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 - B