In this retrospective study 516 teeth restored with a cast post and core build-up were followed from 1970 till 1990. The data was derived from the dental records of 283 dental clinic patients treated by senior students. The survival rate was found to be 82% after 10 years for post and cores in the anterior region. The most frequent failure characteristic was recementation (46%), followed by rerestoration (32%). The solitary provisions in posterior teeth showed a relative high survival rate, compared with other tooth-types and locations.
s u m m a r y Natural dentitions of elderly people are often reduced and the remaining teeth are heavily restored. It is unknown whether they are satisfied or dissatisfied w ith this situation. To get more insight into this phenom enon 320 dentate non-institutionalized elderly subjects were clinically examined and interviewed by means of a questionnaire. Analysis of the data show ed that only 13% of the subjects had at to the left first molar; 50% had less than four occlusal units, 39% of the subjects were wearing a removable
During the period 1974-1986, 112 post and core build-ups were inserted in 74 patients. The build-ups consisted of a metal prefabricated post (Dentatus, Unimetric or Radix) in combination with a composite core. After an average follow-up period of 7.9 years, 14 failures (12.5%) were noticed. Eight teeth could be rerestored and six teeth had to be extracted. However, when correction was made for teeth with a bad initial prognosis and for extractions not related to the build-up restoration, eight failures remained caused by failure of the build-up (7.5%). The Dentatus posts seemed to increase the risk for failure.
This study covers the characteristics of reduced dentitions in a population of elderly people. The sample consisted of 329 independently living individuals between 55 and 75 years of age. They all had one or more natural teeth and were all interviewed and investigated clinically. The findings showed that 13% of the subjects had a natural dentition with at least the first molars; 4-7 natural occlusal units (defined as 'pairs of opposing teeth that support the occlusion') occurred in 37% of the subjects; 1-4 natural occlusal units in 41% and 0 units in 9% (only anterior contacts). A removable partial denture was worn by 39% of the subjects; most of them were acrylic based dentures (61%). The percentages of restored teeth per subject were high. The need for further restorations, however, was low. Periodontal problems were uncommon; 25% of the subjects had one pocket above 5 mm; 8% had severe problems. Poor oral hygiene was present in a quarter of the cases. Most of the subjects (70%) had no pain or noises in the temporomandibular joint. Only 10% of subjects had more than one sign of craniomandibular dysfunction. Most of the subjects (85%) visit their dentist regularly and 65% had their last tooth extraction more than three years ago. A majority mentioned that they have never had problems with their dentition in the past; 50% had had no real toothache for the last five years. However, problems with food-packing were often mentioned. It can be concluded that, although the dentitions of the elderly in this population are often reduced, their dentitions are in general in good condition and few give TMJ problems.
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