Use of mini implants for the two-implant retained mandibular overdenture: A prospective study.

Background: The two-implant retained mandibular overdenture utilizing nonsplinted implants is a proven treatment modality for completely edentulous patients. However, a lacuna still exists regarding the suitability of mini dental implants for this purpose. The purpose of the study was to evaluate implant stability and crestal bone loss in single-piece mini dental implants loaded with immediate or conventional loading protocols to retain a mandibular overdenture. Method: Twenty-four completely edentulous patients were rehabilitated using conventional maxillary complete denture and a mandibular two-implant retained overdenture utilizing nonsplinted single piece mini implants. The implants were loaded with immediate or conventional loading protocols. Implant stability (with Periotest TM) and crestal bone loss (with radiovisiograph and radiographic grid) were evaluated at the time of loading and at one, two, and six months after loading. Statistical analysis was done with the Independent Samples "t" test and One-Way ANOVA. Results: Mean Periotest Values observed were significantly more negative in implants loaded with the conventional loading protocol. Crestal bone loss was significantly lesser in the immediate loading protocol but was still higher than the requisite 1.5 mm postulated by established criteria. Conclusion: Two single-piece nonsplinted mini implants may be sufficient to retain a mandibular overdenture utilizing the immediate loading protocol. Further studies with a longer duration of observation and larger sample size are required.

Custom-fabricated nasal conformers and surgical stents in the management of midfacial acid burn injuries: A clinical report.

Acid burn injuries in the midfacial region cause contracture of the skin and nasal aperture, which can lead to nasal airway obstruction. Management of such complicated situations requires a multidisciplinary approach, including prosthetic intervention. This article describes a clinical treatment for fabricating a custom nasal conformer for a 28-year-old man who presented with a history of an acid burn injury leading to obstructed external nares and fusion of the tip and columella of the nose with the philtrum of the upper lip. The prosthesis served the dual function of maintaining the nasal airway passage and preventing the contracture of the graft placed over the upper lip during reconstructive surgery.

Clinical evaluation of "componeers" and direct composite veneers using minimally invasive enamel preparation technique: In vivo study.

AIM: The aim of this study was to evaluate the clinical behavior of prefabricated componeers and direct composite veneering. The objective of the study was to compare the changes in color, surface texture, marginal integrity, and gingival response for componeers and direct composite veneers. SETTINGS AND STUDY DESIGN: This was an in vivo, comparative study. MATERIALS AND METHODS: Ten patients indicated for anterior veneers were selected and divided into Groups A and B of five patients each. Group A was restored with componeers and Group B with direct composite veneers. Both the groups were compared for color changes, surface textural changes, marginal integrity, and gingival response, starting immediately post veneering and at 3, 6, 9, and 12 months subsequently. STATISTICAL ANALYSIS USED: Friedman's two-way analysis of variance and Mann-Whitney test were used for statistical analysis. RESULTS: Results for color ranged from excellent to good with minimal color changes post veneering. Overall, "gingival response," in both the groups, showed statistically significant differences in mean rank scores (P ≤ 0.05). The data depicted an improvement in gingival response for all patients during the period of the study. Surface textural changes were significant only for maxillary right canine and maxillary left lateral incisor (P = 0.024 and 0.039, respectively) in both the groups. Maxillary right canine in both the groups showed significant changes in marginal integrity. Intergroup comparison of gingival response, surface texture, and marginal integrity depicted no significant difference between the groups (P > 0.05). CONCLUSIONS: This study concluded that the intergroup comparison of componeers and direct composite veneers for the parameters, gingival response, surface texture, and marginal integrity did not depict any significant differences. Both the groups displayed minimal changes in color, surface texture, and marginal integrity and improved gingival response.

Integration of Digital and Analog Workflow to Achieve Predictable Esthetics: A Novel Approach.

The use of digital smile designing simplifies the restoration of esthetics. In this article, a case of diastema and incisal notching in anterior teeth was rehabilitated with porcelain laminate veneers using combination of digital and analog workflow.

Management of compromised residual alveolar ridges using hollow denture with three-dimensional printed spacer and specialized impression technique.

Impression making in compromised residual alveolar ridge is a regular challenge in rehabilitating patients with conventional removable complete dentures. In patients who cannot afford implant-supported dentures, specialized impression technique is a viable and justified option for fabrication of complete dentures. More often, the stability of denture in such patients becomes a deciding factor between failure and success. Furthermore, increased interarch space may result in increased height of maxillary and/or mandibular dentures with corresponding increase in weight, which further compromises the retention and stability of the prosthesis. This article describes an amalgamation of Hobkirk's impression technique in a case of resorbed maxillary residual alveolar ridge with a flabby anterior segment and fabrication of hollow maxillary dentures using a "three-dimensional printed dental spacer" with a "double-flask technique." The weight of the final prosthesis was reduced therefore contributing to improved retention and stability of the final prosthesis.

Rehabilitation strategies for partially edentulous-prosthodontic principles and current trends.

The prosthetic considerations for treatment of partially edentulous patients involve evaluation of important aspects such as presence of certain functional or skeletal deficits, orientation of the occlusal plane, free-way space, size and location of edentulous areas, number, strategic location and quality of the likely abutment teeth, vertical dimension, and the type of occlusion. A comprehensive evaluation, multidisciplinary approach and a sequential treatment plan, worked out in harmony with the patient's perceptions are important factors to ensure a successful outcome. This article discusses the principles, current trends and importance of clinical decisions in designing a treatment strategy when confronted with complex situations of partial edentulism.

Comparative evaluation of clinical performance of two self-etch adhesive systems with total-etch adhesive system in noncarious cervical lesions: An in vivo study.

BACKGROUND: The growing demands for esthetic restorations have stimulated intensive research in the field of adhesive dentistry. Dental adhesive systems are used to promote adhesion between composite resins and dental structure. In the fundamental principles of adhesion, the primary mechanism contributing to the formation of adhesion is micromechanical bonding between the restoration and the tooth. The bond strength of self-etching adhesives to dentin was found to be almost equal to that of total-etch adhesives. The aim of the present prospective, double-blind, randomized controlled clinical trial was to evaluate and compare the clinical performance of two self-etch adhesive systems with total-etch adhesive system in noncarious cervical lesions (NCCLs). MATERIALS AND METHODS: In each patient, three teeth were randomly assigned according to the adhesive system used to Group A (total-etch adhesive system), Group B (two-bottle self-etch adhesive system), and Group C (one-bottle self-etch adhesive system). The clinical efficacy of these adhesive systems was determined by evaluating the retention rate, marginal integrity, and postoperative sensitivity at the following three levels: baseline, 6 months, and 18 months by following the Modified USPHS criteria introduced by Vanherle et al. RESULTS: In the present study, the retention rate at 18 month in Group A, Group B, and Group C of 96%, 92%, and 92% was observed, respectively. A marginal integrity at 18 months was 88%, 80%, and 84% for Group A, Group B, and Group C, respectively. Postoperative sensitivity at 18 months was 16%, 12%, and 12% for Group A, Group B, and Group C, respectively. CONCLUSION: The clinical performance of total-etch and self-etch adhesive systems in NCCLs did not differ significantly with regard to the evaluated parameters - retention, marginal integrity, and postoperative sensitivity.

Aesthetic and functional rehabilitation of a case of mutilated dentition and loss of vertical dimensions.

Cases of severe attrition are a common finding in daily clinical practice. Attrition leads to loss of vertical dimension, chewing inefficiency and poor esthetics. These cases require complete oral rehabilitation which can be successfully achieved by a systematic approach integrating various concepts of prosthodontics. The primary aim of such complex treatment modalities is to regain the lost function, esthetics, comfort and confidence for the patient. The following case report describes the complete oral rehabilitation of a patient diagnosed of mutilated dentition and reduced vertical dimensions due to severe attrition. A detailed treatment plan was chalked out which included institution of proper oral hygiene measures, extraction of teeth with poor prognosis, restoration of carious teeth, endodontic treatment for carious teeth with periapical involvement. This was followed by foundation restorations of teeth that were crucial for the final prostheses. Patient was given transitional restorations for about 6 weeks with the aim of regaining the lost vertical dimensions. Final rehabilitation was done by fixed dental prostheses.