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Concept: Prosthodontics


A patient exhibited severe abrasion of resin posterior denture teeth including perforation of the denture base. New dentures were provided to explore the application of zirconia teeth for complete dentures. [Correction added to online publication 07 November 2012: “Zirconium” corrected to “Zirconia”.] Traditional denture procedures were combined with fixed prosthodontic CAD/CAM procedures to fabricate custom-designed four-tooth posterior segments in hollow crown form to reduce weight and with a retentive form for interlocking to the denture base. The new dentures were successful in reducing wear of the denture teeth over the short-term follow-up period.

Concepts: Nitrogen, Teeth, Tooth enamel, Dentures, Zirconium dioxide, Prosthodontology, Prosthodontics


This article describes a multidisciplinary approach combining surgical and prosthodontic treatment of a completely edentulous patient who presented with a severe skeletal class III relationship and was diagnosed as American College of Prosthodontists Prosthodontic Diagnostic Index (ACP PDI) class IV. The use of a complete denture serving as diagnostic tool, surgical guide, and definitive restoration is presented. Computer-aided surgical simulation was used to achieve an accurate diagnostic and surgical plan. Maxillary Lefort class I and mandibular sagittal split osteotomy surgical treatment was performed to correct arch discrepancy. The surgical procedure demonstrated a clinically acceptable maxillomandibular relationship and stability. The patient was satisfied with the esthetics and demonstrated improved oral function following prosthesis insertion.

Concepts: Diagnosis, Dentures, Class III railroad, Prosthodontics


Abstract The objective of the present study is the evaluation of the comprehensive 5-year results of fixed mandibular dentures fabricated from metal-acrylic or metal-ceramics according to the ‘All-on-4'™ protocol. Twenty-seven patients that received immediately loaded 'All-on-4'™ fixed mandibular dentures in 2005 were included in the study, and they were evaluated up to 5 years after denture integration. Endpoints were chosen in accordance with the 2007 Pisa consensus and included bone resorption, the Oral Health Impact Profile (OHIP), the Sulcus Fluid Flow Rate (SFFR), and prosthodontic complications. The initial situation in both groups was largely identical. Bone loss remained under 2 mm after 5 years in all implants and showed no group difference. The SSFR showed a gradual increase in both groups, and acrylic-bearing implants showed a substantially and significantly higher flow rate from the third year onward. The subjective improvement as expressed by the OHIP score was immediate and dramatic, and it showed no group differences. All acrylic restorations showed some extent of abrasion, and veneer fractures occurred in 4 patients (28.6%). Besides a single fracture of a fixation screw, there were no prosthetic complications in patients with ceramic suprastructures. According to bone loss and subjective outcome, acrylic and ceramic suprastructures apperared to be equivalent after 5 years; however, sulcus flow and prosthodontic complications suggest that the economic advantage of acrylic dentures may be specious. The rational choice of implant suprastructures requires comprehensive, long-term observation. Short-term economical benefits might be cancelled out in the long run.

Concepts: Time, Bone, Bone fracture, Fracture, Fluid dynamics, Economics, Dentures, Prosthodontics


The aim of this study was to investigate whether advanced simulation parameters, such as simulation exam scores, number of student self-evaluations, time to complete the simulation, and time to complete self-evaluations, served as predictors of dental students' preclinical performance. Students from three consecutive classes (n=282) at one U.S. dental school completed advanced simulation training and exams within the first four months of their dental curriculum. The students then completed conventional preclinical instruction and exams in operative dentistry (OD) and fixed prosthodontics (FP) courses, taken during the first and second years of dental school, respectively. Two advanced simulation exam scores (ASES1 and ASES2) were tested as predictors of performance in the two preclinical courses based on final course grades. ASES1 and ASES2 were found to be predictors of OD and FP preclinical course grades. Other advanced simulation parameters were not significantly related to grades in the preclinical courses. These results highlight the value of an early psychomotor skills assessment in dentistry. Advanced simulation scores may allow early intervention in students' learning process and assist in efficient allocation of resources such as faculty coverage and tutor assignment.

Concepts: Completeness, Education, Skill, Learning, Resource allocation, Final examination, Prosthodontics, Fixed prosthodontics


Repeated fracture of the denture base is a common problem in prosthodontics, and it represents a nuisance and a time sink for the clinician. Therefore, the possibility of increasing repair strength using new reinforcement materials is of great interest to prosthodontists.

Concepts: Materials science, Dentures, Prosthodontics, Methyl methacrylate


There are 7 categories of additive manufacturing (AM) technologies, and a wide variety of materials can be used to build a CAD 3D object. The present article reviews the main AM processes for polymers for dental applications: stereolithography (SLA), digital light processing (DLP), material jetting (MJ), and material extrusion (ME). The manufacturing process, accuracy, and precision of these methods will be reviewed, as well as their prosthodontic applications.

Concepts: Present, Time, Engineering, Computer program, Prosthodontics


This final article in a series of three on producing complete dentures which the patient considers attractive, describes selecting the denture teeth, setting the front teeth at the chairside, the try-in visits, processing, fitting and reviewing the dentures. The role of the patient as captain of the ship, the dental nurse as the patient’s support and liaison officer, and the clinician as the first technical officer is outlined. The use of immediate replay video technology in allowing a patient to see what the trial denture really looks like is described. It is vital that the patient is completely happy with its appearance in every detail before any denture is finished. Dealing with post-fitting aesthetic problems is considered.

Concepts: Teeth, Oral hygiene, Dentures, Human physical appearance, Sexual attraction, Prosthodontology, Prosthodontics, Denturist


Although digital technology has advanced the visualization of treatment planning and rehabilitation in prosthodontics, the field of maxillofacial prosthetics is in vital need of an accessible document for exchange of interactive three-dimensional (3D) model visualization without requiring installation of any additional software. This article introduces a 3D data documentation method for effective interactive digital visualization in maxillofacial prosthetics using a portable documentation format (PDF).

Concepts: Computer graphics, Object-oriented programming, Visualization, Software engineering, Vector graphics, Prosthodontics, Information science, Interactive visualization


Studies investigating the precision of 3-dimensional (3D) printed casts for fixed prosthodontics are scarce.

Concepts: Cultural studies, Prosthodontics, Fixed prosthodontics


Edentulism presents an ongoing challenge for prosthodontic dentistry. Many aspects of complete denture construction lack contemporary evidence. One such aspect is denture occlusion. Balanced occlusion (BO) has become the prevailing occlusal scheme. It has been suggested that canine guidance (CG) is unsuitable for complete denture occlusion due to an increased risk for tipping of the prostheses. However it may be indicated in patients with minimal alveolus resorption. There has been limited evidence suggesting the superiority of either occlusal scheme over another. This article investigates the available literature assessing complete denture occlusion by means of clinical trials or reviews of evidence. We utilised PRISMA guidelines to investigate the effect of complete denture occlusal scheme (balance occlusion vs. canine guidance) on functional or quality of life. Seven studies were included for review. All studies were poor to moderate quality with the majority lacking randomisation, blinding and demographic data from the study sample. The available evidence suggests that the differences between occlusal schemes may be small, challenging the notion that BO may be the optimal occlusal scheme. There is a need for high-quality clinical research, investigating both chewing ability and quality of life in complete denture wearers in the long-term.

Concepts: Clinical trial, Medical statistics, The Canon of Medicine, Randomized controlled trial, Clinical research, Meta-analysis, Dentures, Prosthodontics