Jeffrey L. Shotwell

Color stability of long-term soft denture liners.

The use of resilient denture liners in complete denture construction has become increasingly popular for providing comfort for denture wearers. The primary disadvantage of these materials is that the physical and mechanical properties change rapidly with time in a service environment. The purpose of this study is to evaluate the color stability of five commercially available soft denture liners as a function of accelerated aging. Color measurements were made before aging with a colorimeter and data processor. The samples were then weathered for 100 hours in an accelerated aging chamber in the presence of a xenon ultraviolet visible-light source, an intermittent water spray at 110 degrees F, and 90% humidity. After aging, color measurements were made again and color differences (delta E) were calculated. Results were statistically tested with analysis of variance and Scheffé intervals were calculated at 0.96. It was concluded that accelerated aging can be used to evaluate color stability of soft denture liners.

Factors associated with the appearance of gingival papillae

AIM The purpose of this study was to evaluate factors associated with the fill of inter-dental spaces by gingival papillae. MATERIALS AND METHODS Ninety-six adult subjects were evaluated. Papilla score (PS), tooth form/shape, interproximal contact length and gingival thickness were recorded for 672 maxillary anterior and first pre-molar interproximal sites. Statistical analyses included a non-parametric chi(2) test, anova, the Mixed Procedure for SAS and Pearsons correlation coefficient (r). RESULTS Papilla deficiency was more frequent in older subjects (p<0.05), as papilla height decreased 0.012 mm with each year of increasing age (p<0.05). Competent papillae (complete fill inter-dentally) were associated with: (1) crown width: length >or=0.87; (2) proximal contact length >or=2.8 mm; (3) bone crest-contact point <or=5 mm; and (4) interproximal gingival tissue thickness >or=1.5 mm. Gingival thickness correlated negatively with PS (r=-0.37 to -0.54) and positively with tissue height (r=0.23-0.43). Tooth form (i.e. crown width to length ratio) correlated negatively with PS (r=-0.37 to -0.61). Other parameters failed to show any significant effects. CONCLUSIONS Gingival papilla appearance was associated significantly with subject age, tooth form/shape, proximal contact length, crestal bone height and interproximal gingival thickness.

Multidisciplinary treatment approach for enhancement of implant esthetics.

A “team approach” that includes different specialties from the initial stages of implant treatment is important to achieve predictable and esthetically pleasing outcomes in compromised dental replacement cases. This report describes a severely compromised case that was properly managed by the combined efforts of a team of specialists. Briefly, prior to tooth extraction, orthodontic forced eruption was applied to coronally displace the attachment apparatus (i.e., hard and soft tissues). Then, atraumatic tooth extraction together with immediate implant placement was performed. The “sandwich bone augmentation” technique was used to augment the deficient buccal alveolar ridge. A second stage surgery was performed 6 months after healing, revealing 100% of bone fill/augmentation. This technique allowed fabrication of a final restoration that respected the proportions of the natural dentition in a case that would otherwise result in a poor esthetic outcome.

Color comparisons of denture teeth and shade guides

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Combination stone and resilient material for removable partial denture remount cast described and compared with two other remount cast procedures

A procedure for making a combination remount cast of stone and elastomeric material for removable partial dentures is described in detail and is compared quantitatively with two other methods for making remount casts for removable partial dentures. This method does not require blocking out the undercuts in the denture base or around the clasps.

Performance criteria in preclinical denture prosthodontics

This article has reported on a preliminary study of selected criteria used by The University of Michigan, School of Dentistry Complete Denture Department. Self-evaluation opportunities by students and assessment of performance by instructors using objective criteria have been developed for each phase of complete denture prosthodontics and placed within a text illustrating methods to reach the desired standards. Agreement between all evaluations of the selected criteria studied occurred on 75% of the responses, while agreement by instructors experienced with criteria evaluations occurred on 81%. Further, extensive study into quality assessment must be initiated within the educational setting before valid and reliable criteria can be developed for the private sector. Additional research will be critical to peer-review mechanisms which attempt to be more than grievance committees.

An evaluation of a polyvinyl occlusal splint for improving the health of inflamed maxillary supporting mucosa of complete denture patients.

A study was made to determine the effects of a polyvinyl occlusal splint on improving the health of inflamed maxillary supporting mucosa. Color slides were made before and after treatment of the maxillary supporting mucosa of 22 edentulous patients wearing dentures during a 15-day test period. The control group consisted of 13 patients, and the experimental group was comprised of nine patients who wore the occlusal splint over the maxillary denture. The 35 mm color slides taken before and after treatment were evaluated by 50 examiners to determine if the health of the maxillary supporting mucosa was better, the same, or worse after the 15-day test period. Fourteen of the examiners were retested to determine the reliability of the viewer. An observable change was noted in the experimental group at a p value less than 1 in 100,000. These findings indicate that the occlusal splint was effective in improving the health status in 64.7% of the experimental patients and that the experimental method was valid.

Ability of edentulous subjects to reproduce mandibular border tracings

A pilot study has been described in which edentulous subjects were examined for their ability to reproduce lateral border movements, as measured by the PRI. The results of this study suggest that edentulous subjects, utilizing stabilized baseplates to support a pantograph, are capable of making reproducible lateral border movements as measured by the PRI.