Comparison of Crestal Bone Loss and Osteocalcin Release Kinetics in Immediately and Delayed Loaded Implants: A Randomized Controlled Trial.

PURPOSE: To compare concentration and release kinetics of osteocalcin and crestal bone loss under immediate and delayed loading conditions during osseointegration. MATERIALS AND METHODS: Forty-one patients who were indicated for rehabilitation with dental implants randomly received either implant with placement of permanent prosthesis after 3 months (delayed loading) or implant with placement of permanent prosthesis within 7 days (immediate loading). Radiographic assessment of crestal bone loss at the mesial and distal surface was done at 3, 6, and 12 months after implant placement. Peri-implant sulcular fluid was collected immediately from the buccal surface at two sites after implant insertion and also, at 7, 15, 30, and 90 days after surgery. The level of osteocalcin was evaluated using ELISA and data were compared using two sample t-test. Differences between two groups were analyzed by unpaired Student's t test. Intragroup comparison was done by repeated measures ANOVA. RESULTS: Mean crestal bone loss was lower in the immediate loading group compared to the delayed loading group at 3, 6, and 12 months (p < 0.001). Intragroup comparison revealed a statistically significant increase in osteocalcin levels in both group I (delayed loading) (F = 26712.2) and group II (immediate loading) (F = 10497.2) at the predetermined time intervals. CONCLUSIONS: Less crestal bone loss and early release of osteocalcin was found in the immediately loaded group than in the delayed loaded group. The study substantiates that immediately loaded implants show less crestal bone as well as early release of osteocalcin facilitating upregulation of bone metabolism, improving long term health of bone and prognosis of implants. Immediately loaded implants can be a better treatment protocol provided there is adequate bone and primary stability.

Penetrating injury of face by a large machine bolt-a rare case report.

Foreign bodies are often encountered by oral and maxillofacial surgeons and may present a diagnostic challenge, due to many factors such as nature of foreign body material, the size of the object, difficult access and a close anatomical relationship of the foreign body to vital structures. There are foreign bodies like glass pieces, plastic materials, wooden pieces are not seen in routine radiographs and often misdiagnosed. To reduce the chances of complications presence of foreign body in the patients head and neck region must be thoroughly investigated by the surgeon. Penetrating injuries by blunt object is rare finding in maxillofacial region. Here we present an unusual case of penetrating injury by a large machine bolt (15.0 cm) in a 7 year old child, embedded on left side of face.

Mercury and other biomedical waste management practices among dental practitioners in India.

OBJECTIVES: The objective of the study was to assess the awareness and performance towards dental waste including mercury management policy and practices among the dental practitioners in North India. MATERIALS AND METHODS: An epidemiologic survey was conducted among 200 private dental practitioners. The survey form was composed of 29 self-administered questions frame based on knowledge, attitude, and those regarding the practices of dentists in relation to dental health-care waste management. The resulting data were coded and a statistical analysis was done. RESULTS AND DISCUSSION: About 63.7% of the dentists were not aware of the different categories of biomedical waste generated in their clinics. Only 31.9% of the dentists correctly said that outdated and contaminated drugs come under cytotoxic waste. 46.2% said they break the needle and dispose of it and only 21.9% use needle burner to destroy it. 45.0% of the dentists dispose of the developer and fixer solutions by letting them into the sewer, 49.4% of them dilute the solutions and let them into sewer and only 5.6% return them to the supplier. About 40.6% of the dentists dispose of excess silver amalgam by throwing it into common bin. CONCLUSION: It was concluded that not all dentists were aware of the risks they were exposed to and only half of them observe infection control practices.

A simplified approach for placing the iris disc on a custom made ocular prosthesis: report of four cases.

This case report describes a series of four cases of different age group, in which a simplified approach was applied for positioning the iris disc on a custom made ocular prosthesis. For each of the patient, a pre-fabricated eye was selected; whose iris and pupil closely matched that of the natural eye. This was duplicated for use as a tray in impression procedure. Iris portion of the stock eye was trimmed out and oriented on the cast according to previously transferred pupillary mark. This stock eye-wax pattern combination was tested in the eye socket, modified accordingly and finally cured in transparent heat cured acrylic resin. The technique to fabricate ocular prosthesis in present case reports modifies pre-fabricated eye prosthesis to a custom-made fit and aesthetics. This helped us to overcome the disadvantages of poor fit, inadequate movement and complex painting procedure and technique involved in making a custom-made ocular prosthesis. It can be concluded that close adaptation of the custom-made ocular prosthesis to the tissue bed provides maximum comfort and restores full physiologic function to the accessory organs of the eye.

Extensive ossifying fibroma of jaw.

Ossifying fibroma of bone is a central neoplasm of bone and it is more common in young adult with marked predilection for mandible and also it is more common in female. Lesion is generally asymptomatic until growth produces a noticeable swelling and mild deformity. It presents an extremely variable roentographic appearance depending upon the stage of development. This lesion is composed basically of many delicate interlacing collagen fibers, seldom arranged in discrete bundle, interspersed by large numbers of active, proliferating fibroblasts. The lesion should be excised conservatively. We present a case of huge ossifying fibroma arising from maxilla.

High performance liquid chromatographic determination of residual monomer released from heat-cured acrylic resin. An in vivo study.

PURPOSE: Heat-polymerized acrylic resins are used in dentistry for complete denture fabrication. Despite the polymerization method, conversion of monomer into polymer is often incomplete with free or unreacted residual monomer remaining in the polymerized resin. The aim of this study was to determine the amount of residual monomeric methyl methacrylate (MMA) leaching in the saliva of patients wearing complete dentures in their postinsertion period. MATERIALS AND METHODS: Thirty edentulous participants as first-time complete denture wearers (age 60 to 65 years) were selected. All the prostheses were fabricated using a similar standard technique with a heat-cured acrylic resin denture base material. Saliva samples were collected at time intervals of 1 hour, 1 day, and 3 days postdenture insertion. Participants were asked to discharge saliva every 30 seconds into a pre-weighed screw-capped container for a 5-minute period. MMA levels were measured using high performance liquid chromatography. Data were analyzed by ANOVA and Tukey-HSD. RESULTS: The maximum concentration of monomer released into saliva peaked 1 day after insertion of the complete dentures. The mean (SD) MMA content was 0.04 ± 0.01 (µg/ml) 1 hour after insertion, and 0.3 ± 0.09 (µg/ml), and 0.05 ± 0.01 (µg/ml) on the first and third days postinsertion, respectively. CONCLUSIONS: Although the released monomeric MMA was not at toxic levels, it could potentially sensitize complete denture patients or elicit an allergic reaction. The risk of the residual material as a primary irritant for a sensitizing reaction could be minimized by immersion of the denture in water for 24 hours before insertion.

Prosthetic rehabilitation of partial ear loss with custom-made acrylic attachment and long-term soft liner.

BACKGROUND: The craniofacial implants are used for retaining the prostheses although these are costly and often require complex laboratory procedures. The aim of this case report is to describe a case of successful rehabilitation of partial ear loss with long-term soft liner and mechanically retained by custom-made heat-cured acrylic attachment. CASE DESCRIPTION AND METHODS: A female patient underwent a scalp avulsion injury and lost major portion of her hair and upper part of the left ear till the antitragus. A partial auricular prosthesis was fabricated, and mechanical retention was achieved through custom-made heat-cured acrylic attachment engaged in anatomic undercuts of remained ear. FINDINGS AND OUTCOMES: Permanent soft liner provided a life-like appearance and consistency to the prosthetic ear and bonded to custom-made heat-cured acrylic attachment through chemical cross-linking. CONCLUSION: Patient accepted the prosthesis satisfactorily without any social and psychological embracement. This technique simplified the clinical and laboratory procedures and reduced the cost of the prosthesis.

Platyhelminthes in tongue--a rare case and review.

Humans are the only known definitive host of the tapeworm Taenia solium and become a carrier by eating undercooked pork contaminated with "Cysticercus cellulosae" (cysticerci). Pigs act as an intermediate host and acquire cysticercosis by ingestion of eggs or proglottids from human feces, which develop into cysticerci within tissue, mostly without causing clinical symptoms in the host. Cysticercosis occurs in humans in a context of "fecal peril" by ingestion of egg-contaminated soil, water, vegetation, or auto-infestation. It has been reported in the published data that the separation of swine from humans, healthy cooking, and hygienic practices would lead to the eradication of the disease. However, cysticercosis is still a major public health problem in endemic regions, with more than 50 million infected people and is now a re-emerging disease in industrialized countries owing to human migration. It is the second most common cause of seizures in tropical countries. We report a case of oral cysticercosis in a 28-year-old woman who presented with a painless swelling in the ventral portion of the tongue. An excisional biopsy was performed, and histopathologic examination revealed a cystic cavity containing the tapeworm.

Lost salt technique for severely resorbed alveolar ridges: An innovative approach.

The success of a complete denture relies on the principles of retention, stability and support. The prosthodontist skill lies in applying these principles efficiently in critical situations. Severely resorbed maxillary edentulous ridges that are narrow and constricted with increased inter ridge space provide decreased support, retention and stability. The consequent weight of the processed denture only compromises them further. This article describes a case report of an edentulous patient with resorbed ridges where a simplified technique of fabricating a hollow maxillary complete denture using lost salt technique was used for preservation of denture bearing areas. The hollowing of the denture reduces the weight of the denture, thereby enhancing stability and retention, reducing the further resorption of the jaws.

Split obturator: An innovative approach.

A palatal prosthesis can improve function by closing the palatal defect, preventing regurgitation, and improving swallowing and speech. Although techniques have been previously described for fabrication of palatal obturator, but there has not been any technique to devise an obturator for a patient with palatal defect with a quadhelix orthodontic appliance overlying it. One cannot wait in such patients for completion of lengthy orthodontic treatment and then think of devising prosthesis as the patient cannot carry out normal functions like swallowing and speech without the closure of defect. This article focuses on an innovative method of fabricating a palatal obturator which aims at restoring the above-mentioned functions along with improving aesthetics. It also enables us to devise the fabrication of prosthesis in two parts for easy insertion and removal and as well as to be self-cleansable. Such prosthesis would markedly improve patient psychology and confidence.