Specialisation and specialist education in prosthetic dentistry in Europe

This presentation reports on the results of a meeting of prosthodontists from selected European countries. The aim of the meeting was to analyse and promote specialisation and specialist education in Prosthetic Dentistry in Europe. Representatives for Europe were selected from the European Prosthodontic Association (EPA) board, the Education and Research Committee of International College of Prosthodontists (ICP), countries with a legally recognised speciality, countries without a recognised speciality but organised training programmes and countries with neither of these situations. Data about specialisation and specialist training in Prosthodontics in Europe was scrutinised and discussed. The programmes for countries with specialist training had relatively similar content, mostly of three years duration. There was strong agreement that a recognised speciality raises the level of care within the discipline for both specialists and non-specialists. In several of the countries where a speciality had been introduced it had been initiated by pressure from public health planning authorities. The conclusions are that from a professional viewpoint an advancement of the speciality over Europe would develop the discipline, improve oral health planning and quality of patient care. A working group for harmonisation was recommended.     

The marginal fit of cemented galvanoceramic crowns

Galvanoceramic restorations were constructed for five extracted teeth. Following cementation, the margins were photographed (magnification X 33) and the prints mounted to produce a continuous image of the entire margin. Cement film thickness measurements were made at 0.1-mm intervals. The five cemented restorations were then embedded in resin, sectioned longitudinally, and examined under a microscope (X 125). The mean gap at the restoration margin, as measured by each technique, was 18 microns and 19 microns, respectively. These results were consistent with the clinical impressions of cemented galvanoceramic restorations completed at the University of Tübingen.     

Oral health-related quality of life in patients treated with fixed, removable, and complete dentures 1 month and 6 to 12 months after treatment

PURPOSE: This study described oral health-related quality of life (OHRQoL) before and after treatment in patients with fixed, removable, and complete dentures. MATERIALS AND METHODS: OHRQoL was measured using the German version of the Oral Health Impact Profile (OHIP-G) in a convenience sample of 107 prosthodontic patients at baseline and 1 and 6 to 12 months after treatment. The sum of OHIP-G item responses (OHIP-G49, range 0 to 196) characterized OHRQoL impairment in 42 patients treated with fixed prosthodontics, 31 patients treated with removable dentures, and 34 patients treated with complete dentures. OHIP-G49 medians were compared with the OHRQoL level in a general population sample (n = 2,026). A multivariable binomial regression analysis, controlling for the effects of baseline OHRQoL and follow-up wave, was used to compare the level of impaired OHRQoL in different prosthodontic treatment groups at follow-ups. RESULTS: OHRQoL improved in 96% of the subjects. OHIP-G49 medians reached the level of OHRQoL in the general population 1 month after treatment (fixed prosthodontics patients 6 OHIP-G units; general population subjects 5 units; removable denture patients 23 units, 15 units in general population subjects; complete denture patients 13 units, 23 units in general population subjects). OHIP-G49 medians were below population norms 6 to 12 months after treatment. In patients treated with removable/complete dentures, the expected posttreatment OHIP-G49 problem rate was 1.9 times the problem rate in patients treated with fixed prosthodontics, holding baseline OHIP-G49 and follow-up wave constant. CONCLUSION: OHRQoL changed substantially comparing pretreatment scores with 1 and 6 to 12 months of follow-up in patients treated with fixed, removable, and complete dentures.     

Chronischer Unterschenkelschmerz: Einklemmung des N. peronaeus communis oder des N. tibialis

Die Unfallchirurgie - Junge Menschen mit chronischen belastungsabhängigen Unterschenkelschmerzen, bei denen normale Druckverhältnisse im Muskelkompartiment herrschen und ein...     

基于牙体牙髓、牙周及功能健康的 显微微创牙体预备

牙体预备技术是口腔美学修复治疗必知必会的核心操作,通过一定量的牙修复体组织的磨除,为目标修复体提供容纳空间、粘接面与完成线等。如何在完成高质量牙体预备的同时还能保存牙体、保护活髓和牙周组织是美学修复牙体预备中亟需解决的难题。本文就微创牙体预备的概念及核心要素,显微牙体预备涉及的解剖生理学、显微牙体预备术前设计进行介绍,并总结了显微牙体预备技术临床路径,提出了显微牙体预备核心因素——量与形的新认知。     

Retentive characteristics of individual and prefabricated polyvinylsiloxane overdenture attachments: alternative treatment options for geriatric patients

Objectives

Stud attachments are often too adhesive and too susceptible to damage for use in geriatric patients, especially when implants are angulated. This study aimed to evaluate alternative anchoring systems comprising individual and prefabricated polyvinylsiloxane (PVS) attachments.

Materials and methods

A total of 182 specimens with individual PVS (IPVS) attachments (Shore hardness [SH] 25, SH50, SH65], prefabricated PVS (PPVS) attachments (SM green, yellow, and red), and Locator attachments (LR blue) were fabricated (n = 7 per group). Retention force was measured using the following parameters: insertion/removal (100, 200, 500, 1000, and 5000 cycles), thermal undulation (10,000 cycles at 5–55 °C; one implant per specimen), implant angulation (0°, 5°, and 10° convergence and divergence; two implants per specimen), and artificial saliva.

Results

Insertion/removal and thermal undulation caused no changes in retention force in SM green and IPVS subgroups; conversely, LR blue, SM red, and SM yellow attachments exhibited significant decreases in retention force of up to 66% (all P ≤ 0.001). Implant angulation produced relevant changes in retention force only in LR blue attachments. Artificial saliva caused a general decrease in retention force.

Conclusions

Retention force of low-retentive PVS attachments proved to be comparatively immune to dislocation and thermal undulation, as well as to implant angulation up to 10°.

Clinical relevance

Low-retentive PVS attachments could be a treatment option if reduced denture retention is required and/or if angulated implants are in place. Clinical studies are necessary to evaluate the materials’ durability under oral conditions.

     

Meta-analysis of treatment need for temporomandibular disorders in adult nonpatients

AIMS: To determine the prevalence of treatment need for temporomandibular disorders in adult populations by meta-analysis of nonpatient studies and to investigate factors influencing temporomandibular disorder treatment-need estimates. METHODS: Population-based and nonpatient studies of adult subjects with temporomandibular disorders published in the English language prior to July 2006 were systematically reviewed. Electronic databases (MEDLINE, CINAHL, and Science Citation Index Expanded) were searched (n = 641). To combine data, fixed- and random-effects meta-regression models were used. Subgroup analyses were performed to assess factors influencing treatment need estimates. RESULTS: Of 676 articles identified, 17 (9,454 subjects) met the study criteria. The prevalence of treatment need for TMD in adults (95% confidence interval) was estimated to be 15.6% (10.0, 23.6) for the fixed effect model and 16.2% (11.2, 21.1) for the random-effects model. Criteria of estimating treatment need and place of study strongly influenced summary estimates of treatment need (P < .001). Need estimates derived from clinical TMD signs were higher than estimates based on subject-reported symptoms (P = .010). Estimates for younger subjects (19 to 45 years) were higher than for older subjects (46+ years; P = .013). CONCLUSION: The treatment need for TMD in the general adult population is substantial and varies according to definition, criteria, and age. Findings of this meta-analysis can be used for planning and allocating health-care resources.