Advanced prosthodontic education: a rationale for a curriculum which integrates fixed and removable prosthodontic education.
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Curriculum↗
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[Progress in scientific prosthodontics and the future of prosthodontics in general practice].
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Family Practice↗
Teaching prosthodontics in general dentistry.
Because of the projected increase in the demand for high-quality prosthodontic services in the future, it will be necessary to upgrade undergraduate prosthodontics and to provide, in addition, improved prosthodontic training in the general dentistry residencies. The Federation of Prosthodontic Organizations is the unified voice of our specialty and must stand at the forefront to provide and direct this training. Every accredited program should be required to offer training in prosthodontics. We cannot expect graduate students to specialize in prosthodontics if we allow it to be downgraded, reduced in scope in our dental schools, and excluded from general dentistry residencies.
General Practice, Dental↗
Gingival enhancement in fixed prosthodontics. Part II: Microbiologic findings.
This study assessed the changes of the subgingival/marginal microflora during fixed prosthodontic procedures and evaluated the effect of adjunctive rinsing with 0.12% chlorhexidine on the subgingival/marginal microflora during fixed prosthodontic treatment. Thirty patients scheduled for fixed prosthodontics were randomly assigned to either rinsing with 15 ml of tap water b.i.d. (control) or rinsing with 15 ml of 0.12% chlorhexidine gluconate b.i.d. (experimental). Subgingival and marginal plaque was analyzed at baseline, before crown preparation (2 weeks), before crown cementation (5 weeks), and 2 weeks after cementation (7 weeks). The fixed prosthodontic procedures alone altered the subgingival and marginal microbiota toward a more health-associated flora. Adjunctive rinsing twice daily with 0.12% chlorhexidine had a significantly greater effect in reducing putative periodontal pathogens compared with the control regimen. This medication was a useful adjunct to regular oral hygiene during fixed prosthodontic procedures by permitting the establishment and maintenance of a microflora compatible with periodontal health.
Adult↗
Orthodontic adjunctive treatment in fixed prosthodontics.
The purpose of this article has been to increase the restorative dentist's appreciation for the rationale justifying preprosthodontic orthodontic treatment. It has not been intended to identify all the specific indications for the use of orthodontic treatment to enhance prosthodontic treatment nor has it been intended as a reference to assist the restorative dentist in placing and using orthodontic appliances. Figure 12 illustrates a typical case in which the combination of orthodontic and prosthodontic treatment resulted in a more favorable outcome than prosthodontic treatment alone. When planning prosthodontic treatment, the dentist should embrace a dynamic view of tooth position and determine whether restorative treatment can be enhanced by tooth movement. Improved tooth position can eliminate potentially pathologic occlusion and create a healthier periodontal environment that is easier to maintain. In addition, it permits the dentist to place restorations that often require less natural tooth reduction during preparation, and that are more esthetic, functional, stable, and durable. Orthodontic treatment that accomplishes these benefits may be limited to a partial fixed appliance localized to one segment of an arch or require a more extensive fixed appliance. Much of this treatment can be accomplished by the interested restorative dentist. Addressing more comprehensive orthodontic problems in patients requiring prosthodontic care is best managed through a restorative dentist and orthodontist team approach to treatment.
Dental Stress Analysis↗
Some factors influencing the quantity of prosthodontic treatment performed by general practitioners in public dental service.
For general dentists in public dental service, Orebro county, the numbers of artificial crowns, pontics, RPD:s and CRD:s produced in 1989 were studied in relation to some background factors. The dentist-related factors were: gender, time in profession, working time per week, and place of graduation. Factors related to dental clinics were: location of the clinic, general prosthodontic activity at the clinic. Multiple regression analyses were used. Two different patterns were found; one for fixed prosthodontics, another for removable prosthodontics. Prosthodontic activity at the clinic, the male sex, and (inversely) time in profession were significantly associated with high production of artificial crowns and pontics. The regression models for removable prosthodontics showed no significance.
Crowns↗
Prosthodontics--Past, present, and future.
1. The geographic areas served by licensed dental mechanics will increase in number and size in the future. 2. There will be increasing difficulties in supplying dental graduates of a high caliber from our faculties of dentistry to serve adequately in the field of prosthodontics. 3. More graduate (postdoctoral) programs will be needed to train dentists to treat difficult prosthetic patients. The need for prosthetic services is still with us and will continue to grow. Only with progressive thought and aggressive action can organized prosthodontics go forward to meet its challenges. A battle is not won on defense alone, for such has been the game plan to date. Currently, dentists have a reasonable way to deliver an important health service to the population at large. However, only with a rapid advancement in the concept of delivery of total prosthodontic care can the best interests of the public be maintained. Finally, the highest standards of practice and ethics must be the guiding principles to any future changes in the delivery of prosthodontic services to the public.
Canada↗
Prosthodontics. Clinical practice--third-party relations. Review of the literature.
The business component of prosthodontics is certain to become a greater focus for those who enter the profession in the 21st century. Whether future professionals are prepared to accept the inevitability of change is, in part, the present generation's responsibility to decide. Prudent management decisions based on basic business principles will be essential to those who venture into prosthodontics in the future. Understanding computers, electronic data transmission, FAX data transfers, and government rules and regulations should be essential components in the education of prosthodontic residents now. When to ask how the law will affect the young practitioners will be as important as where to place the call. Those unfamiliar with governmental regulations that govern any business venture may be caught in a nightmare of fines and economic and personal time loss. Moreover, those who are untrained in dealing with money managers (banks, credit unions, lenders) and patients (where money matters) can be assured of failure. Familiarity with all phases of third-party payments becomes an essential ingredient for future success. However, for those who are knowledgeable about business, the joy of practicing prosthodontics in the 21st century should be rewarding.
Health Expenditures↗
Significance of the Frankfort-mandibular plane angle to prosthodontics.
Cephalometric information, specifically, vertical facial types and the Frankfort-mandibular plane angle, pertinent to prosthodontics has been discussed. The Frankfort-mandibular plane angle (FMA) is formed by the intersection of the Frankfort horizontal plane and the mandibular plane. This angle can be traced and measured by means of a diagnostic overlay. An FMA of 25 +/- 5 degrees is within normal range. A high-angle patient has an FMA of 30 degrees or more, and a low-angle patient has an FMA of 20 degrees or less. A high FMA is characterized by open-bite skeletal patterns, and a low FMA by closed-bite skeletal patterns. The clinical manifestations pertinent to prosthodontics in high- and low-angle (FMA) patients are shown in Table I. However, not all clinical characteristics are present in a given patient. The classification in Table I is a beginning. The authors consider the prosthodontic study of cephalometrics an unexploited research tool. Hopefully, in the future, it will help to bridge the gap of the biological-technical interplay that is such an integral part of prosthodontics.
Alveolar Process↗
Private prosthodontic practice: a status report.
This article reports the data of a national poll of private prosthodontic practitioners. It reports incomes, overhead expenses, staff size, and character of prosthodontic practices. The study also develops a profile for a median prosthodontic practice and practitioner.
Adult↗
The reporting of statistical inferences in selected prosthodontic journals.
Dental periodicals are the fundamental source of prosthodontic research. The ability to understand and contribute to dental literature is basic to the prosthodontic profession. The purpose of this study is to tally relative frequency with which various descriptive (n = 18), graphical (n = 7), and inferential statistical procedures (n = 68) are used in the prosthodontic literature. Our method consists of four procedures: journal selection, choice of 1987 through 1988 articles with inferential statistical content, tally of the statistical procedures in those articles, and quality control procedures used in obtaining these data. At least 50% of 10 prosthodontists selected 17 of 100 journals most likely to be read by prosthodontists. In the 17 journals, 1,320 articles were screened of which 406 were selected and evaluated for their statistical procedures. The bar and line plots were the most common graphical procedures occurring in over one fourth of the 406 articles. Percentages, means, and standard deviations occurred in more than 40%. Although 58% used the .05 significance level, only 0.3% mentioned power. Analysis of variance was used more often than the t tests (42% v 29%), whereas correlation/regression (21%) and chi-square tests (14%) were used less often. The t tests, analysis of variance (Duncan, Tukey, and Student-Newman-Keuls multiple comparison procedures), chi-square tests, correlation and regression, and the Wilcoxon tests occurred in at least 5% of the 406 articles.
Analysis of Variance↗
A predoctoral honors program in prosthodontics.
Over the last 25 years, the advent of new disciplines in dental education and the increasing body of knowledge in various dental specialties have led to a struggle for curriculum hours within many dental schools. At the same time, the amount of time available for teaching clinical skills in dental schools has not increased appreciably, and fewer patients require (or can afford) sophisticated prosthodontic treatment. As a result of these trends, there has been a general decline in the depth and range of clinical skills of recent dental school graduates, particularly in prosthodontics. New York University College of Dentistry has attempted to address this problem by establishing a predoctoral honors program in prosthodontics.
Education, Dental, Graduate↗
The Swedish patient insurance scheme and guarantee insurance for prosthodontic treatment.
During 1975-76 a no-fault compensation system for treatment injuries in dentistry and failures within prosthodontics was introduced in Sweden. The guarantee insurance scheme for prosthetic treatment has changed somewhat during the years and, in 1987, became mandatory for all dentists in Sweden. All necessary retreatment not included in the National Dental Insurance Scheme (eg allergy to dental materials, all treatment following radiotherapy-related xerostomia) is included. For fixed prosthodontics, all replacements are covered by the scheme for the first 2 years. For removable prosthodontics, this is limited to the first year. A patient may choose any dentist in Sweden to carry out the retreatment. The claim system is simple and the number of cases has steadily increased, probably because dentists are becoming more familiar with the system and are willing to use it. The costs are paid for by private practitioners, the Public Dental Service and private dental laboratories. The insurance files are available for research purposes.
Humans↗
Malpractice reports in prosthodontics in Sweden.
Prosthodontics is the branch most often involved in dental malpractice cases in Sweden. The number of cases has increased with the growing production of fixed prosthodontics after the introduction of the National Dental Insurance Scheme and the increase in the number of dentists. Prosthodontic treatment accounted for one-third of the working hours of private practitioners but two-thirds of the sanctions during the period 1974-78. The patients' complaints are often justified in some parts. The most common faults are elementary and have been similar throughout the whole period 1947-1988. Bridges (2-4 units), complete dentures and single crowns are the constructions most often involved in complaints. The maxillary frontal and premolar regions are in this order the regions most often involved. There are no differences between different age groups of dentists concerning the quantity of faults, but there is probably concerning the quality of faults because older dentists get more severe sanctions than younger.
Adult↗
Gingival enhancement in fixed prosthodontics. Part I: Clinical findings.
This study assessed the efficacy of a 0.12% chlorhexidine gluconate (CHX) rinse on the enhancement and maintenance of gingival health in patients receiving fixed prosthodontic treatment. Thirty patient participants in this examiner blind study were randomly assigned into two groups, one control and another group using CHX 15 ml b.i.d. in addition to normal oral hygiene. The medication was used for 2 weeks prior to crown preparation, 3 weeks during provisional crown placement, and 2 weeks after definitive crown cementation. Plaque and gingivitis indices were measured initially and at the three aforementioned points during the 7-week period. The plaque index for the control group decreased by 0.26 units; CHX decreased by 0.63 units at 7 weeks. The gingival index of the control group decreased by 0.37 units; CHX decreased by 0.87 units. Adjunctive use of chlorhexidine with fixed prosthodontic procedures significantly reduced plaque levels and significantly improved gingival health compared with the control patients. Fixed prosthodontic procedures alone decreased plaque levels and increased gingival health.
Adult↗
Measurement of oral status and treatment need among subjects with dental prostheses: are the measures less reliable than the prostheses? Part II: Treatment need in removable prosthodontics.
Evaluation of treatment need in removable prosthodontics has been an important component of many epidemiologic and clinical oral health surveys. Accurate measurement of need for care enhances health care program planning, quality of care evaluation, and good clinical and health services research. Unfortunately, similar to the measures of oral and prosthesis status discussed in Part I of this review, measures of treatment need in removable prosthodontics have generally been neither reliable nor valid, and have lacked scientific credibility. Part II describes existing measures for treatment need in removable prosthodontics.
Dental Care↗
Prosthodontic management of the cleft-palate patient.
Unlike some of the disciplines involved in the treatment of the cleft-palate patient, prosthodontics can have application from birth to death. Prosthodontic care never ends. Once surgical care or speech therapy has been completed, the need for follow-up care is ended unless specific problems manifest. With prosthodontic care, not only a restoration of the anatomic, physiologic, and cosmetic deficiencies but also a continual vigilance for signs of dental and periodontal problems must be undertaken. Preventive care is imperative if long-term preservation of the supporting structures and the well-being of the patient are to be attained.
Adult↗
Discrepancy between need for prosthodontic treatment and complaints in an elderly edentulous population.
Most reports indicate that about two-thirds of the elderly population have poor oral health but that only about one-third complain of a problem. The reason for this discrepancy has never been explained adequately. The objective of this study was to estimate the need for prosthodontic treatment in an edentulous elderly population, and to identify factors associated with complaints, needs for treatment, and the use of dentures. Interviews and examinations were conducted to determine the oral health and dental concerns among 269 residents of longterm care facilities in Vancouver. The need for prosthodontic treatment was considered under theoretical, clinical, and practical conditions, and related to various factors that might help to predict this need. During the interview, about half (54%) of the sample identified a problem, and 83% of the subjects were either using a denture with a major fault or were missing a denture. Seventeen percent of the sample would not benefit from treatment because of a severely resorbed residual ridge, while the presence of a complaint combined with a prosthodontic need indicated that about one-third (36%) would seek and benefit from treatment. The proportion of subjects with complaints was larger among the more educated subjects, and among those who had been recently to a dentist. It was not possible to predict the need for treatment from any of the socioeconomic factors considered. No significant association was observed between the need for treatment and the complaints, and many subjects seemed to be resigned to their discomfort or had unrealistic expectations from their dentures.
Aged↗