Study on Recognition of Denture(s) Using a Structural Equation Modeling

Objectives: Patient's recognition of their denture(s) is one of the important factors in the prosthodontic treatments. It may depend on not only biomechanical or biological factors but also some psychological states of the patients; nevertheless the principal factors were still unclear. The objective of this study was to explore the psychological factors, which may affect to the acceptance of removable dentures.

Methods: 335 candidate items for a questionnaire to assess the recognition of removable dentures were collected from the literatures and the clinical interview records. All items were divided with similar meaning of sentences using the KJ method by the three prosthodontists. Finally, the 50 items were selected for a questionnaire study exploring the psychological factors, which consisted of the patient's recognition, behavior, feeling, opinion and experience with denture(s). Four rating alternatives were made for each item. The subjects were 145 patients between the ages of 39-89 and wearing removable denture(s), who visited at the dental clinic in Aichi-Gakuin University. Exploratory factor analysis (EFA) was performed to create a hypothesized model to describe the denture recognition. This model was tested using a second-order confirmatory factor analysis (CFA).

Results: We found a primary-order factor with 18 items according to the solution of FEA using a maximum likelihood estimation method. The alpha-value from the 18 items was 0.93. Also, the secondary-order factors for the subscales were determined by FFA with the Promax rotation procedure. The constructions of the three subscales were understood from the meaning of the items: “performance of the denture(s)”, “uncomfortableness (sensation)” and “inferiority complex (emotion)”. Goodness-of-fit indicators suggested that the model had good fit to the data on the second-order CFA; CFI=0.92, GFI= 0.84 and RMSEA=0.07.

Conclusion: The denture wearing patients recognize own denture(s) according to not only by the denture performance but also by their sensation and emotion.