Statement of problems: In the area of dental care, the institutionalized elderly have placed the most vulnerable state, and we cannot find their subjective need of dental treatment because of the physical and mental disabilities, But we have no basic investigation of their oral health conditions. Purpose: The aims of the current study were to investigate the oral health status of institutionalized elderly patients who are in the least benefited side of dental service, and to analyze their dental treatment needs. Material and methods: The survey of the oral status was carried out on 758 institutionalized elderly, and 212 elderly who was more than 65 years old from D dental office, and it was based on the Guidelines of Oral Health Research of year 2000 in Republic of Korea. Results and conclusion: The DMFT index of the institutionalized elderly appeared higher than that of the same ages in control group, and it increased with age. The number of residual teeth of the institutionalized elderly appeared lower than that of the same ages in control group, and it decreased with age (P < .05). The number of fixed partial denture in institutionalized elderly was lower than that of the same ages in control group (P < .05). The percentage wearing removable partial denture was not significant between the elderly in institutions and the control group, and was not different according to age between the two groups. The percentage of institutionalized elderly wearing complete denture appeared lower than that of the same ages in control group, and it increased with age. The percentage of institutionalized elderly needing complete denture was higher than that of control group, and the percentage of elderly needing complete denture on the maxilla was higher than that of the mandible. 16.35% of the institutionalized elderly was living without denture in spite of their fully edentulous state. The need for complete denture increased rapidly with age. The number of valued teeth and dental prostheses in shortened dental arch concept and number of occluding pairs of teeth of institutionalized elderly were lower than that of the control group (P < .05). In institutionalized elderly, the number of residual teeth, the number of fixed partial dentures, and the percentage wearing removable partial dentures were higher in the mandible, and the percentage wearing complete dentures was higher in the maxilla (P < .05). The rate of institutionalized elderly needing prosthodontic treatment appeared to be 67.82%, where the number of occluding pairs of teeth was less than 10. When it is difficult to evaluate the subjective need of dental treatment as with the institutionalized elderly, estimation using the number of occluding pairs of teeth can be a useful indicator that can project treatment needs. For the oral health care of institutionalized elderly, it is essential to increase the awareness of nurses and caregivers who take care of them, about the importance of the oral health. Since the average life span and number of residual teeth are increasing gradually, the welfare policy should be changed to implementing regular dental examinations, preservative treatment forms and oral health control of dentulous patients where the traveling-treatment system and visit system are supplemented. And principles should be set that the present denture project of edentulous patients should be done by specialists who'll also be responsible for postmanagement. Through this research of institutionalized elderly, the oral health status which is worsened by aging could be confirmed. And the interest and positive participation of dental society on the elderly should come first in order to solve the rising treatment needs of the elderly patients.
Journal of the korean academy of Pediatric Dentistry
/
v.50
no.4
/
pp.483-494
/
2023
This report presents two cases concerning strategies for improving denture retention in pediatric patients with oligodontia caused by hypohidrotic ectodermal dysplasia (HED). Both patients presented with multiple missing teeth, conical canines, alveolar bone atrophy, and a skeletal Class III tendency. In the first case, a modified form of conical-crown-retained denture was used to cover the canines. This approach was carried out without tooth extraction or coping. In the second case of severe alveolar bone resorption and a distally tilted lower left canine, the tooth was restored with a hybrid ceramic crown. It was subsequently converted into a clasp-retained removable partial denture, utilizing a suction mechanism. Both patients are currently receiving regular check-ups for the maintenance of their prosthetic appliances and the evaluation of their growth patterns. This study presents innovative prosthetic treatment methods for pediatric patients with HED who have inadequate denture retention.
When losing many of the remaining teeth, the relation among them can be put into dynamically unfavorable situation. In the case that the patient without any incompatibilityto the denture, overdenture can be considered. Moreover, we can overcome the dynamical disadvantage, and improve the support, stability, and retention of the partial denture by using implant at the edentulous area. In this case, patient with crossed occlusion between few remaining teeth was treated with maxillary and mandibular partial denture. Single implant fixture was placed at the edentulous space, opposing to the maxillary teeth occluded, and $Locator^{(R)}$ attachment was connected. The patient's esthetic satisfaction was improved by ideally adjusting the tilted occlusal plane. Since the patient was satisfied both esthetically and functionally, and maintained stable during the clinical observation for 6 months after the treatment, we would like to report about it.
Dental computer-aided design (CAD) and computer-aided manufacturing (CAM) technology have rapidly progressed over the past 30 years. The technology, which can be used in the dental laboratory, the dental office and the form of production centers, has become more common in recent years. This technology is now applied to inlays, onlays, crowns, fixed partial dentures, removable partial denture frameworks, complete dentures, templates for implant installation, implant abutments, and even maxillofacial prostheses. Dentists and dental technicians, who want to use these techniques, should have certain basic knowledge about that. This article gives an overview of CAD/CAM technologies, histories and how it applies in prosthetic dentistry.
The purpose of this study was to provide the data for discussion related to oral health promotion policies for the elderly by examining and analyzing the prosthesis conditions and necessity for the fixed and removable dentures among the Korean elderly. The data, obtained from 4,557 elderly aged at 65 or higher who were targeted for the 5th National Health Nutrition Survey, were analyzed through the complex sample frequency analysis, complex sample cross analysis, and complex sample logistic regression analysis. The results of analysis showed significant relevance of whole denture implant and the necessity thereof in older subjects, rural community, and subjects with lower education background, regarding the state of upper jaw/lower jaw prosthesis and the necessity for upper jaw/lower jaw fixed partial denture/whole denture. In addition, the necessity for prosthesis implant was found to have correlation with the income and subjective health condition, while the necessity for artificial teeth(denture) was found to have correlation with the gender, age, education, and subjective oral health condition. Therefore, it is considered necessary to map out the prevention and treatment policies designed to help maintain and promote oral health based on oral health education, along with the policies that aim to recover the neutralized oral health functions, in relation to the oral health of the elderly.
Purpose. The purpose of this study was to analyze the frequency and duration of adjustments after delivery of complete denture according to age, sex, arch with complete denture, insurance coverage of a denture, type of antagonist, the experience of wearing denture, the period of edentulism, and the type of denture base. Materials and methods. For 5 years, medical records of patients aged 65 or older who had treated full dentures were assessed for the frequency and duration of follow-up visits after complete denture delivery. Statistical analysis was performed at the 5% level of significance to analyze the correlation between the frequency and duration of follow-up according to sex, insurance coverage, arch with the complete denture, type of denture base, type of antagonist, experience of wearing a denture, age, and healing period. Results. 247 complete dentures were included in this study. The median frequency of follow-up visits was 3, and the median duration of follow-up was 36 days. Lower dentures had significantly higher frequency of follow-up visits than upper dentures (P = .036). According to the type of antagonist, dentures opposing a complete denture had a significantly higher frequency of follow-up visits than dentures opposing a removable partial denture (P = .016). There was no statistically significant difference in the frequency and duration of adjustments after delivery of complete denture by age, sex, insurance coverage, healing period, the experience of wearing a denture, and type of denture base. Conclusion. Within the limitations of the present study, lower complete dentures or dentures opposing a complete denture had an increased frequency of follow-up visits.
Double crown prostheses can be used in patients who have a few remaining teeth and poor periodontal condition because of secondary splinting of abutments, vertical loading, decrease of the length of lever arm due to fulcrum line located on margin of inner and outer crown. Successful results of treatments using double crown prostheses for the partially edentulous patients who have a few remaining teeth and implant overdenture using a small number of implants have been reported. In this case, there were a few remaining teeth with a very poor periodontal condition in maxilla, and there were a failed implant with severe alveolar bone resorption and shrinkage in the mandible. The main objective of this report is to introduce our case because a double crown partial denture showed satisfactory results in functional and esthetical aspects during more than one-year follow-up period.
Statement of problem: For the long-term success of removable partial dentures, the bonding between metal framework and denture base resin is one of the important factors. To improve bonding between those, macro-mechanical retentive form that is included metal framework design has been generally used. However it has been known that sealing at the interface between metal framework and denture base resin is very weak, because this method uses mechanical bonding. Purpose: Many studies has been made to find a simple method which induces chemical bond, now various bonding system is applied to clinic. In this experiment, shear bond strengths of heat-cured denture base resin to the surface-treated Co-Cr alloy were measured before and after thermocycling. Chemically treated groups with Alloy $Primer^{TM}$, Super-Bond $C&B^{TM}$, and tribochemically treated group with $Rocatec^{TM}$ system were compared to the beadtreated control group. The data were analyzed with two-way ANOVA. Result: 1. Shear bond strength of bead-treated group is highest, and Alloy $Primer^{TM}$ treated group, Super-Bond $C&B^{TM}$ treated group, RocatecTM system treated group were followed. Statistically significant differences were found in each treated group(p<0.05). 2. Surface treatment and thermocycling affected shear bond strength(p<0.05), however there was no interaction between two factors(p>0.05). 3. Shear bond strengths of bead-treated group and Alloy $Primer^{TM}$ treated group showed no statistically significant difference before and after thermocycling(p>0.05), and those of Super-Bond $C&B^{TM}$ treated group and $Rocatec^{TM}$ system treated group showed statistically significant difference after thermocycling(p<0.05).
This study was perfomed to investigate the prosthodontic and periodontal status of the abutment teeth in distally extending bridges(DEBs) (78 cases) and removable partial dentures(RPDs) (43 cases) for 122 patients (55 males and 57 females) visiting department of Periodontology, Seoul National University Hospital. The average wearing periods were 67.8 months for DEBs and 66.4 months for RPDs. 38.4% of the patients in DEBs and 35.9% in RPDs complainted of chewing discomfort and 22.6% and 24.4% were not chewing on the prosthodontically - treated sides, respectively. In DEBs, when the restoration for 2nd molar supported by 1st molar & 2nd premolar was grouped to type 1, 1st molar supported by 1st & 2nd premolars was type 2, and 1st & 2nd molars supported by 1st & 2nd premolars was type 3, there was a significant differences only in the tooth mobility score among clinical parameters (type 2>type 1>type 3). In RPDs, when bilateral free-end case was grouped to type 1, and unilateral case was type 2, there was a significant difference in the Gingival index (type 1>type 2). In DEBs, 62.8% of restoration were overcontoured, 72% had interproximal space closures, 30.5% overextended pontics and 86.6% overhanging margins. In RPDs, 24.4% of the restorations were overcontoured, 45.5% had interproxinal space closures and 58.3% overhanging margins. From these results of this study, periodontal problems caused by prosthodontic defects were considered to be contributing factors in chewing discomfort.
The author studied the actual conditions on the production of dental prosthesis made in laboratories, and also studied interrelationships between dentists and laboratory technicians in both personal and technical aspects. Two hundred-eighty four technicians, work in dental laboratories presently, were surveyed via mail and direct contact during the period from June 1 to June 30 and August 27 to August 28 in 1994 respectively. The obtained results were as follows : 1. Among the respondents, 90.5% we re working in commercial dental laboratories and their laboratories were mainly located in the Seoul area(40.9%, P<0.05). The numbers of employees in these laboratories were less than 10 persons(70.0%, P<0.01), and 75.9% of these laboratories have been in operation less than 15 years. 2. Most laboratory procedures were accomplished according to established disciplines. However, procedures such as die trimming in fixed restorations and the qualifications of the people designing removable partial dentures were not. Other problem areas were boxing of the working cast, the person determining the posterior palatal seal area, selection and arrangement of artificial teeth, occlusion rim correction and laboratory remounting of the processed denture in complete denture restorations. 3. Only half of the requesting dentists could send work authorizations to the laboratories with their work and even so, its contents were quite lacking. Consequently, there must be some standards in writing work authorization. 4. Technicians most desired clean and accurate impressions in fixed and removable dentures, and enough tooth reduction in porcelain fused to metal restorations. 5. For the establishment of better relationships between dentist and dental technician, the respondents desired the establishment of equal footing first(33.5%), and frequent conversations and muture understanding second(25.9%).
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