The share of elderly people in the total population is constantly growing, and thus the need for prosthetic rehabilitation. Life expectancy is increasing. The same patient requires several prosthetic works during his life. However, mobile dentures do not have the same characteristics as natural teeth and require a longer or shorter period of adaptation. During this period, the patient comes for periodic check-ups, and they are recommended to come on their own initiative, if necessary, if specific difficulties arise. The available literature has identified a number of prosthesis-related difficulties.

Loss of retention was the most common problem in one study [1]. Most patients in this study complained that their prosthesis was loose and did not fit. This problem was the primary reason why it was necessary to replace their dentures. Furthermore, patient dissatisfaction with function is also caused by loss of retention. Patients' ability to chew is also impaired as a result of loss of denture retention. The second most commonly observed problem, painful gingiva under the prosthesis, may also be associated with improper adhesion of the prosthesis. Prosthesis looseness has been found to be the most common source of prosthesis wearer complaints, followed by pain [2].

In another study, patients' expectations before treatment were significantly lower than their satisfaction after treatment, both for aesthetics (p<0.001) and for function (p = 0.004) [3].

The OHIP-EDENT instrument has proven to be better than other similar instruments for identifying toothless patient problems [4]. Mobile dentures increased the quality of life of rehabilitated patients, according to the findings of the study [5]. The average mandibular height ratio (mandibular bone loss indicator) decreased with age and time after extraction [6].

Using the need for endodontic abutment intervention as a criterion of failure, 40% of traditional mobile prostheses with a metal base lasted 5 years, while over 20% lasted 10 years. It seems that abutment teeth under the dental crown  shorten the durability of partial dentures with a metal base that have attachments. After 5 years, 10%   to 20% of partial dentures with a metal base had a fracture of the metal frame, while after 10 years 27% to 44% of prostheses of this type had a fracture of the metal frame.

Compared to non-attachment dentures, which rely on occlusal abutments on the teeth, non-attachment dentures required more changes to the denture base. The survival rate was 75% after 5 years and 50% after 10 years, when replacement or not wearing dentures was used as a criterion of failure (half-life) [7].

The limited clinical studies on prosthetic hyposalivation and retention that have been published provide a low level of evidence for the development of clinical practice guidelines. The authors were not able to draw any conclusions about the impact of hyposalivation. The study discussed the causes and symptoms of salivary disorders and xerostomia in the elderly, as well as the role of saliva in denture retention, the impact of dry mouth on denture use, and the treatment of dry mouth problems in denture wearers. Prospective clinical trials are needed to provide an evidence-based paradigm for therapy for people who wear dentures and suffer from dry mouth [8].

Compared to a similar older study, the percentage of mobile dentures with a Kennedy Class II metal base increased, and the percentage of Kennedy Class I, Class III, Class IV dentures remained stable. The findings of this study show that the frequency of using different types of dentures has changed in the last 30 years [9].

Chewing function is improved with new prostheses [10]. Patients with partial edentulousness had the greatest improvement after therapy, while the replacement of complete dentures brought the least benefits to the patient. In this study, the value of the new prosthesis in terms of increasing function and quality of life related to oral health was proven.

In patients with mobile dentures, the quality of dentures had a smaller impact on quality of life caused by general health, manifested through instruments for measuring  oral health related quality of life [11].

Goal

The aim of the research is to examine the number of self-initiated visits of patients in the first two months after prosthetic rehabilitation and to identify the most common difficulties with new prostheses.

Number of 32 (thirty-two) patients of regular flow at the dental prosthetics office, location of the Stari Grad Health Center, Health Center of Sarajevo Kanton were examined and interviewed.

The inclusion factor was the insertion of a new mobile prosthesis. The number of post-insertion self-initiated control visits of patients due to adaptation problems was recorded in a period of two months. The research included those visits that were motivated by functional or subjective difficulties. Functional difficulties are related to retention, stability, aesthetics and balanced occlusion. Subjective difficulties are related to personal experience of comfort when wearing dentures, pain and discomfort. The age and sex of the respondents, the type and frequency of difficulties were registered.

There was no exclusion factor. SPSS software, version 26.0 was used in the statistical analysis.

The study involved 32 people, 21 women and 11 men. The mean age was 66.6 years, SD = 9,333 with a standard error of 1.67. The patients ranged in age from 45 to 84 years.

There were a total of 46 self-initiated visits, with 49 difficulties identified. The average number of visits was 1.4375 visits per patient, ranging from 0 to 5 (standard deviation SD = 1.2975, standard error of arithmetic mean, SEM = 0.233, with variant of 1.68).

Pain and discomfort were identified in 89.8% or 44 cases, and occlusive problem in 10.2% or 5 cases.

In the research, the most numerous difficulty was subjective, while much fewer objective ones were identified, only one type, and that is occlusal imbalance. Occlusion was unbalanced in 5 of 49 patient complaints. Out of a total of five, three were associated with pain and discomfort, and in two cases patients came  exclusively due to occlusal disturbance.

In one similar study, the most common difficulty was a loose denture that did not fit properly, followed by pain in second place [1].

Loss of retention, ulceration, and excessive vertical dimension caused patient dissatisfaction in the second study, which partially agrees with the results of this study [2].

Occlusal difficulties may reduce prosthesis stability, however, no case of patient complaint of prosthesis stability has been reported in this study.

• Declaration of patient consent: There was no need for patients’ consent forms

• Authors' Contributions:  AH gave substantial contribution to the conception or design of the article and in the acquisition, analysis and interpretation of the. Author had main role in article drafting and in process of revision. Author gave final approval for the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved

• Financial support and sponsorship: Nil

• Conflict of interest: There are no conflicts of interest

1. Bilhan, H. et al. “Complication rates and patient satisfaction with removable dentures.” The Journal of Advanced Prosthodontics, vol. 4, no. 2, 2012, pp. 109-115.

2. Sheppard, I.M. and L.R. Schwartz and S.M. Sheppard. “Oral status of edentulous and complete denture-wearing patients.” The Journal of the American Dental Association, vol. 83, no. 3, 1971, pp. 614-620.

3. Bellini, D. et al. “Patients’ expectations and satisfaction of complete denture therapy and correlation with locus of control.” Journal of Oral Rehabilitation, vol. 36, no. 9, 2009, pp. 682-686.

4. El Osta, N. et al. “Comparison of psychometric properties of GOHAI, OHIP-14, and OHIP-EDENT as measures of oral health in complete edentulous patients aged 60 years and more.” Quality of Life Research, vol. 30, no. 4, 2021, pp. 1199-1213.

5. De Carvalho, B.M.D.F. et al. “GOHAI and OHIP-EDENT evaluation in removable dental prostheses users: factorial analysis and influence of clinical and prosthetic variables.” Journal of Prosthodontics, vol. 30, no. 7, 2021, pp. 581-589.

6. Bairam, L.R. and W.A. Miller. “Mandible bone resorption as determined from panoramic radiographs in edentulous male individuals aged 25-80 years.” Gerodontology, vol. 11, no. 2, 1994, pp. 80-85.

7. Vermeulen, A.H.B.M. et al. “Ten-year evaluation of removable partial dentures: survival rates based on retreatment, not wearing and replacement.” The Journal of Prosthetic Dentistry, vol. 76, no. 3, 1996, pp. 267-272.

8. Turner, M. and L. Jahangiri and J.A. Ship. “Hyposalivation, xerostomia and the complete denture: a systematic review.” The Journal of the American Dental Association, vol. 139, no. 2, 2008, pp. 146-150.

9. Curtis, D.A. et al. “Incidence of various classes of removable partial dentures.” The Journal of Prosthetic Dentistry, vol. 67, no. 5, 1992, pp. 664-667.

10. Berteretche, M.V. et al. “Different types of antagonists modify the outcome of complete denture renewal.” International Journal of Prosthodontics, vol. 28, no. 3, 2015, pp. 270-278.

11. Inoue, M. et al. “Denture quality has a minimal effect on health-related quality of life in patients with removable dentures.” Journal of Oral Rehabilitation, vol. 38, no. 11, 2011, pp. 818-826.