Ceramic materials more durable, suitable for fixed prosthetics.

The practice of dentistry progressed with the recent developments and innovations in dental materials. The clinicians need to be familiar with these materials to successfully incorporate them in their practices. Fixed prosthodontics has assumed a growing role in the practice of restorative dentistry since the application of the lost wax casting technique. With the increased life expectancy, a greater demand of fixed prosthodontics is expected in the future. Recent material and technical and clinical advances have made treatment planing and decision-making more complex; most have attempted to improve current techniques to achieve the ideal pleasant smile. Intelligently planned, well documented, evidence-based research has provided a reliable foundation to many of these advances affecting the practice of fixed prosthodontics. This article will attempt to focus on some of these clinically relevant and applicable developments and briefly review the current literature and encourage pratictioners to review subsequent literature.     

The Application of Rapid Prototyping in Prosthodontics

Dentists have used rapid prototyping (RP) techniques in the fields of oral maxillofacial surgery simulation and implantology. With new research emerging for molding materials and the forming process of RP techniques, this method is becoming more attractive in dental prosthesis fabrication; however, few researchers have published material on the RP technology of prosthesis pattern fabrication. This article reviews and discusses the application of RP techniques for prosthodontics including: (1) fabrication of wax pattern for the dental prosthesis, (2) dental (facial) prosthesis mold (shell) fabrication, (3) dental metal prosthesis fabrication, and (4) zirconia prosthesis fabrication. Many people could benefit from this new technology through various forms of dental prosthesis production. Traditional prosthodontic practices could also be changed by RP techniques in the near future.     

Dental implants: a review.

The present article is a review presenting an update on the field of dental implants since the World Workshop in Clinical Periodontics in July 1989. Areas that are discussed include following: 1. Biomaterials and the implant interface, and the interaction of these with the environment. 2. Periodontal considerations including data supporting a perimucosal seal of implant to soft tissue and discussion of the endosseous interface between the bone and the implant. 3. Newer techniques of diagnostic imaging and their determination of bone types are related to the future practice of dental implants. 4. Implant selection and the surgical techniques involved in implant placement. 5. Current ideas of implant prosthodontics, implant maintenance, and the treatment of implant failures. 6. Finally, the use of dental implants in the United States and Sweden.     

The dental student as a technician: Preclinical and clinical laboratory programs in fixed prosthodontics

PURPOSE: A 2-part survey of United States dental schools was conducted. The first part of the survey was published in 1998 and determined the curricular structure, techniques taught, and materials used in predoctoral fixed prosthodontics courses. The purpose of the second part of the survey was to ascertain the delegation of laboratory procedures in preclinical and clinical fixed prosthodontic programs. MATERIALS AND METHODS: The survey was mailed to the course directors of predoctoral fixed prosthodontic programs at 53 US dental schools. Of these, 42 schools returned the completed survey, resulting in a response rate of 79%. RESULTS: Results from this survey show that certain laboratory procedures in preclinical and clinical fixed prosthodontics are completed by dental laboratories (either in-house or commercially available laboratories). CONCLUSIONS: For the preclinical programs of fixed prosthodontics, there is more student involvement in the completion of laboratory procedures in the dental schools surveyed. In clinical fixed prosthodontic programs, there is a high emphasis on patient care and less on laboratory techniques that can be delegated to laboratory technicians.     

数字化口腔修复（4）-直接数字化制造

虽然口腔CAD／CAM方法依然是切削系统中的主流,但是加法制造技术也能更有效、更经济地为口腔医学提供可摘义齿支架和颅面重建的个性化固定装置。伴随更多的个性化材料的发展,修复体制造业将发生由传统的金属和陶瓷向着生物适合性的高强度聚合体、陶瓷和共熔合金方向转变。直接数字化制造将定义口腔医学的未来。数字化扫描、虚拟设计和数字化制造的进步将对传统的牙体预备,印模方法、义齿加工产生冲击。数字化的口腔技工室将经历由传统工匠向懂计算机的技师方向转变,并伴随着更先进的材料的应用,而获得高产量和高质量的回报。虽然,我们还不能够抛弃过去曾经应用于口腔医学中的常规原理,但是现在,口腔界的同仁们将为了患者去挑战和拥抱数字化口腔修复的新技术。     

A Survey of U.S. Prosthodontists and Dental Schools on the Current Materials and Methods for Final Impressions for Complete Denture Prosthodontics

PURPOSE: The purpose of this study was to survey members of The American College of Prosthodontists (ACP) to evaluate current materials and methods for final impressions for complete denture prosthodontics in the United States. In addition, those methods were compared with methods and materials taught in U.S. dental schools via a second survey sent to the chairpersons of prosthodontic/restorative departments. MATERIALS AND METHODS: An anonymous questionnaire was mailed to all 1762 active ACP members in the United States in 2003. A slightly modified questionnaire was also distributed to chairpersons of prosthodontic/restorative departments in the 54 U.S. dental schools. Data analysis was performed via frequency distribution and chi-square statistics. RESULTS: Nine hundred and forty-five questionnaires were returned by members of the ACP (54% return rate) and 42 questionnaires were returned by the U.S. dental schools (78% return rate). The majority of the reporting prosthodontists (88%) and dental schools (98%) use a border-molded custom tray for final impressions for complete denture prosthodontics. The most popular material for border molding was plastic modeling compound (67% of reporting ACP members, and 95% of the responding dental schools). Variability of the materials used for final impressions was observed, with the most popular materials being polyvinylsiloxane for the ACP members (36%) and polysulfide for the dental schools (64%). Statistically significant differences were found in the materials used for border molding by prosthodontists based on the time elapsed since completion of prosthodontic training. No differences were found in the materials used for impression of edentulous arches based on years of experience. Geographic location did not influence the materials and methods used by prosthodontists for complete denture final impressions. CONCLUSIONS: There was variability of the materials and techniques used for final impressions by ACP members and dental schools; however, overall there was an agreement on the materials and techniques used by prosthodontists and dental schools. Distinct trends for increasing use of polyvinylsiloxane and polyether for border molding procedures and impressions of edentulous arches were observed both in members of the ACP and in the U.S. dental schools.     

Twenty years of progress in implant prosthodontics

Prosthodontic focus on the restoration of osseointegrated dental implants has evolved dramatically in the last 20 years. Many of the original guiding principles for restoring implants have changed and/or disappeared altogether, and new ideas have taken their place. It is appropriate that this evolution be examined with a 2-fold focus. First, the art and science of prosthodontics as it relates to dental implants today is the result of very real and important lessons learned during the past 2 decades. Second, an appreciation of the history of implant prosthodontics as it relates to osseointegration gives insight into the future direction of research and clinical exploration aimed at continually improving the state of the art and, ultimately, the quality of care provided to patients. This article reviews what the authors consider the most important aspects of the evolution of osseointegrated implants. Pertinent literature was selected for citation, but the discussion does not represent a comprehensive review of the literature.     

Future perspectives of resin-based dental materials

ObjectiveThis concise review and outlook paper gives a view of selected potential future developments in the area of resin-based biomaterials with an emphasis on dental composites.MethodsA selection of key publications (1 book, 35 scientific original publications and 1 website source) covering the areas nanotechnology, antimicrobial materials, stimuli responsive materials, self-repairing materials and materials for tissue engineering with direct or indirect relations and/or implications to resin-based dental materials is critically reviewed and discussed. Connections between these fields and their potential for resin-based dental materials are highlighted and put in perspective.ResultsThe need to improve shrinkage properties and wear resistance is obvious for dental composites, and a vast number of attempts have been made to accomplish these aims. Future resin-based materials may be further improved in this respect if, for example nanotechnology is applied. Dental composites may, however, reach a completely new quality by utilizing new trends from materials science, such as introducing nanostructures, antimicrobial properties, stimuli responsive capabilities, the ability to promote tissue regeneration or repair of dental tissues if the composites were able to repair themselves.SignificanceThis paper shows selected potential future developments in the area of resin-based dental materials, gives basic and industrial researchers in dental materials science, and dental practitioners a glance into the potential future of these materials, and should stimulate discussion about needs and future developments in the area.     

Soldering in Prosthodontics—An Overview,Part I

The fit of fixed multiunit dental prostheses (FDP), traditionally termed fixed partial dentures (FPDs), is an ongoing problem. Poorly fitting restorations may hasten mechanical failure, due to abutment caries or screw failure. Soldering and welding play an important role in trying to overcome misfit of fixed multiunit prostheses. The term FPD will be used to denote multiunit fixed dental prostheses in this review. This is the first of a series of articles that review the state of the art and science of soldering and welding in relation to the fit of cemented or screw‐retained multiunit prostheses. A comprehensive archive of background information and scientific findings is presented. Texts in dental materials and prosthodontics were reviewed. Scientific data were drawn from the numerous laboratory studies up to and including 2009. The background, theory, terminology, and working principles, along with the applied research, are presented. This first article focuses on soldering principles and dimensional accuracy in soldering. There is some discussion and suggestions for future research and development. Soldering may improve dimensional accuracy or reduce the distortion of multiunit fixed prostheses. Many variables can affect the outcome in soldering technique. Research science has developed some helpful guidelines. Research projects are disconnected and limited in scope.     

A review of selected dental literature on contemporary provisional fixed prosthodontic treatment: report of the Committee on Research in Fixed Prosthodontics of the Academy of Fixed Prosthodontics

One goal of the American Academy of Fixed Prosthodontics is regularly to publish comprehensive literature reviews on selected topics germane to the discipline of fixed prosthodontics. The following report is the result of this goal and focuses on provisional fixed prosthodontic treatment. Major subtopics include materials science and clinical considerations involving natural teeth and dental implants. The interrelationship between provisional and definitive fixed prosthodontic treatment is multifaceted and significant. Provisional therapy involves numerous materials and techniques that require special knowledge and technical experience. In this analysis, technical, clinical, and investigational articles are detailed and presented as a comprehensive literature review to provide contemporary guidelines. Referenced publications were found by conducting a Medline search and were limited to peer-reviewed, English-language articles published from 1970 to the present. Materials used with provisional treatment are discussed in terms of clinical selection and the influence of their physical properties on treatment outcome. Specific product names and manufacturers are included in this report only when they are cited in the original referenced publications.     

Predoctoral removable prosthodontics education

As the 21st century is approached, changes are occurring that directly relate to removable prosthodontics at the undergraduate level. Edentulism will continue to decline, although the need for complete dentures will diminish slowly because of the replacement needs for the existing edentulous population. In the short- to medium-term future, partial edentulism will increase in the older population at the expense of total edentulism. Therefore, the need for removable partial dentures will increase, but subsequently will decline. In the long-term, tooth loss, regardless of etiology, will be reduced. However, the replacement of lost teeth is unlikely to disappear completely as a needed dental service. With 73% of dental schools reporting inadequate or marginal numbers of complete denture patients, Meskin and Entwistle have identified a shortage of patients needing removable prostheses. On the other hand, 50% of the schools report a surplus of removable partial denture patients. Dental school curriculum time related to prosthodontics has declined significantly over the past 20 years. However, over the past 10 years it has risen slightly. Techniques that are taught in dental schools are frequently not being used in practice. Yet the practitioner's interest in removable prosthodontics as it relates to new techniques and materials remains high according to a 1988 survey of Academy of General Dentistry members. Removable prosthodontics was rated first in regards to continuing education courses desired by its members. There are two basic objectives stated in the prologue of the Council on Dental Education Directive on Accreditation Standards. First, faculties are ultimately responsible for the quality of care rendered to the patient population by students.(ABSTRACT TRUNCATED AT 250 WORDS)     

Current prosthodontic practice: A dental laboratory survey

A survey was distributed to dental laboratory owners at the 1988 annual meeting of the Minnesota Dental Laboratory Association. Current laboratory practice in infection control, the use of nonprecious alloys, the amount of time devoted to complete removable prosthodontics, and complete denture laboratory techniques were surveyed. Responses indicate a moderate level of awareness and compliance with infection control techniques recommended by the American Dental Association, a declining demand for removable prosthodontic services, a high percentage of use of nonprecious alloys, and a very high rate of porcelain occlusion requested by dental practitioners. Comparisons with other laboratory surveys and the implications of these results for undergraduate education in prosthodontics are discussed.     

Dental students' motivation and the context of learning

This qualitative study shows dental students' motives for choosing the dental education and how the motives influence their motivation at the first semester of study. Further the study demonstrates the relevance of the context of learning. This issue is of importance when planning a curriculum for the dental education. The material consists of interviews with eight dental students. The results show that dental students were focused on their future professional role, its practical dimensions and their future working conditions. Their motivation for choosing the dental education was found to influence their motivation for studying and their experience of the relevance of the first semester. The dental students who had co-education with the medical students at the first year of study missed a dental context and courses with clinically relevant contents. In conclusion, our data signify the importance of the context of learning. It is recommended that a future curriculum for the dental school should be designed in a way where basic science subjects are taught with both theoretically as well as practically oriented subjects and in a context which is meaningful for the students.     

Clinical Use of an Intraoral Silicoating Technique

I A ceramic fracture rate of metal-ceramic fixed prosthodontics of up to almost 9% calls for an efficient and effective intraoral repair system. For the repair of fractured veneering material, an intraoral silicoating technique was introduced. In contrast to other repair techniques, the silicoating can successfully be used on a variety of dental restorative materials and, therefore, offers additional applications in the field of the intraoral adhesive technique. This silicoating technique, consisting of a chairside air-abrasion device filled with a specific silica-coated air-abrasion medium, has been used intraorally by the authors since 1993 for clinical purposes. The clinical procedure is described for different applications in the field of the adhesive technique: intraoral repair, preconditioning of core buildups, implant abutments, and surfaces of fixed prosthodontics for the bonding of orthodontic brackets or periodontal splints.     

Rehabilitation of the worn dentition

The purpose of this review was to evaluate the literature on the rehabilitation of tooth wear, with some pertinent historical, epidemiological and aetiological aspects of tooth wear provided as background information. In historical skull material, extensive tooth wear, assumed to be the result of coarser diets, was found even in relatively young individuals. Such wear is seldom seen in current populations. Although many of the factors associated with extensive tooth wear in historical material are no longer present or prevalent, new risk factors have emerged. In the young individual, the literature points to a global rise in soft drink consumption as the most significant factor in the development of tooth wear through dental erosion. Among older individuals, lifestyle changes and chronic diseases that are controlled with medications that may, in turn, result in regurgitation and/or dry mouth, are possible reasons amongst others for the widespread clinical impression of an increasing prevalence of tooth wear. The aetiology of tooth wear is multifactorial and the role of bruxism is not known. Clinical controlled trials of restorative and prosthodontic approaches for the range of clinical conditions that wear can give rise to, are limited in number and quality. Equally, the striking lack of evidence regarding the long-term outcomes of treatment methods and materials calls for caution in clinical decision-making. Notwithstanding these observations, clinicians have provided and continue to provide rehabilitative strategies for managing their patients' worn dentitions that range traditionally from extensive prosthodontics to an increasing reliance on adhesive techniques.     

Removable prosthodontics research--quo vadis?

The need to improve removable prosthodontic treatment through research has not diminished. Most recent research reports in prosthodontics are in fixed prosthodontics, indicating a declining interest in removable prosthodontics. A survey of dental schools in the United States and Canada reveals that the financial support for research in removable prosthodontics is a mean of $42,500 per year. Present research is not directed toward solving the major problems in removable prosthodontics. The key to making progress in removable prosthodontic research is to interest capable trainees in securing the necessary basic science and clinical training. Adequate financial support is then needed to conduct the research.     

Evaluation of a rubber-base impression material.

A laboratory experiment has been described that utilized materials found in most dental offices and that was designed to evaluate a distinctly different polysulfide impression material. In this experiment the largest duplicating errors were produced with use of the stock tray and single-mix technique recommended by the manufacturer. This study therefore supports the use of the custom tray and double-mix technique for dental duplication procedures utilizing Neo-Plex impression material. Further investigation is necessary before stock trays and single-mix techniques can be recommended for routine use in fixed prosthodontics.     

The teaching of all-ceramic restorations in Scandinavian dental schools: A survey

The study was designed to survey the curricular requirements, types of clinical experience, and materials/techniques used in teaching programs for all-ceramic restorations in Scandinavian dental schools. All 13 dental schools responded. Ten offered some clinical experience to pre-doctoral students, but only one required one all-ceramic restoration. The departments of fixed prosthodontics had the main teaching responsibility. All-ceramic crowns were taught at 9, veneers at 7, and inlays/onlays at 10 dental schools. A wide range of different teaching concepts, materials, and views on indications and contraindications was reported. It appears as if all-ceramic restorations are regarded as experimental by the teaching institutions, although the dental industry and some practitioners strongly recommend these types of restorations.     

Prosthodontic rehabilitation of a patient with bilateral auricular deformity

Maxillofacial prosthodontics is an art and science which provides life like appearance to the person with facial deformity. Maxillofacial prosthetic rehabilitation for acquired defects has become more complex and sophisticated with advancement in techniques and materials. This case report describes the clinical and laboratory procedure for fabricating an auricular prosthesis for a patient with trauma related bilateral auricular deformity. Ear prosthesis was fabricated in two parts taking retention from external auditory canal.     

The Private Practice of Prosthodontists: Current and Future Conditions of Practice in the United States (Part 2)

PURPOSE: Data are used to examine current and future conditions important to the private practice of prosthodontics. A concern is raised as to whether the future supply of prosthodontists is in sync with the dynamics of the US population and patient population. MATERIALS AND METHODS: Four trends are examined using data from various sources. The trends include: (1) growth in the number of private practicing prosthodontists, (2) projections of the future number of private practicing prosthodontists, (3) first year enrollment in dental schools, and (4) enrollments and graduates in residency programs. RESULTS: The number of private practicing prosthodontists has increased modestly over the past 21 years, growing 1.33% per year. The number of private practitioners is projected to reach 4,125 in 2025. A key variable in this projection is the growing number of elderly adults. While dental school enrollments have been increasing, concern is raised about the amount of exposure by students to an undergraduate curriculum in prosthodontics. There has been a general decline in enrollment in the nation's prosthodontics residency programs at the rate of -2.9% per year. An average of 181 program graduates are needed to achieve the 4125 projected number of private practitioners. CONCLUSION: Increasing demand for services from prosthodontists is supported by an increasing US population size and a growing population of elderly. Efforts to grow the number of private practicing prosthodontists will have to consider several concerns including residency program enrollments, undergraduate exposure to prosthodontics, and the overall economic returns expected from engaging in the private practice of prosthodontics. Choosing a career as a private practicing prosthodontist is a timely consideration and complimented by expected increases in demand for care and favorable financial returns to practice.