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Dentate Patients (dentate + patient)
Selected AbstractsClassification System for the Completely Dentate PatientJOURNAL OF PROSTHODONTICS, Issue 2 2004Thomas J. McGarry DDS The American College of Prosthodontists (ACP) has developed a classification system designed for use by dental professionals in the diagnosis and treatment of completely dentate patients. This classification is the third in a series and is similar to the Classifications for Complete Edentulism and Partial Edentulism previously developed by the ACP. These guidelines are intended to aid practitioners in the systematic diagnosis of each patient which, in turn, should lead to an appropriate treatment. Four categories of a completely dentate situation are defined (Class I,IV), differentiated by specific diagnostic criteria, with Class I representing an uncomplicated clinical situation and Class IV representing the most complex clinical situation. Potential benefits of the system include (1) improved intraoperator consistency, (2) improved professional communication, (3) insurance reimbursement commensurate with complexity of care, (4) an improved screening tool for dental school admission clinics, (5) standardized criteria for outcomes assessment and research, (6) enhanced diagnostic consistency, and (7) a simplified aid in the decision-making process associated with referral. [source] Do pre-irradiation dental extractions reduce the risk of osteoradionecrosis of the mandible?HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 6 2007Daniel T. Chang MD Abstract Background. This study was done to determine if pre-radiotherapy (pre-RT) dental extractions reduce the risk of osteoradionecrosis (ORN). Methods. Between 1987 and 2004, 413 patients with oropharyngeal carcinomas were treated with definitive RT at the University of Florida. Dentate patients underwent pretreatment dental evaluation. Teeth in the RT field were usually extracted if thought to have poor long-term prognosis from dental disease. The endpoint was ,grade 2 ORN using a modified staging system. Patients were excluded for local recurrence, additional RT above the clavicles, or head and neck surgery besides neck dissection. Results. ORN rates were as follows: edentulous, <1%; teeth in-field with pre-RT extractions, 15%; and teeth in-field without pre-RT extractions, 9%. Patients with poor in-field teeth and pre-RT extractions had a higher 5-year incidence of ORN than those who did not have pre-RT extractions (16% vs 6%, p = .48). Likewise, for those with in-field teeth in good condition and pre-RT extractions, the 5-year ORN incidence was higher than for those who did not undergo extractions (15% vs 2%, p = .42). Multivariate analysis revealed increased ORN risk with doses of >70 Gy, once-daily fractionation, or brachytherapy. Conclusion. Pre-RT extractions do not appear to reduce the risk of ORN. © 2007 Wiley Periodicals, Inc. Head Neck, 2007 [source] Measurements of Tooth Movements in Relation to Single-Implant Restorations during 16 Years: A Case ReportCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2005Torsten Jemt LSD ABSTRACT Background: Osseointegrated implants behave as ankylotic abutments, and their positions are not affected by dentofacial changes. Purpose: To measure changes in occlusion in relation to single implants in one patient after more than 15 years in function. Materials and Methods: One 25-year-old female was treated with two single implants in the upper central incisor and bicuspid area after trauma. Study casts made prior to treatment (1987) and after 16 years in function (2004) were scanned by means of an optical scanner. Using the palate as the reference, the models were placed in the same coordinate system and analyzed and compared in a computer-aided design (CAD) program. The results of the measurements of the casts were also compared with clinical photographs taken at the time of treatment (1988), after 9 years (1997), and after 16 years (2004) in function. Results: The clinical photographs showed obvious signs of implant infraposition after 9 years. New crowns were made in the incisor region after 15 years (2002), but signs of infraposition were again present at the final examination (2004). Measurements of the casts indicated small tooth movements with a pattern of slight eruption of upper teeth combined with a palatal inclination, mesial drift, and lingual inclination and crowding of the lower anterior teeth. The small measured vertical eruption of the teeth was less than the observed clinical infraposition of the implant crowns, indicating that the vertical position of the palatal may have changed in relation to the implants as well. Conclusion: Obvious dentofacial changes may take place in adult patients. Teeth may adjust for this, and no major problems may arise in the dentate patient. However, because the positions of implants are not affected by dentofacial changes, other patterns of clinical problems can be seen when implant patients present with these changes. The character and frequency of these dentofacial changes that may compromise implant treatment in the long term are not yet known. [source] Correlation between the Individual and the Combined Width of the Six Maxillary Anterior TeethJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 3 2009LUIZ CARLOS GONÇALVES DMD ABSTRACT Purpose:, There is a consensus in the community of dental research that the selection of undersized artificial maxillary anterior teeth offers an unnatural appearance to the denture. Several methods to select the adequate width of these teeth are of questionable validity, and many dentures have an obviously artificial appearance. This article assessed the relationship between the individual and the combined width of maxillary anterior teeth. Materials and Methods:, Impressions were made of the anterior dentition of 69 dentate undergraduate students with rubber impression silicon, and casts were formed. The individual widths of the maxillary anterior teeth were measured by using a digital caliper (SC-6 digital caliper, Mitutoyo Corporation, Tokyo, Japan), and the combined width was registered by both adding the individual width and using a flexible millimeter ruler. Results:, Student's t -test showed significant differences between the analogous teeth and different sides of the maxillary dental arch (p = 0.001), with the exception of the central incisor (p = 0.984). Pearson's product moment correlation coefficient showed significant positive correlation between all the measurements compared (p = 0.000). Linear regression analysis concluded three mathematical equations to obtain the individual tooth width after measuring the combined width of the six maxillary anterior teeth by using a flexible millimeter ruler. Conclusions:, The individual tooth width can be determined if the combined width of the maxillary anterior teeth is obtained by using a flexible millimeter ruler. CLINICAL SIGNIFICANCE The adequate selection of each maxillary anterior tooth width can offer variance and individuality to the denture, particularly for partially dentate patients. By offering an adequate tooth-to-tooth relationship, the esthetic result of the oral rehabilitation treatment can be improved. [source] Biofilms in the Edentulous Oral CavityJOURNAL OF PROSTHODONTICS, Issue 5 2008Amit Sachdeo BDS, DMSc Abstract Purpose: The oral cavity presents numerous surfaces for microbial colonization. These surfaces produce biofilms of differing complexities unique to each individual. Several studies have looked at biofilms in dentate patients. There has been limited research regarding biofilms on dentures or soft tissues of edentulous patients. The purpose of the present investigation was to provide meaningful data describing microbial ecological relationships in the oral cavity of edentulous patients and to evaluate the microbiota on hard and soft tissue surfaces and saliva in edentulous patients wearing complete dentures. Materials and Methods: Sixty-one edentulous subjects with complete maxillary and mandibular dentures were recruited. "Supragingival" biofilm samples were taken from 28 denture teeth for each subject. Biofilm samples were also taken from the dorsal, lateral, and ventral surfaces of the tongue, floor of mouth, buccal mucosa, hard palate, vestibule/lip, "attached gingiva," and saliva. Samples were individually analyzed for their content of 41 bacterial species using checkerboard DNA,DNA hybridization. Levels and proportions of each species were determined for every sample location. Results: Periodontal pathogens such as Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis were clearly present in the samples from the edentulous subjects. Microbial profiles in samples from the soft tissue surfaces differed among site locations. Samples from the dorsum of the tongue exhibited the highest bacterial counts followed by the "attached gingiva" and the lateral surfaces of the tongue, while the lowest mean counts were found in samples from the buccal mucosa and labial vestibules. Using cluster analysis of the proportions of the test species, three clusters were formed. The first cluster comprised saliva, supragingival plaque, and the lateral and dorsal surfaces of the tongue. The second cluster comprised the other six soft tissue surfaces. Species on the denture palate formed a third cluster. Conclusions: One of the major findings in this study was the detection of periodontal pathogens, A. actinomycetemcomitans and P. gingivalis, in the edentulous subjects, as these species were thought to disappear after removal of all natural teeth. This finding has implications regarding future dental treatment and the general health of individuals. Distinct patterns of microbial colonization were seen on the different soft tissue surfaces. Thus, this investigation provided the first step in defining the organisms that are associated with edentulous patients on both soft (mucosa) and hard surfaces (denture). The study also provided meaningful data that described microbial ecological relationships in the oral cavity of edentulous subjects. The authors believe that this study is the first comprehensive assessment of the microbiota in the complete denture-wearing subject. [source] Classification System for the Completely Dentate PatientJOURNAL OF PROSTHODONTICS, Issue 2 2004Thomas J. McGarry DDS The American College of Prosthodontists (ACP) has developed a classification system designed for use by dental professionals in the diagnosis and treatment of completely dentate patients. This classification is the third in a series and is similar to the Classifications for Complete Edentulism and Partial Edentulism previously developed by the ACP. These guidelines are intended to aid practitioners in the systematic diagnosis of each patient which, in turn, should lead to an appropriate treatment. Four categories of a completely dentate situation are defined (Class I,IV), differentiated by specific diagnostic criteria, with Class I representing an uncomplicated clinical situation and Class IV representing the most complex clinical situation. Potential benefits of the system include (1) improved intraoperator consistency, (2) improved professional communication, (3) insurance reimbursement commensurate with complexity of care, (4) an improved screening tool for dental school admission clinics, (5) standardized criteria for outcomes assessment and research, (6) enhanced diagnostic consistency, and (7) a simplified aid in the decision-making process associated with referral. [source] Submental intubation in complex craniomaxillofacial traumaANZ JOURNAL OF SURGERY, Issue 5 2004Charles Davis The submental route for endotracheal intubation is an alternative to nasal intubation or tracheostomy in the surgical management of patients with complex craniomaxillofacial injuries. The critical indication for submental intubation is the requirement for intraoperative maxillomandibular fixation (MMF) in the presence of injuries that preclude nasal intubation and in a situation where a tracheostomy is not otherwise required. MMF to re-establish dental occlusion is essential for a normal functional result in dentate patients with fractures involving alveolar segments of the jaws. However, MMF precludes orotracheal intubation. Nasotracheal intubation is often used but is contraindicated in the presence of skull base fractures and will interfere with the access to certain fracture types. A tracheostomy has a high potential complication rate and in many patients, an alternative to the oral airway is not required beyond the perioperative period. A submental intubation has been used in 11 selected cases amongst 190 consecutively treated patients with craniomaxillofacial trauma over a 3-year period. These cases have been retrospectively reviewed and there have been no significant complications. The indications and technique used are described. Submental intubation is a simple and useful technique with low morbidity in selected cases of craniomaxillofacial trauma and the author's clinical experience with this technique is described. [source] One-Year Prospective Three-Center Study Comparing the Outcome of a "Soft Bone Implant" (Prototype Mk IV) and the Standard Brånemark ImplantCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2003Bertil Friberg DDS ABSTRACT Background: Oral implant treatment ad modum Brånemark has been used for decades in the rehabilitation of edentate and partially dentate patients. Posterior jaw regions frequently exhibit bone of poor texture, and it is often difficult to obtain primary stability. Thus, it may prove beneficial to deviate from the original protocol and to use implants with a modified design, for example, with a slightly tapered geometry. Purpose: The purpose of the investigation was to compare the early behavior of a modified (prototype Mk IV, Branemark System, Nobel Biocare AB, Gothenburg, Sweden; test) implant with that of the standard Brånemark implant (control) in regions of mainly type 4 bone. Materials and Methods: Three Swedish centers participated, and a total of 44 patients were treated with oral implants for 39 maxillas and 5 mandibles. The study focused on the most distal right and left implant sites (88 implants), which were randomized to receive either a test or a control implant. Various parameters were recorded, such as registered insertion torque (OsseoCare, Nobel Biocare AB), wobbling during insertion, primary and secondary stability (as measured with resonance frequency), and marginal bone loss. The implants were followed up for 1 year. Results.: The test implant more frequently required a higher insertion torque and showed a significantly higher primary stability than the control implant. This difference in stability leveled out over time, and test and control implants exhibited similar secondary stability at abutment operation and at the 1-year visit. Wobbling during insertion was rarely recorded for either of the implant designs. The 1-year cumulative success rate was 93.1% for test implants and 88.4% for control implants. Conclusions: The modified implant design resulted in an increased primary stability, which may be important when placing implants in jaw regions of type 4 bone. However, independent of the achieved primary stability, successful implants tended to approach similar secondary stability in the two designs tested. [source] Biomechanics/risk management (Working Group 2)CLINICAL ORAL IMPLANTS RESEARCH, Issue 2009Mariano Sanz Abstract Introduction: The remit of this workgroup was to update the existing knowledge base in biomechanical factors, navigation systems and medications that may affect the outcome of implant therapy. Material and methods: The literature was systematically searched and critically reviewed. Five manuscripts were produced in five specific topics identified as areas where innovative approaches have been developed in biomechanical factors, navigation systems and medications that may affect the outcome of implant therapy. Results: The results and conclusions of the review process are presented in the following papers, together with the group consensus statements, clinical implications and directions for future research: , To what extent do cantilevers affect survival and complications of implant supported restorations in partially dentate patients? , To what extent does the crown,implant ratio affect survival and complications of implant supported restorations? , A systematic review on the accuracy and the clinical outcome of computer-guided template based implant dentistry. , What is the impact of systemic bisphosphonates on patients undergoing oral implant therapy? , What is the impact of anticoagulants on patients undergoing oral implant therapy? [source] Bone level changes at implants supporting crowns or fixed partial dentures with or without cantileversCLINICAL ORAL IMPLANTS RESEARCH, Issue 10 2008Gian Andrea Hälg Abstract Objective: The aim of this study was to analyze whether or not a cantilever extension on a fixed dental prosthesis (FDP) supported by implants increased the amount of peri-implant bone loss or technical complications compared with reconstructions without cantilevers. Materials and Methods: Fifty-four partially dentate patients with a total of 54 FDPs supported by 78 implants were enrolled in the study. Twenty-seven FDPs were with cantilever and 27 FDPs were without cantilever (control group). All FDPs were supported by one or two implants and were located in the posterior maxilla or mandible. The primary outcome variable was change in peri-implant marginal bone level from the time of FDP placement to the last follow-up visit. FDPs were under functional loading for a period of 3 up to 12.7 years. Statistical analysis was carried out with Student's t -test. Regression analyses were carried out to evaluate the influence of confounding factors on the peri-implant bone level change. In addition, implant survival rates were calculated and technical complications assessed. Results: After a mean observation period of 5.3 years, the mean peri-implant bone loss for the FDPs with cantilevers was 0.23 mm (SD±0.63 mm) and 0.09 mm (SD±0.43 mm) for FDPs without cantilever. Concerning the bone level change at implants supporting FDPs with or without cantilevers no statistically significant differences were found. The regression analysis revealed that jaw of implant placement had a statistically significant influence on peri-implant bone loss. When the bone loss in the cantilever group and the control group were compared within the maxilla or mandible separately, no statistically significant difference was found. Implant survival rates reached 95.7% for implants supporting cantilever prostheses and 96.9% for implants of the control group. Five FDPs in the cantilever group showed minor technical complications, none were observed in the control group. Conclusion: Within the limitations of this study it was concluded that cantilever on FDPs did not lead to a higher implant failure rate and did not lead to more bone loss around supporting implants compared with implants supporting conventional FDPs. In contrast to these results more technical complications were observed in the group reconstructed with cantilever. [source] Evaluation by quantitative magnetic resonance imaging of trabecular bone quality in the dentate and edentulous mandibleCLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2008Cetin Celenk Abstract Objective: To quantify the differences in mandibular trabecular bone quality between edentulous and dentate patients using quantitative magnetic resonance imaging (QMRI). Methods: The patients in this study had been referred to our clinic for QMRI examination for various reasons. A total of 40 male patients (18 dentate, 22 edentulous), 45,55 years of age, were examined. Mandibular T2* axial cross-sections were performed following receipt of consent from each patient. T2* relaxation time values (RTVs) were determined in the trabecular area. Results: The mean mandibular T2* RTVs of dentate and edentulous patients were 181 and 182, respectively. There were no significant differences between the two groups (P=0.929) (Student's t -test). Conclusions: Mandibular trabecular bone quality may not be influenced by edentulousness according to QMRI. [source] |