Current trends in removable prosthodontics.
BACKGROUND: This article discusses trends in the demographics and treatment of the edentulous patient. It is clear that there still is a tremendous need for removable-prosthodontic services today. While the basic process of making dentures has changed little over the past several decades, new materials and techniques can help laboratories and clinicians provide functional, esthetic restorations that offer exceptional value to patients. Implant treatment is a tremendous adjunct to removable prosthodontics in the treatment of edentulous patients, but it is not within the financial reach of all dental patients. CLINICAL IMPLICATIONS: The clinical skills required to deliver excellent complete denture care are also paramount to successful implant prosthodontics (fixed and removable) and esthetic dentistry. Even so, the opportunities to develop these skills and the interest appear to be decreasing at the same time that the need is projected to increase. In service to our patients, the profession must examine this trend closely. (+info)
Surgical simulation of Class III edentulous patient using a 3D craniofacial model: report of a case.
A case of edentulous prognathism in a 46-year-old Japanese male is presented. We described the outcome of the patient who underwent simultaneous sagittal splitting ramus osteotomy of the edentulous mandible, interpositional bone graft of severely atrophic edentulous jaws, and delayed placement of titanium implants for reconstruction. We highly recommend performing a surgical simulation using a craniofacial model of the patient's anatomy created using CT image data. The procedure provides almost ideal maxillary and mandibular contours. (+info)
C-telopeptide pyridinoline cross-links (ICTP) and periodontal pathogens associated with endosseous oral implants.
Detection of periodontal or peri-implant sites exhibiting progressing disease or those at risk of deterioration has proven difficult. Pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (ICTP), a marker specific for bone degradation found in gingival crevicular fluid (GCF), has been associated with both bone and attachment loss in periodontitis and may be useful for predicting disease activity. The aim of this cross-sectional study was to examine the relationship between ICTP levels and subgingival species around implants and teeth from 20 partially and 2 fully edentulous patients. GCF and plaque samples were collected from the mesiobuccal site of each implant and tooth. Radioimmunoassay techniques were utilized to determine GCF ICTP levels. Plaque samples were analyzed utilizing checkerboard DNA-DNA hybridization. Traditional clinical parameters were assessed. Seventy-one implants and 370 teeth from 22 subjects were examined. ICTP levels and subgingival plaque composition were not significantly different between implants and teeth. Implant sites colonized by Prevotella intermedia, Capnocytophaga gingivalis, Fusobacterium nucleatum ss vincentii, and Streptococcus gordonii exhibited odds ratios of 12.4, 9.3, 8.1, and 6.7, respectively of detecting ICTP. These results suggest a relationship between elevated ICTP levels at implant sites and some species associated with disease progression. Longitudinal studies are necessary to determine whether elevated ICTP levels may predict the development of peri-implant bone loss. (+info)
Epidemiological study on improving the QOL and oral conditions of the aged--Part 1: The relationship between the status of tooth preservation and QOL.
In part 1 of this epidemiological study, a survey was conducted for all senior citizens aged 70 and over who resided in a mountainous village in the mid-section of Hyogo Prefecture. It focused on the relationship among the number of existing teeth, life environment, health status, and activities of daily living; and the correlation between oral status and QOL was analyzed. The daily activities of individuals were compared between those having one or more teeth and others who were totally edentulous. Subsequently, it was found that for both males and females, the odds ratio was significantly high for the dentulous individuals, in comparison with edentulous individuals, to exhibit a behavior indicative of a better QOL (such as "opportunity for conversation with family members or others)", "regular physical activities", and "attend meetings or group outings"). The result of this survey indicates that the presence of teeth is very closely related to one's daily activities. It was concluded that preventing tooth loss is vital for maintaining the masticatory function; so to prevent tooth loss, periodontal disease must be averted. (+info)
Is there an association between edentulism and nutritional state?
Edentulous people have difficulty chewing foods that are hard or tough in texture, even when wearing well-made dentures. These individuals typically modify their diets to compensate for loss of oral function. This practice leads to the question of whether the diet of edentulous individuals is adequate to maintain good general health. This overview summarizes articles that describe the changes in diet associated with edentulism. Such changes include reductions in fruits, vegetables, meats and other hard-to-chew foods and are associated with compromised nutrition. The evidence suggests that edentulous individuals lack specific nutrients and, as a result, may be at risk for various health disorders. The authors have recently shown that mandibular prostheses supported by only 2 implants may significantly improve nutritional status in edentulous patients. (+info)
Dental insurance and use of dental services.
OBJECTIVES: This article examines socioeconomic differences in insurance for dental services among Canadians aged 15 or older and factors associated with the use of dental services. DATA SOURCE: The data on dental insurance coverage and use of dental services are from the cross-sectional file of Statistics Canada's 1996/97 National Population Health Survey. The sample size of respondents aged 15 or older was 70,884. ANALYTICAL TECHNIQUES: Logistic regression analysis was used to model variables related to dental insurance coverage and to dental visits in the past year. A weighted bootstrap resampling procedure was used to derive variance estimates. MAIN RESULTS: In 1996/97, 53% of the population aged 15 or older reported having dental insurance, and 59% said they had visited a dentist in the past year. But even when they had insurance, individuals with low incomes and low educational attainment had much lower odds of visiting a dentist than those with higher incomes and more education. (+info)
The relationship between dental status, food selection, nutrient intake, nutritional status, and body mass index in older people.
This paper reviewed the findings from a national survey in Great Britain which assessed whether dental status affected older people's food selection, nutrient intake, and nutritional status. The survey analyzed national random samples of free-living and institution subjects for dental examination, interview, and four-day food diary as well as blood and urine tests In the free-living sample, intakes of non-starch polysaccharides, protein, calcium, non-heme iron, niacin, and vitamin C were significantly lower in edentulous as compared to dentate subjects. People with 21 or more teeth consumed more of most nutrients, particularly non-starch polysaccharides. This relationship in intake was not apparent in the hematological analysis. Plasma ascorbate and retinol were the only analytes significantly associated with dental status. Having 21 or more teeth increased the likelihood of having an acceptable body mass index (BMI). Thus, maintaining a natural and functional dentition defined as having more than twenty teeth into old age plays an important role in having a healthy diet rich in fruits and vegetables, a satisfactory nutritional status, and an acceptable BMI. (+info)
Tooth loss, pancreatic cancer, and Helicobacter pylori.
BACKGROUND: Poor dental health has been associated with increased risks of oral, esophageal, and gastric cancer and may also be associated with pancreatic cancer. In addition, Helicobacter pylori has been found in dental plaque and has been associated with periodontal disease and pancreatic cancer. OBJECTIVE: The objective was to investigate prospectively the relation between dentition history and pancreatic cancer in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study cohort in Finland and the association between dentition history and H. pylori seropositivity in a cross-sectional sample of subjects without cancer (n = 475) from the same cohort. DESIGN: Of the 29,104 male smokers aged 50-69 y in the cohort for whom there were complete data, 174 developed pancreatic cancer from 1985 to 1997. Cox proportional hazard models were used to estimate age-, smoking-, education-, urban living-, and height-adjusted hazard ratios and 95% CIs for pancreatic cancer, and logistic regression models were used to estimate age- and education-adjusted odds ratios for H. pylori carriage. RESULTS: Tooth loss was positively associated with pancreatic cancer (edentulous compared with missing 0-10 teeth: hazard ratio = 1.63; 95% CI: 1.09, 2.46; P for trend = 0.02) but was not significantly associated with H. pylori seropositivity (edentulous compared with missing 0-10 teeth: odds ratio = 1.30; 95% CI: 0.73, 2.32; P for trend = 0.37). CONCLUSION: Additional studies are needed to evaluate the association between tooth loss and pancreatic cancer, as well as cancers at other gastrointestinal sites, particularly with respect to possible biological mechanisms. (+info)