A randomized trial on simplified and conventional methods for complete denture fabrication: cost analysis.

PURPOSE: This study aimed to quantify the costs of complete denture fabrication by a simplified method compared with a conventional protocol. MATERIALS AND METHODS: A sample of edentulous patients needing conventional maxillary and mandibular complete dentures was randomly divided into group S, which received dentures fabricated by a simplified method, and group C, which received conventionally fabricated dentures. We calculated direct and indirect costs for each participant including unscheduled procedures. This study assessed 19 and 20 participants allocated into groups S and C, respectively, and comparisons between groups were conducted by the Mann-Whitney and Student's t-test (α = 0.05). RESULTS: Complete denture fabrication demanded median time periods of 173.2 and 284.5 minutes from the operator for groups S and C respectively, and 46.6 and 61.7 minutes from the dental assistant (significant differences, p < 0.05). There was no difference between groups regarding postinsertion adjustments. Group S showed lower values for costs with materials and time spent by patients than group C during the fabrication stage, but not during adjustments. CONCLUSIONS: The median direct cost of complete denture treatment was 34.9% lower for the simplified method. It can be concluded that the simplified method is less costly for patients and the health system when compared with a conventional protocol for the rehabilitation of edentulous patients.

Occlusion and temporomandibular disorders: a malpractice case with medical legal considerations.

Occlusion and temporomandibular The issue of temporomandibular disorders (TMD) diagnosis and treatment has become a matter of increasing interest in the medical legal field in recent years. The old-fashioned theories based on the occlusal paradigm was proven to be erroneous, and clinicians who still provide irreversible treatments to TMD patients have to be conscious of the potential legal consequences of their behavior. The present paper described an illustrative case report of a patient to whom extensive and irreversible occlusal therapies were performed with the unique aim to provide relief from TMD symptoms. The treatment was unsuccessful and the dental practitioner was called into cause for a professional liability claim. The clinician was judged guilty of malpractice on the basis of the lack of scientific evidence of the irreversible occlusal approaches to TMD, which were erroneously used and did not give the patient any benefit, thus forcing him to a non necessary financial and biological cost. The failure to satisfy the contract with the patient, which is usually not covered by any insurance company, forced the practitioner to give the money back to the patient. The ethical and legal implications of such case were discussed, with particular focus on the concept that medical legal advices need to satisfy the highest standards of evidence and have to be strictly based on scientific knowledge.