Biomedical subjects
Publications and source records attributed to B R Lang.
Three-dimensional coordinate measuring machines for examining the quality of industrial castings were reviewed. The concept was modified and successfully converted to examine the minute geometric configurations of the surfaces of dental materials. The wear of composites has undoubtedly precipitated this perceptive, thorough study.
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In a group of 18 partially edentulous patients provided with immediate complete dentures, changes in hyoid bone position and craniocervical posture were examined on cephalometric radiographs made during 1 year of denture use. The findings indicated that the changes in hyoid bone position largely followed the pattern of forward-upward rotation of the mandible due to ridge resorption. During this course the hyoid position in relation to the cervical spine showed a mean increase. The hyocervical changes, however, showed less variability than the hyomaxillary and hyomandibular changes. The posture of the head and cervical column showed no definite mean changes during the 1-year period. On the other hand, analysis of individual changes revealed that a pronounced decrease in mandibular inclination due to ridge resorption was associated with retroclination of the cervical column and decreased craniocervical angulation. These postural changes may be regarded as adaptive changes to a marked initial change in mandibular position.
A practical approach to restoring the edentulous patient to full occlusion is no easy task. It requires the dentist to establish a philosophy of occlusion, select an occlusal concept to be used with the philosophy, and then choose an occlusal scheme to satisfy the concept and fulfill the philosophy. Several combinations of molds can be used in this manner. Of the three presented, the Trubyte functional/rational combination was found most acceptable. The requirements and techniques in the use of this combination were described.
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In a sample of fifteen partially edentulous subjects assigned for immediate complete denture treatment, a correlation analysis was performed between pre-extraction facial morphology determined from lateral cephalograms, and EMG activity of the anterior temporal and masseter muscles in maximal clench and tapping of teeth. Marked correlations observed between vertical and sagittal jaw relations and mean voltages of the jaw-closing muscles indicated strong biting activity in subjects with a square facial type. No significant associations were observed between biting strength and the age of the subjects. Correlations between facial morphological changes and changes in EMG biting activity after denture insertion and during 1 year of denture wear indicated that the anterior temporal muscles were extremely sensitive to sagittal changes in anterior occlusion. The masseter muscles were less sensitive, but responded in some instances to changes in vertical jaw relationship.
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A factorially designed experiment was chosen to form alloys of a gold-palladium-silver-copper quaternary system. A total of 81 alloys for three levels of concentration of each of the four elements were made and tested for the degree of tarnish in in vivo and in vitro environments. The following conclusions may be drawn: 1. In both the in vitro and in vivo experiments, increasing the gold levels of concentration within an alloy decreased the degree of tarnish. 2. In both the in vitro and in vivo experiments, increasing the palladium levels of concentration within an alloy decreased the degree of tarnish with an influence greater than that produced by the gold content. 3. In the in vitro environment of 2% sodium sulfide solution, the degree of tarnish increased as the levels of concentration of silver to copper were increased. 4. In both the in vitro and in vivo experiments, the effect of the interaction of the four elements on the degree of tarnish and corrosion is directly related not only to the concentration of each element within the alloy, but also to their ratios.
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EMG study of subjects wearing immediate complete upper and lower dentures revealed marked alterations in activity of the jaw closing muscles during the biting actions recorded. This finding suggests that changes in jaw and occlusal relationships due to resorption of residual ridges and settling of the dentures also affects jaw muscle activity. The relations between EMG and morphologic findings will be analyzed further in a separate article.
In eighteen subjects assigned for immediate complete upper and lower dentures, roentgen cephalometric recordings were made before extraction of the residual anterior dentition and 3 weeks, 3 months, 6 months and 1 year after denture insertion. The cephalometric analysis was based on electronic measurements of linear and angular morphological variables and computer head plots generated from 177 reference points (Walker, 1967), derived for each subject for each of the five observation stages. The reduction of the alveolar ridges was most rapid during the first 3 months of denture wear and particularly during the post-extraction period of 3 weeks. The reduction in anterior height of the lower ridge was on average twice as great as that of the upper ridge. The ridge resorption and the accompanying settling of the dentures on the basal seats, measured from lead shots inserted in the dentures, brought about an upward rotation of the mandible with a resulting decrease in occlusal vertical dimension and reduction in overjet of the dentures. In accordance with the amount of ridge reduction, these changes showed great individual variation.
This article has reported on a preliminary study of selected criteria used by The University of Michigan, School of Dentistry Complete Denture Department. Self-evaluation opportunities by students and assessment of performance by instructors using objective criteria have been developed for each phase of complete denture prosthodontics and placed within a text illustrating methods to reach the desired standards. Agreement between all evaluations of the selected criteria studied occurred on 75% of the responses, while agreement by instructors experienced with criteria evaluations occurred on 81%. Further, extensive study into quality assessment must be initiated within the educational setting before valid and reliable criteria can be developed for the private sector. Additional research will be critical to peer-review mechanisms which attempt to be more than grievance committees.
The purpose of this project was to evaluate and report on the timing of procedures involved in complete denture service based on criteria for assessment of quality and to determine the effectiveness of a model of such a delivery system in terms of success of treatment and reduction of cost. It can be concluded that the denture care system may and can be used as a model to provide the base line reference to compare with other denture care delivery systems; the use of criteria for assessment of quality is not only efficient, but is also practical; and a complete denture treatment service of the quality defined by the criteria developed for this model can be provided to patients.
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