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The effect of partial denture design on abutment tooth and saddle movement.

A laboratory investigation designed to simulate the effect of loads applied to a free-end saddle partial denture was carried out. Abutment tooth and also saddle movement were monitored using a photogrammetric method. Loads applied to the denture saddle were transmitted through the occlusal rest and also the clasp components causing movement of both denture saddle and the abutment tooth. The direction of abutment tooth movement was towards the mesial, whether the occlusal rest was situated on the mesial or distal aspect of the tooth crown. It was also evident that the design of the clasp unit used affects the magnitude and direction of abutment tooth movement.

Dental Abutments↗

Oral conditions and aptitude to receive implants in patients with removable partial dentures: a cross-sectional study. part I. oral conditions.

The relationship between a removable partial denture (RPD) and damage caused to residual oral structures is the subject of on-going research. A group of patients wearing RPD, treated in the same way in the same department, were recalled to evaluate their oral hygiene and to compare the clinical condition of abutment teeth with that of non-abutment teeth. The study shows that most patients were unable to maintain high standards of oral hygiene. In the group of patients with non-optimal hygiene the clinical condition of abutment teeth was worse than that of non-abutment teeth. In the group of patients with optimal oral hygiene the condition of abutment teeth and non-abutment teeth was almost identical. To increase the standards of oral hygiene it is strongly advisable to recall and follow up patients on a regular basis.

Aged↗

Deviation from the Broadrick occlusal curve following posterior tooth loss.

Production of an appropriate occlusal curve for dentitions which have become deranged because of tooth loss, overeruption, tipping and drifting can present challenges for the dental technician. An earlier paper (J Oral Rehabil, 2005 32: 895-900.) demonstrates that the use of the Broadrick flag method for producing the occlusal curve is relatively accurate for most intact arches. This study demonstrates that when a posterior tooth has remained unopposed for 5 years or more positional changes, which cause deviation from the Broadrick curve, occur. The extent of the deviation may be extreme, potentially leading to difficulties in restoring a harmonious occlusal scheme. This study also demonstrates that the Broadrick curve may provide an accurate reproduction of the occlusal curve, even when the tooth forming the posterior determinant of the curve is tipped. A moderate degree of tipping of this tooth has little effect on the radius of the Broadrick curve.

Adult↗

Tooth displacement due to occlusal contacts: a three-dimensional finite element study.

The use of the Finite Element Method (FE) is an appropriate way to study occlusal forces and tooth movement. The purpose of this study was to evaluate the effects of different occlusal contact patterns on tooth displacement in an adult dentition using a three-dimensional FE model of a human maxilla and mandible. Initially, images of a computerized tomography scan were redrawn in a computer program (CATIA) followed by the FE mesh construction. The MSC/Patran software was used to develop the FE mesh comprising 520,445 elements and 106,633 nodes. The MSC/Nastran program was utilized as pre and post-processor for all mathematical calculations necessary to evaluate dental and mandibular biomechanics. Four occlusal patterns were tested: FEM 1 - standard occlusal contacts; FEM 2 - removal of mesial marginal and mesial tripoidism contacts; FEM 3 - removal of distal marginal and distal tripoidism contacts; FEM 4 - similar to FEM 3 with added contacts between upper and lower incisors. Small changes in the standard distribution of occlusal contacts resulted in an imbalance of occlusal forces and changes in dental positioning. All simulations tested showed mesial displacement of posterior teeth. The most significant changes were registered in the model presenting unstable occlusal contacts when the anterior teeth were in occlusion (FEM 4). These findings may explain mandibular incisors crowding and maxillary incisors flaring as a result of small variations in dental contacts.

Adult↗

Oral assessment of the dentulous elderly patient.

The percentage of elderly persons retaining natural teeth is increasing. Although many of these individuals cannot be convinced to see a dentist regularly, they are generally seen by a physician or nurse relatively frequently. The physician or nurse can provide a vital service for these patients by performing oral screening examinations. A technique is described for accomplishing this.

Aged↗

Comparison of early telescope loading of non-submerged ITI implants in irradiated and non-irradiated oral cancer patients.

OBJECTIVE: To compare early dental implant loading in irradiated and non-irradiated oral cancer patients in order to accelerate masticatory function improvement and quality of life. PATIENTS AND METHODS: One hundred and fourteen non-submerged interforaminal ITI implants were early loaded in 30 patients after 3 weeks in situ (telescoped overdenture). Nineteen patients received 72 implants (63%) after local irradiation; 11 non-irradiated patients received 42 implants (37%) with a 24-month follow-up. RESULTS: At 24 month follow-up, one early failure had occurred in an irradiated patient (=99% functioning implants in situ). Peri-implant bleeding and plaque index were similarly high in both groups (40 to 68% average). The Results of other measured parameters were as follows (values for mean; irradiated; non-irradiated patients with respective standard deviations; significance of comparison): bone loss (0.9+/-0.9; 1.4+/-0.9; 0.4+/-0.5 mM; P<0.01); Periotest score (-2.7+/-2.7; -2.4+/-2.2; -3.1+/-3.3; P<0.2); gingival recession (0.6+/-0.7 mM; 0.8+/-0.9 mM; 0.4+/-0.5 mM, P<0.02); and peri-implant probing depths (3+/-1.2; 2.6+/-0.6; 3.4+/-1.7 mM; P<0.002). CONCLUSION: The results suggest reliable non-submerged implantation and early loading. However, bone loss in irradiated mandibles, combined with higher average Periotest values and gingival recession in an oral environment of altered saliva quantity, quality, microflora and local scarring, requires extended follow-up.

Aged↗

The effect of plaque control and surgical pocket elimination on the establishment and maintenance of periodontal health. A longitudinal study of periodontal therapy in cases of advanced disease.

The present clinical study was initiated in 1969 to test the hypothesis that microbial plaque is the cause of periodontal disease and that hence even advanced cases of periodontitis can be cured in patients willing to exercise optimal plaque control. The material consisted of 75 patients with severe destruction of the periodontal tissues. The patients were selected for the study because of their ability to maintain plaque-free dentition. Following an initial examination, a preliminary treatment plan was presented to the patients. This plan included detailed instructions in plaque control measures, scaling, root planning and emergency dental care, including endodontic therapy and extractions. Three to six months after the termination of the so-called presurgical treatment, surgical elimination of pathologically deepened pockets was performed. The patients were recalled every 3 to 6 months after the end of the treatment. At these reexaminations the following parameters were assessed: Plaque Index, Gingival Index, Pocket Depths, Marginal alveolar bone topography and height. The results demonstrate that it is possible to treat periodontal disease successfully, even in advanced stages, in patients willing to maintain plaque-free dentition.

Adult↗

The effect of systematic plaque control on bone regeneration in infrabony pockets.

A clinical trial was undertaken to test the hypothesis that periodontitis can be cured and that bone regeneration occurs in infrabony pockets in patients maintained on an optimal standard of oral hygiene. The material comprised 24 patients with advanced periodontal disease. After an initial examination, the patients were randomly distributed into one test group and one control group. All the patients were given instruction and practice in a proper oral hygiene technique, and then subjected to periodontal surgery using the modified Widman flap procedure. Following treatment, during a 2-year period the patients of the test group were recalled once every second week for professional tooth cleaning. The control patients were recalled once every 12 months for prophylaxis. The results showed that all osseous defects of the patients of the test group were refilled with bone. The control patients, on the other hand, could not maintain a high standard of oral hygiene, and exhibited a progressive deterioration of the periodontal tissues during the postsurgical observation time.

Adult↗

The influence of trauma from occlusion on reduced but healthy periodontal tissues in dogs.

The experiments were performed in five dogs fed a soft diet which allowed dental plaque accumulation. Experimental periodontal breakdown was introduced on Day 0. After 180 days trauma from occlusion was produced in 4P and P4 i.e. the mandibular fourth premolars, in the manner described by Svanberg & Lindhe (1973). On day 280 the periodontal pockets around 4P and P4 were eliminated. A notch was prepared in the root at the level of the bottom of the surgically eradicated pocket. In addition, the occlusal trauma in the 4P region was deleted. From Day 280 to Day 370 the teeth of the animals were brushed twice a day. The animals were then sacrificed, radiographs of the premolar regions were taken, and tissue sections comprising 3P4P1M (and P3P4M1) were produced and subjected to microscopic analysis. The results indicate that jiggling type occlusal trauma and tooth hypermobility are not factors which detrimentally affect healing following periodontal surgery.

Alveolar Process↗

Lack of effect of trauma from occlusion on the recurrence of experimental periodontitis.

The experiments were performed in 15 dogs fed a diet which allowed dental plaque accumulation. A phase of experimental periodontal breakdown was initiated on day 0. After 210 days five dogs were sacrificed. In the remaining 10 dogs the periodontal pockets around the fourth lower premolars (4P and P4) were eliminated. During surgery a notch was prepared in the root at the level of the marginal termination of the alveolar bone in order to facilitate measurements in histological sections. From day 210 to day 450 the teeth of the animals were brushed twice daily. After 60 days of healing, i.e. on day 270, five of the dogs were sacrificed. Trauma from occlusion of the jiggling type was on day 270 produced in the P4 region of the remaining dogs by the installation of a cap splint and a bar device. The final five dogs were sacrificed on day 450. Following sacrifice, tissue sections comprising 3P, 4P, 1M and P3, P4, M1 were produced and subjected to microscopic analysis. The experiments revealed that, in the dog, forces produced by occlusal trauma are unable to induce a phase of progressive destruction of the periodontal tissues in tooth regions where the supporting tissues are markedly reduced but non-inflammatory.

Alveolar Process↗

Caries and periodontal status in patients fitted with removable partial dentures.

A 6-year follow-up study was carried out on 28 patients fitted with removable partial dentures. Prior to the prosthetic treatment all patients were given oral hygiene instruction and periodontal therapy where indicated. The removable partial dentures were carefully planned and designed. During the follow-up period the patients were examined at yearly intervals when remotivation, scalings, conservation and prosthetic adjustments were carried out as required. Patient cooperation was excellent and no significant deterioration of the periodontal status of the remaining teeth could be found. In addition the number of newly registered carious lesions was low. A certain degree of deterioration of occlusion, articulation, stability and clasp retention of the dentures fitted did occur, however.

Adult↗