Conservative and prosthetic rehabilitation procedures in the dentition of old people.

The therapeutic possibilities of conservative and prosthetic rehabilitation procedures are set out in this survey. In particular the aim was to find out whether these are suitable for retaining functional dentition into old age. The anatomical characteristics (Figs. 1 and 3) and secondary dysgnathic alterations of the dentition in the period of senescence make dental therapy considerably more difficult. The tooth-coloured filling materials do not behave as permanently in the mouth as could be wished. They are unsuitable for use in posterior teeth, and are in urgent need of improvement. The amalgam filling should still be regarded as the agent of choice for treatment of the cheek teeth, although cast precious metal inlays have been successful over a long period of time (Fig. 6). Too little use is made of veneer crowns in the anterior area with increasing age (Fig. 7), although the prospect of long term success is good. It was possible to establish statistically that tooth-coloured plastics are inferior to ceramic and metal ceramic crowns because of the greater retention of plaque. Ceramic should accordingly be preferred even with bridges in the anterior area. The replacement of missing teeth with removable partial dentures is the typical method of dental treatment for the period of senescence (Figs. 10-12). An attempt was made by bringing together various principles of planning and construction to lay down guidelines for dentures in older patients. With prosthetic care the fact that there are large differences in the physical and mental vitality of the older person, and that vitality frequently decreases rapidly for the most varied reasons, should not be overlooked. Even at this stage dentures should still prove functional.