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the dentist regularly. Patients may be experiencing xerostomia caused by medications they are taking, which may be
managed by Biotene to hydrate oral tissues and relieve
symptoms. High-risk adults with special care needs may
require prescription-strength fluoridated toothpastes. If
the individuals behavior makes it difficult or impossible
to brush the teeth regularly, chlorhexidine sprays may
help prevent root caries, as can chlorhexidine varnish
with thymol. Fluoride applications are indicated at each
dental visit. IRT methods are used for restorations. Noncavitated carious pit and fissure lesions should be sealed
rather than restored.
Older Adulthood (Age 65 and Older).Often older
adults with special needs live in institutions or long-term
care facilities and are assisted with meals and oral hygiene.
They may be given unhealthy snacks to help manage their
behavior. Some lose manual dexterity and cannot brush
their own teeth, nor can staff assist them in some cases.
Xerostomia caused by medications is worse at this age,
which can produce coronal and root caries. Swallowing
can be limited, so medications may be delivered in sugary
liquids. Mobility becomes an issue for many older adults,
making it difficult to make the trip to the dental office.
Medicare does not cover routine preventive and restorative care, and state Medicaid programs may or may not
extend coverage to adults. This raises financial barriers
to care.
The basics of care for older adults are the same as for
younger persons. For those living in group homes, the
dentist should provide written and verbal instructions for
care. Patients with diminished manual dexterity may benefit
from larger toothbrush handles and ultrasonic toothbrushes. Fluoride and sealants are applied regularly. Povidone iodine helps to promote oral health and prevent
Prosthodontics
Cantilevered zirconia ceramic fixed dental prostheses
Background.Zirconia ceramics are widely used in
dental practices worldwide because they offer high fracture
strength and fracture toughness. Based on this good performance, zirconia ceramic may offer benefits when used on
cantilevered all-ceramic resin-bonded fixed dental prostheses (RBFDPs). Because data are lacking on the clinical
outcome of zirconia ceramic RBFDPs, densely sintered zirconia ceramic single-retainer all-ceramic RBFDPs with a cantilevered design were evaluated.
Methods.A total of 42 anterior RBFDPs with a cantilevered single-retainer design were fabricated from yttrium
oxidestabilized zirconium oxide ceramic, then inserted
using Panavia 21 TC as a luting agent after air-abrasion of
the ceramic bonding surface (Fig 1). The mean observation
time was 61.8 months (range 37.2 to 123.5 months).
Results.Two debondings and one biological complication occurred. The debondings occurred after approximately
Volume 59
Issue 6
2014
315
Fig 2.Oral view of a zirconia ceramic RBFDP after 2 years of clinical service. (Courtesy of Sasse M, Kern M: Survival of anterior cantilevered all-ceramic resin-bonded fixed dental prostheses made
from zirconia ceramic. J Dent 42:660-663, 2014.)
316
Dental Abstracts
Sasse M, Kern M: Survival of anterior cantilevered all-ceramic resinbonded fixed dental prostheses made from zirconia ceramic. J Dent
42:660-663, 2014
Reprints available from M Sasse, Dept of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, ChristianAlbrechts Univ, Arnold-Heller Str 16, 24105 Kiel, Germany; fax:
49 431 597 2860; e-mail: msasse@proth.uni-kiel.de