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The aim was to systematically review and find evidence to determine when to extract deciduous teeth and place implants in young individuals with tooth agenesis. A search was made in MEDLINE on combinations of the terms 'tooth agenesis', 'deciduous teeth' and 'dental implants'. Publications with an abstract and written in the English language only were included. To give a background to the clinical management of young individuals with agenesis of teeth, publications on epidemiology of tooth agenesis, persistence of deciduous teeth, treatment outcomes after multi-disciplinary treatment planning and experiences of treatment with dental implants in young individuals were also reviewed. A search on the terms 'tooth agenesis', 'deciduous teeth' and 'dental implants' resulted in nine references and a search on 'dental implants' and 'tooth agenesis' gave 132 references; 46 met the inclusion criteria. Only two were prospective studies on treatment with implants in young individuals. A vast majority of publications on the clinical management of young individuals with tooth agenesis are reflections of clinical experiences and single case reports. Deciduous teeth are extracted for different reasons and at different ages in an optimal plan for a good treatment result from aesthetic and functional point of view. For ethical reasons, randomized clinical trials on when to extract deciduous teeth and place implants cannot be made in young individuals. There was only limited, low level evidence on when to extract deciduous teeth and place implants. Recommendations on treatment are based mainly on clinical experience.

The aim of this article is to highlight the strong worldwide trend of enhancing the opportunities for individuals with rare disorders to get adequate information and treatment. Hypohidrotic ectodermal dysplasia is used as an example.The development in recent years of databases for rare disorders, the establishment of resource centers in dentistry, and the strong movement of user influence by the formation of patient organizations and exchange of information through the Internet are described. Reference is made to the recent Scandinavian consensus conference on ectodermal dysplasia.Motives for the centralization of treatment planning to resource centers for persons with rare disorders, the compilation of treatment outcomes in databases, and the advocation of a multidisciplinary team approach in dentistry are presented.The prosthodontic profession has a key position in the habilitation and rehabilitation of many different diagnoses of rare disorders.

The aim of the study was to assess the prevalence of fixed prostheses, i.e. single crowns and fixed partial dentures, in adults 20-80 years old in two cross-sectional studies carried out in 1983 and 1993 and to analyse whether the choice of material for fixed prostheses had changed during this time period. The material comprised 586 and 593 individuals. A descriptive analysis of number of individuals with fixed prostheses was made concerning the number of crowns and pontics, the distribution in the jaws, and the materials used. The prevalence of individuals with fixed prostheses was shown to increase with age both in 1983 and 1993. In 1993 the number of individuals with fixed prostheses was slightly lower than in 1983 (44 and 48 percent respectively). There was no difference according to gender. The proportion of individuals with fixed prostheses was lower or almost unchanged in the 20-, 30-, 40-, 50-, 60-, and 80-year-olds in 1993 compared to 1983. In the 70-year-olds, however, the proportion of individuals with fixed prostheses was considerably higher in 1993 compared to 1983. Most individuals with fixed prostheses had a small number of crowned teeth, and about half of the individuals had not more than four crowned teeth. Likewise most individuals with pontics had a small number of pontics. The distributions of crowned teeth and pontics in the jaws were similar in 1983 and 1993. Pontics and crowns were more frequent in the upper than in the lower jaw. Crowns made of porcelain or metal ceramic had increased by 1993 in the 30-80 year age groups, and the study thus confirms general clinical experience that porcelain and metal ceramic are more often the materials of choice in fixed prosthodontics in adults today.

The aim of this study was to evaluate the clinical and radiographic performance of patients who received implants and fixed prostheses with laser-welded titanium frameworks.Fifty-eight consecutive patients were treated with 349 osseointegrated implants ad modum Brånemark in the edentulous maxilla at 6 implant centers. The patients were randomly arranged into 2 groups at the time of final impression. Twenty-eight patients received laser-welded titanium frameworks and 30 patients received conventional cast frameworks. Clinical and radiographic data were collected for 2 years in function.The 2 groups of patients showed similar results. The 2-year overall cumulative implant survival rate from the time of implant placement and prosthesis insertion was 93.7% and 96.2%, respectively. The corresponding cumulative survival rate for prostheses was 96.6%. Two patients, 1 from each group, failed completely and resumed using conventional complete dentures. The only obvious factor that could possibly be related to the 2 complete failures was a smoking habit. However, it was not possible to significantly correlate implant failures to smoking habits in this study. No fractures were observed in the frameworks or implant components, and both groups experienced the same frequency of resin veneering material fractures. The overall average marginal bone loss was 0.4 mm (SD 0.8 mm).Patients treated with implant-supported prostheses fabricated with laser-welded titanium frameworks in the edentulous maxilla presented comparable results to patients with conventional cast frameworks after 2 years in function.

Dietary habits and dental caries were analysed in 95 19-year-old Swedish adolescents who had been subjected to different preventive measures during their late teens. A 24-hour recall was used and showed that the intakes of milk and milk products, meat, fish and eggs accorded with recommended norms but not those of vegetables, fruits and berries, and potatoes and root vegetables. Only 6% of the subjects had eaten the recommended three principal meals during the day tested. At the end of the trial, only weak or moderate correlations were found between snacks, including sucrose snacks, and selected clinical variables. Subjects who did not develop new carious lesions during the experimental 2 years had fewer risk factors, defined as the most negative values (quartile limit) for sucrose snack consumption, tooth cleaning score, lactobacillus count, saliva secretion rate and saliva buffer capacity, than those who developed one or more new lesions. During the experimental period, with an overall low caries incidence, no single factor tested for presumed risk was found to be the discriminating factor for occurrence of dental caries.

A follow-up study of composite retained onlay bridges inserted to replace permanent anterior teeth in adolescents was performed. The material comprised 100 bridges and the dominating reasons for replacement of teeth were aplasia and trauma. Clinical controls were performed every six months and the mean observation time was 34 months. (Range 11-59 months). Seventyone bridges were functioning without complications during the observation period. Dislodgement occurred in 29 bridges on 54 different occasions. Dislodgement was seen more frequently in boys. The dominating reason for dislodgement was new trauma during sports activities or fights, which occurred more frequently in patients with trauma as the original reason for replacement of teeth. Owing to the tooth-preserving potential and reversibility, it is considered a valuable method of replacing missing anterior teeth in young individuals. Further investigations should concentrate on technical development aimed at achieving optimum retention and on clinical evaluation over longer periods.

Having natural teeth is a matter of varying importance according to the priorities given to dental health status, compliance with recommendations and demand for dental care. The aim of this study was to assess the relative adjustment needed when one or more teeth are lost and when dentures are provided compared with other life events. The study was conducted as a mailed questionnaire to a sample of 311 20-70 year old subjects in the community of Jönköping. Seventy-five per cent of the sample, with a mean age of 43.2 years, responded. The Social Readjustment Rating Questionnaire, comprising 46 life events, was supplemented with two events concerning tooth loss and denture-wearing. The answers were given on a graphic rating scale with end points 'not difficult at all' and 'more difficult than anything' and coded by values 0 to 20. After calculation of mean values, the questions were rank ordered; the item with the highest mean was given the highest rank. 'Losing one or more teeth' was ranked 28.5 (means = 10.7) and 'getting dentures' 33 (means = 12.0) of the 48 life events investigated. This suggests that a majority of respondents perceived losing teeth and being provided with dentures as more important in terms of adjustment than events such as 'marriage', 'retirement' and 'changing work'. No significant differences in relation to age and sex were found.