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Biomedical subjects

H M Keltjens

Publications and source records attributed to H M Keltjens.

15 recordsLinked to original sources
PubMed1992

Effects of chlorhexidine-containing gel and varnish on abutment teeth in patients with overdentures.

Previous experiments have shown that daily use of 1% chlorhexidine gel strongly reduced caries development in the abutment teeth under overdentures. The present experiment was designed to determine whether intermittent application of chlorhexidine, either in a varnish or in a gel, might be used as an alternative preventive method, less demanding for the patient. To this end, 31 patients were distributed among four treatment groups, with the number of mutans streptococci in plaque and saliva used as a balancing criterion. The treatments consisted of a single application of 40% chlorhexidine varnish, daily application of 1% chlorhexidine gel for one week, or the corresponding placebo treatments with varnish or gel without chlorhexidine. Patients were re-called for bacteriological and clinical examination at various intervals during an eight-week period following treatment. Chlorhexidine varnish and chlorhexidine gel applications significantly suppressed mutans streptococci on the abutment teeth for four and eight weeks, respectively. In agreement with earlier findings, the numbers of Actinomyces viscosus/naeslundii in plaque were significantly increased after chlorhexidine varnish treatment. The chlorhexidine gel reduced plaque accumulation and gingival bleeding for one week but had no long-lasting effect. The results seem to justify a long-term clinical test of intermittent chlorhexidine applications as an alternative for daily use in patients with overdentures.

Analysis of Variance↗
PubMed1991

Cingulum bar as a major connector for mandibular removable partial dentures.

In the international literature and textbooks, the cingulum bar as a mandibular major connector is often neglected. It is a viable alternative to a lingual bar where the distance between the marginal gingivae and the mucolingual fold is restricted. It also provides indirect retention and thereby eliminates the need for a conventional indirect retainer. Patient comfort with an RPD with a cingulum bar seems acceptable because the connector forms one unit with the anterior teeth. The replacement of a lost natural anterior tooth with a denture tooth is not difficult. The metal bulk of the bar may be a disadvantage and esthetics may be compromised if spacing is present. Marked lingual inclination of the anterior teeth prevents the use of a cingulum bar. Different laboratory requirements are discussed.

Denture Design↗
PubMed1991

Effects of fluoride and chlorhexidine on the microflora of dental root surfaces and progression of root-surface caries.

The effects of fluoride and chlorhexidine varnishes on the microflora of dental root surfaces and on the progression of root-surface caries were studied. Forty-four patients, surgically treated for advanced periodontal disease, were distributed at random among three groups. All patients received a standardized preventive treatment. Furthermore, the dentition of the patients in the two experimental groups was treated, at three-month intervals, with chlorhexidine and fluoride varnish, respectively. Patients in the control group received no additional treatment. In the experimental groups, plaque samples were collected from selected sound and carious root surfaces at baseline and at three, six, and nine months after the onset of the study. The presence of root-surface caries was scored at baseline and after one year. In addition, the texture, depth, and color of the root-surface lesions were monitored. Mutans streptococci on root surfaces were suppressed significantly (p less than 0.05) during the whole experimental period in the chlorhexidine varnish group, but not in the fluoride varnish group. A non-significant increase in the number of Actinomyces viscosus/naeslundii was noted after treatment with chlorhexidine and fluoride varnish. The increase in the number of decayed and filled root surfaces after one year was significantly lower in the experimental groups than in the control group. After treatment with chlorhexidine varnish, significantly more initial root-surface lesions had hardened than in the other groups.

Actinomyces↗
PubMed1990

Caries control in overdenture patients: 18-month evaluation on fluoride and chlorhexidine therapies.

The aim of this study was to test the clinical effects of preventive regimens using fluoride and chlorhexidine on caries development in abutment teeth in patients with overdentures. 30 patients with immediate overdentures were distributed at random among three experimental groups. In these groups three different gels (placebo, fluoride, and chlorhexidine-fluoride) were tested by daily application. The patients were recalled at 6-month intervals for a period of 18 months. The life table survival ratios at patient level showed that in the chlorhexidine group caries development in the abutments was significantly reduced. In this group no caries developed. On comparison with the control group (placebo), no preventive effects of the gel were noticed for those in the fluoride group.

Adult↗
PubMed1990

[Removable partial dentures, recent developments].

Improved preventive measures, clinical experience and improved laboratorial procedures have resulted in changes in the design of the removable partial denture. More attention is paid to esthetics, support of free-extension dentures and the biological consequences of the design. Possibilities in prosthodontics concerning these aspects are described.

Denture Design↗
PubMed1990

[Position of removable partial dentures within prosthetic dentistry].

Recent developments in restorative dentistry resulted in a shift towards elderly patients with regard to the application of removable partial dentures (RPD). The half life time of a metal frame RPD is ten years. Negative effects of a RPD on the remaining dentition can be prevented by adequate oral hygiene, which is supervised in a recall program with an individually adjusted interval. Periodontal factors seem to be more important in the design of a RPD than biomechanical factors. Simplicity is a prime guideline in the design, especially in free-end situations.

Aged↗
PubMed1990

[Treatment planning in partial prosthodontics].

The aim of the initial treatment is to eliminate active complicating factors from the partial edentulous mouth, such as caries, periodontal disease and occlusal discrepancies. After evaluation of the results of the initial treatment the prosthetic treatment can be started. A specific preparation of the mouth is necessary to accommodate the remaining dentition to the design of the removable partial denture.

Dental Caries↗
PubMed1990

[Clinical procedures in removable partial prosthodontics].

Restoring oral function with removable partial dentures includes treatments running along several steps and procedures. These treatments should be carefully planned. The dentist should know the steps to be taken to achieve the desired end result.

Denture Bases↗
PubMed1989

[Preventive treatment of high caries-risk patients].

In most patients dental caries can be prevented by the frequent application of low concentrations of fluoride (toothpaste), in addition to restricted intake of sucrose, especially of between-meals snacks. In this paper the antimicrobial treatment against S. mutans with chlorhexidine gel and with chlorhexidine varnish is outlined. In patients treated with overdentures and in periodontally treated patients these antimicrobial treatments resulted in a strong caries reduction.

Chlorhexidine↗
PubMed1987

Microbial aspects of preventive regimes in patients with overdentures.

The aim of this study was to test effects of preventive regimes using fluoride and chlorhexidine to prevent caries and periodontal diseases in 34 patients with overdentures. The patients, who were treated with immediate overdentures, were distributed at random into three experimental groups. In these groups, different gels--a placebo, a fluoride, and a chlorhexidine-fluoride gel--were tested by daily application. Supragingival plaque samples from selected surfaces of two abutment teeth were taken at one week, and at one, three, and six months after initial insertion of the overdenture. The placebo and fluoride gel influenced neither total CFU nor S. sanguis and A. viscosus/naeslundii counts. In the placebo group, but not in the fluoride group, S. mutans levels increased significantly, indicating the caries risk involved in overdentures. The use of chlorhexidine-fluoride gel resulted in a long-term suppression of total CFU. Further, S. mutans was found to be selectively suppressed to below detection level. A. viscosus/naeslundii was initially strongly suppressed, but after three months a partial return of the population was noticed. S. sanguis was relatively insensitive to the chlorhexidine-fluoride gel. It is concluded that a daily application of a chlorhexidine-fluoride gel is effective against plaque formation and S. mutans on abutment teeth in overdentures.

Actinomyces↗
PubMedDate not supplied

Effects of chlorhexidine gel on periodontal health of abutment teeth in patients with overdentures.

The aim of this study was to test the effect of chlorhexidine gel application on periodontal health of abutment teeth in patients with overdentures. 19 patients with immediate overdentures were distributed at random among 2 experimental groups. In these groups, a placebo and chlohexidine gel were daily applied. Patients were recalled at 6-month intervals over a period of 2 years. In both groups, pocket depth, tooth mobility and bleeding index were initially found to decrease after insertion of the overdenture. In the chlorhexidine group, the bleeding index remained very low over the 2-year period. Whereas in the placebo group, the bleeding index gradually returned to the baseline values. The pocket depth in the chlorhexidine group remained below the baseline value, in contrast to values in the control group. The width of the attached gingiva decreased in both the groups, but less in the chlorhexidine group.

Adult↗