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Biomedical subjects

J S Brudvik

Publications and source records attributed to J S Brudvik.

At least 19 recordsLinked to original sources

Relationship between the standards of removable partial denture construction, clinical acceptability, and patient satisfaction.

STATEMENT OF PROBLEM: Little is known about the importance of published fabrication standards in determining the outcome of treatment with mandibular distal extension removable partial dentures in patients of community practices. PURPOSE: This study describes mandibular partial dentures worn by patients from King County, Wash., and examines the validity of standards of design and fabrication by relating the standards to measures of clinical acceptability and patient satisfaction. MATERIAL AND METHODS: Eighty-two people treated in private dental practices who responded to a mail survey about satisfaction with a partial denture were examined. Eight standards of fabrication, overall clinical acceptability of the prosthesis, and tissue health were evaluated clinically. Patient satisfaction was assessed by questionnaire. Associations between variables were assessed by contingency tables and odds ratios. RESULTS: Half the prostheses met 4 or fewer of the 8 standards, and these were responsible for nearly all the displacement of tissue by the framework. Forty-three percent of the dentures (35/82) were rated clinically acceptable. Of the remaining dentures, 38 could be made acceptable by modifications. The remaining 9 dentures needed replacement. Sixty-three percent of the patients examined were satisfied with the dentures. There was a relationship between tissue health and the fabrication standards related to rest form, base extension, stress distribution, and framework fit. This study found no relation between tissue health and other design or fabrication features. None of the standards were found to be related to patient satisfaction. CONCLUSION: This study found partial support for the validity of design/fabrication standards for removable partial dentures. The most important standards are rest form, base extension, and stress distribution. The standards appear to be unrelated to patient satisfaction.

Dental Stress Analysis↗

Surgical template for completely edentulous patients.

Implant angulation is of utmost importance for fabrication of esthetic, hygienic, and functional prostheses, even in the treatment of completely edentulous patients. Most mandibular surgical templates are not reliable because of a lack of stability resulting either from severe resorption of the mandible or from the interference of mucoperiosteal flaps elevated during surgery. This article describes a technique for fabrication and surgical application of a stable template for the completely edentulous mandible. By combining the mandibular template with a maxillary duplicate denture, the problem of lack of stability can be overcome. A consistently reliable reference for implant placement in the edentulous mandible, specifically in relation to implant angulation (trajectory), can be obtained.

Acrylic Resins↗

The swing-lock removable partial denture in clinical practice.

The authors of this article consider that the swing-lock partial denture has a useful place in contemporary clinical dental practice and offers many advantages compared with conventional removable partial dentures in terms of retention and stability, especially in the extremely compromised dentitions. Here they describe the concept of the swing-lock removable partial denture, together with the indications, contraindications, technical and clinical considerations.

Dental Abutments↗

A new procedure to reinforce fixed provisional restorations.

The typical unreinforced fixed partial denture provisional restoration commonly fails because of fractures and loss of cement retention. A procedure to reinforce the provisional restoration with a substructure of orthodontic band material has dramatically increased the longevity of this restoration. The procedure requires commonly available materials without a significant increase in cost or construction time.

Acrylic Resins↗

The tooth-removable partial denture interface.

During the metal finishing phase of removable partial denture construction, metal is removed from all aspects of the casting. The amount removed from areas designed to contact prepared surfaces of abutments is critical to the resulting fit of the partial. Castings were evaluated before and during finishing procedures to measure metal loss at the tooth-removable partial denture interface. Finishing and fitting techniques for controlling the loss of metal are presented.

Calibration↗

In vitro two-body wear of inlay-onlay composite resin restoratives.

Inlay-onlay composite resin restorations have been introduced to the profession as alternatives to amalgam and direct composite resins. Two-body wear testing was performed on three inlay-onlay resins and one direct composite resins using a machine designed to produce sliding wear. The composite resins were opposed by human enamel, type III gold alloy, and porcelain. Of the investigated materials, the homogeneously microfilled inlay-onlay material showed significantly less wear. The direct composite resin showed significantly the greatest wear. The hybrid inlay-onlay resins showed intermediate wear. The hybrid inlay-onlay resins and the direct composite (small particle, heavily filled) resin created wear tracks in the opposing surfaces while the homogeneous microfill inlay-onlay resin did not. The depth of the observed wear tracks in the opposing surface was sufficiently substantial to warrant further investigation into the wear of materials that oppose composite resin restorations.

Analysis of Variance↗

Adaptation of a visible light-cured denture base material.

The Triad light-cured resin system appears to have potential for making processed record bases for special patients. The close adaptation of this material to the dental cast often results in internal voids and defects. These defects are greatly reduced when a dry cast is used instead of one with a high moisture content. Vacuum-assisted adaptation using a sheet of rubber dam in connection with a vacuum adaptor also results in an improved internal surface. Finger pressure alone is not a dependable method of adaptation.

Composite Resins↗

Evaluation of hard direct reline resins.

Peak curing temperatures of hard, direct, autopolymerizing reline resin materials tested were all within ADA specification guidelines. A temperature range of 10 degrees C was demonstrated among materials, with the highest polymerization temperatures recorded for Perm and Lang's Self-Curing Rebase Acrylic, and the lowest for KOOLiner, Flexacryl, and COE-Rect. This temperature difference is probably clinically detectable. However, intraoral testing of polymerization temperatures yielded lower peak values than those observed with specification testing, and the temperature peaks occurred earlier with intraoral conditions. There were significant color changes with simulated aging for three of the products tested: Flexacryl, COE-Rect, and Lang's Self-Curing Rebase Acrylic. The color changes occurred after only 24 hours of accelerated aging. Although there was only a small change in color with aging for Perm and KOOLiner, there was a moderate shift in the color of KOOLiner (delta E = 2.2) before aging. Thus only Perm demonstrated little color change with simulated aging. Of the reline products, one material, KOOLiner, demonstrated lower bond tensile strengths to denture base materials. However, the clinical significance of this was not known. One denture base material (Astron) recorded significantly higher bond strength values for all reline products and failure always took place within the denture base.

Chemical Phenomena↗

Influence of polishing on cast clasp properties.

During the polishing of clasps, two possible changes that could affect their properties are thinning of the clasp and work hardening of the alloy. Two distinctly different clasp pattern forms were selected and 20 samples of each were cast. They were then divided into two groups, polished and unpolished, in an effort to determine the total influence of the polishing procedure on clasp behavior. The results indicate that polishing produces a slightly more flexible clasp. Any influence resulting from possible work hardening is offset by the reduction of clasp thickness. Effects of width/thickness ratios and magnitude of deflections on finishing and polishing techniques may also alter clasp flexibility in the polished clasp.

Dental Polishing↗

Clinical evaluation of removable partial denture rest seat adaptation.

The clinical relationship between the removable partial denture cast occlusal rest and the corresponding rest seat was examined. Under the conditions of the study, it was found that rests of mandibular Class I and II removable partial dentures fit significantly better than those of mandibular Class III and IV prostheses. No significant difference was noted between similar types of maxillary removable partial dentures in this regard. In evaluating the fit of specific portions of the occlusal rest, it was found that the marginal ridge zone was more closely adapted to the rest seat than other zones for all types of removable partial dentures. However, contact, as defined in this analysis, was found to exist on a random basis in all four quadrants of the occlusal rests evaluated. In spite of this fact, one fifth of the occlusal rests did not contact the opposing rest seat at any point. Improved fit with length of service was not substantiated by a cross-sectional analysis. Suggestions were made to assist the clinician in achieving a better fit between the framework and dentition in removable partial dentures.

Dental Abutments↗

Clinical evaluation of patients eight to nine years after placement of removable partial dentures.

Removable partial dentures, constructed following principles outlined in this study, provided reasonable service for an 8- to 9-year period for patients who were wearing them. The oral hygiene of the patients was less than ideal. Few teeth were lost by patients in the study. There were no significant differences in caries incidence, changes in sulcus depths, tooth mobility, or alveolar bone loss between patients who were wearing their dentures and those who were not. There were increased levels of gingival inflammation seen in regions covered by the removable partial dentures and in gingivae apical to clasp arms. Other than these findings, there seemed to be no direct evidence that the removable partial dentures were causing dental or periodontal breakdown.

Adult↗

Soldering of removable partial dentures.

Both high- and low-heat removable partial denture alloys were soldered with combinations of different solders and heat sources. The soldered specimens were subjected to tensile strength testing, and a ranking of joint strength was developed. Joint strengths that were 85% as strong as the as-cast metal were created in both alloy types when 0.800 fine solder was used with an electrosoldering device as a heat source. All other combinations tested resulted in greater reductions in joint strength.

Dental Alloys↗