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Garling A, Krummel A, Kern M. Outcomes of resin-bonded attachments for removable dental prostheses. J Prosthodont Res 2024; 68:100-104. [PMID: 37211411 DOI: 10.2186/jpr.jpr_d_22_00306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE This clinical study aimed to evaluate the outcomes of resin-bonded attachments (RBAs) for precision-retained removable dental prostheses (RDPs) after at least two years of clinical maintenance. METHODS Since December 1998, 205 RBAs (44 bonded to posterior teeth, 161 to anterior teeth) have been inserted in 123 patients (62 females and 61 males; mean age, 63.6 ± 9.6 years) who were recalled annually. The abutment teeth underwent a minimally invasive preparation limited to the enamel. RBAs were cast in a cobalt-chromium alloy with a minimum thickness of 0.5 mm and adhesively luted with a luting composite resin (Panavia 21 Ex or Panavia V5, Kuraray, Japan). We evaluated caries activity, plaque index, periodontal condition, and tooth vitality. The Kaplan-Meier survival curves were used to account for the reasons for failure. RESULTS The mean observation time of RBAs until the last recall visit was 84.5 ± 51.3 months (range, 3.6-270.6). During the observation period, 33 RBAs debonded in 27 patients (16.1%). The 10-year success rate according to the Kaplan-Meier analysis was 58.4%, which dropped to 46.2% after 15 years of observation if debonding was considered a failure. If rebonded RBAs were regarded as surviving, the 10- and 15-year survival rates would be 68.3% and 61%, respectively. CONCLUSIONS The use of RBAs for precision-retained RDPs appears to be a promising alternative to conventionally retained RDPs. As reported in the literature, the survival rate and frequency of complications were comparable with those of conventional crown-retained attachments for RDPs.
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Affiliation(s)
- Anne Garling
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Kiel, Germany
| | - Anna Krummel
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Kiel, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Kiel, Germany
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Cimões R, Pinho RCM, Gurgel BCDV, Borges SB, Marcantonio Júnior E, Marcantonio CC, Melo MARDC, Piattelli A, Shibli JA. Impact of tooth loss due to periodontal disease on the prognosis of rehabilitation. Braz Oral Res 2021; 35:e101. [PMID: 34586215 DOI: 10.1590/1807-3107bor-2021.vol35.0101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 01/21/2023] Open
Abstract
When periodontal disease is diagnosed, it is difficult to predict the clinical response of treatment of a tooth over time because the result of treatment is affected by several factors and will depend on the maintenance and support of periodontal treatment. Rehabilitation with removable dental prostheses, fixed prostheses, and dental implants makes it possible to restore the function and esthetics of patients with tooth loss due to periodontal disease. The predictive factors of tooth loss in periodontitis patients should be assessed by dentists to inform their clinical decision-making during dental treatment planning. This will provide detailed individualized information and level of risk of patients considered suitable for dental rehabilitation. Therefore, the aim of this article was to review the subject of "Impact of tooth loss due to periodontal disease on the prognosis of rehabilitation" and the effect of fixed, removable, and implant-supported prostheses in periodontal patients.
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Affiliation(s)
- Renata Cimões
- Universidade Federal de Pernambuco - UFPE, Health Sciences Centre, Department of Prosthesis and Oral and Maxillofacial Surgery, Recife, PE, Brazil
| | | | | | - Samuel Batista Borges
- Universidade Federal do Rio Grande do Norte - UFRN, Health Sciences Centre, Department of Dentistry, Natal, RN Brazil
| | - Elcio Marcantonio Júnior
- Universidade Estadual Paulista Júlio de Mesquita Filho - Unesp, Faculdade de Odontologia de Araraquara, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | - Camila Chierici Marcantonio
- Universidade Estadual Paulista Júlio de Mesquita Filho - Unesp, Faculdade de Odontologia de Araraquara, Department of Diagnosis and Surgery, Araraquara, SP, Brazil
| | | | - Adriano Piattelli
- University of Chieti, Dental School, Department of Medical, Oral and Biotechnological Sciences, Chieti, Italy
| | - Jamil Awad Shibli
- Universidade de Guarulhos - UnG, Dental Research Division, Department of Periodontology and Oral Implantology, Guarulhos, SP, Brazil
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Abstract
Improvements in oral health including increased retention of natural teeth have given rise to a partially dentate older population. Replacement of missing natural teeth is important to improve function, aesthetics and quality of life for this patient group. A variety of options are available to replace missing teeth in partially dentate older adults, including fixed, removable and implant retained prostheses. This article will discuss the provision of removable partial dentures including treatment planning and denture design. When planning removable partial dentures, careful attention must be paid to stabilising the patient prior to delivering any prosthesis. Partial dentures should be designed to minimise the potential for plaque accumulation with carefully designed metal based frameworks. Acrylic resin can also be utilised with attention to detail to minimise the risk of damage to delicate supporting tissues. Removable dentures have the advantage that they can be readily added to in the event of further tooth loss which may be particularly relevant for older adults. Partial dentures which optimise support, retention and stability can function very successfully and significantly improve patients' oral health related quality of life.
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Affiliation(s)
- Tim Friel
- Senior Lecturer/Honorary Consultant in Primary Dental Care, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London
| | - Sarah Waia
- Clinical Lecturer, Barts and the London School of Medicine and Dentistry, Queen Mary University of London; Speciality Doctor in Restorative Dentistry, Croydon University Hospital; Private Practice, London
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Schwendicke F, Krois J, Jordan R. Can We Predict Usage of Dental Services? An Analysis from Germany 2000 to 2015. JDR Clin Trans Res 2020; 5:349-357. [PMID: 32023133 PMCID: PMC7495688 DOI: 10.1177/2380084420904928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES We aimed to predict the usage of dental services in Germany from 2000 to 2015 based on epidemiologic and demographic data, and to compare these predictions against claims within the statutory health insurance. METHODS Indicators for operative (number of coronally decayed or filled teeth, root surface caries lesions, and fillings), prosthetic (number of missing teeth), and periodontal treatment needs (number of teeth with probing pocket depths (PPDs) ≥ 4 mm) from nationally representative German Oral Health Studies (1997, 2005, 2014) were cross-sectionally interpolated across age and time, and combined with year- and age-specific population estimates. These, as well as the number of children eligible for individual preventive services (aged 6 to 17 y), were adjusted for age- and time-specific insurance status and services' utilization to yield predicted usage of operative, prosthetic, periodontal, and preventive services. Cumulative annual usage in these 4 services groups were compared against aggregations of a total of 24 claims positions from the statutory German health insurance. RESULTS Morbidity, utilization, and demography were highly dynamic across age groups and over time. Despite improvements of individual oral health, predicted usage of dental services did not decrease over time, but increased mainly due to usage shifts from younger (shrinking) to older (growing) age groups. Predicted usage of operative services increased between 2000 and 2015 (from 52 million to 56 million, +7.8%); predictions largely agreed with claimed services (root mean square error [RMSE] 1.9 million services, error range -4.6/+3.8%). Prosthetic services increased (from 2.4 million to 2.6 million, +11.9%), with near perfect agreement to claimed data [RMSE 0.1 million services, error range -8.3/+3.9%]). Periodontal services also increased (from 21 million to 27 million, +25.9%; RMSE 5.2 million services, error range +21.9/+36.5%), as did preventive services (from 22 million to 27 million, +20.4%; RMSE 3 million, error range -13.7/-4.7%). CONCLUSION Predicting dental services seems viable when accounting for the joint dynamics of morbidity, utilization, and demographics. KNOWLEDGE TRANSFER STATEMENT Based on epidemiologic and demographic data, predicting usage of certain dental services is viable when accounting for the dynamics of morbidity, utilization, and demographics.
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Affiliation(s)
- F Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Germany
| | - J Krois
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Germany
| | - R Jordan
- Institute of German Dentists (IDZ), Cologne
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5
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Marotti J, Gatzweiler B, Wolfart M, Sasse M, Kern M, Wolfart S. Implant Placement under Existing Removable Dental Prostheses and the Effect on Follow-Up and Prosthetic Maintenance. J Prosthodont 2018; 28:e752-e763. [PMID: 30028055 DOI: 10.1111/jopr.12943] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2018] [Indexed: 12/25/2022] Open
Abstract
PURPOSE The aim of this prospective clinical study was to compare the maintenance interventions required for solely implant-retained overdentures (I-OD) with that of overdentures retained by a combination of telescopic crowns and implants (T/I-OD). MATERIALS AND METHODS The participants in this study were 22 patients who initially presented either with a removable complete denture (n = 11) or with an overdenture retained by 1 to 2 telescopic crowns on natural teeth (n = 11). Subsequently, the total number of abutments was increased to 5 to 6 (maxilla) or 4 to 5 (mandible) by placing implants in strategically advantageous regions, generating two distinct groups: I-OD and T/I-OD. Ball attachments were connected to the implants and integrated into the existing denture. The maintenance aspects were analyzed according to the type of treatment (preventive, biological, and technical) and to the severity of treatment (minimal, moderate, and extensive). RESULTS During a mean observation time of 6.5 years, the tooth survival rate was 89% (T/I-OD) and the implant survival rate 100% (both groups). The survival rates of the overdentures ranged from 90.9% (I-OD) to 100% (T/I-OD). A mean number of 0.6 (I-ODs) and 2.0 (T/I-OD) treatments were performed for biological reasons; and 8.2 (I-ODs) and 9.6 (T/I-OD) for technical reasons, per patient, during the observation time. From biological aspects, significantly more extensive maintenance was found to be necessary in the T/I-OD group than in the I-OD group. CONCLUSIONS The therapeutic concept of implant placement under existing prostheses was promising when performed in indicated cases.
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Affiliation(s)
- Juliana Marotti
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical School RWTH Aachen University, Aachen, Germany
| | - Bodo Gatzweiler
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical School RWTH Aachen University, Aachen, Germany
| | - Mona Wolfart
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University, Kiel, Germany
| | - Martin Sasse
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University, Kiel, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University, Kiel, Germany
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical School RWTH Aachen University, Aachen, Germany
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Influence of attachment design and material on the retention of resin-bonded attachments. Clin Oral Investig 2018; 23:1217-1223. [DOI: 10.1007/s00784-018-2544-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 06/20/2018] [Indexed: 11/25/2022]
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7
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Moldovan O, Rudolph H, Luthardt RG. Biological complications of removable dental prostheses in the moderately reduced dentition: a systematic literature review. Clin Oral Investig 2018; 22:2439-2461. [PMID: 29959596 DOI: 10.1007/s00784-018-2522-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 06/11/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of the present study was a systematic review and subsequent meta-analysis on biological complications of removable prostheses in the moderately reduced dentition. MATERIALS AND METHODS A systematic literature search in established medical databases (MEDLINE, EMBASE, BIOSIS, SciSearch, Cochrane, FIZ Technik Web) and a hand search of relevant dental journals was conducted. The search terms were relevant MeSH terms, free search terms, and combinations of the two. The search included randomized controlled trials, prospective and retrospective studies with data on biological complications of removable dental prostheses in the moderately reduced dentition with at least 15 participants, an observation period of at least 2 years, and a drop-out rate of less than 25%. The selection of relevant publications was carried out at the title, abstract, and full-text level by at least two of the authors involved. The publications included were tabulated and analyzed. RESULTS Of the original 12,994 matches, 1923 were analyzed by title, 650 by abstract, and 111 according to the full text. A total of 42 publications were ultimately included. The following parameters were evaluated. TOOTH LOSS Results varied, depending on the observation period, between 0 and 18.1% for clasp-retained removable dental prostheses (RDPs), between 5.5 and 29% for attachment-retained RDPs, and between 5.5 and 51.7% for double crown-retained RDPs. CARIES Results varied, depending on the observation period, between 0 and 32.7% for clasp-retained RDPs, between 1.8 and 29% for attachment-retained RDPs, and between 1.8 and 16.4% for double crown-retained RDPs. ENDODONTIC TREATMENT Results varied, depending on the observation period, between 3.5 and 19.2% for clasp-retained RDPs, between 6.9 and 16.4% for attachment-retained RDPs, and between 0.6 and 13.9% for double crown-retained RDPs. TOOTH FRACTURE Results varied, depending on the observation period, between 1.7 and 5.3% for clasp-retained RDPs, between 12.7 and 40% for attachment-retained RDPs, and between 0.4 and 4.4% for double crown-retained RDPs. TOOTH MOBILITY There were no changes or improvements for clasp-retained RDPs. The better the pre-treatment and supportive care is, the smaller the differences are. For double crown-retained RDPs, a slight increase was found in one study. The results for the parameters probing depth and radiological bone loss were inconclusive. GINGIVAL RECESSION Gingival recession seemed to be favored by a mandibular sublingual bar. Compared to fixed restorations, removable restorations seemed to be associated with a more pronounced need for dental treatment. Stringent pre-treatment and supportive care reduced the complication rates. CONCLUSIONS Heterogeneous study designs and data analyses rendered a meta-analysis impossible, so that an evaluation at the highest level of evidence could not be performed. CLINICAL RELEVANCE Within the limitations of this study, it would be correct to state that removable dental prostheses require intensive maintenance. Suitable pre-treatment and supportive care can lower the complication rates, in the absence of which they constitute trigger factors for (additional) biological complications.
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Affiliation(s)
- Ovidiu Moldovan
- Department of Prosthetic Dentistry, Center of Dentistry, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
- , Augsburg, Germany
| | - Heike Rudolph
- Department of Prosthetic Dentistry, Center of Dentistry, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - Ralph G Luthardt
- Department of Prosthetic Dentistry, Center of Dentistry, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
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8
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Botelho MG, Dyson JE, Mui TH, Lam WY. Clinical audit of posterior three-unit fixed-movable resin-bonded fixed partial dentures – A retrospective, preliminary clinical investigation. J Dent 2017; 57:26-31. [DOI: 10.1016/j.jdent.2016.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 11/03/2016] [Accepted: 12/05/2016] [Indexed: 10/20/2022] Open
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9
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Relevance of variations in the opposing dentition for the functionality of fixed and removable partial dentures: a systematic review. Int J Dent 2012. [PMID: 23193407 PMCID: PMC3501960 DOI: 10.1155/2012/876023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The aim of this systematic review was to evaluate the functionality of fixed and removable partial dentures as test interventions in relation to variations in the opposing dentition and their prosthetic restoration. The abstracts identified in the respective databases were screened independently by two investigators. RCTs and uncontrolled studies were considered, provided the patients were included consecutively and the confounding variables were adequately monitored. Seventeen papers were included. The study and publication quality was assessed using a “biometric quality” tool showing an overall poor quality. The reported outcomes, such as survival rates, were in each case obtained from a single study. Two possible trends could be deduced for the endpoint longevity: (a) the first trend in favor of removable partial dentures, compared to fixed partial dentures, with a fully edentulous opposing arch fitted with a removable prosthesis; (b) the second trend in favor of implant-supported partial dentures, compared to conventionally fixed partial dentures, with natural opposing dentition or with a removable partial denture in the opposing arch. No evidence could be generated as to whether, and if so how, variations in the opposing dentition have a bearing on the decision to fit a partially edentulous arch with a fixed or removable partial denture.
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10
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Naumann M, Hohmann C, Happe A, Beuer F, Frankenberger R, Seemann R, Rosentritt M. Are implants more reliable than severely compromised endodontically treated teeth as abutments for zirconia-based FPDs? : In vitro results of long-term preclinical load simulation. Clin Oral Investig 2012; 17:1685-92. [PMID: 23103959 DOI: 10.1007/s00784-012-0866-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 10/17/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The aim was to study the impact of the defect size of endodontically treated incisors compared to dental implants as abutments on the survival of zirconia two-unit anterior cantilever-fixed partial dentures (2U-FPDs) during 10-year simulation. MATERIALS AND METHODS Human maxillary central incisors were endodontically treated and divided into three groups (n = 24): I, access cavities rebuilt with composite core; II, teeth decoronated and restored with composite; and III as II supported by fiber posts. In group IV, implants with individual zirconia abutments were used. Specimens were restored with zirconia 2U-FPDs and exposed to two sequences of thermal cycling and mechanical loading. STATISTICS Kaplan-Meier; log-rank tests. RESULTS During TCML in group I two tooth fractures and two debondings with chipping were found. Solely chippings occurred in groups II (2×), IV (2×), and III (1×). No significant different survival was found for the different abutments (p = 0.085) or FPDs (p = 0.526). Load capability differed significantly between groups I (176 N) and III (670 N), and III and IV (324 N) (p < 0.024). CONCLUSION Within the limitations of an in vitro study, it can be concluded that zirconia-framework 2U-FPDs on decoronated teeth with/without post showed comparable in vitro reliability as restorations on implants. The results indicated that restorations on teeth with only access cavity perform worse in survival and linear loading. CLINICAL RELEVANCE Even severe defects do not justify per se a replacement of this particular tooth by a dental implant from load capability point of view.
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Affiliation(s)
- M Naumann
- Department of Prosthetic Dentistry, Center of Dentistry, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany.
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11
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Wolfart S, Marré B, Wöstmann B, Kern M, Mundt T, Luthardt R, Huppertz J, Hannak W, Reiber T, Passia N, Heydecke G, Reinhardt W, Hartmann S, Busche E, Mitov G, Stark H, Pospiech P, Weber A, Gernet W, Walter M. The Randomized Shortened Dental Arch Study. J Dent Res 2012; 91:65S-71S. [DOI: 10.1177/0022034512447950] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The scientific evidence concerning prosthodontic care for the shortened dental arch (SDA) is sparse. This randomized multicenter study aimed to compare two common treatment options: removable partial dental prostheses (RPDPs) for molar replacement vs. no replacement (SDA). One of the hypotheses was that the follow-up treatment differs between patients with RPDPs and patients with SDAs during the 5-year follow-up period. Two hundred and fifteen patients with complete molar loss in one jaw were included in the study. Molars were either replaced by RPDPs or not replaced according to the SDA concept. A mean number of 4.2 (RPDP) and 2.8 (SDA) treatments for biological or technical reasons occurred during the 5-year observation time per patient. Concerning the biological aspect, no significant differences between the groups could be shown, whereas treatment arising from technical reasons was significantly more frequent for the RPDP group. When the severity of treatment was analyzed, a change over time was evident. When, at baseline, only follow-up treatment with minimal effort is required, over time there is a continuous increase to moderate and extensive effort observed for both groups ( Controlled-trials.com number ISRCTN97265367).
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Affiliation(s)
- S. Wolfart
- Department of Prosthodontics and Biomaterials, Medical Faculty, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - B. Marré
- Department of Prosthetic Dentistry, Technische Universität Dresden, University Hospital Carl Gustav Carus, Dental School, Dresden, Germany
| | - B. Wöstmann
- Department of Prosthetic Dentistry, Justus-Liebig University of Giessen, Gießen, Germany
| | - M. Kern
- Department of Prosthetic Dentistry, Christan-Albrechts University, Kiel, Germany
| | - T. Mundt
- Department of Prosthodontics, Gerodontology and Biomaterials, Dental School, Ernst-Moritz-Arndt University of Greifswald, Greifswald, Germany
| | - R.G. Luthardt
- Ulm University, Center of Dentistry, Department of Prosthetic Dentistry, Albert-Einstein-Allee Ulm, Germany
| | - J. Huppertz
- Department of Prosthetic Dentistry, Julius-Maximilians University of Würzburg, Würzburg, Germany
| | - W. Hannak
- Charité - Universitätsmedizin Berlin, CC3 – Charité, Center for Dental and Craniofacial Sciences, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Campus Benjamin Franklin, Berlin, Germany
| | - T. Reiber
- Department of Prosthetic Dentistry and Dental Material Science, University of Leipzig, Leipzig, Germany
| | - N. Passia
- Department of Prosthetic Dentistry, Albert-Ludwig University of Freiburg, Freiburg, Germany
| | - G. Heydecke
- University Medical Center Eppendorf, Department of Prosthodontics, Hamburg, Germany
| | - W. Reinhardt
- Department of Prosthetic Dentistry and Dental Material Science, Friedrich-Schiller University of Jena, Jena, Germany
| | - S. Hartmann
- Department of Prosthetic Dentistry, Johannes-Gutenberg University of Mainz, Mainz, Germany
| | - E. Busche
- Department of Prosthetic Dentistry, Witten-Herdecke University, Witten, Germany
| | - G. Mitov
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Bonn, Germany
| | - H. Stark
- Danube Privat University Krems, Krems, Austria
| | - P. Pospiech
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, University of Bonn, Bonn, Germany
| | - A. Weber
- Department of Prosthetic Dentistry, Technische Universität Dresden, University Hospital Carl Gustav Carus, Dental School, Dresden, Germany
| | - W. Gernet
- Department of Prosthetic Dentistry, Ludwig-Maximilians University, Munich, Germany
| | - M.H. Walter
- Department of Prosthetic Dentistry, Technische Universität Dresden, University Hospital Carl Gustav Carus, Dental School, Dresden, Germany
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12
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Abstract
The creation of paralleled, milled surfaces in natural or restored abutment teeth, coupled with removable partial denture castings that have optimal contact with these preparations, results in a path of insertion and removal that is controlled in a manner similar to one using conventional precision attachments. Because the milled surfaces are primarily extracoronal, little if any, additional tooth reduction is required for adequate mouth preparation. Avoiding additional tooth reduction minimizes later abutment fracture. The great increase in stability and resistance to rotational movements, when combined with conventional posterior clasping, provides a reasonable alternative to the precision attachment in providing maximal esthetics for the partially edentulous patients.
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Affiliation(s)
- James S Brudvik
- Department of Prosthodontics, University of Washington School of Dentistry, Box 357452, Seattle, WA 989195, USA.
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13
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Abstract
Changes in the retention force of six prefabricated spherical and cylindrical attachments were examined in vitro under continuous loading. The testing machine permitted insertion-separation cycles to be tested under reproducible conditions while a calibrated measuring device determined the insertion and retention forces. At the beginning, during the so-called run-in period, all anchoring elements showed a very unstable behaviour characterized by a varying marked increase and subsequent decrease in the retention force. During the ensuing functional period, the retention force followed a more stable course. In this phase, the frictional attachments having lamellae for activation proved more stable than did the spring-loaded retention attachments. Furthermore, in two of five cylindrical anchors by Gerber, the spring broke. This provides support to the concept that prefabricated attachments should be constructed as robust elements composed of as few individual parts as possible. This would help to ensure that service and repairs remain at a minimum. Frictional attachments with lamellae for activation are to be preferred for use in matrices and patrices over attachments having spring-loaded retention.
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Affiliation(s)
- C E Besimo
- Department of Oral Medicine, Aeskulap Clinic, University of Basel, Basel, Switzerland.
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14
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Rich B, Goldstein GR. New paradigms in prosthodontic treatment planning: a literature review. J Prosthet Dent 2002; 88:208-14. [PMID: 12397249 DOI: 10.1067/mpr.2002.127886] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
New treatment modalities have expanded the choices available to prosthodontists and their patients. At the same time, an explosion of data has called into question the validity and efficacy of certain forms of traditional prosthodontic treatment. Together, these factors have greatly complicated the treatment-planning process. The purpose of this article is to provide a framework for the prosthodontic treatment-planning process that incorporates the latest evidence-based information available. A review of the literature was undertaken through a Medline search. Articles published in English from 1975 through 2001 were evaluated; selected articles were chosen for review on the basis of a subjective judgment of their relevancy and significance to the clinician.
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Affiliation(s)
- Benedict Rich
- College of Dentistry, New York University, New York, NY, USA.
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