Full Mouth Rehabilitation With All-on-Six Concept With Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) Milled Bar Retained Zirconia Prosthesis.

Full-mouth rehabilitation, also known as full-mouth reconstruction or restoration, is the comprehensive process of restoring and rehabilitating the function, aesthetics, and health of all teeth in the upper and lower jaws. This involves a multidisciplinary approach, addressing issues such as occlusion (bite), tooth wear, tooth loss, and periodontal (gum) health to achieve optimal dental function and appearance. This treatment provides a stable and reliable solution for dental problems associated with the complete or partial loss of dental elements. This case report discusses the management of a 72-year-old male patient who came with a chief complaint of decayed, missing, and mobility of his teeth. His medical history included drug-regulated diabetes and chronic periodontitis, which remained a reason behind his deteriorating dental health. The treatment plan encompassed a comprehensive approach, starting with the full-mouth extraction and progressing to the placement of six implants in both the mandibular and maxillary arches for complete restoration. After allowing eight weeks for healing, the impressions for the implants were recorded with the polyvinyl siloxane material. The case demonstrates the application of the all-on-six concept; whereby full arch rehabilitation is possible with the strategic placement of six implants. By employing the latest in advanced computer-aided design/computer-aided manufacturing (CAD/CAM), a zirconia prosthesis that was retained on a milled bar was fabricated-yielding a very high degree of accuracy and excellent aesthetics in the restoration. Restorations with zirconium were done, as it is excellent in aesthetics and functioning. This article considers the importance of precision planning, correct implant placement, and advances in dental science and technology. Most importantly, the conclusion that can be drawn is that the end outcome of total rehabilitation with all-on-six should not only be an affirmation that difficult cases can be managed very well but also the patient's quality of life is improved by using the latest dental procedures.

Troubleshooting Vaginal Stents: A Critical Review of Common Problems and Solutions.

This review aims to examine the use of vaginal stents in clinical practice, specifically for treating vaginal agenesis and related complications and problem associated with vaginal stents. Vaginal agenesis, also known as Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, is a congenital disorder characterized by the uterus not developing or developing only partially. Vaginal stents are medical devices that preserve the structural integrity and patency of the vaginal canal after trauma or surgery. They play an important part in gynecological treatments such as post-radiation therapy, reconstructive surgery, and vaginal stenosis management. The review also discusses the primary applications of vaginal stents, such as preventing adhesions, healing mucosa, and maintaining patency. It also investigates frequent concerns associated with stent use, such as complications and the need for better designs. Vaginal stents are essential in a variety of therapeutic settings, providing major benefits in maintaining vaginal tissue and function. However, their use is fraught with complications, including the risk of infection, discomfort, and the possibility of inappropriate placement.

Crafting Confidence: A Comprehensive Case Study of Full-Mouth Reconstruction Utilizing Implant-Supported Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) Zirconia Restorations.

A 67-year-old male patient reported to the department with a chief complaint of tooth mobility. The patient presented with a medical history of diabetes for which he was on medication, and he also reported a history of chronic periodontitis. After a thorough assessment of the patient, a proper treatment plan was designed, which included full-mouth rehabilitation, prior to which the patient was advised full-mouth extraction. Six implants were inserted into the mandibular and maxillary arches as part of the treatment. After the implant was placed, zirconia was the preferred choice for the restoration because of its superior aesthetic results. Polyvinyl siloxane impression material was used to make implant impressions after an eight-week healing period. The case report provides the technique for the current approach to full-mouth rehabilitation with all six concepts of implant placement. In these situations, it is crucial to plan and insert implants correctly and adhere to the entire treatment plan. Restorations were performed using the latest computer-aided design/computer-aided manufacturing (CAD/CAM) technologies for a more aesthetically pleasing result. The case study highlights the significance of meticulous preparation and implementation for the accomplishment of successful full-mouth rehabilitation.

Emerging Applications of Picture Archiving and Communication Systems and Their Impact on Research and Education: A Literature Review.

In recent times, technological advancements have remarkably improved picture archiving and communication system (PACS) capabilities beyond their conventional use in radiology departments. Researchers and instructors have started employing PACS functionalities to improve medical research processes, promote interdisciplinary collaborations, and facilitate learning. To illustrate this point further, the PACS enables researchers to handle and analyze huge amounts of imaging data with superior precision and speed, supporting innovative studies in areas like disease progression, treatment outcomes, and imaging modalities. Moreover, a PACS integrated with artificial intelligence (AI) algorithms leads to significant improvements in image processing, diagnostic accuracy, and personalized treatment, thus marking a new approach to medical imaging. The PACS supported by AI is mostly transformative since they allow for improved early disease detection capabilities as well as automated image processing and decision assistance, which increase diagnostic accuracy and clinical outcomes. Such systems can rapidly process large quantities of visual data with an accuracy rate surpassing earlier endeavors. In medical research, however, combining PACS with AI allows challenging imaging datasets to be examined, thereby making findings that were not previously possible. The capacity to combine imaging outcomes with clinical information is valuable for medical students and professionals in the field of education. They can access extensive medical image collections and case studies using PACS. This link is critical for teaching and learning as it allows students to interact with concrete events and improve their diagnostic accuracy in a controlled environment. This review discusses how the PACS affects educational courses and clinical outcomes based on the available literature. Our aim was not only to outline recent research or developments but also to present a comprehensive overview regarding the growing role played by PACS in the modern healthcare system and academics. Similarly, we look at the challenges and opportunities associated with the wide adoption of PACS, highlighting possible future areas of study or teaching methodologies. Issues such as data security, interoperability, and the need for defined protocols are included to give an exhaustive understanding of what PACS can and cannot do. Through this study, we stress PACS's revolutionary potential in advancing research methodology and educational practices, eventually contributing to enhanced patient care and knowledge dissemination in healthcare areas. The continual growth of PACS technology and its applications is expected to reshape the landscape of medical research and education, making it a vital component in the quest for medical excellence. By knowing the present trends and future potential, stakeholders in healthcare and education may better employ PACS to reach their objectives and boost overall results.

The Reconstruction of Post-traumatic Cranial Bone Depression by Duplicating an Autogenous Bone Flap With a Prosthetic Polymethyl Methacrylate Cranial Stent.

Cranioplasty is a common surgical procedure used to restore the shape of the calvaria. Autogenous bone flaps provide biological repair with the least morbidity to the donor location. One method for reusing bone autograft during cranioplasty involves low-temperature preservation followed by autoclaving. According to the literature, there was a good to modest improvement in the skull's symmetry, cosmesis, scars, and contour. It was determined that autoclaved frozen autogenous cerebral bone flaps are a safe and reliable method of cranioplasty. Despite its apparent simplicity, cranioplasty has been found to carry a relatively high complication rate, ranging from 12% to 50%, which starkly contrasts with the standard elective craniotomy, with a complication rate typically ranging from 24% to 60%. Complications associated with autogenous bone flap procedures are varied. The presented case report primarily focuses on the duplication of autogenous bone flaps by using clear polymethyl methacrylate.

Influence of Crown Height and Width on Marginal Bone Loss and Long-Term Stability of Dental Implants: A Systematic Review.

Still, a major focus of research in implantology is how crown height and width affect marginal bone loss (MBL) and the long-term durability of dental implants. Maximizing the success of implants and lowering problems depends on an awareness of these elements. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, this systematic review searched pertinent studies across several databases using keywords unique to databases. Studies on MBL and long-term implant stability evaluated in the review included those on crown height and width, horizontal and vertical cantilevers, and prosthesis dimensions. In the chosen studies, we found that both implant success and crestal bone loss were greatly influenced by crown height and width. Particularly in the posterior sections, horizontal cantilevers were connected to both increasing MBL and mechanical problems. Vertical cantilevers also affected MBL; however, their impacts were more obvious in circumstances with greater crown heights. Greater prosthesis widths, especially in the mandibular molar area, were linked to higher MBL. Bone density and insertion torque (IT) were the main determinants of MBL, more than the primary implant stability quotient. Early MBL was influenced by abutment height, mucosal thickness, and implant insertion depth; bone levels stabilized six months later. Short implants allow single crowns to be supported, but in some cases, a higher failure rate was seen. The success and stability of dental implants were found to be mostly dependent on crown height, width, and cantilever design. MBL and long-term stability are greatly influenced by horizontal and vertical cantilevers, which calls for careful design and planning. With specific care for bone density, IT, and early MBL stabilization, both short and standard implants can produce equivalent results. These results highlight the need for customized treatment plans to maximize implant success and lifetime.

Rehabilitation of an Ocular Defect Using a Custom Ocular Prosthesis in a Pediatric Patient.

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.

Rapid Smile Restoration: Basal Implants for the Edentulous Mandible With Immediate Loading.

In the significant atrophic jaws, it is difficult to place dental implants since there is a qualitative and quantitative shortage of future implant beds. Basal implants, also known as cortical or bicortical implants, offer a viable alternative for dental rehabilitation in patients with significant alveolar bone loss. These implants are anchored in the dense basal bone, providing immediate stability and allowing for immediate loading, thereby reducing overall treatment time and eliminating the need for extensive bone grafting procedures. This case report demonstrates the efficacy of basal implants in providing immediate functional and aesthetic restoration for patients with significant alveolar bone loss, by describing a 49-year-old patient who presented with severe alveolar ridge resorption, making traditional implant placement unfeasible. Basal implants were successfully placed, and an immediate prosthesis was delivered, resulting in excellent functional and aesthetic outcomes.

A Mixed-Method Analytical Cross-Sectional Research of Person-Centered Learning Behaviors Among Adolescent and Adult Learners.

Background In their academic lives, students progress from the stage of primary learning to the stage of adolescent learning and then to the stage of adult learning. At every step of learning, learners display particular learning habits, which must be mapped out to maximize learning. Objectives The objective of the present study is to evaluate the person-centered behaviors that influence learning among learners in adolescent and adult age groups by employing a learning behavior questionnaire that has been previously validated. Material and methods A cross-sectional study in which 944 participants were enrolled, including 456 adolescents from English-medium schools (aged 11 to 16 years) and 488 adults from a health professional institute (aged 18 to 23 years). The validated learning behavior questionnaire, which study participants rated on a scale of 0, 1, and 2, served as the study's quantitative component. The focus group discussion that was held for a group of adult and teenage students comprised the study's qualitative component. Using STATA-14 software (StataCorp LLC, College Station, USA), all of the responses were tallied and statistically examined. Results  The mean scores of person-centered learning behaviors were significantly higher for learners in the adult age group than for learners in the adolescent age group. The findings of the component, which was qualitative in nature, were consistent with the findings of the learning behavior questionnaire analysis. For both adults and adolescents, the difference in mean person-centered learning scores was statistically negligible at a 5% level of significance (p=0.415 and p=0.368, respectively). Conclusion The study's checklist, which is self-monitoring in nature, may aid in the evaluation of learning behaviors and make it simpler for adult and adolescent learners to establish excellent learning habits.

Revolutionizing Maxillary Rehabilitation: Zygomatic Implants Addressing Severe Alveolar Atrophy.

This case report describes the care given to a 58-year-old male patient with severe upper jaw atrophy. The treatment strategy involved utilizing zygomatic implants in conjunction with endosteal implants to rehabilitate both the maxilla and mandible. Temporary prostheses were used during the healing phase, followed by the fabrication and placement of final prostheses. The utilization of zygomatic implants offers advantages such as immediate stabilization and function without the need for extensive bone grafting. This approach not only reduces treatment time and costs but also enhances patient outcomes. Furthermore, guided surgical techniques are increasingly employed to ensure precise implant placement, optimizing prosthetic support.

Prevalence of Osteoporosis and Its Effect on Residual Ridge Resorption in Postmenopausal Females of Rural Central Indian Region.

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.

Digitalization in Cranial Reconstruction: Revolutionizing Precision and Innovation.

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.

A Mixed-Method Analytical Cross-Sectional Research on Participation-Centered Learning Behaviors for Adolescent and Adult Learners Utilizing a Validated Learning Behavior Questionnaire.

Background In their academic lives, students progress from the stage of primary learning to the stage of adolescent learning and then to the stage of adult learning. At every step of learning, learners display particular learning habits, which must be mapped out to maximize learning. Objectives The objective of the present study is the evaluation of the participation-centered learning behaviors among adolescent and adult learners employing a validated learning behavior questionnaire. Material and methods This was a cross-sectional research. A total of 944 participants were in the study, including 456 adolescents from English-medium schools (aged 11 to 16) and 488 adults from a health professional institute ( aged 18 to 23 years). The validated learning behavior questionnaire, which study participants rated on a scale of 0, 1, and 2, served as the quantitative component. The focus group discussion that was held for a group of adult and teenage students comprised the study's qualitative component. Using STATA-14 software (StataCorp, College Station, United States), all of the responses were tallied and statistically examined. Results The mean scores of participation-centered learning behaviors were significantly higher in adult learners than in teenage learners. The findings of the qualitative component analyzed were consistent with the findings of the learning behavior questionnaire analysis. Conclusion The study's self-monitoring checklist may aid in the evaluation of learning behaviors and make it simpler for adult and adolescent learners to establish excellent learning habits.

Revolutionizing Neurosurgery: The Cutting-Edge Era of Digitally Fabricated Cranial Stents.

Cranial defects are broadly classified as either congenital or acquired. The prevalence of cranial injuries has notably increased, propelled by a heightened emphasis on aesthetics and the demand for skull reconstruction in contemporary society. Consequently, rehabilitation for these defects has also surged. Surgical correction or repair, known as cranioplasty, not only aims at aesthetic rehabilitation but also addresses psychological issues, improving social acceptance and overall performance. Amid evolving trends, the availability of advanced biomedical tools, technologies, and materials empowers surgeons and prosthodontists, leading to improved outcomes in aesthetics and functionality. One noteworthy technique highlighted in this case report involves using bone cement in conjunction with polymethyl methacrylate, adding novelty to the approach. The interdisciplinary management team, consisting of prosthodontists and neurosurgeons, played a pivotal role in improving neurological status and cosmetic outcomes for the patients.

Quantitate evaluation of photogrammetry with CT scanning for orbital defect.

Facial deformities can be caused by cancer, tumours, trauma, infections, congenital or acquired defects and may lead to alteration in basic functions such as communication, breathing, and mastication and aesthetic thereby affecting quality of life. Traditional processes for manufacturing maxillofacial prostheses involve complicated, time-consuming and tedious processes for the patient and the operator. Impression of the defect area, which is the one of the crucial step in fabrication of prosthesis, is the longest and most difficult process as it requires a long contact with the patient. The digital revolution is now changing the landscape of prosthetic production and making the impression making procedure simpler. Digital technology reduces patient chair side time by providing more accurate display data in less time (3-5 min) than traditional methods. Digital impressions eliminate the need for bulky impression materials and provide a more comfortable patient experience.

Association of Salivary Cortisol With Anxiety in Type 2 Diabetes Mellitus Patients Before and After Complete Denture Rehabilitation: An In-Vivo Analysis.

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.

Appliances Therapy in Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis.

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.

Comparative evaluation of the efficacy of customized maxillary oral appliance with mandibular advancement appliance as a treatment modality for moderate obstructive sleep apnea patients-a randomized controlled trial.

BACKGROUND: Obstructive sleep apnea (OSA) is quite common among the adult population, according to recent epidemiological studies. The most frequently suggested alternate treatment for mild to moderate OSA is oral appliances (OA). The purpose of the present study was to assess as well as compare the effectiveness of custom-made maxillary oral appliances against mandibular advancement appliances in the care of individuals suffering from moderate obstructive sleep apnea. METHODS: A prospective interventional research was carried out with 40 participants. Polysomnography (PSG) was done and the participants with an apnea-hypopnea index (AHI) >15-30 were involved in the research. Study participants were randomly split up into two test groups: group I was the "Control Group" (group treated with a mandibular advancement device (MAD), n=20), while group II was exposed to a "customized maxillary oral appliance" (CMOA, n=20). Both groups had reference measures for AHI, blood oxygen saturation (SpO2), oro-nasal airflow via respiratory disturbance index (RDI), and the Epworth Sleepiness Scale (ESS). Appliances were fabricated and delivered to the respective study group participants. PSG was again conducted after a period of 1 and 3 months of appliance delivery and re-evaluation was done for all the parameters and was compared with reference measurements. The facts were analyzed using descriptive and analytical statistical methods. The statistical program utilized in the study was "SPSS (Statistical Package for Social Sciences) Version 20.1." After 1 and 3 months, the statistical significance between the two study groups was assessed at P<0.05. RESULTS: The analysis of mean AHI, SPO2, RDI, and ESS for both test groups manifested statistically significant measures (P<0.001). The study results revealed a statistically significant depletion in mean AHI scores, improvement in mean SPO2 scores, and reduction in mean RDI scores and ESS scores when compared with reference measurements to 1 month, 1 to 3 months, and between reference measurements and 3 months. CONCLUSION: The CMOA was effective in managing moderate OSA and has great therapeutic potential. It can be an option for the MAD for treating patients suffering from moderate obstructive sleep apnea. TRIAL REGISTRATION: The study was registered under Clinical Trials Registry-India and the registration number is CTRI/2020/07/026936 . Registered on 31 July 2020.

A narrative review on techniques of iris replication in an ocular prosthesis.

The disfigurement associated due to the loss of an eye can cause a significant physical and psychological disturbance. Psychological distress among such unfortunate patients can be reduced by providing an artificial eye. Rehabilitating such patients with an ocular defects is the most challenging task for a prosthodontist. The custom-made ocular prostheses are preferred over the prefabricated stock eye shells as it provides intimate contact with the tissue bed, enabling an ideal fit. For an esthetic ocular prosthesis, the precise positioning of an iris is a primary requirement to avoid the squint eye appearance. Various case reports are documented in the literature for centralizing the iris in the prosthetic eye. This review article explores the established methods and techniques for positioning the iris in a custom-made ocular prosthesis.

Quad Zygoma: A Graftless Solution in Post-mucormycosis Maxillectomy.

Mucormycosis, a fungal infection that commonly affects individuals with diabetes and compromised immune systems, often requires surgical excision and debridement. However, this can result in significant defects, posing a challenge for clinicians in terms of reconstruction and rehabilitation. Prostheses, local and regional pedicled flaps with or without bone grafts, and titanium mesh application are available options for maxillary reconstruction. Soft-tissue flaps are not sufficient to provide osseointegrated implants with both bone repair and structural support, which emphasises the quad zygoma's beneficial role in treating maxillary abnormalities. Patients benefit from quad zygoma, which uses zygomatic implants and eliminates the need for subsequent procedures, which shortens the course of treatment and lowers costs. Because zygomatic implants are securely fixed into the zygoma, temporary prostheses can be loaded right away. Then, four to six months later, a fixed prosthesis may be introduced. Clinical results with zygomatic implants often surpass those of bone grafting, representing a potential novel gold-standard approach for the compromised maxilla. This case report details the rehabilitation of post-mucormycosis patients with maxillary defects using quad zygomatic implants. The absence of complications during follow-up, conducted at 15, 30, 45, and 90 days, and subsequently monthly for two years, highlights the success of this approach. Evaluation parameters included soft tissue recovery, infection, wound separation, stability of prosthesis, eating effectiveness, and aesthetic outcomes. The positive outcomes observed at follow-up appointment emphasize the viability and effectiveness of quad zygomatic implants in addressing maxillary defects post-mucormycosis.