Objective To summarize and analyze the clinical experiences of treatment of complicated geriatric odontoptosis for the purpose of establishing a better technique to cope with such situation.Method The data of 542 outpatients with geriatric odontoptosis,from 1998 till the present treated in the Department of Outpatient,General Hospital of PLA,were summarized and analyzed according to the type and location of odontoptosis,with complications such as severe attrition,periodontitis,food impaction and detective occlusion.The special prosthetic designs on certain cases were also summarized.Some cases were followed-up.Results Removable partial dentares(RPD)with cast framework were prescribed to the geriatric odontoptosis patients.According to the site and type of odontoptosis,four special designed frameworks include casting fence-wall enforced artificial tooth prosthesis for lower clearance cases,metal strengthened plastic occlusive pad or metal occlusive pad for severe attrition cases,casting splint prosthesis for periodontal and food impaction with impaction preventive denture.36 cases were followed up for two years with satisfactory result in 31 cases,but in four cases the clasp was broken.In the cases with failure the dentures were redesigned and fabricated with cast framework,and better results were accomplished.Generally,the patients were accustomed to the new RPD quickly and revisit times were less frequent.The strength of prosthesis was enhanced.It was proved that custom designed framework could solve the clinical dilemma of severe dentition attrition,food impaction and periodontitis,and the odontoptosis was repaired.Conclusion The designed fence-wall prosthesis,metal strengthened plastic occlusal pad and metal occlusal pad,casting splint prosthesis and casting food impaction stop are effective prosthetic procedure for certain cases.

Objective QR-DVT 9000 NEWTOM CT, an oral maxillofacial dedicated CT, was applied in the diagnosis of maxillary sinus related diseases. Its value and technique are summarized. Method Patients with maxillary sinus related diseases were scanned and images were reconstructed with QR-DVT 9000 CT. The axial view of reconstructed image was analyzed in sagittal plane, coronal plane and 3-D. Results QR-DVT 9000 NEWTOM CT could display the position, shape and anatomic relationship of maxillary sinus with adjacent structures in sagittal image, coronal image and 3-D image. Conclusion QR-DVT 9000 NEWTOM CT, an oral maxillofacial dedicated CT, is considerably valuable in the diagnosis of maxillary sinus related diseases, and it can guide clinical surgery more effectively than routine X ray examination.

Objective To introduce and analyze the design, manufacture and clinical effect of the casting full dentition splint in treatment of periodontal disease with or without dentition defect. Methods 148 patients with periodontal disease during 1995 to 1998 were treated with casting full dentition splint after a thorough basic periodontal treatment. The patients were composed of 81 men and 67 women aged 40-69y. The patients were followed up for 1 to 3 years after restoration. General effects of the prosthesis were evaluated based on the chief complain of patients, clinical examination and X-ray examination. Results Among 148 patients, 140 (94.59%) were satisfied with the prosthesis and stable periodontal status, 6 (4.05%) were improved, 2 (1.35%) showed no clinical effect. Conclusion Casting full dentition splint can improve the mastication efficiency in periodontal disease patients. It is an effective and reversible therapeutic method on treatment of the periodontal disease with or without dentition defect.

Objective A fibronectin like peptide was designed and synthesized based on the structure and function relationship study of extra cellular matrix protein in order to search after a kind of new method to improve the bioactivity of hydroxyapatite based biomaterials. Methods A peptides named P19 with two functional groups was synthesized by employing solid phase peptide synthesis. The synthesized peptides were preliminarily purified with Sephadex G 15 column chromatography and further modified with air oxidation method. The purity of P19 were determined with RP HPLC. The molecular weight of peptide was identified with TOF MS. Its binding characteristics and bioactivity was investigated. Results P19 has high affinity with hydroxyapatite and cannot be eluted under physiological condition. Its dissociation constant is 14 3?0 8?mol/L and the maximum of attached peptides by 100?g HA is 2 57?0 51nmol. It can affect the in vitro calcification of gel system. The plate pretreated with P19 can enhance the number of attached cells and the proliferation of attached cells is also promoted. The fibronectin like activity was also proved by the competitive inhibition effect of P19 on the cell attachment. It also can promote the proliferation of UMR 106 cell line. Conclusion The synthesized peptide possess two function as design, it may have extensive application prospect as an ingredients of HA based materials or coating layer of implant

Objective The anterior dentition defects of geriatric patients were restored with modified fixed Maryland Bridge.The clinical design,tooth preparation,fabrication of prosthesis and clinical indication were summarized.Method 24 cases of geriatric patients with anterior dentition defects were restored with modified fixed Maryland Bridge.All selected cases were accompanied with different degree of loosening of neighboring teeth,gingival atrophy and exposure of root.The dentition defects were successfully restored and followed up for 3 to 5 years.Results The overall success rate was 87.5%.Three patients had the prosthesis loosened and re-bonding was necessary.No loosening was found in other patients.There was no swelling or inflammation of gingival underneath the prosthesis.All patients were quite satisfactory with the function and appearance of the prosthesis.Dental calculus was observed in 12 patients,and 2 patients complained of a feeling of foreign body on the side of tongue.Conclusion The modified fixed Maryland Bridge,when used in restoring the dentition defect of geriatric patients,showed the advantages of less tooth reduction,perfect esthetic effect,good fixation of loosening teeth as well as restoration of missing teeth with its splint wings.However,the long-term effect of this technique needs to be further observed.

Objective To evaluate the clinical effect of removable partial denture combined with composite resin veneer on occlusal reconstruction for aged patients with dentition defects,and discuss the critical steps of operation.Methods From Mar.2002 to May 2003,16 outpatients with Kennedy 1 type dentition defects with severe anterior attrition were selected.The distal extension removable partial denture(RPD) was used to reestablish the occlusal vertical dimension.The anterior teeth were bonded with the light-cured composite resin based on removable partial denture.The therapeutic effects for all the patients were assessed at 3-month,2-year and 4-year follow-up after treatment.Composite resin restorations were evaluated with modified USPHS criteria,and removable partial denture were assessed by routine examination and subjective questionnaire.Results After 4 years of observation,all prosthesis remained in good condition.The masticatory ability was increased than ever before and the patients were satisfactory with the esthetic appearance of dentures.The remaining rate of light-cured composite resin was 85.7% 4 years after reconstruction,fulfilling the requirements of esthetics and function.Meanwhile,the dental structure could be preserved and the unsatisfactory appearance of removable partial denture was improved by light-cured composite resin.Conclusions The dentition defects of aged people may be effectively restored by combined application of removable partial denture and composite resin veneer.This treatment has many advantagcs,including less trauma,economy and satisfactory in esthetics,and besides,it may better preserve the dental structure.This treatment is well accepted by aged patients,so it is worthy to do further clinical study.

Objective To evaluate the restorative effects of customarily designed resin bonded fixed partial denture(RBFPD) on single posterior tooth anodontia accompanied by tilted distal abutment,and summarize the indications and characteristics of RBFPD.Methods From 2002 to 2003,18 outpatients with single posterior tooth anodontia accompanied by tilted distal abutment were selected for the present study in the Department of Stomatology,General Hospital of People's Liberation Army.The gradient of tilted abutment was less than 50?.All the teeth with abutments were vital without obvious loosening or abnormal periodontal condition.The position and configuration of occlusion rest and retainer of denture were designed according to the inclination of abutment and cast survey.Titanium alloy or cobalt-chromium porcelain fused to metal RBFPD was prescribed,and all patients were followed up for 5 years.The clinical and X-ray examination were performed at each revisit and the subjective experience of patients was inquired.Results The average gradient of tilted distal abutment was 33?.During the period of 5-year follow-up,in all the 18 patients but 2,all the dentures were in function without detachment.The gum of abutment and the bottom of the pontic were in good condition,and no periodontitis in abutment was observed.There was no obvious change of abutment examined by X-ray during the period of follow-up.The patients were satisfactory with the prosthesis,and the success rate was 88.9% during the period of 5-year follow-up.Conclusion RBFDP used to restore the posterior single tooth anodontia with tilted abutment has the merit of less tooth reduction and reliable clinical effects,and root canal therapy is not necessary for tilted abutment.