Prosthodontic Treatment Plan Research Articles

Comparative Analysis of the Mechanical Properties and Biocompatibility between CAD/CAM and Conventional Polymers Applied in Prosthetic Dentistry.

Modern media often portray CAD/CAM technology as widely utilized in the fabrication of dental prosthetics. This study presents a comparative analysis of the mechanical properties and biocompatibility of CAD/CAM (Computer-Aided Design/Computer-Aided Manufacturing) polymers and conventional polymers commonly utilized in prosthetic dentistry. With the increasing adoption of CAD/CAM technology in dental laboratories and practices, understanding the differences in material properties is crucial for informed decision-making in prosthodontic treatment planning. Through a narrative review of the literature and empirical data, this study evaluates the mechanical strength, durability, esthetics, and biocompatibility of CAD/CAM polymers in comparison to traditional polymers. Furthermore, it examines the implications of these findings on the clinical outcomes and long-term success of prosthetic restorations. The results provide valuable insights into the advantages and limitations of CAD/CAM polymers, informing clinicians and researchers about their suitability for various dental prosthetic applications. This study underscores the considerable advantages of CAD/CAM polymers over conventional ones in terms of mechanical properties, biocompatibility, and esthetics for prosthetic dentistry. CAD/CAM technology offers improved mechanical strength and durability, potentially enhancing the long-term performance of dental prosthetics, while the biocompatibility of these polymers makes them suitable for a broad patient demographic, reducing the risk of adverse reactions. The practical implications of these findings for dental technicians and dentists are significant, as understanding these material differences enables tailored treatment planning to meet individual patient needs and preferences. Integration of CAD/CAM technology into dental practices can lead to more predictable outcomes and heightened patient satisfaction with prosthetic restorations.

Validation and Analysis of an Integrated Device for Recording Bite Force and Masseter Muscle Activity in Dentate Participants: An Observational Study

Introduction: The success of any prosthetic rehabilitation depends on acceptable occlusion and muscle coordination. Occlusal therapy should be an integral part of restorative and prosthetic treatment. A thorough diagnosis of bite force and muscle activity is required to ensure the patient’s masticatory function and comfort. The current system of digitisation lacks devices for the simultaneous evaluation of muscle activity and occlusal bite force, representing a significant limitation in understanding and managing restorative and rehabilitation therapy. Aim: To assess the efficacy of an ingeniously designed integrated device that records occlusal bite force and muscle activity. Materials and Methods: An observational study was conducted among 112 healthy volunteers in the Department of Prosthodontics at Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India, for a period of one month and 45 days, from February 5, 2024 to March 20, 2024. The study aimed to validate the efficacy of a device designed to record bite force and muscle action potential simultaneously. The device consists of two key components: a square Forcesensitive Resistor (FSR) that records changes in resistance in response to applied force and a MyoWare 2.0 muscle sensor with Arduino (Advancer Technologies) for measuring the electrical activity of muscles. Study participants, aged between 21 and 35 years, were seated in an upright position. Muscle activity was recorded with surface electrodes placed on the masseter region, following Surface Electromyography for the Non Invasive Assessment of Muscles (SENIAM) guidelines, while a ground electrode was placed on the neck. Maximum Bite Force (MBF) was measured by placing intraoral pressure sensors, with recordings taken in maximum intercuspation three times, spaced one minute apart for each recording. Both muscle activity and bite force were recorded simultaneously. The Pearson’s correlation coefficient was used to evaluate the correlation between bite forces and muscle action potential with standard average values. Results: The results revealed a strong positive correlation between the masseter muscle activity action potential and the bite force values of the right molar (r=0.964, p<0.001), left molar (r=0.980, p<0.001) and incisor (r=0.550, p=0.002). Conclusion: The device synergistically records muscle activation patterns and bite force distribution, displaying the values in an integrated digital interface. The results of the study reveal that this device can serve as a diagnostic tool in prosthodontic treatment planning.

Evaluation of the Resting Tongue Position in Partially Dentate and Completely Edentulous Patients

Background The human tongue plays a critical role in various oral processes and its position can be significantly affected by dental status, particularly in partially dentate and completely edentulous patients. Understanding the relationship between tongue position and dental status is essential for optimal prosthodontic treatment and patient quality of life. Objective This study aimed to evaluate the differences in the resting tongue position between partially dentate and completely edentulous patients and to understand how these differences could influence prosthodontic treatment strategies. Methods A descriptive cross-sectional study was conducted at the Institute of Dentistry, Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad, from 02-02-2021 to 30-11-2022. The study included 400 patients, divided into partially dentate (200 patients) and completely edentulous (200 patients) groups. Patients were further classified based on gender, age, and Kennedy classification. The tongue position was categorized as normal upper, normal lower, abnormal upper, and abnormal lower. The data was analyzed using SPSS version 22.0, with a significance level set at p≤0.05. Results In the partially dentate group, 57% and 63% were males in Group A and B, respectively, while 43% and 37% were females. In the completely edentulous group, males constituted 50% and 43% in Group A and B, respectively, with females making up the remaining percentages. Age-wise, 63% of partially dentate patients in both groups were aged 35-45, compared to 6% and 12.1% in the completely edentulous groups. Kennedy classification showed varying distributions with Class 2 being most prevalent in partially dentate Group B (43%). Tongue position analysis revealed that normal upper position was present in 28% of partially dentate and 16% of completely edentulous patients, with a statistically significant difference (P < 0.001). Abnormal upper position was noted in 36% of partially dentate and 38% of completely edentulous patients. Conclusion The study concluded significant differences in tongue positions between partially dentate and completely edentulous patients. These findings underscore the importance of considering tongue position in prosthodontic treatment planning, especially for completely edentulous patients.

Comparative Evaluation of Condylar Guidance Angles Measured Using Arcon and Non-Arcon Articulators and Panoramic Radiographs-A Systematic Review and Meta-Analysis.

The condylar guidance value (CGV) measurement constitutes an important part of a holistic prosthodontic treatment plan, with horizontal CGVs (HCGVs) and lateral CGVs (LCGVs) being two of the most prominently recognized. This systematic review aimed at evaluating the efficacy of two different types of CGV measurement protocols-articulators (both arcon and non-arcon) and panoramic radiographs. Additionally, it attempts to determine which of the mentioned methods performs better across several parameters. Several important web databases were searched using search terms derived from medical subject headings (MeSH), using keywords linked to "Arcon articulator", "Condylar guidance angle", "non-arcon articulator", "Panoramic x-ray" and "Radiographic examination", which constituted the first step in the study selection strategy. After completion, the search strategy which initially turned up to 831 papers, eventually ended up with 13 studies. The review and subsequent meta-analysis revealed that panoramic radiographs had noticeably greater efficacy in terms of the CGVs as compared to the articulators in the majority of the studies. Within the articulators, the arcon types recorded slightly higher CGVs than the non-arcon variety owing to the precision of jaw movement simulation in the former. However, further studies are required to validate these findings and establish more precise guidelines for the use of CGV measurement protocols in prosthodontic practice.

Facial Scanners in Dentistry: An Overview

Purpose: This narrative review aims to explore the current status of facial scanning technology in the dental field; outlining the history, mechanisms, and current evidence regarding its use and limitations within digital dentistry. Methods: Subtopics within facial scanner technology in dentistry were identified and divided among four reviewers. Electronic searches of the Medline (PubMed) database were performed with the following search terms: facial scanner, dentistry, prosthodontics, virtual patient, sleep apnea, maxillofacial prosthetics, accuracy. For this review only studies or review papers evaluating facial scanning technology for dental or medical applications were included. A total of 44 articles were included. Due to the narrative nature of this review, no formal evidence-based quality assessment was performed and the search was limited to the English language. No further restrictions were applied. Results: The significance, applications, limitations, and future directions of facial scanning technology were reviewed. Specific subtopics include significant history of facial scanner use and development for dentistry, different types and mechanisms used in facial scanning technology, accuracy of scanning technology, use as a diagnostic tool, use in creating a virtual patient, virtual articulation, smile design, diagnosing and treating obstructive sleep apnea, limitations of scanning technology, and future directions with artificial intelligence. Conclusions: Despite limitations in scan quality and software operation, 3D facial scanners are rapid and non-invasive tools that can be utilized in multiple facets of dental care. Facial scanners can serve an invaluable role in the digital workflow by capturing facial records to facilitate interdisciplinary communication, virtual articulation, smile design, and obstructive sleep apnea diagnosis and treatment. Looking into the future, facial scanning technology has promising applications in the fields of craniofacial research, and prosthodontic diagnosis and treatment planning.

Revisiting maxillary implant overdentures in 2022: A topic review

The challenge for general dental practitioners to provide maxillary implant overdenture treatment for their patients is complicated by multiple, diverse parameters, compared to mandibular implant overdentures. This topic review on maxillary implant overdentures takes into consideration the specifications and challenges of different prosthodontic treatment options for clinicians in 2022. A broad search of the published literature was performed using MEDLINE and PubMed to identify pertinent articles published in English from 1990 to 2021. From an original total of 1176 titles, 106 references were selected. They were reviewed and categorized with respect to seven factors related to the prosthodontic design. These were interarch restorative space, implant number, implant distribution and spread, overdenture base reinforcement, palatal coverage, selection of attachment system and splinted/unsplinted prosthodontic designs. They influence clinical and patient outcomes in terms of implant and prosthesis success, support, retention, prosthodontic maintenance and satisfaction. Maxillary implant overdentures are a reliable treatment option for general dental practitioners, once competent with mandibular overdentures. The decision for adequate treatment for each individual patient is influenced by a diversity of parameters with clinicians needing to have a thorough knowledge and understanding of the anatomic obstacles, facial aesthetics, phonetics, and complete denture principles for essential pre-surgical and prosthodontic treatment planning. Currently there is no optimal number of implants, nor preferred attachment system, regardless of palatal coverage design. There are emerging trends of more evidence for use of reduced number of unsplinted implants simplifying procedures for general dental practice.

Custom fabricated castable ball attachments for Tooth- supported Overdenture

Preservation of what is remaining is the primary goal for any prosthodontic treatment plan. In elderly patients with few remaining teeth, Instead of extraction, a clinician can preserve and utilise the remaining teeth as abutments for an overdenture. The main advantages of a conventional tooth supported overdenture are the preservation of the remaining tooth structure along with its proprioception, preservation of the alveolar bone, additional support to the dentures and above all, the psychological advantage to the patient that they still have their own teeth. The concept of overdentures may not be an elixir, but it is a positive means for delaying the process of complete edentulism and helps in the preservation of bone. A step by step clinical case is presented here which describes the intricacies of tooth supported overdenture.

THE PROSTHODONTIC TREATMENT OF THE MANDIBLE EDENTULOUSNESS. CLINICAL CASE

The article presents a clinical case of the prosthodontic treatment of the mandible edentulousness.
 Edentulousness is a widespread pathology that depends on the social and economic situation in the country, the demographic situation, the level of dental care and prevention organization. The current worldwide trend of population aging leads to an increase in the number of the elderly, and this number is expected to increase in the future. According to the WHO, today about 600 million people are people over 60, and this number will have doubled by 2030 and will constitute 2 billion in 2050 mostly in developed countries. The situation in Ukraine is not better.
 Functional and aesthetic rehabilitation of patients with edentulousness requires a comprehensive approach to the prosthodontic treatment planning. Complete removable laminar dentures on the mandible have a number of disadvantages. Insufficient fixation, stabilization, diction problems, aesthetic problems, decreased self-esteem of the patient are among the key ones. Modern protocols of the prosthodontic treatment require the manufacture of dental prostheses based on intraosseous dental implants.
 Complete dentures based on intraosseous dental implants have a number of advantages over the fixed dentures. Compensation for deficient bone support of the facial soft tissues occurs by means of the basis. Patients’ possibility to remove a secondary restoration by themselves lead to proper hygiene of the oral cavity and peri-implant area in particular.
 The clinical research conducted by S. Wolfart (2016) showed the possibility of fixed/removable dental prosthesis fixation in 14-31 days (early loading) after the surgical stage of implantation provided that 4-6 intraosseous dental implants were installed. The maximum mobilization of the patient to comply with the recommendations and prescriptions is the main task considering the limited postoperative period before the dental prosthesis fixation.
 Our publication describes the treatment of a patient born in 1967, who was diagnosed with a mandible complete absence of teeth. Diagnosis, examination and treatment were performed on the basis of the Department of Dentistry Postgraduate Education of Ivano-Frankivsk National Medical University.
 The described prosthodontic treatment plan involves the manufacture of a complete denture with bar system based on four intraosseous dental implants according to the early loading protocol in a patient with primary treatment of mandible edentulousness.
 The choice of treatment plan was based on the results of past medical history, the patient’s disease, basic and additional methods of examination, analysis of individual indications and contraindications and readiness for the selected treatment plan.
 This treatment protocol has its advantages over the protocol of manufacturing a fixed prosthesis based on intraosseous dental implants such as a higher level of proprioceptive sensations, increased level of hygiene, lower complexity of clinical and laboratory stages, affordability.
 The term of clinical and laboratory stages of manufacturing (from the surgical stage of implant treatment to the fixation of the dental prosthesis) constituted 16 days.
 Additional opportunities for success in clinical and laboratory stages of treatment, the accuracy of manufacture and minimization of complications in the future were created as a result of the combination of digital and analog treatment methods in dental prosthesis manufacturing.

The impact of occluding pairs on the chewing patterns among the elderly

ObjectivesThis study aims to investigate the impact of occluding pairs (OPs) on chewing strokes, chewing time, mealtime duration, and bite force in an aging population. MethodsThe 100 participants included 52 women and 48 men with average age of 71.2 years. The subjects were restricted to those who can eat what they wanted and had no temporomandibular joint disorder (TMD) and dysphagia history; their OPs were counted in the posterior occlusal support zone in accordance with the Eichner classification. Free habitual mastication of a cornstarch cookie was analyzed by recording the number of chewing strokes and the amount of time needed for complete mastication. Strokes were counted by considering the opening and closing mandibular movements. Mealtime was defined as the time spent to finish a lunchbox and accomplish swallowing. Bite force was estimated with a T-Scan III®. A linear regression analysis was used to evaluate the impact of the OPs on the chewing strokes, chewing time, mealtime duration, and bite force. ResultsIn this study, 76% of the participants had 4 OPs and 12% participants had 3 OPs. Increasing the OPs significantly shortened the chewing time and mealtime duration (P = 0.02). The mealtime duration did not notably affect the chewing time (P = 0.237). There was significant association between OPs and bite force (P < 0.0001). ConclusionsIn elderly, increasing OPs significantly raised the bite force and shortened the chewing time and strokes. More OPs might be the key to maintain good chewing function. Clinical significanceAmong the elderly, increasing OPs significantly raised the bite force and shortened the chewing time and mealtime duration. To provide better chewing function, good oral hygiene is important to maintain as many OPs as possible; how to gain more OPs is essential concern in the prosthodontic treatment plan making.

Implementation of a surgical safety checklist for dental implant surgeries in a prosthodontics residency program

Statement of problemSurgical safety checklists are commonly used in medical surgery to reduce errors, yet they are rarely used in the dental office. Presently, research on the implementation of surgical safety checklists in implant dentistry and user adherence is lacking. PurposeThe primary purpose of this quality assessment study was to evaluate user compliance by using a surgical safety checklist for dental implant surgeries in a postgraduate prosthodontics program at the University of Connecticut School of Dental Medicine. The secondary purpose was to identify and analyze the nature, number, and frequency of omitted items on the surgical safety checklist. Material and methodsAll surgical safety checklists completed by 8 prosthodontic residents from 120 dental implant surgeries over the course of 1 academic year were collected as part of the program's quality assessment. Each surgical safety checklist contained 12 preoperative items and 14 postoperative items, giving a total of 26 items to be analyzed for each dental implant surgery. The collected data were then analyzed for user compliance, as well as the nature, number, and frequency of omitted items. ResultsSurgical safety checklists from 120 dental implant surgeries encompassing 262 implants were accessed for the academic year cycle from July 2017 to June 2018. There were 6 additional dental implant surgeries whose checklists were inaccessible. There was a 100% compliance rate for surgical safety checklist completion by all 8 prosthodontic residents across 120 dental implant surgeries. Within the checklists, the rate of incomplete responses or omissions was 2.4% (n=77). The 5 most commonly omitted items on the checklist by residents were preoperative photographs (0.29%), postoperative analgesics or steroids (0.26%), preoperative oral antiseptic rinse (0.22%), postoperative prescriptions (0.19%), and signed prosthodontic treatment plan forms (0.16%). ConclusionsThere was excellent compliance with the implemented dental implant surgical safety checklist across 8 prosthodontic residents, and the number of omitted items was small. Surgical safety checklists appear to be a straightforward method of helping prosthodontic residents in their dental implant surgical training to provide consistent and high-quality safe treatment for patients.

A Prosthodontic Treatment Plan for a Saxophone Player: A Conceptual Approach.

Introduction: A wind instrumentalist was diagnosed with a periapical lesion on tooth 21. The prosthetic rehabilitation options were considered with respect to the embouchure mechanism of the saxophonist. The underlying mechanism associated with the embouchure of the saxophone player was observed in this particular case in order to understand if asymmetrical forces were transmitted to the upper central incisors. Periapical lesions can be harmful to the oral health of musicians. The treatment options thus have to be taken into consideration with special focus on the need for oral rehabilitation on the anterior maxilla. Material and Methods: The patient underwent a radiographic examination with a panoramic X-ray. Subsequently, two piezoresistive sensors (FlexiForce™) were placed on the upper surface of the mouthpiece in order to quantify the pressure applied to the central incisors during the embouchure. In order to understand the values involved during this procedure, the saxophone player was required to play three different notes at different pitches: high, medium, and low. This procedure was repeated three times for each pitch in order to obtain a medium value for each note. Signal acquisition was obtained within software developed for this purpose, with the voltage output observed in LabView 2011®. Results: The panoramic X-ray showed a periapical lesion with the characteristics of a radicular cyst on tooth 21. The FlexiForce™ piezoresistive sensors allowed us to find that greater force (kg) was being applied to tooth 11 in comparison to tooth 21 during the embouchure mechanism. Conclusions: The sensors used in this research are acceptable for identifying the tooth where the greatest pressure is applied during the mouthpiece stabilization. In the case of executing an oral rehabilitation procedure for wind instrumentalists, a clinical examination can be complemented with the aid of bioengineering and the inherent development of sensor technology in order to better understand the embouchure mechanism. Likewise, the prosthetic rehabilitation should be taken into consideration in order to provide minimal changes to the musician’s performance.

A Simplified Method to Identify Patient Face Type for a Prosthodontic Treatment Plan

A Simplified Method to Identify Patient Face Type for a Prosthodontic Treatment Plan

Postoperative irradiation after implant placement: A pilot study for prosthetic reconstruction.

PURPOSEOn maxillofacial tumor patients, oral implant placement prior to postoperative radiotherapy can shorten the period of prosthetic reconstruction. There is still lack of research on effects of post-implant radiotherapy such as healing process or loading time, which is important for prosthodontic treatment planning. Therefore, this study evaluated the effects of post-implant local irradiation on the osseointegration of implants during different healing stages.MATERIALS AND METHODSCustom-made implants were placed bilaterally on maxillary posterior edentulous area 4 weeks after extraction of the maxillary first molars in Forty-eight Sprague-Dawley rats. Experimental group (exp.) received radiation after implant surgery and the other group (control) didn't. Each group was divided into three sub-groups according to the healing time (2, 4, and 8 week) from implant placement. The exp. group 1, 2 received 15-Gy radiation 1 day after implant placement (immediate irradiation). The exp. group 3 received 15-Gy radiation 4 weeks after implant placement (delayed irradiation).RESULTSThe bone mineral density (BMD) was significantly lower in the immediate irradiation groups. BMD was similar in the delayed irradiation group and the control group. The irradiated groups exhibited a lower bone-to-implant contact ratio, although the difference was not statistically significant. The irradiated groups also exhibited a significantly lower bone volume and higher empty lacuna count than the control groups. No implant failure due to local irradiation was found in this study.CONCLUSIONWithin the limits of this study, the timing of local irradiation critically influences the bone healing mechanism, which is related to loading time of prostheses.

Pre-Definitive Prosthodontic Treatment with Rehabilitation Devices

AbstractIn prosthodontic treatment plan, decisions must be made regarding oral tissue rehabilitation and other necessary pre-prosthetic measures. The rehabilitation prostheses are very useful devices in the field of prosthodontics. It is essential that the mouth should be in an optimal state of health prior to commencing prosthetic treatment and failure to achieve this may produce an unsatisfactory treatment result. Depending on a variety of situations, the dentist may find it necessary to modify the patient's existing dentures or, occasionally, to construct a special appliance. This article deals with several preliminary (non-definitive) treatment options available along with a brief account of their rationale.

Understanding Kaplan-Meier and Survival Statistics

This paper aims to explore the mathematics of Kaplan-Meier and survival statistics, explain how the mathematics are relevant for prosthodontic treatment planning, and provide advice for future presentation of such data. The mathematics of the Kaplan-Meier and related survival statistic formulas were explored with hypothetical data consisting of 100 prostheses, reviewed yearly for 10 years. The hypothetical impact of failures (n = 1, 2, 9, or 0) and censored data (n = 5, 9, or 10) were reviewed across three life tables and survival curves. Actual published data of 304 porcelain veneers, reviewed regularly for 16 years, were similarly utilized. The impact of changing the number of failures and censored data on the estimated cumulative survival (ECS) and the standard error (SE) was reviewed across two life tables and survival curves. The ECS and SE are calculated from two data figures: the number of failures that occurred during an interval and the number of prostheses at risk during that same interval. The ECS reduces and its SE enlarges when prostheses fail. These results can also change if prostheses are lost from the study (censored). However, the number of failures is in the numerator of the equation. Therefore, if no failures occur, loss of prostheses from the study cannot change the ECS or the SE. This can dramatically affect the calculated ECS and SE if a prosthesis becomes lost to follow-up rather than presenting as a failure. The hypothetical and actual data were used to explore these concepts. Current techniques for analysis of time-to-event data are imperfect and can be misleading. It therefore behooves authors to strive to improve reporting transparency, journals to support such industry, and readers to remain mindful that the cumulative survival is an estimate, ie, a reflection of reality.

Preprosthetic Orthodontic Intervention for Management of a Partially Edentulous Patient with Generalized Wear and Malocclusion

Prosthodontic management of patients with generalized wear of dentition has been well documented in the literature. Although prosthodontic treatment is designed to correct minor malocclusion and interdental spacing, patients with severe malocclusion accompanied by generalized wear may require preprosthetic orthodontic intervention. Few articles have described the comprehensive treatment of adult orthodontic patients with severe wear of teeth. This article describes the multidisciplinary management of an adult patient with multiple missing posterior teeth, malocclusion, and severe wear of anterior teeth. Preprosthetic orthodontic treatment was planned using occlusograms, visualized treatment objective, and sectioned diagnostic waxing for movement of teeth, according to the prosthodontic treatment plan. Temporary anchorage devices were used to accomplish complex orthodontic tooth movements. The definitive treatment included reestablishing appropriate esthetics, and occlusion and restoration of the entire maxillary arch and posterior mandibular dentition with metal ceramic and full gold restorations. At a 2.5-year follow-up, positions of teeth and integrity of the restorations remained stable. Importance of preprosthetic orthodontic treatment and challenges in management of complex esthetic and functional rehabilitations are discussed in this article.

Concrescence of Erupted Second Molar and Impacted Third Molar: A Rare Case Report

Concrescence represents an uncommon developmental anomaly in which juxtaposed teeth are united in the cementum but not in the dentin. The incidence of concrescent teeth is reported to be highest in the posterior maxilla. The presence of concrescent teeth may influence teeth extraction as well as periodontal, endodontic, orthodontic and even prosthodontic diagnosis and treatment planning. Unexpected complications arising from this condition may lead to legal complications. Therefore, consideration should be given to the possible occurrence, recognition, and implications of this anomaly in diagnosis and treatment planning.The purpose of this article is to report a case of teeth concrescence between an impacted third molar and an erupted second molar with grade III mobility that was identified post-extraction, with a review of literature.

Prosthetic and Surgical Managements of Peri-implantitis at the Flap Reconstruction Site

Patient: A 70-year-old edentulous woman with a flap reconstruction presented Kyushu University Dental Hospital for a masticatory dysfunction because of insufficient retention and stability with her complete denture. She had received 5 implants in the mandible for an implant-supported fixed prosthesis. Although an implant-supported fixed prosthesis could provide improved stability and function, the fixed prosthesis and lack of keratinized mucosa led to the difficulty of cleaning. To improve oral hygiene, an implant-supported overdenture was fabricated after free gingival graft from palate. However, a failure in the graft union and the subgingival plaque resulted in peri-implantitis. The patient received open flap debridement and was treated with antibiotics. Although the patient had used this prosthesis with a slight inflammation for 5 years, a deep pocket was observed around the implant. As a treatment of peri-implantitis, abrasive debridement with beta-TCP was performed. Up to the present, the patient healed uneventfully.Discussion: The implant-supported prosthesis is an alternative to the conventional removable denture and is used to provide predictable retention, stability and function in a flap reconstruction patient. However, we should consider the patient's cleaning ability and the condition of soft tissue around implants.Conclusion: Prosthodontic treatment planning is a complex process that involves various factors such as the surgical factors, occlusion, superstructure and oral hygiene. If we make a plan in the light of these factors, implant-supported prosthesis must offer better function, comfort and predictable result to the patients.

Prosthodontic Treatment Planning: Current Practice, Principles, and Techniques

In this series of articles, the faculty of the University of Southern California New Odontic Seminar have taken the 25 years of documented treatment of sample patient "A.K." and used it as a foundation on which to base discussion of the concepts and technology that have developed in prosthodontic treatment planning. Each of the contributing authors was asked, "What are your thoughts retrospectively if you were to treat the patient A.K. in your practice today?" And, since all dentists are challenged with evidence-based treatment planning, each author was also asked "On what evidence in the literature do you base your treatment planning for patients who need prosthetic therapy?" Dentistry's experience with long-term success of endodontics, periodontics, and implant dentistry is expressed in the presentations discussing when an implant may be better suited for a prosthetic abutment than a restored tooth.

New paradigms in prosthodontic treatment planning: A literature review

New treatment modalities have expanded the choices available to prosthodontists and their patients. At the same time, an explosion of data has called into question the validity and efficacy of certain forms of traditional prosthodontic treatment. Together, these factors have greatly complicated the treatment-planning process. The purpose of this article is to provide a framework for the prosthodontic treatment-planning process that incorporates the latest evidence-based information available. A review of the literature was undertaken through a Medline search. Articles published in English from 1975 through 2001 were evaluated; selected articles were chosen for review on the basis of a subjective judgment of their relevancy and significance to the clinician. (J Prosthet Dent 2002;88:208-14.)