Sleep disorders and oral devices.

Many patients with upper airway sleep disorders can be successfully treated with oral appliance therapy. It is necessary for dentists to recognize these patients and refer them to a physician for further evaluation. Dentists must not become the primary care providers for these patients or attempt to treat a medical problem with an oral appliance without a proper diagnosis, which usually requires a sleep study and can only be diagnosed by a physician. Dentists must also be able to treat the patients referred by physicians and to follow accepted procedures when fabricating, inserting, titrating, and providing follow-up care for oral appliance therapy. In addition, the dental community needs to continue to heighten the awareness in their local medical community and in their patient population as to the possible contribution of oral appliance therapy to the management of snoring and some of the sleep-related breathing disorders.

Laboratory considerations in rotational path removable partial dentures.

Clinical indications and contraindications have been well covered in the literature for rotational path removable partial dentures (RPDs). However, only minimal coverage has been devoted to problems encountered that may prevent the proper fabrication of these restorations by dental technicians. The purpose of this article is to illustrate 2 problems that dental technicians occasionally encounter that make the fabrication of rotational path RPDs difficult or impossible. Design modifications by the clinician can eliminate 2 problems faced by technicians fabricating rotational path RPDs.

Dental considerations in upper airway sleep disorders: A review of the literature.

STATEMENT OF PROBLEM: Upper airway sleep disorders are becoming recognized as common medical concerns. Multiple treatment options have been advocated, including the use of dental devices. Dental practitioners are being asked by the medical profession to become a part of the treatment team. This may be a challenging task because of the large number of dental devices available, rapid advancement in the understanding of this disease, and numerous publications. PURPOSE: This article reviews the anatomic features and etiologic factors of upper airway sleep disorders and medical and dental treatment options. METHODS: The literature review was conducted with an accepted literature research tool, PubMed, developed by the National Library of Medicine. Key words searched included "obstructive sleep apnea," "sleep apnea," "sleep disorders," and "snoring". CONCLUSION: Dental devices are indicated in snoring and mild-to-moderate obstructive sleep apnea patients after medical evaluation and referral.

Intraoral recontouring aid.

This article describes a procedure and a device to expedite the intraoral recontouring of teeth to receive removable partial dentures. This procedure is particularly useful when heights of contour are lowered on posterior teeth and the path of insertion is perpendicular to the plane of occlusion.

Lingualized occlusion. An occlusion for all reasons.

This authors make practical recommendations for a wide variety of clinical situations, including various anteroposterior and buccolingual arch discrepancies. Many of the ideals of the anatomical and mechanical schools of thought are blended. In addition to being a valuable clinical adjunct, Lingualized Occlusion also has great application in undergraduate dental education. It is a simpler occlusal scheme to teach and learn.

A cast orientation index.

This article describes a technique that allows multiple master casts to be precisely oriented to the same path of insertion and withdrawal. This technique is useful in situations where multiple fixed prosthodontic preparations require surveyed restorations and a single master cast is not available.

Cone positioning device for oral radiation therapy.

This article describes the fabrication and modification of a peroral cone-positioning device. The modification provides added cone stability and prevents tongue intrusion into the radiation field. This device provides a repeatable accurate cone/lesion relationship and the fabrication technique is simplified, accurate, and minimizes patient discomfort.

Trajectory surgical guide stent for implant placement.

This article describes a new implant placement surgical guide that gives both implant location and trajectory to the surgeon. Radiopaque markers are placed on diagnostic dentures and a lateral cephalometric radiograph is made that shows the osseous anatomy at the symphysis and the anterior tooth location. The ideal implant location and trajectory data are transferred to a surgical stent that programs the angle and location of the fixtures at time of surgery. The stent has the additional benefit of acting as an occlusion rim, a mouth prop, and tongue retractor. Use of this stent has resulted in consistently programming the placement of implant fixtures that are prosthodontically ideal.

The use of processed silicone to retain the implant-supported tissue-borne overdenture.

A technique is described for constructing the implant-retained overdenture with heat-polymerized silicone that is processed around undercuts in a round bar framework connecting the implants. An acrylic resin circular rest contacting the bar ensures that the implants are loaded in occlusion for stress distribution over the fixtures.

An improved index for the waxed stage of an implant-retained framework.

A method for making an improved index for the waxed stage of Branemark implant-retained frameworks is described. The index improves visibility of the tooth and abutment cylinder relationship permitting the optimization of framework dimensions and contour.

A simplified technique for fabricating esthetic cast metal occlusal surfaces for dentures.

This article describes a simplified method for making esthetic cast metal occlusal surfaces. Monoplane posterior acrylic resin block teeth, cast in a nickel-chrome alloy, are coated with silane and an esthetic composite resin veneer is applied to the buccal surface. These veneered posterior metal teeth are incorporated in the wax setup and the dentures are processed and finished. The dentist's routine technique for delivering dentures to the patient can be followed.

Occlusion in the combination fixed removable prosthodontic patient.

The authors provide a review of the critical aspects of occlusion for the combination fixed removable patient. Articular selection and jaw relation techniques are reviewed, and dental materials combinations are recommended for restoring opposing occlusal surfaces. General objectives and specific recommendations for determining and establishing occlusal schemes are made. Tables outlining occlusal scheme, occlusal morphology, and degree of balance are presented.

Symposium on semiprecision attachments in removable partial dentures. Occlusal relationships.

This article discusses current concepts of occlusion and describes the methods of creating a physiologic occlusion for the partially edentulous patient. Specific recommendations are made for choices of materials, techniques, and occlusal schemes for various edentulous situations.