Behnoush Rashedi

Current concepts and techniques in complete denture final impression procedures

PURPOSE In 2001, a survey of U.S. dental schools was conducted to determine which concepts, techniques and materials are currently prevalent in the teaching of final impression procedures for complete dentures in the predoctoral clinical curriculum. MATERIALS AND METHODS The questionnaire was mailed to the chairperson of the prosthodontic/restorative departments of 54 U.S. dental schools. Of these, 44 schools returned the completed survey resulting in a response rate of 82%. RESULTS Results from this survey show that the majority of schools (71%) teach the selective-pressure technique for final impression making; the majority of the schools (64%) use modeling plastic impression compound for border molding the final impression tray; 39% of the schools do not place vent holes in the final impression tray, 30% of schools place more than one hole and 27% place one hole only; the majority of the schools (98%) are using custom trays for final impressions. Ninety-eight percent of the schools are border molding the custom tray and 70% of schools are using a visible light-cured (VLC) composite resin material to make the trays. Thirty-six percent of the schools are teaching the Boucher impression technique and 34% are teaching the modified Boucher impression technique. CONCLUSIONS Predoctoral clinical complete denture educational programs agree on many aspects of final impression making, however, there is variability in their teachings regarding the impression philosophy and the materials used.

Preclinical complete dentures curriculum survey.

Purpose A survey of U.S. dental schools was conducted in 2001 to determine the curricular structure, teaching philosophies, and techniques used in preclinical complete denture courses. Materials and Methods The questionnaire was mailed to the chairperson of the prosthodontic/restorative departments of 54 U.S. dental schools. Of these, 43 schools returned the completed survey, a response rate of 80%. The mean, median, and range of responses were computed where applicable. Results Results from this survey show that the mean student-to-faculty ratio in the preclinical course was 12:1, with a median of 12:1 and a range of 6:1 to 27:1. The mean number of laboratory hours was 74, with a median of 70.5 and a range of 31.5 to 160. The mean number of lecture hours reported was 28, with a median of 25 and a range 12 to 80. The mean number of practical examinations was 3, with a median of 3 and a range of 0 to 11. Eighty-four percent of the schools have prosthodontists teaching the course. The mean number of months that this course is taught is 5 months, with a median of 5 and a range of 2 to 13. Fifty-eight percent of the schools use the Hanau semiadjustable articulator. Sixty-five percent of the schools use protrusive records to set the articulator. The facebow preservation record is used by 84% of the schools. Conclusions Preclinical complete denture educational programs vary from school to school, yet a large percentage of schools agree on certain topics. Only 28% of dental schools are incorporating new technologies, such as the internet, in their preclinical complete denture curriculum. Nineteen percent of dental schools are using only the Portrait denture teeth, which are newer than the Bioblend and Bioform teeth.

Prosthodontic treatment with implant fixed prosthesis for a patient with ectodermal dysplasia: A clinical report

Oral characteristics of ectodermal dysplasia (ED) include hypodontia or anodontia of the primary or permanent teeth, impacted teeth, malformed and widely spaced peg-like teeth, and underdeveloped alveolar ridges. Patients with this disease often need a multidisciplinary approach to treatment planning and dental treatment to regain appropriate function, esthetics, and comfort. The definitive treatment plan may include removable, fixed, or implant-supported prostheses or a combination of these options. Depending on the remaining available alveolar bone and the pattern of missing teeth, the ideal treatment option for an adult ED patient often includes the use of implants. This clinical report describes the multidisciplinary approach to diagnosis and treatment of ED in a 37-year-old woman. The treatment included a mandibular implant-supported fixed denture and a maxillary conventional overdenture fabricated to establish acceptable occlusal vertical dimension, esthetics, and oral function.

Current concepts for determining the postpalatal seal in complete dentures

PURPOSE In 2001, a survey of U.S. dental schools was conducted to determine the concepts and techniques used for establishing the postpalatal seal (PPS) in a predoctoral dental curriculum. MATERIALS AND METHODS The questionnaire was mailed to the chairperson of the prosthodontic/restorative departments of 54 U.S. dental schools. Of these, 44 returned the completed survey, resulting in a response rate of 82%. RESULTS Results from this survey show that 80% of the schools are teaching a combination of phonation with other methods for locating the vibrating line. The 1 vibrating line concept for establishing the PPS is taught by 80% of schools; 77% of these schools locate the posterior termination of the maxillary denture on the vibrating line. Carving the PPS in the maxillary master cast is taught by 95% of the schools. Most of the schools teach the students to carve the PPS to a depth of 1.0-1.5 mm in the maxillary master cast. Compressibility of the palatal tissues is a consideration during PPS carving for 91% of the schools. The butterfly pattern is the most frequently (75%) described pattern for PPS carving. CONCLUSIONS There is some variability from school to school on performing the PPS in the maxillary denture, although some trends are evident.

Preclinical removable partial dentures curriculum survey

PURPOSE In 2001, a survey of U.S. dental schools was conducted to determine the curricular structure, teaching philosophies, and techniques used in preclinical removable partial denture (RPD) courses and to also establish what newer educational techniques and materials are currently being used by U.S. dental schools. MATERIALS AND METHODS The questionnaire was mailed to the chairpersons of the prosthodontic/restorative departments of 54 U.S. dental schools. Of these, 43 schools returned the completed survey, resulting in a response rate of 80%. The mean, median, and range of responses were computed where applicable. RESULTS Results from this survey show that the mean student-to-faculty ratio in the preclinical RPD course was 12:1, with a median of 10:1 and a range of 6:1 to 27:1. The mean number of laboratory hours was 55, with a median of 50 and a range of 13.5 to 120. The mean number of lecture hours reported was 21, with a median of 20.5 and a range 10 to 60. The mean number of practical examinations was 2, with a median of 3 and a range of 0 to 8. The mean number of written examinations given was 2, with a median of 2 and a range of 1 to 6. Ninety-five percent of the schools have prosthodontists teaching this course. The mean number of months that this course is taught is 4.4 months, with a median of 4 and a range of 1.5 to 10. Fifty-five percent of the schools used the Hanau semiadjustable articulator. One hundred percent of the schools teach students to use a surveyor when designing an RPD, and 84% percent of the schools teach the Krol or the Kratochvil RPI design or a combination of the 2 designs. CONCLUSIONS Preclinical RPD educational programs vary from school to school, yet a large percentage of schools agree on certain topics. Only 19% of dental schools are incorporating new technologies, such as the use of the internet, in their preclinical RPD curriculum.

Tuned aperture computed tomography (TACT®) for cross‐sectional implant site assessment in the posterior mandible

PURPOSE This study was designed to optimize a new radiographic modality known as tuned aperture computed tomography (TACT) for cross-sectional imaging of implant sites in human dry mandibles. MATERIALS AND METHODS Five imaging modalities were compared for image quality and measurement accuracy: (1) conventional hypocycloidal tomograms, (2) TACT images reconstructed using the average method produced using a linear x-ray source movement, (3) TACT images reconstructed using the average method produced using a multidirectional x-ray source movement, (4) minimally reconstructed TACT images without a fiducial marker at the site of interest, and (5) minimally reconstructed TACT images with a fiducial marker at the site of interest. RESULTS The extended Mantel-Haenszel mean score statistic was used to investigate the influence of modality on subjective image quality. A statistically significant difference for certain types of TACT images and multidirectional tomography (P < 0.0001) was observed. Linear TACT and multmin TACT were rated as significantly better than other image modalities (P < 0.0009), whereas multidirectional tomography was rated as being significantly worse than other radiographic modalities (P < 0.0001). For the quantitative assessment, data were normalized and analyzed statistically through a paired-comparisons t test. For each modality, the accuracy for maximum height and height was significantly different from ground truth (P < 0.05). CONCLUSION The qualitative data suggest that visibility of structures important to the choice of implant location and dimension were seen better with certain TACT methods. Quantitative differences from ground truth (actual measurements of the bone-absolute truth) were clinically negligible. TACT appears to offer the potential of superior image quality over the status quo.

Survey of recently board-certified prosthodontists on the board-certification process. Part 2: Preparation and impact

PURPOSE A 2-part survey of recently board-certified prosthodontists was conducted in 2001. The first part of the survey, published in June 2003, determined the trends that assisted the candidates in attaining diplomate status. The second part of the survey was done to determine the preparation methods and resources used to prepare for the examination, the most difficult part of the examination, the most gratifying aspect of becoming board-certified, their current employment status, and whether board certification had any positive impact on their employment. MATERIALS AND METHODS A questionnaire was mailed to 176 diplomates who had become board certified between the years 1993-2001. Of these, 131 board-certified prosthodontists returned the completed survey, resulting in a response rate of 74%. RESULTS Results from this survey showed that 91% of the diplomates had taken the American College of Prosthodontists (ACP) Board Preparation course; most of the diplomates (41%) prepared for the boards by reviewing prosthodontic literature, reading textbooks, using the ACP Study Guide, and seeking the help of other board-certified prosthodontists; 89% of the diplomates felt that achieving board certification had a positive influence in their employment; 39% of the diplomates indicated that Part 2 of the examination was the most difficult to prepare for, and 41% indicated that Part 2 was the most difficult section; the majority of diplomates (31%) were employed by the military, and the most gratifying aspect of becoming board-certified was personal accomplishment (83%). CONCLUSIONS Trends were observed regarding prosthodontists who succeeded with their efforts to challenge the board examination. The majority of the diplomates were employed by the military. Most of the respondents indicated that they took the ACP Board Preparation course and found it helpful. The largest percentage of respondents reported that Part 2 was both the most difficult part to prepare for, as well as the most difficult to complete. The most gratifying aspect of becoming board-certified was personal accomplishment.

Survey of recently board-certified prosthodontists on the board certification process. Part 1: Demographics.

PURPOSE A survey of recently board-certified prosthodontists was conducted in 2001. The purpose of this survey was to identify trends that assisted candidates in attaining diplomate status. MATERIALS AND METHODS A questionnaire was mailed to 176 diplomates who had become board certified between the years 1993 and 2001. Of these, 131 board-certified prosthodontists returned the completed survey, resulting in a response rate of 74%. The mean, median, and range of responses were computed when applicable. RESULTS Results from this survey show that the mean number of years from completion of a postdoctoral program to achieving board certification was 6 years, with a median of 4 years and a range of 1 to 23 years. The mean number of years from the time of completion of a postdoctoral program to board eligibility was 2.3 years, with a median of 1 year and a range of 0 to 22 years. The mean number of years from board eligibility to board certification was 3.9 years, with a median of 3 years and a range of 0 to 17 years. The military was the most frequently reported employment status at the time the respondents took Parts 1-4 of the boards. A total of 54% of the diplomates reported that they challenged Part 1 separately, and then challenged Parts 2, 3, and 4 together; 79% of the diplomates were encouraged by their graduate program director/faculty to challenge the board; and 48% of the diplomates reported that their patients received free dental treatment. CONCLUSIONS Certain trends were observed regarding diplomates who succeeded in their efforts to challenge the board examination. The largest group who challenged the board certification examinations comprised members of the armed forces. Most prosthodontists challenged Part 1 before challenging the remaining 3 parts. In an effort to encourage more prosthodontists to challenge the board examination, numerous changes were made between 1992 and 1998; however, most of the diplomates did not take advantage of those changes.