The journal of

PROSTHETIC DENTISTRY
FEBRUARY, 1975 VOLUME 33, NUMBER 2

Through the eyes of the editor

which must have no vertical overlap of tile anterior teeth.

Ellsworth K. Kelly reviews the high spots in the history of the occlusal surface forms of artificial teeth and reports his study of the relative efficiency of some of the available artificial teeth. His'brief history refers also to the controversy over articulators and theories of occlusion. Many articulating devices were invented, and techniques were developed for balancing the occlusion in them. Subsequently, it became more popular to design and propose new occlusaI forms for posterior teeth. The controversy over teeth, articulators, and theories of occlusion continues. He reports that studies which compared the effectiveness of various tooth forms and the patient re~tction to different tooth forms were inconclusive, and he concludes that other factors are involved. To obtain further information, the author devised a questionnaire which he hopes will provide further information about the relative merits of different tooth forms. His preliminary findings indicate that the two principle factors in a patient's ability to masticate food are the patient's experience ira manipulating his dentures and his ability to exert sufficient force on the denture bases to penetrate the food.:He suggests that, "If simplicity of technique is paramount, the nonanatomic form with monoplane occlusion should be used. For those who are able to take the time and effort and who are able to achieve superior esthetics and possibly phonetics, the anatomic form may be the choice" Thus, he acknowledges the better esthetic opportunity with anatomic teeth, and he points out a major disadvantage of monoplane occlusions

(pp. 122o136)
A. B. Warren and A. A. Caputo report their study of the effects of the retained root preparation or attachment on the transfer of forces from the denture to the basal seat and the periodondum of the retained teeth. They used special photoelastic models to simulate five different attachments or preparations. The models were designed to "eveal stresses when they were photographed under po.l*trized light while forces were applied on the test denture in different directions. By studying the stress patterns revealed in . photographs, they determined the direction and amount of force being applied to the basal seat of the denture and to the abutment teeth and their simulated periodontium. The support, stabilization, and retention varied as would be expected. They found a direct relationship between the stability and retention of the denture and the amount of stress and torque transferred to the supporting structures. The choice of tooth preparation and attachment shouId be made by the dentist on the basis of the strength of, the retained teeth.

(pp. 137-148)
Philip H. Levy discusses a form and function concept of occlusion and jaw relationships and suggests "that mandibles of some patients can be repositloned to conform with a centrie occlusion not in harmony with centric relation. While this may be possible with young patients who have their natural teeth, it would be disastrous

119

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Through the eyes o/ the editor

j. Prosfllet. De,it. February, 1975 some of the mysticism from gnathology by adhering to fundamentals. (pp. 169-177) In recent years, special emphasis has been placed on the 15reve/ition of;periodontal disease. Much of the effort relates to plaque inhibition and removal. This is a logic/d beginning since plaque is a primary etiologic factor in gingivitis. P l a q u e is a sticky substance Which attaches itself to teeth and dental materials present in +the oral cavity. Michael D. Wise and Roland W. Dykema addressed the.mselves to the plaque-retaining quality of four materials used in restorative dentistry. They developed a system to measure the effects +of tooth brush!ng in removing plaque from the four materials." The illuminating results support some concepts and negate others. T h l s " r e a l i s t l e + study should aid the deniist in selecting material and instructing the patient. W.L. (pp. 178-190) Marginal leakage, always presen t , has become a requirement for restorations. Those which have least leakage have withstood .~i'he test of time. Pins have been subjected to similar tests. This issue presents the findings of Kai Chiu Chart and Carl W. Svare on microleakage of retentive pins. They found that cemented pins leaked more than noncemented pins arid that FrictionLock pins leaked more than self-threading pins. They also reported that varnish did not reduce the mieroleakage. This report is not in agreement with the work of Moffa, Razzano, and Folio (J. PROSTHET. DENT. 20: 541-551, 1968) who found that all pins leaked a n d that the leakage increased .with time. Standlee, Collard, +'and. Caputo (J. PROSTUET. DZNT. 24: 185-192, 1970) found that pins failed to seat in their channels and that noncemented p!ns injured the dentin. Perez, Schoeneck, and Yanahara (J. PRosTHET. DENT. 26: 63!-639, 1971) presented measurements of spaces at the fundus and walls of pinholes containing noncemented pins. Both of these reports explain the mechanism of microleakage. Suzuki, G o t o , and Jordan (J. Am. Dent. Assoc. 87: 636640, 1973) found that, short of an exposure, the pulp response to a noncemented pin was minimal despite cracks in the dentin. Continued successful use of all types of pins sugt

with older edentulous patients. Young people have effective propr!oception from their periodontal ligamen!s, and this neurologic guide is missing when the natural teeth are missing. A habitual eccentric closure can be reinforced each time the natural teeth occlude, l~dentulous patients may have a habitual eccentric closure, but .. failure to use it accurately results in path, discomfort, or dislodging of dentures, This response is inadequate for edentulous, patients to relearn or reinforce their habits. The occlusal surfaces of complete dentures must be shaped so they can meet evenly in the position at which the closures are made. The author considers the ccntric relation to be a dynamic quasifixed position of temporary duration which exists in the form of an equilibrium established by the neuromusculature and ligaments. Apparently, concepts of centric relation vary with the use that is to be made of that relation. (pp. 149-157) Hisatoshi Tanakal Israel Finger, and Myron M. P0rterfdiscuss some of the objectives of articulators and describe the technique for using the Hanau XP-51 articulator. The instrument requires the use of a special face-bow and lateral interocclusal records for its adjustment. The adjustment'procedure is critical to the successful use of the instrument. The authors recognize that articulators have no ability of their own. The dentist must understand the basis of design of the instrument he uses a n d the way it operates. Then, he must make the necessary records for the proper adjustment of the articulator. This applies to all dental articulators. (pp. 158-168) Don W. Morgan, Martin C. Cornelia, and Robert S. Staffanou outline a procedure for making a diagnostic wax-up of casts for formia.g fixed restorations. They have simplified the techniques generally used by gnathologlsts. They have cut through some of the controversial techniques and propose one that sticks to essentials. Their discussion is extended by considering (1) the principles of occlusal correction, ( 2 ) the requirements of an optimum occlusion, and (3) the components of occlusal surface morphology. The article attempts to remove

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Through the eyes o[ the editor

121

gests that microleakage is of low intensity as is found for acceptable restorations. W.L.

(pp. 191-195)
G. V. Gillbe reports her study of the interarticular, discs from the , temporornand!bular' or) cranigmandibulr' joints of dogs, sheep, a n d rats.5, S h e ' s e l e c t e d these mammals fro' her sthdy because t h e mandibUlai" movements 'of eaCh animal differ from' the others. The mandibular hinge moti9n of the dog, ithe lateral 'masticatory motion of the sheep, and th e anteroposterlor masticatory movement of the rat are typical for these animals: She found marked differences in the discs of each group of animals and suggeslz that the discs m a y ' h a v e become modified in the animals ,according to their different functions. This suggestion is comparable to the one that the occlusal forms Of teeth and jaw motions are coordinated with each other and with the diets of the animals.

Bert T. Cecconi and Kamal Asgar describe a modified hygroscbpic gold jcasting technique. Waxes of varying consistencies are used to influence where the expansion of the investment is to.0ccur, and by the addition of varying quantities of water to the investment ring, the amount of expansion: i n t h e investment may be controlled. D.H.G. (pp. 216-220)

(pp. 196-204)
Jacob Ehriich and Badri Azaz report their long-term study of acrylic resin tooth, implants which are splinted to adjacent teeth. The implant root was shaped to resemble as much as possible the root of the tooth to be replaced. After several years, the bone around the implants resorbed. The proc edures are similar to those reported by Hodosh, Shklar, and Povar (Dent. Clin. North Am. 14: 103-115, 1970), but there were some critical differences. The tissue surrounding the implant had a.tendency toward eventually increasing pocket depth, mobility, gingival recession, and bone loss even though the early response was favorable. They conclude that the value of acrylic resin implants is questionable. (pp. 205-209) R. W. Hinman, T. A. Lynde, G. B. Pelleu, Jr., and R. W. Gaugler have studied the concentration of beryllium in th-e air during the polishing of partial "denture frameworks. Their results indicate the need for lathe ventilation. The implementation of precautionary measures against all hazards should be Of vital intereit to all when laboratory facilities are planned. D.H.G.

Gustavo Sales presents a technique for constructing a mounting l~latform or jig of acrylic resin; He states that this is a simplification of the split-cast t e c h n i q u e for mounting casts.-To develop his platform, he begins with a sp!it-cas, t mountifig of a patient's casts as a standard for orientation of the maxillary cast. He does n o t indicate whether this .or subsequent mountings were face-bow transfers or arbitrary mountings, although his mounting platform , w i l l not accept a ,wide range of face-bow transfers. One of the' advantages of the ,true split-cast technique is that it allows accurate remounting On the articulator after processing which Dr~ sales' platform will not accomplish. S.H.P.

(pp. 221-223)
Bernard Levin reports on his observations of prosthodontic education, prosthodontic treatment, and prosthodontic research in the United Kingdom, Scandinavia, and' Switzerland. He spent four months-in making these observations, and they are of interest from a number of standpoints. The most striking one seems to be the effect that national health systems have on the practice of prosthodontics by general practitioners. The quality of d e n t u r e service provided to most of the people apparently deter!orates under economic pressures. Theresearch, according to this report, apparently becomes less clinically important and more theoretical with less practical significance for general practitioners. T h e excellent and highly qualified dentists seem to be having a n increasingly difficult time in maintaining their standards. The danger signals for dentistry in the United States are exhibited in this report.

(pp. 210-215)

(pp. 224-232)