Impairments due to tooth loss and prosthetic expectations in patients from an urban area and a rural area in Sweden. A qualitative study.

OBJECTIVES: To explore impairments due to tooth loss and expectations of prosthetic replacements in an urban group and a rural group of patients in Sweden. MATERIAL AND METHODS: Semi-structured interviews were performed on 35 partially edentulous patients from prosthodontic specialist clinics located in an urban area and a rural area in Sweden. The interviews focused on impairments due to tooth loss and expectations of prosthetic restorations. Analysis was made using the grounded theory approach, allowing in-depth investigation of the phenomenon. RESULTS: Functional, aesthetic and social impairments were mentioned, and coping strategies (eg chewing differently and laughing less) and modifications (eg age, time and social setting) of the impairments were described. The rural patient group accepted impairments somewhat better than the urban one. Otherwise, there was only minor difference between the groups. Removable prosthodontic restorations were more acceptable among rural patients. Urban patients insisted more often on implant-based restorations and had higher expectations of longevity. Patients with minor impairments still wanted treatment, based on concerns about the future of their dentition. The interviews themselves generated new thoughts in the patients and were thus considered valuable by the patients. CONCLUSIONS: Impairments due to tooth loss and expectations of prosthetic replacements were expressed in the same way in the rural and urban patient groups. However, in the rural population, there was a higher acceptance of impairments and also of removable prosthetic restorations, whereas the urban population expressed a higher demand for implant-based restorations.

The Shortened Dental Arch concept from the perspective of Swedish General Dental Practitioners: a qualitative study.

The aim was to study the cognizance of and attitudes towards the Shortened Dental Arch (SDA) concept among Swedish General Dental Practitioners (GDPs) and the application of the SDA concept in their treatment planning using Qualitative Content Analysis. Eleven Swedish GDPs were purposively selected and all agreed to participate. In-depth semi-structured interviews were conducted and covered treatment considerations concerning two patient cases and the participants' reflections regarding pre-formulated statements about the SDA concept. Qualitative content analysis was used to analyze this data.The emerging theme was "the SDA concept is irrelevant" in the sense of the GDPs disregarding treatments providing dentitions with loss of posterior teeth. There was a strong reluctance to extract teeth, without consideration of the SDA concept, and a firmly patient-focused attitude towards the needs, age and financial situation of the patients. Within the limitations of this study, Swedish GDPs show little or no cognizance of the SDA concept and it does not seem to be applied in their treatment planning. The results show that the qualitative methodology can be beneficial for further understanding of cognizance and attitudes towards the SDA concept.

Intraoral Digital Impression Technique Compared to Conventional Impression Technique. A Randomized Clinical Trial.

PURPOSE: To compare digital and conventional impression techniques in a randomized clinical trial; specifically, procedure times, patient-centered outcomes, and clinical evaluation of the restorations. MATERIALS AND METHODS: Forty-two patients in need of tooth-supported single crowns and/or fixed partial prostheses up to six units were randomly allocated to one of the impression techniques. The procedure times, dentists' and patients' assessments using a visual analog scale (VAS), and clinical evaluation of the restorations were compared between the two groups. RESULTS: The mean total procedure times for digital and conventional impression technique were 14:33 ± 5:27 and 20:42 ± 5:42, respectively (p < 0.0001). Mean impression times were 7:33 ± 3.37 and 11:33 ± 1.56, respectively (p < 0.0001). Mean VAS scores for the dentist's assessment of difficulty (0 to 100; very difficult = 100) were 24.00 ± 18.02 and 48.02 ± 21.21, respectively (p < 0.0001). Mean VAS scores for the patients' assessment of discomfort (0 to 100; very discomforting = 100) was 6.50 ± 5.87 and 44.86 ± 27.13, respectively (p < 0.0001). Occlusal contacts showed a better result for the digital technique. CONCLUSION: The results of this study demonstrated that the digital technique was more efficient and convenient than the conventional impression technique.

Decision making among Swedish general dental practitioners concerning prosthodontic treatment planning in a shortened dental arch.

The purposes of this study were to describe how dentists evaluated the importance of various patient-related items when planning for a treatment in a shortened dental arch, to analyse common dimensions of the decision-making in comparison to other decision situations, and to identify explanatory factors behind these dimensions. A questionnaire containing different statements regarding the shortened dental arch concept was sent to a random sample of Swedish general dentists (n=189), with a response rate of 54%. The dentists were asked to evaluate items to be considered when planning for a prosthetic treatment in a shortened dental arch. Differences between individuals were great as well as between groups of dentists. Especially delivery system but also place of dental education and attitudinal factors were related to the shortened dental arch decision making process.

Attitudes toward the shortened dental arch concept among Swedish general dental practitioners.

PURPOSE: The purpose of this investigation was to obtain the opinions and assess the attitudes of Swedish general dental practitioners in private practice versus a public health care setting regarding management of patients with a shortened dental arch (SDA). MATERIALS AND METHODS: A questionnaire containing different statements regarding the SDA concept was sent to a random sample of 189 clinicians. Differences between male and female practitioners and between private practitioners (PPs) and those employed by the Public Dental Health Service (PDHS) were tested for statistical significance by the Student t test. RESULTS: The response rate was 54% (102 clinicians). Among the respondents, 62% were men and 38% were women. Fifty-six percent were PPs and 44% were employed by the PDHS. The results showed small differences in attitudes between various groups of practitioners but large individual variations. In general, Swedish general practitioners had a positive attitude toward the SDA concept with respect to oral function and oral comfort. They recognized few risks with a dentition lacking molar support, although female clinicians were more risk conscious. PPs expressed fewer advantages in using the SDA concept than PDHS practitioners with respect to the reduced risk for overtreatment, better patient economy, and the ability for older patients to keep their teeth. CONCLUSION: The results from this questionnaire study indicate that, overall, Swedish general practitioners have an affirmative opinion toward the SDA concept.