Database: MEDLINE <: biomedical, nursing & dental literature, 1966 - Aug 2000.> Search Strategy (You Saved Citations 1-300 From Set 21): ----------------------------------------------------------------------------- 1 exp cohort studies/ 364432 2 prognosis/ 159858 3 exp mortality/ 109455 4 exp morbidity/ 104471 5 (natural adj history).ti,ab. 14498 6 prognos$.ti,ab. 126536 7 course.ti,ab. 191211 8 predict$.ti,ab. 233041 9 exp "Outcome assessment (health care)"/ 101532 10 outcome$1.ti,ab. 169832 11 (inception adj cohort$1).ti,ab. 370 12 disease progression/ 12534 13 exp survival analysis/ 27464 14 or/1-13 1165792 15 exp Denture, partial,fixed/ 6046 16 (fixed adj3 bridge:).mp. 390 17 (fixed adj3 denture:).mp. 1136 18 (crown adj3 bridge:).mp. 532 19 or/15-18 6641 20 14 and 19 575 21 limit 20 to human 556 22 from 21 keep 1-300 300 *************************** <1> UI - 20312071 AU - McLaren EA AU - White SN IN - UCLA Center for Aesthetic Dentistry, USA. TI - Glass-infiltrated zirconia/alumina-based ceramic for crowns and fixed partial dentures. SO - Practical Periodontics & Aesthetic Dentistry 1999 Oct;11(8):985-94; quiz 996 AB - The increased demand for metal-free restorative alternatives has resulted in the proliferation of all-ceramic systems. While these materials can predictably achieve aesthetic results in the anterior, they have traditionally been contraindicated for posterior applications due to the greater stresses present in the region. This article discusses a zirconia/alumina-based ceramic system that has been developed to expand the alternatives for the aesthetic restoration of the dentition. Material properties and considerations for its use in crown restorations, fixed partial dentures, and custom implant abutments are similarly addressed. <2> UI - 20274750 AU - Kronstrom M AU - Palmqvist S AU - Soderfeldt B IN - Department of Prosthetic Dentistry, Central Hospital Skovde, Sweden. mats.kronstrom@ltskar.se TI - Prosthodontic decision making among general dentists in Sweden. II: The choice between fixed and removable partial dentures. SO - International Journal of Prosthodontics 1999 Nov-Dec;12(6):527-33 AB - PURPOSE: The purpose of this study was to describe how dentists evaluated various items related to a treatment choice between fixed partial dentures (FPD) and removable partial dentures (RPD), and to determine if the differences could be explained by dentist-related variables ("social and demographic attributes," "job situation," and "attitudes"). MATERIALS AND METHODS: Questionnaires were sent to a random sample of 2,059 Swedish general dentists, with a response rate of 76%. In the questionnaire, the choice between FPDs and RPDs in a clinical situation was presented. The dentists were asked to mark on 14-item visual analogue scales the relative importance he or she gave the different items. The items were analyzed through principal components analysis, where a 3-factor solution was obtained; the factors were labeled as "time," "health," and "comfort." The factors were run as dependent variables in multiple regression analyses. RESULTS: Great individual variations were seen, but the differences between groups of dentists were small. The items evaluated as most important were "patient's wish," "condition of possible abutment teeth," and "prognosis for delivered treatment." Male dentists gave significantly greater importance to the "health" factor compared to female dentists. The attitudinal variable "patient information" showed significant associations with all 3 factors in the multivariate models. CONCLUSION: Great individual differences were seen regarding the importance of the various items. In multiple regression models, several independent variables showed significant associations, most interestingly the attitudinal variable "patient information." Low explanatory (R2) values indicate that it is necessary to capture more variables of importance for the prosthodontic decision-making process. <3> UI - 20271223 AU - Shannon A IN - Baylor College of Dentistry, Texas, USA. aesthetic-dent@drshannon.com TI - How proper protocol, materials selection, and communication yield aesthetic, functional outcomes and patient satisfaction in complex restorative cases. SO - Dentistry Today 1999 Oct;18(10):42-51 <4> UI - 20247911 AU - Silverstein LH AU - Moskowitz ME AU - Kurtzman D AU - Shatz PC AU - Gornstein RA IN - Medical College of Georgia, Augusta, USA. TI - Prosthetic considerations with periodontal root resective therapy, Part 2. Hemisections. SO - Dentistry Today 1999 Sep;18(9):86-9 AB - When a root and the overlying anatomic crown are removed as a unit, this procedure is referred to as a hemisection. Hemisection of a maxillary or mandibular molar is often a means of retaining teeth needed for restorative abutments or occlusal support. This treatment can yield predictable results using proper diagnostic, endodontic, surgical, and prosthetic techniques. <5> UI - 20228608 AU - Butterworth C IN - Birmingham Dental Hospital. TI - Cleidocranial dysplasia: modern concepts of treatment and a report of an orthodontic resistant case requiring a restorative solution. SO - Dental Update 1999 Dec;26(10):458-62 AB - A case is presented of a young boy with cleidocranial dysplasia, whose multiple supernumerary teeth prevented the eruption of most of his permanent teeth. His maxillary incisor teeth failed to erupt following removal of anterior supernumerary elements and orthodontic traction. Lack of abutment teeth and a difficult maxillary base made prosthetic treatment almost impossible. A horseshoe acrylic denture retained by milled crowns bonded to the deciduous canines and a maxillary first molar proved a very successful restoration. The problems of treating this group of patients are discussed. <6> UI - 20194174 AU - Howe L AU - Barrett V AU - Palmer P IN - Guy's and St. Thomas' Hospitals Trust, London. TI - Dental implants. 7. Basic restorative techniques. SO - British Dental Journal 1999 Nov 13;187(9):473-9 AB - Some restorative techniques for implant supported restorations will be familiar to dentists used to providing conventional crown and bridgework. The differences and principles involved when using implants are identified. <7> UI - 20215897 AU - Silverstein LH AU - Hahn J AU - Kurtzman D AU - Harden S AU - Shatz PC IN - Medical College of Georgia, Augusta, USA. TI - Aesthetic enhancement of pontic sites for fixed partial dentures. SO - Dentistry Today 1998 Nov;17(11):80-5 AB - The ridge expansion technique using tapered osteotomes can be used anywhere in the maxilla when a change in external ridge morphology would be advantageous for both aesthetics and/or proper dental implant placement. Usually subsequent to tooth loss, the maxilla is generally somewhat undercut in form. This ridge expansion technique can be used to reduce the undercut by bulging out the base of the facial/buccal plate. This would recreate the illusion of root prominences (Figure 12) or permit implant fixtures to be inserted in a more upright position. The tapered osteotomes can therefore predictably be used to expand the buccal bone to simulate the presence of a root prominence for optimal aesthetics for placement of a fixed partial denture prosthesis (Figure 13). <8> UI - 20174290 AU - Blatz MB AU - Hurzeler MB AU - Strub JR IN - Department of Prosthodontics, University of Freiburg, Germany. TI - Reconstruction of the lost interproximal papilla--presentation of surgical and nonsurgical approaches. [Review] [78 refs] SO - International Journal of Periodontics & Restorative Dentistry 1999 Aug;19(4):395-406 AB - Modern esthetic dentistry involves not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques. The loss of interproximal dental papillae may cause functional, phonetic, and devastating esthetic problems. Complete and predictable restoration of lost interdental papillae remains one of the biggest challenges in periodontal reconstructive surgery. On reviewing the literature, publications involving surgical and nonsurgical techniques for papilla reconstruction are basically case presentations. Very little scientific data concerning long-term success and predictability of specific techniques has been published so far. Starting with facts about the anatomy and morphology of the interdental tissues, this article gives an overview of surgical and nonsurgical techniques to restore lost interproximal dental papillae. [References: 78] <9> UI - 20098664 AU - Luthardt RG AU - Stossel M AU - Hinz M AU - Vollandt R IN - Technical University Dresden, Medical Faculty Carl Gustav Carus, Dresden, Germany. Ralph.Luthardt@mailbox.tu-dresden.de TI - Clinical performance and periodontal outcome of temporary crowns and fixed partial dentures: A randomized clinical trial. SO - Journal of Prosthetic Dentistry 2000 Jan;83(1):32-9 AB - STATEMENT OF PROBLEM: Different materials (autopolymerizing, dual curing, and light initiated) are used for fabricating provisional restorations during prosthetic treatment. Randomized clinical trials that have evaluated these provisional materials have not been published. PURPOSE: This clinical trial compared the handling, fitting, plaque adherence, gingivitis, color stability, and the subjective assessment of the provisional materials by the patient and the dentist for 2 autopolymerizing (Protemp, Luxatemp), 1 dual-curing (Provipont), and 1 light-initiated (Triad-VLC) material for the manufacturing of temporary crowns and fixed partial dentures. MATERIAL AND METHODS: Thirty subjects in need of 2 similar fixed prosthetic restorations (single crowns :20, three-quarter crowns :2, connected crowns :9, or fixed partial dentures :30) were treated with 1 temporary restoration of Protemp II (control) and one randomly selected from Luxatemp, Provipont, or Triad-VLC materials. The mean time of treatment was 37.5 days (minimum 2 days, maximum 156 days). All restorations were manufactured intraorally with a vacuum-formed template. RESULTS: Mechanical and retentive characteristics revealed a high level of clinical reliability. Plaque adherence of the teeth with temporary restorations was significantly increased (P =.0039) compared with the untreated mesial reference teeth. CONCLUSION: The advantageous mechanical properties of the light-curing and dual-curing materials reviewed in dental literature were clinically offset by disadvantages in handling. <10> UI - 20110282 AU - Clarkson JE AU - Worthington HV AU - Holloway PJ IN - Dental Health Unit, University of Manchester, UK. TI - Development of a classification and index of dental treatment experience for adults. SO - Community Dental Health 1998 Sep;15(3):168-74 AB - OBJECTIVE: To develop and evaluate a classification and index of dental treatment experience for adults. DESIGN: Twenty-four general dental practitioners recorded treatment experience at baseline on 4,211 regularly attending adults of whom 3,878 were re-examined after one year and 3,698 patients completed a questionnaire on factors related to treatment. SETTING: Health authorities of Manchester and Salford. METHOD: Set theory was used to divide the baseline clinical data set into 7 mutually exclusive classes of dental treatment experience. Seven dental specialists used the nominal group technique to weight tooth status to form an index of dental treatment experience (DTE). The ability of the DTE classification and index to discriminate between groups of patients' responses to the questionnaire was compared with the THI and DMFT index. RESULTS: Ninety-nine per cent of the patients fell into 5 hierarchical classes ranging from fillings only to wearing a denture in addition to a crown and/or bridge. When calculated on the baseline data, the classification discriminated between 16 of the 20 variables investigated in the questionnaire. Fifteen significant differences were found between mean scores for groups of patients on the DTE index, 14 on the THI and 8 on the DMFT index. Fifty-five (1%) patients moved their class as a consequence of the treatment carried out during the year. All three indices found significant differences for the same four variables of the 20 tested. CONCLUSION: A classification of dental treatment experience together with an index to measure the severity of that experience has been successfully developed and tested. It appears to have advantages over the traditional DMFT index and is at least as discriminating as the THI. <11> UI - 20101117 AU - Andersson B AU - Scharer P AU - Simion M AU - Bergstrom C IN - Public Dental Service, Sahlgrenska Universitetssjukhuset/Molndal, Sweden. bernt.andersson@ms.se TI - Ceramic implant abutments used for short-span fixed partial dentures: a prospective 2-year multicenter study. SO - International Journal of Prosthodontics 1999 Jul-Aug;12(4):318-24 AB - PURPOSE: This is a 2-year report from an ongoing prospective 5-year multicenter study. The aim of the study was to evaluate the short- and long-term clinical function of CerAdapt ceramic abutments supporting short-span fixed partial dentures (FPD). MATERIALS AND METHODS: Initially, 105 Branemark System implants were placed in a total of 32 patients at 3 different clinics. After initial healing 103 implants remained. For the support of 36 FPDs, 53 ceramic and 50 titanium abutments were connected, 19 on ceramic and 17 on titanium abutments. RESULTS: All patients remained in the study after 2 years. There was a cumulative survival rate of 97.1% for implants and a cumulative success rate of 97.2% for FPDs (94.7% for ceramic and 100% for titanium abutment-supported FPDs). One of 53 ceramic but none of 50 titanium abutments failed, giving a cumulative success rate of 98.1% and 100%, respectively, for the abutments. Soft tissue around abutments and adjacent teeth appeared healthy. More crown margins were placed submucosally at titanium (31%) than at ceramic (14%) abutments, and the level of the periimplant mucosa was relatively stable in relation to the abutment/crown. No differences were seen between ceramic and titanium abutments regarding bleeding of the periimplant mucosa. There was a minimal marginal bone loss recorded after 1 year, which was slightly more at titanium (0.4 mm) than at ceramic (0.2 mm) abutments. All patients and dentists were satisfied with the achieved esthetic result and no FPD was remade because of compromised esthetics. CONCLUSION: So far the ceramic abutments have worked very well and the 2-year results have been very encouraging for CerAdapt abutments supporting short-span FPDs. However, ceramic materials tend to undergo static fatigue, and it is therefore important to wait for the 5-year results before making any more definite statement about the long-term prognosis for CerAdapt abutments. <12> UI - 20101105 AU - Gunne J AU - Astrand P AU - Lindh T AU - Borg K AU - Olsson M IN - Department of Prosthetic Dentistry, Faculty of Odontology, Umea University, Sweden. johan.gunne@protetik.umu.se TI - Tooth-implant and implant supported fixed partial dentures: a 10-year report. SO - International Journal of Prosthodontics 1999 May-Jun;12(3):216-21 AB - PURPOSE: The use of implants for prosthetic rehabilitation of partially edentulous patients is increasing. However, the possibilities of placing implants in the posterior part of the mandible are often limited. The purpose of this longitudinal study with 10 years of follow-up was to evaluate the use of short implants supporting fixed partial dentures (FPD) in the posterior part of the mandible, and to compare implant supported FPDs to tooth-implant supported FPDs. MATERIALS AND METHODS: The patient material comprised 23 patients with residual mandibular anterior teeth, and each patient received FPDs unilaterally. On one side the FPD was supported by two implants, and on the other side by one implant and one tooth, thus permitting intraindividual comparison. The distribution of the two types of FPDs in each jaw was randomized. Implant success rates, marginal bone changes, and mechanical complications were studied. RESULTS: The tooth-implant connection did not demonstrate any negative influences on the overall success rates for the 10-year period, nor were the shorter implants found to be less favorable. CONCLUSION: It is suggested that a prosthetic construction supported by both a tooth and an implant may be recommended as a predictable and reliable treatment alternative in the posterior mandible. <13> UI - 20056193 AU - Gohring TN AU - Mormann WH AU - Lutz F IN - Center for Dental and Oral Medicine, University of Zurich, Zurich, Switzerland. goehring@zzmk.unizh.ch TI - Clinical and scanning electron microscopic evaluation of fiber-reinforced inlay fixed partial dentures: preliminary results after one year. SO - Journal of Prosthetic Dentistry 1999 Dec;82(6):662-8 AB - STATEMENT OF PROBLEM: Restorative dentistry searches for nonmetal reinforcement of esthetic fixed partial dentures (FPDs). PURPOSE: This clinical study evaluated conservative fiber-reinforced composite FPDs bonded to inlay abutments. MATERIAL AND METHODS: Twenty fiber-reinforced composite inlay FPDs were made for 15 patients. Restorations were manufactured with the Targis Vectris glass-fiber-reinforced composite system and a simplified laboratory technique. The 20 bonded inlay FPDs were examined clinically and by SEM after 1 year. RESULTS: All 20 FPDs were intact at the 1-year examination. There were no signs of fracture, surface defects, or excessive wear with SEM. SEM marginal analysis exhibited 91.6% +/- 5% excellent margins at the tooth-luting composite interface and 86. 1% +/- 8% excellent margins at luting composite/restoration interface. CONCLUSION: On the basis of the results of this descriptive study, bonded glass-fiber-reinforced composite inlay FPDs were considered clinically successful at the 1-year examination. <14> UI - 20027163 AU - Drago CJ IN - Gundersen Lutheran Medical Center, La Crosse, WI 54601, USA. cdrago@gundluth.org TI - Use of osseointegrated implants in adult orthodontic treatment: a clinical report. SO - Journal of Prosthetic Dentistry 1999 Nov;82(5):504-9 AB - This article describes the complex dental treatment of an adult patient with multiple missing teeth, mild periodontitis, and a malocclusion. Titanium implants were placed in the posterior mandibular edentulous segments and became osseointegrated. The placement of the mandibular implants was originally designed for orthodontic anchorage. The mandibular implants would subsequently be used for implant-retained crowns on completion of orthodontic treatment. After a 4-month healing period, an impression was made of the implant hexes and a master cast was formed. Two-piece temporary healing abutments were placed on the implants and used to retain orthodontic brackets. The orthodontist retracted the mandibular anterior teeth using the posterior implants for anchorage. The abutment screws of the 2-piece temporary healing abutments were tightened to 20 N-cm at the insertion appointment and did not need to be tightened again during the course of orthodontic therapy. Standard orthodontic brackets were cemented to the 2-piece temporary healing abutments. Orthodontic treatment was accomplished uneventfully. Prosthodontic treatment was completed using the osseointegrated implants to replace the missing teeth. The methods described in this clinical report present clinicians with additional choices in the treatment of complex dental disease using osseointegrated dental implants. <15> UI - 20051365 AU - Rashid SA AU - Al-Wahadni AM AU - Hussey DL IN - Department of Restorative Dentistry, School of Clinical Dentistry, Queen's University, Belfast, Northern Ireland. TI - The periodontal response to cantilevered resin-bonded bridgework. SO - Journal of Oral Rehabilitation 1999 Nov;26(11):912-7 AB - This study investigated 84 cantilevered resin-bonded bridges (CRBB) in 60 patients. These CRBB (single retainer, single pontic) had been in place for an average of 43.6 months. Periodontal health was assessed on abutment teeth and contralateral control teeth. Periodontal indices utilized were Plaque Index (PI), Gingival Index (GI), Bleeding Index (BI), Pocket Depth (PD) and mobility. The marginal adaptation, the gingival extension of the retainers and the presence or absence of caries around each retainer margin were also assessed. Information about the history of debonding was collected and a success rate of 93% was reported. PI, GI and mean PD compared statistically significantly, less favourably, with scores of the control teeth. Marginal adaptation of the retainers was of a high standard and caries did not appear to be a problem. <16> UI - 99437103 AU - Forgie AH AU - Pine CM AU - Longbottom C AU - Pitts NB IN - Unit of Dental and Oral Health, Dundee Dental Hospital and School, UK. a.h.forgie@dundee.ac.uk TI - The use of magnification in general dental practice in Scotland--a survey report. SO - Journal of Dentistry 1999 Sep;27(7):497-502 AB - OBJECTIVES: This study had two aims, first, to quantify the level of the use of magnification in general dental practice in Scotland and second, to determine the current and potential areas of clinical use of magnification by general dental practitioners. METHODS: A questionnaire was sent to all general dental practitioners in Scotland with a Health Board list number (n = 1790). The questionnaire asked the practitioners about their experience of magnification and their opinions on possible areas for clinical use. An information sheet and a prepaid envelope were included with the questionnaire. RESULTS: One thousand two hundred and eighty (72%) of the dentists replied to the questionnaire. Nine percent of the respondents routinely used magnification. The level of routine use of magnification by practitioners increased with time since qualification. The suggested areas of clinical use of magnification by all the respondents were crown and bridge work, diagnosis and radiography. The routine users of magnification had a more positive view of magnification than non-users. CONCLUSIONS: Routine use of magnification was associated with the length of time the practitioner had been qualified and the attendance at a course at which magnification was discussed. The perceived uses of magnification depended on the experience of the practitioner with magnification. It was considered suitable for all clinical procedures except orthodontics and prosthodontics. <17> UI - 99410982 AU - Ibbetson RJ AU - Hemmings KW AU - Ward VJ IN - Eastman Dental Institute for Oral Health Care Science, University College of London. TI - Variations in planning fixed bridgework--a group of dentists at a case-based postgraduate course. SO - British Dental Journal 1999 Aug 14;187(3):159-63 AB - Variations in treatment planning and prescription have been described in relation to routine restorative dentistry. This study examined dentists' decisions regarding treatment planning for fixed bridgework. Fifty five dentists who attended a Continuing Education course on fixed bridgework were given standard information about a patient in the form of study casts, photographs of radiographs and a clinical history. They were asked to design a bridge where a previous one had failed and to complete a proforma which was returned to the course organisers in advance of the event. The response rate was 65%. The data showed wide variation in identification of features of diagnostic importance. Seventy percent of respondents chose to use again as abutments teeth which were extensively damaged and had failed to retain the previous bridge: while only 30% noted features of the occlusion which if left unchanged would have precluded a successful bridge from being made. A further feature was that nearly 70% chose to use multiple abutments to support the bridge. The implications of these results were discussed with respect to current concepts of bridge design. <18> UI - 99354014 AU - Dylina TJ TI - Contour determination for ovate pontics. SO - Journal of Prosthetic Dentistry 1999 Aug;82(2):136-42 AB - The ovate pontic was initially described in 1933, but was only recently considered clinically acceptable. Historically, there has been resistance to ovate pontics, but this resistance lacks scientific and biologic evidence to justify rejection. Explicit instructions are mandatory for predictable results from dental laboratories. This article describes a method for communicating exact dimensions for an ovate pontic that was previously contoured for a patient in a provisional restoration to ensure clinical and histologic success. Polyvinyl siloxane putty is suggested as a matrix material for the predetermined contour. An esthetic and functional restoration will result when these materials and procedures are used in an appropriate sequence. <19> UI - 99354012 AU - Bouvier D AU - Duprez JP AU - Pirel C AU - Vincent B IN - Faculty of Odontology, University of Claude Bernard Lyon I, Lyon, France. TI - Amelogenesis imperfecta--a prosthetic rehabilitation: A clinical report. SO - Journal of Prosthetic Dentistry 1999 Aug;82(2):130-1 <20> UI - 99377107 AU - Kaptein ML AU - De Putter C AU - De Lange GL AU - Blijdorp PA IN - Department of Oral Maxillofacial Surgery, Faculty of Medicine, University of Utrecht, The Netherlands. TI - A clinical evaluation of 76 implant-supported superstructures in the composite grafted maxilla. SO - Journal of Oral Rehabilitation 1999 Aug;26(8):619-23 AB - The aim of the study was to evaluate the material behaviour and nature of implant-supported superstructures in function. A total of 37 overdentures, 26 fixed partial and 13 fixed full dentures with a mean lifetime of 40 months were clinically evaluated in relation to damage, occlusion and articulation, parafunction, retentive devices, hygiene and speech problems. In general 70% of all superstructures were damaged. Fixed partial dentures were significantly less damaged than overdentures and fixed full dentures (P<0.001). A significant high percentage of newly gained parafunction was found (P<0.05). <21> UI - 99342491 AU - Raghoebar GM AU - Batenburg RH AU - Timmenga NM AU - Vissink A AU - Reintsema H IN - Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, University Hospital Groningen, The Netherlands. TI - Morbidity and complications of bone grafting of the floor of the maxillary sinus for the placement of endosseous implants. SO - Mund-, Kiefer- und Gesichtschirurgie 1999 May;3 Suppl 1:S65-9 AB - Placement of endosseous implants in the atrophic maxilla is often limited because of a lack of supporting bone. A technique to augment the floor of the maxillary sinus with autogenous bone graft seems to be a new reliable treatment modality. The morbidity and complication rate of augmentation of the maxillary sinus floor was studied in 75 patients. The sinus floor was augmented with iliac crest (n = 65, 128 sinuses, 276 implants), mandibular symphysis (n = 8, ten sinuses, 21 implants), or maxillary tuberosity grafts (n = 2, two sinuses, two implants). The width of the alveolar crest had to be reconstructed in 52 patients, while in the other 23 patients augmentation and implantation were performed simultaneously. Perforation of the sinus membrane occurred in 45 patients, but this did not predispose them to the development of sinusitis. Loss of bone particles and sequesters were observed in one (diabetic) patient only, in whom a mucosal dehiscence occurred. A second augmentation procedure was successful. Symptoms of transient sinusitis were observed in two of the seven patients with a predisposition for sinusitis. These symptoms were successfully treated with decongestants and antibiotics. One patient developed a purulent sinusitis which resolved after a nasal amrostomy. The bone volume was sufficient for insertion implants in all patients. Twenty of 299 patients (6.7%) in whom Branemark implants had been inserted were lost to follow-up (mean, 32 months); no sinus pathology was observed. The patients received implant-supported overdentures (58 patients) or fixed bridges (17 patients) and experienced no complaints with regard to the grafts or implants. We conclude that the morbidity and complication rate of bone grafting of the floor of the maxillary sinus floor with autogenous bone is low. <22> UI - 99315932 AU - Marunick MT AU - Roumanas ED IN - Department of Otolaryngology Head and Neck Surgery, Wayne State University, Detroit, MI 48201, USA. TI - Functional criteria for mandibular implant placement post resection and reconstruction for cancer. [Review] [50 refs] SO - Journal of Prosthetic Dentistry 1999 Jul;82(1):107-13 AB - STATEMENT OF PROBLEM: Osseointegrated implants used in the mandible post resection and reconstruction for cancer represents a treatment option with the potential for functional improvement and enhanced quality of life. Unfortunately, protocols for their use in this patient population have been empirical and technique-driven with the assumption that they will overcome most, if not all, functional deficits encountered. PURPOSE: The article reviews the salient oral physiologic factors for this group of patients and presents a rational approach and functional criteria for patient selection and implant placement. Other considerations discussed include: timing of implant placement, irradiated and compromised tissues, patient motivation, and tumor prognosis. CONCLUSION: These principles, if followed, may enhance realistic functional outcomes for this patient population. [References: 50] <23> UI - 99307786 AU - Fugazzotto PA AU - De Paoli S TI - Maintenance of regenerated bone beneath pontics: preliminary clinical report of 43 sites. SO - International Journal of Oral & Maxillofacial Implants 1999 May-Jun;14(3):392-7 AB - Ridge augmentation was achieved through the use of guided bone regeneration procedures in pontic areas of 43 planned fixed prostheses. Measurements taken through templates, which fit over the final fixed prostheses, at the time of prosthetic placement and a mean of 123 weeks after prosthesis placement demonstrated a change of less than 0.1 mm in buccopalatal dimensions of the regenerated hard tissues. <24> UI - 99284948 AU - Halterman SM AU - Rivers JA AU - Keith JD AU - Nelson DR IN - U.S. Navy Dental Corps, Naval Dental Center, Norfolk, VA, USA. TI - Implant support for removable partial overdentures: a case report. SO - Implant Dentistry 1999;8(1):74-8 AB - Functional stability and the preservation of remaining alveolar bone are primary, and often elusive, goals when restoring the partially edentulous arch. The incorporation of dental implants for the partial support of removable prostheses offers a practical adjunct in the fulfillment of these objectives. Planning for complex courses of treatment that include dental implants requires close coordination between the surgeon and the restorative dentist. Decisions that deal with type, location, size, number of implant fixtures, and design of the prosthesis are critical. All of these areas must be discussed and established as acceptable to the patient and each clinician before the initiation of treatment. In this report, we present a course of patient treatment in which a removable partial denture is supported by natural remaining teeth in conjunction with osseointegrated implants. <25> UI - 99247843 AU - Djemal S AU - Setchell D AU - King P AU - Wickens J IN - Department of Conservative Dentistry, Eastman Dental Institute for Oral Healthcare Sciences, University of London, UK. TI - Long-term survival characteristics of 832 resin-retained bridges and splints provided in a post-graduate teaching hospital between 1978 and 1993. SO - Journal of Oral Rehabilitation 1999 Apr;26(4):302-20 AB - The clinical performance of 832 resin-retained bridges and splints provided in the adult fixed prosthodontic clinic of a post-graduate teaching hospital was reviewed. Recall data was available for 58.4% of cases and the median survival was 7 years and 10 months. Analysis of clinical variables influencing survival revealed that the design and retainer coverage were significant factors. The experience of the operator carrying out treatment also had a pronounced effect which was not readily explained in terms of the distribution of other significant factors. Resin-retained restorations made with minimal tooth preparation are shown to be capable of extended clinical service and their failure rarely resulted in adverse consequences for the patient. Patient satisfaction with their treatment was reportedly high. <26> UI - 99238730 AU - Goodacre CJ AU - Kan JY AU - Rungcharassaeng K IN - School of Dentistry, Loma Linda University, Loma Linda, CA, USA. TI - Clinical complications of osseointegrated implants. [Review] [96 refs] SO - Journal of Prosthetic Dentistry 1999 May;81(5):537-52 AB - STATEMENT OF PROBLEM: There is no comprehensive review of the literature that identifies the complications reported in clinical dental implant studies. PURPOSE: This article attempted to determine the types of complications that have been reported and to provide data regarding their frequency. METHODS: All available clinical studies from 1981 to 1997, published in English or with English abstract, that presented success/failure data regarding implant treatment were evaluated to determine the types of reported complications and to quantify implant loss as it relates to type of prosthesis, arch, time, implant length, and bone quality. RESULTS: Greater implant loss occurred with overdentures than with other types of prostheses. There was greater loss in the maxilla than mandible with fixed complete dentures and overdentures, whereas little arch difference was noted with fixed partial dentures. Implant loss increased with short implants and poor bone quality. The time of implant loss (preprosthetic vs postprosthetic) varied with type of prosthesis. Surgical complications included neurosensory disturbance, hematoma, mandibular fracture, hemorrhage, and tooth devitalization. Initial and long-term marginal bone changes were identified. Peri-implant soft tissue complications included dehiscence, fistulas, and gingival inflammation/proliferation. Mechanical complications were screw loosening/fracture, implant fractures, framework, resin base and veneering material fractures, opposing prosthesis fractures, and overdenture mechanical retention problems. Some studies also presented phonetic and esthetic complications. CONCLUSIONS: Although the literature presents considerable information on implant complications, variations in study design and reporting procedures limited the available data and therefore precluded proper analysis of certain complications. [References: 96] <27> UI - 99282069 AU - Lekholm U AU - Wannfors K AU - Isaksson S AU - Adielsson B IN - The Branemark Clinic, Public Dental Health and Faculty of Odontology, University of Goteborg, Sweden. TI - Oral implants in combination with bone grafts. A 3-year retrospective multicenter study using the Branemark implant system. SO - International Journal of Oral & Maxillofacial Surgery 1999 Jun;28(3):181-7 AB - A retrospective, multicenter, Scandinavian study of bone grafting of alveolar processes of severely atrophic jaws in combination with implant insertion was conducted with 150 patients. Five different grafting techniques were assessed: local or full onlay; inlay; combination of onlay/inlay grafts; and LeFort I osteotomies. The majority of the patients were treated using a one-stage approach (n = 125) and all had autogenous bone grafts. A total of 781 Branemark implants were inserted, of which 624 were placed in bone grafts and alveolar bone. Twenty-five patients (17%) dropped out during the follow-up period of three years. Within the remaining patients, 77% of the inserted implants (n = 516) were still in function at the end of the follow-up period. A further ten implants were kept mucosa-covered, resulting in an overall implant survival rate of around 80%. Onlays, inlays and LeFort I osteotomies showed almost the same success rates (76-84%), whereas the onlay/inlay technique gave rise to less favourable results (60%). Most of the observed losses (n = 131) took place during healing and the first year of loading. More implants were lost when they were inserted simultaneously with the grafting (23%) than when they were placed in a second stage (10%). The latter technique was used mainly in combination with local onlay grafting (16/25). The failure percentage for implants inserted in non-grafted bone (11%) was lower than for those inserted in bone grafts and alveolar bone (25%). The surviving implants of treated and followed patients served, in 88% of the cases (n = 110), to support fixed bridges or overdentures, albeit, in some instances (n = 23), after additional implant placement. In only 15 patients was it necessary to fall back on conventional removable prostheses or fixed partial bridges. <28> UI - 99178389 AU - Walter M AU - Reppel PD AU - Boning K AU - Freesmeyer WB IN - Department of Prosthodontics, Medical Faculty, Technical University, Dresden, Germany. m.walter@rcs.urz.tu-dresden.de TI - Six-year follow-up of titanium and high-gold porcelain-fused-to-metal fixed partial dentures. SO - Journal of Oral Rehabilitation 1999 Feb;26(2):91-6 AB - In a randomized clinical study 47 titanium and gold-alloy fixed partial dentures (FPDs) were placed during a 1-year period. In the titanium group (n = 22) all metal substructures were made of unalloyed titanium. The titanium substructures were fabricated by copy milling, spark erosion and laser welding (Procera, Nobelpharma). Ceramic veneering was carried out with Duceratin titanium ceramics (Ducera, Germany). In the control group (n = 25) the high-gold alloy Degudent U (Degussa, Germany) and Vita VMK 68 ceramics (Vita, Germany) were used. The longest observation time was 6 years. Only one FPD had to be removed due to metal-ceramic failure (titanium group). The clinical performance of all 125 porcelain-fused-to-metal (PFM) veneers with respect to the longevity of the metal-ceramic compound was described by Kaplan-Meyer survivor analyses. Relating survival to a completely intact ceramic veneer, the 5-year survivor rate was 84% for titanium and 98% for the high-gold alloy. PFM titanium restorations exhibited a significantly increased risk of metal-ceramic failure. However, concerning defects requiring removal, no significant differences in titanium versus high-gold alloy occurred. There were no significant differences in the survival distributions between crowns and pontics within the two groups. <29> UI - 99235897 AU - Murray FJ AU - Blinkhorn AS AU - Bulman J IN - University Dental Hospital of Manchester, UK. TI - An assessment of the views held by recent graduates on their undergraduate course. SO - European Journal of Dental Education 1999 Feb;3(1):3-9 AB - The aim of this study was to ascertain the views of recent graduates on their undergraduate training. 53 Vocational Training scheme organisers were contacted and 37 (70%) responded 391 new dentists on the schemes were sent postal questionnaires to record information on their views of the undergraduate dental curriculum, 247 questionnaires were returned giving a response rate of 63%. 62% of the subjects reported that they had received sufficient practical experience in the provision of crowns, 32% for veneers and 19% for bridgework. 46% of respondents felt able to treat a simple orthodontic case with removable appliances. 63% considered they had insufficient experience in surgical extractions, 40% expressed the opinion that overall, they would like more practical clinical experience included in the undergraduate course particularly in crown/bridgework and surgical extractions. In conclusion, there are areas in which recent graduates consider their undergraduate course to have been lacking. <30> UI - 99234678 AU - Sorensen JA AU - Cruz M AU - Mito WT AU - Raffeiner O AU - Meredith HR AU - Foser HP IN - Dental Clinical Research Center, Portland, Oregon, USA. TI - A clinical investigation on three-unit fixed partial dentures fabricated with a lithium disilicate glass-ceramic. SO - Practical Periodontics & Aesthetic Dentistry 1999 Jan-Feb;11(1):95-106; quiz 108 AB - A lithium disilicate glass-ceramic material has recently been developed for the fabrication of 3-unit fixed partial dentures. Conducted on 60 restorations, this initial trial attempted to define clinical indications and establish design principles for fixed partial dentures fabricated of this ceramic material. The design requisites varied depending on placement on the arch, and the authors concluded that lithium disilicate restorations caused reduced antagonist structure or opposing tooth wear. This investigation demonstrated that when a novel ceramic system was utilized for 3-unit restorations replacing up to the first premolar and attained minimal criteria for connector dimensions, an acceptable clinical success rate was achieved. <31> UI - 99234682 AU - Schnitman PA IN - Wellesley Hills Medical Center, MA 02481-5341, USA. TI - The profile prosthesis: an aesthetic fixed implant-supported restoration for the resorbed maxilla. SO - Practical Periodontics & Aesthetic Dentistry 1999 Jan-Feb;11(1):143-51 AB - This article discusses a method for the predictable fabrication of fixed detachable maxillary reconstructions that abut and precisely follow the gingival contours--regardless of implant angulation or position. The technique reorders the traditional implant protocol and delays abutment selection until the definitive tooth position has been established. In this manner, final abutment selection and framework design become a single, integrated process that results in improved aesthetics, reduced angulation difficulties, and elimination of the phonetic concerns traditionally associated with fixed maxillary prostheses. <32> UI - 99165088 AU - Jansma J AU - Raghoebar GM AU - Batenburg RH AU - Stellingsma C AU - van Oort RP IN - University Hospital Groningen, The Netherlands. j.jansma@kchir.azg.nl TI - Bone grafting of cleft lip and palate patients for placement of endosseous implants. SO - Cleft Palate-Craniofacial Journal 1999 Jan;36(1):67-72 AB - OBJECTIVE: Fixation of a prosthesis or single tooth replacement using osseointegrated implants has the potential to overcome functional and psychological inconveniences that many patients experience from such appliances. However, the dimensions of the recipient site are relatively often inadequate for implant placement. This study assessed grafting of this site with autogenous bone as a solution for the latter problem. METHODS: Ten cleft lip and palate patients had bone grafts; six had iliac crest grafts to the maxillary sinus floor (31 implants), and four had chin bone grafts to the local defect in the anterior maxilla (six implants). Implants were inserted during the grafting procedure (one patient) or after 3 months (nine patients). RESULTS: No inflammation of the bone grafts or the maxillary sinus occurred. One implant was lost during the healing phase. Four single tooth restorations, one fixed bridge, and five implant-supported overdentures were made. During the follow-up, which was 47 months (range, 28 to 65 months) in the anterior maxilla group and 56 months (range, 28 to 68 months) in the posterior maxilla group, no loss of implants was observed, and all prosthetic appliances functioned well. CONCLUSIONS: It is concluded that bone grafting followed by placement of dental implants can serve as a reliable alternative for conventional prosthetic rehabilitation of cleft patients. <33> UI - 99229004 AU - Priest G TI - Single-tooth implants and their role in preserving remaining teeth: a 10-year survival study. SO - International Journal of Oral & Maxillofacial Implants 1999 Mar-Apr;14(2):181-8 AB - The use of teeth as abutments for fixed and removable partial dentures can result in biologically destructive consequences. Teeth adjacent to edentulous spaces should exhibit improved prognoses if restorative trauma is to be avoided or minimized. Implants offer a method of tooth replacement without relying upon the surrounding dentition for support. This investigation evaluates implant survival and prosthetic complications of implants that replaced single missing teeth and were placed in clinical practice during a 10-year period. It further examines preoperative status and survival of teeth adjacent to these implant restorations during the same 10-year time span. Ninety-nine patients treated with 116 implants and 112 single-tooth implant prostheses in a prosthodontic practice were examined between 1988 and 1998. The purpose of this study was to evaluate the role of implants in preventing the use of intact teeth for initial support of prostheses and in avoiding the use of additional teeth as abutments upon the replacement of existing restorations. Three implants failed over a 10-year period, for a survival rate of 97.4%. Complications included the loss of 2 implant crowns, screw loosening, broken screws, cement washout, margin exposure, and porcelain fracture. Of 196 teeth adjacent to edentulous spaces, 156 (79.6%) were intact or minimally restored. Only 3 of these teeth were restored as part of initial prosthodontic therapy. Over the ensuing 10 years, only 1 tooth required a replacement restoration, and 1 tooth was extracted. Results of this patient evaluation demonstrated that implant survival over a 10-year period was favorable, with minimal prosthetic complications. Furthermore, teeth adjacent to single-tooth implants exhibited an extremely low complication rate. This report indicates that implants can be effective in preserving intact teeth in patients undergoing initial prosthodontic therapy and in preventing the use of additional teeth as abutments in patients whose existing prostheses must be replaced. <34> UI - 99200683 AU - Quirynen M AU - Mongardini C AU - Lambrechts P AU - De Geyseleer C AU - Labella R AU - Vanherle G AU - van Steenberghe D IN - Department of Periodontology, Faculty of Medicine, Catholic University Leuven, Belgium. Marc.Quirynen@med.kuleuven.ac.be TI - A long-term evaluation of composite-bonded natural/resin teeth as replacement of lower incisors with terminal periodontitis. SO - Journal of Periodontology 1999 Feb;70(2):205-12 AB - BACKGROUND: In patients with severe peridontitis, lower incisors are prone to terminal breakdown. This study assessed the longevity of composite-bonded resin/natural teeth (reinforced only with a stainless steel mesh) as replacements for periodontally lost lower incisors. METHODS: Besides the longevity of the restoration, the periodontal condition of the abutment teeth, and the general satisfaction of the patient were evaluated retrospectively via a phone interview, in combination with an analysis of the patient's clinical dental file. RESULTS: The cumulative proportion of survival rate of these composite restorations was 80% after 5 years of function. No statistically significant difference was found between the survival distribution of one- and two-pontic bridges (P = 0.66). The abutment teeth demonstrated stable probing depths and a negligible loss in attachment (0.1 mm/year). The satisfaction ratings were also favorable. CONCLUSIONS: The data seem to suggest that composite bonding of 1 or 2 teeth can be considered a semi-permanent rehabilitation for the replacement of 1 or 2 periodontally lost lower incisors. <35> UI - 99097374 AU - Malament KA AU - Socransky SS IN - Department of Graduate Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass, USA. TI - Survival of Dicor glass-ceramic dental restorations over 14 years: Part I. Survival of Dicor complete coverage restorations and effect of internal surface acid etching, tooth position, gender, and age. SO - Journal of Prosthetic Dentistry 1999 Jan;81(1):23-32 AB - STATEMENT OF PROBLEM: There are no long-term data on Dicor glass-ceramic restoration survival in the human oral cavity and the effect that different technical and clinical variables have on survival. PURPOSE: This prospective study examined the relationship of different clinical parameters on the survival of Dicor glass-ceramic restorations in the human oral cavity. MATERIAL AND METHODS: A total of 417 subjects (from 17 to 91 years of age) participated. All subjects required single unit fixed prosthodontics in any area of the mouth and/or 3-unit fixed partial dentures or cantilevered anterior restorations. They were offered the option of a gold or conventional metal-ceramic restoration, or a Dicor restoration with potentially improved esthetic results, better wear characteristics, and diminished oral plaque accumulation. Overall survival of the restorations was determined and the effect of various clinical parameters evaluated with Kaplan-Meier survival curves. Log rank tests were used to determine statistically significant differences among parameters. RESULTS: For the 1444 units placed, 188 failures were recorded. Total time at risk for the units was 7319 years providing an estimated risk of 2.45% per year. Probabilities of survival of "typical" acid-etched Dicor and nonacid-etched Dicor restorations were 76% and 50%, respectively, at 14.1 years (P <.001). Probabilities of survival of typical acid-etched and nonacid-etched Dicor complete coverage restorations were virtually identical to those observed in the full data set. There was a 2.2 times greater risk of failure associated with the use of nonacid-etched Dicor complete coverage than acid-etched restorations (P <.01). Complete coverage restoration survival was highest in the incisor region and decreased to the molars in both arches. Second molars showed the highest failure rate. No complete coverage restorations failed on lateral incisors during the entire study. Probability of survival of a typical acid-etched Dicor complete coverage restoration in male subjects was 71%, and 75% for female subjects at 14.1 years (P <.01). The major difference appeared to be due to a greater failure rate in the maxillary arch of the male. Survivor functions of acid-etched Dicor complete coverage restorations for subjects in <33 years, 33 to 52 years, and 52 years age groups were 88% at 9 years, 62% at 14 years, and 82% at 14 years, respectively. CONCLUSIONS: Dicor restorations can survive successfully over time with certain reservations. Long-term survival improved significantly when restorations were acid-etched before luting. Complete coverage restoration failures per year decreased from molars to incisors in both arches, suggesting that complete coverage restorations on molars represented a serious risk. No Dicor complete coverage restoration on lateral incisors failed during the study. Restorations failed less often in female than male subjects. <36> UI - 99160673 AU - Cortellini P AU - Stalpers G AU - Pini Prato G AU - Tonetti MS IN - University of Bern, Bern, Switzerland. TI - Long-term clinical outcomes of abutments treated with guided tissue regeneration. SO - Journal of Prosthetic Dentistry 1999 Mar;81(3):305-11 AB - STATEMENT OF PROBLEM: Guided tissue regeneration (GTR) is an efficacious and predictable treatment modality for deep intrabony defects around natural teeth and abutments. However, long-term prognosis of abutments treated with regeneration has to be proven. PURPOSE: This study investigated the long-term stability of clinical outcomes obtained with regeneration in strategically important abutments. MATERIAL AND METHODS: Sixteen deep intrabony defects around strategically important abutments in 16 patients were treated according to the principles of GTR. After completion of initial periodontal therapy and placement of long-term provisional fixed partial dentures, nonresorbable membranes were applied. Membranes were removed after 6 weeks. All patients remained in a supervised recall program. Final fixed partial dentures were placed 1 year after surgery. Clinical outcomes were evaluated at 1 year and then 4 to 8 years after surgery. RESULTS: Clinical attachment level gains of 5.3 +/- 1.8 mm, reductions in pocket depth (6.1 +/- 2 mm), and increases in the percentage of radiographic bone support (31% +/- 18%) were observed at 1 year. At long-term follow-up visits, clinical attachment levels remained stable with respect to 1 year (-0.1 +/- 0.6 mm; P =.4). The percentage of radiographic bone support slightly increased as compared with 1 year (1% +/- 3%, P =. 04), and pocket depths (0.8 +/- 0.8 mm, P =.004). CONCLUSIONS: This study indicated that tooth support can be gained with GTR and maintained over time in patients recalled regularly. <37> UI - 99122999 AU - Diaz-Arnold AM AU - Vargas MA AU - Haselton DR IN - University of Iowa, College of Dentistry, Iowa City 52242, USA. TI - Current status of luting agents for fixed prosthodontics. [Review] [92 refs] SO - Journal of Prosthetic Dentistry 1999 Feb;81(2):135-41 AB - STATEMENT OF THE PROBLEM: The long-term clinical outcome of fixed prosthodontic treatment depends, in part, on the use of adhesives that can provide an impervious seal between the restoration and the tooth. There are several types of available luting agents, each possessing unique properties and handling characteristics. No one product is ideal for every type of restoration. PURPOSE: The purpose of this article is to review available dental luting agents, discuss improvements and drawbacks in newly formulated adhesives, and present the indications for their use. RESULTS: Each cement type is physically and chemically unique. A single adhesive will not suffice in modern day clinical practice. [References: 92] <38> UI - 99128661 AU - Pollack RP IN - Department of Periodontology, Boston University School of Graduate Dentistry, Massachusetts, USA. TI - Non-crown and bridge stabilization of severely mobile, periodontally involved teeth. A 25-year perspective. SO - Dental Clinics of North America 1999 Jan;43(1):77-103 AB - It is the author's belief, after analyzing forces and stresses on the periodontium for more than 30 years, that stabilization of severely mobile teeth can retain teeth, if in health, almost indefinitely. Because these teeth are retained using restorative materials, recurrent caries is a problem that needs to be treated. Tooth loss resulting from caries can occur. In the author's 26 years of using extracoronal adhesive resins for splinting, the technology of adhesive bonding and restorative resins have been improved. Earlier shortcomings of the physical properties of these materials never dissuaded the author from recommending splinting. When the cases were presented to the patient and the referring dentist, the types of the current materials used to splint teeth were immaterial. Realizing that improvements in adhesives and resins would be developed, the near-hopeless teeth were retained. Because the elderly population is the fastest-growing segment of the population, caries control is more of a concern than it was 50 or more years ago. Because teeth are being retained longer in this cohort, and because caries has a greater potential to exist, supportive periodontal therapy and recalls and caries examination become more important. <39> UI - 99450261 AU - Palmer R AU - Howe L IN - Guy's Kings and St. Thomas' Medical and Dental School, London. TI - Dental implants. 3. Assessment of the dentition and treatment options for the replacement of missing teeth. SO - British Dental Journal 1999 Sep 11;187(5):247-55 <40> UI - 99459715 AU - Poi WR AU - Sonoda CK AU - Salineiro SL AU - Martin SC IN - Department of Surgery and Integrated Clinic, Faculty of Dentistry, Universidade Estadual Paulista-UNESP, Aracatuba, Sao Paulo, Brasil. TI - Treatment of root perforation by intentional reimplantation: a case report. SO - Endodontics & Dental Traumatology 1999 Jun;15(3):132-4 AB - Intentional reimplantation is defined as a procedure in which an intentional tooth extraction is performed followed by reinsertion of the extracted tooth into its own alveolus. In this paper, intentional reimplantation is described and discussed as a treatment approach to root canal instrument separation in conjunction with root perforation. An 8-year follow-up case report is presented. The reimplanted tooth is now a fixed bridge abutment. Although successful in this case, the intentional reimplantation procedure should be considered a treatment of last resort, that is, when another treatment option is not viable for the treatment of root perforation/instrument retrieval. <41> UI - 20000730 AU - Lekholm U AU - Gunne J AU - Henry P AU - Higuchi K AU - Linden U AU - Bergstrom C AU - van Steenberghe D IN - Branemark Clinic, Public Dental Health and Faculty of Odontology, University of Goteborg, Sweden. lekholm@odontologi.gu.se TI - Survival of the Branemark implant in partially edentulous jaws: a 10-year prospective multicenter study. SO - International Journal of Oral & Maxillofacial Implants 1999 Sep-Oct;14(5):639-45 AB - A total of 127 partially edentulous patients, treated according to the Branemark protocol, was followed for 10 years after completion of prosthetic treatment. The patients ranged in age from 18 to 70 years, and 57% were female. Four hundred sixty-one implants were placed in 56 maxillae and 71 mandibles. In 125 patients, 163 fixed partial prostheses were attached to the implants; a majority of the prostheses (83%) were located in posterior regions. At the end of the 10-year period, 73% of the implants could be traced either as failed or in function, providing cumulative implant survival rates of 90.2% and 93.7% for the maxilla and mandible, respectively. Of the original fixed prostheses, 63% (cumulatively 86.5%) were still in use, whereas the level of continuous cumulative prosthesis function, including primary and remade restorations, was 94.3% at the end of the evaluation period. Marginal bone resorption at the implants was low (mean = 0.7 mm), and mucosal health was good. No severe complications apart from the above-mentioned implant and prosthetic failures were reported. The Branemark Implant System is a safe and predictable method for restoring partially edentulous patients, as demonstrated by this 10-year follow-up investigation. <42> UI - 20000734 AU - Mericske-Stern R AU - Perren R AU - Raveh J IN - Department of Removable Prosthodontics, University of Bern, Switzerland. regina.mericske@zmk.unibe.ch TI - Life table analysis and clinical evaluation of oral implants supporting prostheses after resection of malignant tumors. SO - International Journal of Oral & Maxillofacial Implants 1999 Sep-Oct;14(5):673-80 AB - Seventeen mostly elderly patients, 13 men and 4 women, were consecutively admitted for implant-prosthodontic treatment after they had undergone resection of malignant tumors in the oral cavity. A total of 53 dental implants (ITI-Straumann) was placed, 12 in the maxilla, 41 in the mandible. The prosthetic rehabilitation consisted of overdenture therapy in 15 patients, and 2 patients were treated with fixed partial prostheses. Thirty-three implants were prescribed for patients who received radiotherapy either before or after implant placement. The average dose varied between 50 and 74 Gy. Eighteen implants were located in grafted bone from the fibula, scapula, or hip. For 2 patients, hyperbaric oxygen therapy was also prescribed after osteoradionecrosis had developed. One implant was lost before prosthetic loading. During an observation period of up to 7 years after loading, 3 more implants were removed. All implant losses occurred in the mandibles of patients who had received radiotherapy. A life table analysis was performed, and the cumulative survival rates, calculated for 2, 3, and 5 years, were 93%, 90%, and 90% respectively. No failures or complications were observed with technical components of the implants or prostheses. All prostheses could be maintained during the entire observation time. Although in the present investigation the survival rate of implants was slightly lower than under standard conditions, the treatment with implant-supported prostheses seemed to be advantageous for patients who had undergone intraoral resections. <43> UI - 20000741 AU - Isidor F AU - Brondum K AU - Hansen HJ AU - Jensen J AU - Sindet-Pedersen S IN - Department of Prosthetic Dentistry and Stomatognathic Physiology, Royal Dental College, University of Aarhus, Denmark. TI - Outcome of treatment with implant-retained dental prostheses in patients with Sjogren syndrome. SO - International Journal of Oral & Maxillofacial Implants 1999 Sep-Oct;14(5):736-43 AB - The purpose of this investigation was to evaluate the outcome of treatment with implant-retained prostheses in patients suffering from Sjogren syndrome. Eight women were included in the study; all had suffered oral symptoms of Sjogren syndrome for many years. Seven patients were edentulous in both arches, and 1 patient was edentulous in the maxilla only. All patients reported poor or very poor comfort levels with their conventional dentures. It was the intention to treat each arch that showed subjective and objective denture problems with a complete fixed prosthesis after placement of 6 implants. In all, 54 Branemark dental implants were placed in these patients. No implants were lost, but 7 implants in 4 patients were clinically not osseointegrated at the time of the abutment connection procedure. Because of nonosseointegrated implants and lack of jawbone, 3 arches were treated with an implant-retained overdenture. Fixed prostheses were made with a titanium framework of premachined components welded together (Procera) and acrylic resin teeth and flanges. Patients answered a questionnaire regarding their oral function before the onset of treatment and 1 month and 2 years after treatment. An average radiographic bone loss of 0.7 mm from the time of implant placement to 1 year after treatment was observed; additional bone loss of less than 0.6 mm was recorded 4 years after treatment. During the first year of function 2 implants lost osseointegration. No prostheses were lost or remade. Treatment with implant-retained prostheses considerably increased the prosthetic comfort and function of the patients. Two years after prosthetic treatment, only 1 patient indicated poor comfort of the prostheses, while the remaining patients reported good or very good comfort levels. <44> UI - 20018839 AU - Misch CE IN - University of Pittsburgh, School of Dental Medicine, Department of Surgical Sciences, USA. TI - Endosteal implants for posterior single tooth replacement: alternatives, indications, contraindications, and limitations. SO - Journal of Oral Implantology 1999;25(2):80-94 AB - Patients frequently need treatment to replace single teeth in the posterior regions. A number of different kinds of therapy have been used to treat this problem, including (1) removable partial denture, (2) acid-etched resin-retained prosthesis, (3) maintenance of the missing space, (4) a fixed partial denture, or (5) an implant-supported prosthesis. The purpose of this article is to assess the strengths and weaknesses of each of these treatments. The author concludes that single tooth implants are generally the best choice for dealing with a missing single tooth in the posterior regions of the mouth. <45> UI - 99121520 AU - Machuca G AU - Martinez F AU - Infante P AU - Machuca C AU - Bullon P IN - Department of Oral Medicine, Periodontics and Integrated Odontology, Faculty of Odontology, University of Seville, Spain. TI - Integrated orthodontic, surgical, and prosthodontic treatment of advanced malocclusion. SO - Quintessence International 1998 Oct;29(10):659-66 <46> UI - 99147297 AU - Wenz HJ AU - Lehmann KM IN - Department of Preclinical and Maxillofacial Prosthodontics, Marburg School of Dental Medicine, Philipps University, Germany. wenz@mailer.uni-marburg.de TI - A telescopic crown concept for the restoration of the partially edentulous arch: the Marburg double crown system. SO - International Journal of Prosthodontics 1998 Nov-Dec;11(6):541-50 AB - PURPOSE: This article describes the concept of the Marburg double crown system (MDC system) in the treatment of partially edentulous patients. Long-term success is assessed by a review of patient records. MATERIALS AND METHODS: Double crowns with clearance fit are used to retain tooth-, mucosa-, and implant-supported removable partial dentures (RPD). To achieve retention, an additional attachment, the TC-SNAP system, is used. All metal components are fabricated in a single cobalt-chromium-molybdenum alloy; the framework (including outer crowns) is cast in one piece. Because of the framework's rigidity, the RPD can be constructed without major and minor connectors. The denture base adjacent to the abutments is fabricated using a perioprotective design that is similar to fixed partial dentures. One hundred eleven dentures, of which 49 (44%) were fabricated for patients with intraoral defects, were evaluated by reviewing patient records. RESULTS: The mean age of the patients at the time of insertion was 57.5 years (+/- 12.3). The mean number of double crowns per denture was 3.5 +/- 2.1 (range, 1 to 9). The probability that a patient will have lost all abutment teeth 10 years after insertion of the denture is 4%. The probability that a patient will have kept all teeth that abut the denture 5 years after insertion is 87%; 10 years after insertion the probability is 80%. CONCLUSION: The Marburg double crown system is a versatile and successful means of achieving the long-term restoration of the partially edentulous jaw. Insertion and removal of the denture and routine oral hygiene are easy to perform, even for patients with limited manual dexterity. As a full-arch reconstruction, the MDC system enables easy adjustment, modification, and relining with low follow-up costs. <47> UI - 99147298 AU - Jemt T AU - Bergendal B AU - Arvidsson K AU - Bergendal T AU - Karlsson U AU - Linden B AU - Palmqvist S AU - Rundcrantz T AU - Bergstrom C IN - Prosthetic Division, Branemark Clinic, Public Dental Health, Goteborg, Sweden. torsten.jemt@odontologi.gu.se TI - Laser-welded titanium frameworks supported by implants in the edentulous maxilla: a 2-year prospective multicenter study. SO - International Journal of Prosthodontics 1998 Nov-Dec;11(6):551-7 AB - PURPOSE: The aim of this study was to evaluate the clinical and radiographic performance of patients who received implants and fixed prostheses with laser-welded titanium frameworks. MATERIALS AND METHODS: Fifty-eight consecutive patients were treated with 349 osseointegrated implants ad modum Branemark in the edentulous maxilla at 6 implant centers. The patients were randomly arranged into 2 groups at the time of final impression. Twenty-eight patients received laser-welded titanium frameworks and 30 patients received conventional cast frameworks. Clinical and radiographic data were collected for 2 years in function. RESULTS: The 2 groups of patients showed similar results. The 2-year overall cumulative implant survival rate from the time of implant placement and prosthesis insertion was 93.7% and 96.2%, respectively. The corresponding cumulative survival rate for prostheses was 96.6%. Two patients, 1 from each group, failed completely and resumed using conventional complete dentures. The only obvious factor that could possibly be related to the 2 complete failures was a smoking habit. However, it was not possible to significantly correlate implant failures to smoking habits in this study. No fractures were observed in the frameworks or implant components, and both groups experienced the same frequency of resin veneering material fractures. The overall average marginal bone loss was 0.4 mm (SD 0.8 mm). CONCLUSION: Patients treated with implant-supported prostheses fabricated with laser-welded titanium frameworks in the edentulous maxilla presented comparable results to patients with conventional cast frameworks after 2 years in function. <48> UI - 99147304 AU - Walton TR IN - University of Sydney, Faculty of Dentistry, Australia. twalton@mail.usyd.edu.au TI - The outcome of implant-supported fixed prostheses from the prosthodontic perspective: proposal for a classification protocol. SO - International Journal of Prosthodontics 1998 Nov-Dec;11(6):595-601 AB - PURPOSE: This article proposes a classification protocol for reporting the outcome of implant-supported fixed partial dentures. MATERIALS AND METHODS: A review of the literature revealed a contrast between the accepted criteria for assessing and presenting the outcome of osseointegrated implants and the deficient and misleading assessment and presentation of the outcome of the prostheses supported by these implants. A classification protocol comprising 6 well-defined fields with objective standards that accounts for retreatment as well as failure is proposed. This protocol has been applied where possible to reports on the outcome of fixed partial dentures in several published articles. RESULTS: In all cases there was a stark difference between the authors' claims of success and the outcome according to the 6-field protocol. It is accepted that the outcome of a given prosthesis does not necessarily correspond to the outcome of the overall prosthodontic treatment, as the latter also involves an assessment of outcome as perceived by the patient and accounts for planned revisions. CONCLUSION: If adopted, the proposed protocol would allow meaningful comparisons between prosthesis designs and between different implant systems' capacities to support such designs. It would also assist in evaluating the cost-effectiveness of implant-supported treatments. <49> UI - 99061365 AU - Ormianer Z AU - Gross M IN - Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel. TI - A 2-year follow-up of mandibular posture following an increase in occlusal vertical dimension beyond the clinical rest position with fixed restorations. SO - Journal of Oral Rehabilitation 1998 Nov;25(11):877-83 AB - While resting mandibular posture is continuously changing, repeatable relations of 'physiologic rest position' (PRP) and 'clinical rest position' (CRP) are described in the literature. The PRP is defined as a position of minimal muscle activity and CRP as a more closed clinical reference relation. Relaxed resting posture (RRP) is a repeatable postural range obtained by operator-induced relaxation techniques. This article reports on measurements of mandibular posture in a patient group following an increase in occlusal vertical dimension (OVD) with fixed restorations beyond CRP over 2 years. The relationship of CRP and RRP in the restored and a non-restored control group is compared. The relationship of RRP and corresponding masseteric EMG values to baseline minimal EMG levels is reported for both groups. Resting face height adapted to the increased OVD and remained consistent over 1 and 2 years. The RRP was greater and significantly different from CRP in both groups (P = 0.0001). Results indicated that both CRP and RRP were postural ranges and not specific postural positions. The RRP occurred at minimum baseline EMG levels for both groups and appears to be consistent with physiologic rest position. The possibility of achieving minimal EMG levels at varying interocclusal rest space relations is discussed. <50> UI - 99052528 AU - Mayfield L AU - Skoglund A AU - Nobreus N AU - Attstrom R IN - Faculty of Odontology, Lund University, Malmo, Sweden. TI - Clinical and radiographic evaluation, following delivery of fixed reconstructions, at GBR treated titanium fixtures. SO - Clinical Oral Implants Research 1998 Oct;9(5):292-302 AB - Conditions following incorporation of fixed reconstructions, at endosseous titanium implants augmented at local bony dehiscence and fenestration defects using a bioabsorbable Resolut membrane were studied in 7 patients. Fixture stability, radiographic marginal bone levels and peri-implant soft tissue status were evaluated at 21 membrane treated and 17 control fixtures (installed in regions of adequate bone volume), following a 2-year period of functional loading. Prosthetic reconstructions were removed and clinical examination and Periotest values revealed that all fixtures were stable. All peri-implant soft tissues were clinically healthy. The mean probing depths at buccal sites for fixtures with original dehiscence (n = 10) and fenestration (n = 11) defects were 1.6 +/- 0.7 mm and 1.2 +/- 0.4 mm respectively. The control fixture group had a mean buccal probing depth of 1.4 +/- 0.6 mm. At abutment connection radiograph membrane treated fixtures had significantly lower marginal bone levels than control fixtures, indicating that optimal bone regeneration was not achieved at all defects. Mean radiographic bone loss 23-27 months following delivery of fixed reconstructions for original dehiscence and fenestration defect fixtures was 0.7 +/- 0.8 mm and 0.8 +/- 0.6 mm respectively at mesial surfaces, and 0.8 +/- 0.7 mm and 0.6 +/- 0.5 mm at distal surfaces. In the control fixture group a mean loss of 0.7 +/- 0.5 mm at mesial surfaces and 0.5 +/- 0.4 mm at distal surfaces was found. Results showed no significant difference in the rate of bone loss following functional loading between membrane treated and control fixtures. <51> UI - 99052531 AU - Kaptein ML AU - Hoogstraten J AU - de Putter C AU - de Lange GL AU - Blijdorp PA IN - Sub-Department of Psychological Methods/Social Dentistry and Information, University of Amsterdam, The Netherlands. TI - Dental implants in the atrophic maxilla: measurements of patients' satisfaction and treatment experience. SO - Clinical Oral Implants Research 1998 Oct;9(5):321-6 AB - Maxillary bone reconstruction in combination with placement of dental implants is a treatment modality reported since 1980 for patients suffering from maxillary atrophy and difficulties with wearing removable prosthesis. This study reports on patient experience and satisfaction among 88 consecutive patients concerning surgical and prosthetic aspects of their treatment. A questionnaire was used to gather the data. Patient satisfaction was measured on a scale from 1 to 5 (1 = bad/few, 5 = very good/much). The satisfaction index with regard to the total treatment was 4.1 +/- 0.9. A total of 90% of the patients responded that they would go through the treatment again or recommend the treatment to a friend if necessary. The post-operative pain index scored 2.6 +/- 1.2. The acceptation of the post-operative pain at the crista iliaca was 86.1% and of the maxilla 89.9%. It is concluded that the results of measurements of patient satisfaction after maxillary bone reconstruction in combination with placement of dental implants were acceptable. <52> UI - 99052534 AU - Nordin T AU - Jonsson G AU - Nelvig P AU - Rasmusson L IN - Department of Oral and Maxillofacial Surgery, Sundsvall Hospital, Sweden. TI - The use of a conical fixture design for fixed partial prostheses. A preliminary report. SO - Clinical Oral Implants Research 1998 Oct;9(5):343-7 AB - A specially designed, TiO2-blasted titanium fixture, partially conical and microthreaded, the Astra Tech Fixture ST, was used for rehabilitation of partial edentulism in the posterior mandible. Superior to the mandibular canal 25 fixtures were placed in 10 patients. Fixed metal-ceramic bridges were then performed. After 1-year follow-up, all bridges were found to be clinically stable. The implant survival rate was 100% and the mean marginal bone resorption was 0.05 +/- 0.11 mm. <53> UI - 99060967 AU - Kaptein ML AU - de Putter C AU - de Lange GL AU - Blijdorp PA IN - Department of Oral Maxillofacial Surgery, Prosthodontics and Special Dental Care, Faculty of Medicine, University of Utrecht, The Netherlands. TI - Survival of cylindrical implants in composite grafted maxillary sinuses. SO - Journal of Oral & Maxillofacial Surgery 1998 Dec;56(12):1376-80; discussion 1380-1 AB - PURPOSE: This retrospective study investigated the survival of dental implants placed in the maxilla after composite grafting of the sinus and an average of 55 months of loading. PATIENTS AND METHODS: Maxillary sinuses of 88 patients were grafted with autogenous cancellous bone combined with dense hydroxyapatite particles. After an average healing period of 3.4 months, hydroxyapatite-coated titanium endosseous implants were placed. A total of 388 implants were placed in grafted sinus floors, and 82 were placed in onlay grafted nonsinus position in the canine region. The implants were loaded with overdentures and fixed bridges 4 months (mean) after implantation, with a follow-up for a mean of 55 months. RESULTS: The cumulative implant survival was calculated according to the Kaplan-Meier method. Implant survival from the time of loading was 89% in full reconstructed cases and 90% in partially edentulous cases. The overall cumulative implant survival rate, including the loss in the surgical stage, was 82%. CONCLUSION: Implant loss in composite grafted maxillae after 70 months of follow-up was similar to loss in nongrafted maxillae. <54> UI - 98453130 AU - Akiyama Y AU - Fukuda H AU - Hashimoto K IN - Department of Dentistry and Oral Surgery, Hitachi Taga Hospital, Hitachi-city, Japan. TI - A clinical and radiographic study of 25 autotransplanted third molars. SO - Journal of Oral Rehabilitation 1998 Aug;25(8):640-4 AB - This paper is a report on 25 autotransplantations of third molars with complete root formations. The study consists of 23 patients in whom 25 third molars were transplanted. The mean age was 29.6 years (range 20-54). In nine cases third molars were directly transplanted into the new socket. In 11 cases the sockets were widened and made deeper with a bur. In five cases the recipient beds were made by splitting osteotomy of the alveolar region. The transplanted third molars were stabilized with silk sutures, resin, wire splint or circumferential wiring for 1-6 weeks. Two-three weeks after transplantation, the root canals were treated and filled. After operation, the marginal and the periapical conditions were examined clinically and radiographically. The transplanted teeth clinically appeared to become firmer with the passage of time. Progressive root resorption was not found and good results were obtained. This study shows that autotransplantation of third molars with complete root formation produces an acceptable result using the procedures outlined. <55> UI - 99007997 AU - Trier AC AU - Parker MH AU - Cameron SM AU - Brousseau JS IN - U.S. Army Dental Activity, Fort Gordon, Ga., USA. TI - Evaluation of resistance form of dislodged crowns and retainers. SO - Journal of Prosthetic Dentistry 1998 Oct;80(4):405-9 AB - STATEMENT OF PROBLEM: The concept of limiting taper has been described as a boundary between tapers that do and those that do not provide resistance form for a preparation. There is controversy as to whether this boundary that divides preparations with from those without resistance form translates clinically into a boundary for success. PURPOSE: This investigation evaluated the resistance form of abutments of crowns or retainers that have been dislodged to determine the clinical correlation between restoration dislodgment and lack of resistance form in the preparation. MATERIAL AND METHODS: Dies were fabricated from single crowns and retainers of fixed partial dentures that came loose and evaluated for resistance form. A total of 44 abutments were evaluated and included 1 incisor, 15 premolars, and 28 molars. Data from a previous study on the percentage of abutments lacking resistance form for restorations leaving a large dental laboratory was used for comparative statistical tests. RESULTS: Forty-two of the 44 abutments (95%) lacked resistance form. All molar abutments and 93% of premolar abutments lacked resistance form in one or more directions. The one incisor abutment did not lack resistance form. Chi-square test revealed a statistically significant difference in the percentage lacking resistance form between the group composed of clinical failure (uncemented crowns) and the group leaving a dental laboratory with P = .0005 for the molars, and P = .0005 for the premolars. CONCLUSION: The clinical dislodgment of cast restorations is associated with the lack of resistance form in the preparations. In this study, there was a relationship between clinical success or failure and the all-or-none nature of resistance form; dislodged crowns come almost exclusively from preparations with tapers that did not provide resistance form. <56> UI - 98452138 AU - Cho JY IN - Baylor College of Dentistry, Dallas, Texas 75246, USA. TI - The periodontist and the edentulous area--localised ridge augmentation. [Review] [17 refs] SO - International Dental Journal 1998 Jun;48(3 Suppl 1):326-9 AB - The replacement of missing dentition by implant-borne dental restoration has been shown to be a highly predictable treatment method with good long-term prognosis. Subsequently, the use of implant-borne restorations has gradually increased over the use of conventional partial dentures and fixed restorations in recent years. Sufficient bone volume is the most important factor for successful implant-borne restoration, but often an insufficient amount of bone is found at implant sites. A new surgical approach to enlarge the width of alveolar crest was introduced by Buser et al. in 1996. This new approach is based on the principle of guided bone regeneration technique using a barrier membrane with autogenous bone grafts in the form of bone blocks, chips and particles. This promising new surgical technique allows placement of dental implants for implant-borne restorations in partially edentulous patients who were previously not considered to be implant candidates because of insufficient bone at the implant sites. [References: 17] <57> UI - 99024234 AU - Petropoulos VC AU - Weintraub A AU - Weintraub GS IN - University of Pennsylvania School of Dental Medicine, Dept. of Restorative Dentistry, Philadelphia 19104-6003, USA. TI - Predoctoral fixed prosthodontics curriculum survey. SO - Journal of Prosthodontics 1998 Sep;7(3):183-91 AB - PURPOSE: In 1996, a survey of American dental schools was conducted. The purpose of the survey was to determine the curricular structure, techniques taught, and materials used in predoctoral fixed prosthodontics courses. MATERIALS AND METHODS: The survey was mailed to the course directors of predoctoral fixed prosthodontic programs at 53 American dental schools. Of these, 42 schools returned the completed survey, resulting in a response rate of 79%. The mean, median, and the range of responses were computed where applicable. RESULTS: The results from this survey show that the mean student-to-faculty ratio in the preclinical course was 11:1, with a median of 10:1 and a range of 5:1 to 25:1. The mean number of laboratory clock hours was 164, with a median of 148 and a range of 81 to 288. The mean number of lecture hours reported was 42, with a median of 35 and a range of 20 to 80. Fifty-five percent of the schools used the Hanau semiadjustable articulator. The most commonly used provisional technique was the thermoplastic custom external surface form (44%). The finish line of choice for the full metal restoration was the chamfer placed circumferentially (74%). The finish line of choice for the porcelain-fused-to-metal restoration was the shoulder placed facially and the chamfer placed lingually (38%). CONCLUSIONS: Predoctoral fixed prosthodontics education and technical experience varies from school to school, yet a large percentage of schools agree on certain topics. <58> UI - 99040437 AU - Ganz SD IN - University of Pennsylvania School of Dental Medicine, USA. SDGimplant@aol.com TI - The replacement of a unilateral partial denture with an implant-supported fixed prosthesis: a clinical report. SO - Implant Dentistry 1998;7(3):159-65 AB - Various treatment options have been advocated to restore short span edentulous spaces. For a single edentulous space, some clinicians have advocated the use of a unilateral removable partial denture because this design has certain advantages for the patient, and it does not require the preparation of adjacent teeth for the fabrication of a fixed partial denture. However, potentially serious consequences associated with this design type have been reported. The unilateral partial denture can become dislodged, swallowed, or aspirated, which can result in hospitalization, perforation of the gastrointestinal tract, possibly followed by surgical intervention to retrieve the prosthesis. Although an implant-supported single tooth replacement has been widely accepted and documented as a predictable treatment alternative, few clinical cases present have been presented in which potential severe iatrogenic damage can be so easily avoided. A treatment alternative that avoids potential hazards inherent in the design of a unilateral partial denture has been presented in this article. <59> UI - 99012567 AU - Rossein K TI - A predictable technique in removing permanently cemented restorations. SO - Dentistry Today 1998 May;17(5):92-3 <60> UI - 98387553 AU - Studer SP AU - Mader C AU - Stahel W AU - Scharer P IN - Department of Fixed and Removable Prosthodontics and Dental Materials, School of Dental Medicine, Zurich University, Switzerland. TI - A retrospective study of combined fixed-removable reconstructions with their analysis of failures. SO - Journal of Oral Rehabilitation 1998 Jul;25(7):513-26 AB - The survival rate and the reasons for failures of 130 combined fixed-removable reconstructions (CFR), incorporated in 112 patients, were assessed. Each CFR reconstruction was classified depending on its attachments: 76 reconstructions were attached with rigid, precise attachments, and constituted the rigid group; 54 reconstructions were attached with either semi-precision or individual attachments and were defined as the semi-rigid group. Of the 130 reconstructions, 41 were determined as complete successes, 39 as partial successes and 50 as failures, leading to 37 major repairs and to 13 new reconstructions. Three reconstructions failed due to technical reasons, 36 due to biological reasons and for 11 reconstructions, both categories of reasons were responsible for their failure. In total, technical reasons were counted 15 times in comparison to 73 biological reasons for those 50 failed reconstruction, with 29 fractured abutment teeth as the most common biological reason. Within the rigid group, 45 failed reconstructions were observed, whereas within the semi rigid group only 5 failures occurred, leading to an 8-year survival estimate (+/- SD) of 30.1% (+/- 6.9%) for the rigid group and 93.1% (+/- 3.9%) for the semi rigid group. Beside the attachment type, the anatomy of the partially edentulous tooth arch in form of the free-end situation and the dentate opposing jaw were identified as risk factors. <61> UI - 98320284 AU - Budtz-Jorgensen E AU - Bochet G IN - Division of Gerodontology and Prosthodontics, Section of Dental Medicine, University of Geneva, Switzerland. TI - Alternate framework designs for removable partial dentures. [Review] [58 refs] SO - Journal of Prosthetic Dentistry 1998 Jul;80(1):58-66 AB - STATEMENT OF PROBLEM: The removable partial denture is usually less appreciated than the fixed partial denture by both patients and prosthodontists. This negative attitude could be due to problems associated with the wearing of a removable partial denture and concern essentially with comfort, esthetics, masticatory function, occlusal stability, and maintenance of oral hygiene. Such problems could be limited if treatment planning is made carefully, according to simplified and logical principles for framework design, and if oral hygiene and the fit of the dentures are regularly controlled. PURPOSE: This article reviews the factors associated with the prognosis of treatment with removable partial dentures. Furthermore, the article describes framework design applied in different clinical situations and compares them with more conventional designs. It seems important to consider a framework design that privileges comfort, esthetics, and oral hygiene rather than to follow mechanical rules that are entirely theoretical and have not been confirmed scientifically or clinically. [References: 58] <62> UI - 98433647 AU - Robbins JW IN - University of Texas Health Science Center at San Antonio, Dental School, Department of General Dentistry 78284-7914, USA. TI - Intraoral repair of the fractured porcelain restoration. [Review] [25 refs] SO - Operative Dentistry 1998 Jul-Aug;23(4):203-7 AB - Until recently, there was no predictable technique for repairing the fractured porcelain restoration. However, with the advent of many new products related to bonding porcelain, there are techniques available today to repair fractured porcelain with moderate expectations of success. [References: 25] <63> UI - 98376681 AU - Schlumberger TL AU - Bowley JF AU - Maze GI IN - University of Nebraska Medical Center College of Dentistry, Lincoln, USA. TI - Intrusion phenomenon in combination tooth-implant restorations: a review of the literature. [Review] [29 refs] SO - Journal of Prosthetic Dentistry 1998 Aug;80(2):199-203 AB - STATEMENT OF PROBLEM: Controversy regarding the connection of implants to natural teeth in fixed partial dentures has emerged in response to clinical reports of intrusion of the natural teeth. Although theories have been proposed to explain this phenomenon, the cause of the intrusion remains unknown. Numerous longitudinal studies have demonstrated that teeth can be successfully connected to implants. The use of rigid connectors, or nonrigid connectors with the keyway on the implant, are described as mechanisms to prevent intrusion of the natural tooth. PURPOSE: This article reviews the literature that pertains to this subject and includes treatment modalities that may be helpful in preventing intrusion. [References: 29] <64> UI - 98433621 AU - Arvidson K AU - Bystedt H AU - Frykholm A AU - von Konow L AU - Lothigius E IN - Department of Prosthetic Dentistry, Faculty of Odontology, Karolinska Institutet, Stockholm, Sweden. TI - Five-year prospective follow-up report of the Astra Tech Dental Implant System in the treatment of edentulous mandibles. SO - Clinical Oral Implants Research 1998 Aug;9(4):225-34 AB - This report of the 1st 2 prospective studies using the Astra Tech Implant System and fixed detachable bridges for rehabilitation of mandibular edentulism, presents clinical and radiographic data at the 5-year follow-up. The original material comprised 109 subjects, 56 of whom had been included in the original study, using the 1st generation Astra Tech Implant. Two subjects were excluded and the 3-year follow-up report was based on the remaining 54 subjects and 310 fixtures. After some minor changes to the fixture and the abutment, the 2nd generation Astra Tech Implant was used in 53 subjects and 308 fixtures. In all 16 subjects were lost to follow-up and the 5-year results are based on the remaining 91 subjects with 517 fixtures in function: 5 fixtures were lost due to mobility at abutment installation and during the 1st year, 2 fixtures were removed due to pain, and after 4 years in situ 1 fixture failed. As no clinical or radiographic differences were obvious in the annual registrations of the 2 studies the results have been combined. The fixed bridges were removed at 3 and 5 years to test each fixture and none was mobile. The cumulative fixture survival rate at 5 years was 98.7% and the bridge survival rate was 100%. Of the sites 82% were plaque free, and 96.8% showed no signs of inflammation. Over the 5-year period after bridge insertion, i.e. from baseline registration, there was only minor deterioration in marginal bone levels as measured on standardized intraoral radiographs: the mean differences in mm and standard deviations (SD) were -0.09 (0.27) in the 1st year, -0.20 (0.40) in the 3rd year, and -0.26 (0.53) in the 5th year. According to the stringent clinical and radiographic criteria by Albrektsson and co-workers, the successful treatment outcome and the survival rate in 91 subject over 5 years, indicates that the Astra Tech Dental Implant System with fixed detachable bridges is an appropriate method for rehabilitation of mandibular edentulism. <65> UI - 98433622 AU - Karlsson U AU - Gotfredsen K AU - Olsson C IN - Department of Prosthodontics, Norrkoping, Sweden. TI - A 2-year report on maxillary and mandibular fixed partial dentures supported by Astra Tech dental implants. A comparison of 2 implants with different surface textures. SO - Clinical Oral Implants Research 1998 Aug;9(4):235-42 AB - In 50 partially edentulous patients, 133 (48 maxillary; 85 mandibular) Astra Tech dental implants of 2 different surface textures (machined; TiO-blasted) were alternately installed, supporting 52 fixed partial dentures (FPDs). Before abutment connection 2 machined implants (1 mandibular; 1 maxillary) were found to be non-osseointegrated and were replaced. Another implant could not be restored due to a technical complication. Two FPDs were remade because of technical complications, both because of abutment fractures. Thus, after 2 years in function, the cumulative survival rates were 97.7% and 95.7% for implants and prostheses, respectively. There was no statistically significant difference in survival rate between the 2 types of implants, 100% (TiO-blasted) vs 95.3% (machined), P = 0.24. After 2 years in function, when both jaw and type of implants were combined, the mean (SD) marginal bone loss was 0.24 (0.69) mm. No statistically significant difference in bone loss was found between the 2 types of implant after 2 years of loading, 0.04 (0.82) mm, P > 0.30. <66> UI - 98376680 AU - Watson R AU - Marinello C AU - Kjellman O AU - Rundcrantz T AU - Fahraeus J AU - Lithner B IN - Department of Prosthetic Dentistry, King's Dental Institute, King's College School of Medicine and Dentistry, London, United Kingdom. TI - Do healing abutments influence the outcome of implant treatment? A three-year multicenter study. SO - Journal of Prosthetic Dentistry 1998 Aug;80(2):193-8 AB - STATEMENT OF THE PROBLEM: It is not known if healing abutments replaced subsequently with permanent abutments adversely affect the soft tissues and marginal bone levels around dental implants. PURPOSE: This study evaluated the mucosal condition and marginal bone levels 3 years after placement of healing abutments in patients provided with fixed prostheses supported by Branemark implants. MATERIAL AND METHODS: Data were analyzed retrospectively from 117 patients treated at five centers in which 318 healing abutments were placed on maxillary and 112 on mandibular implants. A prospective 3-year appraisal with a specific protocol assessed the response of mucosal cuffs and marginal bone levels surrounding surviving implants. RESULTS: Exchange of abutments did not affect expected survival rates of implants (94% maxilla, 99% mandible) or produce mean levels of marginal bone loss greater than anticipated for the system. Mean marginal bone levels correlated significantly with the jaw. Most patients achieved good oral hygiene and favorable peri-implant soft tissue health. CONCLUSION: No evidence was found to suggest abutment exchange adversely affects outcome of implant treatment. <67> UI - 98380741 AU - Shugars DA AU - Bader JD AU - White BA AU - Scurria MS AU - Hayden WJ Jr AU - Garcia RI IN - Department of Operative Dentistry, University of North Carolina School of Dentistry, Chapel Hill 27599-7450, USA. TI - Survival rates of teeth adjacent to treated and untreated posterior bounded edentulous spaces [see comments]. CM - Comment in: J Am Dent Assoc 1998 Nov;129(11):1522 SO - Journal of the American Dental Association 1998 Aug;129(8):1089-95 AB - It is widely assumed that if posterior bounded edentulous spaces, or BESs, are not treated, the adjacent teeth ultimately will be lost. The authors examined this assumption by determining the survival of teeth adjoining 569 treated and untreated BESs. In the short term, the assumption was not supported. The great majority of untreated BESs did not result in loss of an adjacent tooth. Treatment with a removable partial denture did not increase the likelihood of adjacent tooth survival, while treatment with a fixed partial denture did result in modestly improved survival of adjacent teeth. <68> UI - 98364584 AU - Creugers NH AU - De Kanter RJ AU - Verzijden CW AU - Van't Hof MA IN - Department of Occlusal Reconstruction and Oral Function, College of Dental Science, Medical Faculty, University of Nijmegen, The Netherlands. n.creugers@dent.kun.nl TI - Risk factors and multiple failures in posterior resin-bonded bridges in a 5-year multi-practice clinical trial. SO - Journal of Dentistry 1998 Jul-Aug;26(5-6):397-402 AB - OBJECTIVES: A randomized controlled clinical trial was undertaken, to study the influence of some patient- and operator-dependent variables on the survival of posterior resin-bonded bridges (PRBBs) and to assess the survival of replacement' PRBBs. This report contains some of the results of the 5-year analysis. METHODS: Survival was defined at three levels: (1) complete survival (without any debonding), (2) functional survival (i.e. survival after one loss of retention) and (3) replacement survival (survival of 'replacement' PRBBs, inserted after rebonded bridges suffered a second dislodgement). Potential risk factors were analysed with Cox's proportional hazards model and differences were tested for significance with the Breslow test. Observed effects are expressed as conditional-relative-risk (CRR). Survival of 'replacement' PRBBs was assessed with the Kaplan-Meier method. RESULTS: Factors showing significant influences on complete survival were: 'location' (highest risk for mandibular PRBBs: CRR = 2.2), 'aetiology' (higher risk in treatment of aplasia: CRR = 2.9), and 'time of existence' (open spaces existing less than 2 years before insertion of PRBB: CRR: 2.0). The factor 'large open spaces in the mandible' was a risk for both complete and functional survival (CCR values 3.1 and 3.5, respectively). The survival of mandibular and maxillary 'replacement' PRBBs after 5 years was 19 +/- 7% and 31 +/- 18%, respectively. CONCLUSIONS: Risk factors for PRBBs were: 'location', 'aetiology', 'time of existence', 'isolation method' and 'large open spaces in the mandible'. Mandibular 'replacement' PRBBs showed such an unacceptably low survival rate that fabrication is not recommended. <69> UI - 98310364 AU - Hakestam U IN - Department of Prosthetic Dentistry, Lund University, Malmo, Sweden. TI - On the prosthodontic patient. An investigation of factors influencing patient expectations and satisfaction with extensive prosthodontic care. SO - Swedish Dental Journal - Supplement 1998;128:1-53 <70> UI - 98291370 AU - Galindo D AU - Soltys JL AU - Graser GN IN - Department of Prosthodontics, University of Rochester Eastman Dental Center, N.Y., USA. TI - Long-term reinforced fixed provisional restorations. SO - Journal of Prosthetic Dentistry 1998 Jun;79(6):698-701 AB - Extensive prosthodontic treatment often requires fabrication of long-term provisional restorations. Numerous materials and techniques have been described for prolonged insertion of interim restorations. This article describes a procedure for fabrication of long-term reinforced heat-processed provisional restorations based on a diagnostic wax-up. Reinforced heat-processed provisional restorations reduced flexure, which minimizes progressive loss of cement and diminished the possibility of recurrent decay. Occlusal stability and vertical dimension were maintained because of greater wear resistance. Occlusion, tooth contours, and pontic design developed in the provisional restoration were duplicated in the definitive restoration. The use of a matrix from a diagnostic wax-up facilitated fabrication of the prosthesis, and made the procedure less time-consuming and more predictable. <71> UI - 98375380 AU - Sorensen JA AU - Kang SK AU - Torres TJ AU - Knode H IN - Oregon Health Sciences University, School of Dentistry, Portland 97201-3097, USA. TI - In-Ceram fixed partial dentures: three-year clinical trial results. SO - Journal of the California Dental Association 1998 Mar;26(3):207-14 AB - In-Ceram is a sintered, high-alumina-content, glass-infiltrated ceramic core material reported to have sufficient strength for all-ceramic fixed partial dentures. While Vita/Vident recommends that In-Ceram should be used only for anterior FPDs, the purpose of this study was to push the sintered alumina material to its limits by testing posterior FPDs with premolar and molar pontics. This prospective clinical trial tested the longevity of 61 three-unit In-Ceram alumina FPDs. The failed specimens were analyzed to determine factors contributing to failure. The abutment teeth were prepared for full crown retainers with shoulder margins and 1.3 mm of axial reduction. All FPDs were cemented with an encapsulated glass ionomer. None of the patients reported postcementation sensitivity. During the three-year period, seven FPDs fractured through the connector area. By location of the pontic, failure rates were 0 percent for anteriors, 11 percent for premolars and 24 percent for molars. Based on the results of this clinical study at the three-year point, In-Ceram alumina can be reliably utilized for anterior FPDs as indicated by a 100 percent success rate. The findings do not support the use of In-Ceram alumina for posterior FPDs as was advised by the porcelain manufacturer. Glass ionomer cement can be predictably used to cement In-Ceram FPDs with few clinical side effects. Because of a technological malfunction, this article could not be presented with the others on ceramic restorations that appeared in the February issue. <72> UI - 98375327 AU - Smedberg JI AU - Ekenback J AU - Lothigius E AU - Arvidson K IN - Department of Prosthetic Dentistry, St Erik Hospital, Stockholm, Sweden. JI.Smedberg@protetik.Pl.se TI - Two-year follow-up study of Procera-ceramic fixed partial dentures. SO - International Journal of Prosthodontics 1998 Mar-Apr;11(2):145-9 AB - PURPOSE: The aim of this prospective study was to determine whether a machine-fabricated titanium fixed partial denture veneered with a low-temperature fused porcelain is an acceptable treatment modality. MATERIALS AND METHODS: The study originally included 25 patients with 37 fixed partial dentures of three to seven units, with a total of 151 units including 98 abutments. A clinical examination using the California Dental Association quality evaluation system and radiologic examination and registration of complications was conducted at the time of insertion and after 1 and 2 years. RESULTS: After 2 years, 123 units (including 80 abutments) remained for examination. Twenty-eight units (including 18 abutments) were lost during the follow-up period. The losses were because of drop-out (eight cases), root fracture (two cases), caries (six cases), and periodontitis (two cases). One fixed partial denture fractured after 18 months and was therefore remade. In all, porcelain fractures occurred in two patients, both with severe parafunctional habits. At baseline, the California Dental Association rating system for marginal integrity was "excellent" for 72 abutments and "acceptable" for 26 abutments. At the 2-year follow-up the corresponding rating was "excellent" for 46 abutments, "acceptable" for 30 abutments, and "not acceptable" for four abutments. The latter marginal defects were corrected with restorations. For surface and color the corresponding ratings were "excellent" for 137 units and "acceptable" for 14 units at baseline, and "excellent" for 80 units and "acceptable" for 43 units at the 2-year follow-up. Bleeding index increased from 24% at baseline to 33% after 2 years. CONCLUSION: The study confirms that for an observation period of 2 years, fixed partial dentures made by the Procera method seem to be an acceptable treatment modality. They are a suitable alternative to fixed partial dentures with porcelain fused to high-noble alloys. <73> UI - 98375325 AU - Lindquist E AU - Karlsson S IN - Department of Prosthetic Dentistry, Faculty of Odontology, Goteborg University, Sweden. TI - Success rate and failures for fixed partial dentures after 20 years of service: Part I. SO - International Journal of Prosthodontics 1998 Mar-Apr;11(2):133-8 AB - PURPOSE: The objective of this study was to identify failures and to assess rate for fixed partial dentures constructed 20 years earlier by general practitioners in Sweden. MATERIALS AND METHODS: The original group consisted of 164 patients who had received prosthodontic treatment in 1974 comprising fixed partial dentures with at least five units. They had all been selected at random from the files of the Swedish Federal Dental Insurance Register. Twenty years later, 98 of them could be located and 72 of them agreed to participate in a clinical examination. The majority of drop-outs of the original group had died, could not be traced, or could not participate because of medical reasons. The examination focused on removed prostheses and/or units and a number of other clinically valid variables that will be reported in a forthcoming article. The 26 patients not participating in the clinical examination were interviewed by telephone. RESULTS: The examined participants had a total of 140 fixed partial dentures, 557 retainers, and 383 pontics still in service. When the number of failed and removed prostheses was calculated, a cumulative success rate of 65% was found, i.e., one third had been lost since 1974. There was no difference in failures between fixed partial dentures with or without cantilevers during the previous 8 years compared to the first 12 years in service. Loss of retention together with periodontal and esthetic problems, wear, and discoloration of acrylic veneers were the most frequently reported reasons for removal. CONCLUSIONS: The cumulative success rate for fixed partial dentures placed in 1974 was 65%. Failed prostheses had in most cases been replaced by a new fixed partial denture. <74> UI - 98358518 AU - Andersson M AU - Razzoog ME AU - Oden A AU - Hegenbarth EA AU - Lang BR IN - Department of Prosthodontics, School of Dentistry, University of Michigan, Ann Arbor 48109, USA. TI - Procera: a new way to achieve an all-ceramic crown. [Review] [32 refs] SO - Quintessence International 1998 May;29(5):285-96 AB - The Procera System embraces the concept of computer-assisted design and computer-assisted machining to fabricate an all-ceramic crown composed of a densely sintered, high-purity aluminum oxide coping combined with a compatible veneering porcelain. Strength, precision of fit, color stability, cementation, and wear characteristics are among the many factors that concern clinicians when fabricating all-ceramic restorations with this new crown system. This article presents, in summary form, the data from the many studies on Procera AllCeram crowns that have been conducted at clinical and laboratory centers around the world. The evidence reported in these studies clearly demonstrates that the Procera AllCeram crown represents a combination of computer technology and creativity for which a positive prognosis can be made. Today its application is restricted to single crowns; however, with continued development, multiple unit all-ceramic anterior and posterior fixed partial dentures are clearly in the future. [References: 32] <75> UI - 98301852 AU - Preiskel HW AU - Tsolka P IN - United Medical School of Guy's, London, United Kingdom. TI - Telescopic prostheses for implants. SO - International Journal of Oral & Maxillofacial Implants 1998 May-Jun;13(3):352-7 AB - This retrospective study investigated the outcome of 73 telescopic implant-supported fixed prostheses. Fifty-four prostheses were entirely cement-retained, and 19 incorporated a screw-clamping unit. The rate of complications was low and in most cases minor in nature. Cement-retained prostheses involving a distal cantilevered extension required the greatest postoperative maintenance. Despite the small number of combined screw- and cement-retained prostheses, the lack of complications and ease of retrievability make this approach worthy of further study. <76> UI - 98272406 AU - Soderfeldt B AU - Palmqvist S IN - Centre for Oral Health Sciences, Lund University, Malmo, Sweden. TI - A multilevel analysis of factors affecting the longevity of fixed partial dentures, retainers and abutments. SO - Journal of Oral Rehabilitation 1998 Apr;25(4):245-52 AB - There is a methodological problem in analysis of data belonging to different hierarchical levels, e.g. patient, arch, and tooth. A method for multilevel modelling (MLM) that resolves this problem is available. This method which is presented in this article, was used to reanalyse previously published long-term treatment results concerning the longevity of fixed partial dentures, retainers and abutments. The main results were consistent, indicating that no great faults were committed when using the conventional logistic regression method. There were, however, differences when calculating the combined risks for various situations. The conventional method was found to over- and underestimate probabilities of survival in different cases, compared to the MLM method. Especially when the most negative factors were combined, the conventional method had a tendency to underestimate the risk. For example, if an abutment had the combination 'endodontically treated'; 'FPD placed by 'another dentist''; 'distal abutment'; and 'marginal bone loss > 50%'; the probability of the tooth remaining after 18-23 years was only 20% according to the MLM method but 35% according to the conventional method. It was concluded that MLM is the method of choice for many situations in dental research where data belonging to different levels are to be analysed. <77> UI - 98235856 AU - Scurria MS AU - Bader JD AU - Shugars DA IN - Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill 27599-7450, USA. TI - Meta-analysis of fixed partial denture survival: prostheses and abutments. SO - Journal of Prosthetic Dentistry 1998 Apr;79(4):459-64 AB - STATEMENT OF PROBLEM: Few estimates of the probability of various outcomes associated with replacement of missing teeth with fixed partial dentures have been reported. Existing longitudinal studies have reported widely disparate results for the survival of fixed partial dentures, but these studies have used different definitions of failure and varying periods of follow-up. PURPOSE: This study used meta-analysis to formulate annual probability estimates for three categories of fixed partial denture or abutment survival. METHODS: A systematic review of the English language literature since 1960 identified eight studies that met the preset inclusion criteria. Estimated annual survival proportions were back-calculated based on the Kaplan-Meier model and these proportions were combined through a fixed effects model meta-analysis. The probabilities and corresponding 95% confidence intervals at 5, 10, and 15 years for the three categories of survival are reported. RESULTS: For the aggregate population represented by the limited longitudinal studies available, this meta-analysis indicated that less than 15% of fixed partial dentures were removed or in need of replacement at 10 years; whereas, nearly one third were removed or in need of replacement at 15 years. Less than 5% of abutments were removed at 10 years. <78> UI - 98235860 AU - Emtiaz S AU - Tarnow DP IN - Department of Implant Dentistry, New York University, College of Dentistry, NY, USA. TI - Processed acrylic resin provisional restoration with lingual cast metal framework. SO - Journal of Prosthetic Dentistry 1998 Apr;79(4):484-8 AB - Fixed provisional prostheses are fabricated to maintain, improve, and/or change oral function and esthetics for varying periods. It is important to know when to provide a provisional prostheses and how to make one so that it will meet the needs of the patient. This article describes a modification of the design of a cast metal reinforced processed acrylic resin provisional restoration for extensive, long-term reconstruction with implants, because some of the treatments rendered to patients require temporization for up to 2 years. This design has been used by the authors since 1991, and has resulted in fewer problems of fracture of the provisional restorations. In addition, removable partial dentures are rarely needed, even when large spans exist between remaining abutments in serial extractions. This procedure also permits performing guided bone regeneration for deficient ridges without the problem of transmucosal loading, while still maintaining the patient's esthetics and function after surgery. <79> UI - 98276044 AU - Fish DR AU - Morris-Allen DM IN - Department of Physical Therapy, Exercise and Nutrition Sciences, University at Buffalo, USA. TI - Musculoskeletal disorders in dentists. SO - New York State Dental Journal 1998 Apr;64(4):44-8 AB - Occupational injuries involving musculoskeletal tissues are often related to repetitive movements of upper limbs and prolonged postures such as sitting and standing--activities common in dentistry. Surveys of the incidence of musculoskeletal disorders among dentists are few, but in Nebraska, 29 percent of more than 1,000 dentists reported symptoms of peripheral neuropathy in the upper limbs or neck. The Nebraskan dentists reported that crown and bridge work was most likely to evoke altered sensations in their upper limbs. Furthermore, since 47 percent of carpal tunnel syndrome cases in the general population are work-related and are often associated with repetitive motions, it is reasonable to suspect that dentists may be at risk for this musculoskeletal disorder. And, since it is estimated that 60 percent to 80 percent of adults will experience low back pain at one time or another, resulting in it being the second leading cause of absences from work in the general population, dental practitioners are most likely to be among those susceptible to this problem. This article focuses on two ailments afflicting dentists: carpal tunnel syndrome and low back pain. <80> UI - 98307219 AU - Bonilla ED IN - Department of Restorative Dentistry, University of California, Los Angeles, USA. prosthod@ucla.edu TI - Fabrication of an amalgam core using a customized acrylic resin shell. SO - Quintessence International 1998 Mar;29(3):143-9 AB - This article describes a build-up technique that uses a customized acrylic resin shell for restoring endodontically treated molars that are involved in three-unit fixed partial denture design. The shell confines the amalgam without impinging on the periodontium to ensure a proper core foundation, an ideal tooth preparation, and a more predictable final restoration. <81> UI - 98331782 AU - Behr M AU - Leibrock A AU - Stich W AU - Rammelsberg P AU - Rosentritt M AU - Handel G IN - Poliklinik fur Zahnarztliche Prothetik, Universitat Regensburg, Germany. Michael.Behr@klinik.uni-regensburg.de TI - Adhesive-fixed partial dentures in anterior and posterior areas. Results of an on-going prospective study begun in 1985. SO - Clinical Oral Investigations 1998 Mar;2(1):31-5 AB - Within the framework of an on-going prospective clinical study begun in 1985, 120 adhesive-fixed partial dentures (AFPD) continued to be examined. The manufacture and the fitting of the AFPDs were carried out following a standard procedure. The preparation technique and the metal framework conditioning (silica-coating, sand-blasting and electrochemical etching) has varied throughout the duration of the study. Using Kaplan-Meier analysis, the survival rate was determined and an analysis of risk with regard to location factors (anterior, posterior; maxilla, mandible), conditioning and preparation techniques (retentive/non-retentive) was determined using the Cox regression model. The location of the AFPD had no influence on the survival rate. The survival time was determined mainly by the preparation technique. Strict preparation of seating grooves and pin holes made a 95% survival rate possible after 10 years (Kaplan-Meier estimation). Without retention, the risk of failure increased by a factor of 3.7. <82> UI - 98255118 AU - Muller J AU - Schon F AU - Helms J IN - Klinik fur Hals-, Nasen-, Ohren-Heilkunde, Universitat Wurzburg. TI - [Reliable fixation of cochlear implant electrode mountings in children and adults--initial experiences with a new titanium clip]. [German] SO - Laryngo- Rhino- Otologie 1998 Apr;77(4):238-40 AB - BACKGROUND: There is a reported 1% incidence of delayed migration of extrusions of the electrode arrays out of the cochlea. METHODS: A titanium clip to fix the electrode array of the MED EL Combi 40 Cochlear Implant System is described. The clip is designed and shaped in a double U configuration. The clip material allows easy adaption to the individual anatomical situation. The clip is fixed to a bony bridge at the incus bar and fixes the electrode in a plane parallel to the chorda facial angle. It is closed around the electrode similarly to a stapes piston around the incus. Additional tests which examined the possible risk of damaging the electrode carrier and clinical findings are described. RESULTS: The clip was used in 23 cases with a follow-up period up to 1 year. No signs for dislocation of the electrode were found. In one revision case the clip was covered with a thin mucosal layer. The electrode array showed no signs of damage. Intraoperative findings confirmed the experimental tests on the electrode fixation. CONCLUSION: The titanium clip facilitates safe and quick fixation of the electrode array and prevents dislocation. its flexibility and shape minimizes the risk of damage. <83> UI - 98244051 AU - Culy G AU - Tyas MJ IN - School of Dental Science, University of Melbourne. TI - Direct resin-bonded, fibre-reinforced anterior bridges: a clinical report. SO - Australian Dental Journal 1998 Feb;43(1):1-4 AB - Direct resin composite cantilever bridges were placed in patients to replace 26 single upper anterior teeth and one upper premolar. Twenty-four bridges were simple cantilevers, and three were fixed-fixed bridges. The bridges were constructed with hybrid resin composite placed around a resin-impregnated plasma-etched polyalkane fibre bundle bonded to the abutment tooth enamel by the acid-etch technique. Twenty-five bridges were assessed at 10 +/- 1 months. Two had fractured due to trauma, however, in both cases the pontic remained attached to the abutment tooth by the fibre bundle. This method of tooth replacement is viewed as a rapid, simple, cost-effective means of replacing anterior teeth in selected patients. <84> UI - 98294117 AU - Block MS AU - Kent JN AU - Kallukaran FU AU - Thunthy K AU - Weinberg R IN - Department of Oral and Maxillofacial Surgery, LSU School of Dentistry, New Orleans 70119, USA. TI - Bone maintenance 5 to 10 years after sinus grafting. SO - Journal of Oral & Maxillofacial Surgery 1998 Jun;56(6):706-14; discussion 714-5 AB - PURPOSE: This radiographic study determined the amount of bone around hydroxyapatite (HA)-coated dental implants that were placed into bone-grafted maxillary sinuses. PATIENTS AND METHODS: Postoperative complex motion tomograms using the Grossman technique were taken on 16 patients who had 27 maxillary sinus grafts performed using particulate autogenous iliac bone with and without demineralized bone, autogenous iliac corticocancellous block with and without demineralized bone, and autogenous jaw bone with demineralized bone. Bone levels were measured from the new floor of the grafted sinus to the apex of the implant and to the alveolar crest. The resulting bone level measures were compared with the type of graft used. All patients had been restored for 5 to 10 years after simultaneous graft and implant placement. RESULTS: For all patients summed together, the average amount of bone from the top of the graft to the apex of the implant was 3.3 +/- 3.1 mm, and the average amount of bone from the top of the graft to the alveolar crest was 17.6 +/- 3.1 mm. The average level of bone in the sinuses of patients grafted with autogenous iliac bone was greater than the average level of bone in those grafted with autogenous bone combined with demineralized bone. CONCLUSION: The results of this study indicate that autogenous bone grafts are maintained in the maxillary sinus, but the results with autogenous bone alone are better than when demineralized bone is added. However, this difference may not be clinically significant. <85> UI - 98242510 AU - Garcia LT AU - Oesterle LJ IN - Department of Restorative Dentistry, University of Colorado Health Sciences Center, School of Dentistry, Denver 80262, USA. TI - Natural tooth intrusion phenomenon with implants: a survey. SO - International Journal of Oral & Maxillofacial Implants 1998 Mar-Apr;13(2):227-31 AB - A common assumption when planning for treatment for a fixed partial denture potentially involving an osseointegrated implant is to avoid connection between the implant and natural tooth abutment because of the differences in mobility and potential long-term effects. A large population was surveyed to measure the incidence of natural tooth intrusion in implant-assisted fixed partial dentures (IAFPD) and to try to identify a correlation between type of implant and/or type of connector. Natural tooth intrusion occurred in 3.5% of the patient population specifically treated with IAFPD. No correlation could be made between incidence of intrusion and the type of implant or type of connector used. <86> UI - 98242507 AU - Wyatt CC AU - Zarb GA IN - Department of Clinical Dental Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada. TI - Treatment outcomes of patients with implant-supported fixed partial prostheses. SO - International Journal of Oral & Maxillofacial Implants 1998 Mar-Apr;13(2):204-11 AB - Implant and prosthesis success for 77 partially edentulous patients, provided with 97 fixed prostheses, supported by 230 Branemark implants, in place for up to 12 years (mean 5.41 years), were documented in this study. Implant losses per location mirrored their placement, with no difference between zones I and II or between the maxilla and mandible. The implant success rate was 94%, and continuous prosthesis stability was 97%. These results indicate that the Branemark implant-supported fixed partial prosthesis is a highly efficacious treatment. <87> UI - 98109774 AU - Appelbaum MB AU - Arvay JM IN - Department of Prosthodontics and Biomaterials, University of Medicine and Dentistry of New Jersey, USA. TI - Phased-in comprehensive care: a concept and case report. SO - Journal of the American Dental Association 1998 Jan;129(1):98-102 AB - A complicated case often requires a multidisciplinary approach. But such an approach makes it difficult for the practitioner to offer the patient a definitive treatment plan. This article outlines the concept of a phased-in comprehensive treatment plan and reports on a case in which such a plan was used successfully. <88> UI - 98198871 AU - De Kanter RJ AU - Creugers NH AU - Verzijden CW AU - Van't Hof MA IN - Department of Oral Function and Prosthetic Dentistry, Dental School, University of Nijmegen, The Netherlands. TI - A five-year multi-practice clinical study on posterior resin-bonded bridges. SO - Journal of Dental Research 1998 Apr;77(4):609-14 AB - Previous clinical observations have revealed that resin-bonded bridges for posterior tooth replacements are less retentive than anterior resin-bonded bridges. Improved bonding procedures and preparation designs, however, may have a positive effect on the functional durability of these restorations. The present study reports the final analysis of a randomized controlled clinical trial in which different designs of posterior resin-bonded bridges were evaluated for a period of at least 5 years. The operational hypothesis was that the bonding system and the preparation design used in posterior resin-bonded bridges have an influence on the survival and clinical functioning of these restorations. Survival in this study was defined at two levels: (1) 'complete' survival (survival without any debonding), and (2) 'functional' survival (survival including loss of retention on one occasion and successful rebonding of the original RBB without further debonding). With regard to 'complete' survival, no significant differences were found between the bonding systems used for adherence of the restorations to abutment teeth (etching/Clearfil F2, sandblasting/Panavia EX, and silica-coating/Microfill Pontic C). The variable 'preparation form' (conventional preparation form vs. modified preparation form) for complete survival was statistically in favor of the modified preparation form (62% vs. 46%), but did not influence the functional survival. With regard to 'functional' survival, the combination of silica coating and Microfill Pontic C was more retentive than the other bonding systems (90% survival vs. 72% and 75%, p < 0.01). Factor location was found to be highly significant for both survival levels [Cox's PH model, p = 0.0002 (Cox, 1972)]: The five-year 'complete' survival rates were 65% for maxillary restorations and 40% for mandibular restorations, while the five-year 'functional' survival rates were 89% and 68%, respectively. It is concluded that preparation of grooves in abutment teeth for posterior resin-bonded bridges is beneficial to their chance of survival. Resin-bonded bridges placed in the maxilla have a better prognosis than those made in the mandible. The bonding systems used in this study appear to have no influence on the chance of failure. In rebonded posterior resin-bonded bridges, the bonding system silica-coating/Microfill Pontic C was more retentive than the other systems tested. <89> UI - 98083444 AU - Bosse LP AU - Taylor TD IN - Department of Prosthodontics, School of Dental Medicine, University of Connecticut Health Center, Farmington, USA. TI - Problems associated with implant rehabilitation of the edentulous maxilla. [Review] [17 refs] SO - Dental Clinics of North America 1998 Jan;42(1):117-27 AB - Implant rehabilitation of the edentulous maxilla is one of the most challenging endeavors that faces the restorative dentist. Comprehensive diagnosis and precise evaluation of the patient's needs followed by appropriate treatment planning provide the restorative dentist with the necessary tools to satisfy patient expectations and the realization that this patient would greatly benefit from this treatment or that the patient should be referred to a prosthodontist for further evaluation. Not enough emphasis can be placed on adequate placement of the implants by the surgeon. As with any rehabilitation, aesthetics are of prime importance to the patient, and proper occlusion confers longevity to the prosthesis. Whether a removable or fixed implant-supported prosthesis is fabricated, every step is crucial and is reflected in the final product. When all sequences of treatment are properly executed, the successful implant rehabilitation of the maxilla is one of the most gratifying procedures for both the restorative dentist and the patient. [References: 17] <90> UI - 98416320 AU - Meyenberg KH AU - Imoberdorf MJ IN - Crown and Bridge Department, University of Zurich Dental School, Switzerland. TI - The aesthetic challenges of single tooth replacement: a comparison of treatment alternatives. SO - Practical Periodontics & Aesthetic Dentistry 1997 Sep;9(7):727-35; quiz 737 AB - Several options are currently available to address the challenge of restoring a single tooth in the maxillary anterior region. To select the most appropriate treatment option for each patient, every case should be evaluated individually and all available options reviewed. The learning objective of this article is to review the treatment options and the selection of appropriate treatment modalities. The soft tissue contour around pontics and implants is discussed for efficiency, predictability, and aesthetic excellence. Three clinical cases illustrate and document three different treatment modalities in the maxillary anterior region--a single tooth implant-supported restoration, combined with porcelain laminate veneers; an adhesive bridge, combined with a porcelain laminate veneer; and a conventional porcelain-fused-to-metal bridge. <91> UI - 98216041 AU - Makkonen TA AU - Holmberg S AU - Niemi L AU - Olsson C AU - Tammisalo T AU - Peltola J IN - Department of Oral and Maxillofacial Surgery, University of Turku, Finland. TI - A 5-year prospective clinical study of Astra Tech dental implants supporting fixed bridges or overdentures in the edentulous mandible. SO - Clinical Oral Implants Research 1997 Dec;8(6):469-75 AB - In a 5-year prospective clinical study, 155 endosseous implants were installed in the mandible anterior to the mental foramina in 33 edentulous patients (13 males and 20 females). Usually 6 implants were installed for fixed prostheses (FP), 13 patients with 77 implants, and 4 implants for overdentures (OD) with a Dolder bar, 20 patients with 78 implants. At the time of abutment connection 1 implant in 2 patients was found to be loose and removed. However, in both these patients overdentures were successfully placed on the remaining 3 implants. Narrow-beam radiography was used for radiological evaluation. The mean (SD) total marginal bone loss in 5 years was 0.48 (0.38) mm (0.36 (0.22) mm in the FP group and 0.56 (0.45) mm in the OD group). Very few complications were reported during the 5 years, most of them being related to the superstructures. The overall cumulative implant survival rate was 98.7% (100% in the FP group and 97.4% in the OD group). The survival rate of the superstructures was 100%. The present study has demonstrated that Astra Tech implants offer reliable and predictable medium-term support for fixed prostheses and overdentures in the edentulous mandible. <92> UI - 98275093 AU - Bragger U AU - Burgin WB AU - Hammerle CH AU - Lang NP IN - University of Berne, School of Dental Medicine, Clinic for Periodontology and Fixed Prosthodontics, Switzerland. TI - Associations between clinical parameters assessed around implants and teeth. SO - Clinical Oral Implants Research 1997 Oct;8(5):412-21 AB - The aim of the present study was to clinically assess the peri-implant and periodontal conditions 1 year after placement of oral implants (ITI Dental Implant System) in partially edentulous patients. In all, 127 patients (median age 50 years, range 17 to 79) were examined. They were all treated according to a concept of comprehensive dental care and had received fixed partial dentures (FPD). Significant differences were observed between implants and contralateral control teeth with respect to mean pocket probing depth (PPD) (2.55 mm at implants/2.02 mm at teeth), mean probing attachment level (PAL) (2.97 mm/2.53 mm) and bleeding on probing (BOP) (24%/12%) (Wilcoxon matched pairs sign rank test, P < or = 0.01), whereas mean modified plaque index (0.22/0.30), mean modified bleeding index (0.35/0.44) and mean recession (-0.42 mm/-0.51 mm) did not significantly differ between implants and teeth. Compared to control teeth, the width of keratinized mucosa at implants was significantly smaller at lingual, but not at buccal aspects. Regression analyses showed no significant association between the amount of keratinized mucosa and degree of inflammation. Recession, PPD and PAL were slightly influenced by the amount of keratinized mucosa indicating greater resistance to probing. Grouping the implants according to various lengths, type of fixation of the FPD or combination with natural teeth did not result in statistically significant different clinical parameters, whereas grouping according to different localization within the oral cavity did. For example, the mean PAL in 83 anterior implants was 2.52 mm, whereas 175 posterior implants had a mean PAL of 3.18 mm (Mann-Whitney U-test, P < or = 0.01). Regression analyses between the mean PAL for all implants in each patient and the mean PAL of the corresponding dentition revealed an r2 of 0.23 (P < or = 0.01). Using multiple regression analysis, the mean PAL of the implants showed to be significantly influenced by the combined factors "fullmouth" PII, "fullmouth" BOP and mean PAL of all teeth. The results of this study suggest that in partially edentulous patients the overall periodontal condition may influence the clinical condition around implants and thus reinforces the importance of periodontal treatment prior to and supportive periodontal therapy after the incorporation of osseointegrated oral implants. <93> UI - 98159162 AU - Stelzel M AU - Flores-de-Jacoby L AU - Ciancio S IN - Department of Periodontology, Philipps University, Marburg, Germany. TI - The influence of end abutment and cantilever fixed partial dentures on periodontal health. SO - International Journal of Periodontics & Restorative Dentistry 1997 Aug;17(4):368-77 AB - The influence of end abutment and cantilever fixed partial dentures on periodontal health was examined in 12 patients with periodontally reduced residual dentition. The prosthetic appliances had been integrated for 4 to 6 years before the first follow-up examination and had no technical defects at baseline. Two follow-up examinations were performed at a 12-month interval to record clinical and microbiologic parameters of 62 abutment teeth, 45 of which were fitted with end abutment fixed partial dentures and 17 with cantilever fixed partial dentures. Both types of fixed partial dentures were represented in all patients. The patients were on a 6 to 8-week recall schedule throughout the study period and had good oral hygiene. At both examinations, subgingival plaque samples were taken at all proximal surfaces and evaluated by dark-field microscopy. The clinical parameters used were Gingival Index, Plaque Index, pocket probing depth, and attachment level. The results showed that both types of fixed partial dentures were compatible with periodontal health subject to optimal oral hygiene. The clinical parameters recorded remained stable at a very low level throughout the study period and were almost identical in both groups. A slight gain in clinical attachment level, with a mean value of 0.19 mm for abutment teeth fitted with cantilever fixed partial dentures and of 0.32 for end abutment fixed partial dentures, was registered during the study period. The composition of the subgingival plaque showed a microflora reflecting virtually health periodontal conditions. The proportion of motile rods and spirochetes was slightly elevated in both groups. In conclusion, it can be stated that both fixed partial denture types display identical characteristics in the periodontally damaged dentition and do not lead to deterioration of the periodontal situation if oral hygiene is closely monitored. <94> UI - 98159165 AU - Milano F AU - Melsen B IN - Department of Orthodontics, Aarhus University, Denmark. TI - Guided tissue regeneration using bioresorbable membranes: what is the limit in the treatment of combined periapical and marginal lesions?. SO - International Journal of Periodontics & Restorative Dentistry 1997 Oct;17(5):416-25 AB - The maintenance of single teeth may often be of crucial importance for the prognosis of the total dentition. In such cases, as when a single tooth supports a fixed partial denture, a special effort should be made to maintain that tooth. This study reports the treatment of six such terminal cases. The results of a combination of local and systemic antibiotics and the use of guided tissue regeneration with resorbable membranes and grafting material is demonstrated. After defect debridement and root planing, the defects were filled with Biostite (Coletica), and Paroguide (Coletica) membranes were placed. The results at reentry demonstrated the efficacy of these treatments, and all six treatments were considered successful. The influence of the individual components used in treatment is discussed. <95> UI - 98247604 AU - Fartash B AU - Arvidson K IN - Department of Prosthetic Dentistry, Faculty of Odontology, Karolinska Institutet, Stockholm, Sweden. TI - Long-term evaluation of single crystal sapphire implants as abutments in fixed prosthodontics. SO - Clinical Oral Implants Research 1997 Feb;8(1):58-67 AB - 49 patients participated in a prospective study of treatment of total or partial edentulism with fixed prosthodontics supported by Bioceram sapphire implants. 15 patients were treated for maxillary or mandibular edentulism, and 7 for a missing maxillary anterior tooth. The remaining 27 patients, with Applegate-Kennedy Class I-IV residual dentitions, were treated with fixed bridges supported by free-standing implants, or bridges supported by teeth and implants. Implant success, prosthesis stability, radiographic marginal bone level as well as parameters for peri-implant health were evaluated. The study began in 1982, and clinical treatment of the last patients was completed in 1988, i.e., a follow-up period ranging from 7 to 13 years. Of the patients treated for total mandibular edentulism, one implant fractured after 6 years in situ. The bone implant score (BIS) values for those implants were at the time for the bridge cementation 63.5 +/- 1.4 and at 1, 2, 3 and 5 year follow-ups 62.1 +/- 1.4, 61.9 +/- 1.5, 61.5 +/- 1.6, and 60.95 +/- 1.3, respectively. The success rate was 100%, 100% and 97.7% for the mandible at 3, 5 and 10 years, respectively. Of the 7 edentulous patients treated with maxillary fixed bridges, 6 implants in 1 patient had to be removed after 1 year in service. Another 2 patients lost all their implants, 6 each, after 36 months. 6 implants in the 4th patient did not fulfil the criteria for success and were rated as failures at the four year follow-up. The success rate was thus 58.1%, 44.2% and 44.2% for the maxilla at 3, 5 and 10 year follow-ups, respectively. Of the 7 patients in whom single missing teeth were replaced, 1 implant in the premolar region was lost during the 1st year post-operatively, but no other complications or changes in BIS were observed. Of the 27 patients treated for partial edentulism (56 implants total) 1 implant, of a 4-unit free standing maxillary bridge fractured after 6 years and was later replaced. There were no statistically significant differences in BIS changes for the implants when used as abutments for partial maxillary or mandibular edentulism. The cumulative success rates for the implants in the partially maxilla were 96.3, 92.6 and 92.6 at the 3, 5 and 10 years respectively and 100% in the mandible over the whole period. <96> UI - 98247619 AU - de Bruyn H AU - Collaert B AU - Linden U AU - Bjorn AL IN - Center for Periodontology and Implantology Brussels, Belgium. TI - Patient's opinion and treatment outcome of fixed rehabilitation on Branemark implants. A 3-year follow-up study in private dental practices. SO - Clinical Oral Implants Research 1997 Aug;8(4):265-71 AB - In this study, patient opinion on oral rehabilitation by means of Branemark implants was investigated. All patients were referred to a periodontal clinic for implant installation and treated by one and the same operator. Prosthetic restorations were performed by dentists, who had no previous experience with prostheses on implants, but had completed a postgraduate training course. Patient opinion was obtained through questionnaires, pertaining to satisfaction and oral function. A comparison was made between pre-implant situation, short-term (< 4 months) and long-term functioning (3 years) with the implant-restorative rehabilitation. In total, 61 patients participated in the study; 23 received a full lower arch bridge and 18 a full upper arch bridge, while 20 patients got partial bridges. Of 298 installed implants, 7 failed at abutment connection (2.3%) and 1 during the 3-year follow-up interval (0.3%). The study results indicated that a great majority of patients were very satisfied with the treatment. Comfort with eating, aesthetics, phonetics and overall satisfaction improved significantly and nearly all patients said that they would undergo the treatment again or recommend it to others. Patients experienced their implants as "natural" teeth. The conclusion is that rehabilitation ad modum Branemark, even in the hands of non-specialized dentists, can be of high quality, improving oral function and satisfying the needs and demands of patients. <97> UI - 98247620 AU - Nishimura K AU - Itoh T AU - Takaki K AU - Hosokawa R AU - Naito T AU - Yokota M IN - Medical Foundation Itoh-kai Itoh Dental Clinic, Kumamoto, Japan. TI - Periodontal parameters of osseointegrated dental implants. A 4-year controlled follow-up study. SO - Clinical Oral Implants Research 1997 Aug;8(4):272-8 AB - The aim of this study was to evaluate the periodontal parameters of osseointegrated dental implants. The condition of the peri-implant mucosa was assessed using periodontal parameters, i.e., of plaque index, bleeding on probing, probing pocket depth, probing attachment level and Periotest scores as well as a radiographic parameter, over a 4-year follow-up period. 32 non-submerged ITI dental implants, all placed in the mandible, were studied in 12 patients who had good oral hygiene. All patients were regularly recalled at 6-month intervals. The overall implant success rate was 100%. None of the implants showed any signs of inflammation, radiographic bone loss or any detectable mobility during the follow-up period. Methods similar to those used to evaluate the natural dentition were effectively employed to assess the clinical status of the dental implants. The diagnostic value of these parameters could not, however, be determined from this study due to the absence of any peri-implant tissue complications. The results indicated that some periodontal parameters of healthy peri-implant mucosa might be slightly different from healthy periodontal tissue. <98> UI - 98156284 AU - Walton JN AU - MacEntee MI IN - Division of Prosthodontics, Faculty of Dentistry, University of British Columbia, Vancouver, Canada. TI - A prospective study on the maintenance of implant prostheses in private practice. SO - International Journal of Prosthodontics 1997 Sep-Oct;10(5):453-8 AB - This study examined the adjustments, repairs, time, and costs required to maintain 69 implant prostheses in private prosthodontic practice for an average of 22 months after placement. For the removable prosthesis design, the most common adjustment was contouring the prosthesis and the most common repair was retentive component replacement. Screw tightening or fracture repair were the most frequently needed modifications for fixed implant prostheses. Each removable implant prosthesis averaged four times as many postplacement adjustments and almost twice as many repairs as did each fixed implant prosthesis, and the mean length of each maintenance appointment was also longer for removable prostheses. Mean repair costs were approximately 60% higher for the removable design. <99> UI - 98156291 AU - Sundh B AU - Odman P IN - Department of Prosthetic Dentistry, Faculty of Odontology, Goteborg University, Sweden. Bo.Sundh@odontologi.gu.se TI - A study of fixed prosthodontics performed at a university clinic 18 years after insertion. SO - International Journal of Prosthodontics 1997 Nov-Dec;10(6):513-9 AB - This study obtained information on the long-term efficiency of prosthetic rehabilitation with fixed partial dentures performed by undergraduate students. From a list of discharged patients treated from 1975 to 1976 by undergraduate students at a dental school, 101 were recalled for free clinical examinations after 6, 11, and 18 years. A total of 163 fixed partial dentures were inserted. The majority (85%) of the fixed partial dentures were acrylic resin veneer-gold restorations; 15% were metal ceramic restorations. During this study period, 14 individuals died, leaving 138 fixed partial dentures to be examined. Of these, 35 (25%) were removed after a mean of 11 years in function, which left 75% in place and functioning after 18 years. The main causes for removal included caries, periodontitis, root fracture, and endodontic complications. Fewer metal ceramic restorations than acrylic resin veneer-gold restorations were removed. The removal rate for abutments with cast posts and cores was higher than the removal rate of total abutments. There was no difference in removal frequency between fixed partial dentures with moderate cantilever extensions and those with end-supported extensions. <100> UI - 98135896 AU - Hakestam U AU - Karlsson T AU - Soderfeldt B AU - Ryden O AU - Glantz PO IN - Department of Prosthetic Dentistry, Faculty of Odontology, Lund University, Malmo, Sweden. TI - Does the quality of advanced prosthetic dentistry determine patient satisfaction?. SO - Acta Odontologica Scandinavica 1997 Dec;55(6):365-71 AB - In a clinical follow-up study 42 patients were selected from an original sample of 335 individuals who had undergone extensive prosthetic treatment. The selection was done in accordance with a treatment satisfaction measure. The selected patients' appliances were classified in accordance with the California Dental Association (CDA) quality assessment system. Altogether, most of the new reconstructions were rated as satisfactory. The removable partial dentures had a somewhat higher share of non-acceptable appliances according to the CDA criteria. There was an association between the CDA categories and patient satisfaction. Using logistic regression analysis and knowing the CDA rating, we could correctly classify 67% of the patients with regard to the satisfaction measure. The satisfaction measure was modified on the basis of an interview, improving the model to 83% correctly classified. It was concluded that the technical quality of the prosthodontic treatment was associated with patient satisfaction. <101> UI - 98145053 AU - Probster B AU - Henrich GM IN - Department of Prosthetic Dentistry, Johannes Gutenberg University, Mainz, Germany. TI - 11-year follow-up study of resin-bonded fixed partial dentures. SO - International Journal of Prosthodontics 1997 May-Jun;10(3):259-68 AB - The clinical performance of 325 resin-bonded fixed partial dentures (RBFPD) placed between 1984 and 1995 was reviewed. The primary indications of the 264 patients treated were trauma and aplasia. Two hundred eighty-three of the resin-bonded fixed partial dentures were primary restorations, and 42 of the restorations were secondary and tertiary after the loss of the primary resin-bonded fixed partial denture. Including the rebonded restorations, the survival rate calculated using the Kaplan-Meier method was 76% after 5 years and 60% after 10 years. Analysis of the data showed that casting alloy, pretreatment of the bonding surfaces, luting agent, and mobility of the abutment teeth were decisive prognostic factors for success. Base metal alloys, silicoating, mesh retention, and immobile abutments were positive factors. In contrast to other reports in the literature, retentive abutment preparation did not result in a higher survival rate than unprepared abutments. Small restorations in the bonding area did not affect the survival. No differences in survival rate were found for resin-bonded fixed partial dentures in the maxillae or mandible, or in the anterior and posterior regions. Multiunit resin-bonded fixed partial dentures had a smaller probability of survival than three-unit resin-bonded fixed partial dentures. Carious lesions were found on 4% of the abutment teeth. <102> UI - 98145036 AU - Walton TR IN - University of Sydney Faculty of Dentistry, Australia. TI - A ten-year longitudinal study of fixed prosthodontics: 1. Protocol and patient profile. SO - International Journal of Prosthodontics 1997 Jul-Aug;10(4):325-31 AB - This article is the initial report of a 10-year study of all fixed prosthodontic treatment performed in a specialist prosthodontic practice between January 1983 and December 1992. A set management protocol was maintained throughout the study. Three hundred forty-four patients who underwent 411 treatment episodes involving 768 crowns and 346 fixed partial dentures (786 abutments, 599 pontics) were recalled between July and December 1993. A classification system detailing outcome with well-defined parameters and including repair requirements was developed. This report limits discussion to the study parameters and patient profile. Of the total treatment episodes, 8.5% required some form of retreatment over the survey period. Of these, 5.5% involved prostheses that had failed, and 3.0% involved prostheses that had been repaired. Females sought fixed prosthodontic treatment more than males in a ratio of 2:1. Aesthetic considerations were the most common reasons for patients seeking crowns, while replacement of failed prostheses was the predominant reason for patients seeking fixed partial dentures. <103> UI - 98079338 AU - Nystrom E AU - Lundgren S AU - Gunne J AU - Nilson H IN - Department of Oral and Maxillofacial Surgery, Umea University, Sweden. TI - Interpositional bone grafting and Le Fort I osteotomy for reconstruction of the atrophic edentulous maxilla. A two-stage technique. SO - International Journal of Oral & Maxillofacial Surgery 1997 Dec;26(6):423-7 AB - This study presents the results from ten consecutive patients who, because of insufficient bone volume for conventional implant placement in the maxilla, were treated with an interpositional bone graft and Le Fort I osteotomy. The endosteal implants were placed six months after the osteotomy. A total of 60 screw-shaped titanium implants (Branemark) were placed, of which three failed to integrate during the six-month healing period. No further implants were lost during the follow-up period, ranging from 15 to 39 months after placement of the implants. All patients received fixed bridges and all have continued to function efficiently. <104> UI - 98083557 AU - Rubenstein JE AU - Taylor TD IN - School of Dentistry, University of Washington, Seattle, USA. TI - Apical nerve transection resulting from implant placement: a 10-year follow-up report. SO - Journal of Prosthetic Dentistry 1997 Dec;78(6):537-41 <105> UI - 98114780 AU - Wathen WF TI - Restorative dentistry in the millennium: adhesive, esthetic, predictable: [editorial]. SO - Quintessence International 1997 May;28(5):291 <106> UI - 98055116 AU - Neyt LF AU - De Clercq CA AU - Abeloos JV AU - Mommaerts MY IN - Division of Maxillo-Facial Surgery, A.Z. St Jan Brugge, Belgium. TI - Reconstruction of the severely resorbed maxilla with a combination of sinus augmentation, onlay bone grafting, and implants. SO - Journal of Oral & Maxillofacial Surgery 1997 Dec;55(12):1397-401 AB - PURPOSE: A new method of reconstruction of the atrophic maxilla by combining a bilateral sinus floor elevation and cancellous bone graft with buccal and labial onlay graft using L-shaped corticocancellous blocks from the posterior iliac crest is presented. PATIENTS AND METHODS: Seventeen patients were treated with this procedure. One hundred one IMZ implants were placed in 14 patients, and 22 Branemark implants were placed in three patients. Patients were observed for 6 months after prosthetic rehabilitation. RESULTS: All patients were fully rehabilitated with fixed bridges except one, who preferred an overdenture. Only two implants were lost at the time of the abutment connection. Some bone resorption was seen around six implants. The success rate with this procedure was 92.7% 6 months after prosthetic rehabilitation if implants with bone resorption were considered failures. CONCLUSIONS: These preliminary results indicate that this surgical procedure is suitable for reconstruction of most atrophic maxillas. <107> UI - 98086958 AU - Piattelli A AU - Degidi M AU - Marchetti C AU - Scarano A IN - Dental School University of Chieti, Italy. apiattelli@unich.it TI - Histologic analysis of the interface of a titanium implant retrieved from a nonvascularized mandibular block graft after a 10-month loading period. SO - International Journal of Oral & Maxillofacial Implants 1997 Nov-Dec;12(6):840-3 AB - The combined use of bone grafts and osseointegrated implants appears to improve the long-term prognosis of transplanted bone. One question pertaining to the use of grafted bone is whether the biologic reaction to implants placed in grafted bone is the same as that seen under nongrafted conditions. A mandibular discontinuity defect in a 63-year-old female patient was repaired with a nonvascularized block graft into which 3 titanium implants were placed. After a 10-month loading period, one of the implants was retrieved and treated to obtain thin ground sections. The histologic examination showed mature bone in close contact with the implant surface; no gaps, fibrous tissue, or inflammatory cells were seen at the interface. No resorption phenomena were present. The bone at the interface was highly mineralized. The features of the regenerated bone and the bone-implant interface in grafted bone were similar to those seen in nongrafted situations; no differences were found with results presented in the literature concerned with retrieved implants placed into vascularized grafts. <108> UI - 98061556 AU - Besimo C AU - Gachter M AU - Jahn M AU - Hassell T IN - Department of Prosthodontics, School of Dentistry, University of Basel, Switzerland. TI - Clinical performance of resin-bonded fixed partial dentures and extracoronal attachments for removable prostheses. SO - Journal of Prosthetic Dentistry 1997 Nov;78(5):465-71 AB - STATEMENT OF PROBLEM: It is important to evaluate the long-term clinical performance of resin-bonded fixed partial dentures and extracoronal attachments for removable prostheses. PURPOSE: A prospective, long-term clinical study was conducted to evaluate the success of resin-bonded fixed partial dentures since 1985 and of resin-bonded extracoronal attachments from 1987. METHODS: Until 1993, a total of 130 resin-bonded fixed partial dentures had been seated in 101 patients, as well as 12 removable partial dentures (RPDs) with 24 extracoronal retainers in 10 patients. The clinical treatment protocol and the laboratory procedures were standardized. By the end of 1993, it was possible to reexamine 98 patients with a total of 127 resin-bonded fixed partial dentures and all 10 patients with removable partial dentures. The average time in function for the resin-bonded fixed partial dentures at the time of examination was 3.4 years and 2.3 years for the removable restorations. RESULTS: During the period of observation, one retainer failed on six of the resin-bonded fixed partial dentures, which represents a failure rate of 4.7%. Debonding of extracoronal attachments was recorded for 8.3% of the total number of retainers. CONCLUSION: The resin-bonded fixed partial denture technique can be considered to be a clinically reliable method of treatment, and permits the expansion of indications beyond a classical three-unit resin-bonded fixed partial denture. Long-term clinical success of removable partial dentures with resin-bonded extracoronal retainers warrants additional clinical studies. <109> UI - 98039729 AU - Napankangas R AU - Salonen MA AU - Raustia AM IN - Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Oulu, Finland. TI - A 10-year follow-up study of fixed metal ceramic prosthodontics. SO - Journal of Oral Rehabilitation 1997 Oct;24(10):713-7 AB - The aim of this retrospective study was to record patients' satisfaction with fixed metal ceramic bridges and crowns made by dental students and to evaluate the functioning and condition of the bridges and crowns clinically and radiologically. Out of the 60 patients treated at the Institute of Dentistry during 1984-85, 30 patients attended the follow-up examination (16 women, mean age 39, range 23-62 years and 14 men, mean age 44, range 26-65 years). The anamnestic data and data regarding treatment procedures were collected from the patient files. The patients had been supplied with 41 crowns and 24 bridges (mean 3.9 units, range 3-6 units), which included 61 abutments and 33 pontics or cantilever extensions (abutment/pontic ratio 1.85: 1). Marginal fidelity was unsatisfactory in 13% of the crowns and bridges and gingival bleeding and pockets of 4-6 mm were noted in 27% and 12% of cases, respectively. None of the subjects had caries in the abutments. <110> UI - 98018778 AU - Ramstad T AU - Jendal T IN - Department of Plastic Surgery, Rikshospitalet, Oslo, Norway. TI - A long-term study of transverse stability of maxillary teeth in patients with unilateral complete cleft lip and palate. SO - Journal of Oral Rehabilitation 1997 Sep;24(9):658-65 AB - The aim of this study was to investigate the long term post-treatment transverse stability of the maxillary dental arch in subjects with unilateral complete cleft lip and palate (UCLP) treated by the Harvold/Bohn method of orthodontic expansion and prosthodontic retention. The treatment of 22 consecutive patients, primarily operated on during the period 1957-60, was completed at a mean age of 18.1 years by the provision of a fixed partial retention prosthesis across the cleft using the cleft side central incisor and canine only as abutment teeth. The cleft side lateral incisor was missing in each case. Dental casts were made at the time of abutment preparation and at six subsequent times with the final observation 13.5 years after treatment completion. Measurements of any shift in the transverse position of cleft side and non-cleft side canines, premolars and first molars were made on standardized photographs of the casts. A constructed anteroposterior palatal line served as 'midline' reference. A mean reduction of width at the final observation, as recorded from the palatal surface to the reference line, was for the cleft side canine: -0.4 mm, the premolar immediately distal to the prosthesis and the first molar: both -1.2 mm. The corresponding mean width reductions on the noncleft side were: canine -0.9 mm, premolar -1.2 mm, first molar -1.6 mm. The rate of movement towards the midline decreased linearly with In(time) for all variables (P < 0.02) but for the cleft side canine. <111> UI - 98018783 AU - Serdar Cotert H AU - Ozturk B IN - Faculty of Dentistry, Department of Prosthodontics, Ege University, Izmir, Turkey. TI - Posterior bridges retained by resin-bonded cast metal inlay retainers: a report of 60 cases followed for 6 years. SO - Journal of Oral Rehabilitation 1997 Sep;24(9):697-704 AB - Between May 1989 and July 1994, 60 adhesive fixed partial posterior dentures retained by resin-bonded cast metal inlays were placed under controlled conditions. The influence of various prognostic factors on the event free and overall service duration was investigated with univariate and multivariate analysis. The majority of the failures (16 of 18) were caused by loss of adhesion at the metal cement interface and were observed either as debonding of the restorations completely or dislodgement of a single retainer. The other two failures appeared as secondary caries. Univariate analysis demonstrated that, retainer type, approximal configuration and dentine exposition had no effect on the event free service duration. On the other hand, gingival finishing level and luting agent were found to have an effect.Univariate testing was also conducted for the overall service duration and none of the variables were found to have an effect. Multivariate Cox Regression Analysis was performed to estimate the influence of categorical covariates: type of retainer, approximal preparation modification, gingival finishing level, preparation depth and luting agent on survival rates of event free and overall service duration. Luting agent was found to be the single independent prognostic variate (P < 0.0001) for the event free service duration and the other covariates were rejected. For overall service duration, none of the variables were found to be effective. <112> UI - 97479996 AU - Sullivan DY AU - Sherwood RL AU - Mai TN TI - Preliminary results of a multicenter study evaluating a chemically enhanced surface for machined commercially pure titanium implants [published erratum appears in J Prosthet Dent 1998 Mar;79(3):365]. SO - Journal of Prosthetic Dentistry 1997 Oct;78(4):379-86 AB - PURPOSE: This report presents the preliminary results of a prospective multicenter study to evaluate the efficacy of a chemically etched pure titanium surface on screw-type dental implants. MATERIAL AND METHODS: The results of 147 implants placed in 75 patients were evaluated and followed for up to 3 years, using clinical and radiographic examinations. The implants were inserted to support single crowns, overdentures, and fixed prostheses, as dictated by the individual patient's need. RESULTS: Of the 147 implants placed, 5 were lost and the remaining implants were followed throughout, to the end of the study period. Crestal bone levels adjacent to each implant were monitored and the amount of total bone loss was calculated. Clinically healthy peri-implant gingival tissues were observed on 95% of the implants, whereas 88.3% demonstrated no bleeding on probing and no recession during the follow-up period. According to the criteria used in this study, the total success rate was calculated to be 96.6%. <113> UI - 97478144 AU - Lindh T AU - Gunne J AU - Danielsson S IN - Department of Prosthetic Dentistry, Faculty of Odontology, Umea University, Sweden. TI - Rigid connections between natural teeth and implants: a technical note. SO - International Journal of Oral & Maxillofacial Implants 1997 Sep-Oct;12(5):674-8 AB - In the posterior partially edentulous jaw, implants may be used to supplement existing natural dentition. Frequently, the maxillary sinuses and the mandibular nerve preclude the fabrication of freestanding implant-retained prostheses. However, if an implant and a natural abutment are combined, a fixed prosthesis can be fabricated, restoring the arch into the premolar area. The histories of three patients with attachments connecting implant-retained ceramotitanium crowns with crowns on natural abutments are described. A design for a rigid custom-made attachment for the Branemark system, using standard components with a machine-duplication, spark-erosion technique, is suggested. <114> UI - 97478137 AU - Preiskel HW AU - Tsolka P IN - United Medical School, Guy's Hospitals, London, United Kingdom. TI - The DIA anatomic abutment system and telescopic prostheses: a clinical report. SO - International Journal of Oral & Maxillofacial Implants 1997 Sep-Oct;12(5):628-33 AB - Implant-supported prostheses may benefit from the versatility of design and favorable appearance offered by telescopic restorations. This project investigated the effectiveness of 208 abutments designed and produced by Dental Imaging Associates and the 73 prostheses supported by them over a 2-year period. No complications were found in the single-tooth group, although the sample was small (n = 7). Only 8.17% of the 208 abutment screws became loose during the initial postloading period. Once retightened, 2.4% of the total loosened for the second time. Higher screw-loosening rates were found in maxillary restorations, while the inclusion of a distal cantilevered pontic produced a significant increase in maintenance requirements. <115> UI - 97455723 AU - Kopeikin VN AU - Burtsev BL TI - [The use of fixed dentures attached with the aid of composite materials]. [Russian] SO - Stomatologiia 1997;76(4):71-3 <116> UI - 97406745 AU - Libby G AU - Arcuri MR AU - LaVelle WE AU - Hebl L IN - College of Dentistry, University of Iowa, Iowa City, USA. TI - Longevity of fixed partial dentures. SO - Journal of Prosthetic Dentistry 1997 Aug;78(2):127-31 AB - STATEMENT OF PROBLEM: The anticipated length of service and reasons for replacement of fixed partial dentures (FPDs) are a frequent inquiry by patients. Previous reports have provided limited information on material and techniques used in restoration or standards in evaluations of restorations at delivery. PURPOSE: This study determined the reasons for failure and length of service for FPDs delivered with specific clinical, radiographic, and laboratory procedures. METHODS: A clinical and retrospective chart review was conducted on all patients with FPDs who were treated in the prosthodontic clinic at the University of Iowa Hospital for routine dental hygiene recalls during a 6-month period. Fifty patients were examined with a total of 89 FPDs. Of the 89 FPDs, 13, or 15%, were identified as failures or had been replaced because of failure. Dental caries was the most frequent cause of failure (38%), followed by periapical involvements (15%), perforated occlusal surfaces (15%), fractured post and cores (8%), defective margins (8%), fractured teeth (7%), and porcelain failures (8%). The mean length of service for failed FPDs ranged from 16.0 years, because of failure from dental caries, to 4.1 years, because of a fractured post and core. RESULTS: A linear regression model of years in service against number of failed FPDs indicated that the number of years in service provided no information on predictability of failure for FPDs. CONCLUSIONS: This study supported previous reports of dental caries as the primary cause for failure of FPDs, but specific radiographic, clinical, and laboratory procedures can increase the length of service of these restorations. <117> UI - 97406751 AU - Teixeira ER AU - Wadamoto M AU - Akagawa Y AU - Kimoto T IN - Department of Removable Prosthodontics, Hiroshima University School of Dentistry, Japan. TI - Clinical application of short hydroxylapatite-coated dental implants to the posterior mandible: a five-year survival study. SO - Journal of Prosthetic Dentistry 1997 Aug;78(2):166-71 AB - STATEMENT OF PROBLEM: The surgical and restorative procedures at the posterior region of the maxilla and the mandible present a complex task in the treatment of partially edentulous patients. PURPOSE: The purpose of this study was to investigate the applicability of short hydroxylapatite-coated dental implants to the posterior mandible of partially edentulous patients. MATERIAL AND METHODS: Eight and 11 mm implants were evaluated as to their cumulative survival rate, clinical status (plaque index, gingival index, probing depth), and marginal bone loss over a 5-year period. RESULTS AND CONCLUSIONS: The verified overall cumulative survival rate was 94% for implants and 91% for prostheses. These results suggest predictable success for the application of short implants to the posterior mandible. <118> UI - 97380354 AU - Parein AM AU - Eckert SE AU - Wollan PC AU - Keller EE IN - Department of Dental Specialties, Mayo Clinic, Rochester, Minn, USA. TI - Implant reconstruction in the posterior mandible: a long-term retrospective study. SO - Journal of Prosthetic Dentistry 1997 Jul;78(1):34-42 AB - STATEMENT OF PROBLEM: Because there is a lack of long-term data, it is unclear whether the determinants of implant and prosthesis survival include the location, angle, design, or number of implants and use of prosthesis cantilevers. PURPOSE: This retrospective study evaluated the long-term outcome, determinants of outcome, and the type and prevalence of prosthetic complications in a series of patients treated consecutively with Branemark implants in the partially edentulous posterior mandible. MATERIAL AND METHODS: A total of 392 consecutively placed Branemark implants were inserted in 152 partially edentulous patients and restored with 56 single-tooth and 168 fixed partial dentures restorations. RESULTS: The cumulative success rates of implants and prostheses were 89.0% +/- 0.03% and 81.9% +/- 0.03%, respectively, at 6 years, with no further decrease in success noted during the remainder of the 10-year study. Significantly fewer major complications were found in prostheses supported by one or more implants, located exclusively in premolar sites, versus prostheses supported by either molar implant(s) or both premolar and molar implants. In single-tooth restorations, fewer major complications were seen in the cemented restorations, compared with the screw retained. CONCLUSION: The results were strongly influenced by the phase of experience. <119> UI - 97321736 AU - Lovgren R AU - Andersson B AU - Bergovist S AU - Carlsson GE AU - Ekstrom PF AU - Odman P AU - Sundqvist B IN - Public Dental Service Clinic, Kungshamn, Sweden. TI - Clinical evaluation of ceramic veneered titanium restorations according to the Procera technique. SO - Swedish Dental Journal 1997;21(1-2):1-10 AB - The aim of the present study was to present the design and one-year results of a study of crowns and fixed partial dentures (FPDs) made with the Procera system. All patients at one clinic needing fixed prosthodontic restorations during a two-year period were invited. All 260 patients accepted to participate and they received 333 ceramic veneered Procera restorations-242 single crowns and 91 FPDs. The loss of patients during the one-year follow-up was only 5%. The restorations were evaluated according to a modified version of the California Dental Association rating system. Practically all Procera restorations were judged as satisfactory both at base line and at the one-year follow-up examination. Two crowns and one FPD showed fractures of the ceramic veneering. Another FPD had a fracture of a welded joint. Three single crowns came loose but could be recemented. In conclusion, the ceramic veneered Procera titanium restorations were well accepted by the patients and the success rate was high during the one-year follow-up period. <120> UI - 97347777 AU - Arutiunov SD TI - [The principles of designing stump pin inserts in pathological tooth abrasion]. [Russian] SO - Stomatologiia 1997;76(3):51-4 AB - A total of 278 patients aged 40 to 67 with pathological abrasion of hard dental tissues were treated. Decreased occlusion height was diagnosed in 152 (54.67%) of these. In 146 patients abutment teeth under permanent dentures were fixed with cast stump pin insertions. Complications occurred in 9.6% cases: perforation of the wall of the root canal (1.14%), failure of cementing (3.98%), fracture of the root (1.14%), breaking of a fragment of the root at the neck of the tooth (2.84%), and inflammations of the marginal periodontium (0.57%). In order to prevent these complications and improve the fixation of cast stump pin insertion, we used our modifications of cast stump pin insertions (n = 394) for anterior and lateral teeth. The incidence of complications decreased more than 5 times. Follow-up of 2 to 8 years showed 1.78% of complications. <121> UI - 97318425 AU - Creugers NH AU - De Kanter RJ AU - van 't Hof MA IN - TRIKON, Department of Oral Function and Prosthetic Dentistry, Dental School University of Nijmegen, Nijmegen, The Netherlands. TI - Long-term survival data from a clinical trial on resin-bonded bridges. SO - Journal of Dentistry 1997 May-Jul;25(3-4):239-42 AB - OBJECTIVES: A clinical trial, involving 203 resin-bonded bridges (RBBs) was undertaken to investigate the influence of retainer-type and luting material on the survival of these restorations. METHODS: For this evaluation, 157 patients were available (14% of the original sample was lost to follow-up or excluded from the study following the stopping criteria). Fifty per cent of the patients were questioned concerning the fate of the RBBs and 59% of questioned patients were examined clinically. The patients that were seen for examination were representatives of the experimental groups. The findings from the clinical examination were compared with the data obtained from the questionnaire. Missing data were censored at the date of the last available information. Kaplan-Meier estimates were calculated to assess the survivals at the endpoints and compared using Cox's proportional hazards procedure. RESULTS: A significant difference was found between perforated (P-type) and etched (E-type) RBBs (P = 0.05) for original bonded restorations but not when rebonded RBBs were taken into account. The results of the survival analysis were: anterior P-type, 49 +/- 7% after 10.5 years: anterior E-type, 57 +/- 7% after 10.5 years; posterior P-type, 18 +/- 11% after 6.8 years; posterior E-type, 37 +/- 13% after 10.2 years. Survivals of RBBs that were rebonded once during the evaluation period were 62 +/- 9% (11.0 years) for anterior RBBs and 51 +/- 11% (10.2 years) for posterior RBBs. CONCLUSIONS: The factor location (anterior versus posterior) was as in previous analyses, highly significant. Differences in survival between cementation materials were not significant. <122> UI - 97204033 AU - Kucey BK TI - Implant placement in prosthodontics practice: a five-year retrospective study. SO - Journal of Prosthetic Dentistry 1997 Feb;77(2):171-6 AB - Dental implants have revolutionized dentistry in every aspect of treatment including surgery, restorative dentistry, and orthodontic treatment planning. PURPOSE: This retrospective study analyzes the treatment of completely and partially edentulous patients in a prosthodontics practice and the Edmonton Implant Seminar. MATERIAL AND METHODS: All implant surgery was performed by the prosthodontist. The majority of implants (336) were restored by the prosthodontist (71%). A total of 135 restorations were provided by 12 different general practitioners (29%) in a study group environment. RESULTS: Of 471 implants that were placed, 453 (96.2%) integrated successfully. Treatment groups were divided into single implant restoration (19.3%), fixed partial dentures (51%), overdentures (12.3%), and mandibular fixed partial denture cantilever (17.6%). Retention of final prosthesis was 99.4%. Of 18 failures, four occurred between Stage I and II surgeries, 11 occurred between Stage II surgery and final impressions, and three occurred after placement of final restorations. All three restorative failures were single implants. CONCLUSION: The results indicated that implant placement by a prosthodontist is comparable to the success of previous studies. <123> UI - 97181297 AU - Chai J AU - McGivney GP AU - Munoz CA AU - Rubenstein JE IN - Nobel Biocare Center for Excellence, School of Dentistry, University of Michigan, Ann Arbor, USA. TI - A multicenter longitudinal clinical trial of a new system for restorations. SO - Journal of Prosthetic Dentistry 1997 Jan;77(1):1-11 AB - STATEMENT OF PROBLEM: A new method for fabrication of crowns and fixed partial dentures (Procera system) that involves electric discharge machining and copy milling has been developed. The metal used is unalloyed titanium, which can be processed as a single coping or multiple units joined to a pontic by laser welding. PURPOSE: The single-unit coping or the fixed partial denture (FPD) substructure is then veneered with a low-fusing porcelain. MATERIAL AND METHODS: In this article the clinical application of this technique was evaluated by six major universities in the United States. A total of 114 patients participated in this study, which involved 126 restorations (55 maxillary and 71 mandibular prostheses). There were 179 abutments, of which 73 were crowns and 53 were three-unit FPDs. Surface and color, anatomic form, and margin integrity were assessed 1 month after cementation and at 1 year with the California Dental Association (CDA) quality assessment evaluation system. RESULTS: No statistically significant differences in CDA scores between the 1 month evaluations and the 1 year assessments were found for surface and color (p = 0.68), anatomic form (p > 0.99), or margin integrity (p = 0.57). By use of the lowest ranking in the three categories as the overall quality of the restoration, only 3.3% (two crowns and two FPDs) were not acceptable at the 1-month visit and 4.5% (two crowns and three FPDs) were not acceptable at the 1-year evaluation. At-the 1-month visit 96.6% (114) of the restorations were considered to be satisfactory, whereas 95.5% (107 restorations) were evaluated similarly at the 1-year evaluation. CONCLUSIONS: The Procera system demonstrated, by use of the CDA criteria, its capability to produce quality prostheses that were rated satisfactory more than 95% of the time after insertion and maintained this high rating at least for 1 year. <124> UI - 97233703 AU - Olsen CB AU - Bourke LF IN - Royal Dental Hospital of Melbourne, Victoria. TI - Recessive dystrophic epidermolysis bullosa. Two case reports with 20-year follow-up. SO - Australian Dental Journal 1997 Feb;42(1):1-7 AB - These two case reports highlight the enormous clinical difficulties faced by dentists in providing satisfactory long-term dental care to patients who suffer from Epidermolysis bullosa. Problems of bullae formation in oral soft tissues and subsequent scarring are outlined in relation to the difficulty of maintaining satisfactory oral hygiene and a diet leading to minimal dental caries experience. The behavioural problems of maintaining patient compliance for preventive and restorative dentistry in this painful and debilitating disease are illustrated in these case reports. Difficulties in providing restorative care, either under local anaesthesia or general anaesthesia are discussed, and a novel replacement of non-viable carious anterior teeth using a nine-unit porcelain fused to metal Rochette type bridge is presented. Dental management of patients with Epidermolysis bullosa should commence at birth, and non-compliance in dental attendances should be followed up by social workers to prevent the disastrous oral morbidity that frequently occurs in such patients. <125> UI - 97208274 AU - Bishop K AU - Priestley D AU - Deans R AU - Joshi R IN - Charles Clifford Dental Hospital, Sheffield, UK. TI - The use of adhesive metal-ceramic restorations as an alternative to conventional crown and bridge materials. SO - British Dental Journal 1997 Feb 8;182(3):101-6 AB - A compromise is often necessary when choosing the most appropriate material in the construction of crowns and bridges. The most commonly used material is porcelain fused to metal since it is aesthetic and has acceptable physical characteristics to be used in the restoration of both anterior and posterior teeth. Unfortunately, to achieve a predictable and durable result extensive tooth preparation is invariably necessary. More conservative alternatives such as dentine-bonded crowns may have inferior physical characteristics and allow less predictable control over the occlusal contour. This paper describes the construction of fixed restorations which use both lost wax and refractory die techniques in their construction. This results in a restoration which has the combined advantages of both traditional porcelain fused to metal and dentine-bonded crowns and bridges. <126> UI - 98116645 AU - Antonescu E IN - Discipline de Clinique et Therapie d'Edentation Totale, Faculte de Stomatologie, Universite de Medecine et Pharmacie Gr. T. Popa, Iasi. TI - [Clinical observations on the effects of a fixed denture on odonto-periodontal tissues]. [French] SO - Revista Medico-Chirurgicala a Societatii de Medici Si Naturalisti Din Iasi 1996 Jul-Dec;100(3-4):203-10 <127> UI - 98114762 AU - Wood M AU - Kern M AU - Thompson VP AU - Romberg E IN - Department of Restorative Dentistry, University of Maryland at Baltimore, Dental School 21201, USA. TI - Ten-year clinical and microscopic evaluation of resin-bonded restorations. SO - Quintessence International 1996 Dec;27(12):803-7 AB - A clinical recall was conducted for 103 patients who were functioning with resin-bonded restorations for approximately 10 years. The purpose of this study was to evaluate marginal adaptation of the cast metal retainers. Following clinical evaluations, replicas of incisal and occlusal margins were examined in the scanning electron microscope to determine marginal separation and microscopic patterns of the resin composite interface between metal and tooth. Anterior abutments exhibited better clinical adaptation and fewer voids and debonds than did posterior abutments. Larger microscopic marginal separations were associated with those retainers that had clinically detectable voids or defects. <128> UI - 97386100 AU - Tonetti MS AU - Pini Prato G AU - Stalpers G AU - Cortellini P IN - Department of Periodontology and Fixed Prosthodontics, University of Bern, Switzerland. TI - Guided tissue regeneration of deep intrabony defects in strategically important prosthetic abutments. SO - International Journal of Periodontics & Restorative Dentistry 1996 Aug;16(4):378-87 AB - This study reports the clinical outcomes obtained in a longitudinal cohort of 23 patients treated by guided tissue regeneration for strategically important teeth compromised by the presence of deep intrabony defects. After completion of initial periodontal therapy and placement of a provisional fixed partial denture, a nonresorbable e-PTFE membrane was applied to isolate the defect. Changes in probing attachment level, probing pocket depths, and radiographic bone support were evaluated 12 months after removal of the membrane. Clinically and statistically significant improvements in outcome measurements were observed: a probing attachment level gain of 5.3 +/- 1.7 mm, a reduction in probing pocket depths of 6.1 +/- 2 mm, and an increase in the percentage of radiographic bone support of 31% +/- 18%. The results obtained were highly reproducible with 91.3% of the cases resulting in probing attachment level gains of 4 mm or more. The evidence provided in this investigation indicates that guided tissue regeneration can predictably increase the functional support, and possibly improve the prognosis of strategically important abutments. Guided tissue regeneration therapy should, therefore, be one of the options discussed in treatment planning for complex periodontal-prosthetic cases. <129> UI - 97370886 AU - Braun JM TI - Enhanced aesthetics using provisionalization. SO - Signature 1996 Winter;:10-3 AB - The proper fabrication of provisional restorations is integral to the overall success of restorative dentistry, as these templates are the initial architecture for the completed case. In a clinical setting, restorations may be utilized for an extended period, during which time the clinician and patient must feel confident. Due partially to a new generation of dental materials with unique properties, provisionalization can be predictably achieved. This article reviews the clinical criteria for the fabrication of interim restorations using a light cure/dual phase temporary crown and bridge material (Provipont DC, Ivoclar Vivadent, Amherst, NY) and its effect on the overall success of restorative procedures, including anterior and posterior restorations. <130> UI - 97304854 AU - Rose LF AU - Weisgold AS IN - School of Dental Medicine, University of Pennsylvania, USA. TI - Teeth or implants: a 1990s dilemma. SO - Compendium of Continuing Education in Dentistry (Jamesburg, NJ) 1996 Dec;17(12):1151-9; quiz 1158 AB - Using endosseous implants to replace missing teeth is a highly predictable process when the precepts defined by Branemark are followed. The question of whether or not to extract periodontally compromised teeth, however, remains controversial. This article presents a case report illustrating some of the concerns involved when treating a patient with a combination of natural teeth and implants, and proposes several compelling questions regarding the treatment decisions made in this case. <131> UI - 97296100 AU - Bragger U AU - Hugel-Pisoni C AU - Burgin W AU - Buser D AU - Lang NP IN - University of Berne, School of Dental Medicine, Switzerland. TI - Correlations between radiographic, clinical and mobility parameters after loading of oral implants with fixed partial dentures. A 2-year longitudinal study. SO - Clinical Oral Implants Research 1996 Sep;7(3):230-9 AB - The aim of present study was to correlate the changes in the peri-implant tissues occurring after functional loading of non-submerged titanium implants and assessed by radiographic, clinical and mobility measurements. 11 patients with distal extension situations received 18 implants of the ITI Dental Implant System. After a healing period of 3 months, the suprastructures were fabricated and seated 5 months post-surgically. For the assessment of peri-implant bone changes, standardized vertical bitewing radiographs with reproducible exposure geometry were evaluated using computer assisted densitometric image analyses (CADIA) and bone height measurements. Since the radiographic evaluations were performed at mesial and distal sites only, the clinical parameters from these implant aspects were included in the analysis. Clinical periodontal parameters modified for the use around implants were obtained, damping characteristics were expressed as Periotest readings and standardized radiographs were obtained at 1, 3, 6, 12 and 24 months after loading. In addition, radiographs were also taken at the start of functional loading. The data obtained from this small sample of implants demonstrated a wide range of different tissue alterations when using radiographic, clinical and mobility assessments. The parameters of probing attachment level (PAL) in combination with radiographic parameters obtained at 1, 3, and 6 months after loading were good predictors for the peri-implant tissue status at 2 years. This was shown by means of multiple stepwise regression analyses. Mobility measurements did not reveal valuable predictive information with the statistical models applied. Assessments of probing attachment levels using periodontal probes rendered information on peri-implant tissue alterations, which were closely correlated to the radiographically measurable peri-implant bone changes. <132> UI - 97180060 AU - Ferrari M AU - Cagidiaco MC AU - Kugel G IN - Postgraduate Program of Restorative Dentistry, University of Siena, Italy. TI - All-ceramic fixed restorations: a preliminary clinical evaluation. SO - Practical Periodontics & Aesthetic Dentistry 1996 Jan-Feb;8(1):73-80; quiz 82 AB - This article is a preliminary evaluation of a limited size clinical trial of all-ceramic fixed restorations. The maxillary anterior region in each of eight patients was restored with single-unit and three-unit fixed restorations, using a particular all-ceramic system. Patient selection, laboratory procedures, clinical techniques, patient follow-up, and the interim clinical results of the restorations, are presented and evaluated. The learning objective of this article is to review and update the knowledge of all-ceramic restorative materials and clinical procedures. Two of the eight cases in the study are presented to illustrate the clinical results. <133> UI - 97144963 AU - Venturelli A IN - Catholic University Cordoba Republica Argentina, School of Medicine, Argentina. TI - A modified surgical protocol for placing implants in the maxillary tuberosity: clinical results at 36 months after loading with fixed partial dentures. SO - International Journal of Oral & Maxillofacial Implants 1996 Nov-Dec;11(6):743-9 AB - The purpose of this study was to investigate the impact of a modified surgical protocol and the survival of implants placed in the posterior maxilla. Forty-two implants were placed in the maxillary posterior area of 29 partially edentulous patients (17 men, 12 women; mean age 50 years; range 38 to 62 years) according to the modified surgical protocol. Twenty-nine of these implants had been placed into the maxillary tuberosity. All implants were checked radiologically every 12 months with a customized film holder. The restorations were fixed partial prostheses. Only 1 of the 42 implants was lost at stage 2 surgery. Results suggest that considerable benefits may be obtained by modifying a standard surgical protocol to maximize the results for a particular anatomic site. <134> UI - 97052658 AU - Wood M AU - Thompson VP AU - Romberg E AU - Morrison G IN - Department of Restorative Dentistry, Baltimore College of Dental Surgery, Dental School, University of Maryland at Baltimore, USA. TI - Resin-bonded fixed partial dentures. II. Clinical findings related to prosthodontic characteristics after approximately 10 years. SO - Journal of Prosthetic Dentistry 1996 Oct;76(4):368-73 AB - A clinical study was conducted for patients who were functioning with resin-bonded fixed partial dentures for approximately 10 years. The purpose of this study was to evaluate the periodontal health and determine the prosthodontic characteristics of the fixed partial dentures. Results indicated that plaque indexes, probing, recession, and loss of attachment were greater for abutments than for control teeth. The differences were statistically significant but clinically small. The bonded restorations were generally well adapted and contoured for case of cleaning. <135> UI - 97052667 AU - Yang HS AU - Chung HJ AU - Park YJ IN - Department of Prosthodontics, Chonnam National University, Dental School, Kwangju, Korea. TI - Stress analysis of a cantilevered fixed partial denture with normal and reduced bone support. SO - Journal of Prosthetic Dentistry 1996 Oct;76(4):424-30 AB - A two-dimensional finite element model was constructed to analyze the simulated mechanical behavior of a cantilevered fixed partial denture. The variations of the models were made by altering the degree of bone support, the number of splinted abutments, and the length of the pontics. High stress concentrations were observed around the connectors of the fixed prosthesis and the tooth closest to the cantilever. Reduced bone support increased the deflection and stress concentrations. There was reduction in displacement and stress concentration when the teeth were splinted together. To improve the prognosis of the fixed partial denture cantilever, the number of abutments should be increased and the number of pontics decreased. <136> UI - 97095437 AU - Brogniez V AU - Lejuste P AU - Pecheur A AU - Reychler H IN - Service de Prothese dentaire, Universite Catholique de Louvain, Bruxelles. TI - [Prosthetic dental rehabilitation on osseointegrated implants placed in irradiated mandibular bone. Apropos of 50 implants in 17 patients treated over a period of 5 years]. [French] SO - Revue de Stomatologie et de Chirurgie Maxillo-Faciale 1996 Oct;97(5):288-94 AB - The authors report on their experience with prosthetic dental rehabilitation of 17 patients after surgery and radiotherapy for oncologic diseases of the oral cavity. 50 implants were inserted either in the mandibular residual bone or in a bone graft. These implants were inserted at least 5 months after radiotherapy, and functionally loaded at least 5 months after implanting. Depending on the degree of edentation, 2 to 6 implants were necessary to allow for a functional removable or fixed denture. 2 implants were lost because of lack of osseointegration and 10 were lost because of death of 4 patients. The longest observation period was 56 months and the mean observation time was 29 months. Not any osteoradionecrosis occurred : nevertheless, implantation in irradiated bone must remain a carefully planned operation in selected patients with a rigourous therapeutic protocol. <137> UI - 97116786 AU - Decock V AU - De Nayer K AU - De Boever JA AU - Dent M IN - Department of Fixed Prosthesis and Periodontology, University of Gent Dental School, Belgium. TI - 18-year longitudinal study of cantilevered fixed restorations. SO - International Journal of Prosthodontics 1996 Jul-Aug;9(4):331-40 AB - One hundred thirty-seven cantilevered fixed partial dentures made between 1974 and 1990 were clinically and radiographically evaluated. Thirty-three of the prostheses were located in the mandible (11 in the anterior and 22 in the posterior region) and 104 were located in the maxillae (58 anterior prostheses and 46 posterior prostheses). Median duration was 84 +/- 3.6 months. During the 18 years, 41 (30%) failed. Of those that "failed," 28 (68%) were in the maxillae and 13 (32%) were in the mandible. Reasons for failure included abutment fracture (4), loosening with or without caries (18), secondary caries (9), fracture of prosthesis (2), fracture of extension (1), periodontal problems (6), and apical reaction (1). Failures occurred significantly more when endodontically treated abutments were used. More mandibular restorations failed than did maxillary units, but the difference was not significant. The prosthesis length ratio and the crown length-bone ratio did not influence the failure rate. The overall success rate of cantilever fixed prostheses was 70% over a period of 18 years. <138> UI - 97021261 AU - Bishop K AU - Briggs P AU - Kelleher M IN - Department of Restorative Dentistry, Charles Clifford Dental Hospital, Sheffield. TI - Margin design for porcelain fused to metal restorations which extend onto the root. SO - British Dental Journal 1996 Mar 9;180(5):177-84 AB - A 90 degree shoulder is probably the most commonly used margin design for porcelain fused to metal (PFM) restorations. However, this design requires the removal of a significant amount of tooth tissue to provide a predictable restoration. This increases the risk of irreversible damage to the pulp, particularly if little tooth tissue is present, for example on exposed roots. In these situations more conservative designs, such as the 135 degree shoulder or deep chamfer, should be considered. Ideally these designs should be used with an all-metal margin since this is associated with the most predictable marginal seal. Where an all metal margin is aesthetically unacceptable a porcelain butt or subgingival margin can be considered. Newer techniques, such as resin bonded crowns, which minimise tooth destruction and provide acceptable aesthetics may be a viable alternative to traditional PFM restorations. Unfortunately, these newer techniques have not been evaluated long-term. <139> UI - 97134019 AU - Briggs P AU - Dunne S AU - Bishop K IN - Department of Restorative Dentistry, King's College Dental Institute, London. TI - The single unit, single retainer, cantilever resin-bonded bridge. SO - British Dental Journal 1996 Nov 23;181(10):373-9 AB - Resin-bonded restorations have many advantages over conventional alternatives. Advances in adhesive technology together with a better understanding of the clinical function of such restorations have allowed resin-bonded bridges to play an important role in everyday clinical practice. This paper highlights the role and importance of the single abutment, single pontic cantilever resin-bonded bridge. Clinical experience might suggest that the cantilever design offers a viable alternative to other designs. Furthermore, the paper suggests that when cantilever resin-bonded bridges fail initially, re-bond often leads to predictable long-term success. Factors such as patient selection, abutment preparation, retainer design and the aesthetic limitations of resin-bonded bridges are also discussed. The authors can claim that further clinical studies are necessary to identify exactly what factors influence the success of cantilever and other resin-bonded designs. <140> UI - 97128358 AU - Watson RM AU - Davis DM IN - Department of Dental Prosthetics, King's Dental Institute, King's College School of Medicine and Dentistry, London. TI - Follow up and maintenance of implant supported prostheses: a comparison of 20 complete mandibular overdentures and 20 complete mandibular fixed cantilever prostheses. SO - British Dental Journal 1996 Nov 9;181(9):321-7 AB - Two independently selected groups of 20 patients who were edentulous in te mandible, were followed up on a regular basis over a 5-year period following restoration with a lower implant stabilised prosthesis and conventional upper denture. Significantly more treatment was required by those who received complete mandibular overdentures than those provided with complete fixed mandibular prostheses. In addition to adjustment for the relief of denture trauma to the mucosa, more mechanical problems arose with overdenture implant prostheses. <141> UI - 96409652 AU - Boening KW IN - Department of Prosthodontics, Medical Faculty Carl-Gustav-Carus, Technical University Dresden, Germany. TI - Clinical performance of resin-bonded fixed partial dentures. SO - Journal of Prosthetic Dentistry 1996 Jul;76(1):39-44 AB - Resin-bonded fixed partial dentures (RBFPDs) initially recorded poor survival rates because of indefinite tooth preparations and arbitrary selection of composite resin cements. In this study, 46 RBFPDs were inserted for a longitudinal study up to 45 months. The influence of location--anterior/posterior, or maxilla/mandible--and the inclusion of pontics in occlusal excursions on the survival rates was investigated. Periodontal parameters were recorded from abutments and controls (teeth). Eight RBFPDs lost retention and two RBFPDs failed because of porcelain fractures. The anterior to posterior location and the maxillary or mandibular arch had significant influence on the survival rates. Gingival scores of abutments and controls differed significantly, but statistically significant differences were not recorded for plaque scores. <142> UI - 97065317 AU - Singer A AU - Serfaty V IN - Department of Oral Rehabilitation, Ichilov Hospital, Sourasky Medical Center, Tel Aviv, Israel. TI - Cement-retained implant-supported fixed partial dentures: a 6-month to 3-year follow-up. SO - International Journal of Oral & Maxillofacial Implants 1996 Sep-Oct;11(5):645-9 AB - This study presents a follow-up of 92 implant-supported fixed partial dentures that have been cement retained for 6 months up to 3 years. Included in the study were 41 women and 29 men. A total of 225 implants were placed (86 in the maxilla and 139 in the mandible). Fixed partial dentures, including single-tooth restorations, were temporarily cemented using Temp-Bond or IRM. Complications encountered were cement washout, procelain fracture, loose central screws, and implant failure. This study suggests an alternative to screw-retained prostheses; the method presented may lower the reported complications. <143> UI - 97074095 AU - Jokstad A AU - Mjor IA IN - Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Oslo, Norway. TI - Ten years' clinical evaluation of three luting cements. SO - Journal of Dentistry 1996 Sep;24(5):309-15 AB - OBJECTIVE: The aim of the present clinical longitudinal study was to observe, over 10 years, the prognosis of abutment teeth restored with fixed prostheses retained by glass ionomer luting cements and one conventional zinc phosphate cement. METHODS: Three dentists prepared 135 abutment teeth in 61 patients to retain 81 fixed prostheses. The prostheses were retained by two glass ionomer luting cements (Ketac-Cem, Fuji Ionomer), or a conventional zinc phosphate cement (De Trey Zinc Zement Improved). The patients were examined yearly for 10 years. RESULTS: Post-operative hypersensitivity occurred in five teeth restored with glass ionomer luting cement. The prevailing reason for abutment tooth failure was secondary caries (n = 21) and pulp necrosis (n = 5). Non-parametric survival estimates indicated that 80-85% of the abutment teeth remained intact after 5 years and 71-81% after 10 years. CONCLUSIONS: The 10-year results indicate that the prognosis of abutment teeth restored with fixed prostheses is good, regardless of whether a glass ionomer or a zinc phosphate luting cement is used. <144> UI - 96409582 AU - Allen PF AU - Witter DF AU - Wilson NH AU - Kayser AF IN - Department of Restorative Dentistry, Dental School, University of Manchester, U.K. TI - Shortened dental arch therapy: views of consultants in restorative dentistry in the United Kingdom. SO - Journal of Oral Rehabilitation 1996 Jul;23(7):481-5 AB - This paper reports the results of a study on the attitudes of the consultants in restorative dentistry (CRD) in the UK towards shortened dental arch therapy (SDAT). Data were collected by means of questionnaire, with a response of 67% achieved. The results indicate that 95% (n = 87) of the 91 participants in the study were of the opinion that SDA has a place in contemporary clinical practice. Eighty (88%) of the participants reported having prescribed SDA therapy during the last 5 years, the number of these patients requiring > 5 units of crown and bridgework being typically less than 25%. Forty-one (45%) of the participants reported patients being considered for SDAT expressing reservations about the outcome of their treatment, although around 75 (82%) of the participants indicated that SDAT was satisfactory in terms of oral function, comfort and well being. Experience of having to extend shortened dental arches following SDAT was limited to 34 (37%) of the participants. It is concluded that SDA is widely accepted but not widely practiced by CRDs in the UK and that, in patients satisfying existing criteria, the outcome of SDAT may be found to be acceptable in approximately 82% of cases. <145> UI - 97002720 AU - Swartz B AU - Svenson B AU - Palmqvist S IN - Department of Prosthetics, Postgraduate Dental Education Center, Orebro, Sweden. TI - Long-term changes in marginal and periapical periodontal conditions in patients with fixed prostheses: a radiographic study. SO - Journal of Oral Rehabilitation 1996 Feb;23(2):101-7 AB - Patients treated at a prosthodontic department during the years 1968-73 with fixed restorations (at least five units) were followed up in 1991-92. The aim of the present study was to compare marginal and periapical periodontal conditions on radiographs from 1968-73 and 1991-92 and relate the changes to the results of the prosthodontic treatment. In the group in which the restorations remained unchanged, 90% of the abutments that were not root filled and showed no periapical radiolucency when the restorations were placed, were still not root filled and showed no periapical radiolucency at the follow-up examination. The corresponding figure for the group in which the restorations had been replaced was only 69%. The changes in marginal bone levels also differed between the groups. In the group with remaining restorations, 66% of the surfaces were given the same score on a five-point scale both in 1968-73 and in 1991-92. In the other group, only 54% were scored the same on both occasions. Thus, unfavourable changes in both periapical and marginal periodontal conditions were associated with poorer results for the fixed restorations. <146> UI - 96377705 AU - Budtz-Jorgensen E IN - Division of Gerodontology and Removable Prosthodontics, University of Geneva, Switzerland. TI - Restoration of the partially edentulous mouth--a comparison of overdentures, removable partial dentures, fixed partial dentures and implant treatment. [Review] [89 refs] SO - Journal of Dentistry 1996 Jul;24(4):237-44 AB - OBJECTIVES: Loss of posterior teeth may result in the loss of neuromuscular stability of the mandible, reduced masticatory efficiency, loss of vertical dimension of occlusion and poor aesthetics. Prosthetic rehabilitation should aim at restoring the vertical dimension and increasing the occlusal contact area in the premolar/molar region. Overdentures are particularly indicated in patients with a severe loss of periodontal attachment, uncertain periodontal prognosis and complicated functional or aesthetic conditions. Removable partial dentures are particularly indicated in Kennedy Class I cases when there is need for a simple and economic solution. Placement of a removable partial denture with occlusal overlays is a simple way to restore occlusal face height. Cross-arch cantilevered fixed partial dentures are primarily indicated for stabilization of periodontally weakened abutments. Short unilateral or bilateral bridges are a solution in patients who refuse removable appliances and who cannot afford more extensive rehabilitation with fixed prosthodontics. Rehabilitation with a fixed partial denture supported by means of osseointegrated implants is the optimal solution in Kennedy Class II cases provided that the bone conditions are appropriate. For any prosthetic treatment, a definite recall system should be established depending on the patient's degree of cooperation, caries susceptibility, periodontal status and the rate of residual ridge resorption. This is essential in order to obtain a satisfactory prognosis. In a patient with poor oral hygiene, the best solution, with regard to the prognosis of the remaining teeth, is to abstain from any prosthetic treatment. METHODS: This manuscript reviews the current literature to identify treatment options for the Kennedy Class I and II partially edentulous patient. [References: 89] <147> UI - 96377707 AU - Hussey DL AU - Linden GJ IN - Division of Restorative Dentistry, School of Clinical Dentistry, Queen's University of Belfast, Northern Ireland, UK. TI - The clinical performance of cantilevered resin-bonded bridgework. SO - Journal of Dentistry 1996 Jul;24(4):251-6 AB - OBJECTIVES: The technique of resin-bonded bridgework is a well-accepted clinical technique to replace missing teeth. This study assesses the clinical performance of cantilevered resin-bonded bridgework provided in a university teaching hospital environment. METHODS: One-hundred and twelve patients who had a total of 142 cantilevered bridges were either examined or completed a questionnaire regarding their bridgework. The following data were recorded for each resin-bonded bridge: gender of patient, age at bridge cementation, date of initial cementation, tooth replaced, abutment(s) involved, and grade of clinician responsible for the provision of the bridge. Details of the incidence of debonding with date(s) and the subsequent treatment in relation to the debonded resin-bonded bridge were recorded. The subjects examined indicated their degree of satisfaction with their bridgework on a visual analogue scale. RESULTS: There were 112 patients with a total of 142 bridges, 116 (82%) maxillary and 26 (18%) mandibular. The mean length of clinical service was 36.2 months (s.d. 17.2 months). Only single pontics were included in the bridges, with almost half (49%) replacing a lateral incisor. Of the cantilever resin-bonded bridges studied, 88% remained bonded over the period of the study. A success rate of 94% is reported. CONCLUSION: This study confirms the clinical success of cantilever resin-bonded bridges particularly in the replacement of maxillary lateral incisors, maxillary premolar and permanent mandibular teeth. <148> UI - 96418018 AU - Hansson O AU - Bergstrom B IN - School of Dentistry, Karolinska Institute, Huddinge, Sweden. TI - A longitudinal study of resin-bonded prostheses. SO - Journal of Prosthetic Dentistry 1996 Aug;76(2):132-9 AB - Resin-bonded fixed partial dentures, without definitive tooth preparation and current resinous cements and perceptive treatment, have had an inordinate number of dislodgments in initial restorative efforts. A longitudinal examination of resin-bonded prostheses was performed after a mean observation time exceeding 6 years. To prevent stress fatigue fractures of the cement bondings, one proximal groove was prepared in dentin for each anterior abutment and the inner surfaces of the frameworks were silicoated. Five of 34 prostheses debonded, and the bond strength between resin and high gold alloys was too low to resist fatigue fractures during this study. The results of this study and other reports suggested a need for increased retention and resistance form of the frameworks to improve longevity of resin-bonded prostheses. <149> UI - 96310254 AU - Nemcovsky CE AU - Serfaty V IN - Section of Periodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel. TI - Alveolar ridge preservation following extraction of maxillary anterior teeth. Report on 23 consecutive cases. SO - Journal of Periodontology 1996 Apr;67(4):390-5 AB - The purpose of this article was to clinically evaluate the predictability of a surgical procedure to preserve the alveolar ridge after extracting maxillary anterior teeth with advanced bone loss. This procedure is indicated when a tooth-supported fixed partial denture will rehabilitate the area. Non-resorbable hydroxyapatite crystals are used as graft material and a rotated pediculated split thickness palatal flap covers them. Twenty-three patients who were treated with this procedure were followed for 12 to 24 months. Results were predictable with minimal postoperative ridge deformation. Indications for this procedure are discussed. <150> UI - 96242173 AU - Carlson BR AU - Yontchev E IN - Branemark Osseointegration Center, Carlanderska Hospital, Gothenburg, Sweden. TI - Long-term observations of extensive fixed partial dentures on mandibular canine teeth. SO - Journal of Oral Rehabilitation 1996 Mar;23(3):163-9 AB - Twelve patients were followed for 15 years after treatment with a 12-unit cantilever fixed partial denture on the mandibular canines opposite to a complete maxillary denture. Four constructions failed and had to be removed but four were still in function after 15 years. Four patients died during the observation period still wearing their constructions. Endodontic complications, pulpal necrosis and loss of retention of posts were the most frequent, while caries and periodontal lesions were rare. The maintenance costs over the years were fairly low even compared to maintenance costs for patients treated with implants. Extensive mandibular cantilever fixed partial dentures may be used in the rehabilitation of patients with a very reduced dentition and a history of difficulties adapting to removable dentures. <151> UI - 96224633 AU - Kern M AU - Kleimeier B AU - Schaller HG AU - Strub JR IN - Department of Prosthodontics, Albert-Ludwigs University, School of Dentistry, Freiburg, Germany. TI - Clinical comparison of postoperative sensitivity for a glass ionomer and a zinc phosphate luting cement. SO - Journal of Prosthetic Dentistry 1996 Feb;75(2):159-62 AB - In 60 patients, 120 partial and full-coverage restorations were cemented on vital abutment teeth with either a glass ionomer or a zinc phosphate luting cement. A split-mouth design and a patient blind data acquisition protocol were used. During an average observation period of 17.3 months there were no differences between the two types of luting cements in regard to subjective and clinical parameters. A high incidence of postoperative hypersensitivity, which is often said to accompany the use of glass ionomer luting cements, was not observed. With the cementation method used in this study, the glass ionomer cement Ketac-Cem Maxicap was an acceptable alternative to conventional zinc phosphate cement. Capsule systems make the clinical handling of glass ionomer luting cements safe and easy and should be used routinely in dental practice. <152> UI - 96242177 AU - Yi SW AU - Carlsson GE AU - Ericsson I AU - Wennstrom JL IN - Department of Periodontology, Faculty of Odontology, Goteborg University, Sweden. TI - Long-term follow-up of cross-arch fixed partial dentures in patients with advanced periodontal destruction: evaluation of occlusion and subjective function. SO - Journal of Oral Rehabilitation 1996 Mar;23(3):186-96 AB - The study aimed to investigate occlusal factors in fixed partial dentures (FPDs) still in service for more than 10 years, and to assess the patients' opinions regarding oral function with these constructions. Thirty-four patients with 43 FPDs were examined clinically concerning occlusion and by means of a questionnaire on functional aspects. The most common occlusal contact pattern was group function (51% on both sides, 7% on one side) while canine protected occlusion was recorded in 16% on both sides, 7% on one side. Balanced occlusion (19%) was mainly found when the FPD occluded against a complete denture and when there were few abutments and a small amount of abutment supporting tissue. The number and intensity of the occlusal contacts were assessed by means of thin occlusal sheets (50 microns). On average, one occlusal contact was observed on each dental unit with antagonist. The average number of sheets that could be introduced between the antagonists when the patient bit hard in the intercuspal position was two without significant differences between different areas (anterior/posterior) or type of dental unit (abutment, pontics, cantilever section). In the cantilever sections there were looser contacts (more interocclusal sheets) more distally. The great majority of patients were satisfied with the function of their FPDs (mastication, phonetics, aesthetics, comfort, and hygiene). Subjective function was not significantly influenced by FPD design, occlusal factors or number of FPD units. The only significant difference observed was that patients with a small amount of supporting tissues said they had more difficulties with hard foods than the others had. Although a stable occlusion was found in all FPDs, none of the other occlusal parameters examined were related to the long-term results. <153> UI - 96243022 AU - Priest GF TI - Failure rates of restorations for single-tooth replacement. [Review] [81 refs] SO - International Journal of Prosthodontics 1996 Jan-Feb;9(1):38-45 AB - Failure rates of traditional fixed partial dentures, resin-bonded prostheses, and implant restorations for the replacement of a single missing tooth are compared in this literature review. A lack of documented longevity studies involving conventional fixed partial dentures makes failure rates difficult to determine. Reported failures ranged from only 3% over 23 years to 20% over 3 years. The major causes of loss were caries and endodontically and periodontally related complications. Research concerning resin-bonded fixed partial dentures was more prevalent, but indicated that overall retention of these prostheses may be unpredictable. Failure rates were quite divergent, ranging from 10% over 11 years to 54% over 11 months. Debonding was the usual cause of failure. Clinical reports of single-tooth implant replacements have followed stricter protocols than the other two alternatives. Short-term studies indicated favorable success rates for these restorations, but these must be confirmed by long-term evaluations. Failures ranged from 9% over 3 years to 0% over 6.6 years. These comparisons should be considered in treatment planning a restoration for the replacement of a single missing tooth. [References: 81] <154> UI - 96243018 AU - Kaus T AU - Probster L AU - Weber H IN - Department of Prosthodontics, School of Dentistry, University of Tubingen, Germany. TI - Clinical follow-up study of ceramic veneered titanium restorations--three-year results. SO - International Journal of Prosthodontics 1996 Jan-Feb;9(1):9-15 AB - Eighty-four titanium restorations having 125 ceramic veneers were placed for 32 patients. One hundred sixteen (93%) of the veneers could be reexamined after 21 to 41 months. Two of the restorations required removal because of a partial veneer loss. A Kaplan-Meier survival analysis was performed, giving a survival probability of .85 for single crowns and .59 for fixed partial dentures after a time interval of 30 months, regarding the veneer cracking or chipping. There was a significantly higher survival probability for single crowns than for fixed partial dentures (P=.001, logrank test). It was concluded that ceramic veneered titanium restorations should be limited to single crowns. <155> UI - 96241506 AU - Samama Y TI - Fixed bonded prosthodontics: a 10-year follow-up report. Part II. Clinical assessment. SO - International Journal of Periodontics & Restorative Dentistry 1996 Feb;16(1):52-9 AB - The survival rates of resin-bonded fixed partial dentures, bonded splints, and bonded combination splints and fixed partial dentures (splints with pontics replacing one or two missing teeth) were determined. For statistical analysis, the splints and splint-prostheses were combined into one group. The average age of all devices combined was 5.7 years. Eleven of 145 resin-bonded fixed partial dentures failed; the survival rate was 83.0%. There was no statistically significant difference between the survival rates of prostheses, whether bonded to prepared teeth or unprepared teeth. Fifteen of 98 splints and splint-prostheses failed. The survival rate of splints and splint-prostheses bonded to prepared teeth (71.6%) was higher than that of splints and splint-prostheses bonded to unprepared teeth (53.6%). To determine the continuing relevance of resin-bonded prostheses, the number of instances in which implant dentures could have been used was calculated. Implant treatment would have been possible in only 14 or 98 cases. <156> UI - 96256570 AU - Stokholm R AU - Isidor F IN - Department of Prosthetic Dentistry and Stomatognathic Physiology, Royal Dental College, Aarhus University, Denmark. TI - Resin-bonded inlay retainer prostheses for posterior teeth. A 5-year clinical study. SO - International Journal of Prosthodontics 1996 Mar-Apr;9(2):161-6 AB - This study evaluated posterior resin-bonded prostheses using inlays as retainers. Thirty-nine patients missing at least one premolar or first molar received 51 resin-bonded fixed partial dentures with high noble alloy inlay retainers and a metal ceramic pontic. Resin luting material bonding to the framework was secured by the Silicoating method (24 fixed partial dentures), lost sugar crystal method (13 fixed partial dentures), or tin plating (14 fixed partial dentures). Clinical examinations were performed 1 week, 1 month, 6 months, 1 year, 2 years, and 5 years after cementation. None of the fixed partial dentures with silicoating or sugar crystal impressions lost retention, whereas two of the tin-plated fixed partial dentures required replacement. Resin-bonded inlay-retained prostheses appear to be a favorable alternative to other types of fixed partial dentures. <157> UI - 96216337 AU - Diedrich PR AU - Fuhrmann RA AU - Wehrbein H AU - Erpenstein H IN - Department of Orthodontics, Medical Faculty, Rheinisch-Westfalisch Technische Hochschule Aachen, Germany. TI - Distal movement of premolars to provide posterior abutments for missing molars. SO - American Journal of Orthodontics & Dentofacial Orthopedics 1996 Apr;109(4):355-60 AB - In 24 patients with missing molar teeth in the upper and/or in the lower jaw, 32 premolars were distalized. The mean orthodontic distalizing distance was 9.4 mm (SD 2.6). After distalization all these teeth served as posterior abutments for fixed restorations. The investigation period ranged between 2.5 to 14.1 years, average 9.6 years (SD 3.2). The clinical examination criteria were sensitivity, mobility, probing depth, sulcus bleeding index; the radiologic criteria were root resorption (lateral and apical) marginal bone level and axial position. None of the 32 premolar abutments were lost during investigation period. All the teeth maintained their vitality. The measured probing depths and sulcus bleeding indices were low. Of the teeth tested 40.6% revealed localized lateral root resorption on the pressure side; the average postorthodontic depth of root resorption was 0.7 mm (SD 0.3), and the length 2.3 mm (SD 0.6). The follow-up examination revealed a partial repair of the lateral root lesions. The extent of apical root resorption amounted to 0.9 mm (SD 1.1). The marginal bone level showed a bone loss of 0.5 mm mesially and 0.2 mm distally. The findings confirm that the distalized premolar functioning as a posterior bridge abutment represents a prognostically favorable alternative to an implant. <158> UI - 96245052 AU - Kerschbaum T AU - Haastert B AU - Marinello CP IN - Department of Preclinical Dentistry, School of Dentistry, University of Cologne, Germany. TI - Risk of debonding in three-unit resin-bonded fixed partial dentures. SO - Journal of Prosthetic Dentistry 1996 Mar;75(3):248-53 AB - Resin-bonded fixed partial dentures are considered practical and conservative but have not always enjoyed longitudinal success. The long-term survival of 1637 three-unit resin-bonded fixed partial dentures was analyzed. A multistate analysis that included parameters such as debonding, rebonding, or renewal of the restoration was used. Five years after insertion 66.1% (+/- 3.7%) of the originally inserted prostheses remained in place. If additional rebonding was computed, the probability of survival was 82.0% (+/- 3.0%). Reconstruction of the metal frame after one or more dislodgements raised the success rate to 87.1% (+/- 2.6%). Rebonded resin-bonded fixed partial dentures developed a greater risk of debonding. The risk of failure for refabricated fixed partial dentures was similar to that of the originally inserted resin-bonded fixed partial dentures. There were no signs of greater caries incidence after multiple recementation procedures. <159> UI - 96245049 AU - Drago CJ AU - Wagner S IN - Gundersen Clinic, Ltd., La Crosse, Wisc. USA. TI - Procedure to predictably seat multiple, hexed abutments onto endosseous implants: a clinical report. SO - Journal of Prosthetic Dentistry 1996 Mar;75(3):234-7 AB - The use of implants to restore the dentition of partially edentulous patients has increased over the past several years. Optimal esthetic results depend on satisfactory implant placement. Occasionally, implants are placed in less than optimal positions, which may require modification in the prosthesis design and increase the technical difficulty. In these instances, preangled or customized abutments can be used. If more than one of these abutments has to be used, accurate orientation of the hexed components to the implants and each other may be a problem. This clinical report illustrated a simple, inexpensive procedure to transfer the orientation of two or more hexed abutments from a master cast to the mouth. This procedure reduced the time needed to orient the hexed abutments correctly in laboratory and clinical situations. It may also reduce the chances of the patient aspirating or swallowing abutments or screws. <160> UI - 96176355 AU - White BA AU - Albertini TF AU - Brown LJ AU - Larach-Robinson D AU - Redford M AU - Selwitz RH IN - Center for Health Research, Kaiser Permanente, Portland, Oregon, USA. TI - Selected restoration and tooth conditions: United States, 1988-1991. SO - Journal of Dental Research 1996 Feb;75 Spec No:661-71 AB - The DMF index provides one source of information on past and present dental caries experience; however, important limitations hinder its ability to characterize fully the impact of dental caries. The purpose of this paper is to describe a measure of selected restoration and tooth conditions that supplements information from the DMF index and to report on the application of this measure as part of the Third National Health and Nutrition Examination Survey, Phase 1, conducted between 1988 and 1991. Data from this survey were used to estimate the prevalence and severity of selected disaggregated physical and biological oral conditions among dentate adults aged 18 to 74 years. Trained, standardized, and calibrated dentist examiners assessed 28 permanent teeth or tooth spaces for each of 6,767 subjects. Teeth or tooth spaces were classified based on criteria for: defective intracoronal restorations, crowns, or bridges; gross loss of tooth structure associated with a restoration; pulpal involvement; or retained roots. Approximately 40.5%, or 61.6 million, dentate adults had at least one tooth or tooth space that met the criteria. Among all persons, an average of 0.9 teeth or tooth spaces met the criteria for at least one category. Adults with at least one scored tooth or tooth space had an average of 2.2 such teeth or tooth spaces. Data from this assessment supplement information available from the DMF index to provide a broader profile of the impact of dental caries on permanent teeth of US adults. <161> UI - 96181208 AU - Zhukovsky L AU - Godder B AU - Settembrini L AU - Scherer W IN - Division of Restorative and Prosthodontic Sciences, New York University, College of Dentistry, New York, New York, USA. TI - Repairing porcelain restorations intraorally: techniques and materials. SO - Compendium of Continuing Education in Dentistry (Jamesburg, NJ) 1996 Jan;17(1):18, 20, 22 passim; quiz 30 AB - Ceramic and metal-ceramic restorations have the potential to fracture. Repairing porcelain restorations has become a serious cosmetic and clinical problem. By using porcelain-repair systems, porcelain fractures can be predictably fixed without removal of a prosthesis. The newest porcelain-repair systems show excellent durability of adhesion as well as bond strength. This article presents an overview of the techniques and materials and compares the four most-popular intraoral porcelain-repair systems. <162> UI - 98233345 AU - Abrams SH TI - A case study. Ridge-lapped implants: can they be used?. SO - Implant Society 1995;5(6):2-4 <163> UI - 98263536 AU - Samama Y TI - Fixed bonded prosthodontics: a 10-year follow-up report. Part I: Analytical overview. SO - International Journal of Periodontics & Restorative Dentistry 1995 Oct;15(5):424-35 AB - Developments in biomaterials in the field of adhesion have made possible a less invasive dentistry. Improvements in adhesive polymers along with the analysis of certain failures in resin-bonded prostheses have suggested the micropreparation of abutment teeth. A long-term study of resin-bonded prostheses and splints was undertaken. The success rate of this protocol is presented for a study period of 10 years (1984 to 1993). These results indicated that the resin-bonded prosthesis is a viable option in patients who are missing one or two teeth. Of 145 prostheses, 11 failed, resulting in an overall survival rate of 83% (Kaplan-Meier test). Furthermore, the study confirmed that, for splints, preparation is important to counter the major stresses related to tooth mobility in patients with periodontal disease. <164> UI - 97105118 AU - Quinn F AU - Gratton DR AU - McConnell RJ TI - The performance of conventional, fixed bridgework, retained by partial coverage crowns. SO - Journal of the Irish Dental Association 1995;41(1):6-9 AB - A retrospective study was carried out on 248 partial coverage retained fixed bridges, in 211 patients. All were inserted at an undergraduate dental clinic and their length of service ranged from 1 to 19 years. In 211 prostheses, on which current information was available a total of 20 (9.5%) bridges had failed. The reasons for failure were loss of retention and, to a lesser extent, caries. Using a LIFE TABLE of survival, it was calculated that the percentage of short span, partial veneer retained prostheses that would survive TEN years was 76.5% +/- 5.99% (standard error). This figure is comparable to that quoted for resin-bonded bridges, and hence would militate against the use of conventional partial coverage fixed retainers on intact teeth. Where abutment teeth are heavily restored, full coverage retainers provide a more predictable, long term result. <165> UI - 97096910 AU - Berte JJ AU - Brandt RL AU - Baker PS IN - Department of Prosthodontics, University of Florida College of Dentistry, Gainesville 32610-0435, USA. TI - Synergistic relationship between luting and priming agents and gold restorations plated with stannic oxide. SO - General Dentistry 1995 Sep-Oct;43(5):413-5 AB - Bonding to dentin and enamel has increased restorative treatment options, provided the materials are used to optimum advantage. Restorative dentists must understand the indications and the proper mechanisms for using these materials. As with many techniques and procedures, it takes more time to describe than to accomplish. The tooth-conditioning and cementing steps are standard treatment procedures used daily in most dental offices. Tin-plating and preparing the metal surface are laboratory procedures and consume no chair time. The clinical advantages of bonding--such as resistance to microleakage and recurring decay, enhanced retention, preservation of tooth structure, and extended restoration prognosis--far outweigh the modest increase in placement time. <166> UI - 96340210 AU - Amet EM AU - Phinney TL TI - Fixed provisional restorations for extended prosthodontic treatment. SO - Journal of Oral Implantology 1995;21(3):201-6 AB - During extensive and extended prosthodontic treatment, there is need for a durable esthetic fixed provisional restoration that can be easily modified as treatment is completed and that is cost-effective. The needed strength of provisional restorations can be underestimated, and the management of complex treatment is then more difficult and the prosthetic results less predictable. Knowledge of the criteria for treatment restorations and the adequacies of their construction is essential for the prevention of catastrophic failures, patient management problems, and compromised results. Many times in complex prosthodontic treatment, changes are needed in esthetics, the plane of occlusion, incisal edge position, lip support, and type of occlusion, or the soft and/or hard tissues need to be altered or grafted surgically. In addition, after first- and second-stage implant surgery and extractions, there is a need for immediate tooth replacement with extended time between prosthodontic treatments. These prosthodontic changes and challenges can be addressed with reinforced acrylic provisional restorations that are adequately cemented and retained during the interim stage of healing and treatment. In addition, the provisional restoration should serve as a guide for the final restoration while esthetics and phonetics are evaluated for patient acceptance. This article describes the materials used with an indirect technique for fabrication of an extended-treatment acrylic provisional restoration that uses an internal cast metal support system for strength. This support system consists of metal bands or copings with extensions into edentulous areas and that have been opaqued to neutralize the metallic color. A matrix of vinyl polysiloxane made from the diagnostic wax-up simplifies construction of the acrylic, resulting in a strong, ridged, yet esthetic result. <167> UI - 96198523 AU - Ziada HM AU - Benington IC AU - Orr JF IN - Department of Restorative Dentistry, Queen's University of Cork, Republic of Ireland. TI - Photoelastic stress analysis in resin bonded bridge design. SO - European Journal of Prosthodontics & Restorative Dentistry 1995 Sep;3(5):217-22 AB - The aim of this investigation was to determine the stress magnitudes and directions in resin bonded bridges. 3D models (2.5 x life size) were prepared from photoelastic materials that represented the ratio of the elastic moduli of enamel and metal. The models were loaded during a stress freezing cycle and sectioned to view in a transmission polariscope. The fringes observed, indicated that the stress magnitudes concentrated at the proximo-lingual line angles to the pontic. The stress trajectories were plotted to show the pattern of stress direction. The stress factors which may contribute to debonding of these designs were analysed. It is suggested that the use of vertical grooves at the proximolingual line angles to the edentulous area in the preparation should reduce the stresses and hence improve the long term prognosis. <168> UI - 96198529 AU - Chao YL AU - Meijer HJ AU - Van Oort RP AU - Versteegh PA IN - Department of Oral-Maxillofacial Surgery and Maxillofacial Prosthetics, University Hospital Groningen, The Netherlands. TI - The incomprehensible success of the implant stabilised overdenture in the edentulous mandible: a literature review on transfer of chewing forces to bone surrounding implants. [Review] [50 refs] SO - European Journal of Prosthodontics & Restorative Dentistry 1995 Dec;3(6):255-61 AB - The approach of implant stabilised overdentures has become one of the routine treatment modalities for compromised edentulous ridges. The purpose of this literature review is to analyze survival rates of loaded implants, occlusal forces and stress distributions of implant stabilised overdentures in edentulous mandibles and of fixed loaded implants at least over a medium-term period. which is comparable with fixed prostheses. Patients with implant stabilised overdentures and with fixed bridges on implants generate similar occlusal forces. The number of implants under a prosthetic construction seems to have less influence on stress distribution than design of the superstructure and related direction of forces. [References: 50] <169> UI - 96195100 AU - Stewart RB AU - Staab GH IN - Department of Prosthodontics, University of Detroit Mercy School of Dentistry, Michigan, USA. TI - Cross-sectional design and fatigue durability of cantilevered sections of fixed implant-supported prostheses. SO - Journal of Prosthodontics 1995 Sep;4(3):188-94 AB - PURPOSE: Characterizing the fatigue behavior of cantilevered implant-supported prostheses requires an understanding of both the material and its intended application. The relationships between applied load, component geometry, and the fatigue characteristics of a specific material often can be difficult to establish. Four different cross-sectional designs of cantilevered frameworks used clinically were tested for fatigue durability, and the results were compared with theoretical tip deflections and stresses. MATERIALS AND METHODS: Fatigue tests were conducted on specimens with I-, U-, and L-shaped and elliptical cross-sections after static stress analysis. Specimens with uniform cantilevered length were sprued, invested and cast from the same high-palladium alloy. Statistical results, SEM evaluation of fracture surfaces, and theoretical predictions provided further insight into the framework design. RESULTS: Based on intraoral space restrictions, corrections for dimensional changes inherent in casting, the mean number of cycles to failure for each cross-sectional geometry, and the performance of design groups as predicted by static analysis can be ranked in order from best to worst as I, L, U, and then elliptical. SEM evaluation showed varying degrees of porosity and shrinkage cavities specific to the specimen cross-sections. CONCLUSIONS: Four designs for the cantilevered sections of implant-supported frameworks were evaluated for fatigue durability and were compared with the results of the theoretical analysis. As tested, fatigue durability was predictable when compared with theoretical calculations of tip deflection and normal stress. Although all four shapes have considerable merit for rigidity, in limited intermaxillary conditions, the I- and L-shaped cross-sections may optimize performance and use of space. <170> UI - 96177090 AU - Mojon P AU - Rentsch A AU - Budtz-Jorgensen E IN - Division of Gerodontology and Removable Prosthodontics, Institute for Dental Medicine, University of Geneva, Switzerland. TI - Relationship between prosthodontic status, caries, and periodontal disease in a geriatric population. SO - International Journal of Prosthodontics 1995 Nov-Dec;8(6):564-71 AB - This study evaluated the influence of prosthodontic status on caries a and periodontal disease in a hospitalized population of elderly people. Among the data gathered was information on caries, gingival condition, oral hygiene, plaque accumulation, and factors related to the prevalence, type and quality of the prostheses present. There was no significant association between the type of rehabilitation and the economic, social, or educational variables, but it appeared that removable partial denture wearers had less concern for oral health. Root caries and periodontal diseases were more frequent when the restoration, either fixed or removable, was defective. Th results of this study indicate the importance of oral hygiene instruction and regular recalls among removable partial denture wearers. <171> UI - 96177084 AU - Nethander G IN - Department of Oral and Maxillofacial Surgery, Faculty of Odontology, Goteborg University, Goteborg, Sweden. TI - Oral restoration with fixed partial dentures on transplanted abutment teeth. SO - International Journal of Prosthodontics 1995 Nov-Dec;8(6):517-26 AB - Thirty-five fully developed teeth were autogenously transplanted for 24 partially edentulous adult patients to enable the placement of fixed partial dentures. Restoration was successfully carried out on 22 patients during the follow-up period up to 13 years after surgery. Two restorations failed, one because of root fracture and another as a result of ankylosis of the transplanted tooth. Six transplanted abutment teeth showed root resorption and/or loss of attachment without consequence for the dental restoration. The proportion of successful tooth transplantations was 97% after 1 year, 94% after 2 years, and 88% from 6 to 13 years. Transplantation of teeth using a two-stage surgical technique could provide the necessary dental support for fixed partial dentures even for patients with atrophic alveolar bone. <172> UI - 96162542 AU - Romberg E AU - Wood M AU - Thompson VP AU - Morrison GV AU - Suzuki JB IN - Department of Oral Health Care Delivery, Dental School, University of Maryland, Baltimore, USA. TI - 10-year periodontal response to resin bonded bridges. SO - Journal of Periodontology 1995 Nov;66(11):973-7 AB - The purpose of this study was to evaluate the long-term (10 years +/- 15 months) periodontal response to resin bonded bridges (RBRs). A total of 103 patients who had RBRs bonded between 1980 and 1984 were recalled. Periodontal evaluations were made by two clinicians for all abutment teeth and for selected control teeth with intact, non-restored lingual surfaces. Periodontal indices consisted of: plaque index (PI), gingival index (GI), gingival recession, probing depth, and loss of attachment. Paired t tests indicated no significant difference in overall GI between experimental and control sites, but a significant difference in PI and probing depth with experimental sites (abutment teeth) showing higher PI and greater probing depths. Significant differences were found in overall recession and attachment loss, again with more recession and attachment loss observed on the abutment teeth as compared to the controls. Site specific analyses for PI, probing, and loss of attachment showed small but significant differences between experimental and control teeth in 15 of 21 sites. Although these findings may be statistically significant, the clinical impact for resin bonded restorations functioning for over 10 years is minimal and is comparable to periodontal response to other types of restorations. <173> UI - 96135622 AU - Otto T IN - Zahntechnisches Labor Hans-Peter Spielmann, Zurich. TI - [Resin-bonded bridges. A genuine alternative therapy for private practice or a long-term temporary measure?]. [Review] [24 refs] [German, French] SO - Schweizer Monatsschrift fur Zahnmedizin 1995;105(12):1552-9 <174> UI - 96084113 AU - Nevalainen M AU - Ruokolainen T AU - Rantanen T AU - Makila E AU - Kononen M IN - Department of Prosthetic Dentistry, University of Helsinki, Finland. TI - Comparison of partial and full crowns as retainers in the same bridge. SO - Journal of Oral Rehabilitation 1995 Sep;22(9):673-7 AB - The purpose of this study was to assess longitudinally the success of partial and full crown abutment pairs in the same bridges. Fifty patients with a mean age of 45 years (range 22-70 years) were examined during spring 1981 (1-5 year follow-up), 33 of whom were examined a second time during spring 1990 (10-15 year follow-up). The status of the partial crowns, full crowns, and their abutment teeth was assessed using standardized questions, and clinical and radiographic examinations. At the first follow-up examination, all partial and full crowns, and consequently all bridges, were still in use. Before the second follow-up examination one of the full crown abutments had become badly decayed, and the bridge, including the partial crown, had been removed. The failure rate was 0.2% per year for the full crown as a unit, and consequently 0.2% per year for the bridge as a unit. <175> UI - 96062695 AU - Olsson M AU - Gunne J AU - Astrand P AU - Borg K IN - Department of Oral and Maxillofacial Surgery, Karnsjukhuset, Skovde, Sweden. TI - Bridges supported by free-standing implants versus bridges supported by tooth and implant. A five-year prospective study. SO - Clinical Oral Implants Research 1995 Jun;6(2):114-21 AB - The clinical question at issue, whether it is possible to combine implants and natural teeth via fixed bridges, is of current interest. The treatment of the subjects of this prospective study was performed between June 1984 and December 1986. This article presents the 5-year results of the study. The consecutive patient material comprised 23 patients with Applegate Kennedy Class I residual dentition in the mandible and a complete maxillary denture. All 23 patients were provided with implants ad modum Branemark in each mandibular quadrant. One side was randomized to rehabilitation with fixed bridge between the distal tooth of the residual dentition and an implant; the other side received a free-standang bridge on 2 implants. The fixture survival rate was 88%. No difference was found between the two sides. Bridge stability was 89% for the implant bridges and 91% for the combination bridges. The change in marginal bone level at the implants was small during the 5-year follow up period (on average 0.1-0.3 mm) and with no difference between the two sides. In conclusion, it was not possible to demonstrate any higher risk of implant or prosthetic failure for tooth-implant fixed bridges compared with implant-supported bridges. <176> UI - 96039371 AU - Naert IE AU - Rosenberg D AU - van Steenberghe D AU - Tricio JA AU - Nys M IN - Department of Prosthetic Dentistry, Faculty of Medicine, Catholic University of Leuven, Belgium. TI - The influence of splinting procedures on the periodontal and peri-implant tissue damping characteristics. A longitudinal study with the Periotest device. SO - Journal of Clinical Periodontology 1995 Sep;22(9):703-8 AB - The aim of the present study was to evaluate the capability of the Periotest device in detecting and monitoring functional changes in the periodontal as well as in the pari-implant damping characteristics. In the first part of this study, 107 teeth were splinted by means of 40 full acrylic fixed prostheses (AFP) and another 37 teeth were splinted by means of 14 ceramometallic fixed prostheses (C-MFP). The Periotest measurements of individual teeth were done the day the fixed prostheses were cemented temporary (PTV 1), and again after a mean observation period of 27.4 days (PTV 2). In the 2nd part, 78 osseointegrated two-stage implants were splinted by means of 23 full acrylic fixed prosthesis (AFP) and other 18 implants were left without it. Using the same abutment length, Periotest measurements were performed, at abutment connections and before installation of the final prosthesis. In a 3rd part, using both implants and teeth as abutments, 29 osseointegrated implants were connected with 25 abutment teeth by means of 7 AFP. The measurements were performed at the beginning of the prosthetic treatment and 2, 4 and 6 weeks later. After splinting teeth by means of AFP for the observation period, no statistically significant reduction in PTVs was found. When on the other hand, a C-MFP was used, PTV 2 showed a significant reduction. The PTVs at abutment connection went down after a period of time, during which some implants were interconnected by means of an AFP and others were not.(ABSTRACT TRUNCATED AT 250 WORDS) <177> UI - 96072526 AU - Steflik DE AU - Koth DL AU - Robinson FG AU - McKinney RV AU - Davis BC AU - Morris CF AU - Davis QB IN - Department of Oral Pathology, Medical College of Georgia, School of Dentistry, Augusta 30912-0200, USA. TI - Prospective investigation of the single-crystal sapphire endosteal dental implant in humans: ten-year results. SO - Journal of Oral Implantology 1995;21(1):8-18 AB - This study conducted a longitudinal prospective clinical study of the single-crystal sapphire (Al2O3) cylindrical screw-shaped endosteal dental implant, and attempted to establish clinical parameters to evaluate implant success or failure. Twenty-eight mandibular implants (17 patients) were placed. After six weeks' healing, 23 implants in 15 patients served as distal abutments for fixed prostheses (baseline). Implants were evaluated for bleeding index, crevicular fluid volume index, plaque accumulation index, radiographic index, mobility index, and patient comfort. Any implant failing in three of these criteria or implants removed were judged as failures. After 10 years, of the 21 baseline implants recalled (two implants were lost to recall), 17 were fully functional, for an 81% success rate. The use of qualitative and quantitative clinical evaluation parameters as utilized in this study appears to be important and useful in assessments of the clinical serviceability of dental implants. These parameters can be used in human clinical trials as well as in experimental animal studies. <178> UI - 96078804 AU - Losev FF AU - Kniazeva MB AU - Saakian ShKh AU - Kalamkarova SKh AU - Pogosov VR AU - Berezhnaia TN TI - [The efficacy of using metal ceramic dentures fixed on pulpectomized teeth]. [Russian] SO - Stomatologiia 1995;74(2):58-60 AB - A total of 432 patients aged 34 to 60 were examined, 226 of them aged 31 to 59 were admitted for treatment. Out of 1980 examined cermet crowns fixed on depulped teeth complications were detected round 412 (20.88%). Inflammations of the gingiva were found near 218 crowns, apical chronic periodontitis in 98 cases, functional over-exercise of the periodontium in 61, ceramic fracture in 18, failure of cement fixation in 17 cases. When all prophylactic measures are taken, apical periodontitis was properly treated, and dental channels filled during pulp removal, if indicated, complications develop almost three times less frequently, occurring in 7.4% of cases. <179> UI - 96055152 AU - Yi SW AU - Ericsson I AU - Carlsson GE AU - Wennstrom JL IN - Department of Periodontology, Faculty of Odontology, Goteborg University, Sweden. TI - Long-term follow-up of cross-arch fixed partial dentures in patients with advanced periodontal destruction. Evaluation of the supporting tissues. SO - Acta Odontologica Scandinavica 1995 Aug;53(4):242-8 AB - The aim of the study was to evaluate the periodontal conditions in patients treated more than 10 years ago for advanced periodontal disease and rehabilitated with cross-arch fixed partial dentures (FPDs). Of 50 randomly selected patients, 34 subjects carrying 43 FPDs agreed to participate in a clinical and radiographic follow-up examination. The FPDs were divided into three groups on the basis of prosthesis design (end abutments, unilateral cantilever, and bilateral cantilevers) and amount of supporting tissues at the time of bridge installation. Seventy per cent of the FPDs were found to be unchanged, whereas the rest had been modified due to various complications leading to extraction of one or more of the abutment teeth. Six FPDs (14%) had been partially replaced by FPDs anchored to osseointegrated dental implants. A total of 21 (8%) of the original 274 abutment teeth had been extracted. Longitudinal changes in the amount of periodontal support were minimal over the average of 15 years of follow-up. FPD design or initial amount of supporting tissues was found not to have significant influence on longitudinal changes in periodontal conditions. It was concluded that combined periodontal and prosthodontic treatment of patients with advanced loss of periodontal support may provide a high rate of long-term successful outcome, provided proper adequate periodontal and prosthetic treatment and maintenance care are given. <180> UI - 96004971 AU - Priest G TI - An 11-year reevaluation of resin-bonded fixed partial dentures. SO - International Journal of Periodontics & Restorative Dentistry 1995 Jun;15(3):238-47 AB - Clinical success of resin-bonded fixed partial dentures is primarily dependent on their long-term retention. Retention rates of resin-bonded prostheses placed in 66 patients treated by three dentists in private practice were evaluated in the present study. Seventy-seven resin-bonded fixed partial dentures were followed over a period of 1 year to 11 years. Thirty (39%) became dislodged, but nine were successfully rebonded; thus there were 21 failures (27%). Prosthesis location and operator expertise minimally influenced the longevity of these restorations, but the luting agents tested in this sample had a profound impact on retention. Debonding rates were excessive for some materials tested, whereas other agents proved to be predictable. Modifications in preparation design that enhanced resistance form were also likely contributors to improved retention rates. <181> UI - 96024178 AU - Dario LJ TI - How occlusal forces change in implant patients: a clinical research report. SO - Journal of the American Dental Association 1995 Aug;126(8):1130-3 AB - The author recorded the occlusion of 100 patients with fixed implant prostheses on 571 endosseous root form implants when the implants were placed. He made six subsequent occlusal contact comparisons at three-month intervals. Hyperocclusion occurred on implant prostheses in nearly half of the patients during the test period, with the majority of changes occurring in the first three to six months. These changes in the distribution of occlusal contact forces may partially explain the reports of early implant failure by other investigators, and they suggest the need for a more vigorous post-insertion occlusal evaluation. <182> UI - 96036290 AU - Schneider DM TI - Differing porcelain systems. [Review] [56 refs] SO - Current Opinion in Cosmetic Dentistry 1995;:107-13 AB - Current research in ceramics has centered on improving the strength, fit, and bondability of porcelain. Several different approaches to accomplishing these ends have led to the development of stronger cores, castable glass, computer-generated restorations, and chemically altered basic ceramics. Improvements in these basic parameters of clinical success have led to the use of all-ceramic systems such as inlays, onlays, conservative veneers, anterior and posterior crowns, and even fixed partial dentures. Porcelain veneers and full-coverage ceramic crowns have held up well clinically. Porcelain inlays and fixed partial dentures have presented problems with fit and strength, respectively, that may need correcting before they are clinically predictable in all situations. Nevertheless, it is apparent that modern dental porcelain technology has come a long way since it was originally introduced as an esthetic replacement for less cosmetic, metal-based restorations. [References: 56] <183> UI - 96036288 AU - Passes H AU - Furman M AU - Rosenfeld D AU - Jurim A IN - Jamaica Hospital, New York 11030, USA. TI - A case study of lasers in cosmetic dentistry. [Review] [27 refs] SO - Current Opinion in Cosmetic Dentistry 1995;:92-9 AB - The dental laser offers revolutionary advantages over traditional cosmetic dental treatment for our patients. These advantages include precision, hemostasis, sterility, and minimal postoperative pain and swelling. The laser interacts with tissue to vaporize it in a predictable manner that produces predictable results. It is used in periodontal plastic surgery, gingivectomy, soft-tissue crown lengthening, crown and bridge gingival retraction, composite curing, biopsy, frenectomy, stage II implant recovery, and more. Fixed prosthetic impressions can be taken immediately following gingivoplasty and sutures and postoperative dressings are eliminated. This paper presents a case study in cosmetic dentistry to demonstrate many of these applications and summarizes current opinion regarding them. It also briefly describes what a laser is and how it works. [References: 27] <184> UI - 95350242 AU - Posnick JC AU - Tompson B IN - Craniofacial Center, Georgetown University Medical Center, Washington, D.C., USA. TI - Cleft-orthognathic surgery: complications and long-term results. SO - Plastic & Reconstructive Surgery 1995 Aug;96(2):255-66 AB - We reviewed the complications and long-term results of a consecutive series of adolescents (67 males, 49 females; age range 15 to 25 years; mean 18 years) born with a cleft who underwent primary repair in childhood and later developed a jaw deformity and malocclusion that required orthognathic surgery. Between 1986 and 1992, 116 adolescents with either unilateral cleft lip and palate (n = 66), bilateral cleft lip and palate (n = 33), or isolated cleft palate (n = 17) underwent an orthognathic procedure that included a Le Fort I osteotomy; 32 also underwent simultaneous sagittal split osteotomies of the mandible; and 87 underwent osteoplastic genioplasty. Clinical follow-up ranged from 1 to 7 years (mean 40 months) at the close of the study. The preoperative clinical examination varied according to cleft type and individual variation, but all patients had maxillary hypoplasia. Additional cleft-related deformities included residual oronasal fistula and bony defects, clefted alveolar ridges that retained dental gaps, and mobile premaxilla that lacked union to the lateral segments. Overall, 89 percent of residual fistulas underwent successful closure as part of the orthognathic procedure. Surgical cleft dental gap closure was achieved and maintained to the extent planned at 92 percent of the cleft sites. A fixed (prosthetic) bridge was used successfully for dental rehabilitation to close the gap in all other patients at each cleft site (n = 9). All patients with alveolar clefts (n = 99) maintained keratinized mucosa along the labial surface of the cleft-adjacent teeth (n = 264 teeth). Complications were few and generally not serious. There was no segmental bone loss of teeth because of aseptic necrosis or infection. Only 5 percent of cleft adjacent teeth underwent a degree of gingival recession and root exposure as a result of the maxillary osteotomy procedure; all were retained long term. The long-term maintenance of overjet and overbite measured directly from the late (> 1 year) postoperative lateral cephalometric radiograph indicated that 97 percent of patients maintained a positive overjet and 89 percent maintained a positive overbite; 5 percent shifted to a neutral overbite. The methods used to manage jaw deformity, malocclusion, residual oronasal fistula, and bony defects in adolescents born with a cleft are safe and reliable and offer the patient an enhanced quality of life. They also provide a stable foundation in which final soft-tissue lip and nose revisions may be carried out. <185> UI - 95355653 AU - Kelly JR AU - Tesk JA AU - Sorensen JA IN - Dental & Medical Materials Group, National Institute of Standards and Technology, Gaithersburg, MD 20899, USA. TI - Failure of all-ceramic fixed partial dentures in vitro and in vivo: analysis and modeling. SO - Journal of Dental Research 1995 Jun;74(6):1253-8 AB - Hertzian cone cracks visible at the loading site of 20 all-ceramic fixed partial dentures (FPDs), tested in vitro, led to the hypotheses that failure was due to the propagation of localized contact damage crack systems (Hertzian stress state) and that such damage was an unlikely clinical failure mode. Fractographic analysis of the 20 laboratory-failed and nine clinically-failed all-ceramic FPDs allowed for definitive testing of these hypotheses and a comparison between in vitro and in vivo failure behavior. In all cases, failure occurred in the FPD connectors (none from contact damage), with approximately 70 to 78% originating from the interface between the core and veneer ceramics. The coincidence between failure origins provides strong evidence that the in vitro test modeled aspects of structural behavior having clinical importance. The fractographic observations, coupled with the in vitro failure load data, furnished very specific boundary conditions which were applied to constrain mathematical models of FPD connector failure. Finite element analysis (FEA) of the laboratory FPDs found that maximum principal tensile stresses would occur at locations consistent with the fractographic observations only if: (1) there were appropriate elastic moduli differences between the ceramics; and (2) a small amount of abutment rotation was allowed. Weibull failure probability (Pf) calculations, incorporating FEA stress profiles, very closely replicated the laboratory failure distribution only when: (1) the veneer ceramic was much weaker than the core ceramic; and (2) the Weibull modulus of the core-veneer interface was much lower than that for the free veneer surface (i.e., the interface is of lower quality with regard to defects).(ABSTRACT TRUNCATED AT 250 WORDS) <186> UI - 95328838 AU - Pang SE IN - Community Dental Clinic, Institute of Dental Health, Singapore. TI - A report of anterior In-Ceram restorations. SO - Annals of the Academy of Medicine, Singapore 1995 Jan;24(1):33-7 AB - Thirty-one patients were restored with 35 anterior crowns and 7 anterior fixed partial dentures. The restorations were fabricated in In-Ceram, an all-porcelain ceramic material. The restorations were evaluated for fractures, tooth wear, recurrent caries, gingival inflammation and tooth sensitivity in a 21-month follow-up. Three of the 35 crowns fractured. The failure for the crowns was 8.5%. The remaining crowns provided excellent function and aesthetics. They had been in the mouth between 2.5 and 21 months. There were no fractures in the 7 fixed partial dentures. These had been in service between 4.5 and 21 months. More long-term clinical studies are recommended to determine the survival of In-Ceram fixed partial dentures. <187> UI - 95340265 AU - Jemt T AU - Lekholm U IN - Branemark Clinic, Public Dental Health Service, University of Gothenburg, Sweden. TI - Implant treatment in edentulous maxillae: a 5-year follow-up report on patients with different degrees of jaw resorption. SO - International Journal of Oral & Maxillofacial Implants 1995 May-Jun;10(3):303-11 AB - In a retrospective study, 150 patients with edentulous maxillae were selected for treatment with Branemark implants. The patients were arranged into four different groups, based on jaw shape prior to implant placement. After second-stage surgery, they were provided with either fixed prostheses, removable overdentures followed by fixed prostheses after at least 1 year, or overdentures for the whole period. Patients were followed up for 5 years, with implant and prosthesis survival, annual visits, marginal bone loss, and complications recorded. Results of the study indicated that treatment outcome in edentulous maxillae might be predicted by careful presurgical evaluation of jaw shape. Five-year cumulative implant failure rates varied from 7.9% for patients considered to have enough bone to be provided with fixed prostheses immediately after second-stage surgery to 28.8% for those with severely resorbed jaws receiving an overdenture. The corresponding cumulative prosthesis failure rates were 3.0% and 18.9%, respectively. Patients provided with autogenous bone grafts compared favorably to the group presenting severely resorbed jaws and provided with overdentures, but showed a compromised result compared to the group with the least resorption. Failure of implant treatment correlated significantly with bone quality and ratio of 7-mm implants. All groups, except those treated with bone grafts, showed an average marginal bone level of 1.2 mm after 5 years, irrespective of type of prosthesis. The bone-grafted group showed a corresponding mean level of 2.3 mm after 5 years of function. Regarding clinical complications, a different pattern, mainly related to the type of prosthetic construction used, was observed between the groups. The number of visits clearly indicated that severely resorbed jaws provided with overdentures were the most demanding. <188> UI - 95341433 AU - De Wijs FL AU - Cune MS AU - De Putter C IN - Department of Oral Surgery, Faculty of Medicine, University of Utrecht, The Netherlands. TI - Delayed implants in the anterior maxilla with the IMZ-implant system. SO - Journal of Oral Rehabilitation 1995 May;22(5):319-26 AB - One hundred and seventy-three IMZ two-stage implants have been clinically and radiologically evaluated for a 5 year period. The implants were placed in the anterior region of the maxillae of 81 patients to replace lost incisors, cuspids and bicuspids. The implants were placed 3 months or later after loss of natural anterior teeth when the resorption was already in an advanced stage. The implants used in this study consisted of titanium coated with hydroxylapatite. The prosthetic restorations placed on the implants consisted of fixed or removable partial dentures and single crowns. The cumulative percentage for implant survival after 3 years, with a mean follow-up of 33.5 (s.d. 17.8) months was 96.1%. Although the prosthetic restorations aesthetically often were a compromise they did prove highly satisfactory to both patients and dentists. <189> UI - 95341434 AU - Leempoel PJ AU - Kayser AF AU - Van Rossum GM AU - De Haan AF IN - Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, The Netherlands. TI - The survival rate of bridges. A study of 1674 bridges in 40 Dutch general practices. SO - Journal of Oral Rehabilitation 1995 May;22(5):327-30 AB - The survival rate of 1674 bridges and the influence of several factors on the lifetime of bridges were analysed, based on data from patient records that belonged to a random sample of 40 Dutch general practices. It appears that the 12 year survival rate of the bridges is 87%. There is a significant difference in the survival rate between the bridges that meet and do not meet Ante's law, and only a weak significant difference between the bridges with vital vs. non-vital abutment teeth. Gender and age of the patient, length of the bridge, presence of a post and core build-up, or the construction of the bridge (conventional fixed vs. cantilever pontic) appear to have no influence on the survival rate of the bridges in this sample. <190> UI - 95292167 AU - Ibbott CG AU - Oles RD IN - Department of Oral Biology, College of Dentistry, University of Saskatchewan, Saskatoon. TI - Immediate implant post-surgical complications [published erratum appears in J Can Dent Assoc 1995 May;61(5):381]. SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1995 Mar;61(3):193-8 AB - Immediate surgical implants provide a convenient means of replacing missing teeth without requiring hard tissue reduction of restoration-free potential fixed partial denture abutments. Although the procedure is described as "predictable," complications and failures do occur. This report presents four cases of immediate implant complications and their management, and discusses possible causes of the untoward results. Careful pre-operative planning, adequate surgical technique and post-surgical management, timely and suitable loading, and meticulous hygiene maintenance can serve to minimize implant complications and failures. The prospective immediate implant patient must be provided with sufficient information to allow informed consent to be given. Minimal requirements are a description of the procedures in terms the patient can understand, an explanation of potential risks and complications, and adequate disclosure of information about alternative therapies. <191> UI - 95277766 AU - Cohen BD IN - Department of Adult Restorative Dentistry, University of Nebraska Medical Center, Lincoln, USA. TI - The use of orthodontics before fixed prosthodontics in restorative dentistry. [Review] [18 refs] SO - Compendium 1995 Jan;16(1):110, 112, 114 passim; quiz 120 AB - For a variety of reasons, orthodontic intervention is often overlooked as a viable modality to correct occlusal, axial, rotational, and space discrepancies before undertaking fixed prosthetic rehabilitation. However, patient treatment is being enhanced as never before by such intervention. This valuable treatment option facilitates tooth preparation, path of insertion, optimum oral hygiene, and a better pontic and abutment design, while occlusal forces can be directed against the long axes of the teeth for a more predictable prognosis. Moreover, this interdisciplinary approach can be cost-effective to patients and their treating dentists from the standpoint of producing more stable, durable, and esthetic restorations. [References: 18] <192> UI - 95256540 AU - Brown D AU - McCabe JF AU - Clarke RL AU - Nicholson J AU - Curtis R AU - Sherriff M AU - Hatton PV AU - Strang R AU - Ireland AJ AU - Watts DC IN - United Medical and Dental Schools, Guy's Hospital, London. TI - Dental materials: 1993 literature review. [Review] [293 refs] SO - Journal of Dentistry 1995 Apr;23(2):67-93 <193> UI - 95225907 AU - Owall B IN - Department of Prosthetic Dentistry, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Denmark. TI - Precision attachment-retained removable partial dentures: Part 2. Long-term study of ball attachments. SO - International Journal of Prosthodontics 1995 Jan-Feb;8(1):21-8 AB - Patients provided with 24 ball attachment-retained removable partial dentures were followed up to 23.5 years. The prosthetic treatment included fixed partial dentures in 8 arches, and combinations of crowns and splint bars in 16 arches. All ball attachment matrices were supplied with vertical occlusal stops in contact with the patrices. A nonresilient hinged coupling was established between fixed partial dentures and removable partial dentures. Seventeen arches had only two or three remaining teeth. A total of 66 abutments for fixed partial dentures were included, 30 of which were root canal treated and supplied with posts. No technical failures (loss of retention/cement failure, root or tooth fracture, metal framework fracture) with the fixed partial dentures were recorded. With the removable partial dentures, additional retention with clasps was introduced in 2 of the dentures (in addition to 8 originally), 2 had to be remade after fractures, and 4 dentures were relined. <194> UI - 95225803 AU - Henry PJ AU - Bower RC AU - Wall CD IN - Division of Restorative Dentistry, University of Western Australia. TI - Rehabilitation of the edentulous mandible with osseointegrated dental implants: 10 year follow-up. SO - Australian Dental Journal 1995 Feb;40(1):1-9 AB - Long-term retrospective studies on the efficacy of implant retained bridgework are relatively few. In this study, 10 year follow-up results are reported on the rehabilitation of the edentulous mandible with osseointegrated implant anchored bridges. Fifteen patients were closely maintained and monitored using the conventional indices used in longitudinal periodontal research, together with serial intraoral periapical and extraoral panoramic radiographs. The need for prosthetic maintenance and the effects of the treatment on soft tissues, supporting bone, opposing dentition and the behavioural aspects of such rehabilitation are discussed. Based on the reviewed results of the study and numerous other investigations, the treatment of mandibular edentulism with fixed bridges supported by osseointegrated implants ad modum Branemark is a highly effective method, giving predictable long-term results. <195> UI - 95239641 AU - Miller TE IN - Department of Restorative Dentistry, Dental School, University of Maryland, Baltimore, USA. TI - Implications of congenitally missing teeth: orthodontic and restorative procedures in the adult patient. SO - Journal of Prosthetic Dentistry 1995 Feb;73(2):115-22 AB - Missing teeth are a concern to the patient and restorative dentist, and this social liability can be a multifactorial problem that involves esthetics, phonetics, disease, function, and stabilization. Dental caries, trauma, and periodontal disease are usually identified by pain, food impaction, discomfort, and lack of esthetics or poor phonetics. Restorative dentists are concerned with all aspects of the general health and appearance of the stomatognathic system and not only have the responsibility for immediate correction of an extant problem, but also for ensuring long-term "outcomes." The perceptive integration of interspecialty orthodontic treatment before restorative dentistry can obviate deleterious circumstances that threaten successful completion of the treatment plan. The prerestorative repositioning of malposed adjacent teeth in spaces created by congenitally missing teeth is illustrated with clinical treatment of three patients. <196> UI - 95185464 AU - Prosterman B AU - Prosterman L AU - Fisher R AU - Gornitsky M IN - Dental Department, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec. TI - The use of implants for orthodontic correction of an open bite. SO - American Journal of Orthodontics & Dentofacial Orthopedics 1995 Mar;107(3):245-50 AB - This case illustrates the integration of maxillofacial surgery, orthodontics, prosthodontics and periodontics in the treatment of an adult male. A traumatic injury to the lower jaw was the stimulus for the patient to seek orthodontic correction of a severe malocclusion including crossbites and an anterior open bite. The loss of a large portion of the anterior alveolar process of the lower jaw including six teeth was corrected with an implant bearing prosthesis which was subsequently used as anchorage to correct the malocclusion. Through the combined efforts of the above disciplines, properly orchestrated, this patient was treated in an effective and successful manner. <197> UI - 95165272 AU - Keller EE IN - Department of Oral and Maxillofacial Surgery, Mayo Medical Center, Rochester, MN 55905. TI - Reconstruction of the severely atrophic edentulous mandible with endosseous implants: a 10-year longitudinal study. SO - Journal of Oral & Maxillofacial Surgery 1995 Mar;53(3):305-20 <198> UI - 98201315 AU - Schweikert ED TI - Multiple cantilevers: an alternative to dental implants. SO - Dentistry Today 1994 Jul;13(7):38, 40-1 AB - A solution to the problem of missing posterior teeth is presented. The prerequisite for solving this problem is that the remaining teeth must be positioned in one form or another in a triangle, as one can see in Figs. 2, 3 and 4. The tripod effect, in connection with the controlling effect of the mechano-receptors in the periodontal ligaments of the remaining abutment teeth, permit us to construct a functional fixed prosthesis. The feather-edged or knife-edged preparation technique creates long axial walls. Together with the parallel prepared abutment teeth, this must be viewed as the main-retentive feature for fixed prostheses with multiple cantilevers. In extreme situations, where one is uncertain about the outcome of a case, provisional laboratory fabricated restorations are excellent for evaluating the stability of the cross-arch splinted teeth. The whole bridge occasionally shows some mobility. As long as the mobility shows no increase over a period of time, and does not interfere with the patient's chewing ability, a permanent bridge with multiple cantilevers can be inserted. I usually include no more than three cantilevered pontics on each side of the arch in a multiple cantilevered bridge. A second molar is not replaced by a third cantilevered pontic. Its position in the arch may cause an overly strong lever action on the fixed prosthesis. <199> UI - 98201408 AU - Strupp WC Jr TI - Predictable crown and bridge with core build-ups. SO - Dentistry Today 1994 Oct;13(10):96-7 <200> UI - 97105124 AU - Kells BE AU - Hussey DL IN - Department of Restorative Dentistry, Queen's University, Belfast, Northern Ireland. TI - Audit of casual patient attendance at a restorative dentistry clinic. SO - Journal of the Irish Dental Association 1994;40(4):94-7 AB - The aim of this prospective study was to audit casual attendance at the Conservation clinic of the School of Clinical Dentistry, Belfast. Details of 500 consecutive casual patient attendances were collected over a four month period. There were 253 male and 247 female patients with a mean age of 43.4 years. Fifty-eight percent of patients lived within five miles of the clinic with 16% travelling more than 15 miles. Sixty-five per cent of patients were self-referred, 27% were referred from within the School and 3% were referred from their General Dental Practitioner. Pulpal or endodontic problems were diagnosed in 42% of cases, 25% presented with loss of a crown or bridge and 14% complained of a pain-free loss of the filling. Half the patients were given a further appointment to attend the Conservation clinic while only 33% were directed to the General Dental Services for further care. It was concluded that the majority of casual attendees to the Conservation clinic were local residents who referred themselves for treatment. A minority of patients were currently under treatment at the School of Clinical Dentistry but over 65% remained their immediate responsibility. Recommendations for improvements in the current service were also made. <201> UI - 96004993 AU - Hosseini A IN - Department of Restorative Dentistry, Mashhad University, School of Dentistry, Iran. TI - Clinical evaluation of resin-bonded prostheses: Rochette technique. SO - Quintessence International 1994 Aug;25(8):567-71 AB - Ninety patients, with a total of 90 resin-bonded prostheses placed in a private dental office from 1981 to 1991, were recalled for clinical evaluation of their restorations. Tissue condition, patient satisfaction, prosthesis failures by location and by sex of patient were assessed. Debondings occurred in both the mandibular and maxillary arches. In the present study, there were no gender-based differences in the rate of debonding and prostheses with more than two retainers were more likely to have problems. <202> UI - 95170859 AU - Goodacre CJ AU - Spolnik KJ IN - Loma Linda University School of Dentistry, California. TI - The prosthodontic management of endodontically treated teeth: a literature review. Part I. Success and failure data, treatment concepts. [Review] [54 refs] SO - Journal of Prosthodontics 1994 Dec;3(4):243-50 AB - Part I of this three-part literature review discusses the incidence of endodontic treatment required after prosthodontic procedures, whether crowns are needed on endodontically treated teeth, the primary purpose of posts, the causes of post and core failure, root fracture incidence data, and post design considerations. Pertinent questions are addressed based on the past 25 years of dental literature. [References: 54] <203> UI - 95156341 AU - el Charkawi HG AU - Zekry KA AU - el Wakad MT IN - Prosthodontics Department, Cairo University, Egypt. TI - Stress analysis of different osseointegrated implants supporting a distal extension prosthesis. SO - Journal of Prosthetic Dentistry 1994 Dec;72(6):614-22 AB - Controversy exists when implants are used to restore distal extension in edentulous patients. Some have advocated the use of a rigidly connected implant to the natural abutment teeth and others have recommended the inclusion of a stress-breaking element. In this study, a comparison between these two approaches was done. With the technology of strain gauges, it was possible to record stresses under a rigid and a resilient implant system connected to a natural abutment with the same prosthesis under the same loading conditions. The results of this study showed that a resilient implant system was better for the abutment and the implant. This study provides a test method that will help dentists in choosing implants for their patients with predictable results. <204> UI - 95127864 AU - Ericsson I AU - Randow K AU - Glantz PO AU - Lindhe J AU - Nilner K IN - Department of Periodontology, Faculty of Odontology, University of Goteborg, Sweden. TI - Clinical and radiographical features of submerged and nonsubmerged titanium implants. SO - Clinical Oral Implants Research 1994 Sep;5(3):185-9 AB - A clinical and radiographical study was performed to evaluate whether initial submergence of titanium fixtures is an obligate treatment measure for the establishment of proper bone anchorage when implants a.m. Branemark are used. The sample was comprised of 11 subjects with edentulous mandibles. A split-mouth design was employed; in the right mandibular quadrant a traditional 2-step procedure for fixture installation and abutment connection was utilized, while in the left quadrant a 1-step procedure was carried out, i.e., fixtures were placed and abutments were connected in one and the same session. Three to 4 months after fixture installation, fixed bridgeworks were fabricated and rigidly connected to the implants. Clinical examinations (including probing pocket depth, bleeding on probing and implant stability test) were performed after 12 and 18 months. Radiographs were taken following insertion of the bridges and at the 12- and 18-month re-examinations. The probing pocket depth, the bleeding on probing, the implant stability and the radiographic determinations were similar for the 2 groups of treatment alternatives. This indicates that titanium fixtures a.m. Branemark can be properly anchored (osseointegrated) in mandibular bone and successfully used for bridge retention also when a 1-step procedure is used for implant installation. <205> UI - 95112532 AU - Hanson BS AU - Liedberg B AU - Owall B IN - Department of Community Health Sciences, Lund University, Malmo General Hospital, Lund. TI - Social network, social support and dental status in elderly Swedish men. SO - Community Dentistry & Oral Epidemiology 1994 Oct;22(5 Pt 1):331-7 AB - The objective of this study was to investigate whether there were associations between different aspects of social network and social support and dental status. The study sample (n = 621) comprised a random half of all male residents in Malmo, Sweden, born in 1914. Five hundred (80.5%) participated. Eight conceptually different aspects of social networks and social support were measured, and all men were clinically examined regarding number of teeth, prevalence of removable dentures, fixed bridges and anterior open tooth spaces. We found that some aspects of dental status were associated with social class, while others were associated with different aspects of social network and social support. Prevalence of complete dentures and fixed bridges was strongly associated with social class, a low number of functioning teeth was associated with both low social class belonging and an insufficient social network and social support, while anterior open tooth spaces were associated mostly with an insufficient social network and social support. This study shows that there are significant associations between some aspects of dental status and the social network and social support of the individual, while other aspects of dental status are associated with social class, which from a psychosocial perspective contribute to a deeper understanding of the backgrounds of dental status. <206> UI - 95101092 AU - Carlsson GE AU - Lindquist LW IN - Department of Prosthetic Dentistry, University of Goteborg, Sweden. TI - Ten-year longitudinal study of masticatory function in edentulous patients treated with fixed complete dentures on osseointegrated implants. SO - International Journal of Prosthodontics 1994 Sep-Oct;7(5):448-53 AB - Twenty-three edentulous patients who had been treated with a mandibular fixed complete denture retained by osseointegrated implants were followed over a 10-year period. Nine of these patients had received a maxillary fixed implant-supported complete denture prosthesis after the initial placement of the mandibular restoration, while the remainder still used a conventional maxillary complete denture. The maximal occlusal force or mastication efficiency index of those having fixed implant-supported prostheses in both arches did not differ markedly from those having only a mandibular restoration. However, at the 3-year examination, lower values were recorded for the self-rated masticatory ability, while higher values were given after 10 years. It was concluded that placement of a mandibular fixed implant-supported prosthesis in dissatisfied complete denture wearers led to a dramatic improvement of masticatory function that was quite acceptable for many patients. However, some patients subsequently demanded a maxillary fixed prosthesis to feel satisfactorily rehabilitated. <207> UI - 95087973 AU - Bacher M AU - Goz G AU - Leber E AU - Ney T AU - Horn H AU - d'Hoedt B AU - Probster L IN - Poliklinik fur Kieferorthopadie, Universitat Tubingen. TI - [Orthodontics and implantology. Their course and results after joint planning]. [German] SO - Fortschritte der Kieferorthopadie 1994 Oct;55(5):261-7 AB - The therapeutical repertoire for treating patients with missing teeth was significantly expanded by the development of modern implant methods. We have performed a retrospective analysis covering all children who between 1977 and 1993 had been considered for implants as a method for gap management. All patients were pretreated up to early adolescence using standard orthodontic procedures. Unfortunately, it turned out that an originally planned implant was not suitable in approximately 2/3 of the patients because of inadequate alveolar conditions. These patients were subsequently treated by conventional orthodontic gap closure or adhesive prosthetics. <208> UI - 95083841 AU - Myers ML AU - Caughman WF IN - Department of Oral Rehabilitation, Medical College of Georgia, School of Dentistry, Augusta 30912-1260. TI - Provisional treatment for resin-bonded fixed partial dentures. SO - Quintessence International 1994 Jul;25(7):465-9 AB - The resin-bonded fixed partial denture is a conservative option for the replacement of a missing tooth. It has a good prognosis and offers several advantages over a conventional fixed partial denture. However, it does not allow for placement of a provisional fixed partial denture. In some situations, it is important to provide some type of interim treatment. This can be accomplished by several techniques, that include placement of either a removable or bonded replacement tooth. The provisional treatment can provide an esthetic solution and maintain tooth position while the fixed partial denture is being made by the dental laboratory. <209> UI - 95051924 AU - Kellett M AU - Verzijden CW AU - Smith GA AU - Creugers NH IN - Department of Restorative Dentistry, University Dental Hospital of Manchester, UK. TI - A multicentered clinical study on posterior resin-bonded bridges: the 'Manchester trial'. SO - Journal of Dentistry 1994 Aug;22(4):208-12 AB - This study was designed to investigate and identify factors relevant to the success and failure of posterior resin-bonded bridges (PRBBs) related to the patient, technique, operator and bridge design. It was a long-term controlled clinical trial and formed part of a multicentered study on PRBBs. Data are presented 2.5 years from the start of the study. Following a strict protocol for case selection, 54 posterior, resin-bonded, fixed-fixed, three unit bridges were placed in 45 patients. Twenty-four patients with 27 PRBBs attended for 2.5-year recall. Treatment variables were limited to one of two operators and either a conventional tooth preparation or a more extensive modified preparation was performed. The allocation of treatment modalities was performed using a computer program to balance patient variables such as age, gender, location of bridge, restoration of abutment teeth. All bridges were produced in one laboratory, treated to produce a silicate-coating bond and placed using Microfill Pontic C (Kulzer, Wehrheim, Germany). Data relating to the patients, the open spaces, bridge preparation, bridge placement and subsequent annual evaluation were recorded. The survival of PRBBs in the maxilla was 77% and in the mandible 47%. <210> UI - 95007155 AU - Fleming AE TI - The Endopore dental implant system: implant treatment simplified. SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1994 Sep;60(9):785-9 AB - The Endopore implant system is a new dental implant system that is distinctly different from other implant systems presently available. Its unique design allows for ease of placement, use of shorter implants, three-dimensional ingrowth of bone (and thus greater resistance to torque), and a faster healing period. Its truncated-conical design allows for better distribution of stress and more leeway for error when it is placed adjacent to vital structures or in narrow regions of bone. The prosthetic components have been deliberately designed to be simple and cost-effective, yet provide all the variety that is required to restore any clinical situation. For an overdenture, the unique abutment and prosthetic technique allows for a cost-effective method of providing stability to an existing or newly-fabricated full denture. For fixed prosthetics, the prosthetic components have been designed to allow the use of straight-forward crown and bridge techniques, with a minimal number of additional laboratory parts or costs required to restore the case. Furthermore, a full arch can be restored with a screw-retained fixed/retrievable restoration, using the new UMA abutments. The surgical and prosthetic techniques required by the Endopore system are simple and inexpensive, and could be managed by a general dentist with a good knowledge of sterile surgical technique. Multicentre trials by private practitioners in Canada and the United States indicate that implant treatment by a general practitioner using the Endopore system can be predictably and reliably successful.(ABSTRACT TRUNCATED AT 250 WORDS) <211> UI - 95018369 AU - Pham AN AU - Fiorellini JP AU - Paquette D AU - Williams RC AU - Weber HP IN - Harvard School of Dental Medicine, Boston, MA 02115. TI - Longitudinal radiographic study of crestal bone levels adjacent to non-submerged dental implants. SO - Journal of Oral Implantology 1994;20(1):26-34 AB - To investigate changes in alveolar crestal bone levels adjacent to dental implants prior to and after functional loading, dental radiographs of 103 implants from consecutively treated patients were taken at four time-points: immediately after surgical insertion, at 3-6 months after surgery, at 12 months, and at 24 months after surgery. A computer-assisted method was used to measure the percent of bone change (%BC) relative to the shoulder-apex length of the implants at mesial and distal sites. Differences in the mean rates of %BC between the pre-loading period (3-6 months post-surgery) and the post-loading periods PLP1 and PLP2 (6-12 months and 12-24 months post-surgery, respectively) were evaluated. Rates of % BC during PRE, PLP1, and PLP2 were also determined for locations (maxilla or mandible) and types (screw or press-fit). Significantly higher rates of % bone loss per month were found for all implants during PRE compared with PLP1 and PLP2, and during PLP1 compared with PLP2. During PRE, maxillary implants had a significantly higher rate of bone loss compared with mandibular implants. During PLP1, mandibular implants showed some further loss, whereas maxillary implants exhibited a small but significant gain. No significant difference was found during PLP2. Bone loss adjacent to press-fit implants was significantly higher than that adjacent to the screw type during PRE, while no difference was found during the post-loading periods. <212> UI - 94367442 AU - Bergendal T AU - Hugoson A AU - Kvint S AU - Lundgren D IN - Department of Prosthodontics, Institute for Postgraduate Dental Education, Jonkoping, Sweden. TI - A radiological inventory of possible sites for cylinder implants in edentulous regions of the jaws. An epidemiological study. SO - Swedish Dental Journal 1994;18(3):75-85 AB - Implant treatment is nowadays requested as an alternative mode of treatment for both total and partial edentulousness. The purpose of the study was to assess the maximum number of possible implant sites in a group of adults. The study material comprised 579 persons divided into the age-groups 20, 30, 40, 50, 60 and 70 years. Based on radiological examination, the subjects were grouped according to Eichner's index. They comprised both dentate and edentulous individuals. Templates, marked with cylinder implants of different dimensions, were placed over edentulous regions. The possible number of cylinder-shaped endosseous implants that could be placed anterior to the second molar was assessed in relation to bone availability and anatomical structures. Gaps treated with fixed bridges were not registered. Altogether 1,048 presumptive fixture sites were marked, of which 78% in the age-groups 60 and 70 years. Eichner groups C 1-3, which comprised the edentulous persons, constituted 12% of the subjects and accounted for 57% of the possible number of implants. All edentulous mandibles and 70% of the edentulous maxillae were judged suitable for placement of implants. On average 5.5 and 5.8 sites were marked per edentulous maxilla and mandible, respectively. Groups B1-4 comprised 21% of the subjects and accounted for 37% of the implants. It is discussed that implant treatment in totally edentulous jaws will increase in relative terms in Sweden as in other Scandinavian countries, i.e. the percentage of edentulous jaws treated with implants will increase. In absolute terms, however, the treatment will probably decrease owing to a marked decrease in the number of edentulous individuals. The future need for implant treatment in the residual dentition will probably increase but it is difficult to predict by how much. <213> UI - 94331733 AU - Khayat P AU - Nader N IN - Department of Oral Implantology, University of Paris VII, France. TI - The use of osseointegrated implants in the maxillary tuberosity. SO - Practical Periodontics & Aesthetic Dentistry 1994 May;6(4):53-61; quiz 62 AB - Because of the reduced amount of bone often found in the posterior maxilla, osseointegrated implants are rarely used distally to the first molar region. In order to provide adequate posterior support for a fixed bridge or a removable prosthesis and to avoid the potential problems related to cantilevers, a specific technique of placement is employed. This paper describes and evaluates a study on the clinical outcome of 65 osseointegrated implants using this technique, placed in 51 patients, with a maximum observation time of 4 years, in which the absolute success rate was 95%. Short-term results support the use of osseointegrated implants in the maxillary tuberosity. The learning objective of this article is to present this technique to a larger segment of the dental profession. <214> UI - 94340049 AU - Staab GH AU - Stewart RB IN - Department of Engineering Mechanics, Ohio State University, Columbus. TI - Theoretical assessment of cross sections for cantilevered implant-supported prostheses. SO - Journal of Prosthodontics 1994 Mar;3(1):23-30 AB - PURPOSE: Occlusal forces concentrate at the cantilevered section(s) of fixed implant-supported prostheses. Investigators in early clinical applications of these prostheses described fractures of the metal alloy framework at the cantilevered-distal abutment junction. Improved performance was noticed when the framework's cross-sectional area was increased and the metal alloys used had an increased tensile strength and elastic modulus. Long-term service of a cantilevered implant-supported prosthesis is directly dependent on the fatigue life of the metal alloy framework. Two fatigue durability factors that are alterable by the technician/clinician are the framework material and the cross-sectional design of the structure. These factors can increase rigidity and alter the stress distribution through the framework. The importance of cross-sectional design on the rigidity may become more critical in situations with decreased intermaxillary space, especially if lengthened cantilevers are required or patients show discernible parafunctional habits. The theoretical aspects of beam deflection and the cross-sectional design of cantilevered structures under stress were investigated in this study. A subsequent report will provide results from experimental evaluations of designs similar to those assessed in this study. MATERIALS AND METHODS: The cross-sectional designs considered are an L, I, U and a nearly elliptical-shaped configuration. The size of the framework was determined by approximating the total cross-sectional space available for the restoration, minus the space required for artificial teeth in severe restrictions. All theoretical and actual specimens were modeled within these confines. Some allowance for the contours of the inferior surface of the artificial teeth was made to optimize the dimensions of each framework. Calculations enabled comparison of relative deflection and stress characteristics of each design group and predictions of fatigue durability. RESULTS: The displacements of each cantilever were found to be dependent upon the heights of each framework. As evaluated, the L and elliptical designs experienced larger maximum end deflections than the I- and U-shaped designs. The maximum normal stresses were observed to be less in the I and elliptical sections than in the U and L sections. CONCLUSIONS: The space restrictions for limited intermaxillary conditions reveal that the I cross-sectional design may provide the least displacement and smallest maximum normal stress under conditions in which each framework is subjected to an identical load. Each of the framework cross sections considered, however, is a viable candidate for use. The effectiveness of any particular shape in an intraoral environment cannot be easily assessed from the simple statistical analysis. Limitations of the predictability with statistical analysis as opposed to actual mechanical testing or in vivo use was noted. Less severe space restrictions would probably improve the estimated performance of the other designs. <215> UI - 94336103 AU - Thyne GM AU - Hunter KM IN - Wellington Surgical Clinic. TI - Primary reconstruction of the mandible with iliac bone and titanium implants following resection of a recurrent odontogenic keratocyst. SO - New Zealand Dental Journal 1994 Jun;90(400):56-9 AB - An aggressive surgical management of a mandibular odontogenic keratocyst in a young female patient is described. This management stratagem was followed in view of a histological finding of epithelial dysplasia and the possible, although unlikely, chance of squamous cell carcinoma developing in the cyst lining. Primary bone grafting and immediate fixture placement of implants were used to make good the mandibular resection site. This was thought to be the best option for management, minimising the number of surgical interventions and providing a framework for fixed bridgework in an area of the mouth that is difficult to reconstruct adequately. A successful outcome to the treatment has been observed, with graft survival, osseointegration of fixtures, the provision of functional and aesthetically pleasing implant-borne bridgework and, to date, the absence of clinical or radiographic evidence of recurrence of the cyst. <216> UI - 94259924 AU - Degrange M AU - Charrier JL AU - Attal JP AU - Asmussen E IN - Groupe de Recherche Biomateriaux, Faculte de Chirurgie Dentaire, Universite Paris V, France. TI - Bonding of luting materials for resin-bonded bridges: clinical relevance of in vitro tests. SO - Journal of Dentistry 1994;22 Suppl 1:S28-32 AB - A retrospective clinical study on 78 resin-bonded bridges placed between 1981 and 1992 was used to validate the wedge test in the assessment of the bonding of resin-based luting material. According to the correlation obtained between the findings of the in vivo and the in vitro studies, the wedge test may be considered to be predictive of the clinical performance of resin bonds. The life expectancy of resin-bonded bridges bonded with the 4 META containing material tested appears to be longer than that for bridges bonded with conventional resin cements. <217> UI - 94266372 AU - Hemmings KW AU - Schmitt A AU - Zarb GA IN - Institute of Dental Surgery/Eastman Dental Hospital, London, England. TI - Complications and maintenance requirements for fixed prostheses and overdentures in the edentulous mandible: a 5-year report. SO - International Journal of Oral & Maxillofacial Implants 1994 Mar-Apr;9(2):191-6 AB - Overdentures and fixed prostheses were consecutively placed into 50 edentulous mandibles and were followed for 5 years. During this period of follow-up, 25 overdentures were supported by 68 implants with a success rate of 92.65%, and 25 fixed restorations were supported by 132 implants with a success rate of 90.15%. Postinsertion adjustment in the first year was more common for the overdentures. Thereafter, fixed prostheses had more complications and required more maintenance than overdentures, the average number of recalls per year being 2.27 and 1.57 respectively. The main complications were associated with the peri-implant mucosa, abutment and gold screws, acrylic-resin components, and retentive clips. Overdentures offer an attractive alternative to fixed prostheses in the treatment of the edentulous mandible. <218> UI - 94271423 AU - Gunne J AU - Jemt T AU - Linden B IN - Department of Prosthetic Dentistry, Faculty of Odontology, University of Umea, Sweden. TI - Implant treatment in partially edentulous patients: a report on prostheses after 3 years. SO - International Journal of Prosthodontics 1994 Mar-Apr;7(2):143-8 AB - There has been an increasing interest in the use of implants for partially edentulous patients. This introduces other biomechanical situations than those experienced in completely edentulous patients. In a prospective multicenter study, 521 implants in 154 patients were loaded with 197 free-standing prostheses. The patients have been followed for 3 years. The cumulative success rate for the prostheses was 94.8% and for the implants it was 93.9%. Most of the lost prostheses were only supported by two implants. A frequent technical complication was fracture and loosening of gold screws, which was more frequent in prostheses supported by only two implants. <219> UI - 94275561 AU - Jensen J AU - Reiche-Fischel O AU - Sindet-Pedersen S IN - Department of Oral & Maxillofacial Surgery, Aarhus University Hospital, Denmark. TI - Nerve transposition and implant placement in the atrophic posterior mandibular alveolar ridge. SO - Journal of Oral & Maxillofacial Surgery 1994 Jul;52(7):662-8; discussion 669-70 AB - The results obtained with a modified surgical technique for transposition of the inferior alveolar nerve followed by immediate placement of endosseous implants in mandibles with moderate to severe atrophy are presented. Ten transpositions of the inferior alveolar nerve together with the installation of 21 implants were performed in six patients. The mean postoperative follow-up time was 23 months, with a range of 12 to 46 months. All implants with functioning pontics remained stable, with no mobility nor signs or symptoms of pain and infection during the follow-up period. Postoperative radiographic evaluation disclosed no pathologic bone loss around the implants. Neurosensory evaluation was performed using the two-point discrimination test. One patient with unilateral transposition had objective neurosensory dysfunction at 12 months postoperative, although all the nerve function were reported as normal by the patients. Strict patient selection criteria are necessary, with full awareness by the patient of the possibility of long-term or even permanent nerve paresthesia, when this procedure is contemplated. <220> UI - 94249005 AU - Kalamkarov KhA AU - Losev FF AU - Pogosov VR AU - Karagoian GKh AU - Margvelashvili VV AU - Chikunov SO TI - [The preparation of the maxillodental system before using using metal-ceramic dentures]. [Russian] SO - Stomatologiia 1994 Jan-Mar;73(1):34-9 AB - Orthodontic treatment using cermet dentures was carried out in 496 patients aged 26 to 60. Therapeutic surgical and orthodontic treatment of the maxillodental system was carried out before denture fixation. Late results in periods from 1 to 5 years were followed up in 396 patients. No complications were observed in 384 (96.9%). Only 12 patients developed complications: porcelain fracture in 4, periodontal inflammations in 5, and a partial relapse of occlusion reduction and distal dislocation of the mandible in 3. <221> UI - 94235836 AU - Studer S AU - Pietrobon N AU - Wohlwend A IN - Department of Prosthodontics and Dental Materials, Dental School, Zurich University, Switzerland. TI - Maxillary anterior single-tooth replacement: comparison of three treatment modalities. [Review] [52 refs] SO - Practical Periodontics & Aesthetic Dentistry 1994 Jan-Feb;6(1):51-60; quiz 62 AB - The correct treatment of a single missing maxillary anterior tooth in the aesthetically prominent area has become more challenging. The missing tooth can today be replaced by one of three prosthodontic treatment modalities--conventional fixed bridge, resin-bonded bridge, and single-tooth implant. The most important factors to be considered are the predictability of aesthetics, the preservation of the enamel shield and the dentinal and pulpal tissue, and the preservation of the periodontium and the alveolar bone. The learning objective of this article is a critical discussion of these three modalities as a replacement of a missing anterior single tooth to aid in selection of the most appropriate treatment in each individual clinical case. [References: 52] <222> UI - 94240207 AU - Hansson O IN - Department of Prosthodontics, School of Dentistry, Karolinska Institute, Sweden. TI - Clinical results with resin-bonded prostheses and an adhesive cement. SO - Quintessence International 1994 Feb;25(2):125-32 AB - The longevity of resin-bonded prostheses made of a high-gold alloy and bonded with Super-Bond C&B (C&B Metabond) were tested clinically. Minimal preparation and large surface area of retainer coverage were used. The inner surfaces of the retainers were air abraded with aluminum oxide and heat treated in an oven at 400 degrees C to get an oxidized layer for bonding. The results of the adhesive technique were unsatisfactory compared with studies with resin-bonded prostheses using conventional mechanical retention techniques and nonadhesive resin cements. All fractures were at the resin-metal interface. Early debonds occurred; seven of 13 prostheses were detached after 11 months. The median survival time was only 9 months. The adhesion of resin-bonded prostheses must still be based on mechanical retention between cement and metal, because a way of attaining good durability of the bonding joints to water with Super-Bond is yet to be found. <223> UI - 94242533 AU - Burke FJ AU - Grey NJ IN - Department of Restorative Dentistry, University Dental Hospital of Manchester. TI - Repair of fractured porcelain units: alternative approaches [see comments]. CM - Comment in: Br Dent J 1994 Jun 11;176(11):412 SO - British Dental Journal 1994 Apr 9;176(7):251-6 AB - Laboratory studies have demonstrated high bond strengths between a number of resin systems to metal and porcelain, as well as to tooth substance. In circumstances where fracture of a porcelain bridge or crown has occurred, it may appear reasonable to attempt a repair using one of these systems in conjunction with abrasion of the fractured surface, although current knowledge does not allow an accurate prediction of the longevity of the repair under oral conditions. <224> UI - 94248304 AU - Clark RK AU - Comfort MB IN - Department of Prosthetic Dentistry, University of Hong Kong, Prince Philip Dental Hospital. TI - The edentulous mandible opposed by natural maxillary teeth: a report of six cases treated with implant-retained prostheses. SO - Quintessence International 1994 Jan;25(1):15-22 AB - Dental restoration of the edentulous mandible opposing natural maxillary teeth is often associated with a number of problems, particularly in the occlusion, and an accelerated rate of alveolar bone resorption in the edentulous mandible resulting from occlusal loading. The advent of osseointegrated implants would seem to provide a new means of treating these cases. Accordingly, the cases of six patients for whom either fixed partial dentures or over-dentures supported by Branemark implants were provided, are reviewed. Three of the mandibles were normal and three had bone grafts. Results so far indicate that this is a viable alternative for treating such cases. <225> UI - 94249004 AU - Kopeikin VN AU - Kishmishian AA AU - Anisimov IuL AU - Anisimova SV AU - Lebedenko IIu AU - Malyi AIu AU - Titov IuF TI - [A clinical evaluation of the use of dentures with a Simet glass-ceramic coating]. [Russian] SO - Stomatologiia 1994 Jan-Mar;73(1):32-4 AB - Positive follow-up results achieved in patients with metal-glass ceramic dentures coated with Simet permit the authors to recommend glass ceramic Simet for wide clinical introduction. In reconstructive dental prosthetics with metal glass ceramic and cermet materials the dentures should be modelled in the articulator. Preventive examinations are recommended once in half a year. <226> UI - 94249006 AU - Trezubov VN AU - Shteingart MZ AU - Emgakhov VS AU - Sukharev MF AU - Sultan M TI - [The results of using Unifas cement for denture fixation]. [Russian] SO - Stomatologiia 1994 Jan-Mar;73(1):39-40 AB - Unifas cement was used for fixation of cermet dentures in 104 patients. Clinical follow-up of 3 months to 3 years duration demonstrated sufficiently high adhesive characteristics, resistance to oral fluid and mechanic loading effects of this cement, which is recommended for wide clinical practice. <227> UI - 94217071 AU - Seaton P TI - Mechanics of tensile and shear stress generation in fixed partial denture retainers. [Review] [9 refs] SO - Journal of Prosthetic Dentistry 1994 Mar;71(3):237-44 AB - Movements caused by the application of chewing loads to a fixed partial denture (FPD) are predictable. There are translational and rotational movements of the FPD and flexure of the structure. The location and magnitude of tensile and shear stresses affecting cement within retainers during mastication is related to the type of movement and determined by differences in mobility of abutments at each end of the FPD, length of span, and point of chewing load. The incidence of cement failure could be reduced with improved strategic stress resistance. [References: 9] <228> UI - 94165283 AU - Verzijden CW AU - Creugers NH AU - Mulder J IN - Department of Oral Function and Prosthetic Dentistry, Dental School, University of Nijmegen, The Netherlands. TI - A multi-practice clinical study on posterior resin-bonded bridges: a 2.5-year interim report. SO - Journal of Dental Research 1994 Feb;73(2):529-35 AB - A clinical trial of 201 posterior resin-bonded bridges (PRBBs) was conducted partially in a University clinic and partially in general dental practices, for study of the influence of some experimental variables on the survival of these restorations. This report contains the results of an interim analysis which was done after 2.5 years' follow-up. No significant differences were found among the bonding systems used to adhere the PRBBs (Clearfil F2/etching, Panavia EX/sandblasting, and Microfill Pontic C/silicate-coating), or among the different preparation forms. PRBBs made in general dental practices were as retentive as those made in the University clinic. The "location" factor was found to be highly significant (p = 0.0001). The survival rates were 81% for maxillary PRBBs and 56% for mandibular PRBBs. <229> UI - 94166018 AU - Metz JE AU - Brackett WW IN - Department of General Dentistry, University of Tennessee, College of Dentistry, Memphis. TI - Performance of a glass ionomer luting cement over 8 years in a general practice. SO - Journal of Prosthetic Dentistry 1994 Jan;71(1):13-5 AB - For this report, 1230 cast restorations luted with a glass ionomer cement were followed up for 8 years. The results show an absence of secondary caries, 99% retention of restorations, and a 4% incidence of irreversible pulpitis. The infrequent thermal sensitivity previously observed after cementation in this group of restorations did not recur. <230> UI - 94166019 AU - Altieri JV AU - Burstone CJ AU - Goldberg AJ AU - Patel AP IN - Department of Prosthodontics, School of Dental Medicine, University of Connecticut Health Center, Farmington. TI - Longitudinal clinical evaluation of fiber-reinforced composite fixed partial dentures: a pilot study. SO - Journal of Prosthetic Dentistry 1994 Jan;71(1):16-22 AB - This report describes a clinical pilot study that monitored a group of 12 patients who have received 14 single tooth replacement experimental restorations made with prefabricated continuous fiber-reinforced composite (FRC) frameworks. Because these restorations represent a purely adhesive restorative system, tooth preparation was not performed. The Kaplan-Meier survival probability at 12 months was approximately 50%. The restoration with the longest service life was a mandibular molar replacement that has remained in service 24 months. With improved survival times, bonded FRC definitive restorations should be plausible. <231> UI - 94166020 AU - Shackleton JL AU - Carr L AU - Slabbert JC AU - Becker PJ IN - Department of Prosthetic Dentistry, University of the Witwatersrand, Johannesburg, South Africa. TI - Survival of fixed implant-supported prostheses related to cantilever lengths. SO - Journal of Prosthetic Dentistry 1994 Jan;71(1):23-6 AB - Various lengths of cantilevers for fixed implant-supported prostheses have been recommended in the literature. No scientific data are available for selecting specific lengths, and different views are reported. Authors contend that longer cantilevers lead to increased risk of failure. This study examined survival of fixed implant-supported prostheses using different cantilever lengths and offers clinical support for the contention. <232> UI - 94367229 AU - Van den Bossche L AU - Quirynen M IN - Afdeling Parodontologie School voor Tandheelkunde, Mondziekten en Kaakchirurgie. TI - [Conservative treatment of the antero-inferior region using natural elements. The bonded pontic as semi-definitive rehabilitation in subterminal periodontitis: a study of 12 patients]. [French] SO - Revue Belge de Medecine Dentaire 1993;48(3):29-38 AB - This study involved 12 patients with chronic adult periodontitis in which 1 or 2 lower incisors had to be extracted due to extreme bone loss. The resulting diastemata were closed by means of the acid-etch technique. Patient's own teeth were used as pontics after endodontic treatment. They were connected to a metal framework by means of composite and this restoration was anchored to the rest dentition. Radiographical analysis (no further bone loss around abutment teeth) as well as clinical parameters indicated the long-term successful periodontal reaction to this treatment. The low number of losses illustrated the longevity (mean = 8 years and 3 months) of the rehabilitation. <233> UI - 94236146 AU - Carlson BR AU - Grondahl K AU - Carlsson GE IN - Department of Prosthetic Dentistry, Faculty of Odontology, University of Goteborg, Sweden. TI - Five-year radiographic follow-up of extensive mandibular fixed partial dentures. SO - European Journal of Prosthodontics & Restorative Dentistry 1993 Sep;2(1):35-9 AB - A group of patients with severely reduced dentitions were restored with 12-unit mandibular fixed partial dentures supported on the two canines and maxillary complete dentures. Eight patients were followed radiographically for 2 years and five of these for up to 5 years. Orthopantomograms, lateral and oblique-lateral cephalograms and intraoral radiographs were used. There were no great radiographically detectable changes either around the abutments or in the jaws. Six of the eight bridges tilted distally during the first 2 years. This downward tilting of the distal parts of the bridge resulted in a marked resorption under the cantilever sections in some patients. <234> UI - 94198800 AU - Akeel R AU - Fernandes CP AU - Vassilakos N IN - Department of Prosthetic Dentistry, The London Hospital Medical College, UK. TI - Masticatory efficiency of patients treated with implant retained fixed bridges in the upper jaw over a 2-year period. SO - European Journal of Prosthodontics & Restorative Dentistry 1993 Mar;1(3):131-3 AB - The aim of this study was to investigate the effect of the rehabilitation of the upper jaw with a fixed bridge supported by Branemark implants upon patient's masticatory efficiency. Five patients wearing complete dentures in the upper jaw were selected for the study. Chewing tests using Optosil tablets were performed before fixture installation, immediately after bridge connection and 2 years after bridge delivery. The results indicated that treatment with fixed bridges retained by osseointegrated implants did not give immediate improvements in masticatory efficiency. Only after the subjects had enough time to adapt to the reconstruction was an improvement in the masticatory efficiency index observed. <235> UI - 94167458 AU - Barrack G IN - Division of Restorative and Prosthodontic Sciences, New York University, College of Dentistry. TI - The etched cast restoration--clinical techniques and long-term results. SO - Quintessence International 1993 Oct;24(10):701-13 AB - The etched cast restoration was introduced as the "Maryland bridge" in 1980. The technique has continued to evolve with modifications in tooth structure and framework design as well as improvements in luting resins, including some that chemically bond to the alloy. The conservation of tooth structure and the avoidance of involving the gingival crevice remain the major advantages of the technique. Research has shown that the etched cast restoration, when designed with a retentive framework, exhibits bond strengths comparable with those of traditional complete coverage restorations. The main purpose for this retentive framework is to limit the stresses placed on the resin, thus preventing the phenomenon of stress fatigue in the resin. Clinical observations and an 11-year clinical study involving 127 restorations confirm this research. The long-term success rate in this study was 92.9%. <236> UI - 94131475 AU - Glantz PO AU - Nilner K IN - Department of Prosthetic Dentistry, University of Lund, Malmo, Sweden. TI - Patient age and long term survival of fixed prosthodontics. SO - Gerodontology 1993 Jul;10(1):33-9 AB - The possible relationship between patient age and the long term survival of fixed prostheses was studied in a randomised group of persons, who had received restorative treatment by general practitioners 15 years prior to this study. These fixed partial dentures had a mean extension of 6.9 units and a mean pontic/abutment ratio of 0.47. The group studied consisted of 77 persons who agreed to participate from an original group of 150 persons. Of the original group 20 had died, 17 were not traceable or unable to participate for medical reasons, and 36 declined to participate. The outcome of the treatment was compared between the following age subgroups (age as at the time of the original treatment) by division of the data at 37, 60 and 65 years. In these subgroups between 20 and 50 per cent of the prostheses had been lost or partially lost during the fifteen year period. Most of the failures and unacceptable quality ratings were found to be caused by fractures, loss of retention and/or dental caries. However, no systematic differences were found between any of the age subgroups studied. <237> UI - 94128182 AU - Walton JN AU - MacEntee MI IN - Department of Clinical Dental Sciences, Faculty of Dentistry, Vancouver, British Columbia, Canada. TI - A retrospective study on the maintenance and repair of implant-supported prostheses. SO - International Journal of Prosthodontics 1993 Sep-Oct;6(5):451-5 AB - This study reviewed the prosthodontic treatment and aftercare required by 29 patients with 32 implant-supported prostheses (12 fixed and 20 removable) placed on 107 implants. Patients were followed for 4 to 39 months. The majority of implant-supported prostheses (53%) were placed in the mandible. Visual analogue scales were used by the patients to rate their satisfaction with their prostheses and their chewing ability. Approximately one third of the patients studied required three or more relines of their existing dentures between first- and second-stage surgeries, while over half of the definitive implant-supported prostheses required a major adjustment or repair. Removable prostheses required 78% of the total repairs and accounted for 80% of those prostheses that needed repeated repairs. In general, patients were very satisfied with their implant-supported prostheses, but 17% complained of mild speech difficulties and 7% noted slight difficulty in cleaning their fixed prostheses. Overall, the short-term prosthetic management required for the implant-supported prostheses in this study was substantial, particularly with the removable prostheses, and this should be taken into account when evaluating prosthetic options. <238> UI - 94128178 AU - Barrack G AU - Bretz WA IN - Department of Restorative and Prosthodontic Sciences, College of Dentistry, New York University. TI - A long-term prospective study of the etched-cast restoration. SO - International Journal of Prosthodontics 1993 Sep-Oct;6(5):428-34 AB - The etched-cast restoration was introduced in 1980, and a prospective study was initiated in March 1981 to determine if resin-bonded prostheses would prove to be a long-term alternative to traditional complete and partial coverage restorations. All resin-bonded restorations placed since that time in the author's private prosthodontic practice have been recorded in the study. The success rate of 127 restorations has been 92.9%, with a mean longevity of 5 years and 8 months. <239> UI - 94151789 AU - Terekhin AF AU - Googe LA AU - Lepilin AV TI - [The use of bar attachment in removable dentures]. [Russian] SO - Stomatologiia 1993 Oct-Dec;72(4):56-7 AB - The results of treatment of 230 patients with dentition defects are presented. Plate, arch, and removable bridge dentures were used fixed with a special clammer suggested by the authors. The follow-up has shown good functional and esthetic characteristics of the suggested denture designs. <240> UI - 94134504 AU - Ledermann PD AU - Hassell TM AU - Hefti AF IN - Department of Periodontology, University of Florida, Gainesville. TI - Osseointegrated dental implants as alternative therapy to bridge construction or orthodontics in young patients: seven years of clinical experience. SO - Pediatric Dentistry 1993 Sep-Oct;15(5):327-33 AB - Young patients often require fixed bridgework or orthodontic therapy in cases of traumatic tooth loss or congenitally missing teeth. Dental implants represent an alternative to the more conventional treatment methods. We report positive experience over a seven-year period with 42 titanium Ha-Ti implants in 34 patients aged 9 to 18 years. Fourteen implants were placed into prepared tooth sockets immediately after traumatic luxation of anterior teeth in 12 patients aged 9 to 18 years (median age 16). An additional 22 patients (median age 15.5, range 11 to 18) also received implants (N = 28), but these were placed only after healing of extraction sites, or as substitutes for congenitally missing teeth. Implants remained in situ for an average of 7.7 months before loading. During the healing period, three implants were lost due to additional trauma and one became infected. The 38 remaining implants osseointegrated and since have been loaded for five to 79 months in successful function. There was no difference between immediate and delayed implants in clinical success. These experiences demonstrate that appropriate, versatile, osseointegrated implants can provide a successful treatment method for young patients, without damaging adjacent teeth. <241> UI - 94083592 AU - Dickerson WG TI - A conservative alternate to single tooth replacement: a three-year follow-up. SO - Practical Periodontics & Aesthetic Dentistry 1993 Aug;5(6):43-8; quiz 49 AB - This article discusses a clinical procedure/technique for placing a conservative bridge in posterior teeth, using a heat-and-pressure-cured resin, reinforced with plasma-coated fibers. Several cases are used to illustrate the procedure. The learning objective of this article is the understanding of the technique and the materials used, thereby enabling implementation. <242> UI - 94046119 AU - Raghoebar GM AU - Brouwer TJ AU - Reintsema H AU - Van Oort RP IN - Department of Oral and Maxillofacial Surgery, University Hospital Groningen, The Netherlands. TI - Augmentation of the maxillary sinus floor with autogenous bone for the placement of endosseous implants: a preliminary report. SO - Journal of Oral & Maxillofacial Surgery 1993 Nov;51(11):1198-203; discussion 1203-5 AB - Placement of endosseous implants in the atrophic maxilla is often restricted because of lack of supporting bone. In this article, experience with augmentation of the maxillary sinus floor with autogenous bone grafts to enable insertion of endosseous implants is described. The technique is aimed at providing a cortical layer on top of the graft to ensure a reliable seal of the maxillary sinus and to achieve optimal stability of the bone graft in case of simultaneously placement of dental implants. The procedure was used in 25 patients, using iliac crest grafts (22 patients, 86 implants), symphyseal bone grafts (two patients, six implants), or a maxillary tuberosity bone graft (one patient, one implant). Ninety-three Branemark implants (Nobelpharma, Gotenburg, Sweden) were inserted in 47 grafted maxillary sinuses. The mean follow-up was 16 months (range, 6 to 36 months). No inflammation of the bone grafts nor of the maxillary sinus occurred. The sinus membrane was perforated accidentally in eight cases during the surgical procedure. Five implants (5.4%), all inserted in iliac crest grafts, were lost during the healing period. The patients received implant supported overdentures (16 patients) or bone-anchored bridges (nine patients). From this preliminary study it is concluded that augmentation of the maxillary sinus floor with bone grafts for the insertion of endosseous implants is a promising solution for patients with atrophic maxillae and functional problems with their partial or full dentures. <243> UI - 94053623 AU - Mericske EA AU - Mericske-Stern R IN - Department of Removable Prosthodontics, School of Dental Medicine, University of Bern, Switzerland. TI - Overdenture abutments and reduced periodontium in elderly patients. A retrospective study. SO - Schweizer Monatsschrift fur Zahnmedizin 1993;103(10):1245-51 AB - Among elderly patients attending a private office, a large number was seen having only few remaining teeth with advanced reduction of periodontal support. The long-term effect of overdenture rehabilitation within a mean observation time of 5.9 years (2 to 10 years) could be assessed in 109 patients (average age 74.1 years) wearing a total of 125 overdentures. After completion of treatment, 76% had regularly followed the maintenance care program. The degree of bone loss of the selected abutment teeth was assessed by means of radiographs. 56% showed a highly reduced periodontal support with bone loss of more than 50% of the root length. No, or moderate loss of periodontal support was found in only 9.5%. The overdentures were initially retained by 359 cast gold copings. Biologic and technical failures were registered for 54 copings and examined with regard to the reduction of periodontal support of the abutment teeth. Repair and treatment were prescribed for 30 copings, including guided tissue regeneration for 6 abutments. Twenty-four abutment roots with copings were extracted. Although most biologic failures were encountered in abutment teeth with severe reduction of the periodontium, the failure rate was not statistically higher for these abutments. <244> UI - 94052542 AU - Naert IE AU - Bevers L AU - Nijs L IN - Department of Prosthetic Dentistry, Catholic University of Leuven, School of Dentistry, Oral Pathology, and Maxillofacial Surgery, Faculty of Medicine, Belgium. TI - A clinical study of an intracoronal fixed partial denture attachment system. SO - Quintessence International 1993 Jun;24(6):397-403 AB - An alternative tooth replacement system, based on pin retention, was clinically evaluated for up to 4 years in a prospective study. Thirty-two Universal Dental Anchorage anchors, supporting 28 fixed partial prostheses in 25 patients, were placed. Most of these prostheses had a cast complete crown on one abutment; on the other abutment, the UDA anchor functioned as a support for the extension pontine. After a mean observation period of 2 years, nine anchors failed. Around five of the failed anchors, caries was present; this occurred after 2 years or more of function of the prostheses. Early failure (4/9) were registered in the first year of function and were caused by loss of retention (three) or anchor fracture (one). The periodontal condition of the UDA anchor abutment teeth was not significantly different from that of the contralateral side. The number of failures, especially the number caused by recurrent caries, is cause for concern. <245> UI - 94046693 AU - Rammelsberg P AU - Pospiech P AU - Gernet W IN - University of Munich School of Dentistry, Department of Prosthodontics, Germany. TI - Clinical factors affecting adhesive fixed partial dentures: a 6-year study. SO - Journal of Prosthetic Dentistry 1993 Oct;70(4):300-7 AB - One hundred forty-one adhesive fixed partial dentures were placed under controlled conditions for a 6-year longitudinal study. The influence of location (anterior/posterior, maxilla/mandible), tooth preparation techniques (retentive/less invasive), and four different methods of metal conditioning (sandblasting/electrolytic etching and/or pyrolytic/tribochemical silane coating) on the survival rate was investigated. Failures were caused by loss of adhesion at the metal-cement interface. The retentive tooth preparation reduced the risk of failure to almost one twentieth, but the intraoral location did not influence survival time. The effect of silane-coating on longevity was extremely positive and was not reflected by successful retainers. <246> UI - 94054497 AU - Kalamkarov KhA AU - Losev FF AU - Chikunov SO AU - Margvelashvili VV AU - Kalamkarova SKh AU - Saakian ShKh TI - [Orthodontic treatment in the distal displacement of the mandible]. [Russian] SO - Stomatologiia 1993 Jul-Sep;72(3):49-53 AB - A total of 598 patients with various occlusions and dentition defects were examined; 112 (18.7%) of these presented with distal dislocation of the mandible. Shortening of interalveolar distance was found to play an important role in the pathogenesis of this dislocation. This shortening occurs in abnormal teeth abrasion and loss of many molars and premolars maintaining the occlusion height. Masticatory function was found disordered in 56 (50% of patients with distal dislocation of the mandible. Orthodontic treatment of these patients was carried out by sagittal shift of the mandible to a distance of 1 to 2 mm and subsequent fitting with prostheses. Good results were attained in 94.55% of cases. <247> UI - 94055639 AU - Glantz PO AU - Nilner K AU - Jendresen MD AU - Sundberg H IN - Department of Prosthetic Dentistry, Faculty of Odontology, University of Lund, Malmo, Sweden. TI - Quality of fixed prosthodontics after 15 years. SO - Acta Odontologica Scandinavica 1993 Aug;51(4):247-52 AB - Interviews and/or clinical examinations by means of the California Dental Association quality evaluation system were carried out in a group of persons who had received extensive restorative treatments with fixed partial dentures 15 years before this study. The studied group consisted of 77 persons who agreed to participate from an original group of 150 persons selected at random from the Swedish Dental Insurance System records. Of the original group 20 had died, 17 were not traceable or not able to participate for medical reasons, and 36 declined to participate. Thirty-two per cent of the recorded reconstructions had been lost, and 8% partially lost during the 15-year period. Thirty-five per cent of the reconstructions were rated as Satisfactory, whereas the remaining ones had mixed clinical quality ratings. Failures and Not Acceptable quality ratings were found to be caused mainly by fractures, loss of retention, and/or dental caries. <248> UI - 94008816 AU - Creugers NH IN - Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, The Netherlands. TI - Resin-retained bridges in the treatment of traumatized dentition. [Review] [14 refs] SO - Endodontics & Dental Traumatology 1993 Apr;9(2):53-6 AB - Resin-retained bridges can be used as the definitive treatment, as well as for interim treatment. Compared with conventional fixed prostheses, there are some advantages which make this treatment especially useful in traumatized dentition. The ultra conservative approach makes the adhesive bridge a standard treatment option in cases of uncertain prognostic factors. However, in such specific situations as traumatized dentition some complicating factors may be present. These complicating factors must be recognized and eliminated to create situations in which this kind of restoration can be successful. Therapeutic and patient-related factors are discussed using data from longitudinal clinical studies. Available clinical information indicates the anterior adhesive bridge to a 'permanent restoration'. However, a benefit-cost analysis is necessary to weigh the value of this restorations. [References: 14] <249> UI - 94000235 AU - Palmqvist S AU - Swartz B IN - Department of Prosthetics, Postgraduate Dental Education Center, Orebro, Sweden. TI - Artificial crowns and fixed partial dentures 18 to 23 years after placement. SO - International Journal of Prosthodontics 1993 May-Jun;6(3):279-85 AB - Patients receiving artificial crowns and fixed partial dentures at a prosthodontic clinic were examined 18 to 23 years after treatment. The long-term results were good, especially for the metal ceramic restorations: 79% remained unchanged and only 3% had been removed. The success rate for the gold-resin restorations was less favorable: 43% remained unchanged and 33% had been removed. The use of one cantilever extension unit had not negatively influenced the results for the fixed partial dentures. Generally, those abutment teeth that had been removed during the observation period had received previous endodontic treatment before restorations had been placed. Endodontic complications on abutment teeth were more frequent in the mandible than in the maxillae. <250> UI - 94000233 AU - Thayer KE AU - Williams VD AU - Diaz-Arnold AM AU - Boyer DB IN - College of Dentistry, University of Iowa, Iowa City. TI - Acid-etched, resin bonded cast metal prostheses: a retrospective study of 5- to 15-year-old restorations. SO - International Journal of Prosthodontics 1993 May-Jun;6(3):264-9 AB - Eighty-five resin bonded prostheses were evaluated in a retrospective study over a 15-year period. All had been in function for at least 4.5 years. Multifactorial variables were studied to ascertain their effect on debonding and the health of the oral tissues. The results showed: (1) the caries rate of the retainer teeth was 6%, (2) the mean gingival indices for the prostheses were significantly higher (P > .0001) than those of the remaining dentition, (3) 61% of the restorations had not debonded (if failure resulting from trauma was not included, the incidence of debonding dropped to 19%), and (4) all patients liked their prostheses. <251> UI - 94000232 AU - Probster L IN - Department of Prosthodontics, Eberhard-Karls-University, Tubingen, Germany. TI - Survival rate of In-Ceram restorations. SO - International Journal of Prosthodontics 1993 May-Jun;6(3):259-63 AB - This paper reports on 76 consecutively placed In-Ceram restorations (61 complete-coverage crowns and 15 fixed partial dentures). Their survival rates were determined using the Kaplan-Meier method. During the 35-month observation period no crown failures occurred, a five-unit fixed partial denture fractured, and another fixed partial denture was removed because of periodontal complications. Thus, In-Ceram complete-coverage ceramic crowns are apparently indicated for anterior and posterior teeth. A larger number of subjects must be studied to assess the indication for all-ceramic fixed partial dentures. <252> UI - 93367086 AU - Boyer DB AU - Williams VD AU - Thayer KE AU - Denehy GE AU - Diaz-Arnold AM IN - Department of Operative Dentistry, College of Dentistry, University of Iowa, Iowa City 52242. TI - Analysis of debond rates of resin-bonded prostheses. SO - Journal of Dental Research 1993 Aug;72(8):1244-8 AB - Debonding rates of 164 resin-bonded prostheses (RBP) placed from 1974 to 1985 were examined at recall. The yearly debond rates were calculated, the cumulative probability of failure was determined for the debonded RBPs, and Weibull distribution parameters were determined. For perforated prostheses, there was a high initial debond rate, followed by slowly decreasing rates for about 5 years. Increasing rates after 5 years indicated the beginning of wear-out. The Weibull parameters for the wear-out period of the perforated prostheses were: characteristic life = 128 (SE = 2) months, modulus = 1.27 (0.06), and threshold parameter = 0. Data were available for etched frameworks for 6 years and showed decreasing debond rates during this time. The characteristic life of the etched bridges was 318 (84) months. The cumulative failure data were also modeled with a cubic polynomial distribution that resulted in a U-shaped hazard function. <253> UI - 93366401 AU - Bahat O TI - Treatment planning and placement of implants in the posterior maxillae: report of 732 consecutive Nobelpharma implants. SO - International Journal of Oral & Maxillofacial Implants 1993;8(2):151-61 AB - One to nine Nobelpharma osseointegrated implants were placed in the posterior maxillae of 213 consecutive partially edentulous patients. Reconstruction was completed with a ceramic fixed partial denture with follow-up of 5 to 70 months (mean 30.3 months) after loading. Thirty-four implants in 29 patients failed; eight were replaced and one of these failed. Thus, the overall failure rate was 4.8% (35/732). The failure rate in type IV bone was only slightly higher than that in types II and III bone (5.5% versus 4.6%). The failure rate in the entire molar area was 5.3% compared with 4.5% in the premolar area (P = NS), and the failure rate of 7-mm implants was 9.5% compared with 3.8% for implants of all other lengths (P = .01). <254> UI - 93359537 AU - Valderhaug J AU - Ellingsen JE AU - Jokstad A IN - Department of Prosthetic Dentistry, Dental Faculty, University of Oslo, Norway. TI - Oral hygiene, periodontal conditions and carious lesions in patients treated with dental bridges. A 15-year clinical and radiographic follow-up study. SO - Journal of Clinical Periodontology 1993 Aug;20(7):482-9 AB - A longitudinal study, extending over a period of 15 years, was carried out in a group of 102 patients who received 108 bridges made by the senior students at the Dental Faculty, University of Oslo, in 1967/68. The study included 343 abutment teeth, and the remaining teeth in the same jaw which received the restoration, 525 in all, served as control. The oral hygiene, gingival condition, pocket depth, caries on crowned teeth, location of crown margins and changes of alveolar bone level were recorded during the study. During the first 10 years, the patients received oral hygiene prophylaxis every 6 months. The mean age of the patients at the beginning of the study was 48 years. Of the original group of 102 patients, 88 attended the clinical examination after 5 years, 71 after 10 years, and 55 after 15 years. The amount of plaque did not differ between the crowned teeth and the control teeth during the observation period, while GI score 2 and 3 was more frequent in crowned teeth than in the control teeth during this period. This was mainly observed when the crown margins were located sub-gingivally. A slight increase in mean pocket depth was recorded in the crowned teeth while the mean pocket depth for the control teeth remained at the same level during the 15 years. Caries lesions were recorded in 3.3% of the abutment tooth surfaces at the 5th year, in 10.0% at the 10th year and in 12.0% at the 15th year examination. No statistical differences in bone loss could be detected between the control teeth and the crowned teeth. <255> UI - 93351698 AU - Parker MW IN - Branch Dental Clinic, Naval Submarine Base Bangor, Silverdale, Washington. TI - The significance of occlusion in restorative dentistry. SO - Dental Clinics of North America 1993 Jul;37(3):341-51 AB - All occlusal therapy relates ultimately to the hinge position of the mandible. By consensus, the optimum hinge position is centric relation, the most anterosuperior position of the condyles in the glenoid fossae, articulating against the eminences, with the disks properly interposed. Also by consensus, the optimum occlusal scheme is mutual protection, in which the posterior teeth contact simultaneously and equally in centric occlusion, the canines disclude the posterior teeth in lateral excursions, and the anterior teeth disclude the posterior teeth in protrusion. Whenever CR cannot be used as the starting point of occlusal treatment, or when sufficient canine support is lacking, the clinician may have to prescribe a treatment condylar position other than CR or modify the occlusal scheme. Mutual protection occlusion is the simplest to develop and CR is the simplest starting point. Departures from these ideals create added complexities for the dentist. The greater the number of excursive contacts in the occlusal scheme, the more involved the equilibration of those contacts. A treatment condylar position other than CR may not be repeatable when needed, and two studies suggest that it may change over time. Without a stable, repeatable foundation supporting it, the occlusion may be in jeopardy. The removal of occlusal interferences, although not warranted as a routine prophylactic measure, is indicated under certain conditions. When beginning a significant amount of occlusal treatment, the clinicians may remove closing interference to achieve CR at the desired vertical dimension. They may remove excursive interferences that they do not want to perpetuate in the new scheme. Selective removal may alleviate the signs of trauma from occlusion. There may be periodontal justification for axializing and equilibrating occlusal forces. Nonaxial forces on teeth with cervical erosion should be reduced as a means of limiting further erosion and protecting cervical restorations. When occlusal disharmony has been shown to reactivate a TMD, an equilibration or a more extensive rehabilitation may be necessary in the second phase of TMD treatment. In the symptomatic phase of a TMD, however, only reversible measures are appropriate. In this time of fast-moving change in restorative techniques and products, all operative dentists should raise their consciousness of occlusal principles. Occlusal forces set limits on the selection of materials and often prescribe the design features needed for a successful outcome. With structurally or periodontally compromised teeth, the occlusal planning to minimize nonaxial forces lies at the heart of the restoration. Virtually all restorative dentistry is affected by the occlusal forces of the teeth in function.(ABSTRACT TRUNCATED AT 400 WORDS) <256> UI - 93319610 AU - Zarb GA AU - Schmitt A IN - Faculty of Dentistry, University of Toronto, Ontario, Canada. TI - The longitudinal clinical effectiveness of osseointegrated dental implants in posterior partially edentulous patients. SO - International Journal of Prosthodontics 1993 Mar-Apr;6(2):189-96 AB - While considerable data have been published on the use of the osseointegration technique in the anterior region of the edentulous mouth, there remains scant information on its success in the posterior areas of either the maxillae or mandible. This prospective study was begun in the mid-1980s to test the effectiveness of this technique in the treatment of partially edentulous posterior areas of the maxillae and mandible, and in situations where the implant-supported prosthesis carries a significant portion of the total occlusal load. One hundred five implants were placed into 46 edentulous areas in 35 patients. After periods of loaded service ranging from 2.6 to 7.4 years (mean 5.2 years), of the 41 implants placed in maxillae, 40 (97.6%) remain in function, and of the 64 placed in mandibles, 59 (92.2%) remain in function. The overall implant survival rate of 94.3% suggests that partially edentulous areas in the posterior zones of either arch can be treated prosthodontically using osseointegrated implants with predictable success. <257> UI - 93319609 AU - Zarb GA AU - Schmitt A IN - Department of Prosthodontics, Implant Prosthodontics Research Teaching and Service Unit, Faculty of Dentistry, University of Toronto, Canada. TI - The longitudinal clinical effectiveness of osseointegrated dental implants in anterior partially edentulous patients. SO - International Journal of Prosthodontics 1993 Mar-Apr;6(2):180-8 AB - For many years the technique of osseointegration in the anterior part of the mouth has been used with predictable success to treat completely edentulous arches. This prospective study was begun in the mid-1980s to adapt this technique to the partially edentulous situation in this same anterior region of both the maxillae and mandible. Ninety-four implants were placed into 34 edentulous areas in 30 partially edentulous patients. Forty-seven (94%) of the 50 implants placed into maxillae and 39 (88.6%) of the 44 placed into mandibles remain in function after periods of loading ranging from 2 to 8 years (mean 4.7 years). This average success rate of 91.5% was sufficient to ensure a 100% resolution of the selected patients' maladaptive prosthodontic experiences. These results suggest that past experiences with osseointegration in the anterior of the completely edentulous mouth can be replicated in patients with anterior partial edentulism. <258> UI - 93288833 AU - Henry PJ AU - Tolman DE AU - Bolender C IN - Department of Restorative Dentistry, University of Western Australia, Perth. TI - The applicability of osseointegrated implants in the treatment of partially edentulous patients: three-year results of a prospective multicenter study. SO - Quintessence International 1993 Feb;24(2):123-9 AB - Nine clinical centers using the Branemark System participated in a prospective study of 159 partially edentulous patients between 18 and 70 years of age. Clinical parameters evaluated were Plaque Index, gingivitis, pocket depth, Bleeding Index, tooth mobility, prosthesis stability, and stomatognathic function. Change in bone height around fixtures was measured radiographically. After 3 years, 460 loaded fixtures, supporting 174 prostheses in 139 patients, remain in the study. The complications, failures, and technical problems are presented. After 3 years of this 5-year study, results suggest that implant-based treatment of partially edentulous patients may achieve a success rate comparable to that obtained in edentulous patients. <259> UI - 93301226 AU - Smales RJ AU - Berekally TL AU - Webster DA IN - Department of Dentistry, University of Adelaide, South Australia. TI - Predictions of resin-bonded bridge survivals, comparing two statistical models. SO - Journal of Dentistry 1993 Jun;21(3):147-9 AB - The purpose of this study was to compare the predictive accuracy of the standard Weibull distribution model with that of a modification, or mixture model, for resin-bonded etched-metal bridge survivals. A total of 189 bridges placed in adult patients treated by students and staff at a teaching hospital was evaluated over periods of up to 8 years. Survival predictions based on the actual survival data accumulated in 1989 were compared with the later survival data updated in 1992. Comparison of the two fitted Weibull predictive curves with the life table survival estimates from the 1992 updated data demonstrated clearly the improved accuracy of the mixture model for predicting survivals of the resin-bonded bridges in this study. <260> UI - 93277781 AU - Dunne SM AU - Millar BJ IN - Department of Conservative Dentistry, King's College School of Medicine and Dentistry, Denmark Hill, London. TI - A longitudinal study of the clinical performance of resin bonded bridges and splints. SO - British Dental Journal 1993 Jun 5;174(11):405-11 AB - A total of 382 resin bonded bridges and splints were fitted, in 309 patients, in a teaching hospital. The restorations were evaluated after a period ranging from 5 months to 8 years. During the evaluation period 125 restorations (33%) debonded of which 69 (55%) were rebonded. The survival rates of the rebonded restorations at first, second, third or fourth rebond, where necessary, did not differ from the survival rate of the same restorations up to the first debond. Restorations constructed using the Rochette design had a significantly higher debond rate than the other designs. However, since they also exhibited a high rebond rate Rochette restorations continued to perform well over the study period. Splints had a higher debond rate as did restorations placed in patients in the age group 11 to 20 years, restorations involving more than two abutment teeth, and restorations containing more than one tooth pontic. <261> UI - 93247010 AU - Denissen HW AU - Wijnhoff GF AU - Veldhuis AA AU - Kalk W IN - University of Nijmegen, School of Medicine and Dentistry, The Netherlands. TI - Five-year study of all-porcelain veneer fixed partial dentures. SO - Journal of Prosthetic Dentistry 1993 May;69(5):464-8 AB - Improvements in enamel-dentinal bonding systems combined with the introduction of new ceramics have encouraged replacement of missing anterior teeth in specific patients with porcelain veneer fixed partial dentures. Metal substructures are not needed, and more natural tooth structure can be preserved because the preparation of abutments is conservative. Twelve porcelain veneer fixed partial dentures were monitored for 5 years, and fractures attributed to degradation of the gingival margins occurred in the veneer surface of the fixed partial dentures. The success rate of 75% was dependent on rigid patient selection criteria, strength of the major connectors, and precise adjustment of occlusion to prevent overloading. The failing margins were attributed to the degeneration, attrition, and deterioration of the composite resin cements. Despite these limitations, patients were extremely satisfied with the esthetics. Improvement in the mechanical properties of composite resin cement will ameliorate the prognosis with this approach. <262> UI - 93263852 AU - Berekally TL AU - Smales RJ IN - Adelaide Dental Hospital. TI - A retrospective clinical evaluation of resin-bonded bridges inserted at the Adelaide Dental Hospital. SO - Australian Dental Journal 1993 Apr;38(2):85-96 AB - The clinical performance of resin-bonded Rochette and Maryland bridges inserted by various operators at the Adelaide Dental Hospital is reported. Thirty-four Rochette bridges (30 anterior, 4 posterior) and 228 Maryland bridges (150 anterior, 78 posterior) were assessed. Clinical data were compiled on types of bridge failure, factors influencing bridge retention, and the effects of the prostheses on abutment teeth and supporting tissues. The failure rate for Rochette bridges over 6 years was 75 per cent with a median survival of 2.14 years. Debonding occurred in 70 per cent of bridge failures. The failure rate for Maryland bridges over 5 years was 42 per cent with a median survival of 2.60 years. Pontic fracture (29 per cent) and debonding (20 per cent) were the main failures observed. Porcelain pontics performed significantly better than the processed hybrid resin pontics (P < 0.01). The main reasons for debonding included occlusal stresses, non-retentive bridge designs and resin cement failure. A life-table analysis showed no significant difference in the overall cumulative survival rates between Rochette and Maryland bridges. Bridge design and the choice of pontic material and resin cement emerged as significant factors influencing the success rate of the bridges examined. <263> UI - 93204074 AU - Anderson RJ AU - Janes GR AU - Sabella LR AU - Morris HF IN - Department of Veterans Affairs Hospital, Hines, Ill. TI - Comparison of the performance on prosthodontic criteria of several alternative alloys used for fixed crown and partial denture restorations: Department of Veterans Affairs Cooperative Studies project 147. SO - Journal of Prosthetic Dentistry 1993 Jan;69(1):1-8 AB - In a 10-year, multicenter, double-blind clinical trial, comparisons of the clinical behavior of crown and fixed partial denture restorations were made between a gold alloy and four less costly alternative alloys. The endpoints of interest were (1) the development of unacceptable ratings on any of 11 individual prosthodontic criteria and an overall rating, (2) the removal of the restoration, and (3) an event combining unacceptable overall rating and restoration removal. Each of 630 patients had two restorations completed, one from gold-palladium alloy and the other from one of four alternative alloys. The patients were enrolled during a period of 3 1/2 years, with some patients followed up as long as 10 years after restoration. Analysis of the endpoints showed that one of the alternative alloys was significantly poorer than the other materials for certain criteria. <264> UI - 93155948 AU - Besimo C IN - Department of Prosthetics, University of Basle School of Dentistry, Switzerland. TI - Resin-bonded fixed partial denture technique: results of a medium-term clinical follow-up investigation. SO - Journal of Prosthetic Dentistry 1993 Feb;69(2):144-8 AB - Results of a clinical investigation with cast metal, electrolytically etched, resin-bonded fixed partial dentures (FPDs) are reported. These FPDs were inserted under standardized conditions. The FPDs had been in place and functioning for an average time of 21.4 months. Sixty-five patients with a total of 82 resin-bonded FPDs were followed up. There was a retentive failure in only one FPD. All patients were satisfied from both functional and esthetic points of view. The results of this study indicate that the concept of treatment with resin-bonded FPDs should be considered as an alternative to conventional treatment. <265> UI - 93157797 AU - Gerber C TI - [Periodontology SGP 1991 (IV)]. [German, French] SO - Schweizer Monatsschrift fur Zahnmedizin 1993;103(1):52-7 <266> UI - 93326253 AU - Hansson O AU - Moberg LE IN - Department of Prosthodontics, Karolinska Institute, Huddinge, Sweden. TI - Clinical evaluation of resin-bonded prostheses. SO - International Journal of Prosthodontics 1992 Nov-Dec;5(6):533-41 AB - Resin-bonded prostheses were clinically evaluated following a mean period of 41 months. The abutment teeth were minimally prepared, and one groove was placed on the surface approximating the edentulous space. Retainers were treated using the Silicoater technique. Thirty-four prostheses were made for 32 patients. Four patients were lost from the study and 30 units were re-examined. Two prostheses had debonded. The results suggest that resin-bonded prostheses can be successful if meticulous attention is given to the procedures outlined. <267> UI - 93326250 AU - Garrett NR AU - Hasse AL AU - Kapur KK IN - Department of Veteran Affairs, West Los Angeles Medical Center, California 90073. TI - Comparisons of tactile thresholds between implant-supported fixed partial dentures and removable partial dentures. SO - International Journal of Prosthodontics 1992 Nov-Dec;5(6):515-22 AB - This study compared the tactile sensitivity of splinted abutment and denture teeth of 16 fixed partial dentures (FPD) supported by blade implants and 16 removable partial dentures (RPD) in patients with Kennedy Class I and Class II edentulous conditions. No significant differences were noted between the tactile thresholds of the natural abutment teeth and artificial teeth in the FPD and RPD groups. The splinted abutment teeth required 45.4 g, or 5.4 to 5.8 times higher occlusal loads than did those needed for the comparable nonsplinted teeth, to detect the stimulus. A further increase of 54% in thresholds with the FPD and over 100% with the placement of the RPD indicated the superiority of the RPD in terms of load distribution as a result of the cross-arch splinting and mucosal support. Moderate positive correlations (r = 0.37 to 0.46; P < .05) between tactile thresholds and masticatory performance were found, signifying that reduced tactile perception was not responsible for the incomplete restoration of the masticatory function with RPDs or FPDs but might be contributing to increased masticatory performance within both treatment groups. <268> UI - 93285381 AU - Becker IM TI - Routine restorative procedures that yield predictive results. SO - Dental Economics 1992 Nov;82(11):120-1 <269> UI - 93222426 AU - Weber HP AU - Buser D AU - Fiorellini JP AU - Williams RC IN - Department of Periodontology, Harvard School of Dental Medicine, Boston. TI - Radiographic evaluation of crestal bone levels adjacent to nonsubmerged titanium implants. SO - Clinical Oral Implants Research 1992 Dec;3(4):181-8 AB - Several parameters have been described to determine success or failure in long-term evaluations of dental implants. One of these parameters is the observation of changes in peri-implant bone levels. Studies on submerged implants have analyzed the bone level changes in the pre- and post-loading phases. No such data exist for intentionally nonsubmerged implants. The purposes of this study were: (1) to test the applicability and reproducibility of a simple computer-assisted method in the evaluation of changes in peri-implant bone levels; (2) to establish a baseline for the longterm radiographic follow-up; and (3) to evaluate changes in crestal bone levels adjacent to nonsubmerged ITI implants between the 1-year and 2-year examination. Standardized periapical radiographs were obtained from 80 implants at the 1-year and 2-year follow-up examinations after their placement. The implants were located in different jaw areas of 55 patients and supported single crowns or short-span fixed partial dentures. For each implant, the distance from implant shoulder to first crestal bone contact (DIB) was measured at the proximal surfaces with a digitizer/computer assembly. Statistically significant greater mean DIB were found at the 1-year (baseline) evaluation for: (1) maxillary sites overall (4.10 x 1.02 mm (SD)) compared with mandibular sites overall (3.61 +/- 1.03 mm); (2) maxillary anterior sites (4.08 +/- 0.97 mm) compared with mandibular posterior sites (3.60 +/- 1.05 mm); and (3) maxillary posterior sites (4.13 +/- 1.12 mm) compared with mandibular posterior sites. No statistically significant changes in DIB occurred in any of the jaw locations between the 1-year and 2-year evaluations.(ABSTRACT TRUNCATED AT 250 WORDS) <270> UI - 93155927 AU - Carlson BR AU - Carlsson GE AU - Helkimo E AU - Yontchev E IN - University of Goteborg, Sweden. TI - Masticatory function in patients with extensive fixed cantilever prostheses. SO - Journal of Prosthetic Dentistry 1992 Dec;68(6):918-23 AB - Eleven patients with complete maxillary dentures and 12-unit fixed partial dentures that included the mandibular canines were studied before and during specific intervals after prosthodontic treatment. Established methods for evaluation of oral function were used and the last examination was performed 30 months after treatment. All patients reported that their masticatory function had been substantially improved and there were no symptoms of dysfunction in the masticatory system. Masticatory efficiency improved after the prosthodontic treatment because both the number of cycles before the initial swallow and the total number of strokes including the time for completed mastication diminished after treatment. The occlusal force elevated after the prosthodontic treatment. Although great individual variations were recorded for all occasions and force levels, forces recorded on the extensions of the cantilever were similar to those on the canine regions. <271> UI - 93088028 AU - Brunner T AU - Walti D AU - Menghini G IN - Kantonale Volkszahnklinik Zurich. TI - [The late results with a fixed denture in less well-off adults. A retrospective study]. [German] SO - Schweizer Monatsschrift fur Zahnmedizin 1992;102(9):1029-36 AB - In this retrospective study 141 patients were re-examined after having been treated with at least two crowns or one fixed bridge each at the Cantonal Public Dental Clinic of Zurich (Volkszahnklinik) between 1974 and 1984. After an average "wearing time" of more than 9 years, 88% of the crowns and 92% of the bridges were still in function. 4 patients had already lost all their reconstructions incorporated in the "Volkszahnklinik" and were not examined clinically. 115 (84%) of the remaining 137 patients were satisfied with their reconstructions. The mean papillary bleeding index (PBI) was significantly higher on crowned teeth compared to the untreated teeth. The mean probing depth of the crowned premolars and incisors was also significantly higher compared to that of the natural teeth. The results of the study show that the success rate of fixed reconstructions fitted at the Cantonal Public Dental Clinic of Zurich are within the ranges reported by other similar institutions. <272> UI - 93085008 AU - Creugers NH AU - Kayser AF IN - Department of Oral Function and Prosthetic Dentistry, Dental School University of Nijmegen, The Netherlands. TI - An analysis of multiple failures of resin-bonded bridges. SO - Journal of Dentistry 1992 Dec;20(6):348-51 AB - A clinical trial involving 203 resin-bonded bridges (RBBs) was undertaken to investigate the influence of several variables on the survival of these prostheses. This article presents the experiences with rebonded and replacement RBBs after failure of the originally bonded RBBs. A total of 62 dislodged and rebonded RBBs was included in this study and evaluated using Kaplan-Meier estimates. Rebonded RBBs that dislodged for a second time were replaced by another type of RBB ('replacement' RBBs, n = 32). The study revealed that rebonded RBBs were more susceptible to dislodgement than originally bonded RBBs. Fifty per cent survival was reached 2.1 years after rebonding. The sooner the first dislodgement occurred, the lower the retention rate of the rebonded RBB (PH-model, beta = 0.78, P = 0.02). Also some failure characteristics were evaluated. Failure characteristics (i.e. fracture site and partial versus complete dislodgement) of first and second dislodgement were not correlated (Chi-square, P values > 0.25). The survival of 'replacement' RBBs was significantly better than the survival of multiply failure RBBs (median survivals respectively 1.6 years and 1.0 year, P = 0.03). From the results of this study it may be concluded that the survival rates of rebonded and replacement RBBs were unacceptable. <273> UI - 93081471 AU - Wedgwood D AU - Jennings KJ AU - Critchlow HA AU - Watkinson AC AU - Shepherd JP AU - Frame JW AU - Laird WR AU - Quayle AA IN - Royal Shrewsbury Hospital. TI - Experience with ITI osseointegrated implants at five centres in the UK. SO - British Journal of Oral & Maxillofacial Surgery 1992 Dec;30(6):377-81 AB - Experience with the two-part ITI titanium implant system at five centres in the UK is reported. A total of 461 implants were inserted in 176 patients, who received 189 prostheses. Criteria for the assessment of success following implantation are listed. Results over a 3-year period showed a success rate of 94% when implants were used for mandibular overdentures and crown and bridge prosthetics. A lower success rate in the edentulous maxilla was recorded. <274> UI - 93061862 AU - Gadzhiev SA AU - Mamedov MA AU - Starikov NA AU - Teologova EL TI - [Use of pin spherical fixators in designing splint prostheses]. [Russian] SO - Meditsinskaia Tekhnika 1992 Jul-Aug;(4):14-5 <275> UI - 93042468 AU - De Bruyn H AU - Collaert B AU - Linden U AU - Flygare L IN - Lund University, Malmo, Sweden. TI - A comparative study of the clinical efficacy of Screw Vent implants versus Branemark fixtures, installed in a periodontal clinic. SO - Clinical Oral Implants Research 1992 Mar;3(1):32-41 AB - The clinical success of 85 Screw Vent and 107 Branemark implants, consecutively installed in a private periodontal clinic under the same conditions and by the same operator, is compared. Mobile implants were removed and considered as failures. Intra-oral radiographs were assessed for the presence of peri-implant radiolucencies and for analysis of bone loss after functional loading. 85 Screw Vent implants were installed in 31 patients. Of 23 implants installed in 9 mandibles, none failed after 16.8 (range 12-25) months of function. Of 62 Screw Vent implants installed in 23 maxillae, 6 failed at abutment connection, 1 failed after 2 months and 2 after 13 months of function. The absolute failure rate after 13.2 (range 6-24) months was 9/62. Mean loss of bone was 1.47 mm (-1.0- +4) after 12 months of functional loading. 107 Branemark fixtures were installed in 25 patients. Of 51 fixtures inserted in 12 mandibles, none failed; of 56 fixtures installed in 13 maxillae 1 failed before and 2 failed during abutment connection. The absolute failure is 3/56. All remaining fixtures were immobile after loading. 13 fixtures were more than 6 months in function. Only short-term comparison between both systems is possible because the observation time is longer for the Screw Vent implants. In the 1st year, only 1 implant system was available to the periodontist. Short-term comparison reveals 11.3% versus 5.3% of cumulative failure after 6 months for the Screw Vent and Branemark implants, respectively. The results indicate that clinical efficacy is as effectively obtained with Screw Vent as with Branemark implants in the mandible. The outcome of treatment with Screw Vent implants in the maxilla seems less predictable. <276> UI - 93012127 AU - Stockstill JW AU - Bowley JF AU - Attanasio R IN - Department of Adult Restorative Dentistry, University of Nebraska Medical Center College of Dentistry, Lincoln. TI - Clinical decision analysis in fixed prosthodontics. [Review] [20 refs] SO - Dental Clinics of North America 1992 Jul;36(3):569-80 AB - Structured clinical decision analysis in dentistry in fixed prosthodontics, as in any branch of dentistry, allows the practitioner to think through more clearly the problems at hand based on the clinical data and extenuating factors presented by the patient. This discipline of decision making is intended to complement the experience level and educational background of the clinician in assisting him or her through the decision process. Additionally, CDA helps the clinician define not only the pre-existing condition of the patient prior to irreversible therapy, but also which treatment strategies may best be suited for that individual over an extended period. The systematic nature of decision analysis stimulates the focusing of one's attention on those factors considered to be germane to the overall complexity of the case and, at the same time, excluding those factors having little or no influence on its final outcome. With further implementation of computerized databases and procedural outcome probabilities based on clinical and laboratory studies as well as the clinical experience of those choosing to use it, the future for structured, formalized clinical decision analysis seems quite promising. [References: 20] <277> UI - 93012130 AU - Spalding PM AU - Cohen BD IN - Department of Orthodontics, University of Nebraska Medical Center College of Dentistry, Lincoln. TI - Orthodontic adjunctive treatment in fixed prosthodontics. [Review] [24 refs] SO - Dental Clinics of North America 1992 Jul;36(3):607-29 AB - The purpose of this article has been to increase the restorative dentist's appreciation for the rationale justifying preprosthodontic orthodontic treatment. It has not been intended to identify all the specific indications for the use of orthodontic treatment to enhance prosthodontic treatment nor has it been intended as a reference to assist the restorative dentist in placing and using orthodontic appliances. Figure 12 illustrates a typical case in which the combination of orthodontic and prosthodontic treatment resulted in a more favorable outcome than prosthodontic treatment alone. When planning prosthodontic treatment, the dentist should embrace a dynamic view of tooth position and determine whether restorative treatment can be enhanced by tooth movement. Improved tooth position can eliminate potentially pathologic occlusion and create a healthier periodontal environment that is easier to maintain. In addition, it permits the dentist to place restorations that often require less natural tooth reduction during preparation, and that are more esthetic, functional, stable, and durable. Orthodontic treatment that accomplishes these benefits may be limited to a partial fixed appliance localized to one segment of an arch or require a more extensive fixed appliance. Much of this treatment can be accomplished by the interested restorative dentist. Addressing more comprehensive orthodontic problems in patients requiring prosthodontic care is best managed through a restorative dentist and orthodontist team approach to treatment. [References: 24] <278> UI - 93013987 AU - Jemt T AU - Linden B AU - Lekholm U IN - University of Gothenburg, Sweden. TI - Failures and complications in 127 consecutively placed fixed partial prostheses supported by Branemark implants: from prosthetic treatment to first annual checkup. SO - International Journal of Oral & Maxillofacial Implants 1992 Spring;7(1):40-4 AB - Ninety-six partially edentulous maxillae and mandibles were consecutively treated with 127 freestanding fixed prostheses supported by 354 implants. The patients were followed for 1 year and the overall success rate was 98.6% for the examined implants. None of the inserted prostheses was lost during the observation period. The most commonly reported problems during the first year of function were related to loose gold screws and esthetic complaints, complications that were easily resolved. Furthermore, the total number of complications was low and was less than has been reported for routine full-arch fixed prostheses. <279> UI - 93012128 AU - Plesh O AU - Stohler CS IN - Department of Restorative Dentistry, School of Dentistry, University of California, San Francisco. TI - Prosthetic rehabilitation in temporomandibular disorder and orofacial pain patients. Clinical problem solving. [Review] [37 refs] SO - Dental Clinics of North America 1992 Jul;36(3):581-9 AB - Good clinical decision making represents an integral part of quality care. A definition of the dental problem and its significance from a dental point of view, in combination with a good working hypothesis of the nature of the concurrent TMD condition are prerequisites of any successful clinical problem solving. It is hoped that, with time, we will be in a position to call upon hard data on the probability and utility of successful outcome for each treatment alternative. This will bring the needed structure and scientific validity to a terribly complex albeit clinically important problem. [References: 37] <280> UI - 93017330 AU - Creugers NH AU - Kayser AF AU - Van't Hof MA IN - TRIKON, Department of Oral Function and Prosthetic Dentistry, Nijmegen, The Netherlands. TI - A seven-and-a-half-year survival study of resin-bonded bridges. SO - Journal of Dental Research 1992 Nov;71(11):1822-5 AB - A clinical trial, concerning 203 resin-bonded bridges (RBBs), was performed for investigation of the influence of retainer-type and cementation materials on the survival of these restorations. The survival rates after a 7.5-year follow-up were 75% for anterior RBBs and 44% for posterior bridges. Etched metal RBBs (E-bridges) were significantly more retentive than perforated RBBs (P-bridges); the survival rates were 78% and 63%, respectively. With respect to the cementation materials, Clearfil F, in combination with E-bridges, had the best overall survival (89%, anterior and posterior). Maxillary anterior RBBs were more susceptible to failure than mandibular anterior RBBs. <281> UI - 93020538 AU - Simon JF AU - Gartrell RG AU - Grogono A IN - Department of Operative Dentistry, University of the Pacific School of Dentistry, San Francisco, Calif. TI - Improved retention of acid-etched fixed partial dentures: a longitudinal study. SO - Journal of Prosthetic Dentistry 1992 Oct;68(4):611-5 AB - Debonding of acid-etched fixed partial dentures has been a problem since their introduction. A study was conducted to determine whether this problem could be resolved by modifying the mechanical retention of tooth preparations. Retentive grooves were prepared at the line angles to create mechanical locks for the resin bonded fixed partial denture. The 4-year retention of posterior resin-bonded fixed partial dentures improved from 60% to 95% by the placement of the proximal grooves. This study was conducted in a dental school clinic during a period of 10 to 52 months. The results demonstrated that design modifications were necessary to improve clinical longevity so that the restoration could be considered "permanent" in the traditional sense. The less-experienced dentist may be more confident of the treatment with the recommended modifications and projected longevity. <282> UI - 93031958 AU - Bezvestnyi GV AU - Abdullov II AU - Rozov IuV TI - [Clinical and technical measures to improve the fit of whole-cast fixed dentures to the denture bed]. [Russian] SO - Stomatologiia 1992 Mar-Apr;(2):91-3 AB - Basing on the literature data and their clinical experience, the authors analyze the following factors influencing the union of whole-cast permanent dentures and denture bed: shape of the prepared tooth, use of various types of benches, presence of free space for cement, compensation for the alloy shrinkage, simplification of placing the dentures by perforating the crowns, use of vibration, lesser volumes of cement put into the crown, and various methods of transferring the masticatory pressure to the denture over the course of denture fixation. Practical significance of these factors is estimated. <283> UI - 92407825 AU - Hochman N AU - Yaffe A AU - Ehrlich J IN - Department of Prosthodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel. TI - Splinting: a retrospective 17-year follow-up study. SO - Journal of Prosthetic Dentistry 1992 May;67(5):600-2 AB - A retrospective 17-year, longitudinal study monitoring 66 patients with fixed partial denture and removable partial denture restorations revealed that perceptive splinting was beneficial and enhanced the longevity of the restoration. The study discussed the advantages and disadvantages of splinting, the survival rate of splints and splinted teeth, and the importance of oral hygiene and a periodic maintenance program. <284> UI - 92406363 AU - Mecall RA AU - Rosenfeld AL TI - The influence of residual ridge resorption patterns on implant fixture placement and tooth position. 2. Presurgical determination of prosthesis type and design. SO - International Journal of Periodontics & Restorative Dentistry 1992;12(1):32-51 AB - The incorporation of prosthetic information into a presurgical implant treatment plan is essential to provide accurate guidelines for fixture placement by the surgeon. Part I of this article presented a modified surgical technique that enables the restorative dentist to construct a prosthesis compatible with the final tooth position. Part II describes a technique in which a computer profile image is used to identify the determinants of the optimal final tooth position and discusses the impact of these determinants on the prosthetic design. Guidelines that could be used to predict the final prosthetic design are also presented. <285> UI - 92373602 AU - Himmel R AU - Pilo R AU - Assif D AU - Aviv I IN - Department of Oral Rehabilitation, Tel Aviv University, Maurice and Gabriela Goldschleger School of Dental Medicine, Israel. TI - The cantilever fixed partial denture--a literature review. [Review] [21 refs] SO - Journal of Prosthetic Dentistry 1992 Apr;67(4):484-7 AB - The cantilever fixed partial denture (FPD) is a restoration with one or more abutments at one end and unsupported at the other end. Forces transmitted through the cantilevered pontics can cause tilting and rotational movements of the abutments. In a cross-arch unilateral cantilever FPD, the distal cantilevered unit is subjected to comparatively less force than the contralateral posterior abutment. The unilateral lack of terminal abutments causes lateral bending forces activate peripheral inhibitory feedback reactions from the periodontal and/or temporomandibular mechanoreceptors. The greatest strain in distal cantilevered FPDs is recorded mesial to the most distal retainer because most fractures occur in this location. To improve the prognosis of the FPD cantilever, the number of abutments should be increased and the number of pontics decreased. The abutment teeth need long roots and acceptable alveolar support. Prepared abutments require adequate length and parallel axial walls. An equilibrated and harmonious occlusion is necessary, as well as exemplary oral hygiene. A cantilevered FPD with adequate periodontal support can replace any tooth in the dental arch, but is especially useful as an alternative to a removable partial denture. The cantilevered FPD requires at least two abutment teeth. The only documented exception permitting a single abutment is the replacement of a maxillary lateral incisor with the canine as an abutment. An alternative to the cantilevered FPD is the osseointegrated implant. As osseointegrated implants become more popular, the need for the tooth-supported cantilevered FPD may decline, but it will remain an alternative treatment modality. [References: 21] <286> UI - 92364961 AU - Sze AJ IN - Department of Restorative Dentistry, University of California, School of Dentistry, San Francisco. TI - Duplication of anterior provisional fixed partial dentures for the final restoration. SO - Journal of Prosthetic Dentistry 1992 Aug;68(2):220-3 AB - Using the provisional restoration as a testing ground to increase the predictability of a final restoration is well understood. With the resolution of issues through a well-developed provisional restoration comes the challenge of duplicating its contours in the final prosthesis. A method is described using elastomer impression putty and a molten wax technique by which the contours of a provisional anterior fixed partial denture can be duplicated. The described method is particularly useful when the replication of a specific irregular tooth arrangement is mandated. <287> UI - 92368750 AU - Jennings KJ AU - Critchlow HA AU - Lilly P AU - Broad MT IN - Department of Prosthodontics, Glasgow Dental Hospital and School. TI - The clinical use of ITI transmucosal implants. SO - British Dental Journal 1992 Jul 25;173(2):67-71 AB - The ITI implant system has a background of research and development of over 15 years. It is distinctive in that the implant fixtures are transmucosal from the time of placement, requiring only a single stage in surgical treatment. In a relatively simplified approach to prosthetic management, standard overdenture components and conventional fixed partial denture techniques are used. In this report the assessment, surgical treatment and post-operative management of patients using ITI Bonefit implants are described and early results from 168 consecutive fixtures placed over a period of 3 years indicated. <288> UI - 92336741 AU - Palmqvist S AU - Soderfeldt B AU - Arnbjerg D IN - Department of Prosthetics, Postgraduate Dental Education Center, Orebro, Sweden. TI - Explanatory models for total edentulousness, presence of removable dentures, and complete dental arches in a Swedish population. SO - Acta Odontologica Scandinavica 1992 Jun;50(3):133-9 AB - On the basis of data from a questionnaire study of 3000 inhabitants of Orebro County, Sweden, aged 45-69 years, the relative importance of various socioeconomic factors for dental conditions were analyzed in stepwise logistic regression models. Two different patterns were found: one in relation to the best dental condition (complete dental arches), another in relation to the poorest conditions (total edentulousness and presence of removable dentures). Next to age, education and income showed the highest predictive values in relation to the presence of removable dentures and total edentulousness. Place of residence and gender seemed to be of less importance than earlier. In relation to complete dental arches, there were lower values for most variables. One of only four significant variables was the attitude variable 'importance of good dental appearance'. The results may indicate the development of a new pattern of influences on dental conditions, mainly based on education and attitudes. <289> UI - 92339057 AU - Mazurat RD IN - Department of Rehabilitative Dental Science, Faculty of Dentistry, University of Manitoba, Winnipeg. TI - Longevity of partial, complete and fixed prostheses: a literature review [published erratum appears in J Can Dent Assoc 1992 Jul;58(7):528]. [Review] [31 refs] SO - Journal / Canadian Dental Association. Journal de l Association Dentaire Canadienne 1992 Jun;58(6):500-4 AB - A review of the dental literature reveals a lack of consensus as to the longevity of conventional prosthodontic therapy. The reasons for this are suggested and best estimates of the longevity of partial, complete and fixed prostheses are presented based on the available literature. A renewed interest in survival studies, hopefully based on sound parameters that outline the reasons for failure, as well as replacement indicators, is required to update our knowledge of survival rates. [References: 31] <290> UI - 92327590 AU - Haastert B AU - Hickel R AU - Holste T AU - Kerschbaum T IN - Klinik und Poliklinik fur Zahn-, Mund- und Kieferheilkunde der Universitat zu Koln. TI - [The factors affecting the risk for the loss of resin-bonded bridges]. [German] SO - Schweizer Monatsschrift fur Zahnmedizin 1992;102(4):416-21 AB - 1310 three-unit resin-bonded bridges were examined for their failure rates. After five years 86% (+/- 4%) were still in situ. 64% (+/- 5%) didn't need rebonding. Significant prognostic factors were: preparation of abutments, surface treatment (net retention, silicoating), type of luting agent (Bis GMA) and mobility of the abutments. <291> UI - 92167114 AU - Naert I AU - Quirynen M AU - van Steenberghe D AU - Darius P IN - Department of Prosthetic Dentistry, Catholic University of Leuven, Belgium. TI - A six-year prosthodontic study of 509 consecutively inserted implants for the treatment of partial edentulism. SO - Journal of Prosthetic Dentistry 1992 Feb;67(2):236-45 AB - A total of 509 consecutive Branemark TM implants (Nobelpharma AB, Gothenburg, Sweden) were inserted in 146 patients between December 1982 and May 1989, on which 217 fixed partial dentures were planned. The cumulative failure rates after abutment connection were 3.9% and 4.1% for the maxillae and mandible, respectively. The lack of continuous prosthesis stability was limited to 4.1% for the maxillae and 5.4% for the mandible. The average annual marginal bone loss was 0.77 mm (SD = 1.0) and 0.96 mm (SD = 0.9) for the maxillae and mandible, respectively, during the first year and averaged 0.1 mm for the following years. The mode of connection between teeth and implants or the use of porcelain instead of composite resin as occlusal material did not influence the marginal bone height around the implants. Technical complications were most often related to the materials used. The results of a medium-term follow-up encourage the use of the Branemark osseointegration system in the treatment of partial edentulism. <292> UI - 93182997 AU - Behrend DA TI - Aesthetic control in fixed prosthodontics. SO - Annals of the Royal Australasian College of Dental Surgeons 1991 Oct;11:68-74 AB - Leaving the aesthetic results of fixed prosthodontic treatment to chance, or to the judgment of a technician without guidance, leads to many surprises and disappointments. This paper describes techniques for planning the aesthetic outcome in the dental surgery, conveying the specifications to the dental technician and controlling the various aesthetic elements during construction of the restoration. <293> UI - 92316575 AU - Buser D AU - Weber HP AU - Bragger U AU - Balsiger C IN - School of Dental Medicine, University of Berne. TI - Tissue integration of one-stage ITI implants: 3-year results of a longitudinal study with Hollow-Cylinder and Hollow-Screw implants. SO - International Journal of Oral & Maxillofacial Implants 1991 Winter;6(4):405-12 AB - This study examined the tissue integration of one-stage, nonsubmerged ITI implants over a period of 3 years. Fifty-four implants were placed in 38 partially edentulous patients. Following healing (at least 3 months), all 54 implants were free of peri-implant infections and revealed no detectable mobility. Radiographs showed no signs of peri-implant radiolucencies, and the implants were in favorable positions for prosthetic restoration. Following incorporation of fixed partial dentures, patients were enrolled in a hygiene recall program with 3-month intervals and were examined once a year. Based on predefined criteria, each implant was classified as successful or failing. After the 3-year observation period, 51 of 53 implants (96.2%) were considered successfully integrated. (One patient with one implant dropped out of the study.) Two implants exhibited recurrent peri-implant infections and were classified as late failures. These results indicate that one-stage ITI implants can achieve successful tissue integration on a predictable basis and that it can be maintained over a period of at least 3 years. <294> UI - 92316585 AU - Hulterstrom M AU - Nilsson U IN - Public Dental Service, Uppsala, Sweden. TI - Cobalt-chromium as a framework material in implant-supported fixed prostheses: a preliminary report. SO - International Journal of Oral & Maxillofacial Implants 1991 Winter;6(4):475-80 AB - Sixty-six consecutive patients treated at the Prosthodontic Clinic in Uppsala, Sweden, received implant-supported fixed prostheses of the Branemark type. The prosthesis frameworks were made of cobalt-chromium alloys. Different techniques for attaching the gold cylinders to the frameworks were used. Mechanical attachment with self-curing polymethyl methacrylate (PMMA), partial soldering combined with PMMA attachment, and soldering only were used. No abnormal tissue reactions were seen. Radiographic examination of the fixtures was performed at the time of prosthesis placement and at the 1- and 3-year follow-ups. A few cases of minor bone loss were detected but not related to the materials used in the superstructures. <295> UI - 92273563 AU - Buth K AU - Fodi J AU - Kersten G IN - Zentrums fur Zahn-, Mund- und Kieferheilkunde der Medizinischen der Ernst-Moritz-Arndt-Universitat Greifswald. TI - [Adhesive bridge and marginal periodontium--results of a prospective study after a period of wear of 2-3 years]. [German] SO - Deutsche Stomatologie 1991;41(4):121-4 AB - After a period of wear of 2-3 years in 48 adhesive bridges periodontal criteria (SBI and PI) were determined around the abutment teeth and compared with the condition before the insertion of the restaurations. Significant increase in the index values on the oral side of these abutment teeth was found out. Here the distance from the gingiva to the margin of restaurations was smaller than 1 mm. <296> UI - 92289497 AU - Kramer A AU - Weber H IN - Zentrums fur Zahn-, Mund- und Kieferheilkunde der Universitat Tubingen. TI - [The effect of bedding type on implant and abutment tooth in tooth/implant-supported bridgework]. [German] SO - Deutsche Zahnarztliche Zeitschrift 1991 Oct;46(10):686-8 AB - 17 distal extension cases were treated with IMZ implants supporting a fixed-removable bridge connected to a natural tooth abutment with a precision attachment. Instead of the polyoxmethylene internal shock absorber an identically dimensioned titanium element was incorporated in the implants of every second patient. Patients were monitored on a recall schedule. Implant and tooth mobility, pocket probing depth, and bone loss were the parameters evaluated. The results after a mean incorporation time of 16.5 months indicate that, at least during this initial time of function, there are no differences between a mobile and rigid bedding of the superstructure on the implants. <297> UI - 92285405 AU - Ericson A AU - Nilsson B AU - Bergman B IN - Abteilung fur Prothetik, Zahnmedizinische Fakultat, Universitat von Umea. TI - [Clinical results in patients treated with conical crown supported restorations]. [German] SO - Quintessenz 1991 Aug;42(8):1237-52 <298> UI - 92289488 AU - Rammelsberg P AU - Gernet W AU - Pospiech P AU - Pahle M IN - Poliklinik fur Zahnarztliche Prothetik der Universitat Regensburg. TI - [Clinical comparison of bonded bridges as a function of preparation and metal conditioning. Statistical analysis of failures]. [German] SO - Deutsche Zahnarztliche Zeitschrift 1991 Oct;46(10):653-6 AB - A total of 107 bonded bridges could be re-evaluated after a mean period of 2.3 years and a maximum of 5 years. The preparation of mechanical retentive aids, such as grooves and bores resulted in a significant reduction of failure rates after one year. Electrolytical etching or silicoating of the CoCr restorations failed to have any effect on the failure rates of those bridges that were provided with adequate mechanical retention. <299> UI - 92238957 AU - Owall B IN - Department of Prosthetic Dentistry and Stomatognathic Physiology, Royal Dental College, Aarhus C, Denmark. TI - Precision attachment retained removable partial dentures: 1. Technical long-term study. SO - International Journal of Prosthodontics 1991 May-Jun;4(3):249-57 AB - Patients provided with 53 distal extension-base removable partial dentures retained using rigid intracoronal slide attachments were followed up to 25 years. The initial treatment consisted of fixed partial dentures involving all remaining teeth in the treated arches and removable partial dentures having a cast cobalt-chromium framework. The removable dentures showed few complications and little need for relining. The failures primarily involved the fixed partial dentures. Seven arches required complete dentures as a result of technical complications in five patients. Cement failures, root fractures, and fractures of the fixed prostheses were most problematic. The survival rate was about 65% up to 15 years, and a survival time of 50% was extrapolated to 20 years. <300> UI - 92258891 AU - Astrand P AU - Borg K AU - Gunne J AU - Olsson M IN - Department of Oral and Maxillofacial Surgery, University Hospital, Linkoping, Sweden. TI - Combination of natural teeth and osseointegrated implants as prosthesis abutments: a 2-year longitudinal study. SO - International Journal of Oral & Maxillofacial Implants 1991 Fall;6(3):305-12 AB - Twenty-three patients with Kennedy Class I mandibular dentition were supplied with prostheses in the posterior parts of the mandible. On one side they were given a prosthesis supported by two implants (prosthesis Type I) and on the other side they received a prosthesis supported by one implant and one natural tooth (prosthesis Type II). Sixty-nine fixtures were inserted and 46 prostheses constructed. Eight of the fixtures were lost during the observation period. The failure rate of the implants was about the same in the two types of prostheses; five fixtures belonged to prostheses Type I (10.9%) and two fixtures belonged to prostheses Type II (8.7%), while one fixture was lost prior to loading. From a theoretical point of view, the combination of a tooth and an osseointegrated implant should encounter problems with regard to the difference in bone anchorage and there should be a risk of biomechanical complications. However, the results of this study did not indicate any disadvantages in connecting teeth and implants in the same restoration.