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British Journal of Healthcare and Medical Research - Vol. 10, No. 1
Publication Date: February 25, 2023
DOI:10.14738/jbemi.101.13819. Montaldi, M. R., Fortes, C. V., Ribeiro, A. B., Silva, C. H. L. D., & Dantas, R. O. (2023). Influence of Adhesive Use on Swallowing in
Removable Complete Denture Wearers. British Journal of Healthcare and Medical Research, Vol - 10(1). 131-141.
Services for Science and Education – United Kingdom
Influence of Adhesive Use on Swallowing in Removable
Complete Denture Wearers
Running Title: Denture Adhesive Effects on Swallowing
Marina Rodrigues Montaldi
Ribeirão Preto Medical School,
University of São Paulo, Ribeirão Preto SP, Brazil
Caroline Vieira Fortes
Ribeirão Preto School of Dentistry,
University of São Paulo, Ribeirão Preto SP, Brazil
Adriana Barbosa Ribeiro
Ribeirão Preto School of Dentistry,
University of São Paulo, Ribeirão Preto SP, Brazil
Cláudia Helena Lovato da Silva
Ribeirão Preto School of Dentistry,
University of São Paulo, Ribeirão Preto SP, Brazil
Roberto Oliveira Dantas
Ribeirão Preto Medical School,
University of São Paulo, Ribeirão Preto SP, Brazil
ABSTRACT
Background: The objective of conventional complete dentures is to reestablish the
functions of the stomatognathic system in edentulous individuals. Adhesives are
used for denture retention to help the masticatory function. The objective of this
investigation was to evaluate the effect of denture adhesive on the swallowing of
complete denture wears. Methods: Nine upper and lower complete denture wearers
and 14 individuals with teeth were assessed with videofluoroscopy at 30 frames by
second and analyzed frame by frame. The denture wears subjects were assessed
without dentures, with dentures without adhesive, and with dentures and adhesive.
Duplicate assessments were made with swallows of 10-mL thin-liquid bolus, 10-mL
extremely thick bolus, 5-g cookies, and 2-g toasts. Results: Laryngeal vestibule
closure, pharyngeal transit, upper esophageal sphincter opening, and
oropharyngeal transit took longer in denture wearers than in controls. Laryngeal
vestibule closure time and upper esophageal sphincter opening when swallowing
thin liquid were shorter with dentures and adhesive than without adhesive. With
extremely thick bolus, the pharyngeal transit time and upper esophageal sphincter
opening were shorter with adhesive use. Residues in the oral cavity occurred more
frequently in the denture wearers than in the controls, for all boluses. Removable
complete denture wearers have longer pharyngeal transit of thin liquid and
extremely thick boluses, which decreases with adhesive use. Conclusion: Adhesive
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British Journal of Healthcare and Medical Research (BJHMR) Vol 10, Issue 1, February - 2023
Services for Science and Education – United Kingdom
use cause a favorable effect on pharyngeal swallowing of thin and thick boluses in
complete denture wearers.
Keywords: Deglutition, Denture, Denture Bases, Denture Retention
INTRODUCTION
Removable conventional complete dentures are mucous-supported whose purpose is to
adequately reestablish function and aesthetics, helping improve the quality of life of edentulous
older adults. However, alveolar bone resorption compromises denture retention, support, and
stability, harming its wearer [1]. Implants are indicated to solve this problem, but their use is
limited by psychological conditions, systemic health, or socioeconomic factors [2].
Wearing and removing dentures may affect oropharyngeal movements and bolus transport
during feeding [3,4]. Dentures adhesives have as function to increase the adhesive and cohesive
properties between the inner denture surface and mucosa, being an alternative that improves
complete denture retention and stability on the supporting area, improve masticatory function,
decrease food accumulation between the denture and mucosa [5,6], and improve the wearer's
quality of life [7]. Adhesives ensure more efficient mastication, enabling fully ground and
crushed food bolus and avoiding swallowing difficulties [8] without irritating the mucosa [9].
Dysphagia is characterized as any difficulty or discomfort in the passage of the food bolus from
the mouth to the stomach [10]. These difficulties may result from neurological or muscle
changes or mechanical obstacles [11]. With normal function, food bolus transportation in the
oral cavity is estimated to take 1 to 2 seconds; in the pharynx, less than 1 second; and in the
esophagus, 8 to 10 seconds [12]. However, this process may be changed by removable complete
dentures or edentulousness [13]. So, adhesive use in combination with removable complete
dentures may help the swallowing process.
Videofluoroscopy is considered the best method to assess the oral and pharyngeal phases of
swallowing, as it dynamically assesses the transit of the swallowed material through the mouth,
oropharynx, hypopharynx, and upper esophageal sphincter (UES) [14].
The objective of this investigation was to evaluate the effect of denture adhesive on the
swallowing of individuals with complete dentures. The hypothesis was that adhesive use
benefits swallowing in denture wearers, nearing the swallowing dynamics of individuals with
teeth.
MATERIAL AND METHOD
Ethical Approval
This study was approved by the Human Research Ethics Committee of the School of Dentistry
of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil (CAAE:
95824818.0.0000.5419). The subjects were included in the research after signing an informed
consent form (ICF). The anonymity of the individuals was preserved.
Volunteers
The study included two groups of participants. The denture wearers group comprised
completely edentulous individuals who wore mandibular as well as a maxillary denture
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Montaldi, M. R., Fortes, C. V., Ribeiro, A. B., Silva, C. H. L. D., & Dantas, R. O. (2023). Influence of Adhesive Use on Swallowing in Removable Complete
Denture Wearers. British Journal of Healthcare and Medical Research, Vol - 10(1). 131-141.
URL: http://dx.doi.org/10.14738/jbemi.101.13819
followed up at the School of Dentistry of Ribeirão Preto, University of São Paulo (FORP-USP).
The control group comprised individuals with teeth recruited by personal invitation. All
participants were initially interviewed to register their age, educational attainment,
occupation, medical and dental history, and time of denture wearing (for those who wore it).
They were also submitted to clinical examination to assess the denture-supporting tissues and
the characteristics of the dentures, according to the inclusion and exclusion criteria.
Inclusion and Exclusion Criteria
Individuals with a mandibular as well as maxillary denture were invited to make up the denture
wearers group. The base and teeth of the dentures were made of acrylic resin; they had been
wearing them for a minimum of 3 months and a maximum of 5 years, in satisfactory wearing
conditions and adequate maxillomandibular relationship, evaluating by expert professional.
Individuals with lesions on the mucosa, fractured denture, or worn teeth were excluded. The
14 volunteers in the control group had at least 24 well-preserved teeth.
Individuals with restrictions on food intake, dysphagia, xerostomia, acute or chronic diseases,
neurological diseases, or impaired cognitive function were not included.The denture wearers
group subjects were submitted to three forms of swallowing assessment with
videofluoroscopy, as follows: no wearing complete dentures, wearing dentures without
adhesive, and wearing dentures with adhesive. The adhesive used was Corega Ultra® applied
for seven days. Corega Ultra is composed of sodium/calcium mixed partial poly salts
(methylvinylether/maleic acid), carboxymethylcellulose, mineral oil, and petroleum jelly
(GlaxoSmithKline – Argentina).
The patients were given the adhesive along with a kit containing a denture brush (Denture
brush – Condor S.A., Santa Catarina, Brazil) and neutral liquid soap (JOB Química, Produtos para
Limpeza Ltda., Monte Alto, São Paulo, Brazil) for hygiene care; they also received written and
verbal instructions. The participants were instructed to apply the adhesive daily, according to
the manufacturer’s instructions, on the inner surface of the upper and lower complete dentures
and wear them throughout the day, removing them for hygiene after meals and reapplying the
adhesive before wearing the dentures again. The patients were instructed to sleep at night
without dentures.
Videofluoroscopy
The videofluoroscopic examination was made with an Arcomax angiograph (Philips, model BV
300, Veenpluis, the Netherlands), recording images at 30 frames per second. The subjects
remained seated, sustaining usual cervical posture, feet flat on the floor, in the Frankfurt plane.
The equipment was positioned to pick up transverse images of the mouth, pharynx, and upper
part of the esophagus.
During the assessments, the volunteers were instructed to chew and/or swallow the thin liquid,
thick and solid boluses, as they would normally do. Duplicate assessments were made by
randomly ingesting liquid, thick bolus, and solid foods. The volunteers helped themselves with
10 mL of liquid, thick foods, cookie and toast as solid food. The denture wearers subjects were
assessed in two moments. In the first one, they were assessed wearing the denture without
adhesive and then without the dentures – in which case, the toast was not included. The second
assessment took place after 7 days of using the adhesive daily; the subjects were wearing the