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Dental implants are becoming a necessary component of the dental profession. The first bone resorption at the implant surface has an impact on implant success. Bone alterations surrounding the implant are a significant factor in determining the implant's effectiveness. Reducing the loss of peri-implant crestal bone has been a constant goal. In dental implantology, several procedures are carried out to improve implant stability and the healing of the bone. The ability of photobiomodulation techniques or low-level laser therapy (LLLT) to speed up osseointegration by inducing cellular metabolism and stimulating tissue healing has made them popular. This case study details the implant loading in a patient treated with photobiomodulation to achieve implant stability and who has compromised bone type or D4.
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In an effort to improve dentogingival aesthetics, scientific research has been developing non-surgical techniques and dental restorative materials. A 45-year-old female reported to the hospital with a complaint of an unpleasant aesthetic in the anterior region of the maxilla. She has an irregular contour of the gingiva in her anterior region and no temporomandibular problems. There is a history of trauma, but she did not take any treatment for it, which caused discolouration. Plaque index was retained by the surface roughness. Due to this reason, the patient's appearance, self-esteem, and quality of life have decreased. The purpose of this case is to provide a system-based clinical example of oral rehabilitation for anterior teeth. The patient didn't like the way she looked, and hence aesthetic and functional rehabilitation was planned. Treating the dentogingival asymmetry was the first step in the therapeutic approach. An in-ceram zirconia permanent porcelain metal-free crown was positioned after the temporary crowns were cemented into place. It should be mentioned that in clinical situations, the integration of periodontal and prosthetic treatment is crucial. Additionally, it is stated that the in-ceram zirconia system can produce satisfactory results when applied appropriately. For the main anterior teeth, zirconia crowns have offered an alternate treatment option that addresses aesthetic concerns and facilitates the installation of extra-coronal restorations. This article describes a case involving the aesthetic and functional restoration of severely damaged maxillary incisors using zirconia crowns.
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A common clinical condition affecting the alveolar ridges of the mandibular or maxillary arches is known as a "flabby ridge." This condition involves a superficial region of movable soft tissue. It is particularly prevalent among long-term denture users, especially in the lower anterior region. Flabby ridges occur when hyperplastic soft tissue replaces the alveolar bone, resulting in mobile, hypermobile, and frequently edematous tissue. This condition is most commonly found in the edentulous areas of the oral cavity, especially in the maxillary anterior region. To provide a good fit for the patient, it is necessary to create a denture with accurate morphology, unique contours, and mobility of flabby tissue. The presence of a flabby ridge can significantly impact the stability, fit, and functionality of dentures. Management of flabby tissue includes various methods such as impression techniques, surgical intervention, and denture designing. This case report aims to provide an improved and controlled application of polyvinyl siloxane impression material in managing flabby tissue conditions, which is commonly used in dental practices. It presents a modified window technique for making impressions of anterior mandibular flabby tissues with their natural, undistorted state, leading to a more accurate and stable denture fit.
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A person's facial appearance matters in both social and professional contexts. Losing teeth has an impact on phonetics and mastication, but it also has an aesthetic effect on the lower face's appearance. Cheek sinking is caused by a decrease in muscular tone and an increase in the rate of resorption of the alveolar ridges. An edentulous patient will transform aesthetically if they receive facial as well as dental rehabilitation. The patient's social contacts and sense of self-worth both improve as a result. When an individual exhibits significant alveolar process resorption, traditional dentures are unable to offer sufficient support, hence requiring supplementary cheek support. Appliances for elevating or plumping the cheeks can be used for this. A 68-year-old male patient reported to the department of prosthodontics with a chief complaint of missing teeth and poor aesthetics. After a complete examination, a complete denture prosthesis with a detachable cheek plumper was planned. Press button retention for cheek plumpers is an advantage due to its easy installation and use. This article outlines a straightforward, inexpensive, and non-invasive process for creating a non-detachable cheek plumper using a press button for those who are edentulous. The two-in-one prosthesis enhances the appearance of the face while also replacing lost teeth.
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Edentulism is characterized by the loss of teeth, which can significantly impact oral health and the quality of life of older patients. Among the challenges faced by individuals with edentulism is the occurrence of flabby ridges, a common consequence of prolonged tooth loss. Flabby ridges, characterized by soft, compressible tissue in the edentulous ridge area, present unique management challenges for dental professionals. Fibrous or flabby alveolar ridges present challenges in the fabrication of predictable prostheses. Impression making, a critical step in prosthodontic treatment, becomes particularly problematic as forces exerted during the process can distort the mobile denture-bearing tissues, which will cause the denture to become unstable and loose. This case report aims at an impression technique that can enhance the treatment outcomes for edentulous patients with fibrous alveolar ridges as this decreases the pressure over flabby tissue.
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AIM: To determine the correlation between body mass index (BMI), bone mineral density (BMD), and residual ridge resorption (RRR) in postmenopausal females and the effect of osteoporosis on RRR. MATERIALS AND METHODS: A study was conducted with 60 postmenopausal female individuals. BMI was calculated using the weight and height of the patient using a formula. BMD was assessed and graded using a T-score. RRR was determined using the Tallgren method. RESULTS: Most individuals showed a higher BMI (63.33%), which is in the overweight or obese category. BMD was lower in approximately 68.33% of patients, and RRR was significantly higher in about 60% of total patients. CONCLUSION: The higher the BMI values, the lesser the BMD and the higher the RRR.
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Neglect initially starts as an infection, evolving into a disease. During the COVID-19 pandemic, lifestyle changes and disturbed food intake have weakened immune systems, making individuals more susceptible to secondary infections. Mucormycosis poses a significant threat, especially during the COVID-19 pandemic when immune systems may be compromised. The impact of the disease extends beyond physical health, affecting psychological and social well-being due to the challenges, such as difficulties in mastication, speech, and swallowing post-surgery. The mention of maxillectomy highlights the severe nature of some cases, necessitating surgical intervention to remove the affected tissue. Anatomical and functional losses following surgical excision of the maxilla and surrounding tissues need to be recovered as soon as possible. After surgery, prostheses can and should be used to restore speech, mastication, and deglutition - three essential physiological activities. Thus, a patient's treatment approach should include prosthetic planning before surgical intervention and rehabilitation after the surgery. If they are carefully handled at the moment of surgery, the overall continuity created by maxilla resection includes at least the oral, nasal, and maxillary sinus cavities, which may prove to be a useful future location for prosthesis retention. As a result, the prosthodontist's role becomes crucial in assisting the surgeon in taking all necessary precautions that are beneficial to the patient.
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Tooth loss and subsequent complete denture rehabilitation can profoundly affect a patient's psychological and social well-being. Dentures play an important role in helping individuals regain a sense of normalcy as well as facilitating communication in today's appearance-conscious society. However, common issues with dentures include discomfort while chewing and dissatisfaction with esthetics and speech. Prosthetic rehabilitation for complete denture patients should aim not just at replacing missing teeth but at fully restoring masticatory functions and appearance. This article outlines a simple, economical, and esthetically pleasing approach to rehabilitating patients with complete dentures, particularly those with resorbed ridges and with difficulty in phonetics. The focus is on comprehensively restoring the patient's orofacial complex.
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The utilization of natural teeth as denture abutments offers a significant advantage in retarding the residual ridge resorption (RRR). This approach distributes stress concentration between the denture-bearing areas and abutment teeth, thereby mitigating issues such as loss of sensory feedback, compromised mastication, and aesthetic concerns. Overdentures, by providing additional support and stability, play a pivotal role in reducing RRR while enhancing stability and retention. A cast partial denture (CPD) becomes the first choice in cases of long edentulous span where cross-arch stabilization is required. The simplicity of insertion, removal, and maintenance, coupled with effective oral hygiene practices, make CPDs a practical solution. This case presentation illustrates the successful prosthetic rehabilitation of a partially dentate patient through the implementation of a maxillary overdenture and mandibular CPD underscoring the efficacy of this treatment modality in achieving optimal outcomes. The combination of these prostheses restored the masticatory function, improved the aesthetics, and enhanced the quality of life of the patient. This case highlights the effectiveness of dual-arch prosthetic solutions in achieving comprehensive rehabilitation in partially dentate patients.
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In a rare condition known as vaginal agenesis, the uterus (womb) may develop only partially or not at all, while the vagina fails to develop altogether. It is common to diagnose vaginal agenesis, when a female does not start menstruation at puberty. This is a prenatal disorder that may also be linked to bone or kidney issues. Mullerian agenesis, Mullerian aplasia, and Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome are other names for the illness. Treatment modalities encompass surgical and nonsurgical interventions, including the utilization of prefabricated or customized vaginal stents for neovagina reconstruction and maintenance. This case report describes the development of a neovagina in a 27-year-old female diagnosed with vaginal agenesis, a characteristic of MRKH syndrome. A customized clear acrylic stent, designed to provide a resilient surface, serves as a straightforward and cost-efficient alternative for managing this condition. Significantly, it enhances patient's compliance and comfort during treatment, addressing both the physical and psychological ramifications of this congenital anomaly. This customized vaginal stent not only provides a practical solution but also contributes to enhancing the quality of life for individuals grappling with vaginal agenesis, thereby offering a promising avenue for addressing the multifaceted challenges associated with this condition.
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Cranioplasty for cranial defects can be complex and challenging in composite defects. The intricate 3D structure of the craniofacial skeleton poses various difficulties encountered in surgical reconstruction. The continuous progress in computer-aided design and computer-aided manufacturing design, and fabrication technology has led to a growing array of applications for visual analog scale and 3D printing in craniofacial surgery, encompassing preoperative assessment, the creation of cutting guides, and the development of custom implants and stereolithographic models. Within this review, the authors detail the present and developing applications of virtual surgical planning, 3D bioprinting, augmented reality, and virtual reality in craniofacial reconstruction.
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Prosthodontics, which is removable and fixed, is the branch dealing with the replacement of missing teeth. Implant therapy is the popular treatment modality and commonly preferred treatment option by many patients and clinicians for missing teeth in recent years. Primary implant stability (PIS) is one of the crucial factors for osseointegration. It has been considered a crucial factor in the success of implants. Moreover, several factors influence PIS. On the other hand, both secondary implant stability and osseointegration are influenced by the PIS. Bone density, bone volume, bone-to-implant contact, and other factors that enhance or degrade the primary stability. Certain host sites such as the maxillary posterior region demand more dense bone to achieve desired results as they are the low-density areas of the jaw. So, a new promising and growing innovative concept of osseodensification (OD) offers a great solution with multiple benefits and desirable results. This review article aims to enlighten the multiple benefits of OD technique and their mechanism of action.
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Effective treatment planning is crucial for implant-supported dental prostheses' success, requiring a thorough assessment of various factors, including bone quality, quantity, and available space. Evaluating space availability, encompassing height, width, and angulation, is imperative to ensure optimal implant positioning devoid of anatomical limitations. Adequate vertical space is essential for accommodating the implant-supported restoration while preserving proper occlusal function and esthetics. However, not all cases adhere to ideal standards, especially those featuring limited interocclusal space, as seen in scenarios of long-standing edentulous areas lacking prior prosthetic rehabilitation. Ideally, the interocclusal space should measure between 8-12 mm vertically. This case report details the management of reduced interocclusal space through the strategic placement of deeply positioned implants and the incorporation of a screw-retained fixed partial denture, effectively addressing the challenges associated with limited space.
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Congenital partial hypodontia is a commonly encountered disorder, presenting a challenge for adolescents seeking treatment, as existing options often come with drawbacks. Among these options, the Maryland Bridge stands out for its accessibility and notable benefits in terms of both strength and aesthetics. This article explores the merits of this treatment modality, supported by a detailed case study demonstrating its successful application. An 18-year-old patient was referred to our hospital with a complaint of missing bilateral maxillary incisors. Upon clinical examination, it became apparent that the orthodontic treatment was done and exhibited the absence of bilateral incisors in the upper arch. Subsequent diagnosis confirmed congenital partial hypodontia. To address the missing teeth, a treatment plan centered around the use of a Maryland Bridge was devised. One of the persistent challenges faced by restorative dentists is devising solutions for congenitally missing lateral incisors. Despite the availability of numerous therapeutic alternatives, none are without their limitations. However, the outcome of the rehabilitation in this case proved to be notably aesthetically pleasing, effectively fulfilling the intended purpose. As a result, this article advocates for the Maryland Bridge as a viable option for patients facing similar dental challenges.
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This case report presents an overview of the workflow and advantages of computer-aided design and manufacture (CAD/CAM) technology in designing single crowns for anterior restoration. The workflow of CAD/CAM systems involves extraoral scanning, virtual crown design, and automated milling processes. The advantages of CAD/CAM technology include enhanced accuracy, reduced chairside time, and improved patient satisfaction. Considerations for material selection, clinical indications, and associated factors in CAD/CAM single-crown design are also discussed. Additionally, CAD/CAM provided accurate and lifelike restoration contours, ensuring optimal fit, function, and aesthetics. This technology proved highly beneficial in this case for several reasons. This case illustrates the significant advantages of CAD/CAM technology in modern dental practice, offering precise, efficient, and aesthetically pleasing solutions for single dental crowns.
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In order to effectively address challenges related to anterior teeth restoration and achieve natural-looking results, considerations such as shape, size, gingival contour, and color are crucial. Due to an increasing desire for visually appealing alternatives that are free of metal, materials such as dental zirconia have become popular because of their superior aesthetics and mechanical characteristics. This case report presents clinical insights into anterior teeth rehabilitation with the use of layered zirconia fixed dental prostheses. It delves into the experiences associated with zirconia dental restorations on both endodontically treated and vital abutments, aiming to discern how various factors influence treatment outcomes. Beginning with the design of the restoration, its intricacies significantly impact its fit, strength, and overall durability. Moreover, the composition of zirconia used plays a pivotal role, as different formulations offer varying degrees of mechanical properties, influencing factors such as resilience and wear resistance. The shade selection is also scrutinized, as it directly affects the restoration's aesthetic integration with surrounding natural teeth, contributing to a more harmonious smile. Furthermore, the layering technique employed, particularly when additional porcelain or ceramic layers are applied, is essential for both cosmetic enhancement and structural integrity. Lastly, considerations of occlusion are paramount, ensuring proper alignment and contact between teeth to prevent premature wear and discomfort. By exploring these facets in zirconia restorations across different abutment types, this inquiry seeks to illuminate best practices for achieving favorable treatment outcomes in dental restoration procedures. The choice of zirconia composition, framework design, and shade must be carefully tailored to suit the characteristics of each individual abutment. This emphasizes the significance of adopting a tailored approach to tackle the distinct challenges posed by every clinical scenario. The manuscript provides detailed observations from a clinical case involving the restoration of anterior teeth utilizing monolithic zirconia-fixed dental prostheses. Through a combination of root canal treatment and composite buildup, successful restoration was achieved, with meticulous attention paid to aesthetic considerations. The utilization of computer-aided designing/computer-aided manufacturing (CAD/CAM) technology in crafting zirconia restorations ensured precise fit and superior biocompatibility, contributing to the overall success of the treatment. The study underscores the importance of personalized treatment strategies in achieving optimal outcomes in anterior teeth restoration, emphasizing the need for careful consideration of various factors such as design, composition, and shade selection. Overall, the findings shed light on the potential of zirconia-based restorations in addressing the unique challenges associated with anterior teeth rehabilitation, offering valuable insights for dental practitioners striving to deliver aesthetically pleasing and functionally sound outcomes for their patients.
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This review explores the pivotal role of sustainable dentistry with a specific focus on the recycling of gypsum products in prosthodontics. As oral health practices increasingly impact the environment, the adoption of sustainable approaches becomes imperative. The review delves into the environmental challenges posed by gypsum waste in prosthodontics and examines current recycling techniques, presenting key findings and successful case studies. The call to action is directed towards the dental community, urging practitioners, educators, and policymakers to prioritize sustainable practices, encompassing responsible waste management and the incorporation of eco-friendly materials. Looking to the future, the review envisions a promising landscape for sustainable dentistry in prosthodontics, propelled by emerging technologies and a collective commitment to environmentally conscious oral healthcare. Ultimately, this review serves as a catalyst for positive change, advocating for a transformative shift toward sustainability within the dental community.
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The virtual articulator (VA) is a technology that simulates the jaw relation in a computer-generated setting. Augmented and virtual reality have been utilized as digital technology, which aids in many areas of dentistry and dental education. Today, a practicing dentist must keep up with the newer technologies, but with technology evolving so quickly it becomes challenging. In dentistry, the possibilities for digitization and technological advancements are limitless. Virtual articulators (VAs) allow a complete occlusion analysis using dental models that replicate all mandibular motions in static and dynamic scenarios. VA when executed in addition to other software enhances treatment planning and patient education, allowing quicker and more precise individualized diagnoses. The main objective of this study was to describe and evaluate the study outcomes in the available research on VAs, assess their needs, and evaluate their advantages and limitations in various aspects. A PubMed Central search was made of dental journals, with the identification of 135 articles out of which 30 were finally selected. The investigations conducted to evaluate the VA's dependability provide good visualization of the quantity and location of the dynamic interactions. A precise instrument for fully analyzing occlusion in a real patient is the virtual articulator.
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Background Complete edentulism negatively impacts emotional, physical, social, and psychological well-being, leading to a decline in quality of life and heightened stress and anxiety. Stressful situations associated with edentulism can elevate cortisol levels, potentially increasing the risk of diabetes. Rehabilitation with complete dentures needs careful evaluation for its impact on general health, considering stress points and systemic effects. This study aimed to assess salivary cortisol levels in type 2 diabetes mellitus patients before and after complete denture rehabilitation, highlighting the intricate relationship between diabetes, cortisol, and the stress response. Methods This is a cross-sectional study centered on individuals with diabetes who were completely edentulous and undergoing evaluation by the outpatient prosthodontic department. Glycated hemoglobin, anxiety levels, and the fabrication of complete dentures were all accomplished with the participants' consent. Patients underwent evaluations before and one month after receiving complete denture rehabilitation. Results An absolute correlation between salivary cortisol levels and anxiety may be established because anxiety levels dramatically decreased during complete denture rehabilitation. Conclusion By learning how the patient's general health is related to their new set of complete dentures and how to correlate that information with dental rehabilitation, professionals can help patients better adapt to their new set of dentures.
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Obstructive sleep apnea (OSA) is a recurrent partial or complete obstruction of the upper airway during sleep caused by narrowing or collapse of the pharyngeal wall. It leads to microstimulation and oxyhemoglobin desaturation, resulting in sleepiness and loud snoring. OSA negatively affects the cardiovascular system and may contribute to neurocognitive impairment. The aim of this systematic review is to evaluate the effectiveness and efficacy of appliance therapy in obstructive sleep apnea. The effectiveness was assessed by using the Apnea Hypopnea Index (AHI). An electronic search of the Cochrane Library, PubMed, and Google Scholar was conducted between 1998 and 2021. Articles were independently assessed by three reviewers. The quality of a randomised control trial (RCT) is assessed using the Cochrane risk of bias method. The tool GRADE was used to achieve the desired level of confidence for each outcome reported. Several studies used continuous positive airway pressure (CPAP), mandibular advancement devices (MAD), and tongue retention devices (TRD). The meta-analysis included a total of six papers that met the inclusion criteria. Results showed that CPAP significantly improved AHI compared with an oral appliance (random effects: difference in means = 8.40, 95% CI = 7.21 to 9.60). It was also found that oral appliance (OA) therapy significantly improved AHI compared with baseline before appliance therapy (random effects: mean difference = 13.40, 95% CI = 10.87 to 15.93; p.00001). For mild to moderate OSA, CPAP is considered the gold standard. Our meta-analysis of six RCTs found favorable evidence for OSA patients receiving oral devices; however, they were less effective than CPAP. A subgroup analysis found that MAD may be a beneficial treatment for mild to moderate OSA patients who do not respond to CPAP. The findings suggest that oral appliances may be an effective treatment for OSA, especially in patients with mild to moderate OSA.