Reconstructive Surgery with Autogenous Chin Block Graft for Esthetic Rehabilitation of Deficient Anterior Maxillary Region.

Endosseous implants have revolutionized the field of Implants and Prosthodontics. Implant placement is a viable option in the treatment of partial and full edentulism. However, placement of implants in alveolar deficiencies may lead to adverse angulations, mechanical overload and esthetic dissatisfaction. When minimum dimensions for implant placement are not present in alveolar process, it is necessary to augment the size of the ridge. This can be achieved by various methods and materials. Here in this article presented a successful case of a 27 year old male patient with horizontal ridge augmentation in anterior left central incisor region using autogenous chin graft followed by the placement of implants after a period of six months of grafting and finally the prosthesis given after a period of six months of healing of implants.

Improved Fabrication of Implant Retained Auricular Prosthesis with Digital Technologies.

A 28-year-old male patient came to the prosthodontics department seeking replacement for his congenital defect left ear. With the use of digital technology, a silicone implant supported bar retained auricular prosthesis that is an exact match in size, shape, and orientation to the existing contralateral ear was made.

Clinical outcomes of implant-supported prosthetic rehabilitation of severely atrophic maxilla: A systematic review.

Aim: The purpose of this systematic review is to evaluate the clinical outcomes for the various methods of rehabilitation of a severely atrophic maxilla with the help of implant-supported fixed prosthesis. Materials and Methods: The relevant publications published between 2013 and 2022 and written only in English were identified using an electronic search. The primary research question for this study was developed based on the PICO framework, which stands for population, intervention, control, and outcomes which was "What are the clinical outcomes of implant-supported prosthetic rehabilitation in patients with severely atrophic maxilla?" The relevancy of the articles was confirmed by examining their titles, abstracts, and complete texts to determine whether they satisfied the requirements for inclusion. Utilizing specialized study design-related bias assessment forms, the risk of bias was evaluated. Results: The database search resulted in 1568 results; however, 1529 of them were eliminated because of insufficient, duplicate, or missing data. Additionally, manual searching yielded 11 articles. After 50 full-text papers were assessed for eligibility, 17 articles were eliminated. Thus, 33 studies in total are included in the current systematic review. Risk of bias analysis and GRADE evidence analysis were performed. Data were found to be heterogeneous and thus meta-analysis could not be done and narrative synthesis is presented. Conclusion: The patient's condition and the clinician's expertise play a role in taking the decision on choice of technique for the fixed implant-supported rehabilitation of the severely atrophic maxilla. A high success and survival rate is produced by the majority of fixed implant-assisted prostheses despite the biologic and prosthetic problems. A single approach cannot be recommended as the gold standard. The choice is dependent on the patient's biological factors as well as the clinician's expertise. The included studies were assessed using GRADE criteria. The quality of evidence is low-medium. Therefore, to better comprehend the clinical effectiveness of the treatment alternatives, more well-designed randomized controlled trials with longer follow-up period are required.

Satisfaction in conventional acrylic complete denture patient with and without denture liners - a systematic review.

To make a new complete denture, a series of steps is needed, and it is a time-consuming process. Which is not possible in every patient due to financial and medical reasons. The old denture can be relined by denture liners in less clinical and laboratory steps and can successfully increase the efficiency of ill-fitting dentures however, patient satisfaction with denture liners is doubtful. This systematic review was organized from the preferred reporting items for systematic reviews' checklist, and the methods were registered on the international prospective register of systematic reviews (PROSPERO- CRD42020210227). The main systematic review is to assess satisfaction in convectional acrylic complete denture with or without denture liners. Search engines such as PubMed, Science Direct, Cochrane, Ovid, and Google Scholar were used to extract information. The risk of bias was measured with the help of the Cochrane collaboration tool. Initially we found 1711 articles out of which 6 were finalised as per PICO criteria. Patient satisfaction was evaluated by using a visual analogue scale and questionnaire method, which shows denture liners group has more patient satisfaction. Acrylic denture liner and silicon denture liner shows better patient satisfaction compared to the conventional acrylic denture. Among denture liners, there is no significant difference.

Stomatognathic Risk Factors and Clinical Manifestations of Temporomandibular Disorders in Indian Population: A Case-control Study.

AIM: This study was aimed to compare the risk factors and associated clinical manifestations of patients with temporomandibular disorders (TMDs) in the Indian population. MATERIALS AND METHODS: A total of 52 patients were explored according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and compared with 48 controls. The mean age of the study group was 30.96 ± 11.60 years, 41% were males and 59% were females. The mean age in the control group was 31.5 ± 9.9 years (37.5% males), measuring differences in TMD risk factors (self-perceived stress, parafunctions, occlusal interferences, history of orthodontic treatment, and/or extraction). RESULTS: The most common sign observed in the selected subjects was the joint sound (clicking) (42%), followed by mandibular deviation 39% as the second most common sign. Myofascial pain (MFP) (single or multiple diagnoses) was the most frequent diagnosis (n = 40, 76%), followed by disc displacement with reduction (DDWR) (32.1%), arthralgia (30%), and disc displacement without reduction (DDWoR) (7.6%). More than one DC/TMD diagnosis was established in 63.2% of the patients. The risk factors like presence of clenching, stress perception, parafunctions, tooth wear, and occlusal interferences were significantly more frequent in all the cases than in the respective controls. CONCLUSIONS: In the studied population, the presence of TMD was found to be positively related to factors namely female gender, parafunction, occlusal interferences, psychological stress, and tooth wear. Myofascial pain is the commonest diagnosis (either single or in combination). It is followed by DDWR (either single or in combination with others). Double diagnosis is also common. CLINICAL SIGNIFICANCE: Temporomandibular disorders showed a female predilection and were found to be positively related to factors, viz., parafunction, occlusal interferences, stress, and tooth wear. Clinicians should also be aware of common clinical manifestations of TMDs and their related stomatognathic risk factors to provide comprehensive oral care and to identify such factors for disease prevention.

A Systematic Review to Evaluate Knowledge, Attitude, and Practice Regarding Biomedical Waste Management among Dental Teaching Institutions and Private Practitioners in Asian Countries.

OBJECTIVE: The objective of this study was to assess knowledge, attitude, and practices among dental teaching institutions and private practitioners in Asian countries. MATERIALS AND METHODS: Systematic review of observational studies on BMW management was conducted. We searched the following electronic bibliographic databases: PubMed/MEDLINE and Google Scholar. Manual search was carried out for similar topics in the National Medical Library, New Delhi. In addition, the bibliographies were manually searched. There was no disagreement between the two reviewers. This review was reported and conducted in step with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Only studies written in English and published until November 2019 were included. This review was registered in International Prospective Register of Systematic Reviews (PROSPERO registration number is CRD42019124900). RESULTS: In this review, of 678 articles, 24 articles met inclusion criteria. Available scientific studies showed that knowledge regarding BMW management guidelines varied from 33% to 100% among dentists. Most of the studies reported that knowledge and practice regarding segregation of BMW was limited. Most of the study subjects were aware of hazardous effects of amalgam and had amalgam separator. Studies done in Chennai and Karnataka, approximately one-third dentists were not following BMW guidelines for sharp management and most of them were disposing of sharps in general waste bins. CONCLUSION: On the basis of the current evidence and data extracted from the various databases, it can be concluded that knowledge regarding BMW management guidelines among dentists is inadequate and practice regarding the same is poor. Regular training sessions and Continuing Dental Education (CDE) on BMW management guidelines and updates need to be organized for improvement of knowledge and practice regarding BMW among dentists.

Comparative evaluation of diametral tensile strength of phosphate-bonded investment (ringless) material by using air-drying method, conventional hot air oven, microwave oven, and combination of microwave and conventional oven: An in vitro study.

AIM: This study evaluated and compared the diametral tensile strength (DTS) of phosphate-bonded investment (PBI) material (ringless) used in removable cast partial denture fabrication. SETTINGS AND DESIGN: Comparative - Invitro study. MATERIALS AND METHODS: The PBI material, Wirovest used in this study was subjected to four different drying methods. A total of 80 specimens were prepared in a cylindrical form; 20 specimens were air dried for 2 h, 20 specimens were dried in a conventional oven at 230°C for 1 h, 20 specimens were dried in microwave oven at 600 W for 10 min, and remaining 20 specimens were dried first in microwave oven and then in conventional oven. The dried specimens were tested at 2-h interval for diametral compression at a crosshead speed of 0.5 cm/min. STATISTICAL ANALYSIS USED: Pairwise analysis. RESULTS: The microwave drying technique and drying by combination method resulted in greater DTS, respectively. CONCLUSION: Within the limitation of this study, PBI specimens dried in microwave oven at 600W for 10 min increased the diametral strength and are also a time-saving procedure.

Effect of Repeated Microwave Disinfection on the Surface Hardness of a Heat-Cured Denture Base Resin: An In vitro Study.

STATEMENT OF THE PROBLEM: Disinfection of complete dentures is very crucial to prevent cross-contamination and infection. Microwave disinfection is a quick, easy, and effective means to disinfect dentures. However, the effect of repeated microwave cycles on the surface hardness property of heat-cured polymethyl methacrylate (PMMA) resin is not known. MATERIALS AND METHODS: A total of 60 samples of heat-cured PMMA resin were fabricated for surface hardness. Each group was divided into four groups, according to the number of microwave cycles (MWC) applied for disinfection: control group (no disinfection) 0MWC, 1MWC group, 3MWC group, and 5MWC group. RESULTS: No significant change on the surface hardness of a heat-cured denture base resin on repeated microwave disinfection. CONCLUSION: The repeated microwave disinfection showed statistically nonsignificant change on the surface hardness of the PMMA resin. Microwave disinfection can be safely used in regular practice to avoid cross-contamination and can also be suggested to patients for the regular denture hygiene.

An evaluation of patient's decisions regarding dental prosthetic treatment.

INTRODUCTION: For fabricating dental prostheses that meet patients' demands and have good longevity and function, appropriate treatment planning and decision-making are required. Therefore, not only technical skills and clinical judgment of the dentist are needed, but also patients' attitude toward treatment plays a critical role in posttreatment satisfaction. AIM: The aim of this study is to investigate the factors affecting decision-making and the selection of dental prosthesis by the patients. MATERIALS AND METHODS: A cross-sectional survey to determine patients' attitudes about replacement of teeth was conducted. This survey was performed with the help of a prevalidated questionnaire, which contained the demographic data of every patient, whether or not they accept the treatment plan proposed by the dentist, and a close-ended multiple choice question stating the reasons cited by them if they decline the proposed treatment plan. RESULTS: The data were subjected to statistical analysis by Chi-square test at a significance level of P < 0.05. A relationship between the demographical information such as age, gender, educational status, marital status, and monthly income of each patient and the single best reason opted by them to not undergo the proposed treatment plan was established. CONCLUSIONS: In the sample of population studied, most of the patients declined the proposed treatment plan and accepted the alternate one. High expenditure is the most common reason for this rejection.

Spectrophotometric evaluation of shade reproduction of pressable all-ceramic system on un-stained and stained tooth: An in vitro study.

PURPOSE: To evaluate the shade reproduction of a pressable all-ceramic system placed on unstained and stained extracted maxillary central incisor using a color measurement spectrophotometer. In addition, to compare shade reproduction of this material with low translucency and medium opacity on unstained tooth and medium and high opacity on stained tooth. MATERIALS AND METHODS: Total 45 discs, with difference in the opacity of core, were used. After spectrophotometric evaluation, shade reproduction of the discs was compared and calculated by formula: Δ E* = ([Δ L*](2)+ [Δ a*](2)+ [Δ b*](2))(1/2). RESULTS: Student's t-test showed that in a sample of 15, the values of Δ E* for Group I - LT (Us.T.) lie between 0 and l, for Group II - MO (for Us. as well as S.T.) between l and 2, for Group III - HO (S.T.) are all above 5. Comparison among groups after t-test showed that mean Δ E* values of Group I - LT is less than Group II - MO for the unstained tooth, Δ E* for Group II - MO is less than average Δ E* value of Group III - HO for stained tooth. CONCLUSION: All-ceramic with low translucency can be used for the fabrication of restoration on the unstained tooth as it gives the best shade reproduction. The medium opacity material may be used on the unstained as well as on stained tooth. However, the clinical implication of high opacity is limited when applied over the stained tooth as it is giving a shade reproduction, which is not within acceptable limits.

"Split Cast Mounting: Review and New Technique".

For the fabrication of a prosthesis, the Prosthodontist meticulously performs all the steps. The laboratory technician then make every effort/strives to perform the remaining lab procedures. However when the processed dentures are remounted on the articulator, some changes are seen. These changes may be divided into two categories: Pre-insertion and post-insertion changes, which deal with the physical properties of the materials involved (Parker, J Prosthet Dent 31:335-342, 1974). Split cast mounting is the method of mounting casts on the articulator. It is essentially a maxillary cast constructed in two parts with a horizontal division. The procedure allows for the verification of the accuracy of the initial mounting and the ease of removal and replacement of the cast. This provides a precise means of correcting the changes in occlusion occurring as a result of the processing technique (Nogueira et al., J Prosthet Dent 91:386-388, 2004). Instability of the split mounting has always been a problem to the Prosthodontist thereby limiting its use. There are various materials mentioned in the literature. The new technique by using Dowel pins and twill thread is very easy, cheaper and simple way to stabilize the split mounting. It is useful and easy in day to day laboratory procedures. The article presents different methods of split cast mounting and the new procedure using easily available materials in prosthetic laboratory.

Stabilizing the Carbon Marker During Surveying: An Innovative Technique.

Dental surveyor has been defined as an instrument used to determine the relative parallelism of two or more surfaces of the teeth or other parts of the cast of a dental arch. Therefore the primary purpose of surveying is to identify the modifications of oral structures that are necessary to fabricate a removable partial denture that will have a successful prognosis. It is the modification of tooth surfaces to accommodate placement of the component parts of the partial denture in their designated ideal position on abutment teeth that facilitates this prognosis. Routinely, during marking the survey line, the carbon marker breaks many a times, as it is somehow brittle in structure, even after holding it in the metal sheath. This unnecessarily lengthens the working time of the operator as well as laboratory personnel. In the above mentioned new technique, the plastic refill sheath holds the carbon marker easily and securely. This serves the marking on the cast without breakage of carbon marker, thus saves the operator's time. The plastic refill sheath is easily available and economical.

An evaluation of dimensional accuracy of one-step and two-step impression technique using addition silicone impression material: an in vitro study.

The study is aimed to evaluate the dimensional accuracy, the effect of undercut of two different configurations and the elastic recovery of addition silicone impression material assessed indirectly, by measuring the dimensions on stone models recorded from the impression of the master model, using one-step and two-step impression technique, for addition silicone impression materials. Measurements are taken to evaluate horizontal or linear and vertical dimensional changes, of the abutment V and abutment C from the stainless steel model. Heavy body/light body material is used for making one-step impression technique in a custom tray. Putty/light body is used for taking two-step technique in a stock metal tray. Improved die stone is used for pouring the impression. The different 11 locations on the dies produced by two different techniques are measured microscopically on image analyzer and compared with those of stainless steel model. Anova test was applied to test the differences of mean values of inter and intra abutment measurements, to calculate p value. Unpaired t test was applied to calculate t value. Results showed less deviation of stone models produced by one-step technique from stainless steel model, whereas the deviation of stone models produced by two-step is comparatively more. (p < 0.01). This difference of deviation is significantly less in one-step as compared to two-step technique. One-step is sufficiently dimensionally accurate than two-step technique in conjunction with addition silicone impression material. They have the best elastic recovery from the two undercut configurations.

Comparative evaluation of impact and flexural strength of four commercially available flexible denture base materials: an in vitro study.

Poly-methyl methacrylate is a rigid material. It is generally observed that the impact and flexural strength of this material is not satisfactory and that is reflected in the continuous efforts to improve these mechanical properties. Hence there was a serious need to make another material which could overcome the limitations of the existing materials and could have better properties, like thermoplastic materials. The study was aimed to evaluate and compare the impact strength and the flexural strength of four different flexible denture base materials (thermoplastic denture base resins) with the conventional denture base material (high impact polymethyl-methacrylate). Two, machine made master moulds of metal blocks according to the size of sample holder of the equipment were prepared to test the impact and flexural strength. Total 40 samples, 10 for each group of flexible denture base materials namely: De-flex (Deflex, United Kingdom), Lucitone FRS (Densply, Germany), Valplast (Novoblast, USA), and Bre-flex (Bredent, Germany) in specially designed flask by injection molded process. For different flexible materials, the time, temperature and pressure for injecting the materials were followed as per the manufacturer's instructions. Total 20 samples for control (Trevelon denture base materials) were prepared by compression moulded process, for each test. ANOVA test was applied to calculate p value. Unpaired t test was applied to calculate t-value. Tukey-Kramer multiple test was provided for comparison between the groups for flexural and impact strength. From the statistical analysis, it was found that, the impact strength of Group III (Valplast) was found to be the highest than all other groups and nearer to the control group. Whereas Group IV (Bre-flex) had the maximum flexural strength. The flexural strength of Group I (De-flex) was lowest than all other groups and nearer to control group. The values were found to be statistically significant but clinically non-significant with the control (p < 0.001). The overall results of the study showed that, Group III (Valplast) had the maximum impact strength and Group I (De-flex) had the lowest flexural strength, whereas Group IV (Bre-flex) had the maximum flexural strength and lowest impact strength.