Impact of Human Genome Project on treatment of frail and edentulous patients.
OBJECTIVE
Because of ongoing increases in life expectancy and deferment of edentulousness to older age, dentists are facing a different challenge to satisfy elderly denture wearers with a higher prevalence of chronic diseases. This discussion introduces the Human Genome databases as novel and powerful resources to re-examine the core problems experienced by frail and edentulous patients.


BACKGROUND
Recent studies demonstrated that mandibular implant overdentures do not necessarily increase masticatory function, perception and satisfaction in denture wearers with adequate edentulous residual ridges. It has been demonstrated that the rate of edentulous residual ridge resorption significantly varies among individuals. The prognosis and cost-effectiveness of denture treatment, with or without implants, may largely depend on how the edentulous ridge is maintained. However, reliable clinical methods permitting dentists to predict the long-term health of the edentulous residual ridge are lacking.


METHODS
With the completion of the Human Genome Project, the genomic sequence database from this multinational consortium will provide a unique resource to determine the genetic basis of similarity and diversity of humans.


RESULTS
One base pair in every 100 to 300 base pairs of the genome sequence varies among humans, suggesting that genetic diagnosis using the single nucleotide polymorphisms (SNPs) may provide a novel opportunity to differentiate our edentulous patients.


CONCLUSIONS
Future dental service for the elderly will require a personalized care paradigm, using highly sensitive diagnostic technology such as SNP genomic analysis, for recommending the treatment with greatest potential benefit.
Nishimura
Ichiro
I
The Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA. ichiron@dent.ucla.edu
Garrett
Neal
N
D000368:Aged; D020029:Base Pairing / Q000235:genetics; D001862:Bone Resorption / Q000235:genetics; D016321:Dental Care for Aged; D019094:Dental Prosthesis, Implant-Supported; D003824:Denture, Complete; D003828:Denture, Overlay; D016330:Frail Elderly; D016045:Human Genome Project; D006801:Humans; D007575:Jaw, Edentulous / Q000235:genetics / Q000534:rehabilitation*; D008334:Mandible / Q000473:pathology; D008409:Mastication / Q000502:physiology; D010347:Patient Care Planning; D017060:Patient Satisfaction; D020641:Polymorphism, Single Nucleotide / Q000235:genetics