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OBJECTIVE: No controlled clinical study has evaluated Oral Health Related Quality of Life (OHRQOL) of immediately placed and loaded implants retaining mandibular overdentures. This pilot study evaluated the impact of immediate loading of delayed versus immediately placed dental implants on overdenture patients' OHRQOL. MATERIALS AND METHODS: Two patient treatment groups received a maxillary conventional complete denture, opposing a mandibular overdenture immediately loaded on implants with ball attachments; In group one a delayed implant placement surgical protocol was followed, whereas in group two, patients had mandibular teeth extracted and two implants immediately placed. OHRQOL for these patients was evaluated using a visual analog scale for 48 questions related to 6 domains; comfort, function, speech, esthetics, self-image and dental health. RESULTS: There was no significant difference between the two groups when comparing answers to the pre- and post-treatment questionnaires. Pooled data showed significant differences for all domains between the pre-treatment and post-treatment responses, denoting improvement after an implant retained mandibular overdenture was delivered. CONCLUSION: There was an improved quality of life in patients receiving immediately loaded mandibular overdentures supported by either delayed or immediately placed implants.

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Metalloproteinases (MPs) are Zn(+)-dependent endoproteolytic enzymes, abundant in crotalid and viperid snake venoms. Most snake venom metalloproteinases (svMPs) are active on extracellular matrix components and this effect is thought to result in bleeding as a consequence of the basement membrane disruption in capillaries. Jararhagin and ACLH are hemorrhagic svMPs from Bothrops jararaca and Agkistrodon contortrix laticinctus venom, respectively. Both enzymes demonstrate proteolytic activity on fibrinogen and fibronectin and jararhagin inhibits collagen-induced platelet aggregation in vitro. This work describes the expression, purification and successful refolding of the recombinant ACLH zymogen (rPRO-ACLH) as well as the catalytic domain of jararhagin (rCDJARA). The heterologous proteins were produced in E. coli, an in vivo expression system that does not make post-translational modifications. The recombinant refolded proteins did not show any hemorrhagic activity in mice skin, as well as the native deglycosylated jararhagin and ACLH. However, they preserved their proteolytic activity on fibrinogen and fibronectin. It seems that the hemorrhagic properties of these hemorrhagins are dependent on post-translational modifications, whereas their proteolytic activity is not dependent on such modifications.

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As the dental students of the Class of 2000 entered the Comprehensive Care Clinic at the University of Colorado School of Dentistry in the spring of their second year (spring of 1998), a different, competency-based set of clinical expectations was communicated to them. These students were presented a list of "Recommended Core Experiences" and told that the "requirements" for completion of the Comprehensive Care Program were 1) successful performance on all departmental competency examinations, and 2) timely completion of the comprehensive dental treatment appropriate to each assigned patient. This study examined the number of procedures completed during the six semesters in the Comprehensive Care Clinic for the Class of 2000, as compared to the clinical activity for the Class of 1999 during the same stage of their career. The overall mean number of clinical procedures performed per student was 7 percent greater for the students in the Class of 2000 than for those in the Class of 1999. These results suggest that numerical requirements are not necessary to ensure dental student productivity and that, in fact, students can complete more clinical procedures in a comprehensive care clinical environment without numerical requirements.

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A model for treatment planning is presented to help emphasize the most important elements of the clinical decision-making process for older adult patients. The patient's concerns and needs in the domains of function, symptoms, pathology, and esthetics are the central elements of the process. With sophisticated assessment methods and creative interventions, the dentist can work with each patient to identify and successfully address his or her needs and concerns. This model is applied to two clinical cases which illustrate the importance of considering innovative treatment plans, even when the patient is advanced in years.

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In a recent report on oral health, Surgeon General Satcher reminded us of the need to change the attitudes of families concerning the importance of oral health. In prosthodontics and restorative dentistry, remarkable developments are occurring daily. Specialties are changing, and different types of dental practices are emerging. The introduction of computer technology has greatly affected the way the restorative dentist practices, and the evolution of cyberschools are no longer a fantasy. Adhesive dentistry has replaced the manner in which we prepare, restore, and bond restorations to teeth. The entire field of ceramics and methods of fabricating esthetic restorations are entering a new era. The exceptional prognosis of various implant systems has changed the way we think about maintaining hopeless teeth. Through tissue engineering, the 21st century may be revolutionary in the way we replace missing teeth and lost tooth structure.

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A common assumption when planning for treatment for a fixed partial denture potentially involving an osseointegrated implant is to avoid connection between the implant and natural tooth abutment because of the differences in mobility and potential long-term effects. A large population was surveyed to measure the incidence of natural tooth intrusion in implant-assisted fixed partial dentures (IAFPD) and to try to identify a correlation between type of implant and/or type of connector. Natural tooth intrusion occurred in 3.5% of the patient population specifically treated with IAFPD. No correlation could be made between incidence of intrusion and the type of implant or type of connector used.

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