Treatment planning for replacing missing teeth in UK general dental practice: current trends.

The aim of this study was to examine the confidence, barriers and attitudes towards the replacement of missing teeth by general dental practitioners (GDPs). The perceived impact of the recently introduced National Health Service (NHS) contract on the provision of prosthodontic treatments was also considered. Pre-piloted postal questionnaires were mailed to 500 GDPs in Wales. Open- and closed-ended questions were utilised to establish confidence, adequacy of training and attitudes towards treatments for replacing missing teeth. Two hundred and seventeen completed questionnaires were received (response rate = 43.4%). Many respondents described themselves as 'confident' or 'very confident' in the provision of removable partial dentures (RPDs) (acrylic = 100%, metal based = 99.5%), cantilever resin-bonded bridges (94.4%) and conventional bridgework (98.6%). GDPs were 'not confident' providing fixed-fixed resin-bonded bridges (21.1%) or implants (81.4%). Financial barriers were identified to the provision of prosthodontic treatments, including comments such as "the new [National Health Service] contract does limit the treatments available". Privately funded patients were more likely to be offered a fixed bridge or implant replacement of a missing upper first molar, whereas non-privately funded patients were more likely to be offered no treatment (P < 0.01). Most respondents reported confidence at providing more routine forms of prosthodontic care such as RPDs and bridges. It appears that funding arrangements may have an impact on treatments offered to replace missing teeth, particularly under the current NHS contract.

[Stress analysis of prosthodontics by finite element method].

Finite element stress analysis has been widely used in stomatology. In this article, we summarized the stress distributions of all-ceramic crowns, post crowns, fixed partial dentures and implant support fixed dentures; and with the use of finite element method, we investigated the stress levels of the periodontal ligament of abutment. The results showed: the tensile stress and compressive stress concentrated at the cervical margin of all-ceramic crown and post crown; the stress at the surface of the crown was the highest; the stress concentration exhibited at the connector of fixed parital denture, the molar was an ideal abutment tooth for the fixed bridge; the largest stress appeared around the neck of the implant abutment. These results have provided a theoretical basis for clinical dentistry in terms of restoration design and manufacture. It is suggested that clinical dentists should be careful to avoid the horizontal laoding applied on the prostheses so as to improve the resistance of abutment tooth to fracture.

Changes over time in the clientele and restoration pattern in a dental school prosthodontic department.

The clientele and the production of single artificial crowns and fixed partial dentures in the Department of Prosthodontics were compared from 1964/68-1982/87. In the first period 65 per cent of the single crowns were made for women versus 55 per cent in the second. In the first period 69 per cent of the crowns were placed in the upper jaw as against 60 per cent in the second period. On average 1.6 crowns were made per female patient in the first period versus 1.4 per male patient. In the second period both sexes averaged 1.8 units. In both jaws the percentage of root-filled crowned teeth had increased in the second period to 60 per cent from 48 per cent in the upper jaw and 46 per cent in the lower jaw. In both sexes maxillary and mandibular teeth were crowned on average 13 years later in the second period than in the first. Sixty per cent of the fixed partial dentures were made for women in the first period versus 55 per cent in the second. In the first period 74 per cent of the bridges were made for the upper jaw as against 70 per cent in the second period. The mean pontic to abutment ratio was 0.7 in both periods. The maximum number of bridges in the first period were made for patients 40-59 years of age versus 50-69 years in the second period.(ABSTRACT TRUNCATED AT 250 WORDS)

Contemporary implant concepts in aesthetic dentistry--part 3: adjacent immediate implants in the aesthetic zone.

This series of articles has discussed contemporary concepts in the treatment planning of dental implants in edentulous ridges and immediate single-tooth implants in the aesthetic zone. This presentation broadens the discussion to include the wider application of immediate implants, highlighting the surgical and restorative considerations affecting their immediate placement and provisionalization. It highlights the application of immediate implants in both single- and multiple-unit applications and provides detailed demonstrations of the involved implant and restorative components required by such procedures.

Future needs for fixed and removable partial dentures in the United States.

STATEMENT OF PROBLEM: Because of the decline in missing teeth among most adults, prosthodontic advanced training programs are concerned about the need for prosthodontics in the future. PURPOSE: An analysis was conducted to project the unmet need for fixed and removable partial dentures in the years 2005, 2010, and 2020. MATERIAL AND METHODS: Unmet need was calculated as follows: Total need equals the number of persons in each age cohort multiplied by the percentage who need a fixed or removable partial denture multiplied by the average procedure time required to provide the service. Total unmet need then equals total need minus the annual supply of prosthodontic services delivered by prosthodontists and general practitioners. RESULTS: Projected results indicate that total unmet need will increase from 488 million hours in 2005 to 517 million hours in 2010 and to 560 million hours in 2020. CONCLUSION: The significance of the results is that unmet prosthodontic need will increase and exceed the supply of services for the foreseeable 20-year future. Practicing dentists will find that a sizable minority of the population will continue to need fixed and removable partial denture services.

Desarrollo psicomotor en prótesis fija / Psychomotor development in fixed prosthodontics

La preclínica en Odontología, cuya estrategia es de laboratorio para el aprendizaje de destrezas motoras, se basa en el concepto del modelo Flexner, sustentado en la taxonomía de Bloom, la cual describe la selección de las situaciones de aprendizaje clasificadas en áreas cognoscitivas, afectivas y psicomotoras, siendo estas últimas las que incluyen habilidades ó destrezas motoras. Se han propuesto distintas taxonomías para el desarrollo psicomotor en Odontología, desde algunas simplificadas, con maniquíes, con dientes sembrados, con dibujo, hasta la computarizada, virtual, a distancia. Es indispensable la revisión de los planes de estudio en Odontología para establecer una posición de avanzada en la preclínica, la cual pudiera estar dada en el concepto de la clínica aplicada.

The preclinical in dentistry, whose strategy is of laboratry for the learning of motor skills, is based on the concep of Flexner, sustained in taxonomie of Bloom, cal describes the selection of classified situations of learning in cognoscitivas, affective areas and psicomotor, being these you complete those that include motor abilities or skills. They have seted out different taxonomies for development motor in dentistry, from some simplified, with maniquies, to teeth seeded, drawings, to the computerized ones, virtual, at a distance. The revision of the curricula to establish advance position of the preclinical is indispensable, which cold be based on the concept of applied clinical.

Avaliação das condutas adotadas por profissionais na utilização de coroas metalo-cerâmicas / Assessment of clinical proceedings adopted by dental professionals regarding the employment of ceramic fused to metal crowns

A fim de avaliar a opinião da classe odontológica sobre a utilização das coroas metalo-cerâmicas na prática odontológica, aplicou-se um questionário de 20 questões a cirurgiões-dentistas da cidade de Aracaju - SE, e a cirurgiões-dentistas e estudantes de pós-graduação em odontologia, na área de prótese dental, da cidade de Bauru-SP. Concluiu-se que: 1. As coroas metalo-cerâmicas são o tipo de restauração protética mais empregado em Odontologia. 2. A maioria dos dentistas refere-se às coroas metalo-cerâmicas como restaurações bem sucedidas, indicando superfícies oclusais metálicas para a maioria dos pacientes. 3. Apesar da maior parte dos profissionais utilizar as ligas de níquel-cromo nas coroas metalo-cerâmicas de seus pacientes, os mesmos prefeririam que ligas nobres ou semi-nobres fossem empregadas em suas próprias restaurações. 4. A maioria dos entrevistados emprega as coroas metalo-cerâmicas na restauração de dentes anteriores (57,23 por cento). Entretanto, esse valor se deve à preferência dos dentistas de Aracaju (78 por cento) por esse tipo de restauração, ao passo que, em Bauru, prevaleceu o número de respostas favoráveis às coroas de porcelana pura. 5. O cimento de fosfato de zinco foi o cimento de escolha da maioria dos profissionais. 6. A preferência da maior parte dos entrevistados, com relação à porcelana utilizada foi pela porcelana Vita (34,34 por cento), em comparação às porcelanas Noritake e Dulceram Plus (13,86 por cento). 6. Ficou evidente o desejo dos entrevistados quanto ao desenvolvimento de mecanismos que facilitem o reparo das coroas metalo-cerâmicas.

Prótese parcial fixa Cantilever e sua implicação na dentição natural e/ou implantes dentários

Apesar do avanço no uso dos implantes ósseo integrados para repor dentes perdidos, razões anatômicas, médicas, econômicas ou psicológicas podem contra-indicar o seu emprego. Nestes casos, os pacientes preferem optar pela prótese parcial fixa ao invés da prótese removível...

Prótese parcial fixa: solução estética para rebordos anteriores reabsorvidos

No tratamento de reabilitação em pacientes com rebordos anteriores severamente reabsorvidos, a prótese parcial removível é recomendada, uma vez que esta adequa o suporte labial ou cirurgias...

Prótese adesiva, uma revisäo da literatura: resumo do trabalho apresentado ao Departamento de Prótese Restauradora da Escola de Farmácia e Odontologia de Alfenas na conclusäo do curso de especializaçäo em prótese dentária / Adesive prosthesis, a literature review: summary of a work presented to the Department of restorative prosthesis of Escola de Farmacia e Odontologia de Alfenas

Esta revisäo da literatura sobre prótese adesiva mostra a indicaçäo, vantagens, desvantagens e técnicas de confecçäo e fixaçäo. Este trabalho destaca que säo necessários mais estudos clínicos que demonstrem ou näo a eficácia de uma técnica e a superioridade de uma em relaçäo à outra

Avaliaçäo da evoluçäo e utilizaçäo dos materiais de moldagem no Brasil / Evaluation of the evolution of impression materials utilized in Brazil

Neste estudo houve a preocupaçäo de se saber, em termos percentuais, quais os materiais de moldagem que estäo sendo utilizados pelo cirurgiäo-dentista brasileiro, quando do processo de confecçäo de prótese fixas. A evoluçäo dos materiais de moldagem processada na última década também foi notada na análise deste trabalho