Hamular frenum modification: a removable denture prosthesis retention and stability enhancement.

A removable denture prosthesis, whether partial or complete, often requires preprosthetic surgery to achieve optimum stabilization and retention. While the hamular frenum may produce significant dynamic dislodging forces, a literature review did not reveal any reports dealing with this problem. A hamular frenum reduction surgical procedure using the free autogenous gingival graft procedure is described. Prosthetic function may be enhanced by eliminating the dynamic disrupting force of the hamular frenum along with improving posterior maxillary tuberosity contour and, as necessary, premaxillary form, allowing these contours to work in concert to develop a "cupping" stabilizing and retentive complex.

A simplified approach to optimizing denture stability with lingualized occlusion.

Occlusal prematurities are destructive and destabilizing influences in complete dentures. Unless denture bases are adequately and evenly stabilized, it is virtually impossible to properly equilibrate the occlusion. One reason is that all artificial teeth in a denture unit are physically bound into a single denture base and literally act as a single tooth. Therefore, a single point of occlusal prematurity disrupts the entire denture occlusion and negatively affects the denture base stability and retention, preventing proper equilibration. This article describes a step-by-step approach using an intraoral central bearing point tracing device and lingualized occlusion to achieve an effective and simplified equilibration.

An ethnographic, controlled study of the use of a computer-based histology atlas during a laboratory course.

OBJECTIVE: To evaluate the use and effect of a computer-based histology atlas during required laboratory sessions in a medical school histology course. DESIGN: Ethnographic observation of students' interactions in a factorial, controlled setting. MEASUREMENTS: Ethnographer's observations; student and instructor self-report survey after each laboratory session with items rated from 1 (least) to 7 (best); microscope practicum scores at the end of the course. RESULTS: Between groups assigned the atlas and those not, the ethnographer found qualitative differences in the semantic categories used by students in communicating with each other and with the faculty. Differences were also found in the quality of the interactions and in the learning styles used with and without the computer present in the laboratory. The most interactive learning style was achieved when a pair of students shared a computer and a microscope. Practicum grades did not change with respect to historical controls. Students assigned the atlas, compared with those not assigned, reported higher overall satisfaction (a difference in score of 0.1, P = 0.003) and perceived their fellow students to be more helpful (a difference of 0.11, P = 0.035). They rated the usefulness of the microscope lower (a difference of 0.23, P<0.001). CONCLUSION: A computer-based histology atlas induces qualitative changes in the histology laboratory environment. Most students and faculty reacted positively. The authors did not measure the impact on learning, but they found that there are aspects of using the atlas that instructors must manipulate to make learning optimal. Ethnographic techniques can be helpful in delineating the context and defining what the interventions might be.

An integrated approach to optimizing orofacial health, function, and esthetics: a 5-year retrospective study.

The restorative dentist treats patients with needs that often transcend dental disciplines. This dentist will be responsible for long-term dental maintenance and should logically oversee interdisciplinary reconstruction. This case report demonstrates an integrated treatment approach and 5-year retrospective study involving a patient with maxillary anterior excess, pronounced overjet, and advanced periodontitis. Extraction and radical alveolectomy with removable prosthesis is often considered in such cases; however, results are often less than optimum function, esthetics, and general oral health. In this case, a previously undescribed anterior maxillary rotating segmental ostectomy was integrated with restorative, periodontal, and removable full and partial denture procedures.

A method of prognosticating complete denture outcomes.

A simple examination instrument (the Edentulous Exam form) was developed to be used in a regular and systematic manner to determine outcomes or prognoses for the edentulous patient. Factors that can complicate treatment are discussed. When a dentist can gather information about what a patient is presenting with, a satisfactory outcome or prognosis can be effectively projected before the actual treatment commences.

A metal-based denture with soft liner to accommodate the severely resorbed mandibular alveolar ridge.

A technique is described for designing and making a mandibular denture, for patients with severely resorbed and compromised residual alveolar ridges. The denture base is stabilized by a mucostatic impression technique, myostatic denture base design, weight of a cast metal denture base, and noninterceptive occlusion with monoplane or Centrimatic posterior teeth. The hard metal denture base is made tissue-compatible by means of a soft denture liner attached to a specially relieved cast metal denture base. Over a 2-year period, this technique has successfully provided, in my practice, an alternative to residual alveolar ridge implants and other surgical interventions for 22 edentulous patients with severely resorbed and compromised mandibular residual alveolar ridges.