMID: 33727079.
Other references
Lemos CAA, da Fonte Porto Carreiro A, Rosa CDDRD, Luna Gomes JM, de Oliveira Limirio JPJ, Mendonça G, Pellizzer EP. Does the use of an adhesive improve conventional complete dentures? A systematic review of randomized controlled trials. J Prosthet Dent. 2021 Feb 5:S0022-3913(20)30793-9. doi: 10.1016/j.prosdent.2020.11.041. Online ahead of print.PMID: 33551134 Review.
Elabbasy N, Ahn TJ, Morton P, Han PP, Enciso R, Mulligan R.Efficacy of denture adhesives in complete denture wearers compared to denture wearers not using denture adhesives. A systematic review. Spec Care Dentist. 2021 Mar;41(2):251-270. doi: 10.1111/scd.12562. Epub 2021 Jan 13. PMID: 33438306 Review.
Florêncio Costa RT, Leite Vila-Nova TE, Barbosa de França AJ, Gustavo da Silva Casado B, de Souza Leão R, Dantas de Moraes SL. Masticatory performance of denture wearers with the use of denture adhesives: A systematic review. J Prosthet Dent. 2020 Dec 2:S0022-3913(20)30596-5. doi: 10.1016/j.prosdent.2020.10.011. Online ahead of print.PMID: 33279156 Review.
