The randomized shortened dental arch study (RaSDA): design and protocol

<p>Abstract</p> <p>Background</p> <p>Various treatment options for the prosthetic treatment of jaws where all molars are lost are under discussion. Besides the placement of implants, two main treatment types can be distinguished: replacement of the missing molars with removable dental prostheses and non-replacement of the molars, i.e. preservation of the shortened dental arch. Evidence is lacking regarding the long-term outcome and the clinical performance of these approaches. High treatment costs and the long time required for the treatment impede respective clinical trials.</p> <p>Methods/design</p> <p>This 14-center randomized controlled investigator-initiated trial is ongoing. Last patient out will be in 2010. Patients over 35 years of age with all molars missing in one jaw and with at least both canines and one premolar left on each side were eligible. One group received a treatment with removable dental prostheses for molar replacement (treatment A). The other group received a treatment limited to the replacement of all missing anterior and premolar teeth using fixed bridges (treatment B). A pilot trial with 32 patients was carried out. Two hundred and fifteen patients were enrolled in the main trial where 109 patients were randomized for treatment A and 106 for treatment B. The primary outcome measure is further tooth loss during the 5-year follow-up. The secondary outcome measures encompassed clinical, technical and subjective variables. The study is funded by the Deutsche Forschungsgemeinschaft (German Research Foundation, DFG WA 831/2-1, 2-2, 2-3, 2-4, 2-5).</p> <p>Discussion</p> <p>The particular value of this trial is the adaptation of common design components to the very specific features of complex dental prosthetic treatments. The pilot trial proved to be indispensable because it led to a number of adjustments in the study protocol that considerably improved the practicability. The expected results are of high clinical relevance and will show the efficacy of two common treatment approaches in terms of oral health. An array of secondary outcome measures will deliver valuable supplementary information. If the results can be implemented in the clinical practice, the daily dental care should strongly profit thereof.</p> <p>Trial registration</p> <p>The trial is registered at ClinicalTrials.gov under ISRCTN68590603 (pilot trial) and ISRCTN97265367 (main trial).</p

Effects of different polishing techniques on the surface roughness of dental porcelains

OBJECTIVE: The purpose of this study was to evaluate the effects of different polishing techniques on the surface roughness of dental porcelains. MATERIAL AND METHODS: Fifty-five cylindirical specimens (15x2 mm) were prepared for each feldspathic (Vita VMK 95, Ceramco III) and low-fusing dental porcelain (Matchmaker). Fifty-five specimens of machinable feldspathic porcelain blocks (Vitablocs Mark II), (12x14x18 mm) were cut into 2-mm-thick slices (12x14 mm) with low speed saw. The prepared specimens were divided into 11 groups (n=5) representing different polishing techniques including control ((C) no surface treatment), glaze (G) and other 9 groups that were finished and polished with polishing discs (Sof-Lex) (Sl), two porcelain polishing kits (NTI (Pk), Dialite II (Di)), a diamond polishing paste (Sparkle) (Sp), a zirconium silicate based cleaning and polishing prophy paste (Zircate) (Zr), an aluminum oxide polishing paste (Prisma Gloss) (Pg), and combinations of them. The surface roughness of all groups was measured with a profilometer. The data were analyzed with a 2-way analysis of variance, and the mean values were compared by the Tukey Honestly Significant Difference test (a=0.05). RESULTS: For all porcelain material groups, the lowest Ra values were observed in Group Gl, Group Sl, Group Pk, and Group Di, which were not significantly different from each other (p>0.05).When comparing the 4 different porcelain materials, the machinable feldspathic porcelain block group (Mark II) demonstrated statistically significantly less Ra values than the other porcelain materials tested (p<0.05). No significant difference was observed between the VMK 95 and Ceramco III porcelain groups (p=0.919), also these groups demonstrated the highest Ra values. CONCLUSION: Subjected to surface roughness, the surfaces obtained with polishing and/or cleaning-prophy paste materials used alone were rougher compared to the surfaces finished using Sof-lex, Dialite, and NTI polishing kit. Polishing kits and discs were found more effective than the polishing pastes used alone or combined use with Sof-lex discs, thus improving surface smoothness