Restorative considerations in the dental treatment of the older patient

The older person and his or her dentition will have a clinical presentation and a reaction to treatment that is influenced by his or her unique blend of aging and disease processes. Changes seen in enamel, dentin, pulp, and cementum of the older patient are described in terms of their causes and the impacts of the changes on clinical presentation and treatment choices.     

老年颌面外科病人并存心脑血管病的处理

目的：探讨老年颌面外科病人并存心脑血管病的处理。方法：分析我院2000年1月-2009年2月治疗73例老年颌面外科患者的资料，其中43例并存心脑血管疾病为治疗组，无心脑血管疾病30例为对照组。结果：73例患者均安全渡过麻醉及手术，治疗组术后并发症15例次，发生率34．88％。而30例无心脑血管病的患者术后发生并发症4例，发生率13．33％。并发症发生率与对照组有显著性差异（P〈0．05）。结论：对老年颌面外科病人并存心脑血管病者，应加强围手术期管理，积极治疗并存病，可以耐受较复杂的颌面外科手术。     

A prosthetic treatment approach for a cherubism patient: A clinical report

Cherubism is an early childhood disease that primarily involves the mandible and consists of painless mandibular enlargement with or without maxillary involvement and progresses rapidly over the course of several years. This clinical report describes the fabrication of maxillary fixed partial dentures and a mandibular overdenture for a 21-year-old man with cherubism.     

Periodontal disease in the older patient

Population projections predict an increasing number of dentate older people who will require assessment and treatment of periodontal disease. Studies show that healthy, older patients show no increased risk of periodontal disease progression compared to younger individuals, while periodontal treatment can be equally successful in the older age group. However, co-morbidity can impact negatively on both the periodontal tissues and the dentition. These effects range from a reduced ability to maintain adequate plaque control, to the use of drug and other therapies directly affecting the periodontal tissues and salivary flow. CLINICAL RELEVANCE: An individualized treatment plan is required for older patients, taking account of all factors impacting on the periodontal tissues.     

Caries and the older patient

Ageing of the population, together with prolonged retention of teeth, has brought new challenges to dentistry. Whereas in the past oral care for the elderly was restricted to provision of dentures, older patients are now presenting with dental caries and failed restorations. These problems may have an impact on their general health and quality of life. Poor oral hygiene, xerostomia and diet are among the risk factors for caries in older patients and need to be addressed in order to achieve control of the disease. Carious lesions can be treated conservatively in many cases or may need surgical management. CLINICAL RELEVANCE: Caries is an oral health issue among older patients and can result in tooth loss. Oral health has a great impact on general health and quality of life of elderly people.     

Endodontics and the older patient

The number of elderly people in the population is rising and there is an increasing trend for tooth preservation. Older patients are more likely to have complex medical histories and/or physical disabilities. They are increasingly likely to retain their teeth, which could be heavily restored or broken down and root treatment may be challenging. In order to maintain teeth, a decision needs to be made as to whether or not to carry out endodontic treatment, which may be challenging in itself, and may also be associated with other age-related considerations. This paper considers endodontic issues related to the older patient, bearing in mind the plethora of considerations which may be relevant to root canal treatment. Clinical Relevance: There are many benefits of retaining teeth, but there may be disadvantages.     

Toothwear and the older patient

Toothwear is commonly observed in dentate older patients and may be physiological or pathological in nature. Toothwear can be caused by abrasion, attrition, erosion or a combination of aetiologies. Where treatment is required, a number of options exist, including the use of adhesive materials and fixed and removable prosthodontics. Clinical Relevance: With patients retaining natural teeth into old age, physiological and pathological toothwear amongst dentate older patients is an increasingly common presentation.