Predoctoral dental students' perceptions and experiences with prosthodontics.
Dhima, Matilda; Petropoulos, Vicki C; Salinas, Thomas J; Wright, Robert F
2013-02-01
The aims of this study were to: (1) investigate the perceptions and experiences of predoctoral dental students and advanced standing students on mentorship, exposure to prosthodontics, and future need for the specialty, and (2) establish a baseline of students' perceptions of the impact of prosthodontics on salary, personal and patient quality of life, and the profession of dentistry. A survey was distributed to 494 predoctoral and advanced standing students at the University of Pennsylvania School of Dental Medicine. Questions focused on the perceptions and experiences with the specialty of prosthodontics. A total of 410 surveys were analyzed using Chi Square tests and univariate and multivariate analysis with statistical software. Response rate was 83%. A positive initial introduction to prosthodontics was reported by 57% of students. Most students had positive experiences with prosthodontic faculty and enjoyed laboratory work and challenging/complex dentistry. A greater need for prosthodontists in the future was perceived by 82% of respondents, with 63% reporting that the future of prosthodontics had been emphasized. Students reported (1) a preclinical course directed by prosthodontists and (2) working in the clinic with prosthodontic faculty (p < 0.006) as having the biggest impact on their introduction to prosthodontics. A desire to pursue training or a career in prosthodontics was reported by 3.4% of the respondents, with 1.7% of them pursuing prosthodontics. Enjoyment of providing care in prosthodontics was the most important factor for those who decided to pursue prosthodontic postgraduate training. When compared to other specialties, prosthodontics ranked low with regards to its impact on salary (7(th) ), personal quality of life (5(th) ), patient quality of life (4(th) ), and strengthening of the dental field (7(th) ). Reasons few students are interested in prosthodontics as a career, despite a positive first introduction and high perceived future need for prosthodontists may be attributed to a number of factors. These include insufficient prosthodontically, trained faculty, lack of a mentorship program, lack of an advanced graduate program, a perception of feeling unprepared upon graduation, and misconception of potential income in prosthodontics. © 2012 by the American College of Prosthodontists.
Hirai, Toshihiro
2007-10-01
Prosthodontics is a practical science based on life sciences and health sciences, and takes a role to contribute to the improvement of people's health and welfare. It is true the main field of prosthodontics and/or prosthodontic treatments is oral rehabilitation including recoveries of morphological defects and the functional disability caused by teeth loss. From this point of view, I am sure that the ultimate target of prosthodontics and/or prosthodontic treatments is maintenance and improvement of patient's QOL. To achieve this purpose, I think research, education, and clinical practice to be inseparable and integral in prosthodontics. This ensures that prosthodontics become more academic which can contribute to the society more greatly. Advertisement disclosure of "Prosthodontic Specialist certified by Japan Prosthodontic Society" is our earnest wish. The specialist system is regarded to be effective for the improvement of the medical treatment level, the information provision to the patient, and the promotion of cooperation hospital and clinic. On the other hand, the high quality treatments are severely requested and the specialists are strictly evaluated by the many people more than before. We have to be aware of our responsibility as Prosthodontic Specialists. In addition, Japan Prosthodontic Society is a corporate judicial person, and there is obligation and a responsibility that transmit necessary information to the society certainly and promptly, and present various proposals based on EBM as the opinion leader. Concretely, it is necessary to promote basic researches as well as clinical researches on prosthodontic treatments, and to examine the improvement of educational methods of prosthodontics. Let's reconfirm the purpose of our Society written in the article of incorporation and make an effort to achieve this purpose!
Shin, Jane H; Kinnunen, Taru H; Zarchy, Marisa; Da Silva, John D; Chang, Brian Myung W; Wright, Robert F
2015-01-01
It is important for members of the dental specialties to understand what motivates students to enter the specialty in order to ensure its continuing development and ability to meet patient needs. The aim of this study was to compare ten graduating classes at Harvard School of Dental Medicine (HSDM) regarding students' experiences with and perceptions of prosthodontics and factors influencing those interested in pursuing prosthodontics as a specialty. In 2013, HSDM students in the classes of 2012-16 were surveyed, achieving a response rate of 81%. Survey questions sought information regarding specialty choice, factors influencing the choice, student experiences with prosthodontics, and student perceptions of the dental disciplines. Responses were compared to those from a prior study of the HSDM classes of 2007-11. The responses showed a decrease in negative student experiences with prosthodontics. The students regarded prosthodontics highly for its impact on patient quality of life; however, students interested in pursuing prosthodontics as a specialty decreased. All students said provider enjoyment was most important in choice of specialty. Cost of program, patient type, and program location were factors that especially influenced students interested in prosthodontics. The improved student experiences with and perspectives on prosthodontics may be a result of a curriculum change that led to more prosthodontics procedures and case completions by students. The fall in students interested in prosthodontics may have resulted from prosthodontic faculty transitions that occurred when the survey was conducted, as well as large debt burdens in spite of the fact that prosthodontists' earnings are among the highest in dentistry. Faculty must educate and mentor students about the realities of the profession, provide positive learning experiences in the field, and encourage students who enjoy prosthodontics to pursue specialty training.
1974-08-31
Prosthodontic Appliances - Partial Dentures .... ....... ....... .... 59 2. Removable Prosthodontic Appliances - Full Dentures ..... ........... . 60 3...PROCEDURES I This unit includes the following Modules: Number Title Page 1 Removable Prosthodontic Appliances - Partial Dentures 59. ......... ...... 2...Removable Prostbodontic Appliances - Full Dentures ..... ...... a .. .. .. . 60 3 Fixed Prosthodontic Appliances - Fixed Bridge. . 61 4 Mouthquard
Gender disparities in prosthodontics: authorship and leadership, 13 years of observation.
Kongkiatkamon, Suchada; Yuan, Judy Chia-Chun; Lee, Damian J; Knoernschild, Kent L; Campbell, Stephen D; Sukotjo, Cortino
2010-10-01
The purpose of this study was to examine gender disparities in prosthodontics by reviewing the trend of female authorship in prosthodontic journals and exploring the role of female leadership in prosthodontic organizations and Advanced Education in Prosthodontic (AEP) programs. Three journals representing the prosthodontic specialty were selected to analyze the percentage of female dentist first and last (senior) authors for the years 1995, 2000, 2005, and 2008. Article inclusion criteria were restricted to the first or last authors who held at least a DMD/DDS/BDS degree and were from U.S. institutions. Data on female leadership in prosthodontic organizations and advanced education programs were collected, and the trends were studied. Descriptive statistics were used to analyze the data. A linear regression analysis was performed to investigate the proportion of female authorship compared to male in the dental literature. A Fisher's Exact Test was performed to contrast differences of female first and last authorship in the selected journals between years 1995 and 2008. Overall, there was no statistically significant linear increase in the proportion of either first or last female authorship compared to male authorship over time. With respect to each journal, the linear regression analysis showed that the increase of first female authorship was statistically significant (p= 0.016) compared to male authorship only in the Journal of Prosthetic Dentistry. The percentage of female presidents of prosthodontic organizations has been very limited. A similar trend was also observed in AEP program director positions. Over the past 13 years, female dentists' participation in prosthodontics literature authorship has not increased significantly in the United States. Furthermore, female involvement in prosthodontics leadership has been limited over the past decades. © 2010 by The American College of Prosthodontists.
Ten-year survey of program directors: trends, challenges, and mentoring in prosthodontics. Part 1.
Munoz, Deborah M; Kinnunen, Taru; Chang, Brian M; Wright, Robert F
2011-10-01
This study consisted of two parts. Part 1 was a survey of US program directors, and Part 2 reports on the survey findings distributed to the deans of US dental schools. Both surveys evaluated observations of trends in prosthodontic education. The first survey (2005) of program directors and deans was published in 2007. This second survey was conducted in 2009. The 2009 survey provided 10-year data on trends in prosthodontics as reported by program directors. A national e-mail survey of 46 program directors was used to collect enrollment data for years 1 to 3 of prosthodontics training for US and international dental school graduates, the total number of applicants and applications considered, and the trends over time of applicants to prosthodontics for US dental school graduates and for international graduates. In addition, the program directors were asked to rank 13 key factors that may have contributed to any changes in the prosthodontic applicant pool. Program directors were also asked for information on student financial incentives and whether their programs were state or federally funded, and whether their sponsoring institution was a dental school. Of the 46 program directors, 40 responded, for an 87% response rate. Respondents reported that 66% of their enrollees were graduates of US dental schools. Between 2000 and 2009 the applicant pool in prosthodontics nearly doubled, with 50% of the program directors reporting an increase in US-trained applicants, 42.5% reporting no change, and only 7.5% reporting a decrease. Using the Spearman correlation for the 10-year survey, there was a positive, statistically significant correlation that society's demand for a higher level of training and credentialing and interest in prosthodontics among dental students contributed to an increase in the number of US dental graduates applying to prosthodontic programs. Only four programs offered no financial packages to offset tuition. The remaining 36 respondents reported some financial package. Among the respondents, there were 23 state-sponsored programs and 6 sponsored by private universities; the remaining 9 were sponsored by hospitals or federal agencies. A nearly doubled applicant pool and more US-trained applicants to prosthodontics ensure a much more competitive applicant pool for our specialty. In the 2009 survey, program directors reported that factors such as society's demand for a higher level of training and credentialing, interest in prosthodontics among US dental students, advances in implant, esthetic, and reconstructive dentistry, literature pertaining to the need of prosthodontists for the future, marketing of prosthodontics as a career, and the dollar value of prosthodontic training have all had some impact on increasing the mentored applicant pool to prosthodontic training in the United States. © 2011 by The American College of Prosthodontists.
Retrospective analysis of dental implants placed and restored by advanced prosthodontic residents.
Barias, Pamela A; Lee, Damian J; Yuan, Judy Chia-Chun; Sukotjo, Cortino; Campbell, Stephen D; Knoernschild, Kent L
2013-02-01
The purposes of this retrospective clinical review were to: (1) describe the demographics of implant patients, types of implant treatment and implant-supported prostheses in an Advanced Education in Prosthodontic Program, (2) evaluate the survival rate of dental implants placed by prosthodontic residents from 2006 to 2008, and (3) analyze the relationship between resident year of training and implant survival rate. All patients who received dental implants placed by prosthodontic residents from January 2006 to October of 2008 in the Advanced Prosthodontic Program at the University of Illinois at Chicago College of Dentistry were selected for this study. Age, gender, implant diameter, length, implant locations, surgical and restorative detail, and year of prosthodontic residency training were collected and analyzed. Life-table and Kaplan-Meier survival analyses were performed based on implants overall, locations, year of training, and use of a computer-generated surgical guide. A Logrank statistic was performed between implant survival and year of prosthodontic residency training, location, and use of computer-generated surgical guide (α= 0.05). Three hundred and six implants were placed, and of these, seven failed. Life-table and Kaplan-Meier analyses computed a cumulative survival rate (CSR) of 97% for overall implants and implants placed with a computer-generated surgical guide. No statistical difference was found in implant survival rates as a function of year of training (P= 0.85). Dental implants placed by prosthodontic residents had a CSR comparable to previously published studies by other specialties. The year of prosthodontic residency training and implant failure rate did not have any significant relationship. © 2012 by the American College of Prosthodontists.
Changes in the prosthodontic literature 1966 to 2042.
Carlsson, Gunnar E
2005-05-01
To describe the growth and content of the prosthodontic literature over the last 4 decades, to make a prognosis on its probable development in the coming 4 decades and to discuss changes in the content of the International Journal of Prosthodontics (IJP) from its start in 1988 to 2004. MEDLINE was searched for articles on prosthodontics published between 1966 and April 2004. All volumes of IJP were examined with respect to type, subject area and geographic origin of articles. Using the term "prosthodontics," the MEDLINE search produced 66,600 hits. The proportion of clinical studies increased from 1% during the first 10-year period to 13% since 2001. Articles on removable dentures decreased during the period reviewed, whereas those on implant prosthodontics increased. Randomized controlled trials were rare and often of inadequate quality. Literature reviews have become popular, but many do not follow current guidelines for systematic reviews. A marked change in geographic origin of articles in IJP has occurred, with a decrease in material from North America and an increase in that from Europe and Asia. The Internet and open-access publishing will probably have a great impact on the future development of the prosthodontic literature. Substantial changes have occurred in the prosthodontic literature between 1966 and 2004, and they can be expected to continue with the rapid development of information technology and increased use of the Internet.
A survey of program directors: trends, challenges, and mentoring in prosthodontics. Part 1.
Wright, Robert F; Dunlop, Ryan A; Kim, Frances M; Douglass, Chester W
2008-01-01
This study consisted of two parts. Part 1, a survey of program directors, was conducted to examine current trends in advanced education in prosthodontics in the United States. Part 2 will report on the survey results distributed to the deans of US dental schools to evaluate their observations of trends in prosthodontics. A national e-mail survey of 45 program directors was used to collect enrollment data for years 1 to 3 of prosthodontics training for US and international dental school graduates, the total number of applicants and applications considered, and the trends over time of applicants to prosthodontic programs for US dental school graduates and for international graduates. In addition, the program directors were asked to rank 13 key factors that may have contributed to any changes in the prosthodontic applicant pool. Comments were accepted on why more or less US- or internationally trained applicants have applied. Program directors were also asked for information on student financial incentives, whether their programs were state or federally funded, and whether their sponsoring institution was a dental school. Of the 45 program directors, 39 responded, for an 86.7% response rate. Respondents reported that 64% of their enrollments were graduates of US dental schools. Between 2000 and 2004 the applicant pool in prosthodontics increased by 23%, with 41% of program directors reporting an increase in US-trained applicants, 46.2% reporting no change, and only 12.8% reporting a decrease. Using the Spearman correlation, there was a moderate, positive statistically significant correlation that the following factors contributed to an increase in the number of US dental graduates applying to prosthodontic programs: (1) mentoring by prosthodontists at the predoctoral level, (2) interest in prosthodontics among US dental students, and (3) society's demand for a higher level of training and credentialing, (4) data depicting current and projected income for dental specialists, and (5) number of trained prosthodontists full- or part-time faculty at the predoctoral level. Only five programs offered no financial packages to offset tuition. The remaining 34 respondents reported some financial package. Among the respondents, there were 25 state-sponsored programs, 9 sponsored by private universities, and 5 sponsored by hospitals or federal agencies. An increased applicant pool and more US-trained applicants to prosthodontics programs create a more competitive applicant pool for our specialty. Program directors reported that factors such as mentoring, society's demand for a higher level of training and credentialing, data depicting current and projected income for prosthodontists, exposure to prosthodontic faculty at the predoctoral level, the dollar value of prosthodontic training, and advances in implant, aesthetic, and reconstructive dentistry have all had some impact on increasing the applicant pool to prosthodontic training in the United States.
Thornton, Kathryn; Lee, Damian J; Yuan, Judy Chia-Chun; Knoernschild, Kent L; Campbell, Stephen D; Sukotjo, Cortino
2012-01-01
This study evaluated the quantity of prosthodontic literature produced globally by continent in three prosthodontic journals over a 10-year period, 1998-2008. Prosthodontic research productivity relative to economic status of countries and collaboration among countries grouped by economic status was assessed. Three peer-reviewed prosthodontic journals were used for the analysis of articles published in 1998, 2003, and 2008: The Journal of Prosthetic Dentistry, International Journal of Prosthodontics, and Journal of Prosthodontics. The country of every author listed for each included article was recorded. The number of articles published by each continent and each country was reported. Countries were grouped according to the World Bank economic classification system, and the number of articles published by each economic class was found. The majority of publications over the 10-year period were produced in Asia (Japan), Europe (Germany), and North America (USA). Productivity declined by 14.4% in high-income countries while it increased in upper middle-, lower middle-, and low-income countries. The majority of publications written by upper and lower middle- and low-income countries were independent works. Articles resulting from collaboration increased over time for all economic classes of countries. The origins of prosthodontic literature are becoming more geographically and economically diverse, with increased contributions from Africa, Asia, and South America, and middle- and low-income countries between 1998 and 2008. Collaboration between high-income countries and the other economic group countries increased over time. © 2011 by the American College of Prosthodontists.
Increasing predoctoral dental students' motivations to specialize in prosthodontics.
Zarchy, Marisa; Kinnunen, Taru; Chang, Brian M; Wright, Robert F
2011-09-01
This study provides data about factors that influence dental students' decision of which specialty to pursue and describes program changes in prosthodontics designed to expand student interest in a prosthodontics training program. Of 176 current and recently graduated students at Harvard School of Dental Medicine, 167 responded to the e-mail survey for a 94.9 percent response rate. Using the Pearson chi-square analysis, we analyzed nine factors to determine their contribution to these students' choice of specialty. Two factors, lecture and faculty/mentoring, were highly significant (p<0.006) regarding impact on the students' introductory experience with prosthodontics. When choosing a specialty, 44 percent of all students ranked "enjoyment of providing the specialty service" as the most important factor. Students wishing to specialize in prosthodontics, however, ranked four significant factors: enjoyment of providing the specialty service (p<0.037, p<0.057); faculty influence (p<0.0002, p<0.0001); length of program (p<0.039, p<0.006); and cost of program (p<0.023, p<0.004). Respondents also ranked the nine American Dental Association-recognized specialties regarding their perceptions of future salary and impact on the dental profession. They ranked prosthodontics fourth for future salary and fifth for impact on the profession. At the same time that this study was being conducted, key changes were being made in the graduate prosthodontics program; those appear to have had a positive impact on students' interest in pursuing prosthodontics as a specialty.
Mandibular overdentures: a review of treatment philosophy and prosthodontic maintenance.
Al-Zubeidi, Mohammed I; Payne, Alan G T
2007-12-01
Root overdentures and implant overdentures are two similar treatment options for the nearly-edentulous or edentulous mandible. The purpose of this literature review was to specifically compare their prosthodontic treatment philosophies and follow-up maintenance requirements. Critical comparison of these two prosthodontic treatment philosophies revealed that the foundation for overdentures which is provided by oral implants is more predictable than that provided by the roots of natural teeth. The two treatment modalities have both similarities and differences in their associated prosthodontic maintenance. The findings of this literature review suggest the future possibility that mandibular root overdentures may become obsolete as a treatment approach.
Differential factors that influence applicant selection of a prosthodontic residency program.
Blissett, Ryan; Lee, Meng-Chieh; Jimenez, Monik; Sukotjo, Cortino
2009-04-01
The main objectives of this study were to identify current prosthodontic resident demographics and to analyze factors that may influence applicants in selecting prosthodontics as a career, as well as a specific prosthodontic program. We also investigated the influence of age, gender, relationship status, and year in program on applicant decisions. Two questionnaires were mailed to all prosthodontic residents (N = 304) registered with the American College of Prosthodontists (ACP) Central Office. Part I assessed resident demographics and factors influencing choice of specialty. Part II assessed factors influencing the selection of a specific prosthodontic program. Completed surveys were obtained from 193 of 304 (63.4%) of all prosthodontic residents registered at the ACP Central Office. The completed surveys represented approximately 48% of the total population of prosthodontic residents in the United States. Demographic data revealed that 37% and 62% of the respondents were female and male, respectively (1% did not report gender). The mean age of the respondents was 30.3 years. More residents reported being married than either single or in a relationship. Most residents were accepted to their top choice program. Part I of the survey revealed that the complexity and challenge of treatment planning/treatment, ability to lead multidisciplinary cases, possession of skills/talents suited to the specialty, enjoyment of clinical work, and the intellectual content of the specialty were reported to be the five most influential factors in choosing prosthodontics as a career. Part II demonstrated that applicants place a high emphasis on clinical education, their impression of the program director, advice from predoctoral mentors, their impression of resident satisfaction and happiness, and the opportunity to place dental implants. The factors of least importance are climate and opportunities to moonlight, teach, and conduct research. Dental students consider the complexity and challenge of treatment planning and execution of prosthodontic treatment to be the most important factors in the decision to specialize in prosthodontics. Mentors and predoctoral instructors also strongly influence students. Applicants consider clinical education to be the most important determinant in program selection, but are also influenced by their impression of the program director and his/her philosophy of training. Faculty board certification and the opportunity to place dental implants are also important factors. Relationship status can significantly affect an applicant's choice of program. Teaching and research opportunities appear to be of minor importance to applicants. These findings can be used by the ACP and/or program directors to understand which factors are important to students, enabling them to assess the compatibility of their programs with applicants and modify existing curricula to make their programs more attractive to top candidates.
Evidence-based prosthodontics: fundamental considerations, limitations, and guidelines.
Bidra, Avinash S
2014-01-01
Evidence-based dentistry is rapidly emerging to become an integral part of patient care, dental education, and research. Prosthodontics is a unique dental specialty that encompasses art, philosophy, and science and includes reversible and irreversible treatments. It not only affords good applicability of many principles of evidence-based dentistry but also poses numerous limitations. This article describes the epidemiologic background, fundamental considerations, scrutiny of levels of evidence, limitations, guidelines, and future perspectives of evidence-based prosthodontics. Understanding these principles can aid clinicians in appropriate appraisal of the prosthodontics literature and use the best available evidence for making confident clinical decisions and optimizing patient care. Copyright © 2014 Elsevier Inc. All rights reserved.
Elders with implant overdentures: a 22-year clinical report.
Alsabeeha, Nabeel H M
2012-09-01
To report on the long-term survival and prosthodontic maintenance of two edentulous adults with mandibular overdentures supported by hydroxyapatite (HA)-coated implants. Mandibular implant overdentures are a successful treatment option with positive impact on the quality of life of elderly edentulous adults. Long-term survival of the implants requires continued rigorous prosthodontic maintenance. Two elderly edentulous adults with mandibular overdentures supported by 2 HA-coated implants were presented for prosthodontic rehabilitation after 22 years of placement. The implants were osseo-integrated and surviving at presentation based on accepted criteria. The mandibular implant overdentures suffered recurrent loss of retention and stability. Prosthodontic treatment involving the replacement of defective attachment systems and construction of new sets of mandibular implant overdentures opposing complete maxillary dentures is presented. The long-term survival of mandibular 2-implant overdentures requires continued prosthodontic maintenance. A conservative approach in the rehabilitation of two older edentulous adults with mandibular 2-implant overdentures was described including proper selection of attachment systems. © 2012 The Gerodontology Society and John Wiley & Sons A/S.
Liu, Y S; Li, Z; Zhao, Y J; Ye, H Q; Zhou, Y Q; Hu, W J; Liu, Y S; Xun, C L; Zhou, Y S
2018-02-18
To develop a digital workflow of orthodontic-prosthodontic multidisciplinary treatment plan which can be applied in complicated anterior teeth esthetic rehabilitation, in order to enhance the efficiency of communication between dentists and patients, and improve the predictability of treatment outcome. Twenty patients with the potential needs of orthodontic-prosthodontic multidisciplinary treatment to solve their complicated esthetic problems in anterior teeth were recruited in this study. Digital models of patients' both dental arches and soft tissues were captured using intra oral scanner. Direct prosthodontic (DP) treatment plan and orthodontic-prosthodontic (OP) treatment plan were carried out for each patient. For DP treatment plans, digital wax-up models were directly designed on original digital models using prosthodontic design system. For OP treatment plans, virtual-setups were performed using orthodontic analyze system according to orthodontic and esthetic criteria and imported to prosthodontic design system to finalize the digital wax-up models. These two treatment plans were shown to the patients and demonstrated elaborately. Each patient rated two treatment plans using visual analogue scales and the medians of scores of two treatment plans were analyzed using signed Wilcoxon test. Having taken into consideration various related factors, including time, costs of treatment, each patient chose a specific treatment plan. For the patients chose DP treatment plans, digital wax-up models were exported and printed into resin diagnostic models which would be utilized in the prosthodontic treatment process. For the patients chose OP treatment plans, virtual-setups were used to fabricate aligners or indirect bonding templates and digital wax-up models were also exported and printed into resin diagnostic models for prosthodontic treatment after orthodontic treatment completed. The medians of scores of DP treatment plan and OP treatment plan were calculated and analyzed by IBM SPSS 20. The median of scores of DP treatment plan was 8.4, the minimum value was 6.9 and the maximum value was 9.3. The median of scores of OP treatment plan was 9.0, the minimum value was 7.9 and the maximum value was 9.6. The median of scores of OP was significantly higher than that of DP (Z=-3.23, P<0.01). Finally, 12 patients chose OP treatment plans and 8 patients chose DP treatment plans. For cases with complex esthetic problems in anterior teeth, a digital workflow can demonstrate final treatment outcome and help patients make suitable treatment decisions. In our study, the orthodontic-prosthodontic multidisciplinary treatment plan is feasible which can provide predictions of treatment outcome and improve esthetic outcome with patients' satisfaction.
Sailer, Herman F.; Tarawneh, Fadi; Fourkas, Panagiotis; Antoniades, Dimitrios Z.; Athanasiou, Athanasios E.
2010-01-01
This case report describes the combined surgical, orthodontic and prosthodontic rehabilitation of an adult female patient with a previous history of follicular ameloblastoma, which was treated through partial mandibulectomy and an immediate replacement of missing bone with an autologous calvarial bone graft. Orthodontic treatment was undertaken in order to restore occlusal disturbances and obtain sufficient space for two dental implants and an optimum prosthodontic rehabilitation. PMID:20396452
Education for specialization in prosthodontics in Switzerland and the role of EPA.
Mericske-Stern, Regina
2014-07-01
Advertisement for any dental treatment was rare in Switzerland. Then the use of digital media became popular, particularly in the field of implant- and esthetic-dentistry. In parallel to the dental schools of public universities, private universities and companies built up centers for continuing education that issue specialists diplomas and M.Sc. degrees. Prosthodontics itself is characterized by many sub-disciplines that incorporated their own associations. These also offer graduate training curricula which diminish the significance of specialization in prosthodontics. Specialized prosthodontists do not have a financial benefit in Switzerland where dentistry is not supported by any insurance. In other European countries funding of prosthodontic treatment depends on their healthcare systems. There are four specialties in Dentistry recognized by the European Union (EU). Specialization in prosthodontics was introduced in Sweden already in 1982 and today it is declared in about 20 European countries, while for others no recognized program exists. Thus there are great variations with more recognized specialists in former east European countries. In Switzerland the prosthodontic specialization curriculum was developed and guided by the Swiss Society for Reconstructive Dentistry, and only in 2001 it became fully acknowledged by the Federal Department of Health. The four Swiss Universities offer the 3-year program under the supervision of the society, while the government remains the executive body. In 2003 EPA tried to set up guidelines and quality standards for an EPA recognized specialization. In spite of these attempts and the Bologna Reform in Europe, it appears that the quality standards and the level of education still may differ significantly among European countries. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Osman, Reham B; Ma, Sunyoung
2014-01-01
The purpose of this study was to determine the prosthodontic outcomes of one-piece zirconia implants and their attachment systems in edentulous participants with maxillary and mandibular overdentures after 1 year of a randomized controlled trial. Random allocation of 24 edentulous participants (age range: 45 to 86 years) into titanium (control) or zirconia (test) groups using onepiece implants and a planned unsplinted prosthodontic design was performed. Four maxillary implants (one midpalatal; three anterior crestal) and three mandibular implants (one midsymphyseal; two bilateral distal) were conventionally loaded with the overdentures. Similar attachment systems were used throughout: ball abutment-type patrices (diameter: 2.25 to 3.1 mm as part of the one-piece implants) and custommade plastic matrices (with or without metal housings depending on the patrix size). Prosthodontic outcomes were documented during the first year of the clinical trial. Following three deaths and two dropouts, there were 19 participants who were available at the 1-year recall. Of these participants, 3 had early maxillary implant failure and had to be converted to conventional maxillary complete dentures opposing mandibular implant overdentures. There were 79 maintenance events, 34 in the titanium (control) group and 45 in the zirconia (test) group. Patrix loss occurred as a result of three zirconia implant fractures (one mandibular and two crestal maxillary implants). Maintenance events were principally the replacement of matrices and overdenture fracture. Although relines and replacement overdentures also occurred, overall there were no significant differences in prosthodontic maintenance between the control and test groups. A six-field prosthodontic-success analysis table showed no statistically significant difference between the two groups; however, 50% of participants in each group were allocated to the retreatment (repair) field, which produced a low prosthodontic success rate. Removable overdentures can be used on both one-piece titanium and zirconia implants with these attachment systems, due to no difference in prosthodontic maintenance and success. Before recommending routine use of a "metal-free" overdenture treatment option in clinical practice, consideration must be given to the success of the implants themselves.
Dhima, Matilda; Salinas, Thomas J; Rieck, Kevin L
2013-11-01
To meet functional and esthetic needs in an older adult for treatment of complex skeletal and dentoalveolar deformities using contemporary surgical and prosthodontic protocols. An older adult with dentoalveolar complex and skeletal deformity (mandibular retrognathia) was treated by a combination of virtual planning and current surgical and prosthodontic protocols. Treatment planning steps and sequencing are presented. Skeletal, soft tissue, and dental harmonies were attained without biological or mechanical complications. Definitive oral rehabilitation was completed with a maxillary complete denture and a mandibular metal ceramic fixed implant-retained prosthesis. A surgical and prosthodontic team approach in combination with technologic advances can predictably optimize esthetic and functional outcomes for patients with complex skeletal and dentoalveolar deformities. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Jiang, T
2017-12-09
Glossary of Prosthodontic Terms is a standardized vocabulary with international influence. Its ninth edition was published in J Prosthet Dent in 2017, 12 years after the last edition. During this period, great development has taken place in the dental prosthetics due to dental implant and digital dentistry as well as application of new materials and technologies. The research results of dental adhesion, aesthetic dentistry, orofacial function, and tissue regeneration has been fully applied in dental clinic. This paper attempts to capture and accurately understand the changes of some important, especially controversial academic concepts through the comparison of the seventh, eighth and ninth edition of vocabulary. Four parts including new terms, obsolete terms, terms with updated concept, and terms with the continuity of concept are used to show the important progress of prosthodontics.
Arunachalam, Kuthalingam Subbiah; Solomon, EGR
2012-01-01
The intent of this article was to analyze the potential hazards and risks involved in persons exposed to prosthodontic practice. These risks include exposure to physical and chemical hazards, dental materials, infectious environment, inappropriate working pattern and psychosocial stress. The potential harm of these hazards and its prevention is highlighted. Prosthodontists, students, dental technicians, and others working in the prosthodontic clinics and laboratory should be aware of the specific risk factors and take measures to prevent and overcome these hazards. PMID:23236581
Yuan, Judy Chia-Chun; Lee, Damian J; Knoernschild, Kent L; Campbell, Stephen D; Sukotjo, Cortino
2010-09-01
Author characteristics and the extent of dental literature authorship globalization have not been widely investigated, especially in prosthodontics. The purpose of this study was to examine trends in authorship characteristics in prosthodontics. Articles published in The Journal of Prosthetic Dentistry (JPD), International Journal of Prosthodontics (IJP), and Journal of Prosthodontics (JP) in 1998, 2003, and 2008 were reviewed. Abstracts, letters to the editor, and book reviews were not included in the investigation. The authors' educational degrees had to be listed in the publications for the articles to be included. For each article, number of authors, degrees of all authors, academic ranks of first and last authors, and geographic origin were recorded. Descriptive and analytic analyses (alpha=.05), including a generalized linear model, Kruskal-Wallis, Mann-Whitney U, or chi-square tests, were used as appropriate. A total of 998 articles met the inclusion criteria from the 3 selected journals for the years studied. Across all 3 journals, the mean number of authors per article increased significantly from 2.9 in 1998 to 3.6 in 2008 (Kruskal-Wallis, P<.001). The mean number of authors per article increased steadily on all continents, except for Africa and Oceania. A steady increase of authors with higher degrees was observed. There was a significant increase in the proportion of senior-ranking faculty as last author over time (chi-square=5.57, df=1, P=.018). The contributions from Asia and South America increased over time. The number of authors per article, the number of authors with higher educational degrees, and the percentage of senior-ranking faculty as last author steadily increased in the prosthodontic literature from 1998 to 2008. The trend of globalization of authorship was evident in the prosthodontic literature. Copyright © 2010 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.
Vidzis, Aldis; Cema, Ingrida; Brinkmane, Anda; Krasta, Ingrida; Broka, Kristine
2012-01-01
The quality of life is closely related with condition of oral health, influence of subjective factors on the whole human body and patients perception of their oral health. In spite of the fact that the most part of Latvian retirement age residents use low-quality dentures and assess them satisfactory, these patients often have problems associated with quality of dentures. The aim of the present study was to evaluate oral health status, prosthodontics indicators and patients satisfaction with oral health among Latvian retirement age residents. There were examined 465 retirement age volunteers (170 men and 295 women), 116 of them in dental clinic Sandent (Riga, 24.9% - control group), 137 (29.5%) in nursing homes in Zemgale and 212 (45.6%) in nursing homes in Kurzeme (Zemgale and Kurzeme are districts of Latvia). There were assessed quantity of prosthodontics among patients with partial defects of dental arches, there were estimated quality of dentures and patients satisfaction with existing prosthodontics. Oral health indicators among Latvian retirement age population are better than the same indicators among elderly residents of nursing homes. Among nursing homes residents with partial edentulousness in most of cases in oral cavities remained only few residual teeth which needed treatment. Removable and fixed dental prostheses used by nursing homes residents do not meet denture's quality criteria. Self-evaluation of dentures quality among retirement age residents of nursing homes is better and not correspond with existing dentures quality. In Latvia the quantity of prosthodontics in respect of partial removable dentures among the retired who regularly visit a dentist does not significantly differ from European retirement age population's dental prosthodontics quantity. Dental prosthodontics indicators of residents of nursing homes in Latvia are unsatisfactory (p<0.001). In retirement age population self-evaluation with quality of dentures is higher than actually existing.
Jivănescu, Anca; Bratu, Dana Cristina; Tomescu, Lucian; Măroiu, Alexandra Cristina; Popa, George; Bratu, Emanuel Adrian
2015-01-01
Using two measurement methods (a three-dimensional laser scanning system and a digital caliper), this study compares the lower face morphology of complete edentulous patients, before and after prosthodontic rehabilitation with bimaxillary complete dentures. Fourteen edentulous patients were randomly selected from the Department of Prosthodontics, at the Faculty of Dental Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania. The changes that occurred in the lower third of the face after prosthodontic treatment were assessed quantitatively by measuring the vertical projection of the distances between two sets of anthropometric landmarks: Subnasale - cutaneous Pogonion (D1) and Labiale superius - Labiale inferius (D2). A two-way repeated measures ANOVA model design was carried out to test for significant interactions, main effects and differences between the two types of measuring devices and between the initial and final rehabilitation time points. The main effect of the type of measuring device showed no statistically significant differences in the measured distances (p=0.24 for D1 and p=0.39 for D2), between the initial and the final rehabilitation time points. Regarding the main effect of time, there were statistically significant differences in both the measured distances D1 and D2 (p=0.001), between the initial and the final rehabilitation time points. The two methods of measurement were equally reliable in the assessment of lower face morphology changes in edentulous patients after prosthodontic rehabilitation with bimaxillary complete dentures. The differences between the measurements taken before and after prosthodontic rehabilitation proved to be statistically significant.
A method for communication analysis in prosthodontics.
Sondell, K; Söderfeldt, B; Palmqvist, S
1998-02-01
Particularly in prosthodontics, in which the issues of esthetic preferences and possibilities are abundant, improved knowledge about dentist patient communication during clinical encounters is important. Because previous studies on communication used different methods and patient materials, the results are difficult to evaluate. There is, therefore, a need for methodologic development. One method that makes it possible to quantitatively describe different interaction behaviors during clinical encounters is the Roter Method of Interaction Process Analysis (RIAS). Since the method was developed in the USA for use in the medical context, a translation of the method into Swedish and a modification of the categories for use in prosthodontics were necessary. The revised manual was used to code 10 audio recordings of dentist patient encounters at a specialist clinic for prosthodontics. No major alterations of the RIAS manual were made during the translation and modification. The study shows that it is possible to distinguish patterns of communication in audio-recorded dentist patient encounters. The method also made the identification of different interaction profiles possible. These profiles distinguished well among the audio-recorded encounters. The coding procedures were tested for intra-rater reliability and found to be 97% for utterance classification and lambda = 0.76 for categorization definition. It was concluded that the revised RIAS method is applicable in communication studies in prosthodontics.
Effects of team-based learning on fixed prosthodontic education in a Japanese School of Dentistry.
Takeuchi, Hisahiro; Omoto, Katsuhiro; Okura, Kazuo; Tajima, Toyoko; Suzuki, Yoshitaka; Hosoki, Maki; Koori, Motoharu; Shigemoto, Shuji; Ueda, Mayu; Nishigawa, Keisuke; Rodis, Omar Marianito Maningo; Matsuka, Yoshizo
2015-04-01
The aims of this study were to evaluate the quality of team-based learning (TBL) in prosthodontics education for fourth-year dental students at Tokushima University School of Dentistry and to compare this teaching method with traditional lecture-based delivery. Participants in the study were 36 students (22 males and 14 females) who attended the TBL-style fixed prosthodontics course. Ten 60-minute classes were held. The first three were traditional lecture-style classes and were followed by one class introducing the TBL style. The remaining six classes constituted the TBL-format fixed prosthodontics course. The effectiveness of TBL was evaluated through student questionnaires at the end of each class and the results of the term-end examination. The questionnaire revealed high student approval for TBL-style learning, and active group discussion among students during TBL was a key factor in these ratings. In the results of the term-end examination, there were significantly higher scores on the questions that covered TBL-taught material than those covering traditional lecture-taught topics. The results of this study suggest that TBL-style lecture was more effective than traditional-style lecture for teaching fixed prosthodontics and that TBL was a more efficient mode of delivering dental education than traditional lecture-based teaching.
Papageorgiou, Spyridon N; Kloukos, Dimitrios; Petridis, Haralampos; Pandis, Nikolaos
2015-01-01
The objective of this study was to assess the risk of bias of randomized controlled trials (RCTs) published in prosthodontic and implant dentistry journals. The last 30 issues of 9 journals in the field of prosthodontic and implant dentistry (Clinical Implant Dentistry and Related Research, Clinical Oral Implants Research, Implant Dentistry, International Journal of Oral & Maxillofacial Implants, International Journal of Periodontics and Restorative Dentistry, International Journal of Prosthodontics, Journal of Dentistry, Journal of Oral Rehabilitation, and Journal of Prosthetic Dentistry) were hand-searched for RCTs. Risk of bias was assessed using the Cochrane Collaboration's risk of bias tool and analyzed descriptively. From the 3,667 articles screened, a total of 147 RCTs were identified and included. The number of published RCTs increased with time. The overall distribution of a high risk of bias assessment varied across the domains of the Cochrane risk of bias tool: 8% for random sequence generation, 18% for allocation concealment, 41% for masking, 47% for blinding of outcome assessment, 7% for incomplete outcome data, 12% for selective reporting, and 41% for other biases. The distribution of high risk of bias for RCTs published in the selected prosthodontic and implant dentistry journals varied among journals and ranged from 8% to 47%, which can be considered as substantial.
Kloukos, D; Papageorgiou, S N; Doulis, I; Petridis, H; Pandis, N
2015-12-01
The purpose of this study was to examine the reporting quality of randomised controlled trials (RCTs) published in prosthodontic and implantology journals. Thirty issues of nine journals in prosthodontics and implant dentistry were searched for RCTs, covering the years 2005-2012: The Journal of Prosthetic Dentistry, Journal of Oral Rehabilitation, The International Journal of Prosthodontics, The International Journal of Periodontics & Restorative Dentistry, Clinical Oral Implants Research, Clinical Implant Dentistry & Related Research, The International Journal of Oral & Maxillofacial Implants, Implant Dentistry and Journal of Dentistry. The reporting quality was assessed using a modified Consolidated Standards of Reporting Trials (CONSORT) statement checklist. Data were analysed using descriptive statistics followed by univariable and multivariable examination of statistical associations (α = 0·05). A total of 147 RCTs were identified with a mean CONSORT score of 69·4 (s.d. = 9·7). Significant differences were found among journals with the Journal of Oral Rehabilitation achieving the highest score (80·6, s.d. = 5·5) followed by Clinical Oral Implants Research (73·7, s.d. = 8·3). Involvement of a statistician/methodologist was significantly associated with increased CONSORT scores. Overall, the reporting quality of RCTs in major prosthodontic and implantology journals requires improvement. This is of paramount importance considering that optimal reporting of RCTs is an important prerequisite for clinical decision-making. © 2015 John Wiley & Sons Ltd.
Acharya, Varun; Chambers, Mark S
2015-06-01
Multimodality cancer therapy involving surgical resection, chemotherapy, and radiation therapy is frequently employed in the management of head and neck cancer. Patients who have undergone such therapy face substantial challenges during and after treatment. Prosthodontic rehabilitation is essential during and after tumor ablation to restore function, esthetics, and minimize interruption in daily routine. This clinical report describes the challenges faced by a patient undergoing multimodality therapy for a squamous cell carcinoma of the maxillary sinus and the stages involved in prosthodontic rehabilitation. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Health Manpower Information System (HMIS)
1986-03-10
Pathology/Diagnosis 3107 Oral Maxillofacial Surgery 3108 Orthodontics 3109 Pedodontics 3110 Periodontics 3111 Public Health Dentistry 3112 Prosthodontics...Executive Dentistry 3103 Endodontics 3102 Oral Pathology/Diagnosis 3107 Oral Maxillofacial Surgery 3108 Orthodontics 3109 Pedodontics 3110 Periodontics 3111...Pathology/Diagnosis 3107 Oral Maxillofacial Surgery 3108 Orthodontics 3109 Pedodontics 3110 Periodontics 3111 Public Health Dentistry 3112 Prosthodontics
Jivanescu, Anca; Miglionico, Antonio; Barua, Souman; Hategan, Simona Ioana
2017-07-01
The Amelogenesis Imperfecta is associated with malocclusion and usually requires an interdisciplinary treatment. Due to the patient's refusal of orthodontic treatment, prosthodontics-based treatments alternative was considered and planned. The patient was treated with zirconia-based fixed partial dentures, which resulted in improved occlusion, better oral health, and improved esthetic appearance.
A survey of the removable prosthodontic clinical experience of dental students.
Herring, H W; Stephens, A P
1982-08-01
A survey was sent to every dental school in the contiguous United States and Puerto Rico to solicit answers to 15 questions concerning various aspects of the prosthodontic education of the dental student. It was found that student clinical experiences differed significantly among the regions in terms of the total number of prosthodontic patients treated per student. Fees also differed significantly among the regions. No comment was made on the possible effects of denturism on either the type of patient or the number of removable prosthodontic patients available for treatment by dental students. Concerning the difficulty in securing the various types of patients, all categories were mentioned as being somewhat in short supply, although the greatest shortage was complete denture patients. There was no universally recognized solution to the shortage of patients, although lowering of fees and substitution of requirements were mentioned most frequently. Pertaining to the presence or absence of a strict requirement system, the vast majority of schools reported use of at least some type of requirement system, though not necessarily a strict one.
Additive Manufacturing Techniques in Prosthodontics: Where Do We Currently Stand? A Critical Review.
Alharbi, Nawal; Wismeijer, Daniel; Osman, Reham B
The aim of this article was to critically review the current application of additive manufacturing (AM)/3D-printing techniques in prosthodontics and to highlight the influence of various technical factors involved in different AM technologies. A standard approach of searching MEDLINE, EMBASE, and Google Scholar databases was followed. The following search terms were used: (Prosth* OR Restoration) AND (Prototype OR Additive Manufacture* OR Compute* OR 3D-print* OR CAD/CAM) AND (Dentistry OR Dental). Hand searching the reference lists of the included articles and personal connections revealed additional relevant articles. Selection criteria were any article written in English and reporting on the application of AM in prosthodontics from 1990 to February 2016. From a total of 4,290 articles identified, 33 were seen as relevant. Of these, 3 were narrative reviews, 18 were in vitro studies, and 12 were clinical in vivo studies. Different AM technologies are applied in prosthodontics, directly and indirectly for the fabrication of fixed metal copings, metal frameworks for removable partial dentures, and plastic mock-ups and resin patterns for further conventional metal castings. Technical factors involved in different AM techniques influence the overall quality, the mechanical properties of the printed parts, and the total cost and manufacturing time. AM is promising and offers new possibilities in the field of prosthodontics, though its application is still limited. An understanding of these limitations and of developments in material science is crucial prior to considering AM as an acceptable method for the fabrication of dental prostheses.
Factors Influencing Resident Choice of Prosthodontic Residency Program.
Wojnarwsky, Pandora Keala Lee; Wang, Yan; Shah, Kumar; Koka, Sreenivas
2017-06-01
The decision by prosthodontic residency program directors to employ the Match process highlights the need to understand applicant priorities that influence their choice of which programs to rank highly. The purpose of this study is to determine the factors that were most important to residents when choosing from among nonmilitary based prosthodontics dental residency programs in the United States. Following completion of a pilot study, all currently enrolled prosthodontic residents at nonmilitary residency programs were invited to participate via the internet. The study consisted of a survey instrument asking residents to rank 26 possible factors that might impact an applicant's choice of residency program. In addition, the instrument collected other possible influencing variables including gender and debt load. Mean rank scores were compared to determine the most and least important factors. Kruskal-Wallis test was used to compare specific factors between the possible influencing variables. Two hundred and thirty residents completed the survey instrument, representing a 54.1% response rate of possible participants. With regard to factors influencing program choice, reputation of the residency program was the factor ranked the highest by participants, followed in descending order by the program director's personality, curriculum content, access to use of the latest digital technology, and opportunities for dental implant placement. Quality of schools for children, community outreach opportunities, and the ability to moonlight were ranked as the least important factors. Male and female residents ranked factors such as tuition/stipend, curriculum content, and community outreach opportunities significantly differently. Depending on debt load, residents ranked the factors tuition/stipend, ability to moonlight, curriculum content, and safety of the area where the program is differently. Current prosthodontic residents valued the reputation of the program as the most important factor when applying to residency. Participant gender and debt load influence the factors chosen by residents as more or less important. These data will assist prosthodontic educators position their programs in the best possible light to attract applicants to their programs. © 2017 by the American College of Prosthodontists.
Haeberle, C Brent; Abreu, Amara; Metzler, Kurt
2015-01-01
Vinyl polysiloxane (VPS) has multiple applications in prosthodontics. This article describes how a bite registration fast-set VPS material was used to identify length overextension and/or excessive border thickness of denture flanges. In addition, the advantages of VPS over conventional materials are presented.
Women in Prosthodontics: A Brief Look at Pioneers, Leaders, and Inspirers.
Afshari, Fatemeh S; Yuan, Judy Chia-Chun; Sukotjo, Cortino
2017-07-01
There are several women pioneers in prosthodontics, and each deserves recognition and admiration for all she has achieved in helping bridge the gender gap in dentistry. Women have come a long way from being first depicted as a thieving woman assistant in early 1523 to becoming award-winning, Board-certified clinicians, program directors, department chairs, and deans of dental schools. However, current female resident membership in the American College of Prosthodontists is less than 40%. Women in leadership roles are still scarce, and advancement is still needed. This article provides a brief summary of the history of prosthodontics, highlighting prominent women prosthodontists and their stories, while providing inspiration for future prosthodontists, men as well as women. © 2017 by the American College of Prosthodontists.
Comparison between flipped classroom and team-based learning in fixed prosthodontic education.
Nishigawa, Keisuke; Omoto, Katsuhiro; Hayama, Rika; Okura, Kazuo; Tajima, Toyoko; Suzuki, Yoshitaka; Hosoki, Maki; Shigemoto, Shuji; Ueda, Mayu; Rodis, Omar Marianito Maningo; Matsuka, Yoshizo
2017-04-01
We previously investigated the effects of team-based learning (TBL) on fixed prosthodontic education and reported that TBL could have higher efficiency with high student satisfaction than traditional lecture. In the current report, we introduced flipped classroom to the fixed prosthodontic education and compared their effectiveness based on the final examination score in addition to TBL. Participants were 41 students from Tokushima University School of Dentistry who attended a fixed prosthodontics course. The first six classes adopted the flipped classroom style while the latter eight classes adopted TBL. To evaluate the relationship between learning styles and their effectiveness, we compared results from the term-end examination between the curriculum covered by flipped classroom and TBL-style classes. To draw comparisons, a referential examination with the same questions was conducted to eight faculty members who had not attended any of these classes. Term-end examination results showed that TBL classes had slightly higher scores than flipped classroom classes. Referential examination results also showed higher scores for the same curriculum and no significant interaction was found between class formats and the term-end and referential examination scores. Analysis revealed no noticeable difference in the effectiveness of the class formats. Our previous study reported that TBL had higher efficiency than traditional style lecture. In the current study, there was no statistical difference in the examination score between flipped classroom and TBL. Therefore, we conclude that both styles are highly effective than traditional style lecture and constitute valid formats for clinical dental education. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Jyotsna, S; Rajesh, G; Wadgave, Umesh; Sankeshwari, Banashree; Nayak, Sushma S; Vyas, Rashmi
2017-01-01
Introduction Preclinical dental education promotes development of competency and expertise before students work on patients, but this phase is devoid of exposure to real patients leading to challenges in teaching-learning. Aim The aim of this study was to explore the challenges faced by students during the process of learning preclinical prosthodontics. Materials and Methods Two Focus Group Discussions (FGDs) were conducted with two different groups of students and one FGD was held with prosthodontics faculty. The FGDs explored the student’s and faculty perceptions on the topics which were difficult for the students to understand and their suggestions on how these topics can be made easier to understand. The discussions were audio taped with prior consent and transcribed. Results The students and the faculty felt that the subject of prosthodontics is vast, difficult to visualize and also difficult to correlate theory with practical aspects. Lack of clinical exposure coupled with use of conventional methods of teaching were identified as reasons for difficulty in understanding the subject. Both students and faculty members suggested that use of simulation, demonstrations, and videos could augment the learning process for the students. Early clinical exposure will help solve many problems encountered during learning and contribute to a better understanding. Conclusion The students and faculty expressed a “need” for early clinical exposure to enhance the learner’s understanding of the preclinical aspects of the subject. The present study highlights the need for change in instruction methods to enhance the learning experiences in preclinical prosthodontics of dental undergraduate students in India. PMID:28969263
Iwaki, Maiko; Kanazawa, Manabu; Sunaga, Masayo; Kinoshita, Atsuhiro; Minakuchi, Shunsuke
2013-03-01
A live broadcasting system was developed as part of dental education with Information and Communication Technology (ICT) at Tokyo Medical and Dental University. The purpose of this study was to utilize this system in complete denture prosthodontics, especially for the procedure of making a definitive impression with custom tray border molding in edentulous patients, and to evaluate its effectiveness. Live broadcast lectures on complete denture prosthodontics were given to fourth-year students in 2009 (fifty-nine students) and in 2010 (sixty-five students). To evaluate this lecture, a questionnaire was distributed to the students and faculty members after the lecture. Almost all the students and faculty members rated the lecture as good. Students commented that the lecture was "intelligible," "inspiring," "improved understanding," "good because they could ask questions in real time," "helped to know the actual time," "good for all the students to see the same case," and "close to real experience and induced a sense of tension." The results of this study suggested that a live broadcast lecture would help students experience the real clinical situation and aid in teaching complete denture prosthodontics.
Mobile learning app: A novel method to teach clinical decision making in prosthodontics.
Deshpande, Saee; Chahande, Jaishree; Rathi, Akhil
2017-01-01
Prosthodontics involves replacing lost dentofacial structures using artificial substitutes. Due to availability of many materials and techniques, clinician's clinical decision-making regarding appropriate selection of prosthesis requires critical thinking abilities and is demanding. Especially during graduate training years, learners do not receive the exposure to a variety of cases, thus their clinical reasoning skills are not developed optimally. Therefore, using the trend of incorporating technology in education, we developed a mobile learning app for this purpose. The aim of this study was to evaluate learners' perceptions of this app's utility and impact on their clinical decision-making skills. After taking informed consent, interns of the Department of Prosthodontics of VSPM Dental College, Nagpur, India, during the academic year May 2015-May 2016 were sent the link for the app to be installed in their Android smartphones. Their perceptions were recorded on a feedback questionnaire using 5-point Likert scale. The script concordance test (SCT) was used to check for changes in clinical reasoning abilities. Out of 120 students who were sent the link, 102 downloaded the link and 92 completed the feedback questionnaire and appeared for the SCT (response rate: 76%). The overall response to the app was positive for more than two-thirds of interns, who reported a greater confidence in their clinical decision-making around prostheses through this app and 94% of the students felt that this app should be regularly used along with conventional teaching techniques. Mean SCT scores were pretest 41.5 (±1.7) and posttest 63 (±2.4) (P < 0.005). Clinical decision-making in prosthodontics, a mobile learning app, is an effective way to improve clinical reasoning skills for planning prosthodontic rehabilitation. It is well received by students.
Location of prosthodontic treatment and oral health-related quality of life--an exploratory study.
Sukumar, Smitha; John, Mike T; Schierz, Oliver; Aarabi, Ghazal; Reissmann, Daniel R
2015-01-01
Prosthodontic treatment has a positive effect on oral health-related quality of life (OHRQoL); however, there is a paucity of studies assessing the impact of OHRQoL based on where in the mouth ("location") the treatment is performed. This exploratory study investigated the association of the location (anterior, posterior region) of prosthodontic treatment with magnitude and nature of OHRQoL changes. In this non-randomized prospective clinical study, 190 adult patients (17-83 years) were recruited at baseline and 104 were available for the follow-up analyses. Of those, 50 patients received treatment only in the posterior segment and 54 patients in both anterior and posterior regions. Treatment included conventional fixed partial prostheses, removable prostheses or a combination of both. OHRQoL was assessed with the German language version of the 49-item Oral Health Impact Profile (OHIP) at baseline and the questionnaire was repeated 4-6 weeks post-treatment. Magnitude and effect size of changes in summary and sub-scale scores were calculated and data analyzed. Patients experienced a substantially impaired OHRQoL (mean OHIP score: 32.3 points) at baseline and an improvement in OHRQoL of 6.8 OHIP points following treatment. This study showed a greater improvement in OHRQoL in patients treated in both regions compared to those treated in the posterior region alone, especially in the function and aesthetic domains. This explorative study suggests that OHRQoL improvement is affected by where prosthodontic treatment is performed in the mouth. Greater understanding of qualitative aspects of reconstructive therapies is needed for improved treatment planning and patient consent. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Papageorgiou, Spyridon N; Kloukos, Dimitrios; Petridis, Haralampos; Pandis, Nikolaos
2015-10-01
To assess the hypothesis that there is excessive reporting of statistically significant studies published in prosthodontic and implantology journals, which could indicate selective publication. The last 30 issues of 9 journals in prosthodontics and implant dentistry were hand-searched for articles with statistical analyses. The percentages of significant and non-significant results were tabulated by parameter of interest. Univariable/multivariable logistic regression analyses were applied to identify possible predictors of reporting statistically significance findings. The results of this study were compared with similar studies in dentistry with random-effects meta-analyses. From the 2323 included studies 71% of them reported statistically significant results, with the significant results ranging from 47% to 86%. Multivariable modeling identified that geographical area and involvement of statistician were predictors of statistically significant results. Compared to interventional studies, the odds that in vitro and observational studies would report statistically significant results was increased by 1.20 times (OR: 2.20, 95% CI: 1.66-2.92) and 0.35 times (OR: 1.35, 95% CI: 1.05-1.73), respectively. The probability of statistically significant results from randomized controlled trials was significantly lower compared to various study designs (difference: 30%, 95% CI: 11-49%). Likewise the probability of statistically significant results in prosthodontics and implant dentistry was lower compared to other dental specialties, but this result did not reach statistical significant (P>0.05). The majority of studies identified in the fields of prosthodontics and implant dentistry presented statistically significant results. The same trend existed in publications of other specialties in dentistry. Copyright © 2015 Elsevier Ltd. All rights reserved.
Brand, Henk S; Kamell, Hassib; Kharbanda, Aron K; Dozic, Alma
2013-09-01
The aim of this study was to explore the materials and procedures used by students in dental schools across Europe for teaching fixed prosthodontics. An online questionnaire, containing twenty-eight dichotomous, multiple-choice, and Likert scale rating questions, was sent to students in forty dental schools. After excluding dental schools in which less than 10 percent of the students responded, 775 questionnaires from ten schools remained for statistical analysis. Among these respondents, acrylic resin teeth were said to be the most commonly used material during preclinical practice (46-96 percent), and use of extracted teeth varied from 8 to 65 percent. At nine of the ten institutions, metal-ceramic was reported to be most commonly used for fixed dental prostheses. There was large variation in the type of finish line for a metal-ceramic fixed dental prosthesis: students at five institutions reported using a shoulder finish line, three a chamfer finish line, and two a shoulder-bevel finish line. A similar variation was observed with regard to the final cementation of metal-ceramic fixed dental prostheses: students at four institutions reporting most frequently using glass ionomer cement, with three using zinc phosphate cement and three using carboxylate cement. The responding European dental students varied considerably in their opinions about whether they were preclinically properly trained for the first preparation on a patient and in their overall rating of their education in fixed prosthodontics. Responding students in the United Kingdom, Sweden, and Nijmegen, The Netherlands, rated their fixed prosthodontics training overall the highest. Overall, this study found a wide variation amongst dental schools with regard to their education in fixed prosthodontics and their rating of this teaching.
Trends in Computer-Aided Manufacturing in Prosthodontics: A Review of the Available Streams
Bennamoun, Mohammed
2014-01-01
In prosthodontics, conventional methods of fabrication of oral and facial prostheses have been considered the gold standard for many years. The development of computer-aided manufacturing and the medical application of this industrial technology have provided an alternative way of fabricating oral and facial prostheses. This narrative review aims to evaluate the different streams of computer-aided manufacturing in prosthodontics. To date, there are two streams: the subtractive and the additive approaches. The differences reside in the processing protocols, materials used, and their respective accuracy. In general, there is a tendency for the subtractive method to provide more homogeneous objects with acceptable accuracy that may be more suitable for the production of intraoral prostheses where high occlusal forces are anticipated. Additive manufacturing methods have the ability to produce large workpieces with significant surface variation and competitive accuracy. Such advantages make them ideal for the fabrication of facial prostheses. PMID:24817888
Patel, Rajiv M; Baker, Paul
2015-01-01
Crown lengthening surgery aims to increase the amount of supragingival tooth tissue by resection of the soft and/or hard tissues to enable otherwise unrestorable teeth to be restored by increasing the retention and resistance forms of the teeth. Restoration of the worn dentition may require significant prosthodontic knowledge and skill. A prosthodontist should be involved from the beginning of the management of the patient. A number of key stages should be considered for correct management. Although the periodontist may guide the prosthodontist with regards to what may or may not be possible surgically, the overall treatment plan should be prosthodontically driven. Clinical Relevance: Toothwear of the anterior dentition provides a unique challenge to restore not only function but also to manage the aesthetic demands of the patient. To ensure that the correct outcome is reached, clinicians should be familiar with the normal anatomical proportions and relationships to enable planning and treatment to take place.
2010-03-01
Periodontics (1760) • Prosthodontics (1769) • Public Health Dentistry (1775) • Oral Pathology (1780) • Orofacial Pain (1785) • Dental Research (1790...Health Dentistry 1 Temporomandibular Dysfunction/ Orofacial pain 1 Dental Research 1 Exodontia (Advanced Clinical Practice - ACP) 3 Endodontics (ACP) 3...Prosthodontics 1769 9 Public Health Dentistry 1775 0 Oral Pathology 1780 3 50 Specialty Code Number of Specialists Orofacial Pain 1785 1
2016-06-01
bases, in The International journal of prosthodontics. 1990. p. 528-37. 8. Gharechahi, J., et al., Dimensional Changes of Acrylic Resin Denture Bases...by Different Techniques. Journal of Biomedical Materials Research Part B: Applied Biomaterials, 2006. 22 14. Yannikakis, S., et al...Prosthodontic Graduate Program Naval Postgraduate Dental School Uniformed Services University of the Health Sciences in partial fulfillment of the
Expanding prosthodontic services to the older patient in dental practices.
Warpeha, Walter S
2011-01-01
Numerous articles report on the unmet dental needs of the older patient, yet few have suggested strategies to overcome barriers to care for this unique demographic. At a time when prosthodontic services, including dental implants, offer improved outcomes, the elderly remain the least served of all patient groups. Obstacles to treatment include ageism, medical and dental complexity, financial limitations, and patients' resistance to treatment. Expanding prosthodontic care of the elderly requires a departure from traditional patient management techniques. The attempt to reverse ageism in your practice must go beyond simple awareness. Those offĩces that can relate to, treat with respect, and fulfill the health aspirations of the older patient create the atmosphere where care is more readily accepted. A successful team approach to patient management depends upon the ability to listen and respond to the elderly denture patient with information on denture maintenance and implant enhancements. An essential piece is encouraging regular recall for all denture wearers by every staff member. A well documented problem area in dental practice is the timely replacement of worn out or inadequate dentures. By using a simple assessment tool called the Satisfaction/Condition Score along with motivational interviewing, we have found increased treatment acceptance among our existing patients. Use of these suggestions in a general dentistry practice is more likely to encourage the older patient to better accept enhanced prosthodontic services.
Use of the Internet for educational applications in prosthodontics.
van Putten, M C
1996-08-01
Internet is the common term for the information superhighway. The Internet has become a major information resource for educational, governmental, and business institutions. This article reviews the current operation of the Internet as a background for discussing educational opportunities for instruction in prosthodontics. Electronic mail, news groups, file transfer protocol, Gopher, and network navigators are discussed. The use of the World Wide Web for educational purposes by The Ohio State University College of Dentistry Department of Restorative and Prosthetic Dentistry is described.
Prosthodontic perspective to all-on-4® concept for dental implants.
Taruna, M; Chittaranjan, B; Sudheer, N; Tella, Suchita; Abusaad, Md
2014-10-01
The clinical success and longevity of endosteal dental implants as load bearing abutments are controlled largely by the mechanical setting in which they function. The treatment plan is responsible for the design, number and position of the implants. In biomechanically compromised environment such as poor quality bone, strain to the crestal bone can be reduced by increasing the anterioposterior spread of implants, placement of longer implants and maximizing the number of implants. The All-on-4(®) concept is one such treatment procedure which enlightens us for its use in the completely edentulous patients and which also leaves behind the routine treatment alternative of conventional dentures with successful outcome in the short term, long term and the retrospective studies that have been done in the past. The area of concern for any treatment alternative lies in the success of the prosthesis and its prosthodontic perspective involving the principles of occlusion. This article reviews the All-on-4(®) concept and its prosthodontic aspects.
Urken, Mark L; Roche, Ansley M; Kiplagat, Kimberly J; Dewey, Eliza H; Lazarus, Cathy; Likhterov, Ilya; Buchbinder, Daniel; Okay, Devin J
2018-03-14
Palatomaxillary defects were historically restored with a prosthetic obturator; however, advances in local and free tissue transfer has provided a viable alternative for appropriately selected patients with palatomaxillary defects. A retrospective chart review of patients who underwent palatomaxillary reconstruction by the lead author between 1998 and 2016 was conducted. Patients who were restored with a palatal obturator were excluded. One hundred forty patients were reconstructed with a total of 159 local, regional, and free flaps with a 96.7% success rate. Seventy-four patients (52.8%) underwent prosthodontic rehabilitation, with 183 implants placed and an 86% success rate. Palatomaxillary reconstruction applying a systematic approach, using a multitude of techniques, is a safe and effective way to restore patients without compromising the ability to maintain surveillance. Prosthodontic rehabilitation can be achieved in a high percentage of patients using dental implants, leading to optimal aesthetic and functional results. © 2018 Wiley Periodicals, Inc.
Rationale for the Use of CAD/CAM Technology in Implant Prosthodontics
Abduo, Jaafar; Lyons, Karl
2013-01-01
Despite the predictable longevity of implant prosthesis, there is an ongoing interest to continue to improve implant prosthodontic treatment and outcomes. One of the developments is the application of computer-aided design and computer-aided manufacturing (CAD/CAM) to produce implant abutments and frameworks from metal or ceramic materials. The aim of this narrative review is to critically evaluate the rationale of CAD/CAM utilization for implant prosthodontics. To date, CAD/CAM allows simplified production of precise and durable implant components. The precision of fit has been proven in several laboratory experiments and has been attributed to the design of implants. Milling also facilitates component fabrication from durable and aesthetic materials. With further development, it is expected that the CAD/CAM protocol will be further simplified. Although compelling clinical evidence supporting the superiority of CAD/CAM implant restorations is still lacking, it is envisioned that CAD/CAM may become the main stream for implant component fabrication. PMID:23690778
Prosthodontic Perspective to All-On-4® Concept for Dental Implants
Chittaranjan, B; Sudheer, N; Tella, Suchita; Abusaad, Md.
2014-01-01
The clinical success and longevity of endosteal dental implants as load bearing abutments are controlled largely by the mechanical setting in which they function. The treatment plan is responsible for the design, number and position of the implants. In biomechanically compromised environment such as poor quality bone, strain to the crestal bone can be reduced by increasing the anterioposterior spread of implants, placement of longer implants and maximizing the number of implants. The All-on-4® concept is one such treatment procedure which enlightens us for its use in the completely edentulous patients and which also leaves behind the routine treatment alternative of conventional dentures with successful outcome in the short term, long term and the retrospective studies that have been done in the past. The area of concern for any treatment alternative lies in the success of the prosthesis and its prosthodontic perspective involving the principles of occlusion. This article reviews the All-on-4® concept and its prosthodontic aspects. PMID:25478475
Vera, Carolina; Barrero, Carlos; Shockley, William; Rothenberger, Sandra; Minsley, Glenn; Drago, Carl
2014-10-01
Traditionally, patients with maxillofacial defects have been challenging to treat. A multitude of challenges associated with maxillofacial prosthetic treatment are not typically seen with patients who need conventional prosthodontic treatment. These types of patients generally require replacement of significant amounts of hard and soft tissues than do conventional prosthodontic patients. Most maxillofacial patients also warrant more emotional support than do conventional prosthodontic patients. Successful maxillofacial prosthetics still need to embrace the traditional goals of prosthodontic treatment: stability, support, retention, and esthetics. It is unlikely that a maxillofacial prosthesis will exactly duplicate the anatomy and function of missing or damaged structures. Although craniofacial implants (CFI's) have lower cumulative survival rates (CSR's) than intraoral endosseous implants, osseointegrated CFI's have proven to be significant adjuncts to improving retention of maxillofacial prostheses. However, CSR's of CFI's have been reported to be lower than CSR's for intraoral endosseous implants. Lately, computer-assisted design and computer-assisted machining (CAD/CAM) has been used in dentistry to facilitate fabrication of implant-supported frameworks. CAD/CAM protocols have numerous advantages over conventional casting techniques, including improved accuracy and biocompatibility, and decreased costs. The purpose of this paper is to review the literature on cumulative survival rates (CSR's) reported for CFI's and to illustrate the treatment of a maxillofacial patient using CFI's and a CAD/CAM copy-milled framework for retention and support of a nasal prosthesis. © 2014 by the American College of Prosthodontists.
In vitro cytotoxicity evaluation of elemental ions released from different prosthodontic materials.
Elshahawy, Waleed M; Watanabe, Ikuya; Kramer, Phillip
2009-12-01
This study investigated the cytotoxicity of elemental ions contained in four fixed prosthodontic materials (gold, nickel-chromium, stainless-steel alloys and CAD-CAM ceramics). According to the determination of elements released from prosthodontic materials by using inductively coupled plasma mass spectroscopy, similar amounts of elements Pd, Ag, Zn, Cu, Ni, Cr, Mo, Be, Fe, Al, and K were prepared as salt solutions. Wells with a tenfold higher concentration of the tested elements were used as positive controls, while a well without any tested element was used as a negative control. These salt solutions were tested for cytotoxicity by culturing mouse L-929 fibroblasts in the salt solutions for a 7-day period of incubation. Then, the percentage of viable cells for each element was measured using trypan blue exclusion assay. The data (n=5) were statistically analyzed by ANOVA/Tukey test (p<0.05). The results showed a statistically significant difference for the cytotoxic effect of the tested elements salt solutions. For the released element concentrations the lowest percentage of viable cells (mean+/-SD) was evident with Zn, Cu or Ni indicating that they are the highly toxic elements. Be and Ag were found to be intermediate in cytotoxic effect. Fe, Cr, Mo, Al, Pd or K were found to be the least cytotoxic elements. Zn and Cu released from gold alloys, and Ni released from nickel-chromium alloys, which are commonly used as fixed prosthodontic restorations, show evidence of a high cytotoxic effect on fibroblast cell cultures.
Murthy, Varsha; Sethuraman, K R; Choudhury, Sunayana; Shakila, P
2017-11-01
The aim of this study was to investigate whether prosthodontic residents' attitudes toward provider-client communication would be shaped by a tailor-made communications skills course. In 2016, the pre-intervention attitudes of all six second- and third-year prosthodontic residents in a three-year residency at an academic dental institution in India were assessed using the Communication Skills Attitude Scale (CSAS). The residents' performance was then video-recorded while they treated complete denture patients and was analyzed using the Kalamazoo scale, a validated scale for communication skills assessment. The residents' weaknesses were identified, and a custom-made generic module was designed along with individual guidance counseling for addressing aspects relevant to complete denture patients. The residents' attitudes were again assessed immediately after they completed the training using CSAS, as well as after two and four months using Balint sessions. Analysis of the recordings showed that few of the deficiencies during intraoral procedures were contextual, and the Kalamazoo scale did not address them: these were noted as being "beyond Kalamazoo." After the training, the residents reported awareness of their weaknesses and feeling motivated to practice their newly acquired skills. The Balint sessions showed that they had started valuing patients' agendas and the rapport-building process, and they reported transfer of skills when treating other types of prosthodontic patients. In this study, a customized communication skills module brought about a positive change in residents' attitudes, which was sustained over four months. Similar training could be implemented in other dental specialties.
Layton, Danielle
The aim of this study was to outline how search strategies can be systematic, to examine how the searches in recent systematic reviews in prosthodontic and implant-related journals were structured, and to determine whether the search strategies used in those articles were systematic. A total of 103 articles published as systematic reviews and indexed in Medline between January 2013 and May 2016 were identified from eight prosthodontic and implant journals and reviewed. The search strategies were considered systematic when they met the following criteria: (1) more than one electronic database was searched, (2) more than one searcher was clearly involved, (3) both text words and indexing terms were clearly included in the search strategy, (4) a hand search of selected journals or reference lists was undertaken, (5) gray research was specifically sought, and (6) the articles were published in English and at least one other language. The data were tallied and qualitatively assessed. The majority of articles reported on implants (54%), followed by tooth-supported fixed prosthodontics (13%). A total of 23 different electronic resources were consulted, including Medline (by 100% of articles), the Cochrane Library (52%), and Embase (37%). The majority consulted more than one electronic resource (71%), clearly included more than one searcher (73%), and employed a hand search of either selected journals or reference lists (86%). Less than half used both text words and indexing terms to identify articles (42%), while 15% actively sought gray research. Articles published in languages other than English were considered in 63 reviews, but only 14 had no language restrictions. Of the 103 articles, 5 completed search strategies that met all 6 criteria, and a further 12 met 5 criteria. Two articles did not fulfill any of the criteria. More than 95% of recent prosthodontic and implant review articles published in the selected journals failed to use search strategies that were systematic, and this undermines the conclusions. Many resources are available to help investigators design search strategies for systematic reviews that minimize the risk of omitting important data, including the simple criteria presented in this paper.
The analysis of cost-effectiveness of implant and conventional fixed dental prosthesis.
Chun, June Sang; Har, Alix; Lim, Hyun-Pil; Lim, Hoi-Jeong
2016-02-01
This study conducted an analysis of cost-effectiveness of the implant and conventional fixed dental prosthesis (CFDP) from a single treatment perspective. The Markov model for cost-effectiveness analysis of the implant and CFDP was carried out over maximum 50 years. The probabilistic sensitivity analysis was performed by the 10,000 Monte-Carlo simulations, and cost-effectiveness acceptability curves (CEAC) were also presented. The results from meta-analysis studies were used to determine the survival rates and complication rates of the implant and CFDP. Data regarding the cost of each treatment method were collected from University Dental Hospital and Statistics Korea for 2013. Using the results of the patient satisfaction survey study, quality-adjusted prosthesis year (QAPY) of the implant and CFDP strategy was evaluated with annual discount rate. When only the direct cost was considered, implants were more cost-effective when the willingness to pay (WTP) was more than 10,000 won at 10(th) year after the treatment, and more cost-effective regardless of the WTP from 20(th) year after the prosthodontic treatment. When the indirect cost was added to the direct cost, implants were more cost-effective only when the WTP was more than 75,000 won at the 10(th) year after the prosthodontic treatment, more than 35,000 won at the 20(th) year after prosthodontic treatment. The CFDP was more cost-effective unless the WTP was more than 75,000 won at the 10(th) year after prosthodontic treatment. But the cost-effectivenss tendency changed from CFDP to implant as time passed.
Cobalt-chromium alloys in fixed prosthodontics in Sweden
Kassapidou, Maria; Franke Stenport, Victoria; Hjalmarsson, Lars; Johansson, Carina B.
2017-01-01
Abstract Aim: The aim of this study was to compile the usage of Co-Cr alloys in fixed prosthodontics (FP) among dental laboratories in Sweden. Methods: From March to October 2015, questionnaires were sent to 542 registered dental laboratories in Sweden. The questionnaires were divided in two parts, one for fixed dental-supported prosthodontics (FDP) and one for fixed implant-supported prosthodontics (FIP). Reminders were sent three times. Results: In total of 542 dental laboratories, 55% answered the questionnaires. Most dental laboratories use Co-Cr in FP, 134 (74%) in FDP and 89(66%) in FIP. The laboratories used Co-Cr alloys of various compositions in the prostheses, 35 for FDP and 30 for FIP. The most commonly used Co-Cr alloys for tooth-supported FDPs were (a) Wirobond® 280, (b) Cara SLM and (c) Wirobond® C. For implant-supported frameworks the frequently used alloys were: (a) Cara SLM, (b) Cara Milled and (c) Wirobond® 280. Except for the difference in composition of these alloys, they were also manufactured with various techniques. In tooth-supported prostheses the dominating technique was the cast technique while newer techniques as laser-sintering and milling were more commonly reported for implant-supported constructions. A fourth technique; the ‘pre-state’ milling was reported in FDP. Conclusion: More than 30 different Co-Cr alloys were reported as being used in FP. Thus, there is a need for studies exploring the mechanical and physical behavior and the biological response to the most commonly used Co-Cr alloys. PMID:29242813
Prosthodontic Rehabilitation for a Patient with Down Syndrome: A Clinical Report.
Alqahtani, Nasser M; Alsayed, Hussain D; Levon, John A; Brown, David T
2017-01-24
Patients with Down syndrome can present with a variety of oral manifestations such as hypodontia, periodontal disease, premature tooth loss, reduced salivary flow, crowding of teeth in both arches, and decreased occlusal vertical dimension. The intellectual ability of people with Down syndrome varies widely. They present with a mild-to-moderate intellectual disability that restricts their ability to communicate and adjust to their environment, which can add complexity in the overall dental treatment. There is little information in the literature regarding the prosthodontic rehabilitation for patients with Down syndrome in combination with dental implant placement. An implant-assisted removable partial dental prosthesis can be a cost-effective treatment alternative for carefully chosen patients with Down syndrome. This article presents the treatment of a 44-year-old male patient with Down syndrome and a moderate intellectual disability who presented with congenital and acquired tooth loss with significant occlusal discrepancies. The treatment included a prosthodontic approach that used a single dental implant, which will be described and illustrated in this article. © 2017 by the American College of Prosthodontists.
[Analysis and prevention of dust pollution caused by 5 common prosthetic materials].
Yang, Xiang-Wen; Wei, Bin; Zhu, Cao-Yun; Qian, Liang; Li, Yi-Han
2017-10-01
To analyze and evaluate dust pollution in prosthodontic clinic and make proposal for reasonable protection. This study analyzed the particle size, element composition and dust concentration of 5 materials which were commonly used in dental restorations (veneering ceramics, cobalt-chromium alloy, photosensitive plastic, hard base resin, advanced artificial teeth) by using scanning electron microscopy (SEM), X-ray energy dispersive spectrometer(EDS) and dust concentration laser tester, in order to assess the effects of prosthodontic dust posed on medical staff health and put forward reasonable suggestions for prevention and control of dust pollution. The particle size of veneering ceramics, cobalt-chromium alloy, photosensitive plastic, hard base resin and advanced artificial teeth was (2.15±3.00), (33.78±24.33), (7.78±11.86), (31.16±44.35) and (28.45±39.21)μm, respectively. The time weighted average respirable dust concentration of veneering ceramics was 0.393 mg/m 2 which was beyond the scope of national security. Dust pollution is serious in prosthodontic clinic to which we should pay more attention and take appropriate prevention measures.
Prosthodontic Rehabilitation of Patients with Bell's Palsy: Our Experience.
Rajapur, Anand; Mitra, Nirban; Prakash, V Jeevan; Rah, Sajad Ahmad; Thumar, Sagar
2015-01-01
Bell's palsy is an idiopathic unilateral lower motor neuron paresis or paralysis of the facial nerve of sudden onset. It involves loss of muscular control on the affected side of the face. This paper reports the prosthodontic management of patients with Bell's palsy and also describes a technique to stabilize the jaw movements in complete denture patients using interim dentures. A 65-year-old male edentulous patient and a 55-year-old female edentulous patient reported to the department of prosthodontics to get their missing teeth replaced. They both gave history of facial paralysis and were diagnosed for Bell's palsy. Interim training dentures with flat occlusal tables were fabricated first to correct and stabilize their mandibular movements. During initial 4 weeks, there was poor functioning of the interim dentures. Gradually by 8(th) week the patients started stabilizing the interim dentures and were functional. After observing the improvement when the patients had no pain and could stabilize and use the treatment dentures successfully, definitive complete dentures were fabricated. This case report presents a systematic approach to successively rehabilitate edentulous patients with Bell's palsy.
Prosthodontic Rehabilitation of Patients with Bell’s Palsy: Our Experience
Rajapur, Anand; Mitra, Nirban; Prakash, V Jeevan; Rah, Sajad Ahmad; Thumar, Sagar
2015-01-01
Bell’s palsy is an idiopathic unilateral lower motor neuron paresis or paralysis of the facial nerve of sudden onset. It involves loss of muscular control on the affected side of the face. This paper reports the prosthodontic management of patients with Bell’s palsy and also describes a technique to stabilize the jaw movements in complete denture patients using interim dentures. A 65-year-old male edentulous patient and a 55-year-old female edentulous patient reported to the department of prosthodontics to get their missing teeth replaced. They both gave history of facial paralysis and were diagnosed for Bell’s palsy. Interim training dentures with flat occlusal tables were fabricated first to correct and stabilize their mandibular movements. During initial 4 weeks, there was poor functioning of the interim dentures. Gradually by 8th week the patients started stabilizing the interim dentures and were functional. After observing the improvement when the patients had no pain and could stabilize and use the treatment dentures successfully, definitive complete dentures were fabricated. This case report presents a systematic approach to successively rehabilitate edentulous patients with Bell’s palsy. PMID:26668488
Prosthodontic management of a patient with ectodermal dysplasia.
Nandini, Yamini
2013-12-01
Ectodermal dysplasia is a rare congenital disease that affects the ectodermal structures. It is characterized by hypotrichosis, hypohidrosis and hypodontia. A 14-year-old boy with ectodermal dysplasia presenting with oligodontia and marked resorption of the maxillary and mandibular alveolar ridges is reported. Prosthetic rehabilitation in the form of a maxillary and mandibular partial denture was made with metal crowns on existing lower teeth to achieve appropriate vertical dimension. Significant improvement in speech, masticatory function and facial esthetics was achieved. Removable prosthodontics can provide an acceptable solution to esthetic, functional and psychological rehabilitation in patients with ectodermal dysplasia.
Haiyang, Yu; Tian, Luo
2016-06-01
Target restoration space (TRS) is the most precise space required for designing optimal prosthesis. TRS consists of an internal or external tooth space to confirm the esthetics and function of the final restoration. Therefore, assisted with quantitive analysis transfer, TRS quantitative analysis is a significant improvement for minimum tooth preparation. This article presents TRS quantity-related measurement, analysis, transfer, and internal relevance of three TR. classifications. Results reveal the close bond between precision and minimally invasive treatment. This study can be used to improve the comprehension and execution of precise esthetic prosthodontics.
Huettig, Fabian; Behrend, Florian
2016-01-01
It is unknown what disadvantages are faced by patients deciding for a prosthodontic treatment by inexperienced students. Commonly, the related extra effort and time are compensated by cost reduction of treatment fees. Thereby, the dental schools subsidize treatments to teach clinical prosthodontics. The aim of this study was to clarify the benefits to patients as well as the efforts of the dental school. Data collected from three courses in a dental school in Germany were patient gender, age, occupation, zip code, number of visits, scope of treatment including costs, financial discount, and remaining copayment. Travel costs were calculated based on zip code. Balance of travel costs and treatment discount was defined as financial benefit. The results showed that 185 patients (95 male) aged 32 to 82 years (median=58) were treated with fixed restorations (FR, n=110), telescopic dentures (TD, n=87), complete dentures (CD, n=17), or other (RD, n=3). The mean number of visits was 11 for FR, 12 for TD, and 9 for CD. Single distance to the clinic ranged from 0.6 to 65 miles (median=12). Total costs of prosthodontics were reduced by 19% on average. The mean financial benefit was 429 USD (median=298, min=-482, max=4025). The financial benefits were found to differ widely, including additional expenditures of patients. Participation, travel burden, and copayment did not depend on age, gender, or occupation. The financial benefit was relativized because students needed at least twice the sessions of a dentist. As a result, the financial efforts of dental schools are significant and compromise a cost-covering education.
Montero, Javier; Dib, Abraham; Guadilla, Yasmina; Flores, Javier; Santos, Juan Antonio; Aguilar, Rosa Anaya; Gómez-Polo, Cristina
2018-02-01
The aim of this study was to compare the perceived competence for treating prosthodontic patients of two samples of fourth-year dental students: those educated using traditional methodologies and those educated using problem-based learning (PBL). Two cohorts of fourth-year dental students at a dental school in Spain were surveyed: the traditional methods cohort (n=46) was comprised of all students in academic years 2012 and 2013, and the PBL cohort (n=57) was comprised of all students in academic years 2014 and 2015. Students in both cohorts reported the number of prosthodontic treatments they carried out per year and their perceived level of competence in performing such treatments. The results showed that the average number of treatments performed was similar for the two cohorts, except the number of metal-based removable partial dentures was significantly higher for students in the traditional (0.8±1.0) than the PBL (0.4±0.6) cohort. The level of perceived competence to treat complete denture patients for the combined cohorts was significantly higher (7.3±1.1) than that for partial acrylic dentures (6.7±1.5) and combined dentures (5.7±1.3). Students' clinical competence in prosthodontics mainly depended on number of treatments performed as the operator as well as the assistant. Students in the traditional methods cohort considered themselves to be significantly more competent at treating patients for removable partial and fixed prostheses (7.8±1.1 and 7.6±1.1, respectively) than did students in the PBL cohort (6.4±1.5 and 6.6±1.5, respectively). Overall, however, the study found that practical experiences were more important than the teaching method used to achieve students' perceived competence.
Imbery, Terence A; Diaz, Nicholas; Greenfield, Kristy; Janus, Charles; Best, Al M
2016-10-01
Preclinical fixed prosthodontics is taught by Department of Prosthodontics faculty members at Virginia Commonwealth University School of Dentistry; however, 86% of all clinical cases in academic year 2012 were staffed by faculty members from the Department of General Practice. The aims of this retrospective study were to quantify the quality of impressions, accuracy of laboratory work authorizations, and most common errors and to determine if there were differences between the rate of errors in cases supervised by the prosthodontists and the general dentists. A total of 346 Fixed Prosthodontic Laboratory Tracking Sheets for the 2012 academic year were reviewed. The results showed that, overall, 73% of submitted impressions were acceptable at initial evaluation, 16% had to be poured first and re-evaluated for quality prior to pindexing, 7% had multiple impressions submitted for transfer dies, and 4% were rejected for poor quality. There were higher acceptance rates for impressions and work authorizations for cases staffed by prosthodontists than by general dentists, but the differences were not statistically significant (p=0.0584 and p=0.0666, respectively). Regarding the work authorizations, 43% overall did not provide sufficient information or had technical errors that delayed prosthesis fabrication. The most common errors were incorrect mountings, absence of solid casts, inadequate description of margins for porcelain fused to metal crowns, inaccurate die trimming, and margin marking. The percentages of errors in cases supervised by general dentists and prosthodontists were similar for 17 of the 18 types of errors identified; only for margin description was the percentage of errors statistically significantly higher for general dentist-supervised than prosthodontist-supervised cases. These results highlighted the ongoing need for faculty development and calibration to ensure students receive the highest quality education from all faculty members teaching fixed prosthodontics.
Hypohidrotic ectodermal dysplasia: a felicitous approach to esthetic and prosthetic management.
Singh, Tapan; Singh, Ronauk; Singh, Gurendra Pal; Singh, Jitender Pal
2013-05-01
Ectodermal dysplasia is a hereditary disease characterized by congenital dysplasia of one or more ectodermal structure and other accessory appendages. The oral manifestations are anodontia and poor bony foundation which impairs both esthetic as well as the masticatory function. The prosthodontic management of patients with such dysplastic condition necessitates a multidisciplinary approach. This case report describes the prosthodontic oral rehabilitation of a 16 years old female pediatric patient with ectodermal dysplasia. How to cite this article: Singh T, Singh R, Singh GP, Singh JP. Hypohidrotic Ectodermal Dysplasia: A Felicitous Approach to Esthetic and Prosthetic Management. Int J Clin Pediatr Dent 2013;6(2):140-145.
Prosthodontic rehabilitation of a patient with aggressive periodontitis
Livingstone, David; Murthy, Varsha; Reddy, Vineela Katam; Pillai, Ajay
2015-01-01
Aggressive periodontitis previously termed as juvenile periodontitis is characterised by rapid destruction of the periodontium at a relatively young age. Rehabilitation of these patients is often challenging and difficult. Controlling the disease and restoring periodontal health is essential for successful prosthodontic rehabilitation. This clinical report describes an interdisciplinary approach in the rehabilitation of a young adult patient with generalised aggressive periodontitis. Treatment objectives included plaque control, prevention of further attachment loss, reduction/elimination of pockets, and prosthetic rehabilitation to enhance aesthetics and restore masticatory function. One year recall evaluation revealed stable periodontal support with no further loss of attachment and no other complications. PMID:25743856
A survey to determine agreement regarding the definition of centric relation.
Goldstein, Gary; Andrawis, Mark; Choi, Mijin; Wiens, Jonathan; Janal, Malvin N
2017-03-01
The definition of centric relation (CR) has been both controversial and divisive, with little consensus. The purpose of this study was to determine whether agreement can be reached on a definition for CR among the Fellows of the Academy of Prosthodontics, the organization that writes the Glossary of Prosthodontic Terms. A survey of the Fellows of the Academy of Prosthodontics was conducted at the organization's annual business meeting. Of the 83 eligible Fellows in attendance, 72 responded to the survey, a response rate of 86%. Of those, the 5 responders who did not indicate a preferred definition and the 2 that chose 2 definitions were censored, yielding an analyzable sample of 65 for the definitions. The most common definition received 19 votes, the next 16, and the third 13, with the other 6 definitions receiving from 2 to 5 votes. Some of the variability in definition depended on the era of training. Disagreement and confusion continues regarding the definition of centric relation. Some of this disagreement can be explained by training era. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Choi, Y K; Park, D Y; Kim, Y
2014-11-01
Many health issues have been reported to be associated with poor nutritional status. We sought to examine the association between nutritional intake and oral health status in elderly people. The association between perceived disability in mastication and prosthodontic status was analysed using multiple logistic regression. Multiple linear regression was used to analyse the association between prosthodontic status and nutritional intake. The elderly subjects with partial or full dentures reported chewing difficulties 1.62-fold more frequently (95% CI: 1.06-2.49) than those with natural teeth or a fixed prosthesis after adjusting for gender, TMD (temporomandibular disorder), household income and education level. Additionally, daily nutritional intakes of energy, protein, fat, ash, calcium, phosphorus and thiamine were decreased significantly in elderly with partial or full dentures compared with those with no prosthesis or with a fixed prosthesis (P < 0.05). Our findings underline oral health status and perceived disability in mastication are associated with dietary imbalances in the elderly. We suggest that the evaluation of patients' nutritional status should be considered as a part of an overall plan for dental hygiene care. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Masticatory muscle activity assessment and reliability of a portable electromyographic instrument.
Bowley, J F; Marx, D B
2001-03-01
Masticatory muscle hyperactivity is thought to produce muscle pain and tension headaches and can cause excessive wear or breakage of restorative dental materials used in the treatment of prosthodontic patients. The quantification and identification of this type of activity is an important consideration in the preoperative diagnosis and treatment planning phase of prosthodontic care. This study investigated the quantification process in complete denture/overdenture patients with natural mandibular tooth abutments and explored the reliability of instrumentation used to assess this parafunctional activity. The nocturnal EMG activity in asymptomatic complete denture/overdenture subjects was assessed with and without prostheses worn during sleep. Because of the large variance within and between subjects, the investigators evaluated the reliability of the 3 instruments used to test nocturnal EMG activity in the sample. Electromyographic activity data of denture/overdenture subjects revealed no differences between prostheses worn versus not worn during sleep but demonstrated a very large variance factor. Further investigation of the instrumentation demonstrated a consistent in vitro as well as in vivo reliability in controlled laboratory studies. The portable EMG instrumentation used in this study revealed a large, uncontrollable variance factor within and between subjects that greatly complicated the diagnosis of parafunctional activity in prosthodontic patients.
In vitro shear bond strength of cementing agents to fixed prosthodontic restorative materials.
Piwowarczyk, Andree; Lauer, Hans-Christoph; Sorensen, John A
2004-09-01
Durable bonding to fixed prosthodontic restorations is desirable; however, little information is available on the strength of the bond between different cements and fixed prosthodontic restorative materials. This study determined the shear-bond strength of cementing agents to high-gold-content alloy castings and different dental ceramics: high-strength aluminum oxide (Procera AllCeram), leucite-reinforced (IPS Empress), and lithium disilicate glass-ceramic (IPS Empress 2). Prepolymerized resin composite cylinders (5.5 mm internal diameter, n=20) were bonded to the pretreated surfaces of prosthodontic materials. High-gold-content alloy and high-strength aluminum oxide surfaces were airborne-particle-abraded, and pressable ceramics were hydrofluoric acid-etched and silanized prior to cementing. The cementing agents tested were a zinc-phosphate cement (Fleck's zinc cement), glass ionomer cements (Fuji I, Ketac-Cem), resin-modified glass ionomer cements (Fuji Plus, Fuji Cem, RelyX Luting), resin cements (RelyX ARC, Panavia F, Variolink II, Compolute), and a self-adhesive universal resin cement (RelyX Unicem). Half the specimens (n=10) were tested after 30 minutes; the other half (n=10) were stored in distilled water at 37 degrees C for 14 days and then thermal cycled 1000 times between 5 degrees C and 55 degrees C prior to testing. Shear-bond strength tests were performed using a universal testing machine at a constant crosshead speed of 0.5 mm/min. Statistical analysis was performed by multifactorial analysis of variance taking interactions between effects into account. For multiple paired comparisons, the Tukey method was used (alpha=.05). In a 3-way ANOVA model, the main factors substrate, cement, time, and all corresponding interactions were statistically significant (all P <.0001). In subsequent separate 1-way or 2-way ANOVA models for each substrate type, significant differences between cement types and polymerizing modes were found (all P <.001). None of the cement types provided the highest bonding values with all substrate types. After 14 days of water storage followed by thermal cycling, only the self-adhesive universal resin cement (RelyX Unicem) and 2 of the resin cements (Panavia F and Compolute) exhibited strong bond strengths to specific prosthodontic materials. In contrast, zinc-phosphate, glass ionomer, and resin-modified glass ionomer cements showed the lowest values of all tested cementing agents after 14 days of water storage followed by thermal cycling.
Hakestam, U; Söderfeldt, B; Rydén, O; Glantz, P O
1997-09-01
To assess simple questions for identifying patient personality traits among a normal Swedish population and to assess possible relationships between personality and symptoms, attitudes, dental problems, and received dental care, a questionnaire was sent to 489 subjects awaiting prosthodontic treatment (response rate 84.2%). Three personality traits could be identified: "Fearful-depressed" subjects consumed more tranquillisers, were worried and had many symptoms, whilst "Open-minded" were optimistic about treatment, had high expectations and few symptoms. "Control-minded" did not reveal worries and guarded their autonomy. It was concluded that personality indicators were related to clinically relevant factors: salience of teeth, perceptions of problems, dental attendance pattern, expectations and perceptions of symptoms.
Applications of cone beam computed tomography for a prosthodontist.
John, George Puthenpurayil; Joy, Tatu Elenjickal; Mathew, Justin; Kumar, Vinod R B
2016-01-01
Cone beam computed tomography (CBCT) is a medical imaging technique of X-ray computed tomography where the X-rays are divergent, forming a cone. CBCT systems have been designed for imaging hard tissues of the maxillofacial region. The increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. This article is intended to elaborate and enunciate on the various applications and benefits of CBCT, in the realm of maxillofacial prosthodontics, over and beyond its obvious benefits in the rehabilitation of patients with implants. With the onus of meticulous reconstruction of near ideal occlusion resting on the prosthodontist, CBCT provides a unique imaging option, which can be a boon in various aspects of prosthodontic practice - from imaging of the temporomandibular joint for accurate movement simulation, to template assisted maxillofacial reconstruction or even over denture therapy. CBCT could play a crucial role in lessening the burden of a hectic prosthodontic routine for the clinician and critically contribute to accurate and effective treatment for the patient. Apart from the authors' clinical experiences shared here, a web-based search for relevant articles in this specific area of interest was also conducted. The selected articles were critically reviewed and the data acquired were systematically compiled.
Data regarding articles retracted from PubMed indexed dental journals from India.
Shamim, Thorakkal
2018-06-01
This data aimed to audit the articles retracted from PubMed indexed dental journals from India. The PubMed indexed journals considered are Indian Journal of Dental research, Journal of Indian Society of Periodontology, Contemporary Clinical Dentistry, Journal of Indian Society of Pedodontics and Preventive Dentistry, Journal of Oral and Maxillofacial Pathology and Journal of Indian Prosthodontic Society for type of article, name of dental specialty, topic of individual dental specialties, causes for retraction of article and authorship trend of retracted articles using web-based search. Among PubMed indexed Indian dental journals,the number of retracted articles were as follows: Indian Journal of Dental research (4) followed by Journal of Indian Society of Periodontology (3), Contemporary Clinical Dentistry (3), Journal of Indian Society of Pedodontics and Preventive Dentistry (2), Journal of Oral and Maxillofacial Pathology (2) and Journal of Indian Prosthodontic Society (1). Out of 15 retracted articles from PubMed indexed Indian dental journals, case reports (7) form a major share followed by original articles(6) and review articles (2). Among the dental specialties of retracted articles, oral pathology and microbiology (5) constitute the major share followed by periodontics (4), pedodontics (4), oral medicine and radiology (1) and prosthodontics (1). Duplicate publication (7), plagiarism (5) and authorship dispute (3) are the causes for the retraction of article.
Applications of cone beam computed tomography for a prosthodontist
John, George Puthenpurayil; Joy, Tatu Elenjickal; Mathew, Justin; Kumar, Vinod R. B.
2016-01-01
Cone beam computed tomography (CBCT) is a medical imaging technique of X-ray computed tomography where the X-rays are divergent, forming a cone. CBCT systems have been designed for imaging hard tissues of the maxillofacial region. The increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. This article is intended to elaborate and enunciate on the various applications and benefits of CBCT, in the realm of maxillofacial prosthodontics, over and beyond its obvious benefits in the rehabilitation of patients with implants. With the onus of meticulous reconstruction of near ideal occlusion resting on the prosthodontist, CBCT provides a unique imaging option, which can be a boon in various aspects of prosthodontic practice – from imaging of the temporomandibular joint for accurate movement simulation, to template assisted maxillofacial reconstruction or even over denture therapy. CBCT could play a crucial role in lessening the burden of a hectic prosthodontic routine for the clinician and critically contribute to accurate and effective treatment for the patient. Apart from the authors’ clinical experiences shared here, a web-based search for relevant articles in this specific area of interest was also conducted. The selected articles were critically reviewed and the data acquired were systematically compiled. PMID:27134420
Interdisciplinary interface between fixed prosthodontics and periodontics.
Abduo, Jaafar; Lyons, Karl M
2017-06-01
Although periodontal factors do not usually have a direct effect on the survival of a fixed prosthesis, harmony between the prosthesis and the periodontium is critical otherwise esthetics, the longevity of the prosthesis and the periodontium will be compromised. A close interdisciplinary relationship between periodontics and prosthodontics is therefore necessary to avoid an unsatisfactory treatment outcome, requiring extensive and expensive retreatment. The design of the prosthesis, the number and quality of the abutment teeth, the preparation and the pontic, the occlusion and the material need to be considered when planning prosthodontic treatment. The location of the preparation margin and the contour and emergence profile of the prosthesis will influence the response of the gingival tissues to the prosthesis. Pontic design and cleansibility also contribute to the response of the gingival tissues as well as to the clinical and esthetic outcome. Even an optimal pontic design will not prevent inflammation of the mucosa adjacent to the pontic if pontic hygiene is not maintained by removal of plaque. Case selection and the patients' ability to carry out adequate oral hygiene are therefore essential for longevity of the prosthesis, and regular reviews provide an opportunity for early detection and treatment of failures. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Vieira, Antonio Hélio; Leles, Cláudio Rodrigues
2014-01-01
Motivations for seeking and undergoing prosthodontic care are poorly understood and are not often explored for clinical purposes when determining treatment need and understanding the factors related to the demand for health care and effective use. This article uses the Theory of Planned Behavior construct to identify factors related to the motivations of edentulous subjects to seek and undergo prosthodontic treatment. The conceptual framework of the Theory of Planned Behavior includes attitude toward behavior, an individual’s positive or negative evaluation of self-performance of the particular behavior; the subjective norm, an individual’s perception of social normative pressures or relevant others’ beliefs that he or she should or should not perform such behavior; and perceived behavioral control, or an individual’s perceived ease or difficulty in performing the particular behavior, determined by the total set of accessible control beliefs. These components mediate a subject’s intention and behavior toward an object and may also explain health-related behaviors, providing strong predictions across a range of health behaviors. This study suggests categories for each component of the Theory of Planned Behavior, based on clinical evidence and practical reasoning. Attitudes toward behavior include perceived consequences of no treatment, perceived potential benefits and risks of treatment, dental anxiety, previous experiences, and interpersonal abilities of the health care providers. The subjective norm includes the opinions of relevant others, advertisement, professionally defined normative need, perceived professional skills, and technical quality of care. Perceived behavioral control includes subject’s time, availability and opportunity, treatment costs, subject’s perceived need, and accessibility to dental care. This conceptual model represents a theoretical multidimensional model that may help clinicians better understand the patient’s treatment behaviors and provide additional information for clinical research on patient’s adherence to interventions in prosthodontics. PMID:25246777
Patel, Devangkumar Rajnikant; O'Brien, Tim; Petrie, Aviva; Petridis, Haralampos
2014-01-01
Purpose The purpose of this systematic review was to review clinical studies of fixed tooth-supported prostheses, and to assess the quality of evidence with an emphasis on the assessment of the reporting of outcome measurements. Multiple hypotheses were generated to compare the effect of study type on different outcome modifiers and to compare the quality of publications before and after January 2005. Materials and Methods An electronic search was conducted using specific databases (MEDLINE via Ovid, EMBASE via Ovid, Cochrane Library) through July 2012. This was complemented by hand searching the past 10 years of issues of the Journal of Oral Rehabilitation, Journal of Prosthetic Dentistry, Journal of Prosthodontics, and the International Journal of Prosthodontics. All experimental and observational clinical studies evaluating survival, success, failure, and complications of tooth-supported extracoronal fixed partial dentures, crowns, and onlays were included. No restrictions on age or follow-up time were placed. Results The electronic search generated 14,869 papers, of which 206 papers were included for full-text review. Hand-searching added 23 papers. Inclusion criteria were met by 182 papers and were included for the review. The majority were retrospective studies. Only 8 (4.4%) were randomized controlled trials. The majority of the studies measured survival and failure, and few studies recorded data on success; however, more than 60% of the studies failed to define survival, success, and failure. Many studies did not use any standardized criteria for assessment of the quality of the restorations and, when standardized criteria were used, they were modified, thereby not allowing for comparisons with other studies. There was an increase of 21.8% in the number of studies evaluating outcome measurements of all-ceramic restorations in past 8 years. Conclusions Prosthodontic literature presents with a reduced percentage of RCTs compared to other disciplines in dentistry. The overall quality of recording prosthodontic outcome measurements has not improved greatly in the past 8 years. PMID:24947268
Al-Sowygh, Zeyad H; Sukotjo, Cortino
2011-02-01
This study investigated the perspectives of foreign-trained dentists (FTDs) in comparison with US-trained Dentists (USTDs) in Advanced Education in Prosthodontics (AEP) programs on their current clinical training and future goals. This study was conducted by analyzing data from previously published literature. When appropriate, Chi-square statistical analysis was conducted to determine the influence of where the AEP residents earned their DMD/DDS degree (FTDs/USTDs) on all variables. Only results that yielded significant differences were discussed. A majority of both FTDs and USTDs were male. Most USTDs were married, while most FTDs were single. Most FTDs were not US citizens and most originated from Asia, followed by the Middle East, South America, and Europe. Significantly more FTDs had higher ranks in their dental schools, had more advanced degrees, and spent more time practicing before entering the AEP programs. In selecting AEP programs, FTDs placed significantly higher values on a program's reputation and research opportunities. During their AEP training, FTDs paid significantly higher tuition and received lower stipends, but obtained more financial support from families. On the other hand, USTDs received significantly more financial aid and earned income from part-time work, but had significantly higher total educational debts. USTDs showed a significantly higher interest in becoming a student member of the American College of Prosthodontists and participated actively in prosthodontics organizations. USTDs were more interested in becoming maxillofacial prosthodontists, while FTDs were more interested in pursuing academic careers. FTDs differed from USTDs in several ways. Because of their interests in academics and research, FTDs may potentially have a positive impact on the development of the prosthodontics discipline. This information may be beneficial for AEP program directors in accommodating the needs of FTDs, and for FTDs in better preparing for their AEP training. © 2010 by The American College of Prosthodontists.
Prosthodontic rehabilitation of completely edentulous patient with partial glossectomy.
Garg, Aditi
2016-01-01
Oral cancer accounts for about 40% of all cancers inflicting the human beings. Those involving the tongue results in mild to severe deficiencies of phonation, deglutition, mastication, and taste depending upon the degree and extent tissues involved. Often rehabilitation of such patient is a challenge for the prosthodontist and involves a careful observation and evaluation of the residual oral function and ways to restore them. This article presents a case report of prosthodontic rehabilitation completely edentulous patient, who underwent partial glossectomy following surgical resection of the squamous cell carcinoma involving left lateral borders of the tongue. An attempt was made to restore the comfort and function of the patient with the help of palatal augmentation prosthesis, with additional assistance through speech therapy and simple oral exercises.
Content and goals of preclinical prosthodontic programs at german-language dental schools.
Hey, Jeremias; Stimmelmayr, Michael; Hirsch, Christian; Beuer, Florian
2014-04-01
The Association for Dental Education in Europe (ADEE) makes recommendations regarding the skills graduates of European dental schools need to achieve and advises dental schools regarding necessary changes to be made to the curriculum. In 2010 to 2011, a survey was conducted in German-language dental schools to validate the curricula and goals of preclinical prosthodontic programs with regard to laboratory work. The survey was mailed to the course instructors of the preclinical programs at 37 dental schools. Of these, 35 schools returned the completed survey, resulting in a response rate of 95%. Bent wire, wax-up exercises, metal-ceramic single crowns, fixed dental prostheses, cast metal single crowns, temporary removable dental prostheses, and full dentures were part of the dental laboratory work at most schools; however, most instructors considered laboratory work as less important, and there were few similarities among the programs in this area. According to the instructors responsible for preclinical education, honing of fine motor skills, realistic self-assessment, and the ability to work independently were the main goals of the programs. The results of this survey show that with regard to laboratory work, there were more differences than similarities among preclinical prosthodontic programs at German-language dental schools, contrary to the recommendations of the ADEE. These findings should be taken into account when program reforms are planned. © 2013 by the American College of Prosthodontists.
Materials for interocclusal records and their ability to reproduce a 3-dimensional jaw relationship.
Ockert-Eriksson, G; Eriksson, A; Lockowandt, P; Eriksson, O
2000-01-01
The purpose of this study was to determine if accuracy and dimensional stability of vinyl polysiloxanes and irreversible hydrocolloids stabilized by a tray used for fixed prosthodontics, removable partial, and complete denture cases are comparable to those of waxes and record rims and if storage time (24 hours or 6 days) affects dimensional stability of the tested materials. Two waxes, two record rims, three vinyl polysiloxanes, and one irreversible hydrocolloid (alginate) were examined. Three pairs of master casts with measuring steel rods were mounted on an articulator (initial position). Five records were made of each material, and the upper cast was remounted after 24 hours or 6 days so that deviations from the initial position could be measured. Vinyl polysiloxanes reinforced by a stabilization tray were the most accurate materials able to reproduce a settled interocclusal position. Mounting casts (fixed prosthodontics cases) without records gave accuracy similar to wax records. Record rims used for removable partial and complete denture cases produced lesser accuracy than vinyl polysiloxanes and irreversible hydrocolloid stabilized by a tray. Accuracy was not significantly affected by storage time. The results show that accuracy of vinyl polysiloxanes and irreversible hydrocolloids reinforced by a tray is superior to that of record rims with regard to the complete denture case and is among the most accurate with regard to the removable partial denture case. For fixed prosthodontics, however, reinforcement is unnecessary.
Alsabeeha, Nabeel; Payne, Alan G T; De Silva, Rohana K; Swain, Michael V
2009-04-01
To review the literature on mandibular single-implant overdentures (opposing complete maxillary dentures), and present surgical and prosthodontic perspectives of a novel approach for this treatment option. An electronic search through the databases of Pubmed, Embase and Medline using the linked key words 'mandibular single implant overdentures' was performed. The search was limited to English language articles published up to August 2008. Hand searches through articles retrieved from the electronic search, peer-reviewed journals and recent conference proceedings were also conducted. A limited number of reports were identified on mandibular single-implant overdentures (opposing maxillary complete dentures). They comprised of case-series reports, short-term prospective trials and current randomized-controlled clinical trials. Different loading protocols with different implant systems have been used, but always with regular diameter implants. Specific anatomical and vascular dangers of the mandibular midline symphysis are identified including a novel surgical approach using a currently available short, wide diameter tapered implant. In addition, the prosthodontic rationale for using a larger attachment system (incorporating a platform switch) for mandibular single-implant overdentures is described. The review reveals that there is a lack of published randomized clinical trials using mandibular single-implant overdentures, opposing maxillary complete dentures. Without the evidence from randomized clinical trials, routine use of this novel approach cannot be recommended, compared with using regular diameter implants and matching attachment systems.
Prosthodontic rehabilitation of completely edentulous patient with partial glossectomy
Garg, Aditi
2016-01-01
Oral cancer accounts for about 40% of all cancers inflicting the human beings. Those involving the tongue results in mild to severe deficiencies of phonation, deglutition, mastication, and taste depending upon the degree and extent tissues involved. Often rehabilitation of such patient is a challenge for the prosthodontist and involves a careful observation and evaluation of the residual oral function and ways to restore them. This article presents a case report of prosthodontic rehabilitation completely edentulous patient, who underwent partial glossectomy following surgical resection of the squamous cell carcinoma involving left lateral borders of the tongue. An attempt was made to restore the comfort and function of the patient with the help of palatal augmentation prosthesis, with additional assistance through speech therapy and simple oral exercises. PMID:27141173
Mehra, Mamta; Vahidi, Farhad; Berg, Robert W
2014-06-01
The purpose of the study was to survey program directors of postdoctoral prosthodontic programs in the United States regarding their programs' complete denture impression techniques. The key objectives of the survey were to identify the current trends in complete denture impression making and to determine which techniques and materials are taught in US postdoctoral prosthodontic programs. An online survey was sent to all program directors of US postdoctoral prosthodontic programs. The survey comprised two sections: preliminary impressions and final impressions. The survey contained 22 questions that would take approximately 5 minutes to complete. All responses remained anonymous throughout the survey. The response rate for the survey was 87%. A majority of the programs did not separately border mold the tray prior to making the preliminary impressions (82%). The impression material of choice for the preliminary impression was irreversible hydrocolloid (88%). Selective pressure was the predominantly used impression philosophy (80%). All programs border molded the custom tray, and 95% recorded the borders in sections. The material of choice for border molding the custom tray was modeling plastic impression compound (71%). The most commonly used impression material for the final impressions was polyvinylsiloxane (PVS) (42%), and the second most commonly used impression material was polysulphide (32%). The most common technique for locating the posterior palatal seal was marking intraorally and transferring onto the final impression (65%). Most programs routinely advised their patients not to wear their existing dentures for at least 24 hours before the final impressions were made (83%). Based on the results of this study, the following conclusions can be drawn: (1) The most commonly used material for the preliminary impression was irreversible hydrocolloid and for the final impression was PVS. (2) Modeling plastic impression compound was used by most programs to border mold the custom trays. (3) Selective pressure was the predominantly used impression philosophy. (4) A majority of the programs made a special consideration for excessive movable (flabby) tissue. (5) Most programs routinely advised their patients to not wear their existing dentures for at least 24 hours before the final impressions were made. © 2013 by the American College of Prosthodontists.
... to the Second Edition: Kathleen Kapp-Simon, PhD, Psychology David J. Reisberg, DDS, Prosthodontics James Sidman, MD, ... Speech ...........................................................................................................................8 Your Ears, Nose and Throat .......................................................................................10 Social Relationships ..........................................................................................................11 Looking Toward the Future ........................................................................................13 Stories ...
Complications in implant dentistry
Hanif, Ayesha; Qureshi, Saima; Sheikh, Zeeshan; Rashid, Haroon
2017-01-01
After tooth loss, an individual may seek tooth replacement so that his/her function and esthetics could be restored. Clinical prosthodontics, during the past decade, has significantly improved and developed according to the advancements in the science and patient's demands and needs. Conventional options in prosthodontics for substituting a missing single tooth include the removable partial denture, partial and full coverage bridgework, and resin-bonded bridgework. Dental implants have gained increasing popularity over the years as they are capable of restoring the function to near normal in both partial and completely edentulous arches. With substantial evidence available, fixed implant-supported prosthesis are fully acknowledged as a reliable treatment option for the replacement of single or multiple missing teeth nowadays. While dental implants are increasingly becoming the choice of replacement for missing teeth, the impediments associated with them are progressively emerging too. PMID:28435381
Methodological quality and descriptive characteristics of prosthodontic-related systematic reviews.
Aziz, T; Compton, S; Nassar, U; Matthews, D; Ansari, K; Flores-Mir, C
2013-04-01
Ideally, healthcare systematic reviews (SRs) should be beneficial to practicing professionals in making evidence-based clinical decisions. However, the conclusions drawn from SRs are directly related to the quality of the SR and of the included studies. The aim was to investigate the methodological quality and key descriptive characteristics of SRs published in prosthodontics. Methodological quality was analysed using the Assessment of Multiple Reviews (AMSTAR) tool. Several electronic resources (MEDLINE, EMBASE, Web of Science and American Dental Association's Evidence-based Dentistry website) were searched. In total 106 SRs were located. Key descriptive characteristics and methodological quality features were gathered and assessed, and descriptive and inferential statistical testing performed. Most SRs in this sample originated from the European continent followed by North America. Two to five authors conducted most SRs; the majority was affiliated with academic institutions and had prior experience publishing SRs. The majority of SRs were published in specialty dentistry journals, with implant or implant-related topics, the primary topics of interest for most. According to AMSTAR, most quality aspects were adequately fulfilled by less than half of the reviews. Publication bias and grey literature searches were the most poorly adhered components. Overall, the methodological quality of the prosthodontic-related systematic was deemed limited. Future recommendations would include authors to have prior training in conducting SRs and for journals to include a universal checklist that should be adhered to address all key characteristics of an unbiased SR process. © 2013 Blackwell Publishing Ltd.
Prosthetic rehabilitation of patients with hypohidrotic ectodermal dysplasia: A systematic review.
Schnabl, D; Grunert, I; Schmuth, M; Kapferer-Seebacher, I
2018-04-21
Hypohidrotic ectodermal dysplasia (HED) comprises a large group of inherited disorders of ectodermal structures, characterised by hypo- or anhidrosis, hypotrichosis and hypo- or oligo- or anodontia. We aimed to systematically assess the spectrum of prosthodontic approaches with regard to the patients' age and to provide clinical implications for practicing dentists. An electronic and manual search was conducted in four databases (Medline, LIVIVO, Cochrane Library, Web of Science Core Collection). Publications of multiple study designs written in English or German without data restrictions, reporting on prosthodontic treatment of patients diagnosed with HED and afflicted with oligo- or anodontia, were included. In total, 75 articles on 146 patients were analysed according to the patients' age. In children aged 2-17 years, removable full or partial (over)dentures represented standard treatment. In the mandible, implant-supported removable dentures on two interforaminal implants presented an alternative, already in young childhood. In cases with more than six teeth per jaw, also fixed (resin) bridges were used, frequently after orthodontic treatment. In adults, fixed or removable reconstructions with the help of up to eight implants per jaw, usually placed after bone augmentation procedures, were standard. Ten case reports/series with long-term follow-up illustrated the need for consistent maintenance including denture renewals. Prosthodontic rehabilitation should start in early childhood and needs to be revised in accordance with the patients' growth. Treatment should be carried out by a multidisciplinary team addressing variable demands in different age groups. © 2018 John Wiley & Sons Ltd.
Digital Denture Fabrication in Pre- and Postdoctoral Education: A Survey of U.S. Dental Schools.
Fernandez, Monica A; Nimmo, Arthur; Behar-Horenstein, Linda S
2016-01-01
To survey chairs of prosthodontics or restorative departments and program directors of postdoctoral prosthodontic programs in the United States regarding digital denture fabrication. The key objectives of the survey were to identify the current trends in complete denture fabrication using CAD/CAM technology and to determine how and to what extent this technique is taught and used in U.S. pre- and postdoctoral prosthodontic programs. An invitation to participate in an online survey was sent to 52 prosthodontics/restorative chairs of U.S. dental schools and to all of the 50 program directors of postdoctoral prosthodontics programs. A version of the survey with the same questions was sent to a national sample of prosthodontics/restorative chairs and program directors of postdoctoral prosthodontics. The 20-item survey took approximately 15 minutes to complete. Dependent samples paired t-test was run on items that were the same in both surveys. The response rate for the survey was 63% for department chairs and 44% for program directors. All respondents with the exception of one department chair were aware of CAD/CAM technology used for denture fabrication. More than half of the program directors (52.4%) compared to 12.1% of chairs have incorporated some aspects of CAD/CAM denture fabrication technology into their curriculum. When asked if the fabrication cost prevented introducing this technology in the predoctoral/postdoctoral curriculum, 52.4% of the department chairs affirmed this response compared to 12.1% of the program directors. There was a significant difference between groups when asked if they had incorporated the CAD/CAM denture fabrication technique into the postgraduate/predoctoral curriculum. Department chairs reported less usage of CAD/CAM technology. Only 12.1% of department chairs reported using some aspects of CAD/CAM technology in the predoctoral curriculum compared to 52.4% in the postdoctoral curriculum (F = 13.528, p ≤ 0.001). While this technology is used in four predoctoral clinics, none of the chairs reported including CAD/CAM denture fabrication in their preclinical complete denture courses. For the schools using the technology, 33.3% of postdoctoral and 30.3% of predoctoral programs use it to make a denture with a try-in step; however, 19% of the postdoctoral and 18.2% of predoctoral programs process the dentures without a try-in appointment. Slightly less than half (42.9%) of graduate programs are using the technology to make just the denture bases. Only a small proportion (10% or less) of the total number of dentures processed in post- and predoctoral programs are made using CAD/CAM technology. The proportion of postdoctoral programs that process cases using CAD/CAM technology was significantly higher than in predoctoral programs (F = 5.106, p ≤ 0.028). Many schools indicated that they are in a "trial phase" to evaluate the technique, especially at the predoctoral level. Also, 19% (n = 4) of postdoctoral and 15.2% (n = 5) of predoctoral respondents have created continuing education courses. Of postdoctoral programs, 38.1% (n = 8) plan to introduce this technology at some point in the near future (next 1 to 4 years); 27.3% of predoctoral programs plan to as well. All program directors and department chairs who participated in the survey are aware of this technology with the exception of one department chair. More than half of the program directors reported that they have incorporated this technology in their curricula compared to only 12% of department chairs. Currently, only 10% or less of complete denture cases are processed using the CAD/CAM technology, at either the post- or predoctoral levels. Both groups reported that the main use of this technology is for the fabrication of denture bases and for processing dentures including the try-in step. The majority of respondents in both groups indicated they plan to add digital denture fabrication into their curricula within the next 1 to 4 years. © 2015 by the American College of Prosthodontists.
Choudhury, Minati; Banu, Fathima; Natarajan, Shanmuganathan; Kumar, Anand; Tv, Padmanabhan
2018-02-16
Interdisciplinary prosthodontics goes beyond our imagination into fields that have a direct effect on our total body health and quality of life. Removal of an eye has a detrimental effect on the psychology of the patient. Enucleation involves removal of the eyeball proper and leads to an enophthalmic socket with a shrunken eye, which has a crippling effect on patient's emotional and social life. Custom-made eye prosthesis simulates the characteristics of the companion eye and helps in restoring the normal facial appearance. Restoration of saccadic eye movements occurring during speech is desirable because this greatly contributes to a normal facial expression. This can be achieved by an orbital implant, which helps in orbital volume replacement and restoration of prosthesis movement and comfort. This article describes prosthodontic rehabilitation of enucleated eye sockets with orbital implants for two patients.
Livaditis, G J
2001-10-01
A clinical protocol is described for the treatment of intentional and unavoidable exposed pulps during crown preparation. The protocol includes a definitive cavity preparation to create space in the exposed dentin for an adhesive pulp barrier; procedures to develop the highly desirable hybrid zone to prevent microleakage; the use of a specific resinous material that serves as a long-term pulp barrier with a relatively neutral and biocompatible impact on the pulp; and the use of precise bipolar electrocoagulation to provide durable hemostasis for restoration of the pulp wall and a relatively clot-free surgical wound to facilitate healing. The protocol involves the application of gentle surgical and restorative procedures to support the inherent healing process to restore the health of the pulp. The patient presented was part of a larger investigation and was selected in an attempt to identify a fixed prosthodontic application of the proposed pulp therapy protocol.
Sreeraj, R; Krishnan, Vinod; V, Manju; Thankappan, Krishnakumar
This study compared masticatory and swallowing functional outcomes in maxillectomy patients who underwent surgical and prosthetic rehabilitation or prosthetic rehabilitation only following surgical resection. This comparative cross-sectional study involved 20 maxillectomy patients and compared their masticatory and swallowing functions following combined surgical and prosthodontic management vs an exclusively prosthodontic approach. Masticatory performance was measured by an originally modified sieve method using hydrocolloid material, and video fluoroscopic examination was employed for swallowing assessments. Masticatory performance was significantly better in the patient group treated with flaps and removable denture prostheses compared to patients treated with obturator prosthesis alone. Swallowing outcomes were comparable in both groups. Flap reconstruction followed by an obturator prosthesis seems to be a preferable option when planning for functional rehabilitation in maxillectomy patients. Further research is needed to substantiate the functional outcomes noted in this study.
Kelly, Paul; Drago, Carl J
2009-10-01
Large defects of dentofacial structures may result from trauma, disease (including neoplasms), and congenital anomalies. The location and size of the defects are related to difficulties that patients report relative to speech, mastication, swallowing, facial esthetics, and self-image. This article reports on the evaluation and treatment of a patient who suffered significant trauma to the lower and mid-face secondary to a gunshot injury. It describes the initial presentation, life-saving procedures, and subsequent bone grafts, implant placement, and prosthetic treatments required to rehabilitate the patient to a condition that closely approximated his preoperative condition. This clinical report confirms that no matter the degree of complexity involved in treating the results of significant facial trauma, successful treatment is dependent on thorough physical and radiographic examinations, development of the appropriate diagnoses, and treatment based on sound prosthodontic and surgical principles.
Al-Almaie, Saad
2017-01-01
This rare case report describes prosthodontic complications resulting from a dental implant was placed surgically more distally in the area of the missing mandibular first molar with a cantilever effect and a crest width of >12 mm in a 59-year-old patient who had a history of bruxism. Fracture of abutment is a common complication in implant was placed in area with high occlusal forces. Inability to remove the broken abutment may most often end up in discarding the implant. Adding one more dental implant mesially to the previously placed implant, improvisation of technique to remove the broken abutment without sacrificing the osseointegrated dental implant, fabrication with cemented custom-made abutment to replace the broken abutment for the first implant, and the use of the two implants to replace a single molar restoration proved reliable and logical treatment solutions to avoid these prosthodontic complications.
Zygogiannis, Kostas; Wismeijer, Daniel; Aartman, Irene Ha; Osman, Reham B
2016-01-01
Different treatment protocols in terms of number, diameter, and suprastructure design have been proposed for immediately loaded implants that are used to support mandibular overdentures opposed by maxillary conventional dentures. The aim of this study was to investigate the influence of these protocols on survival rates as well as clinical and prosthodontic outcomes. Several electronic databases were searched for all relevant articles published from 1966 to June 2014. Only randomized controlled trials and prospective studies with a minimum follow-up of 12 months were selected. The primary outcomes of interest were the success and survival rates of the implants. Prosthodontic complications were also evaluated. Fourteen studies fulfilled the inclusion criteria. Of the studies identified, nine were randomized controlled trials and five were prospective studies. The mean follow-up period was 3 years or less for the vast majority of the studies. The reported survival and success rates were comparable to that of conventional loading for most of the included studies. No specific immediate loading protocol seemed to perform better in terms of clinical and prosthodontic outcomes. Immediate loading protocols of mandibular overdentures seem to be a viable alternative to conventional loading. It was not possible to recommend a specific treatment protocol related to the number, diameter of the implants, and attachment system used. Long-term, well-designed studies comparing different immediate loading modalities could help to establish a protocol that delivers the most clinically predictable, efficient, and cost-effective outcome for edentulous patients in need of implant overdentures.
Zou, Duohong; Wu, Yiqun; Huang, Wei; Wang, Feng; Wang, Shen; Zhang, Zhiyong; Zhang, Zhiyuan
2013-01-01
To evaluate telescopic crown (TC), bar, and locator attachments used in removable four implant-supported overdentures for patients with edentulous maxillae. A total of 30 maxillary edentulous patients were enrolled in a 3-year prospective study. Ten patients (group A) were treated with overdentures supported by TCs, 10 patients (group B) with overdentures supported by bar attachments, and 10 patients (group C) with overdentures supported by locator attachments. A total of 120 implants were used to restore oral function. During the 3-year follow-up period, implant survival and success rates, biologic and mechanical complications, prosthodontic maintenance efforts, and patient satisfaction were evaluated. All 30 patients were available for the 3-year follow-up and exhibited 100% implant survival and success rates. Peri-implant marginal bone resorption was not statistically significant for the three groups. There were lower plaque, bleeding, gingiva, and calculus indices in group C compared with groups A and B. The number of prosthodontic maintenance visits revealed eight complications in the TC group, seven complications in the bar group, and four complications in the locator group. However, there were no differences in the clinical effects of the overdentures in the three groups. Within the limits of this prospective study, it was concluded that the locator system produced superior clinical results compared with the TC and bar attachments in terms of peri-implant hygiene parameters, the frequency of prosthodontic maintenance measures, cost, and ease of denture preparation. However, longer-term prospective studies are required to confirm these results.
Development and evaluation of learning module on clinical decision-making in Prosthodontics.
Deshpande, Saee; Lambade, Dipti; Chahande, Jayashree
2015-01-01
Best practice strategies for helping students learn the reasoning skills of problem solving and critical thinking (CT) remain a source of conjecture, particularly with regard to CT. The dental education literature is fundamentally devoid of research on the cognitive components of clinical decision-making. This study was aimed to develop and evaluate the impact of blended learning module on clinical decision-making skills of dental graduates for planning prosthodontics rehabilitation. An interactive teaching module consisting of didactic lectures on clinical decision-making and a computer-assisted case-based treatment planning software was developed Its impact on cognitive knowledge gain in clinical decision-making was evaluated using an assessment involving problem-based multiple choice questions and paper-based case scenarios. Mean test scores were: Pretest (17 ± 1), posttest 1 (21 ± 2) and posttest 2 (43 ± 3). Comparison of mean scores was done with one-way ANOVA test. There was overall significant difference in between mean scores at all the three points (P < 0.001). A pair-wise comparison of mean scores was done with Bonferroni test. The mean difference is significant at the 0.05 level. The pair-wise comparison shows that posttest 2 score is significantly higher than posttest 1 and posttest 1 is significantly higher than pretest that is, pretest 2 > posttest 1 > pretest. Blended teaching methods employing didactic lectures on the clinical decision-making as well as computer assisted case-based learning can be used to improve quality of clinical decision-making in prosthodontic rehabilitation for dental graduates.
Korduner, E-K; Collin Bagewitz, I; Vult von Steyern, P; Wolf, E
2016-12-01
The aim of this investigation was to study the clinical prosthodontic decision-making process relating to dentitions with compromised molars among Swedish general dental practitioners (GDPs). Eleven Swedish GDPs were purposively selected, and all agreed to participate. Then, in-depth, semi-structured interviews were conducted and covered treatment considerations concerning two authentic patient cases, initially with complete dental arches, and later, a final treatment based on a shortened dental arch (SDA) was discussed. The cases involved patients with compromised teeth situated mainly in the molar regions. One patient suffered from extensive caries and the other from severe periodontal disease. Qualitative content analysis was used to analyse the data. In the systematic analysis, two main categories were identified: holistic and functional approach. Among the interviewed GDPs, focus was put on patients' needs, background history and motivation for treatment as well as the preservation of molar support. Within the limitations of this study, the following can be concluded: keeping a dental arch with molars seems to be important to Swedish general dental practitioners. The SDA concept does not seem to have a substantial impact on the prosthodontic decision-making relating to dentitions with compromised molars. The dentist's experiences, as well as colleagues' or consulting specialist advice together with aetiological factors and the patient's individual situation, influence the decision-making more than the SDA concept. The conflicting results in the prosthetic decision-making process concerning the relevance of age and the need for molar support need further investigation, for example based on decisions made in the dentist's own clinical practice. © 2016 John Wiley & Sons Ltd.
Walton, T R; Layton, D M
2012-09-01
The aim of this study was to apply a novel economic tool (cost satisfaction analysis) to assess the utility of fixed prosthodontics, to review its applicability, and to explore the perceived value of treatment. The cost satisfaction analysis employed the validated Patient Satisfaction Questionnaire (PSQ). Patients with a known prostheses outcome over 1-20 years were mailed the PSQ. Five hundred patients (50·7%) responded. Remembered satisfaction at insertion (initial costs) and current satisfaction (costs in hindsight) were reported on VAS, and the difference calculated (costs with time). Percentage and grouped responses (low, <40%; medium, 40-70%; high, > 70%) were analysed in relation to patient gender, age and willingness to have undergone the same treatment again, and in relation to prostheses age, type, complexity and outcome. Significance was set at P = 0·05. Averages were reported as means ± standard error. Satisfaction with initial costs and costs in hindsight were unrelated to patient gender and age, and prostheses age, type and complexity. Patients with a failure and those who would elect to not undergo the same treatment again were significantly less satisfied with initial costs (P = 0·021, P < 0·001) and costs in hindsight (P = 0·021, P < 0·001) than their counterparts. Patient's cost satisfaction (entire cohort) had significantly improved from 53 ± 1% at insertion to 81 ± 0·9% in hindsight (28 ± 1% improvement, P < 0·001). Patient cost satisfaction had also significantly improved, and the magnitude of improvement was the same within every individual cohort (P = 0·004 to P < 0·001), including patients with failures, and those who in hindsight would not undergo the same treatment again. Low satisfaction was reported by 166 patients initially, but 94% of these reported improvements in hindsight. Fourteen patients (3%) remained dissatisfied in hindsight, although 71% of these would still choose to undergo the same treatment again. Cost satisfaction analysis provided an evaluation of the patient's perspective of the value of fixed prosthodontic treatment. Although fixed prosthodontic treatment was perceived by patients to be expensive, it was also perceived to impart value with time. Cost satisfaction analysis provides a clinically useful insight into patient behaviour. © 2012 Blackwell Publishing Ltd.
A Clinical Implant Program in the Predoctoral Curriculum.
ERIC Educational Resources Information Center
Bell, Fred A.; And Others
1991-01-01
Six senior dental students participated in a preprosthetic surgery clinic and then performed implant surgery on patients. Patient reactions were highly favorable. Students and faculty found the prosthodontic phase more difficult than the surgical. Program continuation at the predoctoral level is anticipated. (MSE)
Deshpande, Saee; Chahande, Jayashree
2014-01-01
Purpose Successful prosthodontic rehabilitation involves making many interrelated clinical decisions which have an impact on each other. Self-directed computer-based training has been shown to be a very useful tool to develop synthetic and analytical problem-solving skills among students. Thus, a computer-based case study and treatment planning (CSTP) software program was developed which would allow students to work through the process of comprehensive, multidisciplinary treatment planning for patients in a structured and logical manner. The present study was aimed at assessing the effect of this CSTP software on the clinical judgment of dental students while planning prosthodontic rehabilitation and to assess the students’ perceptions about using the program for its intended use. Methods A CSTP software program was developed and validated. The impact of this program on the clinical decision making skills of dental graduates was evaluated by real life patient encounters, using a modified and validated mini-CEX. Students’ perceptions about the program were obtained by a pre-validated feedback questionnaire. Results The faculty assessment scores of clinical judgment improved significantly after the use of this program. The majority of students felt it was an informative, useful, and innovative way of learning and they strongly felt that they had learnt the logical progression of planning, the insight into decision making, and the need for flexibility in treatment planning after using this program. Conclusion CSTP software was well received by the students. There was significant improvement in students’ clinical judgment after using this program. It should thus be envisaged fundamentally as an adjunct to conventional teaching techniques to improve students’ decision making skills and confidence. PMID:25170288
Witter, Dick J; Woda, Alain; Bronkhorst, Ewald M; Creugers, Nico H J
2013-05-01
To analyse the masticatory function of subjects characterised by different occlusal and prosthodontic status. Using Optosil(®) as a test food, the masticatory normative indicator (MNIOPT) was used to differentiate between sufficient ('normal') and impaired masticatory function. Outcomes of occlusal force and masticatory tests were aggregated from three earlier studies dealing with four denture groups and three natural dentition groups. The four denture groups had a complete removable dental prosthesis in the upper jaw, and displayed one of the four following lower jaw prosthodontic rehabilitations: (i) complete removable dental prosthesis on a low mandible; (ii) complete removable dental prosthesis on a higher mandible; (iii) overdenture on natural roots; and (iv) overdenture on dental implants. The three natural dentition groups were: (i) shortened dental arch; (ii) complete dentition in older participants, and (iii) complete dentition in younger participants. All participants were women. They performed the same tests twice, and outcomes were averaged. A MNIOPT value of 3.68 mm was determined from the participants with complete natural dentitions. Applying the MNIOPT to the participants in the denture groups pointed at a considerable chance for impaired masticatory function, except for participants in the overdenture -implants group. The four denture groups compensated for reduced masticatory efficiency by increased number of masticatory cycles and prolonged mastication time until 'swallowing'. Nevertheless, they also 'swallowed' larger particles compared to the complete dentition group. For a given patient or for a group of subjects with specific dental conditions, MNI enables to discriminate between a sufficient ('normal') and an impaired masticatory function. Copyright © 2013 Elsevier Ltd. All rights reserved.
Gratton, D G; Kwon, S R; Blanchette, D R; Aquilino, S A
2017-11-01
Proper integration of newly emerging digital assessment tools is a central issue in dental education in an effort to provide more accurate and objective feedback to students. The study examined how the outcomes of students' tooth preparation were correlated when evaluated using traditional faculty assessment and two types of digital assessment approaches. Specifically, incorporation of the Romexis Compare 2.0 (Compare) and Sirona prepCheck 1.1 (prepCheck) systems was evaluated. Additionally, satisfaction of students based on the type of software was evaluated through a survey. Students in a second-year pre-clinical prosthodontics course were allocated to either Compare (n = 42) or prepCheck (n = 37) systems. All students received conventional instruction and used their assigned digital system as an additional evaluation tool to aid in assessing their work. Examinations assessed crown preparations of the maxillary right central incisor (#8) and the mandibular left first molar (#19). All submissions were graded by faculty, Compare and prepCheck. Technical scores did not differ between student groups for any of the assessment approaches. Compare and prepCheck had modest, statistically significant correlations with faculty scores with a minimum correlation of 0.3944 (P = 0.0011) and strong, statistically significant correlations with each other with a minimum correlation of 0.8203 (P < 0.0001). A post-course student survey found that 55.26% of the students felt unfavourably about learning the digital evaluation protocols. A total of 62.31% felt favourably about the integration of these digital tools into the curriculum. Comparison of Compare and prepCheck showed no evidence of significant difference in students' prosthodontics technical performance and perception. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Ma, Sunyoung; Tawse-Smith, Andrew; De Silva, Rohana K; Atieh, Momen A; Alsabeeha, Nabeel H M; Payne, Alan G T
2016-06-01
The surgical placement of four maxillary implants for overdentures may not be obligatory when opposing mandibular two-implant overdentures. To determine 10-year surgical outcomes and implant success of three narrow diameter implants in edentulous maxillae with conventional loading. Forty participants with mandibular two-implant overdentures were randomly allocated for surgery for maxillary overdentures. Using osteotomes, three implants of similar systems were placed with a one-stage procedure and 12-week loading with splinted and unsplinted prosthodontic designs. Marginal bone and stability measurements were done at surgery, 12 weeks, 1-, 2-, 5-, 7-, 10 years. One hundred seventeen implants were placed in 39 participants, with 35 being seen at 1 year; 29 at 2 years; 28 at 5 years; 26 at 7 years; and 23 (59%) at 10 years. Marginal bone loss was 1.35 mm between surgery and 12 weeks; 0.36 mm between 12 weeks and 1 year; 0.48 mm between 1 and 5 years; and 0.22 mm between 5 and 10 years. Implant stability quotients were 56.05, 57.54, 60.88, 58.80, 61.17 at surgery, 12 weeks, 1 year, 5 years, and 10 years. Four-field tables by implant showed success rates of 82% at 1 year; 69.2% at 2 years; 66.7% at 5 years; 61.5% at 7 years; 51.3% at 10 years. Data showed no differences between surgical technique, systems, or prosthodontic designs. Surgical placement with osteotomes of three narrow diameter implants for maxillary overdentures, opposing mandibular two-implant overdentures, is an acceptable approach, subject to strict patient selection. Implant success is independent of prosthodontic design. © 2015 Wiley Periodicals, Inc.
Zou, Duohong; Wu, Yiqun; Huang, Wei; Zhang, Zhiyong; Zhang, Zhiyuan
2013-01-01
The objective of this study was to compare implant survival and success rates, peri-implant parameters, and prosthodontic maintenance efforts for implant-supported telescopic crown overdentures and bar overdentures to restore maxillary edentulism. This retrospective clinical study involved patients with maxillary edentulism who were fitted with implant-supported overdentures from January 2004 to June 2007. During a 5- to 8-year follow-up period, the implant survival and success rates, biologic and mechanical complications, prosthodontic maintenance, and patient satisfaction were retrospectively analyzed. The data were evaluated statistically and P < .05 was considered to be statistically significant. Forty-four patients with maxillary edentulism received implant-supported removable overdentures. Twenty-one patients chose telescopic crown overdentures and 23 patients chose bar overdentures. A total of 41 patients and 201 implants were available for follow-up. The implant survival and success rates, average bone resorption, and subjective patient satisfaction scores showed no difference between the telescopic crown and the bar overdenture group at follow-up. However, there were higher values for Plaque and Calculus Indexes in the bar group compared with the telescopic crown group, and these values showed a statistically significant difference annually from the 3-year follow-up (P < .05). Each year, the number of prosthodontics maintenance procedures per patient did not significantly differ between the telescopic crown (approximately 0.36 to 0.58) and bar groups (approximately 0.30 to 0.49) (P = .16). Although there were higher plaque and calculus levels in the bar group and more maintenance was required for the telescopic crown group, overdentures provided a healthy peri-implant structure for implants in both groups. Implant-supported telescopic crown or bar overdentures can provide a good treatment option for patients with edentulous maxillae.
Al-Zubeidi, Mohammed I; Alsabeeha, Nabeel H M; Thomson, W Murray; Payne, Alan G T
2012-05-01
Patient-based outcomes with maxillary overdentures on a minimum number of implants, opposing mandibular 2-implant overdentures are not evident in the literature. To evaluate patient's satisfaction with maxillary 3-implant overdentures, opposing mandibular 2-implant overdentures, using two different attachment systems over the first 2 years of service. Forty participants wearing mandibular 2-implant overdentures for 3 years were randomly allocated to one of two similar implant system groups to receive maxillary 3-implant overdentures. Twenty participants were allocated to splinted and unsplinted attachment system treatment groups for each system. Patient satisfaction with pre-treatment complete maxillary dentures, with maxillary 3-implant overdentures at baseline and annually for 2 years, was measured using visual analogue scale questionnaires and the oral health impact profiles. Palatal coverage of the maxillary overdentures was reduced at the first annual recall. Data showed significant improvement in pain reduction, comfort, stability, and function variables of the visual analogue scale after treatment. Analysis by prosthodontic design using visual analogue scale showed no significant difference. The total oral health impact profile-14 scores after treatment for all participants, regardless of prosthodontic design, were significantly lower (more satisfied). The overall oral health impact profile-20E score at baseline was significantly higher (more satisfied) compared with pre-treatment conventional maxillary dentures. No significant changes were observed in the first or second years compared with baseline results. Twenty-two participants (84.6%) preferred reduced palatal coverage, regardless of prosthodontic design, after 1 year. Twenty participants (76.9%) still preferred reduced palatal coverage at the end of the second year. The provision of maxillary 3-implant overdentures to oppose mandibular 2-implant overdentures significantly improve levels of patient satisfaction compared with conventional maxillary dentures. © 2011 Wiley Periodicals, Inc.
Sleep less and bite more: sleep disorders associated with occlusal loads during sleep.
Kato, Takafumi; Yamaguchi, Taihiko; Okura, Kazuo; Abe, Susumu; Lavigne, Gilles J
2013-04-01
Occlusal overload during sleep is a significant clinical issue that has negative impacts on the maintenance of teeth and the longevity of dental prostheses. Sleep is usually viewed as an 'out-of-functional' mode for masticatory muscles. However, orodental structures and prostheses are not free from occlusal loads during sleep since masticatory muscles can be activated at a low level within normal sleep continuity. Thus, an increase in masticatory muscle contractions, by whatever the cause, can be associated with a risk of increased occlusal loads during sleep. Among such conditions, sleep bruxism (SB) is a type of sleep-related movement disorders with potential load challenge to the tooth and orofacial structures. Patients with SB usually report frequent tooth grinding noises during sleep and there is a consecutive increase in number and strength of rhythmic masticatory muscle activity (RMMA). Other types of masticatory muscle contractions can be non-specifically activated during sleep, such as brief contractions with tooth tapping, sleep talking, non-rhythmic contractions related to non-specific body movements, etc.; these occur more frequently in sleep disorders. Studies have shown that clinical signs and symptoms of SB can be found in patients with sleep disorders. In addition, sleep becomes compromised with aging process, and a prevalence of most sleep disorders is high in the elderly populations, in which prosthodontic rehabilitations are more required. Therefore, the recognition and understanding of the role of sleep disorders can provide a comprehensive vision for prosthodontic rehabilitations when prosthodontists manage complex orodental cases needing interdisciplinary collaborations between dentistry and sleep medicine. Copyright © 2013 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Krennmair, Gerald; Krainhöfner, Martin; Waldenberger, Otmar; Piehslinger, Eva
2007-01-01
The aim of this retrospective study was to present the results of implants and natural teeth used as combined abutments to support maxillary telescopic prostheses. Between 1997 and 2004, 22 patients with residual maxillary teeth underwent prosthodontic rehabilitation with supplementary implant placement of implant-tooth-supported telescopic prostheses. A total of 60 supplementary implants (mean: 2.9 implants; SD: 1.6; range: 1 to 5 per patient) were placed in strategic position and connected with 48 natural abutment teeth (mean: 2.2 teeth; SD: 0.9; range: 1 to 4 per patient) using telescopic crowns. The follow-up registration included implant and natural tooth survival rates and peri-implant and periodontal parameters, along with prosthodontic maintenance. Natural tooth abutments were additionally followed to compare their periodontal parameters at baseline to the follow-up examination. After a mean of 38 months (12 to 108 months) no implants or natural tooth abutments were lost (survival rate: 100%). There was no fracture, endodontic treatment, loss, or intrusion of natural teeth used for telescopic abutments. Implant abutments showed high stability and excellent periimplant soft tissue conditions. Natural tooth abutments used for double crowns also showed uneventful progress. A low rate of prosthodontic maintenance was seen, with implant screw abutment loosening as the most severe complication (3 of 60 implants; 5%). On the basis of this retrospective clinical review, the following conclusions were drawn: (1) successful function over a prolonged period and a minor complication rate of implant-tooth-supported telescopic maxillary dentures may be anticipated, and (2) the great variety of treatment modalities offered by tooth-implant support for telescopic prostheses appears to be useful as a treatment option for the maxilla in elderly patients.
Implant-supported titanium prostheses following augmentation procedures: a clinical report.
Knabe, C; Hoffmeister, B
2003-03-01
This report describes a novel technique for fabricating retrievable implant-supported titanium (Ti) prostheses in patients requiring a comprehensive treatment plan involving the combined efforts of maxillofacial surgery and implant prosthodontics. Following bone graft reconstructive surgery and implant placement prosthetic treatment was initiated by inserting ITI-Octa abutments. An impression was made, and a framework was fabricated by fusing Ti-cast frameworks to prefabricated titanium copings by laser-welding. This was followed by veneering or fabrication of a removable denture with Ti metal re-enforcement. Favourable clinical results have been achieved using these screw-retained Ti implant-supported restorations for patients treated with reconstructive bone graft-surgery, with clinical observation periods ranging from three to four years. The present observations suggest that these screw-retained implant-supported Ti prostheses may be a meaningful contribution to implant prosthodontics, facilitating retrievable restorations of optimum biocompatibility, good marginal precision and with a good esthetic result. However, controlled clinical studies are needed to establish the long-term serviceability of these Ti restorations.
Prosthodontic and speech rehabilitation after partial and complete glossectomy.
Lauciello, F R; Vergo, T; Schaaf, N G; Zimmerman, R
1980-02-01
A multidisciplinary approach to the rehabilitation of four glossectomy patients has been presented. Points emphasized were the anatomic defects, their effect on the three oral functions of mastication, deglutition, and speech, and the various prosthetic modifications found most effective to restore the impaired oral functions.
Implant Education Programs in North American Dental Schools.
ERIC Educational Resources Information Center
Arbree, Nancy S.; Chapman, Robert J.
1991-01-01
A survey of 52 dental schools found that dental implant techniques were taught in 34 pre- and 34 postdoctoral curricula, involving mostly prosthodontics and oral surgery departments, with periodontology departments lagging behind. Most predoctoral programs did not have research involvement. Cooperation among specialties is recommended over implant…
Spark erosion implant prosthetics in the management of an acquired maxillofacial defect.
Bloem, T J; Baxter, W D; Vivas, J
1996-03-01
The concept and use of spark erosion (EDM) prosthetics in implant prosthodontics has been described and demonstrated in its application to a patient suffering maxillofacial trauma. The advantages and disadvantages of this technology have been discussed for the edification of the restorative and surgical provider.
ERIC Educational Resources Information Center
Feil, Philip
1992-01-01
A survey investigated the application of constructs related to acquisition of psychomotor skills in the preclinical dental curriculum in 220 departments of operative dentistry, fixed and removable prosthodontics, pediatric dentistry, and periodontics. Results indicate insufficient opportunities for students to define desired outcomes and…
Prosthetic Rehabilitation of Defects of the Head and Neck
Salinas, Thomas J.
2010-01-01
Patients afflicted with head and neck cancer, traumatic injuries to the head and neck, or those with congenital or developmental defects benefit from multidisciplinary team management. The head and neck region participates in complex physiologic processes that can often be impeded by these circumstances. Evaluation of the patient by the maxillofacial prosthodontist can assist the other members of the team in providing treatment planning options for the patients. Intraoral defects arising from these circumstances can be treated with prosthodontics that serve to assist with speech, swallowing, and to some degree mastication. If chemotherapeutic or radiation modalities are also used to treat the head and neck, assessment of the patient by the maxillofacial prosthodontist may prove to identify factors that may predispose to undesirable sequelae. Preventive treatment by elective tooth extraction, prosthodontic assessment, and patient education prove to assist in predictable management of these oftentimes complex presenting conditions. Facial defects arising from similar circumstances can be an alternative or adjunct to plastic surgical reconstruction and offer the added advantage of tumor surveillance in susceptible patients. PMID:22550451
Szánto, Erika; Gera, István
2011-12-01
To day a relatively high percentage of elderly population of the industrialized world suffers with different cardiovascular diseases and are on permanent antihypertensive therapy. One of the most frequently used drugs is the calcium channel blockers prescribed against high blood pressure. The most common oral side effect of these drugs is the gingival enlargement that might develop even on otherwise healthy gingiva. The incidence of chronic periodontitis in this age group is also high and the Ca antagonist medication in those individuals might substantially modify the clinical course of periodontal inflammation leading to gingival enlargement and hypertrophic pocket wall. The case presented here is a 52 years old hypertonic woman with a long history of Ca-antagonist therapy and generalized chronic periodontitis combined with gingival hyperplasia. After the change of medication the 1,5 years comprehensive periodontal endodontic and prosthodontic therapy restored patient's periodontal health and provided complex dental rehabilitation. Nevertheless, only regular periodontal supportive therapy could ensure predictable outcome and guarantee long lasting periodontal health.
Tanoue, Naomi
2007-10-01
For any kind of research, "Research Design" is the most important. The design is used to structure the research, to show how all of the major parts of the research project. It is necessary for all the researchers to begin the research after planning research design for what is the main theme, what is the background and reference, what kind of data is needed, and what kind of analysis is needed. It seems to be a roundabout route, but, in fact, it will be a shortcut. The research methods must be appropriate to the objectives of the study. Regarding the hypothesis-testing research that is the traditional style of the research, the research design based on statistics is undoubtedly necessary considering that the research basically proves "a hypothesis" with data and statistics theory. On the subject of the clinical trial, which is the clinical version of the hypothesis-testing research, the statistical method must be mentioned in a clinical trial planning. This report describes the basis of the research design for a prosthodontics study.
Six-year clinical outcome of single implant-retained mandibular overdentures--a pilot study.
Passia, Nicole; Wolfart, Stefan; Kern, Matthias
2015-10-01
The aim of this prospective pilot study was to evaluate the prosthodontic maintenance as well as the implant outcome of single implant-retained mandibular overdentures over an observation period of 6 years. Eleven edentulous patients received one single implant in the midline of the mandible. Denture bases were temporarily relined and 2 months later provided with a ball attachment for implant retention. Implant related parameters and prosthodontic maintenance interventions were assessed 4 weeks after implant loading and then once a year. Over a mean observation period of 75.9 months, no implant was lost. The most frequent prosthetic maintenance intervention was activation of the matrix due to loss of retention, followed by exchange of the female part. Eight denture bases had to be repaired after a fracture in the midline area. Within the limitations of this preliminary clinical study, the concept of a single midline implant to retain a mandibular complete denture was a successful treatment option for elderly edentulous patients. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Thalji, Ghadeer N; Cooper, Lyndon F
2010-08-01
Dental agenesis is a common developmental anomaly among human populations. It presents with varying degrees of severity. Oligodontia present in the permanent dentition may have significant esthetic, psychosocial, as well as functional implications. A case of oligodontia in an adolescent patient treated with conventional overdentures is presented in this article. A thorough medical and dental history were taken. Comprehensive clinical and radiographic examinations were made. Diagnostic casts were mounted. The prosthetic denture teeth were set and followed by esthetic and phonetic evaluation. Following approval by the patient, the overdentures were processed in heat cure resin using the conventional techniques. Good esthetic results were achieved. Patient was satisfied with the final prostheses. Simple prosthodontic solutions can be utilized to aid patients with dental agenesis. These have great implications for the patient's self image. Oligodontias are common. The literature frequently addresses esthetic rehabilitation using fixed prostheses and dental implants. This case report illustrates the value of removable prosthodontic procedures as one approach to fulfilling the requirements of esthetic rehabilitation of a young oligodontia patient.
Wetzels, Jan Willem; Koole, Ron; Meijer, Gert J; de Haan, Anton F J; Merkx, Matthias A W; Speksnijder, Caroline M
2016-04-01
The timing of placement as well as the functional benefit of interforaminal implants in edentulous patients treated for oral cancer is unclear. Fifty-six patients were recruited at 2 institutions. In 1 institution, interforaminal implants were placed during ablative surgery, the other institution used conventional prosthodontics with optional placement of implants postsurgery (postponed-placement). Masticatory performance, bite force, and subjective masticatory function were assessed before and 6 months, 1 year, and 5 years after surgery. Implant-retained overdentures (IODs) demonstrated the highest bite force and the least problems with solid food and food choice. Masticatory performance was equal for IODs and conventional dentures. After 5 years, IODs from patients in the during-ablative-surgery cohort tend to have higher bite force and masticatory performance than those from patients in the postponed-placement cohort. IODs produce the highest overall masticatory function. Implant placement during ablative surgery seems to be functionally beneficial. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2103-E2111, 2016. © 2016 Wiley Periodicals, Inc.
Filius, Marieke A P; Cune, Marco S; Koopmans, Petra C; Vissink, Arjan; Raghoebar, Gerry M; Visser, Anita
2018-04-24
Long-term assessments of implant survival and treatment outcome in patients with oligodontia are lacking. The purpose of this retrospective clinical study was to assess which factors determine a long-term implant survival and treatment outcome of up to 25 years in a cohort of patients with oligodontia. The medical records of all patients with oligodontia treated with fixed implant prosthodontics between January 1991 and December 2015 in the Department of Oral and Maxillofacial Surgery at the University Medical Center Groningen, the Netherlands, were assessed. Specifically, this involved the retrieval of records on the need for and mode of bone augmentation, implant survival, and survival of and adverse events associated with the prosthodontics. The Kaplan-Meier estimator was used to analyze implant and superstructure survival. Log-rank tests were used to compare the survival of subgroups. A total of 126 patients with oligodontia were treated with dental implants. Of the 777 implants in total, 56 were lost, resulting in a 5-year cumulative survival of 95.7% (95% confidence interval [CI], 94.2% to 97.2%) and a 10-year cumulative survival of 89.2% (95% CI, 86.2% to 92.2%). The survival of implants placed in regions where bone augmentation surgery had been performed was significantly lower. The 5-year cumulative superstructure survival was 90.5% (95% CI, 87.6% to 93.5%), and the 10-year cumulative superstructure survival was 80.3% (95% CI, 75.3% to 85.3%). The performance of the screw-retained and cemented superstructures was comparable, but the survival of single crowns was significantly higher than the survival of fixed partial dentures (P<.001). Implant treatment is a predictable treatment option for patients with oligodontia with a favorable long-term outcome. Survival of implants in augmented areas is lower. Copyright © 2018 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Loza-Herrero, María A; Rivas-Tumanyan, Sona; Morou-Bermudez, Evangelia
2015-11-01
The success rate of implant-retained prostheses in a postdoctoral prosthodontics program was unknown and could not be related to any set of potential clinical issues or patient characteristics. The purpose of this study was to determine the success rate of implant-retained prostheses placed by prosthodontic residents between 1997 and 2012 and to evaluate the associations between patient classifications and specific restoration characteristics as related to prosthesis success or failure. A total of 272 prostheses in 119 patients were clinically evaluated. Success was defined as the absence of prosthetic complications or any implant-related complication that affected prosthesis survival. Logistic regression was used to evaluate associations between prosthesis success/failure and a wide array of study variables, adjusting for patient age, sex, and prosthesis longevity. The overall success rate was 71%, with a mean prosthesis age of 4.5 years (range: 4 months to 16.8 years). Implant single crowns were the most successful prosthesis type (81% success). The most common complications observed were porcelain fractures in fixed dental prostheses (15%) and lack of stability (31%) and retention (29%) in removable dental prostheses. Having a removable prosthesis (versus natural dentition) in the opposing occlusion significantly decreased the odds of success (OR=0.26, 95% CI: 0.11-0.64). Definitively cemented fixed prostheses were more successful than those cemented with an interim cement (OR=4.56, 95% CI: 1.37-15.22). The overall success rate of the implant-retained prostheses placed in the program was low compared with previously published studies. This study revealed the need for an efficient, comprehensive recall system for patients receiving implant-retained prostheses, either fixed or removable. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Abduo, Jaafar; Bennamoun, Mohammed; Tennant, Marc; McGeachie, John
2016-01-01
Improving dental esthetics is a main objective of prosthodontic treatment. Recently, digital diagnostic waxing has been proposed as an alternative to conventional diagnostic waxing; however, the impact on esthetics has not been evaluated. The purpose of this study was to evaluate the impact of diagnostic waxing on biometric esthetic variables and to compare the esthetic outcome achieved by digital waxing with conventional waxing. Three biometric variables were evaluated: perceived frontal proportion (PFP), width/height (W:H) ratio, and symmetry. Maxillary casts of 13 patients were collected. All of them had maxillary anterior teeth that required prosthodontic treatment. Two forms of diagnostic waxing were executed: conventional and digital waxing. Measurements of the esthetic variables were conducted digitally. For the PFP, a frontal image was made and the width of each tooth was measured. Subsequently, the PFP values of the lateral incisor to central incisor and of the canine to central incisor were calculated. In addition, the height and width of each tooth was measured to calculate the W:H ratio. Using the previous measurements, the symmetry between the right and left sides was determined. No consistent or recurrent PFP was detected for any cast. The diagnostic waxing did not alter the PFP of the pretreatment casts. The diagnostic waxing had restored the W:H ratio to what is assumed to be a natural ratio. An improvement in symmetry was detected after the diagnostic waxing and was more prominent after the digital waxing. However, no significant difference was found between the 2 diagnostic waxing methods. The 2 diagnostic waxing methods influenced the esthetic variables of the anterior maxillary teeth and yielded similar outcomes. Digital waxing appears to be a reasonable alternative, but further investigations are needed to ensure its practicality. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Krennmair, Gerald; Seemann, Rudolf; Fazekas, Andres; Ewers, Rolf; Piehslinger, Eva
2012-01-01
To determine patient satisfaction and preference for implant-supported mandibular overdentures (IOD) retained with ball or Locator attachments. In addition, peri-implant conditions and prosthodontic maintenance efforts for the final attachments were evaluated after 1 year of function. In this crossover clinical trial, 20 edentulous patients were recruited to receive two mandibular implants in the canine region and were provided with implant-retained mandibular overdentures and new complete maxillary dentures. Implant-retained mandibular overdentures were stabilized with either ball attachments or Locator attachments, in random order. After 3 months of function, the attachments in the existing denture were changed. Questionnaires on satisfaction/complaints with the prostheses were administered at baseline (with the old dentures) and after 3 months of function with each attachment, thus providing for an intraindividual comparison. The decision for the final attachment chosen was based on the patient's preference. For the definitive attachment, peri-implant conditions (peri-implant marginal bone resorption, pocket depth, and Plaque Index, Gingival Index, and Bleeding Index) as well as prosthodontic maintenance efforts and satisfaction score were evaluated after an insertion period of 1 year. Nineteen (95%) patients completed the study (1 dropout). Patient satisfaction improved significantly (P<.05) from baseline (old dentures) to the new prostheses retained with each of the two attachment types for all domains of satisfaction. However, there were no differences between ball or Locator attachment for any items of satisfaction evaluated and neither attachment had a significant patient preference. No differences for peri-implant parameters or for patient satisfaction were noted between the definitive attachments (ball, n=10; Locator, n=9) after 1 year. Although the overall incidence rate of prosthodontic maintenance did not significantly differ between both retention modalities, the Locator attachment required more postinsertion aftercare (activation of retention) than the ball anchors.
Moghadam, Marjan; Jahangiri, Leila
2015-08-01
An electronic quality assurance (eQA) program was developed to replace a paper-based system and to address standards introduced by the Commission on Dental Accreditation (CODA) and to improve educational outcomes. This eQA program provides feedback to predoctoral dental students on prosthodontic laboratory steps at New York University College of Dentistry. The purpose of this study was to compare the eQA program of performing laboratory quality assurance with the former paper-based format. Fourth-year predoctoral dental students (n=334) who experienced both the paper-based and the electronic version of the quality assurance program were surveyed about their experiences. Additionally, data extracted from the eQA program were analyzed to identify areas of weakness in the curriculum. The study findings revealed that 73.8% of the students preferred the eQA program to the paper-based version. The average number of treatments that did not pass quality assurance standards was 119.5 per month. This indicated a 6.34% laboratory failure rate. Further analysis of these data revealed that 62.1% of the errors were related to fixed prosthodontic treatment, 27.9% to partial removable dental prostheses, and 10% to complete removable dental prostheses in the first 18 months of program implementation. The eQA program was favored by dental students who have experienced both electronic and paper-based versions of the system. Error type analysis can yield the ability to create customized faculty standardization sessions and refine the didactic and clinical teaching of the predoctoral students. This program was also able to link patient care activity with the student's laboratory activities, thus addressing the latest requirements of the CODA regarding the competence of graduates in evaluating laboratory work related to their patient care. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Invasive cervical resorption and the oro-facial cleft patient: a review and case series.
O'Mahony, A; McNamara, C; Ireland, A; Sandy, J; Puryer, J
2017-05-12
Introduction Invasive cervical resorption (ICR) has an unknown aetiology, yet it exhibits very aggressive behaviour compared with typical external root resorption, posing a high risk of tooth loss.Aim To investigate the number of patients at the Dublin Cleft Prosthodontic Department with an oro-facial cleft who experienced ICR and to identify any possible aetiological factors.Materials and method A retrospective investigation of all oro-facial cleft patients treated at the Dublin Cleft Prosthodontic Department, St James's Hospital, Dublin. All patients' clinical and radiological records were reviewed. Patients where tooth loss became inevitable due to Class 4 ICR were analysed.Results From 588 oro-facial cleft patients, 14 (2.38%) patients with ICR were identified. Of these eight (57%) were female and six (43%) were male. Mean age at diagnosis was 28 years (range = 16-49 years). Cleft type: six (42.1%) unilateral cleft lip and palate, eight (57.9%) bilateral cleft lip and palate. Seventeen ICR affected teeth in total, with eleven (65%) maxillary central incisors, two (12%) maxillary lateral incisors, four (23%) maxillary canines, and one (7%) central, lateral and canine affected. Some, (N = 10, 71.4%) presented with ICR resulting in immediate tooth loss. Other patients (N = 4, 28.6%) developed ICR during or following prosthodontic treatment at the Cleft Centre. Tooth loss for this cohort, though not immediate, was inevitable. All had undergone fixed orthodontic appliance treatment and twelve had received dento-alveolar bone grafts. A number (N = 7, 50%) had undergone osteotomy, two (14%) had received night guard vital dental whitening and one had a history of trauma.Conclusions ICR, given its aggressive nature and ill-understood aetiology, poses significant treatment challenges. The most severe form of ICR (Class 4) leads inevitably to tooth loss. The slow-moderate progression of ICR may explain the late presentation found in this study, reinforcing the importance of long-term follow-up of this special dental care group.
Krennmair, Gerald; Krainhöfner, Martin; Piehslinger, Eva
2008-01-01
The aim of the present retrospective investigation was to evaluate implant-supported maxillary overdentures using either anterior (group 1) or posterior (group 2) maxillary implant placement. Maxillary overdentures were planned with support by either 4 implants placed in the maxillary anterior region (group 1) or 6 to 8 implants placed in augmented maxillary posterior regions (group 2, bilateral sinus augmentation) and anchored either on an anterior or on 2 bilaterally placed milled bars. Cumulative implant survival rate, peri-implant conditions (marginal bone loss, pocket depth, Plaque Index, Gingival Index, Bleeding Index, and Calculus Index) and the incidence and type of prosthodontic maintenance were assessed and compared for the 2 groups. In addition, the cumulative survival rate for implants placed in grafted regions was compared with that of implants placed in nongrafted regions. Thirty-four patients (16 for group 1 and 18 for group 2) with 179 implants were available for follow-up examination after a mean period of 42.1 +/- 20.1 months. Four initially placed implants failed to osseointegrate and were replaced, but no further losses were seen during the loading period, for a 5-year cumulative implant survival rate of 978%. No differences in implant survival rates were seen between either the group-1 (98.4%) and group-2 (97.4%) concepts or nongrafted (98.0%) and grafted (97.5%) implants. The peri-implant parameters showed a healthy soft tissue, good oral hygiene, and an acceptable degree of peri-implant marginal bone loss. The rigid fixation of all overdentures was associated with a low incidence of prosthodontic maintenance, without any significant differences between the 2 groups. In well-planned overdenture treatment programs, a high survival rate and excellent peri-implant conditions can be achieved for implants placed in the anterior or posterior maxilla. Rigid anchorage of maxillary overdentures either on an extended anterior milled bar or on 2 bilateral posterior milled bars provides for a low incidence of prosthodontic maintenance.
Alsabeeha, Nabeel H M; Payne, Alan G T; De Silva, Rohana K; Thomson, W Murray
2011-03-01
To determine surgical and prosthodontic outcomes of mandibular single-implant overdentures, opposing complete maxillary dentures, using a wide diameter implant and large ball attachment system compared with different regular diameter implants with standard attachment systems. Thirty-six edentulous participants (mean age 68 years, SD 9.2) were randomly assigned into three treatment groups (n=12). A single implant was placed in the mandibular midline of participants to support an overdenture using a 6-week loading protocol. The control group received Southern regular implants and standard ball attachments. One group received Southern 8-mm-wide implants and large ball attachments. Another group received Neoss regular implants and Locator attachments. Parametric and non-parametric tests of a statistical software package (SPSS) were used to determine between groups differences in marginal bone loss, implant stability, implant, and prosthodontic success (P<0.05). Implant success after 1 year was 75% for Southern regular implant (control) group; and 100% for the Southern wide and Neoss regular implant groups (P=0.038). Mean marginal bone loss at 1 year was 0.19 mm (SD 0.39) without significant differences observed. Implant stability quotient (ISQ) at baseline was significantly lower for the Southern regular (control) group than the other two groups (P=0.001; P=0.009). At 1 year, no significant difference in implant stability was observed (mean ISQ 74.6, SD 6.1). The change in implant stability from baseline to 1 year was significant for the control group (P=0.025). Prosthodontic success was comparable between the groups but the maintenance (41 events overall, mean 1.2) was greater for the Locator and the standard ball attachments. Mandibular single-implant overdentures are a successful treatment option for older edentulous adults with early loading protocol using implants of different diameters and with different attachment systems. © 2010 John Wiley & Sons A/S.
Hruska, A R; Borelli, P
1991-10-01
Procedures for casting, laboratory soldering, and intraoral welding of titanium for dental restorations are described and illustrated. Pure titanium and titanium 6A1-4Va alloy castings may be used for virtually any prosthodontic rehabilitation as well as for implants, with the proper equipment and technique.
A Novel Interactive Online Module in a Traditional Curriculum through a Blended Learning Approach
ERIC Educational Resources Information Center
Gibbard, Leslie Laing; Salajan, Florin
2009-01-01
A unique approach was planned and implemented for undergraduate dental students that would reinforce the principles of removable partial denture (RPD) design. 162 students were grouped according to their year of dental studies (66 second-year students and 96 third-year students) within the Discipline of Prosthodontics at the Faculty of Dentistry,…
[Fixed partial denture on implants. Prosthodontic and biomechanical considerations].
del Rio Highsmith, J; Garcia-Lomas, S; Mandinazagoitia, C
1990-01-01
In this issue are analyzed the factors that support the selection of the partial edentulous patients, for the construction of partial fixed prosthesis implantosupported, and the biomechanical considerations that we have to consider in relation to: relation implant-bone, the use of natural teeth, part of the jaw, length of the space, opponent jaw and materials.
1989-03-01
career ladder assist dental officers in the performance of restorative, endodontic, orthodontic , pedodontic, periodontic, prosthodontic, and dental...representative location for orthodontic , pedodontic, and medi- cal readiness functions Randolph AFB TX Typical USAF Clinic In addition to interviews at the...the 2,230 personnel surveyed and are listed below. The relative time spent by respondents in each duty is pre - sented in Table 3. Selected background
Schweiger, Josef; Neumeier, Peter; Stimmelmayr, Michael; Beuer, Florian; Edelhoff, Daniel
2013-04-01
Implant-supported prosthetic restorations with veneered crowns and fixed dental prostheses are a proven, scientifically accepted treatment concept in fixed prosthodontics. However, in this area of indication there is a comparatively high technical complication rate, which occurs mainly in the area of the superstructure in the form of minor or major chipping of the veneering material. Various studies have shown that purely implant-supported restorations are subjected to higher loading than those on natural abutment teeth due to the special biomechanical conditions. A possible approach to prevent technical complications is to create higher stability for the implant superstructure through the use of high-strength materials. This would, however, result in undiminished overloading being transmitted to the implant components and could cause increased technical and biological complications. This article describes a new procedure for the use of replaceable veneers made from high-performance polymer material on modified implant abutments. By storing digital datasets for the veneer section, it can be replaced easily and quickly if it becomes worn or is fractured. A reduction in the stresses for the implant components and biological structures under the polymer is also to be expected due the material properties of polymers.
Implementation of a laboratory quality assurance program: the Louisville experience.
Metz, Michael J; Abdel-Azim, Tamer; Miller, Cynthia J; Lin, Wei-Shao; ZandiNejad, Amirali; Oliveira, Gustavo M; Morton, Dean
2014-02-01
Remakes, or the refabrication of dental prostheses, can occur as a result of inherent inaccuracies in both clinical and laboratory procedures. Because dental schools manage large numbers of predoctoral dental students with limited familiarity and expertise as related to clinical prosthodontic techniques, it is likely these schools will experience an elevated incidence of laboratory remakes and their ramifications. The University of Louisville School of Dentistry, not unlike other dental schools, has experienced remakes associated with both fixed and removable prosthodontic procedures. Limitations in faculty standardization and variable enforcement of established preclinical protocols have been identified as variables associated with the high percentage of remakes documented. The purpose of this study was to introduce the implementation of a new multidepartmental quality assurance program designed to increase consistency and quality in both information provided to commercial dental laboratories and the prostheses returned. The program has shown to be advantageous in terms of cost-effectiveness and treatment outcomes. A statistically significant decrease in remake percentages has been recorded from inception of this program in December 2010 until December 2012. Furthermore, this program has resulted in more consistent communication between the dental school and commercial dental laboratories, among faculty members, and between faculty and students.
[Glossodynia or burning mouth syndrome: equivalence or difference].
Redinova, T L; Redinov, I S; Val'kov, V A; Zlobina, O A; Kozhevnikov, S V
2014-01-01
The term "Burning Mouth Syndrome (BMS)" is being used much more often than "Glossodynia", complicating diagnostic and treatment tactic choice. The aim of the study was to determine the difference between "Glossodynia" and "BMS" considering absence or presence of intraoral metal prosthetic devices and burning sensation in the mouth. To establish the frequency of glossodynia and BMS 2355 patient records were analyzed admitting consultation for oral diseases for the last 10 years. Clinically we examined 408 patients aged 40 to 70. The research results showed that 17% of patients complained of "burning mouth": 10.2% of them had these symptoms due to oral mucosa diseases; 58.0% had glossodynia, 27.4% had discomfort because of intolerance to metal prosthodontic materials and 4.4% had combined pathology. Glossodynia and intolerance to metal prosthodontic materials had much in common in terms of clinical features, but the last one may be specified by changes in saliva composition. BMS thus proved to be the common definition corresponding to various diseases of oral mucosa and intolerance to intraoral metal appliances, while glossoldynia is a distinct neurogenic disease which is difficult to treat and requires comprehensive approach involving neurologist and physician.
Abduo, Jaafar
2017-01-01
This study evaluated and compared the effect of conventional and digital wax-ups on three lateral occlusion variables: contact number, contact area, and steepness. Dental casts of 10 patients with Angle Class I relationship were included in the study. All patients required fixed prosthodontic treatment that would affect lateral occlusion. The casts of all patients received conventional and digital wax-ups. For pretreatment, conventional wax-up, and digital wax-up casts, contact number, contact area, and occlusion steepness were measured at four lateral positions, that is, at excursions of 0.5, 1.0, 2.0, and 3.0 mm from maximal intercuspation. Lateral occlusion scheme variables were affected by use of diagnostic wax-ups. For all types of casts, contact number decreased as excursion increased. The two types of wax-ups had similar contact number patterns, and contact number was significantly greater for these casts than for pretreatment casts in the earlier stages of excursion. Similarly, contact area gradually decreased with increasing excursion in the pretreatment and conventional and digital wax-up casts. There was only a minimal decrease in occlusion steepness as excursion increased. However, lateral occlusion was generally steeper for digital wax-up casts.
[Assessment tools in early detection of osteoporosis in dentistry].
Knezović Zlatarić, Dubravka; Pandurić, Josip; Korsić, Mirko; Dodig, Damir
2007-03-01
Osteoporosis, one of the major skeletal diseases in older age, is characterised by low bone mass and microarchitectural deterioration with a resulting increase in bone fragility and hence susceptibility to fracture. In this review we analyse the systemic and local factors associated with oral bone mass loss. Systemic factors most often correlated with the oral bone mass loss include osteoporosis, renal diseases, hormonal disorders, diet and the impact of different drugs on the bony structure. Chronic periodontal disease, early loss of teeth or the effect of inadequate prosthodontic appliance on the residual ridge are the local factors associated with mandibular bone loss. Different assessment tools for the assessment of mandibular oral bone loss have been proposed, such as DXA absorptiometry, quantitative computed tomography, intraoral microdensitometry, SCORE index and the assessment of the thickness and quality of the mandibular inferior cortical border. Qualitative and quantitative assessment of the mandibular bony structure is of great importance in all fields of dentistry - from periodontology to endodontics and prosthodontics, especially in dental implantology. It is important to make the correct indication prior to dental implant therapy, and taking into account the systemic and local factors mentioned above, assess both the actual quality and quantity of the mandible.
Medical Surveillance Monthly Report (MSMR). Volume 15, Number 6, July-August 2008
2008-08-01
subgroups were defi ned as: i) Physicians, medicine – aviation/aerospace, allergy, ER, anesthesia , dermatology, family medicine, pediatrics, 16 VOL. 15...urologic), podiatry; iii) Dentists – general / comprehensive / public health dentistry , end-, orth-, ped-, peri-, and prosthodontics, OMF surgery...administrators; v) Nurses, OR / surgical / anesthesia – nurse anesthetist, OR nurse, nurse midwife, critical care nurses; and vi) Biomedical science, allied
Marginal Fit of CEREC Crowns at Different Finish Line Curvatures
2015-06-01
percolation of bacteria {Beschnidt & Strub, 1999). This will compromise 13 the longevity of the tooth, increasing the risk of dental caries caused...and Practice of Caries Prevention. Journal of american dental association, 131, 887-899. Ferrari, M. {1991). Cement thickness and microlikage under...Prosthodontic Graduate Program Naval Postgraduate Dental School Uniformed Services University of the Health Sciences in partial fulfillment of the
Bond Potential of Lithium Disilicate to Heat-Cured Polymethylmethacrylate (PMMA)
2016-06-07
Restitution of maxillary anterior esthetics with all-ceramic components. International Dental Journal , 52(1): 47-56. Albarky M, Guazzato M, Swain MV...2004). An introduction to silanes and their clinical applications in dentistry. The International Journal of Prosthodontics, 17(2): 155-164...autopolymerizing denture resin and light cured composite resin to denture teeth. International Dental Journal , 52(1): 20-24. Zarb GA and Bolender
Dental Assistant Specialty, AFS 981X0.
1982-12-01
GRP588, N=37) E. Prosthodontic Assistants (GRP453, N=35) F. Preventive Dentistry-Operative Assistants (GRP486, N=15) G. Orthodontic Assistants (GRP477, N...basic functions. Their assistance to the dentist involved preparing materials and instruments to be used in treating the patient, performing patient pre ...Mix surgical packs or periodontal dressings Don or doff surgical caps, gowns, gloves, shoes, or covers Disassemble or assemble prophylaxis hand pieces
The status of undergraduate implant education in dental schools outside the United States.
Seckinger, R J; Weintraub, A M; Berthold, P; Weintraub, G S
1995-01-01
Over the past 20 years the incorporation of implant dentistry into academia has been documented in some detail for North American dental schools but has not been pursued on an international level. In June of 1993, we surveyed 51 dental schools outside of the United States affiliated with the University of Pennsylvania School of Dental Medicine's Office of International Relations concerning their teaching involvement with implant dentistry. Results from the 44 (86 percent) responding schools suggest that implant dentistry is being incorporated into predoctoral curriculums. Industrialized countries were more inclined to provide implant education. Insufficient time and the thought that the predoctoral level was not the place for implant dentistry were cited as some of the reasons for not incorporating implant dentistry into the curriculum. Oral surgery, prosthodontics, and periodontics departments developed and administered the implant curriculum. Formats varied among schools with respect to allotted time, curricular placement, laboratory experience, and clinical participation. Didactic material most frequently presented included a historical overview, diagnosis and treatment planning, classification of dental implants, and surgical and prosthetic concepts. Clinical involvement varied from actual implant placement to observation of prosthodontic procedures. Results were categorized based on the TOEFL (Test of English as a Foreign Language) classification of countries in six regions.
Does apical root resection in endodontic microsurgery jeopardize the prosthodontic prognosis?
Cho, Sin-Yeon
2013-01-01
Apical surgery cuts off the apical root and the crown-to-root ratio becomes unfavorable. Crown-to-root ratio has been applied to periodontally compromised teeth. Apical root resection is a different matter from periodontal bone loss. The purpose of this paper is to review the validity of crown-to-root ratio in the apically resected teeth. Most roots have conical shape and the root surface area of coronal part is wider than apical part of the same length. Therefore loss of alveolar bone support from apical resection is much less than its linear length.The maximum stress from mastication concentrates on the cervical area and the minimum stress was found on the apical 1/3 area. Therefore apical root resection is not so harmful as periodontal bone loss. Osteotomy for apical resection reduces longitudinal width of the buccal bone and increases the risk of endo-perio communication which leads to failure. Endodontic microsurgery is able to realize 0 degree or shallow bevel and precise length of root resection, and minimize the longitudinal width of osteotomy. The crown-to-root ratio is not valid in evaluating the prosthodontic prognosis of the apically resected teeth. Accurate execution of endodontic microsurgery to preserve the buccal bone is essential to avoid endo-perio communication. PMID:23741707
Takahashi, Toshihito; Gonda, Tomoya; Tomita, Akiko; Mizuno, Yoko; Maeda, Yoshinobu
2016-01-01
As maxillary implant overdentures are being increasingly used in clinical practice, prosthodontic complications related to these dentures are also reported more often. The purpose of this study was to examine the influence of palatal coverage and implant distribution on the shear strain of maxillary implant overdentures. A maxillary edentulous model with implants inserted in the anterior, premolar, and molar areas was fabricated. Two kinds of experimental overdentures, with and without palatal coverage, were also fabricated, and two strain gauges were attached at the midline of the labial and palatal sides. A vertical occlusal load of 98 N was applied through a mandibular complete denture, and the shear strain in each denture was compared by analysis of variance (P = .05). In all situations, the shear strain in palateless dentures was significantly higher than in dentures with palate on both sides (P < .05). In dentures with palate, the shear strain was lower when anterior implants were present. Palateless maxillary implant overdentures exhibited much higher strain than overdentures with palate regardless of the implant distribution; this may cause more prosthodontic and implant complications. The most favorable configuration to prevent complications in maxillary implant overdentures was palatal coverage that was supported by more than four widely distributed implants.
Evaluation of the new TAMZ titanium alloy for dental cast application.
Zhang, Y M; Guo, T W; Li, Z C
2000-12-01
To reveal the potential of the new titanium alloy as dental prosthodontic materials. Dental castings of TAMZ alloy were investigated in the casting machine specially designed for titanium. A mesh pattern was used to count the castability value. The mechanical properties were measured by means of a universal testing machine. Optical micrography was done on the exposed cross-section of TAMZ alloy casting. From the surface to the inner part the Knoop hardness in reacted layer of TAMZ alloy casting was measured. The structure and elemental analyses of the reacted layer were made by SEM and element line scanning observation. The castability value (Cv = 98%) and the tensile test (sigma b = 850 Mpa, sigma 0.2 = 575 Mpa, delta = 7.33%) data were collected. The castings microstructure showed main alpha phase and small beta phase. Knoop hardness in the surface reacted layer was greater than that in the inner part. From the SEM and element line scanning observation, there are three different layers in the surface reacted layer of the TAMZ alloy castings, and higher level of element of O, Al, Si and Zr were found in the reacted layer while the Si permeated deeper than others. TAMZ alloy can be accepted as a material for dental alloy in prosthodontics.
Quality of life in patients with obturator prostheses.
Riaz, Nabeela; Warriach, Riaz Ahmad
2010-01-01
Oral cancer has a profound impact on the quality of life for patients and their families. Functionally, the mouth is an important organ for speech, swallowing, chewing, taste and salivation. These functions become compromised due to surgical ablation of the tumour. Obturator prosthesis is a common prosthdontic rehabilitative option for maxillectomy patients. The purpose of this study was to investigate how patients with maxillofacial defects evaluate their quality of life after maxillectomy and prosthodontic therapy with obturator prostheses. Thirty patients were included in the study (11 female, 19 male). The patients were interviewed by using a standardised questionnaire developed by University of Washington (UW-QOL). The detailed questionnaire was adjusted for obturator patients and internalised most parts of obturator functioning scale (OFS). Quality of life after prosthodontic therapy with obturator prostheses was 54 +/- 22.9% on average. Functioning of the obturator prosthesis, impairment of ingestion, speech and appearance, the extent of therapy, and the existence of pain had significant impact on the quality of life (p<0.005). Orofacial rehabilitation of patients with maxillofacial defects using obturator prostheses is an appropriate treatment modality. To improve the situation of patients prior to and after maxillectomy sufficient information about the treatment, adequate psychological care and speech therapy should be provided.
Soldering in prosthodontics--an overview, part I.
Byrne, Gerard
2011-04-01
The fit of fixed multiunit dental prostheses (FDP), traditionally termed fixed partial dentures (FPDs), is an ongoing problem. Poorly fitting restorations may hasten mechanical failure, due to abutment caries or screw failure. Soldering and welding play an important role in trying to overcome misfit of fixed multiunit prostheses. The term FPD will be used to denote multiunit fixed dental prostheses in this review. This is the first of a series of articles that review the state of the art and science of soldering and welding in relation to the fit of cemented or screw-retained multiunit prostheses. A comprehensive archive of background information and scientific findings is presented. Texts in dental materials and prosthodontics were reviewed. Scientific data were drawn from the numerous laboratory studies up to and including 2009. The background, theory, terminology, and working principles, along with the applied research, are presented. This first article focuses on soldering principles and dimensional accuracy in soldering. There is some discussion and suggestions for future research and development. Soldering may improve dimensional accuracy or reduce the distortion of multiunit fixed prostheses. Many variables can affect the outcome in soldering technique. Research science has developed some helpful guidelines. Research projects are disconnected and limited in scope. © 2011 by The American College of Prosthodontists.
Nitrous Oxide-Oxygen Sedation: USAF Dental Guidelines.
1981-11-01
prosthodontic tooth o rd ...r. 1-,t doA ,stry. Also, N20-0, sedation can be used a- . :., :> , ires -uch as periodontal scaling, orthodontic ad. ’ ci ... of...amnesia Plane 3 - total analgesia and amnesia; leads to loss of consciousness II - dream and/or delirium (unconsciousness) III - surgical (four depths...obtain N20. Cylinders can be bought without question at surgical supply houses. People without means but with desire and opportunity turn to theft. A
2016-06-26
COMP ARIS ON OF INTERNAL ADAPTATION OF FIXED RESTO RA TIO NS FABRICATED FROM FOUR DIFFERENT MATERIALS BY A THREE-AXIS MILL by Bryan Paul...copyrighted material in the thesis manuscript titled: COMPARISON OF INTERNAL ADAPTATION OF FIXED RESTORATIONS FABRICATED FROM FOUR DIFFERENT...RESTORATIONS FABRICATED FROM FOUR DIFFERENT MATERIALS BY A THREE-AXIS MILL LCDR Bryan Paul Rasmussen, DC USN Prosthodontics Dept., 2016 Directed by
A systematic approach to the control of esthetic form.
Preston, J D
1976-04-01
A systematic, orderly approach to the problem of establishing harmonious phonetics, esthetics, and function in fixed restorations has been described. The system requires an initial investment of time in performing an adequate diagnostic waxing, but recoups that time in many clinical and laboratory procedures. The method has proved a valuable asset in fixed prosthodontic care. The technique can be expanded and combined with other techniques with a little imagination and artistic bent.
Removable partial overdentures with natural root structure and osseointegrated fixtures.
Jackson, T R
1990-10-01
The development and refinement of osseointegration have had primary impetus in treatment of the totally edentulous patient. The same principles, however, may be applied to the partially edentulous patient. Osseointegrated fixtures used in conjunction with mechanical or magnetic attachments may be used to construct partial or full overdentures. This allows treatment with removable prosthodontics in many cases in which it is not practical to achieve anchorage for a fixed prosthesis.
Implant rehabilitation for a patient with Hallerman-Streiff syndrome: a case report.
Abadi, Behruz J; Van Sickels, Joseph E; McConnell, Thomas A; Kluemper, G Thomas
2009-01-01
Hallermann-Streiff syndrome is a rare genetic disorder characterized by craniofacial malformations, sparse hair, eye abnormalities, dental defects, degenerative skin changes, and short stature. The syndrome has many implications for dental treatment. Patients typically present with multiple missing and poorly formed teeth. The purpose of this case report is to discuss the overall management of a patient with Hallermann-Streiff syndrome by oral maxillofacial surgery, orthodontic treatment, and prosthodontic reconstruction.
Identification, Characterization, and Utilization of Adult Meniscal Progenitor Cells
2017-11-01
approach including row scaling and Ward’s minimum variance method was chosen. This analysis revealed two groups of four samples each. For the selected...articular cartilage in an ovine model. Am J Sports Med. 2008;36(5):841-50. 7. Deshpande BR, Katz JN, Solomon DH, Yelin EH, Hunter DJ, Messier SP, et al...Miosge1,* 1Tissue Regeneration Work Group , Department of Prosthodontics, Medical Faculty, Georg-August-University, 37075 Goettingen, Germany 2Institute of
1988-07-30
8a. NAME OF FUNDING/SPONSORING 8b. OFFICE SYMBOL 9. PROCUREMENT INSTRUMENT IDENTIFICATION NUMBER ORGANIZATION (If applicable) 8c. ADDRESS (City, State...Services are provided in General Dentistry, Oral Surgery, Periodontics, Prosthodontics, Endodontics , and Orthodontics (MHR 1987, 4-5). The hospital also...appointment D. Shields 4 clerks using a rotary wheel file. Schedules were forwarded to outpatien records to pull the patient record prior to the clinic
Pinho, Teresa; Neves, Manuel; Alves, Célia
2012-08-01
This article describes the complex dental treatment of an adult patient with multiple missing teeth, mild chronic periodontitis, and a malocclusion with a cant of the occlusal plane. After periodontal treatment, titanium implants and a miniscrew were placed to correct the occlusal plane canting with orthodontic treatment. Prosthodontic treatment was completed by using osseointegrated implants to replace the missing teeth. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.
Market segmentation and service: a strategy for success.
Marchack, B W
1995-03-01
Current trends for health care reform and increasing emphasis on managed care threaten to erode the base of patients of many practices. A constant flow of new patients is critical to the success of a dental practice. This article discusses the nature of business markets and similarities between industries and their correlation to the delivery of prosthodontic services. The purpose of this article is to offer a strategy for increasing new patient flow without the use of advertising.
Stafeev, А А
2015-01-01
False formation of connective tissues have a great influence on structure and function of organs and tissues of the human body. In prosthodontics, the changes in connective tissues greatly occur during clinical stages of preparing metal ceramic dentures. The algorithm of treatment patients with connective tissue dysplasia during metal ceramic dentures was developed and introduced into practical dentistry based on studying the morphology and functionality of dentition and clinical experience.
Li, Zhongjie; Xia, Yingfeng; Chen, Kai; Zhao, Hanchi; Liu, Yang
Prosthodontic oral rehabilitation procedures are time consuming and require efforts to maintain the confirmed maxillomandibular relationship. Several occlusal registrations and impressions are needed, and cross-mounting is performed to transfer the diagnostic wax-up to master working casts. The introduction of a digital workflow protocol reduces steps in the required process, and occlusal registrations with less deformation are used. The outcome is a maintained maxillomandibular position that is accurately and conveniently transferred.
Prosthodontic Treatment Using Vital and Non Vital Submerged Roots-Two Case Reports
Shankar, Y. Ravi; Srinivas, K.; Surapaneni, Hemchand; Reddy, S.V. Sudhakar
2013-01-01
Residual ridge resorption has been considered as an inevitable consequence after extraction of the teeth. There is a gradual loss of the alveolar bone due to the pattern of bone remodeling. In spite of the availability of newer treatment modalities like endodontic restoration and periodontic procedures for preservation of the remaining teeth they are not feasible for the patients in severe stages where restoration might not be possible. The only reliable method of preserving the remaining bone is by maintaining the functional health of the teeth. Over the years, many studies showed that roots which are fractured and left behind during extractions are retained into the alveolar bone with no evidence of pathosis. Over denture as a treatment option was developed in an effort to preserve the remaining alveolar bone by retaining the natural teeth or roots. In over denture treatment, the teeth selected as abutments are prone to caries and periodontal disease over a period of time, hence evolved the vital or non vital root submergence concept. After a thorough radiographic and clinical examination, few teeth without pathosis are retained that eventually are surgically submerged in the alveolar ridge. After healing, the over denture with reaining vital or non vital teeth preserve the integrity of the bone, making the treatment an effective and successfull preventive prosthodontic treatment. PMID:24298542
Factors associated with tooth loss and prosthodontic status among Sudanese adults.
Khalifa, Nadia; Allen, Patrick F; Abu-bakr, Neamat H; Abdel-Rahman, Manar E
2012-01-01
A study was conducted to determine the degree of tooth loss, factors influencing tooth loss, and the extent of prosthodontic rehabilitation in Sudanese adults (≥ 16 years old) attending outpatient clinics in Khartoum State. Pearson and multivariate analyses were used to examine the relationships between tooth loss and specific characteristics determined through interviews and clinical examinations. The mean number of missing teeth was 3.6 (SD, 4.9) and the prevalence of edentulism was 0.1%. The prevalence of tooth loss (missing at least one tooth) was 78%; 66.9% of tooth loss was due to caries, and 11.2% was attributable to other reasons. Prosthetic replacement of missing teeth was evident in 3%, whereas a need for prosthetic replacement was evident in 57%. Having < 20 teeth was associated with age, gender, and socioeconomic status; tooth loss due to caries was associated with age, tribe, frequency of tooth-brushing, and a low rate of dental consultation. Tooth loss due to other reasons was associated with age, tribe, education, periodontal pocketing, tobacco use, tooth wear, and prosthetic status. The results of the present study indicated that the major cause of tooth loss was dental caries, thus emphasizing the importance of a public prevention-based healthcare program. Replacement of missing teeth was uncommon in the study subjects, which may reflect lack of access to this type of oral healthcare.
The complete digital workflow in fixed prosthodontics: a systematic review.
Joda, Tim; Zarone, Fernando; Ferrari, Marco
2017-09-19
The continuous development in dental processing ensures new opportunities in the field of fixed prosthodontics in a complete virtual environment without any physical model situations. The aim was to compare fully digitalized workflows to conventional and/or mixed analog-digital workflows for the treatment with tooth-borne or implant-supported fixed reconstructions. A PICO strategy was executed using an electronic (MEDLINE, EMBASE, Google Scholar) plus manual search up to 2016-09-16 focusing on RCTs investigating complete digital workflows in fixed prosthodontics with regard to economics or esthetics or patient-centered outcomes with or without follow-up or survival/success rate analysis as well as complication assessment of at least 1 year under function. The search strategy was assembled from MeSH-Terms and unspecific free-text words: {(("Dental Prosthesis" [MeSH]) OR ("Crowns" [MeSH]) OR ("Dental Prosthesis, Implant-Supported" [MeSH])) OR ((crown) OR (fixed dental prosthesis) OR (fixed reconstruction) OR (dental bridge) OR (implant crown) OR (implant prosthesis) OR (implant restoration) OR (implant reconstruction))} AND {("Computer-Aided Design" [MeSH]) OR ((digital workflow) OR (digital technology) OR (computerized dentistry) OR (intraoral scan) OR (digital impression) OR (scanbody) OR (virtual design) OR (digital design) OR (cad/cam) OR (rapid prototyping) OR (monolithic) OR (full-contour))} AND {("Dental Technology" [MeSH) OR ((conventional workflow) OR (lost-wax-technique) OR (porcelain-fused-to-metal) OR (PFM) OR (implant impression) OR (hand-layering) OR (veneering) OR (framework))} AND {(("Study, Feasibility" [MeSH]) OR ("Survival" [MeSH]) OR ("Success" [MeSH]) OR ("Economics" [MeSH]) OR ("Costs, Cost Analysis" [MeSH]) OR ("Esthetics, Dental" [MeSH]) OR ("Patient Satisfaction" [MeSH])) OR ((feasibility) OR (efficiency) OR (patient-centered outcome))}. Assessment of risk of bias in selected studies was done at a 'trial level' including random sequence generation, allocation concealment, blinding, completeness of outcome data, selective reporting, and other bias using the Cochrane Collaboration tool. A judgment of risk of bias was assigned if one or more key domains had a high or unclear risk of bias. An official registration of the systematic review was not performed. The systematic search identified 67 titles, 32 abstracts thereof were screened, and subsequently, three full-texts included for data extraction. Analysed RCTs were heterogeneous without follow-up. One study demonstrated that fully digitally produced dental crowns revealed the feasibility of the process itself; however, the marginal precision was lower for lithium disilicate (LS2) restorations (113.8 μm) compared to conventional metal-ceramic (92.4 μm) and zirconium dioxide (ZrO2) crowns (68.5 μm) (p < 0.05). Another study showed that leucite-reinforced glass ceramic crowns were esthetically favoured by the patients (8/2 crowns) and clinicians (7/3 crowns) (p < 0.05). The third study investigated implant crowns. The complete digital workflow was more than twofold faster (75.3 min) in comparison to the mixed analog-digital workflow (156.6 min) (p < 0.05). No RCTs could be found investigating multi-unit fixed dental prostheses (FDP). The number of RCTs testing complete digital workflows in fixed prosthodontics is low. Scientifically proven recommendations for clinical routine cannot be given at this time. Research with high-quality trials seems to be slower than the industrial progress of available digital applications. Future research with well-designed RCTs including follow-up observation is compellingly necessary in the field of complete digital processing.
1988-06-30
INSTRUMENT IDEtIFICATION NUMBER Se. ADDRESS City. State d ZIP Code) 10. SOURCE OF F JNOING NOS. _____ 11. TITLE ( ct Secure l w i a i n A S tu O f...Services are provided in General Dentistry, Oral Surgery, Periodontics, Prosthodontics, Endodontics , and Orthodontics (MHR 1987, 4-5). The hospital also...appointment w 1 ~ -*~*~’ . ~ *~ V -, . ~ ~. ~ £~ £ *~%~ * D. Shields 4 clerks using a rotary wheel file. Schedules were forwarded to outpatient records
Revilla-León, Marta; Özcan, Mutlu
2018-04-22
There are 7 categories of additive manufacturing (AM) technologies, and a wide variety of materials can be used to build a CAD 3D object. The present article reviews the main AM processes for polymers for dental applications: stereolithography (SLA), digital light processing (DLP), material jetting (MJ), and material extrusion (ME). The manufacturing process, accuracy, and precision of these methods will be reviewed, as well as their prosthodontic applications. © 2018 by the American College of Prosthodontists.
Nene, Salil; Gautam, Rajaganesh; Sharif, Kanaan; Gupta, Gaurav
2012-01-01
This report describes a combined orthodontic and surgical treatment approach for a severe skeletal Class III malocclusion in a young Indian woman with serious esthetic concerns. The case required significant surgical correction in the anteroposterior and vertical planes, involving surgeries in both the maxilla and the mandible. The case required the use of mini-implant anchorage in the presurgical phase as well as postorthodontic prosthodontic rehabilitation to replace missing posterior teeth to restore the occlusal table.
A Simplified Technique for Fabrication of Orbital Prosthesis
Thakral, G.K.; Mohapatra, Abhilash; Seth, Jyotsna; Vashisht, Pallavi
2014-01-01
Eye is a vital organ not only for vision, but also an important component of facial expression, and over-all personality of a person. Loss of eye, apart from leading to impaired vision has a crippling effect on the psychology of the patient. Prosthodontic rehabilitation of such cases includes fabrication of prosthesis by acrylic resin, silicone and implants. However, not all patients are willing to use implants for maxillofacial rehabilitation. Therefore, a custom made orbital prosthesis serves as an affordable and satisfactory alternative. PMID:25121068
Complete Dentures Fabricated with CAD/CAM Technology and a Traditional Clinical Recording Method.
Janeva, Nadica; Kovacevska, Gordana; Janev, Edvard
2017-10-15
The introduction of computer-aided design/computer-aided manufacturing (CAD/CAM) technology into complete denture (CD) fabrication ushered in a new era in removable prosthodontics. Commercially available CAD/CAM denture systems are expected to improve upon the disadvantages associated with conventional fabrication. The purpose of this report is to present the workflow involved in fabricating a CD with a traditional clinical recording method and CAD/CAM technology and to summarize the advantages to the dental practitioner and the patient.
Observations of ’Economical’ Fixed Prosthodontic Alloys,
1982-01-01
Office) 15. SECURITY CLASS. (of this ,.portj Ia. OS7RI~fl3 ~TATM~T1of5sA. DECLASSIFICATION/OO44GRAUTIV S Unlimited 17. 0137 PI3UT10ON STATEMENT (of the...however, the silver-palladium and silver-indium materials require ~DA~3 47 EOfl4O tO’/SfOBOLTE UNCLASSIFIED 8 2’ 02 R -/ SECURITY CLASSIFICATION OF...ous grain boundary netowrk , whereas those of Salivan revealed large grains, discontinuous grain boundaries and prominent subgrains. Microstructures
Eitner, Stephan; Wichmann, Manfred; Schlegel, Karl Andreas; Kollmannsberger, Judith Elisabeth; Nickenig, Hans-Joachim
2012-01-01
Little is known about the impact of different stages of implant therapy on oral health-related quality of life (OHRQoL). The aim of this study was to assess OHRQoL before, during, and after completion of prosthodontic implant therapy by patients and treating physicians, who were predicted to evaluate OHRQoL in different ways. Over a period of six months, 16 randomly selected patients were assessed for OHRQoL with a German version of the Oral Health Impact Profile (OHIP-G, range 0-220). Patients assessed themselves before surgery, during the period of complete osseointegration, and after prosthodontic treatments. Additionally, physicians assessed OHRQoL and OHIP subscales with a visual analogue scale. Patients reported significant changes in median OHIP scores (preoperative: 76.5; healing period: 84.3; postoperative: 29.5; p<0.01), as did physicians (preoperative: 7.1; postoperative: 2; p<0.01). The most prevalent patient-reported problem was "worried" (subscale: psychological discomfort), whereas the subscale "functional limitation" was identified most frequently by physicians. Preoperative, intermediate, and post-treatment assessments of OHRQoL exhibited significantly different OHIP scores. In contrast to the physicians' assessments, the most unfavourable OHIP scores were reported by patients during the healing period, while the psychological dissatisfaction OHIP subscale represented the most important patient factor. Copyright © 2011 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Pourat, Nadereh; Choi, Moonkyung Kate; Chen, Xiao
2018-02-06
Preventive dental health services are intended to reduce the likelihood of development of tooth decay and the need for more intensive treatment overtime. The evidence on the effectiveness of preventive dental care in reducing treatment services and expenditures is lagging for adults, particularly those with lower incomes and chronic conditions. We assessed the impact of preventive dental services on dental treatment service use and expenditures overall and by category of service. We calculated the annual numbers of preventive (periodic diagnostic and prophylactic procedures) and treatment (restorative, surgery, prosthodontic, endodontic, and periodontic) services per beneficiary using Medicaid enrollment and claims data for beneficiaries with three categories of conditions (diabetes, heart disease, and respiratory disease) from 10 largest California counties. We used Cragg hurdle exponential regression models controlling for past service use, demographics, length of enrollment, and county. We found that using preventive services in 2005-2007 was associated with higher likelihood and number of treatment dental services used, but associated with lower treatment expenditures in 2008. The reduction in expenditures was noted only in restorative, prosthodontics, and periodontic services. The findings provide much needed evidence of the contribution of preventive dental care in maintaining oral health of low-income adults with chronic conditions and potential for savings to the Medicaid program. Providing lower cost preventive dental care to the individuals with chronic conditions would achieve better oral health and lower treatment expenditures. © 2018 American Association of Public Health Dentistry.
Bohner, Lauren Oliveira Lima; Neto, Pedro Tortamano; Ahmed, Ahad Shahid; Mori, Matsuyoshi; Laganá, Dalva Cruz; Sesma, Newton
2016-07-01
The aim of this review was to update the literature with regard to the digital methods available by CEREC Chairside system to register and design the occlusion, to report their efficacy and technical innovations in the field of Restorative Dentistry. A search strategy was performed using the key-words: "virtual articulator," or "CAD-CAM and occlusal recording," or "CAD-CAM and occlusion register," or "CAD-CAM and occlusal contacts," or "CAD-CAM and prosthesis." Inclusion criteria comprised studies evaluating the use of digital methods available by CEREC System for occlusal registration and design during prosthodontics treatment. PubMed and Cochrane library and reference lists were searched up to January 2016. The search resulted in 280 articles after removing duplicates. Subsequently, 233 records were excluded and 49 studies were selected for reading in full. Eleven articles were considered eligible for the systematic review (4 in vitro and 7 clinical studies). Scientific evidence suggests that digital methods were accurate to register and design the occlusion of dental prostheses. Nevertheless, further clinical studies are required to establish a conclusion with regard to its accuracy in prosthodontics treatment. Digital technologies allow the design of occlusal surfaces of CAD-CAM fabricated prostheses using innovative approaches. This systematic review aimed to update the literature to help dentists determine the most appropriate digital method to register and design the occlusal surface of CAD-CAM crowns. (J Esthet Restor Dent 28:208-220, 2016). © 2016 Wiley Periodicals, Inc.
Tsirogiannis, Panagiotis; Neophytou, Sophia; Reul, Anika; Heydecke, Guido; Reissmann, Daniel R
2017-01-01
To develop a reliable and valid instrument for the comprehensive assessment of patients' burdens during dental impression making, the Burdens in Dental Impression Making Questionnaire, BiDIM-Q. The item pool was generated in a convenience sample of 20 prosthodontic patients using semi-structured face-to-face interviews. The final instrument was tested in 145 consecutively recruited patients, and psychometric properties of the BiDIM-Q were determined. Four different impression materials were used according to the manufacturers' instructions and indications: alginate, c-silicone, polyvinylsiloxane, and polyether. The final BiDIM-Q consisting of 12 items showed sufficient reliability, indicated by Cronbach's alpha of .82 and an average inter-item correlation of .29. Validity was supported by Pearson correlation coefficients for the correlation between the instrument's total score with the patients' overall satisfaction rating (r=.63), and by the correlation matrix for the correlations of the patients' perceptions with the practitioners' satisfaction ratings. Overall, patient perceived burdens were low with highest burdens observed when using polyether in partially dentate patients for pick-up impressions, while lowest burdens were reported when using c-silicone for impressions of edentulous jaws. The BiDIM-Q is a reliable and valid tool for assessing patient-based process-related quality of care in dentistry allowing a deeper insight into patients' perspective during dental impression making. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Zou, Duohong; Wang, Feng; Wu, Yiqun; Huang, Wei; Zhang, Chenping; Zhang, Zhiyuan
2015-01-01
To evaluate the performance of dental implant-supported telescopic crown (TC)-retained overdentures to restore the oral function of patients who have insufficient jawbone volume resulting from tumor resection or trauma. From January 2004 to December 2008, implant-supported TC-retained overdentures were used to restore the oral function of patients with severe bony defects resulting from tumor resection or trauma. Clinical data, including implant success and survival rates, biologic and mechanical complications, prosthodontic maintenance efforts, and patient satisfaction, were analyzed annually after delivery of the final prostheses. Twenty-four patients were treated, and a total of 88 implants were inserted to support TC-retained overdentures. The mean modified plaque index of implants remained low (<20%), and the majority of implants (>76.3%) in the study showed the absence of bleeding on probing at follow-up visits. Peri-implant marginal bone loss (MBL) ranged from 0.8 to 1.2 mm. There was no statistically significant difference in the MBL between maxillary and mandibular implants (P = .43). The implant success rate was 100% after 5 years, and the prosthodontic maintenance and complication rate was 0.22 times per year. More than 90% of patients were satisfied with the restoration of their oral function using TCs. Based on our study of 24 patients treated with TC-retained overdentures, it appears that this treatment may be a viable option for patients with insufficient jawbone volume.
Wiedemair, Verena; Mayr, Sophia; Wimmer, Daniel S; Köck, Eva Maria; Penner, Simon; Kerstan, Andreas; Steinmassl, Patricia-Anca; Dumfahrt, Herbert; Huck, Christian W
2017-07-01
Water absorbed to poly(methyl methacrylate) (PMMA)-based CAD/CAM (computer-assisted design/computer-assisted manufacturing) prosthodontics can alter their properties including hardness and stability. In the present contribution, water absorption and desorption kinetics under defined experimental conditions were monitored employing several supplementary and advanced Fourier transform infrared (FT-IR) spectroscopic techniques in combination with multivariate analysis (MVA). In this synergistic vibrational spectroscopic multimethod approach, first a novel near-infrared (NIR) diffuse fiber optic probe reflection spectroscopic method was established for time-resolved analysis of water uptake within seven days under controlled conditions. Near-infrared water absorbance spectra in a wavenumber range between 5288-5100 cm -1 (combination band) and 5424-5352 cm -1 (second overtone) were used establishing corresponding calibration and validation models to quantify the amount of water in the milligram range. Therefore, 14 well-defined samples exposed to prior optimized experimental conditions were taken into consideration. The average daily water uptake conducting reference analysis was calculated as 22 mg/day for one week. Additionally, in this study for the first time NIR two-dimensional correlation spectroscopy (2D-COS) was conducted to monitor and interpret the spectral dynamics of water absorption on the prosthodontics in a wavenumber range of 5100-5300 cm -1 . For sensitive time-resolved recording of water desorption, a recently developed high-temperature, high-pressure FT-IR reaction cell with water-free ultra-dry in situ and operando operation was applied. The reaction cell, as well as the sample holder, was fully made of quartz glass, with no hot metal or ceramic parts in the vicinity of the high temperature zone. Applying a temperature gradient in the range of 25-150 ℃, mid-infrared (MIR) 2D-COS was successfully conducted to get insights into the dynamic behavior of O-H (1400-1800 cm -1 ) absorption bands with increasing temperature over time and the release of CO 2 (2450 cm -1 ) from the polymers. In addition, an ATR FT-IR imaging setup was optimized in order to investigate the surface homogeneity of the PMMA-based resins with a spatial resolution to 2 µm. From this vibrational spectroscopic multimethod approach and the collection of several analytical data, conclusions were drawn as to which degree the surface structure and/or its porosity have an impact onto the amount of water absorption.
Palatal obturators in patients after maxillectomy.
Cardelli, P; Bigelli, E; Vertucci, V; Balestra, F; Montani, M; DE Carli, S; Arcuri, C
2014-01-01
Prosthodontic management of palatal defects is fundamental to improve patient's life undergoing to a maxillary surgical treatment. A lot of maxillary defects are a direct consequence of surgical treatment of malformations, neoplasms or trauma. The obturators are prosthesis used to close palatal defects after maxillectomy, to restore masticatory function and to improve speech. The primary goals of the obturator prosthesis are to preserve the remaining teeth and tissue and to provide comfort, function, and aesthetics to the patients. Different materials and retention methods are a characteristic of new types of obturators.
Vamsi Krishna, C H; Babu, Jaya Krishna; Fathima, Tanveer; Reddy, G V K
2014-01-01
The prosthodontic rehabilitation of maxillary defects is a challenging and demanding task which requires careful pre-surgical and post-surgical planning. Maxillary defects can be congenital or acquired. Acquired defects include those following trauma or surgical treatment of benign or malignant neoplasms. A prosthodontist encounters problems such as absence of support, poor retention, and lack of prosthesis stability in treating these patients. The present case report describes a procedure to fabricate a definitive hollow bulb obturator prosthesis for the rehabilitation of a total maxillectomy defect. PMID:24671313
Palatal obturators in patients after maxillectomy
CARDELLI, P.; BIGELLI, E.; VERTUCCI, V.; BALESTRA, F.; MONTANI, M.; DE CARLI, S.; ARCURI, C.
2014-01-01
SUMMARY Prosthodontic management of palatal defects is fundamental to improve patient’s life undergoing to a maxillary surgical treatment. A lot of maxillary defects are a direct consequence of surgical treatment of malformations, neoplasms or trauma. The obturators are prosthesis used to close palatal defects after maxillectomy, to restore masticatory function and to improve speech. The primary goals of the obturator prosthesis are to preserve the remaining teeth and tissue and to provide comfort, function, and aesthetics to the patients. Different materials and retention methods are a characteristic of new types of obturators. PMID:25992263
Acceptability of instructional videos.
Rayyan, Mohammad; Elagra, Marwa; Alfataftah, Nida; Alammar, Amirah
2017-08-01
Over the past few decades, instructional videos have been incorporated as important tools in the dental classroom setting. This study aimed to investigate the acceptability of video demonstrations in comparison with live broadcasting and with the traditional face-to-face demonstrations in preclinical fixed prosthodontic classes. A group of dental students who have been exposed to three different methods of delivering practical demonstrations - face-to-face demonstrations, live broadcasting and recorded instructional videos - were included in the study. Preferences regarding these three methods were investigated using a questionnaire comprising a number of closed- and open-ended questions. Descriptive statistics were used to analyse the survey data using spss software. Survey comments were summarised and coded into categories. A total of 163 questionnaires were distributed, and 145 responses were returned (a response rate of 89%). Ninety-two students (63%) considered the recorded video demonstrations to be the most convenient. Moreover, ninety-seven students (67%) found live demonstrations to be the least convenient. The majority of students either agreed (67 students) or strongly agreed (60 students) that watching the video before the session made it easier for them to perform the procedure in the lab. Recorded instructional videos were the preferred method of delivering practical demonstrations for students in the preclinical courses of fixed prosthodontics. Instructors must focus on using the technological aids to increase their positive interaction with students. Instructional videos have been incorporated as important tools in the dental classroom setting. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.
Digital technology in fixed implant prosthodontics.
Joda, Tim; Ferrari, Marco; Gallucci, German O; Wittneben, Julia-Gabriela; Brägger, Urs
2017-02-01
Digital protocols are increasingly influencing prosthodontic treatment concepts. Implant-supported single-unit and short-span reconstructions will benefit mostly from the present digital trends. In these protocols, monolithic implant crowns connected to prefabricated titanium abutments, which are created based on data obtained from an intraoral scan followed by virtual design and production, without the need of a physical master cast, have to be considered in lieu of conventional manufacturing techniques for posterior implant restorations. No space for storage is needed in the complete digital workflow, and if a remake is required a replica of the original reconstruction can be produced quickly and inexpensively using rapid prototyping. The technological process is split into subtractive methods, such as milling or laser ablation, and additive processing, such as three-dimensional printing and selective laser melting. The dimensions of the supra-implant soft-tissue architecture can be calculated in advance of implant placement, according to the morphologic copy, and consequently are individualized for each patient. All these technologies have to be considered before implementing new digital dental workflows in daily routine. The correct indication and application are prerequisite and crucial for the success of the overall therapy, and, finally, for a satisfied patient. This includes a teamwork approach and equally affects the clinician, the dental assistant and the technician as well. The digitization process has the potential to change the entire dental profession. The major benefits will be reduced production costs, improvement in time efficiency and fulfilment of patients' perceptions of a modernized treatment concept. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Nikzad, Sakineh; Azari, Abbas; Mahgoli, Hosseinali; Akhoundi, Nasrin
2012-03-01
Dental students in programs around the world typically pass preclinical courses before entering the clinic and working on actual patients. Since fixed prosthodontics is a preclinical course that requires a great deal of effort, students may experience a substantial amount of stress that may affect their self-confidence and/or clinical performance. In this study, an instructional video CD (VCD) and study guide depicting the step-by-step procedures involved in a metal-ceramic tooth preparation and provisional crown fabrication was prepared. Students at the Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran, were divided randomly into two groups. Group A students trained as usual with live patients, and Group B students were given a copy of the VCD and study guide following a lecture. The students in Group B were encouraged to read the study guide and watch the VCD after live demonstrations. Then, both groups practiced individually on mannequins. At the end of the course, the students completed a sixteen-item questionnaire about their stress level, self-confidence, and knowledge base. The results showed that the students exposed to the extra media performed significantly better on some practical phases, e.g., laboratory procedures. A moderate, insignificant correlation was detected between exposure to media and decreasing the students' stress and self-esteem. We concluded that supplementary teaching aids such as a VCD and study guide may improve the clinical performance of dental students to some extent, but the live demonstration is still preferred by students.
Bruxism and prosthetic treatment: a critical review.
Johansson, Anders; Omar, Ridwaan; Carlsson, Gunnar E
2011-07-01
Based on the findings from available research on bruxism and prosthetic treatment published in the dental literature, an attempt was made to draw conclusions about the existence of a possible relationship between the two, and its clinical relevance. MEDLINE/PubMed searches were conducted using the terms 'bruxism' and 'prosthetic treatment', as well as combinations of these and related terms. The few studies judged to be relevant were critically reviewed, in addition to papers found during an additional manual search of reference lists within selected articles. Bruxism is a common parafunctional habit, occurring both during sleep and wakefulness. Usually it causes few serious effects, but can do so in some patients. The etiology is multifactorial. There is no known treatment to stop bruxism, including prosthetic treatment. The role of bruxism in the process of tooth wear is unclear, but it is not considered a major cause. As informed by the present critical review, the relationship between bruxism and prosthetic treatment is one that relates mainly to the effect of the former on the latter. Bruxism may be included among the risk factors, and is associated with increased mechanical and/or technical complications in prosthodontic rehabilitation, although it seems not to affect implant survival. When prosthetic intervention is indicated in a patient with bruxism, efforts should be made to reduce the effects of likely heavy occlusal loading on all the components that contribute to prosthetic structural integrity. Failure to do so may indicate earlier failure than is the norm. Copyright © 2011 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Park, Carly F; Sheinbaum, Justin M; Tamada, Yasushi; Chandiramani, Raina; Lian, Lisa; Lee, Cliff; Da Silva, John; Ishikawa-Nagai, Shigemi
2017-05-01
Objective self-assessment is essential to learning and continued competence in dentistry. A computer-assisted design/computer-assisted manufacturing (CAD/CAM) learning software (prepCheck, Sirona) allows students to objectively assess their performance in preclinical prosthodontics. The aim of this study was to evaluate students' perceptions of CAD/CAM learning software for preclinical prosthodontics exercises. In 2014, all third-year dental students at Harvard School of Dental Medicine (n=36) were individually instructed by a trained faculty member in using prepCheck. Each student completed a preclinical formative exercise (#18) and summative examination (#30) for ceramometal crown preparation and evaluated the preparation using five assessment tools (reduction, margin width, surface finish, taper, and undercut) in prepCheck. The students then rated each of the five tools for usefulness, user-friendliness, and frequency of use on a scale from 1=lowest to 5=highest. Faculty members graded the tooth preparations as pass (P), marginal-pass (MP), or fail (F). The survey response rate was 100%. The tools for undercut and taper had the highest scores for usefulness, user-friendliness, and frequency of use. The reduction tool score was significantly lower in all categories (p<0.01). There were significant differences in usefulness (p<0.05) and user-friendliness (p<0.05) scores among the P, MP, and F groups. These results suggest that the prepCheck taper and undercut tools were useful for the students' learning process in a preclinical exercise. The students' perceptions of prepCheck and their preclinical performance were related, and those students who performed poorest rated the software as significantly more useful.
Psychometric properties of the Albanian version of the Orofacial Esthetic Scale: OES-ALB.
Bimbashi, Venera; Čelebić, Asja; Staka, Gloria; Hoxha, Flurije; Peršić, Sanja; Petričević, Nikola
2015-08-26
The aim was to adapt the Orofacial Esthetic Scale (OES) and to test psychometric properties of the Albanian language version in the cultural environment of the Republic of Kosovo. The OES questionnaire was translated from the original English version according to the accepted techniques. The reliability (internal consistency), and validity (construct, convergent and discriminative) were tested in 169 subjects, test-retest in 61 dental students (DS), and responsiveness in 51 prosthodontic patients with treatment needs (PPTN). The corrected item correlation coefficients of OES-ALB ranged from 0.686 to 0.909. The inter-item correlation coefficient ranged between 0.572 and 0.919. The Cronbach's alpha was 0.961 and IIC 0.758. Test- retest was confirmed by good ICCs and by no significant differences of the OES scores through the period of 14 days without any orofacial changes (p > 0.05). Construct validity was proved by the presence of one-factor composition that assumed 79.079% of the variance. Convergent validity showed significant correlation between one general question about satisfaction with orofacial esthetics and the OES summary score, as well as between the sum of the 3 OHIP-ALB49 questions related to orofacial aesthetics and the OES summary score. Discriminative validity was confirmed with statistically significant differences between DS, prosthodontic patients without treatment need and PPTN (p < 0.01). Responsiveness was confirmed by a significant increase of OES scores after PPTN patients received new fixed partial or removable dentures (P < 0.001). The results proved excellent psychometric properties of the OES-ALB questionnaire in the Republic of Kosovo.
Patterns of impaired oral health-related quality of life dimensions.
John, M T; Rener-Sitar, K; Baba, K; Čelebić, A; Larsson, P; Szabo, G; Norton, W E; Reissmann, D R
2016-07-01
How dental patients are affected by oral conditions can be described with the concept of oral health-related quality of life (OHRQoL). This concept intends to make the patient experience measurable. OHRQoL is multidimensional, and Oral Function, Oro-facial Pain, Oro-facial Appearance and Psychosocial Impact were suggested as its four dimensions and consequently four scores are needed for comprehensive OHRQoL assessment. When only the presence of dimensional impact is measured, a pattern of affected OHRQoL dimensions would describe in a simple way how oral conditions influence the individual. By determining which patterns of impact on OHRQoL dimensions exist in prosthodontic patients and general population subjects, we aimed to identify in which combinations oral conditions' functional, painful, aesthetical and psychosocial impact occurs. Data came from the Dimensions of OHRQoL Project with Oral Health Impact Profile (OHIP)-49 data from 6349 general population subjects and 2999 prosthodontic patients in the Learning Sample (N = 5173) and the Validation Sample (N = 5022). We hypothesised that all 16 patterns of OHRQoL dimensions should occur in these individuals who suffered mainly from tooth loss, its causes and consequences. A dimension was considered impaired when at least one item in the dimension was affected frequently. The 16 possible patterns of impaired OHRQoL dimensions were found in patients and general population subjects in both Learning and Validation Samples. In a four-dimensional OHRQoL model consisting Oral Function, Oro-facial Pain, Oro-facial Appearance and Psychosocial Impact, oral conditions' impact can occur in any combination of the OHRQoL dimensions. © 2016 John Wiley & Sons Ltd.
Digital cross-mounting: A new opportunity in prosthetic dentistry.
Venezia, Pietro; Torsello, Ferruccio; D'Amato, Salvatore; Cavalcanti, Raffaele
2017-01-01
The prosthodontic management of complex rehabilitations requires several stages of treatment including one or more provisional restorations. The design and adjustments of the provisional are made to achieve an optimal functional and esthetic outcome for the patient. However, the adjustments needed are both time and cost consuming. Therefore, once a satisfactory provisional is made, the information should not be lost during the following stages of treatment. The purpose of this clinical case is to illustrate "digital cross-mounting," a procedure used to precisely transfer information from the provisional to the final fixed rehabilitation in a digital workflow.
Prosthodontic Rehabilitation of the Patient with Severely Worn Dentition: A Case Report
Hatami, Mahnaz; Sabouhi, Mahmoud; Samanipoor, Siamak; Badrian, Hamid
2012-01-01
The management of tooth wear has been a subject of increasing interest from both preventive and restorative points of view. This paper describes the full mouth rehabilitation of a 63-year-old bruxer man with a severely worn dentition and other dental problems including unsuitable restorations and several missing teeth. The treatment entailed using cast posts and cores, metal-ceramic restorations, and a removable partial denture. As with the treatment procedure of such cases, equal-intensity centric occlusal contacts on all teeth and an anterior guidance in harmony with functional jaw movements were especially taken into account. PMID:22830062
Rastogi, Jyoti; Jain, Chandni; Singh, Harkanwal Preet
2012-01-01
Overlay complete dentures are simple, reversible and economical treatment modality for patients with congenital or acquired disorders that severely affect the tooth development. It satisfies both the esthetic and functional demands where the extraction of teeth is not generally indicated. In pediatric patients, the overlay dentures establish a relatively stable occlusion that improves patient's tolerance to the future treatment procedures for worn dentition. This clinical report highlights the imperative need of appropriate treatment strategy and application of maxillary and mandibular overlay dentures in a pediatric patient who suffered from congenitally mutilated and worn dentition. PMID:23236577
Pera, F; Pesce, P; Solimano, F; Tealdo, T; Pera, P; Menini, M
2017-05-01
Frameworks made of carbon fibre-reinforced composites (CFRC) seem to be a viable alternative to traditional metal frameworks in implant prosthodontics. CFRC provide stiffness, rigidity and optimal biocompatibility. The aim of the present prospective study was to compare carbon fibre frameworks versus metal frameworks used to rigidly splint implants in full-arch immediate loading rehabilitations. Forty-two patients (test group) were rehabilitated with full-arch immediate loading rehabilitations of the upper jaw (total: 170 implants) following the Columbus Bridge Protocol with four to six implants with distal tilted implants. All patients were treated with resin screw-retained full-arch prostheses endowed with carbon fibre frameworks. The mean follow-up was 22 months (range: 18-24). Differences in the absolute change of bone resorption over time between the two implant sides (mesial and distal) were assessed performing a Mann-Whitney U-test. The outcomes were statistically compared with those of patients rehabilitated following the same protocol but using metal frameworks (control group: 34 patients with 163 implants - data reported in Tealdo, Menini, Bevilacqua, Pera, Pesce, Signori, Pera, Int J Prosthodont, 27, 2014, 207). Ten implants failed in the control group (6·1%); none failed in the test group (P = 0·002). A statistically significant difference in the absolute change of bone resorption around the implants was found between the two groups (P = 0·004), with greater mean peri-implant bone resorption in the control group (1 mm) compared to the test group (0·8 mm). Carbon fibre frameworks may be considered as a viable alternative to the metal ones and showed less marginal bone loss around implants and a greater implant survival rate during the observation period. © 2017 John Wiley & Sons Ltd.
Barber, Andrew; Puryer, James; Leary, Sam; McNally, Lisa; O’Sullivan, Dominic
2016-01-01
The aim of this study was to describe Dental Foundation year one dentists’ attitudes towards prosthodontic decision making for edentulous patients, and identify whether there are gender differences in these attitudes. All South West Deanery trainees were invited to take part in the study between May and June 2011 and a previously piloted questionnaire was administered to the trainees by their training programme directors. The questionnaire posed questions based upon a clinical scenario of discussing treatment options with patients. Seventy-two questionnaires were used in the analysis (91% overall response rate). Trainees perceived their own values to be less important than the patient’s values (p < 0.001) in decision making, but similar to the patient’s friend’s/relative’s values (p = 0.1). In addition, the trainees perceived the patient’s values to be less important than their friend’s/relatives (p < 0.001). Sixty-six per cent of trainees acknowledged an influence from their own personal values on their presentation of material to patients who are in the process of choosing among different treatment options, and 87% thought their edentulous patients were satisfied with the decision making process when choosing among different treatment options. Fifty-eight per cent of trainees supported a strategy of negotiation between patients and clinicians (shared decision making). There was no strong evidence to suggest gender had an influence on the attitudes towards decision making. The finding of a consensus towards shared decision making in the attitudes of trainees, and no gender differences is encouraging and is supportive of UK dental schools’ ability to foster ethical and professional values among dentists. PMID:29563454
Restricted mouth opening and its definitive management: A literature review.
Kumar, Bhushan; Fernandes, Aquaviva; Sandhu, Prabhdeep Kaur
2018-01-01
This review was intended to discuss the various possible modifications suggested in the literature for prosthetic steps and surgical corrective procedures in nonresponding or complicated cases during rehabilitation of patients with restricted mouth opening. Medline, PubMed, and Google were searched electronically for articles using keywords: microstomia and treatment options for restricted mouth opening. The various articles on prosthodontic rehabilitation in microstomia were segregated. From these, various modifications in the prosthetic steps were reviewed. Oral hygiene maintenance is difficult for patient either due to limited access or due to associated lack of manual dexterity, so dental decay and periodontal problems are more extensive in such patients; hence, tooth loss is a common finding. All prosthetic procedures require wide mouth opening to carry out various steps, starting from tray placement during impression making to the final prosthesis insertion, especially removable prosthesis. Various prosthetic modifications given by authors are included in this review for each step in prosthodontic management. A total of eight stock tray designs, 12 custom tray designs, and 17 removable prosthesis designs are discussed along with fixed (either tooth-supported or implant-supported) and maxillofacial prosthesis. However, some patients require surgical intervention also for the correction of microstomia either for function or for esthetic purpose before prosthetic rehabilitation and are also enumerated here. Among all prosthetic restorative options, removable prosthesis is most difficult for dentist to fabricate as conventional methods are either very difficult or impossible to apply. To get a more accurate final prosthesis, we need to modify these steps according to the existing case. Several modifications available are discussed here which can help while managing these patients.
Samuelson, David B; Divaris, Kimon; De Kok, Ingeborg J
2017-04-01
This study compared the acceptability and relative effectiveness of case-based learning (CBL) versus traditional lecture-based (LB) instruction in a preclinical removable prosthodontics course in the University of North Carolina at Chapel Hill School of Dentistry DDS curriculum. The entire second-year class (N=82) comprised this crossover study's sample. Assessments of baseline comprehension and confidence in removable partial denture (RPD) treatment planning were conducted at the beginning of the course. Near the end of the course, half of the class received CBL and LB instruction in an RPD module in alternating sequence, with students serving as their own control group. Assessments of perceived RPD treatment planning efficacy, comprehension, and instruction method preference were administered directly after students completed the RPD module and six months later. Analyses of variance accounting for period, carryover, and sequence effects were used to determine the relative effects of each approach using a p<0.05 statistical significance threshold. The results showed that the students preferred CBL (81%) over LB instruction (9%), a pattern that remained unchanged after a six-month period. Despite notable period and carryover effects, CBL was also associated with higher gains in RPD treatment planning comprehension (p=0.04) and perceived efficacy (p=0.01) compared to LB instruction. These gains diminished six months after the course-a finding based on a 49% follow-up response rate. Overall, the students overwhelmingly preferred CBL to LB instruction, and the findings suggest small albeit measurable educational benefits associated with CBL. This study's findings support the introduction and further testing of CBL in the preclinical dental curriculum, in anticipation of possible future benefits evident during clinical training.
Schierz, Oliver; Reissmann, Daniel
2016-10-01
To compare the impact of canine guided vs. bilateral balanced occlusion on oral health related quality of life (OHRQoL) as a patient-reported outcome measure. In this randomized single-blind crossover trial, 19 patients have been provided with new complete dentures in the maxilla and mandible. OHRQoL was assessed using the 49-item Oral Health Impact Profile (OHIP-49) before the start of the prosthodontic treatment (B), 3 months after insertion of the new dentures (T1), and 3 months after rework into the alternative concept (T2). Multilevel mixed-effect linear regression models were computed to determine the effect provided by the new set of dentures and the specific impact of the occlusal concept on OHRQoL using summary scores of the OHIP-49 and of a 19-items subset specific for edentulous patients (OHIP-EDENT). At baseline, participants' OHRQoL was substantially impaired indicated by an average OHIP-49 score of 42.1 points and an OHIP-EDENT score of 21.1 points. The effect of provision of a new set of complete dentures was a statistically significant decrease of 8.3 points (OHIP-49) and 4.0 points (OHIP-EDENT), respectively, representing a clinically relevant improvement in OHRQoL. When wearing dentures with bilateral balanced occlusion, participants showed on average 1.6 points higher OHIP-49 scores and 0.9 points higher OHIP-EDENT scores compared to canine guided dentures. This effect of the occlusal concept was neither statistically nor clinically significant. Both investigated occlusal concepts for complete dentures were comparable in their effect on patients' perceptions with none being considerably superior in terms of OHRQoL. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Shibata, Satoko; Stegaroiu, Roxana; Nakazawa, Akari; Ohuchi, Akitsugu
2017-03-01
(i) To assess comprehension of oral care-related terms among caregivers and nurses working at long-term care facilities, using a newly developed test; (ii) to analyse the effect of participant characteristics on their comprehension. Effective mutual communication between dental professionals and caregivers/nurses is essential for providing information on daily oral care for institutionalised elders. A 36-item word-knowledge test in Japanese was developed to assess comprehension of oral care-related terms. The test was administered to a convenience sample of 236 nursing staff (198 caregivers and 38 nurses) at six long-term care facilities in Niigata City, Japan, and its reliability and validity were verified. Associations of participant characteristics with their responses were investigated by multiple regression analysis. Mean percentage of correct responses (accuracy rate) for nursing staff was approximately 62% (highest for oral care products and lowest for prosthodontic terms). Test internal reliability was high (Cronbach's alpha >0.8). Concurrent validity (test ability to distinguish between characteristically different groups) was confirmed. Mean accuracy rate was significantly higher among nurses (78.5 ± 19.3%) than among caregivers (58.7 ± 22.8%), and among respondents with interest in oral care (64.2 ± 21.1%) than among those with no such interest (51.5 ± 28.9%). The word-knowledge test was valid and reliable for nursing staff of six long-term care facilities in Niigata City. Their comprehension was low for perioral and intraoral structures, related symptom and disease names, and prosthodontics terms related to oral care. Understanding of oral care-related terms among the nursing staff was related to their occupation and interest in oral care. © 2016 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.
Venkat, R; Gopichander, N; Vasantakumar, M
2010-01-01
Obstructive sleep apnea is the most frequent cause for insomnia in the populace. Snoring is mulled over as the potential factor that can lead the sequel to obstructive sleep apnea. Although the etiology and deterrence measures for snoring are yet to be undoubtedly clarified by our scientific sorority, various means of surgical corrections have been affirmed and put into practice, with a substantial degree of success. Despite this, it is implicit that a noninvasive method of managing obstructive sleep apnea is more relevant for overcoming this condition. This manuscript intends to establish how snoring can be controlled prosthodontically by different modalities of scientifically defensible approaches. The most effective among the modalities was affirmed as the investigative analyses of the treatment outcomes with each modality. NOVEL METHODS: Four new methods of managing obstructive sleep apnea--uvula lift appliance, uvula and velopharynx lift appliance, nasopharyngeal aperture guard, and soft palate lift appliance were demonstrated through this article. The four new modalities stated and one conventional modality of mandibular advancement appliance for managing obstructive sleep apnea, a total of five types of appliance therapies, were described with case reports for each. Five individuals undergoing the appliance therapy were chosen for each modality. The treatment outcome with each modality was examined by analysis of clinical predictors and also by means of standard investigation, with nasal and oral endoscopic analyses. Among the five types of appliance therapies, the nasopharyngeal aperture guard provided the best treatment outcome in terms of clinical predictors and endoscopic analyses. Nasopharyngeal aperture guard, the novel method stated in this article is the better modality for managing obstructive sleep apnea, among the five different appliance therapies.
A randomised controlled trial of complete denture impression materials.
Hyde, T P; Craddock, H L; Gray, J C; Pavitt, S H; Hulme, C; Godfrey, M; Fernandez, C; Navarro-Coy, N; Dillon, S; Wright, J; Brown, S; Dukanovic, G; Brunton, P A
2014-08-01
There is continuing demand for non-implant prosthodontic treatment and yet there is a paucity of high quality Randomised Controlled Trial (RCT) evidence for best practice. The aim of this research was to provide evidence for best practice in prosthodontic impressions by comparing two impression materials in a double-blind, randomised, crossover, controlled, clinical trial. Eighty-five patients were recruited, using published eligibility criteria, to the trial at Leeds Dental Institute, UK. Each patient received two sets of dentures; made using either alginate or silicone impressions. Randomisations determined the order of assessment and order of impressions. The primary outcome was patient blinded preference for unadjusted dentures. Secondary outcomes were patient preference for the adjusted dentures, rating of comfort, stability and chewing efficiency, experience of each impression, and an OHIP-EDENT questionnaire. Seventy-eight (91.8%) patients completed the primary assessment. 53(67.9%) patients preferred dentures made from silicone impressions while 14(17.9%) preferred alginate impressions. 4(5.1%) patients found both dentures equally satisfactory and 7 (9.0%) found both equally unsatisfactory. There was a 50% difference in preference rates (in favour of silicone) (95%CI 32.7-67.3%, p<0.0001). There is significant evidence that dentures made from silicone impressions were preferred by patients. Given the strength of the clinical findings within this paper, dentists should consider choosing silicone rather than alginate as their material of choice for secondary impressions for complete dentures. ISRCTN 01528038. This article forms part of a project for which the author (TPH) won the Senior Clinical Unilever Hatton Award of the International Assocation for Dental Research, Capetown, South Africa, June 2014. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Basnet, Bishal Babu; Parajuli, Prakash Kumar; Singh, Raj Kumar; Suwal, Pramita; Shrestha, Pragya; Baral, Dharanidhar
2015-01-01
Establishment of proper occlusal vertical dimension (OVD) is one of the important tasks for successful prosthodontic therapy. An ideal method for determining OVD in terms of cost, time, and instrument requirements has been sought in prosthodontics by various investigators. However, no such single method has been formulated. In the current anthropometric study, the relationship of the length of the thumb to the OVD was tested in two ethnic groups of Nepal, Aryans, and Mongoloids. The result of this study can be useful in determining proper OVD in edentulous patients. The primary aim of the present study was to evaluate the correlation between the length of the thumb and OVD in Aryan and Mongoloid ethnic groups. The secondary aim was to compare the correlation between OVD and other anatomic measurements (eye-ear distance and pupil-to-rima oris distance) in these ethnicities. The OVD, thumb length, eye-ear distance and distance between pupil of eye and rima oris were measured in a total of 500 adult dentulous volunteers. The correlation between OVD and thumb length as well as other anatomic measurements was checked with Pearson's product moment correlation coefficient. Linear regression analysis was performed to determine the relationship of OVD to the length of the thumb. The thumb length was significantly (P≤0.05) correlated with strong and positive values (Pearson's coefficient =0.874 in the whole population, 0.826 in Aryans, and 0.944 in Mongoloids). Regression analysis showed that thumb length was significantly related to OVD in both ethnic groups. Within the limitations of the present study, the result implies that thumb length can be used as an adjunct for establishing OVD in the edentulous patients.
Rubric system for evaluation of crown preparation performed by dental students.
Habib, S R
2018-03-01
This study aimed to investigate the use of an analytic rubric system for the evaluation of all-ceramic crown preparation on the right maxillary central incisor performed by the dental students. Seventy-two-third-year students and 8 faculty members from prosthodontics participated in this double-blind study. The students prepared an ivorine tooth # 11 for all-ceramic crown. The students were given clear instructions regarding the all-ceramic crown preparation and informed about the criteria for the assessment of the preparation. An analytic rubric based on 10-point scale for assessment of various preparation parameters was used by the 8 examiners. Descriptive statistics, ANOVA and post hoc Tukey tests were used for statistical analysis. One-way analysis of variance indicated significance amongst the examiners for all the parameters except for time management. The overall mean scoring by examiners was 7.60 ± 1.18, with highest and lowest mean scores for Examiner 1 (8.02 ± 1.06) and Examiner 4 (6.82 ± 1.50), respectively. The highest number of interexaminer variation (difference) in scoring was found for two plane reduction, and the least difference amongst the examiners was observed for finishing of margins and walls of the preparation. Examiner 4 had the highest number of significant difference with the rest of the examiners. The students scored least marks in axial reduction (56.33%) and preservation of adjacent teeth (66.9%). Criteria-based assessment using analytic rubric for crown preparations in pre-clinical fixed prosthodontics is an effective tool for finding the errors/weak areas of dental students. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Patterns of impaired oral health-related quality of life dimensions
John, Mike T.; Rener-Sitar, Ksenija; Baba, Kazuyoshi; Čelebić, Asja; Larsson, Pernilla; Szabo, Gyula; Norton, Wynne E.; Reissmann, Daniel R.
2016-01-01
Background How dental patients are affected by oral conditions can be described with the concept of oral health-related quality of life (OHRQoL). This concept intends to make the patient experience measurable. OHRQoL is multidimensional and Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact were suggested as its four dimensions and consequently four scores are needed for comprehensive OHRQoL assessment. When only the presence of dimensional impact is measured, a pattern of affected OHRQoL dimensions would describe in a simple way how oral conditions’ influence the individual. Objective By determining which patterns of impact on OHRQoL dimensions (Oral Function-Orofacial Pain-Orofacial Appearance-Psychosocial Impact) exist in prosthodontic patients and general population subjects, we aimed to identify in which combinations oral conditions’ functional, painful, aesthetical, and psychosocial impact occurs. Methods Data came from the Dimensions of OHRQoL Project with OHIP-49 data from 6,349 general population subjects and 2,999 prosthodontic patients in the Learning Sample (N=5,173) and the Validation Sample (N=5,022). We hypothesized that all 16 patterns of OHRQoL dimensions should occur in these individuals who suffered mainly from tooth loss, its causes and consequences. A dimension was considered impaired when at least one item in the dimension was affected frequently. Results The 16 possible patterns of impaired OHRQoL dimensions were found in patients and general population subjects in both Learning and Validation Samples. Conclusions In a four-dimensional OHRQoL model consisting of Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact, oral conditions’ impact can occur in any combination of the OHRQoL dimensions. PMID:27027734
Prasad, Rahul; Al-Keraif, Abdulaziz Abdullah; Kathuria, Nidhi; Gandhi, P V; Bhide, S V
2014-02-01
The purpose of this study was to determine whether the ringless casting and accelerated wax-elimination techniques can be combined to offer a cost-effective, clinically acceptable, and time-saving alternative for fabricating single unit castings in fixed prosthodontics. Sixty standardized wax copings were fabricated on a type IV stone replica of a stainless steel die. The wax patterns were divided into four groups. The first group was cast using the ringless investment technique and conventional wax-elimination method; the second group was cast using the ringless investment technique and accelerated wax-elimination method; the third group was cast using the conventional metal ring investment technique and conventional wax-elimination method; the fourth group was cast using the metal ring investment technique and accelerated wax-elimination method. The vertical marginal gap was measured at four sites per specimen, using a digital optical microscope at 100× magnification. The results were analyzed using two-way ANOVA to determine statistical significance. The vertical marginal gaps of castings fabricated using the ringless technique (76.98 ± 7.59 μm) were significantly less (p < 0.05) than those castings fabricated using the conventional metal ring technique (138.44 ± 28.59 μm); however, the vertical marginal gaps of the conventional (102.63 ± 36.12 μm) and accelerated wax-elimination (112.79 ± 38.34 μm) castings were not statistically significant (p > 0.05). The ringless investment technique can produce castings with higher accuracy and can be favorably combined with the accelerated wax-elimination method as a vital alternative to the time-consuming conventional technique of casting restorations in fixed prosthodontics. © 2013 by the American College of Prosthodontists.
McGinley, Emma Louise; Moran, Gary P; Fleming, Garry J P
2013-11-01
The study employed a three-dimensional (3D) human-derived oral mucosal model to assess the biocompatibility of base-metal dental casting alloys ubiquitous in fixed prosthodontic and orthodontic dentistry. Oral mucosal models were generated using primary human oral keratinocyte and gingival fibroblast cells seeded onto human de-epidermidised dermal scaffolds. Nickel-chromium (Ni-Cr) and cobalt-chromium (Co-Cr) base-metal alloy immersion solutions were exposed to oral mucosal models for increasing time periods (2-72h). Analysis methodologies (histology, viable cell counts, oxidative stress, cytokine expression and toxicity) were performed following exposure. Ni-based alloy immersion solutions elicited significantly decreased cell viability (P<0.0004) with increased oxidative stress (P<0.0053), inflammatory cytokine expression (P<0.0077) and cellular toxicity levels (P<0.0001) compared with the controls. However, the Ni-free Co-Cr-based alloy immersion solutions did not elicit adverse oxidative stress (P>0.4755) or cellular toxicity (P<0.2339) responses compared with controls. Although the multiple analyses highlighted Ni-Cr base-metal alloy immersion solutions elicited significantly detrimental effects to the oral mucosal models, it was possible to distinguish between Ni-Cr alloys using the approach employed. The study employed a 3D human-derived full-thickness differentiated oral mucosal model suitable for biocompatibility assessment of base-metal dental casting alloys through discriminatory experimental parameters. Increasing incidences of Ni hypersensitivity in the general population warrants serious consideration from dental practitioners and patients alike where fixed prosthodontic/orthodontic dental treatments are the treatment modality involved. The novel and analytical oral mucosal model has the potential to significantly contribute to the advancement of reproducible dental medical device and dental material appraisals. Copyright © 2013 Elsevier Ltd. All rights reserved.
Cruise medicine: the dental perspective on health care for passengers during a world cruise.
Sobotta, Bernhard A J; John, Mike T; Nitschke, Ina
2008-01-01
Although more than 100 million passengers have taken a cruise since 1980, it is not known what dental treatment needs occur at sea. The routine dental documentation of a 2-month period at sea on a cruise ship carrying 1,619 passengers was analyzed. The subjects for the study were 57 passengers (3.5% of 1,619), with a mean age of 71 years (+/-9.8 y). Age, gender, number of natural teeth and implants, prosthetic status, diagnosis, treatment performed, percentage of emergency and routine procedures, number of appointments, duration of appointment, time since last visit to the dentist, and cabin category as indicator of socioeconomic status were extracted. Oral health-related quality of life (OHRQoL) was measured using the 14-item Oral Health Impact Profile. Passengers had a mean number of 20 natural teeth plus substantial fixed and removable prosthodontics. Emergency dental treatment accounted for 97% of the chairside time. The three most frequent emergency diagnoses were defective restorations (36%), pulpal disease (20%), and defective prosthesis and caries (both 11.5%). Common emergency therapies provided were complex surgical-prosthodontic rehabilitation, various endodontic treatments, and extractions. Per 1,000 persons/month, passengers required 21.6 emergency plus 2.5 routine appointments; 49% of passengers had seen a dentist within 3 months before going to sea. Passengers do attend their dentist for routine care/checkups before the voyage, yet experience complex dental emergencies. This is due to the presence of a high number of restorations that fail unexpectedly. Some failures are so severe that they would have forced the passenger to abort the cruise had there been no dental service available. The ease of access to quality dental care may explain the relatively low level of perceived problems as characterized by OHRQoL scores.
Michalak, Maciej; Wysokińska-Miszczuk, Joanna; Wilczak, Magdalena; Paulo, Michał; Bożyk, Andrzej; Borowicz, Janusz
2012-02-29
Parafunctions (harmful habits) play a crucial role in the formation of temporo-mandibular joint (TMJ) dysfunction syndrome with disc displacement. Disorder symptoms in temporo-mandibular joints manifest themselves in the eye and ear but are usually not associated with the dysfunction of temporo-mandibular joints and that might lead to errors in diagnosis. The aim of the study was to examine the influence of missing teeth and parafunctions on the occurrence of ear and eye symptoms in patients treated in the Department of Prosthodontics of the Medical University of Lublin. The patient group consisted of 753 women and 253 men aged 10 to 82 years who had been treated in the Department of Prosthodontics, Medical University of Lublin in the years 2003-2008 due to various symptoms associated with temporo-mandibular joint dysfunction. Eye (24.84%, n = 785) and ear (33.38%, n = 785) syndromes occur on average more often in patients with parafunctions than without them (15.98%, n = 219 and 23.29%, n = 219). However, only parafunctions involving tooth contact should be taken into consideration when diagnosing eye and ear syndromes. The data presented here show that the number of missing teeth does not have a significant influence on the frequency of occurrence of parafunctions. Parafunctions have become a very important factor in the diagnosis of diseases and pathological symptoms of eye and ear as the rate at which they occur is growing. The kind of parafunction is very important. Only those involving tooth contact should be taken into consideration when diagnosing eye and ear syndromes.
Michalak, Maciej; Wysokińska-Miszczuk, Joanna; Paulo, Michał; Bożyk, Andrzej; Borowicz, Janusz
2012-01-01
Introduction Parafunctions (harmful habits) play a crucial role in the formation of temporo-mandibular joint (TMJ) dysfunction syndrome with disc displacement. Disorder symptoms in temporo-mandibular joints manifest themselves in the eye and ear but are usually not associated with the dysfunction of temporo-mandibular joints and that might lead to errors in diagnosis. The aim of the study was to examine the influence of missing teeth and parafunctions on the occurrence of ear and eye symptoms in patients treated in the Department of Prosthodontics of the Medical University of Lublin. Material and methods The patient group consisted of 753 women and 253 men aged 10 to 82 years who had been treated in the Department of Prosthodontics, Medical University of Lublin in the years 2003-2008 due to various symptoms associated with temporo-mandibular joint dysfunction. Results Eye (24.84%, n = 785) and ear (33.38%, n = 785) syndromes occur on average more often in patients with parafunctions than without them (15.98%, n = 219 and 23.29%, n = 219). However, only parafunctions involving tooth contact should be taken into consideration when diagnosing eye and ear syndromes. The data presented here show that the number of missing teeth does not have a significant influence on the frequency of occurrence of parafunctions. Parafunctions have become a very important factor in the diagnosis of diseases and pathological symptoms of eye and ear as the rate at which they occur is growing. Conclusions The kind of parafunction is very important. Only those involving tooth contact should be taken into consideration when diagnosing eye and ear syndromes. PMID:22457683
Evaluation of impression accuracy for a four-implant mandibular model--a digital approach.
Stimmelmayr, Michael; Erdelt, Kurt; Güth, Jan-Frederik; Happe, Arndt; Beuer, Florian
2012-08-01
Implant-supported prosthodontics requires precise impressions to achieve a passive fit. Since the early 1990s, in vitro studies comparing different implant impression techniques were performed, capturing the data mostly mechanically. The purpose of this study was to evaluate the accuracy of three different impression techniques digitally. Dental implants were inserted bilaterally in ten polymer lower-arch models at the positions of the first molars and canines. From each original model, three different impressions (A, transfer; B, pick-up; and C, splinted pick-up) were taken. Scan-bodies were mounted on the implants of the polymer and on the lab analogues of the stone models and digitized. The scan-body in position 36 (FDI) of the digitized original and master casts were each superimposed, and the deviations of the remaining three scan-bodies were measured three-dimensionally. The systematic error of digitizing the models was 13 μm for the polymer and 5 μm for the stone model. The mean discrepancies of the original model to the stone casts were 124 μm (±34) μm for the transfer technique, 116 (±46) μm for the pick-up technique, and 80 (±25) μm for the splinted pick-up technique. There were statistically significant discrepancies between the evaluated impression techniques (p ≤ 0.025; ANOVA test). The splinted pick-up impression showed the least deviation between original and stone model; transfer and pick-up techniques showed similar results. For better accuracy of implant-supported prosthodontics, the splinted pick-up technique should be used for impressions of four implants evenly spread in edentulous jaws.
Manfredini, Daniele; Serra-Negra, Junia; Carboncini, Fabio; Lobbezoo, Frank
Bruxism is a common phenomenon, and emerging evidence suggests that biologic, psychologic, and exogenous factors have greater involvement than morphologic factors in its etiology. Diagnosis should adopt the grading system of possible, probable, and definite. In children, it could be a warning sign of certain psychologic disorders. The proposed mechanism for the bruxism-pain relationship at the individual level is that stress sensitivity and anxious personality traits may be responsible for bruxism activities that may lead to temporomandibular pain, which in turn is modulated by psychosocial factors. A multiple-P (plates, pep talk, psychology, pills) approach involving reversible treatments is recommended, and adult prosthodontic management should be based on a common-sense cautionary approach.
Guttal, Satyabodh Shesharaj; Kulkarni, Sudhindra S; Kudva, Adarsh; Thakur, Srinath
2015-01-01
Surgical treatment of malignancies in the oral cavity (mandible, tongue, floor of the mouth, alveolus, buccal sulcus) often results in an unfavourable anatomic condition for prosthodontic rehabilitation. Hence, maxillofacial prosthetic rehabilitation becomes a mightier task when resection is accompanied by radiation therapy. In selected cases, implant therapy comes to rescue. The following report throws light on the case of prosthetic rehabilitation of a patient who underwent right marginal mandibulectomy and right partial glossectomy, with the aid of a single implant, semi precision attachment and magnet supported partial denture. PMID:26501028
Ectodermal Dysplasia with Anodontia: A Report of Two Cases
Bani, Mehmet; Tezkirecioglu, Ali Melih; Akal, Nese; Tuzuner, Tamer
2010-01-01
Ectodermal dysplasia is a hereditary disorder that occurs as a consequence of disturbances in the ectoderm of the developing embryo. The triad of nail dystrophy, alopecia or hypotrichosis and palmoplantar hyperkeratosis is usually accompanied by a lack of sweat glands and a partial or complete absence of primary and/or permanent dentition. Two case reports illustrating the prosthetic rehabilitation of 2 young boys with anhidrotic ectodermal dysplasia associated with severe anodontia are presented. Since the oral rehabilitation of these cases is often difficult; particularly in pediatric patients, treatment should be administered by a multidisciplinary team involving pediatric dentistry, orthodontics, prosthodontics and oral-maxillofacial surgery. PMID:20396456
Emami, Elham; St-Georges, Annie; de Grandmont, Pierre
2012-01-01
In this case report, we describe the successful long-term treatment of a patient with dental agenesis. The initial treatment plan included an orthodontic phase to provide adequate space for replacing missing lateral incisors with implants. However, because of some complications encountered after 2 years of orthodontic treatment, a revised treatment plan was considered to achieve functional and esthetic goals. The patient was completely satisfied 5 years after being treated with two 2-unit cantilevered resin-bonded fixed partial dentures supported by the cuspids. This conservative treatment plan was cost-effective without having any significant biological cost.
Ebrahim, Fouad-Hassan; Kulkarni, Gajanan
2013-01-01
We describe a case of complex trauma to the early mixed dentition in which tooth avulsion, intrusion, extrusion and lateral luxation were managed effectively using a fixed, non-rigid orthodontic splint after treatment with a traditional wire-composite splint had failed. The use of orthodontic brackets and flexible wires provided several advantages, such as the ability to splint severely malpositioned teeth; easy assessment without removing the splint; slow, gentle repositioning of traumatized teeth; and gradual reestablishment of the arch form allowing for ease of future prosthodontic rehabilitation. Therefore, orthodontic appliances should be considered as a viable option for managing complex dental trauma.
Rehabilitation strategies for partially edentulous-prosthodontic principles and current trends.
D'Souza, Dsj; Dua, Parag
2011-07-01
The prosthetic considerations for treatment of partially edentulous patients involve evaluation of important aspects such as presence of certain functional or skeletal deficits, orientation of the occlusal plane, free-way space, size and location of edentulous areas, number, strategic location and quality of the likely abutment teeth, vertical dimension, and the type of occlusion. A comprehensive evaluation, multidisciplinary approach and a sequential treatment plan, worked out in harmony with the patient's perceptions are important factors to ensure a successful outcome. This article discusses the principles, current trends and importance of clinical decisions in designing a treatment strategy when confronted with complex situations of partial edentulism.
Role of Cone Beam Computed Tomography in Diagnosis and Treatment Planning in Dentistry: An Update.
Shukla, Sagrika; Chug, Ashi; Afrashtehfar, Kelvin I
2017-11-01
Accurate diagnosis and treatment planning are the backbone of any medical therapy; for this reason, cone beam computed tomography (CBCT) was introduced and has been widely used. CBCT technology provides a three-dimensional image viewing, enabling exact location and extent of lesions or any anatomical region. For the very same reason, CBCT can not only be used for surgical fields but also for fields such as endodontics, prosthodontics, and orthodontics for appropriate treatment planning and effective dental care. The aim and clinical significance of this review are to update dental clinicians on the CBCT applications in each dental specialty for an appropriate diagnosis and more predictable treatment.
Geminiani, Alessandro; Papadimitriou, Dimitrios E V; Ercoli, Carlo
2011-11-01
Several techniques have been proposed to manage patients with insufficient bone height for implant placement in the posterior maxilla. The lateral approach to sinus elevation is a successful procedure, with percentages of success close to 100%. Unfortunately, a frequent complication encountered during sinus elevation procedure is perforation of the Schneiderian membrane. In this clinical report, the authors present the application of a diamond coated sonic tip and an air-driven sonic instrument, commonly used in prosthodontics for the preparation of the lateral window osteotomy during sinus augmentation procedures. Copyright © 2011 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.
Parameswari, B Devi; Rajakumar, M; Jagadesaan, N; Annapoorni, H
2017-11-01
Palatal defect can be repaired by reconstructive surgery and/or a dental prosthesis. We present prosthodontic rehabilitation of two partially edentulous patients, both with surgically induced palatal defect and explains how to achieve the goal for esthetics and phonetics. This also describes the fabrication of a hollow obturator by two piece method, which is simple and may be used as definitive obturator for maximum comfort of the patient. In both the above cases, since the mouth opening is restricted due to surgery, obturator prosthesis is given as two pieces retained with opposite poles of magnet, which facilitates the removal and insertion of the prosthesis.
Novel management of intractable chylous fistula with the application of an impression paste.
Mingxing, Lu; Guowen, Sun; Zhiyong, Wang; Wei, Han
2013-01-01
Chylous fistula is a kind of complication during neck dissection that rarely happens, but might lead to some serious clinical outcome. The standard treatments include local compressive bandaging, negative pressure drainage, ligation of the fistula orifice, alimentary control, and, occasionally, the use of somatostatin. Among them, the simplest is compressive bandaging, but the bandage can easily become loosened and cannot achieve the necessary pressure effect. In this paper, the novel application of an impression paste, which is normally used in prosthodontic treatments, will be introduced. It might be a very practical method for the treatment of these surgical complications in hospitals where advanced treatment modalities are not available.
Shamim, Thorakkal
2013-09-01
Iatrogenic lesions can affect both hard and soft tissues in the oral cavity, induced by the dentist's activity, manner or therapy. There is no approved simple working classification for the iatrogenic lesions of teeth and associated structures in the oral cavity in the literature. A simple working classification is proposed here for iatrogenic lesions of teeth and associated structures in the oral cavity based on its relation with dental specialities. The dental specialities considered in this classification are conservative dentistry and endodontics, orthodontics, oral and maxillofacial surgery and prosthodontics. This classification will be useful for the dental clinician who is dealing with diseases of oral cavity.
Cleansing and surface modifying agents on implants: fixation and related aspects of aesthetics.
Ling, B C; Gillings, B R
1995-01-01
With the prognosis of dental implant replacement of missing teeth becoming better each year, practitioners are focusing their attention on the aesthetic aspects of implantology. However, improvement in aesthetics is only possible with the improvement in implant technology, surgical techniques and prosthodontic procedures. This study aimed at evaluating the effects of various physical and chemical agents on the implant surface; with the view of obtaining increased surface area and biocompatibility. The study found that the treatment of air-aluminum oxide blasted implants using a mixture of 30% HNO3-5% HF acids produced a surface which meets the consideration of aesthetics for implants placed in the anterior maxillary region.
Rehabilitation of maxillary arch with attachment-retained mesh-reinforced single complete denture
Vamsi Krishna, C H; Rao, A Kaleshwar; Sekhar, N Chandra; Shastry, Y Mahadev
2014-01-01
Fabrication of conventional complete dentures was one of the most commonly advised treatment options to mange edentulous patients since many years. One of the commonly encountered challenging tasks in prosthodontics is a clinical situation in which patients have maxillary completely edentulous arches opposing mandibular natural dentition. This situation can be effectively managed by retaining some of the natural teeth as overdenture abutments. Tooth supported overdenture retained by attachments will improve retention, support and stability, and reduces rate of ridge resorption along with psychological benefits to the patients by providing tactile sensation. The present case report describes management of patients with edentulous maxillary arch opposing natural mandibular dentition-rehabilitated attachment-retained mesh-reinforced overdenture. PMID:24574522
Rehabilitation of maxillary arch with attachment-retained mesh-reinforced single complete denture.
Vamsi Krishna, C H; Rao, A Kaleshwar; Sekhar, N Chandra; Shastry, Y Mahadev
2014-02-26
Fabrication of conventional complete dentures was one of the most commonly advised treatment options to mange edentulous patients since many years. One of the commonly encountered challenging tasks in prosthodontics is a clinical situation in which patients have maxillary completely edentulous arches opposing mandibular natural dentition. This situation can be effectively managed by retaining some of the natural teeth as overdenture abutments. Tooth supported overdenture retained by attachments will improve retention, support and stability, and reduces rate of ridge resorption along with psychological benefits to the patients by providing tactile sensation. The present case report describes management of patients with edentulous maxillary arch opposing natural mandibular dentition-rehabilitated attachment-retained mesh-reinforced overdenture.
Yoon, Hyung-In
2016-10-01
This report is to present the treatment procedure and clinical considerations of prosthodontic management of a patient who had undergone a partial mandibulectomy and fibular free flap surgery. A 59-year-old man with a squamous cell carcinoma received a partial mandibular resection. Microsurgical reconstruction with a fibular free flap surgery and implant-supported zirconia-fixed prosthesis produced by computer-aided manufacturing led to successful results for the oral rehabilitation of mandibular defects. The implant-supported zirconia-fixed prosthesis can be recommended for use in patients with mandibulectomy and fibular free flaps. Close cooperation between the surgeon and the prosthodontist is mandatory for the satisfaction of the patient.
Oral Rehabilitation of an Osteopetrosis Patient with Osteomyelitis
Celakil, Tamer; Dogan, Merve; Rohlig, Bilge Gokcen; Evlioglu, Gulumser; Keskin, Haluk
2016-01-01
Osteopetrosis is a congenital disorder characterized by increasing osteoclastic function resulting in osteomyelitis in the jaws. Orofacial findings in osteopetrosis patients are unerupted, malformed, or delayed teeth and many dental caries due to vulnerable enamel and dentin and osteomyelitis. Many reports have described that maxilla is an uncommon site of occurrence for osteomyelitis due to cortical bone morphology and collateral circulation. This report aims to discuss clinical features and prosthodontic management of a patient with clinical features of adult form of osteopetrosis and osteomyelitis in both jaws. The patient has reported better masticatory and speech efficiency with removable dentures in maxillary and mandibular jaw and also self-esteem improvement and family interaction. PMID:27148461
Oral Rehabilitation of an Osteopetrosis Patient with Osteomyelitis.
Celakil, Tamer; Dogan, Merve; Rohlig, Bilge Gokcen; Evlioglu, Gulumser; Keskin, Haluk
2016-01-01
Osteopetrosis is a congenital disorder characterized by increasing osteoclastic function resulting in osteomyelitis in the jaws. Orofacial findings in osteopetrosis patients are unerupted, malformed, or delayed teeth and many dental caries due to vulnerable enamel and dentin and osteomyelitis. Many reports have described that maxilla is an uncommon site of occurrence for osteomyelitis due to cortical bone morphology and collateral circulation. This report aims to discuss clinical features and prosthodontic management of a patient with clinical features of adult form of osteopetrosis and osteomyelitis in both jaws. The patient has reported better masticatory and speech efficiency with removable dentures in maxillary and mandibular jaw and also self-esteem improvement and family interaction.
Gill, Simrone K; Roohpour, Nima; Topham, Paul D; Tighe, Brian J
2017-11-01
Nature provides many interesting examples of adhesive strategies. Of particular note, the protein glue secreted by marine mussels delivers high adhesion in wet and dynamic environments owing to existence of catechol moieties. As such, this study focuses on denture fixatives, where a non-zinc-containing commercial-based formulation has been judiciously modified by a biomimetic catechol-inspired polymer, poly(3,4-dihydroxystyrene/styrene-alt-maleic acid) in a quest to modulate adhesive performance. In vitro studies, in a lap-shear configuration, revealed that the catechol-modified components were able to enhance adhesion to both the denture base and hydrated, functional oral tissue mimic, with the resulting mode of failure prominently being adhesive rather than cohesive. These characteristics are desirable in prosthodontic fixative applications, for which temporary adhesion must be maintained, with ultimately an adhesive failure from the mucosal tissue surface preferred. These insights provide an experimental platform in the design of future biomimetic adhesive systems. Mussel adhesive proteins have proven to be promising biomimetic adhesive candidates for soft tissues and here for the first time we have adapted marine adhesive technology into a denture fixative application. Importantly, we have incorporated a soft tissue mimic in our in vitro adhesion technique that more closely resembles the oral mucosa than previously studied substrates. The novel biomimetic-modified adhesives showed the ability to score the highest adhesive bonding out of all the formulations included in this study, across all moisture levels. This paper will be of major interest to the Acta Biomaterialia readership since the study has illustrated the potential of biomimetic principles in the design of effective prosthodontic tissue adhesives in a series of purpose-designed in vitro experiments in the context of the challenging features of the oral environment. Copyright © 2017 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.
Effects of joint configuration for the arc welding of cast Ti-6Al-4V alloy rods in argon.
Taylor, J C; Hondrum, S O; Prasad, A; Brodersen, C A
1998-03-01
Titanium and its alloys are more commonly used in prosthodontics and welding has become the most common modality for their joining. Studies on the welding of titanium and its alloys have not quantified this value, though its importance has been suggested. This study compared the strength and properties of the joint achieved at various butt joint gaps by the arc-welding of cast Ti-6Al-4V alloy tensile bars in an argon atmosphere. Forty of 50 specimens were sectioned and welded at four gaps. All specimens underwent tensile testing to determine ultimate tensile strength and percentage elongation, then oxygen analysis and scanning electron microscopy. As no more than 3 samples in any group of 10 actually fractured in the weld itself, a secondary analysis that involved fracture location was initiated. There were no differences in ultimate tensile strength or percentage elongation between specimens with weld gaps of 0.25, 0.50, 0.75, and 1.00 mm and the as-cast specimens. There were no differences in ultimate tensile strength between specimens fracturing in the weld and those fracturing in the gauge in welded specimens; however, as-cast specimens demonstrated a higher ultimate tensile strength than welded specimens that fractured in the weld. Specimens that fractured in the weld site demonstrated less ductility than those that fractured in the gauge in both welded and as-cast specimens, as confirmed by scanning electron microscopy examination. The weld wire showed an oxygen scavenging effect from the as-cast parent alloy. The effects of the joint gap were not significant, whereas the characteristics of the joint itself were, which displayed slightly lower strength and significantly lower ductility (and thus decreased toughness). The arc-welding of cast titanium alloy in argon atmosphere appears to be a reliable and efficient prosthodontic laboratory modality producing predictable results, although titanium casting and joining procedures must be closely controlled to minimize heat effects and oxygen contamination.
Influence of scanning system and dentist's level of training in the accuracy of digital impressions
NASA Astrophysics Data System (ADS)
Hategan, Simona; Gabor, Alin; Zaharia, Cristian; Sinescu, Cosmin; Negrutiu, Meda Lavinia; Jivanescu, Anca
2016-03-01
Background: The principal aim of our study was to evaluate digital impressions, taken with spray powder and powderfree scan systems, in order to determine the influence of the dentist's commitment to training as a critical factor regarding quality. Material and method: Two digital intraoral impression systems from the same manufacture (Sirona) : Apollo DI and CEREC Omnicam, were used to scan 16 crown preparations on teeth on a typodont maxillary model. Because an Apollo Di intraoral camera is a powder system, an adhesive was applied before using the powder spray. Three groups were used to scan the crown preparations in order to determine coating thickness homogeneity. One group consisted of senior year dental students, a second consisted of prosthodontics residents, and the third consisted of prosthodontics specialists. The same procedure was applied with a CEREC Omnicam intraoral camera, which is a powder-free system. By using the two systems software parameters we were able to determine the scanning precision. Results: Homogeneity scores for Apollo Di regarding the spray layer was significantly thinner for all dental surfaces in the first group, while the second group had thinner coatings for buccal and distal surfaces. For the third group, the crown preparations were coated more homogeneously than the first two groups. The powder-free system CEREC Omnicam can, to a degree, mask the lack of experience in direct optical impressions by avoiding the poor quality coating, which can lead to defective marginal adaptation of definitive restoration. Conclusions: The dentist's lack of experience can be mitigated, and partially avoided, by using powder-free systems. At the same time, the dentist can give more time towards learning how to integrate computerized fabricated restoration into the practice. The commitment to training is a critical factor in the successful integration of the technology. In addition, scanning marginal preparation details needs time in order to develop technical and manual skills.
Waddell, J Neil; Payne, Alan G T; Swain, Michael V; Kieser, Jules A
2010-03-01
Soldered or cast bars are used as a standard of care in attachment systems supporting maxillary and mandibular implant overdentures. When failures of these bars occur, currently there is a lack of evidence in relation to their specific etiology, location, or nature. To investigate the failure process of a case series of six failed soldered bars, four intact soldered bars, and one intact cast milled bar, which had been supporting implant overdentures. A total of 11 different overdenture bars were removed from patients with different configuration of opposing arches. A failed bar (FB) group (n = 6) had failed soldered overdenture bars, which were recovered from patients following up to 2 years of wear before requiring prosthodontic maintenance and repair. An intact bar (IB) group (n = 5) had both soldered bars and a single cast milled bar, which had been worn by patients for 2 to 5 years prior to receiving other aspects of prosthodontic maintenance. All bars were examined using scanning electron microscopy to establish the possible mode of failure (FB) or to identify evidence of potential failure in the future (IB). Evidence of a progressive failure mode of corrosion fatigue and creep were observed on all the FB and IB usually around the solder areas and nonoxidizing gold cylinder. Fatigue and creep were also observed in all the IB. Where the level of corrosion was substantial, there was no evidence of wear from the matrices of the attachment system. Evidence of an instantaneous failure mode, ductile and brittle overload, was observed on the fracture surfaces of all the FB, within the solder and the nonoxidizing gold cylinders, at the solder/cylinder interface. Corrosion, followed by corrosion fatigue, appears to be a key factor in the onset of the failure process for overdenture bars in this case series of both maxillary and mandibular overdentures. Limited sample size and lack of standardization identify trends only but prevent broad interpretation of the findings.
Wang, Rong; Xu, Xin
2015-12-01
To compare the effect of 2 methods of occlusion adjustment on occlusal balance and muscles of mastication in patients with dental implant restoration. Twenty patients, each with a single edentulous posterior dentition with no distal dentition were selected, and divided into 2 groups. Patients in group A underwent original occlusion adjustment method and patients in group B underwent occlusal plane reduction technique. Ankylos implants were implanted in the edentulous space in each patient and restored with fixed prosthodontics single unit crown. Occlusion was adjusted in each restoration accordingly. Electromyograms were conducted to determine the effect of adjustment methods on occlusion and muscles of mastication 3 months and 6 months after initial restoration and adjustment. Data was collected and measurements for balanced occlusal measuring standards were obtained, including central occlusion force (COF), asymmetry index of molar occlusal force(AMOF). Balanced muscles of mastication measuring standards were also obtained including measurements from electromyogram for the muscles of mastication and the anterior bundle of the temporalis muscle at the mandibular rest position, average electromyogram measurements of the anterior bundle of the temporalis muscle at the intercuspal position(ICP), Astot, masseter muscle asymmetry index, and anterior temporalis asymmetry index (ASTA). Statistical analysis was performed using Student 's t test with SPSS 18.0 software package. Three months after occlusion adjustment, parameters of the original occlusion adjustment method were significantly different between group A and group B in balanced occlusal measuring standards and balanced muscles of mastication measuring standards. Six months after occlusion adjustment, parameters of the original occlusion adjustment methods were significantly different between group A and group B in balanced muscles of mastication measuring standards, but was no significant difference in balanced occlusal measuring standards. Using occlusion plane reduction adjustment technique, it is possible to obtain occlusion index and muscles of mastication's electromyogram index similar to the opposite side's natural dentition in patients with single unit fix prosthodontics crown and single posterior edentulous dentition without distal dentitions.
Besford, J N; Sutton, A F
2018-01-12
Patients requiring dentures are getting older and as a result can be difficult to treat owing to various co-morbidities. This series of papers presents an overview of the processes involved in making removable dentures which the patient considers to be functionally and aesthetically successful. We hope not only to provide technical suggestions but also to address the issue of the clinician's, technician's and dental nurse's relationships with the dentally depleted patient. It is increasingly clear from defence organisation reports that this has a decisive effect on the success of this fundamentally difficult enterprise ('The only branch of dentistry in which you are trying to attach something to nothing' [Hubert Aïche]). It seems best to conduct the planning and the treatment itself as a co-production - the patient assuming responsibility for choosing between the treatment options offered and playing the leading role in making aesthetic decisions. Distinctions are drawn between the idealised whiter-than-white, 'nobody-in-particular', attention-seeking denture at one extreme, and the highly personalised, discreet and naturalistic denture at the other. Reproducing nature in this way is time consuming and therefore expensive, but many 'denture sufferers' see it as good value. Methods for creating the latter, which through its very normality switches off the social observer's attention, are explained in detail in papers two and three of this series. These papers are designed to help clinicians and technicians involved in providing removable prosthodontics improve the appearance of their dentures and increase their patients' aesthetic satisfaction. They are not scientific articles in the Popperian sense of advancing theories which are capable of being falsified. Instead, they are an amalgamation of 72 years of combined experience in providing removable dental prostheses. We have found this branch of dentistry immensely interesting and have on many occasions had the satisfaction of seeing our patients' lives changed for the better.
Khan, Saadika; Musekiwa, Alfred; Chikte, Usuf M. E.; Omar, Ridwaan
2014-01-01
This review examined differences in functional outcomes and patient satisfaction when shortened dental arches are left untreated compared to their restoration to complete arch lengths with different prosthodontic interventions. Methods A protocol was developed according to the criteria for a systematic review. All relevant databases were searched to identify appropriate clinical trials regardless of language or publication status. Predetermined eligibility criteria were applied, trial quality assessed and data extracted for each study. Relevant outcomes assessed were: functioning ability, patient satisfaction and harmful effects on oral structures. Results Searches yielded 101 articles: 81 from electronic databases and 20 from reference lists of retrieved articles (PEARLing searches). Sixty-nine citations were assessed for eligibility after removing 32 duplicate records. After reading titles and abstracts, a total of 41 records were excluded and the full-texts of the remaining 28 records were read. Only 21 records were included for the SR because 7 records were excluded after reading the full-text reports. These 21 records report the outcomes of four randomized controlled trials (RCTs) and one non-randomized clinical trial (CT) which were pre-specified and used for this review. No on-going studies were found and no eligible studies were excluded for failure to report the reviewer’s pre-specified outcomes. Outcomes were reported in the retrieved 21 articles. A narrative explanation of the pre-specified outcomes is reported for the 3 comparison groups (which were based on the different interventions used for the individual clinical trials). The shortened dental arch as a treatment option is encouraging in terms of functioning, patient satisfaction and cost-effectiveness. By using only high quality studies it was expected that the results would be more reliable when making conclusions and recommendations, but some of the included studies had to be downgraded due to methodological errors. PMID:24992473
Clinical Characteristics of Abutment Teeth with Gingival Discoloration.
Ristic, Ljubisa; Dakovic, Dragana; Postic, Srdjan; Lazic, Zoran; Bacevic, Miljana; Vucevic, Dragana
2017-04-06
The grey-bluish discoloration of gingiva (known as "amalgam tattoo") does not appear only in the presence of amalgam restorations. It may also be seen in cases of teeth restored with cast dowels and porcelain-fused-to-metal (PFM) restorations. The aim of this article was to determine the clinical characteristics of abutment teeth with gingival discoloration. This research was conducted on 25 patients referred for cast dowel and PFM restorations. These restorations were manufactured from Ni-Cr alloys. Ninety days after cementing the fixed prosthodontic restorations, the abutment teeth (n = 61) were divided into a group with gingival discoloration (GD) (n = 25) and without gingival discoloration (NGD) (n = 36). The control group (CG) comprised the contralateral teeth (n = 61). Plaque index, gingival index, clinical attachment level, and probing depth were assessed before fabrication and also 90 days after cementation of the PFM restorations. The gingival index, clinical attachment level, and probing depths of the abutment teeth that had GD were statistically higher before restoration, in comparison with the abutment teeth in the NGD and control groups. Ninety days after cementation, the abutment teeth with GD had significantly lower gingival indexes and probing depths, compared to the abutment teeth in the NGD group. Both abutment teeth groups (GD and NGD) had significantly higher values of clinical attachment levels when compared to the control group. There were no statistically significant differences in plaque index values between the study groups. The results of this study indicated that impairment of periodontal status of abutment teeth seemed to be related to the presence of gingival discolorations. Therefore, fabrication of fixed prosthodontic restorations requires careful planning and abutment teeth preparation to minimize the occurrence of gingival discolorations. With careful preparation of abutment teeth for cast dowels and crown restorations it may be possible to decrease the frequency of gingival discolorations adjacent to abutment teeth. © 2017 by the American College of Prosthodontists.
A 5-year randomized trial to compare 1 or 2 implants for implant overdentures.
Bryant, S R; Walton, J N; MacEntee, M I
2015-01-01
The hypothesis of this 5-y randomized clinical trial was that there would be no significant difference in the satisfaction of edentulous participants with removable complete overdentures attached to 1 or 2 mandibular implants. Secondary aims were to test changes in satisfaction between and within the groups from baseline to 5 y and differences between the groups in implant survival and prosthodontic maintenance over 5 y. Each of the 86 participants (mean age, 67 y) was randomly allocated to receive either 1 implant in the midline (group 1) or 2 implants in the canine areas (group 2) attached to a mandibular overdenture opposing a maxillary complete denture. Satisfaction was self-assessed by participants on a visual analog scale at baseline prior to implants, as well as at 2 mo and 1, 3, and 5 y with implant overdentures, whereas implant survival and prosthodontic maintenance were assessed by clinical examination. After 5 y, 29 participants in group 1 and 33 in group 2 were available, with most dropouts due to death. Satisfaction with the implant denture after 5 y was significantly (P < 0.001) higher than at baseline in both groups and remained with no significant difference (P = 0.32) between the groups. No implants failed in group 1 but 5 failed before loading in 4 participants in group 2. Most participants required maintenance or occasionally denture replacement, and although differences between the groups were not statistically significant, group 1 experienced almost twice as many fractured dentures usually adjacent to the implant attachment. We conclude that there were no significant differences after 5 y in satisfaction or survival of implants with mandibular overdentures retained by 1 implant or 2 implants. Additional research is required to confirm long-term treatment effectiveness of single-implant dentures and the implications of prosthetic maintenance with implant overdentures (ClinicalTrials.gov: NCT02117856). © International & American Associations for Dental Research 2014.
Long term rehabilitation of a total glossectomy patient.
Bachher, Gurmit Kaur; Dholam, Kanchan P
2010-09-01
Malignant tumours of the oral cavity that require resection of the tongue result in severe deficiencies in speech and deglutition. Speech misarticulation leads to loss of speech intelligibility, which can prevent or limit communication. Prosthodontic rehabilitation involves fabrication of a Palatal Augmentation Prosthesis (PAP) following partial glossectomy and a mandibular tongue prosthesis after total glossectomy [1]. Speech analysis of a total glossectmy patient rehabilitated with a tongue prosthesis was done with the help of Dr. Speech Software Version 4 (Tiger DRS, Inc., Seattle) twelve years after treatment. Speech therapy sessions along with a prosthesis helped him to correct the dental sounds by using the lower lip and upper dentures (labio-dentals). It was noticed that speech intelligibility, intonation pattern, speech articulation and overall loudness was noticeably improved.
Xie, Qing-tiao; Huang, Xuan-ping; Jiang, Xian-fang; Yang, Yuan-yuan; Li, Hua; Lin, Xi
2013-08-01
To evaluate the clinical effect of joint reconstruction by using autogenous coronoid process graft to treat temporomandibular joint(TMJ) ankylosis. Nine cases of TMJ ankylosis from September 2008 to September 2010 were surgically treated by joint reconstruction with autogenous coronoid process graft, using autogenous articular disc or prosthodontic membrane as interpositional material. Mouth opening, occlusion and cone beam CT(CBCT) were used for evaluation before and after surgery. Satisfactory mouth opening was achieved in all patients and no one got occlusal changes or reankylosis during follow-up. CBCT showed that coronoid process graft reached bone union with the ramus and turned to be round. It is effective to cure TMJ ankylosis through joint reconstruction with autogenous coronoid process graft.
Polat, Zelal Seyfioğlu; Tacir, Ibrahim Halil
2007-01-01
This article describes the restoration of an intruded root using a custom-made metal dowel and metal-ceramic veneer core restoration. The treatment plan for this patient consisted of restoring the missing esthetics and eliminating psychological trauma by utilizing the root of the intruded maxillary left central incisor to replace both missing central incisor crowns. This treatment will preserve space and bone until the patient is old enough for another prosthodontic restoration to be considered. As the lost fragments were not recovered, we considered this restoration of the intruded root to be the best therapeutic option, considering the effect on the patient's psyche. The patient was satisfied with the final result.
Rungcharassaeng, K; Kan, J Y
1999-02-01
A stable record base is essential for accurate interocclusal centric relation records in a completely edentulous patient. In implant prosthodontics, several procedures have been suggested for the fabrication of a stable record base. However, these procedures necessitate removal of the healing abutments during the interocclusal record procedure and the trial denture placement, which makes the procedures tedious and time-consuming. When the implant-prosthesis interface is subgingival, the patient may also experience discomfort during these procedures. This article describes a procedure for fabricating a stable record base that uses the healing abutments, which eliminates the necessity of the healing abutment removal and its consequences. Advantages and disadvantages of this procedure are also discussed.
Correction of a malpositioned endosseous implant by a segmental osteotomy: a case report.
Raghoebar, Gerry M; Visser, Anita; Vissink, Arjan
2005-01-01
A mandibular overdenture supported by 2 or 4 endosseous implants has been proven to be a reliable treatment modality for patients suffering from conventional denture problems. However, fabrication of an implant-retained mesostructure to support an overdenture is not possible in all cases. Malpositioning of implants is a common cause of failure in such cases. A case is presented in which a ball attachment caused pain and severe swelling of the floor of the mouth because of the lingual inclination of an endosseous implant. The lingual inclination of the implant was corrected by a segmental osteotomy. Six weeks later, prosthodontic treatment began, and the resultant overdenture supported by a Dolder bar was quite acceptable for the patient.
A Different Pontic Design for Fiber-Reinforced Composite Bridgeworks: A Clinical Report
Kumbuloḡlu, Ovul; Özdemir, Niler; Aksoy, Gökhan; User, Atilla
2007-01-01
Objectives This clinical report describes a relatively simple but esthetic, non-invasive and functional prosthodontic treatment option for a patient with missing tooth. Methods A patient with a missing maxillary left canine was non-invasively treated with a fiber reinforced composite (FRC) bridgework with an all ceramic (Empress II, Ivoclar Vivadent, Schaan, Liech-tenstein) pontic design, using laboratory technique. Results The restoration has served the patient for 2 year, seemingly without discomfort, and it has not required any maintenance. The patient has kept up with his oral hygiene. Conclusions Although additional clinical experience is necessary, fiber-reinforced composite materials can be used in combination with a lithium disilicate ceramic material in fixed partial dentures. PMID:19212498
Kalsi, Harpoonam J; Wang, Yon Jon; Bavisha, Kalpesh; Bartlett, David
2010-03-01
The average number of visits for the construction of metal-based and acrylic dentures by junior hospital staff was 10 visits. Our hypothesis was that supervision would optimise the number of visits and reduce any need for remakes. The first audit cycle was retrospective and included all patients treated by SHOs in the Prosthodontics Department. The standard of care was compared to the British Society for the Study of Prosthetic Dentistry. The re-audit showed that the time taken to completion was reduced by 2 visits for both denture types and the average length of time was reduced from 31 weeks to 22 weeks. These improvements were directly related to improved supervision by senior staff.
Atieh, Momen A; Alsabeeha, Nabeel H M; Payne, Alan G T; Duncan, Warwick; Faggion, Clovis M; Esposito, Marco
2015-05-28
Alveolar bone changes following tooth extraction can compromise prosthodontic rehabilitation. Alveolar ridge preservation (ARP) has been proposed to limit these changes and improve prosthodontic and aesthetic outcomes when implants are used. To assess the clinical effects of various materials and techniques for ARP after tooth extraction compared with extraction alone or other methods of ARP, or both, in patients requiring dental implant placement following healing of extraction sockets. The following electronic databases were searched: the Cochrane Oral Health Group's Trials Register (to 22 July 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2014, Issue 6), MEDLINE via OVID (1946 to 22 July 2014), EMBASE via OVID (1980 to 22 July 2014), LILACS via BIREME (1982 to 22 July 2014), the Meta Register of Current Controlled Trials (to 22 July 2014), ClinicalTrials.gov (to 22 July 2014), the World Health Organization International Clinical Trials Registry Platform (to 22 July 2014), Web of Science Conference Proceedings (1990 to 22 July 2014), Scopus (1966 to 22 July 2014), ProQuest Dissertations and Theses (1861 to 22 July 2014) and OpenGrey (to 22 July 2014). A number of journals were also handsearched. Trial authors were contacted to identify unpublished randomised controlled trials. There were no restrictions regarding language and date of publication in the searches of the electronic databases. We included all randomised controlled trials (RCTs) on the use of alveolar ridge preservation techniques with at least six months of follow-up. Outcome measures were: changes in the bucco-lingual/palatal width of alveolar ridge, changes in the vertical height of the alveolar ridge, complications, the need for additional augmentation prior to implant placement, aesthetic outcomes, implant failure rates, peri-implant marginal bone level changes, changes in probing depths and clinical attachment levels at teeth adjacent to the extraction site, and complications of future prosthodontic rehabilitation. Two review authors extracted data independently and assessed risk of bias for each included trial. Corresponding authors were contacted to obtain missing information. Results were combined using random-effects models with mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes, with 95% confidence intervals (95% CI). We constructed 'Summary of findings' tables to present the main findings. A total of 50 trials were potentially eligible for inclusion, of which 42 trials were excluded. We included eight RCTs with a total of 233 extraction sites in 184 participants. One trial was judged to be at unclear risk of bias and the remaining trials were at high risk of bias. From two trials comparing xenograft with extraction alone (70 participants, moderate quality evidence), there was some evidence of a reduction in loss of alveolar ridge height (MD -2.60 mm; 95% CI -3.43 to -1.76) and width (MD -1.97 mm; 95% CI -2.48 to -1.46). This was also found in one trial comparing allograft with extraction (24 participants, low quality evidence): ridge height (MD -2.20 mm; 95% CI -0.75 to -3.65) and width (MD - 1.40 mm; 95% CI 0.00 to -2.80) and height. From two RCTs comparing alloplast versus xenograft no evidence was found that either ridge preservation technique caused a smaller reduction in loss of ridge height (MD -0.35 mm; 95% CI -0.86 to 0.16) or width (MD -0.44 mm; 95% CI -0.90 to 0.02; two trials (55 participants); moderate quality evidence). There was insufficient evidence to determine whether there are clinically significant differences between different ARP techniques and extraction based on the need for additional augmentation prior to implant placement, complications, implant failure, or changes in peri-implant marginal bone levels and probing depths of neighbouring teeth. We found no trials which evaluated parameters relating to clinical attachment levels, specific aesthetic or prosthodontic outcomes. There is limited evidence that ARP techniques may minimise the overall changes in residual ridge height and width six months after extraction. There is also lack of evidence of any differences in implant failure, aesthetic outcomes or any other clinical parameters due to the lack of information or long-term data. There is no convincing evidence of any clinically significant difference between different grafting materials and barriers used for ARP. Further long term RCTs that follow CONSORT guidelines (www.consort-statement.org) are necessary.
Management of a high risk epileptic patient under conscious sedation: A multidisciplinary approach
Chellathurai, Burnice Nalina Kumari; Thiagarajan, Ramakrishnan; Jayakumaran, SelvaKumar; Devadoss, Pradeep; Elavazhagan
2016-01-01
Epilepsy, characterized by the risk of recurrent seizures, is a chronic disease that afflicts about 5% of the world's population. The main dental problems associated with epileptic patients include gingival hyperplasia, minor oral injuries, tooth trauma, and prosthodontic problems, which require the dental treatment. Stress and fear are the most common triggering factors for the epilepsy in dental chair. Therefore, a more appropriate method of treating such epileptic patients may be warranted. Conscious sedation is a technique of providing good anesthesia and analgesia to patients, the main advantage of which is the patient's rapid return to presentation levels. Midazolam used as a sedative agent has anticonvulsant properties. This case report highlights a case requiring multiple dental procedures carried out in a high risk epileptic patient under conscious sedation. PMID:27041847
The prediction in computer color matching of dentistry based on GA+BP neural network.
Li, Haisheng; Lai, Long; Chen, Li; Lu, Cheng; Cai, Qiang
2015-01-01
Although the use of computer color matching can reduce the influence of subjective factors by technicians, matching the color of a natural tooth with a ceramic restoration is still one of the most challenging topics in esthetic prosthodontics. Back propagation neural network (BPNN) has already been introduced into the computer color matching in dentistry, but it has disadvantages such as unstable and low accuracy. In our study, we adopt genetic algorithm (GA) to optimize the initial weights and threshold values in BPNN for improving the matching precision. To our knowledge, we firstly combine the BPNN with GA in computer color matching in dentistry. Extensive experiments demonstrate that the proposed method improves the precision and prediction robustness of the color matching in restorative dentistry.
[Computer aided design and manufacture of the porcelain fused to metal crown].
Nie, Xin; Cheng, Xiaosheng; Dai, Ning; Yu, Qing; Hao, Guodong; Sun, Quanping
2009-04-01
In order to satisfy the current demand for fast and high-quality prosthodontics, we have carried out a research in the fabrication process of the porcelain fused to metal crown on molar with CAD/CAM technology. Firstly, we get the data of the surface mesh on preparation teeth through a 3D-optical grating measuring system. Then, we reconstruct the 3D-model crown with the computer-aided design software which was developed by ourselves. Finally, with the 3D-model data, we produce a metallic crown on a high-speed CNC carving machine. The result has proved that the metallic crown can match the preparation teeth ideally. The fabrication process is reliable and efficient, and the restoration is precise and steady in quality.
Torus palatinus and torus mandibularis in edentulous patients.
Al Quran, Firas A M; Al-Dwairi, Ziad N
2006-05-01
To determine the prevalence of tori in Jordanian edentulous patients, the sex variation in their distribution, and their clinical characteristics. Three hundred and thirty eight patients were examined in the Prosthodontic Clinic in the Department of Restorative Dentistry at Jordan University of Science and Technology. The location, extent, and clinical presentation of tori were recorded related to the age and sex of patients. The overall prevalence of tori was 13.9%. The prevalence of torus palatinus was 29.8% (14/47), while that of torus mandibularis was significantly higher 42.6% (20/47). Both types of tori were associated with each other in 27.7% of cases (13/47). There was no significant difference in the prevalence of tori between males and females. There seems to be a strong association between mandibular and palatal tori.
Using implants for prosthodontic rehabilitation of a 4-year-old with ectodermal dysplasia.
Toomarian, Lida; Ardakani, Mohammad Reza Talebi; Ramezani, Jamileh; Adli, Amin Rezaei; Tabari, Zahra Alizadeh
2014-01-01
Ectodermal dysplasia (ED) is an inherited disorder that affects ectodermally derived organs, such as teeth. Pathogenesis is thought to involve an altered epithelium-mesenchymal interaction. ED patients have oligodontia (or sometimes anodontia) in addition to other abnormalities involving the skin, sweat glands, or hair. Many different subtypes have been introduced in the literature. This article describes the case of a 4-year-old patient who, after being diagnosed with ED, was put on a treatment plan that involved mandibular implants, reshaping of the maxillary primary central incisors, and prosthetic dental rehabilitation. Due to the child's rapid growth, both dentures were changed 9 months post-treatment. Two years post-treatment, the maxillary denture was changed again and the child was placed under close supervision.
The Use of 3D Metal Printing (Direct Metal Laser Sintering) in Removable Prosthodontics.
Laverty, Dominic P; Thomas, Matthew B M; Clark, Paul; Addy, Liam D
2016-11-01
The use of 3D printing is expanding and it is envisaged that it will have an increasing presence within dentistry. Having an appreciation and understanding of such technology is therefore paramount. It is currently used to produce a variety of dental objects/prostheses. This paper briefly looks at 3D printing in dentistry and specifically describes the use of the direct metal laser sintering 3D printing technique in the production of cobalt chromium removable prosthesis frameworks. Clinical relevance: Understanding the different technologies that can and are being used within the dental field is important, particularly as it is a rapidly changing field. Having an understanding of such technologies will allow practitioners to utilize such technologies appropriately in the management of their patients.
Vajdovich, I; Fazekas, A
1999-01-01
This paper reports on 10 years of clinical experience with implant prosthodontic treatment of total edentulism. During this period, of the 735 implants that were inserted, only 19 were lost, a 97.4% success rate. The authors believe that evaluating the success of implant treatment requires examining the health of the peripilastrium with periodontologic methods. The indices the authors used for such an evaluation were plaque accumulation, crevicular fluid flow rate, and sulcus bleeding; crevicular fluid flow proved the most satisfactory for estimating the health of peri-implant tissues. The results demonstrate that peri-implant-tissue health is similar to that of the tissues surrounding nontreated natural teeth and better than that of the tissues surrounding natural teeth wearing crowns.
Prosthetic rehabilitation in patient with achalasia cardia — A rare case report
Kondaka, Sudheer; Rao, Bathala L.; Reddy, Juturi R.; Akula, Rajesh
2016-01-01
Achalasia Cardia is an idiopathic esophageal motor disorder distinguished by the loss of esophageal peristalsis and insufficient relaxation of the lower esophageal sphincter. The oral manifestation of the disease is dental erosion caused by the regurgitation of the gastric contents and vomiting. A female patient aged 14 years reported to the Department of Prosthodontics, Lenora Institute of Dental Sciences, with complaints concerning aesthetics and pain in relation to several teeth. Patient gave history of loss of tooth structure over the past few years with associated sensitivity and pain in several teeth. Patient also gave history of inability to consume sufficient amount of food owing to the repeated vomiting. This paper aims to present a rare case report of achalasia cardia by rehabiliting the remaining teeth with overlay denture. PMID:27583229
Periodontics, Implantology, and Prosthodontics Integrated: The Zenith-Driven Rehabilitation
Cabral, Guilherme
2017-01-01
A customized treatment plan is important to reach results that will satisfy the patient providing esthetics, function, and long-term stability. This type of oral rehabilitation requires professionals from different dental specialties where communication is a major key point. Digital Smile Design allows the practitioners to plan and discuss the patient's condition to establish the proper treatment plan, which must be driven by the desired zenith position. The ideal gingival position will guide the professionals and determine the need to perform surgical procedures or orthodontic movement before placing the final restorations. In this article, the zenith-driven concept is discussed and a challenging case is presented with 4-year follow-up where tooth extraction, immediate implant placement, bone regeneration, and a connective tissue graft were performed. PMID:28713600
The Impact of the Crown-Root Ratio on Survival of Abutment Teeth for Dentures.
Tada, S; Allen, P F; Ikebe, K; Zheng, H; Shintani, A; Maeda, Y
2015-09-01
Crown-root ratio (CRR) is commonly recorded when planning prosthodontic procedures. However, there is a lack of longitudinal clinical data evaluating the association between CRR and tooth survival. The aim of this longitudinal practice-based study was to assess the impact of CRR on the survival of abutment teeth for removable partial dentures (RPDs). Data were collected from 147 patients provided with RPDs at a dental hospital in Japan. In total, 236 clasp-retained RPDs and 856 abutment teeth were analyzed. Survival of abutment teeth was assessed using Kaplan-Meier methods and Cox's proportional hazard (PH) regression. The Cox PH regression was used to assess the prognostic significance of initial CRR value with adjustments for clinically relevant factors, including age, sex, frequency of periodontal maintenance programs, occlusal support area, type of abutment tooth, status of endodontic treatment, and probing pocket depth. Abutment teeth were divided into 1 of 5 risk groups according to CRR: A (≤0.75), B (0.76-1.00), C (1.01-1.25), D (1.26-1.50) and E (≥1.51). The 7-year survival rate was 89.1% for group A, 85.9% for group B, 86.5% for group C, 76.9% for group D, and 46.7% for group E. The survival curves of groups A, B, and C were illustrated to be quite similar and favorable. The multivariable analysis treating CRR as a continuous variable allowed estimation of the hazard ratio at any specific CRR value. When CRR = 0.80 was set as a reference, the estimated hazard ratio was 0.58 for CRR = 0.50 (95% confidence interval [CI], 0.36-0.91), 1.13 for CRR = 1.00 (95% CI, 0.93-1.37), 1.35 for CRR = 1.25 (95% CI, 1.02-1.80), 1.53 for CRR = 1.50 (95% CI, 1.15-2.08), or 1.95 for CRR = 2.00 (95% CI, 1.44-2.65). These practice-based longitudinal data provide information to improve the evidence-based prognosis of teeth in providing prosthodontic procedures. © International & American Associations for Dental Research.
Soni, Tej Prakash; Gupta, Anil K; Sharma, Lalit M; Singhal, Pawan; Yadav, Dinesh; Bansal, Umesh
2017-01-01
‘The multidisciplinary approach: expanding treatment horizons for head and neck cancer’ was the major theme of the Indo Global Summit on Head and Neck Oncology (IGSHNO 2017-BMCON-IV). The meeting, held in Jaipur (Rajasthan, India) from 24 to 26 February 2017, assembled 600 participants from India and worldwide. It was organised by the Bhagwan Mahaveer Cancer Hospital and Research Centre (BMCHRC), Jaipur. BMCHRC Jaipur is one of the largest superspeciality oncology research and treatment centres in north India. The vision of BMCHRC has been to foster collaboration between oncologists, encouraging dialogue in an open forum that improves the care and outcomes of patients with cancer using the latest advances in cancer treatment. IGSHNO 2017 was part of this aim and vision. The organising team, including Dr Anil Gupta (Organising Secretary), Dr Lalit Mohan Sharma (Organising Secretary), Dr Pawan Singhal (Chairperson, scientific programme), Dr Tej Prakash Soni (Treasurer, Organising Secretary, Radiotherapy workshop), Dr Umesh Bansal and Dr Dinesh Yadav (Joint Organising Secretary), Dr Anjum Khan (Organising Secretary, Palliative care workshop), Dr Gaurav Pal Singh (Organising Secretary, Dental and prosthodontics workshop) and Dr (Maj Gen) SC Pareek (Medical Director, BMCHRC, Jaipur, India) worked hard for the previous 6 months to make this conference a successful academic event. IGSHNO 2017, held over three days, is a chance for oncologists from different parts of India to come together and discuss ongoing research, recent announcements and introduce new developments in head and neck cancer. It consisted of 51 lectures, seven debates, 10 panel discussions, oral paper presentations, e-poster sessions, a quiz for postgraduate students, a live surgery workshop, a prosthodentics workshop for dentists, a radiotherapy contouring workshop for radiation oncologists, a pain and palliative care workshop and a meet the expert session—all focusing on the multidisciplinary treatment of head and neck cancer. Special highlights from IGSHNO 2017 included the radiotherapy contouring workshop, the live surgery workshop by internationally renowned head and neck oncosurgeons, the dental and prosthodontics workshop and the pain and palliative care workshop. PMID:28626489
Corrosive and cytotoxic properties of compact specimens and microparticles of Ni-Cr dental alloy.
Ristic, Ljubisa; Vucevic, Dragana; Radovic, Ljubica; Djordjevic, Snezana; Nikacevic, Milutin; Colic, Miodrag
2014-04-01
Nickel-chromium (Ni-Cr) dental alloys have been widely used in prosthodontic practice, but there is a permanent concern about their biocompatibility due to the release of metal ions. This is especially important when Ni-Cr metal microparticles are incorporated into gingival tissue during prosthodontic procedures. Therefore, the aim of this study was to examine and compare the corrosion and cytotoxic properties of compact specimens and microparticles of Ni-Cr dental alloy. Ni-Cr alloy, Remanium CSe bars (4 mm diameter), were made by the standard casting method and then cut into 0.5-mm-thick disks. Metal particles were obtained by scraping the bars using a diamond instrument for crown preparation. The microstructure was observed by an optical microscope. Quantitative determination and morphological and dimensional characterization of metal particles were carried out by a scanning electron microscope and Leica Application Suite software for image analysis. Corrosion was studied by conditioning the alloy specimens in the RPMI 1640 medium, containing 10% fetal calf serum in an incubator with 5% CO2 for 72 hours at 37°C. Inductively coupled plasma-optical emission spectrometry was used to assess metal ion release. The cytotoxity of conditioning medium (CM) was investigated on L929 cells using an MTT test. One-way ANOVA was used for statistical analysis. After casting, the microstructure of the Remanium CSe compact specimen composed of Ni, Cr, Mo, Si, Fe, Al, and Co had a typical dendritic structure. Alloy microparticles had an irregular shape with a wide size range: from less than 1 μm to more than 100 μm. The release of metal ions, especially Ni and Mo from microparticles, was significantly higher, compared to the compact alloy specimen. The CM prepared from compact alloy was not cytotoxic at any tested dilutions, whereas CM from alloy microparticles showed dose-dependent cytotoxicity (90% CM and 45% CM versus control; p < 0.005). Ni-Cr microparticles showed less corrosion resistance and lower biocompatibility than compact alloy. This could affect health on long-term exposure, especially in sensitized individuals. © 2013 by the American College of Prosthodontists.
Soni, Tej Prakash; Gupta, Anil K; Sharma, Lalit M; Singhal, Pawan; Yadav, Dinesh; Bansal, Umesh
2017-01-01
'The multidisciplinary approach: expanding treatment horizons for head and neck cancer' was the major theme of the Indo Global Summit on Head and Neck Oncology (IGSHNO 2017-BMCON-IV). The meeting, held in Jaipur (Rajasthan, India) from 24 to 26 February 2017, assembled 600 participants from India and worldwide. It was organised by the Bhagwan Mahaveer Cancer Hospital and Research Centre (BMCHRC), Jaipur. BMCHRC Jaipur is one of the largest superspeciality oncology research and treatment centres in north India. The vision of BMCHRC has been to foster collaboration between oncologists, encouraging dialogue in an open forum that improves the care and outcomes of patients with cancer using the latest advances in cancer treatment. IGSHNO 2017 was part of this aim and vision. The organising team, including Dr Anil Gupta (Organising Secretary), Dr Lalit Mohan Sharma (Organising Secretary), Dr Pawan Singhal (Chairperson, scientific programme), Dr Tej Prakash Soni (Treasurer, Organising Secretary, Radiotherapy workshop), Dr Umesh Bansal and Dr Dinesh Yadav (Joint Organising Secretary), Dr Anjum Khan (Organising Secretary, Palliative care workshop), Dr Gaurav Pal Singh (Organising Secretary, Dental and prosthodontics workshop) and Dr (Maj Gen) SC Pareek (Medical Director, BMCHRC, Jaipur, India) worked hard for the previous 6 months to make this conference a successful academic event. IGSHNO 2017, held over three days, is a chance for oncologists from different parts of India to come together and discuss ongoing research, recent announcements and introduce new developments in head and neck cancer. It consisted of 51 lectures, seven debates, 10 panel discussions, oral paper presentations, e-poster sessions, a quiz for postgraduate students, a live surgery workshop, a prosthodentics workshop for dentists, a radiotherapy contouring workshop for radiation oncologists, a pain and palliative care workshop and a meet the expert session-all focusing on the multidisciplinary treatment of head and neck cancer. Special highlights from IGSHNO 2017 included the radiotherapy contouring workshop, the live surgery workshop by internationally renowned head and neck oncosurgeons, the dental and prosthodontics workshop and the pain and palliative care workshop.
Hahnel, Sebastian; Schwarz, Simone; Zeman, Florian; Schäfer, Lina; Behr, Michael
2014-06-01
The aims of this pilot study were to investigate the prevalence of xerostomia and hyposalivation and their impact on quality of life in a cohort of elderly patients including dental status and the character of potential prosthetic restorations as independent variables. Patients aged 60 years or older without any objective or subjective need for prosthodontic treatment taking part in a regular recall programme were included in the trial. Quality of life was assessed using the German version of the GOHAI; prevalence and severity of xerostomia was investigated using the shortened version of the Xerostomia Inventory (XI). Stimulated salivary flow rate was determined using a sialometric approach. Dental status and the character of prosthetic restorations (no/fixed restorations and removable but tooth-supported dentures vs. gum-supported dentures) were assessed in a clinical examination by experienced dentists specialized in prosthodontic treatment. A total of 68 patients were included in the trial; a prevalence of xerostomia of 16% and a prevalence of hyposalivation of 31% were identified. The quality of life in the study cohort decreased significantly as a function of xerostomia severity but not salivary flow; moreover, a significant impact of the number of teeth/implants in the upper jaw and the presence of gum-supported dentures in both jaws on GOHAI scores could be identified. Within the limitations of a pilot study, the results support the assumption that the quality of life in elderly patients is particularly related to their subjective perception of xerostomia. A decline in salivary flow, the dental status and the character of prosthetic restorations appear to play a subordinate role for the quality of life in elderly patients. The quality of life in elderly patients may be severely diminished due to an increased subjective perception of dry mouth. Dental treatment should focus on alleviating xerostomia, whereas the impact of dental status and prosthetic restoration appear to be subordinate. Copyright © 2014 Elsevier Ltd. All rights reserved.
Yamakura, Daiki; Takahashi, Toshiyuki; Kameyama, Atsushi; Noro, Akio; Sugiyama, Toshiko; Kondo, Yoshihiro; Sugiyama, Setsuko; Haruyama, Akiko; Takeda, Tomotaka; Nakajima, Kazunori
2013-01-01
Six years have passed since the introduction of legislation mandating at least 1 year of clinical training for those who have passed the national dentist examination. To determine whether clinical training has been appropriately implemented at the General Dentistry Department of Tokyo Dental College Chiba Hospital, a managed-type clinical training facility, the number of patients treated and types of dental and dental technical work performed by dental residents trained by the department were summarized and analyzed. The number of patients treated per dental resident increased from 11 in 2006 to 15 in 2011. By treatment type, periodontic treatment was the most frequently performed throughout the study period, followed by endodontic treatment. Conservation treatment, prosthodontic treatment with crowns/bridges, and prosthodontic treatment with dentures were performed at a similar moderate frequency, while oral surgical treatment was performed least frequently throughout the study period. The frequency of periodontic treatment increased slightly, whereas that of endodontic treatment decreased slightly or remained almost unchanged after introduction of the mandatory clinical training system. When the distribution of dental treatment performed at our department was compared with that of dental treatment performed by general dentists across Japan in 2011, our department showed a slightly lower frequency of periodontic treatment and higher frequency of endodontic treatment than the national total, whereas the frequency of other types of treatment was similar between the two populations. These results demonstrated that appropriate clinical training has been provided by our department to meet the purpose of offering dentists the opportunity to acquire the basic diagnostic and treatment abilities that would enable them to provide appropriate treatment for injuries and diseases frequently encountered in daily practice. The study also revealed some problems, such as a decreasing number of residents engaging in dental technical work each year. For additional improvement in the quality of dental clinical training, more analyses are needed to further identify and address potential problems in the system.
Dawood, A; Marti Marti, B; Sauret-Jackson, V; Darwood, A
2015-12-01
3D printing has been hailed as a disruptive technology which will change manufacturing. Used in aerospace, defence, art and design, 3D printing is becoming a subject of great interest in surgery. The technology has a particular resonance with dentistry, and with advances in 3D imaging and modelling technologies such as cone beam computed tomography and intraoral scanning, and with the relatively long history of the use of CAD CAM technologies in dentistry, it will become of increasing importance. Uses of 3D printing include the production of drill guides for dental implants, the production of physical models for prosthodontics, orthodontics and surgery, the manufacture of dental, craniomaxillofacial and orthopaedic implants, and the fabrication of copings and frameworks for implant and dental restorations. This paper reviews the types of 3D printing technologies available and their various applications in dentistry and in maxillofacial surgery.
NASA Astrophysics Data System (ADS)
Romînu, Roxana Otilia; Sinescu, Cosmin; Romînu, Mihai; Negrutiu, Meda; Laissue, Philippe; Mihali, Sorin; Cuc, Lavinia; Hughes, Michael; Bradu, Adrian; Podoleanu, Adrian
2008-09-01
Bonding has become a routine procedure in several dental specialties - from prosthodontics to conservative dentistry and even orthodontics. In many of these fields it is important to be able to investigate the bonded interfaces to assess their quality. All currently employed investigative methods are invasive, meaning that samples are destroyed in the testing procedure and cannot be used again. We have investigated the interface between human enamel and bonded ceramic brackets non-invasively, introducing a combination of new investigative methods - optical coherence tomography (OCT) and confocal microscopy (CM). Brackets were conventionally bonded on conditioned buccal surfaces of teeth The bonding was assessed using these methods. Three dimensional reconstructions of the detected material defects were developed using manual and semi-automatic segmentation. The results clearly prove that OCT and CM are useful in orthodontic bonding investigations.
Liang, Qin-ye; Wu, Xia-yi; Lin, Xue-feng
2012-04-01
To investigate the surface roughness property of the titanium castings cast in a new investment for titanium casting. Six wax patterns (20 mm × 20 mm × 0.5 mm) were invested using two investments: three in a new titanium investment material and three in the control material (Rematitan Plus). Six titanium specimens were obtained by conventional casting. After casting, surface roughness of the specimens were evaluated with a surface profilometer. The surface roughness of the specimens cast in new titanium investment material was (1.72 ± 0.08) µm, which was much smaller than that from Rematitan Plus [(1.91 ± 0.15) µm, P < 0.05]. The surfaces of titanium cast using these two investment materials are both smooth enough to fulfill the demand of the titanium precision-casting for prosthodontic clinical use.
Interdisciplinary treatment of a patient with multiple missing teeth and periodontitis.
Ahn, Jae-Chan; Lee, Jae-Hong; Yoon, Joon-Ho; Lee, Ji-Yeon; Kim, Jung-Hoon
2018-02-01
A 49-year-old woman with several missing and periodontically compromised teeth was referred to the orthodontic department of National Health Insurance Service Ilsan Hospital by the periodontic department for interdisciplinary treatment. Multiple posterior teeth had been extracted 10 days earlier. Her chief complaint was crowding of the anterior teeth, and she wanted to improve both esthetics and function. Orthodontic, periodontic, and prosthodontic treatments were undertaken in the proper timing and sequence with an interdisciplinary approach. As a result, improved periodontal health and a stable occlusion and vertical dimension were achieved. Although there were limited teeth and alveolar bone for anchorage, good esthetic and functional treatment results were obtained through the application of temporary anchorage devices and proper biomechanics. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
[Application and outlook of three-dimensional printing in prosthetic dentistry].
Sun, Y C; Li, R; Zhou, Y S; Wang, Y
2017-06-09
At present, three-dimensional (3D) printing has been applied in many aspects in the field of prosthodontics, such as dental models, wax patterns, guide plates, dental restoration and customized implants. The common forming principles include light curing, sintering and melting-condensation, the materials include pure wax, resin, metal and ceramics. However, the printing precision and the strength of multi-material integrated forming, remains to be improved. In addition, as a technology by which the internal structure of a material can be customized manufacturing, further advantage of 3D printing used in the manufacture of dental restoration lies in the customization functional bionic micro-structures, but the related research is still in its infancy. The review briefly summarizes the commonly used 3D printing crafts in prosthetic dentistry, and details clinical applications and evaluations, provides references for clinical decision and further research.
Effect of Fixed Metallic Oral Appliances on Oral Health.
Alnazzawi, Ahmad
2018-01-01
There is a substantial proportion of the population using fixed metallic oral appliances, such as crowns and bridges, which are composed of various dental alloys. These restorations may be associated with a number of effects on oral health with variable degrees of severity, to review potential effects of using fixed metallic oral appliances, fabricated from various alloys. The MEDLINE/PubMed database was searched using certain combinations of keywords related to the topic. The search revealed that burning mouth syndrome, oral pigmentation, hypersensitivity and lichenoid reactions, and genotoxic and cytotoxic effects are the major potential oral health changes associated with fixed prosthodontic appliances. Certain oral disorders are associated with the use of fixed metallic oral appliances. Patch test is the most reliable method that can be applied for identifying metal allergy, and the simultaneous use of different alloys in the mouth is discouraged.
Aviation dentistry: current concepts and practice.
Zadik, Y
2009-01-10
With the growing number of air passengers, flight attendants, leisure pilots as well as military and airline pilots, dentists may increasingly encounter flight-related oral conditions requiring treatment. Moreover, dentists should prevent the creation of in-flight hazards when treating aircrew members. The aim of this article is to introduce the concepts of aviation (aerospace) medicine and dentistry. Data were gathered to cover the following issues: head and facial barotraumas (barotrauma-related headache, external otitic barotrauma, barosinusitis and barotitis-media), dental barotrauma (barometric pressure-related tooth injury), barodontalgia (barometric pressure-related oro-dental pain), and dental care for aircrews. Special considerations have to be made when planning restorative, endodontic, prosthodontic and surgical treatment to an aircrew patient. This article supplies the dental practitioner with some diagnostic tools as well as treatment guidelines. Principles of prevention, periodic examination, dental-related flight restriction (grounding) and dental documentation (for forensic purposes) are described as well.
A technique for transferring a patient's smile line to a cone beam computed tomography (CBCT) image.
Bidra, Avinash S
2014-08-01
Fixed implant-supported prosthodontic treatment for patients requiring a gingival prosthesis often demands that bone and implant levels be apical to the patient's maximum smile line. This is to avoid the display of the prosthesis-tissue junction (the junction between the gingival prosthesis and natural soft tissues) and prevent esthetic failures. Recording a patient's lip position during maximum smile is invaluable for the treatment planning process. This article presents a simple technique for clinically recording and transferring the patient's maximum smile line to cone beam computed tomography (CBCT) images for analysis. The technique can help clinicians accurately determine the need for and amount of bone reduction required with respect to the maximum smile line and place implants in optimal positions. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Pawah, Salil; Sikri, Arpit; Rexwal, Pushpanjali; Aggarwal, Prachi
2017-01-01
Along with function, aesthetics plays an important role in treating partially or completely edentulous patients. Ageing, trauma, tooth loss and neuromuscular disorders have a high impact on tonicity of facial musculature, elasticity of skin as well as function of muscles. Patients affected with Bell’s palsy face functional, aesthetic as well as psychological impairment. Common problems are the partial closure of upper eyelid, sagging of lower eyelid and drooping of angle of mouth leading to facial asymmetry, along with difficulty in eating, drinking and speaking. The key to aesthetic restoration is to support and harmonize the collapsed facial musculature with the help of various prosthodontic treatment approaches. This case report attempts to focus on treating completely edentulous patient affected with Bell’s palsy with special prosthesis supporting angle of mouth and lower eyelid using novel technique. PMID:28658922
Schuh, Cristian; Adiel Skupien, Jovito; Mesko, Mauro Elias; Valentini, Fernanda; Pereira-Cenci, Tatiana; Boscato, Noéli
2014-12-01
The present clinical report describes the prosthodontic management for a patient with uncontrolled bleeding and diabetes mellitus treated with a maxillary complete denture and a mandibular partial fixed dental prosthesis designed to interface with a removable cast framework partial denture retained by 2 ERA attachments. This approach was undertaken to improve both retention and stability of the distal extension Kennedy Class I removable partial denture. The rehabilitation provided better anterior esthetics than if treated with a conventional clasp retained removable partial denture, by employing a simple, practical design and offering a significant biomechanical advantages, restoring both oral health and function. Thus, this treatment modality, involving an ERA system and transfixation in fixed crowns, is an effective treatment and can be indicated as a clinical alternative for edentulous and partially edentulous patients with systemic disorders or for patients in economic situations that might preclude implant-based rehabilitation.
Chen, Junning; Ahmad, Rohana; Li, Wei; Swain, Michael; Li, Qing
2015-01-01
The prevalence of prosthodontic treatment has been well recognized, and the need is continuously increasing with the ageing population. While the oral mucosa plays a critical role in the treatment outcome, the associated biomechanics is not yet fully understood. Using the literature available, this paper provides a critical review on four aspects of mucosal biomechanics, including static, dynamic, volumetric and interactive responses, which are interpreted by its elasticity, viscosity/permeability, apparent Poisson's ratio and friction coefficient, respectively. Both empirical studies and numerical models are analysed and compared to gain anatomical and physiological insights. Furthermore, the clinical applications of such biomechanical knowledge on the mucosa are explored to address some critical concerns, including stimuli for tissue remodelling (interstitial hydrostatic pressure), pressure–pain thresholds, tissue displaceability and residual bone resorption. Through this review, the state of the art in mucosal biomechanics and their clinical implications are discussed for future research interests, including clinical applications, computational modelling, design optimization and prosthetic fabrication. PMID:26224566
A laboratory silicone for preclinical training in ear prosthesis.
Anand, Vijay; Haribabu; Vimala; Gnanasamband, Vimala
2013-07-01
This article describes an industrial elastic silicone as a material for the laboratory fabrication of ear prosthesis. It has been tested for toxicity in lab animals by the SGS India Pvt. Ltd and approved as a material to pass the parameter of abnormal toxicity. This material therefore can be safely recommended for laboratory exercise to fabricate facial prosthesis. The high cost of the maxillo facial silicone materials prohibits their use for facial prosthesis in pre-clinical training of post-graduate students in maxillofacial prosthodontics. For this reason, pre-clinical laboratory exercise in facial prosthesis is inadequate. A few institutions use polymethyl methacrylate resins which are rigid and do not have elastic characteristics of silicone, which is used for facial defects. This cost-effective industrial silicone material which mimics the elastic and color characteristics of the conventional silicones can be recommended for preclinical exercises.
Chen, Amy Yi-Ling; Chen, Kevin
2017-01-01
Incontinentia pigmenti (IP) is a uncommon gene disorder, heritage with X-linked dominant mode. IP patients have a characteristic dentition varying from marked hypodontia to delayed eruption and conical crowns on both dentitions. A 5½-year-old girl, whose mother and younger sister were also diagnosed with IP, has the whirling-like pigmented skin lesion over her trunk and four extremities. Four primary teeth and multiple permanent tooth germs were found to be congenital missing. Dental considerations of further treatment were discussed with her parents including the preservation of primary molars, possible interim prosthesis in mixed or permanent dentition, full mouth rehabilitation with orthodontic and prosthodontic combined treatment, and implant therapy in adulthood. Early and longitudinal involvement of pediatric dentist to deal with the dental complications of IP can not only solve the esthetic problem and oral function but also maintain the oral health of children with IP to adulthood. PMID:28729805
Aruna, U; Thulasingam, C
2013-12-01
Patients who undergo segmental or hemi-mandibulectomy suffer from various postoperative problems in esthetics and function. The solution to such problem is providing a mandibular guidance appliance to correct mandibular deviation to resected side due to loss of muscle action on the affected side. This article describes the treatment of a female patient who underwent segmental mandibulectomy on right side secondary to adenoid cystic carcinoma of the base of tongue. An acrylic guidance appliance was constructed to help control the mandibular deviation and co-ordinate masticatory movements. The prosthesis was worn continuously by the patient for 1 month which corrected the occlusion on the left side. To compensate for the open-bite caused due to rotation of mandible following partial mandibulectomy, an overlay removable partial denture was given. The patient was satisfied with the improvement in esthetics and mastication.
Ceramic dental biomaterials and CAD/CAM technology: state of the art.
Li, Raymond Wai Kim; Chow, Tak Wah; Matinlinna, Jukka Pekka
2014-10-01
Ceramics are widely used as indirect restorative materials in dentistry because of their high biocompatibility and pleasing aesthetics. The objective is to review the state of the arts of CAD/CAM all-ceramic biomaterials. CAD/CAM all-ceramic biomaterials are highlighted and a subsequent literature search was conducted for the relevant subjects using PubMed followed by manual search. Developments in CAD/CAM technology have catalyzed researches in all-ceramic biomaterials and their applications. Feldspathic glass ceramic and glass infiltrated ceramic can be fabricated by traditional laboratory methods or CAD/CAM. The advent of polycrystalline ceramics is a direct result of CAD/CAM technology without which the fabrication would not have been possible. The clinical uses of these ceramics have met with variable clinical success. Multiple options are now available to the clinicians for the fabrication of aesthetic all ceramic restorations. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Ladda, R; Gangadhar, SA; Kasat, VO; Bhandari, AJ
2013-01-01
Ectodermal dysplasias are rare hereditary disorders characterized by abnormal development of certain tissues and structures of ectodermal origin. The condition is important for dentists as it affects teeth resulting in hypodontia or anodontia and dentist plays an important role in rehabilitation of the patient. Affected young children with anodontia not only have difficulties in eating and speaking but can also feel that they look different from their contemporaries. Well-fitting and functioning prosthesis could be a great help during their schooling years as it will improve appearance and thus boost their self confidence. We report a case of hypohidrotic ectodermal dysplasia in an 8-year-old boy who exhibited anodontia and was successfully rehabilitated with conventional complete dentures in both maxillary and mandibular arches. The aim of the treatment was to improve psychological development apart from promoting better functioning of the stomatognathic system. PMID:23919206
Esthetics in periodontics and implantology.
Zucchelli, Giovanni; Sharma, Praveen; Mounssif, Ilham
2018-06-01
Periodontal plastic surgery comprises an increasing part of clinical periodontology. Clinical trials have traditionally used professionals to judge esthetic outcome, and few studies have addressed patient needs and requests (true end points). Development of universally accepted and validated methods for professional esthetic assessment, together with standardized questionnaires for patient-perceived outcome, may help to provide better insights into the true needs and benefits of periodontal and implant-associated plastic surgery. In this volume of Periodontology 2000, experienced researchers and clinicians from different subdisciplines of periodontology evaluate: treatment of gingival recession with or without papilla elevation; clinical crown lengthening in the natural dentition and in prosthodontic preparative treatment; periodontal regeneration around natural teeth; and soft-tissue augmentation in edentulous areas. Similarly, experts in different areas of implant science address esthetic outcomes with single and multiple implant rehabilitation, alveolar ridge preservation, implant positioning and immediate implant placement in the esthetic zone. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Chávez, Elisa M; LaBarre, Eugene; Fredekind, Richard; Isakson, Paul
2010-01-01
The University of the Pacific, Arthur A. Dugoni School of Dentistry in San Francisco established a comprehensive dental care program at Laguna Honda Hospital, a public, skilled nursing facility. The program had three goals: (1) to provide dental students and residents an opportunity to provide oral health care for adults who were frail and medically compromised who could not come into the clinics, (2) to increase students' access to patients who needed removable prosthodontics, and (3) to fulfill Pacific's commitment to public service. Laguna Honda and Pacific pooled their resources to bring comprehensive dental care to patients who were not able to access the dental school clinics. The long-term goals are to restore and maintain the oral health of those who reside in the facility, and to educate future dentists to provide oral health care for similar populations.
Alveolar distraction osteogenesis: revive and restore the native bone.
Sant, Sumedha; Jagtap, Amit
2009-12-01
In prosthodontics, knife-edge bony alveolar ridges can cause a problem in their rehabilitation. The distraction osteogenesis process raises the medullary component of the alveolus, allowing the labial plate of the existing natural bone to be displaced. This process involves mobilization, transport, and fixation of a healthy segment of bone adjacent to the deficient site. It entails use of the gradual controlled displacement of surgically created fractures, which results in simultaneous expansion of soft tissue and bone volume. A mechanical device, the alveolar distraction device, is used for this purpose. This modality of treatment can be used in implant dentistry cases for rehabilitation of resorbed ridges. The objective of this overview is to explain this procedure wherein the alveolar housing, including the osseous and soft-tissue components, is enlarged in a single, simultaneous process, which makes creation of an appropriate alveolar morphology possible.
Combined orthodontic and periodontic treatment in a child with Papillon Lefèvre syndrome.
AlSarheed, Maha A; Al-Sehaibany, Fares S
2015-08-01
A 9-year-old girl with Papillon-Lefèvre syndrome (PLS) was treated orthodontically 24 months after the start of mechanical and antibiotic therapy in adjunct with periodontal treatment every 6 weeks. After achieving stable periodontal conditions, orthodontic treatment was commenced to correct the teeth position, facial profile, and maxillary protraction. Following the combination therapy and a failure to detect Actinobacillus actinomycetemcomitans from any site in the oral cavity, orthodontic treatment with a fixed appliance was performed aside from creating space for eruption of permanent teeth. We found that combined periodontal and orthodontic treatment of PLS may be successful with a complex interdisciplinary regimen and close follow up. This is a 2-year follow-up case report of a girl with PLS. Orthodontic and periodontic therapy were offered using combined treatments of orthodontic and periodontal with the benefit of prosthodontic consultation, resulting in a treatment plan.
Combined orthodontic and periodontic treatment in a child with Papillon Lefèvre syndrome
AlSarheed, Maha A.; Al-Sehaibany, Fares S.
2015-01-01
A 9-year-old girl with Papillon-Lefèvre syndrome (PLS) was treated orthodontically 24 months after the start of mechanical and antibiotic therapy in adjunct with periodontal treatment every 6 weeks. After achieving stable periodontal conditions, orthodontic treatment was commenced to correct the teeth position, facial profile, and maxillary protraction. Following the combination therapy and a failure to detect Actinobacillus actinomycetemcomitans from any site in the oral cavity, orthodontic treatment with a fixed appliance was performed aside from creating space for eruption of permanent teeth. We found that combined periodontal and orthodontic treatment of PLS may be successful with a complex interdisciplinary regimen and close follow up. This is a 2-year follow-up case report of a girl with PLS. Orthodontic and periodontic therapy were offered using combined treatments of orthodontic and periodontal with the benefit of prosthodontic consultation, resulting in a treatment plan. PMID:26219452
Patel, D; Patel, N; Brennan, P A; Kwok, J
2017-11-01
Cleidocranial dysplasia is a hereditary congenital disorder that results in delayed ossification of midline structures, and is caused by mutations in the RunX2 (runt-related transcription factor 2) gene located on the short arm of chromosome 6. Successful treatment depends on multidisciplinary assessment and a comprehensive staged treatment plan. We present a case series of 12 patients who were managed with a specifically tailored combination of surgery, orthodontics, and prosthodontics to provide a functional dentition and restore their smile and facial contour. Successful dental rehabilitation can be challenging in this group because patients often have multiple dental anomalies and a reduced quantity and density of alveolar bone. Rehabilitation with early intervention and a carefully planned multidisciplinary approach has been successful in the long term. Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Li, Z; Liu, Y S; Ye, H Q; Liu, Y S; Hu, W J; Zhou, Y S
2017-02-18
To explore a new method of whole-process digital esthetic prosthodontic rehabilitation combined with periodontic surgery for complicated anterior teeth esthetic defects accompanied by soft tissue morphology, to provide an alternative choice for solving this problem under the guidance of three-dimensional (3D) printing digital dental model and surgical guide, thus completing periodontic surgery and digital esthetic rehabilitation of anterior teeth. In this study, 12 patients with complicated esthetic problems accompanied by soft tissue morphology in their anterior teeth were included. The dentition and facial images were obtained by intra-oral scanning and three-dimensional (3D) facial scanning and then calibrated. Two esthetic designs and prosthodontic outcome predictions were created by computer aided design /computer aided manufacturing (CAD/CAM) software combined with digital photography, including consideration of white esthetics and comprehensive consideration of pink-white esthetics. The predictive design of prostheses and the facial appearances of the two designs were evaluated by the patients. If the patients chose the design of comprehensive consideration of pink-white esthetics, they would choose whether they would receive periodontic surgery before esthetic rehabilitation. The dentition design cast of those who chose periodontic surgery would be 3D printed for the guide of periodontic surgery accordingly. In light of the two digital designs based on intra-oral scanning, facing scanning and digital photography, the satisfaction rate of the patients was significantly higher for the comprehensive consideration of pink-white esthetic design (P<0.05) and more patients tended to choose priodontic surgery before esthetic rehabilitation. The 3D printed digital dental model and surgical guide provided significant instructions for periodontic surgery, and achieved success transfer from digital design to clinical application. The prostheses were fabricated by CAD/CAM, thus realizing the whole-process digital esthetic rehabilitation. The new method for esthetic rehabilitation of complicated anterior teeth esthetic defects accompanied by soft tissue morphology, including patient-involved digital esthetic analysis, design, esthetic outcome prediction, 3D printing surgical guide for periodontic surgery and digital fabrication is a practical technology. This method is useful for improvement of clinical communication efficiency between doctor-patient, doctor-technician and doctors from different departments, and is conducive to multidisciplinary treatment of this complicated anterior teeth esthetic problem.
Dental impression technique using optoelectronic devices
NASA Astrophysics Data System (ADS)
Sinescu, Cosmin; Barua, Souman; Topala, Florin Ionel; Negrutiu, Meda Lavinia; Duma, Virgil-Florin; Gabor, Alin Gabriel; Zaharia, Cristian; Bradu, Adrian; Podoleanu, Adrian G.
2018-03-01
INTRODUCTION: The use of Optical Coherence Tomography (OCT) as a non-invasive and high precision quantitative information providing tool has been well established by researches within the last decade. The marginal discrepancy values can be scrutinized in optical biopsy made in three dimensional (3D) micro millimetre scale and reveal detailed qualitative and quantitative information of soft and hard tissues. OCT-based high resolution 3D images can provide a significant impact on finding recurrent caries, restorative failure, analysing the precision of crown preparation, and prosthetic elements marginal adaptation error with the gingiva and dental hard tissues. During the CAD/CAM process of prosthodontic restorations, the circumvent of any error is important for the practitioner and the technician to reduce waste of time and material. Additionally, OCT images help to achieve a new or semi-skilled practitioner to analyse their crown preparation works and help to develop their skills faster than in a conventional way. The aim of this study is to highlight the advantages of OCT in high precision prosthodontic restorations. MATERIALS AND METHODS: 25 preparations of frontal and lateral teeth were performed for 7 different patients. The impressions of the prosthetic fields were obtained both using a conventional optoelectronic system (Apolo Di, Syrona) and a Spectral Domain using OCT (Dental prototype, working at 860 nm). For the conventional impression technique the preparation margins were been prelevated by gingival impregnated cords. No specific treatments were performed by the OCT impression technique. RESULTS: The scanning performed by conventional optoelectronic system proved to be quick and accurate in terms of impression technology. The results were represented by 3D virtual models obtained after the scanning procedure was completed. In order to obtain a good optical impression a gingival retraction cord was inserted between the prepared tooth and the gingival tissue for a better elevation of the tooth cervical margin preparation. Spectral OCT was enforced in order to observe the quality but also the advantages coming from this technology. No special preparation was performed for this operation. CONCLUSION: Considering these aspects, OCT could be used as a valuable tool for dental impression technology, being non-invasive but also non-destructive on the marginal gingival tissue, in comparison with conventional optoelectronic technology where the gingival retraction cord is still mandatory.
Stem cells in dentistry--part I: stem cell sources.
Egusa, Hiroshi; Sonoyama, Wataru; Nishimura, Masahiro; Atsuta, Ikiru; Akiyama, Kentaro
2012-07-01
Stem cells can self-renew and produce different cell types, thus providing new strategies to regenerate missing tissues and treat diseases. In the field of dentistry, adult mesenchymal stem/stromal cells (MSCs) have been identified in several oral and maxillofacial tissues, which suggests that the oral tissues are a rich source of stem cells, and oral stem and mucosal cells are expected to provide an ideal source for genetically reprogrammed cells such as induced pluripotent stem (iPS) cells. Furthermore, oral tissues are expected to be not only a source but also a therapeutic target for stem cells, as stem cell and tissue engineering therapies in dentistry continue to attract increasing clinical interest. Part I of this review outlines various types of intra- and extra-oral tissue-derived stem cells with regard to clinical availability and applications in dentistry. Additionally, appropriate sources of stem cells for regenerative dentistry are discussed with regard to differentiation capacity, accessibility and possible immunomodulatory properties. Copyright © 2012 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Influence of water immersion on the mechanical properties of fiber posts.
Komada, Wataru; Inagaki, Tasuku; Ueda, Yoji; Omori, Satoshi; Hosaka, Keiichi; Tagami, Junji; Miura, Hiroyuki
2017-01-01
The purpose of this study was to evaluate the influence of water immersion on the mechanical properties of three kinds of glass fiber posts and the fracture resistance of structures using resin composites with glass fiber posts. Each post was divided into three groups; a control group and two water immersion groups (30 and 90 days). Flexural strength was determined by three-point bending test. Each structure was divided into two groups; a control group and a water immersion group for 30 days. The fracture strength of structures was determined by a static loading test. In the flexural strength, two kinds of post in water immersion groups showed lower values than control groups. In the fracture strength, two kinds of structures in water immersion group showed lower values than control groups. The prefabricated glass fiber posts and structures using resin composites with glass fiber posts were affected by water immersion. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Correlation of psychomotor skills and didactic performance among dental students in Saudi Arabia.
Afify, Ahmed R; Zawawi, Khalid H; Othman, Hisham I; Al-Dharrab, Ayman A
2013-01-01
The objective of this study is to investigate the correlation between the psychomotor skills and the academic performance of dental students. Didactic and preclinical scores were collected for students who graduated from the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia, in 2011. Three courses (Dental Anatomy, Removable Prosthodontic Denture, and Orthodontics) were selected. Correlations comparing didactic and practical scores were done for the total samples, then for the males and females separately. There was no significant correlation between the practical and didactic scores for the three courses for the total sample. There was a significant correlation between all three subjects in the didactic scores. For females, the results showed that there was only a significant correlation between the practical and didactic scores for Dental Anatomy. For males, no correlation was observed between the practical and didactic scores for all subjects. In the present sample, didactic performance did not correlate well with the students' psychomotor performance.
NASA Astrophysics Data System (ADS)
Fabiano, F.; Puliafito, V.; Calabrese, L.; Borsellino, C.; Bonaccorsi, L. M.; Giordano, A.; Fabiano, V.; Cordasco, G.
2016-04-01
Neodymium-iron-boron magnets are able to ensure a magnetic flux with high maximum energy product also at miniaturized size. In the past, due to their marked corrosion in saliva they were unsuccessfully implemented in orthodontic systems. Thereby, we propose a multi-layered organic-inorganic coating able to supply anticorrosion resistance, wear resistance and durability to the whole assembly. We evaluated the influence on the magnetic force of commercial nickel plated and silanized Nd-Fe-B during aging time in synthetic Fusayama saliva. Two magnets based-micromagnetic simulations were performed in order to analyze the magnetic field generated which is linked to the magnetic force. Our key results underline that the proposed hybrid coating does not affect the magnetic force of Nd-Fe-B magnets, moreover, preventing corrosion degradation in aggressive solution. Thus the limiting aspects avoiding the use of Nd-Fe-B magnets for orthodontic and prosthodontic applications can be overcome by using silane agents as surface coating.
Future directions in the use of dental implants.
Bloem, T J
1989-10-01
Future development in implant prosthodontics should be based on the fundamentals of sound research and reliable clinical implementation. The goals should be to research the safety and efficacy of implants with regard to materials, host receptor site and interfacial zone; to develop acceptable uniform standards of evaluation; and to submit findings to scientific methods of analysis in determining benefit-to-risk factors. This presentation will offer a glimpse at some current developments in basic and clinical research focusing on studies in biocompatability and host acceptance; the implant-tissue interface; processes in osteogenesis related to vascularization of host sites; and bioengineering studies related to stress analysis and dimensional accuracy of impression systems for implants. The presentation will further describe future direction in research, training and implementation of services through development of an interdisciplinary team. A center is proposed to address the need for combined efforts in clinical and basic science research, the broad scope of implant utilization, and the teaching of implant procedures within an academic setting and to our colleagues.
Milardovic Ortolan, Sladana; Strujic, Mihovil; Aurer, Andrej; Viskic, Josko; Bergman, Lana; Mehulic, Ketij
2012-01-01
This case report describes the management of a crown-root fractured maxillary right central incisor and a crown fractured maxillary left central incisor using two different techniques. A complex procedure was designed to manage this case including orthodontic extrusion to move the fracture line above the alveolar bone and surgical recontouring of the altered gingival margin. Finally, the right incisor was restored prosthodontically. Prosthetic treatment was based on performing a post and core, and all-ceramic crown on the extruded tooth. The left, less-damaged incisor was restored directly using composite resin. The treatment resulted in good esthetics and secured periodontal health. This case report demonstrates that a multidisciplinary treatment approach is a reliable and predictable option to save a tooth. How to cite this article: Ortolan SM, Strujic M, Aurer A, Viskic J, Bergman L, Mehulic K. Esthetic Rehabilitation of Complicated Crown Fractures Utilizing Rapid Orthodontic Extrusion and Two Different Restoration Modalities. Int J Clin Pediatr Dent 2012;5(1):64-67.
Correlation of psychomotor skills and didactic performance among dental students in Saudi Arabia
Afify, Ahmed R; Zawawi, Khalid H; Othman, Hisham I; Al-Dharrab, Ayman A
2013-01-01
Objectives The objective of this study is to investigate the correlation between the psychomotor skills and the academic performance of dental students. Methods Didactic and preclinical scores were collected for students who graduated from the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia, in 2011. Three courses (Dental Anatomy, Removable Prosthodontic Denture, and Orthodontics) were selected. Correlations comparing didactic and practical scores were done for the total samples, then for the males and females separately. Results There was no significant correlation between the practical and didactic scores for the three courses for the total sample. There was a significant correlation between all three subjects in the didactic scores. For females, the results showed that there was only a significant correlation between the practical and didactic scores for Dental Anatomy. For males, no correlation was observed between the practical and didactic scores for all subjects. Conclusion In the present sample, didactic performance did not correlate well with the students’ psychomotor performance. PMID:24159266
Kamble, Vaibhav D; Parkhedkar, Rambhau D
2013-01-01
Amelogenesis Imperfecta (AI) is a genetically determined and enamel mineralization defect reported, depicted as “Hereditary brown teeth.” AI is characterized as a clinical entity and its clinical manifestations, histological appearance, and genetic pattern are characterized by their heterogeneity. The need for prosthodontic management of this group of patients varies. Some patients need oral hygiene instructions only, whereas others need extensive dental treatment that includes composite restorations, metal ceramic crowns, all ceramic crowns, porcelain veneers. A 20-year-old male patient presented with sensitive, discoloured, and mutilated teeth, with a decreased vertical dimension of occlusion. The 4-year recall examination revealed no pathology associated with the full mouth rehabilitation, and the patient’s aesthetic and functional expectations were satisfied. The rehabilitation included all-ceramic crowns on anterior teeth and metal-ceramic crowns on posterior teeth following endodontic treatment and a crown-lengthening procedure for eliminating tooth sensitivity, improving the aesthetics and occlusion, and for restoring function. PMID:24551735
Forensic odontology: A prosthodontic view
Gosavi, Sulekha; Gosavi, Siddharth
2012-01-01
The most common role of the forensic dentist is the identification of deceased individuals. Dental identifications have always played a key role in natural and manmade disaster situations, and in particular, the mass casualties normally associated with aviation disasters. Because of the lack of a comprehensive fingerprint database, dental identification continues to be crucial in the world. An all-acrylic resin appliance such as a full denture or an all-acrylic partial denture (or orthodontic appliance), prior to delivery, could be inscribed with the patient's full name on a substrate (paper, metal) and sealed inconspicuously into the surface of a denture by various processes. It has been noted by several authors that in many cases of air disaster where the limbs are completely burnt off, some denture materials survive, especially the posterior part of acrylic dentures and metal-based dentures. Thus, marked dental prostheses (full and partial dentures, mouthguards and removal orthodontic appliances) would lead to rapid identification in the event of accidents and disaster. PMID:23087581
Rakhshan, Vahid
2015-01-01
Congenitally missing teeth (CMT), or as usually called hypodontia, is a highly prevalent and costly dental anomaly. Besides an unfavorable appearance, patients with missing teeth may suffer from malocclusion, periodontal damage, insufficient alveolar bone growth, reduced chewing ability, inarticulate pronunciation and other problems. Treatment might be usually expensive and multidisciplinary. This highly frequent and yet expensive anomaly is of interest to numerous clinical, basic science and public health fields such as orthodontics, pediatric dentistry, prosthodontics, periodontics, maxillofacial surgery, anatomy, anthropology and even the insurance industry. This essay reviews the findings on the etiology, prevalence, risk factors, occurrence patterns, skeletal changes and treatments of congenitally missing teeth. It seems that CMT usually appears in females and in the permanent dentition. It is not conclusive whether it tends to occur more in the maxilla or mandible and also in the anterior versus posterior segments. It can accompany various complications and should be attended by expert teams as soon as possible. PMID:25709668
Esthetics and Biocompatibility of Composite Dental Laminates.
D'Souza, Dsj; Kumar, M
2010-07-01
Advances in modern dental materials provide patients with a choice of natural looking veneers to provide esthetic restorations. These may be directly fabricated composite resin veneers or indirectly fabricated veneers. This study was carried out to evaluate the clinical effect of new generation indirect veneering composites and to compare them with veneers fabricated from direct composite restorations. The present study was carried out in the Prosthodontics department of a medical college. A total of forty patients requiring restoration of the anterior teeth using composite veneers were selected and either of the two materials was used to fabricate the veneers. Clinical evaluation was done for esthetics and periodontal health. Statistical analysis showed that there were no significant changes to the periodontal health during the period of the study. The evidence obtained from this study indicates that both direct as well as indirect composite materials had clinically acceptable outcomes in terms of restoration of esthetics. Biocompatibility with the periodontal tissues of both materials was also evident by the improvement in oral health indices used in the study.
Abdurahiman, V T; Abdul Khader, M; Sanju John Jolly
2013-12-01
Treating partial edentulousness forms a major share of prosthodontic clinical practice. The purpose of this study was to find out the frequency of partial edentulism, its arch distribution status, awareness to restore, and the ratio of removable to fixed prosthesis among a student sample aged 18-25 years. The methodology selected was a questionnaire survey followed by clinical examination of the student community from Tirur taluk, Malappuram district, Kerala. The results showed that the frequency of partial edentulism among the surveyed group was significant with predominance in maxillary posterior edentulousness in men and mandibular posterior edentulousness in women. Though there was not any significant gender difference in the partial edentulism, women were more aware than men to restore it. All restored cases were with fixed bridges and no anterior edentulousness was found. The study also revealed a lack of awareness and need to educate the population.
Conservative orthodontic-prosthodontic approach for excessive gingival display: A clinical report.
del Castillo, Rafael; Hernández, Ana M; Ercoli, Carlo
2015-07-01
A differential diagnosis of excessive gingival display is critical in determining appropriate treatment options and sequence. Anterior tooth malposition for patients with deep vertical overlap has been suggested as one of the 3 main causes of excessive gingival display. Specifically, patients with Angle class II, division 2 malocclusions show an occlusal scheme that might be responsible for additional anterior tooth wear when compared with individuals without malocclusion. In the long term, this condition can cause dentoalveolar compensation and overeruption of maxillary incisors with concomitant coronal movement of the gingival margin with excessive gingival display. A combined orthodontic and restorative treatment was proposed as a conservative treatment to reposition maxillary anterior teeth and their gingival margins to a more ideal position and create the necessary interocclusal restorative space to restore worn teeth with ceramic restorations, enhance dental and facial esthetics, and reestablish anterior guidance. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Reston, E G; Bueno, Rpr; Closs, L Q; Zettermann, J
Internal bleaching in endodontically treated teeth requires care and protection to prevent harm to the periodontal ligament due to peroxide and may result in external root resorption. There is a myriad of treatment options when this occurs, such as monitoring, extraction, and subsequent rehabilitation with implants or fixed prosthodontics. In some cases, such as the one described here, a conservative attempt to maintain the tooth as a single structure can be made by sealing the resorptive defect. In the present case, we show a multidisciplinary approach where orthodontics, periodontics, and restorative dentistry were involved in treating the maxillary right central incisor (#8) of a 65-year-old patient with extensive cervical resorption, whose chief complaint was esthetics. The proposed treatment was extrusion of the tooth followed by curettage and restoration of the defect with glass ionomer cement. The patient has been followed for 15 years with no signs of recurrence, maintenance of periodontal health, and patient satisfaction with the esthetic outcome.
End points and assessments in esthetic dental treatment.
Ishida, Yuichi; Fujimoto, Keiko; Higaki, Nobuaki; Goto, Takaharu; Ichikawa, Tetsuo
2015-10-01
There are two key considerations for successful esthetic dental treatments. This article systematically describes the two key considerations: the end points of esthetic dental treatments and assessments of esthetic outcomes, which are also important for acquiring clinical skill in esthetic dental treatments. The end point and assessment of esthetic dental treatment were discussed through literature reviews and clinical practices. Before designing a treatment plan, the end point of dental treatment should be established. The section entitled "End point of esthetic dental treatment" discusses treatments for maxillary anterior teeth and the restoration of facial profile with prostheses. The process of assessing treatment outcomes entitled "Assessments of esthetic dental treatment" discusses objective and subjective evaluation methods. Practitioners should reach an agreement regarding desired end points with patients through medical interviews, and continuing improvements and developments of esthetic assessments are required to raise the therapeutic level of esthetic dental treatments. Copyright © 2015 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Esthetic Rehabilitation of Anterior Teeth with Copy-Milled Restorations: A Report of Two Cases.
Rani, Sapna; Devi, Jyoti; Jain, Chandan; Mutneja, Parul; Verma, Mahesh
2017-01-01
Digitalization has become part and parcel of contemporary prosthodontics with the probability of most of the procedures being based on the digital techniques in the near future. This digital revolution started in the latter half of the 20th century by converting analog objects/signals into digital bits and bytes. Recent developments in all-ceramic materials and systems of computer-aided designing and computer-aided manufacturing (CAD/CAM), copy milling, and so forth offer excellent esthetics and superb biocompatibility. Copy milling system for ceramics enables milling of the zirconia cores of all-ceramic restorations precisely and also if this system is properly used the procedure for fabricating all-ceramic restorations can be substantially simplified. This case report presents fabrication of all-ceramic Maryland Bridge and post-core with a copy milling system for esthetics and preservation of integrity of tooth. For both of the patients, the use of biologic, all-ceramic, copy-milled restorations resulted in clinical success and recovered function and esthetics.
Postsurgical Orthodontic Treatment Planning: a Case Report with 20 Years Follow-up.
Farronato, Giampietro; Garagiola, Umberto; Carletti, Vera; Cressoni, Paolo; Mortellaro, Carmen
2011-01-01
Traditionally, maxillofacial deformities are corrected surgically after an initial orthodontic treatment phase. However in, this article, the authors emphasize the postsurgical therapeutic protocol which is extremely important for determining the final and permanent retention of the corrected occlusion. A 55 year old female with severe skeletal Class II malocclusion is presented. Combined surgical and orthodontic correction of the malocclusion was used. : The step-by-step procedure the authors followed for the postsurgical therapy is described. The goals of the postoperative therapy were to restore and rehabilitate neuromuscular function, obtain occlusal stabilization, grind teeth selectively, and final occlusion retention. The importance of a surgical occlusal splint for rehabilitating stomatognathic neuromuscular function postoperatively was demonstrated. Furthermore, the orthodontic-prosthodontic treatment ensured occlusion stability after the surgical correction. The long-term results confirmed the efficacy of the treatment protocol presented here from both functional and aesthetical perspectives. Postsurgical orthodontic treatment is an important step in the surgical and orthodontic therapy of maxillofacial deformities.
Idiopathic condylar resorption: The current understanding in diagnosis and treatment
Young, Andrew
2017-01-01
Idiopathic condylar resorption (ICR) is a condition with no known cause, which manifests as progressive malocclusion, esthetic changes, and often pain. Cone-beam computed tomography and magnetic resonance imaging are the most valuable imaging methods for diagnosis and tracking, compared to the less complete and more distorted images provided by panoramic radiographs, and the higher radiation of 99mtechnetium-methylene diphosphonate. ICR has findings that overlap with osteoarthritis, inflammatory arthritis, physiologic resorption/remodeling, congenital disorders affecting the mandible, requiring thorough image analysis, physical examination, and history-taking. Correct diagnosis and determination of whether the ICR is active or inactive are essential when orthodontic or prosthodontic treatment is anticipated as active ICR can undo those treatments. Several treatments for ICR have been reported with the goals of either halting the progression of ICR or correcting the deformities that it caused. These treatments have varying degrees of success and adverse effects, but the rarity of the condition prevents any evidence-based recommendations. PMID:28584413
An investigation of thermal changes of various permanent dental cements.
Duymus, Zeynep Yesil; Yilmaz, Baykal; Karaalioglu, F Osman
2009-05-01
The aim of this study was to investigate and compare the temperature rises which occurred during the setting reactions of different permanent cements used to lute fixed partial prosthodontics. In this study, four cements were used. They were mixed in three different proportions: according to manufacturers' recommendations, at doubled powder ratio, and at doubled liquid ratio. With a thermocouple, the temperature rises which occurred during the setting reactions were measured. For each proportion, the measurement was repeated five times such that a total of 60 measurements were done for the four different cements. Data were analyzed using analysis of variance (ANOVA). ANOVA results showed that cement type and the interaction between cement type and the powder-liquid ratio were statistically significant factors (p<0.001). Similarly, the powder-liquid ratio was a statistically significant (p<0.01) factor. Among the dental cements tested, zinc phosphate cement showed the highest temperature rise during setting reaction, whereas glass ionomer cement showed the lowest.
Computer-aided design of tooth preparations for automated development of fixed prosthodontics.
Yuan, Fusong; Sun, Yuchun; Wang, Yong; Lv, Peijun
2014-01-01
This paper introduces a method to digitally design a virtual model of a tooth preparation of the mandibular first molar, by using the commercial three-dimensional (3D) computer-aided design software packages Geomagic and Imageware, and using the model as an input to automatic tooth preparing system. The procedure included acquisition of 3D data from dentate casts and digital modeling of the shape of the tooth preparation components, such as the margin, occlusal surface, and axial surface. The completed model data were stored as stereolithography (STL) files, which were used in a tooth preparation system to help to plan the trajectory. Meanwhile, the required mathematical models in the design process were introduced. The method was used to make an individualized tooth preparation of the mandibular first molar. The entire process took 15min. Using the method presented, a straightforward 3D shape of a full crown can be obtained to meet clinical needs prior to tooth preparation. © 2013 Published by Elsevier Ltd.
Fabrication of fixed implant prostheses using function bite impression technique (FBI technique).
Suzuki, Yasunori; Shimpo, Hidemasa; Ohkubo, Chikahiro; Kurtz, Kenneth S
2012-10-01
The patient was partially edentulous, lacking both the first mandibular molars. The FBI and the conventional impression technique were used for the fabrication of implant-fixed prosthesis replacing the right and left molars, respectively. In the FBI technique, the definitive impression was made under occlusal force and functionally generated path (FGP) recording at the same time. The right and left occlusal contact areas were compared after completing the implant-fixed prosthesis rehabilitation. It has been suggested that accuracy of the impression and maxillomandibular registration is necessary to ensure a satisfactory long-term clinical outcome. The transfer of the exact position of the implants to the working cast is even more important because implants lack the mobility of natural teeth. There are displacement differences between implants and natural teeth under occlusal force. The FBI technique may compensate for this difference in accuracy. Using the FBI technique, a precise prosthesis could be produced by completing simultaneously the maxillomandibular registration, impression and FGP. Copyright © 2012 Japan Prosthodontic Society. All rights reserved.
Effect of storage time on the viscoelastic properties of elastomeric impression materials.
Papadogiannis, Dimitris; Lakes, Roderic; Palaghias, George; Papadogiannis, Yiannis
2012-01-01
The aim of this study was to evaluate creep and viscoelastic properties of dental impression materials after different storage times. Six commercially available impression materials (one polyether and five silicones) were tested after being stored for 30 min to 2 weeks under both static and dynamic testing. Shear and Young's moduli, dynamic viscosity, loss tangent and other viscoelastic parameters were calculated. Four of the materials were tested 1 h after setting under creep for three hours and recovery was recorder for 50 h. The tested materials showed differences among them, while storage time had significant influence on their properties. Young's modulus E ranged from 1.81 to 12.99 MPa with the polyether material being the stiffest. All of the materials showed linear viscoelastic behavior exhibiting permanent deformation after 50h of creep recovery. As storage time affects the materials' properties, pouring time should be limited in the first 48 h after impression. Copyright © 2011 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Sreedevi, S; Sanjeev, R; Ephraim, Rena; Joseph, Mathai
2014-01-01
This case report deals with the interdisciplinary approach of a 28-year-old lady with Amelogenesis imperfecta of the hypoplastic kind. The patient came with a chief illness of worn out teeth, unsatisfactory esthetics and severe sensitivity of teeth. Her family history revealed a related situation in her father’s brother and her sister. On clinical assessment, the crowns of all teeth were worn out. The plan of the treatment was to protect as much tooth structure, restore the vertical dimension, and improve esthetics and masticatory function. The treatment procedures involved prosthodontic, endodontic, and periodontic interventions. After recording the vertical height, endodontic treatment and crown lengthening were performed with respect to the lower anteriors. The lost vertical height was regained in stages by insertion of full coverage crowns for all the teeth. The patient’s esthetic and functional needs were met with systematic and sequential interdisciplinary treatment approach. PMID:25628493
Denture reconstruction of the edentulous upper jaw in cleft palate using implants--clinical report.
Dostálová, T; Holakovský, J; Bartonová, M; Seydlová, M; Smahel, Z
2007-01-01
Early prosthodontic therapy (usually at around 18 years of age) often leads to early loss of teeth and in extreme cases to complete loss of dentition at between 40 and 50 years of age. This report describes the clinical features of two middle-aged cleft patients. Edentulous maxilla with cleft defect was treated with 6 implants supported by fixed appliance. Treatment of the whole dental arch on the basis of implants is currently frequently used as it provides a possibility of thorough functional and aesthetic therapy to a patient. The biomechanics of the reconstruction enables individual adjustment of the shape of the dental arch. The problem in cleft patients involves other diameter relations in the dental arch caused by the defect alone or also by affecting the growth of the maxillary segment by surgery. A potentially removable framework is therefore the main method of choice because the position of the implants must be prosthetically modified.
Edwards, Beatrice J; Hellstein, John W; Jacobsen, Peter L; Kaltman, Steven; Mariotti, Angelo; Migliorati, Cesar A
2008-12-01
and Overview. In 2005, the American Dental Association (ADA) Council on Scientific Affairs convened an expert panel to develop clinical recommendations for dentists treating patients who are receiving oral bisphosphonate therapy. The Journal of the American Dental Association published the resulting report in 2006. This 2008 advisory statement is the first of projected periodic updates of the 2006 clinical recommendations. This 2008 advisory statement concludes, on the basis of a review of the current literature, that for patients receiving bisphosphonate therapy, the risk of developing bisphosphonate-associated osteonecrosis (BON) of the jaw apparently remains low. It also newly concludes that current screening and diagnostic tests are unreliable for predicting a patient's risk of developing the condition. This statement updates the 2006 recommendations regarding general dentistry, management of periodontal diseases, implant placement and maintenance, oral and maxillofacial surgery, endodontics, restorative dentistry and prosthodontics, and orthodontics.
Esthetic Rehabilitation of Anterior Teeth with Copy-Milled Restorations: A Report of Two Cases
Jain, Chandan; Mutneja, Parul; Verma, Mahesh
2017-01-01
Digitalization has become part and parcel of contemporary prosthodontics with the probability of most of the procedures being based on the digital techniques in the near future. This digital revolution started in the latter half of the 20th century by converting analog objects/signals into digital bits and bytes. Recent developments in all-ceramic materials and systems of computer-aided designing and computer-aided manufacturing (CAD/CAM), copy milling, and so forth offer excellent esthetics and superb biocompatibility. Copy milling system for ceramics enables milling of the zirconia cores of all-ceramic restorations precisely and also if this system is properly used the procedure for fabricating all-ceramic restorations can be substantially simplified. This case report presents fabrication of all-ceramic Maryland Bridge and post-core with a copy milling system for esthetics and preservation of integrity of tooth. For both of the patients, the use of biologic, all-ceramic, copy-milled restorations resulted in clinical success and recovered function and esthetics. PMID:28326203
Quiudini, Paulo Roberto; Pozza, Daniel Humberto; Pinto, Ary Dos Santos; de Arruda, Mauricio Ferraz; Guimarães, Antonio Sergio
2017-07-01
Due to the bite force importance in functionality of the masticatory system, this study aimed to characterize it in dolichofacial and brachyfacial individuals. A sample comprised by 190 patients was divided into two groups: 90 severe dolichofacial, and 100 severe brachyfacial individuals classified according to the VERT index and the face height ratio (Jarabak quotient). Bite force was measured by using an adjusted digital dynamometer and proper methodology. The sample met the parametric assumptions and presented statistical significance when right and left sides of dolichofacial and brachyfacial individuals were compared. However, within the same group, no differences between the left and right sides were found. Generally, bite force was higher for male, left masticator, age between 41-50 years, weighing over 100kg and between 1.81 and 1.90m tall. Based on the results of this cross-sectional study, it was possible to conclude that the bite force in severe brachyfacial individuals was significantly higher than in severe dolichofacial individuals, being influenced by gender, weight and height. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Fundamentals of cone beam computed tomography for a prosthodontist
John, George Puthenpurayil; Joy, Tatu Elenjickal; Mathew, Justin; Kumar, Vinod R. B.
2015-01-01
Cone beam computed tomography (CBCT, also referred to as C-arm computed tomography [CT], cone beam volume CT, or flat panel CT) is a medical imaging technique of X-ray CT where the X-rays are divergent, forming a cone.[1] CBCT systems have been designed for imaging hard tissues of the maxillofacial region. CBCT is capable of providing sub-millimeter resolution in images of high diagnostic quality, with short scanning times (10–70 s) and radiation dosages reportedly up to 15–100 times lower than those of conventional CT scans. Increasing availability of this technology provides the dental clinician with an imaging modality capable of providing a three-dimensional representation of the maxillofacial skeleton with minimal distortion. The aim of this article is to sensitize the Prosthodontist to CBCT technology, provide an overview of currently available maxillofacial CBCT systems and review the specific application of various CBCT display modes to clinical Prosthodontic practice. A MEDLINE search for relevant articles in this specific area of interest was conducted. The selected articles were critically reviewed and the data acquired were systematically compiled. PMID:26929479
Song, In-Seok; Lee, Mi-Ran; Ryu, Jae-Jun; Lee, Ui-Lyong
Dental implants positioned in severely atrophied anterior maxillae require esthetic or functional compromises. This case report describes the rehabilitation of a severely atrophied alveolar ridge with a three-dimensional (3D) computer-aided design/computer-aided manufacture (CAD/CAM) surgical guide. A 50-year-old woman had a severely atrophied anterior maxilla with unfavorably positioned dental implants. Functional and esthetic prosthodontic restoration was difficult to achieve. An anterior segmental osteotomy was planned to reposition the dental implants. A 3D surgical guide was designed for precise relocation of the segment. The surgical guide firmly grasped the impression copings of the dental implants, minimizing surgical errors. Three-dimensional gingival simulation was used preoperatively to estimate the appropriate position of the gingiva. Rigid fixation to the surrounding bone allowed immobilization of the implant-bone segment. Satisfactory esthetic and functional outcomes were attained 6 months after surgery. Finally, a severely atrophied alveolar ridge with unfavorably positioned dental implants was recovered with minimal esthetic and functional deterioration using gingival simulation and a 3D CAD/CAM surgical guide.
Effect of Framework in an Implant-Supported Full-Arch Fixed Prosthesis: 3D Finite Element Analysis.
Menini, Maria; Pesce, Paolo; Bevilacqua, Marco; Pera, Francesco; Tealdo, Tiziano; Barberis, Fabrizio; Pera, Paolo
2015-01-01
The aim of this study was to analyze through a three-dimensional finite element analysis (3D-FEA) stress distribution on four implants supporting a full-arch implant-supported fixed prosthesis (FFP) using different prosthesis designs. A 3D edentulous maxillary model was created and four implants were virtually placed into the maxilla and splinted, simulating an FFP without framework, with a cast metal framework, and with a carbon fiber framework. An occlusal load of 150 N was applied, stresses were transmitted into peri-implant bone, and prosthodontic components were recorded. 3D-FEA revealed higher stresses on the implants (up to +55.16%), on peri-implant bone (up to +56.93%), and in the prosthesis (up to +70.71%) when the full-acrylic prosthesis was simulated. The prosthesis with a carbon fiber framework showed an intermediate behavior between that of the other two configurations. This study suggests that the presence of a rigid framework in full-arch fixed prostheses provides a better load distribution that decreases the maximum values of stress at the levels of implants, prosthesis, and maxillary bone.
Toupenay, Steve; Fournier, Benjamin Philippe; Manière, Marie-Cécile; Ifi-Naulin, Chantal; Berdal, Ariane; de La Dure-Molla, Muriel
2018-06-15
Hereditary enamel defect diseases are regrouped under the name "Amelogenesis Imperfecta" (AIH). Both dentitions are affected. Clinical expression is heterogeneous and varies between patients. Mutations responsible for this multigene disease may alter various genes and the inheritance can be either autosomal dominant or recessive, or X-linked. Until now, no therapeutic consensus has emerged for this rare disease. The purpose of this article was to report treatments of AIH patients from childhood to early adulthood. Treatment of three patients of 3, 8 16 years old are described. Each therapeutic option was discussed according to patients' age and type of enamel alteration. Paediatric crowns and resin based bonding must be preferred in primary teeth. In permanent teeth, non-invasive or minimally invasive dentistry should be the first choice in order to follow a therapeutic gradient from the less invasive options to prosthodontic treatments. Functional and aesthetic issues require patients to be treated; this clinical care should be provided as early as possible to enable a harmonious growth of the maxillofacial complex and to prevent pain.
Predoctoral dental implant education at Creighton University School of Dentistry.
Parrish, Lawrence; Hunter, Richard; Kimmes, Nici; Wilcox, Charles; Nunn, Martha; Miyamoto, Takanari
2013-05-01
The purpose of this report is to describe the dental implant education that predoctoral students receive and to characterize the patient population receiving implants at Creighton University School of Dentistry (CDS). CDS has no postdoctoral residency programs. Therefore, clinical management of diagnosis, treatment planning, surgical aspects, restoration, complications, and maintenance of dental implants requires significant involvement by predoctoral dental students. CDS implant education involves radiology diagnostic assets of the General Dentistry Department (including the use of Cone Beam Computed Tomography), as well as faculty and equipment from the Departments of Oral and Maxillofacial Surgery, Periodontics, and Prosthodontics, with a majority of students satisfied with their didactic preparation for their clinical experiences. Focusing on a three-year window from August 2007 to August 2010 and using electronic health records, this study found that a total of 242 implants were placed, out of which six failed within one year of placement and had to be removed. The average age of the population of 153 patients was found to be 53.3 years, with a range of eighteen to eighty-nine. Treatment outcomes compared very favorably with those published in the literature.
Digital Versus Conventional Impressions in Fixed Prosthodontics: A Review.
Ahlholm, Pekka; Sipilä, Kirsi; Vallittu, Pekka; Jakonen, Minna; Kotiranta, Ulla
2018-01-01
To conduct a systematic review to evaluate the evidence of possible benefits and accuracy of digital impression techniques vs. conventional impression techniques. Reports of digital impression techniques versus conventional impression techniques were systematically searched for in the following databases: Cochrane Central Register of Controlled Trials, PubMed, and Web of Science. A combination of controlled vocabulary, free-text words, and well-defined inclusion and exclusion criteria guided the search. Digital impression accuracy is at the same level as conventional impression methods in fabrication of crowns and short fixed dental prostheses (FDPs). For fabrication of implant-supported crowns and FDPs, digital impression accuracy is clinically acceptable. In full-arch impressions, conventional impression methods resulted in better accuracy compared to digital impressions. Digital impression techniques are a clinically acceptable alternative to conventional impression methods in fabrication of crowns and short FDPs. For fabrication of implant-supported crowns and FDPs, digital impression systems also result in clinically acceptable fit. Digital impression techniques are faster and can shorten the operation time. Based on this study, the conventional impression technique is still recommended for full-arch impressions. © 2016 by the American College of Prosthodontists.
Maxillectomy defects: a suggested classification scheme.
Akinmoladun, V I; Dosumu, O O; Olusanya, A A; Ikusika, O F
2013-06-01
The term "maxillectomy" has been used to describe a variety of surgical procedures for a spectrum of diseases involving a diverse anatomical site. Hence, classifications of maxillectomy defects have often made communication difficult. This article highlights this problem, emphasises the need for a uniform system of classification and suggests a classification system which is simple and comprehensive. Articles related to this subject, especially those with specified classifications of maxillary surgical defects were sourced from the internet through Google, Scopus and PubMed using the search terms maxillectomy defects classification. A manual search through available literature was also done. The review of the materials revealed many classifications and modifications of classifications from the descriptive, reconstructive and prosthodontic perspectives. No globally acceptable classification exists among practitioners involved in the management of diseases in the mid-facial region. There were over 14 classifications of maxillary defects found in the English literature. Attempts made to address the inadequacies of previous classifications have tended to result in cumbersome and relatively complex classifications. A single classification that is based on both surgical and prosthetic considerations is most desirable and is hereby proposed.
Pombo Castro, María; Luaces Rey, Ramón; Arenaz Búa, Jorge; Santana-Mora, Urbano; López-Cedrún Cembranos, José Luís
2013-10-01
Oral manifestations in ectodermal dysplasia include oligodontia, alveolar ridges hypoplasia, and others. Due to the special conditions in terms of unhealthy teeth and lack of bone, implant-supported rehabilitation seems to offer the most satisfactory outcome. A 27-year-old male diagnosed with ectodermal dysplasia was referred to our department for oral rehabilitation. Oral manifestations included oligodontia, maxillary and mandibular atrophy, mandibular alveolar ridge with knife-edge morphology, and conical teeth. Treatment planning consisted of a Le Fort I osteotomy with interpositional grafts, bilateral sinus lift, and placement of maxillary and mandibular inlay and onlay corticocancellous grafts, using autologous iliac crest bone. In the second surgery, all remaining teeth were removed and 11 endosteal implants were placed. Six months after implant placement, a bimaxillary fixed implant-supported prosthesis was delivered, maintaining a satisfactory esthetic and functional result after a 2-year follow-up. The use of combined preprosthetic techniques allows the placement of endosteal implants and a fixed implant-supported prosthesis in patients with oligodontia and ectodermal dysplasia, providing an esthetic and functional oral rehabilitation.
Influence of Articulating Paper Thickness on Occlusal Contacts Registration: A Preliminary Report.
Brizuela-Velasco, Aritza; Álvarez-Arenal, Ángel; Ellakuria-Echevarria, Joseba; del Río-Highsmith, Jaime; Santamaría-Arrieta, Gorka; Martín-Blanco, Nerea
2015-01-01
The objective of this preliminary study was to determine if the occlusal contact surface registered with an articulating paper during fixed prosthodontic treatment was contained within the area marked on a thicker articulating paper. This information would optimize any necessary occlusal adjustment of a prosthesis' veneering material. A convenience sample of 15 patients who were being treated with an implant-supported fixed singleunit dental prosthesis was selected. Occlusal registrations were obtained from each patient using 12-μm, 40-μm, 80-μm, and 200-μm articulating paper. Photographs of the occlusal registrations were obtained, and pixel measurements of the surfaces were taken and overlapped for comparison. The results showed that the thicker the articulating paper, the larger the occlusal contact area obtained. The differences were statistically significant. In all cases, the occlusal registrations obtained with the thinnest articulating paper were contained within the area marked on the thickest articulating paper. The results suggested that the use of thin articulating papers (12-μm or 40-μm) can avoid unnecessary grinding of veneering material or teeth during occlusal adjustment.
2014-01-01
Cobalt-Chromium (Co-Cr) alloys are classified as predominantly base-metal alloys and are widely known for their biomedical applications in the orthopedic and dental fields. In dentistry, Co-Cr alloys are commonly used for the fabrication of metallic frameworks of removable partial dentures and recently have been used as metallic substructures for the fabrication of porcelain-fused-to-metal restorations and implant frameworks. The increased worldwide interest in utilizing Co-Cr alloys for dental applications is related to their low cost and adequate physico-mechanical properties. Additionally, among base-metal alloys, Co-Cr alloys are used more frequently in many countries to replace Nickel-Chromium (Ni-Cr) alloys. This is mainly due to the increased concern regarding the toxic effects of Ni on the human body when alloys containing Ni are exposed to the oral cavity. This review article describes dental applications, metallurgical characterization, and physico-mechanical properties of Co-Cr alloys and also addresses their clinical and laboratory behavior in relation to those properties. PMID:24843400
Rapid prototyping--when virtual meets reality.
Beguma, Zubeda; Chhedat, Pratik
2014-01-01
Rapid prototyping (RP) describes the customized production of solid models using 3D computer data. Over the past decade, advances in RP have continued to evolve, resulting in the development of new techniques that have been applied to the fabrication of various prostheses. RP fabrication technologies include stereolithography (SLA), fused deposition modeling (FDM), computer numerical controlled (CNC) milling, and, more recently, selective laser sintering (SLS). The applications of RP techniques for dentistry include wax pattern fabrication for dental prostheses, dental (facial) prostheses mold (shell) fabrication, and removable dental prostheses framework fabrication. In the past, a physical plastic shape of the removable partial denture (RPD) framework was produced using an RP machine, and then used as a sacrificial pattern. Yet with the advent of the selective laser melting (SLM) technique, RPD metal frameworks can be directly fabricated, thereby omitting the casting stage. This new approach can also generate the wax pattern for facial prostheses directly, thereby reducing labor-intensive laboratory procedures. Many people stand to benefit from these new RP techniques for producing various forms of dental prostheses, which in the near future could transform traditional prosthodontic practices.
2011-01-01
Objectives Reconstruction of large mandiblular defects following ablative oncologic surgery could be done by using vascularized bone transfer or, more often, primarily with simultaneous or delayed bone grafting, using load bearing reconstruction plates. Bending of these reconstruction plates is typically directed along the outer contour of the original mandible. Simultaneously or in a second operation vascularized or non-vascularized bone is fixed to the reconstruction plate. However, the prosthodontic-driven backward planning to ease bony reconstruction of the mandible in terms of dental rehabilitation using implant-retained overdentures might be an eligible solution. The purpose of this work was to develop, establish and clinically evaluate a novel 3D planning procedure for mandibular reconstruction. Materials and methods Three patients with tumors involving the mandible, which included squamous cell carcinoma in the floor of the mouth and keratocystic odontogenic tumor, were treated surgically by hemimandibulectomy. Results In primary alloplastic mandible reconstruction, shape and size of the reconstruction plate could be predefined and prebent prior to surgery. Clinical relevance This study provides modern treatment strategies for mandibular reconstruction. PMID:21968330
Information system analysis of an e-learning system used for dental restorations simulation.
Bogdan, Crenguţa M; Popovici, Dorin M
2012-09-01
The goal of using virtual and augmented reality technologies in therapeutic interventions simulation, in the fixed prosthodontics (VirDenT) project, is to increase the quality of the educational process in dental faculties, by assisting students in learning how to prepare teeth for all-ceramic restorations. Its main component is an e-learning virtual reality-based software system that will be used for the developing skills in grinding teeth, needed in all-ceramic restorations. The complexity of the domain problem that the software system dealt with made the analysis of the information system supported by VirDenT necessary. The analysis contains the following activities: identification and classification of the system stakeholders, description of the business processes, formulation of the business rules, and modelling of business objects. During this stage, we constructed the context diagram, the business use case diagram, the activity diagrams and the class diagram of the domain model. These models are useful for the further development of the software system that implements the VirDenT information system. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
[Three-dimensional computer aided design for individualized post-and-core restoration].
Gu, Xiao-yu; Wang, Ya-ping; Wang, Yong; Lü, Pei-jun
2009-10-01
To develop a method of three-dimensional computer aided design (CAD) of post-and-core restoration. Two plaster casts with extracted natural teeth were used in this study. The extracted teeth were prepared and scanned using tomography method to obtain three-dimensional digitalized models. According to the basic rules of post-and-core design, posts, cores and cavity surfaces of the teeth were designed using the tools for processing point clouds, curves and surfaces on the forward engineering software of Tanglong prosthodontic system. Then three-dimensional figures of the final restorations were corrected according to the configurations of anterior teeth, premolars and molars respectively. Computer aided design of 14 post-and-core restorations were finished, and good fitness between the restoration and the three-dimensional digital models were obtained. Appropriate retention forms and enough spaces for the full crown restorations can be obtained through this method. The CAD of three-dimensional figures of the post-and-core restorations can fulfill clinical requirements. Therefore they can be used in computer-aided manufacture (CAM) of post-and-core restorations.
Lyons, Karl M; Darby, Ivan
2017-06-01
Periodontics cannot be practiced in isolation as frequently many patients have multiple dental needs or medical health issues requiring management. In addition, pathology may manifest in the periodontal tissues, and the onset and progression of periodontitis can be affected by systemic conditions, such as diabetes, and vice versa. The focus of this volume of Periodontology 2000 is interdisciplinary periodontics, and the articles included discuss the interactions and the interrelationshipbetween periodontal tissues/periodontal diseases and endodontics, fixed prosthodontics, implant dentistry, esthetics, gerodontology, radiology, orthodontics, pediatric dentistry, oral and maxillofacial surgery, oral pathology, special needs dentistry and general medicine. Previous volumes of Periodontology 2000 have covered some of the interactions between periodontal diseases and other dental disciplines, especially implant dentistry, 'and the interaction between periodontal disease and systemic disease', but there has not been a volume on interdisciplinary periodontics. The intention therefore is to show how and why periodontics should be interdisciplinary, as well as the benefits of an interdisciplinary approach; in addition, the potential consequences of using a discipline in isolation are discussed. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Oral dyskinesia: a clinical overview.
Blanchet, Pierre J; Rompré, Pierre H; Lavigne, Gilles J; Lamarche, Claude
2005-01-01
Dentists may be the first health care professionals to recognize unusual and abnormal oral movements collectively termed oral dyskinesias. The aims of this clinical overview are to raise the dental community's awareness about this important and complex topic and describe the clinical features and management of the main entities. A MEDLINE search of the different entities reported in the English and French literature was conducted. The main findings of a field study on oral dyskinesia were also reviewed. Involuntary movement disorders are often drug related. In other cases, excessive oral movements may occur at any age in relation to various neuropsychiatric conditions. Orofacial dystonia apparently triggered by dental procedures has also been reported. Edentulousness has been associated with oral stereotypes. In a survey of 352 edentulous elderly individuals attending daycare centers, only 7% displayed visible oral sterotypes, and ill-fitting dentures were suggested as a possible triggering factor for the majority. A multidisciplinary evaluation is desirable in the care of individuals with oral dyskinesia and in the selection of those who may benefit from a prosthodontic approach. A good knowledge of potentially offending drugs may allow avoidance of unnecessary procedures.
Dental laboratory technology education in China: current situation and challenges.
Zheng, Liwei; Yue, Li; Zhou, Min; Yu, Haiyang
2013-03-01
Modern dentistry and dental education in China were first introduced from abroad by Dr. Lindsay in 1907. However, advancements in the field of dental laboratory technology did not occur to the same degree in specialties such as prosthodontics and orthodontics. Since the 1990s, orders from abroad demanding dental appliances surged as the image of China as the "world's factory" strengthened. The assembly line model, in which technicians work like simple procedure workers, was rapidly applied to denture production, while the traditional education system and apprenticeship systems demonstrated little progress in these years. The lack of advancement in dental laboratory technology education caused insufficient development in China's dental technology industry. In order to alter the situation, a four-year dental laboratory technology undergraduate educational program was established in 2005 by West China School of Stomatology, Sichuan University (WCSS, SCU). This program was based on SCU's undergraduate education and WCSS's junior college education systems. The program introduced scientific methods in relevant subjects into laboratory technicians' training and made many improvements in the availability of trained faculty, textbooks, laboratory facilities, and curriculum.
Kargül, B; Alcan, T; Kabalay, U; Atasu, M
2001-01-01
Patients with hypohidrotic ectodermal dysplasia (HED) are characterized by the clinical manifestations of hypodontia, hypohidrosis, hypotrichosis and a highly characteristic facial physiognomy. This disorder is inherited as an X-linked trait. This report presents three cases with HED in which the clinical evaluation (intraoral and radiological), genetic findings and SEM examination of hair. Boys 6 to 14 year old and a 11 year old girl were referred to the Marmara University, Faculty of Dentistry, complaining of oligodontia in the maxillary and mandibular arches and delay in eruption of other teeth. Peg-shaped teeth have been observed. The dermatoglyphs of the patients were striking. SEM examination of hair demonstrated a distinctly abnormal longitudinal grooving along the entire length of each hair and a desquamation of the surface cuticles. The treatment was planned in a multidisciplinary odontological group involving pediatric dentistry, orthodontics, prosthodontics and oral surgery and maxillofacial radiology of future dental habilitation. A specially designed overdenture, a removable prosthesis and osseointegrated implants were constructed. Periodic recall visits were advised, to monitor the dentures and implants during periods of growth and development, and eruption of the permanent teeth.
Benjamin Franklin and the dentist: the story of R. C. Skinner.
Ring, Malvin
2006-01-01
Among Benjamin Franklin's papers was a letter from a young British immigrant, R. C. Skinner, asking for a loan of only twenty dollars to help this young man begin the practice of dentistry in this country. Although we don't know what the great man's response was to this appeal, Skinner went on to achieve fame in his profession. He was the first dentist ever, in this country, to be appointed to a hospital staff; he established the first free dental clinic for the poor; and he authored the first book on dentistry ever published in America, earning him the title "The Father of American Dental Literature." From a newspaper advertisement of 1794, further information has been gleaned about Skinner's practice: he not only did conventional dentistry, but also supplied missing eyes, ears, noses and legs. This was a forerunner of the contemporary subspecialty of prosthodontics termed "maxillofacial prosthetics". An interesting list of Skinner's services and his fees for each, gives us a good picture of what dentistry was like in Colonial America.
Assessment of Facial Golden Proportions among North Maharashtri-an Population
Sunilkumar, L N; Jadhav, Kalpana S; Nazirkar, Girish; Singh, Shailendra; Nagmode, Pradnya S; Ali, Fareedi Mukram
2013-01-01
Background: Divine Proportion in Orthodontics and Prosthodontics has always been intriguing. This was applied to the North Maharashtrian population to evaluate the relationship between facial esthetics and the golden proportions. Materials & Methods: Facial proportions were assessed by examining photographs of sum total of 300 subjects of North Maharashtrian population. Young adults with a skeletal and dental Class 1 occlusion, competent lips, and balanced facial proportion were selected. Photographic prints were taken and manually parameters were plotted and analysis was done. Results: The measurements of anterior facial height showed proportionality with the total facial height. The values showed shorter lower anterior facial height and deviation of facial width parameters from the divine proportion indicating small mouth, nose, and narrow-set eyes with respect to the inter-temporal width. Conclusion: There is soft-tissue facial balance of North Maharashtrian population in comparison with the golden proportion. However, certain parameters show some deviation from the divine proportion.. How to cite this article: Sunilkumar L N, Jadhav K S, Nazirkar G, Singh S, Nagmode P S, Ali F M. Assessment of Facial Golden Proportions among North Maharashtrian Population. J Int Oral Health 2013; 5(3):48-54. PMID:24155602
Oral mark in the application of an individual identification: From ashes to truth.
Chugh, Anshul; Narwal, Anumeha
2017-01-01
Forensic odontology is the branch of dentistry which deals with the proper handling, examination, evaluation and presentation of dental findings in the interest of justice. After major disasters and perimortem assaults such as earthquakes, fires, severe head and neck trauma or gross decomposition, accurate and early identification of dead and injured becomes important. In the absence of other records in such cases, identification is based on restorations, missing teeth and prosthetic devices such as partial and complete removable/fixed prosthesis or implant retained devices. This brings out the major role of prosthodontics to investigate the identity of suspects in the criminal cases as well as the deceased human beings in traumatic injuries or in disasters. Denture identification systems are being used as means of postmortem identification of edentulous persons which has evolved from the inclusion of some form of printed label in a denture to more high-tech methods. The provision of implant retained complete lower denture, antemortem, and postmortem radiographs of edentulous persons and correlation of bite marks using special impression techniques provide another potential source of evidence for human identification. Hence, this literature review throws some light on the role played by prosthodontist in forensic odontology.
The role of orthodontics in the regeneration of the degenerated dentition.
Melsen, B
2016-03-01
The demand for regeneration of a degenerated dentition has been increasing as a result of the development of societies, where the life expectancy is increasing and fighting age-related changes is in focus. Whereas removable dentures were acceptable and considered a norm earlier, patients do, to an increasing degree,demand fixed prosthetics; consequently, the development of implants has had an important impact. The balance in the chewing organ will change with time, due to age-related changes within the bone and the loss of teeth due to caries or periodontal disease, and malocclusions may develop or aggravate. The re-establishment of an aesthetical and functional satisfactory solution cannot be reached by replacing teeth by fixed prosthodontics and implants. The aim of this update was threefold: firstly, to demonstrate that age-related changes, often unnoticed by both the patient and the general dentist, can lead to degeneration of the dentition; secondly, to explain how an interdisciplinary approach can make regeneration of even severe degeneration possible; and finally, to show the importance of the general dentist in the maintenance of the obtained results. Treatments should not aim for short-term results but focus on maintainable results. © 2015 John Wiley & Sons Ltd.
The smiling scan technique: Facially driven guided surgery and prosthetics.
Pozzi, Alessandro; Arcuri, Lorenzo; Moy, Peter K
2018-04-11
To introduce a proof of concept technique and new integrated workflow to optimize the functional and esthetic outcome of the implant-supported restorations by means of a 3-dimensional (3D) facially-driven, digital assisted treatment plan. The Smiling Scan technique permits the creation of a virtual dental patient (VDP) showing a broad smile under static conditions. The patient is exposed to a cone beam computed tomography scan (CBCT), displaying a broad smile for the duration of the examination. Intraoral optical surface scanning (IOS) of the dental and soft tissue anatomy or extraoral optical surface scanning (EOS) of the study casts are achieved. The superimposition of the digital imaging and communications in medicine (DICOM) files with standard tessellation language (STL) files is performed using the virtual planning software program permitting the creation of a VDP. The smiling scan is an effective, easy to use, and low-cost technique to develop a more comprehensive and simplified facially driven computer-assisted treatment plan, allowing a prosthetically driven implant placement and the delivery of an immediate computer aided design (CAD) computer aided manufacturing (CAM) temporary fixed dental prostheses (CAD/CAM technology). Copyright © 2018 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Zawawi, Khalid H; Afify, Ahmed R; Yousef, Mohammed K; Othman, Hisham I; Al-Dharrab, Ayman A
2015-01-01
This longitudinal study was aimed to investigate the association between didactic grades and practical skills for dental students and whether didactic grades can reliability predict the dental students' practical performance. Didactic and practical grades for graduates from the Faculty of Dentistry, King Abdulaziz University, between the years 2009 and 2011 were collected. Four courses were selected: Dental Anatomy, Operative Dentistry, Prosthodontics, and Orthodontics. Pearson product-moment correlation analyses between didactic and practical scores were conducted. There was only a significant correlation between didactic and practical scores for the Dental Anatomy course (P<0.001). There was also a significant correlation between all four subjects in the didactic scores (P<0.001). Only the scores of male students showed a significant correlation in the Operative Dentistry course (P<0.001). There were no correlations between Orthodontic grades. Moreover, a poor degree of reliability was found between didactic and practical scores for all subjects. Based on the findings of this study, the relationship between didactic grades and practical performance is course specific. Didactic grades do not reliably predict the students' practical skills. Measuring practical performances should be independent from didactic grading.
Chen, Hu; Liu, Jing; Li, Hong; Ge, Wenqi; Sun, Yuchun; Wang, Yong; Lü, Peijun
2015-02-01
The objective was to study the relationship between laser fluence and ablation efficiency of a femtosecond laser with a Gaussian-shaped pulse used to ablate dentin and enamel for prosthodontic tooth preparation. A diode-pumped thin-disk femtosecond laser with wavelength of 1025 nm and pulse width of 400 fs was used for the ablation of dentin and enamel. The laser spot was guided in a line on the dentin and enamel surfaces to form a groove-shaped ablation zone under a series of laser pulse energies. The width and volume of the ablated line were measured under a three-dimensional confocal microscope to calculate the ablation efficiency. Ablation efficiency for dentin reached a maximum value of 0.020 mm3∕J when the laser fluence was set at 6.51 J∕cm2. For enamel, the maximum ablation efficiency was 0.009 mm3∕J at a fluence of 7.59 J∕cm2.Ablation efficiency of the femtosecond laser on dentin and enamel is closely related to the laser fluence and may reach a maximum when the laser fluence is set to an appropriate value. © 2015 Society of Photo-Optical Instrumentation Engineers (SPIE)
[Fiber-reinforced composite in fixed prosthodontics].
Pilo, R; Abu Rass, Z; Shmidt, A
2010-07-01
Fiber reinforced composite (FRC) is composed of resin matrix and fibers filler. Common types of fibers: polyethylene, carbon and glass. Fibers can be continuous and aligned, discontinuous and aligned, discontinuous and randomly oriented. The architecture of the fibers is unidirectional, woven or braided. The two main types are: dry fibers or impregnated. Inclusion of fibers to resin composite increased its average flexural strength in 100-200 MPa. FRC can be utilized by the dentist in direct approach (splinting, temporary winged bridge) or indirect approach (laboratory made fixed partial denture). Laboratory fixed partial denture (FPD) is made from FRC substructure and Hybrid/Microfill particulate composite veneer. Main indications: interim temporary FPD or FPD in cases of questionable abutment teeth, in aesthetic cases where All Ceram FPD is not feasible. Retention is attained by adhesive cementation to minimally prepared teeth or to conventionally prepared teeth; other options are inlay-onlay bridges or hybrid bridges. Contraindications are: poor hygiene, inability to control humidity, parafunction habits, and more than two pontics. Survival rate of FRC FPD over 5 years is 75%, lower compared to porcelain fused to metal FPD which is 95%. Main reasons for failure are: fracture of framework and delamination of the veneer. Part of the failures is repairable.
Clinical evaluation of fiber-reinforced epoxy resin posts and cast post and cores.
Ferrari, M; Vichi, A; García-Godoy, F
2000-05-01
This retrospective study evaluated treatment outcome of cast post and core and Composipost systems after 4 yrs of clinical service. 200 patients were included in the study. They were divided in two groups of 100 endodontically treated teeth restored with a post. Group 1: Composipost systems were luted into root canal following the manufacturer's instructions. Group 2: Cast post and cores were cemented into root canal preparations with a traditional technique. The patients were recalled after 6 months, 1, 2 and 4 yrs and clinical and radiographic examinations were completed. Endodontic and prosthodontic results were recorded. Group 1: 95% of the teeth restored with Composiposts showed clinical success; 3% of these samples were excluded for noncompliance and 2% showed endodontic failure. Group 2: Clinical success was found with 84% of teeth restored with cast post and core. 2% of these samples were excluded for noncompliance, 9% showed root fracture, 2% dislodgment of crown and 3% endodontic failure. Statistical evaluation showed significant differences between Groups 1 and 2 (P < 0.001). The results of this retrospective study indicated that the Composipost system was superior to the conventional cast post and core system after 4 yrs of clinical service.
Accelerated treatment protocols: full arch treatment with interim and definitive prostheses.
Drago, Carl
2012-01-01
With the advent of titanium, root form implants and osseointegration, dental treatment has undergone a metamorphosis in recent years. These new techniques enable dentists to provide anchorage for various kinds of prostheses that improve masticatory function, esthetics, and comfort for patients. Implant treatment protocols have been improved relative to implant macro- and micro-geometries, surgical and prosthetic components, and treatment times. Over the past 20 years, immediate occlusal function (also known as loading) has been established as a predictable treatment modality, provided certain specific criteria are met. In many cases, edentulous patients, crippled by the loss of their teeth, can undergo outpatient surgical and prosthetic procedures and return to a masticatory function that is near normal--sometimes after only one day of surgical and prosthetic treatment. This treatment option is also available for patients with advanced, generalized periodontal disease. Computer-assisted design/Computer-assisted manufacturing (CAD/CAM) has transformed how dental prostheses are made, offering improved accuracy, longevity, and biocompatibility; along with reduced labor costs and fewer complications than casting technologies. This article reviews the principles associated with immediate occlusal loading and illustrates one specific accelerated prosthodontic treatment protocol used to treat edentulous and partially edentulous patients with interim and definitive prostheses.
Zawawi, Khalid H; Afify, Ahmed R; Yousef, Mohammed K; Othman, Hisham I; Al-Dharrab, Ayman A
2015-01-01
Objectives This longitudinal study was aimed to investigate the association between didactic grades and practical skills for dental students and whether didactic grades can reliability predict the dental students’ practical performance. Materials and methods Didactic and practical grades for graduates from the Faculty of Dentistry, King Abdulaziz University, between the years 2009 and 2011 were collected. Four courses were selected: Dental Anatomy, Operative Dentistry, Prosthodontics, and Orthodontics. Pearson product-moment correlation analyses between didactic and practical scores were conducted. Results There was only a significant correlation between didactic and practical scores for the Dental Anatomy course (P<0.001). There was also a significant correlation between all four subjects in the didactic scores (P<0.001). Only the scores of male students showed a significant correlation in the Operative Dentistry course (P<0.001). There were no correlations between Orthodontic grades. Moreover, a poor degree of reliability was found between didactic and practical scores for all subjects. Conclusion Based on the findings of this study, the relationship between didactic grades and practical performance is course specific. Didactic grades do not reliably predict the students’ practical skills. Measuring practical performances should be independent from didactic grading. PMID:25878519
Fu, Zhen-nan; Lin, Xue-feng
2013-11-01
To assess the effect of removable partial dentures (PRD) restoration on oral health-related quality of life (OHRQOL) of subjects with shortened dental arches (SDA) using the Chinese version of the Oral Health Impact Profile (OHIP-14). Consecutive patients with shortened dental arches were recruited from the Department of Prosthodontics, Foshan Chancheng Hospital of Stomatology. The Chinese version of OHIP-14 was administered to each subject before treatment and after treatment. The subjective outcomes of removable partial dentures therapy on SDA were collected and the pre- and post-treatment scores of the Chinese version of OHIP-14 were compared. After treatment, significant decrease in patients' total score of OHRQOL [before: 9 (6, 12) ; after: 4 (2.25, 6)] was detected, as well as physical pain subscale, physical disability subscale and handicap subscale; and the score of OHRQOL in function limitation subscale increased [before: 0(0,0); after: 2(1, 2)]. The main impacts of shortened dental arch with intact anterior region affecting patients' OHRQOL are physical disability.From a quality-of-life perspective, patients with SDA can perceive benefits from RPD.
Al Quran, Firas A M; Hazza'a, Abdalla; Al Nahass, Nabeel
2010-12-01
This study aimed at determining the most reliable ala-tragus line as a guide for the orientation of the occlusal plane in complete denture patients by use of cephalometric landmarks on dentate volunteers. Analysis was made for prosthodontically related craniofacial reference lines and angles of lateral cephalometric radiographs taken for 47 dentate adults. Variables were determined and data were analyzed using SPSS (SPSS, Inc., Chicago, IL). Occlusal plane angle formed between the occlusal plane and Camper's plane had the lowest mean value in the angle formed with Camper's I, which represents the measure taken from the superior border of the tragus of the ear with a score of 2.1°. The highest was measured in the angle formed with Camper's III with a score of 6.1°, while the angle formed with Camper's II was 3.2°. The differences between the three planes in relation to the occlusal plane was significant (p < 0.001). The superior border of the tragus with the inferior border of the ala of the nose was most accurate in orienting the occlusal plane. © 2010 by The American College of Prosthodontists.
Prosthodontics an “arsenal” in forensic dentistry
Bathala, Lakshmana Rao; Rachuri, Narendra Kumar; Rayapati, Srinivas Rao; Kondaka, Sudheer
2016-01-01
After major disasters such as earthquakes, fires, floods, tsunami, bomb blasts or terrorist attacks, accurate, and early identification of the dead and injured becomes an utmost importance. Restorations, cariesteeth, missingteeth and/or prostheses are most useful aids for the dental identification. At times, only identifiable remains are a victim's partial or complete dentures. The central principle of dental identification is that postmortem dental remains can be compared with antemortem dental records which include, studycasts, radiographs, etc., to confirm the identity of the victims. Marking/labeling dentures have been considered an important aid in forensic dentistry. Other than finger printing, when compared with all the methods, the marking/labeling of dentures is an accurate and rapid method to identify the unknown victims. There are no standardized methods to follow, but dental practitioners needs to maintain some dental records of their patients. This may include documentation of the “marking of dentures.” The preparedness is the key to success in mass disaster identification. The aim of this review article is to discuss the methods of denture identification, advantages of denture labeling for the rapid identification during major disasters/accidents and the importance of maintaining the patient records. PMID:28123274
Selvi, Firat; Guven, Erdem; Mutlu, Deniz
2011-05-01
Facial-nerve paralysis is seldom seen and may occur because of a broad spectrum of causes. The most commonly seen cause of facial paralysis is the Bell palsy; iatrogenic causes and tumors are relatively rare. Facial asymmetry, drooling, garbled speech, and difficulty in feeding: all adversely affect the psychosocial conditions of the patients. Fascial and tendon sling procedures may be performed for the static treatment of the unilateral permanent facial paralysis. These techniques are used both for the correction of the asymmetry of the face, especially by providing static support for the corner of the mouth, and to prevent drooling. Microstomia after a sling procedure is not a previously observed complication in the literature. A patient is presented with the surgical management of the complication of microstomia that had risen because of a static treatment of his unilateral facial paralysis via a tendon that passes circularly through his orbicularis oris muscle. Oral rehabilitation thereafter was maintained with the support of dental implants and fixed prosthodontics. The most efficient treatment protocol was decided with an interdisciplinary consultation of the oral and maxillofacial surgeon, the plastic surgeon, and the prosthodontist.
Dental responsibility loadings and the relative value of dental services.
Teusner, D N; Ju, X; Brennan, D S
2017-09-01
To estimate responsibility loadings for a comprehensive list of dental services, providing a standardized unit of clinical work effort. Dentists (n = 2500) randomly sampled from the Australian Dental Association membership (2011) were randomly assigned to one of 25 panels. Panels were surveyed by questionnaires eliciting responsibility loadings for eight common dental services (core items) and approximately 12 other items unique to that questionnaire. In total, loadings were elicited for 299 items listed in the Australian Dental Schedule 9th Edition. Data were weighted to reflect the age and sex distribution of the workforce. To assess reliability, regression models assessed differences in core item loadings by panel assignment. Estimated loadings were described by reporting the median and mean. Response rate was 37%. Panel composition did not vary by practitioner characteristics. Core item loadings did not vary by panel assignment. Oral surgery and endodontic service areas had the highest proportion (91%) of services with median loadings ≥1.5, followed by prosthodontics (78%), periodontics (76%), orthodontics (63%), restorative (62%) and diagnostic services (31%). Preventive services had median loadings ≤1.25. Dental responsibility loadings estimated by this study can be applied in the development of relative value scales. © 2017 Australian Dental Association.
Butterworth, C J; Rogers, S N
2017-12-01
This aim of this report is to describe the development and evolution of a new surgical technique for the immediate surgical reconstruction and rapid post-operative prosthodontic rehabilitation with a fixed dental prosthesis following low-level maxillectomy for malignant disease.The technique involves the use of a zygomatic oncology implant perforated micro-vascular soft tissue flap (ZIP flap) for the primary management of maxillary malignancy with surgical closure of the resultant maxillary defect and the installation of osseointegrated support for a zygomatic implant-supported maxillary fixed dental prosthesis.The use of this technique facilitates extremely rapid oral and dental rehabilitation within a few weeks of resective surgery, providing rapid return to function and restoring appearance following low-level maxillary resection, even in cases where radiotherapy is required as an adjuvant treatment post-operatively. The ZIP flap technique has been adopted as a standard procedure in the unit for the management of low-level maxillary malignancy, and this report provides a detailed step-by-step approach to treatment and discusses modifications developed over the treatment of an initial cohort of patients.
Multidisciplinary full-mouth rehabilitation with soft tissue regeneration in the esthetic zone.
Liebermann, Anja; Frei, Stefan; Pinheiro Dias Engler, Madalena Lucia; Zuhr, Otto; Prandtner, Otto; Edelhoff, Daniel; Saeidi Pour, Reza
2018-01-01
Oral rehabilitation often requires a multidisciplinary approach including restorative dentistry, prosthodontics, and periodontology to fulfill high esthetic and functional demands, frequently combined with changes in the vertical dimension. The presence of gingival recessions can be associated with numerous factors, such as brushing or preparation trauma and persistent inflammation of the gingiva due to inadequate marginal fit of restorations. Because gingival recessions can cause major esthetic and functional problems, obtaining stability of the gingival tissue around prosthetic restorations is of essential concern. Modifications of the occlusal vertical dimension require sufficient experience of the whole dental team. Especially in patients with functional problems and craniomandibular dysfunction, a newly defined occlusal position should be adequately tested and possibly adjusted. This case report presents a complete prosthetic rehabilitation combined with a periodontal surgical approach for a patient with gingival recessions and functional/esthetic related problems. The vertical dimension was carefully defined through long-term polymethyl methacrylate provisionals as a communication tool between all parts involved. All-ceramic crowns were inserted after periodontal healing as definitive rehabilitation. Complex rehabilitation in patients with high esthetic demands including soft tissue corrections requires a multidisciplinary team approach that consists of periodontal surgeon, dentist and dental technician. © 2017 Wiley Periodicals, Inc.
Zirconia in fixed prosthesis. A literature review
Román-Rodríguez, Juan L.; Ferreiroa, Alberto; Solá-Ruíz, María F.; Fons-Font, Antonio
2014-01-01
Statement of problem: Evidence is limited on the efficacy of zirconia-based fixed dental prostheses. Objective: To carry out a literature review of the behavior of zirconium oxide dental restorations. Material and Methods: This literature review searched the Pubmed, Scopus, Medline and Cochrane Library databases using key search words “zirconium oxide,” “zirconia,” “non-metal restorations,” “ceramic oxides,” “veneering ceramic,” “zirconia-based fixed dental prostheses”. Both in vivo and in vitro studies into zirconia-based prosthodontic restoration behavior were included. Results: Clinical studies have revealed a high rate of fracture for porcelain-veneered zirconia-based restorations that varies between 6% and 15% over a 3- to 5-year period, while for ceramo-metallic restorations the fracture rate ranges between 4 and 10% over ten years. These results provoke uncertainty as to the long-term prognosis for this material in the oral medium. The cause of veneering porcelain fractures is unknown but hypothetically they could be associated with bond failure between the veneer material and the zirconia sub-structure. Key words:Veneering ceramic, zirconia-based ceramic restoration, crown, zirconia, tooth-supported fixed prosthesis. PMID:24596638
Accelerating effects of cellulase in the removal of denture adhesives from acrylic denture bases.
Harada-Hada, Kae; Mimura, Sumiyo; Hong, Guang; Hashida, Tatsumi; Abekura, Hitoshi; Murata, Hiroshi; Nishimura, Masahiro; Nikawa, Hiroki
2017-04-01
Studies of effective methods for the easy removal of denture adhesives from a denture base are not well represented in the literature. We previously assessed the removability of denture adhesives by immersing within denture cleaners, showing that some cleaners have a weak effect, insufficiently effective in daily use. In this study, we prepared a cellulase, as a potential component for denture adhesive removers, and we examined whether the addition of cellulase to denture cleaners is effective in the removal of cream denture adhesives. We prepared the cellulase Meicelase as one component for the liquefaction of denture adhesives. We used two denture cleaners and two cream adhesives. After the immersion of plates in sample solutions, we evaluated the area of the sample plate still covered with adhesives. Biofilm removal assay was also performed using denture cleaners containing cellulase. The addition of cellulase accelerated the removal of cream adhesives in immersion experiments to a rate faster than that of water and denture cleaners. However, it did not influence the removability of Candida albicans biofilms from acrylic resin specimens. Cellulase hastened the liquefaction of cream adhesives. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Apaydin, Aysegul; Sermet, Bulent; Ureturk, Sevin; Kundakcioglu, Abdulsamet
2014-09-17
Amelogenesis imperfecta refers a group of hereditary diseases affecting the teeth and can present a variety of clinical forms and appearances, compromising esthetic appearance. Amelogenesis imperfecta variably reduces oral health quality and can result in severe psychological problems. We present the management of an amelogenesis imperfecta Angle class III malocclusion case with speech, esthetics and functional problems. This is an example of the rarely presented delayed eruption with multiple morphologic dental alterations and edentulous maxilla.There are only a few available reports in which this method is used method to correct sagittal discrepancies in edentulous patients.Our treatment plan consisted of a preoperative diagnostic and prosthodontics phase (including preparation of guiding prosthesis), followed by a surgical phase of Le Fort I osteotomy, distraction osteogenesis to correct the malocclusion, implant insertion and a follow up final restorative phase. Our treatment strategy attempts to serve patient needs, achieving function and esthetics while also minimizing the risk of reconstruction failure. Treatment not only restored function and esthetics, but also showed a positive psychological impact and thereby improved perceived quality of life.
Exploratory factor analysis of the Oral Health Impact Profile.
John, M T; Reissmann, D R; Feuerstahler, L; Waller, N; Baba, K; Larsson, P; Celebić, A; Szabo, G; Rener-Sitar, K
2014-09-01
Although oral health-related quality of life (OHRQoL) as measured by the Oral Health Impact Profile (OHIP) is thought to be multidimensional, the nature of these dimensions is not known. The aim of this report was to explore the dimensionality of the OHIP using the Dimensions of OHRQoL (DOQ) Project, an international study of general population subjects and prosthodontic patients. Using the project's Learning Sample (n = 5173), we conducted an exploratory factor analysis on the 46 OHIP items not specifically referring to dentures for 5146 subjects with sufficiently complete data. The first eigenvalue (27·0) of the polychoric correlation matrix was more than ten times larger than the second eigenvalue (2·6), suggesting the presence of a dominant, higher-order general factor. Follow-up analyses with Horn's parallel analysis revealed a viable second-order, four-factor solution. An oblique rotation of this solution revealed four highly correlated factors that we named Oral Function, Oro-facial Pain, Oro-facial Appearance and Psychosocial Impact. These four dimensions and the strong general factor are two viable hypotheses for the factor structure of the OHIP. © 2014 John Wiley & Sons Ltd.
Shamim, Thorakkal
2015-01-01
There is a paucity of information about the relationship of forensic odontology with various dental specialties in the articles published in the Journal of Forensic Odonto-Stomatology. This study aimed to find the relationship of forensic odontology with various dental specialties in the articles published in the Journal of Forensic Odonto-Stomatology from 2005 to 2012 over an 8-year period. Bibliometric analysis was performed using web-based search during December 2013. Out of the total 97 published articles, the maximum number of published articles were related to oral medicine and radiology (20) and community dentistry (20), followed by orthodontics (18), prosthodontics (15), and oral pathology and microbiology (8), pedodontics (7), oral and maxillofacial surgery (4) and conservative dentistry and endodontics (3). Among the articles published in Journal of Forensic Odonto-Stomatology, mass disasters (10) and bite mark analysis (10), followed by sexual dimorphism (8) and dental fraud and malpractice (8), followed by craniofacial superimposition (6) and identification (6) form the major attraction of the contributors. This paper has tried to evaluate the new working classification proposed for forensic odontology based on its relationship with other dental specialties.
Civil liability: characterization of the demand for lawsuits against dentists.
Zanin, Alice Aquino; Herrera, Lara Maria; Melani, Rodolfo Francisco Haltenhoff
2016-08-18
In light of the fact that dentists may be held civilly liable for their practice, it is important to understand the current situation of lawsuits filed against these professionals by studying current legal decisions and the literature. The objective of this study was to analyze the case law of the Court of Justice of São Paulo, Brazil, relative to the profile of patients and professionals, the most commonly involved specialties, the amounts litigated and the court decisions pertaining to civil liability lawsuits against dentists. In an inductive approach, a single researcher screened and collected civil liability rulings by accessing the Court's website, and following a statistical-descriptive procedure and an indirect observation technique. The most frequently involved specialty was prosthodontics. However, oral and maxillofacial surgery was related to a higher incidence of damages awarded to settle claims and to higher damage amounts. The dentist was found guilty in 44.32% of the cases researched. Pecuniary damages ranged between R$ 485.50 and R$ 12,530.00, and non-pecuniary damages ranged between R$ 2,500.00 and R$ 70,000.00. Most lawsuits were filed by women against male dentists. An increase in the relative number of lawsuits against companies versus individuals was observed.
Evaluation of the occlusal contact of crowns fabricated with the bite impression method.
Makino, Sachi; Okada, Daizo; Shin, Chiharu; Ogura, Reiko; Ikeda, Masaomi; Miura, Hiroyuki
2013-09-30
In prosthodontic treatment, reconstruction of a proper occlusal contact relationship is very important as well as reconstruction of a proper interproximal relationship and marginal fitness. Unfortunately, occlusal relationships are sometimes lost in the process of occlusal adjustment of crowns. The purpose of this study was to compare the occlusal contacts of single crown fabricated by two different types of impression techniques. Nine subjects, whose molars required treatment with crown restoration, were enrolled in this study. Full cast crowns were fabricated using two types of impression techniques: the conventional impression method (CIM) and the bite impression method (BIM). The occlusal contacts of crowns were precisely evaluated at the following stages: after occlusal adjustment on the articulator (Step 0), before occlusal adjustment in the mouth (Step 1), after occlusal adjustment at the intercuspal position (Step 2), and after occlusal adjustment during lateral and protrusive excursions (Step 3). The number of occlusal contacts of the crowns on the functional cusps fabricated with BIM was significantly greater than that with CIM after occlusal adjustment. For this reason, the crowns fabricated with BIM might have a more functionally desirable occlusal surface compared to the crowns fabricated with CIM.
Ergonomics and musculoskeletal disorder: as an occupational hazard in dentistry.
Gopinadh, Anne; Devi, Kolli Naga Neelima; Chiramana, Sandeep; Manne, Prakash; Sampath, Anche; Babu, Muvva Suresh
2013-03-01
Musculoskeletal disorders (MSDs) are commonly experienced in dentistry. The objective of this study is to determine the prevalence of ergonomics and MSDs among dental professionals. A cross-sectional survey was conducted among 170 dentists of different specialties. The questionnaire gathered information regarding demographic details, MSDs, work duration, working status, awareness of ergonomics, etc. Data was analyzed using SPSS version 15.0. Student's t-test and analysis of variance (ANOVA) test was used for comparison in mean scores. Stepwise multiple linear regression analysis was used to assess the independent variables that significantly influenced the variance in the dependent variable (pain). It was found that 73.9% of the participants reported musculoskeletal pain and most common painful sites were neck and back. More than half of the participants, i.e. 232 (59.3%) were aware of correct ergonomic posture regarding dental. Almost percentage of pain increased significantly with increase in age and working time. Among all specialties, prosthodontics were found to have more prevalence of MSDs. The appearance of musculoskeletal symptoms among dental professionals was quite common. It suggested that ergonomics should be covered in the educational system to reduce risks to dental practitioners.
The role of single immediate loading implant in long Class IV Kennedy mandibular partial denture.
Mohamed, Gehan F; El Sawy, Amal A
2012-10-01
The treatment of long-span Kennedy class IV considers a prosthodontic challenge. This study evaluated the integrity of principle abutments in long Kennedy class IV clinically and radiographically, when rehabilitated with conventional metallic partial denture as a control group and mandibular partial overdentures supported with single immediately loaded implant in symphyseal as a study group. Twelve male patients were divided randomly allotted into two equal groups. First group patients received removable metallic partial denture, whereas in the second group, patients received partial overdentures supported with single immediately loaded implant in symphyseal region. The partial dentures design in both groups was the same. Long-cone paralleling technique and transmission densitometer were used at the time of denture insertion, 3, 6, and 12 months. Gingival index, bone loss, and optical density were measured for principle abutments during the follow-up. A significant reduction in bone loss and density were detected in group II comparing with group I. Gingival index had no significant change (p-value < 0.05). A single symphyseal implant in long span class IV Kennedy can play a pivotal role to improve the integrity of the principle abutments and alveolar bone support. © 2010 Wiley Periodicals, Inc.
Patel, Mit B; Bencharit, Sompop
2009-01-01
Treatment options for patients with severe attrition resulting in reduced occlusal vertical dimension are often limited to fixed prosthesis to reestablish proper occlusal vertical dimension and functional occlusion. In some cases such as when there are limited finances, minimal esthetic concerns, and medical considerations fixed prosthesis may not be the ideal treatment option. Overlay removable partial dentures (ORPDs) can be used as a provisional or interim prosthesis as well as permanent prosthesis in these cases. While ORPDs can provide a reversible and relatively inexpensive treatment for patients with a significantly compromised dental status, there is not much scientific evidence in the literature on ORPDs. Most studies published on ORPDs to date are primarily reviews and clinical reports. In this article, literatures on ORPDs are summarized and a patient treated with interim and permanent ORPDs is presented. This article reviews previously published literatures on the use of ORPDs. Indications, advantages and disadvantages are discussed. Treatment protocol with an example of the prosthodontic treatment of a patient with severely worn dentition with an interim ORPD and later a permanent ORPD are discussed in details. PMID:19915723
An interview with Marissa C. Keesler
Catharino, Fernanda; Closs, Luciana Q.; Mucha, Nelson; Lima, Roberto
2014-01-01
Dr. Marissa Keesler attended dental school at Creighton University in Omaha, Nebraska and in 1987 received her Doctor of Dental Surgery degree with high honors. In 1989, she graduated from Marquette University with a Certificate and Master of Science degree in Orthodontics. Dr. Keesler has been an Adjunct Professor in the Marquette Graduate Orthodontic Department since 1990 and has been a guest speaker at several universities and orthodontic groups nationally and internationally. She has contributed to the development of several orthodontic textbooks in topics related to multidisciplinary treatment and the indirect bonding technique. Dr. Keesler is a member of the American Association of Orthodontists and many other local and national dental and orthodontic societies such as the Edward H. Angle Society of Orthodontists and the Pierre Fauchard Academy. She also has Diplomate status with the American Board of Orthodontics and is a graduate of the AEO Roth/Williams Center. Dr. Keesler has been in specialty practice since 1989 and has had a full-time private practice in Neenah since 1992. In 2000, she was joined by her husband, Dr. Jeffrey T. Keesler, who has a dual specialty in Prosthodontics and Orthodontics. Dr. Roberto Lima Filho PMID:25076507
Preliminary impression techniques for microstomia patients
Kumar, K. Aswini; Bhat, Vinaya; Nair, K. Chandrasekheran; Suresh, Reshma
2016-01-01
The Prosthetic rehabilitation of microstomia patients presents difficulties at all the stages. The difficulty starts with the preliminary impression making. This is due to the tongue rigidity and the decreased oral opening. A maximum oral opening which is smaller than the size of the tray can make prosthetic treatment challenging. Due to the restricted mouth opening, insertion and removal of the impression trays is extremely cumbersome and various modifications of the trays have been used in the past. Among these are the flexible trays and the sectional trays used with different modes of reassembling the segments extra orally after the impression is made. This article reviews the literature published from 1971 to 2015 concerning preliminary impression techniques used in making impressions for patients with microstomia based on various tray designs. An electronic search was performed across three databases (PubMed, Science Direct and Google Scolar) for relevant citations. The keywords/combinations used for the search were microstomia, limited/constricted/restricted mouth opening/oral access, trismus, sectional trays, impressions and prosthetic/prosthodontic rehabilitation. The search was limited to papers written in English which resulted in a total of 45 related articles of which 17 articles were included for discussion of this review. PMID:27621540
SPEECH EVALUATION WITH AND WITHOUT PALATAL OBTURATOR IN PATIENTS SUBMITTED TO MAXILLECTOMY
de Carvalho-Teles, Viviane; Pegoraro-Krook, Maria Inês; Lauris, José Roberto Pereira
2006-01-01
Most patients who have undergone resection of the maxillae due to benign or malignant tumors in the palatomaxillary region present with speech and swallowing disorders. Coupling of the oral and nasal cavities increases nasal resonance, resulting in hypernasality and unintelligible speech. Prosthodontic rehabilitation of maxillary resections with effective separation of the oral and nasal cavities can improve speech and esthetics, and assist the psychosocial adjustment of the patient as well. The objective of this study was to evaluate the efficacy of the palatal obturator prosthesis on speech intelligibility and resonance of 23 patients with age ranging from 18 to 83 years (Mean = 49.5 years), who had undergone inframedial-structural maxillectomy. The patients were requested to count from 1 to 20, to repeat 21 words and to spontaneously speak for 15 seconds, once with and again without the prosthesis, for tape recording purposes. The resonance and speech intelligibility were judged by 5 speech language pathologists from the tape recordings samples. The results have shown that the majority of patients (82.6%) significantly improved their speech intelligibility, and 16 patients (69.9%) exhibited a significant hypernasality reduction with the obturator in place. The results of this study indicated that maxillary obturator prosthesis was efficient to improve the speech intelligibility and resonance in patients who had undergone maxillectomy. PMID:19089242
NASA Astrophysics Data System (ADS)
Stratul, Stefan-Ioan; Sinescu, Cosmin; Negrutiu, Meda; de Sabata, Aldo; Rominu, Mihai; Ogodescu, Alexandru; Rusu, Darian
2014-01-01
Holographic evaluations count among recent measurement tools in orthodontics and prosthodontics. This research introduces holography as an assessment method of 3D variations of gingival retractions. The retraction of gingiva on frontal regions of 5 patients with periodontitis was measured in six points and was evaluated by holographic methods using a He-Ne laser device (1mV, Superlum, Carrigtwohill, Ireland) inside a holographic bank of 200 x 100cm. Impressions were taken during first visit and cast models were manufactured. Six months after the end of periodontal treatment, clinical measurements were repeated and the hologram of the first model was superimposed on a final model cast, by using reference points, while maintaining the optical geometric perimeters. The retractions were evaluated 3D in every point using a dedicated software (Sigma Scan Pro,Systat Software, SanJose, CA, USA). The Wilcoxon test was used to compare the mean recession changes between baseline and six months after treatment, and between values in vivo and the values on hologram. No statistically significant differences between values in vivo and on the hologram were found. In conclusion, holography provides a valuable tool for assessing gingival retractions on virtual models. The data can be stored, reproduced, transmitted and compared at a later time point with accuracy.
Selected applications for current polymers in prosthetic dentistry - state of the art.
Kawala, Maciej; Smardz, Joanna; Adamczyk, Lukasz; Grychowska, Natalia; Wieckiewicz, Mieszko
2018-05-10
Polymers are widely applied in medicine, including dentistry, i.e. in prosthodontics. The following paper is aimed at demonstrating the applications of selected modern polymers in prosthetic dentistry based on the reported literature. The study was conducted using the PubMed, SCOPUS and CINAHL databases in relation to documents published during 1999-2017. The following keywords were used: polymers with: prosthetic dentistry, impression materials, denture base materials, bite registration materials, denture soft liners, occlusal splint materials and 3D printing. Original papers and reviews which were significant from the modern clinical viewpoint and practical validity in relation to the possibility of using polymeric materials in prosthetic dentistry, were presented. Denture base materials were most commonly modified polymers. Modifications mainly concerned antimicrobial properties and reinforcement of the material structure by introducing additional fibers. Antimicrobial modifications were also common in case of relining materials. Polymeric materials have widely been used in prosthetic dentistry. Modifications of their composition allow achieving new, beneficial properties that affect quality of patients' life. Progress in science allows for a more methodologically-advanced research on the synthesis of new polymeric materials and incorporation of new substances into already known polymeric materials, that will require systematization and appropriate classification. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.
Characteristics Identified for Success by Restorative Dental Science Department Chairpersons.
Wee, Alvin G; Weiss, Robert O; Wichman, Christopher S; Sukotjo, Cortino; Brundo, Gerald C
2016-03-01
The primary aim of this study was to determine the characteristics that current chairpersons in restorative dentistry, general dentistry, prosthodontics, and operative dentistry departments in U.S. dental schools feel are most relevant in contributing to their success. The secondary aim was to determine these individuals' rankings of the importance of a listed set of characteristics for them to be successful in their position. All 82 current chairs of the specified departments were invited to respond to an electronic survey. The survey first asked respondents to list the five most essential characteristics to serve as chair of a department and to rank those characteristics based on importance. Participants were next given a list of ten characteristics in the categories of management and leadership and, without being aware of the category of each individual item, asked to rank them in terms of importance for their success. A total of 39 chairpersons completed the survey (47.6% response rate; 83.3% male and 16.2% female). In section one, the respondents reported that leadership, vision, work ethic, integrity, communication, and organization were the most essential characteristics for their success. In section two, the respondents ranked the leadership characteristics as statistically more important than the management characteristics (p<0.0001) for being successful in their positions.
Vaidyanathan, Tritala K; Vaidyanathan, Jayalakshmi; Arghavani, David
2016-12-01
Purpose: The goal of this investigation was to characterize the compliance properties in selected polymers used for temporary (provisional crown and bridge) applications. Method: Polymethyl methacrylate (PMMA)- and polyethyl methacrylate (PEMA)-based JET and TRIM II were investigated along with two bisacryl composite resins (LUXATEMP and PROTEMP 3 GARANT). Rectangular samples of the resins were subjected to creep-recovery tests in a dynamic mechanical analyzer at and near the oral temperature (27 °C, 37 °C and 47 °C). The instantaneous (elastic), and time-dependent viscoelastic, and viscoplastic compliance profiles of the materials were determined and analyzed as a function of materials and temperature. Results: Highly significant ( p = 0.0001) differences among means of elastic, viscoelastic and viscoplastic compliance values were found as a function of materials. TRIM II showed an order of magnitude higher viscoplastic deformation than the other three materials (LUXATEMP, PROTEMP 3 GARANT and JET). Conclusions: The results indicate that PEMA is susceptible to significantly greater elastic, viscoelastic, and more importantly to viscoplastic compliant behavior compared with bisacryl composite and PMMA provisional crown and bridge materials. This indicates high-dimensional instability and poor stiffness and resiliency in PEMA appliances vis-à-vis those of PMMA and bisacryl composites.
[Oral health related knowledge and health behavior of parents and school children].
Lalić, Maja; Aleksić, Ema; Gajić, Mihajlo; Malesević, Doka
2013-01-01
The family provides the background for developing behaviors, attitudes and knowledge related to oral health of children. The aim of this study was to compare oral health behavior of parents and their children and to asses the impact of parental behavior on children's oral health. This cross-sectional study included 99 parent--child pairs (12 to 15 years old). Data on oral health behavior, knowledge and attitudes regarding oral hygiene, fluorides and nutrition of parents and their children were collected by questionnaires. The parental dental health was assessed according to self-reported data on tooth loss and prosthodontic rehabilitation, while the dental status of children was determined by clinical examination. The parents reported the use of dental floss (p < 0.001) and mouth rinses (p < 0.05) more often than their children and they had better knowledge on fluorides. Approximately one third of parents thought they should not control sugar consumption of their child. There was a statistically significant correlation between parental oral hygiene and their habit to control the child in brushing with the child's oral health status. Oral health education activities directed towards the prevention of risk factors for developing caries should involve both parents and their children, because parental behavior is a significant predictor of children's oral health.
Bidra, Avinash S
2015-06-01
Bone reduction for maxillary fixed implant-supported prosthodontic treatment is often necessary to either gain prosthetic space or to conceal the prosthesis-tissue junction in patients with excessive gingival display (gummy smile). Inadequate bone reduction is often a cause of prosthetic failure due to material fractures, poor esthetics, or inability to perform oral hygiene procedures due to unfavorable ridge lap prosthetic contours. Various instruments and techniques are available for bone reduction. It would be helpful to have an accurate and efficient method for bone reduction at the time of surgery and subsequently create a smooth bony platform. This article presents a straightforward technique for systematic bone reduction by transferring the patient's maximum smile line, recorded clinically, to a clear radiographic smile guide for treatment planning using cone beam computed tomography (CBCT). The patient's smile line and the amount of required bone reduction are transferred clinically by marking bone with a sterile stationery graphite wood pencil at the time of surgery. This technique can help clinicians to accurately achieve the desired bone reduction during surgery, and provide confidence that the diagnostic and treatment planning goals have been achieved. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
A paradigm shift for bone quality in dentistry: A literature review.
Kuroshima, Shinichiro; Kaku, Masaru; Ishimoto, Takuya; Sasaki, Muneteru; Nakano, Takayoshi; Sawase, Takashi
2017-10-01
The aim of this study was to present the current concept of bone quality based on the proposal by the National Institutes of Health (NIH) and some of the cellular and molecular factors that affect bone quality. This is a literature review which focuses on collagen, biological apatite (BAp), and bone cells such as osteoblasts and osteocytes. In dentistry, the term "bone quality" has long been considered to be synonymous with bone mineral density (BMD) based on radiographic and sensible evaluations. In 2000, the NIH proposed the concept of bone quality as "the sum of all characteristics of bone that influence the bone's resistance to fracture," which is completely independent of BMD. The NIH defines bone quality as comprising bone architecture, bone turnover, bone mineralization, and micro-damage accumulation. Moreover, our investigations have demonstrated that BAp, collagen, and bone cells such as osteoblasts and osteocytes play essential roles in controlling the current concept of bone quality in bone around hip and dental implants. The current concept of bone quality is crucial for understanding bone mechanical functions. BAp, collagen and osteocytes are the main factors affecting bone quality. Moreover, mechanical loading dynamically adapts bone quality. Understanding the current concept of bone quality is required in dentistry. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Pandita, Amrita; Jain, Teerthesh; Yadav, Naveen S; Feroz, S M A; Pradeep; Diwedi, Akankasha
2013-03-01
Aim of the present study was to comparatively evaluate dimensional accuracy of newely introduced elastomeric impression material after repeated pours at different time intervals. In the present study a total of 20 (10 + 10) impressions of master model were made from vinyl polyether silicone and vinyl polysiloxane impression material. Each impression was repeatedly poured at 1, 24 hours and 14 days. Therefore, a total of 60 casts were obtained. Casts obtained were scanned with three-dimensional (3D) laser scanner and measurements were done. Vinyl polyether silicone produced overall undersized dies, with greatest change being 0.14% only after 14 days. Vinyl polysiloxane produced smaller dies after 1 and 24 hours and larger dies after 14 days, differing from master model by only 0.07% for the smallest die and to 0.02% for the largest die. All the deviations measured from the master model with both the impression materials were within a clinically acceptable range. In a typical fixed prosthodontic treatment accuracy of prosthesis is critical as it determines the success, failure and the prognosis of treatment including abutments. This is mainly dependent upon fit of prosthesis which in turn is dependent on dimensional accuracy of dies, poured from elastomeric impressions.
Restoring Anterior Aesthetics by a Rotational Path Cast Partial Denture: An Overlooked Technique
Bhat, Bala Saraswati; Arora, Himanshu
2016-01-01
Cast Partial Dentures (CPD) has long been known to restore missing teeth in patients with minimal invasion on hard and soft tissues. Although satisfactory otherwise, the main concern in CPD is the anterior display of metal. Also the technique sensitive lab procedures, together with the esthetic concern have built an iceberg around the frequent utilization of this treatment modality. With the advent of various techniques to get rid of the metallic display, it was predicted to have more CPD’s done in the dental arena. But the conceptual technicalities of the procedure took away the limelight from this treatment modality and focused on the fixed prosthodontics. Although feasible in a large number of patients, fixed prosthesis still has areas of restriction. It is here, when we apply our knowledge and skill of esthetic CPD. Esthetic CPD eliminates the metal display by utilizing desirable undercuts. The engaging action of the framework into these undercuts paves way for a rotational motion to seat the remaining prosthesis. Hence dual path of insertion helps eliminating the anterior clasp. In this case report dual path of insertion is discussed for replacing anterior teeth in an old male patient who had mild esthetic concerns. Following the conservative approach of CPD (over FPD) esthetic and restorative treatment was planned with patient’s consent. PMID:27437375
Shahid, Fazal; Alam, Mohammad Khursheed; Khamis, Mohd Fadhli
2015-01-01
Objective: To investigate the maxillary and mandibular anterior crown width/height ratio and its relation to various arch perimeters, arch length, and arch width (intercanine, interpremolar, and intermolar) groups. Materials and Methods: The calculated sample size was 128 subjects. The crown width/height, arch length, arch perimeter, and arch width of the maxilla and mandible were obtained via digital calliper (Mitutoyo, Japan). A total of 4325 variables were measured. The sex differences in the crown width and height were evaluated. Analysis of variance was applied to evaluate the differences between arch length, arch perimeter, and arch width groups. Results: Males had significantly larger mean values for crown width and height than females (P ≤ 0.05) for maxillary and mandibular arches, both. There were no significant differences observed for the crown width/height ratio in various arch length, arch perimeter, and arch width (intercanine, interpremolar, and intermolar) groups (P ≤ 0.05) in maxilla and mandible, both. Conclusions: Our results indicate sexual disparities in the crown width and height. Crown width and height has no significant relation to various arch length, arch perimeter, and arch width groups of maxilla and mandible. Thus, it may be helpful for orthodontic and prosthodontic case investigations and comprehensive management. PMID:26929686
[Comparison among three translucency parameters].
Fang, Xiong; Hui, Xia
2017-06-01
This study aims to compare the three commonly used translucency parameters in prosthodontics: transmittance (T), contrast ratio (CR), and translucency parameter (TP). Six platelet specimens were composed of Vita enamel and dental porcelain. The initial thickness was 1.2 mm. The specimens were gradually ground to 1.0, 0.8, 0.6, 0.4, and 0.2 mm. T, color parameters, and reflection were measured by a spectrocolorimeter for each corresponding thickness. T, CR and TP were calculated and compared. TP increased, whereas CR decreased, with decreasing thickness. Moreover, T increased with decreasing thickness, and exponential relationships were found. Two-way ANOVA showed statistical significance between T and thickness, except between T and the 1.2 mm and 1.0 mm enamel porcelain groups. No difference was found among the coefficient variations (CV) of T, CR and TP. Curve fitting indicated the existence of exponential relationships between T and CR and between T and TP. The values for goodness of fit with statistical significance were 0.951 and 0.939, respectively (P<0.05). Under the experimental conditions, T, TP and CR achieved the same CV. T and TP, as well as T and CR, were found with exponential relationships. The value of CR and TP could not represent the translucency precisely, especially when comparing the changing ratios.
NASA Astrophysics Data System (ADS)
Kyotoku, B. B. C.; Braz, A. K. S.; Braz, R.; Gomes, A. S. L.
2007-02-01
Fiber-reinforced composites are new materials which have been used for a variety of dental applications, including tooth splinting, replacement of missing teeth, treatment of dental emergencies, reinforcement of resin provisional fixed prosthodontic restorations, orthodontic retention, and other clinical applications. Different fiber types are available, but little clinical information has been disseminated. The traditional microscopy investigation, most commonly used to study this material, is a destructive technique, which requires specimen sectioning and are essentially surface measurements. On the basis of these considerations, the aim of this research is to analyze the interior of a dental sample reinforced with fiber after a mechanical and thermal cycling to emulate oral conditions using optical coherence tomography (OCT). The device we are using is a home built Fourier domain OCT working at 800 nm with 6 μm resolution. The results are compared with microscopy images to validate OCT as a working method. In long term, fractures allow bacterial invasion provoking plaque and calculus formation that can cause caries and periodontal disease. Therefore, non invasive imaging of the bridge fiber enables the possibility of periodic clinical evaluation to ensure the patient health. Furthermore, OCT images can provide a powerful method for quantitative analysis of crack propagation, and can potentially be used for in vivo assessment.
Effect of silver nano particles on flexural strength of acrylic resins.
Sodagar, Ahmad; Kassaee, Mohammad Zaman; Akhavan, Azam; Javadi, Negar; Arab, Sepideh; Kharazifard, Mohammad Javad
2012-04-01
Poly(methyl methacrylate), PMMA, is widely used for fabrication of removable orthodontic appliances. Silver nano particles (AgNps) have been added to PMMA because of their antimicrobial properties. The aim of this study is to investigate the effect of AgNps on the flexural strength of PMMA. Acrylic liquid containing 0.05% and 0.2% AgNps was prepared for two kinds of acrylic resins: Rapid Repair &Selecta Plus. Two groups without AgNps were used as control groups. For each one, flexural strength was investigated via Three Point Bending method for the 15 acrylic blocks. Two-way ANOVA, one way ANOVA and Tukey tests were used for statistical analysis. Rapid Repair without AgNps showed the highest flexural strength. Addition of 0.05% AgNps to Rapid Repair, significantly decreased its flexural strength while, continuing the addition up to 0.2% increased it nearly up to its primary level. In contrast, addition of AgNps to Selecta Plus increased its flexural strength but addition of 0.05% nano particles was more effective than 0.2%. The effect of AgNps on flexural strength of PMMA depends on several factors including the type of acrylics and the concentrations of nano particles. Copyright © 2011 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Orthodontic extrusion for pre-implant site enhancement: Principles and clinical guidelines.
Alsahhaf, Abdulaziz; Att, Wael
2016-07-01
The aim of this paper is to provide a concise overview about the principles of pre-implant orthodontic extrusion, describe methods and techniques available and provide the clinicians with guidelines about its application. A number of reports describe orthodontic extrusion as a reliable method for pre-implant site enhancement. However, no standard protocols have been provided about the application of this technique. The literature database was searched for studies involving implant site enhancement by means of orthodontic extrusion. Information about the principles, indications and contraindications of this method, type of anchorage, force and time were obtained from the literature. Despite that the scarce data is largely limited to case reports and case series, implant site enhancement by means of orthodontic extrusion seems to be a promising option to improve soft and hard tissue conditions prior to implant placement. Orthodontic extrusion is being implemented as a treatment alternative to enhance hard and soft tissue prior to implant placement. While the current literature does not provide clear guidelines, the decision making for a specific approach seems to be based on the clinician's preferences. Clinical studies are needed to verify the validity of this treatment option. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Prevalence of hypodontia in a sample of Sudanese orthodontic patients
Hassan, Duaa Abdulrahman; Abuaffan, Amal H; Hashim, Hayder A
2014-01-01
Objective: The aims of this study were to determine the prevalence of hypodontia in the permanent dentition in a sample of Sudanese patients who sought orthodontic treatment and to compare the results with the reported findings of other populations. Materials and Methods: Orthodontic files including orthopantomographs of 1069 patients (760 females and 309 males - more than 8 years old) were examined and inspected for evidence of hypodontia. Results: The prevalence of hypodontia of the present sample was 5.1%. Hypodontia was found considerably more frequently in the mandible than in the maxilla. The distribution of missing teeth was noticed in the left side more than in the right side. The most frequently missing teeth were the maxillary lateral incisors, followed by the mandibular second premolars, maxillary second premolars and mandibular left lateral incisor. The majority of patients had two or three teeth missing, but rarely more than 5 teeth missing. Conclusions: The prevalence of hypodontia of this study was within the range of that reported in the literature. The incidence of hypodontia in the anterior segment requires great need for orthodontic and prosthodontic treatment. With early detection of hypodontia, alternative treatment modalities can be planned and performed with a multidisciplinary team approach restoring the esthetic and function. PMID:25143929
Gratton, David G; Kwon, So Ran; Blanchette, Derek; Aquilino, Steven A
2016-01-01
The aim of this study was to evaluate the effect of digital tooth preparation imaging and evaluation technology on dental students' technical abilities, self-evaluation skills, and the assessment of their simulated clinical work. A total of 80 second-year students at one U.S. dental school were assigned to one of three groups: control (n=40), E4D Compare (n=20), and Sirona prepCheck (n=20). Students in the control group were taught by traditional teaching methodologies, and the technology-assisted groups received both traditional training and supplementary feedback from the corresponding digital system. Three outcomes were measured: faculty technical score, self-evaluation score, and E4D Compare scores at 0.30 mm tolerance. Correlations were determined between the groups' scores from visual assessment and self-evaluation and between the visual assessment and digital scores. The results showed that the visual assessment and self-evaluation scores did not differ among groups (p>0.05). Overall, correlations between visual and digital assessment scores were modest though statistically significant (5% level of significance). These results suggest that the use of digital tooth preparation evaluation technology did not impact the students' prosthodontic technical and self-evaluation skills. Visual scores given by faculty and digital assessment scores correlated moderately in only two instances.
Tasaka, Akinori; Kikuchi, Manaki; Nakanishi, Kousuke; Ueda, Takayuki; Yamashita, Shuichiro; Sakurai, Kaoru
2018-01-01
The objective of the present study was to investigate the relationship between masticatory function-related factors (masticatory performance, occlusal contact area, maximum bite force, number of chewing strokes, and muscle activity) and the stress-relieving effects of chewing. A total of 28 healthy male subjects were instructed to rest or chew for 10min after 30min of stress loading with arithmetic calculations. Their stress state was assessed by measuring salivary cortisol levels. Saliva was collected at three time points: before stress loading, immediately after stress loading, and 10min after stress loading. Compared to resting, chewing produced a significantly greater reduction in the rate of change in salivary cortisol levels 10min after stress loading. A negative correlation was observed between the rate of decrease in salivary cortisol levels and the number of chewing strokes. No significant correlation was observed between the rate of decrease in salivary cortisol levels and other measurement items. In healthy dentulous people, the number of chewing strokes has been shown to be a masticatory function-related factor that affects stress relief from chewing, suggesting the possibility that more appropriate chewing would produce a greater effect psychological stress relief. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Shamim, Thorakkal
2015-01-01
Background: There is a paucity of information about the relationship of forensic odontology with various dental specialties in the articles published in the Journal of Forensic Odonto-Stomatology. This study aimed to find the relationship of forensic odontology with various dental specialties in the articles published in the Journal of Forensic Odonto-Stomatology from 2005 to 2012 over an 8-year period. Methods: Bibliometric analysis was performed using web-based search during December 2013. Results: Out of the total 97 published articles, the maximum number of published articles were related to oral medicine and radiology (20) and community dentistry (20), followed by orthodontics (18), prosthodontics (15), and oral pathology and microbiology (8), pedodontics (7), oral and maxillofacial surgery (4) and conservative dentistry and endodontics (3). Among the articles published in Journal of Forensic Odonto-Stomatology, mass disasters (10) and bite mark analysis (10), followed by sexual dimorphism (8) and dental fraud and malpractice (8), followed by craniofacial superimposition (6) and identification (6) form the major attraction of the contributors. Conclusion: This paper has tried to evaluate the new working classification proposed for forensic odontology based on its relationship with other dental specialties. PMID:26097336
Wang, Gaoqi; Zhang, Song; Bian, Cuirong; Kong, Hui
2016-01-01
The purpose of the study was to verify the finite element analysis model of three-unite fixed partial denture with in vitro electronic strain analysis and analyze clinical situation with the verified model. First, strain gauges were attached to the critical areas of a three-unit fixed partial denture. Strain values were measured under 300 N load perpendicular to the occlusal plane. Secondly, a three-dimensional finite element model in accordance with the electronic strain analysis experiment was constructed from the scanning data. And the strain values obtained by finite element analysis and in vitro measurements were compared. Finally, the clinical destruction of the fixed partial denture was evaluated with the verified finite element analysis model. There was a mutual agreement and consistency between the finite element analysis results and experimental data. The finite element analysis revealed that failure will occur in the veneer layer on buccal surface of the connector under occlusal force of 570 N. The results indicate that the electronic strain analysis is an appropriate and cost saving method to verify the finite element model. The veneer layer on buccal surface of the connector is the weakest area in the fixed partial denture. Copyright © 2015 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Rapid prototyping modelling in oral and maxillofacial surgery: A two year retrospective study.
Suomalainen, Anni; Stoor, Patricia; Mesimäki, Karri; Kontio, Risto K
2015-12-01
The use of rapid prototyping (RP) models in medicine to construct bony models is increasing. The aim of the study was to evaluate retrospectively the indication for the use of RP models in oral and maxillofacial surgery at Helsinki University Central Hospital during 2009-2010. Also, the used computed tomography (CT) examination - multislice CT (MSCT) or cone beam CT (CBCT) - method was evaluated. In total 114 RP models were fabricated for 102 patients. The mean age of the patients at the time of the production of the model was 50.4 years. The indications for the modelling included malignant lesions (29%), secondary reconstruction (25%), prosthodontic treatment (22%), orthognathic surgery or asymmetry (13%), benign lesions (8%), and TMJ disorders (4%). MSCT examination was used in 92 and CBCT examination in 22 cases. Most of the models (75%) were conventional hard tissue models. Models with colored tumour or other structure(s) of interest were ordered in 24%. Two out of the 114 models were soft tissue models. The main benefit of the models was in treatment planning and in connection with the production of pre-bent plates or custom made implants. The RP models both facilitate and improve treatment planning and intraoperative efficiency. Rapid prototyping, radiology, computed tomography, cone beam computed tomography.
Bilhan, Hakan; Geckili, Onur; Mumcu, Emre; Bilmenoglu, Caglar
2011-12-01
The aim of this clinical study was to evaluate the prosthodontic maintenance requirements during the first year of service of mandibular overdentures supported by interforaminal implants and to assess the influence of attachment type, implant number, and bite force on these requirements. Fifty-nine patients treated with mandibular implant overdentures between the years 2004 and 2009 and appearing in the 12th-month recall were included in this study. The overdentures constituted 4 groups: 2 single interforaminal implants (1 group with locator and 1 group with ball attachments), 3 single interforaminal implants, 3 splinted interforaminal implants (bar), and 4 splinted interforaminal implants (bar). During the examination, prosthetic parameters such as occlusion, tissue adaptation, condition of the retentive mechanism (matrice and patrice), and the condition of the denture-bearing tissues were evaluated and recorded. No statistically significant relation was found between attachment type, bite force values, implant number, and the occurring complications except the need for relining, which was found significantly more in the ball attachments than in other attachment groups (P = .03). After 12 months following the overdenture insertion, there seems to be no relation between occurring complications and patient-related factors, such as maximum bite force, age, and gender, as well as factors related to the overdentures such as number and type of attachments.
Confirmatory factor analysis of the Oral Health Impact Profile.
John, M T; Feuerstahler, L; Waller, N; Baba, K; Larsson, P; Celebić, A; Kende, D; Rener-Sitar, K; Reissmann, D R
2014-09-01
Previous exploratory analyses suggest that the Oral Health Impact Profile (OHIP) consists of four correlated dimensions and that individual differences in OHIP total scores reflect an underlying higher-order factor. The aim of this report is to corroborate these findings in the Dimensions of Oral Health-Related Quality of Life (DOQ) Project, an international study of general population subjects and prosthodontic patients. Using the project's Validation Sample (n = 5022), we conducted confirmatory factor analyses in a sample of 4993 subjects with sufficiently complete data. In particular, we compared the psychometric performance of three models: a unidimensional model, a four-factor model and a bifactor model that included one general factor and four group factors. Using model-fit criteria and factor interpretability as guides, the four-factor model was deemed best in terms of strong item loadings, model fit (RMSEA = 0·05, CFI = 0·99) and interpretability. These results corroborate our previous findings that four highly correlated factors - which we have named Oral Function, Oro-facial Pain, Oro-facial Appearance and Psychosocial Impact - can be reliably extracted from the OHIP item pool. However, the good fit of the unidimensional model and the high interfactor correlations in the four-factor solution suggest that OHRQoL can also be sufficiently described with one score. © 2014 John Wiley & Sons Ltd.
Setting up of teeth in the neutral zone and its effect on speech
Al-Magaleh, Wafa’a Radwan; Swelem, Amal Ali; Shohdi, Sahar Saad; Mawsouf, Nadia Mohamed
2011-01-01
Rational goals for denture construction are basically directed at the restoration of esthetics and masticatory function and the healthy preservation of the remaining natural tissues. Little concern has been given to the perfection and optimization of the phonetic quality of denture users. However, insertion of prosthodontic restorations may lead to speech defects. Most such defects are mild but, nevertheless, can be a source of concern to the patient. For the dental practitioner, there are few guidelines for designing a prosthetic restoration with maximum phonetic success. One of these guidelines involves the setting up of teeth within the neutral zone. The aim of this study was to evaluate, subjectively and objectively, the effect on speech of setting up teeth in the neutral zone. Three groups were examined: group I (control) included 10 completely dentulous subjects, group II included 10 completely edentulous patients with conventional dentures, and group III included the same 10 edentulous patients with neutral zone dentures. Subjective assessment included patient satisfaction. Objective assessment included duration taken for recitation of Al-Fateha and acoustic analysis. Subjectively, patients were more satisfied with their neutral zone dentures. Objectively, speech produced with the neutral zone dentures was closer to normal than speech with conventional dentures. PMID:23960527
Validity of Peer Evaluation for Team-Based Learning in a Dental School in Japan.
Nishigawa, Keisuke; Hayama, Rika; Omoto, Katsuhiro; Okura, Kazuo; Tajima, Toyoko; Suzuki, Yoshitaka; Hosoki, Maki; Ueda, Mayu; Inoue, Miho; Rodis, Omar Marianito Maningo; Matsuka, Yoshizo
2017-12-01
The aim of this study was to determine the validity of peer evaluation for team-based learning (TBL) classes in dental education in comparison with the term-end examination records and TBL class scores. Examination and TBL class records of 256 third- and fourth-year dental students in six fixed prosthodontics courses from 2013 to 2015 in one dental school in Japan were investigated. Results of the term-end examination during those courses, individual readiness assurance test (IRAT), group readiness assurance test (GRAT), group assignment projects (GAP), and peer evaluation of group members in TBL classes were collected. Significant positive correlations were found between all combinations of peer evaluation, IRAT, and term-end examination. Individual scores also showed a positive correlation with group score (total of GRAT and GAP). From the investigation of the correlations in the six courses, significant positive correlations between peer evaluation and individual score were found in four of the six courses. In this study, peer evaluation seemed to be a valid index for learning performance in TBL classes. To verify the effectiveness of peer evaluation, all students have to realize the significance of scoring the team member's performance. Clear criteria and detailed instruction for appropriate evaluation are also required.
Masticatory performance alters stress relief effect of gum chewing.
Nishigawa, Keisuke; Suzuki, Yoshitaka; Matsuka, Yoshizo
2015-10-01
We evaluated the effects of gum chewing on the response to psychological stress induced by a calculation task and investigated the relationship between this response and masticatory performance. Nineteen healthy adult volunteers without dental problems undertook the Uchida-Kraepelin (UK) test (30 min of reiterating additions of one-digit numbers). Before and immediately after the test, saliva samples were collected from the sublingual area of the participants. Three min after the UK test, the participants were made to chew flavorless gum for 3 min, and the final saliva samples were collected 10 min after the UK test. The experiment was performed without gum chewing on a different day. Masticatory performance was evaluated using color-changing chewing gum. Salivary CgA levels at immediately and 10 min after the UK test were compared with and without gum chewing condition. Two-way repeated measures analysis of variance revealed significant interaction between gum chewing condition and changes in CgA levels during post 10 min UK test period. A significant correlation was found between changes in CgA levels and masticatory performance in all participants. Our results indicate that gum chewing may relieve stress responses; however, high masticatory performance is required to achieve this effect. Copyright © 2015 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Evaluation of the attractive force of different types of new-generation magnetic attachment systems.
Akin, Hakan; Coskun, M Emre; Akin, E Gulsah; Ozdemir, A Kemal
2011-03-01
Rare earth magnets have been used in prosthodontics, but their tendency for corrosion in the oral cavity and insufficient attractive forces limit long-term clinical application. The purpose of this study was to evaluate the attractive force of different types of new-generation magnetic attachment systems. The attractive force of the neodymium-iron-boron (Nd-Fe-B) and samarium-cobalt (Sm-Co) magnetic attachment systems, including closed-field (Hilop and Hicorex) and open-field (Dyna and Steco) systems, was measured in a universal testing machine (n=5). The data were statistically evaluated with 1-way ANOVA and post hoc Tukey-Kramer multiple comparison test (α=.05). The closed-field systems exhibited greater (P<.001) attractive force than the open-field systems. Moreover, there was a statistically significant difference in attractive force between Nd-Fe-B and Sm-Co magnets (P<.001). The strongest attractive force was found with the Hilop system (9.2 N), and the lowest force was found with the Steco system (2.3 N). The new generation of Nd-Fe-B closed-field magnets, along with improved technology, provides sufficient denture retention for clinical application. Copyright © 2011 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.
Berg, Rob; Call, Richard L; Maguire, Kerry; Berkey, Douglas B; Karshmer, Bernard A; Guyton, Brad; Tawara-Jones, Karen
2010-04-01
The University of Colorado Denver School of Dental Medicine has operated a community-based dental education program for all of its students since 1985. A database of student productivity has been maintained in a standardized format, capable of multiyear compilation, since 1994. This study utilizes twelve years of these data to profile the type and amount of clinical treatment that can be provided by a typical fourth-year dental student during a 100-day community-based training experience. Between 1994 and 2006, the school's 423 graduates provided a mean of 922 treatment procedures per student at a mean of 498 patient visits per student. During a typical four-week clinical affiliation, each student provided a mean of approximately twenty-seven restorations on permanent teeth, sixteen restorations on primary teeth, and twenty-four oral surgery procedures (extractions). Students also gained considerable experience in periodontics, fixed and removable prosthodontics, and endodontics. Self-assessed competency ratings tended to increase after completing the program, as did willingness to treat underserved populations after graduation. About 16 percent of graduates reported planning to practice in the public sector after completing dental school. A community-based experience such as this appears to offer an opportunity to substantially augment dental students' clinical training experiences.
Schnutenhaus, Sigmar; Luthardt, Ralph G; Rudolph, Heike; Götz, Werner
2015-01-01
Objectives: Cleidocranial dysplasia (CCD) is a rare congenital malformation syndrome, inherited autosomal-dominantly. During a course of treatment including surgical, implantological and restorative procedures, an opportunity arose to histologically examine biopsies of the maxilla and mandible of a CCD patient 47 years of age. Case report: The aim of this case report is to present the results of the histological evaluation of the alveolar bone and the surgical pretreatment for and placement of six implants each in the maxilla and the mandible. The implants were inserted in a minimally invasive procedure using 3D template guidance. Following uneventful healing of the implants, ceramically veneered bridges were cemented on individual titanium abutments. Since the patient had not received orthodontic treatment in childhood-which would have been the treatment modality of choice-this implantological and prosthodontic approach was necessary. Biopsies were taken from the maxilla and the mandible before placing the implants. Histological evaluation showed bone with strong, coarsely interconnecting trabeculae, especially in the maxilla. Both the bone and the gingiva otherwise exhibited a normal structure without pathological features or anomalies. Conclusion: The clinical parameters and histological evaluation of this one clinical case suggest that the concepts familiar from general oral implantology in terms of surgical and prosthetic procedures can be adopted for older patients with CCD. PMID:26339428
Markovics, Dóra; Szendi, Róbert; Vicko, Kristina; Rajnics, Zsolt; Marada, Gyula; Radnai, Márta
2016-03-01
The treatment of patients having a completely edentulous maxillary arch and lower anterior teeth present is frequent in the dental practice. In these cases some specific changes can be detected in the oral cavity and on orthopantomograms. These signs were summarized and described first by Kelly (1972). Aim of the study was to examine the presence of the specific signs of the combination syndrome among the patients between 2009 and 2014. With the help of the electronic patient registry system used by the University of Pécs, 319 patients were filtered who were diagnosed with anodontia code (K0000 International Classification of Diseases (ICD)) in the examined period. 220 patients' orthopantomograms were evaluated searching for specific symptoms of the combination syndrome. 34 patients had complete edentulous maxilla and anterior teeth in the mandible. 4 patients (11.7%) showed the main sign of the combination syndrome, i.e. the maxillary anterior bone loss. Hypertrophy of maxillary tuberosity (9 cases, 26.4%), extrusion of the lower anterior teeth (6 cases, 17.6%) and great resorption of the distal mandibular ridge (16 cases, 47%) was diagnosed on the X-rays. The clinical examination of three patients supported the radiological findings. The combination syndrome was detectable, but the incidence rate was lower in this population in comparison with the data available in dental scientific publications.
Effects of a shade-matching light and background color on reliability in tooth shade selection.
Najafi-Abrandabadi, Siamak; Vahidi, Farhad; Janal, Malvin N
2018-01-01
The purpose of this study was to evaluate the effects of a shade-matching light (Rite-Lite-2, AdDent) and different viewing backgrounds on reliability in a test of shade tab matching. Four members of the Prosthodontic faculty matched 10 shade tabs selected for a range of shades against the shade guide. All raters were tested for color blindness and were calibrated prior to the study. Matching took place under four combinations of conditions: with operatory light or the shade-matching light, and using either a pink or a blue background. Reliability was quantified with the kappa statistic, separately for agreement of value, hue, and chroma for each shade tab. In general, raters showed fair to moderate levels of agreement when judging the value of the shade tabs, but could not agree on the hue and chroma of the stimuli. The pink background led to higher levels of agreement than the blue background, and the shade-matching light improved agreement when used in conjunction with the pink but not the blue background. Moderate levels of agreement were found in matching shade tab value. Agreement was generally better when using the pink rather than the blue background, regardless of light source. The use of the shade-matching light tended to amplify the advantage of the pink background.
[A ten-year clinical study of cracked teeth restored with glass ceramic crowns].
Luo, X P; Yuan, Y; Shi, Y J; Qian, D D
2016-10-09
Objective: To evaluate the clinic performance of high strength glass ceramic crowns for the painful cracked teeth during a 10-year observation period. Methods: Forty-two posterior teeth from 36 patients were diagnosed as having a crack, biting painful and sensitivity to cold were selected in the Department of Prosthodontic, Institute and Hospital of Stomatology, Nanjing University Medical School. The lost-wax hot pressed glass ceramic crowns were bonded on the minimally invasive prepared teeth by modern adhesive technology. Patients were interviewed and went through clinic examination after one week, one month, and every six months. Results: The effectiveness of 42 glass ceramic crowns for cracked teeth was evaluated for a mean observation time over 10-year. At the first week, 29(81%) patients were free of pain, three still had sensitivity to cold and chewing pain, three still had sensitivity to cold, one had painful to cold and hot. After one month, two patients still had chewing pain, and one tooth needed endodontic treatment after six months. In 10 years, 2(5%) all ceramic crowns were broken, the other 40 restorations kept good clinical performances with a 10-year survival rate of 95%. Conclusions: The high strength glass ceramic crowns are very effective and successful in treating the cracked teeth and then keep the good mastication function and appearance.
Reissmann, Daniel R; Remmler, Antje; John, Mike T; Schierz, Oliver; Hirsch, Christian
2012-12-01
The assessment of changes in oral health-related quality of life (OHRQoL) is challenging because individuals' concepts and internal standards of OHRQoL may change over time. The aim of this study was to detect response shifts in OHRQoL assessments made using the Oral Health Impact Profile (OHIP). Oral health-related quality of life was assessed in a consecutive sample of 126 patients seeking prosthodontic care. Patients were asked to rate their OHRQoL before treatment started and 1 month after treatment was finished, using the German 49-item version of the OHIP. When rating their OHRQoL after treatment, patients were also asked to rate their pre-treatment OHRQoL without having access to their baseline data. The response shift was calculated as the difference in OHIP summary scores between the initial assessment and the retrospective baseline assessment. The OHIP mean scores decreased from 31.8 at the initial baseline assessment to 24.4 after treatment. The retrospective baseline assessment resulted in an OHIP mean score of 38.1, corresponding to a response shift of 6.3 OHIP points. The effect size (Cohen's d = 0.21) of the response shift was considered small. The response shift phenomenon and its magnitude have important implications for dental practice, where patients and dentists often assess perceived treatment effects retrospectively. © 2012 Eur J Oral Sci.
Reissmann, Daniel R; Erler, Antje; Hirsch, Christian; Sierwald, Ira; Machuca, Carolina; Schierz, Oliver
2018-03-01
Aim of this exploratory study was to investigate whether a retrospective assessment of oral health-related quality of life (OHRQoL) using the Oral Health Impact Profile (OHIP) is susceptible to bias such as implicit theory of change and cognitive dissonance. In this prospective clinical study, a sample of 126 adult patients (age 17-83 years, 49% women) requiring prosthodontic treatment was consecutively recruited. The OHRQoL was assessed using the 49-item OHIP at baseline and at follow-up. Additionally, patients were asked at follow-up to retrospectively rate their oral health status at baseline (retrospective pretest or then-test) and the change in oral health status using a global transition question. Furthermore, patients' ratings of overall oral health and general health were used as validity criteria for the OHRQoL assessments. Response shift was calculated as the difference between the initial and retrospective baseline assessments. Baseline and retrospective pretest did not differ substantially in terms of internal consistency and convergent validity. Response shift was more pronounced when patients perceived a large change in OHRQoL during treatment. Retrospective pretests were more highly correlated with the baseline than with the follow-up assessment. Findings suggest that retrospective assessments of OHRQoL using the OHIP-49 are susceptible to bias. Cognitive dissonance is more likely to appear as a source of bias than implicit theory of change.
Titanium in dentistry: historical development, state of the art and future perspectives.
Jorge, Juliana Ribeiro Pala; Barão, Valentim Adelino; Delben, Juliana Aparecida; Faverani, Leonardo Perez; Queiroz, Thallita Pereira; Assunção, Wirley Gonçalves
2013-06-01
Titanium is a metallic element known by several attractive characteristics, such as biocompatibility, excellent corrosion resistance and high mechanical resistance. It is widely used in Dentistry, with high success rates, providing a favorable biological response when in contact with live tissues. Therefore, the objective of this study was to describe the different uses of titanium in Dentistry, reviewing its historical development and discoursing about its state of art and future perspective of its utilization. A search in the MEDLINE/PubMed database was performed using the terms 'titanium', 'dentistry' and 'implants'. The title and abstract of articles were read, and after this first screening 20 articles were selected and their full-texts were downloaded. Additional text books and manual search of reference lists within selected articles were included. Correlated literature showed that titanium is the most used metal in Implantology for manufacturing osseointegrated implants and their systems, with a totally consolidated utilization. Moreover, titanium can be also employed in prosthodontics to obtain frameworks. However, problems related to its machining, casting, welding and ceramic application for dental prosthesis are still limiting its use. In Endodontics, titanium has been used in association to nickel for manufacturing rotatory instruments, providing a higher resistance to deformation. However, although the different possibilities of using titanium in modern Dentistry, its use for prostheses frameworks still needs technological improvements in order to surpass its limitations.
Today's dental student is training for tomorrow's elderly baby boomer.
Lee, S J; Nelson, L P; Lin, J; Tom, F; Brown, R S; Jones, J A
2001-01-01
We are constantly reminded of the exploding elderly population and the increasing demand to meet their needs. But do we fully understand and appreciate the impact that this fastest-growing segment of the population will have upon our profession? Whether we realize it or not, today's dental student is training for tomorrow's elderly baby boomer. The baby boomer generation is 76 million strong, representing 19 years worth of births spanning from 1946-1964. That makes the oldest baby boomer 55 years old and the youngest 37 years old. What does this all mean? That from 2011-2030, the age group of 65 years of age and older will make up approximately 22% of the population, vastly changing our patient population, not to mention a significant increase in patient load. The future holds promise for not only a busy career, but also potentially a financially rewarding one as well. To some extent, we are all going to be geriatric clinicians. There is little doubt that there will be a great demand for services in restorative dentistry, prosthodontic dentistry, endodontics, periodontics, oral surgery, and perhaps orthodontics. As the baby boomers benefited from fluoride and sanitation, more people have been able to maintain their dentition and health into their older years. Dental students graduating today will be only beginning the prime of their careers as the baby boomers make their introduction in full force in the year 2011.
Starcke, Edgar N; Engelmeier, Robert L; Belles, Donald M
2010-06-01
At the dawn of the 20th century, all was not well with the practice of "plate prostheses." Removable prosthodontics had been degrading for several decades and was now generally in low esteem, even though there had been many significant advances. W. E. Walker had introduced adjustable condylar guides, George Snow, the facebow, and Carl Christensen, a method for clinically measuring the condylar inclines. Nevertheless, the average practicing dentist was still using simple hinge articulators and was apathetic to the deplorable state of the artificial teeth available; however, this was all going to change dramatically when two dentists, Alfred Gysi and J. Leon Williams, working together between 1910 and 1914, presented to the profession the "Trubyte Artificial Tooth System" that embodied both a typal system for selecting anterior teeth and new posterior occlusal carvings that made possible, for the first time, the articulation of artificial teeth. This incited many of prosthetic dentistry's elite to introduce their own theories of mandibular movement and the articulators that they designed to reflect those theories. The intense debates that ensued, both in the meeting halls and in the literature, were numerous and lasted for decades. At the time, the "Articulator Wars" had both positive and negative consequences. Today, with many of the "Articulator Wars" issues remaining as part of the practice of dentistry, the "Articulator Wars" can be considered a phenomenon of enlightenment.
Soft tissue sealing around dental implants based on histological interpretation.
Atsuta, Ikiru; Ayukawa, Yasunori; Kondo, Ryosuke; Oshiro, Wakana; Matsuura, Yuri; Furuhashi, Akihiro; Tsukiyama, Yoshihiro; Koyano, Kiyoshi
2016-01-01
The aim of this study was to provide an overview on the biology and soft tissue sealing around dental implants and teeth. This is a narrative review performed through scientific articles published between 1977 and 2014, indexed in MEDLINE and PubMed databases. The study selected articles that focused on epithelial sealing around dental implant or teeth with cell biology and histology of soft tissue. Implant therapy has been widely applied in dental rehabilitation for many years, with predictable long-term results. The longevity and functionality of dental implants is dependent on both osseointegration around the implant body and the establishment of a soft tissue barrier that protects the underlying hard tissue structures and the implant itself. The health and stability of the peri-implant mucosa also affects the esthetics of the implant. The healing and maintenance of the epithelial and connective tissues around implants are increasingly recognized as being fundamental to implant success. However, there has been little research into the function or formation of the soft tissue seal around dental implants, and the roles of this unique mucosal interface remain unclear. This narrative review explores the extent of the current knowledge of soft tissue barriers around implants from both a basic and clinical perspective, and aims to consolidate this knowledge and highlight the most pertinent questions relating to this area of research. Copyright © 2015 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Framework design and pontics of fiber-reinforced composite fixed dental prostheses - An overview.
Perea-Lowery, Leila; Vallittu, Pekka K
2018-05-11
Fiber-reinforced composite (FRC) fixed dental prostheses (FDPs) have shown good performance in clinical applications due to their good mechanical properties and minimally invasive approach. However, typical failure patterns of FRC FDPs are often localized at the pontic site. That reflects the structural considerations at the framework and pontic location that need to be examined when creating these kinds of prostheses. Peer-reviewed articles and other scientific literature were reviewed for providing up-to-date information on how pontics of FRC FDPs can be made. A thorough literature search was done using PubMed and Google Scholar. Two individuals did an assessment of the articles in order to include those related to pontics and framework design of FRC FDPs. The search terms used were "fiber-reinforced dental prosthesis" and "Pontics of fiber-reinforced dental prosthesis". These findings indicate that a cross-sectional fiber design, substructure and thicker pontics made of a variety of materials might reduce failures at the pontic site. The thickness of pontics of FRC FDPs interrelated with the vertical positioning of the FRC framework influences the load-bearing capacities of prostheses of these kinds. The understanding of the factors involved in the fabrication of pontics of FRC FDPs may overcome the drawbacks identified in these prostheses, thus extending their longevity. Copyright © 2018 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Oral Rehabilitation of Young Adult with Amelogenesis Imperfecta.
Leung, Vincent Ws; Low, Bernard; Yang, Yanqi; Botelho, Michael G
2018-05-01
Amelogenesis imperfecta is a heterogeneous group of hereditary disorders that affect the enamel formation of the primary and permanent dentitions while the remaining tooth structure is normal. Appropriate patient care is necessary to prevent adverse effects on dental oral health, dental disfigurement, and psychological well-being. This clinical report presents a 27-year-old Chinese male with amelogenesis imperfecta (AI) and his restorative management. This clinical report presents a 27-year-old Chinese male with AI and his restorative management. Extraoral examination showed a skeletal class III profile and increased lower facial proportion. Intraorally, all the permanent dentition was hypoplastic with noticeable tooth surface loss and a yellow-brown appearance. This was complicated with a mild maloc-clusion and food packing on his posterior teeth. The patient wanted to improve his appearance and masticatory efficiency. Orthodontic treatment was performed to treat the mild malocclu-sion and create physiological interproximal spacing to minimize tooth preparation and facilitate oral hygiene. This report demonstrates how a multidisciplinary approach for the management of AI can achieve a predictable, functional, and esthetic outcome. Orthodontic treatment facilitated a conservative prosthodontic treatment outcome by selectively increasing interproximal space, minimizing tooth preparation, correcting posterior bilateral cross-bite, as well as an anterior reverse overjet and derotation of the canines. This case report demonstrates the effective restoration of AI using a multidisciplinary approach to overcome crowding using a relatively conservative approach.
Patient's Perception on the Esthetic Outcome of Anterior Fixed Prosthetic Treatment.
Alshiddi, Ibraheem F; BinSaleh, Saad M; Alhawas, Yasser
2015-11-01
Patient's perception to the esthetic result of the treatment received can be different from a dentist opinion. Understanding patient's opinion, demand and expectation is part of successful treatment procedure. The purpose of this study was to investigate patient's opinion about the esthetic result of the fixed prosthetic treatment received in upper anterior teeth. About 90 volunteer subjects, 58 males and 32 females were given a self-evaluation questionnaire with 11 questions to respond as Yes or No. The questions regarded the esthetic result of a fixed prosthodontic treatment received for their upper anterior teeth. The same questioner was completed for each subject by three clinicians through clinical photographs for different views of subject's smile. Agreement between patients and clinicians was calculated for all subjects to evaluate patient's perception to their esthetic results. An agreement of 47.8 to 72.2% was observed between patients and clinicians, and the average agreement was 53.64 to 60%. The highest agreement was related to satisfaction with the color of the crown and/or bridge margin while the least agreement was related to the satisfaction with the natural looking of the restoration. There was variability in the agreement between the patients and the dentists with the satisfaction of the esthetic result of anterior restoration. Factor, such as gender, age and educational level may affect the results of the agreement.
Mino, Takuya; Maekawa, Kenji; Ueda, Akihiro; Higuchi, Shizuo; Sejima, Junichi; Takeuchi, Tetsuo; Hara, Emilio Satoshi; Kimura-Ono, Aya; Sonoyama, Wataru; Kuboki, Takuo
2015-04-01
The aim of this article was to investigate the accuracy in the reproducibility of full-arch implant provisional restorations to final restorations between a 3D Scan/CAD/CAM technique and the conventional method. We fabricated two final restorations for rehabilitation of maxillary and mandibular complete edentulous area and performed a computer-based comparative analysis of the accuracy in the reproducibility of the provisional restoration to final restoration between a 3D scanning and CAD/CAM (Scan/CAD/CAM) technique and the conventional silicone-mold transfer technique. Final restorations fabricated either by the conventional or Scan/CAD/CAM method were successfully installed in the patient. The total concave/convex volume discrepancy observed with the Scan/CAD/CAM technique was 503.50mm(3) and 338.15 mm(3) for maxillary and mandibular implant-supported prostheses (ISPs), respectively. On the other hand, total concave/convex volume discrepancy observed with the conventional method was markedly high (1106.84 mm(3) and 771.23 mm(3) for maxillary and mandibular ISPs, respectively). The results of the present report suggest that Scan/CAD/CAM method enables a more precise and accurate transfer of provisional restorations to final restorations compared to the conventional method. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Analysis of maxillofacial prosthetics at university dental hospitals in the capital region of Korea
Lee, Jong-Ho
2016-01-01
PURPOSE The purpose of this study was to investigate the demographic patterns of maxillofacial prosthetic treatment to identify the characteristics and geographic distribution of patients with maxillofacial prosthetics in the capital region of Korea. MATERIALS AND METHODS This retrospective analytical multicenter study was performed by chart reviews. This study included patients who visited the department of prosthodontics at four university dental hospitals for maxillofacial prosthetic rehabilitation. Patients with facial and congenital defects or with insufficient medical data were excluded. The patients were classified into three categories based on the location of the defect. Patients' sex, age, and residential area were analyzed. Pearson's chi-square test with a significance level of 0.05 was used to analyze the variables. RESULTS Among 540 patients with maxillofacial prosthetics, there were 284 (52.59%) male patients and 256 (47.41%) female patients. The number of the patients varied greatly by hospital. Most patients were older than 70, and the most common defect was a hard palate defect. Chi-square analysis did not identify any significant differences in sex, age, and distance to hospital for any defect group (P>.05). CONCLUSION The results of this study indicated that there was imbalance in the distribution of patients with maxillofacial prosthetic among the hospitals in the capital region of Korea. Considerations on specialists and insurance policies for the improvement of maxillofacial prosthetics in Korea are required. PMID:27350859
Dickie, J; Shearer, A C; Ricketts, D N J
2014-02-01
This audit aimed to assess the quality of communication between dental students/qualified dentists and dental technicians, increase the percentage of satisfactorily completed laboratory prescriptions and reduce the number of errors that can result from poor communication. A subsidiary aim was to educate students and staff in this respect. An audit of laboratory prescription completion was conducted within Dundee Dental Hospital. Four hundred and eighteen prescriptions for indirect fixed restorations completed by dental undergraduates and qualified staff were audited over a three month period (first audit cycle). Educational reminders on laboratory prescriptions were then provided to undergraduates and qualified staff, a further three hundred and twenty-two prescriptions were audited (second audit cycle) and compared with the first cycle. Satisfactorily completed prescriptions increased from 28% to 43% following basic educational intervention. However, this percentage still signifies a poor level of completion and the need for improvement. Some aspects of the prescription were completed better than others, but overall the standard remained poor with a significant number failing to comply with guidelines set by the UK General Dental Council, the European Union's Medical Devices Directive and the British Society for Restorative Dentistry (BSRD). Further undergraduate and staff training on laboratory prescription writing will be necessary through staff training events and developments in the undergraduate curriculum. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Gingival displacement: Survey results of dentists' practice procedures.
Ahmed, Sumitha N; Donovan, Terry E
2015-07-01
A high percentage of fixed prosthodontic restorations require a subgingival margin placement, which requires the practice of gingival displacement or a deflection procedure to replicate the margins in impression. The purpose of this study was to learn the different gingival displacement techniques that are currently used by dentists in their practice and to compare the current concepts of gingival displacement with previously published articles. A survey of questions pertaining to gingival deflection methods was distributed as part of continuing education (CE) course material to dentists attending CE meetings in 7 states in the U.S. and 1 Canadian province. Question topics included initial patient assessment procedures, gingival displacement methods, dentist's knowledge and assessment of systemic manifestations, and brand names of materials used. Ninety-four percent of the participants were general practitioners with 24.11 ± 12.5 years of experience. Ninety-two percent used gingival displacement cords, while 20.2% used a soft tissue laser and 32% used electrosurgery as an adjunct. Sixty percent of the dentists used displacement cords impregnated with a medicament. Of the preimpregnated cords, 29% were impregnated with epinephrine, 13% with aluminum chloride, and 18% with aluminum potassium sulfate. The study showed a steady decrease compared with results of previously published articles in the use of epinephrine as a gingival deflection medicament. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
MALAGUTI, G.; ROSSI, R.; MARZIALI, B.; ESPOSITO, A.; BRUNO, G.; DARIOL, C.; DI FIORE, A.
2016-01-01
SUMMARY Objectives The aim of this in vitro study is to evaluate the marginal and internal fit of zirconia core crowns manufactured following different digital and traditional workflows. Methods A 6° taper shoulder prepared abutment tooth was used to produce 20 zirconia core crowns using four different scanning techniques: scanned directly with the extraoral lab scanner, scanned with intraoral scanner, dental impressions using individual dental tray and polyether, dental casts from a polyether impressions. Marginal and internal fits were evaluated with digital photography and the silicone replica method. Results Medium marginal gaps were 76,00 μm ± 28.9 for extraoral lab scanner, 80.50 μm ± 36,2 for intraoral scanner, 88.10 μm ± 34,8 for dental impression scan and 112,4 μm ± 37,2 for dental cast scan. Medium internal gaps were 23.20 μm ± 10,3 for extraoral lab scanner, 16.20 μm ± 8.3 for intraoral scanner, 27.20 μm ± 16.7 for dental impression scan and 30.20 μm ± 12.7 for dental cast scan. Conclusion Internal gap were extensively lower than 70 μm described in literature. Marginal fit was higher than ideal values for all the techniques but within the limit of clinical success. Intraoral scanners obtained the best results for internal gap. PMID:28280529
Shenoy, Gayathri M; Dragan, Irina F; Pagni, Sarah; Murphy, Jennipher; Karimbux, Nadeem
2018-06-01
The Basic Science/Clinical Science Spiral Seminar Series (BaSiCSsss) was implemented at Tufts University School of Dental Medicine in 2013. In the series, teams of dental students from all four years presented components of a clinical case, supported by evidence-based dentistry concepts. The role of the third-year student on each team was to present questions based on the PICO (Population, Intervention, Comparison, Outcome) method to support the treatment plan for the selected case. The primary aim of this study was to identify the dental discipline from which the PICO question was chosen, and the secondary aim was to review the level of evidence (journal impact factor, study design, and year of publication) of sources used to support the PICO questions. Presentations compiled during the 2014-15 and 2015-16 academic years were reviewed. The PICO questions and additional details from the publications used as reference (choice of journal, year of publication, study design) were reviewed. A total of 224 presentations were reviewed. The results showed that most topics were from the subjects of periodontology and prosthodontics. Systematic reviews and cohort studies were the most often used types of study design. The majority of the articles cited were recently published. The students used supporting references for the clinical questions published recently with a high level of evidence.
THE EVOLUTION OF THE JOURNAL OF APPLIED ORAL SCIENCE: A BIBLIOMETRIC ANALYSIS
Ferraz, Valéria Cristina Trindade; Amadei, José Roberto Plácido; Santos, Carlos Ferreira
2008-01-01
The purpose of this study was to make a brief diagnosis of the evolution of the Journal of Applied Oral Science (JAOS) between 2005 and 2007, by reviewing quantitative and qualitative aspects of the articles published in the JAOS within this period. All articles published in the JAOS in the time span established for this survey were analyzed retrospectively and a discussion was undertaken on the data referring to the main bibliometric indexes of production, authorship, bibliographic sources of the published articles, and the most frequently cited scientific journals in the main dental research fields. A total of 247 papers authored and coauthored by 1,139 contributors were reviewed, most of them being original research articles. The number of authors per article was 4.61 on the average. Regarding the geographic distribution, the authors represented almost all of the Brazilian States. Most published articles belonged to the following dental research fields: Endodontics, Restorative Dentistry, Dental Materials and Prosthodontics. The ranking of the most frequently cited scientific journals included the most reputable publications in these dental research fields. In conclusion, between 2005 and 2007, the JAOS either maintained or improved considerably its bibliometric indexes. The analysis of the data retrieved in this study allowed evaluating the journal's current management strategies, and identifying important issues that will help outlining the future directions for the internationalization of this journal. PMID:19082402
A standardization model based on image recognition for performance evaluation of an oral scanner.
Seo, Sang-Wan; Lee, Wan-Sun; Byun, Jae-Young; Lee, Kyu-Bok
2017-12-01
Accurate information is essential in dentistry. The image information of missing teeth is used in optically based medical equipment in prosthodontic treatment. To evaluate oral scanners, the standardized model was examined from cases of image recognition errors of linear discriminant analysis (LDA), and a model that combines the variables with reference to ISO 12836:2015 was designed. The basic model was fabricated by applying 4 factors to the tooth profile (chamfer, groove, curve, and square) and the bottom surface. Photo-type and video-type scanners were used to analyze 3D images after image capture. The scans were performed several times according to the prescribed sequence to distinguish the model from the one that did not form, and the results confirmed it to be the best. In the case of the initial basic model, a 3D shape could not be obtained by scanning even if several shots were taken. Subsequently, the recognition rate of the image was improved with every variable factor, and the difference depends on the tooth profile and the pattern of the floor surface. Based on the recognition error of the LDA, the recognition rate decreases when the model has a similar pattern. Therefore, to obtain the accurate 3D data, the difference of each class needs to be provided when developing a standardized model.
A study of parallelism of the occlusal plane and ala-tragus line.
Sadr, Katayoun; Sadr, Makan
2009-01-01
Orientation of the occlusal plane is one of the most important clinical procedures in prostho-dontic rehabilitation of edentulous patients. The aim of this study was to define the best posterior reference point of ala-tragus line for orientation of occlusal plane for complete denture fabrication. Fifty-three dental students (27 females and 26 males) with complete natural dentition and Angel's Class I occlusal relationship were selected. The subjects were photographed in natural head position while clenching on a Fox plane. After tracing the photographs, the angles between the following lines were measured: the occlusal plane (Fox plane) and the superior border of ala-tragus, the occlusal plane (Fox plane) and the middle of ala-tragus as well as the occlusal plane (Fox plane) and the inferior border of ala-tragus. Descriptive statistics, one sample t-test and independent t-test were used. P value less than 0.05 was considered significant. There was no parallelism between the occlusal plane and ala-tragus line with three different posterior ends and one sample t-test showed that the angles between them were significantly different from zero (p<0.05). However, the supe-rior border of ala-tragus line had the lowest mean angle, 1.80° (3.12) and was almost parallel to the occlusal plane. The superior border of the tragus is suggested as the posterior reference for ala-tragus line.
Precision of Fit of Titanium and Cast Implant Frameworks Using a New Matching Formula
Sierraalta, Marianella; Vivas, Jose L.; Razzoog, Michael E.; Wang, Rui-Feng
2012-01-01
Statement of the Problem. Fit of prosthodontic frameworks is linked to the lifetime survival of dental implants and maintenance of surrounding bone. Purpose. The purpose of this study was to evaluate and compare the precision of fit of milled one-piece Titanium fixed complete denture frameworks to that of conventional cast frameworks. Material and Methods. Fifteen casts fabricated from a single edentulous CAD/CAM surgical guide were separated in two groups and resin patterns simulating the framework for a fixed complete denture developed. Five casts were sent to dental laboratories to invest, cast in a Palladium-Gold alloy and fit the framework. Ten casts had the resin pattern scanned for fabrication of milled bars in Titanium. Using measuring software, positions of implant replicas in the definitive model were recorded. The three dimensional spatial orientation of each implant replica was matched to the implant replica. Results. Results demonstrated the mean vertical gap of the Cast framework was 0.021 (+0.004) mm and 0.012 (0.002) mm determined by fixed and unfixed best-fit matching coordinate system. For Titanium frameworks they were 0.0037 (+0.0028) mm and 0.0024 (+0.0005) mm, respectively. Conclusions. Milled one-piece Titanium fixed complete denture frameworks provided a more accurate precision of fit then traditional cast frameworks. PMID:22550486
Troeltzsch, Markus; Messlinger, Karl; Brodine, Brian; Gassling, Volker; Troeltzsch, Matthias
2014-10-01
To investigate the efficacy of conservative dental treatment (occlusal splint and pharmacologic therapy) and invasive therapy (prosthetic restorations) in the treatment of tension-type headache (TTH). The study sample was composed of 70 patients who presented with symptomatic TTH and were assigned to three treatment groups according to their treatment needs. Group A (30 patients): a conservative treatment protocol with a combination of an occlusal splint and analgesic and muscle relaxant medication. Group B (10 patients): invasive prosthodontic procedures. Group C (30 patients): patients who refused any type of treatment but consented to the study served as a control group. Pain quality was measured with the Headache Impact Test (HIT-6). The statistical analysis was performed with the Wilcoxon rank test (P≤.05). Conservative treatment with splints and analgesic medication and invasive treatment by prosthetic rehabilitation relieved the TTH symptoms. The patients who received treatment experienced a significant reduction in their discomfort after 6 months (P≤.01), whereas the patients who refused therapy remained, on average, at the same pain level (P≤.117). In group A, the HIT-6 score was reduced for 26 patients, and in group B for 8 patients. In group C a reduction of HIT-6 scores was observed in 10 patients. Conservative or invasive occlusal adjustments may serve as a useful tool in the treatment of TTH.
Pitigoi-Aron, Gabriela; King, Patricia A; Chambers, David W
2011-12-01
The number of U.S. and Canadian dental schools offering programs for dentists with degrees from other countries leading to the D.D.S. or D.M.D. degree has increased recently. This fact, along with the diversity of educational systems represented by candidates for these programs, increases the importance of identifying valid admissions predictors of success in international dental student programs. Data from 148 students accepted into the international dental studies program at the University of the Pacific from 1994 through 2004 were analyzed. Dependent variables were comprehensive cumulative GPA at the end of both the first and second years of the two-year program. The Test of English as a Foreign Language (TOEFL) and both Parts I and II of the National Board Dental Examination (NBDE) were significant positive predictors of success. Performance on laboratory tests of clinical skill in operative dentistry and in fixed prosthodontics and ratings from interviewers were not predictive of overall success in the program. Although this study confirms the predictive value of written tests such as the TOEFL and NBDE, it also contributes to the literature documenting inconsistent results regarding other types of predictors. It may be the case that characteristics of individual programs or features of the applicant pools for each may require use of admissions predictors that are unique to schools.
The decade of overdentures: 1970-1980.
Fenton, A H
1998-01-01
Jaw bones resorb when teeth are lost. People cannot function as well with complete dentures compared with their natural teeth. As more people are living longer and these cumulative effects become increasingly documented, dentists in the 1970s attached more importance to keeping teeth. The concept of overdentures developed as a simple and economic alternative to prolong the retention and function of the last few teeth in a compromised dentition. The previous option was extensive fixed prosthodontics. An overdenture is a complete or removable partial denture that has one or more tooth roots to provide support. Rather than extracting all compromised teeth, the crowns, and pulpal tissue of selected teeth (usually two anterior teeth) are removed. The remaining root projecting through the mucosa is restored and/or contoured. With the crown removed, there is space to cover the area with a denture. The root has less mobility, and its retention retards bone resorption. Overdentures with roots are more stable, and patients can chew better than with dentures supported on residual alveolar bone and mucosal tissue alone. Keeping even a few teeth has a strong psychological value for some patients. Patients who have lost teeth, adjacent tissue, and bone need replacement of more oral structures than tooth crowns alone can provide. A complete denture with flange contours can restore tissue and appearance. The conventional tooth-supported overdenture concept continues to be an accepted treatment modality and has now been adapted to implants.
Assessment of masticatory performance by means of a color-changeable chewing gum.
Tarkowska, Agnieszka; Katzer, Lukasz; Ahlers, Marcus Oliver
2017-01-01
Previous research determined the relevance of masticatory performance with regard to nutritional status, cognitive functions, or stress management. In addition, the measurement of masticatory efficiency contributes to the evaluation of therapeutic successes within the stomatognathic system. However, the question remains unanswered as to what extent modern techniques are able to reproduce the subtle differences in masticatory efficiency within various patient groups. The purpose of this review is to provide an extensive summary of the evaluation of masticatory performance by means of a color-changeable chewing gum with regard to its clinical relevance and applicability. A general overview describing the various methods available for this task has already been published. This review focuses in depth on the research findings available on the technique of measuring masticatory performance by means of color-changeable chewing gum. Described are the mechanism and the differentiability of the color change and methods to evaluate the color changes. Subsequently, research on masticatory performance is conducted with regard to patient age groups, the impact of general diseases and the effect of prosthetic and surgical treatment. The studies indicate that color-changeable chewing gum is a valid and reliable method for the evaluation of masticatory function. Apart from other methods, in clinical practice this technique can enhance dental diagnostics as well as the assessment of therapy outcomes. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Ogino, Takamichi; Ueda, Takayuki; Ogami, Koichiro; Koike, Takashi; Sakurai, Kaoru
2017-01-01
We examined how chewing rate and the extent of reactive hyperemia affect the blood flow in denture-supporting mucosa during chewing. The left palatal mucosa was loaded under conditions of simulated chewing or simulated clenching for 30s, and the blood flow during loading was recorded. We compared the relative blood flow during loading under conditions that recreated different chewing rates by combining duration of chewing cycle (DCC) and occlusal time (OT): fast chewing group, typical chewing group, slow chewing group and clenching group. The relationship between relative blood flow during simulated chewing and the extent of reactive hyperemia was also analyzed. When comparing the different chewing rate, the relative blood flow was highest in fast chewing rate, followed by typical chewing rate and slow chewing rate. Accordingly, we suggest that fast chewing increases the blood flow more than typical chewing or slow chewing. There was a significant correlation between the amount of blood flow during simulated chewing and the extent of reactive hyperemia. Within the limitations of this study, we concluded that slow chewing induced less blood flow than typical or fast chewing in denture-supporting mucosa and that people with less reactive hyperemia had less blood flow in denture-supporting mucosa during chewing. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Harder, Sönke; Wolfart, Stefan; Egert, Christopher; Kern, Matthias
2011-10-01
The aim of this preliminary prospective study was to evaluate the clinical outcome, the oral health-related quality of life (OHRQoL), and the subjective chewing ability of patients with mandibular complete dentures retained by a single implant placed in the mandible midline. Patients wearing complete dentures were treated with a single implant in the mandible, followed by relining of the dentures and incorporation of ball attachments for implant retention. Implant outcome, prosthodontic maintenance, subjective chewing ability, and the oral health impact profile of the patients were assessed at baseline and at four weeks after connecting the denture and implant. Eleven patients were enrolled in this investigation, and the mean observation period was 43.4 months (minimum period: 35, maximum period: 52 months). No implants were lost during observation period, but four dentures needed repair because of the fracture of the denture base in the midline area. A significant improvement was observed in the OHRQoL of the patients after the attachment of the mandibular dentures with a single midline implant. Furthermore, the subjective chewing ability of the patients was significantly improved after implant connection. Within the limitations of this preliminary prospective clinical study, single implant-supported mandibular overdentures were a successful treatment option for older edentulous patients who showed improvements in their OHRQoL and chewing ability. Copyright © 2011 Elsevier Ltd. All rights reserved.
Rapid prototyping modelling in oral and maxillofacial surgery: A two year retrospective study
Stoor, Patricia; Mesimäki, Karri; Kontio, Risto K.
2015-01-01
Background The use of rapid prototyping (RP) models in medicine to construct bony models is increasing. Material and Methods The aim of the study was to evaluate retrospectively the indication for the use of RP models in oral and maxillofacial surgery at Helsinki University Central Hospital during 2009-2010. Also, the used computed tomography (CT) examination – multislice CT (MSCT) or cone beam CT (CBCT) - method was evaluated. Results In total 114 RP models were fabricated for 102 patients. The mean age of the patients at the time of the production of the model was 50.4 years. The indications for the modelling included malignant lesions (29%), secondary reconstruction (25%), prosthodontic treatment (22%), orthognathic surgery or asymmetry (13%), benign lesions (8%), and TMJ disorders (4%). MSCT examination was used in 92 and CBCT examination in 22 cases. Most of the models (75%) were conventional hard tissue models. Models with colored tumour or other structure(s) of interest were ordered in 24%. Two out of the 114 models were soft tissue models. Conclusions The main benefit of the models was in treatment planning and in connection with the production of pre-bent plates or custom made implants. The RP models both facilitate and improve treatment planning and intraoperative efficiency. Key words:Rapid prototyping, radiology, computed tomography, cone beam computed tomography. PMID:26644837
Oral health condition and reasons for tooth extraction among an adult population (20-64 years old).
Silva-Junior, Manoelito Ferreira; Sousa, Anne Caroline Correia de; Batista, Marília Jesus; Sousa, Maria da Luz Rosário de
2017-08-01
The study characterized the oral health condition and main self-reported reasons for tooth extraction in an adult population. The cross-sectional study examined 248 adults aged 20-64 years, representative of the population of Piracicaba, São Paulo, Brazil. The oral examination conducted in households used the DMFT and CPI indexes, use and necessity of prosthodontics according to the WHO criteria and the presence of visible biofilm. Demographic and socioeconomic data were collected along with reasons for tooth extraction through a questionnaire. Descriptive analysis was stratified by age in groups: 20-44 and 45-64 years old. The average DMFT was 20.37 (EP = 0.50), P = 3.34 (EP = 0.33) for young adults and P = 13.41 (EP = 1.45) for the older adults. Gingival pockets (CPI ≥ 3) were found on 20.5% of young adults and 53.0% of the older ones. While 38.8% used upper prosthesis, 46.7% needed lower prosthesis. Pain was the most prevalent self-reported reason for tooth extraction (37.5%), being this choice primarily because of lack of another treatment option (52%) and done in the private sector (47.2%). We concluded that young adults (20-44 years old) showed less missing teeth, periodontal diseases, and need for prosthetic use. Pain and lack of options of other treatments were the main self-reported reasons for performing tooth extractions.
Bagis, Bora; Ayaz, Elif Aydogan; Turgut, Sedanur; Durkan, Rukiye; Özcan, Mutlu
2012-01-01
Background: This study evaluated the prevalence of the signs and symptoms of temporomandibular joint disorder (TMD) among patients with TMD symptoms. Methods: Between September 2011 and December 2011, 243 consecutive patients (171 females, 72 males, mean age 41 years) who were referred to the Department of Prosthodontics, Faculty of Dentistry, Karadeniz Technical University, Trabzon were examined physically and completed a questionnaire regarding age, gender, social status, general health, antidepressant drug usage, dental status, limited mouth opening, temporomandibular joint (TMJ) sounds, and parafunctions (bruxism, clenching). The data were analyzed using the chi-square test and binary logistic regression model (alpha = 0.05). Results: With a frequency of 92%, pain in the temporal muscle was the most common symptom, followed by pain during mouth opening (89%) in both genders. TMJ pain at rest, pain in the masseter muscle, clicking, grinding, and anti-depressant use were significantly more frequent in females than males. Age (p=0.006; odds ratio 0.954; 95% CI 0.922-0.987) and missing teeth (p=0.003; odds ratio 3.753; 95% CI 1.589-8.863) had significant effects on the prevalence of TMD. Conclusion: Females had TMD signs and symptoms more frequently than males in the study population. The most common problem in both genders was pain. PMID:22991492
Hellstein, John W; Adler, Robert A; Edwards, Beatrice; Jacobsen, Peter L; Kalmar, John R; Koka, Sreenivas; Migliorati, Cesar A; Ristic, Helen
2011-11-01
This narrative review of osteonecrosis of the jaw in patients with low bone mass receiving treatment with antiresorptive agents is based on an appraisal of the literature by an advisory committee of the American Dental Association Council on Scientific Affairs. It updates the committee's 2008 advisory statement. The authors searched MEDLINE for literature published between May 2008 (the end date of the last search) and February 2011. This report contains recommendations based on the findings of the literature search and on expert opinion that relate to general dentistry; periodontal disease management; implant placement and maintenance; oral and maxillofacial surgery; endodontics; restorative dentistry and prosthodontics; orthodontics; and C-terminal telopeptide testing and drug holidays. The highest reliable estimate of antiresorptive agent-induced osteonecrosis of the jaw (ARONJ) prevalence is approximately 0.10 percent. Osteoporosis is responsible for considerable morbidity and mortality. Therefore, the benefit provided by antiresorptive therapy outweighs the low risk of developing osteonecrosis of the jaw. An oral health program consisting of sound hygiene practices and regular dental care may be the optimal approach for lowering ARONJ risk. No validated diagnostic technique exists to determine which patients are at increased risk of developing ARONJ. Discontinuing bisphosphonate therapy may not lower the risk but may have a negative effect on low-bone-mass-treatment outcomes.
Kim, Jenny J; Antoun, Joseph S
2010-12-01
New dental graduates compete for house surgeon positions every year, despite little being known about the work experience gained from such posts. The main objectives of this study were to identify the nature of house surgeons' work experiences, their continued professional development (CPD) opportunities and the impact of hospital experience on their future career pathways. A questionnaire was mailed to all 31 New Zealand dental house surgeons (response rate 100%). The majority of house surgeons (77.4%) found hospital work enjoyable, with nearly all (93.5%) perceiving themselves as better clinicians from their experience. Oral surgery, restorative dentistry, special needs dentistry and removable prosthodontics were the most commonly practised areas. The average weekly number of working hours was 42.3 hours for a normal week and 61.8 hours for an on-call week. Stress levels during on-call work were significantly higher than during day-to-day hospital work (p < 0.05). Departmental seminars were reported to be the most common form of CPD available at hospitals (74.2%), followed by hands-on clinical training (61.3%). More than half of the house surgeons (58.1%) planned to pursue a specialist career, with nearly 13% wishing to return to a New Zealand hospital in the future. A dental house surgeon position remains an attractive choice and offers an enjoyable experience for young graduates. Hospitals provide ample CPD opportunities and appear to play an influential role in a house surgeon's career pathway.
3D printed simulation models based on real patient situations for hands-on practice.
Kröger, E; Dekiff, M; Dirksen, D
2017-11-01
During the last few years, the curriculum of many dentistry schools in Germany has been reorganised. Two key aspects of the applied changes are the integration of up-to-date teaching methods and the promotion of interdisciplinarity. To support these efforts, an approach to fabricating individualised simulation models for hands-on courses employing 3D printing is presented. The models are based on real patients, thus providing students a more realistic preparation for real clinical situations. As a wide variety of dental procedures can be implemented, the simulation models can also contribute to a more interdisciplinary dental education. The data used for the construction of the models were acquired by 3D surface scanning. The data were further processed with 3D modelling software. Afterwards, the models were fabricated by 3D printing with the PolyJet technique. Three models serve as examples: a prosthodontic model for training veneer preparation, a conservative model for practicing dental bonding and an interdisciplinary model featuring carious teeth and an insufficient crown. The third model was evaluated in a hands-on course with 22 fourth-year dental students. The students answered a questionnaire and gave their personal opinion. Whilst the concept of the model received very positive feedback, some aspects of the implementation were criticised. We discuss these observations and suggest ways for further improvement. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Thetakala, Ravi Kumar; Chandrashekar, B R; Sunitha, Siddanna; Sharma, Priyanka
2017-01-01
The aim of this study is to assess the quantum of articles published by various dental specialties in a National and an International Forensic Odontology Journal from January 1, 2010, to December 31, 2014. The present study is a 5-year retrospective content analysis study. Data were collected from two forensic odontology journals (Journal of Forensic Odonto Stomatology [JOFS] and Journal of Forensic Dental Sciences [JFDS]) which are subscribed by institutional library. The article contents were scrutinized by one investigator and categorized into nine individual dental specialties based on the new working classification proposed for forensic odontology. The quantum of articles published by various dental specialties and the various focus areas in each specialty were assessed using Chi-square test. Among all the published articles, a maximum number of articles were related to the Department of Oral Medicine and Radiology (32.6%) in JFDS with Cheiloscopy (46.7%) being more focused area and to the Department of Prosthodontics (25.7%) in JFOS with Bite mark analysis (66.7%) being more focused area. There was a scarcity of information about the relationship of forensic odontology with various dental specialties in the articles published in JFDS and JFOS. The editorial board of journals should expand and elaborate their scope of journals to various focus areas of forensic odontology. This will encourage the researchers to explore in the different focus areas which are most neglected as of now.
The use of tungsten as a chronically implanted material.
Shah Idil, A; Donaldson, N
2018-04-01
This review paper shows that tungsten should not generally be used as a chronically implanted material. The metal has a long implant history, from neuroscience, vascular medicine, radiography, orthopaedics, prosthodontics, and various other fields, primarily as a result of its high density, radiopacity, tensile strength, and yield point. However, a crucial material criterion for chronically implanted metals is their long-term resistance to corrosion in body fluids, either by inherently noble metallic surfaces, or by protective passivation layers of metal oxide. The latter is often assumed for elemental tungsten, with references to its 'inertness' and 'stability' common in the literature. This review argues that in the body, metallic tungsten fails this criterion, and will eventually dissolve into the soluble hexavalent form W 6+ , typically represented by the orthotungstate [Formula: see text] (monomeric tungstate) anion. This paper outlines the metal's unfavourable corrosion thermodynamics in the human physiological environment, the chemical pathways to either metallic or metal oxide dissolution, the rate-limiting steps, and the corrosion-accelerating effects of reactive oxidising species that the immune system produces post-implantation. Multiple examples of implant corrosion have been reported, with failure by dissolution to varying extents up to total loss, with associated emission of tungstate ions and elevated blood serum levels measured. The possible toxicity of these corrosion products has also been explored. As the field of medical implants grows and designers explore novel solutions to medical implant problems, the authors recommend the use of alternative materials.
Decreased levels of matrix metalloproteinase-2 in root-canal exudates during root canal treatment.
Pattamapun, Kassara; Handagoon, Sira; Sastraruji, Thanapat; Gutmann, James L; Pavasant, Prasit; Krisanaprakornkit, Suttichai
2017-10-01
To determine the matrix metalloproteinase-2 (MMP-2) levels in root-canal exudates from teeth undergoing root-canal treatment. The root-canal exudates from six teeth with normal pulp and periradicular tissues that required intentional root canal treatment for prosthodontic reasons and from twelve teeth with pulp necrosis and asymptomatic apical periodontitis (AAP) were sampled with paper points for bacterial culture and aspirated for the detection of proMMP-2 and active MMP-2 by gelatin zymography and the quantification of MMP-2 levels by ELISA. By gelatin zymography, both proMMP-2 and active MMP-2 were detected in the first collection of root-canal exudates from teeth with pulp necrosis and AAP, but not from teeth with normal pulp, and their levels gradually decreased and disappeared at the last collection. Consistently, ELISA demonstrated a significant decrease in MMP-2 levels in the root-canal exudates of teeth with pulp necrosis and AAP following root canal procedures (p<0.05). Furthermore, the MMP-2 levels were significantly lower in the negative bacterial culture than those in the positive bacterial culture (p<0.001). The levels of MMP-2 in root-canal exudates from teeth with pulp necrosis and AAP were gradually reduced during root canal procedures. Future studies are required to determine if MMP-2 levels may be used as a biomolecule for the healing of apical lesions, similar to the clinical application of MMP-8 as a biomarker. Copyright © 2017 Elsevier Ltd. All rights reserved.
Donovan, Terence E; Marzola, Riccardo; Murphy, Kevin R; Cagna, David R; Eichmiller, Frederick; McKee, James R; Metz, James E; Albouy, Jean-Pierre
2016-11-01
It is clear the contemporary dentist is confronted with a blizzard of information regarding materials and techniques from journal articles, advertisements, newsletters, the internet, and continuing education events. While some of that information is sound and helpful, much of it is misleading at best. This review identifies and discusses the most important scientific findings regarding outcomes of dental treatment to assist the practitioner in making evidence-based choices. This review was conducted to assist the busy dentist in keeping abreast of the latest scientific information regarding the clinical practice of dentistry. Each of the authors, who are considered experts in their disciplines, was asked to peruse the scientific literature published in 2015 in their discipline and review the articles for important information that may have an impact on treatment decisions. Comments on experimental methodology, statistical evaluation, and overall validity of the conclusions are included in many of the reviews. The reviews are not meant to stand alone but are intended to inform the interested reader about what has been discovered in the past year. The readers are then invited to go to the source if they wish more detail. Analysis of the scientific literature published in 2015 is divided into 7 sections, dental materials, periodontics, prosthodontics, occlusion and temporomandibular disorders, sleep-disordered breathing, cariology, and implant dentistry. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Effect of thermal cycling on flexural properties of carbon-graphite fiber-reinforced polymers.
Segerström, Susanna; Ruyter, I Eystein
2009-07-01
To determine flexural strength and modulus after water storage and thermal cycling of carbon-graphite fiber-reinforced (CGFR) polymers based on poly(methyl methacrylate) and a copolymer matrix, and to examine adhesion between fiber and matrix by scanning electron microscopy (SEM). Solvent cleaned carbon-graphite (CG) braided tubes of fibers were treated with a sizing resin. The resin mixture of the matrix was reinforced with 24, 36, 47 and 58wt% (20, 29, 38 and 47vol.%) CG-fibers. After heat polymerization the specimens were kept for 90 days in water and thereafter hydrothermally cycled (12,000 cycles, 5/55 degrees C). Mechanical properties were evaluated by three-point bend testing. After thermal cycling, the adhesion between fibers and matrix was evaluated by SEM. Hydrothermal cycling did not decrease flexural strength of the CGFR polymers with 24 and 36wt% fiber loadings; flexural strength values after thermocycling were 244.8 (+/-32.33)MPa for 24wt% and 441.3 (+/-68.96)MPa for 36wt%. Flexural strength values after thermal cycling were not further increased after increasing the fiber load to 47 (459.2 (+/-45.32)MPa) and 58wt% (310.4 (+/-52.79)MPa). SEM revealed good adhesion between fibers and matrix for all fiber loadings examined. The combination of the fiber treatment and resin matrix described resulted in good adhesion between CG-fibers and matrix. The flexural values for fiber loadings up to 36wt% appear promising for prosthodontic applications such as implant-retained prostheses.
Lajnert, Vlatka; Pavičić, Daniela K; Gržić, Renata; Kovač, Zoran; Pahor, Dana; Kuis, Davor; Simonić-Kocijan, Sunčana; Antonić, Robert; Bakarčić, Danko
2012-06-01
To study the impact of age, gender, tooth colour and maxillary anterior teeth status on patient's satisfaction with their dental appearance. A total of 259 Caucasian subjects participated in the study (119 men, mean age 56 years; 140 women, mean age 61 years) divided into three age groups (young <35 age; middle aged 35-54 age; old ≥55 age). Their maxillary anterior teeth status was classified into three groups: (1) natural teeth (NTG) group; (2) composite filling group (CFG) and (3) porcelain-fused-to-metal fixed prosthodontic restoration group (FPDG). The participants judged appearance and tooth colour using a scale with three categories: completely dissatisfied, moderately dissatisfied and completely satisfied. Almost half of the participants were completely satisfied with their dental appearance and tooth colour. Half of the 'young' and 'middle-aged' participants with natural maxillary anterior teeth were completely satisfied and half of the 'old' participants were moderately satisfied with their dental appearance and tooth colour. The majority of participants with composite restorations (45-51%) were moderately satisfied with their dental appearance, one-third of 'young' and 'middle-aged' participants were moderately satisfied or dissatisfied with their tooth colour and more than 70% of older participants were dissatisfied with their tooth colour (p > 0.05). Satisfaction with the appearance of the maxillary anterior teeth differed both between individuals of different age and different dental status. © 2011 The Gerodontology Society and John Wiley & Sons A/S.
Implant dentistry curriculum in undergraduate education: part 1-a literature review.
Kroeplin, Birgit S; Strub, Joerg R
2011-01-01
The aim of this literature review was to evaluate to what extent oral implant dentistry was integrated into undergraduate educational programs worldwide. An online search of PubMed (MEDLINE and additional life science journals) was performed for articles published from 1966 to January 2010 using combinations of select medical subject headings. Additionally, the ISI Web of Knowledge database (MEDLINE: 1950 to present, Web of Science: 1945 to present) was searched using "education" and "implant" as search terms. The online search was supplemented with a manual search of dental journals in the fields of education, prosthodontics, and implant dentistry and of the reference lists of selected full-text articles. Surveys comparing different undergraduate dental implant curricula and articles describing the undergraduate dental implant curriculum of a single university were identified. Postgraduate or continuing education programs for dental practitioners or master and specialist programs were excluded. Twenty-five articles met the inclusion criteria of this review. The percentage of universities that included implant dentistry in undergraduate education increased from 51% in 1974 to 97% in 2006 for universities in the United States and to 100% for surveyed European universities. All curricula included lectures (mostly 1 to 20 hours) and 30% to 42% included laboratory courses, but the level of clinical experience differed greatly between surveyed universities. Because oral implant dentistry has become a standard treatment alternative, the undergraduate dental curricula should include its application in treatment planning, observation of placing and restoring implants, and treating patients with implant-retained or -supported restorations.
Yuan, Xiaohui; Tan, Fei; Xu, Haitao; Zhang, Shaojun; Qu, Fuzhen; Liu, Jie
2017-07-01
The aim of this study is to investigate the effects of different electrolytes on the titanium-porcelain bond strength after micro-arc oxidation (MAO) treatment. Three electrolytes at the same concentration were used as MAO reaction solutions: Na 2 SiO 3 , KF, and MgSiF 6 . Blasting treatment was chosen as a control. After MAO treatment in each electrolyte, the titanium-porcelain bond strengths were measured by the three-point bending test, as described in ISO 9693. The morphologies and elemental compositions of the MAO coating on the titanium substrate were evaluated by scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS). The interface between the titanium and porcelain was also observed by SEM and EDS. The MAO coatings created in different electrolytes exhibited completely different morphologies and compositions. The bond strengths of the Na 2 SiO 3 and MgSiF 6 groups were significantly higher than those of the other groups (p<0.05). Additionally, the titanium-porcelain interfaces were compact in the former two groups, whereas pores and cracks were visible at the interfaces in the other groups. These results indicate that MAO treatment with an appropriate electrolyte could be an effective method to increase the titanium-porcelain bonding strength. According to ISO 9693, titanium-porcelain restorations subjected to MAO treatment with an appropriate electrolyte could be appropriate for clinical use. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Kinumatsu, Takashi; Umehara, Kazuhiro; Nagano, Kyosuke; Saito, Atsushi
2014-01-01
We report a patient with severe chronic periodontitis requiring regenerative periodontal surgery and different types of prosthesis in the maxillary and mandibular regions. The patient was a 57-year-old woman who presented with the chief complaint of occlusal pain. An initial clinical examination revealed that 73% of sites had a probing depth of ≥4 mm, and 60% of sites exhibiting bleeding on probing. Radiographic examination revealed vertical bone defects in the molar region and widening of the periodontal ligament space around teeth #17 and 24. Initial periodontal therapy was implemented based on a clinical diagnosis of severe chronic periodontitis. Surgical periodontal therapy was subsequently performed at selected sites. Periodontal regenerative therapy using enamel matrix derivative was performed on #14, 15, and 35-37. Tunnel preparation was performed on #46 as it had a 2-wall vertical bony defect and Degree 3 furcation involvement. Other sites with residual periodontal pockets were treated by modified Widman flap surgery. After a re-evaluation, functional rehabilitation was implemented with a removable maxillary partial denture and a fixed mandibular bridge. No further deterioration was observed in the periodontal condition of most of the teeth during a 2-year period of supportive periodontal therapy (SPT). The patient is currently still undergoing SPT and some minor problems remain. However, the results suggest that treatment and subsequent maintenance for severe periodontitis with traumatic occlusion can be successful as long as the appropriate periodontal and prosthodontic treatment is planned and careful SPT carried out.
Periodontal-endodontic lesion of a three-rooted maxillary premolar: report of a case.
Blanchard, Steven B; Almasri, Amjad; Gray, Jonathon L
2010-05-01
A 43-year-old African American male initially presented for a dental evaluation of a recurrent swelling on the buccal aspect of tooth #12. His medical history was unremarkable except for a 20-pack year history of smoking. He was eventually diagnosed as having a necrotic pulp #12, and received root canal treatment. The patient's problem was unresolved, and he was subsequently referred for a periodontal evaluation with a presumptive diagnosis of a periodontal abscess. A flap was reflected from teeth #11 through #15. A buccal furcation invasion was discovered on #12. Shortly thereafter, three distinct roots with three grade III furcation invasions were located. The tooth was deemed untreatable, and was extracted. The thin buccal plate of the extraction socket was preserved using freeze-dried bone allograft to facilitate future prosthodontic replacement. Healing was uneventful. Periodontal open flap debridement surgery was provided for the remainder of the mouth, and the patient was placed on a 3-month recall program. Periodontitis associated with endodontic lesions are among the most daunting diagnostic and therapeutic challenges faced by periodontists. This is particularly true for maxillary premolars with multiple roots. The tooth in this case, once periodontally involved, had a very poor prognosis. The prognosis was further compromised by the pulpal involvement. Therapy consisted of extraction of the tooth to relieve the patient's discomfort and treating the adjacent teeth with periodontal open flap debridement surgery. A review of the literature pertinent to the diagnosis and management of periodontal-endodontic lesions is also presented.
[Flipped classroom as a strategy to enhance active learning].
Wakabayashi, Noriyuki
2015-03-01
This paper reviews the introduction of a flipped class for fourth grade dentistry students, and analyzes the characteristics of the learning method. In fiscal 2013 and 2014, a series of ten three-hour units for removable partial prosthodontics were completed with the flipped class method; a lecture video of approximately 60 minutes was made by the teacher (author) and uploaded to the university's e-learning website one week before each class. Students were instructed to prepare for the class by watching the streaming video on their PC, tablet, or smartphone. In the flipped class, students were not given a lecture, but were asked to solve short questions displayed on screen, to make a short presentation about a part of the video lecture, and to discuss a critical question related to the main subject of the day. An additional team-based learning (TBL) session with individual and group answers was implemented. The average individual scores were considerably higher in the last two years, when the flipped method was implemented, than in the three previous years when conventional lectures were used. The following learning concepts were discussed: the role of the flipped method as an active learning strategy, the efficacy of lecture videos and short questions, students' participation in the class discussion, present-day value of the method, cooperation with TBL, the significance of active learning in relation with the students' learning ability, and the potential increase in the preparation time and workload for students.
Yamaguchi, Satoshi; Yamanishi, Yasufumi; Machado, Lucas S; Matsumoto, Shuji; Tovar, Nick; Coelho, Paulo G; Thompson, Van P; Imazato, Satoshi
2018-01-01
The aim of this study was to evaluate fatigue resistance of dental fixtures with two different fixture-abutment connections by in vitro fatigue testing and in silico three-dimensional finite element analysis (3D FEA) using original computer-aided design (CAD) models. Dental implant fixtures with external connection (EX) or internal connection (IN) abutments were fabricated from original CAD models using grade IV titanium and step-stress accelerated life testing was performed. Fatigue cycles and loads were assessed by Weibull analysis, and fatigue cracking was observed by micro-computed tomography and a stereomicroscope with high dynamic range software. Using the same CAD models, displacement vectors of implant components were also analyzed by 3D FEA. Angles of the fractured line occurring at fixture platforms in vitro and of displacement vectors corresponding to the fractured line in silico were compared by two-way ANOVA. Fatigue testing showed significantly greater reliability for IN than EX (p<0.001). Fatigue crack initiation was primarily observed at implant fixture platforms. FEA demonstrated that crack lines of both implant systems in vitro were observed in the same direction as displacement vectors of the implant fixtures in silico. In silico displacement vectors in the implant fixture are insightful for geometric development of dental implants to reduce complex interactions leading to fatigue failure. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Minati, C; Shanmuganathan, N; Jain, Bhakti S; Padmanabhan, T V
2014-01-01
Auricular defects present reconstructive challenges, especially if they are bilateral. Surgical reconstruction provides effective results for defects; however for some patients surgical intervention is contraindicated. This case report describes an easy clinical technique to rehabilitate a patient with auricular defects. The prime purpose of this treatment rendered was to restore the lost auricular structure to the patient's satisfaction in an elegant, comfortable and cost effective manner. A thirteen year old female patient, who had bilaterally missing ears, was referred with a chief complaint of discomfort caused due to her existing hair band prosthesis and unsatisfactory esthetics. There was constant formation of ulcers at the site where the prosthesis came in contact with the skin. Considering the patient's age, ease of use and economic status, hair band retained ear prosthesis was selected. Silicone ear prostheses were fabricated on acrylic substructure to ensure fit, esthetics. Beneath the acrylic plates, a thin layer of soft silicone material was attached. The ear prostheses of both sides were connected with a metal hair band to retain. The newly fabricated prosthesis overcame the limitations of the existing one. The patient and her parents were satisfied with the results. The hair band retained silicone ear prosthesis is esthetic, economical and easy to use as a facial prosthesis. The addition of soft liner provided a cushion-like effect, thus reducing the formation of any ulcers due to pressure. Copyright © 2013 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
A Study of Parallelism of the Occlusal Plane and Ala-Tragus Line
Sadr, Katayoun; Sadr, Makan
2009-01-01
Background and aims Orientation of the occlusal plane is one of the most important clinical procedures in prostho-dontic rehabilitation of edentulous patients. The aim of this study was to define the best posterior reference point of ala-tragus line for orientation of occlusal plane for complete denture fabrication. Materials and methods Fifty-three dental students (27 females and 26 males) with complete natural dentition and Angel’s Class I occlusal relationship were selected. The subjects were photographed in natural head position while clenching on a Fox plane. After tracing the photographs, the angles between the following lines were measured: the occlusal plane (Fox plane) and the superior border of ala-tragus, the occlusal plane (Fox plane) and the middle of ala-tragus as well as the occlusal plane (Fox plane) and the inferior border of ala-tragus. Descriptive statistics, one sample t-test and independent t-test were used. P value less than 0.05 was considered significant. Results There was no parallelism between the occlusal plane and ala-tragus line with three different posterior ends and one sample t-test showed that the angles between them were significantly different from zero (p<0.05). However, the supe-rior border of ala-tragus line had the lowest mean angle, 1.80° (3.12) and was almost parallel to the occlusal plane. Conclusion The superior border of the tragus is suggested as the posterior reference for ala-tragus line. PMID:23230496
Seok, Ujeong; Ji, Sangeun; Yoo, Seunghoon; Kim, Jongsoo; Kim, Seungoh
2016-01-01
Background The objective of the present study was to examine the status of patients who had received dental treatment under intravenous (IV) sedation at Chungnam Dental Clinic for the Disabled in Korea from its inception to the present time, and to review the analysis results. Methods Retrospective analysis was performed on 305 cases of patients who had received dental treatments under IV sedation between January 2011 and May 2016. The analysis examined the patient's sex, age, primary reason for IV sedation, duration of anesthesia and dental treatment, type of dental treatment performed, number of clinical departments involved in the dental treatment and level of multidisciplinary cooperation, and annual trends. Results Most dental treatments using intravenous sedation were performed on medically disabled patients or dentally disabled patients with an extreme gag reflex or dental phobia. The mean duration of IV sedation was 72.5 min, while the mean duration of treatment was 58.0 min. The types of dental treatments included surgical treatment (n = 209), periodontal treatment (n = 28), prosthodontic treatment (n = 28), restorative treatment (n = 23), implant surgery (n = 22), endodontic treatment (n = 9), reduction of temporomandibular joint dislocation (n = 1), and treatment of traumatic injuries (n = 1), with treatments mostly performed on adult patients. Conclusions With increasing demand for minimally painful treatment, cases using IV sedation are on an upward trend and are expected to continue to increase. PMID:28879305
Radiofrequency Glow Discharge as a Mode of Disinfection for Elastomeric Impression Materials.
Mathew, Susan; Alani, Mathew M; Nair, K N Velayudhan; Haridas, Sayij; Reba, P B; Thomas, Sherin A
2017-02-01
Prosthodontic practice involves procedures in which impressions of the maxillary and mandibular arches are mandatory. Cross infection is one of the major problems that can occur in regular dental practice. Every dentist should take utmost care to prevent cross infection as oral cavity is the source of variety of microorganisms which can often cause diseases that can be fatal. Although precautions, such as wearing of gloves and mask, sterilization of instruments are given importance, the need for disinfection of impressions is often neglected. Hence, the aim of the study was to assess the disinfection potential of radiofrequency glow discharge (RGD) by microbiological studies. Disinfection potential of RGD on addition silicone (Reprosil, Dentsply, Milford DE, USA) was assessed. Total sample size was 20. Samples were divided into two groups of 10 each. Group I - control group and group II -RGD-treated group. Main groups were subdivided into subgroups A and B. Data collected were analyzed. The RGD-treated samples were found to be culture sterile which meant that there were no signs of growth of any organisms, thus proving the disinfection potential of RGD. From this study, we can conclude that RGD is a very rapid and handy device, which can disinfect saliva contaminated elastomeric impression material surfaces. When compared with the difficulties and lack of efficiency encountered in disinfecting impressions by immersion and spray atomization, RGD can be very handy in dental clinics, as it is a very rapid and convenient method for infection control.
Prevalence and clinical characteristics of tori and jaw exostoses in a teaching hospital in Jordan.
Sawair, Faleh A; Shayyab, Mohammad H; Al-Rababah, Mohammad A; Saku, Takashi
2009-12-01
To determine the prevalence and clinical characteristics of oral bony outgrowths (OBOs); torus palatinus (TP), torus mandibularis (TM), and exostoses in Jordanian dental patients. This cross-sectional study was conducted between November 1 and December 31, 2008 at the University of Jordan Hospital, Amman, Jordan. Clinical examinations of 618 patients (354 men and 264 women), 10-82 years of age, were conducted to determine the presence of OBOs. There were 239 subjects (38.7%) who had OBOs. Nearly one-third (34.6%) had TP, TM, or both. The prevalence rates were 25.7% for TM, 15.4% for TP, and 14.4% for exostoses. The OBOs were mostly noted in patients in their fifth decade of life, with attrition, clenching, or bruxism. Women had more TP, but gender differences were not statistically significant in cases of TM and exostoses. Most TP were large in size (71.6%), spindle (41.1%), or flat (40%) in shape, and located at the premolar-molar region (45.3%). The TM were mostly medium to large in size (84.9%), bilateral (81.1%), composed of single node (69.2%), and located at the premolar region (65.4%). Of the studied subjects, 7.1% had mandibular buccal exostosis, 10% had maxillary buccal, and 2.4% had palatal exostoses. Statistically significant associations were noticed between the concurrent existence of OBOs. A relatively high prevalence of OBOs was noted, and this should be taken into consideration when planning periodontal surgery and prosthodontic treatment.
The use of tungsten as a chronically implanted material
NASA Astrophysics Data System (ADS)
Shah Idil, A.; Donaldson, N.
2018-04-01
This review paper shows that tungsten should not generally be used as a chronically implanted material. The metal has a long implant history, from neuroscience, vascular medicine, radiography, orthopaedics, prosthodontics, and various other fields, primarily as a result of its high density, radiopacity, tensile strength, and yield point. However, a crucial material criterion for chronically implanted metals is their long-term resistance to corrosion in body fluids, either by inherently noble metallic surfaces, or by protective passivation layers of metal oxide. The latter is often assumed for elemental tungsten, with references to its ‘inertness’ and ‘stability’ common in the literature. This review argues that in the body, metallic tungsten fails this criterion, and will eventually dissolve into the soluble hexavalent form W6+, typically represented by the orthotungstate WO42- (monomeric tungstate) anion. This paper outlines the metal’s unfavourable corrosion thermodynamics in the human physiological environment, the chemical pathways to either metallic or metal oxide dissolution, the rate-limiting steps, and the corrosion-accelerating effects of reactive oxidising species that the immune system produces post-implantation. Multiple examples of implant corrosion have been reported, with failure by dissolution to varying extents up to total loss, with associated emission of tungstate ions and elevated blood serum levels measured. The possible toxicity of these corrosion products has also been explored. As the field of medical implants grows and designers explore novel solutions to medical implant problems, the authors recommend the use of alternative materials.
Retrospective study of combined splinting restorations in the aesthetic zone of periodontal patients
Liu, X.; Zhang, Y.; Zhou, Z.; Ma, S.
2016-01-01
Aims This retrospective study evaluated the clinical performance of combining a fiber-reinforced, composite-resin (FRC) bonded splint; bridge; fiber post; and/or resin veneer for the restoration of periodontally-involved anterior teeth. Methods Sixty-three patients with periodontally-involved anterior teeth each received one of the following splinting restorations: FRC-bonded splint-bridges (SB), a combination of an FRC-bonded splint and resin veneer (SV), or FRC-bonded splints (S). Six patients with healthy periodontal teeth received orthodontic retainers with FRC-bonded splints (OS) as a control. Modified USPHS criteria were used to evaluate the effects of rehabilitation, and the periodontal pocket depth (PPD) and clinical attachment level (CAL) of the natural teeth were measured. Results All restorations resulted in good aesthetic outcomes. SV, S in combination with fiber posts and OS all resulted in 100% acceptable ratings for each category that was directly evaluated at each follow-up. The mean PPD was 3.5 ± 1.0 mm at baseline, decreased to 3.3 ± 1.0 mm after one year (p <0.05), and subsequently increased to 3.5±1.0 mm again after four years (p >0.05). These changes were similar to those in the mean CAL. Conclusion A combination of a FRC-bonded splint, bridge, fiber post and/or resin veneer for minimally invasive prosthodontic treatment in the aesthetic zone is a good choice for periodontal patients. PMID:26964599
Singh, Kunwarjeet; Gupta, Nidhi
2012-01-01
To suggest a custom bar supported overdenture treatment modality for prosthodontic management of patients with severe gag reflex. Some patients have a severe gag reflex and cannot tolerate conventional maxillary complete dentures with maximum palatal coverage and extensions of all borders. The condition further gets complicated in patients suffering from respiratory problems along with severe gag reflex. Severe gagging acts as a barrier to treat such patients with accepted clinical procedures and prevent patients from wearing the prosthesis. By saving some of the remaining natural teeth and fabricating, a horse shoe shape palateless simple tooth or bar supported overdenture can be successfully used for treating such patients. The remaining maxillary right and left canines were prepared with the tapered round end diamond bur to receive copings of custom bar after intentional root canal treatment of same teeth. Impression was made with light body and putty of the polyvinyl siloxane elastomer with double step putty wash technique. Impression was poured with die stone. Wax pattern of copings with bar was fabricated with inlay wax which was invested and casted. After retrieving the bar, it was finished and its fit was evaluated. The coping-bar assembly was finally cemented with the glass ionomer cement. Palateless overdenture was fabricated by conventional technique used for the fabrication of complete denture. Palateless custom bar supported overdenture procedure can be successfully used for the management of patients with severe gag reflex with improved denture retention, stability, chewing efficiency and comfort of the patient.
Sun, Xu; Zhai, Jun-Jiang; Liao, Jian; Teng, Min-Hua; Tian, Ai; Liang, Xing
2014-01-01
Objectives: To evaluate masticatory efficiency (ME) and oral health-related quality of life (OHRQoL) in patients rehabilitated with implant-retained mandibular overdentures. Methods: In this randomized controlled clinical trial, 50 edentulous patients visiting the Implant Center and Department of Prosthodontics, West China College of Stomatology, Sichuan University, Chengdu, China between June 2010 and June 2012 were selected and received 2 implant-retained mandibular overdenture treatments. All patients were rehabilitated with maxillary complete dentures. The ME and OHRQoL were determined both one month before the mandibular complete denture was anchored to the osseointegrated implants, and 6 months after anchoring. Paired t-tests were used to compare means of ME, and oral health impact profile-49 (OHIP-49) domains scores between pre- and post-implant. Linear regression models were utilized to seek correlations between ME and OHIP domains scores. Results: The ME increased from pre- to post-implant retained mandibular overdentures significantly (p<0.001). The total OHIP score and 4 subscales scores were changed significantly from pre- to post-implant; namely, functional limitation, psychological discomfort, physical disability, and physical pain. The total OHIP score, functional limitation, physical disability, and physical pain subscale scores were related to ME. Conclusion: Implant-retained mandibular over dentures can significantly improve patients’ ME and OHRQoL. The improvement in OHRQoL is mainly because of the improved ME. An improved chewing experience, and pain relief also contributes to improvement of OHRQoL. PMID:25316463
Properties of a color-changeable chewing gum used to evaluate masticatory performance.
Hama, Yohei; Kanazawa, Manabu; Minakuchi, Shunsuke; Uchida, Tatsuro; Sasaki, Yoshiyuki
2014-04-01
To clarify the basic properties of a color-changeable chewing gum to determine its applicability to evaluations of masticatory performance under different types of dental status. Ten participants with natural dentition aged 26-30 years chewed gum that changes color during several chewing strokes over five repetitions. Changes in color were assessed using a colorimeter, and then L*, a*, and b* values in the CIELAB color system were quantified. Relationships between chewing progression and color changes were assessed using regression analysis and the reliability of color changes was assessed using intraclass correlation coefficients. We then measured 42 dentate participants (age, 22-31 years) and 47 complete denture wearers (age, 44-90 years) to determine the detectability of masticatory performance under two types of dental status. Regression between the number of chewing strokes and the difference between two colors was non-linear. The intraclass correlation coefficients were highest between 60 and 160 chewing strokes. Dentate and edentulous groups significantly differed (Wilcoxon rank sum test) and values were widely distributed within each group. The color of the chewing gum changed over a wide range, which was sufficient to evaluate the masticatory performance of individuals with natural dentition and those with complete dentures. Changes in the color values of the gum reliably reflected masticatory performance. These findings indicate that the color-changeable chewing gum will be useful for evaluating masticatory performance under any dental status. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
The effect of obturator bulb height on speech in maxillectomy patients.
Kwon, H B; Chang, S W; Lee, S H
2011-03-01
The purpose of this study was to compare the speech function of low height bulb obturators with that of high height bulb obturators. Thirteen maxillectomy patients, who underwent post-operative prosthodontic rehabilitations, were included. Two obturators of the same design except for different bulb heights were fabricated for each maxillectomy patient. One of the two obturators had high bulb design and the other had low bulb design. After one of the obturators was used for a period of 3 weeks, the patient's speaking functions were evaluated by measuring nasalance scores, formant frequencies, and vowel working space areas. The same procedures were repeated with the second obturator following another 3-week period of usage. In addition, the effect of delivery sequence and anatomic conditions related to maxillectomy were analysed. The results demonstrated that the nasalance scores with the low bulb obturators were significantly higher than those with the high bulb obturators. There were no significant differences in formant frequencies based on the bulb height of the obturators. The vowel working spaces for the two obturators were similar in shape and there were no significant differences between the vowel working space areas created by the two obturators. The delivery sequence affected the results. However, there were no significant differences related to the other anatomical variables. Although low bulb obturators might function similarly with high bulb obturators in terms of the articulation of speech, they would exhibit a difficulty in controlling hypernasality in maxillectomy patients. © 2010 Blackwell Publishing Ltd.
The effect of mucosal cuff shrinkage around dental implants during healing abutment replacement.
Nissan, J; Zenziper, E; Rosner, O; Kolerman, R; Chaushu, L; Chaushu, G
2015-10-01
Soft tissue shrinkage during the course of restoring dental implants may result in biological and prosthodontic difficulties. This study was conducted to measure the continuous shrinkage of the mucosal cuff around dental implants following the removal of the healing abutment up to 60 s. Individuals treated with implant-supported fixed partial dentures were included. Implant data--location, type, length, diameter and healing abutments' dimensions--were recorded. Mucosal cuff shrinkage, following removal of the healing abutments, was measured in bucco-lingual direction at four time points--immediately after 20, 40 and 60 s. anova was used to for statistical analysis. Eighty-seven patients (49 women and 38 men) with a total of 311 implants were evaluated (120 maxilla; 191 mandible; 291 posterior segments; 20 anterior segments). Two-hundred and five (66%) implants displayed thick and 106 (34%) thin gingival biotype. Time was the sole statistically significant parameter affecting mucosal cuff shrinkage around dental implants (P < 0.001). From time 0 to 20, 40 and 60 s, the mean diameter changed from 4.1 to 4.07, 3.4 and 2.81 mm, respectively. The shrinkage was 1%, 17% and 31%, respectively. The gingival biotype had no statistically significant influence on mucosal cuff shrinkage (P = 0.672). Time required replacing a healing abutment with a prosthetic element should be minimised (up to 20/40 s), to avoid pain, discomfort and misfit. © 2015 John Wiley & Sons Ltd.
The Historical Evolution of Dental Impression Materials.
Papadiochos, Ioannis; Papadiochou, Sofia; Emmanouil, Ioannis
The concept of impression making process in dentistry began in the mid 1800s. Dentists realized that the construction of a prosthetic restoration required both a detailed capture of the oral tissues along with stone cast fabrications. To accomplish these goals, impression materials were essential. Beeswax represents the first impression material, while important bechmarks during the historical evolution of dental impression materials are considered to be the introduction of dental trays in the early 1800s and the invention of the gutta-percha, thermoplastic resins and plaster of Paris. The double (corrective) impression technique, along with the functional impression concept that was established after mid 1800s, are also identified as pivotal innovations. During the 20th century, the advances in material development slowed significantly since the majority of the current impression materials had already been invented. However, the introduction of elastomeric impression materials in the field of prosthodontics that offered the advantages of accuracy and dimensional stability substantially upgraded both the impression accuracy and the quality of the final restoration. Presently, the dental practitioner has access to a variety of impression materials and should be aware of their properties, indications and limitations as well. Futhermore, while continuous attempts are being made to enhance these materials, the ideal impression material has yet to be developed. The purpose of this article was to provide a comprehensive review about the historical development of impression dental materials. Copyright American Academy of the History of Dentistry.
Zakkula, Srujana; B, Sreedevi; Anne, Gopinadh; Manne, Prakash; Bindu O, Swetha Hima; Atla, Jyothi; Deepthi, Sneha; Chaitanya A, Krishna
2014-04-01
Prosthodontic treatment involves clinical procedures which influence speech performance directly or indirectly. Prosthetic rehabilitation of missing teeth with partial or complete maxillary removable dentures influences the individual voice characteristics like Phonation, resonance etc. To evaluate the effect of Acrylic palatal plate thickness (1mm-3mm) of maxillary prosthesis on phonation. Twelve subjects were selected randomly between the age group of 20-25 years who have full complement of teeth and have no speech problems. Speech evaluation was done under four experimental conditions i.e. Without any experimental acrylic palatal plate (control), with experimental acrylic palatal plates of thickness 1 mm, 2 mm and 3 mm respectively. The speech material for phonation test consisted of Vowels sounds /a/, /i/, and /o/. Speech analysis to assess phonation was done using digital acoustic analysis (PRAAT software). The obtained results were statistically analyzed by One-way ANOVA and Tukey's multiple post-hoc for comparison of four experimental conditions with respect to different vowel sounds. Mean harmonics to noise ratio (HNR) values obtained for all the Experimental conditions did not show significant difference (p>0.05). In conclusion, an increase in the thickness of the acrylic palatal plate of maxillary prosthesis for about 1 mm - 3mm in complete or partial maxillary removable dentures resulted in no significant effect on phonation of vowel sounds /a/, /i/ and /o/. Increasing the thickness of the palatal plate from 1 mm to 3 mm has not shown any significant effect on the phonation.
Epidemiological survey on edentulousness.
Reddy, N Simhachalam; Reddy, Nallala Amarendra; Narendra, R; Reddy, Sashi Deepth
2012-07-01
India has a large geriatric population of 77 millions, comprising 7.7% of its total population. One of the major handicaps in the elderly is loss of teeth, affecting their mastication, dietary intake and nutritional status. The present study was planned to assess the level of edentulousness, cause of edentulousness, denture wearing and denture needs of the middle and elderly in the society and study was correlated between habits and socioeconomic variables, diet and body mass index (BMI). A total of 500 subjects (random sampling) from dental outpatient were studied. A prepared questionnaire was developed, explained, interviewed and questions were filled personally. The level of edentulousness was found to be high in the subjects with low socioeconomic status and in advancing age with no significant difference between male and females. Another finding was very low level of denture wearing of 62% needing complete denture and partial denture only 10.4% of subjects wearing dentures. Mixed diet population had higher level of edentulousness compared with vegetarians. The BMI was correlated with level of edentulousness. The study clearly showed that there is lack of dental awareness, so dental education and motivation in very important. The study concludes that the need for prosthodontics care will increase due to the increase in life span. This study is clinically significant with regard to knowing the root cause of edentulism, either partial or complete. Out of 62% tooth loss, dental caries (37.4%) topped the cause for tooth loss followed by combination of dental caries and periodontal disease (12.2%).
Koyama, Shigeto; Kanetaka, Hiroyasu; Sagehashi, Yoshinori; Sasaki, Keiichi; Sato, Naoko
2018-03-09
Patients treated with maxillofacial prosthetics often experience emotional problems because of the remaining facial skin concavity such as a surgical scar. In such cases, cosmetic treatment can potentially correct their skin tone imperfections and deformities. This study aimed to evaluate the clinical availability of novel cosmetics-based material for craniofacial small concavity by initiating a cosmetic treatment in a preliminary case. Eighteen patients with aesthetic problems such as craniofacial deformities, small defects, and concavities on their faces underwent cosmetic treatment that was performed by makeup practitioners. Data were collected from the patient's charts and a survey questionnaire. A visual analog scale was used to conduct a survey regarding the satisfaction levels of the patients following cosmetic treatment with a novel cosmetics-based material. The cosmetic treatment was performed for a concavity on the left midface of a 67-year-old woman with partial maxillectomy. The novel cosmetics-based material was manufactured from a semi-translucent oil base. The satisfaction level of the patient increased after undergoing the cosmetic treatment. Regarding clinical applications, the novel cosmetics-based material can help reduce their cosmetic disturbance and restore the small deformity. These results suggest that the cosmetic treatment with the novel cosmetics-based material can be used as a subsidiary method for facial prostheses or an independent new method for correcting patients' small craniofacial concavity and for reducing visible deformity. Copyright © 2018 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Evaluation of participants' perception and taste thresholds with a zirconia palatal plate.
Wada, Takeshi; Takano, Tomofumi; Tasaka, Akinori; Ueda, Takayuki; Sakurai, Kaoru
2016-10-01
Zirconia and cobalt-chromium can withstand a similar degree of loading. Therefore, using a zirconia base for removable dentures could allow the thickness of the palatal area to be reduced similarly to metal base dentures. We hypothesized that zirconia palatal plate for removable dentures provides a high level of participants' perception without influencing taste thresholds. The purpose of this study was to evaluate the participants' perception and taste thresholds of zirconia palatal plate. Palatal plates fabricated using acrylic resin, zirconia, and cobalt-chromium alloy were inserted into healthy individuals. Taste thresholds were investigated using the whole-mouth gustatory test, and participants' perception was evaluated using the 100-mm visual analog scale to assess the ease of pronunciation, ease of swallowing, sensation of temperature, metallic taste, sensation of foreign body, subjective sensory about weight, adhesiveness of chewing gum, and general satisfaction. For the taste thresholds, no significant differences were noted in sweet, salty, sour, bitter, or umami tastes among participants wearing no plate, or the resin, zirconia, and metal plates. Speech was easier and foreign body sensation was lower with the zirconia plate than with the resin plate. Evaluation of the adhesiveness of chewing gum showed that chewing gum does not readily adhere to the zirconia plate in comparison with the metal plate. The comprehensive participants' perception of the zirconia plate was evaluated as being superior to the resin plate. A zirconia palatal plate provides a high level of participants' perception without influencing taste thresholds. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Advancements in CAD/CAM technology: Options for practical implementation.
Alghazzawi, Tariq F
2016-04-01
The purpose of this review is to present a comprehensive review of the current published literature investigating the various methods and techniques for scanning, designing, and fabrication of CAD/CAM generated restorations along with detailing the new classifications of CAD/CAM technology. I performed a review of a PubMed using the following search terms "CAD/CAM, 3D printing, scanner, digital impression, and zirconia". The articles were screened for further relevant investigations. The search was limited to articles written in English, published from 2001 to 2015. In addition, a manual search was also conducted through articles and reference lists retrieved from the electronic search and peer-reviewed journals. CAD/CAM technology has advantages including digital impressions and models, and use of virtual articulators. However, the implementation of this technology is still considered expensive and requires highly trained personnel. Currently, the design software has more applications including complete dentures and removable partial denture frameworks. The accuracy of restoration fabrication can be best attained with 5 axes milling units. The 3D printing technology has been incorporated into dentistry, but does not include ceramics and is limited to polymers. In the future, optical impressions will be replaced with ultrasound impressions using ultrasonic waves, which have the capability to penetrate the gingiva non-invasively without retraction cords and not be affected by fluids. The coming trend for most practitioners will be the use of an acquisition camera attached to a computer with the appropriate software and the capability of forwarding the image to the laboratory. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Effect of Carbon Dioxide Laser on Increasing Vestibular Depth in Cleft Lip and Palate Patients.
Yassaei, Sogra; Aghili, Hossein; Azam, Alireza Navab; Moghadam, Mahjobeh Gholdani; Safari, Isa
2017-09-01
Shallow upper buccal sulcus deformity in cleft lip and palate patients is one of the common secondary deformities after primary cleft lip and palate repair; this deformity may prevent or complicate orthodontic and prosthodontic procedures causing aesthetic and functional problems. A number of methods are described to increase the anterior maxillary sulcus in these patients. This study assessed the use of a carbon dioxide laser (CO 2 ) to increase the sulcus depth. Fifteen patients with cleft lip and palate (eight unilateral and seven bilateral) were studied. The surgical procedure was performed using CO 2 laser. The vestibular depth and lip length were measured at three time points namely before surgery (T0), 1 week following surgery (T1), and 4 months following surgery (T2). After data collection, statistical analyses were done using PASW ® version 18 SPSS. The mean values of vestibular depth were 9.46 ± 1.92, 13.83 ± 1.88, and 13.23 ± 1.76 mm for T0, T1, and T2, respectively. The vestibular depth significantly increased after 4 months of follow-up (p = 0.001). The mean amount of vestibular depth gain was not significantly different in unilateral and bilateral cleft groups (p = 0.908). The mean value of upper lip length increased by a mean of 1.23 mm and was statistically significant (p = 0.001). Upper buccal sulcus reconstruction with CO 2 laser provides successful and stable results. CO 2 laser application is suggested as an alternative to conventional vestibuloplasty.
Reliability of conventional shade guides in teeth color determination.
Todorović, Ana; Todorović, Aleksandar; Gostović, Aleksandra Spadijer; Lazić, Vojkan; Milicić, Biljana; Djurisić, Slobodan
2013-10-01
Color matching in prosthodontic therapy is a very important task because it influences the esthetic value of dental restorations. Visual shade matching represents the most frequently applied method in clinical practice. Instrumental measurements provide objective and quantified data in color assessment of natural teeth and restorations. In instrumental shade analysis, the goal is to achieve the smallest deltaE value possible, indicating the most accurate shade match. The aim of this study was to evaluate the reliability of commercially available ceramic shade guides. VITA Easyshade spectrophotometer (VITA, Germany) was used for instrumental color determination. Utilizing this device, color samples of ten VITA Classical and ten VITA 3D - Master shade guides were analyzed. Each color sample from all shade guides was measured three times and the basic parameters of color quality were examined: deltaL, deltaC, deltaH, deltaE, deltaElc. Based on these parameters spectrophotometer marks the shade matching as good, fair or adjust. After performing 1,248 measurements of ceramic color samples, frequency of evaluations adjust, fair and good were statistically significantly different between VITA Classical and VITA 3D Master shade guides (p = 0.002). There were 27.1% cases scored as adjust, 66.3% as fair and 6.7% as good. In VITA 3D - Master shade guides 30.9% cases were evaluated as adjust, 66.4% as fair and 2.7% cases as good. Color samples from different shade guides, produced by the same manufacturer, show variability in basic color parameters, which once again proves the lack of precision and nonuniformity of the conventional method.
Bisphosphonates and osteonecrosis of the jaw.
Shannon, Jodi; Shannon, John; Modelevsky, Steven; Grippo, Anne A
2011-12-01
Bisphosphonates are used worldwide as a successful treatment for people with osteoporosis, which is the major underlying cause of fractures in postmenopausal women and older adults. These agents are successful at increasing bone mass and bone trabecular thickness, decreasing the risk of fracture, and decreasing bone pain, enabling individuals to have better quality of life. Bisphosphonates are also used to treat multiple myeloma, bone metastasis, and Paget's disease; however, bisphosphonate treatment may result in negative side effects, including osteonecrosis of the jaw (ONJ). ONJ involves necrotic, exposed bone in the jaw, pain, possible secondary infection, swelling, painful lesions, and various dysesthesias, although less-severe cases may be asymptomatic. First-generation bisphosphonates, which do not contain nitrogen, are metabolized into a nonfunctional, cytotoxic analogue of adenosine triphosphate and cause osteoclast death by starvation. Second-generation bisphosphonates are nitrogen-containing agents; these inhibit osteoclast vesicular trafficking, membrane ruffling, morphology, and cytoskeletal arrangement by inhibiting farnesyl diphosphate synthase in the mevalonate pathway. Physicians treating older adults with osteoporosis and cancer should work together with dental practitioners, pharmacists, and other clinicians to inform individuals receiving bisphosphonates of their possible side effects and to suggest precautionary steps that may minimize the risk of osteonecrosis, particularly of the jaw. These include practicing good oral hygiene; scheduling regular dental examinations and cleanings; and cautioning people who are scheduling treatment for periodontal disease, oral and maxillofacial therapy, endodontics, implant placement, restorative dentistry, and prosthodontics. Recommendations for management of people with ONJ include an oral rinse, such as chlorhexidine, and antibiotics. © 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.
Methodological quality assessment of paper-based systematic reviews published in oral health.
Wasiak, J; Shen, A Y; Tan, H B; Mahar, R; Kan, G; Khoo, W R; Faggion, C M
2016-04-01
This study aimed to conduct a methodological assessment of paper-based systematic reviews (SR) published in oral health using a validated checklist. A secondary objective was to explore temporal trends on methodological quality. Two electronic databases (OVID Medline and OVID EMBASE) were searched for paper-based SR of interventions published in oral health from inception to October 2014. Manual searches of the reference lists of paper-based SR were also conducted. Methodological quality of included paper-based SR was assessed using an 11-item questionnaire, Assessment of Multiple Systematic Reviews (AMSTAR) checklist. Methodological quality was summarized using the median and inter-quartile range (IQR) of the AMSTAR score over different categories and time periods. A total of 643 paper-based SR were included. The overall median AMSTAR score was 4 (IQR 2-6). The highest median score (5) was found in the pain dentistry and periodontology fields, while the lowest median score (3) was found in implant dentistry, restorative dentistry, oral medicine, and prosthodontics. The number of paper-based SR per year and the median AMSTAR score increased over time (median score in 1990s was 2 (IQR 2-3), 2000s was 4 (IQR 2-5), and 2010 onwards was 5 (IQR 3-6)). Although the methodological quality of paper-based SR published in oral health has improved in the last few years, there is still scope for improving quality in most evaluated dental specialties. Large-scale assessment of methodological quality of dental SR highlights areas of methodological strengths and weaknesses that can be targeted in future publications to encourage better quality review methodology.
Sim, Ji-Young; Jang, Yeon; Kim, Woong-Chul; Kim, Hae-Young; Lee, Dong-Hwan; Kim, Ji-Hwan
2018-03-31
This study aimed to evaluate and compare the accuracy. A reference model was prepared with three prepared teeth for three types of restorations: single crown, 3-unit bridge, and inlay. Stone models were fabricated from conventional impressions. Digital impressions of the reference model were created using an intraoral scanner (digital models). Physical models were fabricated using a three-dimensional (3D) printer. Reference, stone, and 3D printed models were subsequently scanned using an industrial optical scanner; files were exported in a stereolithography file format. All datasets were superimposed using 3D analysis software to evaluate the accuracy of the complete arch and trueness of the preparations. One-way and two-way analyses of variance (ANOVA) were performed to compare the accuracy among the three model groups and evaluate the trueness among the three types of preparation. For the complete arch, significant intergroup differences in precision were observed for the three groups (p<.001). However, no significant difference in trueness was found between the stone and digital models (p>.05). 3D printed models had the poorest accuracy. A two-way ANOVA revealed significant differences in trueness among the model groups (p<.001) and types of preparation (p<.001). Digital models had smaller root mean square values of trueness of the complete arch and preparations than stone models. However, the accuracy of the complete arch and trueness of the preparations of 3D printed models were inferior to those of the other groups. Copyright © 2018 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Kon, Haruka; Botelho, Michael George; Bridges, Susan; Leung, Katherine Chiu Man
2015-04-01
The aim of this research was to evaluate the effectiveness of a clinical instructional video with a structured worksheet for independent self-study in a complete denture program. 47 multilingual dental students completed a task by watching an instructional video with subtitles regarding clinical complete denture procedures. After completion, students evaluated their learning experience, and 11 students participated in focus group interviews to gain further insight. A mixed-methods approach to data collection and analysis provided descriptive statistical results and a grounded theory approach to coding identified key concepts and categories from the qualitative data. Over 70% of students had favorable opinions of the learning experience and indicated that the speed and length of the video were appropriate. Highly positive and conflicting negative comments regarding the use of subtitles showed both preferences for subtitles over audio and vice versa. The use of a video resource was considered valuable as the replay and review functions allowed better visualization of the procedures, which was considered a good recap tool for the clinical demonstration. It was also a better revision aid than textbooks. So, if the students were able to view these videos at will, they believed that videos supplemented their self-study. Despite the positive response, videos were not considered to replace live clinical demonstrations. While students preferred live demonstrations over the clinical videos they did express a realization of these as a supplemental learning material for self-study based on their ease of access, use for revision, and prior to clinical preparation. Copyright © 2015 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Muddugangadhar, B. C.; Sangur, Rajashekar; Rudraprasad, I. V.; Nandeeshwar, D. B.; Kumar, B. H. Dhanya
2015-01-01
Purpose: This study compared the flow rate and pH of resting (unstimulated) and stimulated whole saliva before and after complete denture placement in different age groups. Materials and Methods: Fifty healthy, non-medicated edentulous individuals of different age groups requiring complete denture prostheses were selected from the outpatient department. The resting (unstimulated) and stimulated whole saliva and pH were measured at three stages i.e., i)Before complete denture placement;ii)Immediately after complete denture placement; andiii)After 2 to 3 months of complete denture placement. Saliva production was stimulated by chewing paraffin wax. pH was determined by using a digital pH meter. Results: Statistically significant differences were seen in resting(unstimulated) and stimulated whole salivary flow rate and pH obtained before, immediately after, and after 2 to 3 months of complete denture placement. No statistically significant differences were found between the different age groups in resting (unstimulated) as well as stimulated whole salivary flow rate and pH. Conclusion: Stimulated whole salivary flow rates and pH were significantly higher than resting (unstimulated) whole salivary flow rates and pH obtained before, immediately after, and after 2 to 3 months of complete denture placement. No age related variations in whole salivary flow rate and pH were observed in healthy, non-medicated individuals. Clinical Implications: The assessment of salivary flow rate, pH in different age groups is of prognostic value, which is an important aspect to be considered in the practice of removable prosthodontics. PMID:26929540
Accurate 3D kinematic measurement of temporomandibular joint using X-ray fluoroscopic images
NASA Astrophysics Data System (ADS)
Yamazaki, Takaharu; Matsumoto, Akiko; Sugamoto, Kazuomi; Matsumoto, Ken; Kakimoto, Naoya; Yura, Yoshiaki
2014-04-01
Accurate measurement and analysis of 3D kinematics of temporomandibular joint (TMJ) is very important for assisting clinical diagnosis and treatment of prosthodontics and orthodontics, and oral surgery. This study presents a new 3D kinematic measurement technique of the TMJ using X-ray fluoroscopic images, which can easily obtain the TMJ kinematic data in natural motion. In vivo kinematics of the TMJ (maxilla and mandibular bone) is determined using a feature-based 2D/3D registration, which uses beads silhouette on fluoroscopic images and 3D surface bone models with beads. The 3D surface models of maxilla and mandibular bone with beads were created from CT scans data of the subject using the mouthpiece with the seven strategically placed beads. In order to validate the accuracy of pose estimation for the maxilla and mandibular bone, computer simulation test was performed using five patterns of synthetic tantalum beads silhouette images. In the clinical applications, dynamic movement during jaw opening and closing was conducted, and the relative pose of the mandibular bone with respect to the maxilla bone was determined. The results of computer simulation test showed that the root mean square errors were sufficiently smaller than 1.0 mm and 1.0 degree. In the results of clinical application, during jaw opening from 0.0 to 36.8 degree of rotation, mandibular condyle exhibited 19.8 mm of anterior sliding relative to maxillary articular fossa, and these measurement values were clinically similar to the previous reports. Consequently, present technique was thought to be suitable for the 3D TMJ kinematic analysis.
Impact of tooth replacement on the nutritional status of partially dentate elders.
McKenna, Gerald; Allen, P Finbarr; O'Mahony, Denis; Cronin, Michael; DaMata, Cristiane; Woods, Noel
2015-11-01
The aim of this study was to compare the impact of two different tooth replacement strategies on the nutritional status of partially dentate older patients. Nutritional status was measured using the full version of the Mini Nutritional Assessment (MNA) and the short form of the Mini Nutritional Assessment (MNA-SF). A randomised controlled clinical trial was conducted (Trial Registration no. ISRCTN26302774). Partially dentate patients aged 65 years and older were recruited and randomly allocated to the two different treatment groups: the removable partial dentures (RPD) group and the shortened dental arch (SDA) group. Nutritional status was measured using the MNA and MNA-SF administered at baseline and 1, 6 and 12 months after treatment intervention by a research nurse blinded to the treatment group allocation of all participants. Data collected using the full version of the MNA showed significant improvements in mean MNA scores over the length of the study (p < 0.05). For the entire patient group, there was a mean increase of 0.15 points at 6 months and a further increase of 0.19 points at 12 months. These increases were similar within the treatment groups (p > 0.05). For MNA-SF, the analysis showed that there were no significant differences recorded over the data collection points after treatment intervention (p < 0.05). Tooth replacement using conventional and functionally orientated treatment for the partially dentate elderly showed significant improvements in MNA score 12 months after intervention. Prosthodontic rehabilitation may play an important role in the nutritional status of partially dentate elders.
Graduate and Undergraduate Geriatric Dentistry Education in a Selected Dental School in Japan
Kitagawa, Noboru; Sato, Yuji; Komabayashi, Takashi
2010-01-01
Geriatric dentistry and its instruction are critical in a rapidly aging population. Japan is the world’s fastest-aging society, and thus geriatric dentistry education in Japan can serve as a global model for other countries that will soon encounter the issues that Japan has already confronted. This study aimed to evaluate geriatric dental education with respect to the overall dental education system, undergraduate geriatric dentistry curricula, mandatory internships, and graduate geriatric education of a selected dental school in Japan. Bibliographic data and local information were collected. Descriptive and statistical analyses (Fisher and Chi-square test) were conducted. Japanese dental schools teach geriatric dentistry in 10 geriatric dentistry departments as well as in prosthodontic departments. There was no significant differences found between the number of public and private dental schools with geriatric dentistry departments (p = 0.615). At Showa University School of Dentistry, there are more didactic hours than practical training hours; however, there is no significant didactic/practical hour distribution difference between the overall dental curriculum and fourth-year dental students’ geriatric dental education curriculum (p=0.077). Graduate geriatric education is unique because it is a four-year Ph.D. course of study; there is neither a Master’s degree program nor a certificate program in Geriatric Dentistry. Overall, both undergraduate and graduate geriatric dentistry curricula are multidisciplinary. This study contributes to a better understanding of geriatric dental education in Japan; the implications of this study include developing a clinical/didactic curriculum, designing new national/international dental public health policies, and calibrating the competency of dentists in geriatric dentistry. PMID:21985207
Fredriksson, M; Astbäck, J; Pamenius, M; Arvidson, K
1998-08-01
The Composipost dowel is made of stretched, aligned carbon fibres embedded in an epoxy-resin matrix. It is widely used in Europe and Canada for the restoration of endodontically treated teeth and was introduced in the United States 2 years ago as the C-Post dowel. This retrospective study evaluated treatment outcome of the Composipost system after 2 to 3 years. A total of 236 patients treated during a 1-year period by seven Swedish dental practitioners were included. Of those, 146 patients consented and data were collected from the dental records of the remaining patients. Thus, the material comprised 236 teeth restored with carbon fiber-reinforced epoxy resin post, 130 maxillary and 106 mandibular teeth, with a mean restoration time of 32 months (range 27 to 41). Periodontal conditions, radiographic signs, and prosthodontic results were recorded. Five teeth (2%) had been extracted for reasons unrelated to the Composipost system. Periodontal conditions such as plaque accumulation, gingival health, bleeding on probing, and pocket depth around the teeth with Composipost dowels were similar to the control teeth. No dislodgment or root or post fractures were observed clinically or on radiographs. Radiographic examination of bone height measured from the apex to the bone margin mesially and distally showed differences on the mesial side but not on the distal surface (p < 0.05) between the Composipost-treated teeth and the controls. Promising results after 2 to 3 years of clinical service indicate that this system can be a viable alternative to conventional post-and-core systems.
Oral health care needs among the middle-aged and the elderly in Hong Kong.
Lo, E C; Corbet, E F; Holmgren, C J
1994-10-01
A sample of 372 35-44-yr-olds and 537 noninstitutionalized 65-74-yr-olds were clinically examined in an oral health survey of Hong Kong Chinese conducted in 1991. The examination procedures and diagnostic criteria for assessing restorative and extraction treatment need followed those recommended by the World Health Organization. The Community Periodontal Index-based periodontal treatment needs involving index teeth or their replacements were computed from separate clinic scores for maximum probing depth, presence of calculus, and bleeding after probing. A set of criteria for assessing prosthodontic treatment need was specially laid down for this survey. Examiners were calibrated before the survey, and the interexaminer reliability was found to be generally good. Besides reporting the various individual normative treatment need items in the traditional way, the present analysis used some holistic treatment-need categories which may have manpower-requirement implications for the classification of subjects. All dentate subjects surveyed required some treatment. Only 6% of the elderly, all edentulous, required denture work only. Of the 35-44-yr-olds, 42% needed scaling and oral hygiene instruction only, which could be provided by dental hygienists. The treatment needs of the vast majority of the middle-aged and the elderly (mainly scaling; simple fillings; and extractions, dentures, or both) could be easily handled by general dentists. Only about one-fifth of the subjects in both age groups required some complex care such as endodontics, crowns, and advanced periodontal treatment, which could be delivered by senior dentists or dentists with specialist training.
Maghami, Ebrahim; Homaei, Ehsan; Farhangdoost, Khalil; Pow, Edmond Ho Nang; Matinlinna, Jukka Pekka; Tsoi, James Kit-Hon
2018-05-03
The aim of this study was to investigate and quantify the effect of preparation design parameters on a premolar restored with two different CAD/CAM ceramic crowns by three-dimensional finite element analysis (FEA). A restored human first premolar was digitized by a micro-CT scanner and a 3D model was created by a medical image processing software (Mimics). Following segmentation, dentine and ceramic were extracted by a surface meshing software (3-matic). Models with different preparation designs with three convergence angles (6°, 12° and 20°) and two preparation heights (3.1mm and 4.1mm) were produced. Mesh generation for models was performed in IA-FEMesh software with a lithium disilicate glass ceramic (LD, E=95.9GPa) and a polymer-infiltrated ceramic (PIC, E=30.1GPa) as the restorative materials. A 5-mm diameter stainless steel hemisphere was employed as an indenter. Twelve models were analyzed numerically in Abaqus™. The results indicated that preparation height was found to be a major factor affecting stress distribution in different components. In all models, the maximum principal stress of the ceramic crowns was found in contact area against the indenter. This stress was lesser in the longer abutment than the shorter one and it was greater for LD ceramic. Convergence angle had limited effect on stress distribution of ceramic crown in all models. The preparation height appeared to play a more important role in the stress distribution of ceramic crown than the convergence angle. Copyright © 2018 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Raut, Anjana; Rao, Polsani Laxman; Vikas, B V J; Ravindranath, T; Paradkar, Archana; Malakondaiah, G
2013-01-01
Acrylic resins have been in the center stage of Prosthodontics for more than half a century. The flexural fatigue failure of denture base materials is the primary mode of clinical failure. Hence there is a need for superior physical and mechanical properties. This in vitro study compared the transverse strength of specimens of thermopressed injection-molded and conventional compression-molded polymethylmethacrylate polymers and examined the morphology and microstructure of fractured acrylic specimens. The following denture base resins were examined: Brecrystal (Thermopressed injection-molded, modified polymethylmethacrylate) and Pyrax (compression molded, control group). Specimens of each material were tested according to the American Society for Testing and Materials standard D790-03 for flexural strength testing of reinforced plastics and subsequently examined under SEM. The data was analyzed with Student unpaired t test. Flexural strength of Brecrystal (82.08 ± 1.27 MPa) was significantly higher than Pyrax (72.76 ± 0.97 MPa). The tested denture base materials fulfilled the requirements regarding flexural strength (>65 MPa). The scanning electron microscopy image of Brecrystal revealed a ductile fracture with crazing. The fracture pattern of control group specimens exhibited poorly defined crystallographic planes with a high degree of disorganization. Flexural strength of Brecrystal was significantly higher than the control group. Brecrystal showed a higher mean transverse strength value of 82.08 ± 1.27 MPa and a more homogenous pattern at microscopic level. Based on flexural strength properties and handling characteristics, Brecrystal may prove to be an useful alternative to conventional denture base resins.
Yoshinari, Masao; Uzawa, Shinobu; Komiyama, Yataro
2016-10-01
The aim of this in vitro study was to evaluate tensile bond strengths and corrosion resistance of CoCr alloys joined with gold cylinder by a soldering system in comparison with the conventional cast-joining system. CoCr alloys joined with gold cylinder by a soldering system using a high-fusing gold solder (CoCr/Solder/Gold cylinder), gold alloy joined with gold cylinder by a cast joining system (Gold alloy/Gold cylinder) and CoCr castings were fabricated. The tensile bond strength and corrosion resistance in 0.9% NaCl solution (pH 7.4 and pH 2.3) were evaluated. Scanning electron microscopy (SEM) of the fractured surface and electron probe microanalysis (EPMA) of the joined interfaces were also performed. The tensile bond strengths of the CoCr/Solder/Gold cylinder specimens showed similar values as the Gold alloy/Gold cylinder specimens. SEM observation and EPMA analyses suggested firm bonding between the CoCr alloy and gold cylinder. The released elements from the CoCr/Solder/Gold cylinder specimens were similar to ones from CoCr castings. Results showed that superstructures made of CoCr alloys joined with the gold cylinder using a high-fusing gold solder had sufficient bond strength and high corrosion resistance. These hybrid frameworks with cobalt-chromium alloy and gold cylinder are promising prosthesis for implant superstructures with the low cost and favorable mechanical properties instead of conventional high-gold alloys. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Dental students' preferences and performance in crown design: conventional wax-added versus CAD.
Douglas, R Duane; Hopp, Christa D; Augustin, Marcus A
2014-12-01
The purpose of this study was to evaluate dental students' perceptions of traditional waxing vs. computer-aided crown design and to determine the effectiveness of either technique through comparative grading of the final products. On one of twoidentical tooth preparations, second-year students at one dental school fabricated a wax pattern for a full contour crown; on the second tooth preparation, the same students designed and fabricated an all-ceramic crown using computer-aided design (CAD) and computer-aided manufacturing (CAM) technology. Projects were graded for occlusion and anatomic form by three faculty members. On completion of the projects, 100 percent of the students (n=50) completed an eight-question, five-point Likert scalesurvey, designed to assess their perceptions of and learning associated with the two design techniques. The average grades for the crown design projects were 78.3 (CAD) and 79.1 (wax design). The mean numbers of occlusal contacts were 3.8 (CAD) and 2.9(wax design), which was significantly higher for CAD (p=0.02). The survey results indicated that students enjoyed designing afull contour crown using CAD as compared to using conventional wax techniques and spent less time designing the crown using CAD. From a learning perspective, students felt that they learned more about position and the size/strength of occlusal contacts using CAD. However, students recognized that CAD technology has limits in terms of representing anatomic contours and excursive occlusion compared to conventional wax techniques. The results suggest that crown design using CAD could be considered as an adjunct to conventional wax-added techniques in preclinical fixed prosthodontic curricula.
Maxillary "All-On-Four" treatment using zygomatic implants. A mechanical analysis.
de Moraes, P H; Olate, S; Nóbilo, M de Arruda; Asprino, L; de Moraes, M; Barbosa, J de Albergaría
2016-04-01
Zygomatic implants may be used for dental rehabilitation in atrophic maxillae. The aim of this study was to establish experimentally the areas of stress distribution using 2 kinds of "All-On-Four" maxillary procedures. The best position to insert the implants was selected using polyurethane craniomaxillary models and surgical guides were made. Group 1 was designed with two posterior zygomatic implants and two conventional anterior implants, and group 2 with two posterior zygomatic implants and two anterior zygomatic implants. A titanium bar was built to link the 4 implants in both groups. Photoelastic replicas of these models were made and the implants were inserted using the surgical guides. An Instrom 4411 testing machine was used to perform a unilateral compressive loading at the level of the right first molar until 2mm of displacement was obtained. Group 1 showed a high strain concentration in the right lateral orbital region at the level of the apex of the zygomatic implant. Less strain was noticed at the apical levels of the conventional implants in the anterior sector and of the contralateral zygomatic implant. Group 2 showed high strains in the lateral inferior orbital area. The load was low in the alveolar bone sector. Zygomatic bone and paranasal structures are loaded at high levels when zygomatic implants are used to stabilize a full maxillary prosthodontic rehabilitation on 4 implants. The use of 4 zygomatic implants loads the alveolar bone to a lower extent and seems better suited from a mechanical point of view than the use of 2 zygomatic implants. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Relationship and inter observer agreement of tooth and face forms in a Saudi subpopulation.
Habib, Syed Rashid; Shiddi, Ibraheem Al; Al-Sufyani, Mohammed D; Althobaiti, Fahad A
2015-04-01
To determine the relationship of tooth form with the face form by different observers and further investigate the inter observer agreement on tooth forms, face forms, their relationship among male Saudis. A comparative cross-sectional study. Department of Prosthodontics, College of Dentistry, King Saud University, Riyadh, KSA, from February till August 2013. Ninety four male participants aged 18 - 35 years were randomly recruited for the study. Full-face and anterior teeth (intraoral) digital photographs in the frontal plane were recorded. The outline tracings of the face and the tooth were obtained using Autocad (version 2010) software. The outline of the tooth was enlarged proportionately, without altering the length to width ratio to fit the face outline. The outlines were then evaluated visually by 6 prosthodontists and results were tabulated. The most common type of face form (49.65%) and tooth form (56.38%) was square tapering. Using the visual method, a good relationship (31.41%), moderate relationship (35.31%), weak relationship (19.68%) and no relationship (13.65%) between the tooth form and face form was found by the observers. Overall kappa for inter observer agreement on face form, tooth form and their relationship was 0.24, 0.17 and 0.26 respectively. The kappa values showed a fair agreement between the observers. The study results indicated that there was no highly defined relationship between the tooth form and face form in the studied Saudi subpopulation. A fair agreement was found between the observers for classifying the tooth forms, face froms and their relationship.
Effect of the bitterness of food on muscular activity and masticatory movement.
Okada, Yamato; Shiga, Hiroshi
2017-10-01
The purpose of this study was to clarify the effect of the bitterness of food on muscular activity and masticatory movement. Twenty healthy subjects were asked to chew a non-bitter gummy jelly and a bitter gummy jelly on their habitual chewing side. The masseter muscular activity and the movement of mandibular incisal point were recorded simultaneously. For all cycles excluding the first cycle, parameters representing the muscular activity (total integral value and integral value per cycle) and masticatory movement (path, rhythm, and stability) were calculated and compared between the two types of gummy jellies. The total integral value of masseter muscular activity during the chewing of bitter gummy jelly was significantly smaller than during the chewing of non-bitter gummy jelly, however, no definite trends in the integral value per cycle and the stability of movement were observed. The parameters representing the movement path tended to be small during the chewing of bitter gummy jelly than during the chewing of non-bitter gummy jelly. The masticatory width was significantly smaller during the chewing of bitter gummy jelly. The parameters representing the rhythm of movement were significantly longer during the chewing of bitter gummy jelly than during the chewing of non-bitter gummy jelly. From these results it was suggested that the bitterness of food does not affect the integral value per cycle or the stability of the masticatory movement, but it does affect the movement path and rhythm, with narrowing of the path and slowing of the rhythm. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Relationship between masticatory performance using a gummy jelly and masticatory movement.
Uesugi, Hanako; Shiga, Hiroshi
2017-10-01
The purpose of this study was to clarify the relationship between masticatory performance using a gummy jelly and masticatory movement. Thirty healthy males were asked to chew a gummy jelly on their habitual chewing side for 20s, and the parameters of masticatory performance and masticatory movement were calculated as follows. For evaluating the masticatory performance, the amount of glucose extraction during chewing of a gummy jelly was measured. For evaluating the masticatory movement, the movement of the mandibular incisal point was recorded using the MKG K6-I, and ten parameters of the movement path (opening distance and masticatory width), movement rhythm (opening time, closing time, occluding time, and cycle time), stability of movement (stability of path and stability of rhythm), and movement velocity (opening maximum velocity and closing maximum velocity) were calculated from 10 cycles of chewing beginning with the fifth cycle. The relationship between the amount of glucose extraction and parameters representing masticatory movement was investigated and then stepwise multiple linear regression analysis was performed. The amount of glucose extraction was associated with 7 parameters representing the masticatory movement. Stepwise multiple linear regression analysis showed that the opening distance, closing time, stability of rhythm, and closing maximum velocity were the most important factors affecting the glucose extraction. From these results it was suggested that there was a close relation between masticatory performance and masticatory movement, and that the masticatory performance could be increased by rhythmic, rapid and stable mastication with a large opening distance. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Digitised evaluation of speech intelligibility using vowels in maxillectomy patients.
Sumita, Y I; Hattori, M; Murase, M; Elbashti, M E; Taniguchi, H
2018-03-01
Among the functional disabilities that patients face following maxillectomy, speech impairment is a major factor influencing quality of life. Proper rehabilitation of speech, which may include prosthodontic and surgical treatments and speech therapy, requires accurate evaluation of speech intelligibility (SI). A simple, less time-consuming yet accurate evaluation is desirable both for maxillectomy patients and the various clinicians providing maxillofacial treatment. This study sought to determine the utility of digital acoustic analysis of vowels for the prediction of SI in maxillectomy patients, based on a comprehensive understanding of speech production in the vocal tract of maxillectomy patients and its perception. Speech samples were collected from 33 male maxillectomy patients (mean age 57.4 years) in two conditions, without and with a maxillofacial prosthesis, and formant data for the vowels /a/,/e/,/i/,/o/, and /u/ were calculated based on linear predictive coding. The frequency range of formant 2 (F2) was determined by differences between the minimum and maximum frequency. An SI test was also conducted to reveal the relationship between SI score and F2 range. Statistical analyses were applied. F2 range and SI score were significantly different between the two conditions without and with a prosthesis (both P < .0001). F2 range was significantly correlated with SI score in both the conditions (Spearman's r = .843, P < .0001; r = .832, P < .0001, respectively). These findings indicate that calculating the F2 range from 5 vowels has clinical utility for the prediction of SI after maxillectomy. © 2017 John Wiley & Sons Ltd.
Chowdhury, Nafees Uddin; Otomaru, Takafumi; Murase, Mai; Inohara, Ken; Hattori, Mariko; Sumita, Yuka I; Taniguchi, Hisashi
2011-01-01
An objective assessment of speech would benefit the prosthetic rehabilitation of maxillectomy patients. This study aimed to establish a simple, objective evaluation of monosyllable /sa/ utterances in maxillectomy patients by using a psychoacoustic system typically used in industry. This study comprised two experiments. Experiment 1 involved analysis of the psychoacoustic parameters (loudness, sharpness and roughness) in monosyllable /sa/ utterances by 18 healthy subjects (9 males, 9 females). The utterances were recorded in a sound-treated room. The coefficient of variation (CV) for each parameter was compared to identify the most suitable parameter for objective evaluation of speech. Experiment 2 involved analysis of /sa/ utterances by 18 maxillectomy patients (9 males, 9 females) with and without prosthesis, and comparisons of the psychoacoustic data between the healthy subjects and maxillectomy patients without prosthesis, between the maxillectomy patients with and without prosthesis, and between the healthy subjects and maxillectomy patients with prosthesis. The CV for sharpness was the lowest among the three psychoacoustic parameters in both the healthy males and females. There were significant differences in the sharpness of /sa/ between the healthy subjects and the maxillectomy patients without prosthesis (but not with prosthesis), and between the maxillectomy patients with and without prosthesis. We found that the psychoacoustic parameters typically adopted in industrial research could also be applied to evaluate the psychoacoustics of the monosyllable /sa/ utterance, and distinguished the monosyllable /sa/ in maxillectomy patients with an obturator from that without an obturator using the system. Copyright © 2010 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Thomason, J M; Kelly, S A M; Bendkowski, A; Ellis, J S
2012-01-01
The McGill consensus statement on overdentures (14) was published following a symposium held at McGill University in Montreal, Canada in 2002. A panel of relevant experts in the field stated that: The evidence currently available suggests that the restoration of the edentulous mandible with a conventional denture is no longer the most appropriate first choice prosthodontic treatment. There is now overwhelming evidence that a two-implant overdenture should become the first choice of treatment for the edentulous mandible (14). In 2009, a further consensus statement was released as a support and follow-up to the McGill consensus statement. This report was jointly created by members of the BSSPD (British Society for the Study of Prosthetic Dentistry) Council and the panel of presenters at the BSSPD conference in York, UK in April 2009 (15). This report also highlighted that since the McGill statement in 2002, uptake by dentists of implant technology for complete denture wearers has been slow. The York statement concluded that 'a substantial body of evidence is now available demonstrating that patients' satisfaction and quality of life with ISOD mandibular overdentures is significantly greater than for conventional dentures. Much of this data comes from randomised controlled trials (15). Whilst it is accepted that the two-implant overdenture is not the gold standard of implant therapy it is the minimum standard that should be sufficient for most people, taking into account performance, patient satisfaction, cost and clinical time. Copyright © 2011 Elsevier Ltd. All rights reserved.
Clark, Glenn T; Mulligan, Roseann; Baba, Kazuyoshi
2011-04-01
This article reports on the lessons learned while teaching an 8-week-long online course about the principles of clinical research design in Japan. Student activity data and how it relates to performance in the course are presented. As prolog, this article focuses on the barriers and solutions to creating and delivering a web-based course and it lists and discusses the most common concerns that educators often have about this process, namely, cost of the system and time requirement of the faculty. Options that must be considered when selecting the support software and hardware needed to conduct live streaming lecture, online video-based conference course are presented. The ancillary role of e-mail based distribution lists as an essential instruction tool within an interactive, instructor-supervised online course is discussed. This article then discusses the inclusion of active learning elements within an online course as well as the pros and cons regarding open-book versus closed book, proctored testing. Lastly, copyright issues the online instructor should know about are discussed. The student tracking data show that as the course progresses, students will reduce the number for page viewings. We speculate that this reduction is due to a combination of conflicting priorities plus increasing efficiency of the students at extracting the critical information. The article also concludes that software and hardware costs to deliver an online course are relatively minor but the faculty's time requirement is initially substantially higher than teaching in a conventional face-to-face course. Copyright © 2011 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Muddugangadhar, B C; Sangur, Rajashekar; Rudraprasad, I V; Nandeeshwar, D B; Kumar, B H Dhanya
2015-01-01
This study compared the flow rate and pH of resting (unstimulated) and stimulated whole saliva before and after complete denture placement in different age groups. Fifty healthy, non-medicated edentulous individuals of different age groups requiring complete denture prostheses were selected from the outpatient department. The resting (unstimulated) and stimulated whole saliva and pH were measured at three stages i.e., i)Before complete denture placement;ii)Immediately after complete denture placement; andiii)After 2 to 3 months of complete denture placement. Saliva production was stimulated by chewing paraffin wax. pH was determined by using a digital pH meter. Statistically significant differences were seen in resting(unstimulated) and stimulated whole salivary flow rate and pH obtained before, immediately after, and after 2 to 3 months of complete denture placement. No statistically significant differences were found between the different age groups in resting (unstimulated) as well as stimulated whole salivary flow rate and pH. Stimulated whole salivary flow rates and pH were significantly higher than resting (unstimulated) whole salivary flow rates and pH obtained before, immediately after, and after 2 to 3 months of complete denture placement. No age related variations in whole salivary flow rate and pH were observed in healthy, non-medicated individuals. The assessment of salivary flow rate, pH in different age groups is of prognostic value, which is an important aspect to be considered in the practice of removable prosthodontics.
Alhajj, Mohammed Nasser; Amran, Abdullah Ghalib; Halboub, Esam; Al-Basmi, Abdulghani Ali; Al-Ghabri, Fawaz Abdullah
2017-07-01
This study aimed at developing the Arabic version of the Orofacial Esthetic Scale (OES-Ar) and to investigate its psychometric properties among Arabic-speaking population with and without esthetic impairments. Translation and cross-cultural adaptation was done according to the standard guidelines. Internal consistency was assessed on 230 participants. For test-retest reliability, 50 subjects with natural teeth were recalled within a period of 2 weeks. Validity of the OES-Ar was tested by construct, convergent, and discriminant validity tests. Responsiveness to esthetic changes was assessed in 60 patients. The results showed excellent internal consistency with Cronbach's alpha value of 0.92 and inter-item correlation average value of 0.60. The ICC values ranged from 0.87 to 0.96 which indicated excellent agreement. Construct validity of the OES-Ar was confirmed to be one-factor structure (one-dimensional). For convergent validity, a significant correlation was found between OES summary score and overall impression of the orofacial esthetic as well as between OES summary score and the summary score of the three questions of the OHIP-49Ar related to esthetic. The discriminant validity test revealed significant differences between different study groups (P<0.001). Responsiveness to treatment was confirmed by significant differences between pre- and post-treatment OES total summary score (P<0.001). The OES-Ar has excellent psychometric properties making it valuable instrument to assess orofacial esthetics in Arabic-speaking patients. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Pesson, D M; Bakou, O D; Didia, E L E; Kouame, A; Blohoua, M R J J; Djeredou, K B
2015-12-01
Access to cervical margins allows the practitioner to record the entire cervical margin in order to provide a true copy to the technician. This requires a gingival displacement obtainable by different techniques. This study aimed to assess the implementation of gingival displacement methods prior to impression taking in fixed prosthodontics. This is a descriptive and cross-sectional survey of sample of 71 dentists practising in Abidjan, Ivory Coast; which ran from October 2nd, 2010 to November 14th, 2010. A survey form was administered to dentists. The questionnaire was organised around the following headings: identification of dentists and practice of gingival displacement methods. The data processing done using software Epi Info 6 and Excel XP on Window XP, allowed calculation of frequencies, means and proportions and the establishment of connection between variables with the chi2 test. The significance level was set at p < 0.05. The results of the survey indicate that non-surgical methods of gingival displacement, including retraction cords and temporary crowns are those they use most frequently (76.4%) because the vast majority of practitioners (87.22%) believe the most traumatic to the periodontium are surgical methods. Our study showed that the gingival displacement methods are frequently carried out in daily practice, regardless of the topography of the abutment teeth and their number, but with a preference for non-surgical methods, particularly those using retraction cords and temporary crowns. The use of injectable gingival displacement paste is not harmful to the periodontal tissues, easy to use and have a very efficient haemostatic action. It should also be known and practiced.
Dry mouth: a critical topic for older adult patients.
Han, Phuu; Suarez-Durall, Piedad; Mulligan, Roseann
2015-01-01
Diminished salivary flow, or dry mouth impacts the oral health of many older adults, dentate and edentulous. As a result typical oral conditions can prove more challenging to both the patient's comfort and home care and the treatment selected by the clinician. This paper will review issues of dry mouth from a clinical and symptomatic perspective and will include the condition's causes, treatment and prevention. We performed a review of PubMed using the words: older adults, dry mouth, xerostomia, radiation-induced xerostomia, and salivary gland hypofunction. We selected 90 articles with a clinical application perspective. When it comes to treatment of dry mouth conditions, either objective or subjective, there are no easy answers as to the best course of action for a specific individual. While most of the cited studies have examined the most difficult cases of dry mouth (e.g., Sjögren's syndrome, and that seen during and post head and neck cancer treatments), there are many older adults who demonstrate dry mouth from the use of multiple medications. This paper presents a summary of the etiology, diagnosis, prevention, and pharmacological and non-pharmacological treatment of dry mouth (salivary hypofunction and xerostomia in older adults). It is important to understand the causes of dry mouth and to educate our patients. Starting a prevention program as early as possible considering the most practical, cost effective and efficient treatments with the best risk-benefit ratio will help to diminish dry mouth symptoms and sequelae. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Berge, Morten E; Berg, Einar; Ingebrigtsen, Jana
2013-05-01
The curriculum of the dental faculty at the University of Bergen, Norway, was revised and a new curriculum implemented in 1998 based on the principles of holistic teaching and patient-centered treatment. The first candidates graduated in 2003. The change of curricula, experience gained, and lack of an evidence base for holistic teaching justify a general discussion of all relevant aspects associated with this approach. The purpose of this article was to make a contribution towards such a discussion. A PubMed search regarding holistic teaching in dentistry was performed. Of the 211 entries on holistic teaching, few discussed holism in depth; none reported outcome measures comparing old and new curricula. Data collected from students graduating in 2003 (new curriculum) and 2000 (old curriculum) on their satisfaction with the teaching comprise a possible outcome measure. In most respects, using prosthodontics as an example, no differences between the two groups of students were found. Students studying under the new holistic curriculum were less satisfied than those studying under the old one regarding the number of available teachers and teachers' feedback on student performance. Both holistic teaching/patient-centered treatment and a more traditional subject-specific approach have advantages and disadvantages, and neither can be practiced in its pure form for ethical and practical reasons. The quantitative results of this study did not support the hypothesis that holism improved students' satisfaction with the teaching. A wide discussion of holism in dental education is needed, along with outcome measures when curricula are changed.
Alani, A; Kelleher, M; Hemmings, K; Saunders, M; Hunter, M; Barclay, S; Ashley, M; Djemal, S; Bishop, K; Darbar, U; Briggs, P; Fearne, J
2015-05-08
Cosmetic dentistry has become increasingly popular, largely as a result of social trends and increased media coverage. This understandable desire for the alleged 'perfect smile' needs to be tempered with an appropriate awareness of the significant risks associated with invasive cosmetic procedures such as veneers and crowns. Patients need to be properly informed that elective removal of healthy enamel and dentine can result in pulpal injury and poorer periodontal health in the longer term, particularly if they are young. The duty of candour means that they ought to be informed that aggressive reduction of sound tooth tissue is not biologically neutral and results in structural weakening of their teeth. Less invasive procedures such as bleaching on its own or for example, combined with direct resin composite bonding, can satisfy many patient's demands, while still being kinder to teeth and having much better fall-back positions for their future requirements. It is the opinion of the British Endodontic Society, British Society for Restorative Dentistry, Restorative Dentistry UK, Dental Trauma UK, British Society of Prosthodontics and the British Society of Paediatric Dentistry that elective invasive cosmetic dental treatments can result in great benefit to patients, but that some aggressive treatments used to achieve them can produce significant morbidities in teeth which were previously healthy. This is a worrying and growing problem with many ethical, legal and biologic aspects, but many adverse outcomes for patients who request cosmetic dental improvements are preventable by using biologically safer initial approaches to treatment planning and its provision.
Arora, Mansi; Kohli, Shivani; Kalsi, Rupali
2016-05-01
Dual arch impression technique signifies an essential improvement in fixed prosthodontics and has numerous benefits over conventional impression techniques. The accuracy of working dies fabricated from dual arch impression technique remains in question because there is little information available in the literature. This study was conducted to compare the accuracy of working dies fabricated from impressions made from two different viscosities of impression materials using metal, plastic dual arch trays and custom made acrylic trays. The study samples were grouped into two groups based on the viscosity of impression material used i.e. Group I (monophase), whereas Group II consisted of Dual Mix technique using a combination of light and heavy body material. These were further divided into three subgroups A, B and C depending on the type of impression tray used (metal dual arch tray, plastic dual arch tray and custom made tray). Measurements of the master cast were made using profile projector. Descriptive statistics like mean, Standard Deviation (SD) were calculated for all the groups. One way analysis of variance (ANOVA) was used for multiple group comparisons. A p-value of 0.05 or less was considered statistically significant. The gypsum dies obtained with the three types of impression trays using two groups of impression materials were smaller than the master models in dimensions. The plastic dual arch trays produced dies which were the least accurate of the three groups. There was no significant difference in the die dimensions obtained using the two viscosities of impression materials.
Iwashita, Hayato; Tsukiyama, Yoshihiro; Kori, Hidehiro; Kuwatsuru, Rika; Yamasaki, Yo; Koyano, Kiyoshi
2014-10-01
Missing posterior teeth can decrease masticatory function and cause horizontal mastication deviation, i.e., mastication predominance. Mastication predominance may lead to abnormal tooth attrition and temporomandibular disorders. This study evaluated masticatory performance and mastication predominance in patients with missing posterior teeth to investigate effects of missing posterior teeth on masticatory performance and mastication predominance. Thirty volunteers with normal dentition (control group), 30 patients with unilateral missing posterior teeth (unilateral group), and 23 patients with bilateral missing posterior teeth (bilateral group) participated. Gummy jellies were used to evaluate participants' masticatory performance, and electromyography was used to assess the degree of mastication predominance. Chewing gums, gummy jellies, and peanuts were used as foods of various hardnesses for evaluating mastication predominance. Compared with the control group, masticatory performance did not differ in the unilateral group but was significantly decreased in the bilateral group. With chewing gum and gummy jellies, the degree of mastication predominance was significantly increased in both unilateral and bilateral groups than the control group. With peanuts, the degree of mastication predominance was significantly increased in the unilateral group than the control group. Although masticatory performance was not decreased in the unilateral group, the degree of mastication predominance was increased. Decreased masticatory performance was observed in the bilateral group, and for foods with normal hardness and soft foods, the degree of mastication predominance was increased. These results suggested that mastication predominance should be considered in the recovery of masticatory performance in patients with missing posterior teeth. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Awareness, attitude, and expectations toward dental implants among removable prostheses wearers.
Al-Dwairi, Ziad N; El Masoud, Bilal Mohammed; Al-Afifi, Sanaa A; Borzabadi-Farahani, Ali; Lynch, Edward
2014-04-01
To assess removable denture patient awareness, expectations, and source of information about dental implants (DIs). Three hundred patients [150 removable partial denture (RPD) wearers and 150 complete denture wearers (CDWs)] attended the removable prosthodontic clinic at Faculty of Dentistry, Jordan University of Science and Technology. Patients were evaluated using a pilot-tested, 21-question questionnaire. Ninety-six percent of participants were aware of DIs, with no difference between CDWs and RPD wearers (p > 0.05). The participants' friends and relatives were the main source of information (63.4%), followed by dentists (32.4%). Improvement in function was the predominant reason (55.7%) for patients to consider DIs. Fear of unknown side effects was the major factor in preventing patients from choosing DIs (11.7%), followed by high cost (9.7%) and surgical risk (8.7%). Approximately 89% had no information or were poorly informed about DIs. Over two-thirds of patients did not know about the care (78.3%) of DIs, causes of DI failure (69.7%), or DI duration of service (80.7%). Only 24.7% knew that DIs would be anchored to the jawbone; however, 27.3% and 56.7% of CDWs and RPD wearers, respectively, preferred (p < 0.05) to have their teeth replaced with DIs. High costs were considered the major disadvantage of DIs in 45% of participants, followed by fear of surgery (27.3%), and long treatment times (24.7%). There was a high awareness about DIs among removable denture patients; however, this awareness was associated with a low level of accurate information. © 2013 by the American College of Prosthodontists.
Marei, Mona K.; El Backly, Rania M.
2018-01-01
Dentistry is a continuously changing field that has witnessed much advancement in the past century. Prosthodontics is that branch of dentistry that deals with replacing missing teeth using either fixed or removable appliances in an attempt to simulate natural tooth function. Although such “replacement therapies” appear to be easy and economic they fall short of ever coming close to their natural counterparts. Complications that arise often lead to failures and frequent repairs of such devices which seldom allow true physiological function of dental and oral-maxillofacial tissues. Such factors can critically affect the quality of life of an individual. The market for dental implants is continuously growing with huge economic revenues. Unfortunately, such treatments are again associated with frequent problems such as peri-implantitis resulting in an eventual loss or replacement of implants. This is particularly influential for patients having co-morbid diseases such as diabetes or osteoporosis and in association with smoking and other conditions that undoubtedly affect the final treatment outcome. The advent of tissue engineering and regenerative medicine therapies along with the enormous strides taken in their associated interdisciplinary fields such as stem cell therapy, biomaterial development, and others may open arenas to enhancing tissue regeneration via designing and construction of patient-specific biological and/or biomimetic substitutes. This review will overview current strategies in regenerative dentistry while overviewing key roles of dental mesenchymal stem cells particularly those of the dental pulp, until paving the way to precision/translational regenerative medicine therapies for future clinical use. PMID:29770323
Warin, Pongsakorn; Rungsiyakull, Pimduen; Rungsiyakull, Chaiy; Khongkhunthian, Pathawee
2018-01-01
To investigate the strains around mini-dental implants (MDIs) and retromolar edentulous areas when using different numbers of MDIs in order to retain mandibular overdentures. Four different prosthetic situations were fabricated on an edentulous mandibular model including a complete denture (CD), and three overdentures, retained by four, three or two MDIs in the interforaminal region with retentive attachments. A static load of 200N was applied on the posterior teeth of the dentures under bilateral or unilateral loading conditions. The strains at the mesial and distal of the MDIs and the retromolar edentulous ridges were measured using twelve strain gauges. Comparisons of the mean microstrains among all strain gauges in all situations were analyzed. The strain distribution determined during bilateral loading experienced a symmetrical distribution; while during unilateral loading, the recorded strains tended to change from compressive strains on the loaded side to tensile strains. Overall, the number of MDIs was found to be passively correlated to the generated compressive strain. The highest strains were recorded in the four MDIs followed by three, two MDIs retained overdenture and CD situations, respectively. The highest strain was found around the terminal MDI. The use of a low number of MDIs tends to produce low strain values in the retromolar denture-bearing area and around the terminal MDIs during posterior loadings. However, when using a high number of MDIs, the overdenture tends to have more stability during function. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Magnet-retained implant-supported overdentures: review and 1-year clinical report.
Ceruti, Paola; Bryant, S Ross; Lee, Jun-Ho; MacEntee, Michael I
2010-01-01
Open-field aluminum-nickle-cobalt magnets have been used in prosthodontics for many years, but success has been limited because these magnets are susceptible to corrosion by the saliva and because their retentive force is weak relative to the initial retention offered by mechanical attachments. More recently, magnets have been made from alloys of the rare earth elements samarium and neodymium, which provide stronger magnetic force per unit size. In addition, a new generation of laser-welded containers has improved protection from salivary corrosion. The current resurgence of interest in this type of attachment appears justified because, unlike mechanical attachments, magnets have potential for unlimited durability and might therefore be superior to mechanical ball or bar attachments for the retention of removable prostheses on implants. To date, no long-term prospective trials have been conducted to confirm the clinical durability of this new generation of magnets for retaining dentures on either teeth or implants. The aim of this study was to document initial clinical experiences and levels of satisfaction among edentulous patients treated with mandibular implant-supported overdentures retained using a new generation of rare-earth magnetic attachments. At the outset, all but one of the 17 patients had had several years of experience with implant-supported overdentures. During the first year, the mean overall satisfaction among these 17 patients increased from less than 70 to over 90 out of 100 (standardized visual analogue scale). No unusual difficulties were encountered in rendering the treatment or maintaining the attachments. This report offers preliminary evidence of the excellent potential of these magnets for retaining mandibular implant-supported overdentures.
Geriatric dentistry content in the curriculum of the dental schools in Chile.
León, Soraya; Araya-Bustos, Francisca; Ettinger, Ronald L; Giacaman, Rodrigo A
2016-09-01
The purpose of this study was to identify the status of pre-doctoral geriatric dentistry education among all Chilean dental schools. Chile is one of the most rapidly ageing countries in Latin America. Consequently, specific knowledge and training on the needs of elderly populations need to be emphasised in dental schools. The current extent and methods of teaching geriatric dentistry among the dental schools in Chile are unknown. A web-based questionnaire was developed and sent to all 19 Chilean dental schools to identify which schools had a formal programme on geriatric dentistry and ask about their format, content and type of training of the faculty who taught in the programmes. Data were analysed, and a comparison was made among the schools. Sixteen (84%) of the participant schools reported teaching at least some aspects of geriatric dentistry, using various methodologies, but only 7 (37%) had specific courses. Of those schools reporting a didactic content on geriatric dentistry, 71% included clinical training, either in the school's dental clinics or in an extramural service. Contents mostly included demographics of ageing, theories of ageing and medical conditions. More than half of the faculty (57%) stated that they had formal training in geriatric dentistry, 43% were trained in prosthodontics, public health or other areas. Although most dental schools taught geriatric dentistry, only some had a specific course. Most schools with formal courses followed the international curriculum guidelines for geriatric dentistry. © 2014 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.
Kohli, Shivani; Kalsi, Rupali
2016-01-01
Introduction Dual arch impression technique signifies an essential improvement in fixed prosthodontics and has numerous benefits over conventional impression techniques. The accuracy of working dies fabricated from dual arch impression technique remains in question because there is little information available in the literature. Aim This study was conducted to compare the accuracy of working dies fabricated from impressions made from two different viscosities of impression materials using metal, plastic dual arch trays and custom made acrylic trays. Materials and Methods The study samples were grouped into two groups based on the viscosity of impression material used i.e. Group I (monophase), whereas Group II consisted of Dual Mix technique using a combination of light and heavy body material. These were further divided into three subgroups A, B and C depending on the type of impression tray used (metal dual arch tray, plastic dual arch tray and custom made tray). Measurements of the master cast were made using profile projector. Descriptive statistics like mean, Standard Deviation (SD) were calculated for all the groups. One way analysis of variance (ANOVA) was used for multiple group comparisons. A p-value of 0.05 or less was considered statistically significant. Results The gypsum dies obtained with the three types of impression trays using two groups of impression materials were smaller than the master models in dimensions. Conclusion The plastic dual arch trays produced dies which were the least accurate of the three groups. There was no significant difference in the die dimensions obtained using the two viscosities of impression materials. PMID:27437342
Karl, M; Franz, M; Grobecker-Karl, T; Scheib, M
2017-11-13
Rapid developments in CAD/CAM technology necessitate the adaptation of curriculum content. Limited resources hinder institutions in holding state of the art equipment available for student training. A workshop given by an industry partner was organised as part of the final pre-clinical course in prosthodontics for the academic years 2015 and 2016. The workshop on dental ceramics and CAD/CAM technology comprised of lectures and practical demonstrations. Multiple-choice examinations prior to and after the workshop as well as questionnaires were used for assessing effectiveness and students' perception. The test scores and evaluation results were compared using Fisher's exact test of homogeneity (α = 0.05). The workshop improved students' performance in the written examination. With the exception of 1 question, students having attended the workshop performed significantly better (P < .05). The majority of students felt that the workshop fostered their knowledge in the field of dental ceramics and CAD/CAM. Whilst only a small portion (<10%) disapproved industry-supported education, up to 45% of the participants considered the workshop as sales promotion. The students were undecided on whether or not competitor companies should be invited to present on the same topic and whether or not more industry-supported courses would be beneficial. Industry-supported education appears to be a necessity in the field of CAD/CAM dentistry, but care has to be taken to select adequate partners, and the content of courses has to be controlled. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Heinemann, F; Mundt, T; Biffar, R; Gedrange, T; Goetz, W
2009-12-01
The aims of this case series was to evaluate the success rate of implants and their restorations, the sinus bone graft resorption, and the marginal bone loss around the implants when nanocristalline HA embedded in a silica matrix was exclusively used as grafting material. In 13 partially edentulous patients of a private practice having missing teeth in the posterior maxilla and a subantral bone height between 3 and 7 mm, 19 sinus augmentations (100% Nanobone, Artoss, Rostock, Germany) by the lateral lift technique were performed. The implants (Tiolox/Tiologic Implants, Dentaurum, Ispringen, Germany) were simultaneously placed. After 6 to 9 months 37 implants were restored with fixed dental prostheses. The clinical evaluation included peri-implant parameters, periotest measurements and the restorations. The radiographic bone heights over time were estimated with linear mixed models. The implant success rate was 100% after three years. The periotest values (between -7 and -6) after implant abutment connection indicated a solid osseointegration. The mean rates of the marginal bone loss over the first year were higher (mesial: -0.55, distal: -0.51 mm) than the annual rates thereafter (mesial: -0.09 mm, distal: -0.08 mm). The mean rates of changes in the total bone height were neglectable (<0.2 mm) and not significant. The prosthodontic and esthetic evaluation revealed a successful outcome. Within the limits of this clinical report it may be concluded that maxillary sinus augmentation using 100% nanocristalline HA embedded in a silica matrix to support implants is a reliable procedure.
Dynamic Modelling of Tooth Deformation Using Occlusal Kinematics and Finite Element Analysis.
Benazzi, Stefano; Nguyen, Huynh Nhu; Kullmer, Ottmar; Kupczik, Kornelius
2016-01-01
Dental biomechanics based on finite element (FE) analysis is attracting enormous interest in dentistry, biology, anthropology and palaeontology. Nonetheless, several shortcomings in FE modeling exist, mainly due to unrealistic loading conditions. In this contribution we used kinematics information recorded in a virtual environment derived from occlusal contact detection between high resolution models of an upper and lower human first molar pair (M1 and M1, respectively) to run a non-linear dynamic FE crash colliding test. MicroCT image data of a modern human skull were segmented to reconstruct digital models of the antagonistic right M1 and M1 and the dental supporting structures. We used the Occlusal Fingerprint Analyser software to reconstruct the individual occlusal pathway trajectory during the power stroke of the chewing cycle, which was applied in a FE simulation to guide the M1 3D-path for the crash colliding test. FE analysis results showed that the stress pattern changes considerably during the power stroke, demonstrating that knowledge about chewing kinematics in conjunction with a morphologically detailed FE model is crucial for understanding tooth form and function under physiological conditions. Results from such advanced dynamic approaches will be applicable to evaluate and avoid mechanical failure in prosthodontics/endodontic treatments, and to test material behavior for modern tooth restoration in dentistry. This approach will also allow us to improve our knowledge in chewing-related biomechanics for functional diagnosis and therapy, and it will help paleoanthropologists to illuminate dental adaptive processes and morphological modifications in human evolution.
Variation in work tasks in relation to pinch grip strength among middle-aged female dentists.
Ding, Hebo; Leino-Arjas, Päivi; Murtomaa, Heikki; Takala, Esa-Pekka; Solovieva, Svetlana
2013-11-01
We aimed to investigate the relationship of task variation during dental work history with pinch grip strength among dentists. We measured pinch grip strength among 295 female Finnish dentists aged 45-63 years. Variation in dental work tasks during work history was empirically defined by cluster analysis. Three clusters of task variation emerged: low (most work time in restoration treatment/endodontics), moderate (about 50% in the former and 50% in prosthodontics/periodontics/surgery), and high (variable tasks including administrative duties). Hand radiographs were examined for the presence of OA in the wrist and each joint of the 1-3rd fingers. Information on hand-loading leisure-time activities, and joint pain was obtained by questionnaire. Glove size was used as a proxy for hand size. BMI (kg/m2) was based on measured weight and self-reported height. Dentists with low variation of work task history had an increased risk of low pinch grip strength in the right hand (OR 2.3, 95% CI 1.2-4.3), but not in the left (1.13, 0.62-2.08), compared to dentists with high task variation, independent of age, hand size, hand-loading leisure-time activities, BMI and symptomatic hand OA. The dentists with the most hand-loading tasks were at an increased risk of low pinch grip strength, independent of e.g. symptomatic hand OA. It is advisable among dentists to perform as diverse work tasks as possible to reduce the risk of decreased pinch grip strength. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.
Garlapati, Tejesh Gupta; Krithikadatta, Jogikalmat; Natanasabapathy, Velmurugan
2017-10-01
This in-vitro study tested the fracture resistance of endodontically treated molars with Mesial-Occluso-Distal (MOD) cavities restored with fibre reinforced composite material everX posterior in comparision with hybrid composite and ribbond fiber composite. Fifty intact freshly extracted human mandibular first molars were collected and were randomly divided into five groups (n=10). Group 1: positive control (PC) intact teeth without any endodontic preparation. In groups 2 through 6 after endodontic procedure standard MOD cavities were prepared and restored with their respective core materials as follows: group 2, negative control (NC) left unrestored or temporary flling was applied. Group 3, Hybrid composite (HC) as a core material (Te-Econom Plus Ivoclar Vivadent Asia) group 4, Ribbond (Ribbond; Seattle, WA, USA)+conventional composite resin (RCR) group 5, everX posterior (everX Posterior GC EUROPE)+conventional composite resin (EXP) after thermocycling fracture resistance for the samples were tested using universal testing machine. The results were analysed using ANOVA and Tukey's HSD post hoc tests. Mean fracture resistance (in Newton, N) was group 1: 1568.4±221.71N, group 2: 891.0±50.107N, group 3: 1418.3±168.71N, group 4:1716.7±199.51N and group 5: 1994.8±254.195N. Among the materials tested, endodontically treated teeth restored with everX posterior fiber reinforced composite showed superior fracture resistance. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
B, Sreedevi; Anne, Gopinadh; Manne, Prakash; Bindu O, Swetha Hima; Atla, Jyothi; Deepthi, Sneha; Chaitanya A, Krishna
2014-01-01
Background: Prosthodontic treatment involves clinical procedures which influence speech performance directly or indirectly. Prosthetic rehabilitation of missing teeth with partial or complete maxillary removable dentures influences the individual voice characteristics like Phonation, resonance etc. Aim: To evaluate the effect of Acrylic palatal plate thickness (1mm-3mm) of maxillary prosthesis on phonation. Materials and Methods: Twelve subjects were selected randomly between the age group of 20-25 years who have full complement of teeth and have no speech problems. Speech evaluation was done under four experimental conditions i.e. Without any experimental acrylic palatal plate (control), with experimental acrylic palatal plates of thickness 1 mm, 2 mm and 3 mm respectively. The speech material for phonation test consisted of Vowels sounds /a/, /i/, and /o/. Speech analysis to assess phonation was done using digital acoustic analysis (PRAAT software). The obtained results were statistically analyzed by One-way ANOVA and Tukey’s multiple post-hoc for comparison of four experimental conditions with respect to different vowel sounds. Results: Mean harmonics to noise ratio (HNR) values obtained for all the Experimental conditions did not show significant difference (p>0.05). In conclusion, an increase in the thickness of the acrylic palatal plate of maxillary prosthesis for about 1 mm - 3mm in complete or partial maxillary removable dentures resulted in no significant effect on phonation of vowel sounds /a/, /i/ and /o/. Conclusion: Increasing the thickness of the palatal plate from 1 mm to 3 mm has not shown any significant effect on the phonation. PMID:24959508
Robison, Nathan E; Tantbirojn, Daranee; Versluis, Antheunis; Cagna, David R
2016-08-01
Denture tooth fracture or debonding remains a common problem in removable prosthodontics. The purpose of this in vitro study was to explore factors determining failure strengths for combinations of different denture tooth designs (shape, materials) and injection or compression molded denture base resins. Three central incisor denture tooth designs were tested: nanohybrid composite (NHC; Ivoclar Phonares II), interpenetrating network (IPN; Dentsply Portrait), and microfiller reinforced polyacrylic (MRP; VITA Physiodens). Denture teeth of each type were processed on an injection molded resin (IvoBase HI; Ivoclar Vivadent AG) or a compression molded resin (Lucitone 199; Dentsply Intl) (n=11 or 12). The denture teeth were loaded at 45 degrees on the incisal edge. The failure load was recorded and analyzed with 2-way ANOVA (α=.05), and the fracture mode was categorized from observed fracture surfaces as cohesive, adhesive, or mixed failure. The following failure loads (mean ±SD) were recorded: NHC/injection molded 280 ±52 N; IPN/injection molded 331 ±41 N; MRP/injection molded 247 ±23 N; NHC/compression molded 204 ±31 N; IPN/compression molded 184 ±17 N; MRP/compression molded 201 ±16 N. Injection molded resin yielded significantly higher failure strength for all denture teeth (P<.001), among which IPN had the highest strength. Failure was predominantly cohesive in the teeth, with the exception of mixed mode for the IPN/compression group. When good bonding was achieved, the strength of the structure (denture tooth/base resin combination) was determined by the strength of the denture teeth, which may be affected by the processing technique. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
Application of photogrammetry for analysis of occlusal contacts.
Shigeta, Yuko; Hirabayashi, Rio; Ikawa, Tomoko; Kihara, Takuya; Ando, Eriko; Hirai, Shinya; Fukushima, Shunji; Ogawa, Takumi
2013-04-01
The conventional 2D-analysis methods for occlusal contacts provided limited information on tooth morphology. This present study aims to detect 3D positional information of occlusal contacts from 2D-photos via photogrammetry. We propose an image processing solution for analysis of occlusal contacts and facets via the black silicone method and a photogrammetric technique. The occlusal facets were reconstructed from a 2D-photograph data-set of inter-occlusal records into a 3D image via photogrammetry. The configuration of the occlusal surface was reproduced with polygons. In addition, the textures of the occlusal contacts were mapped to each polygon. DIFFERENCE FROM CONVENTIONAL METHODS: Constructing occlusal facets with 3D polygons from 2D-photos with photogrammetry was a defining characteristic of this image processing technique. It allowed us to better observe findings of the black silicone method. Compared with conventional 3D analysis using a 3D scanner, our 3D models did not reproduce the detail of the anatomical configuration. However, by merging the findings of the inter-occlusal record, the deformation of mandible and the displacement of periodontal ligaments under occlusal force were reflected in our model. EFFECT OR PERFORMANCE: Through the use of polygons in the conversion of 2D images to 3D images, we were able to define the relation between the location and direction of the occlusal contacts and facets, which was difficult to detect via conventional methods. Through our method of making a 3D polygon model, the findings of inter-occlusal records which reflected the jaw/teeth behavior under occlusal force could be observed 3-dimensionally. Copyright © 2012 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Does artificial aging affect mechanical properties of CAD/CAM composite materials.
Egilmez, Ferhan; Ergun, Gulfem; Cekic-Nagas, Isil; Vallittu, Pekka K; Lassila, Lippo V J
2018-01-01
The purpose of this study was to determine the flexural strength and Weibull characteristics of different CAD/CAM materials after different in vitro aging conditions. The specimens were randomly assigned to one of the six in vitro aging conditions: (1) water storage (37°C, 3 weeks), (2) boiling water (24h), (3) hydrochloric acid exposure (pH: 1.2, 24h), (4) autoclave treatment (134°C, 200kPa, 12h), (5) thermal cycling (5000 times, 5-55°C), (6) cyclic loading (100N, 50,000 cycles). No treatment was applied to the specimens in control group. Three-point bending test was used for the calculation of flexural strength. The reliability of the strength was assessed by Weibull distribution. Surface roughness and topography was examined by coherence scanning interferometry. Evaluated parameters were compared using the Kruskall-Wallis or Mann-Whitney U test. Water storage, autoclave treatment and thermal cycling significantly decreased the flexural strength of all materials (p<0.05), whereas HCl exposure or cyclic loading did not affect the properties (p>0.05). Weibull moduli of Cerasmart™ and Lava™ Ultimate were similar with control. Vita Enamic ® exhibited similar Weibull moduli in all aging groups except the HCl treated group (p>0.05). R a values of Cerasmart™ and Lava™ Ultimate were in the range of 0.053-0.088μm in the aged groups. However R a results of Vita Enamic ® were larger than 0.2μm. Flexural strength of newly developed restorative CAD/CAM materials was significantly decreased by artificial aging. Cyclic loading or HCl exposure does not affect to the flexural strength and structural reliability of Cerasmart™ and Lava™ Ultimate. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Lajnert, Vlatka; Kovacevic Pavicic, Daniela; Pavlic, Andrej; Pokrajac-Bulian, Alessandra; Spalj, Stjepan
2018-06-01
To create and validate a brief questionnaire designed for the assessment of satisfaction with smile aesthetics and to test its efficiency as a patient-centred outcome measure of aesthetic interventions in dentistry. A team of three specialists - two from prosthodontics and one psychologist - used a self-evaluation scale consisting of five elements in order to rate self-perceived smile aesthetics. A total of 671 subjects (63% female), 18-86 years of age, were included in the investigation. The internal consistency, validity and stability of the questionnaire, along with the responsiveness induced by the tooth-whitening procedure, were evaluated. The relationship between self-perceived satisfaction with the smile aesthetics and the clinical status of the dentition was assessed. The questionnaire had one dimension accounting for 64.3% of variance and showed a high level of reliability (Cronbach α = 0.859). It measured a construct similar to concern with tooth appearance and the desire to improve this appearance (r = -0.403 and r = -0.353, respectively; P < 0.001). High test-retest reliability was demonstrated (intraclass correlation coefficient = 0.985). The questionnaire was able to detect an increase in satisfaction with smile aesthetics as a result of the tooth-whitening procedure (P = 0.016). Clinical predictors of greater satisfaction with smile aesthetics were greater tooth display when smiling, decreased chroma and the absence of gingivitis, as well as absence of crowded, fractured and restored teeth in the anterior segment. A new questionnaire, titled the Smile Aesthetics Satisfaction Scale (SASS), showed good psychometric properties and its use can be recommended. © 2018 FDI World Dental Federation.
An overview of U.S. predoctoral dental implant programs and their directors.
Barwacz, Christopher A; Avila-Ortiz, Gustavo; Allareddy, Veerasathpurush; Tamegnon, Monelle; Hoogeveen, Kaitlin
2015-03-01
The aim of this study was to provide an overview of current predoctoral implant programs in the United States, including curricular characteristics and clinical practices regarding implant therapy education and program directors' characteristics. An electronic survey was sent to predoctoral implant program directors of all 64 accredited U.S. dental schools; 52 of the 60 eligible programs responded, for a response rate of 87%. The responding program directors were primarily affiliated with either prosthodontics departments (44%) or restorative dentistry departments (40%). Structurally, 80.8% of the responding schools integrate their implant programs into the third year of the curriculum. Clinical implant therapy exercises reported were simulation exercises without direct patient care (90.4% of responding schools) and direct patient care under supervision (94.2%). The most frequently taught restorative modalities are posterior single-tooth implant crown (96.2%), mandibular implant-retained overdenture (88.5%), and anterior implant-supported single crown (61.5%). A majority (74.5%) of responding programs utilize analog surgical guide planning, while 25.5% reported use of digital guided surgery planning software. All schools in the Northwest and 66.7% in the South Central regions utilize custom abutments as the primary abutment design, while a majority of schools in the North Central (62.5%), Northeast (53.8%), Southwest (66.7%), and Southeast (80%) regions use stock abutments (p=0.02). Regional differences were significant with regard to fixation modality, with all the Northwest programs using screw retention and 90% of Southeast and 87.5% of North Central programs using cement retention (p=0.002). This study demonstrated that while institutions share program director and curricular similarities, clinical practices and modalities vary significantly by region.
Minakuchi, Hajime; Sogawa, Chiharu; Hara, Emilio Satoshi; Miki, Haruna; Maekawa, Kenji; Sogawa, Norio; Kitayama, Shigeo; Matsuka, Yoshizo; Clark, Glenn T; Kuboki, Takuo
2014-10-01
The aim of this study was to evaluate the correlation between sleep bruxism (SB) frequency and serotonin transporter (SERT)-driven serotonin (5-HT)-uptake in platelets. Subjects were dental trainee residents and faculty members of Okayama University Hospital who were aware of having severe or no SB. SB frequency was assessed for 3-consecutive nights by a self-contained electromyographic detector/analyzer, which indicated individual SB levels as one of four grades (score 0, 1, 2 and 3). Subjects were classified as normal control (NC) when SB scores indicated only 0 or 1 during the 3 nights, or as severe SB for scores 2 or 3. Those subjects whose scores fluctuated from 0 to 3 during the 3 nights were omitted from further analysis. Fasting peripheral venous blood samples were collected in the morning following the final SB assessment. Amounts of SERTs proteins collected from peripheral platelets were quantified using ELISA, and SERTs transport activity was assessed by uptake assay using [3H]-5-HT. Thirteen severe SB subjects and 7 NC subjects were eligible. Gender distribution, mean age, 5-HT concentration and total amounts of SERT protein in platelets showed no significant differences between NC and severe SB (p=0.85: Chi-squared test; p=0.64, 0.26, 0.46: t-test). However, [3H]-5-HT uptake by platelets was significantly greater in NC compared to severe SB subjects (12.79±1.97, 8.27±1.91 fmol/10(5) platelets/min, p<0.001, t-test). The results of this pilot study suggest a possible correlation between peripheral platelet serotonin transporter uptake ability and SB severity. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Kim, Dong-Yeon; Kim, Ji-Hwan; Kim, Hae-Young; Kim, Woong-Chul
2018-01-01
To evaluate the marginal and internal gaps of cobalt-chromium (Co-Cr) alloy copings fabricated using subtractive and additive manufacturing. A study model of an abutment tooth 46 was prepared by a 2-step silicone impression with dental stone. Fifteen stereolithography files for Co-Cr alloy copings were compiled using a model scanner and dental CAD software. Using the lost wax (LW), wax block (WB), soft metal block (SMB), microstereolithography (μ-SLA), and selected laser melting (SLM) techniques, 15 Co-Cr alloy copings were fabricated per group. The marginal and internal gaps of these Co-Cr alloy copings were measured using a digital microscope (160×), and the data obtained were analyzed using the non-parametric Kruskal-Wallis H-test and post-hoc Mann-Whitney U-test with Bonferroni correction. The mean values of the marginal, axial wall, and occlusal gaps were 91.8, 83.4, and 163μm in the LW group; 94.2, 77.5, and 122μm in the WB group; 60.0, 79.4, and 90.8μm in the SMB group; 154, 72.4, and 258μm in the μ-SLA group; and 239, 73.6, and 384μm in the SLM group, respectively. The differences in the marginal and occlusal gaps between the 5 groups were statistically significant (P<.05). The marginal gaps of the LW, WB, and SMB groups were within the clinically acceptable limit, but further improvements in the μ-SLA and SLM approaches may be required prior to clinical implementation. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
Usefulness of a rotation-revolution mixer for mixing powder-liquid reline material.
Yamaga, Yoshio; Kanatani, Mitsugu; Nomura, Shuichi
2015-01-01
The purpose of this study was to evaluate the distribution of bubbles, degree of mixing, flowability and mechanical strength of powder-liquid reline material by manually and with a rotation-revolution (planetary) mixer, and to determine the usefulness of a rotation-revolution mixer for this application. Powder-liquid reline material (Mild Rebaron, GC, Tokyo, Japan) was mixed with a powder to liquid ratio of 1:0.62 according to the manufacturer's instruction. Two methods were used to mix it: mixed by manually ("manual-mixing") and automatically with a rotation-revolution mixer (Super Rakuneru Fine, GC, Tokyo, Japan; "automatic-mixing"). Disc-shaped specimens, 30 mm in diameter and 1.0mm in thickness, were used to observe the distribution of bubbles in at 10× magnifications. Flowability tests were carried out according to the JIS T6521 for denture base hard reline materials. A three point bending test was carried out by a universal testing machine. Elastic modulus and flexural stress at the proportional limit were calculated. A median of 4 bubbles and inhomogeneous were observed in manual-mixed specimens. However, no bubbles and homogeneous were observed in automatic-mixed specimens. Flowability was within the JIS range in all mixing conditions and did not differ significantly across conditions. The elastic modulus was the same for manual-mixed and automatic-mixed specimens. On the other hand, the flexural stress at the proportional limit differed significantly between manual-mixed and automatic-mixed specimens. The results confirm that rotation-revolution mixer is useful for mixing powder-liquid reline material. Automatic-mixing may be recommended for clinical practice. Copyright © 2014 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.