Dental care and treatment needs of elderly in nursing homes in Saarland: perceptions of the homes managers.

OBJECTIVE: To investigate nursing home managers' perceptions and attitudes towards oral health care and access to dental services for aged care facility residents. METHOD: Questionnaires containing 28 closed-ended questions were mailed to all 114 nursing homes in Saarland, Germany. Descriptive statistics were calculated for response items. RESULTS: Facility response rate was 39%. None of the nursing homes in this study offered systematic dental health care. Initial dental screening was carried out only in one facility. In 81%, dental examinations only took place if required. Although stationary dental equipment was available only in one home, dental treatment was carried out in 71% of the cases by a dentist in the nursing home. Eighty-four per cent of the homes' managements rated the state of the dentition of the inhabitants as satisfying. Over half of the managers indicated satisfaction with the know-how of their nursing staff concerning oral hygiene procedures. The most significant barriers to provision of dental care in the facilities according to their managers were staff shortage, lack of interest of the inhabitants and financial concerns. CONCLUSIONS: The results of this study showed an urgent need for estimating a programme for systematic dental care for institutionalised elder people in the federal state of Saarland.

Investigations of subcritical crack propagation of the Empress 2 all-ceramic system.

INTRODUCTION: The mechanical properties and slow crack propapagation of the all-porcelain system Empress 2 (Ivoclar Vivadent, Schaan, Liechtenstein) with its framework compound Empress 2 and the veneering compounds "Empress 2 and Eris were examined. METHODS: For all materials, the fracture strength, Weibull parameter and elastic moduli were experimentally determined in a four-point-bending test. For the components of the Empress 2 system, the fracture toughness K(IC) was determined, and the crack propagation parameters n and A were determined in a dynamic fatigue method. Using these data, life data analysis was performed and lifetime diagrams were produced. The development of strength under static fatigue conditions was calculated for a period of 5 years. RESULTS: The newly developed veneering ceramic Eris showed a higher fracture strength (sigma(0)=66.1 MPa) at a failure probability of P(F)=63.2%, and crack growth parameters (n=12.9) compared to the veneering ceramic Empress 2 (sigma(0)=60.3 MPa). For Empress 2 veneer the crack propagation parameter n could only be estimated (n=9.5). This is reflected in the prognosis of long-term resistance presented in the SPT diagrams. For all materials investigated, the Weibull parameter m values (Empress 2 framework m=4.6; Empress 2 veneer m=7.9; Eris m=6.9) were much lower than the minimum demanded by the literature (m=15). SIGNIFICANCE: The initial fracture strength value alone is not sufficient to characterize the mechanical resistance of ceramic materials, since their stressability is time-dependent. Knowledge about the crack propagation parameters n and A are of great importance when preclinically predicting the clinical suitability of dental ceramic materials. The use of SPT diagrams for lifetime calculation of ceramic materials is a valuable method for comparing different ceramics.