Osseointegrated dental implants have been proven successful in the treatment of edentulism . Several techniques have been described for the successful restoration of the edentulous ridges, one being the fixed complete dentures . Among the procedures used in the fabrication of those prostheses is the milled bar .
Since the conventional cast framework distortion occurs during the conventional laboratory fabrication procedures, the elimination of errors caused by expansion of investment and the shrinkage of the alloy should result in a more accurate framework. Other variables that might have affected the fit of a framework include setting expansion of the stone used for the master casts, polymerization shrinkage of the resin framework, and machining accuracy of the components used to fabricate the master cast. A previous study by Jemt demonstrated that a welded one-piece titanium framework has less discrepancy with the fit of the implant frameworks when compared to cast frameworks . What makes the present study different is the fact that the bar is milled from a single block of titanium and not welded smaller components. The mechanism used to digitize the definitive cast and the framework pattern in the present study was completed in the same manner that is done within commercial dental laboratories. Among the reasons that makes this technique successful is the reduction of human and material errors during the fabrication process.
One of the most important aspects of high-quality complete denture therapy occurs early in the treatment sequence. Because complete denture fabrication is an indirect restorative procedure, an analogue of the edentulous ridges must be developed to be able to proceed with denture construction in the laboratory. The degree to which this analogue accurately represents oral contours and condition, both anatomically and functionally, determines in large part the quality of the therapeutic outcome. The method used to capture critical anatomic information for transport to the laboratory construction process involves making impressions of the denture-bearing tissues and peripheral structures and fabricating dental casts.
A wide variety of impression procedures has been described for conventional complete denture therapy.3-21 Procedures vary with respect to impression materials used, the design and construction of impression trays, intended extensions of peripheral borders, pressure delivered to denture-bearing tissues, and the incorporation of oral function during impression making. Conventional wisdom, as determined by experts in the field and taught in many US dental schools, involves impression-making procedures that include: (1) primary irreversible hydrocolloid impressions used to generate gypsum diagnostic casts; (2) construction of custom impression trays with varying design features; (3) intraoral adaptation of custom-tray border dimensions using border-molding techniques; and (4) definitive impressions made with a suitable impression material.22-25
Although discussed in great detail elsewhere,39-42 this modern approach to impression making takes advantage of two recent developments: anatomically designed thermoplastic stock impression trays and a wide range of viscosity-specific VPS impression materials. Readers are encouraged to review the descriptive articles previously published detailing step-by-step impression-making procedures for conventional complete dentures, immediate complete dentures, implant overdentures, removable prosthesis relines, and external impressions.39-42 The current discussion will focus on highlights of the impression technique used during conventional complete denture construction.
Historically, a number of techniques have been suggested for registering inter-arch relationships during complete denture construction, including direct inter-occlusal records, graphic recordings, and functional records. Direct inter-occlusal recording methods are frequently taught in US dental schools24 and are frequently used by clinicians in private practice. To achieve accurate and precise registrations using direct inter-occlusal methods, it is imperative that: (1) patients demonstrate cooperative and physiologically capable mandibular motion; (2) well-fitting, stable, and reasonably retentive record bases and occlusal rims are available; and (3) operators are experienced and skilled in the procedures being performed. The lack of any one of these factors can ultimately result in the recording of an inappropriate maxillo-mandibular relationship and treatment failure.
The professional development of new-and-improved impression procedures and methods for recording interocclusal jaw relationships, complete denture posterior tooth forms, and occlusal schemes are but a few of the innovations available to aid in the conventional treatment of edentulous patients. Though dental implant therapy has had a profound impact on the way dentistry approaches the management of edentulism, continued methodological improvements in conventional treatment regimens must keep pace with the ongoing needs of the ever-expanding edentulous population.
Although certification is costly and requires a sustained commitment, it has many benefits for dental technicians, laboratory owners and the dental customer. CDTs and RGs have not only demonstrated competency, but they have shown determination and commitment in completing the certification process. The attained skill and knowledge of the CDT is highly desirable to laboratories. Having this certification provides the dental technician with the advantage of higher salaries, advancement and job satisfaction.
The extensive knowledge gained by the CDT and RG during the required continuing education process assures the laboratory owner, dental customer and the public that this individual is a true student of the profession with a solid commitment to remain at the cutting edge of his or her field.
This is a state-of-the art electronic program covering all aspects of complete dentures (CDs). It is designed to meet the needs of dental students, practicing dentists, dental laboratory technicians, and educators at all levels. This one-of-a-kind evidence-based eBook transcends traditional textbooks through the integration of digital technology, 3D resources, color images, and evidence based referencing. It is the ultimate resource for treating edentulous patients with complete dentures.
Although dental implants are an increasingly popular treatment for restoring dentition in completely edentulous patients, not everyone desires or is suitable for this procedure. Conventional dentures still provide a predictable treatment outcome or may be required to help patients transition from dentures to implant-retained prostheses.
Some infection-control practices routinely used by health-care practitioners cannot be rigorously examined for ethical or logistical reasons. In the absence of scientific evidence for such practices, certain recommendations are based on strong theoretical rationale, suggestive evidence, or opinions of respected authorities based on clinical experience, descriptive studies, or committee reports. In addition, some recommendations are derived from federal regulations. No recommendations are offered for practices for which insufficient scientific evidence or lack of consensus supporting their effectiveness exists. Background In the United States, an estimated 9 million persons work in health-care professions, including approximately 168,000 dentists, 112,000 registered dental hygienists, 218,000 dental assistants (3), and 53,000 dental laboratory technicians (4). In this report, dental health-care personnel (DHCP) refers to all paid and unpaid personnel in the dental health-care setting who might be occupationally exposed to infectious materials, including body substances and contaminated supplies, equipment, environmental surfaces, water, or air. DHCP include dentists, dental hygienists, dental assistants, dental laboratory technicians (in-office and commercial), students and trainees, contractual personnel, and other persons not directly involved in patient care but potentially exposed to infectious agents (e.g., administrative, clerical, housekeeping, maintenance, or volunteer personnel). Recommendations in this report are designed to prevent or reduce potential for disease transmission from patient to DHCP, from DHCP to patient, and from patient to patient. Although these guidelines focus mainly on outpatient, ambulatory dental health-care settings, the recommended infection-control practices are applicable to all settings in which dental treatment is provided.
Wicking: Absorption of a liquid by capillary action along a thread or through the material (e.g., penetration of liquids through undetected holes in a glove).Review of Science Related to Dental Infection ControlPersonnel Health Elements of an Infection-Control Program A protective health component for DHCP is an integral part of a dental practice infection-control program. The objectives are to educate DHCP regarding the principles of infection control, identify work-related infection risks, institute preventive measures, and ensure prompt exposure management and medical follow-up. Coordination between the dental practice's infection-control coordinator and other qualified health-care professionals is necessary to provide DHCP with appropriate services. Dental programs in institutional settings, (e.g., hospitals, health centers, and educational institutions) can coordinate with departments that provide personnel health services. However, the majority of dental practices are in ambulatory, private settings that do not have licensed medical staff and facilities to provide complete on-site health service programs. In such settings, the infection-control coordinator should establish programs that arrange for site-specific infection-control services from external health-care facilities and providers before DHCP are placed at risk for exposure. Referral arrangements can be made with qualified health-care professionals in an occupational health program of a hospital, with educational institutions, or with health-care facilities that offer personnel health services. 2b1af7f3a8