Dental & Oral Health

Fixed and removable prosthodontics in the rehabilitation of the worn and or depleted dentition Various demographic surveys from around the world show a continual decline in the overall rates of edentulousness and an increased rate of tooth retention. However tooth loss of one to several teeth is still a not uncommon occurrence, be it from; caries, periodontal disease or trauma and this tendency towards gradual tooth loss increases with age. Counterpointed against tooth loss are varying levels of tooth tissue loss from parafunctional activities (bruxism), abrasion, attrition and or erosion and with differential levels of tooth over eruption, tilting and or dento-alveolar compensation. Osseo-integrated implants may be seen as a "gold" standard treatment for the rehabilitation of missing teeth but their costs, requirements for surgical intervention and ongoing maintenance requirements can preclude this treatment option from many of our patients. It is here that conventional and adhesive fixed partial dentures (bridges) and possibly in combination with removable partial dentures and adhesive restorations still provides valuable treatment options for our patients with worn and or depleted dentitions. This lecture will outline a variety of different treatment modalities used in replacing missing teeth and tooth tissue loss utilizing; conventional fixed bridgework, adhesively retained restorations & bridgework and the integration of crowns and removable partial dentures and applicable to the general dental practitioner. Clinical tips are highlighted throughout the lecture for dental practitioners to aid in their management of some of these very challenging cases when seen in practice. The use of the re organization approach to the worn and or depleted dentition will be compared and contrasted against the use of the conformative approach. Clinical examples will be used to highlight techniques and taken from clinical practice, undergraduate & postgraduate clinical teaching. The research evidence will be presented as the underpinning foundations for a methodical approach to the clinical management & importantly the biological costs of the different treatment options for each of the prosthodontic options chosen in replacing missing teeth. Finally, the role of the patient and the impact on their oral health of different interventions can be accessed through the use of Oral Health Related Quality of Life (OHRQoL) studies.