Occlusal records in the production of mounted study casts for tooth wear planning and management.

This article forms part of a series looking at management of patients with tooth wear. Articulated study casts can be essential in assisting the clinician to plan and communicate proposed treatment to the dental technician and patient. Their production is often seen as straightforward, but a lack of attention to detail can quickly lead to articulated casts that do not replicate the patient clinical presentation. This in turn will lead to inaccurate planning and potentially a suboptimal treatment outcome. This article discusses a collection of the clinical records needed to produce accurate articulated study casts, which can be utilised for tooth wear planning. It also aims to present the evidence base for the recommendations outlined.

Analysis of Residual Ridge Morphology in a Group of Edentulous Patients Seeking NHS Dental Implant Provision-A Retrospective Observational Lateral Cephalometric Study.

A convenience sample of 154 edentulous patients referred for implant provision at a Regional National Health Service Dental Hospital in the North West of England were identified. The cephalometric radiographs that were taken as part of the patient baseline investigation were assessed. Digital tracing was used to measure the anterior maxillary and mandibular bone height and ridge angle with respect to the maxillary and mandibular planes. The mean height of the bone in the maxilla was found to be 14 mm, and the mean ridge angle for the anterior maxillary residual ridge is 104°. The mean height of bone in the mandible was 18 mm, while the mean ridge angle for the anterior mandibular residual ridge was 77°. Using the Cawood and Howell classification demonstrated that class VI mandibles were the most common. The cross-sectional shape of the mandible varied, with the triangular shape most common. Although there was adequate bone stock for implant placement in these cases, the mandibular residual ridge resorption presents a lingual inclination to the residual bone. The limited residual ridge position and inclination would dictate that conventional implant placement could be challenging.

Occlusion: is there a third way? A discussion paper.

This paper does not set out to describe the reasons why a new concept of dental care should be deemed as acceptable and recognised as mainstream. Rather, the starting point of this paper is the belief that some dentists who are increasing the overall vertical dimension for worn dentition patients are not using the protocols of the traditional 're-organised approach'. If adhesive direct restorations are used, there seems to be anecdotal indication that despite not restoring in the terminal hinge axis, it can have a successful outcome.So, while not criticising this approach simply because it does not follow orthodoxy, the paper has two objectives. It hopes to stimulate some debate and research on this subject. Furthermore, by suggesting some parameters for what might be considered a new approach, it aims to improve patient outcome.