GERODONTOLOGY
COMPLETE PROSTHESES TREATMENT – PRESENT AND FUTURE PERSPECTIVES
Sorin Uram-Ţuculescu 1a , Marian-Vladimir Constantinescu 2b
¹Department of Prosthodontics, VCU School of Dentistry, Virginia Commonwealth University, Richmond, VA - 23298-0566, USA
²Holistic Dental & Medical Institute - ROPOSTURO, RO - 020082 Bucharest, Romania
DDS, MS, PhD, Associate Professor
DDS, PhD, Professor, President
a
b
Received: October 28, 2017
Revised: November 04, 2017
Accepted: November 23, 2 017
Published: November 24, 2017
Academic Editor: Sever Toma Popa, DDS, PhD, Professor, Faculty of Dental Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy
Cluj-Napoca, Cluj-Napoca, Romania
Cite this article:
Uram-Ţuculescu S, Constantinescu MV. Complete prostheses treatment – Present and future perspectives. Stoma Edu J. 2017;4(4):282-288.
ABSTRACT
DOI: 10.25241/stomaeduj.2017.4(4).art.5
Background: Background: Tooth loss is a public health problem across the globe, especially in low-
income populations. Traditional complete denture treatment is time consuming, and less embraced
by general practitioners.
Objective: The purpose of this paper is to review data on prevalence, future projections, and
treatment modalities for edentulism. Most edentulous patients receiving care are treated with
conventional, tissue-supported prostheses. Possible ways to improve efficiency in complete denture
treatment, and ameliorate access to care are investigated.
Data Sources: Information was obtained mainly from PubMed, American College of Proshodontists
databases, and non-indexed sources.
Study selection: Considering the scarcity of information on some topics (simplified complete
denture fabrication methods, digital techniques), a wide range of papers were selected for analysis,
from systematic reviews, randomized controlled trials, cross-sectional studies to case presentations,
expert opinions, surveys, and dental organizations’ reports.
Data extraction: The web search included the following key words: edentulism, demographic,
implant, removable, denture, simplified, digital, denturist.
Data Synthesis: The future of traditional complete denture treatment remains questionable,
considering the reduced appetite of general practitioners and patients for time consuming
treatments. Simplified techniques deserve an increasing attention from practitioners and dental
educators, as available data suggest that they produce similar outcomes, when compared to
traditional methods. Digital technologies are expected to further improve treatment outcomes,
within simplified protocols. As mid-level dental providers became a reality in some jurisdictions,
denturism could be considered part of the solution, especially in underserved areas.
Keywords: edentulism, prosthesis, simplified, digital, curriculum.
1. Introduction
Despite significant advances in prevention and oral
care, tooth loss remains a public health problem,
especially in low income populations 1,2 and the
elderly. 3,4 Access to care in the underserved segment
of population is a long standing problem. 5 Overall,
the prevalence of edentulism is still high, even in
developed countries. 6,7,8
While prevalence of edentulism is decreasing from
decade to decade, the increase in senior population
fuels the need/demand for complete prostheses
for decades to come. The Dental practitioners are
expected to face a serious task in providing care
for a large number of edentulous patients, most
of them seniors, with specific needs that have to
be addressed accordingly. 9 Upgraded treatments
with documented benefits, 3,10,11,12,13,14,15 including
implant overdentures and implant-supported fixed
prostheses are available, but are only address a
fraction of the edentulous population, due mainly
to increased costs. As such, the tissue-supported
complete prostheses appear to be the mainstay in
the treatment of edentulism, 3,6,12,13,16,17,18 despite the
fact that they do not constitute optimal replacements
for the lost function, with lower bite forces and
altered masticatory muscle activity. 19
Trends in the dental work force indicate that the ratio
of dentists to the population in the U.S. will be in 2020
less than in was in 2010, 20 due to a faster increase in
population, as compared to the increase in number
of dental graduates. In addition to the shortage of
dentists in the US, 21 a shortage of dental technicians 22
is expected to add to the already established issue of
access to care.
Increased chair time expenditure for removable
prosthodontics due to numerous steps makes
denture treatment less attractive for practitioners, 23
as revenue per time unit is lower, compared to other
*Corresponding author:
Associate Professor Sorin Uram-Ţuculescu, DDS, MS, PhD, Department of Prosthodontics, VCU School of Dentistry, Virginia Commonwealth University, Wood Memorial Building, 3rd Floor, Room # 304 D, 521
North 11th Street PO Box 980566, Richmond, VA 23298-0566, USA , Tel: (804)-628-3742, Fax: (804)-827-1017, e-mail: [email protected]
282
Stoma Edu J. 2017;4(4): 282-288
http://www.stomaeduj.com