Predictable prosthetic space maintenance during staged complete-mouth rehabilitation.

Staged complete-mouth rehabilitation to accommodate a patient's financial constraints during the course of treatment is presented. Clear acrylic resin added to the anterior cameo surface of the maxillary fixed complete denture (FCD) served as a space maintainer. The restoration of the maxillary FCD addressed the patient's chief complaint. By adding the space maintainer, supraeruption of mandibular anterior teeth and encroachment of the prosthetic space, which could have resulted in additional treatment, was avoided. During the second stage of the complete-mouth rehabilitation, zirconia restorations were used to restore the mandibular arch to the maxillary FCD after straightforward removal of the space maintainer. This allowed a smooth transition after a delay in treatment without having to modify the previous treatment.

Application of digital technology in the prosthodontic management of a patient with myasthenia gravis: A clinical report.

Application of digital technology in the treatment of a patient with myasthenia gravis and an excessively resorbed mandibular residual alveolar ridge is presented. The patient requested replacement of worn maxillary and mandibular prostheses. Treatment involved fabricating a new maxillary complete denture that was similar in appearance to the one being replaced and rebasing the existing and clinically acceptable mandibular fixed framework. The interim phase of treatment involved fabricating a mandibular milled prosthesis similar in morphology to the existing fixed complete denture with computer-aided design and computer-aided manufacturing technology. This facilitated conversion of an interim prosthesis by using an orientation device and eliminated the need for the patient to adapt to an interim removable complete denture.

Comparison of treatment outcomes in digital and conventional complete removable dental prosthesis fabrications in a predoctoral setting.

STATEMENT OF PROBLEM: Scientific evidence is lacking regarding the clinical effectiveness of digital complete removable dental prostheses (CRDP). PURPOSE: This prospective clinical study was conducted to compare clinical treatment outcomes, patient satisfaction, and dental student preferences for digitally and conventionally processed CRDP in a predoctoral setting. MATERIAL AND METHODS: This clinical study rated and compared CRDP fabricated by predoctoral students, using a 2-appointment digital prosthesis fabrication process as opposed to the conventional 5-appointment process. Fifteen completely edentulous patients were treated in the predoctoral clinic at Loma Linda University School of Dentistry. Fifteen predoctoral (third- and fourth-year) dental students fabricated 2 sets of maxillary and mandibular CRDP for each patient. Each patient received 1 conventional set and 1 digital (AvaDent) set of CRDP. Faculty and patient ratings, patient and student preferences, and perceptions of the conventional versus digital prostheses were recorded and analyzed. The average treatment time for the fabrication of each type of prostheses was analyzed. RESULTS: Significantly higher average scores were observed for digital dentures than for conventional dentures according to criteria evaluated by faculty (P=.007). Patients reported significantly higher overall average satisfaction scores with digital dentures (P=.001). Patients preferred the digital dentures (P<.01). Significantly higher scores were observed for the retention of the digital maxillary complete denture (P=.001) compared with that for the digital mandibular and conventional complete dentures. Students preferred digital prostheses compared with conventional prostheses (P<.05). The conventional process required significantly more clinical time for each patient than with the digital process of fabrication (P<.01). CONCLUSIONS: The digital process proved to be an equally effective and more time-efficient option than the conventional process of prosthesis fabrication in the predoctoral program. The digital denture process was preferred and effectively used by predoctoral dental students under faculty supervision.

Gingival displacement for impression making in fixed prosthodontics: contemporary principles, materials, and techniques.

The clinical success and longevity of indirect restorations depend on the careful and accurate completion of several procedures. One of the challenging procedures is management of the gingival tissues and gingival esthetics. The goal for management of gingival tissues and gingival esthetics is to maintain the normal appearance of healthy gingival. Achieving this goal requires optimal health before treatment and minimal trauma during treatment. The best way of optimizing health and minimizing trauma is to avoid contacting the gingiva with restorative materials.