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It is a well-known saying that the eyes are "windows to the soul." The absence or loss of any facial part, particularly the vision, can lead to severe physical as well as emotional trauma. Losing any part of the face causes the patient societal, physical, and psychological anguish. An ocular prosthesis aims to improve social acceptance and boost self-confidence by restoring the facial appearance. A pediatric dental specialist should be a part of the maxillofacial prosthesis team since maxillofacial prosthetic rehabilitation in young children can be challenging, especially with the less cooperative ones. The following case report describes these challenges in relation to a 5-year-old boy who had his eye enucleated due to trauma. The purpose of the case was to provide custom-built, acrylic ocular prostheses in as comfortable and atraumatic manner as possible by the maxillofacial prosthetic team. How to cite this article: Bansod AV, Pisulkar S, Beri A, et al. Rehabilitation of an Ocular Defect Using a Custom Ocular Prosthesis in a Pediatric Patient. Int J Clin Pediatr Dent 2024;17(4):479-482.
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Long-term implant rehabilitation is still a problem. After about three months of implantation, the patient should go through rehabilitation to allow for osseointegration. However, poor patient cooperation during lengthy treatments or patient neglect, especially during patient-intensive treatments, can lead to a range of issues that require distinct approaches to solve. A fixed prosthetic is currently the most sought-after course of treatment. Implant misplacement can be a concern, especially during the prosthetic stage. Following the appropriate protocols, one of which has been discussed in this report, makes it possible to achieve prosthetic outcomes for a number of difficult cases. In the case described in this report, resin-retained restoration was used as an alternative to an implant-supported prosthesis because of the non-optimal position of the implant at the time of the prosthetic phase, which was due to discontinuation of treatment on the part of the patient. The conservative preparation of abutment teeth and pontic covering the non-optimally placed implant gave the best outcome and satisfaction on the part of the patient.
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Prosthetic eye implantation is a significant intervention for individuals facing ocular trauma or congenital defects. We present the case of an eight-year-old boy who underwent prosthetic eye implantation following enucleation due to a severe injury. The patient had suffered from impaired vision and psychological distress due to the visible absence of his natural eye. The prosthetic eye not only restored his facial symmetry but also revitalized his self-esteem and confidence. This case report highlights the successful outcome of prosthetic eye implantation in pediatric patients and underscores the importance of addressing both physical and psychological aspects of ocular trauma in young individuals.
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Mucormycosis has been prevalent in the past few years with the COVID-19 pandemic largely affecting the maxilla due to its proximity to the respiratory corridor. Resection of the maxillary dentition along with the maxillary bone itself has a huge psychosocial impact on the patient. When seeking prosthetic rehabilitation, poor esthetics, difficulty in mastication, and social embarrassment are the patients' concerns. Hence, it becomes great responsibility for the clinician to restore the patient's natural teeth while causing him/her minimum discomfort. This article describes such a case of post-COVID-19 mucormycosis that has been provisionally restored by the means of all-on-four zygomatic implants.
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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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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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Severe alveolar ridge atrophy following tooth removal poses a common and worsening issue in edentulous jaws, affecting patient comfort and quality of life. The All-on-4 approach involves axially positioning two anterior implants and distally orienting two posterior implants, reducing cantilever length and enabling prostheses with 12 teeth. This less invasive option, utilizing distal tilting of implants at 30°, offers biomechanical advantages and has shown short-term success, though long-term research is limited. Immediate-loading treatments are gaining popularity for their high survival rates. Understanding the biomechanics of implant-supported prostheses is crucial for long-term success, emphasizing the importance of optimal occlusal schemes. Challenges such as bone defects and surgical complexity have led to the exploration of achieving full-arch fixed restorations with fewer implants, building upon Brånemark's early work with four implants. The All-on-4 concept, originating in 1999, proves to be a viable treatment option, providing excellent long-term results and improved load distribution in challenging clinical circumstances. This case report explores the successful rehabilitation of a jaw using the All-on-4 implant prosthesis concept, a technique strategically placing four implants in completely edentulous jaws to support a fixed, immediately loaded prosthesis.
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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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This clinical report explores the effectiveness of dental implants for rehabilitating fully edentulous arches, with a focus on the all-on-six treatment approach. Implant-supported fixed restorations, particularly using six implants, are presented as an expected and cost-effective solution for the rapid repair of the edentulous patient, avoiding the need for bone grafting. This report details the successful rehabilitation of a patient's completely edentulous arches using the all-on-six concept, highlighting the meticulous planning and execution involved. It concludes that precise diagnostic and implant planning, along with thorough attention to all the features, is crucial for successful implant-supported fixed prostheses, with the all-on-six concept offering improved clinical and radiological outcomes for atrophied maxillae.
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The attachment of a fixed partial denture (FPD) on a pier abutment may be necessary in some partially edentulous instances because of the pattern of lost teeth. Nonetheless, it has been noted that using a stiff FPD to restore two lost teeth and an intermediate pier abutment is not the best course of action. In this case, using a stiff connector concentrates the stresses on the pier abutment. In this situation, the pier abutment serves as a pivot, increasing the debonding of the fixed dental prosthesis and ultimately compromising the success of the FPD. Connectors that are not stiff can solve these issues. A nonrigid connector allows abutments to move independently and distributes shear forces to the supporting bone. Instead of the typical rigid connector, the nonrigid connector serves as a stress breaker between the retainer and the pontic.
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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.
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Congenital clefts impair function and appearance, thus impacting a patient's social and mental health. A multidisciplinary team that can offer comprehensive treatment from infancy through maturity and beyond can successfully address these abnormalities. Dental rehabilitation is very important for these patients; these abnormalities should be identified and must be treated accordingly. Hence it is of utmost importance to know the success rate and changes in quality of life from patient satisfaction in order to plan future treatment goals when coming across such cases. The aim of this article is to determine success rate, esthetics, and patient satisfaction in implant-based oral rehabilitation in bone-grafted regions of cleft patients. Registration was carried out in PROSPERO (International Prospective Register of Systematic Review) with registration number CRD42022329861 on May 7, 2022. Medical Subject Headings (MeSH) terms such as cleft lip, cleft palate, survival rate, and dental implants were used to handpick articles via an electronic database. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to compile all the data gathered from an electronic database. According to the collected data, 93.5% of the survival rate with dental implants was noted irrespective of the type of bone grafts used. Also, improvement in quality of life was achieved in these patients. Effectiveness, esthetics, and success rate are very well achievable with implants in cleft patients. Although the aesthetics are not equivalent to that of dental implants in normal patients, patient satisfaction is still satisfactory in patients with dental implants in bone-grafted regions of cleft lip and palate.
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Aim This study aims to evaluate the role of dentures and dietary advice on the nutritional status of complete edentulous patients using the mini nutritional assessment-short form (MNA®-SF). Objective The objective of this study is to assess patients' nutrition using MNA®-SF before denture insertion and nutritional advice, to evaluate patients' nutrition using MNA®-SF after denture insertion and nutritional advice at one month and three months, and to assess and compare pre- and post-insertion differences in nutrition using MNA®-SF. Material and Method An observational study was conducted among 50 completely edentulous patients using the MNA®-SF questionnaire. They were asked the questions at baseline and then after they were given complete dentures, after which they were recalled after one month and three months to assess the nutritional status using MNA®-SF. All the questions were in the native language, so it was easy to understand the question and respond to it. Result It was found that the patient's nutritional status had significant changes, which shows that the dietary advice and complete denture affected the patient's nutritional status. Conclusions This study helped assess the efficacy and application of MNA®-SF in completely edentulous patients. In this study, we provided nutritional guidance to patients in addition to complete denture prostheses to encourage them to have healthy eating habits.
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One of the most crucial issues in modern dentistry is restoring a patient's lost dental aesthetic appearance. To do this, new therapeutic tools and techniques have been appearing on the market day by day. For anterior teeth, where aesthetics are extremely essential, the majority of dentists prefer more conservative and aesthetic treatments, such as direct and indirect laminate veneer restorations over full-ceramic crowns. The meteoric emergence of veneers has been one of dentistry's most successful innovations. It is a coating of tooth-coloured material that is put to a tooth to aesthetically restore any intrinsic discoloration or localised or generalised abnormalities. Any restoration work ought to be created using mechanical, biological, and aesthetic criteria. Patients may experience significant aesthetic issues as a result of the colour, form and structural and positional anomalies of their anterior teeth. This is a report depicting a case of porcelain laminate veneers using computer-aided design/computer-aided manufacturing (CAD/CAM).
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The patient's state of health is significantly impacted by aesthetics. The face undergoes various changes as we age, including the loss of fat and muscle tonicity. The loss of teeth and these modifications accentuate the look of sunken cheeks. As a result, facial deformity may have an effect on a person's mental health, especially young people who are edentulous patients. Cheek plumpers and complete dentures (CDs) can be utilized to help these people recover or enhance aesthetics. The manufacturing of a CD with magnets is described in this case report.
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Disfigurement of the face has a significant impact not only on the appearance and function but also on the psychological well-being of an individual. Due to tooth loss, various psychological problems can occur. Dentures can help patients regain a sense of normalcy and also boost their confidence to live in society. Complete denture restores phonetics, esthetics, and mastication. A 63-year-old male patient reported to the Department of Prosthodontics with the chief complaint of total loss of teeth and wanted to get treated for the same. The purpose of this article is to describe changes in impression techniques, dental material, methodologies in teeth setting, and novel approaches to enhance the esthetics to optimize the results in a final complete denture. To reestablish the patient's masticatory, apparatus steps of complete denture fabrication were revisited accompanied by the modern application of innovative techniques with the base of historical concept.
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An absence or any disfigurement to the eye leads to psychological handicap for the patient. An ocular defect is a defect of an eye because of a cyst, road traffic accident, or enucleation of an eye due to infection. While correcting this type of defect, maxillofacial prosthodontists should consider all aspects such as esthetics, comfort, and functions of the ocular prosthesis, which gives a lifelike appearance to the prosthesis. A prosthetic eye wearer patient complained of asymmetry and opaque appearance of the ocular prosthesis. The patient had lost his eye in a road traffic accident and has been wearing a prosthesis for 8-12 months but is not pleased with how the prosthesis looks. A novel prosthesis created by the use of sublimation transfer technology and three-dimensional printing to improve the esthetics exactly replicates the contralateral normal eye. In a proposed case report, an algorithm for the fabrication of customized ocular prostheses was improved. A smooth blend of conventional as well as digital methods is used to optimize the results.
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To meet the challenges of rehabilitating anterior teeth and achieving natural-looking restorations, it is essential to address issues such as improper shape, size, irregular gingival contour, and unaesthetic shades. The increasing demand for aesthetically pleasing and metal-free solutions has popularized materials like dental zirconia, offering optimal aesthetics and desirable mechanical properties. Within this context, a case report highlights clinical experiences with layered zirconia fixed dental prostheses designed specifically for anterior teeth. The report focuses on the prosthetic rehabilitation of both endodontically treated and vital abutments, exploring the influence of zirconia composition, design, layering technique, shade selection, occlusion, and the unique clinical challenges associated with each condition. The selection of zirconia composition, framework design, and shade in layered zirconia prostheses is intricately tied to the characteristics of the abutments. This interconnectedness underscores the importance of a thoughtful and customized approach to address the specific requirements of each clinical scenario.
