The denture box. An aid to denture hygiene.

This paper re-visits the need for patients or their carers to maintain as low a level of denture biofilm as possible. It notes that the handling of dentures is unpleasant to carers and suggests a method of reducing this contact to a minimum but yet allow efficient cleaning by means of brushing. It also highlights the potential damage that can occur due to mishandling or accident. The denture box acts as a safe storage unit and finally, it suggests that its 'footprint' allows accurate recovery in an institution where dentures can be inadvertently mingled.

An investigation of complete denture teaching in the UK: part 2. The DF1 experience.

AIM: This paper, the second in a series of two (see 2013; 215: 177-181), investigates the opinions of a cohort of dental foundation year 1 (DF1) practitioners regarding their skills and competence in relation to their educational background in complete dentures. MATERIALS AND METHODS: With the permission of the Dean of the London Deanery a questionnaire was emailed to the ten London Foundation year 1 training schemes for distribution to approximately 100 DF1s. Five schemes responded with total of 56 completed questionnaires (56%). RESULTS: The average number of complete dentures made as undergraduates was three. Forty-six percent had no experience in making copy dentures. An average of 2 (median 2.05) immediate replacement dentures were made; only 10% made 8-15 dentures. None had experience in implant-supported dentures. Thirty-five percent enjoyed their undergraduate training whereas 45% did not. Thirty-seven percent felt that their training had given them experience and confidence in complete dentures but 32% were of the opposite opinion. Sixty-three percent felt complete dentures were an important or very important aspect of dentistry. Six percent completely disagreed. The majority were confident in making impressions while 39% lacked confidence in registering jaw relations. Thirty-five percent were confident with chairside adjustments at the intermediary treatment stages but 28% were not. Sixty-three percent were confident in the fitting of new dentures and 64% with the after-care. There was no significant gender difference in the responses. There was a significant difference between the London and non-London trained DF1s. The London trained respondents made significantly fewer dentures than the non-London trained cohort. The latter also rated complete denture treatment as being more important. The comments section revealed that 43% felt that they had a lack of experience; only 5% were confident, 16% thought that complete denture treatment would become obsolete and only 5% recognised the continuing importance of complete denture treatment. CONCLUSION: There is a disparity between the comments which indicate a lack of confidence in complete denture treatment and the response to the questionnaire. Other authors have commented on the lack of experience that has resulted in new graduates entering vocational training with little confidence in complete denture techniques. This report has highlighted these difficulties with respect to a current cohort of DF1s.

An investigation of complete denture teaching in the UK: part 1. A survey of undergraduate teaching.

AIM: This paper is the first in a series of two that investigate the undergraduate teaching of complete dentures in the UK. MATERIALS AND METHODS: A questionnaire was sent by email to 13 UK dental schools enquiring about the number of hours spent in the lecture theatre, laboratory and clinic. The schools were also asked to give their views about the preparedness of the new graduates for dealing with complete dentures in general practice. RESULTS: There was great disparity between schools in the overall number of lectures delivered. Two schools claimed 28 hours and the remainder varied between 6-15 hours. Four schools devoted more time to laboratory work whereas three schools spent more time in the clinic. One school reported no dedicated clinical time for complete dentures. There appears to be a regional variation with northern UK dental schools spending more time on the teaching of complete dentures. The quota for complete dentures varied from three in most schools to eight in one school and none in another. Comments from the dental schools varied from a reported lack of suitable complete denture cases, to concerns with insufficient curricular time devoted to the subject and a subsequent lack of clinical competence on graduation. Some schools have integrated complete denture teaching into the general prosthodontic course as it is considered inappropriate to teach different aspects of prosthetics in isolation. CONCLUSION: Competence in complete dentures falls short of what is expected. With a single exception all the schools seem to have low expectations for their undergraduate students to be practically trained and experienced in the production of complete dentures. Despite the advent of implants and the introduction of clinical dental technicians, there is and will continue to be a need for the competent treatment of the edentulous population by general practitioners.

BDJ UCL Eastman CPD programme: an online survey.

OBJECTIVE: To ascertain from participants of the BDJ UCL Eastman CPD programme its value to their professional endeavours, and in particular to determine whether they would object to making it more robust especially in the way that the CPD hours are achieved. DESIGN: An online questionnaire survey. METHOD: Participants were encouraged to complete an online survey of nine questions by 31 July 2012. RESULTS: Of the 3,292 participants who began the survey, it was completed by 3,070 (93.2%). Of those, 2,952 (91.1%) thought that additional learning tools would be helpful. The ability to resubmit incorrect answers was preferred by 2,549 (80.1%) of the respondents. Two thousand two hundred and fourteen participants (69.9%) raised no objection to making the scoring system more robust and 953 (30.1%) objections to this proposition were recorded. Ninety-eight percent (3,128) favoured the regular inclusion and flagging of core subjects and 95% of these respondents thought it would be useful to record these separately. The most preferred method of obtaining verifiable CPD was cited by 1,075 (39.5%) participants as reading journals followed by attending lectures and hands-on courses. The BDJ was the preferred journal to achieve both verifiable and general CPD. Most participants (1,930; 67.7%) use a home computer to take part in this initiative while a significant minority use tablets and smart-phones. CONCLUSION: This survey showed that the BDJ UCL Eastman CPD journal-based verifiable CPD programme remains a popular method of fulfilling the GDC regulations and that the majority of participants are in favour of making the process more rigorous.

British Dental Journal based Continuing Professional Development: a survey of participating dentists and their views.

OBJECTIVE: There is little information available on journal based verifiable continuing professional development (CPD). The aim of this study was to survey those dentists who have undertaken this form of CPD and elicit their views. DESIGN: A questionnaire survey. METHOD: Four hundred dentists who had registered to undertake CPD with the British Dental Journal (BDJ) were randomly selected and sent a questionnaire. RESULTS: Three hundred and twelve questionnaires were returned (78%) of these 181 (58%) were male and 131 (42%) were female. Of the 312, 307 had undertaken the BDJ CPD initiative. Two hundred and sixty eight respondents (87.3%) agreed/strongly agreed that the BDJ CPD satisfied their personal CPD needs. Two hundred and eighty three (92.2%) agreed/strongly agreed that their knowledge has been increased as a result of undertaking the BDJ CPD initiative. Two hundred and twenty agreed/strongly agreed (71.7%) that an element of their clinical practice had changed as a result of undertaking the BDJ CPD initiative. CONCLUSION: Journal based learning appears to be an effective way of undertaking verifiable CPD.

The size of occlusal rest seats prepared for removable partial dentures.

OBJECTIVE: The aim of this study was to test whether rest seats cut by a group of general dental practitioners for a removable partial denture differed in size and shape from those prepared by either a group of postgraduate students or their academic teachers. METHOD: The occlusal surfaces of a number of plastic teeth were scanned by a laser profilometer. Each tooth was then placed in a set of articulated phantom head dental arches. 30 dental practitioners, 16 postgraduates and 11 dental academics were asked to cut a rest seat preparation in the mesial marginal ridge suitable for the construction of a removable chromium cobalt partial denture. The tooth was removed from the models, rescanned, and this data converted to grey level images for measurement of the width, length and area of each rest seat. Depth was calculated as the difference between the pre and post preparation scanned profiles. RESULTS: There was a wide variation in the size of the individual rest seat preparations. There was no significant difference between the measured parameters from the images of the preparations made by academic staff and postgraduate students. The two sets of data were therefore combined. The length, width and area of the rest seats prepared by the staff and postgraduate group were significantly greater than those cut by the dental practitioner group. However, there was no significant difference in the depths measured. The outline form of the rests prepared by the dental practitioners was often round with sharply defined margins contrasting with the smooth triangular preparation the staff and postgraduates prepared. CONCLUSION: A 'refresher' in tooth modification for GDPs designing partial dentures would improve the long term success of the prosthesis.

Removable prostheses.

Reconstruction of the dentition extensively damaged through tooth surface loss may require the use of removable prostheses. This can be the most appropriate type of treatment when either the teeth are very severely worn or the patient wishes a simpler and more economical approach than a fixed reconstruction.

The rigid lingual connector: is it a paradox?

The design of removable partial dentures has progressed both clinically and in laboratory research. Nonetheless, there still appears to be a conflict between the empirical practice and the scientific data available. On this basis, the authors question several aspects of the lingual connector. If lingual connectors are required to be rigid, how is this best achieved and can it be assured that designs impart sufficient rigidity? On the contrary, is it possible to make the connector too rigid? No conclusions are attempted in this theoretical discussion, but research to resolve the dilemma is encouraged.

An examination of the rigidity of major connectors for removable partial dentures: an in-vitro study investigating horizontal loading of mandibular connectors.

This study investigated the rigidity imparted by the dimensions and cross-sectional shape of major connectors for a range of arch-forms. Sixteen cobalt chromium castings in all were fabricated, four in the form of standardised lingual bars, four as thickened lingual bars, four as lingual plates and two as modified sublingual bars. Arch-forms varied in length, radius of curvature and mid-sagittal angulation. All connectors were tested in compression on an Instron machine with and without a resilient base. The latter simulated the displacement of the periodontal membrane. A further apparatus was constructed to record the transmission of applied loads to the contralateral side of the arch; again resilient material was used as an analogue to the periodontal ligament. Results indicated that connector deflection varied directly with its length and inversely with its radius of curvature and the minimum cross-section of the anterior third. A 20 degrees change in mid-sagittal angulation was not significant. The theoretical relationships between a connector's dimensions and its rigidity were not confirmed. Regions of minimum connector dimension limited rigidity. The lingual bars and plates did not distribute lateral stresses effectively to the contralateral side of the arch and were found to be less rigid than the modified sublingual bars.