Retrospective Assessment of Endodontically Treated Teeth Replaced by Dental Implants.

INTRODUCTION: This study investigated endodontically treated teeth that were replaced by dental implants at the University of North Carolina (UNC) at Chapel Hill School of Dentistry. The primary objective of this study was to determine the reasons leading to the extraction of endodontically treated teeth and their subsequent replacement with dental implants. The secondary objective was to evaluate the proportion of these teeth that, according to experienced endodontists, could have been preserved. METHODS: The UNC-Chapel Hill's dental electronic health records between 2004 and 2019 were probed for implant placement that replaced root canal-treated teeth. Preextraction radiographs and clinical charts were examined to ascertain the primary reason related to the extraction and to compile a profile for each case. In cases in which endodontic failure was the primary reason for extraction, radiographs and clinical findings were evaluated by 2experienced endodontists to assess potential treatment options. RESULTS: Between 2004 and 2019, 29.3% (1564 of 5229) of teeth replaced by dental implants at UNC School of Dentistry had undergone root canal treatment, with the mandibular first molar being the most commonly replaced tooth. The leading reasons for extraction were recurrent caries associated with defective restoration (26.6%), fracture of coronal structure (21.5%), vertical root fracture (20.9%), compromised periodontal condition (13.8%), and endodontic failure (2.4%). Two experienced endodontists evaluated extractions due to endodontic failure and concluded that 61.7% of them could have been candidates for endodontic retreatment. CONCLUSION: Substantial loss of tooth structure was the leading cause of extraction of root canal-treated teeth, followed by vertical root fracture and periodontal disease. Although endodontic failure constituted a minor portion of the reasons for extraction, a considerable number of teeth were extracted due to vertical root fractures following root canal treatment. A significant proportion of the extracted teeth due to endodontic failure could have been considered as potential candidates for endodontic retreatment.

Fatigue resistance of 3D printed anatomic post-and-core after mastication simulation.

STATEMENT OF PROBLEM: Rigid post-and-core systems have traditionally been used in the restoration of endodontically treated teeth and are regarded by many as the standard treatment. Flexible materials, including nanoceramic resins, are being increasingly implemented as post-and-core systems, but data supporting their use are lacking. PURPOSE: The purpose of this in vitro study was to compare the fatigue resistance of conventional cast metal and nanoceramic 3-dimensionally (3D) printed resin post-and-core systems with teeth without posts. MATERIAL AND METHODS: Thirty freshly extracted human maxillary premolars were endodontically treated and divided into 3 subgroups (n=10) according to the restorative procedure: cast metal post-and-core (CM), nanoceramic 3D printed resin post-and-core (3DR), and without a post (0P). The CM post-and-core group was fabricated conventionally, while the 3DR group was printed using a 3D resin printing material. For the 0P group, the teeth were restored with a composite resin foundation after root canal obturation. Complete coverage 3-mol% monolithic zirconia restorations were cemented on all specimens. The specimens were exposed to simultaneous mastication simulation (1.2 million cycles) and thermocycling (10 000 cycles at 5 ºC to 55 ºC) and analyzed based on the failure of specimens. Data were analyzed using the Kruskal-Wallis survival analysis and the Wilcoxon rank sum test (α=.05). RESULTS: The Kruskal-Wallis test indicated statistically significant differences among the cycles needed to reach failure for each of the 3 groups (P<.001). At 1.2 million cycles, there were no CM failures. The 3DR group failed at a median value of 950 000 cycles, while the 0P group failed at a median value of 222 500 cycles (P<.001). CONCLUSIONS: All the endodontically treated teeth that received CM survived the 1 200 000 simulated mastication cycles. Both 3DR and 0P specimens fractured at the crown cervical third during mastication simulation.

Developing entrustable professional activities for general dentistry at the University of North Carolina.

INTRODUCTION: As part of curriculum innovation, the University of North Carolina (UNC) Adams School of Dentistry identified core entrustable professional activities (EPAs) that graduates must demonstrate for practice readiness. This paper describes the development of the UNC EPAs and the perceptions of the general dentistry faculty. METHODS: Upon establishing a blueprint of knowledge, skills, and attitudes of UNC graduates, using a distributed leadership approach, faculty teams developed EPAs focused on the patient care process. The American Dental Education Association Compendium of Clinical Competency Assessments and Commission on Dental Accreditation Standards informed the team's work. Perceptions of the assessment framework were examined using a questionnaire completed by 13 general dentistry faculty considering the importance, accuracy, and agreement of each EPA, associated domains of competence, and encounter management on a 6-point rating scale. RESULTS: Distributed leadership was a useful strategy in EPA development to disperse decision-making and build ownership. Through multiple iterations, four EPAs (assessment, plan of care, collaborative care, and provision of care) with associated sub-EPAs emerged. EPAs included a description, required knowledge and skills, and rubrics for assessment. The general dentistry faculty reported a high level of importance, accuracy, and agreement with EPAs, domains of competence, and encounter management. DISCUSSION: EPAs provide a standardized manner to describe the comprehensive work dentists perform, shifting away from individual competencies. The UNC EPAs provide the foundation for longitudinal measures of competence preparing graduates for independent practice. With limited EPAs frameworks available in dentistry, we aim to inform the development and implementation of EPAs across dental education.

Effect of simulated toothbrushing on the surface roughness of LOCATOR abutments: An in vitro study.

STATEMENT OF PROBLEM: Studies evaluating the effect of toothbrushing and toothpaste abrasivity on the surface roughness of LOCATOR abutments are lacking. PURPOSE: The purpose of this in vitro study was to compare the surface roughness of LOCATOR abutments before and after simulated toothbrushing with different toothpastes to make recommendations for the home care of patients with LOCATOR abutments. MATERIAL AND METHODS: LOCATOR bone-level overdenture abutments (N=36) were analyzed with a confocal laser scanning microscope (Keyence VK-X1100) at ×5 magnification. Surface scans were made to determine the degree of surface roughness (Ra). Two toothpastes of different abrasivity (Colgate Total and Crest ProHealth) and deionized water were used as the brushing media (n=12). Each toothpaste was mixed with water in a 1:2 ratio. The abutments were brushed using soft nylon toothbrushes for 30 000 cycles in a ZM-3.12 toothbrushing simulator, which has been interpreted as 3 years of regular use. All specimens were then reanalyzed under the microscope. Changes in surface texture were compared by using a repeated measures analysis of variance (ANOVA) statistical test and a pairwise Sídák multiple comparisons test (α=.05). RESULTS: The mean surface roughness value of LOCATOR abutments at baseline ranged between 1.34 µm and 1.35 µm. After 30 000 cycles of toothbrushing simulation, the mean value increased to 1.62 µm (DI water, P=.001), 1.74 µm (Colgate Total, P<.001), and 2.03 µm (Crest ProHealth, P<.001). All brushing media resulted in a statistically significant increase in surface roughness (P<.001). CONCLUSIONS: LOCATOR abutments demonstrated significant increases in surface roughness after being subjected to toothbrushing, regardless of the brushing medium. Whitening toothpaste caused significantly more surface roughness than nonabrasive toothpaste and deionized water. Deionized water resulted in the lowest increase in surface roughness.

Using a change management model to develop and implement dental curricula: A case study.

Curriculum transformation is a guiding principle and driving force to continued institutional growth and innovation in oral health education. The transformation process starts from the need and desire for change to achieve the strategic goals of curriculum invocation. The design and implementation process must follow a systematic approach to ensure the oral health curricula are meeting the demands of preparing learners for their future careers and are in line with the institutional strategic goals and processes. The process of curriculum transformation needs to be carefully crafted and implemented to include all constituents and have clear and measurable outcomes to define its path and results. The University of North Carolina at Chapel Hill Adams School of Dentistry is undergoing the journey of oral health curriculum innovation and transformation. The goal of this paper is to describe the change management process using Kotter's organizational model that may apply to other schools aiming to innovate dental curricula.

Digital restorative workflows for developmental dental defects in young patients: A case series.

BACKGROUND: Digital technology is rapidly changing the provision of oral health care, although its adoption for the oral health care of young patients has lagged. The authors describe digitally supported treatment approaches for managing treatment of developmental dental defects in the early permanent dentition. CASE DESCRIPTION: Four adolescent patients with amelogenesis imperfecta received transitional anterior restorations for esthetic and functional rehabilitation using a variety of digital workflows. Combinations of restoration type, materials, and fabrication methods were selected to meet the needs of each patient on the basis of their specific amelogenesis imperfecta phenotype and chief symptoms. These cases highlight the application of digital technology in pediatric and adolescent dentistry for managing the treatment of developmental dental defects. PRACTICAL IMPLICATIONS: Digitally supported restorative approaches, as described in this report, offer broad applicability of materials and techniques directed at treating the complex restorative needs of young patients in the transitional and early permanent dentition.

Preparing for implementation of an entrustable professional activity assessment framework.

Following the adoption of competency-based education in dentistry in the 1990s, entrustable professional activities (EPAs) were introduced in the field of medicine in the mid-2000s to help educators better determine the competence of trainees. More recently, the field of dental education has begun exploring EPAs as a framework for assessing competence while ensuring compliance with accreditation standards. This paper explores one dental school's process of preparing for implementation of a major curriculum change using an EPA assessment framework, shifting away from the use of singular assessments for competency determination to a global and longitudinal approach using a constellation of data to determine practice readiness. This paper describes how the EPA framework was developed, including the complementary capacities, assessment tool development and programming, and data reporting to follow learner progression and determine practice readiness. We discuss lessons learned leading up to implementation, and we position this perspective as a space to describe opportunities and complexities to consider when using a longitudinal assessment system. We attend to the tension between the current language of Commission of Dental Accreditation Standards as "competencies" and the evolving conversation of operationalizing EPAs while addressing accreditation Standards. To do this, we describe the process of finalizing our EPA framework and preparing for initial implementation in a new curriculum.

Survivability and fracture resistance of monolithic and multi-yttria-layered zirconia crowns as a function of yttria content: A mastication simulation study.

OBJECTIVE: To compare four different types of monolithic zirconia crowns in terms of survival rate and fracture resistance after thermocycling and/or thermo-mechanical loading in a chewing simulator. METHODS: Partially stabilized zirconia (PSZ) crowns with fiber-reinforced resin die assemblies (n = 80) were fabricated using: multi-yttria-layered 5Y-PSZ/3Y-PSZ, multi-yttria-layered 5Y-PSZ/4Y-PSZ, monolithic 4Y-PSZ, and monolithic 3Y-PSZ as control (n = 20). Half of the samples in each group were subjected to thermo-mechanical loading under 110 N, 1.4 Hz, 1.2 million cycles with simultaneous thermocycling (10,000 cycles, 5-55°C). The other half were subjected to thermocycling alone. The samples were loaded to failure to measure their fracture resistance. The data were analyzed using by two-way ANOVA and Tukey's HSD post-hoc test (α = 0.05). RESULTS: All specimens survived the aging protocols. The yttria content significantly affected the fracture resistance of the crowns (p < 0.0001). The mean fracture resistance, from highest to lowest: 3Y-PSZ, 4Y-PSZ, followed by the two multi-yttria-layered systems. The mean difference between the two multi-yttria-layered systems were not statistically significant (p = 0.98). The mechanical loading protocol did not affect the mean fracture resistance within each group (p = 0.18). CONCLUSIONS: Within each group, there was no difference in fracture resistance after thermocycling alone and thermo-mechanical loading. However, increasing the yttria concentration at the occlusal third of the crown decreased its fracture resistance. CLINICAL SIGNIFICANCE: The term "monolithic zirconia" alone without specifying the actual yttria content is misleading. This term represents different materials with different mechanical properties. The yttria content has an inverse relationship with the fracture resistance of zirconia crowns. The fracture resistance of multi-layer zirconia crowns is determined by the amount of the weaker zirconia phase at the occlusal part of the restoration rather than enforced by the stronger zirconia at the cervical part of the crown.

Should dentistry be a specialty of medicine? Two viewpoints.

Dentistry and dental education are well-established domains with deep-rooted institutions, educational programs, organizational structures, and advanced specialty fields. Almost 100 years ago, Dr. William Gies, founder of the Columbia University College of Dental Medicine, stated that to best serve the oral health needs of the population, dentistry should be considered a specialty of medicine, and dental students should have the same solid foundation in the basic and clinical sciences as medical students. More recently, the report on "Advancing Dental Education in the 21st Century" recommends an increase in the integration of dental and medical education as a means to address 2 of its key challenges: "shrinking demand for dental services" and "shifting practice environment." However, it has also been argued that making dentistry and dental education a subspecialty of medicine and medical education will create logistical, structural, regulatory, and financial dilemmas. Instead of a drastic change to current dental educational, organizational, and institutional models, some argue a contemporary approach to dental education is required to ensure dentists are well prepared to address the healthcare needs of the population and future healthcare delivery systems and practice models. Recognizing the need for change in dental education to keep pace with changes in patient demographics and healthcare systems, the dental profession has the responsibility and opportunity to develop new models and paradigms that improve educational and clinical outcomes in our educational programs and future practice.

Marginal Fit Evaluation of CAD/CAM All Ceramic Crowns Obtained by Two Digital Workflows: An In Vitro Study Using Micro-CT Technology.

PURPOSE: To evaluate the marginal fit of CAD/CAM all ceramic crowns made from lithium disilicate and zirconia using two different fabrication protocols (model and model-less). MATERIALS AND METHODS: Forty anterior all ceramic restorations (20 lithium disilicate, 20 zirconia) were fabricated from digital impressions using a CEREC Bluecam scanner. Two different digital workflows were used: a fully digital model-less approach and a printed model digital approach. The crowns were cemented on the respective prepared typodont teeth and marginal gap was evaluated using Micro-CT. Each specimen was analyzed in sagittal and trans-axial orientations, allowing evaluation of the marginal fit (vertical and horizontal) on each surface. Logarithmic transformation was used with a significance of 0.05. After that a reliability analysis was performed by re-measuring four randomized selected images for each specimen and performing intraclass correlations to determine any systematic bias in the measurements. RESULTS: Vertical measurements in the lingual, distal and mesial views had an estimated marginal gap ranging from 101.9 to 133.9 µm for lithium disilicate crowns and 126.4 to 165.4 µm for zirconia. No significant differences were found between model and model-less techniques. CONCLUSIONS: Both workflows are valid protocols for the fabrication of monolithic ceramic restorations. The use of a printed model did not improve the marginal fit of lithium disilicate or zirconia crowns. Both materials are also clinically acceptable, no matter which workflow was used to obtain the restoration.

Management of Implant/Prosthodontic Complications.

Dental implants continue to grow in popularity because they are a predictable treatment to replace missing teeth. They have a high success rate; however, they are still associated with some clinical complications. This article discusses a diverse range of complications related to the restorative and mechanical aspects of dental implants and the management of such complications, as well as potential factors contributing to them.

The digitally replicated denture technique: A case report.

OBJECTIVE: Conventional complete denture protocols require several patient appointments with multiple laboratory procedures. There are multiple workflows incorporating digital technology that can expedite the process, whereas increasing predictability. The proposed digitally replicated denture technique (DRDT) demonstrates a predictable workflow for fabricating complete dentures for patients with existing dentures. CLINICAL PROCEDURE: A patient's existing maxillary and mandibular complete dentures were scanned with an intraoral scanner. The generated STL was then printed using a desktop 3D printer. This served as a custom tray and record base to decrease patient chair time and associated laboratory procedures. CONCLUSION: The DRDT workflow incorporates digital technology into a complete denture protocol to minimize laboratory steps and chair time when fabricating complete dentures for patients with existing prostheses. CLINICAL SIGNIFICANCE: The use of a digitally replicated denture using rapid prototyping can streamline the process of complete denture fabrication for patients with existing dentures.

The effect of single tooth implant restorations on the survival, morbidity, pulpal, and periapical health of adjacent teeth: A chart review.

PURPOSE: To determine whether the placement and restoration of a single tooth posterior implant affects the survival, morbidity, pulpal, and periapical health of adjacent natural teeth. MATERIALS AND METHODS: A retrospective chart review identified patients who received single posterior tooth implants between August 2004 and July 2015 at the UNC SOD and met the study inclusion criteria. Preoperative and postoperative records were reviewed; survival and changes in coronal, pulpal, and periapical status of teeth adjacent to the implant and contralateral tooth were recorded. Dichotomous survival, restoration, and retreatment outcomes were analyzed using conditional logistic regression with patient as strata and implant versus control as the predictor. Exact odds ratio estimates and the 95% confidence intervals were obtained for the relationship of implant versus control side and outcomes. RESULTS: Five hundred and fifty-five sites with follow-up time averaging 5 years ± 30.8 months were reviewed. Teeth adjacent to implants had 1.75 (95% CI: 1.17, 2.64) times the odds of restorative retreatments as compared to controls (P = .005). On the implant side, 48 adjacent teeth (4.5%) were more heavily restored at follow up, while 84 (7.9%) experienced retreatment with comparable number of surfaces restored. On the contralateral side, 54 adjacent teeth (5.0%) were more heavily restored, and 56 (5.2%) experienced comparable levels of retreatment. In addition, 17 (1.7%) implant adjacent teeth required root canal treatment, compared to 12 (1.2%) on the contralateral side; 1 implant adjacent tooth required root canal retreatment. Forty-two teeth (3.8%) adjacent to implants were lost, compared to 35 (3.2%) adjacent to natural teeth. CONCLUSIONS: The incidence for restorative retreatment was significantly higher on teeth adjacent to implant restorations as compared to the contralateral controls. There were no significant differences in the survival, morbidity, pulpal, or periapical health of teeth adjacent to single tooth implants compared to those adjacent to the contralateral natural tooth.

Accuracy evaluation of intraoral optical impressions: A clinical study using a reference appliance.

STATEMENT OF PROBLEM: Trueness and precision are used to evaluate the accuracy of intraoral optical impressions. Although the in vivo precision of intraoral optical impressions has been reported, in vivo trueness has not been evaluated because of limitations in the available protocols. PURPOSE: The purpose of this clinical study was to compare the accuracy (trueness and precision) of optical and conventional impressions by using a novel study design. MATERIAL AND METHODS: Five study participants consented and were enrolled. For each participant, optical and conventional (vinylsiloxanether) impressions of a custom-made intraoral Co-Cr alloy reference appliance fitted to the mandibular arch were obtained by 1 operator. Three-dimensional (3D) digital models were created for stone casts obtained from the conventional impression group and for the reference appliances by using a validated high-accuracy reference scanner. For the optical impression group, 3D digital models were obtained directly from the intraoral scans. The total mean trueness of each impression system was calculated by averaging the mean absolute deviations of the impression replicates from their 3D reference model for each participant, followed by averaging the obtained values across all participants. The total mean precision for each impression system was calculated by averaging the mean absolute deviations between all the impression replicas for each participant (10 pairs), followed by averaging the obtained values across all participants. Data were analyzed using repeated measures ANOVA (α=.05), first to assess whether a systematic difference in trueness or precision of replicate impressions could be found among participants and second to assess whether the mean trueness and precision values differed between the 2 impression systems. RESULTS: Statistically significant differences were found between the 2 impression systems for both mean trueness (P=.010) and mean precision (P=.007). Conventional impressions had higher accuracy with a mean trueness of 17.0 ±6.6 µm and mean precision of 16.9 ±5.8 µm than optical impressions with a mean trueness of 46.2 ±11.4 µm and mean precision of 61.1 ±4.9 µm. CONCLUSIONS: Complete arch (first molar-to-first molar) optical impressions were less accurate than conventional impressions but may be adequate for quadrant impressions.

Evidence Regarding the Treatment of Denture Stomatitis.

Denture stomatitis is a common inflammatory condition affecting the mucosa underlying complete dentures. It is associated with denture microbial biofilm, poor denture hygiene, poor denture quality, and nocturnal denture use. Numerous treatment methodologies have been used to treat stomatitis; however, a gold standard treatment has not been identified. The aim of this systematic review is to report on the current knowledge available in studies representing a range of evidence on the treatment of denture stomatitis.

Dental students' perceived preparedness to treat patients in clinic after a fixed prosthodontics course: survey results of a case study.

Previous research regarding dental students has found modest predictive value in preclinical didactic course grades in predicting clinical performance, but systematic assessment of students' feedback on their perceived preparedness has received little attention as a preclinical assessment methodology. The aim of this study was to assess the perceptions of the dental students at one U.S. academic dental institution regarding their preparedness for clinical performance following the preclinical fixed prosthodontics course. Third- and fourth-year dental students participated in a survey about their perceived preparedness to diagnose and treat patients with fixed prosthodontics needs in the school's dental clinics. The respondents (79 out of 161 students, for a response rate of 49%) rated each item on a five-point Likert scale. Responses about which preclinical procedures of the course prepared students the least and the best were consistent for the third- and fourth-year students. Less than 60% of all responding students felt prepared for planning complex cases and performing laboratory-related procedures. The findings of this study indicate that improvement is required in teaching students about laboratory procedures and problem-solving to adequately prepare them for clinical treatment of patients with fixed prosthodontics needs.

Clinical outcomes of three different crown systems with CAD/CAM technology.

STATEMENT OF PROBLEM: Computer-aided design and computer-aided manufacturing (CAD/CAM) generated restorations are gaining popularity. However, limited clinical evidence is available for single-unit posterior CAD/CAM restorations fabricated with established and newer crown materials. PURPOSE: The purpose of this clinical study was to assess the restoration quality of and gingival response to CAD/CAM fabricated posterior single-tooth restorations with different processing technologies. MATERIAL AND METHODS: Twenty-two individuals in need of posterior complete coverage crowns were recruited under an institutional review board approved protocol. Teeth were randomized to 1 of 3 groups: metal ceramic, lithium disilicate, and monolithic zirconia. An unprepared or minimally restored tooth on the contralateral side was chosen as a control tooth for gingival measurements with each participant. Teeth were prepared and scanned intraorally by 1 of 3 experienced practitioners. A total of 32 restorations were digitally designed and fabricated with either milling technology or rapid-prototype printing and casting with conventional porcelain application. Restorations were evaluated with modified United States Public Health Service criteria for contour, marginal adaptation, occlusion, and shade. Gingival crevicular fluid volume and bleeding on probing were recorded preoperatively, at 1-month and 6-month postcementation visits. Polyvinyl siloxane impressions were made of the buccal margin of cemented restorations and evaluated with microcomputed tomography to assess marginal adaptation (horizontal discrepancy). The Mantel Haenszel row mean score was used to assess whether the crown systems differed with respect to the modified United States Public Health Service criteria. Linear mixed models were used to assess whether the average gingival volumes were affected by the explanatory variables (crown system, tooth status [treated vs control], or visit). A generalized estimating equation approach was used to assess whether bleeding on probing was affected by the explanatory variables. One-way ANOVA was used to assess marginal discrepancy values among the crown systems (α=.05 for all tests). RESULTS: Twelve metal ceramic, 10 lithium disilicate, and 10 zirconia restorations were fabricated for 22 participants. Zirconia restorations were significantly different from the other 2 crown systems (P<.001) with respect to occlusion. No occlusal adjustment was needed on 80% of the zirconia restorations. The average gingival crevicular fluid volumes did not differ among crown systems, between treated and control groups, or over time. The average horizontal marginal discrepancy was significantly different between lithium disilicate and zirconia crowns (P=.027), with zirconia crowns having the least amount of horizontal marginal discrepancy. CONCLUSIONS: Given the small sample size and limitations of this study, CAD/CAM-generated restorations for posterior teeth made from different materials had acceptable clinical results.

Denture adhesive use in complete dentures: clinical recommendations and review of the literature.

This literature review sought to determine the advantages and disadvantages of denture adhesive use among complete denture patients. Manuscripts were obtained by searching the National Library of Medicine's PubMed database, Cochrane Collaboration Library, ADA Center for Evidence-Based Dentistry website, and EMBASE database. A total of 85 abstracts were reviewed, and 38 articles that met the inclusion criteria for this review were selected. The inclusion criteria included clinical trials and case series in which 10 or more patients were treated, as well as Cochrane collaboration reviews and in vitro studies where clinical relevance could be determined. The selected manuscripts were reviewed using a standardized manuscript review matrix. Although denture adhesives improve the retention and function of complete dentures, standardized guidelines are needed for the proper use, application, and removal of denture adhesives. Additionally, long-term studies are warranted on the biologic effects of denture adhesives. There is a need to establish a regular recall program for complete denture patients.

Evidence-based guidelines for the care and maintenance of complete dentures: a publication of the American College of Prosthodontists.

The current rates of edentulism have been estimated to be between 7% and 69% of the adult population internationally. In the United States, while the incidence of edentulism continues to decline, rapid population growth coupled with current economic conditions suggest that edentulism and conventional denture use will continue at current or higher numbers. Unfortunately, evidence-based guidelines for the care and maintenance of removable complete denture prostheses do not exist. In 2009, the American College of Prosthodontists (ACP) formed a task force to establish evidence-based guidelines for the care and maintenance of complete dentures. The task force comprised members of the ACP, the Academy of General Dentistry, American Dental Association (ADA) Council on Scientific Affairs, the American Dental Hygienists' Association, the National Association of Dental Laboratories, and representatives from GlaxoSmithKline Consumer Healthcare. The review process included the assessment of over 300 abstracts and selection of over 100 articles meeting inclusion criteria of this review. The task force reviewed synopses of the literature and formulated 15 evidence-based guidelines for denture care and maintenance. These guidelines were reviewed by clinical experts from the participating organizations and were published in February 2011 issue of The Journal of the American Dental Association for widespread distribution to the dental community. These guidelines reflect the views of the task force.

Evidence-based guidelines for the care and maintenance of complete dentures: a publication of the American College of Prosthodontists.

The current rates of edentulism have been estimated to be between 7 percent and 69 percent of the adult population internationally. In the United States, while the incidence of edentulism continues to decline, rapid population growth coupled with current economic conditions suggest that edentulism and conventional denture use will continue at current or higher numbers. Unfortunately, evidence-based guidelines for the care and maintenance of removable complete denture prostheses do not exist. In 2009, the American College of Prosthodontists (ACP) formed a task force to establish evidence-based guidelines for the care and maintenance of complete dentures. The task force comprised members of the ACP, the Academy of General Dentistry, the American Dental Association Council on Scientific Affairs, the American Dental Hygienists' Association, the National Association of Dental Laboratories and GlaxoSmithKline Consumer Healthcare. The review process included the assessment of over 300 abstracts and selection of over 100 articles meeting the inclusion criteria of this review. The task force reviewed synopses of the literature and formulated 15 evidence-based guidelines for denture care and maintenance. These guidelines were reviewed by clinical experts from the participating organizations and are being published in The Journal of the American Dental Association for widespread distribution to the dental community. These guidelines reflect the views of the task force.