Howard M. Landesman

The influences of fear, anxiety, and depression on the patient's adaptive responses to complete dentures. Part III

The iatrosedative interview is an effective method of helping patients who are unable to adapt to dentures because of fear, anxiety, and depression. It creates an indispensable trusting relationship in the process of determining the factors responsible for the maladaptiveness and offers a solution to the problem.

A comparison of gingival inflammation related to retraction cords

Potassium aluminum sulfate, aluminum chloride, and 8% racemic epinephrine did not demonstrate practical differences, although potassium aluminum sulfate produced fewer inflammatory changes than the other agents. 2. It appears that factors other than the chemical agent (e.g., physiologic differences in patients) may play a role in the amount of gingival inflammation induced. 3. Additional studies using a larger sample size and an untreated control site should be undertaken.

A practical questionnaire for predicting denture success or failure

The need and value to predict success and failure in treatment of denture patients are great. The psychological and emotional factors involved are just as important as if not more important than the oral and systemic findings. The value of a simple questionnaire for the edentulous and immediate denture patients has been presented. The authors believe that all schools should present advanced information on the psychological aspects of dental care.

An 18-month clinical evaluation of semiprecious and nonprecious alloy restorations

SEM studies indicate that the control alloy, Minigold, WLW, and Litecast metals presented similar results in relation to marginal fit when proper techniques are followed. Clinical evaluation based on the criteria of gingival irritation, patient sensitivity, and abrasion demonstrated no statistically significant differences between the casting alloys tested and the control. The control alloy had significantly fewer restorations with tarnish and corrosion than either WLW or Litecast. There was no significant difference between the control alloy and Minigold in terms of tarnish and corrosion.

A technique for the delivery of complete dentures

This article describes a technique for the delivery of complete dentures which allows the patient to adapt to a mandibular prosthesis and, at the same time, to functionally make a final refitted mandibular impression.

Resorption of the edentulous mandible after a vestibuloplasty with skin grafting

T, Id rote ures to improve the basal seat for an inadequately supported mandibular complete denture have been attempted from the time dentists began replacing natural dentition with artificial removable prostheses. As early as 1874 Thiersch’ described a technique of using epidermal grafting. This appears to have stimulated others to expand the technique and develop the skin grafting vestibuloplasty and lowering of the floor of the mouth (VSG and LFM) procedure.2-‘4 Research indicates that the VSG and LFM procedure is an effective treatment modality for patients who complain of an ill fitting denture, poor masticatory function, and pain. l5 The purpose of the VSG and LFM is to create a larger basal area of fixed epithelium for improved stability and support of the prosthesis. The procedure is an apparent improvement over other techniques because it offers several benefits, such as: (1) fixed tissue on which the denture rests allows stability during mastication and speech; (2) lengthening of the denture flanges, which provides a broader denture base to more widely distribute occlusal forces; (3) enhancing patient comfort, as the skin is a better stress-bearing tissue than mucosa; and (4) longevity of the result. Because VSG and LFM repositions muscle attachments, the question arises as to whether the mandibular resorption following this procedure is more rapid than in the untreated mandible. Hillerup,16 in a survey of 15 patients following a vestibular sulcus extension using the technique of Edlan and Mejchar,“~“’ reported that the procedure fails to protect alveolar bone and may even provoke accelerated bone resorption. However, the procedure of Edlan and Mejchar does not incorporate the use of a skin graft in conjunc-

How dentists learned about resin-bonded prostheses

The need and value to predict how dentists learn about new information after they graduate from dental school is important to educators. The results of a simple questionnaire designed to determine how dentists became aware of and later learned about the RBP has been presented. The authors believe that CDE should play a vital role in providing dentists with the awareness and knowledge of new dental technology.

The making of a prosthodontist: Advanced prosthodontic education at the University of Southern California

F or a system of education to be successful, it must be appropriate to the needs of that civilization. A superb example is the era from 1860 to 1917 which has been termed the “creative” period in higher education-a period in which great progress was made because the development of new patterns and processes in education proceeded at the same pace as the civilization and was appropriate to the new social order. We, as educators, must be cognizant of today’s realities and tomorrow’s needs so that we may provide an enlightened and progressive environment for learning. If we become stagnant and teach the concept of “what was good enough for our fathers, is good enough for us,” we are holding back the clock. Prepaid health insurance programs are here, group practice is on the rise, the use of expanded-duties auxiliaries seems certain, and peer review and quality control committees are already functioning in some states. l Some educators believe that as a result of these changes, the dentist who engages in general practice will assume more of the responsibility that previously has been delegated to the specialist and, in the future, the number of dental specialists will decrease.2 We are all aware of the hazards of overspecialization. One needs only to be reminded of the overspecialized group of engineers who were involved in our space program in the 1960’s. Some of these people are today pumping gasoline or driving taxicabs. Still others are sitting unproductively on their front porches remembering “the good old days.” For prosthodontics to survive as a specialty, I believe that it should not be fragmented into areas such as fixed prosthodontics or removable prosthodontics. In 1969, the Federation of Prosthodontic Organizations3 published its “Guidelines for Advanced Prosthodontic Education.” It was stated that a program should include instruction in all branches of prosthodontics-complete and removable partial denture prosthodontics, fixed prosthodontics, and maxillofacial prosthodontics. The

Dental education and practice in the 21st century: Opportunities for excellence

This study describes the environment that can be expected for dental education and dental practice as the 21st century approaches. The study uses data from many sources, including the recent report from the Institute of Medicine, which provides a comprehensive analysis of the variables that will affect dental education and practice in the next decade. Dental education and practice will be able to thrive if the new forces are carefully examined and the challenges are met promptly.