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Are removable prosthodontics becoming a lost art? An update on periodontal treatment

Sept. 2, 2015
Dental schools are presently emphasizing the use of endosseous implants to replace single teeth, partially edentulous situations, and completely edentulous dental arches. This is happening primarily in wealthy urban areas. Consequently, removable prosthodontics is taking a back seat.

This article originally appeared in RDH eVillage Focus, a newsletter prepared for dental professionals looking for hard-hitting, current information. You can subscribe here.

The guidelines for the prevention and treatment of periodontal disease are constantly changing. This article will highlight some of the recent articles regarding periodontal treatment.

The decline of removable prosthodontics We know that placement and monitoring of implants has been the focus of many recent articles and meetings, such as Europerio 8. According to a new article, dental schools are presently emphasizing the use of endosseous implants to replace single teeth, partially edentulous situations, and completely edentulous dental arches. (1) This is happening primarily in wealthy urban areas. Consequently, removable prosthodontics is taking a back seat. This is posing numerous problems that need to be addressed within the profession.

We are also aware that many people are not candidates for implant procedures for a variety of reasons, ranging from medical illnesses to drug, alcohol, and tobacco abuse. According to an article in the Journal of Dentistry and Oral Care, the teaching and need for removable prosthodontics is becoming a lost art. (1) Consequently, it tests the restorative dentist to be able to construct optimal functioning removable complete and partial dentures. (1) The authors suggest that removable prosthetics be used initially as a diagnostic tool. After the patient adjusts to their recently restored vertical and horizontal dimensions, and is comfortable with their facial appearance, they can then decide to have implants if they wish. The removable prosthesis can be a guide for proper implant placement, leading to progressive implant treatment planning.

Local antimicrobials and perio
In other news, adjunct local antimicrobials provide statistically significant benefits over subgingival debridement alone in patients with chronic periodontitis. (2) The authors of a JADA article asked, “In adult patients with periodontitis, does subgingival debridement (SD) with local antimicrobials (LAs) compared with SD alone or placebo lead to better periodontal outcomes?” (2) The conclusion is that the evidence supports the adjunctive use of local antimicrobials (LAs) with SD in deep or recurrent periodontal sites, mostly with use of vehicles with proved sustained release of the antimicrobial. (2) According to a Critical Summary Assessment, the review was well-done. The clinical significance of the added benefits may be in doubt, preventing any clear guidelines for their adjunctive use in patients with chronic periodontitis.

For the latest in research, visit the Journal of Clinical Periodontology, and view the Abstracts of EuroPerio8, London, UK, 3-6 June, at no charge. And finally, for the primary and secondary prevention of periodontal and peri-implant diseases, visit the Journal of Clinical Periodontology.

References
1. Zinner ID, Markovits S, Miller RD, et al. Viable Alternatives to Implantology. J Dent Oral Care. 2015;1: 102. doi: 10.15744/2454-3276.1.102.
2. Durand R. Adjunct local antimicrobials provide statistically significant benefits over subgingival debridement alone in patients with chronic periodontitis. J Dent Am Assoc. 2015;146:341–343. http://jada.ada.org/article/S0002-8177%2814%2900059-2/fulltext.