Morphological Comparison of Residual Ridge in Impression for Removable Partial Denture between Digital and Conventional Techniques: A Preliminary In-Vivo Study.

Although digital impression using an intraoral scanner (IOS) has been applied for removable partial denture (RPD) fabrication, it is still unclear how the morphology of a residual ridge recorded by digital impression would differ from that recorded by conventional impression. This in vivo study investigated the morphological difference in the recorded residual ridge between digital and conventional impressions. Vertical and horizontal displacements (VD and HD) in residual ridges recorded by digital and conventional impressions were assessed in 22 participants (15 female; mean age 78.2 years) based on the morphology of the tissue surface of in-use RPD. Additionally, the mucosal thickness of the residual ridge was recorded using an ultrasound diagnostic device. VD and HD were compared using the Wilcoxon signed-rank test, and the correlation of mucosal thickness with VD and HD was analyzed using Spearman's ρ. The VD of digital impression was significantly greater than that of a conventional impression (p = 0.031), while no significant difference was found in HD (p = 0.322). Meanwhile, the mucosal thickness showed no significant correlation with the recorded morphology of the residual ridge, regardless of the impression techniques. It was concluded that the digital impression would result in a greater displacement in the height of the residual ridge from the morphology of in-use RPD than the conventional impression.

Fabrication of milled removable partial dentures using a custom plate with prefabricated artificial teeth.

PURPOSE: Although digital removable partial dentures have been previously described, there have been no reports on how to fabricate them in one piece. This study proposes a new method for fabricating patient-specific digital removable partial dentures using a custom plate. METHODS: First, a gypsum model was scanned using a laboratory scanner and a removable partial denture was designed using computer-aided design (CAD) software based on standard tessellation language data. The metal clasp was fabricated from Ti-6Al-4V using a 3D printer. For custom plate fabrication, a resin plate frame was designed using computer-aided design (CAD) software and fabricated using a 3D printer. An artificial tooth and metal clasp were fixed on the base surface of the frame, an auto-polymerizing resin was poured into the frame for the denture base, and the artificial tooth and metal clasp were packed to form a custom plate. The plate was cut using a milling machine. Subsequently, the support attached to the denture was removed and polished for complete fabrication of the denture. CONCLUSIONS: Our novel removable partial denture fabrication method is more efficient than the conventional method. The obtained removable partial dentures demonstrated satisfactory accuracy.

Effect of tension and compression on dynamic alveolar histomorphometry.

Here, we tested the hypothesis that tensile and compressive stresses generated in the alveolar bone proper regulate site-specific cellular and functional changes in osteoclasts and osteoblasts. Thirty-two 13-week-old male mice were randomly divided into four groups: two experimental groups with vertical loading obliquely from the palatal side to the buccal side of the maxillary molar (0.9 N) 30 min per day for 8 or 15 days and unloaded controls (n = 8). Calcein and alizarin were administered 8 and 2 days before euthanization, respectively, to detect the time of bone formation. Undecalcified sections parallel to the occlusal plane were prepared on the palatal root and the surrounding alveolar bone in the middle of the root length. The alveolar perimeter was divided into 12 equal regions for site analysis, and the bone histomorphometric parameters were obtained for each region. Data from in vivo microfocus computed tomography were used to construct animal-specific finite element models. 2D stress distribution images were overlain on histology images obtained from the same location. Significant differences in the total perimeter between groups and between loading and unloading in each region were statistically analyzed (α = 0.05). Osteoclast counts and the alizarin label ratio were significantly higher in the loaded group than in the unloaded group in regions where the maximum von Mises and principal tensile stresses were the highest along the perimeter. The label ratio of calcein was significantly lower in the 8-day loaded group than in the unloaded group, indicating that the calcein-labeled surface was resorbed by osteoclasts that appeared during the loading period. The effect of loading was mitigated by an increase in the maximum principal compressive stress. We conclude that bone resorption and bone formation are functions of site-specific tension and compression in the alveolar bone proper, confirming our hypothesis. This finding is critical for the advancement of diagnosis and treatment planning in clinical dentistry.

Retentive force of a conical crown with CAD/CAM-fabricated PEEK and zirconia secondary crowns on titanium implant abutments.

This study aimed to evaluate the retentive force of polyetheretherketone (PEEK) and zirconia secondary crowns on ready-made titanium implant abutments (with height, diameter, and taper as 5.5 mm, 4.5 mm, and 6°, respectively) as the primary crown. PEEK, zirconia, and titanium secondary crowns were fabricated using a CAD/CAM system. Insertion and removal tests of secondary crowns on the primary crown were conducted for 2,000 cycles. The initial retentive forces recorded at the 100th cycle for PEEK, zirconia, and titanium were 13.0±7.9, 2.9±2.6, and 27.6±1.7 N, respectively. The retentive forces of PEEK and zirconia showed no significant difference among all cycles. However, the retentive force of the titanium used as a control decreased (20.3±2.8 N) significantly at the 2,000th cycle. Although the retentive force of PEEK was lower than that of titanium, it was within the range that can provide a suitable retentive force of 5 N for removable dental prostheses.

Evaluation of PEEK and zirconia occlusal rest designs for removable partial dentures based on finite element analysis.

Purpose We aimed to assess removable partial denture occlusal rests composed of polyether-ether-ketone (PEEK) and zirconia, using finite element analysis.Methods Three-dimensional PEEK and zirconia rest models, including the occlusal rest (1.5 mm thickness at the basal portion, 3.0 mm width) and minor connector (1.5 mm thickness, 6.0 mm height), and rest seat models with mechanical properties of enamel were constructed. The radius of transitional curvature between the rest and minor connector was 0.1-0.5 mm. The rest and rest seat model interfaces were set as frictional contacts (µ = 0.1), and the base of the rest seat model was restrained in all the directions. A 100 N downward load was applied perpendicular to the bottom surface of the minor connector. The maximum value of the first principal stress (Max-S1) was compared to the flexural and fatigue strengths of each material. Occlusal rests with 1.0-2.0 mm thickness, 2.0-3.5 mm width, and 0.5 mm radius of transitional curvature were analyzed.Results Max-S1 was observed at the transitional part and decreased with increasing radius of the transitional curvature, rest width, and thickness. PEEK rests with at least 1.5 mm thicknesses and 3.0 mm widths showed lower Max-S1 than the flexural strength. Max-S1 of all PEEK rests exceeded the PEEK fatigue strength, whereas Max-S1 of the zirconia rests was lower than the zirconia fatigue strength.Conclusions Zirconia occlusal rests with conventional metal rest designs have sufficient fatigue strength. PEEK occlusal rests have insufficient fatigue strength and may not withstand repeated mastication.

Knowledge acquisition efficacy of a remote flipped classroom on learning about removable partial dentures.

PURPOSE: Coronavirus disease 2019 has forced the use of remote education worldwide. In 2020, the authors conducted a fully digitized, remote flipped (RF) classroom focusing on removable partial dentures. This study aimed to evaluate the learning outcomes of the RF classroom and compare these with those of the on-site classroom. METHODS: The fourth-year dental students in 2017-2019 attended on-site flipped classroom (OF; n=70) or on-site lecture classroom (OL; n=67), and those in 2020 (n=58) attended the RF classroom. Lecture videos and text were provided online in the OF and RF groups, while only the text was given to the OL group. Individual and group tests were conducted to assess knowledge acquisition one week after all the classes ended. A one-way analysis of variance following Tukey's test was performed to compare individual/group test scores among the OF, OL, and RF groups. Multilevel linear regression analysis was performed to identify the factors associated with an increase in each test score. RESULTS: The mean individual test scores in the RF and OF groups were significantly higher than in the OL group (P<0.01). The mean group test score in the RF group was significantly higher than in the OF and OL groups (P<0.001). The multilevel analysis identified remote and flipped classroom styles in the individual test, and the remote style in the group test, as significant effective factors in learning (P<0.05). CONCLUSIONS: These results suggest that the RF classroom is more effective than the on-site lecture in knowledge acquisition in undergraduate prosthodontic education.

Stress distribution of one-piece and two-piece mini-Implant overdentures with various attachment systems and diameters: A finite element analysis.

PURPOSE: We investigated and compared the stress distribution within one- and two-piece mini-implants for overdentures with three different attachments (ball, Locator, and magnet) and two different diameters using three-dimensional finite element (3D FE) analysis and a monotonic bending test. The goal was to identify the most beneficial implant attachment system design for mini-implant overdentures with a lower risk of implant fracture. METHODS: Twelve 3D FE models simulating a mandible segment with one- and two-piece mini-implants with different attachment systems, diameters, and overdentures were created using three-dimensional computer-aided design (CAD) software. Vertical and oblique forces (45° to the longitudinal axis of the implant) of 100 N were applied to the dentures. The stress distribution was analyzed. A bending test was performed on a mini-implant (Locator, 2.4 mm) using a testing machine to quantify the load at yield stress. RESULTS: One-piece mini-implants showed lower maximum stress compared to two-piece mini-implants. Among the three designs, the magnet attachment systems showed the maximum stress. The maximum von Mises stress occurred at the neck of the implants, which was surrounded by cortical bone in all models, and under both loading conditions. CONCLUSIONS: Focusing on the attachments and one- and two-piece designs of mini-implant overdentures using CAD models to reduce confounding factors affecting the stress distribution, we concluded that one-piece mini-implants tended to show lower stress compared to two-piece mini-implants. Mini-implant overdentures with Locator and ball attachments demonstrated lower stress within the implants compared to those with magnet attachments under vertical and oblique loading conditions.

Effect of Scanning Origin Location on Data Accuracy of Abutment Teeth Region in Digital Impression Acquired Using Intraoral Scanner for Removable Partial Denture: A Preliminary In Vitro Study.

The aim of this study was to investigate the effect of scanning origin location on the data accuracy of removable partial denture (RPD) abutment teeth region in digital impressions acquired by an intraoral scanner. A mandibular partially edentulous model including the following target abutment teeth was used: the left second molar (#37); left first premolar (#34); and right second premolar (#45). The following scanning strategies were tested: the strategy starting from #37 to mesial direction (37M); strategies starting from #34 to mesial (34M) and distal directions (34D), and strategies starting from #45 to mesial (45M) and distal directions (45D). The evaluated measures were trueness, precision, and linear accuracy. One-way and two-way ANOVA were performed for the comparison of trueness and linear accuracy, while Kruskal-Wallis test was performed for the precision comparison (α = 0.05). 45M and 45D showed significantly superior trueness of #34 to 37M and 34D. 45M also showed significantly superior trueness of #45 to 34. 45D showed significantly inferior linear accuracy of #34 and superior linear accuracy of #45 compared to other strategies. It was concluded that scanning origin location would have an impact on data accuracy of RPD abutment teeth region in digital impressions acquired by intraoral scanner.

Effect of retention hole designs in artificial teeth on failure resistance of the connection with thermoplastic resin.

This study aimed to evaluate the effect of retention hole designs in artificial teeth on failure resistance of the connection with a thermoplastic denture base resin. Artificial teeth with the following retention hole designs were attached to polyester and polyamide resins: no hole, vertical hole, horizontal hole, and vertical and horizontal holes. An artificial tooth with no hole attached to polymethyl methacrylate was prepared as the control. The load was applied until connection failure occurred between the artificial tooth and resin, and failure resistance was detected. Although the control showed the highest resistance, the artificial tooth with vertical and horizontal holes showed higher resistance than those with other retention hole designs in both thermoplastic resins. Providing vertical and horizontal retention holes in artificial teeth may be effective in improving failure resistance of the connection with thermoplastic resins.

Fracture resistance of CAD/CAM restorative materials in mismatched removable partial denture rests: An in vitro experimental and finite element analysis.

To evaluate the fracture resistance of computer-aided design and computer-assisted manufacturing restorations as the abutment of removable partial dentures, experimental blocks, with the rest seat made of feldspar, hybrid resin composite, lithium disilicate glass ceramic, or zirconia, were subjected to loading by a metallic occlusal rest. The rest contacted the rest seat with an accurate fit and two mismatch contact conditions: bottom and sidewall contact. Zirconia exhibited the highest fracture load, and the fracture load of the accurate fit was significantly higher than that of the sidewall contact (p<0.05) and insignificantly higher than that of the bottom contact (p>0.05). A finite element analysis of the sidewall contact revealed a higher tensile stress concentration at the bottom of the rest seat than the other contact conditions. The mismatch between the rest and the restoration reduced fracture resistance, while zirconia as the abutment withstood the average occlusal force of the posterior region.

A systematic review of digital removable partial dentures. Part I: Clinical evidence, digital impression, and maxillomandibular relationship record.

PURPOSE: This study comprehensively reviewed the current status of digital workflows in fabricating removable partial dentures (RPDs) using evidence from clinical trials and case reports. STUDY SELECTION: We performed a systematic review of the literature on the materials and fabrication of RPDs using digital technologies published in online databases from 1980 to 2020. We selected eligible articles from the search results, retrieved information on digital RPDs from these, and conducted a qualitative analysis. We report evidence from clinical papers and case reports, digital impression-taking methods, and maxillomandibular relationship (MMR) records. RESULTS: A case report electronically published in 2019 introduced a clasp-retained RPD fabricated via a full-digital workflow without a gypsum definitive cast. Computer-aided design and computer-aided manufacturing of double-crown-retained RPDs with nonmetal materials were described in some case reports. Intraoral scanners were used to obtain digital impressions and MMR records in the fabrication of digital RPDs, which have potential advantages for reducing the number of clinical appointments and simplifying laboratory procedures. Evidence from clinical trials is scarce; a randomized controlled trial reported higher patient satisfaction with digital clasp-retained RPDs than with conventional RPDs. CONCLUSIONS: Full-digital RPDs can be fabricated without a gypsum definitive cast. However, the indication for full-digital RPDs is limited to cases with Kennedy Class III/IV partially edentulous arches with several missing teeth. Challenges in digital impression-taking and MMR recording remain to be solved to extend these indications. More evidence from clinical trials is required to evaluate the efficacy and usefulness of digital RPDs.

A systematic review of digital removable partial dentures. Part II: CAD/CAM framework, artificial teeth, and denture base.

PURPOSE: This study comprehensively reviewed the current status of the digital workflow of removable partial dentures (RPDs) and summarized information about the fabrication methods and material properties of the dental framework, artificial teeth, and denture base. STUDY SELECTION: We performed a systematic review of the literature published in online databases from January 1980 to April 2020 regarding RPD fabrication and materials used in the related digital technology. We selected eligible articles, retrieved information regarding digital RPDs, and conducted qualitative/quantitative analyses. In this paper, the computer-aided design/computer-aided manufacturing (CAD/CAM) framework, artificial teeth, and denture base materials are reported. RESULTS: A variety of materials, such as cobalt-chromium alloy, titanium, zirconia, and polyether ether ketone, are used for dental CAD/CAM frameworks. The mechanical strength of the metal materials used for the CAD/CAM framework was superior to that of the cast framework. However, the fitness and surface roughness of the framework and clasp fabricated using a selective laser melting (SLM) method were not superior to those obtained via cast fabrication. Most material properties and the surface roughness of poly methyl methacrylate (PMMA) discs used for digital RPDs were superior to those of heat-cured PMMA. CONCLUSION: The use of a CAD/CAM framework and PMMA disc for digital RPDs offers numerous advantages over conventional RPDs. However, technical challenges regarding the accuracy and durability of adhesion between the framework and denture base remain to be solved. In digital fabrication, human technical factors influence the quality of the framework.

Flexural and fatigue properties of polyester disk material for milled resin clasps.

To evaluate the flexural and fatigue properties of a polyester disk material used in milled resin clasps of removable partial dentures, experimental polyester disk (mPE), injection-molded polyester (iPE), and polymethyl methacrylate disk (mPMMA) were examined by three-point bending tests and cyclic fatigue tests at 0.75 or 1.50 mm deflection. The mPE exhibited significantly higher flexural strength than the iPE (p<0.05). Meanwhile, the mPMMA displayed higher flexural modulus and strength than the polyesters. The mPE exhibited a significantly lower residual strain than the iPE at the cyclic 0.75 mm deflection (p<0.05); however, microcracks were observed in the mPE at the 1.50 mm deflection. The mPMMA showed a high residual strain at the 0.75 mm deflection and fractured within 1,000 cycles at the 1.5 mm deflection. The higher flexural strength and lower residual strain of the mPE compared with the iPE suggest the advantages of milled resin clasps within a limited deflection.

Influence of retainer and major connector designs of removable partial dentures on the stabilization of mobile teeth: A preliminary study.

The purpose of this study was to investigate the influence of retainers and major connector designs on the stabilization of remaining mobile teeth using removable partial dentures (RPDs). We prepared experimental RPDs with several retainer designs and major connectors for lower Kennedy class I models. The simulated RPD insertion and removal test was conducted and retentive force and mobility of mobile remaining teeth with and without RPD placement were measured throughout a simulation test. Regardless of reduction of retentive force, the placement of RPDs using cast clasps and/or lingual plates resulted in reduced mobility of the remaining teeth than use of wrought wire clasps and/or lingual bars. The results suggested that cast clasps and lingual plates are effective for the stabilization of mobile, remaining teeth. Additionally, the stabilizing effect of RPD on abutment teeth was not diminished, despite decreases in retentive force.

Influence of block-out on retentive force of thermoplastic resin clasps: an in vitro experimental and finite element analysis.

PURPOSE: The purpose of this study was to determine the effect of block-out preparation, used to eliminate the undercut area, on the retentive force and stress distribution of resin clasps. METHODS: A total of 72 polyester and polyamide resin clasps were fabricated on a premolar abutment crown following six block-out preparations. A combination of two types of vertical block-outs and three types of horizontal block-outs (on the missing side) was used on the abutment tooth. Each clasp was subjected to an in vitro removal test using a universal testing machine. The retentive force and traces of the clasp on the abutment tooth were recorded and analyzed with one-way analysis of variance and post hoc comparisons (α=0.05). Non-linear finite element analysis was performed to assess the stress distributions of the resin clasps. RESULTS: Resin clasps with a vertical block-out of 0.75mm undercut showed significantly higher retentive force than those with the 0.5mm undercut. Resin clasps with horizontal block-out showed significantly lower retentive force than those without horizontal block-out. There was no significant difference between the two thermoplastic resins. The maximum first principal stress of the resin clasp was concentrated under the shoulder of the clasp and strongly influenced by the width of horizontal block-out in the finite element analysis. CONCLUSIONS: This in vitro experiment suggested that a horizontal block-out is necessary even for a 0.5-mm undercut. The design of the resin clasp should be considered from two aspects: retentive force and deformation risk.

The ball-on-disk cyclic wear of CAD/CAM machinable dental composite and ceramic materials.

The purpose of this study was to investigate the wear volume and the principal strain of machinable dental composite and ceramics in simulated mastication. A ball-on-disk wear test was performed for 3,000 cycles in water, using nine ball/disk combinations of three commercial CAD/CAM materials: feldspathic, lithium disilicate glass ceramics, and a highly loaded composite material (n = 7 for each combination). The wear volume was optically measured using a digital scanner and analyzed for statistical differences based on the materials (α = 0.05). We used non-linear finite element analysis to calculate the principal strain. The wear volume of the ball was significantly larger than that of the disk when hardness and fracture toughness of the former was lower than that of the latter and vice versa (P < 0.05). The lithium disilicate glass ceramic constantly showed lower wear volume than the opposing antagonist. Except for the same material pairs of feldspathic and composite, the ball or disk specimen that showed a larger wear in the occluding pair coincided with the one with higher maximum strain. It was not possible to predict the magnitude of wear, whereas the result suggested a strong association between the maximum strain and wear volume of the ceramic surface.

Influence of denture tooth thickness on fracture mode of thin acrylic resin bases: An experimental and finite element analysis.

STATEMENT OF PROBLEM: The optimum selection of denture teeth for patients with a reduced interarch distance has not been established. PURPOSE: The purpose of this in vitro study was to investigate the influence of denture tooth material and thickness on the fracture resistance of thin acrylic resin denture bases. MATERIAL AND METHODS: Acrylic resin (AC), composite resin (CO), or ceramic (CE) molar denture teeth were embedded in denture base blocks (2.0 mm thick). The distance from the central fossa to the tooth base was 0.5, 1.0, 2.0, or 2.5 mm for AC and CO, and 1.0 mm for CE (n=7), with a total thickness of 2.5 mm for all specimens. Each specimen was placed on a 3-point flexural setup with a shorter (8 mm) or longer (12 mm) support span than the tooth width and vertically loaded. A finite element analysis was performed to assess the stress distributions. The effects of tooth thickness and support span were statistically tested with ANOVA, followed by the Tukey honestly significant difference post hoc test (α= .05). RESULTS: With the shorter support, the mean fracture load was higher in CO than AC, regardless of the tooth thickness. Under the longer support, the mean fracture load with the CO decreased significantly as the tooth thickness increased, with increased maximum stress. Some CO tooth specimens of 2.0 mm or 2.5 mm thickness failed at the tooth-denture base interface at significantly lower loads than those exhibited by tooth fractures. CE showed minor cracks before bulk fracture. CONCLUSIONS: Higher fracture resistance was indicated with CO; however, the resistance decreased as the thickness of the CO tooth increased.

Finite element contact analysis as a critical technique in dental biomechanics: a review.

PURPOSE: Nonlinear finite element contact analysis is used to mathematically estimate stress and strain in a time- and status-dependent mechanical model. However, the benefits and limitations of this method have not been thoroughly examined. STUDY SELECTION: The current review summarizes the utility of contact analysis in characterizing individual stressors: (1) tooth-to-tooth contact, (2) restorative interface, and (3) bone-implant integration. RESULTS: Opposing tooth contact, friction, and sliding phenomena were simulated to estimate stress distribution and assess the failure risk for tooth enamel, composite, and ceramic restorations. Mechanical tests such as the flexural tests were simulated with the contact analysis to determine the rationale underlying experimental findings. The tooth-restoration complex was modeled with interface contact elements that simulate imperfect bonding, and the normal and tangential stresses were calculated to predict failure progression. Previous studies have used a friction coefficient to represent osseointegration adjacent to dental implants, but the relationship between interface friction and the bone quality is unknown. An understanding of the local stress and strain may better predict loss of osseointegration, however, the effective stress as a critical contributor to bone degradation and formation has not been established. CONCLUSIONS: Contact analysis provides numerous benefits for dental and oral health sciences, however, a fundamental understanding and improved methodology are necessary.

Effect of high-pressure polymerization on mechanical properties of PMMA denture base resin.

The aim of this study was to assess the effect of high-pressure polymerization on mechanical properties of denture base resin. A heat-curing denture base resin and an experimental PMMA were polymerized under 500MPa of pressure by means of an isostatic pressurization machine at 70°C for 24h to make rectangular specimens whose dimensions were 30mm×2mm×2mm. Each specimen was deflected on a three-point flexural test until either fracture occurred or the sample was loaded up to 8mm in deflection. The molecular weight of the PMMA without filler was analyzed using the high-speed liquid chromatography system. Increased ductility without fracture was shown in the specimens subjected to high pressure, while most of the control specimens (ambient pressure) fractured. The mean toughness of the PMMA specimens polymerized under the high pressure was significantly higher than the same material polymerized under ambient pressure (p<0.01). The high pressure groups of the denture resin and the PMMA revealed a significantly lower mean 0.2% yield stress, flexural strength, and elastic modulus than control groups (p<0.01). There were certain amounts of higher molecular weight polymers in the high pressure specimens than were present in the controls. The increased toughness shown in the PMMA polymerized under the high pressure was presumably attributed to the higher molecular weight produced by the pressure. The result suggests a potential application of the high-pressure polymerization to the development of PMMA-based denture resin with improved fracture resistance.

Self-reported seafood intake and atopy in Japanese school-aged children.

BACKGROUND: The effects of fish consumption and n-3 poly-unsaturated fatty acid (PUFA) levels on atopic disorders are inconsistent in previous reports, but few studies have investigated the effects of both fish and n-3 PUFA. The aim of the present study was to investigate whether erythrocyte fatty acids and the consumption of fish are associated with atopic diseases in pre- and early adolescents. METHODS: A total of 135 students with eczema, 136 students with asthma, and 137 healthy control students were selected from fifth and eighth grades in Shunan, Japan. Atopic disorders and dietary intake were evaluated with questionnaires, and total serum IgE was measured using an enzyme-linked immunosorbent assay. In addition, erythrocyte membrane levels of PUFA were assessed via gas chromatography. RESULTS: Total IgE was significantly elevated in the atopic subjects (P < 0.001). The intake of fatty and dried fish or seafood was significantly associated with eczema (odds ratios of the highest quartiles: 0.46, 95% confidence interval (95%CI): 0.22-0.94; 0.34, 95%CI: 0.16-0.71, respectively). Additionally, only erythrocyte eicosapentaenoic acid (EPA) level had a negative association with eczema (P= 0.048). For asthma, the effect of fish consumption was not significant. CONCLUSIONS: Fish consumption was related to a low prevalence of eczema, but not asthma in Japanese pre- and early adolescents. EPA may be involved in this mechanism.