Assessment of Electromyographic Changes in Masseter and Temporalis Muscles for Patients Undergoing Lower Third Molar Surgery: A Prospective Study.

Introduction Lower third molar impaction surgery is one of the most common minor oral surgical procedures done. Trismus has been one of the most common and disturbing postoperative sequelae for patients. The study aimed to evaluate the electrical activity of the masseter and temporalis muscles after mandibular third molar surgery. Materials and methods The research was conducted at Saveetha Dental College and hospitals in the Department of Oral and Maxillofacial Surgery. The study consisted of 20 individuals. The EMG (electromyography) activities of both masseter muscles in each patient were measured before the tooth extraction surgery, postoperatively after 72 hours, and after seven days. The inter-incisal distance was also measured at similar follow-up intervals. Data were analyzed using IBM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp., with p-values less than 0.05 considered statistically significant. The Mann-Whitney U test was used for the comparison of electrical activity between masseter and temporalis on both the operated and non-operated sides during preoperative, postoperative, 72-hour, and postoperative seven-day periods. Results It has been found that the electrical activity of the temporalis is higher than that of the masseter muscle measured at all the intervals of the follow-up period, with statistically significant values (p=0.001). It was noted that all the patients have reduced mouth opening when compared with preoperative (mean mouth opening = 45.6 mm), postoperative 72 hours (mean mouth opening = 31.2 mm), and postoperative seven days (mean mouth opening =35.6 mm). When a comparison was done between temporalis and masseter, the masseter took longer to return to pre-operative electrical activity, which might also imply that for prolonged trismus seen in patients after lower third molar surgery, it is the masseter that is affected and needs recovery for trismus to be resolved.  Conclusion  Based on the results obtained, it can be concluded that there was a reduction in the electrical activity of both the masseter and temporalis post-third molar impaction surgery. It was also found that there was a reduction in mouth opening in patients who underwent lower third molar extraction surgery. Masseter muscle took longer to return to its preoperative electrical activity than temporalis muscle, implying that targeted therapies to accelerate the healing of masseter muscle may prevent prolonged trismus in patients who undergo lower third molar impaction surgery.

Electromyography Analysis of the Masseter Muscle's Activity in the Management of Oral Submucous Fibrosis.

Introduction Oral submucous fibrosis (OSMF) is a persistent, collagen metabolic disorder distinguished by the presence of fibrosis of the connective tissue stroma in the oral mucosa with a higher malignant potential rate for oral cancer. This study aimed to analyze the utility of electromyography (EMG) as the prognostic assessment tool in the management of OSMF with conventional intralesional corticosteroid therapy. Materials and methods This study included 20 OSMF cases of age range 20 to 80 years without systemic comorbidities to assess pre-treatment and post-treatment changes with intralesional corticosteroid therapy as an intervention and to determine if it could be assessed using electromyographic study. Clinical and histopathological grading of OSMF was done. The five clinical parameters were evaluated for measuring treatment prognosis. Among them, mouth opening, tongue protrusion, and burning sensation assessments were quantitative parameters, and palpable fibrotic bands and mucosa colour were qualitative parameters. As OSMF involves changes in muscle plane in moderately advanced and advanced cases, EMG was used as an assessment tool for measuring muscle activity. Among the muscles of mastication, the masseter and temporalis were selected for evaluation. Twenty age and gender-matched healthy controls were required for this study as there are no standardized normal values for amplitude and onset of activity in muscle analysis. The EMG activity of the right and left temporalis and masseter muscles were recorded using surface electrodes and were correlated with five clinical assessment parameters. Results In the right masseter, the rest amplitude of 1.6010 µV of the OSMF was statistically significant (p-value: 0.050) when compared with 4.1275 µV of the control. The clench amplitude of 133.370 µV of the OSMF was statistically significant (p-value: 0.062) when compared with 94.310 µV of the control. In the left masseter, the rest amplitude of 1.6695 µV of the OSMF was statistically significant (p-value 0.066) when compared with 2.5735 µV of the control. In the left masseter, the onset of muscle action of 62.670 ms of the OSMF was statistically significant (p-value: 0.017) when compared with 131.835 ms of the control. The clench amplitude differences in the right masseter of 133.370 µV pre-treatment, and 102.775 µV post-treatment were statistically significant (p-value: 0.007). The clench amplitude in the left masseter of 102.535 µV pre-treatment, and 92.090 µV post-treatment were statistically significant (p-value: 0.036). The correlation was seen between tongue protrusion and rest amplitude in the right masseter in OSMF (r = 0.376, p-value: 0.023). Conclusion There was a correlation between tongue protrusion and rest amplitude in the right masseter muscle in OSMF patients before treatment. In the right and left masseter, during rest, the amplitude of the OSMF group was lesser than that of the control group. During clench, in the right masseter, the amplitude of the OSMF group was higher than that of the control group. During clench in the left masseter, the onset of muscle action was lesser in the OSMF group than in the control group. After treatment, there was a reduction in clench amplitude in OSMF patients from their pretreatment values signifying muscle relaxation and a better onset of muscle action.

Maxillofacial Reconstruction With Three Dimensional Resin Bone Substitutes as an Alternative to Transition Group of Metals: A Structured Review.

In recent years, novel technologies and techniques have allowed today the production of controlled architecture materials. Although autogenous bone graft substitutes remain the gold standard, enormous defects require supplementary alloplastic substitutes for reconstruction. Polymers have lately been explored for the same purpose and their biological performance has been under research since the last decade. The aim of this review is to analyse maxillofacial reconstruction with three-dimensional resin bone substitutes. A Problem Intervention Comparison Outcomes (PICO) analysis was done and a search was carried out in the Cochrane Database, PubMed, Google Scholar etc databases and a hand search was done to collect the related literature. All articles for maxillofacial reconstruction with three-dimensional resin bone substitutes were scrutinised. The manuscripts published from 1990 till May 2021, were included in this review. A total of 106 articles were obtained from a PICO-based keyword search, and 91 manuscripts were retrieved after excluding the duplicates. Out of these 57 manuscripts were excluded on the basis of title and abstract. From the remaining 34 studies, 17 were excluded after reading the full text based on the inclusion and exclusion criteria. During data extraction, four studies were removed and finally, 13 studies were included in this research. From this scoping review, we could conclude that polymethylmethacrylate and polylactic acid formulations are very promising resin bone substitutes for 3-dimensional reconstruction of maxillofacial defects. However, rigorous long-term clinical trials are needed to validate this conclusion.

Analyzing the Surface Topography of Hafnium Nitride Coating on Titanium Screws: An In Vitro Analysis.

Background The use of surface coatings to enhance the properties lacking in titanium has attracted significant focus in recent times. Hafnium nitride (HfN) coatings could be explored as promising in the osteoinductive properties of titanium implants. HfN exhibits excellent mechanical attributes, such as hardness and wear resistance, and is often used as a coating on high-end equipment for protection. The findings from this research may carve a new path for the production and optimization of HfN coatings to enhance the longevity and augment properties of implant materials. Thus, the present study was orchestrated to elucidate the surface morphology of HfN coating, ultimately contributing to the advancement of dental implant biomaterials. Materials and methods A total of twenty samples of medical grade commercially pure titanium screws (2 mm diameter and 7 mm length) were procured from G. R. Bioure Surgical System Pvt. Ltd., Ravali, Uttar Pradesh, India, and ten samples were reacted with HfN (0.1 M) (Nano Research Elements, Kurukshetra, Haryana, India) in 100% ethanol and stirred continuously for about 48 hours. Then these screw samples were immersed in the prepared colloidal suspension and sintered for two hours at 400 degrees centigrade. The implant screws were affixed onto metal supports. The magnifications for photomicrographs at ×30, ×200, ×1,500, ×3,000, and ×5,000 were standardized. Elementary semi-quantitative analysis of both dental implants was conducted using energy-dispersive X-ray spectrometry (EDX) coupled with the field emission scanning electron microscope (FE-SEM) equipment (JEOL Ltd., Akishima, Tokyo, Japan). The software used for the analysis of the obtained images is SEM Center. Results The surface analysis using the scanning electron microscope (SEM) showed the coating of HfN over titanium screws. The difference in surface morphology of both the group of implant screws can be visualized under 40.0 and 10.0 mm working distance (WD) for both groups. The surface analysis using the EDX of uncoated titanium screws shows five elements in the spectrum: titanium (Ti), oxygen (O), aluminum (Al), carbon (C), and vanadium (V). The EDX of the HfN-coated screws has two additional metals dispersed in the spectrum, hafnium (Hf). The element characteristics are tabulated with their apparent concentration, k ratio, line type, weight percentage, standard label, and factory label for uncoated titanium screws and HfN-coated titanium screws. Conclusion The study evaluated HfN coating over medical grade commercially pure titanium. The surface topography of coated versus uncoated was visualized. The scanning electron microscope (SEM) images showed a homogenous coating over the titanium surfaces, and the EDX showed elemental dispersion of the coated implant. The study aims to provide a comprehensive understanding of the coating's surface morphology, which will aid in the development of more durable and biocompatible implants. This thereby provides a promising scope for further research of this novel metal coating for use in the biomedical sectors, specifically for dental implants.

Evaluation of Corrosive Properties of Hafnium Nitride Coating Over Titanium Screws: An In Vitro Study.

Background Varied surface coatings have been studied time and again in medical sciences. Whether general or dental, studying the performance of coatings aims to assess their potential to improve the durability and longevity of titanium implants, thereby advancing implant technology for enhanced patient outcomes. Various analytical techniques are utilized to assess the performance of the coating, providing insights into its effectiveness in preventing corrosion. The findings of this evaluation will contribute to our understanding of corrosion mitigation strategies for titanium implants and pave the way for the development of more durable implant materials. This article aims to evaluate the corrosion resistance of an innovative metal compound coating applied over titanium implants.  Materials and methods In this study, a total of 20 medical-grade, commercially pure titanium screws were collected. The dimensions of the titanium screws were 2mm x 7mm. Around 10 of these commercially pure titanium screw samples were used as the control group. Hafnium nitride (HfN) (0.1 M) was mixed with 100% ethanol and stirred using a glass rod for about 48 hours. Then 10 of the implant screw samples were immersed in the prepared sol and sintered at 400o C for two hours. The HfN-coated samples were then used as the test group. The corrosion resistance of both groups was tested using electrochemical impedance spectroscopy and potentiodynamic polarization studies. The Nyquist, Bode impedance, and Bode phase angle plots were obtained and studied.  Results Using the Stern-Geary equation, the corrosion current density was calculated. On analysis, these values indicated that the higher impedance in HfN-coated titanium screws showed higher mean corrosion potential (Ecorr = -0.452 V) and corrosion current density ( icorr = 0.0354 µA/cm2) than the uncoated titanium screws.  Conclusion It was concluded that the corrosion properties of HfN-coated titanium screws had higher impedance and consequently the highest corrosion resistance. This thereby provides a promising scope for further research of this novel metal coating for use in the biomedical sectors, specifically for dental implants.

Assessment of Oral Masticatory Muscle Activity With Different Chewing Gums: A Cross-Sectional Study Based on Electromyogram Analysis.

BACKGROUND: Facial muscles, particularly those involved in mastication, play a pivotal role in the chewing process. Despite their influence on chewing, these muscles undergo alterations during mastication. Examining the relationship between chewed substances and muscle activity can provide insights into various pathological processes and aid in the development of therapeutic chewing techniques. AIM: This study aimed to evaluate the impact of different commercially available chewing gums on the activity of key masticatory muscles. METHOD: Twenty-two participants were recruited for the study. They were instructed to chew four commercially available gums: group 1 comprised sugar gum with a strong flavor; group 2 included gum containing sorbitol; group 3 consisted of gum containing xylitol; and group 4 provided sugar gum with a mild flavor. Electromyogram (EMG) recordings were utilized to assess muscle activity. Various aspects of muscle activity, including chewing time, maximum muscle potential, and coordination between different muscles, were evaluated. Data tabulation and analysis were performed using IBM SPSS software version 23.0 (IBM Corp., Armonk, NY). RESULT: Analysis revealed that in terms of temporalis symmetry, group 2 exhibited the highest mean deviation, while for masseter symmetry, group 3 demonstrated the highest mean deviation. The total deviation for the temporalis and masseter muscles was 72.16% and 65.55%, respectively, indicating greater symmetry in the temporalis muscle. Additionally, group 3 displayed the highest mean deviation in both left and right-sided synergic activity of the muscles. The total deviation for the right and left sides was 64.34% and 65.67%, respectively. CONCLUSION: The findings suggest that sugar-free chewing gums elicit increased muscle activity compared to sugar-containing chewing gums. Furthermore, the utilization of calorie-free chewing gums with a firm texture was associated with better-coordinated muscle activity. These results provide valuable insights into the effects of different chewing gums on masticatory muscle function and coordination, which may have implications for therapeutic interventions and oral health management.

Osteogenic and Biomedical Prospects of Hafnium and Its Compounds: A Scoping Review.

The direct engagement of hafnium (Hf) in biological processes or its critical function in living things is not well understood as of now. Unlike key elements like oxygen, carbon, hydrogen, and nitrogen, which are necessary for life, Hf is not known to have any biological activities or functions. It is essential to acknowledge that scientific research is ongoing and that new findings may have been made. This systematic review aimed to aggregate and analyze the studies that discuss biomedical applications of Hf metal. This systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. The following search strategy was used: two independent researchers conducted electronic searches in databases including PubMed, Embase, Cochrane Database of Systematic Reviews, and Google Scholar. The search was conducted up to August 2023 using the Medical Subject Headings (MeSH) terms "transition elements," "hafnium," and "biomedical research." Boolean operators "AND" and "OR" were used to refine the search. Electronic databases, along with hand searches, identified a total of 38 studies. The various database searches resulted in a total of 38 studies, of which 12 were excluded as duplicates, and five were unavailable for full-text data. The remaining 21 full-text articles were then assessed for their eligibility based on the inclusion and exclusion criteria, and finally, a total of 12 studies were included in the present systematic review. Among the 12 chosen studies, six were on cancer-related targeted radiotherapy or chemoradiotherapy, five were on bone or apatite-forming capabilities, and one was on the treatment of inflammatory bowel disease. The common outcome measures included cell proliferation, osteoblast formation, radiotherapy intensification, and immunotherapy. This review outlines an overall picture of the biomedical uses of Hf metal, a transition element, as a potent biomaterial. In conclusion, this transition element, Hf, has some promising scope in the fields of biomedicine, with a special focus in terms of cancer radiotherapy and osteogenic capabilities.

A Systematic Review on Maxillofacial Prosthesis with Respect to Their Color Stability.

The aim of this systematic review was to identify and analyze the findings of various studies that analyzed the changes in the color stability of maxillofacial prosthetic materials after the addition of various colorants and nanoparticles and assess the change in color after being subjected to either natural or artificial accelerated aging as well as outdoor aging. This systematic review was conducted in accordance with the guidelines of transparent reporting of systematic reviews and meta-analysis (PRISMA Statement). The primary objective of this systematic review was to evaluate the color stability of maxillofacial prosthesis. The secondary objective was to assess the effect of various colorants; pigments; opacifiers; UV absorbers-such as inorganic colorants (dry earth pigments); metal oxides; and organic colorants. The time period of the included studies extended from 2013 to 2023. Electronic database search identified a total of 217 studies. Ten studies were included to meet the research question. All 10 included studies analyzed the effect of various colorants and their exposure to various aging and weathering conditions. It was found that various pigments and nanoparticles had an effect on the color stability. Also weathering and aging conditions had a direct effect on the color stability as well. In terms of disinfection, although there was not much color difference observed, highest change in color stability was observed when rubbing or brushing of the prosthesis was carried out. In conclusion, the color stability of maxillofacial prosthetics is a critical factor that influences both patient satisfaction and the overall cosmetic look. The potential of pigments and nanoparticles to enhance the color stability of silicone-based maxillofacial prosthesis has received much research. By avoiding color fading and discoloration brought on by environmental variables including UV radiation, aging, and chemical exposure, the inclusion of various pigments and nanoparticles has been demonstrated to improve the color stability of silicone maxillofacial prostheses.

Evaluation of Peri-Implant Crestal Bone Loss with Different Implant Systems, Primary Stability, Bone Density and Soft Tissue Thickness: A Retrospective Study.

AIM: The purpose of this retrospective study was to compare, among various implant systems, the influence of primary stability and the bone density and soft tissue biotype of the patient on the amount of peri-implant crestal bone loss after 1 year using radiography. MATERIALS AND METHODS: Included in this retrospective study were patient records of 3583 implant placements utilized from an online dental information archiving software (DIAS). Clinical and radiographic assessments were conducted concurrently with implant placement (baseline) and 1 year post surgery. Statistical analysis was done to examine the mean marginal bone loss significance in the three different implant systems groups (group I: Straumann Roxolid SLAc-tive, group II: Nobel Biocare CC, group III: Straumann SLA), different primary stability values, different bone density. and soft tissue biotype at the time of implant placement. RESULTS: A significant difference was observed in the crestal bone loss with different implant systems used. Group I showed significantly lesser amounts of crestal bone loss when compared to groups II and III. However, the differences in the bone density, ISQ values, and the soft tissue biotype did not exhibit a statistically significant difference in the amount of crestal bone loss. CONCLUSION: Significant MBL preservation for implants with Straumann SLActive when compared to Nobel Biocare CC and Straumann SLA implants. No significant changes were observed with respect to primary stability, bone density, and soft tissue thickness and no correlation among early crestal bone loss and IT, ISQ at surgery, and ISQ at reopening was observed. Straumann Roxolid SLActive implants showed less crestal bone loss probably owing to its hydrophilic surface modification. However, more studies need to be done to evaluate the same.

Surface roughness and marginal adaptation of stereolithography versus digital light processing three-dimensional printed resins: An in-vitro study.

Aim: The aim of this study was to assess surface roughness and marginal adaptation of Stereolithographic versus Digital Light Processed three-dimensional (3D) printed provisional resins. Materials and Methods: A 3-unit fixed partial denture (FPD) preparation was done on ideal model irrespective to 44-46. The Model was scanned and a 3-unit FPD was designed using 3-shape software. The STL file was transferred to two different 3D printers - Sprintray digital light processing (DLP) and Formlabs stereolithography (SLA). Eight samples were printed per group (total of 16 samples) using C and B temporary tooth-colored resin and cured according to the manufacturer's instructions. Marginal adaptation was checked for six surfaces per tooth for all the samples using a stereomicroscope. Surface roughness was also calculated for four samples from each group before and after polishing (pumice slurry + rouge and cotton buff) using a contact profilometer. Results: The mean maximum marginal gap overall, was seen for the DLP group on the mesiobuccal surface of the first premolar, i.e., 178.8 ± 8.35 µm, while the minimal marginal gap was seen for the SLA group on the mesiolingual surface of first molar - 32.5 ± 7.07 µm. Furthermore, all the DLP samples showed a statistically significant higher mean marginal gap as compared to SLA samples (P < 0.005). All the samples showed surface roughness within the acceptable range. There was a statistically significant difference noted in Rz (roughness depth) before and after polishing (P < 0.05). Conclusion: 3D printed temporary resin FPD via SLA showed a much better marginal adaptation (49.6 µm mean marginal gap for 46 and 106.8 µm for 44) as compared to those printed via DLP (101.8 µm mean marginal gap for 46 and 157.5 µm for 44). All the samples showed an acceptable surface roughness. Clinical Relevance: 3D printed temporaries have shown good marginal fit and adaptation and are a viable choice in patients where temporaries has to be given for long term before a final prosthesis can be fabricated (especially for full mouth rehabilitations).

Accuracy of multiple implant impressions using different combinations of impression materials using closed tray technique: An in vitro study.

Decision for precision! The first stage in creating an accurate, passively fitting prosthesis is to replicate the intraoral relationship of implants using impression methods. The technique and the impression material utilized are the key elements that influence the accuracy of the implant imprint. The goal of this study was to assess the accuracy of the described implant impression technique using various impression materials, as well as to look into the clinical aspects that influence implant impression accuracy. Two holes (4.3 mm × 10 mm) were drilled in a U-shaped study plastic model representing the partially edentulous maxilla, and the appropriate Nobel Biocare Replace select implants were implanted. Closed tray copings were placed for the relevant implants, and closed tray impressions were taken with several impression materials (PVS-1) Dentsply, medium-bodied, and 2) Regular setting-Zhermack Elite HD+). To assess passive fit accuracy, a jig trial and RVG IOPA were used. Stereomicroscopy was used to evaluate the precision of the implant and analog interface from two perspectives: buccal and lingual. On the buccal aspect, Group 1 had a mean value of 13703.29, whereas Group 2 had a mean value of 11395.58. On the lingual aspect, Group 1's mean value was 8415.61, whereas Group 2's was 9192.01. In the closed tray technique, no statistically significant differences between different imprint materials were found. There was no significant difference in the accuracy of closed tray implant impression techniques with different impression materials, according to the findings.

Phosphorescent wax - The novel approach of innovation.

The present invention relates to dental compositions that include a phosphorescent material, more particularly, adding phosphorescent material to waxes that used in dentistry. The aim of the study is to develop a wax that has innate phosphorescent properties. Three groups of samples were taken in which the phosphorescent material was added. Three groups were later compared for their phosphorescent property in the material. All the samples in the initial molten state were poured into a mold made of silicone impression material and allowed to set. The material was placed in a dark room, and visual examination was done to compare the materials. From the samples obtained, paraffin wax showed more phosphorescent property than beeswax. The least phosphorescent property was seen in marginal wax. It can be concluded from this study that paraffin wax showed the most phosphorescent property.

Comparative analysis of weld strength of nickel-chromium and cobalt-chromium base metal alloys when submitted to tungsten inert gas welding.

Long span base metal alloy fixed prosthesis and partial dental prosthesis frameworks most often require welding for better fit and adaptation. The type of metal alloys used and its effect on the weld strength of the prosthesis have to be investigated. The aim of the study is to comparatively analyze the weld strength of nickel-chromium (Ni-Cr) and cobalt-chromium (Co-Cr) base metal alloys when subjected to tungsten inert gas (TIG) welding. 10 nickel- and cobalt-based specimens were obtained by casting of castable resin patterns of dimension 25 mm × 3 mm × 1 mm. Welding of the samples was carried out using the Lampert PuK 2 welding equipment, and a three-point bend test using a universal testing machine was carried out to evaluate the weld strength of the specimens. Statistical analysis was carried out using the SPSS software version 23. Higher weld strength was observed in the Co-Cr alloy (mean = 898 MPa) than in the Ni-Cr alloy (mean = 690 MPa), when submitted to TIG welding (P < 0.05). TIG welding could be a better alternative for joining base metal alloys for long span edentulous cases, and cobalt-based alloys could be better alternatives to nickel-based alloys that usually tend to cause hypersensitivity reactions.

Knowledge, awareness, and attitude of dentists toward use of denture adhesives in Tamil Nadu: A questionnaire survey.

Dentists, especially the clinicians, struggle to achieve comfort, stability, and retention in removable dentures, which eliminates need of denture adhesives, and often prescribe denture adherents as an adjunct aid in denture aftercare. The aim of this study was to assess the knowledge, awareness, and attitude of dentists in Tamil Nadu toward use of denture adhesives in clinical practice. This survey was conducted among 150 dentists in Tamil Nadu, of which 128 dentists responded. The survey had 22 close-ended questions circulated through online forms. The data were collected, tabulated, and interpreted. Respondents were 24.2% general practitioners, 14.8% undergraduate students, 25.8% postgraduate students - prosthodontics, 30.5% other than prosthodontics, and 4.7% were prosthodontists. Awareness of usage of denture adhesives, 99.2% of the population responded positively and 1.6% respondents had no awareness. Majority of clinicians were not familiar with the toxic effects and thus a difference in recommendation was seen. The results of this survey conclude that knowledge and attitude of dentists in state of Tamil Nadu pertaining to use of denture adhesives as a retentive adjunct in denture fabrication is good overall, but depth of knowledge about its indication in clinical practice, toxicity, and complications needs some improvement.

Workflow for the full-mouth rehabilitation of a patient with different prosthetic materials in opposing arches: A bold move in desperate scenario.

Fixed rehabilitation is an exhaustive approach for most dental practitioners to treat partial or complete edentulism. In recent years, we are witnessing a digital transformation in prosthodontics and smile makeovers. This requires an in-depth understanding of concepts and the skills to achieve desired clinical results. Many situations of the oral cavity often need fixed rehabilitation treatment. This extensive treatment primarily solves two goals: maintains crown integrity and also achieves optimal esthetics. To restore lost parts of the stomatognathic system, a multidisciplinary approach is of utmost importance. The treatment options may range from removable implant-supported dentures to fixed implant-supported prostheses. The choice of treatment relies on the limitations of anatomic structures and existing. Partial or complete edentulousness can inadvertently reduce the quality of life of the patient and may hinder physiology. This report narrates a combination of two types of dental prosthetic material to obtain a desirable outcome in fixed rehabilitation of a patient. Furthermore, it highlights the management of complete treatment in a limited period and patient appointments.

Comparative analysis of pink and white esthetics of anterior full veneer crown: Indian scenario.

A goal of modern dentistry is to make an esthetic outcome as one of the major modalities in dental treatment. In recent years, more emphasis has been given to esthetic parameters, especially in the anterior regions. The aim of this study was to evaluate the presence of change in pink and white esthetics scores after giving crowns in a single tooth. Subjects for this retrospective study were chosen by randomization from June 2019 to May 2020. A total of 120 subjects were selected which were equally divided with respect to age and gender. The analysis was done with a photographic assessment. The study test was done using paired t-test, and the correlation was evaluated using the Chi-square test. In this study, we observed that there is an increase in pink and white esthetic scores (WES) after the prosthesis is delivered. There was a clinical and statistically significant difference seen with the WES and total score, whereas only clinical but no statistical difference was seen with the pink esthetic score. After giving crowns, there is an increase in overall esthetic score. It is important to have certain standardized indices to score esthetics by which the overall esthetic outcomes can be improved. One such popular index is the pink and white esthetic index, which scores the soft and hard tissue.

Comparative analysis of various temporary computer-aided design/computer-aided manufacturing polymethyl methacrylate crown materials based on color stability, flexural strength, and surface roughness: An in vitro study.

With recent advancements in digital dentistry, computer-aided design/computer-aided manufacturing (CAD/CAM) processed prostheses have been in very much use recently. This study aims to assess and compare the properties of these materials to better enable the practitioners to select the type of materials for use in a normal clinical practice. This research study was commenced after the approval by our Institutional Review Board (IHEC/SDC/PROSTHO/21/119). Twelve specimens of each group (group 1: CAD/CAM milled prostheses and group 2: three-dimensional (3D) printed prostheses using rapid prototyping) were prepared using the ISO standardization 10477:2004. The flexural strength of the samples that were prepared was tested using a universal testing machine and the values obtained were evaluated. Other samples (ISO standardized) were collected for evaluation of color changes postaging and surface roughness of both groups. Unpaired t-test to analyze flexural strength and surface roughness and Paired t-test was used to statistically analyze the values obtained for color stability. Group 1 showed significantly higher flexural strength and significantly better color stability when the samples were subjected to thermocycling. The mean strength obtained for 3D printed polymethyl methacrylate (PMMA) was 80.06MPa, whereas the mean flexural strength recorded for milled PMMA was 128.32 MPa. There was not much difference observed in the surface roughness of both groups. CAD/CAM milled specimens presented with better color stability and strength when compared to 3D printed specimens. Practitioners should be cautious while using three-dimensionally printed temporary prostheses in the posterior tooth region.

Assessment of intraoral scanning technology for multiple implant impressions - A systematic review and meta-analysis.

BACKGROUND: Intraoral scanner (IOS) is a medical device used for capturing direct optical impressions and composed of a handheld camera (hardware), a computer and software. Digital impressions by intraoral scanning have become an increasingly popular alternative to conventional impressions. The aim of this systematic review is to assess the studies regarding the various available technologies for IOS and evaluate the most accurate IOS system for cases with multiple implants and identify the factors that can influence its accuracy. MATERIALS AND METHODS: A comprehensive electronic search was done in online databases, 'Pubmed', 'Google Scholar' and 'Cochrane' based on pre-determined eligibility criteria. In-vitro studies, In-vivo studies and Randomized controlled trials assessing the accuracy of intra-oral scanner technology were selected after thorough screening. The search strategy covered all studies published until February 2019 and yielded a total of 11 articles out of which 8 studies were determined to fulfil the inclusion criteria and were selected for this review. Data extraction from the included studies was conducted by the primary author and reviewed by the second author. RESULTS: The information collected included sample size and population, study design, intervention, scanning methods, comparisons and outcome measures. 5 out of 8 included studies compared the distance deviation of the acquired scans from the true values while the remaining 3 studies gave trueness and precision values as the outcome variables. A forest plot on scanner precision displayed slightly higher precision levels in the TRIOS scanner compared to the other intraoral scanners. CONCLUSION: Despite the limitations this study, it can be concluded that active wavefront sampling is more accurate than the other intraoral scanning technology employed by commercial scanners.