Search

Background: A balanced nutrient intake is important for patients with diabetes. Even if individuals have the same number of residual natural teeth, there are large differences in the masticatory performance between edentulous sites restored with a fixed dental prosthesis, including dental implants, and those restored with a removable dental prosthesis. This study assessed whether the prevalence and control of diabetes differed based on the use of removable dental prostheses through an analysis of nationally representative data., Methods: Overall, 8,155 individuals (3,525 men and 4,630 women) aged ≥ 50 years were included in this study and were classified into the following 3 groups: group 1, did not use any removable dental prostheses (NF); group 2, used removable partial dentures (RPD); and group 3, used removable complete dentures on at least 1 jaw (CD). The characterization of diabetic patients and glycemic control were analyzed and compared among groups. To determine the relationship between diabetes and the use of dental prostheses, multivariable logistic regression analysis was performed ( P < 0.05)., Results: The adjusted odds ratios and 95% confidence intervals for diabetes in men participants in groups NF, RPD, and CD were 1 (reference), 1.165 (0.878-1.544), and 1.491 (1.034-2.151), respectively, after adjusting for confounding factors. Diabetes and glycemic control were significantly associated with the use of removable dental prostheses among men., Conclusion: The use of removable dental prostheses is a potential risk indicator for uncontrolled diabetes in Korean men adults, suggesting the need for a comprehensive approach to minimize the complications of diabetes mellitus., Competing Interests: The authors have no potential conflicts of interest to disclose., (© 2019 The Korean Academy of Medical Sciences.)

Objective: To investigate the status of tooth loss and denture restoration in Chinese adults, analyse the changing trend and provide fundamental data for oral health policy., Methods: According to the protocol of the 4th National Oral Health Survey, a multistage stratified random cluster-sampling method was used to enrol adult subjects aged 35 to 44, 55 to 64 and 65 to 74 years in all 31 provinces, municipalities and autonomous regions of the mainland of China. The status of tooth loss and denture restoration was investigated. SPSS20.0 software was used for statistics analysis., Results: Among the 13,464 subjects investigated, 13.8% had complete dentition, 84.4% had dentition defects, and 1.8% was edentulous. Urban subjects showed a significantly higher proportion of complete dentition than those in rural (P = 0.02), and males showed the statistically higher proportion of complete dentition than females (P = 0.01). The mean of remaining teeth was 26.1 ± 6.90, which in urban areas was significantly higher than in rural areas (P < 0.01). The means of remaining teeth were 29.6 ± 2.3, 26.3 ± 6.1, and 22.5 ± 8.7 in the 35 to 44, 55 to 64 and 65 to 74 age groups, respectively. The detection rate of fixed partial dentures (FPD) was statistically higher in urban than in rural areas and in males than that in females (P < 0.01). The detection rate of removable partial dentures (RPD) was statistically higher in urban areas than in rural locations (P < 0.01). However, the detection rates of irregular denture and unrepair of tooth loss were both significantly lower in urban than in rural areas (P < 0.01). The rate of restoration of tooth loss was 41.6% in Chinese adults., Conclusion: Although the tooth loss and denture restoration status recorded in the survey was improved compared with the results of 10 years ago, more efforts need to be made on strengthening oral health promotion, particularly for elderly people and those living in rural areas.

Objectives: To determine: the knowledge of the participants about removable dentures, importance of tooth replacement; prevalence of tooth loss and denture use; and factors associated with its non-use among an elderly population in Nigeria., Background: Tooth loss without replacement can impact negatively on the quality of life of the elders, thus making use of denture a basic requirement for those with partial or complete edentulous arches in developed countries. It is, however, not known if this is the case among elders in suburban Nigeria., Material and Methods: A cross-section of 392 consenting elderly participants aged ≥65 years residing at Idikan, Ibadan, Nigeria, were interviewed on their biodata, knowledge of removable denture and importance of tooth replacement, history of use of denture and reasons for non-use where applicable. Oral examinations for the presence of missing teeth and denture were conducted by an examiner. Data were analysed with SPSS and P value set at ˂.05., Results: The mean age of the participants was 73 (SD = 9.2) years. About 39% of the participants believed that it was important to replace missing teeth, 56.0% had poor knowledge about tooth replacement options, and 47.7% had at least a missing tooth. Only 7.1% of those with missing teeth had them replaced and all were using removable acrylic partial dentures. Financial constraint was the main reason for non-replacement of missing teeth (80.1%). Age, gender, occupation before retirement, income, level of education and presence of physical impairment were associated with non-use of denture (P ˂ .05)., Conclusion: Many elderly individuals had poor knowledge about removable dentures and the importance of tooth replacement. About half of the participants had full complement of teeth and only 7.1% of those with tooth loss reported denture wear. Major reasons for non-use of dentures were due to economic reasons., (© 2017 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.)

The study studied the ratio of 17 adults with complete loss of teeth and using complete removable acrylic dentures, to the disease, taking into account the degree of stability of dentures during chewing. To determine the type of patient's attitude toward the disease, a clinical test method was used to determine the type of attitude towards the disease, in which the clinical-psychological typology of patients' attitude to 'illness' was realized, which provides the possibility of determining one of the twelve types of response. It was found that when using complete removable dentures, regardless of age and sex, the types of attitude towards the disease were more often noted, with a marked disadaptive behavior with a predominantly intrapsychic orientation of the response to the disease, which was manifested by characteristic reactions such as irritable weakness, anxious, depressed, oppressed state. The use of the cream to fix the removable dental prostheses Corega allowed to improve the stability of complete removable dentures, to eliminate the pronounced phenomena of mental disadaptation, and to create realistic treatment settings for patients, to help restore social ties.

Objective: To determine the influence of sociodemographic characteristics on pattern of removable partial denture use in a tertiary institution over a one-year period., Methods: This was a retrospective study using records of partially dentate patients seeking replacement for their missing teeth within one-year duration. Information retrieved from the patients’ records included demographic characteristics such as gender, age, marital status, occupation, arch type, number and reasons for missing teeth and type of removable partial denture. Statistical analysis was performed using statistical package for social science (SPSS) version 17 (Chicago, IL.). The analysis was done using frequency distribution, cross tabulations, t test and test of significance with chi square. P<0.05 was considered statistically significant., Results: A total of 98 patients were seen over the study period with a male/female ratio of 1:1.45. The patients’ age ranged from 20 to 89 years with a mean age of 47.19 ± 18.37. The number of teeth replaced ranged from 1 to 17 with a mean of 3.13 ± 3.30 teeth. The mean number of missing teeth was significantly higher among patients aged 50 years and above (p = 0.002). Majority (69.4%) of the patients were married and 59.2% were working class (skilled and unskilled). The Kennedy’s Class III saddle was the most prevalent in the maxilla while Class IV was most prevalent in the mandible; a difference that was statistically significant. Conclusion: Socioeconomic status, age and gender influenced the use of removable partial denture.

Objective: To estimate the prevalence of self-reported gingival and periodontal conditions and their association with smoking, oral hygiene, indigenous origin, diabetes and location (urban or rural) in indigenous and non-indigenous adults in Chiapas, Mexico., Methods: A cross-sectional study of 1,749 persons, ≥20 years of age, living in four rural and four urban marginal localities in Comitán (Chiapas, México). The variables investigated were: age; sex; indigenous origin; oral hygiene; halitosis; chewing ability; gingival conditions; periodontitis; smoking; alcoholism; diabetes; and location. Bivariate analysis and a logistic regression model were used to identify the association of periodontitis with the independent variables., Results: In total, 762 (43.6%) indigenous and 987 (56.4%) non-indigenous persons were interviewed. Their mean age was 41 ± 14 years, 66.7% were women and 43.8% lived in rural locations. Gingival problems were reported by 68.5% and periodontitis by 8.7%. In total, 17.9% had used dental services during the previous year, 28.7% wore a removable partial or a complete dental prosthesis, 63.7% had lost at least one tooth, the prevalence of diabetes was 9.2% and the prevalence of smoking was 12.2%. The logistic regression model showed that age, diabetes and the interaction between rural location and indigenous origin were associated with the presence of periodontitis., Conclusions: Indigenous people living in rural areas are more likely to have periodontitis. It is necessary to promote oral health practices in indigenous and marginalised populations with a focus on community-oriented primary care., (© 2016 FDI World Dental Federation.)

Although the shortened dental arch (SDA) concept has been known to all over the world, acceptance of the SDA concept as an oral health standard can be questionable from the patients' point of view, even if it is biologically reasonable. Furthermore, because the health insurance system covers removable partial dentures (RPDs) for all citizens in Japan, SDA patients seem to prefer to receive prosthetic treatment to replace the missing teeth. However, there were few field surveys to investigate the usage rate of RPDs in Japan. The purpose of this study was to determine the usage rate of RPDs in older Japanese subjects and to investigate the factors related to the usage of RPDs. Partially edentate participants (n = 390) were included in this study. Oral examinations were conducted to record several indices. The Cochran-Armitage trend test was used to evaluate the relationship between the number of missing teeth and the usage rate of RPDs. Chi-squared tests and logistic regression analysis were conducted to evaluate the factors related to the usage rate of RPDs. Usage of RPDs had a significantly positive association with the number of missing distal extension teeth and bilaterally missing teeth. The usage rate of RPDs increased as the number of missing distal extension teeth increased (P for trend < 0·001). The conclusion of this study was that participants with missing distal extension teeth had higher usage rates of RPDs than other participants, and the usage rate increased as the number of missing distal extension teeth increased., (© 2015 John Wiley & Sons Ltd.)

Purpose: The aim of the present report is to describe the long-term follow-up of cases treated with implant tooth-supported removable partial denture (ITSRPD) after at least 15 years., Materials and Methods: The study sample comprised 20 consecutively partially edentulous patients treated with ITSRPD. Implants were placed in order to improve unfavorable removable partial denture design resulting from unfavorable teeth distribution and biomechanical considerations, esthetic, or periodontal challenges. All patients were followed up every 6 months for the first 2 years and annually thereafter for at least 15 years. Recall visits for professional cleaning and oral hygiene re-enforcement were scheduled every 3 to 6 mounts., Results: A total of 42 implants were placed in 20 patients and restored with ITSRPD. All implants and prosthetic devices functioned successfully throughout the 15 years of follow-up. Three patients had gone through further implant placement several years after ITSRPD was provided, and a fixed implant-supported restoration was provided on the original and new implants. No implant failure was noted during follow-up, resulting in a rate for implant survival of 100% for the study. Marginal bone loss around implants ranged between 0 and 2 mm (mean 0.64 ± 0.6 mm). During the follow-up period, prosthetic complications were minor and included one rest rupture. All patients answered a questionnaire and were satisfied with the prosthesis. They reported good chewing ability and stability of the prosthetic devices., Conclusions: ITSRPD can be used with predictable long-term results in carefully selected and well-maintained population. Patients should be advised of their role in maintenance, and a comprehensive recall system is mandatory to obtain satisfactory long-term results., (© 2013 Wiley Periodicals, Inc.)

The objective was to compare two cohorts of elderly people, 70 and 80 years old, with respect to dental status and self-assessed chewing ability. The hypotheses were as follows: (i) dental status is associated with self-assessed chewing ability; (ii) chewing ability is poorer among the 80- than the 70-year-old subjects. Identical questionnaires were in 2012 sent to all subjects born in 1942 and 1932, living in two Swedish counties. The response rate was 70.1% resulting in samples of 5697 70- and 2922 80-year-old subjects. Answers to questions on self-assessed chewing ability, dental status and some other factors have been analysed. Dental status varied but was in general good; 72% of the 70- and 60% of the 80-year-old subjects reported that they had all or only few missing teeth. Rate of edentulism was 3% and 7%, respectively. Removable partial dentures were reported by 6% and 10%, respectively, implant treatment by 13% in both cohorts. Self-assessed chewing ability was mostly good and correlated with the number of teeth (Spearman rho = 0.46). A majority of the edentulous subjects assessed their chewing ability as very or fairly good. Logistic regression showed that self-assessed chewing ability was significantly associated with a number of dental variables but also with general health. In conclusion, dental status was relatively good at both ages but somewhat poorer in the older cohort. Dental status, some other dental variables and being healthy were in both age groups significantly associated with self-assessed chewing ability., (© 2015 John Wiley & Sons Ltd.)

Purpose: This study investigated the number and Kennedy Classification of the edentulous arches in patients treated at the Removable Partial Denture (RPD) Clinics of the Fluminense Federal University School of Dentistry (FO-UFF) in Rio de Janeiro, Brazil, from 2005 to 2010., Materials and Methods: A cross-sectional retrospective survey was conducted on patient record charts to identify gender, age, number, and location of the edentulous arches, and Kennedy Class type., Results: One hundred and forty-six patients were analyzed for this study (96 [65.8%] women and 50 [34.2%] men). Two hundred and ninety-two arches were analyzed: 74 arches (25%) were found with intact dentitions, 18 (6.1%) were edentulous arches, and 200 (68.8%) were partially edentulous arches. Ninety-one patients (62.3%) needed oral rehabilitation with RPDs on one arch and 55 (37.7%) in both arches. One hundred and eight (53.2%) partially edentulous mandibles and 92 (46.8%) partially edentulous maxillae were found. Kennedy Class I was more frequent in the mandibular arch (58 patients; 29%) whereas Kennedy Class III was more frequent in the maxillary arch (40 patients; 20%). Patients aged between 51 and 60 years presented the highest percentage of partially edentulous arches (33.6%)., Conclusion: Mandibular Kennedy Class I and maxillary Kennedy Class III presented the highest frequency in patients treated at the FO-UFF. These results are in agreement with previous studies that evaluated the different Kennedy classes in partially edentulous arches., (© 2014 by the American College of Prosthodontists.)

Statement of Problem: Scientific data about the long-term survival of teeth treated with cast post and cores are scarce. Retrospective studies often use different target events for their analyses. A comparison is therefore complicated. For associated tooth-, jaw-, and patient-related factors little evidence exists as to their effect on survival., Purpose: The purpose of this study was to extend the knowledge on the survival of teeth treated with cast post and cores for observation periods of more than 10 years. A decrease or increase in survival times according to the presence or absence of associated parameters needs to be evaluated., Material and Methods: A retrospective evaluation was conducted of all cast post and cores inserted in 1 university clinic between January 1992 and June 2011. A Kaplan-Meier survival analysis was carried out by using extraction as the target event. The survival curves for different tooth types, the presence or absence of adjacent teeth, and the prosthetic restoration of the respective jaws were compared by using the log-rank test (α=.05). A Cox regression model was calculated for multivariate analyses., Results: A total of 717 cast post and cores for 343 patients were recorded. The mean survival time was 13.5 years. A statistically significant decrease in survival times was found for canines (11.9 years) and premolars (13.4 years) versus molars (14.1 years), no adjacent teeth (10.6 years) versus at least 1 adjacent tooth (13.8 years), and the restoration with removable dental prostheses (12.5 years) versus fixed dental prostheses and single crowns (13.9 years). The largest reduction in survival time was found for teeth being used as an abutment for a double crown-retained removable partial dental prosthesis (telescopic denture) (9.8 years). Tooth type and adjacent tooth status remained as significant variables within the multivariate Cox regression model., Conclusions: Cast post and cores have an acceptable long-term survival time. Because different factors may influence survival, considering these factors in treatment planning may increase the long-term success of these restorations., (Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: The purpose of this retrospective clinical study was to evaluate the clinical outcomes of fixed implant-supported dental prostheses (FISDPs) and removable ISDPs (RISDPs) retained by telescopic attachments, the factors influencing survival, and the type and number of maintenance treatments required during the observation period., Materials and Methods: This retrospective clinical study is based on patients who were provided with ISDPs between 2004 and 2010. Patient sex, type of prosthesis, location, opposing dentition, and the effect of continuous follow-up on the probability of a favorable outcome, as well as the number of maintenance treatments, were analyzed. A statistical analysis was performed using the Kaplan-Meier method., Results: A sample of 233 patients with 157 FISDPs and 76 RISDPs supported by a total of 567 implants was randomized and included in the analysis. The mean observation period was 15.9 ± 15.4 months (maximum, 66.0 months). During the observation period, 3.9% of prostheses (7/157 FISDPs and 2/76 RISDPs) ceased to function and 2.3% of implants (13 implants) were lost. The mean survival time was 59.7 ± 2.3 months, with a survival probability of 90.2% after 3 years. Prostheses in the mandible showed significantly higher survival rates than those in the maxilla. Maintenance treatments had to be performed at an earlier stage for patients with RISDPs than for patients with FISDPs. In patients with a conventional removable prosthesis in the opposing arch, the time until maintenance was needed was significantly shorter., Conclusion: Within the limitations of a retrospective study, it can be concluded that the FISDPs and RISDPs show equally good survival rates after 3 years in function. RISDPs showed a greater and earlier need for maintenance treatments during the first years in function.

Background: The traditional measure for assessing dental treatment needs and workforce requirements based solely on normative need (NN) has major shortcomings. The sociodental approach (SDA) to assess needs overcomes some of the shortcomings as it combines normative and subjective needs assessments and also incorporates behavioural propensity (Sheiham and Tsakos 2007). The objective of this study was to estimate and compare prosthodontic treatment needs and workforce requirements, using the normative and the sociodental approaches for different skill mix models., Methods: A cross-sectional study was conducted on 732 university employees aged 30-54 years. Normative prosthodontic need was assessed using the WHO (1997) method. The SDA includes NN and also considers oral impacts, measured through the OIDP index, and behavioural propensity. Estimates of prosthodontic need and dental workforce requirements using the two methods were compared using McNemar and Wilcoxon Signed Rank test respectively. The dental workforce required for prosthodontic treatment based on NN and SDA approaches were then compared using different workforce skill mix models., Results: The proportion of subjects needing prosthodontic treatment was lower by more than 90% when the SDA was used compared to NN. The number of dentists required for prosthodontic treatment per 100,000 people were 98.8 using NN compared to 2.49 using SDA. Using a skill mix approach, the requirements for dentists per 100,000 people decreased slightly when more denture procedures were delegated to dental therapists., Conclusion: There were very much lower levels of prosthodontic treatment needs and workforce requirements when using the sociodental approach compared to normative methods.

Background: Objectives were to: (1) determine whether and how often general dentists (GDs) provide specific dental procedures; and (2) test the hypothesis that provision is associated with key dentist, practice, and patient characteristics., Methods: GDs (n = 2,367) in the United States National Dental Practice-Based Research Network completed an Enrollment Questionnaire that included: (1) dentist; (2) practice; and (3) patient characteristics, and how commonly they provide each of 10 dental procedures. We determined how commonly procedures were provided and tested the hypothesis that provision was substantively related to the three sets of characteristics., Results: Two procedure categories were classified as "uncommon" (orthodontics, periodontal surgery), three were "common" (molar endodontics; implants; non-surgical periodontics), and five were "very common" (restorative; esthetic procedures; extractions; removable prosthetics; non-molar endodontics). Dentist, practice, and patient characteristics were substantively related to procedure provision; several characteristics seemed to have pervasive effects, such as dentist gender, training after dental school, full-time/part-time status, private practice vs. institutional practice, presence of a specialist in the same practice, and insurance status of patients., Conclusions: As a group, GDs provide a comprehensive range of procedures. However, provision by individual dentists is substantively related to certain dentist, practice, and patient characteristics. A large number and broad range of factors seem to influence which procedures GDs provide. This may have implications for how GDs respond to the ever-changing landscape of dental care utilization, patient population demography, scope of practice, delivery models and GDs' evolving role in primary care.

Objectives: This study aimed to explore the relationship between dental disease, complexity and dental treatment needs of care home residents., Methods: Survey of residents in care homes in Wales. Random sample of participants from a random selection of care homes across Wales, UK. Data collection involved questionnaires and dental examinations., Results: Data were collected from 655 care home residents in 213 care homes. Half of all residents reported good or very good oral health but most had dental treatment needs. 73% of dentate residents had active caries, of those, 53% required restorations and 37% needed extractions. All were deemed to require dental examination. 60% of dentate residents and 50% of edentate residents had case complexity, which influenced the delivery of care., Conclusions: There is significant unmet dental treatment need amongst care home residents. Dental disease presence alone is a poor indicator of the need for care and does not account for case complexity or the shift towards a patient centred rather than disease focussed approach to care. Measures for treatment needs and complexity are required when undertaking assessments of oral health needs in care homes., Clinical Significance: Traditional oral health surveys measuring dental disease do not necessarily equate to treatments required for care home residents and do not reflect the complexity and difficulties involved in delivering dental care. This survey highlights dental needs in care homes, and the difficulties involved in delivering care to address these needs., (Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.)

Objectives: The aims of this pilot study were to investigate the prevalence of xerostomia and hyposalivation and their impact on quality of life in a cohort of elderly patients including dental status and the character of potential prosthetic restorations as independent variables., Methods: Patients aged 60 years or older without any objective or subjective need for prosthodontic treatment taking part in a regular recall programme were included in the trial. Quality of life was assessed using the German version of the GOHAI; prevalence and severity of xerostomia was investigated using the shortened version of the Xerostomia Inventory (XI). Stimulated salivary flow rate was determined using a sialometric approach. Dental status and the character of prosthetic restorations (no/fixed restorations and removable but tooth-supported dentures vs. gum-supported dentures) were assessed in a clinical examination by experienced dentists specialized in prosthodontic treatment., Results: A total of 68 patients were included in the trial; a prevalence of xerostomia of 16% and a prevalence of hyposalivation of 31% were identified. The quality of life in the study cohort decreased significantly as a function of xerostomia severity but not salivary flow; moreover, a significant impact of the number of teeth/implants in the upper jaw and the presence of gum-supported dentures in both jaws on GOHAI scores could be identified., Conclusions: Within the limitations of a pilot study, the results support the assumption that the quality of life in elderly patients is particularly related to their subjective perception of xerostomia. A decline in salivary flow, the dental status and the character of prosthetic restorations appear to play a subordinate role for the quality of life in elderly patients., Clinical Significance: The quality of life in elderly patients may be severely diminished due to an increased subjective perception of dry mouth. Dental treatment should focus on alleviating xerostomia, whereas the impact of dental status and prosthetic restoration appear to be subordinate., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objective: To provide a snapshot of the New Zealand dental technology industry and influencing factors., Background: Developing an understanding of the commercial dental laboratory environment in New Zealand can provide insight into the entire dental industry., Methods: A web-based survey was the primary method for data collection, with separate questionnaires used for dental laboratory owners and dental technician employees., Results: The mean net income for dental laboratory owners in New Zealand was similar to that of the United Kingdom, at $40.50 per hour. Clinical dental technicians are the highest paid employees, with a mean of $33.49 per hour. The mean technical charge for complete dentures was $632.59; including clinical services, it was $1907.00. The mean charge for a porcelain-fused-to-metal (PFM) crown was $290.27. Dental laboratory owners expressed fear about the possibility of losing dental clients to overseas laboratories due to the availability and cheap charge of offshore work. Only 25.4% of dental laboratories surveyed had computer-aided design (CAD) facilities, and even fewer (7.9%) had computer-aided manufacturing (CAM) systems., Conclusion: Clinical dental technology appears to be prospering. The dental technology industry appears to be adapting and remains viable, despite facing many challenges.

Introduction: Treatment options for missing tooth/teeth which are mostly commonly caused dental caries, periodontitis and trauma include partial dentures, bridge and implant. In developing countries, missing tooth/teeth replacement constitutes a high unmet dental need. The objective of the study was to determine the prevalence of partial edentulism and prosthetic unmet dental needs among young adults in Nigeria., Materials and Methods: A total of 244 medical students of college of medicine were recruited and studied using interviewer administered questionnaire which elicited information on sociodemographic, tooth loss and replacement. Data was analyzed with SPSS version 16.0 statistical software for windows., Results: There were 98 males (40.2%) and 146 females (59.8%). A total of 35 participants out of the 244 studied participants had missing tooth/teeth giving a prevalence of 14.3%. The major reason of tooth loss was caries (48.6%). The upper left (16.7%) and right (16.7%) had the highest tooth mortality. Of the 35 participants with missing teeth, 4 (11.4%) of had replacement while 31 (88.6%) did not have any form of replacement. The teeth replaced were upper right, left anterior (75%) and upper right posterior (25%). Reasons for non-replacement were not being bothered--14 (45.2%), ignorance of replacement therapy-- 7 (22.6%), misinformation--1 (3.2%) and lack of money--2 (6.5%). Those that replaced 4/42 (9.5%) did so with removable partial dentures (100%). The majority that replaced were females 3/4 (75%). Half (50%) of those that replaced were satisfied and the reasons for non-satisfaction were pain from denture and unnatural feel of denture., Conclusion: Data from this study revealed low prevalence of tooth loss with high unmet tooth replacement needs among the participants. Tooth/teeth replacement options should be incorporated in postoperative instructions after extraction and dental awareness should be improved among medical students.

Background: The aim of this study was to determine the incidence of different Kennedy's classes of partial edentulism during 18 months period., Materials and Methods: Patients were clinically examined for various Kennedy's classes of partial edentulism in the outpatient department (OPD), prosthodontics, GPRDCH, Kurnool (Andhra Pradesh)., Results: Of the total 1,420 OPD patients, Kennedy's class III was the most frequent classification encountered (62%) and followed by Kennedy's class I (18%), class II (11%), and class IV (9%) in decreasing order., Conclusion: The patients with various Kennedy's classes of partial edentulism can be offered various treatment modalities like removable cast partial dentures, fixed partial dentures, over dentures and implant supported dentures. This study can be crucial for screening the population for incidence of tooth loss as a factor of gender and age. Clinical significance: Tooth loss appears to have an important role in the loss of esthetics and mastication. Study of incidence of various classes of partial edentulism provides clinically useful information for dental training and continuing education.

Occlusal performance is a substantial determinant of the quality of dental prosthetic restorations. In the follow-up (SHIP 1) to the Study of Health in Pomerania (SHIP), a representative population of 3300 subjects was studied in the first exploratory evaluation of the occlusion of artificial teeth in the chewing center (first molar region) of partial dentures. A digital analysis of interocclusal records of habitual intercuspation position (ICP) was performed using the Greifswald Digital Analyzing System (GEDAS), a software package that identifies contact points as transparent areas. 562 subjects (280 men aged 61.7 ± 11.9 years and 282 women aged 60.7 ± 10.7 years) had maxillary removable partial dentures (RPDs), and 619 (271 men aged 65.0 ± 11.5 years and 348 women aged 62.4 ± 10.6 years) had mandibular RPDs. Most RPDs were retained with either attachment retainers (11.7% maxilla, 11.7% mandible), cast clasps (38.4% maxilla, 40.7% mandible), telescopes with double crowns (15.7% maxilla, 19.1% mandible), or wrought wire clasps (16.4% maxilla, 8.2% mandible). Some had a combination of different retention elements. The mean number of artificial teeth was 7.8 ± 2.9 in the maxilla and 7.5 ± 3.0 in the mandible. Only the artificial teeth (first molars) in mandibular partial dentures showed differences in the frequency of occlusal contacts between groups (chi-square test). Of these, telescopic crown-retained RPDs had the highest frequency of occlusal contacts (74.4% at tooth 36 and 77.1% at tooth 46), and wrought wire-retained RPDs had the lowest (48.4% at tooth 36 and 45.2% at tooth 46). The results for RPDs with a free-end saddle were comparable and analogous; contact frequencies for those with an interdental saddle did not differ significantly. Notably, the overall frequency of occlusal contacts was greater for tooth 46 (62.9%) than for tooth 36. In conclusion, when replacing teeth in the chewing center, particularly in the mandible, telescopic crown-retained RPDs offer a distinct advantage in terms of occlusal contacts and thus provide better occlusal stability.

Objectives: Predicting the tooth survival is such a great challenge for evidence-based dentistry. To prevent further tooth loss of partially edentulous patients, estimation of individualized risk and benefit for each residual tooth is important to the clinical decision-making. While there are several reports indicating a risk of losing the abutment teeth of RPDs, there are no existing reports exploring the cause of abutment loss by multifactorial analysis. The aim of this practice-based longitudinal study was to determine the prognostic factors affecting the survival period of RPD abutments using a multifactorial risk assessment., Methods: One hundred and forty-seven patients had been previously provided with a total of 236 new RPDs at the Osaka University Dental Hospital; the 856 abutments for these RPDs were analyzed. Survival of abutment teeth was estimated using the Kaplan-Meier method. Multivariate analysis was conducted by Cox's proportional hazard modelling., Results: The 5-year survival rates were 86.6% for direct abutments and 93.1% for indirect abutments, compared with 95.8% survival in non-abutment teeth. The multivariate analysis showed that abutment survival was significantly associated with crown-root ratio (hazard ratio (HR): 3.13), root canal treatment (HR: 2.93), pocket depth (HR: 2.51), type of abutments (HR: 2.19) and occlusal support (HR: 1.90)., Conclusion: From this practice-based longitudinal study, we concluded that RPD abutment teeth are more likely to be lost than other residual teeth. From the multifactorial risk factor assessment, several prognostic factors, such as occlusal support, crown-root ratio, root canal treatment, and pocket depth were suggested., Clinical Significance: These results could be used to estimate the individualized risk for the residual teeth, to predict the prognosis of RPD abutments and to facilitate an evidence-based clinical decision making., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: India has a large geriatric population (60 years and above) of 77 million; comprising 7.7% of its total population. Poor oral health and loss of teeth not only adversely affect the dietary intake and nutritional status and thereby compromise general health, but can also deny them the pleasure of eating food of their choice., Objective: To assess the level of edentulousness, denture wearing and denture needs of the elderly in the community and to study the correlation between oral health parameters and sociodemographic variables which would help us to define better treatment modalities, counselling and thus improve the oral health of our geriatric patients., Materials and Methods: Subjects who were 60 years and above were considered for this study and were randomly selected. Of the 1360 elderly who were enrolled in the study, 780 (57.35%) were males and 580 (42.64%) were female. This sample size is in proportion to the total population for the pilot study. They were given an oral examination and a questionnaire., Results: Fifty seven percent (57%) of the elderly were not satisfied with their oral health status and function., Conclusion: Complete edentulousness of both the arches was highest in the middle socio-economic group, and was the lowest in the low socio-economic group. Less than 50% of edentulous elderly and only 10% of partially edentulous elderly were wearing dentures., (© 2012 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.)

Introduction: To promote oral health among the elderly, we need to know their prosthetic status and prosthetic need. Hence, a survey of prosthetic status and need of elderly inmates of geriatric homes in Hyderabad was done., Materials and Methods: A cross-sectional study was undertaken, and 174 subjects aged 60 years and above were examined of which 103 were male and 71 were female (59.2% males and 40.8% females). The oral examination of the study subjects was carried out using basic oral health surveys, WHO 1997 criteria., Results: Majority of the subjects, 73 (70.8%) males and 53 (74.6%) females had no prosthesis. Only 4.6% had complete dentures and 21.1% had removable partial dentures and 10.9% had single/multiple bridges. Need for any prosthesis was (83.5%) male and 63 (88.7%) female subjects and nearly 82. 8% subjects required one-unit prosthesis., Conclusion: Dental prosthetic status of people living in geriatric homes is very poor and there is high unmet need for prosthetic care existed among the institutionalized elderly surveyed.

With the Internet facilitating access to vast amounts of free information, dental practitioners face providing treatment for an increasingly informed public. However, the available content is not filtered, and it can be difficult for patients to discriminate between research-informed evidence and "glamorised" material of dubious origin. Patients reasonably expect a return for their investment and want to know how long their treatment will last. Clinicians have an obligation to inform their patients so that they can make reasoned decisions about treatment options. Longevity data are also informative for health agencies setting service schedules for publicly funded treatment, and for determining settlements by insurers such as ACC. Historically, much of the prosthodontic treatment performed in practice has relied heavily on dogma, low-level anecdotal evidence, and clinical case reports. This paper considers the literature on fixed and removable prosthodontic restorations and provides a critical review which can be used practically as the basis for informing patients, and to assist decision-makers in making fair and appropriate judgements.

Objectives: In previous studies, increasing number of teeth predicted better survival and the acute needs for dental treatment predicted mortality. We sought to investigate whether restored dentitions by various removable dental prostheses impact cardiovascular (CVD) longevity., Methods: Kuopio Oral Health and Heart study was initiated as a cross-sectional investigation with 256 subjects with diagnosed coronary artery disease [CAD] and 250 age- and sex-matched controls without CAD in 1995-1996. The mean age of both groups was 61, 30% were females. We appended mortality follow-up records to the baseline data and formulated this 15-year follow-up study. We examined the relationship between various types of dental prostheses and cardiovascular mortality by proportional hazard regression analyses. We also explored their correlation to oral and systemic inflammatory markers such as asymptotic dental score and C-reactive protein., Results: In a model adjusted for age, sex and smoking, groups having only natural teeth (NT), removable partial denture(s) [PD] and NT, a PD and a full denture [FD], and FD/FD or FD/NT demonstrated the following hazard ratios for mortality (95% confidence interval). NT both arches: 1.00 [reference]; PD and NT: 0.75 [0.22-2.56]; PD and FD: 1.99 [1.05-3.81]; and FD opposed by FD or NT: 1.71 [0.93-3.13], respectively [p for trend=0.05]. Although statistically not significant, those with PD and NT with mean a number of teeth [Nteeth] of 15.4 had better survival compared with those who had all NT [Nteeth=22.5]; while those who had FD and PD [Nteeth=6.5] had shorter longevity than those with FD/FD or FD/NT [Nteeth=3.5]., Conclusions: Although not all subgroups of dental prostheses reached significant relationship with CVD mortality, our study suggests that not only the number [quantity] of remaining teeth but their maintenance [quality] removing potential inflammatory foci, such as pericoronitis or retained root tips, may positively impact on cardiovascular survival., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Purpose: This survey was conducted to study the prevalence of partial edentulism, the type of removable partial denture (RPD) support, the type of major connectors, and the frequency of their use in relation to the partial edentulism classes encountered, concerning patients in Athens, Greece., Materials and Methods: The material comprised 628 final casts for RPDs. Each cast was photographed in a way that would allow the number of existing teeth, the classification of partial edentulism, the RPD support, and the particular parts of the metal framework to be identified. Data collected were analyzed statistically using prevalence tables and the χ(2) test., Results: Two hundred seventy six (43.9%) casts were for the maxilla and 352 (56.1%) for the mandible. The most frequently encountered group was Kennedy class I for both arches, while class IV was the classification least encountered (p < 0.001). Of all RPDs constructed, 96.8% had a metal framework (tooth-borne and tooth/tissue-borne), while 3.2% of the RPDs were frameless (tissue-borne, acrylic dentures). The U-shaped palatal connector (horseshoe) in the maxilla and the lingual bar in the mandible were the most frequently used for all partial edentulism classes, at 55.2% and 95%, respectively., Conclusions: Analysis of the casts revealed that the type of major connectors selected does not comply with the indications for their applications, considering the lack of dental history and clinical examination. This notes the need for further training dentists and dental technicians in aspects of RPD framework design., (© 2013 by the American College of Prosthodontists.)

Purpose: This study identifies clinical factors that predict multiple tooth loss in a socioculturally diverse population of older adults., Materials and Methods: A total of 193 participants from English-, Chinese-, or Punjabi-speaking communities in Vancouver, British Columbia, with low incomes and irregular use of dental services were followed for 5 years as part of a clinical trial of a 0.12% chlorhexidine mouthrinse. The participants were interviewed and examined clinically, including panoramic radiographs, at baseline and annually for 5 years. Binary logistic regression was used to test the hypothesis that there was no difference between incidence of multiple (≥ 3) tooth loss in older people with various biologic, behavioral, prosthodontic, and cultural variables over 5 years., Results: Multiple tooth loss, which was distributed similarly among the groups in the trial, occurred in 39 (20%) participants over 5 years. The use of removable prostheses was the best predictor of loss, followed by the number of carious surfaces and number of sites with gingival attachment loss > 6 mm. The pattern of prediction was consistent across the three linguocultural groups., Conclusion: The use of removable dentures was the dominant predictor of multiple tooth loss in the three communities, but that tooth loss was not significantly associated with the cultural heritage of the participants.

The objective of this study is to investigate the prevalence of missing teeth and prosthodontic replacements in a Chinese adult population using a hierarchical dental functional classification system. A total of 1,462 dentate subjects over 40 years from Shandong Province, China were included and categorized in the functional classification system with and without tooth replacements. Depending on replacements, subjects could be reclassified (promoted) to categories reflecting higher functionality. "Promotions" were considered indicators for prosthodontic effectiveness. Homogeneities after dichotomization into functional categories appeared to be moderate to good. In the "≥10 teeth in each jaw" branch, mean number of teeth and posterior occluding pairs were 27.93 ± 2.74 and 7.10 ± 1.94, respectively. In the branch "<10 teeth in each jaw," these figures were 16.17 ± 5.54 and 1.49 ± 1.45. Fixed dental prostheses (FDPs) added on average 3.5 artificial teeth; 46% of subjects with FDP promoted to a higher functional level. For removable dental prostheses (RDPs), these numbers were 8.5% and 79%, respectively. Promotion value per tooth added was significantly higher for FDPs. The classification system was able to quantify the effectiveness of teeth replacements. It was shown that RDPs were more effective when higher numbers of teeth were replaced, while FDPs were more effective per artificial tooth added.

Objectives: The aim of this study was to evaluate the frequency of removable partial dentures (RPD) at the Aracatuba Dental School., Methods: The study was conducted by analysing 412 clinical history of patients attended at the RPD clinics in the period from 2000 to 2007., Results: 412 charts were analysed: 148 (35.9%) men and 264 (64.1%) women. The mean age was 53.8 years (men) and 52.4 years (women). A total of 556 dentures were made; of these, 233 (41.90%) were maxillary and 323 (58.09%) were mandibular dentures. The most frequent Kennedy classification found was Class III (maxilla) and Class I (mandible). In the maxilla, 55% (126) of the major connectors were of the anterior-posterior palatal bar, while in the mandible, 64% (202) were the lingual bar. As regards the claps, 401 were circumferential and 318 were bar claps., Conclusion: The mean age of the patients was 52.9 years with higher prevalence of female patients; the most frequent Kennedy's classification was Class I in mandible and Class III in maxilla; the most common major connector was anterior-posterior palatal bar for maxilla and lingual bar for mandible; the circumferential clasps were the most common retainer used in both jaws., (© 2012 The Gerodontology Society and John Wiley & Sons A/S.)

The purpose of this study was to evaluate the effects of a new clinical curriculum on dental student productivity as measured by number of procedures performed in the student teaching practice. Harvard School of Dental Medicine adopted a new clinical education model for the predoctoral program in summer 2009 based upon a Case Completion Curriculum (CCC) rather than a discipline-based numeric threshold system. The two study groups (threshold group and case completion group) consisted of students who graduated in 2009 and 2010. Clinical performance was assessed by clinical productivity across five major discipline areas: periodontics, operative dentistry, removable prosthodontics, fixed prosthodontics, and endodontics. The relationships between the two study groups with regard to number of procedures performed by category revealed that the case completion group performed a significantly higher number of operative and removable prosthodontic procedures, but fewer periodontal and endodontic procedures (p≤0.03). No statistically significant difference in number of procedures was observed with fixed prosthodontic procedures between the two groups. Clinical productivity as a result of redesigning the clinical component of the curriculum varied in selected disciplines. The CCC, in which the comprehensive management of the patient was the priority, contributed to achieving a patient-based comprehensive care practice.

Purpose: This study was done under the auspices of the Swedish International Development Cooperation Agency, whose aim is to improve living conditions in developing countries, including dental aid. Each year the number of medical staff from the European Union willing to help in developing countries increases, and it is thus important to highlight issues of development. From the Middle Asian region, the Republic of Kazakhstan was chosen. At present, few studies have evaluated the prevalence of various types of partial edentulism in this region, and no research has investigated the prosthetic treatment choice in the various types of partial edentulism. The purpose of this study was to determine (i) the prevalence of various types of partial edentulism in patients seeking dental care and (ii) the type of prosthetic restoration most commonly chosen to treat these patients., Materials and Methods: One hundred twelve patient records, together with panoramic radiographs, were studied. Various types of partial edentulism were grouped into four Kennedy classes. Patient records were used to examine which treatment option was chosen for each patient., Results: The most prevalent type of partial edentulism in this patient sample was Kennedy type III, in both the maxilla (50.0%) and the mandible (41.1%). Partial edentulism was most frequently managed by fixed partial dentures (FPDs) in both jaws. Kennedy IV was the least prevalent (7.1% in the maxilla, 5.6% in the mandible) and in most cases treated with removable partial dentures (RPDs) in both jaws., Conclusion: Our results are consistent with previous research on the prevalence of Kennedy classes in Kazakhstan. RPDs were the most common type of prosthetic management for partial edentulism., (© 2012 by the American College of Prosthodontists.)

This retrospective study investigated the frequency and time history of chipping or facings failure of three-unit and four-unit tooth-supported metal ceramic (MC) fixed partial prostheses (FPDs). Six hundred fifty-four MC FPDs were inserted according to a standardized treatment protocol at the Department of Prosthodontics of the Regensburg University Medical Center between 1984 and 2009. Frequency and time history of chipping or facings failure as well as possible risk factors were evaluated on the basis of historical clinical data. We estimated the survival times of FPDs by means of the Kaplan-Meier analysis. The 5-year survival rate (time to renewal of a FPD) of all MC FPDs was 94%; the 10-year survival rate was 87%. Twenty-eight (4.3%) MC FPDs showed chipping; the 5-year free-of-event rate of chipping was 95%, the 10-year rate was 94%. Possible risk factors had no statistically significant influence on chipping or facings failure. The annual hazard rate of MC chipping in the first year was 0.03, i.e., 3 out of 100 person-years of exposure showed chipping. The annual hazard rates for the next 6 years dropped to 0.009, 0.003, 0.007, 0.004, 0.005, and 0.007. Thus, about 3-9 out of 1,000 person-years of exposure showed chipping. Patients with MC FPD may expect a long survival rate of their restoration. During the first year, the risk of chipping may be higher than during the following years. Despite the long period of experience with MC FPDs, chipping of the facing will still occur.

Objective: To appropriately explore risk factors for tooth loss operating at the tooth-level, subject-related factors and a hierarchical data structure have to be considered. The purpose of this study was to evaluate tooth-related and subject-related risk factors affecting tooth loss., Methods: A 10-year longitudinal survey was carried out on 286 elderly subjects. At baseline, the prosthodontic status and abutment function of the 5574 teeth were recorded. Tooth loss was defined as the main outcome variable, and a multilevel logistic regression model considering subject and tooth levels was applied., Results: Tooth loss was found in 75% of subjects and most frequently in molars. A multivariable, multilevel logistic regression revealed that the following tooth-related variables were significantly related to tooth loss over 10 years: maxillary teeth, multirooted teeth, single crowns, abutment teeth for a fixed/removable partial denture (FPD/RPD), and periodontally involved teeth. Among them, single crowns, abutment teeth for an FPD, and teeth with severe periodontal disease at baseline had the highest odds of 5.1, 6.0, and 7.1, respectively., Conclusions: The findings of this study suggest that tooth loss is the result of complex interactions of tooth-related factors. Several tooth-related variables including multirooted teeth, abutments, and single crowns were found to be possible risk factors for tooth loss. Thus, these findings confirm and underline the potential benefit of minimizing prosthetic treatment of molars., (© 2011 John Wiley & Sons A/S.)

Purpose: The aims of this study were to investigate the prevalence of tooth loss in Greek individuals aged 35 to 44 and 65 to 74 years in relation to sociodemographic parameters and to describe their prosthetic status and needs., Materials and Methods: A stratified cluster sample of 1,188 middle-aged adults and 1,093 senior citizens was selected according to World Health Organization (WHO) guidelines for national pathfinder surveys. Tooth loss and prosthetic status and needs were recorded according to WHO criteria. Sociodemographic data were collected through face-to-face interviews., Results: Complete edentulism affected 0.3% of individuals aged 35 to 44 years and 31.5% of those aged 65 to 74 years. Most middle-aged adults (92.1%) had ≥ 21 natural teeth, while the corresponding percentage for the senior citizens was 23.1%. The mean number of missing teeth was 5.2 in middle-aged adults and 21.6 in senior citizens. The multivariate analysis showed that education level was the only predictor of tooth loss in both age groups. Approximately 38% of those aged 35 to 44 years and 80% of those aged 65 to 74 years had dental prostheses, while 47.6% of middle-aged adults and 66.3% of senior citizens did not need any prosthetic treatment. The need for complete dentures was relatively low in both age groups. Comparisons of the present results with those of 1985 indicate that the dentate status of Greek adults aged 35 to 44 years has not improved. Furthermore, the prevalence of tooth loss in the elderly population was high compared with internationally reported findings., Conclusion: The replacement of missing teeth with fixed or removable prostheses will continue to be common in Greece for the foreseeable future.

Unlabelled: The aim was to study the prevalence and distribution of number of teeth, number of intact and decayed teeth and prevalence and distribution of removable dentures and periodontal disease over 25 years 1983-2008. Two cross-sectional studies (EpiWux) were performed in the County of Dalarna, Sweden in 1983 and 2008. In the 1983 study a random sample of 1012 individuals were invited to participate in this epidemiological and clinical study and 1440 individuals in 2008. A total number of 1695 individuals, stratified into geographical areas (rural and urban areas), in the age groups 35, 50, 65 and 75 answered a questionnaire and were also clinically and radiographically examined.The number of edentulous individuals decreased from 15% in 1983 to 3% in 2008. Number of teeth increased from 22.7 in 1983 to 24.2 in 2008 and decayed surfaces per tooth showed a three-time reduction over this period of time. As a consequence of better oral status the prevalence of complete removable dentures in both jaws decreased from 15% in 1983 to 2% in 2008. Individuals with moderate periodontitis decreased from 45% in 1983 to 16% in 2008., Conclusion: Covering a period of 25 years the present study can report dramatic improvements in all aspects of dental status that were investigated.This is encouraging for dental care professionals, but will not necessarily lead to less demand for dental care in the future as the population is aging with a substantial increase in number of teeth.

The aim of this study was to investigate the clinical outcome of removable partial dentures (RPDs) designed to minimize denture mobility during function. Using archived files of the undergraduate program between 2003 and 2005 at Tokyo Medical and Dental University, a list of 169 patients treated with 184 RPDs was created. The RPDs had either an acrylic resin-base or a cobalt-chrome framework-base. Two examiners telephoned all the listed patients and interviewed 118 patients (70%) regarding the use of their RPDs. Of 118 patients, 42 (36%) had stopped using, mainly due to problems with abutment teeth in resin-based dentures, and replacement in cobalt-chrome-based dentures. There was no significant difference in mean age, gender distribution, mean number of remaining/abutment teeth, distribution of denture arch, and Kennedy classification between denture use and nonuse groups (p>0.05). The nonuse group showed a significantly higher percentage of resin-base compared to the use group (p = 0.006). Logistic regression analysis indicated that resin-base was a significant risk factor for nonuse (p = 0.008). The present findings suggest that abutment teeth should be selected carefully, especially in this type of resin-based RPDs, and that the denture base material may be a critical factor which determines denture use.

Unlabelled: The elderly are influenced from a various and complex combination of factors, such us individual genetic predispositions, lifestyle, society and environment, the sum of all the individual life experiences concerning the dental care, the caries, the periodontal and iatrogenic diseases., Aim: This paper evaluates the dental treatment in the elderly., Material and Methods: The study was performed on 112 patients, aged over 65, at the Clinical Department of Dental Semiology und Geriatric Dentistry, Iaşi, Romania., Results: The treatment interventions were dental hygiene procedures (in 97 patients), restaurations (in 29 patients), removable partial and total denture preocedures (in 50 patients), fixed prosthetic procedures (in 18 patients), rebasing of dentures (in 25 patients) and teeth extractions (in 26 patients). There were 36 endodontic emergencies and 15 periodontal emergencies and 8 emergencies that resulted from other causes., Conclusions: The periodical dental examinations and the proper daily oral hygiene routine are still important in the old age and they should not be neglected, because the prosthetical components request also treatment interventions.

Statement of Problem: Current demographic information on the number and types of removable partial dentures is lacking in the prosthodontic literature., Purpose: This study was designed to investigate patterns of tooth loss in patients receiving removable partial dentures (RPDs) in eastern Wisconsin., Material and Methods: Digital images (1502) of casts at 5 dental laboratories in eastern Wisconsin were collected. Any prescription requesting fabrication of a removable partial denture was photographed twice. The first photograph was made immediately upon arrival at the laboratory, while the second photograph was made immediately before being returned to the prescribing dentist for the first time. A calibrated investigator analyzed all the photographs for Kennedy Classification, type of RPD, major connector, and other details. Data were analyzed with descriptive statistics. Fisher's exact test was used to confirm repeatability., Results: Kennedy Class I was the most common RPD with a frequency of 38.4%. More than 40% of prescriptions had no design input from the dentist. One in 3 RPDs used acrylic resin or flexible frameworks. One in 5 RPDs had no rests. The horseshoe major connector was the most common maxillary major connector, while the lingual plate was the most common in the mandible., Conclusions: RPDs remain a common prosthodontic treatment in this region. Non-metal RPD frameworks are a common treatment type and rarely include rests. These data indicate a changing partially edentulous patient population and a variable commitment to standard levels of prosthodontic care., (Copyright © 2011 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.)

The aim of the study was to determine whether there is any relationship between the presence of removable dentures and squamous cell carcinoma of the anterior two thirds of the tongue in a Portuguese population. A retrospective cross-sectional study was conducted on patients with a biopsy-proven diagnosis of squamous cell carcinoma of the tongue, who were seen and treated at the Department of Head and Neck Surgery of the Portuguese Institute of Oncology 'Francisco Gentil', Lisbon, Portugal, during a 3-year period. Several factors were examined: gender, use of removable dentures, age, location of the lesion, and alcohol and tobacco consumption. One hundred and six cases were selected from the initial 151 cases, with a male:female ratio of 3:1 and the lateral borders being the most commonly affected site. The prevalence in both genders was between the sixth and seventh decade of life. Men were more likely to consume alcohol and tobacco than women, and no relationship was observed between denture use and presence of carcinoma of the tongue. In light of the data obtained, it may be considered that female use of a denture plays an important role, but it cannot be identified as a remarkable etiologic factor.

Objective: To obtain information about the subjective oral health status of non-clinical elderly populations of urban regions of Germany, one in the East and one in the West, by using OHIP-14 and, for first time, the GOHAI, and, furthermore, to compare the results obtained by use of both instruments., Basic Research Design: Cross-sectional., Clinical Setting: Randomly chosen, non-clinical elderly population in urban regions of Germany., Participants: 197 participants (51% male) born in the years 1930-1932., Main Outcome Measures: GOHAI, OHIP-14., Results: Median GOHAI score was 54; median OHIP-14 score was 2. Scores indicative of severely impaired oral health were rare. The effect of living in eastern or western Germany was of minor significance. Although the internal consistency of both measures was comparable and the same positive association with psychological wellbeing, absence of dry mouth, burning mouth, and removable dentures (p < 0.05) was observed, differences occurred. In simultaneous analysis of all items, factor analysis revealed only partial overlap of the items in extracted factors. Furthermore, the extreme score indicating no impairment was five times more frequent for OHIP-14. Of those who scored zero in OHIP-14, only 20% had the GOHAI equivalent score of 60, and for some GOHAI items the answer category for highest impairment was obtained., Conclusions: GOHAI scores for this randomly chosen non-clinical group enable comparison with scores for Germany measured in the future. The differences between GOHAI and OHIP-14 make it necessary to select the most appropriate instrument for a planned purpose and study population.

This study aimed to assess the prevalence of use and need for dental prostheses (UNDP) by individuals at age 24 and their life-course determinants. A representative sample (n = 720) of all 5914 births occurring in Pelotas in 1982 were prospectively investigated, and the UNDP were assessed in 2006. Exploratory variables included demographic and socio-economic, oral health, and dental service utilization patterns during the life-course. The prevalence of UNDP was 2.1% and 29.7%, respectively. Multivariable Poisson regression analysis showed that low socio-economic status through the life-course [Prevalence Ratio (PR) = 1.56 (95% CI: 1.08-2.26)], lower maternal schooling in childhood [PR 2.79 (1.34-5.79)], no oral hygiene instruction by a dentist at age 15 [PR 1.64 (1.11-2.41)], and caries presence at age 15 (high DMFT tertile) [PR 2.90 (1.98-4.24)] were associated with prosthetic treatment needs. These results support the hypothesis that life-course socio-economic, behavioral, and clinical determinants are associated with the need for dental prostheses.

Objective: While most previous epidemiological studies have focused on subject-level risk factors for periodontal destruction, tooth-related factors have not been fully explored. The purpose of this study was to evaluate both tooth-related and subject-related factors affecting periodontal disease progression using a two-level multilevel model., Material and Methods: A longitudinal survey over a period of 10 years was carried out on 286 community-dwelling elderly subjects aged 70 years at baseline. Clinical attachment level (CAL) was measured at six sites per tooth on all teeth present and periodontal disease progression was defined as CAL> or =3 mm., Results: Periodontal disease progression was found in 79% of the subjects and most frequently in maxillary molars. Multilevel logistic regressions revealed that subjects wearing removable dentures were significantly at risk for periodontal disease progression. Abutment teeth for removable/fixed dentures were also significantly more likely to suffer periodontal breakdown. Furthermore, the following tooth-related variables were found to be possible risk factors for periodontal disease progression: maxillary and multirooted teeth., Conclusion: Multirooted teeth and abutments for a fixed denture were possible risk factors for periodontal disease progression.

Objective: Translate, culturally adapt, and validate a new Spanish version of the Oral Health Impact Profile (OHIP) for older persons in Mexico City, Mexico., Methods: A validation study of the new version of OHIP-Mx-49 was carried out through interviews and clinical examinations of people aged 60 or older in the southern area of Mexico City. The following variables were analyzed: sociodemographic (age, sex, marital status, level of schooling, and whether the subject lived alone), clinical (current number of teeth, coronal and root caries, dental hygiene, and the use of removable prostheses and dentures), and self-perception (of the need for dental and general health care). The OHIP-Mx-49 value was calculated as the sum of the scores in seven dimensions: functional limitation, pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. The internal consistency (Cronbach's alpha coefficient), replicability (intraclass correlation coefficient), and convergent and discriminant validity (Mann-Whitney and Kruskal-Wallis tests) were assessed., Results: Of the 131 people interviewed (average age: 73.8 +/- 8.3 years), 77.9% were women. High internal consistency values were obtained for the OHIP-Mx-49 (0.96) and the dimensions (0.79-0.86), and replicability in the instrument (0.877) and all the dimensions except social disability (0.176). The average OHIP-Mx-49 score was 37.1 +/- 35.3; higher scores were observed in people with 1-9 teeth (P = 0.02), people who did not have coronal caries (P = 0.02), and people who perceived a need for dental care (P = 0.01)., Conclusions: The OHIP-Mx-49 is a reliable and valid instrument that can be used with older Mexicans.

This cross-sectional study was conducted to quantify the clinical experience of prosthodontic residents with cast metal removable partial denture (RPD) treatment based on their year of training, geographic location of the program, and nature of the program. A web-based survey consisting of five questions was e-mailed to program directors from forty-two programs across the United States. A 62 percent response rate was obtained (26/42). Thirteen of the programs (50 percent of respondents) stipulated a specific number of RPDs to be done prior to completion of the program. Clinical experience of residents varied vastly based on year of training, geographic location of the program, and nature of the program. Prosthodontic residents from southern states, university-based programs, and public school programs had more clinical experience than residents from other programs. The average clinical experience for a prosthodontic resident during three years of training was eight traditional RPDs and two implant-supported RPDs. This is the first study done exploring this topic and provides baseline information on residents' clinical experience in RPD treatment. Future studies will determine educational trends and reassess this portion of the curriculum in graduate prosthodontics.

This study sought to quantify the incidence of root canal treatment (RCT) failure and identify its predictors in root canals that were performed or referred by general dentistry practices in a practice-based research network (PBRN). This retrospective cohort study involved 174 endodontically treated teeth. Mean duration from initial therapy to follow-up was 8.6 years. Permanent restorations were ultimately placed in 89% of teeth, although 18% of teeth were ultimately extracted anyway. Receiving a permanent restoration was a significant predictor of treatment failure (in other words, patients who did not receive a permanent restoration were more likely to experience RCT failure), whether failure was determined clinically or radiographically. This study of PBRN practices suggests a higher failure rate compared with studies that utilized highly controlled environments or populations with high levels of dental insurance.

The aim of this study was to examine the correlation of subjective dry mouth assessment (xerostomia) with age, sex, denture type, wear duration, denture stability, subjective discomfort, soreness in denture-bearing tissues, and dissatisfaction with chewing, tasting, or speaking in a group of elderly Turkish removable denture wearers. The participants of this study were 229 healthy subjects, 101 males (mean age: 68.1+/-5.2 years) and 128 females (mean age: 66.4+/-4.2 years), all aged 60 years and above. A self-administered structured questionnaire on sensation of dry mouth, its effects in the oral mucosa and ability in the oral functions were given to the participants. Associations of the categorical variables were examined using the chi(2)-test (p<0.05). Satisfaction in the ability of speaking, tasting foods, chewing hard food was determined statistically significant in patients without dry mouth (p<0.05). Overall satisfaction of dentures was significantly higher in patients without dry mouth (p<0.05). Participants with having dry mouth reported soreness in denture-bearing tissues in both complete and removable partial denture (RPD) wearers. It was also found that oral dryness significantly affects oral functions in terms of the satisfaction with removable denture and the ability in the oral functions independent to education level or gender.

Aim: To explore whether tooth replacement in a southern region of Vietnam is in line with the primary health care approach, aiming at health services for all people at affordable costs., Methods: Tooth replacement was investigated by means of prostheses as delivered by four dental laboratories of which the output was considered representative. Information was based on dental casts related to the prostheses., Results: Prostheses replaced almost all missing teeth, irrespective of the types (interrupted or shortened dental arches) and numbers of missing teeth in the dental arch they were made for. Acrylic removable partial dentures were the most common prostheses delivered (65% of removable partial dentures)., Conclusion: It cannot be stated that dental arch conditions in this study were representative for the southern Vietnamese population. However, it is concluded that dental practitioners tend to provide complete dental arches by tooth replacements. This morphologically based approach might introduce over treatment. In line with primary oral health care, a functionally oriented treatment management, including the shortened dental arch concept, should be implemented.

Based on the eigenvalues and the eigenvectors analysis, the principal component analysis has the purpose to identify the subspace of the main components from a set of parameters, which are enough to characterize the whole set of parameters. Interpreting the data for analysis as a cloud of points, we find through geometrical transformations the directions where the cloud's dispersion is maximal--the lines that pass through the cloud's center of weight and have a maximal density of points around them (by defining an appropriate criteria function and its minimization. This method can be successfully used in order to simplify the statistical analysis on questionnaires--because it helps us to select from a set of items only the most relevant ones, which cover the variations of the whole set of data. For instance, in the presented sample we started from a questionnaire with 28 items and, applying the principal component analysis we identified 7 principal components--or main items--fact that simplifies significantly the further data statistical analysis.

In the context of clinical trials, measurement of change is critical. The aim of this study was to determine the minimally important difference (MID) for the Oral Health Impact Profile-20 (OHIP-20) when used with partially dentate patients undergoing treatment that included the provision of removable partial dentures. In a prospective clinical trial, 51 consecutive patients were provided with removable partial dentures. In addition to demographic and dental status data, patients completed an OHIP-20 prior to treatment. One month postoperatively, patients completed a post-treatment OHIP-20 and a global transition scale. Domains assessed in the global transition scale were appearance, ability to chew food, oral comfort, and speech. The MID for the OHIP-20 was calculated using the anchor-based approach. From the initial sample of 51 patients, 44 completed post-treatment questionnaires and were included in the analysis. Change scores in the four transition domains indicated that new dentures had a positive impact in the majority of subjects, especially in perceived impact on chewing and appearance. The study provided a guideline as to what constitutes the MID for the OHIP-20. This benchmark can be used when interpreting the impact of clinical intervention for replacing missing teeth and for power calculation in statistical analyses.

Objectives: To analyse the possible effects of the socioeconomic status (SES) on the prosthetic replacement of missing teeth in working-age people and to explore the role of potential confounders., Methods: Cross-sectional data were collected from 2310 German adults aged 30-59 years. The relationship between each of the three SES indicators (education, income, and occupational status) and dental prostheses were examined by multinomial logistic regression analyses. For that, partially dentate participants with suboptimal and no replacement of missing teeth were compared with partially dentate participants having optimal replacement. Potential confounders (age, sex, dental status, social network and social support) were entered if their inclusion in the model led to >or= 10% change in the coefficient of interest., Results: Social network and social support did not meet the criterion for confounding. In the maxilla, having no replacement was positively associated with lower categories for each of the three SES indicators [Odds ratios (OR) between 1.6 and 2.1; 95% confidence intervals (CI) between 1.1 and 3.4]. Low occupational status was the single predictor for suboptimal dental prostheses (OR=3.2; 95% CI: 1.6-6.2). In the mandible, occupational status showed no association with the prosthetic status, whereas low educational level and low household income were determinants for having no replacement (OR=1.9 and 1.9, 95% CI: 1.0-3.5 and 1.1-3.0, respectively). Low household income was the single determinant for suboptimal replacement of missing teeth (OR=2.4, 95% CI=1.1-5.2)., Conclusion: The findings may indicate the relevance of the financing of prosthodontic treatment. The strong association between various forms of upper dentures and occupational prestige can be seen as key contributing concept to how individuals' characteristics affect the outcome in prosthodontic care.