Introduction: Merging Well-Founded Principles With New Trends in Prosthodontics

Evangelos Rossopoulos, DDS, has been practicing prosthodontics in Whittier, Corona and Huntington Beach California since 1987 and he holds faculty positions at UCLA and the Eastman Institute of Oral Health in Rochester, N.Y. He is the president of the American Prosthodontic Society and is a member of the CDA Presents Board of Managers and a prosthodontist lead at CDA Cares. Conflict of Interest Disclosure: None reported.

“The measure of a man is what he does with power.” — Plato

The term “measure of a man” refers to the character of a person. The character and integrity of a person can be measured by the way they respond to the power they are given. This is true for many aspects of dentistry but especially in the field of prosthodontics. Pierre Fauchard, the father of modern dentistry, replaced missing teeth by carving ivory or bone. Dentists have been introduced to the “power” of many technological advances that greatly shaped the way they serve their patients. As dental professionals, we should always be careful when using these powers to better serve our patients.

This issue features four prosthodontic articles written at four great institutions with the collaboration of dental educators and students. It was important to involve students and residents, as they are the future of our beloved profession. We could devote thousands of issues to the field of prosthodontics, but these articles give us an introduction on how we are able to merge the important “old-time” prosthodontic principles with newer technologies that are used to assist the practitioner and teacher alike.

“One thing I’ve learned after 21 years – you never know what is gonna come through that door.” That is the introduction from Pawn Stars, a popular television show. As we are serving the prosthodontic patient, we can relate to that quote, as it perfectly applies to our professional careers. No prosthodontic patient is alike and they all present with various personalities, different conditions and a wide range of expectations. The unique needs of each of our patients can only be addressed with proper prosthodontic planning and execution. Dr. Konstantinos Chochlidakis and his team of students and other specialists from the Eastman Institute for Oral Health in Rochester, N.Y., address the unique needs of an ectodermal dysplasia patient and gives us an example on how an interdisciplinary and methodical approach can achieve their oral rehabilitation. In general, the proper prosthodontic treatment for patients with special conditions or diseases, despite their unique challenges, can have an amazing effect on the quality of life, as it improves not only their oral health, but also their psychological growth.

Are digital dentures ready for prime time? Digital dentures or computer- engineered complete dentures are increasingly becoming popular and replacing traditionally used protocols in the treatment of our edentulous patients. The CAD/CAM revolution has provided dentists with tools that greatly simplify and improve their prostheses fabrication. However, the speed by which new technologies are introduced has left the practitioners wondering whether they should incorporate it in their practices. There is a fine line between adhering to evidence-based dentistry and striving to position one’s practice at the forefront that is greatly affected by the associated marketing. In our second article, Dr. Sarah Bukhari along with her peers and students from the Loma Linda University School of Dentistry provide us with an up-todate evidence consensus statement in the field of digital dentures in order to assist dentists in their decision to incorporate this technology in their practices.

The Dalai Lama once said, “Open your arms to change but don’t let go of your values.” Dr. Steven Sadowsky from the University of the Pacific, Arthur A. Dugoni School of Dentistry, refers to the fact that denture aesthetics might be compromised when only CAD/CAM technology is used in the virtual teeth setup. Merging with this technology the ability to incorporate an analogue try-in of the denture teeth and the ability to change the individual teeth arrangement can greatly enhance the final result. His article also provides a great overview of denture aesthetics, a very important topic that is greatly underreported in the prosthodontic literature.

Referring to the value of student involvement in their education, Benjamin Franklin once said, “Tell me and I forget. Teach me and I remember. Involve me and I learn.” To enhance our dental students’ initial involvement, a simulated oral environment is necessary before they are ready to treat patients. For many years, typodonts and mannequins have been used to introduce the student to a simulated dental environment. Dr. Kumar C. Shah and two UCLA residents introduce us to the concept of “haptic“ technologies and describe how it is currently being piloted to enhance students’ preclinical dental skills development.

With this issue, we try to relate the challenges that we all face in treating the prosthodontic patient and the individuality that each presents. There is rapid advancement in all aspects of prosthodontics not only related to clinical applications, such as treating the very challenging patient, but also in following research and enhancing teaching methods. Embracing the rapidly developing new technologies is exciting and beneficial; however, following proven principles and adhering to evidence-based practice is essential to better serving our patients.