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目的    评价Cardex-stabon软衬材料用于全口义齿修复的临床效果。方法    选择2006年2月至2009年9月黄石市中心医院口腔科收治的全牙列缺失患者137例,随机分为试验组和对照组,试验组采用Cardex-stabon软衬材料行全口义齿衬垫修复,对照组采用常规方法进行义齿修复。分别于修复后20 d、2个月、6个月通过问卷调查的方式回访,评价患者所戴义齿的效果。结果    在修复后20 d、2个月、6个月时试验组义齿衬垫修复成功率为87.4％、83.9%、80.5%,明显高于对照组（56.0％、54.0%、40.0%）,且差异均有统计学意义（P均 < 0.01）。结论    使用Cardex-stabon软衬材料行全口义齿衬垫修复,能减少传统义齿固位差、咀嚼功能低下等并发症的发生。     

Bio-Liner软衬材料用于全口义齿效果的临床评价

目的研究Bio-Liner软衬材料用于全口义齿的临床效果。方法将102例全牙列缺失患者随机分为2组,A组采用Bio Liner软衬材料全口义齿衬垫修复,B组采用常规方法未用软衬材料修复,分别于修复后1、3、6、12、24个月行满意度临床评价,Ridit统计检验两组有无差异。结果修复后1、36、、12个月,A组患者满意度高于B组,差异有显著性(P<0.01)。24个月后,两组患者满意度差异无显著性(P>0.05)。结论Bio-Liner软衬材料能在短期内提高全口义齿患者的满意度,缩短患者的适应期。     

The prevalence and significance of yeasts in persons wearing complete dentures with soft-lining materials

Fifty-three persons wearing soft-lined mandibular dentures and heat-cured acrylic-resin maxillary dentures were studied, using imprint cultures, to determine the isolation frequency and density of colonization of denture and mucosal surfaces by yeasts. Yeasts were isolated from 35 (66%) of the persons studied. Nine species of Candida and one each of Trichosporon and Saccharomyces were identified. Candida albicans, occurring either alone or together with another strain, was identified in 66% of the isolates and was associated with a higher mean density/cm2 than that of other strains. An association between the method of denture cleaning, denture hygiene, and smoking habits and the isolation of yeasts was demonstrated, but a similar association could not be demonstrated with the sex of the person, denture-wearing habits, type and condition of the soft lining, or the clinical appearance of the mandibular denture-bearing mucosa. Although yeasts are more likely to colonize soft-lining materials than the fitting surface of conventional lower dentures, their presence did not significantly affect the soft-lining material. Further, the increased isolation of yeasts on the fitting surface of the soft-lined mandibular denture was not associated with an increased incidence of inflammatory changes in the mandibular denture-bearing mucosa.     

An in vivo and in vitro study of the loss of plasticizer from soft polymer-gel materials

Polymer-gel materials used as short-term denture soft linings are blended with plasticizers to lower the glass transition temperature (Tg). A lower Tg allows for greater polymer chain mobility, thus producing a more flexible material. The present work evaluated the loss of plasticizers due to leaching both in vivo and in vitro. Two commercial denture soft-lining materials (A and B) were tested. These were both poly(ethyl methacrylate) polymers, blended with alcohol and phthalate esters. A clinical study was conducted in which patients wore, sequentially, dentures bearing (on separate occasions) each of the two soft-polymer lining materials. The two materials A and B were randomly assigned for each of ten patients and were worn for 14 and 30 days, respectively. With one exception, patients wore dentures with both lining materials, for a total of 19 clinical evaluations. The plasticizer loss occurring during the clinical trial was determined by GC analysis from the initial and terminal day sampling of plasticizer content of the soft polymer-gel materials. The results of this analysis were compared with results obtained from an in vitro leachability study by use of sink conditions in water at 37 degrees C for the same two commercial soft polymers conducted over the same time periods of 14 and 30 days. The results indicated that a higher loss of plasticizer occurred in vivo, compared with the in vitro tests for 17 of the 19 clinical evaluations. The average plasticizer lost in vivo from material A at 14 days was 122 +/- 58 mg/g, and for material B at 30 days it was 33 +/- 27 mg/g.(ABSTRACT TRUNCATED AT 250 WORDS)     

Long-term results of telescopic crown retained dentures--a retrospective study

The clinical data for 250 telescopic crown retained dentures involving 617 abutment teeth preparations were collected and analysed in a retrospective study to ascertain the survival rate of the dentures and their abutment teeth. During the study period 10.6% of the abutment teeth had to be extracted. An increased number of telescopic crowns significantly improved the longevity of the prostheses and their associated abutment teeth in most denture designs, but this was not found to be the case with bilateral free-end saddle designs without an anterior bounded saddle. The use of more than four abutment teeth did not result in a higher survival rate.     

A denture-copying technique when providing replacement dentures

A technique is described which makes use of a patient's existing dentures as a guide when constructing replacement dentures. The technique employs readily available materials together with familiar clinical methods and reduces the course of treatment to two or three attendances.     

Soft lining materials: Their status and prospects

Although soft lining materials are inadequate to their requirements, their use is widespread. This paper comprises a preliminary report of a comprehensive study of these materials, which has been undertaken in an attempt to determine which are the better materials, how best to use them and how they may be improved. In addition, some new materials have become available which may have advantages over existing materials.

Fifteen materials are under investigation. These have been analysed, their water absorption, water solubility and visco-elastic properties studied and the effect of bonding these soft lining materials to polymethyl methacrylate determined.

The study is continuing as there are many aspects of these materials which remain to be investigated.     

An investigation of factors influencing patients' use of new complete dentures using structural equation modelling techniques

A review of the literature demonstrated that research had not identified a set of prognostic indicators for prospective complete denture patients, with different authors publishing contradictory results. OBJECTIVE: To investigate possible relationships between patient and clinical factors and denture wear and use of dentures for eating. METHODS: Patients attending Guy's Dental Hospital, London, for provision of complete dentures were recruited. For each patient relevant history was recorded and an examination of the edentulous mouth and existing dentures, where present, was undertaken at the beginning of treatment. At the first post-insertion appointment the edentulous mouth, previous and new dentures were examined. Three months after the review appointment patients were sent a postal questionnaire to assess patient use of dentures and patient satisfaction. Data were analysed using structural equation modelling techniques. RESULTS: 723 patients were recruited. Significant relationships were found between quality of complete dentures and patients' use of complete dentures and between quality of residual edentulous ridges and patients' use of complete dentures. These results contrast with most previous research into prognostic indicators for success in complete denture treatments. CONCLUSIONS: Quality of residual edentulous ridges and quality of new complete dentures predict patients' use of new complete dentures.     

Factors influencing the provision of removable partial dentures by dentists in Ireland

Factors influencing clinical treatment of partially dentate patients are varied, and there is a need to identify factors influencing success in the provision of removable partial dentures. The aim of this study was to assess the attitudes of general dental practitioners (GDPs) in Ireland towards tooth replacement and use of RPDs, in partially dentate older adults. The sample frame was the Register of Dentists in Ireland; data were also collected from a sample of dentists practising under NHS regulations in Northern Ireland. Validated questionnaires were sent to all dentists on the Register of Dentists in the Republic of Ireland, and dentists working under NHS regulations registered with the Central Services Agency in Northern Ireland. Content of the questionnaire included details of the dentist themselves, their dental practice and the profile of partial denture provision. They were also asked to give their views on factors influencing the success or failure of an RPD, the process of providing RPDs and their attitudes to RPD provision. A total of 1,143 responses were received, a response rate of 45%. A mean number of 61 RPDs per annum were provided, with 75% of dentures provided being acrylic based. Respondents indicate their belief that cobalt-chromium based dentures had a longer prognosis than acrylic dentures, but less than half (46%) claim to design the frameworks themselves. Patients' attitudes are considered influential in the success of RPD provision, and their influence on appearance is considered the most important factor influencing success. The most important factors influencing failure are: the patient not requesting a denture; an RPD restoring unbounded saddles; and, lower RPDs. Although considered important, approximately 60% of the sample do not routinely organise follow-up appointments for patients provided with RPDs. The fee structures in the DTSS and DTBS are considered a barrier to quality in the provision of partial dentures.     

Critical Appraisal

The use of all-ceramic fixed partial dentures is still controversial, although materials for ceramic frameworks have been introduced into the market and new materials and techniques and technologies for their fabrication are constantly evolving. In the quest to provide scientific data evaluating these new systems and to provide clinicians with guidelines for their use, in vitro studies followed by clinical ones have been and are currently performed. Although in vitro strength studies provide both clinicians and researchers with useful information for selecting ceramic materials and techniques for further research, they might not directly predict or reflect clinical performance. To enhance their clinical relevance, in vitro studies should better mimic oral conditions, such as cyclic loading and contact stresses, tooth mobility, temperature changes, and chemically assisted degradation. Such in vitro studies simulating oral conditions will provide clinically relevant information. However, clinicians must rely on the results of properly designed clinical studies to determine the efficacy of all-ceramic fixed partial dentures before prescribing such treatment to their patients. This "Critical Appraisal" continues a discussion of the in vitro studies. Part III will discuss the clinical studies on the clinical performance of all-ceramic fixed partial dentures.     

Usage of denture adhesives

OBJECTIVES: There have been few reports in the dental literature on the number of denture wearers who regularly use denture adhesive. The objectives of this study were to see what the incidence of usage of denture adhesive was by a surveyed edentulous population, to determine the degree of success of its usage and the reasons for its current use or nonuse. METHODS: In this study, 146 patients attending the Adelaide Dental Hospital for denture treatment were surveyed regarding their usage of denture adhesive, using a prepared questionnaire. The surveyed group was divided into three categories--those who had never tried denture adhesive, those who had tried denture adhesive but no longer used it, and those who currently used denture adhesive. RESULTS: In the survey, there were 52 males (35.6%) and 94 females (64.4%) and 96 (65.7%) were over 60 years of age. Of these 78 patients (54.9%) had worn their dentures for 10 years or more, and 26 (17.8%) for 20 years or more. A total of 98 patients (67.1%) had never tried denture adhesive: 48 patients (32.9%) had tried denture adhesive but only 10 (6.9%) currently used it. Various reasons for trying denture adhesive and for its continued use or nonuse were given. CONCLUSIONS: In this study, 52% of patients surveyed saw no need for the use of denture adhesive as they managed their dentures well; 20.5% of patients did not know that denture adhesives existed; and 32.9% had tried denture adhesive but only 6.9% continued to use it on a regular basis.     

Clinical evaluation of removable partial dentures 10 years after insertion: success rates, hygienic problems, and technical failures

The aim of this retrospective study was to examine the condition and success rate of various designs of removable partial dentures 10 years after placement. Seventy-four patients treated with 101 mainly conical crown-retained dentures (CCRDs), clasp-retained removable partial dentures (RPDs), or a combination of conical crown and clasp-retained dentures (CRPDs) were reexamined. Prosthetic findings were compared to baseline values at insertion and checked for factors that may affect them. Overall, 36.6% of the prostheses were regarded as successes, 23.8% as partial successes, and 39.6% as failures. Also, only one-third of the prostheses showed neither hygienic problems nor technical failures. The statistical analysis identified no single parameter as significantly affecting the success rate of the partial dentures. Prostheses supported by several abutment teeth had improved success, and RPDs had a higher failure rate (66.7%) than CCRDs (33.3%) and CRPDs (44.8%); however, because of the limited number of RPDs these differences were not statistically significant. Although the prostheses were unsupervised in service, the 60.4% overall success rate of the dentures was somewhat higher than in other studies on precision-retained prostheses. Received: 31 August 1999 / Accepted: 1 December 1999     

Questions and answers on titanium-ceramic dental restorative systems: a literature study.

OBJECTIVE: Titanium ceramics has become a topic of interest for prosthetic applications, thanks to the documented biocompatibility of commercially pure titanium. A number of concepts have been presented, including metal frameworks produced by casting or milling and a number of materials and methods for veneering. However, the concept has not reached a clinical breakthrough since failures have been reported from clinical experiences. METHOD AND MATERIALS: A PubMed search on the following key words was performed: titanium ceramics, long-term results. RESULTS: This review illustrates the fact that it is possible to have success with titanium ceramics on crucial criteria: fit and marginal adaptation, bond strength between metal and ceramics, and esthetic outcome. A review of clinical studies indicates a tendency for success rates to increase with time, which must be explained as a normal learning curve for a technical concept. The learning curve also includes development of materials and methods and the fact that there is a certain amount of technique sensitivity involved in the success rate for titanium ceramics. CONCLUSIONS: There is reason to believe that the outstanding clinical properties of titanium will further catalyze the development of titanium ceramics, and recent experiences clearly indicate that titanium ceramics, being a clinical product ready for use in fixed partial dentures, might already today challenge standard metal ceramics.     

All-ceramic fixed partial dentures,Part I: in vitro studies

The use of all-ceramic fixed partial dentures is still controversial, although materials for ceramic frameworks have been introduced into the market and new materials and techniques and technologies for their fabrication are constantly evolving. In the quest to provide scientific data evaluating these new systems and to provide clinicians with guidelines for their use, in vitro studies followed by clinical ones have been and are currently performed. Although in vitro strength studies provide both clinicians and researchers with useful information for selecting ceramic materials and techniques for further research, they might not directly predict or reflect clinical performance. To enhance their clinical relevance, in vitro studies should better mimic oral conditions, such as cyclic loading and contact stresses, tooth mobility, temperature changes, and chemically assisted degradation. Such in vitro studies simulating oral conditions will provide clinically relevant information. However, clinicians must rely on the results of properly designed clinical studies to determine the efficacy of all-ceramic fixed partial dentures before prescribing such treatment to their patients. The "Critical Appraisals" in this issue and the next discuss the in vitro studies. Fart HI of the series will discuss the clinical studies on the clinical performance of all-ceramic fixed partial dentures.     

Prognosis for Abutment Teeth of Removable Dentures: A Retrospective Study

PURPOSE: This retrospective study evaluates the clinical success of conical crown-retained removable dentures. MATERIALS AND METHODS: Ninety-seven patients were treated with 97 dentures at the University of Frankfurt, Department of Prosthodontics, between 1993 and 2000. The average observation period was 4.9 +/- 2.8 years. The dentures were supported by 445 natural abutment teeth. To evaluate the long-term success of the restorations, the variables abutment loss, tooth mobility, mean probing depths, and radiological bone loss were used. Data were obtained by one clinical examiner at baseline, by systematic evaluation of patient records, and at clinical re-examinations. Survival-time methods were used to analyze time-to-event data. Specifically, the Cox model with frailty term was applied to account for correlations between intra-patient survival data. Thirty abutment teeth had to be extracted during the observation period. RESULTS: Statistical analysis showed no significant effects of the variables tooth mobility (p= 0.42), mean probing depths (p= 0.23), and radiological bone loss (p= 0.59) on the time to tooth extraction. For the non-extracted abutment teeth significant changes during time for the variables tooth mobility (p < 0.0001) and radiological bone loss (p= 0.0240) were observed. CONCLUSION: Removable partial dentures retained by conical crowns have a favorable clinical prognosis.     

全瓷固定桥的研究进展

尽管受脆性、抗弯强度和断裂韧性等材料性能的影响,全瓷固定桥目前尚未成为常规的固定修复手段,但其临床应用和研究报道越来越多,并显示出良好的应用前景。本文对硅酸盐陶瓷、玻璃渗透氧化铝陶瓷和氧化锆陶瓷全瓷桥材料的基础研究和临床研究进行了综述。     

Agreement between clinical measures of quality and patients' rating of fit of existing and new complete dentures

OBJECTIVES: To assess agreement between patients' appreciation of fit and clinical assessment of quality of existing and new complete dentures. MATERIALS AND METHODS: In each case existing complete dentures at the initial visit and new complete dentures at the first post insertion visit were assessed by a prosthodontist using a validated method for assessing denture quality. Patients rated fit of existing and new complete dentures on four-point scales. Weighted Cohen's kappa and multiple correspondence analyses were the statistical methods employed in this study. RESULTS: 459 patients completed the study. A statistically "fair" level of agreement was found between clinical and patient assessment of dentures. There was close correspondence between dentist and patient appreciation when the existing dentures were rated as poor and when the new dentures were rated highly. DISCUSSION: A worthwhile level of agreement between patients' appreciation of fit of complete dentures and the clinical assessment of quality of existing and new complete dentures was found. Marked differences in the nature of agreement for patients' and clinicians' rating of new and existing dentures were demonstrated. These results emphasize the importance of denture quality in achieving patient approval. CONCLUSION: Agreement and correspondence between patient and clinician appreciation of existing and new complete dentures were determined.     

Clinical outcome of glass-fiber-reinforced crowns and fixed partial dentures: a three-year retrospective study.

OBJECTIVE: Glass-fiber-reinforced resin composites for the fabrication of esthetic single crowns and fixed partial dentures have been developed recently. However, little data on the clinical outcome of such restorations have been published. The purpose of this retrospective study was to evaluate the clinical outcome of crowns and fixed partial dentures made from the glass-fiber-reinforced resin composite material Targis/Vectris. METHOD AND MATERIALS: Between 1995 and 1997, 39 patients were treated with 67 single crowns and 83 fixed partial dentures. Twenty-five crowns and 28 fixed partial dentures were cemented with temporary cement, while 42 crowns and 55 fixed partial dentures were cemented with either zinc-phosphate cement or glass-ionomer cement. RESULTS: In September 2001, 57 restorations in 17 patients were still in function. The three-year survival rate calculated according to the Kaplan-Meier method was 58.8% for all restorations. However, after this time, it was 37.5% for crowns and 59.9% for fixed partial dentures cemented with temporary cement, and 55.1% for crowns and 67.9% for fixed partial dentures cemented with zinc phosphate or glass ionomer. The differences between the restoration groups were not statistically significant. CONCLUSION: Glass-fiber-reinforced crowns and fixed partial dentures made with the glass-fiber-reinforced resin composite material Targis/Vectris showed a lower survival rate than that published for metal-ceramic crowns and fixed partial dentures. Therefore, the use of this material for the fabrication of single crowns or fixed partial dentures as permanent restorations cannot be recommended.     

A Pilot Study to Evaluate Different Palate Materials for Maxillary Complete Dentures with Xerostomic Patients

PURPOSE: The hypothesis tested in this pilot study was that materials used for the palatal region of a maxillary denture affect the comfort of the maxillary denture in xerostomic patients. MATERIALS AND METHODS: Xerostomic complete denture wearers were selected to test three different maxillary dentures that were made with different palatal materials. Each denture was worn for a period of 2 weeks. The Kapur Index was used to measure retention. The Oral Health Index Profile (OHIP) was used to determine the patient's perception of each denture after the 2-week period. At the end of the study, the patients were asked to select which of the three dentures they would like as their primary denture. RESULTS: All participants chose the metal-palate dentures, and 4 of 5 selected the titanium-palate denture as their primary denture. Statistical analysis of the OHIP demonstrated that the metal-palate dentures were perceived as being more comfortable than the acrylic-resin dentures. CONCLUSION: This pilot study suggests that for xerostomic patients who have worn complete dentures, their selection of a metal-palate denture as their primary prosthesis strongly suggests that these dentures have properties that make them more comfortable to the patient than acrylic dentures. Subjective patient measurements supported this conclusion that the metal-palate dentures were preferable, while the evaluation method available to the clinician failed to discriminate among the prostheses.     

Contemporary all-ceramic fixed partial dentures: a review

High-strength all-ceramic systems for fixed partial dentures (FPDs)have become available for replacing missing teeth. New core materials have been developed and have evolved in the last decade,with yttrium tetragonal zirconia polycrystals (Y-TZP)-based materials being the most contemporary. With the emphasis on the use of computer-assisted design/computer assisted-manufacturing technology, various production techniques have been developed for enhancing the fabrication of consistent and predictable restorations in terms of strength, marginal fit, and esthetics. Although initial results are limited, results reported in scientific abstracts of ongoing clinical studies assessing the long-term success of three unit all-ceramic FPDs and anecdotal evidence published in peer reviewed articles on the use of Y-TZP-based restorative systems are encouraging. This article reviews the evolution and development of materials and technologies for all-ceramic FPDs.