Fabrication of three-dimensionally printed polylactic acid nasal stent prosthesis for postnasal reconstruction using extraoral scanning and photogrammetry techniques: A report on two patients.

Severe and combined nasal defects associated with trauma or neoplasm excision can cause significant functional and esthetic problems. To avoid nasal synechia following reconstructive surgeries, a nasal stent prosthesis is required to act as an internal scaffold to support the graft and residual tissues. The purpose of the stent is to maintain internal airway patency and to prevent collapse and contracture of the donor tissues. A conventional nasal stent prosthesis has disadvantages, including the difficulty in maintaining adequate thickness and internal patency during fabrication. Hence, this clinical report introduces the fabrication technique for 3- dimensionally printed polylactic acid nasal stent prostheses using extraoral scanning and photogrammetry methods.

Rehabilitation Using Hybrid Technique for Feeding Plate Fabrication in a 3-Month-Old Infant with Cleft Palate Defect Utilising Digital and Conventional Method: A Case Report.

ABSTRACT: Cleft palate leads to difficulty in suckling, speech abnormalities, dental problems, hearing loss and middle ear infections. Feeding plate acts as a barrier between the oral and nasal cavities allowing the normal development of jaws and enhanced nutritional supply to the patient. Fabrication of the feeding plate using digital means provide better adaptability due to the engagement of all the possible favourable anatomic undercuts, thereby, providing better retention. This case report discusses the hybrid technique including both the digital and conventional means for fabrication of a feeding plate to obturate the defect between the oral and nasal cavity.

Surgical Nasal Stent Fabrication Using Innovative Multisegmental Cast to Rehabilitate Anatomic and Functional Dynamicity of Upper Airway: A Case Report.

Aim: The purpose of this case report is to provide a simple, efficient, and novel technique for fabricating a nasal stent utilizing a multisegmental cast to rehabilitate the anatomic and functional dynamicity of the upper airway following primary cleft lip and primary rhinoplasty surgery. Background: Nasal deformity is often associated with congenital unilateral or bilateral cleft lip and palate. Despite primary nasal reconstruction at the time of definitive lip repair, the long-term postoperative outcome of the nasal correction frequently falls short of the surgeon's or patient's expectations. This condition is more prevalent in the Asian population due to undeveloped, thin alar cartilage and thick skin. Case description: A 4-month-old female infant was referred from the Department of Plastic Surgery for the fabrication of a nasal stent after surgical cleft lip repair with nasal reconstruction. A customized nasal stent using a multisegmental cast followed by relining with tissue conditioner was planned to minimize relapse of the nasal defect. Conclusion: The technique described in the present case for nasal stent fabrication is simple, cost-efficient and innovative. Postoperative use of this nasal stent helps to maintain the corrected position of the nose after primary lip and nasal correction, resulting in significantly improved esthetic results. Clinical significance: Nasal surgical correction deteriorates over time, especially within the 1st year of surgery due to tissue memory and contraction of the scar tissue. Hence a nasal stent should be worn after the surgery to maintain the corrected nasal form. How to cite this article: Singh S, Rathee M, Alam M, et al. Surgical Nasal Stent Fabrication Using Innovative Multisegmental Cast to Rehabilitate Anatomic and Functional Dynamicity of Upper Airway: A Case Report. Int J Clin Pediatr Dent 2023;16(S-2):S220-S223.

Comparative evaluation of implant stability and crestal bone level between tapered and cylindrical implants in the posterior regions of the mandible: A prospective, randomized, split-mouth clinical trial.

Purpose: To compare the clinical outcome of tapered and cylindrical implants placed in the posterior region of mandible by measuring implant stability and crestal bone level at the healing period. Materials and Methods: A prospective clinical study was conducted on 15 patients who were included in the study based on the inclusion and exclusion criteria. A total of 30 dental implants were placed in both groups: 15 implants in Group I (tapered implants) and 15 implants in Group II (cylindrical implants) in the posterior region of mandible. Implant stability assessment by periotest was done at the time of implant placement (baseline) and after 3 months. The crestal bone level was measured with the help of radiovisiography (RVG) at the time of implant placement (baseline) and at 3 and 6 months. Results: At baseline, there was statistically significant (P < 0.01) difference in primary implant stability. Tapered implants had higher primary implant stability than cylindrical implants. However, at 3 months, there was no statistically significant (P > 0.05) difference in the secondary implant stability of both the groups. Also, the crestal bone level on the mesial and distal sides of dental implant for tapered and cylindrical implants was statistically nonsignificant (P > 0.05) at all time intervals, that is, at baseline and at 3 and 6 months. Conclusion: Tapered implants had higher primary stability than cylindrical implants, and no difference was found in secondary stability. The crestal bone level was similar for both groups during early healing and early post-loading periods.

Magnet-Retained closed bulb hollow obturator and orbital prosthesis for patient with maxillectomy and orbital exenteration following COVID-Associated mucormycosis.

The rehabilitation of facial deformities is a challenging endeavour that necessitates customising the procedure for each patient. Significant physical and psychological impacts might arise as a result of the deformity in the orofacial region. Post-COVID rhino-orbital mucormycosis has led to rise in extraoral and intraoral defects since 2020. To avoid further surgery, an economical maxillofacial prosthesis is an excellent choice as it is aesthetic, durable, long-lasting and retentive. This case report describes the prosthetic rehabilitation of the patient with post-COVID mucormycosis maxillectomy and orbital exenteration using a magnet-retained closed bulb hollow acrylic obturator and room-temperature vulcanising silicone orbital prosthesis. To enhance retention, a spectacle and medical-grade adhesive were also used.

Surgical Assistance for Favorable Outcome Achieved through Presurgical Nasoalveolar Molding Using Innovative Impression Technique: A Case Report.

Aim: The aim of this case report is to highlight the importance of presurgical nasoalveolar molding (PNAM) in cleft lip and palate (CLP) cases and its impact on primary surgical outcomes. Background: Cleft lip and palate (CLP) is one of the most common congenital malformations of the maxillofacial complex. Of all congenital malformations, it ranks third and has a multifactorial etiology. Such anomalies can have several consequences, such as impaired suckling, defective speech, deafness, malocclusion, gross facial deformity, and bring tremendous stress on the entire family. Surgical correction is required to restore the form and function of the affected area; however, surgery has to be usually deferred due to the age of the newborn patients. Case description: A 12-day-old neonate born with a bilateral cleft of lip and alveolus was referred from the Department of Plastic Surgery. PNAM was planned in consultation with the plastic surgeon. A customized nasoalveolar molding plate was fabricated, and tissue molding was carried out. Following nasoalveolar molding, primary surgical repair was done. Conclusion: Significant reduction in cleft width, approximation of soft tissue of the lip, and improvement in nasal tip alignment were achieved following PNAM. It favorably positioned the tissue segment and minimized the extent of the local tissue dissection and advancement. The synchronous prosthodontics and surgical treatment resulted in optimal treatment outcomes. Clinical significance: The higher level of estrogen and hyaluronic acid in the newborn that remodels the cartilage can be utilized through the light application of forces, and hence hard and soft tissue molding can be achieved without surgery. PNAM acts as a promising adjunct prior to primary surgical closure of the CLP. Thus, PNAM immediately after the birth can serve to significantly augment the surgical outcomes and the extent and/or the number of surgeries can be reduced. How to cite this article: Rathee M, Singh K, Alam M, et al. Surgical Assistance for Favorable Outcome Achieved through Presurgical Nasoalveolar Molding Using Innovative Impression Technique: A Case Report. Int J Clin Pediatr Dent 2023;16(1):153-158.

Surgical Rehabilitation of a Continuous Orbital and Maxillary Defect from Rhino-Orbital Mucormycosis Utilising Digital Technology - A Case Report.

Rationale: COVID-19 has led to a resurgence in cases of mucormycosis, especially the rhino-orbital form affecting the oral cavity, nasal, orbital and cerebral regions. Patient Concerns: The surgical treatment in this patient led to the exenteration of orbital contents and segmental maxillectomy of the affected side leading to facial disfigurement and inability to masticate. Diagnosis: A combined mucormycosis-associated oro-orbital defect was present leading to a communication between oral and orbital cavities. Treatment: Rehabilitation utilising digital technology for removable prosthesis was planned for the combined orbital and oral defect. Outcomes: The independent intraoral and orbital prosthesis reduced the mobility of the orbital prosthesis while performing functional movements. The advancements in digital technology led to the convenient and resilient fabrication of prostheses for large facial defects. Take-away Lessons: The prosthetic rehabilitation of a continuous orbital and oral defect with a hybrid of both digital and conventional means provided an aesthetic, feasible and financially sound solution to the patient.

Rehabilitation of orbital exenteration postsquamous cell carcinoma of orbit using magnet retained two-part silicone and acrylic prosthesis: A case report.

ABSTRACT: Orbital exenteration performed to treat various neoplasms or nonmalignant diseases results in functional, aesthetic, and psychological issues for the patients. If reconstructive surgery is not possible or not desired by the patient, an orbital prosthesis is an excellent choice for cosmetic and psychological rehabilitation. An orbital prosthesis is aesthetic, durable, long lasting, cost-effective, and most importantly retentive. The present case report describes the rehabilitation of an orbital exenteration postsquamous cell carcinoma using a two-part prosthesis, in which retention is achieved by a combination of relining of anatomic undercuts and magnets.

Resilient Customized Hollow Vaginal Stent for the Treatment of Vaginal Agenesis in Mayer-Rokitansky-Kuster-Hauser Syndrome.

Vaginal agenesis is a common congenital anomaly in females and is most commonly associated with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. These patients can be treated with both surgical and nonsurgical procedures. Prefabricated as well as customized vaginal stents are used for the reconstruction and maintenance of neovagina. This case report explains the fabrication of customized tissue conditioner-reinforced acrylic vaginal stent for the treatment of a 20-year-old female having vaginal agenesis associated with MRKH syndrome. This vaginal stent with resilient surface provides a relatively easy, simple, and cost-effective alternative for the treatment of vaginal agenesis. It is also associated with increased compliance and comfort to the patient.

Early functional, esthetic, and psychological rehabilitation of preschool child with nonsyndromic oligodontia and anodontia in mixed dentition stage through conservative systematic approach: A case report with 5-year follow-up.

Missing teeth are a common developmental abnormality in humans. It may manifest as absence of varying numbers of primary and/or secondary teeth. Early treatment and follow-up are the key to successful rehabilitation of young patients with congenitally missing teeth. It is critical that oral rehabilitation is started early to maintain and correct the oral functions. Mucosa borne removable prostheses are the commonly selected treatment options for the young patients who present with oligodontia or anodontia. This clinical report describes esthetic, functional, and psychological rehabilitation of a young boy with severe oligodontia in maxillary arch and anodontia in mandibular arch. The individualized conservative graded approach in prosthetic rehabilitation with removable acrylic prosthesis helped to achieve esthetics, functionality, and psychological benefits.

Post septorhinoplasty custom-made unilateral nasal stent for nasal cleft deformity.

CONTEXT: Nasal cleft deformity is a complicated problem. Utilization of nasal stent in post septorhinoplastyaims at establishing and maintaining airway patency, tissue position, and reduces tissue contracture after surgery. CASE REPORT: A 16-year-old female patient presented with history of surgical reconstruction of congenital cleft lip and cleft palate with secondary septorhinoplasty of nasal cleft deformity. Patient was referred for nasal stent 1 week after septorhinoplasty. This case report provides a novel technique for fabrication of esthetic nasal stent after postseptorhinoplasty for secondary cleft nose deformity correction. CONCLUSION: This case report presents a simple, convenient technique for nasal stent fabrication for prevention of restenosis for cleft nose deformity post secondary septorhinoplasty. Provision of nasal stent allows breathing, maintains esthetics, comfort, nasal patency, and contour with minimal discomfort.

Bisphenol A in dental sealants and its estrogen like effect.

Bisphenol A or BPA-based epoxy resins are widely used in the manufacture of commercial products, including dental resins, polycarbonate plastics, and the inner coating of food cans. BPA is a precursor to the resin monomer Bis-GMA. During the manufacturing process of Bis-GMA dental sealants, Bisphenol A (BPA) might be present as an impurity or as a degradation product of Bis-DMA through esterases present in saliva. Leaching of these monomers from resins can occur during the initial setting period and in conjunction with fluid sorption and desorption over time and this chemical leach from dental sealants may be bioactive. Researchers found an estrogenic effect with BPA, Bis-DMA, and Bis-GMA because BPA lacks structural specificity as a natural ligand to the estrogen receptor. It generated considerable concern regarding the safety of dental resin materials. This review focuses on the BPA in dental sealants and its estrogen-like effect.