Boucher\\\\\\\\\\\\'s Prosthodontic Treatment For Edentulous Patients (11th Edition) [BEST] Download Pdf

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Covering the functional and esthetic needs of edentulous patients, Prosthodontic Treatment for Edentulous Patients: Complete Dentures and Implant-Supported Prostheses, 13th Edition helps you provide complete dentures, with and without dental implant support. It addresses both the behavioral and clinical aspects of diagnosis and treatment and covers treatment modalities including osseointegration, overdentures, implant-supported fixed prosthesis, and the current and future directions of implant prosthodontics. New to this edition are full-color photographs and coverage of immediately loaded complete dental prostheses. From lead editor and respected educator George Zarb, Prosthodontic Treatment for Edentulous Patients provides an atlas of clinical procedures and emphasizes the importance of evidence-based treatment.

The dental health and care of older people is often inadequate.1 Although the prevalence of edentulousness is falling it is still common in the very old, with 57% of UK adults aged 75 years or more edentate.2 Functional and social handicaps are frequently reported by edentate people, for example 41% of complete denture wearers had a dentally related complaint in the recent UK Adult Dental Health Survey.1,2,3,4 Unfortunately many older people become caught between the impact of having no or inadequate dentures, the hardship of meeting the cost of treatment and reduced mobility to attend the dentist.

Boucher\\\\\\\\\\\\'s Prosthodontic Treatment for Edentulous Patients (11th Edition) download pdf

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There is very little evidence as to the effectiveness of domiciliary dental care. In one uncontrolled study oral function improved with dental treatment in a cohort of older handicapped people, most of whom were edentulous.9 More recently, studies using validated quality of life measures have assessed the impact of new prostheses on the oral health related quality of life (OHQoL) of edentate patients.10,11,12,13,14,15 Most studies have compared outcomes from implant retained mandibular overdentures against conventional complete dentures. Non-randomised studies have reported improved OHQoL for participants who received new conventional complete dentures.11,14

The research dentist was trained and calibrated to a consultant prosthodontist for the measures of denture quality and oral anatomy. Intra-observer reliability was tested using Cohen's kappa on 36 edentulous patients and found to be acceptable in a pilot study before the start of the trial. All values of kappa were greater than 0.81 except lower retention (0.61). Follow up examinations with the consultant prosthodontist were arranged for a convenience sample (fitting around both dentists' and the patients' availability) of 20% of the study group to validate the quality of the new dentures. Agreement was measured using Cohens's kappa.

These participants had a high need for treatment. Three quarters of participants reported an oral impact from their oral condition at baseline whilst in the National Diet and Nutrition Survey (NDNS) the prevalence of oral impacts in participants who needed full dentures was only 28%. Although the total scores for OIDP were relatively low they exceeded population-based scores in the NDNS for adults aged 65 years and over.1 These differences reflect the expressed need of the participants and are compatible with other studies where older patients seeking care have higher levels of handicap or worse oral health than non-patient samples.32,33 Additionally, the dentures in this study had more faults than those in the in the NDNS.

Quality of life is a dynamic construct that can change within an individual if their internal standards of measurement or values change.35,36 Interventions that induce an adaptive response shift might compliment any gains in oral health related quality of life over and above those that would be achieved by the new dentures alone. The success of complete denture therapy lies in managing the patient's expectations, understanding their concerns and providing adequate support for them as they learn to adapt to their dentures, not just on the technical quality of the dentures.19,37,38 In this study, open and honest communication was encouraged between patients and the clinician throughout treatment and at follow up. The denture making process was fully explained and patients were informed of what were realistic outcomes from their dentures considering the condition of their oral tissues.

Oral health is an important factor in maintaining health and quality of life in frail older people.32,41,42 Randomised controlled trials provide the gold standard of evidence as to the effectiveness of an intervention.43 This study demonstrated that a domiciliary denture service improved oral health related quality of life of housebound edentulous elders. Access and availability of dental domiciliary services for disabled older people is poor.7,44,45 There is a need for primary care trusts to invest in domiciliary denture care services and more research is required into the effectiveness of other dental treatment in the domiciliary setting.

Purpose and Aim: The aim of this study was to evaluate the reliability of hamular notch-incisive papilla (HIP) plane as an anatomical landmark in establishing occlusal plane in edentulous subjects. Materials and Methods: Seventy subjects were selected from the South Indian population, of which 50 were dentulous and 20 were edentulous. Dental stone casts were fabricated for dentulous and edentulous subjects. Dental stone casts of the dentulous and edentulous subjects, along with occlusal rims were analyzed using the three-dimensional analyzing machines. The angles between the occlusal planes and HIP plane were determined using the reference coordinate system based on characteristic points in the dentition on the cusp tips in dentulous casts and on maxillary occlusal rim on edentulous casts. Results: The HIP plane tends to be parallel to the occlusal plane. There is no statistical difference between sexes. Conclusion: The HIP plane is parallel to the natural occlusal plane and can be used as a reference plane to re-establish the occlusal plane in edentulous patients.

Orientation of the occlusal plane is lost in patients rendered edentulous and should be relocated if complete dentures are to be esthetic and functional. It is difficult to find the optimal position of occlusal plane in every edentulous patient using the reported soft tissue landmarks. [sup][22] Improper use of these landmarks may compromise the functional and esthetic result of the intended prosthetic rehabilitation. [sup][23],[24],[25],[26]