Form and function: a balancing act.
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The treatment of hemophiliacs at the Jena Center of Hemophilia is described from a stomatological point of view, the emphasis being on the advantage involved in treatment on an outpatient basis by close cooperation between stomatologists and internists. The clinical results obtained show quite clearly that this particular method of treatment has proved useful. Finally, the method of using GRF type adhesives is discussed critically, and substitution therapy, which is prerequisite to surgical operations performed on hemophiliacs, is recommended to be continued to be used.
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Aesthetic enhancement of the smile can be as simple as performing tooth whitening or as involved as a full-mouth reconstruction. In instances where porcelain veneers are contraindicated, when subgingival margin placement is required, or when it is necessary to conceal dark substructures or provide occlusal stability, metal-ceramic crowns may be required. This presentation highlights the properties of a metal-composite coping and demonstrates its application in a full mouth reconstruction used by the author to achieve the desired functional and aesthetic outcome.
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The most characteristic oral feature in ectodermal dysplasia is hypodontia. Children and adolescents suffering from ectodermal dysplasia often need extensive and complicated prosthetic treatment. The development of techniques for osseointegrated implants offers new possibilities for the oral habilitation of these children. This paper describes the oral habilitation of a boy with severe ectodermal dysplasia and where Brånemark osseointegrated implants have been used as part of the treatment. The patient was seen at the dental department at the age of 1.5 years. Two conically-shaped upper incisors were at that time the only teeth that had erupted. The treatment was planned in a multidisciplinary odontological group involving paediatric dentistry, orthodontics, prosthodontics, oral surgery and maxillofacial radiology. At the age of 3 years it was verified that the boy had four primary teeth (53, 51, 61, 63) and four permanent teeth (16, 11, 21, 26). There were no teeth in the lower jaw. The alveolar ridges in the edentulous areas were low or missing. During the period 3-6 years of age the boy used an upper partial denture adapted to allow the mesial drift of the 16 and 26 teeth. At the age of 6 years, two Brånemark implants were inserted in the lower front-cuspid region. A specially designed overdenture for the lower jaw was constructed. The overdenture was retained in contact with the male attachments by two cuffs of heat-polymerized resilient silicone. Over the next 4 years the dentures were modified due to the eruption of permanent teeth and growth. However, only minor corrections were necessary concerning the retention system of the lower denture. The implants are well osseointegrated and stable and allow the boy to use a lower denture without any complications.
This case report describes the use of a crown and sleeve coping denture in the treatment of a patient who presented with poor periodontal prognosis of multiple teeth. The prosthesis is designed to splint, stabilize, and retain periodontally involved teeth that are not suitable to support conventional partial dentures. In addition, it offers increased retention and stability.
Many older patients present requiring a multi-disciplinary approach to treatment aimed at restoring their dentition to health, satisfactory function, and appearance. The restorative dentist with specialist knowledge of periodontics, and fixed and removable prosthodontics is well qualified to provide a treatment plan to achieve these goals. The basic principles of formulating a treatment plan are discussed and a case presented which required a combination of occlusal therapy, periodontics, orthodontics and fixed and removable prosthodontics.
For preventing pathological leison its healing as well as slowing down of the progress of the already formed course the employment of prosthetic therapy is suggested. Various solutions are presented which, on basis of their clinical experiences, are deemed successful therapeutics. Finally, in case of the above mentioned statuses attention is called to the possibilities of error in the course of individual stages of work in making denture as well as to the possibility to their elimination.
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