january 2011
Authors:
D.J. Witter, W.G. Brands, J.C. Barčl, N.H.J. Creugers
Source:
NTvT january 2011; 118: 013-019
doi:
10.5177/ntvt.2011.01.10261
Section:
Summary:

An invasive treatment, such as the treatment involving a removable partial denture, requires a well-structured approach. Regulations governing the communication between a healthcare professional and a patient in the Netherlands can be found in the Dutch Medical Treatment Act and the Rules of Conduct for Dentists of the Dutch Society for the Advancement of Dentistry (NMT). According to the regulations in these sources, a healthcare provider needs a patient’s informed consent for any medical treatment and he is required to maintain a file of medical records. Consent should be based on efficacious communication and explanation of treatment options, risks and costs. With regard to the duty to maintain records, a care plan and a treatment plan are required for an invasive treatment. A standard structure and sequence of points for the care plan and the treatment plan will reduce the risk of overlooking essential issues.

Authors:
D.J. Witter, J.C. Barčl, C. de Baat, H.M.A.M. Keltjens, N.H.J. Creugers
Source:
NTvT january 2011; 118: 021-028
doi:
10.5177/ntvt.2011.01.10264
Section:
Summary:

The occlusal system is part of the orofacial system and consists of the maxillary and mandibular alveolar ridge and teeth which are occluding or not or the removable denture teeth. The most prevalent causes of loss of teeth are insufficient oral self care or inadequate professional oral healthcare service. A reduced dentition can be described in terms of diastemas in the anterior region and number of occluding pairs of (pre)molars, differentiated as interrupted or shortened dental arches. Characteristic of a healthy functional occlusal system are the absence of pathology and the possibility to practice all oral functions without inconvenience. The consequences of a reduced occlusal system may be overload and/or migration of teeth, mandibular instability, and impaired esthetics and chewing function. Morphological and functional alterations can be considered to be adaptations to changed situations or to be pathological. The distinction between adaptation and pathology cannot be sharply defined. If prosthetic replacement of teeth is needed, the trend is to avoid removable partial dentures.

Authors:
C. de Baat, D.J. Witter, N.H.J. Creugers
Source:
NTvT january 2011; 118: 032-037
doi:
10.5177/ntvt.2011.02.10243
Section:
Summary:

An acrylic resin removable partial denture is distinguished from other types of removable partial dentures by an all- crylic resin base which is, in principle, solely supported by the edentulous regions of the tooth arch and in the maxilla also by the hard palate. When compared to the other types of removable partial dentures, the acrylic resin removable partial denture has 3 favourable aspects: the economic aspect, its aesthetic quality and the ease with which it can be extended and adjusted. Disadvantages are an increased risk of caries developing, gingivitis, periodontal disease, denture stomatitis, alveolar bone reduction, tooth migration, triggering of the gag reflex and damage to the acrylic resin base. Present-day indications are of a temporary or palliative nature or are motivated by economic factors. Special varieties of the acrylic resin removable partial denture are the spoon denture, the flexible denture fabricated of non-rigid acrylic resin, and the two-piece sectional denture. Furthermore, acrylic resin removable partial dentures can be supplied with clasps or reinforced by fibers or metal wires.

Authors:
C. de Baat, D.J. Witter, H.M.A.M. Keltjens, N.H.J. Creugers
Source:
NTvT january 2011; 118: 039-044
doi:
10.5177/ntvt.2011.01.10255
Section:
Summary:

Following treatment with a removable partial denture, routine oral examinations are required to stabilize the existing condition in a sustainable way and to make possible the timely treatment of anomalies which have appeared. In cases of problems assessed during a routine oral examination in relation to the removable partial dentures, maintenance, restorative and prosthetic treatment may be indicated. Maintenance treatments are indicated for small and easily retrievable alterations. In removable partial denture treatment, adquate space between prepared tooth and denture is essential. Possible prosthetic treatments of a removable partial denture are relining, rebasing, improving or renewing the maxillomandibular relation, repairment, and extension.

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