title: Influence of procedural variations during the laboratory phase of complete denture fabrication on patient satisfaction and denture quality.
abstract: OBJECTIVE
  To compare subjective and objective outcomes of complete dentures fabricated with standard clinical protocols, but omitted selected steps during the laboratory phase.
  
  
  METHODS
  Forty-three edentulous patients (mean age 58.1 years, SD 9.9, range 35-78), were consecutively recruited and randomly assigned to one of four groups according to selected variations of laboratory steps: Group 1 (n=10), omission of secondary casts obtained from impressions in border moulded custom trays; Group 2 (n=10), omission of secondary casts and face-bow articulator mounting; Group 3 (n=10), omission of face-bow mounting; Group 4 (n=13), no steps omitted (control). Clinical procedures for all groups were identical, and performed by senior dental students under supervision of prosthodontists, all of whom were blinded to the Group. At 1-, 4- and 12-weeks after delivery, patients rated their overall satisfaction, as well as a range of functional factors using visual analogue scales. An independent blinded prosthodontist similarly rated four domains of denture quality at the 1-week follow-up.
  
  
  RESULTS
  No significant differences were noted among the groups in all aspects of patients' assessments at all the time points (P>0.1). There were no significant differences in prosthodontists' ratings of denture quality in any of the domains examined (P>0.1).
  
  
  CONCLUSIONS
  Selected omissions of steps (face-bow mounting and/or secondary casts) during the laboratory phase of complete denture fabrication has only a minor role, if any, in subjective and objective outcomes, contrasting with the common belief that such omissions will adversely affect outcomes.
  
  
  CONCLUSIONS
  General practitioners provide most complete dentures. Many do not follow all the procedures they were taught at dental school. Our finding that omitting frequently advocated steps made no difference to patient satisfaction or to denture quality suggests that cost-effectiveness through simplifications be considered in practice and in education.
authors.affiliation: Discipline of Prosthodontics, Department of Restorative Sciences, Faculty of Dentistry, Kuwait University, Kuwait. Electronic address: romar.k@hsc.edu.kw.
authors.forename: Ridwaan
authors.initials: R
authors.lastname: Omar
authors.forename: Yacoub
authors.initials: Y
authors.lastname: Al-Tarakemah
authors.forename: Jaber
authors.initials: J
authors.lastname: Akbar
authors.forename: Sundos
authors.initials: S
authors.lastname: Al-Awadhi
authors.forename: Yousif
authors.initials: Y
authors.lastname: Behbehani
authors.forename: Pierre
authors.initials: P
authors.lastname: Lamontagne
mesh_terms: D000328:Adult; D000368:Aged; D000464:Alginates / Q000737:chemistry; D016302:Centric Relation; D003725:Dental Articulators; D003760:Dental Impression Materials / Q000737:chemistry; D003761:Dental Impression Technique / Q000295:instrumentation; D003767:Dental Occlusion, Balanced; D003768:Dental Occlusion, Centric; D003779:Denture Design / Q000379:methods*; D003824:Denture, Complete / Q000523:psychology* / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007574:Jaw Relation Record / Q000295:instrumentation; D007754:Laboratories, Dental; D008297:Male; D008875:Middle Aged; D003765:Models, Dental; D017060:Patient Satisfaction; D011476:Prosthodontics / Q000193:education; D013335:Students, Dental; D013440:Sulfides / Q000737:chemistry; D014716:Vertical Dimension; D064232:Visual Analog Scale
chemical_list: D000464:Alginates; D003760:Dental Impression Materials; D013440:Sulfides; C032915:polysulfide
keywords: Border moulding; Complete denture; Denture quality; Education; Face-bow; Patient satisfaction