Prototyping of increased vertical dimension of occlusion using an existing removable partial denture and composite resin: a case report.

Full-mouth rehabilitation can be challenging due to the complexity of restoring the vertical dimension of occlusion (VDO) and replacing missing teeth. In partially edentulous patients, the concept of a bonded composite resin prototype for increasing the VDO has previously been applied through the use of an overlay removable partial denture (RPD) with acrylic resin covering the existing dentition. Unfortunately, this type of prosthesis does not always accurately model the function and phonetics intended for the definitive prostheses, and the esthetic result often is less than ideal. It would be advantageous if direct bonding could be used with the patient's existing RPD to model the increased VDO, but this approach has not been reported in the literature. This case report describes the direct bonding of an existing RPD to create a prototype for increased VDO in a partially edentulous patient with a skeletal Class II malocclusion. The successful outcome has been maintained for more than 1 year.

Integrated understanding of urban land, groundwater, baseflow and surface-water quality--the City of Birmingham, UK.

Integrated understanding of urban land, groundwater (shallow and deep), baseflow and surface-water quality relationships is required for effective urban water-quality management. Chemical quality data from across these media have been collected for the Birmingham (UK) aquifer--River Tame conurbation to assess chemical transport from contaminated land to groundwater to baseflow to surface water. Although metals concentrations were high in soils, low leachability and attenuation caused concentrations in groundwaters and baseflow discharging to surface water to be generally low with only sporadic elevated concentrations attributed to localised point sources. Hydrocarbon VOCs (volatile organic compounds) were similarly absent or at low concentration attributable to their ready natural attenuation. Chlorinated VOCs, however, were widely encountered in groundwater, discharging as baseflow to surface water and impacting surface-water quality. This is attributed to their DNAPL (dense nonaqueous-phase liquid) properties and relative recalcitrance although there was some evidence of biodegradation, albeit insufficient to protect surface water and groundwater abstraction receptors. Some inorganic trends were evident across the various media; nitrate was the most significant quality concern. Generic conclusions are drawn on urban water-quality management and the need for risk-based management strategies to optimise use of urban, sporadically contaminated groundwater in conjunction with surface water highlighted.