BACKGROUND: Changes in oral epidemiology have contributed to an older population who are partially dentate in many countries worldwide. This study aims to appreciate older patients’ impressions of the loss of their natural teeth and explore their experience of functionally orientated oral rehabilitation approach. METHODS: Recruitment for this retrospectively registered qualitative study involved a purposive sample of 15 older partially dentate patients. Previously, this group of patients partook in a randomised controlled clinical trial (RCT) on tooth replacement options. Patients who had received functionally orientated tooth replacements according to the Shortened Dental Arch (SDA) principles were invited to participate in a qualitative interview. Each patient received resin-bonded bridgework (RBB) to restore them to a functional dentition of 10 occluding pairs. All patients had previous experience with tooth replacement using Removable Partial Dentures (RPD). Following comprehensive interviews with participants, data was interpreted through thematic analysis. RESULTS: This study’s findings indicated high participant satisfaction with SDA treatment. Patients noted they found resin-bonded prostheses “lightweight,” “neat,” and “fixed”, citing these as contributing factors to the ease with which they adapted to these prostheses. It was also noted that patients perceived their new prostheses to be durable and an improvement on past removable treatments received. However, the patients indicated concern that the SDA treatment provided in the clinical study would not be available to them in a primary care setting. CONCLUSIONS: This qualitative study demonstrates that partially dentate older patients were satisfied with a functionally orientated approach to oral rehabilitation. TRIAL REGISTRATION: (Trial Registration: ISRCTN26302774: 18/10/2013).

Dentists today have an increasing number of ways to restore chewing function lost due to missing teeth. The loss of chewing function has many more consequences than one might initially think. Oral function concerns not only chewing but also proprioception and osseoperception, and it influences brain function too. With this in mind, preserving natural teeth is important, and it is unwise to choose implants in the first instance if a compromised tooth can be saved with some effort or chewing function can be restored with bridges on natural teeth. Options differ on this question: should implants be considered the 'holy grail' or a last resort? Conventional bridgework is still a very relevant treatment option that affects the dynamics of the masticatory system less than implant-supported constructions and also requires less maintenance. A self-critical attitude on the part of a dentist remains necessary if patients are to be treated optimally.

Edentulism (total tooth loss) can be managed with four possible options: no prosthetic replacement, conventional complete dentures, implant-retained overdentures (removable), or implant-supported bridgework (fixed). Selection of these choices is influenced by social, medical, anatomical, technical, and economic factors. The care team involved in the decision-making process (be it patients, clinicians and occasionally commissioners of services) should be aware of the different treatment options and their potential impact on the patient's quality of life (QoL). The cost effectiveness of this impact can also be evaluated. Knowledge of the life-long sequelae of edentulism will also help practitioners guide patients in their treatment planning decisions when they may be approaching an edentulous state, preparing them for the challenges that may lie ahead. This paper aims to address the impact that edentulism has on QoL and the treatment options, focusing on the patient perspective.

The goal of autotransplantation of teeth (ATT) is to provide the patient with a functioning tooth to replace a missing one. In dentistry, this surgery has gained significant approval and popularity; nonetheless, there is still a shortage of thorough evidence about its long-term effects. Tooth transplantation has a rich historical pedigree, and the main factors determining its success are the extra-alveolar period, proper splinting, periodontal ligament treatment, and root growth stage. With its high reported survival rate, autotransplantation is a potential therapeutic option, especially when it comes to replacing damaged anterior maxillary teeth. Collaboration between orthodontists, pediatric dentists, restorative dentists, and oral and maxillofacial surgeons is necessary for the successful execution of this treatment. The extra-alveolar period, proper splinting, periodontal ligament treatment, and the stage of root growth are the main factors that determine success. Although there are many applications for autotransplantation, a good functional and cosmetic result depends on careful patient selection and a proper surgical approach. It is not practical to replace lost teeth in children and teenagers with bridgework or implants as this may interfere with the proper development of the alveolar process and other facial bones. As such, these techniques are not recommended. Alternatively, implanting a tooth from the same person without fully forming its roots might be a good substitute. This method promotes improved mastication, speech, dentofacial development, aesthetics, and arch form integrity by enabling unhindered alveolar growth and root development. Although tooth autotransplantation has not been widely used in clinical dentistry, it is currently seen as a viable option that can replace traditional prosthetics and implant rehabilitation in both financial and medical terms. This review examines several benefits, possible iatrogenic harms, side effects, and important variables that might affect the result of the transplant, in addition to suitable criteria for the best-case selection. It also offers recommendations based on the literature.

The fracture strength of implant supported zirconia-titanium base (Zi-Ti) base restorations with and without modification of submucosal cervical contour is of interest to dentists. 80 zirconia specimens were adjusted onto the Ti-base. One category consisted of specimens that underwent modification. Other category consisted of abutments without modification. There was polishing and recon touring at the interface of Zi-Ti base in cervical regions. Using the universal testing apparatus fracture resistance was assessed for every sample in every category in Newtons (N). The fracture strength of abutments with modification ranged between 4465.79 - 6523.50 N with mean value of 5604.24 ± 497.62 N. On the other hand, values of fracture strength varied between 5511.42 - 7064.33 N. in abutments without modification with mean fracture strength values of 6265.95 ± 331.61. It was observed that the fracture strength was lesser in abutments that underwent modification.

Oral piercing habits are associated with various degrees of complications. Tongue piercing increases the risk of gingival recession and infrabony defects, subsequently leading to localized periodontitis. In the case presented, the patient had persistent swelling and suppuration around her mandibular anterior teeth attributed to tongue piercing jewelry that was placed approximately 12 years prior. Intraoral examinations revealed a localized deep pocket, purulent discharge, swelling, plaque accumulation, bleeding on probing, gingival recession, and teeth mobility. The patient was diagnosed with localized stage III, grade C periodontitis. Following full-mouth debridement and the placement of an extracoronal lingual splint, minimally invasive, papillae-sparing incisions were made, and regenerative therapy with bone allograft and collagen membrane was used to manage the infrabony defects. During the 18-month postoperative follow-up, complete soft-tissue healing was observed along with a significant reduction in pocket depth and the absence of bleeding on probing or suppuration. Radiographic evaluation showed evidence of bone fill. The reported case demonstrates how careful diagnosis and treatment planning are crucial for managing different periodontal defects and emphasizes the importance of proficient periodontal management, which can save teeth that would otherwise be extracted and replaced with implant therapy or fixed bridgework.

Over the past two decades, dental ceramics have experienced rapid advances in science and technology, becoming the fastest-growing field of dental materials. This review emphasizes the significant impact of translucent zirconia in fixed prosthodontics, merging aesthetics with strength, and highlights its versatility from single crowns to complex bridgework facilitated by digital manufacturing advancements. The unique light-conducting properties of translucent zirconia offer a natural dental appearance, though with considerations regarding strength trade-offs compared to its traditional, opaque counterpart. The analysis extends to the mechanical attributes of the material, noting its commendable fracture resistance and durability, even under simulated physiological conditions. Various zirconia types (3Y-TZP, 4Y-TZP, 5Y-TZP) display a range of strengths influenced by factors like yttria content and manufacturing processes. The study also explores adhesive strategies, underlining the importance of surface treatments and modern adhesives in achieving long-lasting bonds. In the realm of implant-supported restorations, translucent zirconia stands out for its precision, reliability, and aesthetic adaptability, proving suitable for comprehensive dental restorations. Despite its established benefits, the review calls for ongoing research to further refine the material's properties and adhesive protocols and to solidify its applicability through long-term clinical evaluations, ensuring its sustainable future in dental restorative applications.

This case report demonstrates the full mouth prosthetic rehabilitation of a patient with generalised compensated tooth wear and oral sub-mucous fibrosis (OSMF). A 50- year-old female with advanced tooth wear and concomitant OSMF presented to the clinic. She was managed in a sequential manner using an occlusal splint, extractions of hopeless teeth, root canal treatment of strategically important teeth, surgical crown lengthening of abutment teeth, and dental implants to replace missing dentition, followed by crown and bridgework to rehabilitate the dentition. All procedures were done on the principles of re-organised occlusal intervention. The outcome was a functional dentition with an aesthetic smile and a satisfied patient. The regaining of mouth opening among OSMF subjects is a challenge. The usual management is prescribing muscle stretching exercises, drugs, or surgery. In the present case, we managed to achieve significant improvement in mouth opening with occlusal splints. The use of such occlusal orthotics has never been reported.

Alumina is a well-known dental ceramic material that has made waves within the dental industry for its good aesthetics and strength when compared to older materials for fixed prostheses, such as crown and bridgework. To be able to confidently use this material, a clinician should understand the physical and optical properties so as to know why and how this material might work in various clinical settings. This part of the ceramic series aims to explore the various alumina-based ceramic systems available on the market and discuss their properties, applications and indications. We also intend to briefly describe the preparation design requirements and cementation protocol for this type of ceramic.