Oral Health Status of 12-year-olds from Regions with and without Coverage of the National Oral Health Comprehensive Intervention Program for Children in China

OBJECTIVE

To investigate the oral health status and related factors of 12-year-olds from regions with and without coverage of the National Oral Health Comprehensive Intervention Program in China by means of analysing national data from the 4th National Oral Health Survey.

METHODS

Data of 12-year-olds participating in the 4th National Oral Health Survey of China were used for statistical analysis. Children who were recruited in the survey completed a dental examination and filled in a questionnaire. Oral health status, pit-and-fissure sealant history, oral hygiene behaviours, sugar consumption habits, status of dental service utilisation, and oral health knowledge were compared between children from regions with and without coverage of the national programme. For the number of decayed, missing and filled permanent teeth (DMFT) and its components, as well as the number of teeth with pit-and-fissure sealants, mean values were statistically tested to see if significance existed between regions covered by the national programme and uncovered regions, whereas caries prevalence and percentage of pit-and-fissure sealants presented were also compared.

RESULTS

Data from 27,821 12-year-old children were analysed, among whom 7,726 were from regions covered by the national programme and 20,095 were from uncovered regions. Statistical significance was found in caries experience and activity, pit-and-fissure sealant history, sugar consumption habits, utilisation of dental services and oral health knowledge when compared between the covered and uncovered regions. Prevalence of dental caries and indices for caries experience and activity was lower in regions covered by the national programme than those not covered, while the percentage of pit-and-fissure sealants presented and the number of teeth with pit-and-fissure sealants exhibited higher in the covered regions. This remained the same even if we focused only on the first molars instead of the full dentition.

CONCLUSION

The National Oral Health Comprehensive Intervention Program for Children in China potentially contributed to better oral health status, behaviour and knowledge in 12-year-old children. The expansion and extension of coverage of the national programme was expected to be beneficial for improving oral health status in children, as well as constructing teams of oral and dental workforce and working mechanisms in some underdeveloped regions.

An Evaluation of Bite Pattern in Children with Severe-Early Childhood Caries Before and After Complete Dental Rehabilitation

PURPOSE

The purpose of this study was to examine the changes in bite characteristics of children before and after the placement of multiple stainless steel crowns (SSCs) under general anesthesia (GA).

METHODS

Twenty children scheduled for treatment under general anesthesia who needed SSCs in three or more posterior quadrants were included in this study. The bite was digitally analyzed and recorded preoperatively and at one and four weeks postoperatively. The occlusion time, number of force outliers, and distribution of force at each visit was recorded and compared.

RESULTS

The placement of the SSCs in children significantly improved the bite characteristics of the participants. The placement of the SSC did not alter occlusion time, and there were no significant differences in occlusion time. While there was an increase in the number of outliers in the first week after the placement of the crown, there was a reduction in the total number of outliers at the end of one month. All the patients treated with bilateral placement of an SSC showed a posterior balanced occlusion post-operatively, a finding that was retained over the one-month follow-up period.

CONCLUSION

Bilateral placement of SSCs under general anesthesia does not significantly alter the occlusion of the child.

Effectiveness of a Preventive Recall Strategy for Children After Dental Rehabilitation with General Anesthesia

PURPOSE

To test a more frequent preventive recall strategy following full-mouth dental rehabilitation (FMDR) in children with early childhood caries (ECC).

METHODS

Patients were randomized into two groups: controls, who were scheduled to return at six-month intervals (6-MR); and the intervention group, who were scheduled to return at three-month intervals (3-MR and 6-MR). At baseline and at each recall, a caries risk assessment (CRA) and dental exam were completed. Analyses followed CONSORT recommendations, resulting in three analyses: intent-to-treat; per-protocol; and an actual recall analysis.

RESULTS

Intent-to-treat analysis showed no significant difference in CRA at six months (P>0.7); per-protocol analysis showed borderline significance (P>.08); and actual recall analysis showed a statistically significant difference in CRA at six months (P=.021). For patients with both 3-MR and 6-MR, 44 percent were assessed at a high caries risk level; for patients with only a 6-MR, 72 percent were assessed as a high caries risk level (P=.021). No significant differences were found in caries incidence at six months.

CONCLUSIONS

Following full-mouth dental rehabilitation, patients who returned for follow-ups at both three- and six-month intervals had a greater decrease in caries risk level compared to patients seen at six-month follow-up intervals.

Enamel Pit Defects and Taurodontism in a Patient with Ring Chromosome 14 and 47,XXX

The purpose of this paper is to describe the clinical findings and management of a case involving a patient with co-occurring ring chromosome 14 syndrome and 47,XXX presenting with enamel pit defects and taurodontism. Ring chromosome 14 syndrome is an unusual condition with uncontrolled seizure disorder as its most significant finding; 47,XXX (trisomy X; triple X) is a more common condition and has characteristic physical and behavioral findings. Neither condition has been associated with enamel pit defects.

Deep Sedation Technique for Dental Rehabilitation of a Patient with Klippel-Feil Syndrome

Klippel-Feil syndrome (KFS) is a congenital anomaly characterized by a defect in the formation or segmentation of the cervical vertebrae, resulting in their fusion. The clinical triad of the syndrome consists of short neck, low posterior hairline, and limited neck movement, although fewer than 50 percent of patients demonstrate all three clinical features. The short neck and its immobility and instability present a significant challenge for endotracheal intubation. The purpose of this paper is to describe the management of a 13-year-old patient with KFS, extensive dental caries, and restricted mouth opening using a deep sedation technique in the operating room, which allowed successful completion of dental treatment.

[Not Available]

In a case report the stomatognathic rehabilitation of a patient with class III malocclusion and mandibular bilateral interdental gaps from the diagnosis and treatment planning through to the stepwise realization of the orthodontic, surgical and prosthetic treatment is presented. Explicit information about the proposed treatment, risks and the prospective outcome beforehand ensured the patient’s compliance during the extensive procedure.

Preformed crowns for decayed primary molar teeth

BACKGROUND

Crowns for primary molars are preformed and come in a variety of sizes and materials to be placed over decayed or developmentally defective teeth. They can be made completely of stainless steel (know as 'preformed metal crowns' or PMCs), or to give better aesthetics, may be made of stainless steel with a white veneer cover or made wholly of a white ceramic material. In most cases, teeth are trimmed for the crowns to be fitted conventionally using a local anaesthetic. However, in the case of the Hall Technique, PMCs are pushed over the tooth with no local anaesthetic, carious tissue removal or tooth preparation. Crowns are recommended for restoring primary molar teeth that have had a pulp treatment, are very decayed or are badly broken down. However, few dental practitioners use them in clinical practice. This review updates the original review published in 2007.

OBJECTIVES

Primary objectiveTo evaluate the clinical effectiveness and safety of all types of preformed crowns for restoring primary teeth compared with conventional filling materials (such as amalgam, composite, glass ionomer, resin modified glass ionomer and compomers), other types of crowns or methods of crown placement, non-restorative caries treatment or no treatment. Secondary objectiveTo explore whether the extent of decay has an effect on the clinical outcome of primary teeth restored with all types of preformed crowns compared with those restored with conventional filling materials.

SEARCH METHODS

We searched the following electronic databases: Cochrane Oral Health Group Trials Register (to 21 January 2015), Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library, 2014, Issue 12), MEDLINE via Ovid (1946 to 21 January 2015) and EMBASE via Ovid (1980 to 21 January 2015). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing trials and Open Grey for grey literature (to 21 January 2015). No restrictions were placed on the language or date of publication when searching the databases.

SELECTION CRITERIA

Randomised controlled trials (RCTs) that assessed the effectiveness of crowns compared with fillings, other types of crowns, non-restorative approaches or no treatment in children with untreated tooth decay in one or more primary molar teeth. We would also have included trials comparing different methods of fitting crowns.For trials to be considered for this review, the success or failure of the interventions and other clinical outcomes had to be reported at least six months after intervention (with the exception of 'pain/discomfort during treatment and immediately postoperatively').

DATA COLLECTION AND ANALYSIS

Two review authors independently assessed the title and abstracts for each article from the search results. and independently assessed the full text for each potentially relevant study. At least two authors assessed risk of bias and extracted data using a piloted data extraction form.

MAIN RESULTS

We included five studies that evaluated three comparisons. Four studies compared crowns with fillings; two of them compared conventional PMCs with open sandwich restorations, and two compared PMCs fitted using the Hall Technique with fillings. One of these studies included a third arm, which allowed the comparison of PMCs (fitted using the Hall Technique) versus non-restorative caries treatment. In the two studies using crowns fitted using the conventional method, all teeth had undergone pulpotomy prior to the crown being placed. The final study compared two different types of crowns: PMCs versus aesthetic stainless steel crowns with white veneers. No RCT evidence was found that compared different methods of fitting preformed metal crowns (i.e. Hall Technique versus conventional technique).We considered outcomes reported at the dental appointment or within 24 hours of it, and in the short term (less than 12 months) or long term (12 months or more). Some of our outcomes of interest were not measured in the studies: time to restoration failure or retreatment, patient satisfaction and costs. Crowns versus fillingsAll studies in this comparison used PMCs. One study reported outcomes in the short term and found no reports of major failure or pain in either group. There was moderate quality evidence that the risk of major failure was lower in the crowns group in the long term (risk ratio (RR) 0.18, 95% confidence interval (CI) 0.06 to 0.56; 346 teeth in three studies, one conventional and two using Hall Technique). Similarly, there was moderate quality evidence that the risk of pain was lower in the long term for the crown group (RR 0.15, 95% CI 0.04 to 0.67; 312 teeth in two studies).Discomfort associated with the procedure was lower for crowns fitted using the Hall Technique than for fillings (RR 0.56, 95% CI 0.36 to 0.87; 381 teeth) (moderate quality evidence).It is uncertain whether there is a clinically important difference in the risk of gingival bleeding when using crowns rather than fillings, either in the short term (RR 1.69, 95% CI 0.61 to 4.66; 226 teeth) or long term (RR 1.74, 95% CI 0.99 to 3.06; 195 teeth, two studies using PMCs with conventional technique at 12 months) (low quality evidence). Crowns versus non-restorative caries treatmentOnly one study compared PMCs (fitted with the Hall Technique) with non-restorative caries treatment; the evidence quality was very low and we are therefore we are uncertain about the estimates. Metal crowns versus aesthetic crownsOne split-mouth study (11 participants) compared PMCs versus aesthetic crowns (stainless steel with white veneers). It provided very low quality evidence so no conclusions could be drawn.

AUTHORS' CONCLUSIONS

Crowns placed on primary molar teeth with carious lesions, or following pulp treatment, are likely to reduce the risk of major failure or pain in the long term compared to fillings. Crowns fitted using the Hall Technique may reduce discomfort at the time of treatment compared to fillings. The amount and quality of evidence for crowns compared to non-restorative caries, and for metal compared with aesthetic crowns, is very low. There are no RCTs comparing crowns fitted conventionally versus using the Hall Technique.

[NONSURGICAL RECONSTRUCTION METHOD INTERDENTALLY PAPILLAE IN THE RESTATION OF APROXIMAL CAVITIES AS ONE OF THE STAGES OF REHABILITATION OF PATIENTS WITH GENERALIZAD PERIODONTITIS]

Reconstruction of missing papilla--the basis of modern concepts of objective treatment of dental diseases. Interproximal spaces are important anatomical structures, as are bulky in the mouth and repeated many times. Violation of relations between different structural elements increases the risk of inflammation in periodontitis. Patients with approximal caries posteriors and generalized periodontitis studied anthropometric parameters of the structures of the interdental spaces and their impact on the volume papilla before and after restoration, carried out with move a contact point to the apex. The results showed that the relationship between anthropometric data interdental had certain patterns in all groups surveyed. Important was a clear relationship between anthropometric indicators of basic elements of interdental spaces. In the absence of the interproximal papilla length (IPL) was on average 7.2 mm, the distance from the gingival margin to the proximal contact--3.9 mm and the horizontal distance between the roots at the enamel--cement border (HDR) reached 3.2 mm. Following the restoration with move a contact point to the apex to an average of 4.5 mm IPL, there was a significant increase in the interdental papillae. In the case of patients prior to treatment was determined by a thin biotype, the small width of attached gingival significant HDR--volume papilla week after restorations movement of the contact point to the root apex contact point is not increased. The results obtained require long-term studies for the possibility of forecasting the success of the restoration or preservation of the interdental papillae in the restoration of approximal cavities on the stages of rehabilitation of patients with generalized periodontitis.

Oral rehabilitation of a 4-year-old child with early childhood caries under general anaesthesia: a case report on long-term outcome

BACKGROUND

Young patients with early childhood caries (ECC) commonly undergo oral rehabilitation under general anaesthesia (GA), often because of problems with behaviour management. Children with a history of ECC are highly susceptible to the development of new caries, even after comprehensive oral rehabilitation.

CASE REPORT

The present paper reports the case of a female patient, aged 4.1 years, with ECC who was referred for treatment to the Department of Paediatric Dentistry of the Universitat Internacional de Catalunya. On account of the requirement for extensive dental treatment, and because of behaviour management problems, her dentition was restored under GA. A combination of restorative approaches and techniques was used, including the placement of composite resins, preformed metal crown restorations, extractions, and space maintainers. The patient was followed for 24 months, both clinically and radiographically. Conclusion This case reflects the need to provide adequate support to children at high risk for ECC, together with their families by developing more acceptable and effective biological and behavioural interventions in order to reduce caries relapse after oral rehabilitation under GA.

[Complete attendance of a caries risk patient]

An adult caries high risk patient reported to the clinic with acute complaint. After an adequate pain control patient was motivated to participate in the required periodontal, oral surgical, conservative dental and prosthodontic treatment. Based on her DMF-index scores, periodontal and plaque indexes, and high rates for Streptococcus mutans (CRT-test), and also her inappropriate diet deriving from her financial and social standing, the 38-year-old female patient was considered as a caries high risk patient. After oral hygienic instruction, motivation, supra and subgingival scaling, and extraction fillings and root canal treatments (including revisions as well) were carried out. Finally complete functional and esthetic rehabilitation have been fulfilled by fixed restorations. Caries is a widespread disease in Hungary, affecting 98,8% of the adult population. According to recent statistics despite an improving tendency, the application of many patients with the need of an entire dental rehabilitation is expected. Besides the importance of prevention and regular controls the treatment planning and the execution of a complete dental treatment remain a rather complex task even without the presence of any systemic diseases. The patients' co-operation may be obtained after a comprehensive medical history and by means of different methods (bacterial tests, plaque indexes etc.) which demonstrate the results, to assure a sufficient and longterm outcome.

Overdenture for total rehabilitation in a child with early childhood caries

The purpose of this case report was to present a clinical case of overdenture in a 3-year-old patient with early loss of his primary maxillary teeth, which were extracted due to the presence of early childhood caries. The treatment of choice was an overdenture using the Dalla Bona retention system, and the upper right canine was used as the retainer. The overdenture was placed to help maintain a normal daily diet that was satisfactory for the child and to re-establish masticatory function, speech, and facial aesthetics in the patient.

[Dissertations 25 years after date 30. Oral hygiene and dental hygienists]

In 1986 the thesis entitled 'Choosing for dental hygienists' was published in The Netherlands. It provided the scientific basis for the further development of the profession of dental hygienists in The Netherlands. Since then, the profession has developed very strongly. In the intervening years, qualified dental hygienists have come to be considered capable of taking over simple restorative treatments from dentists. As a result, treatment, especially in children, can largely be carried out by one person. Nevertheless, recent developments, such as the sharp increase in the number of new dental students, suggest that the re-allocation of responsibilities is proceeding slowly. This suggests that policy makers have not yet unambiguously opted for dental hygienists and prevention.

[System of therapy and prophylaxis of hard tooth tissues pathology in the group of pilots]

Survey of 77 males aged 22 to 55 including 43 pilots (main group), 24 non-flying employees (comparison group) and 10 essentially healthy men with sanitized oral cavity (control group) revealed caries in 100% members of groups 1 and 2. Prevalence of other than caries pathologies was higher in the group of pilots. Analysis of mixed unstimulated saliva showed calcium and phosphates reduction by half in 50% and 30% of pilots, respectively. Investigation of hair elemental composition displayed also deficiency of Ca and P in pilots. The authors recommend methods for dental rehabilitation as an indispensable part of medical care for flying personnel.

Porcelain laminate veneers: restorative management

This article presents the case of a young adult woman who presented with esthetic complaints years after conventional orthodontics. The treatment plan the patient ultimately selected was the placement of 10 indirect porcelain laminate veneers.

Early childhood caries and oral rehabilitation. A treatment quandary

Early childhood caries (ECC) is a virulent form of dental caries that can destroy the primary dentition of toddlers and preschool children. It occurs worldwide, afflicting predominantly disadvantaged children. Although Streptococcus mutans is the most likely causative agent, diet also plays a critical role in the acquisition and clinical expression of this infection. Early acquisition of S. mutans via vertical or horizontal transmission is a key event in the natural history of the disease that coupled with caries promoting feeding behaviours results in accumulation of these organisms to levels exceeding 30% of the total cultivable plaque flora, which in turn leads to rapid demineralization of the tooth structure. Inflicted children may also have other associated health problems, ranging from local infections to oral pain that manifest as difficulty in eating and sleeping, reduced growth and altered behaviour. Oral rehabilitation usually consists of restoration or surgical removal of carious teeth along with recommendations regarding feeding habits. Although treatment can be instituted in the dental clinic, it becomes costly sometimes when cooperative capacity of babies and preschool children necessitates the use of general anaesthesia. Primary prevention of ECC has largely been restricted to counselling parents regarding proper feeding behaviour, oral hygiene measures and new strategies that address the infectious component through use of topical antimicrobial therapy in order to defeat this common oral affliction.

Comprehensive oral rehabilitation with general anesthesia and prosthetic care in the primary dentition: a case report

This case report describes the oral rehabilitation of a 5-year-old male referred by a general dentist to a pediatric dentist due to acute psychological stress to dental treatment and extensive dental caries. The patient's dental restorations and extractions were completed under general anesthesia. Maxillary and mandibular prostheses were completed in the outpatient clinical setting. The treatment plan for this child provided options to improve appearance, self-image and oral function.

Tooth supported prosthetic rehabilitation in a 5-year-old child with early childhood caries

This paper reports the case of a 5-year-old patient with early childhood caries (ECC) and presents an alternative prosthetic treatment with a tooth-supported overdenture. Primary canines were endodontically treated and received intraradicular posts with ball-type attachments to attach a tooth-supported overdenture. The patient was followed for 18 months both clinically and radiographically. In addition to esthetic and functional oral rehabilitation, the prosthetic treatment had an important psychological impact on recovery of patient's self-esteem.

An alternative aesthetic restoration for extensive coronal destruction in primary molars: indirect restorative technique with composite resin

The indirect restorative technique with composite resin has presented efficient results when used in primary teeth. This technique enables the oral rehabilitation. Based on the results presented in the literature concerning clinical performance, this technique is presented as an alternative treatment to the primary teeth with extensive decay by showing a case of rehabilitation of primary molars. The oral rehabilitation using indirect resin composite restoration showed an important concept to be applied in primary dentition due to feasible, low cost, and lower chairside time.

Intracanal reinforcement fiber in pediatric dentistry: a case report

A technique for the restoration of carious primary maxillary incisors using indirect resin composite crowns and intracanal reinforcement fiber is described. Endodontic treatment was previously performed on each tooth. The advantages of using an intracanal reinforcement fiber include resin composite crown reinforcement, translucency, and relative manipulation facility. In addition, the use of indirect resin composite crowns provides good shape and esthetics, as well as reduced chair time for the child. The technique is illustrated in a case report in which indirect resin composite crowns and an intracanal reinforcement fiber are placed in a 3-year-old girl.

Biologic restoration of primary anterior teeth: a case report

Restoration of primary maxillary incisors, severely destroyed by trauma or caries is a commonly faced problem in a Pediatric dental clinic. Most cases are observed in children with early childhood caries. In the past, the only option would have been to extract the affected teeth and replace them with prosthetic substitutes. However, the availability of natural crowns and roots would allow the use of biologic restorations to preserve the integrity of patient's natural dentition as presented in this case report.

Perceived outcomes and parental satisfaction following dental rehabilitation under general anesthesia

PURPOSE

The objective of this study was to evaluate parents' perceptions of their child's quality of life following dental rehabilitation under general anesthesia and to assess their satisfaction with that treatment modality.

METHODS

A survey was sent to 400 parents of patients who had undergone dental rehabilitation. Quality of life outcomes, such as continued presence of pain and inability to eat or sleep, were assessed. Additionally, parental satisfaction with outcomes and processes was evaluated, as was outcome expectation. Descriptive statistics were collected on outcome measures. Contingency testing was employed to compare outcomes by medical or developmentally compromising conditions, gender, or continued use of the initial treatment facility for routine care.

RESULTS

Fifty seven percent of parents returned surveys. A descending hierarchy of improved treatment outcomes was noted, with improvement in pain the predominant outcome, followed by improved abilities to eat and sleep, reported by 86, 69, and 41% of parents, respectively, 72% perceived an improvement in their child's health. Children with medically or developmentally compromising conditions were significantly more likely to have improved abilities to eat and sleep, and had a significantly improved overall health status. Satisfaction and expectations were consistently achieved and were not related to continued use of the initial treatment facility.

CONCLUSIONS

Children with early childhood caries receiving comprehensive treatment under general anesthesia achieved improvements in their quality of life as well as overall health. A hierarchy of improvement was noted, with the greatest improvement noted in pain experience followed by improved abilities to eat and sleep. Parents were overwhelmingly satisfied with outcomes and the process of care, and reported that their expectations had been met.

Composite crown-form crowns for severely decayed primary molars: a technique for restoring function and esthetics

Current developments in esthetic dentistry center around new techniques and materials that improve the ability of the clinician to provide esthetic services. This article describes a step-by-step method of placing composite crown-form crowns on severely decayed primary mandibular molars. The described technique allows for restoring, as close as possible, form and function lost to caries in an esthetic mode in cases of severely decayed primary molars that would have required stainless steel crowns had they been treated traditionally. Disadvantages of this treatment mode are that dryness may not be prevented in the proximal margins, especially where subgingival carious involvement is encountered and the margin areas may be contaminated with gingival fluid or blood. Although no long-term follow-up has been reported for the technique, when strong opposition by the parent or child to the stainless steel crown is encountered, and a desire for esthetic restoration is strongly expressed, the composite crown-form crowns may be considered as an alternative.

The effect of dental rehabilitation on the body weight of children with early childhood caries

PURPOSE

The purpose of this study was to determine the effect of comprehensive dental rehabilitation on the percentile weight and percentile growth velocity of children with early childhood caries (ECC).

METHODS

The percentile weight categories of children with noncontributory medical histories and ECC were compared to caries free comparison patients, before and after comprehensive dental treatment under general anesthesia.

RESULTS

Prior to dental rehabilitation, test subjects' percentile weight categories were significantly less than that of comparison counterparts (P < 0.001). Of the ECC patients, 13.7% weighed less than 80% of their ideal weight, thereby satisfying one of the criteria for the designation of failure to thrive, while none of the comparison patients did so (P < 0.05). Following therapeutic intervention, ECC children exhibited significantly increased growth velocities through the course of the follow-up period (P < 0.001), reflecting the phenomenon of catch up growth. The average length of follow-up for the test and comparison groups were 1.58 and 1.36 years, respectively. At the end of the follow-up period there were no longer any statistically significant differences noted in the percentile weight categories of the test and comparison groups.

CONCLUSION

Comprehensive dental rehabilitation resulted in catch-up growth, such that children with a history of nursing caries no longer differed in percentile weights from comparison patients.

The effect of dental rehabilitation on the body weight of children with failure to thrive: case reports

Four case reports of children with nursing caries and failure to thrive are presented. Without regard to the condition of the dentition, the various cases could be classified as organic, mixed, or nonorganic in etiology. After dental rehabilitation, all patients exhibited an acceleration of weight velocity that resulted in weights above the 5th percentile. During the period of observation, the weight velocity continued to increase with time, consistent with the "catch-up" phenomenon of growth that is observed in nutritionally deprived children.

Clinical performance of resin-bonded fixed partial dentures and extracoronal attachments for removable prostheses

STATEMENT OF PROBLEM

It is important to evaluate the long-term clinical performance of resin-bonded fixed partial dentures and extracoronal attachments for removable prostheses.

PURPOSE

A prospective, long-term clinical study was conducted to evaluate the success of resin-bonded fixed partial dentures since 1985 and of resin-bonded extracoronal attachments from 1987.

METHODS

Until 1993, a total of 130 resin-bonded fixed partial dentures had been seated in 101 patients, as well as 12 removable partial dentures (RPDs) with 24 extracoronal retainers in 10 patients. The clinical treatment protocol and the laboratory procedures were standardized. By the end of 1993, it was possible to reexamine 98 patients with a total of 127 resin-bonded fixed partial dentures and all 10 patients with removable partial dentures. The average time in function for the resin-bonded fixed partial dentures at the time of examination was 3.4 years and 2.3 years for the removable restorations.

RESULTS

During the period of observation, one retainer failed on six of the resin-bonded fixed partial dentures, which represents a failure rate of 4.7%. Debonding of extracoronal attachments was recorded for 8.3% of the total number of retainers.

CONCLUSION

The resin-bonded fixed partial denture technique can be considered to be a clinically reliable method of treatment, and permits the expansion of indications beyond a classical three-unit resin-bonded fixed partial denture. Long-term clinical success of removable partial dentures with resin-bonded extracoronal retainers warrants additional clinical studies.

[A finely dispersed copper alloy for amalgams--a prospective filling material in pediatric dentistry. II. Clinical research]

The authors assess clinical efficacy and possibility of using finely dispersed copper alloy for CMTA amalgam in dentistry. They compare their results with the data of clinical trials of tableted cooper amalgam TMAC-01 which is commercially manufactured at present. CMTA cooper amalgam was found preferable to TMAC-01 amalgam at all stages of carious process compensation in children due to its better strength, increased color stability, and corrosion resistance. This material is recommended for pedodontics for filling carious cavities of the first, second, and fifth class in deciduous molars.

[The frontal bonding of a microprosthesis with respect to arch physiognomy]

A series of 4124 patients who presented at the Gnathoprosthetic Clinic of Iasi with dental coronary lesions were investigated. The dental lesions situated at the level of frontal arches, the possibilities of aggregating the microprostheses at this level and the clinical-technical procedure of realizing them were studied. By the joint efforts of the entire dental team, artificial substitutes completing the lack of dental substance were obtained and the physiognomic function, cosmetic harmony and facial esthetics were fully restored.