Biomedical subjects
Publications and source records attributed to P Finbarr Allen.
Single tooth implant systems have been shown to offer a safe and highly predictable option for the replacement of anterior teeth. There is however, a paucity of evidence on the result of trauma to single tooth implant systems, particularly in the vulnerable anterior maxillary area. This article presents a report on the outcome of a traumatic incident to an osseointegrated single tooth implant.
UNLABELLED: Clear and effective communication of design features between dental practitioners and dental technicians has long been recognized as central to the production of high quality fixed and removable prostheses. In this respect, there is extensive evidence to demonstrate that the quality of communication achieved from general dental practice is not always adequate. Failure to communicate design features effectively can lead to errors in the fabrication of prostheses, or in the production of prostheses with a potential to cause damage to oral structures. CLINICAL RELEVANCE: The aim of this paper is to describe why it is important to communicate adequate design features clearly to dental laboratories.The paper also describes how this may be achieved for a variety of fixed and removable prostheses.
Tooth retention has increased significantly in older adults, and dentists are now challenged by the need to preserve critical teeth. There will be a need to consider endodontic therapy, and this paper describes how successful endodontics can be provided for elderly patients. Strategic treatment planning is essential, and preservation of key teeth will facilitate satisfactory oral function for elderly patients. These teeth may be important in achieving and maintaining an intact anterior dental arch, for removable partial denture retention or preservation of alveolar bone. In some cases, this can only be achieved if endodontic procedures are undertaken. When infection of a root canal is present, there is no reason why good quality endodontic therapy should not work in a healthy elderly patient. Elimination of infection can be challenging in narrow root canals, and a systematic approach for improving access into and negotiating these canals is outlined.
The 'combination syndrome' may present a considerable clinical and technical challenge to the dental practitioner. This clinical scenario classically relates to changes found in the mouth following use of a maxillary complete denture that has opposed natural mandibular anterior teeth. While this condition was first recognized over 30 years ago, the associated difficulties still pervade the practice of prosthetic dentistry today. The purpose of this article is to describe treatment of two patients who exhibited clinical features of this condition, and review some of the relevant literature on this condition.
This article describes the uses of the swing-lock retained removable partial denture in partially dentate patients where the potential for achievable retention with a conventionally designed removable partial denture is less than adequate. The article presents two case reports detailing effective use of the swing-lock concept in removable partial denture design and it is hoped that this article will increase the awareness of practitioners to the use of this prosthesis type when planning removable partial dentures.
Prosthodontic rehabilitation of patients following intra-oral surgical resection is often challenging for both the clinician and patient. With a general increase in life expectancy, it is reasonable that a definitive obturator prosthesis will need to be replaced at least once in the lifetime of a patient. The ability of a patient to become accustomed to such a new prosthesis is often limited by their increased age, and diminished neuromuscular skills and limited tissue support following surgical resection. The purpose of this paper is to describe a duplicating technique for obturator prostheses that has been adapted from conventional complete denture prosthodontics.
In Dentistry, as in other branches of Medicine, it has been recognised that objective measures of disease provide little insight into the impact of oral disorders on daily living and quality of life. A significant body of development work has been undertaken to provide health status measures for use as outcome measures in dentistry. In descriptive population studies, poor oral health related quality of life is associated with tooth loss. There is a less extensive literature of longitudinal clinical trials, and measurement of change and interpretation of change scores continues to pose a challenge. This paper reviews the literature regarding the development and use of these oral health related QoL measures and includes an appraisal of future research needs in this area.
Displaceable tissue on edentulous ridges may present a considerable clinical challenge to dental practitioners when providing complete dentures. Surgical excision techniques or use of dental implants has provided clinicians with methods of addressing this particular difficulty. However careful consideration and application of the principles of complete denture construction can provide a less invasive and less complex form of treatment. This article describes one such clinical scenario, and demonstrates the use of a suitable impression technique that is based on successful manipulation of the thermoplastic nature of the impression material.
The adequacy of prescription for fabrication of cobalt chromium removable partial dentures is often regarded as being less than ideal. This study examines the nature and quality of written instructions and master impression sent to dental laboratories in Ireland for fabrication of cobalt chromium removable partial denture frameworks. Questionnaires were issued to dental laboratories seeking specific information relating to the materials (impression materials and trays) and written instructions supplied, as well as the technicians' opinion regarding the suitability of these materials. One hundred completed questionnaires were returned. One-third of master impressions were made using a plastic stock tray and alginate; technicians felt that one-fifth of master impressions were unsuitable; almost three-fifths of written instructions were inadequate. The quality of clinical information examined was found to be less than adequate.
OBJECTIVES: Using the item-impact method, we developed an alternative short-form Oral Health Impact Profile (OHIP) that has good psychometric properties and minimal floor effects. METHODS: OHIP data were collected from a sample of older Canadians at two points in time. Data from the first administration were used to develop a 14-item short-form measure; data from the second compare the latter's psychometric properties with those of the original short form developed by Slade (1997), who used a controlled regression procedure. RESULTS: The short form based on the item-impact method had only two items in common with the short form derived from the regression approach and contained more high-prevalence items. The regression short form was subject to marked floor effects, while the impact short form had floor effects comparable to those of the full 49-item OHIP. The former discriminated between dentate and edentulous subjects, while the latter did not. Both discriminated between dentate subjects who did and did not wear dentures, those with and without dry mouth, and those with and without chewing problems. Both were also significantly associated with self-ratings of oral health, satisfaction with oral health, and self-perceived need for dental treatment. The strength of the associations was somewhat stronger with the regression short form, indicating that it performed better as a discriminatory instrument. However, because of its floor effects, it was markedly less sensitive to change than the impact short form. There was an indication that item-impact methods of shortening oral health-related quality of life measures produced more stable results across samples than the statistical approach. CONCLUSIONS: Because the content validity of short-form measures is always compromised, different short forms are required for different purposes and different patient populations. The regression short form developed by Slade (1997) is likely to be better when the aim is to discriminate, while the impact short form developed here may be preferable when the aim is to describe the oral health-related quality of life of populations or to detect change.
UNLABELLED: This article describes a technique for improving the stability of mandibular complete dentures for patients who have a diminished mandibular neutral zone. The technique involves making an impression which is shaped by the patient's oral musculature, and which defines the shape and contour of the patient's neutral zone. A case report is presented in which the use of this technique is described. It is hoped that this article will increase the awareness of dental practitioners to the use of this technique. CLINICAL RELEVANCE: The neutral zone impression technique is a useful technique when providing mandibular complete dentures. Its use can overcome some of the denture stability difficulties caused in some patients by a more powerful oral musculature, or in patients who have poor or altered neuromuscular control.
PURPOSE: The aims of this study were to investigate the quality of written instructions given to dental laboratories for fabrication of chrome-cobalt removable partial dentures (RPD) in Ireland, and to examine the extent and nature of technical/laboratory support available for the fabrication of this prosthesis type. MATERIALS AND METHODS: All dental laboratories listed in the commercial telephone book were contacted and invited to participate in the study. Written instructions received by dental technicians for fabrication of chrome-cobalt RPDs were examined for evidence of four design variables: denture base configuration, retention, support, and connector design. The use of diagrams was also examined. RESULTS: Of 112 dental laboratories listed, 100 agreed to take part. Sixteen laboratories had the facilities to fabricate chrome-cobalt frameworks on their premises; 122 sets of written instructions were received. All four design variables were described in 10% (n = 12) of instructions, 7% (n = 9) contained reference to three variables, 13% (n = 16) contained reference to two variables, and 17% (n = 20) contained reference to one variable. No design features were prescribed in 53% (n = 65), and 5% (n = 6) requested the technician to design the prosthesis. Only 7% (n = 8) of instructions included a diagram. CONCLUSION: A high proportion of written instructions to dental laboratories regarding fabrication of chrome-cobalt RPDs contained no reference to the mentioned design variables.