Reappraising prosthodontic treatment goals for older, partially dentate people: Part I. Traditional management strategy.
Identifieur interne : 002371 ( PubMed/Checkpoint ); précédent : 002370; suivant : 002372Reappraising prosthodontic treatment goals for older, partially dentate people: Part I. Traditional management strategy.
Auteurs : R. Omar [Arabie saoudite]Source :
- SADJ : journal of the South African Dental Association = tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging [ 1029-4864 ] ; 2004.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Arcade dentaire (anatomopathologie), Femelle, Humains, Molaire (anatomopathologie), Mâchoire partiellement édentée (rééducation et réadaptation), Mâle, Perte dentaire (rééducation et réadaptation), Planification des soins du patient, Résultat thérapeutique, Sujet âgé, Évaluation des besoins.
- MESH :
- anatomopathologie : Arcade dentaire, Molaire.
- rééducation et réadaptation : Mâchoire partiellement édentée, Perte dentaire.
- Adulte d'âge moyen, Femelle, Humains, Mâle, Planification des soins du patient, Résultat thérapeutique, Sujet âgé, Évaluation des besoins.
English descriptors
- KwdEn :
- MESH :
- pathology : Dental Arch, Molar.
- rehabilitation : Jaw, Edentulous, Partially, Tooth Loss.
- Aged, Female, Humans, Male, Middle Aged, Needs Assessment, Patient Care Planning, Treatment Outcome.
Abstract
In conventional terms, prosthodontic treatment becomes necessary when a patient has missing and/or broken-down teeth. Part I of this two-part series of papers reviews the available evidence for a traditional therapeutic model that seeks purposefully to reconstitute lost morphology, with specific reference to older, partially dentate people, at the population level. Furthermore, because anterior and premolar teeth are indispensable to a number of prime oral functions in most societies, the question of need for replacement relates essentially to that of molar teeth. Research findings are presented which cast doubt on many of the assertions made for the mandatory replacement of all posterior teeth. Specifically, there appears to be a lack of compelling evidence that dental arch integrity is a prerequisite for optimal oral health and function, and favours the prognosis of the remaining dentition. Wide variability in the effects of posterior tooth loss on occlusal stability indicates a 'wait-and-see' management approach rather than immediate replacement, while reported chewing sufficiency in people with reduced but well-distributed dentitions, and a lack of association between the level of posterior support and temporomandibular disorders, further undermine the traditional premise for the mandatory replacement of posterior teeth, specifically molars. With the parallel recognition that the assessment of treatment need must take a broader view of peoples' functional concerns arising from their tooth loss, as well as weighing the cost/benefit ratio of treatment, Part II will compare the merits of the traditional model with the documented functional benefits that a more limited, less morphologically-driven approach may have for the growing, older sector of society.
PubMed: 15449440
Affiliations:
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pubmed:15449440Le document en format XML
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<front><div type="abstract" xml:lang="en">In conventional terms, prosthodontic treatment becomes necessary when a patient has missing and/or broken-down teeth. Part I of this two-part series of papers reviews the available evidence for a traditional therapeutic model that seeks purposefully to reconstitute lost morphology, with specific reference to older, partially dentate people, at the population level. Furthermore, because anterior and premolar teeth are indispensable to a number of prime oral functions in most societies, the question of need for replacement relates essentially to that of molar teeth. Research findings are presented which cast doubt on many of the assertions made for the mandatory replacement of all posterior teeth. Specifically, there appears to be a lack of compelling evidence that dental arch integrity is a prerequisite for optimal oral health and function, and favours the prognosis of the remaining dentition. Wide variability in the effects of posterior tooth loss on occlusal stability indicates a 'wait-and-see' management approach rather than immediate replacement, while reported chewing sufficiency in people with reduced but well-distributed dentitions, and a lack of association between the level of posterior support and temporomandibular disorders, further undermine the traditional premise for the mandatory replacement of posterior teeth, specifically molars. With the parallel recognition that the assessment of treatment need must take a broader view of peoples' functional concerns arising from their tooth loss, as well as weighing the cost/benefit ratio of treatment, Part II will compare the merits of the traditional model with the documented functional benefits that a more limited, less morphologically-driven approach may have for the growing, older sector of society.</div>
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