A forensic identification case and DPid - can it be a useful tool?

OBJECTIVE: The aim of this study was to show DPid as an important tool of potential application to solve cases with dental prosthesis, such as the forensic case reported, in which a skull, denture and dental records were received for analysis. MATERIAL AND METHODS: Human identification is still challenging in various circumstances and Dental Prosthetics Identification (DPid) stores the patient's name and prosthesis information and provides access through an embedded code in dental prosthesis or an identification card. All of this information is digitally stored on servers accessible only by dentists, laboratory technicians and patients with their own level of secure access. DPid provides a complete single-source list of all dental prosthesis features (materials and components) under complete and secure documentation used for clinical follow-up and for human identification. RESULTS AND CONCLUSION: If DPid tool was present in this forensic case, it could have been solved without requirement of DNA exam, which confirmed the dental comparison of antemortem and postmortem records, and concluded the case as a positive identification.

A forensic identification case and DPid - can it be a useful tool?

Abstract Objective The aim of this study was to show DPid as an important tool of potential application to solve cases with dental prosthesis, such as the forensic case reported, in which a skull, denture and dental records were received for analysis. Material and Methods Human identification is still challenging in various circumstances and Dental Prosthetics Identification (DPid) stores the patient's name and prosthesis information and provides access through an embedded code in dental prosthesis or an identification card. All of this information is digitally stored on servers accessible only by dentists, laboratory technicians and patients with their own level of secure access. DPid provides a complete single-source list of all dental prosthesis features (materials and components) under complete and secure documentation used for clinical follow-up and for human identification. Results and Conclusion If DPid tool was present in this forensic case, it could have been solved without requirement of DNA exam, which confirmed the dental comparison of antemortem and postmortem records, and concluded the case as a positive identification.

Stress analysis of a complete maxillary denture under various drop impact conditions: a 3D finite element study.

Complete maxillary dentures are one of the most economic and easy ways of treatment for edentulous patients and are still widely used. However, their survival rate is slightly above three years. It is presumed that the failure reasons are not only due to normal fatigue but also emerge from damage based on unavoidable improper usage. Failure types other than long-term fatigue, such as over-deforming, also influence the effective life span of dentures. A hypothesis is presumed, stating that the premature/unexpected failures may be initiated by impact on dentures, which can be related to dropping them on the ground or other effects such as biting crispy food. Thus, the behavior of a complete maxillary denture under impact loading due to drop on a rigid surface was investigated using the finite element method utilizing explicit time integration and a rate-sensitive elastoplastic material model of polymethylmethacrylate (PMMA). Local permanent deformations have been observed along with an emphasis on frenulum region of the denture, regardless of the point of impact. Contact stresses at the tooth-denture base were also investigated. The spread of energy within the structure via wave propagation is seen to play a critical role in this fact. Stress-wave propagation is also seen to be an important factor that decreases the denture's fatigue life.

Implementation of a laboratory quality assurance program: the Louisville experience.

Remakes, or the refabrication of dental prostheses, can occur as a result of inherent inaccuracies in both clinical and laboratory procedures. Because dental schools manage large numbers of predoctoral dental students with limited familiarity and expertise as related to clinical prosthodontic techniques, it is likely these schools will experience an elevated incidence of laboratory remakes and their ramifications. The University of Louisville School of Dentistry, not unlike other dental schools, has experienced remakes associated with both fixed and removable prosthodontic procedures. Limitations in faculty standardization and variable enforcement of established preclinical protocols have been identified as variables associated with the high percentage of remakes documented. The purpose of this study was to introduce the implementation of a new multidepartmental quality assurance program designed to increase consistency and quality in both information provided to commercial dental laboratories and the prostheses returned. The program has shown to be advantageous in terms of cost-effectiveness and treatment outcomes. A statistically significant decrease in remake percentages has been recorded from inception of this program in December 2010 until December 2012. Furthermore, this program has resulted in more consistent communication between the dental school and commercial dental laboratories, among faculty members, and between faculty and students.

The importance of correct diagnosis in complete dentures treatment.

A 68 years edentulous female, wearing unsuccessful complete dentures, was treated by making a new set of dentures. The main initial complains were unaesthetic teeth, excessive gums display, speech impairment and severe difficulties in mastication. With the patient's full collaboration and following sound established prosthodontics principles, a successful set of full dentures was provided. The main changes performed with the new set of dentures were: A. Provision of three millimeters interocclusal rest space between the vertical dimension while in occlusion and the vertical dimension of rest. B. The full anterior and premolars maxillary teeth and the incisal's third of the mandibular anterior teeth were displayed when patient was speaking, smiling and laughing. No artificial gums were displayed during any normal facial or oral activities. C. The occlusal plane was established after the selection of the anterior teeth. The plane was made parallel to the ala tragus (Camper's) line.

Who is qualified to design?

Now that registration is in place for dental technicians, it is important to know where our experience and knowledge fit into the GDC dental team. Knowing one's position in that team will help it to become a well oiled machine and help us to produce what the patient wants, without costly mistakes. New materials and techniques often open different treatment plan options and using the technologist's experience will help with costs to the dentist and the patient, and avoid possible problems. I wanted to ask a few questions regarding the experience of dental technologists and the training of dental students, to see whether we could blend or share some of the responsibilities of some appliance designs.

[The registration of false teeth and the others].

The quality control of false teeth should include the control for designing and processing. The registration of false teeth should emphasize particularly on the qualification of the makers, technology management, quality control and the labeling.

The effect of denture quality attributes on satisfaction and eating difficulties.

OBJECTIVES: The development of a measure, with complimentary normative and perceived needs, for the investigation of functional impairment of individual patients and the investigation of the physical causative bases of impairment. SUBJECTS: A consecutive sample of 119 complete denture (CD) wearers attending a Greek department of prosthetic dentistry took part in the study. All subjects presented with some complaint(s) of their dentures. METHOD: Functional assessment of dentures (FAD) criteria and structured questionnaires were used covering denture satisfaction (DS) and food difficulties with CDs. The questions used a five-point Likert scale. RESULTS: The results showed that there were statistically significant associations between satisfaction from dentures and eating specified foods. Statistically significant associations were also found between denture qualities and movement of upper dentures and difficulty eating specified foods, but not with an open question on the difficulty of eating unspecified foods. CONCLUSIONS: This study successfully validated a suitable model for the combined evaluation of denture quality with clear diagnostic criteria and closed questions on DS and perceived difficulties when eating specified foods. This could predict the need for treatment, monitor the impact of care and provide a feasible measure to meet the need of everyday clinical situations.

Low dietary quality among older adults with self-perceived ill-fitting dentures.

OBJECTIVE: To examine dietary quality and nutrient intakes of participants wearing dentures with and without poor fit as determined by questionnaire and dental exam. DESIGN: Nutrient intakes, Healthy Eating Index (HEI) score, and serum nutrient values were examined among individuals wearing either adequate- or poor-fitting dentures and individuals who had at least 18 teeth. SUBJECTS/SETTING: Data was collected from 4,820 participants in the Third National Health and Nutrition Examination Survey ages 50 years and older with at least 18 teeth (n=3,207) or those wearing dentures (n=1,613), who responded to a questionnaire about denture fit and had their dentures evaluated by a dentist. STATISTICAL ANALYSES PERFORMED: Analysis of covariance and multivariate linear regression analyses were used to examine associations between individuals fully dentate, wearing good-or ill-fitting dentures, and nutritional status indicators. RESULTS: The group with self-perceived ill-fitting dentures compared with the group with natural teeth had significantly lower total HEI (66.5 vs 68.5 P<.002), vegetables (6.3 vs 6.8 P<.01), and variety scores (7.8 vs 8.2 P<.02); lower ascorbic acid (P<.009) and carotene intakes (P<.004). The group with self-perceived good-fitting dentures did not differ significantly from the dentate group. However, both groups wearing dentures had significantly lower serum levels of vitamins C and E, beta carotene, folate, lutein, and lycopene/zeaxanthin compared with the dentate group. APPLICATIONS/CONCLUSIONS: Dietary quality and intake of certain nutrients was poorer among the group with self-perceived ill-fitting dentures than among those wearing adequate dentures or those with natural teeth. Administering a simple questionnaire to patients about their perceptions of denture fit may be useful in identifying denture wearers at increased risk of dietary inadequacy.

[Simulation of pigmented mucosa in complete dentures: development of an oral pigment index]. / Simulatie van de gepigmenteerde mucosa in gebitsprothesen: ontwikkeling van een classificatie.

In the non-Caucasian population the skin and oral tissues show pigmentation to a variable degree, but much more than in Caucasian. When a person becomes edentulous, the tissues containing oral pigmentation disappear. The patient's ethnic background gives no information to predict the characteristics of individual oral pigmentation; other sources have to be found. The mucosal pigmentation of 106 non-Caucasian, dentate people in Amsterdam and Los Angeles was investigated; a classification-chart of oral pigmentation with six types was designed. This tool makes it possible to help patient, dentist and dental technician to choose an accurate simulation of the contour of oral pigmentation in a denture. It is recommended to document the individual pigmentation before extractions are performed.

Provision of removable denture prosthesis at a university teaching hospital in Kenya.

OBJECTIVE: To compile an audit of removable denture prosthesis fabricated for patients attending a teaching clinic. DESIGN: A retrospective analysis. SETTING: Division of Prosthetic Dentistry, Faculty of Dental Sciences, University of Nairobi, Nairobi, Kenya. METHOD: Clinical records of the patients attended to in the prosthetic teaching clinic from 1993 to 1997 inclusive were analysed to extract information regarding the quality of clinical notes and the pattern of provision of prostheses. RESULTS: A total of 817 patients were provided with dentures of whom 602 were provided with complete upper and lower dentures. Single complete dentures were fabricated for 18 patients and 197 patients had partial dentures fabricated. CONCLUSION: While the number of prostheses provided may be in conformity with the unit resources, clinical notes were found to have significant omissions for which recommendations have been suggested.

Oral health and denture quality: a pilot study in Trinidad

OBJECTIVE: To assess the quality of dentures worn by a sample of the population in Trinidad and respondents' attitude towards their oral health and dentures. DESIGN AND METHODS: Respondents to advertisements in all the local newspapers for persons wearing full dentures were interviewed and examined clinically. Dentures were examined for processing defects. Mandibular functional movements were measured and dentures were evaluated for reproduction of these movements. RESULTS: In the 54 subjects studied none of the dentures were made to function with mandibular jaw movements. For the maxilla and mandibular dentures, 96.8 percent of the axial inclination of the teeth were set incorrectly. All of the denture extensions were found to be short and none had any retention or stability. None of the participants had post delivery visits. The majority (77.5 percent) of all the dentures had never been repaired and 61.3 percent had fractured teeth. A majority (51.6 percent) of participants were found to be in need of palliative treatment and 48.4 percent needed urgent treatment. The primary concerns of the participants were that they were slack (35.5 percent). The majority of dentures sampled (80.6 percent) were made by a dental technician who also did the clinical procedures. CONCLUSIONS: The dentures made in Trinidad fall below acceptable standards and majority were made without any relation to functional jaw movements. However, patients' compliance with their prostheses was high (75 percent). There is an urgent need to a concerted effort by health officials to standardize oral health care.(AU)

Patient satisfaction and dentist evaluation of dentures in South Africa.

Denture satisfaction of 100 indigent South Africans, with a mean age of 70.36 years was assessed. Patient satisfaction was compared with measures of occlusion and stability as determined by a dentist. The mean age of the upper and lower dentures was 20 and 21 years respectively. The quality and function of most of the dentures were regarded by the dentists as poor. Of the 59 per cent upper and 49 per cent lower dentures regarded as satisfactory by the elderly, only 17.5 per cent and 5 per cent respectively were evaluated as having good stability. Sixty-nine per cent of those with complete upper and lower dentures said they could eat with their dentures, while only 11 per cent of this group were rated by the dentist as having good occlusion. There existed a big discrepancy between determinants of patient satisfaction and the dentist's evaluation of good stability and occlusion, indicating that patient satisfaction encompasses qualities other than the measures used by the dentist. Once the threshold of satisfaction was achieved, ill-fitting and looseness of dentures took on lesser importance.

Enceramento dos casquetes para retentores com problemas periodontais / Metallic coping's waxing for abutments with periodontal diaseases

Os autores fazem uma revisäo da literatura e analisam o inter-relacionamento Prótese/Periodontia na restauraçäo de dentes com doenças periodontais e chegam às seguintes conclusöes: o protesista e o periodontista devem trabalhar em perfeita sintonia. Todos os esforços devem visar a obtençäo de preparos corretos e restauraçöes sem sobrecontorno, para evitar o acúmulo de placa bacteriana e, ao mesmo tempo, facilitar o acesso à higienizaçäo. Sempre que possível, as margens cervicais das restauraçöes devem ser supragengivais. Por isso, o enceramento dos casquetes deve ser bem planejado

[Prosthesis treatment of nursing home residents. New prosthesis preparation or improvement of existing one?]. / Prothetische behandeling van verpleeghuisbewoners. Nieuwe prothese vervaardigen of de bestaande verbeteren?

From a clinical point of view one should show restraint in preparing new dentures for elderly people. It is advised to improve existing dentures. This research project shows that both treatments in elderly, somatically handicapped, nursing home residents do not diminish their complaints and dissatisfaction. Obviously, they are best served by a problem-centred treatment.

Repeatability of a specially designed intraoral colorimeter.

A specially modified Minolta CS-100 colorimeter with a DP-101 data processor was designed for intraoral use. To test the repeatability of the results obtained with this specially modified unit, five porcelain and five acrylic resin denture teeth were mounted in a fixed position in front of a fixed mounted meter. Three L*a*b* readings were taken per tooth and mean values were obtained after calibration as a baseline measurement. The readings were repeated on day 3 without recalibration and on day 8 after recalibration. The same-day repeatability showed delta E values < 0.4 in nine of the 10 samples. The day 3 repeatability showed delta E values < 0.4 in only 2 of the 10 samples. The day 8 results, after recalibration, showed delta E values > 0.4 in all of the samples, with a range of 0.57 to 2.75. In vivo testing was performed on five patients with delta E values that ranged from 1.1 to 32.1.

Projeto e planejamento em prótese dentária / Project and planning on dental prosthesis

O objetivo deste trabalho é acrescentar esforços numa tentativa de estabelecer um melhor relacionamento técnico-profissional entre dentistas e protéticos com a interação dos pacientes, meta que vem sendo perseguida há muitos anos pelos profissionais de ambos os setores. Sem uma metodologia de trabalho conveniente e eficaz em que as duas partes possam trabalhar juntas, não se podem vislumbrar possibilidades a curto prazo, sem evidentes prejuízos, para o aperfeiçoamento dos trabalhos nessa área