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PubMed2000

The use of a bone block graft from the chin for alveolar ridge augmentation.

Periodontal disease and tooth loss often leave the patient with an alveolar ridge that is less than adequate for endosseous implant placement. Alveolar bone grafting offers a clinically successful treatment option to regain all or some of this lost bone. This article describes the use of a bone block from the chin for the augmentation of the alveolar ridge. It relates the clinical techniques to the healing process in an effort to better understand the events involved.

Alveolar Ridge Augmentation↗
PubMed2000

Aesthetic considerations for the treatment of partially edentulous patients with removable dentures.

Treatment with removable partial dentures (RPDs) is an affordable solution for anterior or posterior tooth loss. In determining a proper treatment solution, it is important for the clinician to consider the patient's aesthetic expectations, socioeconomic situation, and the prognosis for the prosthesis and remaining dentition. This article presents guidelines to optimize the aesthetic result of this treatment and considers framework and clasp concepts; rotational path design; minimal extension of the denture bases; auxiliary attachments or retentive bars; and implants for retention and support of RPDs.

Dental Clasps↗
PubMed2003

[Composite-bonded bridges reinforced with Ribbond THM ribbon: an alternative of choice to other temporary prosthetic methods].

In the presence of anterior unitary tooth loss, the therapeutical arsenal of the practitioner remains the implant solution. But, at the young patients who have not completed their growth, it's necessary to pass by a transitional stage. The bonded bridges reinforced by a polyethylene fibbers splint such as Ribbond THM constitute an alternative of choice to solve the aesthetic damage in the short and medium term while waiting for the prosthesis with implant. It's a similar case that is reported through this article.

Adolescent↗
PubMed1996

Caries prevalence in the dentition of a late eighteenth century population.

Remains of 92 individuals of known age and a further 71 of unknown age were selected from nearly 1000 skulls exhumed from the crypt of Christ Church, Spitalfields. Ante- and post-mortem tooth loss was assessed and caries prevalence and distribution were studied. Post-mortem loss of teeth was highest in the oldest age group, suggesting that greater care is needed during exhumation to minimize this loss. Juvenile caries levels were high, especially on occlusal surfaces of deciduous molars. Approximal caries was less frequently seen and buccal and lingual sites were only slightly less frequently involved than approximal sites. Root caries was rare, even in the oldest age group. There were differences in prevalence and distribution between males and females but not between those of English and French origins. Caries levels were generally higher in those born after 1750. It is suggested that factors other than diet and oral hygiene may have influenced caries prevalence in this population.

Age Factors↗
PubMed1996

Caries prevention. A continued need worldwide.

This paper provides a global perspective of the changing prevalence, severity, distribution and pattern of dental caries. The prevalence of caries in children and adolescents has declined in most developed countries and it is now a minority of young people who experience most of the disease. All forms of caries have reduced in prevalence but pits and fissures are the surfaces most frequently involved. The caries experience and levels of edentulousness in the adult populations of developed countries have also declined. The prevalence of caries in adults is remarkably constant with age but in older subjects root caries is becoming more prevalent. However, in many developing countries the prevalence of caries in young children is high and is increasing in those populations who are adopting a cariogenic diet. In countries such as Kenya and China, caries is the major cause of tooth loss but levels of edentulousness are low. There are considerable variations in disease levels between and within countries and it is evident that lower socio-economic and certain racial groups exhibit high levels of dental caries. It is essential to sustain the benefit of fluoride to those already receiving it and encourage the use of appropriate and effective strategies and products by those who are not. Water and salt fluoridation should be implemented where deemed feasible and the use of a clinically proven and affordable fluoride toothpaste should be encouraged.

Adolescent↗
PubMed1997

Perceived masticatory function among elderly people.

This study investigated the status and associations of perceived chewing ability of a group of 891 elderly people, aged 55-91 years (average age 66 years). The majority of subjects (69%) considered that they could chew well. Only 9% reported poor chewing ability. This judgement was not associated with age. More men (11%) than women (6%) had reported poor chewing ability. Subjects with better perceived general and craniomandibular health reported better chewing ability. However, although related to permanent tooth loss, the perception of chewing ability was not seemingly associated with prosthetic rehabilitation. All elderly subjects with complete dental arches had no complaints of perceived chewing difficulty. Freedom from symptoms of craniomandibular pain when chewing, bilateral chewing activity and a wide choice of food range or textures were associated with favourably perceived chewing ability. This study identifies several suitable criteria for judging masticatory function and suggests that these may be used to complement chewing ability as an alternative measure of masticatory performance. These criteria are applicable to the elderly person, in particular, and warrant adequate clinical application.

Adaptation, Psychological↗
PubMed2002

Evaluating dental status and prosthetic need in relation to medical findings in Greek patients suffering from idiopathic Parkinson's disease.

Parkinson's disease is one of the common neurological conditions which predominantly affects the elderly but increasingly also younger people. Sufferers present persistent problems with oral health aggravated by extensive tooth loss leading to an impaired dentition. Greece and other countries experiencing the same demographic trends, face growing numbers of sufferers. This study surveyed the dental status and the need for dental treatment of a sample of Greek patients with Parkinson's disease. A structured questionnaire was used. 30% of the participants were younger sufferers. 80% of the elderly group were young elderly. 98% of the participants were denture wearers. Extensive oral problems were recorded in all participants.

Activities of Daily Living↗
PubMed2005

Prosthetic management of an epileptic patient.

This case report illustrates the problems of tooth loss in an epileptic patient. The patient presented with a broken denture following a seizure. She gave a history of breaking and swallowing her dentures during seizures. Before presentation she had worn five upper removable partial dentures. An upper removable partial denture with increased thickness of the acrylic palatal was fabricated and fitted satisfactorily. The patient was taught how to insert and remove the prosthesis as quickly as possible. Epileptic patients can use dentures but run the risk of frequently breaking and swallowing them during seizures. The risk can be reduced if patients and relatives are taught how to remove the dentures prior to or during seizures.

Adult↗
PubMed2005

Perceptions of Chandigarh sports coaches regarding oro-facial injuries and their prevention.

Enthusiastic participation by the younger generation in sports exposes them to a high risk of injuries. In the present study, the perceptions of sports coaches regarding their knowledge and experience of such injuries is evaluated. The coaches considered helmet as the most common protective device followed by mouth guard and facemask. About 58% observed that boxing was associated with oro-facial injuries and protective devices were deemed mandatory by 68% in this event. About 45% saw over five injuries in the last year, mostly soft tissue facial injuries (47%) and tooth loss (33%). Most injuries were in hockey and 32% were due to hits by ball, stick or related hard objects. About 82% were related to nonuse of protective devices. The majority of coaches considered that oro-facial devices be made more popular among sportspersons for their safety while 28% felt they reduced efficiency. The author concludes that there is a need to popularize the use of oro-facial protective devices in a variety of sports events in our country by interacting with coaches, sports administrators and sportspersons as well as familiarizing the Indian dentists in this relatively new field.

Adult↗
PubMed1999

Short and sticky options in the treatment of the partially dentate patient.

As we move into the twenty-first century, patterns of dental disease in adults are changing. Surveys of adult dental health indicate that more people are keeping their teeth for longer in life. In many cases, the ravages of dental disease and the cumulative effect of a lifetime of restorative dentistry lead to gradual tooth loss. For many of these patients, restoration of a complete dentition may not be feasible nor desirable. In recent years, functionally oriented treatment planning has become acceptable in light of recent research findings. Using this approach, treatment efforts and resources are directed principally at retaining the 'strategic' part of the dentition in the long term, ie, the anterior and premolar teeth. This paper describes, with the aid of treated cases, a means of combining a shortened dental arch strategy with resin bonded bridgework. With the aid of recent research in this area of clinical practice, some suggestions as to the use of the technique are also described.

Adult↗
PubMed1999

Quantitative evaluation of the effect of bolus size and number of chewing strokes on the intra-oral mixing of a two-colour chewing gum.

One of the major aims of the dental profession is the maintenance of oral function, specifically chewing ability. However, there are no generally accepted measures of chewing ability or even general agreement as to what level of tooth loss is deemed to require clinical intervention. There is therefore a need for simple objective tests of oral function. In this study a modification of the two-colour chewing gum test devised by Liedberg & Owall (1991, 1995) is described. In this test chewing gum containing two contrasting colours is chewed. On removal from the mouth the bolus is placed in a transparent plastic bag, flattened and a digital image is taken. Several image processing techniques are described and evaluated as measures of the amount of mixing present in the chewed gum. Flattening the gum was found to increase the accuracy of subjective evaluation, which was similar to that achieved by the image processing techniques.

Chewing Gum↗
PubMedDate not supplied

Effect of clenching level on mandibular displacement in Kennedy Class II partially edentulous patients.

PURPOSE: Forceful clenching in the intercuspal position has the potential to cause significant mandibular displacement. Such a displacement can be expected to be exaggerated in patients without molar support. The appropriate clenching level for intercuspal position registration or evaluation in these patients has never been clarified. The aim of this study was to clarify the effect of clenching level and absence of posterior occlusal support on mandibular displacement. MATERIALS AND METHODS: Thirteen women with a unilateral edentulous area posterior to the first premolar were enrolled in this study. They were asked to perform intercuspal clenching at various occlusal force levels, and 3-D mandibular displacements were measured by an optoelectronic method. The effects of "clenching force level" and "side of molar tooth loss" on the displacements of the condylar and second molar points were analyzed. RESULTS: The mandible was elevated without substantial horizontal displacements during each clenching task. The effect of clenching level on vertical mandibular displacement was significant, with a clenching level > or = 50% of maximal voluntary contraction causing significantly greater elevations (P < .05). Clenching > or = 50% of maximal voluntary contraction caused consistent tipping of the mandible, with greater elevation on the edentulous side (P < .05). CONCLUSION: The clenching level should not surpass 50% of maximal voluntary contraction for registration or evaluation of intercuspal position in Kennedy Class II patients.

Aged↗
PubMed1991

[Intellectual development in cases with normal occlusion and malocclusions].

Purpose of this study is to evaluate psychical maturity of two orthodontic groups of examinees. Sample consists of 640 children: 320 are (E) orthognathous (160 girls and 160 boys) and 320 are (PS) dysgnathous (160 girls and 160 boys). They are classified according to their age (7-14 years) into 32 groups, 20 examinees each. The dysgnathous subjects have a specific malocclusion; early tooth loss or secondary crowding. The evaluation of psychical maturity is based on the general success in school and the results of the intelligence test of the "Raven's Progressive Matrices", both are expressed in points. The results are statistically treated and presented in tables and graphs. PS children, in the analyzed sample, develop psychically slower than E children. PS examinees have lower score (in points) of general success in school, as well as in results of the intelligence test. Although the difference in the arithmetic means obtained by the results of the intelligence test between E and PS subjects is statistically significant, (t = 6.76; P = 0.009), clinically it is not considered significant and it is not interpretable, (as when expressed in points it amounts to only two points).

Adolescent↗
PubMed2000

Successful aging--the case for prosthetic therapy.

Reduced chewing ability in community-dwelling older people is linked to the presence of removable dentures and having fewer than 20 natural teeth present. Compensation is provided by chewing longer and swallowing larger food particles. Replacement of posterior tooth loss by fixed or removable prostheses increases the activity of the masticatory muscles, and reduces chewing time and the number of chewing strokes until swallowing. In residents of nursing homes and long-term care facilities undernutrition is prevalent because of general medical problems, reduced appetite, and poor quality of life. Poor oral health and xerostomia are often present and may have a negative effect on masticatory function and nutrition, precipitating avoidance of difficult-to-chew foods. There is no evidence that the provision of prosthetic therapies can markedly improve dietary intakes; however, it might improve oral comfort and quality of life and avoid enteral alimentation.

Aged↗
PubMed1992

Remaining teeth, oral dryness and dental health habits in middle-aged Norwegian rheumatoid arthritis patients.

The aim of the study was to assess the effect of rheumatoid arthritis (RA) upon dental health. A questionnaire was mailed to all seropositive rheumatoid arthritis (RA) patients aged 44-56 yr in the files of the two main departments of rheumatology in South Eastern Norway. Data were obtained from 125 patients, constituting 91% of the target group. The number of remaining teeth in these patients was not related to disease duration or physical dysfunction, whereas a relationship to prolonged use of medication for pain relief was indicated. Factors known to affect tooth loss in the general population, such as smoking habits, dental attendance, interdental cleaning habits, previous dental disease, and place of residence were found to be important in RA patients as well. The RA patients from Oslo had a mean number of 25 remaining teeth, which is the same as reported for the general Oslo population at this age. Oral dryness was reported by more than 50% of the RA patients, but was not related to the number of teeth. The conclusion is that serious and long lasting rheumatoid arthritis had little influence on the number of remaining teeth in this middle-aged group of Norwegians.

Acetaminophen↗
PubMed1998

Periodontal diseases and dental implants in older adults.

Older adults present special problems for the dentist trying to establish or reestablish esthetics. Periodontal diseases are of concern for this population since tooth loss from these widespread problems increases with age. In general, this loss occurs because of increased exposure time to pathogenic bacteria, not some change inherent in the body brought on by the aging process. The profession has begun to place more emphasis on systemic risk factors and their role in modifying periodontal inflammation. The current thinking is that bacteria are necessary to initiate and sustain periodontal diseases, but the clinical manifestation is dictated to a significant extent by systemic factors. Smoking, diabetes, and being positive for the interleukin-1 genotype predispose the patient to developing more severe disease. For those older adults who lose teeth, dental implants have emerged as reliable replacements, and concerns about placing these devices in patients who have lost teeth as a result of periodontitis appear to be largely unfounded.

Aged↗
PubMed1991

Oral prosthodontic rehabilitation for traumatic sports injuries.

Sports injuries to the mouth and oral cavity may be treated with a variety of prosthetic treatment methods. These may include a temporary removable appliance, especially when adjacent teeth are unrestored and free of caries. Other traditional forms of prosthetic rehabilitation can range from conventional clasped removable partial dentures to traditional fixed prosthesis. The use of clip bar overdentures has demonstrated their clinical acceptability, especially for athletes involved in contact sports. The optimal treatment for patients suffering tooth loss, however, is the use of the osseointegrated implant. This concept, developed and refined by P.I. Branemark, permits successful replacement of single as well as multiple lost teeth. Criteria for patient selection must be evaluated carefully, especially for immediate fixture placement in sockets of avulsed teeth. Professional athletes in high-impact contact sports should receive a resilient prosthesis and protective appliance to use during the sport season, followed by a screw-retained nonremovable prosthesis to be used in the off season. Considering all forms of prosthodontic treatment available to patients with missing teeth, the use of osseointegrated implants currently appears to be the most biologically conservative approach. Retrospective studies document the effectiveness of the treatment of partially edentulous jaws, results similar or better than those reported for fully edentulous patients indicate the effectiveness of the Branemark method of osseointegration.

Athletic Injuries↗
PubMed1996

Oral health of representative samples of Germans examined in 1989 and 1992.

This paper presents selected results of two recent representative cross sectional studies of oral health in the German population, conducted by the IDZ (Institute of German Dentists) for the old Federal States (the former Federal Republic of Germany) in 1989 (n= 1741) and the new Federal States (the former German Democratic Republic) in 1992 (n=1519). Each epidemiological study reported both clinical and sociological data. The following average DMFT values were determined: for the children aged 8/9 yr: 1.4; for the adolescents aged 13/14 yr: 4.9; for the adults aged 35-44 yr: 16.1; and for the adults aged 45-54 yr: 17.9. These are the overall averages for "Germany West" and "Germany East" combined. The overall results for periodontal health in adults were as follows: CPITN 0: 4.9%; CPITN 1:11.2%; CPITN 2: 24.6%; CPITN 3: 42.7%; and CPITN 4:16.6% for the adults aged 35-44 yr and CPITN 0: 2.4%; CPITN 1: 8.1%; CPITN 2: 20.4%; CPITN 3: 46.8%; and CPITN 4: 22.3% for the adults aged 45-54 yr. The following average tooth loss figures were calculated for Germany as a whole: age group 35-44 yr: 3.9 missing teeth; age group 45-54 yr: 7.7 missing teeth. In addition, all the morbidity data determined have been analysed for statistical significance in the comparison between "West" and "East" Germany. The prevalences presented are also differentiated according to the socioeconomic status (SES) of the subjects, with the lower social strata as a whole showing higher morbidity prevalences. Comparisons show that caries has declined significantly among children and adolescents in Germany in the last 10-15 yr. Finally, the authors recommend the inclusion of qualitative research techniques when studying the differential causation of the inverse correlation between oral morbidity and social status.

Adolescent↗