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Oral electrical burns occur predominantly in young children and may lead to permanent disfigurement. The etiology and histopathology of oral electrical burns are discussed. Prosthodontic treatment options are presented to provide clinical guidelines for the practitioner.
PURPOSE: This study compared the in vitro tensile bond strength of four prosthodontic adhesives to sandblasted base-metal alloy. MATERIALS AND METHODS: Alloy cylinders were bonded end-to-end with the various adhesives, thermocycled, stored for 28 days, and subjected to a tensile load. RESULTS: Mean tensile bond strengths obtained were: Panvia = 42.3 MPa, Metabond = 31.1 MPa, All-Bond = 28.06 MPa, and F21 = 18.5 MPa. Statistical analysis showed significant differences (P < .05) in mean bond strengths between the adhesive systems. CONCLUSION: Under the conditions of this study, the Panavia system showed the strongest mean tensile bond strengths.
Part I of this three-part literature review discusses the incidence of endodontic treatment required after prosthodontic procedures, whether crowns are needed on endodontically treated teeth, the primary purpose of posts, the causes of post and core failure, root fracture incidence data, and post design considerations. Pertinent questions are addressed based on the past 25 years of dental literature.
Part II of the three-part literature review series addresses factors related to prosthodontic treatment that can affect the apical seal and endodontic success.
Treatment using a Le Fort I osteotomy and sequential prosthodontic rehabilitation is presented. This treatment combination is a viable alternative therapy for the severe extrusion of posterior maxillary dento-osseous segments.
Surgical and prosthodontic implant complications are often an inadvertent sequelae of improper diagnosis, planning, and placement. These complications pose a significant challenge in implant dentistry. Presented in this article is a technique using a highly advanced software program along with a rapid prototyping technology called stereolithography. It permits graphic and complex 3D implant simulation and the fabrication of computer-generated surgical templates. These templates seat directly on the bone and are preprogrammed with the individual depth, angulation, and mesio-distal and bucco-lingual positioning of individual implants as planned during the 3D computer simulation.
49 patients participated in a prospective study of treatment of total or partial edentulism with fixed prosthodontics supported by Bioceram sapphire implants. 15 patients were treated for maxillary or mandibular edentulism, and 7 for a missing maxillary anterior tooth. The remaining 27 patients, with Applegate-Kennedy Class I-IV residual dentitions, were treated with fixed bridges supported by free-standing implants, or bridges supported by teeth and implants. Implant success, prosthesis stability, radiographic marginal bone level as well as parameters for peri-implant health were evaluated. The study began in 1982, and clinical treatment of the last patients was completed in 1988, i.e., a follow-up period ranging from 7 to 13 years. Of the patients treated for total mandibular edentulism, one implant fractured after 6 years in situ. The bone implant score (BIS) values for those implants were at the time for the bridge cementation 63.5 +/- 1.4 and at 1, 2, 3 and 5 year follow-ups 62.1 +/- 1.4, 61.9 +/- 1.5, 61.5 +/- 1.6, and 60.95 +/- 1.3, respectively. The success rate was 100%, 100% and 97.7% for the mandible at 3, 5 and 10 years, respectively. Of the 7 edentulous patients treated with maxillary fixed bridges, 6 implants in 1 patient had to be removed after 1 year in service. Another 2 patients lost all their implants, 6 each, after 36 months. 6 implants in the 4th patient did not fulfil the criteria for success and were rated as failures at the four year follow-up. The success rate was thus 58.1%, 44.2% and 44.2% for the maxilla at 3, 5 and 10 year follow-ups, respectively. Of the 7 patients in whom single missing teeth were replaced, 1 implant in the premolar region was lost during the 1st year post-operatively, but no other complications or changes in BIS were observed. Of the 27 patients treated for partial edentulism (56 implants total) 1 implant, of a 4-unit free standing maxillary bridge fractured after 6 years and was later replaced. There were no statistically significant differences in BIS changes for the implants when used as abutments for partial maxillary or mandibular edentulism. The cumulative success rates for the implants in the partially maxilla were 96.3, 92.6 and 92.6 at the 3, 5 and 10 years respectively and 100% in the mandible over the whole period.
The aim was to study oral sugar clearance in elderly individuals, around 70 yr of age, with various types of prosthodontic reconstructions. Salivary glucose concentration was measured under the tongue after chewing a glucose tablet in four groups of individuals with: 1) complete dentures (CD) (n = 19), 2) removable partial dentures (RPD) (n = 22), 3) fixed partial dentures (FPD) (n = 24), and 4) no dentures (controls) (n = 23). Salivary glucose clearance was also studied after a mouthrinse with 10% glucose in 18 of the 19 individuals with CD and in 13 of the 22 with RPD both with and without the dentures. Saliva samples for glucose analysis were taken, in this part of the experiment, at two separate locations: under the tongue and in the labial vestibule near the mandibular right first molar. After the tablet intake, the group with CD showed the highest initial salivary glucose concentration, the longest oral sugar clearance time and the largest area under the curve, followed by the group with RPD. FPD did not seem to influence the oral sugar clearance. After the glucose rinse, higher values for the various clearance variables were obtained in the vestibule than under the tongue and, to some extent, when the experiments were carried out with than without the dentures. Thus, the results from this study indicate that removable dentures, especially CD, contribute to less effective oral sugar clearance in elderly people and that the oral clearance seems to be more dependent on the site than on the presence or absence of removable dentures in the oral cavity.
Although a detailed understanding of the etiology of hypodontia is lacking, there is a need for awareness among dental professionals of the social and psychological consequences of severe hypodontia, as well as knowledge of those affected by hypodontia have ongoing dental treatment needs. Although, there may be a need for immediate referral of children to different specialists for optimal multidisciplinary treatment planning, most older patients with severe hypodontia can be treated by general practitioners. Practitioners therefore need to be aware of the ramifications of the condition and be capable of providing adequate oral health care for these patients and referring them for additional services when necessary. A case-report series is used to illustrate routine prosthodontic treatments that can be offered to older patients in general dental practice.
A cluster of 10 cases of Mycoplasma pneumoniae infection involving persons working in a prosthodontics laboratory is descrbied. The pattern indicates a point source epidemic. The suspected mode of spread was a fine-particle aerosol generated from abrasive drilling of contaminated false teeth.
Tensile fatigue limits and ultimate tensile strengths of some prosthodontic adhesive systems were determined. Ni-Cr-Be cylinders were: electro-etched, chemically etched, and sand-blasted prior to being bonded end-to-end with BIS-GMA and 4-META adhesives. Bonded specimens were stored in distilled de-ionized water for three days prior to being tested. Fifteen paired specimens per group were subjected to a cyclic tensile load for 1000 cycles. Tensile fatigue limits were determined by the staircase method. Five specimens per group were tested for ultimate tensile strength. In addition, those specimens which survived the 1000 cycles during fatigue testing were also tested for ultimate tensile strength. Statistical evaluations to compare tensile fatigue limits and ultimate tensile strengths for fatigued and non-fatigued specimens were then performed. The results indicated that the tensile fatigue limit and the ratio of fatigue limit to ultimate tensile strength of the sand-blasted, 4-META adhesive system were significantly lower than those of the other systems tested. The application of a cyclic load significantly decreased the ultimate tensile bond strength of the 4-META adhesive. Application of a cyclic load had no significant effect on the ultimate tensile bond strengths of the BIS-GMA systems tested.
A number of studies have been made investigating the properties of dental prosthodontic soft polymer materials. In such materials, which are used as short-term denture soft liners, the polymer component is complexed with one or more plasticizers. This lowers the glass transition temperature, Tg, of the polymer by allowing greater chain mobility and produces a more flexible material. Little information is available relating to the polymer components of such soft-lining materials. The chemical composition and molecular-weight distribution of a polymer help to determine its ability to form a plasticized soft polymer-gel. In the present work, both pyrolysis depolymerization/gas chromatography (GC) and size exclusion chromatography (SEC) have been used to characterize 11 commercial polymer powders. By use of SEC and polymer standards having a narrow molecular-weight range, it has been possible for accurate molecular-weight distributions to be determined for all 11 powders. The peak molecular weights were found to be between 1.79 x 10(5) and 3.28 x 10(5). These values are above the molecular weight at which chain entanglement occurs. The polydispersity ratios (Mw/Mn) were between 2.09 and 4.48. Methacrylate polymers can be readily decomposed thermally to their constituent monomers, which, once recovered, can be analyzed by gas chromatography. The simple pyrolysis apparatus used in the present study was easily assembled and was capable of producing both qualitative and quantitative results. None of the commercial polymers analyzed gave methacrylate decomposition products with pendant chains greater than ethyl (-CH2-CH3). All of the commercial polymers successfully studied by the pyrolysis test method proved to be poly(ethyl [100-79%]/methyl [0-21%] methacrylate) polymers or co-polymers.
A study was done to evaluate the fit of castings made from commercially available alloys promoted by their manufacturers as cheaper alternatives to type III gold for use in fixed prosthodontics. Two nickel-chromium alloys, two silver-palladium alloys, two gold-silver-palladium alloys, a 50% gold alloy, and a type III conventional gold alloy (used as a basis of comparison) were evaluated. After optimum conditions for waxing, investing, and casting were determined experimentally, four crowns (two full crowns and two three quarter crowns) were cast from each alloy. The castings were cleaned by pickling or sandblasting and placed on their respective dies. Only one casting was made from each die. Ten judges were asked to evaluate the marginal fit and completeness of each casting on its die. The judges rated each casting and the ratings were converted into rankings. Type III gold and Forticast tied and were ranked first; Paliney CB was ranked second; Alborium and Albacast tied and ranked third; Aurolite CB was ranked fourth; and Jelenko Experimental and Howmedica III tied and ranked fifth. It was found that the nickel-chromium alloys produced castings that had a tight fit and showed marginal discrepancies even under conditions designed to yield maximum expansion of the investment. These nonprecious metal castings were judged inferior in terms of fit when compared with castings made from noble metal-and precious metal-containing alloys. Existing investments and techniques were adequate for all castings except those made from the nonprecious alloys. It was concluded that low (approximately lambda 50%) gold alloys and palladium-silver-gold alloys that are commerically available can be used as substitutes for type III gold alloy without any loss inthe quality of casting fit.
In dental practice, combined plans of orthodontic and prosthodontic treatment are underused. Indications for a collaborative effort include preservation of integrity of the dental arch, biomechanical factors, limitations in design of prostheses, esthetic appearance, periodontal considerations, prevention of malocclusion, and better retention of position of teeth.
Attempts have been made at formulating standardized nomenclature for implantology. Although these classification systems have advanced the concept of universal nomenclature in implantology, they can be improved upon. Most of them present terms in glossary form, which can limit their applicability. Others deviate significantly from accepted basic terminology and can be foreign or ambiguous to the average clinician. This article outlines the semiotic approach to language formulation, discusses slight changes to accepted conventional prosthodontic terminology to better encompass implant dentistry, and introduces the shortform and support-retention-connection-prosthesis classification systems.
Classic guidelines in osseointegration for root-form dental implants include a long healing period, during which functional load should be avoided. However, the long healing period might impose an intolerable situation on some patients, especially in the completely edentulous situation. Subperiosteal dental implant guidelines demonstrate that the implant upon insertion can be put into immediate function and be restored with the final prosthesis soon after surgery. Studies on immediately functional loaded implant-supported prostheses in patients who are completely edentulous have been reported, exhibiting high success rates comparable with conventionally loaded implants. This article describes the surgical and prosthodontic procedure for the immediately functional loaded mandibular implant overdentures in 2 different dentalimplant modalities, as well as its clinical rationale.
This 21-year retrospective study evaluated the trends observed in the prosthodontic treatment of 269 patients. The patients were divided into three groups. The speech aid group consisted of 203 patients and showed a significant decrease in numbers over time. The maxillary obturator group consisted of 24 patients and did not show a significant change. The infant feeding prosthesis group consisted of 42 patients and showed a significant increase in numbers. Possible reasons for the trends observed are discussed.
Prosthodontic treatment has a long and rich history in the care of patients with cleft lip and palate. Because of increased knowledge of craniofacial growth and development and improved surgical and orthodontic treatment, today's cleft patients receive better care and in less time. This requires less prosthetic intervention. Still, prosthetics retains an important, if somewhat diminished, place in cleft care, and the prosthodontist remains an integral member of the cleft/craniofacial habilitation team. This review presents the current state of the art in dental/prosthodontic care for patients with cleft palate and related craniofacial anomalies.