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Council comments on prefabricated dentures
have ever pithed a patient?” I can guarantee you that C laude Bernard never pithed a patient, y et he is the father o f experim ental m edicine and his contributions as a physician and p h ysiologist are m onum ental. M ight he h ave reached such a zenith w ere he not given th e b est education o f his day? P erhaps, but I w ould not w ant the responsibility for com prom ising such genius ju st to cut a few com ers. I respectfully subm it that you have m issed the im portance o f the issu e at hand. W e do not need a “ favor able academ ic im age” via b asic sci en ces or “ academ ics ju st for the sake o f academ ia,” but if dentistry is to continue its sw ift grow th, dental sci en ce (in its broadest sense) and dental care m ust g o hand in hand. O ne can n ot be forsaken for the other. W IL L IA M C. D O N LO N TU F TS U N IV E R S IT Y SCHOOL OF D E N T A L M E D IC IN E , D ’79 BOSTON
■ Y our M ay editorial has a very ser ious m iscon ception regarding the u se fulness and correlation o f basic sci en ce curricula in dental sch ools. T here is no argument that direct correlation w ith the kymographic dis play o f a m uscle tw itch or the n eed to m em orize long and detailed anatom ic inform ation is not relevant to m ost o f dental practice. H ow ev er, the disci pline that is develop ed in th ese aca dem ic cou rses is more than an exer c ise in m em ory. It prepares the den tal student to organize his thinking along traditional levels o f scientific thought. T h is im plem ents the difficult but im portant transition to integrate som e o f the basic scien ce informa tion to the con cep t o f total patient care. T he logic o f limiting scientific edu cation to on ly that w hich is dem on strated to correlate clinically is a dan gerous precedent that should be re sisted b y professional educators and clinicians everyw here. JOSEPH H . LO VASKO, DDS M U N S T E R , IN D
■ T h e M ay editorial is an exam ple o f the narrow -m indedness w hich seem s to plague dentistry. T h e view point o f
the author might b e reversed if clo sely evaluated, keeping m od em , progres siv e dentistry front stage. Quality dentistry d oes not begin and end w ith a four-pellet amalgam and an im m ediate denture. I w ould b ec o m e an ap p reh en sive patient if m y d entist had a know ledge o f only material im m ediately relative to den tistry. B asic scie n c e education, no mat ter h o w d iverse, can b e u sed to tre m endous advantage in a p rogressive dental practice— even “ frog p h ysiol o g y .” P atien ts’ questions oftentim es require answ ers relative to a broad spectrum o f basic scien ces. Edu cated , logical answ ers by the dentist w ill do m ore to build confidence in his patient than any prosthesis he w ill place in a m outh. A s a practicing dentist w h o still studies b a sic scien ces in his spare tim e, I am con vin ced that the con scien tiou s dentist w ho u ses this know ledge w ill find h im self spending his tim e ex a m in in g n ew referrals w h o have heard o f his reputation for being a w ell-rounded dentist. N o longer will he have idle tim e to w aste on such negative thought, w hich should on ly surface in the dissatisfied and unful filled professional. Su ch d ow n cast attitudes should be om itted from professional journals. T h e dental student has his hands full learning b asic scien ces w ithout the practitioner instilling his narrow m indedness and com plicating an al ready difficult task. G L E N N E. V A N C E , JR., DDS B R ISTO L, T E N N
C o u n c il c o m m e n ts on p r e fa b ric a te d d en tu res m T h e partially prefabricated denture sy stem s m entioned by D r. D a le E. E w ing (A pril J A D A , page 604) have b een follo w ed by the C ouncil on D en tal M aterials and D e v ic e s since 1971. T h e se denture care system s c o n sist o f therm oplastic stock size and shape dentures w hich are m odi fied , generally intraorally, to conform to the individual patient. S in ce 1971 the C ouncil and its con sultants h ave periodically review ed the extant inform ation on partially
prefabricated dentures. T heir findings have b een published in T h e J o u rn a l o f th e A m e r ic a n D e n ta l A sso c ia tio n . T he m o st recen t p osition paper on this tech n iq u e w as published in the A u gu st 1976 issu e (page 380). It is the C ou n cil’s b elief that there are inadequate definitive longitudinal clinical studies dem onstrating safety and e ffectiv en ess o f th ese denture treatm ent sy stem s. C ouncil attem pts to stim ulate an in terest in generating the n ecessa ry clinical data h a v e b een largely un su ccessfu l. Initially, the C ouncil ask ed the producers and m anufac turers to present th ese data. T h e bur den o f p ro o f o f safety and e ffec tiv e n ess o f any product is on the m anu facturer. T h e C ouncil also has recen tly sug g ested this area o f research to the uni form ed serv ices and selected dental sch o o ls. T h e C ouncil, therefore, w ould be in terested in review ing any ob jective, w ell-controlled clinical studies that are available. S om e o f the areas in w hich the C ouncil and its consultants fe e l infor m ation is d eficien t are: — the e a se and e ffectiv en ess o f adapting the prefabricated denture to proper anatom ic and p h ysiologic con tours; — the long-term stability o f the pro duct including elastic m em ory and the effects o f heat; — the safety o f the m aterials in v o lv ed including to x icity and effect on the oral structures and environ ment; — the e ffectiv en ess and accuracy w ith w hich occlu sion can b e d ev el op ed , including the d evelop m en t o f the vertical dim ension, occlu sal plane, and tooth ridge relationships; — the esth etics o f the com pleted denture and the ea se w ith w hich m odi fication s fo r esth etics can be m ade. T h e C ouncil is o f the opinion that, although su ch a technique might be useful fo r a segm en t o f the popula tion, the u se o f the tech n iq u e w ithout adequate scien tific ev id en ce o f safety and effectiv en ess can n ot b e recom m ended. ROBERT V . V IN IN G , DDS C H A IR M A N , C O U N C IL ON D E N T A L M A T E R IA L S A N D D E VIC E S
LETTERS TO THE EDITOR / JADA, Vol. 95, July 1977 ■ 21
■ Y our M ay editorial has a very ser ious m iscon ception regarding the u se fulness and correlation o f basic sci en ce curricula in dental sch ools. T here is no argument that direct correlation w ith the kymographic dis play o f a m uscle tw itch or the n eed to m em orize long and detailed anatom ic inform ation is not relevant to m ost o f dental practice. H ow ev er, the disci pline that is develop ed in th ese aca dem ic cou rses is more than an exer c ise in m em ory. It prepares the den tal student to organize his thinking along traditional levels o f scientific thought. T h is im plem ents the difficult but im portant transition to integrate som e o f the basic scien ce informa tion to the con cep t o f total patient care. T he logic o f limiting scientific edu cation to on ly that w hich is dem on strated to correlate clinically is a dan gerous precedent that should be re sisted b y professional educators and clinicians everyw here. JOSEPH H . LO VASKO, DDS M U N S T E R , IN D
■ T h e M ay editorial is an exam ple o f the narrow -m indedness w hich seem s to plague dentistry. T h e view point o f
the author might b e reversed if clo sely evaluated, keeping m od em , progres siv e dentistry front stage. Quality dentistry d oes not begin and end w ith a four-pellet amalgam and an im m ediate denture. I w ould b ec o m e an ap p reh en sive patient if m y d entist had a know ledge o f only material im m ediately relative to den tistry. B asic scie n c e education, no mat ter h o w d iverse, can b e u sed to tre m endous advantage in a p rogressive dental practice— even “ frog p h ysiol o g y .” P atien ts’ questions oftentim es require answ ers relative to a broad spectrum o f basic scien ces. Edu cated , logical answ ers by the dentist w ill do m ore to build confidence in his patient than any prosthesis he w ill place in a m outh. A s a practicing dentist w h o still studies b a sic scien ces in his spare tim e, I am con vin ced that the con scien tiou s dentist w ho u ses this know ledge w ill find h im self spending his tim e ex a m in in g n ew referrals w h o have heard o f his reputation for being a w ell-rounded dentist. N o longer will he have idle tim e to w aste on such negative thought, w hich should on ly surface in the dissatisfied and unful filled professional. Su ch d ow n cast attitudes should be om itted from professional journals. T h e dental student has his hands full learning b asic scien ces w ithout the practitioner instilling his narrow m indedness and com plicating an al ready difficult task. G L E N N E. V A N C E , JR., DDS B R ISTO L, T E N N
C o u n c il c o m m e n ts on p r e fa b ric a te d d en tu res m T h e partially prefabricated denture sy stem s m entioned by D r. D a le E. E w ing (A pril J A D A , page 604) have b een follo w ed by the C ouncil on D en tal M aterials and D e v ic e s since 1971. T h e se denture care system s c o n sist o f therm oplastic stock size and shape dentures w hich are m odi fied , generally intraorally, to conform to the individual patient. S in ce 1971 the C ouncil and its con sultants h ave periodically review ed the extant inform ation on partially
prefabricated dentures. T heir findings have b een published in T h e J o u rn a l o f th e A m e r ic a n D e n ta l A sso c ia tio n . T he m o st recen t p osition paper on this tech n iq u e w as published in the A u gu st 1976 issu e (page 380). It is the C ou n cil’s b elief that there are inadequate definitive longitudinal clinical studies dem onstrating safety and e ffectiv en ess o f th ese denture treatm ent sy stem s. C ouncil attem pts to stim ulate an in terest in generating the n ecessa ry clinical data h a v e b een largely un su ccessfu l. Initially, the C ouncil ask ed the producers and m anufac turers to present th ese data. T h e bur den o f p ro o f o f safety and e ffec tiv e n ess o f any product is on the m anu facturer. T h e C ouncil also has recen tly sug g ested this area o f research to the uni form ed serv ices and selected dental sch o o ls. T h e C ouncil, therefore, w ould be in terested in review ing any ob jective, w ell-controlled clinical studies that are available. S om e o f the areas in w hich the C ouncil and its consultants fe e l infor m ation is d eficien t are: — the e a se and e ffectiv en ess o f adapting the prefabricated denture to proper anatom ic and p h ysiologic con tours; — the long-term stability o f the pro duct including elastic m em ory and the effects o f heat; — the safety o f the m aterials in v o lv ed including to x icity and effect on the oral structures and environ ment; — the e ffectiv en ess and accuracy w ith w hich occlu sion can b e d ev el op ed , including the d evelop m en t o f the vertical dim ension, occlu sal plane, and tooth ridge relationships; — the esth etics o f the com pleted denture and the ea se w ith w hich m odi fication s fo r esth etics can be m ade. T h e C ouncil is o f the opinion that, although su ch a technique might be useful fo r a segm en t o f the popula tion, the u se o f the tech n iq u e w ithout adequate scien tific ev id en ce o f safety and effectiv en ess can n ot b e recom m ended. ROBERT V . V IN IN G , DDS C H A IR M A N , C O U N C IL ON D E N T A L M A T E R IA L S A N D D E VIC E S
LETTERS TO THE EDITOR / JADA, Vol. 95, July 1977 ■ 21