PubMed · 393741
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N Brien. 1978. [Perhaps a simpler removable partial denture will render better service].. https://pubmed.ncbi.nlm.nih.gov/393741/
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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.
STATEMENT OF PROBLEM: Clinical stresses and situations in the mouths of patients are substantially different; thus, it is not possible to make an exact in vivo comparison of the efficiency of various mouth guards. PURPOSE: This study developed a device and a method to test and quantify the potential of mouth guards to absorb shock and evaluated and compared 5 designs for mouth guards. MATERIAL AND METHODS: Strain gauges and accelerometer sensors were mounted in various positions on the maxilla and inside an artificial skull. Sensors quantified the response of several areas of the skull to inputs of force on the maxillary teeth protected by the mouth guard being investigated. Input of force was applied to the maxillary teeth with a modal hammer equipped with a load cell. Five mouth guards of each of 5 designs were manufactured and placed in position before force was applied to the maxillary teeth. All inputs were measured and analyzed and, from those results, a method was developed to quantify the relative potential of the mouth guards to absorb shock. This method was then used to quantify the shock absorption potential of the 5 types of mouth guard designs. RESULTS: All 5 types of mouth guards provided some measure of protection and were better than no protection. However, the level of protection provided by the 5 mouth guard designs differed.
In the past, most frictional resistance studies have been conducted in a steady state condition that does not simulate the dynamics of the oral environment. Various oral functions as chewing, swallowing, speaking, etc, as well as the oral tissues contacting any orthodontic appliances, result in periodic, repetitive, minute relative motion at the bracket/arch wire interfaces several thousand times each day. This in turn affects the normal forces at the interfaces, and because frictional resistance is directly proportional to the normal force, a pilot study was undertaken to emulate the dynamic environment of the oral cavity and its effect on frictional resistance. Tests of a limited sample of stainless steel arch wires and brackets typically used in sliding mechanics revealed that frictional resistance was effectively reduced to zero each time minute relative movements occurred at the bracket/arch wire interfaces. Factors such as the degree of dental tipping, relative arch wire/slot clearances, and method of tying, did not have a measurable effect on frictional resistance in the simulated dynamics of the oral environment.