Clear acrylic resin device for orientation and placement of a small facial prosthesis.

A small-sized facial prosthesis can be difficult to orient accurately in correct relationship to a defect. This problem may be reduced by embedding a magnet in the prosthesis and constructing a magnetic holding device from clear acrylic resin. This device can be used as a stand during adhesive application to reduce adhesive contamination and acts as orientation guide during prosthesis placement.

A combined direct dowel and indirect core technique.

The dowel-and-core restoration is indicated when inadequate tooth structure remains to retain an extracoronal restoration. A modified technique for fabricating the dowel and core combines the direct technique of forming the dowel in the actual channel with the indirect technique of creating an ideal core contour in the laboratory. This technique allows the operator to create an accurate and passive fit of the dowel pattern in the canal preparation. The technique also introduces the option of retrieving the dowel portion by utilizing a polyvinyl siloxane cast or liner. Further advantages of the technique are reduced chairside time and the ability to capitalize on the preparation of multiple teeth. The technique focuses efforts on achieving an accurate and passive fit of the dowel clinically while delegating the formation of the core to the laboratory.

Depressed taste and smell in geriatric patients.

BACKGROUND: Geriatric patients have a number of dental care problems that younger patients do not encounter. The oral changes associated with aging can have a significant effect on the efficacy of dental treatment. TYPES OF STUDIES REVIEWED: The authors reviewed studies dealing with the causes of depressed sense of taste and smell; the causes included aging, disease, medications and dental problems. Based on their findings, the authors described the location and anatomy of taste buds and receptor cells for smell and explored appetite, saliva, food seasonings, nutrition and dietary recommendations. They also discussed the relationship of smoking and tongue cleaning to taste sensations. RESULTS: The authors found that considerable differences exist between elderly people and young people in regards to sensory perception and pleasantness of food flavors. Salt and bitter taste acuity declines with age, but sweet and sour perceptivity does not. Olfactory acuity also declines with age. The authors found that most of the studies reviewed suggested that the sense of smell is more impaired by aging compared with the sense of taste. Smoking diminishes the taste of food and makes flavorful foods taste flat, while tongue brushing can increase taste sensation for geriatric patients. CLINICAL IMPLICATIONS: Food can become tasteless and unappetizing for geriatric patients as the result of declining taste and smell perception. Geriatric patients should be encouraged to add seasonings to their food instead of relying on excessive consumption of salt and sugar to give their food flavor. Adequate nutrition, tongue cleaning and smoking cessation are recommended for geriatric dental patients.

Improved mouth guard design for protection and comfort.

Mouth guards worn during contact sports have been shown to provide considerable protection against traumatic injuries to the teeth and supporting structures. Of the 3 types available, the custom-made mouth guard is considered superior to stock and mouth-formed mouth guards. The procedure for making a special mouth guard designed for protection and comfort is described.

Simplified methods for fabricating tissue-supported implant-retained overdentures with retention from a resilient liner.

Resilient denture liner materials can be useful for tissue-supported implant-retained overdentures. They allow physiologic movement of the denture toward the tissues. This article presents a technique that offers several advantages over other methods of fabricating the overdenture with a resilient liner, and of transferring the superstructure: the acrylic resin base and the heat-cured resilient liner material are cured simultaneously; superstructure blockout is performed in the laboratory instead of in the mouth, where blockout is difficult; and direct transfer of the superstructure bar is more accurate and eliminates possible fracture of the duplicated superstructure if formed in die stone.

Contact angle measurement on dental implant biomaterials.

Wettability may be one of the surface factors to be considered when selecting dental implant biomaterials. Contact angles of dental implant surface preparations influence wettability and tissue adhesion. The contact angles of eight implant surface preparations were determined in this study. Contact angles were measured by a tele-microscope equipped with a protractor eyepiece. Groups 1 to 6 had a Ti6Al4V substrate. Group 1 was metallurgically polished, group 2 was blasted with 180 microns Al2O3, group 3 was blasted with 710 microns Al2O3, group 4 was hydroxyapatite (HA) blasted (125 microns), group 5 had a Calcitite HA plasma-sprayed coating, and group 6 was coated with plasma-sprayed MP-1 HA. Group 7 was metallurgically polished commercially pure (CP) titanium (grade 1), and group 8 was etched CP titanium (grade 1). Contact angles were measured 30 times for each group with distilled water and glycerol, and the determinations were statistically analyzed. Mean contact angles for groups 1 to 8 were 65.5, 65.3, 62.5, 67.9, 46.6, 81.7, 58.5, and 69.0, respectively, when tested with distilled water, and 70.7, 68.3, 81.6, 75.4, 67.1, 70.7, 62.3, and 82.5, respectively, when tested with glycerol. Analysis of variance and Tukey's Honestly Significant Difference test (p = 0.05) demonstrated significant differences between group 5 and all other groups when groups were tested with distilled water and demonstrated no significant differences between groups 5 and 7 when groups were tested with glycerol. Surface preparation of implant biomaterials affects wettability. In this study, Ti6Al4V coated with Calcitite HA had the lowest contact angles and the best wettability.

Nutrition and the geriatric implant patient.

The clinician must be cognizant of nutritional factors and deficiencies that can adversely affect implant surgery and subsequent prosthodontic rehabilitation for the geriatric patient. There are many nutrients, vitamins, and minerals that may be useful and even necessary for the geriatric implant patient. Dental implants and implant-retained and/or supported prostheses are viable treatment options for older patients when certain age-related and nutritional factors are considered.

Dental implants and the geriatric patient.

Dental care of the aging patient presents a number of problems not encountered in younger patients. Most of these problems result from tissue changes that occur during aging. Dental implants and implant-retained and/or implant-supported prostheses are viable treatment options for older patients. The majority of elderly patients in their younger retirement years are relatively healthy and not limited in activity. The clinician must be aware of the physical, metabolic, and endocrine changes associated with aging and how these changes may affect implant treatment. The elderly deserve the best care the dental profession can offer.