The Glossary of Prosthodontic Terms 4th edition was revised for the first time in four years, and The Glossary of Prosthodontic Terms 5th edition was published on March 25, 2019. In The Glossary of Prosthodontic Terms 5th edition, many newly terms have been included along with academic and era changes, and many of the terms in The Glossary of Prosthodontic Terms 4th edition have changed in their meanings. In this article, we explain the flow of revision, newly listed terms and changes, and also introduce the committee proposal regarding the ideal way of nomenclature. We are glad if readers can read this article and fully use The Glossary of Prosthodontic Terms 5th edition.

In aesthetic recovery by the implant treatment, not only conditions of soft and hard tissue but also three elements of implant placement angulation, position, depth are important factors for the operator. These things have been reported by many clinicians. Additionally, in today, all ceramics for restoration materials are widely applied for implant superstructures in clinically. In the aesthetic dental treatment, the light is one of the influencing factors for receiving good aesthetic results. This holds true for dentistry not only the implant treatments. Further on, the outer form and the colour itself are the important factors. Also, the light translucency is one of the important factors for the aesthetic dental restorative material’s property.

Particularly, zirconia having high mechanical strength, excellent aesthetic properties, biocompatibility and excellent opaque material with an excellent masking potential is increasingly demanded as CAD/CAM technology improves. Furthermore, to achieve close-to nature dental restorations, tooth-coloured materials show significant advantages. Compared to porcelain fused metal crowns, porcelain fused zirconia all ceramic crowns perform better in terms of matching the appearance of natural teeth.

The screw-retained and the cement-retained are adopted for the fixed implant superstructure. In the cement-retained, we can collect two kinds abutments, metal abutments and ceramic abutments out of zirconia. In the systematic review, about abutment survival, there was no statistically difference between metal abutments and zirconia abutments. Although both fixing types have advantages and disadvantages. In the restoration of the maxillary anterior tooth region, the implant placement position and angulation also vary with the difference in the fixing type. The implant placement position and angulation also affect the form of the emergence profile of the superstructure. From these results, difference of the superstructure fixing type will affect the aesthetic results.

The purpose of bone augmentation in implant treatment is not only to acquire bone volume for function but also to improve esthetics and cleanability. Selection of bone augmentation techniques is needed for the implant treatment with considering configurations of the alveolar bone defects. Configurations of alveolar bone defect can be classified into three types, intra-bony defect such as dehiscence type and extraction socket, lateral bone defect and vertical bone defect. Augmentation in lateral and vertical bone defect is recognized as being more difficult compared to that of intra-bony defect because of less supplement of osteogenic cells from residual bone. In addition, external pressure such as occlusal force and labial pressure is strongly significant in external augmentation, and thus the use of space making device is important for resistance of the external pressures. The purpose of this present report describes the selection criteria of bone augmentation technique in each defect’s configurations.

Regarding anterior tooth defects, both patients and dentists are mainly interested in restoring esthetics. Loss of anterior teeth reduces tissue volume in most cases. Therefore, prosthesis-driven implant treatment that places the crown in an ideal position increases the importance of tissue management. Prosthetic designs may result in reduced surgical intervention and shorter treatment times. A patient-oriented strategy that fully considers the patient’s requirements is necessary during planning treatment. This report discusses tissue management that considers prosthetic strategies using cantilevers and gum prostheses.

In recent implant treatment, it is considered that the patient satisfaction is affected by an achievement of their own esthetic goal. The harmony of the prostheses and its surrounding soft tissue is crucial for the achievement. In case of full-arch reconstruction, it is recovered not only functional aspect, but also facial appearance. Therefore, it is necessary to consider the alteration of vertical dimension and lip support after tooth extraction for the esthetic satisfaction. Furthermore, the esthetic outcome after the treatment must stabilize for a long time.

One of the obstacles to esthetic longevity is an implantitis. To prevent the implantitis, precise fit between abutments and prostheses is essential, especially in the fixed implant supported denture. We experienced favorable outcome using intra oral adhesive technique that minimize misfit and would like to present our esthetic cases with various demands.

Providing Born Anchored Bridge (BAB) with an implant based on the patient’s original tooth position leads to improved patient satisfaction. The discussion will proceed with the theme of considering patient-centered treatment options for implant prosthesis in maxillary edentulous cases.

In this time, I read Dr.Hosokawa’s paper, but it is different from the part I agree with.

Since there is a part that stands in stance, I would like to describe that point.

When treating patients with edentulous jaws, maxillary complete dentures are rarely as difficult as mandibular complete dentures. Even patients with strong vomiting reflexes can be cleared by creating a denture with little movement by providing a sufficient impression and well-balanced occlusion.

In this paper, what should I do when it is difficult to apply implant treatment due to the difficulty of the ridge condition? What should I do if I can’t select All-on-4 or Zygoma Implant when I consider the patient’s age, general condition, and economic situation? I will describe these difficult problems with a personal opinion. It would be greatly appreciated if you could refer to how you think about edentulous prosthesis in our country, which is in a super-aged society.

The number of edentulous patients has not been decreasing until now. Some prosthetic interventions are needed for the improvement of quality of life in edentulous. Although the effectiveness of mandibular implant overdenture (IOD) has already been elucidated for mandibular edentulous in McGill consensus, there is a controversy regarding the choice of implant prosthesis for maxillary edentulous. The implant prosthetic design should be selected in maxillary edentulous with taking into consideration of the number of implants, cost effectiveness, function to be improved, patients’ preference and life-stage comprehensively. Based on this debate, my opinion is shown below; 1) in cases where functional recovery and/or esthetic recovery are difficult due to large anatomical limitations, IOD can be selected rather than implant-supported fixed prosthesis (ISFP), 2) ISFP can be selected for patients with discomfort in removable dentures, and IOD should be selected if the improvement of patient satisfaction and functional recovery can be expected by existing denture to some extent, 3) either ISFP or IOD may be selected in accordance with patient’s preference (actually ISFP is more preferred) in the middle age, but ISFP should be gradually shifted to IOD in the later years.

Purpose: The purpose of this study was to clarify the influence of the use of denture adhesive containing alcohol (home reliner) on breath alcohol concentration (BAC) through in vitro and in vivo experiments.

Methods: In the in vitro study, five materials—three kinds of denture adhesives and two tissue conditioners—were examined. The diffusion of alcohol odor was measured over time using a semiconductor odor sensor when each specimen was placed in a semi-closed space simulating the oral cavity. In the in vivo study, healthy young subjects were asked to wear the palatal plates lined with each denture adhesive or tissue conditioner, and the BAC was measured over time with an alcohol detector. One denture adhesive and one tissue conditioner were examined. Furthermore, the palatal plate was removed 5 minutes later after wearing and the BAC after removal was also measured.

Results: In the in vitro study, the odor intensity remained without much reduction one hour later and increased in proportion to the area exposed to the air. In the in vivo study, the BAC was the highest immediately after wearing, and exceeded 0.15 mg/L, which is the threshold for drunken driving, during 5 minutes after wearing. However, the BAC decreased with time, and was 0 mg/L 30 minutes later. The BAC in the lining with denture adhesive was significantly higher than that of tissue conditioner. Although the BAC transiently increased after removing the palatal plate, it became 0 mg/L 10 minutes later.

Conclusion: The use of denture adhesive containing alcohol influenced the BAC. It is suggested that the appropriate use and removal of the denture could reduce the increase of BAC.

Purpose: Attributes of patients treated by CAD/CAM resin crowns on premolars (CAD/CAM crowns) and the prognoses of the CAD/CAM crowns were investigated. In addition, the effects of both the method of core buildup and the cement for luting, on the prognoses were analyzed.

Methods: During the period from April 2014 to March 2016, the gender, age and teeth positions of patients treated by CAD/CAM crowns at Ohu University Dental Hospital were investigated. The results were compared with those of full metal crowns (FMC). Regarding the prognoses of the crowns, the cumulative survival curve of CAD/CAM crowns by the Kaplan-Meier method was drawn and compared with that of FMC by the log-rank test. In addition, the setting position, condition of abutment, and cement used for setting were set as explanatory variables and prognoses as the response variable. These data were analyzed by quantification theory type 2.

Results: In patients treated with CAD/CAM crowns compared with FMC, the percentage of females was significantly higher, but average age was lower. In the 2-year prognosis, a significant number of CAD/CAM crowns detached and the relative risk was high. In analysis by quantification theory type 2, range and biased correlation coefficient showed high values for cements used, but discriminant predictive rate and correlation ratio were low.

Conclusion: While CAD/CAM crowns were in demand among females in their late 50s, there were many detachments. Therefore, it is considered important to control the technique sensitivity factor by understanding the selection of abutment teeth, dental materials and adhesion system.

Purpose: There are few reports on the relationship between the items examined for deterioration of oral function and the oral health related quality of life (OHRQoL), while it is considered that four phases of early frailty signs in the food environment and oral function are related to OHRQoL. In this study, the morbidity of deterioration of oral function and its effect on OHRQoL in community residents in Sapporo were evaluated.

Methods: The subjects of this study were those aged over 65 who agreed to the research. Examinations on oral function were carried out and OHRQoL was evaluated by OHIP-14. For statistical analysis, the Wilcoxon test or Kruskal-Wallis was used for comparison of OHIP-14 and each variable. The Steel-Dwass test was used for multiple comparison. Spearman’s rank correlation coefficient was calculated from the number of items with oral hypofunction and the OHIP-14 score. The odds ratio for OHIP-14 for each test was determined by logistic regression analysis.

Results: The OHIP-14 score was significantly higher for the subjects with less than 20 teeth. Eighteen percent of the subjects corresponded to three items or more and were judged as oral hypofunction. There was a significant correlation between the number of items with oral hypofunction and the OHIP-14 score, and the number of remaining teeth and swallowing were factors significantly related to the OHIP-14 score.

Conclusion: Eighteen percent of the subjects were diagnosed as oral hypofunction among community residents interested in oral health. The number of remaining teeth and swallowing were related to the OHIP-14 score. As the number of items of oral hypofunction increased, OHRQoL decreased.

Patient: The patient was a 59-year-old male with the chief complaint of masticatory dysfunction due to poor fitting of maxillary denture. There was no support of the posterior teeth and the mandibular anterior teeth pushed up the maxillary denture, causing rotational displacement of the denture in the sagittal plane. After pre-prosthetic treatment, a metal-structure denture with metal teeth was fabricated for the maxillary jaw and a metal-based removable partial denture with composite resin denture teeth was delivered in the mandibular jaw.

Discussion: The patient was satisfied with the esthetic and functional performance achieved by using the composite resin teeth and the rigidity of the metal-structure denture.

Conclusion: By appropriate pre-prosthetic treatment and design for an Eichner classification C1 case, support and bracing of a removable partial denture were obtained and masticatory function was improved.

Patient: The patient, a 66-year-old male, complained of masticatory disturbance resulting from loss of molars. To correct the decreased occlusal vertical dimension due to tooth wear, we reconstructed the occlusion using an occlusal splint and provisional restoration. The masticatory disturbance was improved by wearing a combination of fixed and removable prostheses as a final treatment.

Discussion: We used an occlusal splint to acquire proper mandibular position, and a favorable outcome was achieved by means of the final prosthetic treatment.

Conclusion: It is suggested that oral function and esthetics were recovered by occlusal reconstruction and favorable results were obtained for this patient who had decreased occlusal vertical dimension by means of removable prostheses.

Patient: A 61-year-old man with tongue cancer presented with the chief complaint of difficulty in swallowing that was caused by a subtotal glossectomy and reconstructive surgery. Based on the results of a swallowing function assessment, palatal augmentation prostheses (PAPs) were provided. At the first visit, the patient took over 90 minutes per serving to eat category 4 (no chewing) universal design food and enteral formulas.

Discussion: About three years have passed since the PAPs were fitted, and the patient’s oral propulsion and swallow onset have improved. The patient can now consume category 3 (collapsed with tongue) universal design foods within 30 minutes. Enteral formulas are no longer necessary.

Conclusion: For patients with tongue cancer who undergo subtotal glossectomy and reconstruction, wearing PAPs allows them to maintain the ability to orally ingest food.

Patient: The patient was a 57-year-old male who visited our hospital with the chief complaint of masticatory disturbance caused by instability of complete dentures, and discomfort while eating. The lower alveolar ridge had been severely absorbed. The reason for poor retention of the mandibular denture was its inadequate shape, and so a new denture was prepared using the closed mouth impression technique to determine the morphology of the polished surface of the denture after exploring the mobility of the oral mucosa and adjusting the impression tray border.

Discussion: By considering the shape of the patient’s denture base and using the closed mouth functional impression technique, improved retention of the new denture and higher masticatory performance were obtained.

Conclusion: The closed impression technique was effective for this case of mandibular complete denture with severe ridge absorption.

Patient: The patient was a 79-year-old male who complained of insufficient retention of the upper and lower complete dentures and difficulty in mastication. Previous masticatory functional examination showed a low score (glucose concentration 74 mg/dL) and the patient was diagnosed with masticatory disturbance caused by maladaptation to the dentures. New complete dentures were fabricated using dynamic impression, which consequently improved masticatory function.

Discussion: In this case, satisfactory treatment outcomes were obtained with the new complete dentures which transferred functional and morphological elements from the treatment dentures.

Conclusion: As masticatory function improved after treatment, the treatment dentures were effective as the patient adapted to the use of the new complete dentures.

Patient: The patient was an 82-year-old female who complained of ill-fitting denture and difficulty of mastication. The inadequate shape of the denture base resulted in poor retention of the dentures. There were significant bilateral differences in both the height and tissue displacement in the mandible. Complete denture treatment considering the occlusal balance was performed for the maxilla and mandible.

Discussion: A favorable result was obtained by an appropriate treatment policy, sufficient assessment and the classification system of the Japan Prosthodontic Society.

Conclusion: In this case, a positive outcome was achieved by arranging artificial teeth and adjusting the occlusion of the complete dentures in consideration of the occlusal balance.

Patient: The patient was a 27-year-old female with the main complaints of masticatory disturbance and an esthetic problem caused by missing maxillary right and left first premolars. Using diagnostic waxing as a reference, interim prostheses were prepared. After the occlusion was stabilized, the patient was treated with zirconia-based fixed dental prostheses veneered with feldspathic porcelain and partial coverage restorations with lithium disilicate ceramics.

Discussion: Long-term success of the ceramic restorations was achieved with an appropriate adhesive bonding technique and design of definitive prostheses, and the establishment of a suitable mandibular position by using interim prostheses.

Conclusion: The clinical result demonstrated that the use of ceramic restorations achieved long-term excellent esthetics and stable function.

Patient: A 54-year-old female visited our hospital complaining of difficulty in mastication due to malocclusion, after using an oral appliance (OA) for obstructive sleep apnea. After restoring her appropriate occlusion using temporary crowns and a bridge, final prostheses made with a semi-adjustable articulator were inserted. A new OA was fabricated with 1 mm mandibular advancement. Her occlusion and sleep quality remained good for 3 years after completion of the treatment.

Discussion: It is considered that providing as much occlusal contact and guidance on premolars and molars as possible, and a small titration of OA, may help improve mastication and maintain dentition form.

Conclusion: After occlusal treatment of this patient using OA, the design of the OA was considered to minimize occlusal change.

Patient: A 64-year-old male was referred to us complaining of discomfort regarding prosthetic treatment and difficulty of mastication due to bilateral missing molar teeth in the maxilla. Although he had tried dentures with a resin palatal plate three times, he could not wear them because of discomfort due to palatal coverage. First, a palate plate of thermoplastic resin to examine the shape of the plate was made. A metal-based denture made of Co-Cr was fabricated and oral function was improved.

Discussion: The application of a metal-based denture with a customized major connector resulted in patient satisfaction, and stability of the RPD was maintained for four years.

Conclusion: A bilateral distal extension metal-base denture considering the design of the major connection was fabricated for a male patient.

Patient: The patient was a 59-year-old woman examined at our department with chief complaints of masticatory dysfunction due to denture mobility during chewing, unpleasant sensation due to tongue contact with the anterior lingual surface of the upper denture, and esthetic issues due to retainers/artificial teeth. A fixed partial denture in part of the edentulous area and maxilla-mandibular removable partial dentures were fabricated.

Discussion: It is suggested that the selection of the fixed partial denture in the anterior edentulous area and the design of the major connector in the denture improved the esthetic/sensory disturbances, and sensory disturbances, respectively. In addition, because the major connector is shaped so as to leave the anteroposterior palatal region uncovered, it is considered that using the milling technique for the retainers improved denture stability and masticatory disturbances.

Conclusion: Favorable results were obtained by carefully considering the design of prostheses and eliminating the causes of disturbances.

Patient: A 59-year-old female patient complaining of masticatory disturbance due to missing mandibular bilateral molars visited our hospital. She was diagnosed as having an extremely high risk of transition to non-occlusal vertical stop. Therefore, implant prosthetic treatment was performed with the aim of reconstructing the posterior occlusal support and anterior guidance.

Discussion: It was essential to share the present condition with the patient and to accept active prosthetic intervention, since this was a branch point concerning expansion of the edentulous region for her in the future.

Conclusion: Deciding definite anterior guidance and appropriate jaw position by utilizing a provisional restoration is efficient for serious clinical cases with potential expansion of the edentulous region.