Malignancy around implants in patients with a history of a potentially malignant or malignant lesion: a systematic review.

The majority of problematic conditions resulting from dental implant treatment are inflammatory in character, but certain isolated occurrences of primary oral squamous cell carcinoma (OSCC) have been discovered in the area of implants. The goal of this study was to examine whether there is a link between dental implants and the development of OSCC in patients who have a history of a potentially malignant lesion (PML) or malignancy. Using the keywords "carcinoma" AND "dental implants," a search was conducted in the MEDLINE (PubMed), National Center for Biotechnology Information, and Google Scholar databases for case reports and case series in which OSCC was discovered as a primary cancer in the region of dental implants. An initial search identified 260 articles, 247 of which were excluded based on study inclusion or exclusion criteria, leaving 13 articles chosen for inclusion and a total of 30 patients who developed primary oral cancer surrounding osseointegrated titanium-based dental implants. In the studies included in the present review, 22 (73%) of 30 patients with peri-implant cancer had a history of PML or carcinoma. There is no statistical evidence of a direct association between dental implants and OSCC in patients with a history of a PML or malignant lesion. There have been some case reports of OSCC in the region of dental implants in patients with a history of a PML or malignant lesion, but further studies are needed to prove a definitive relationship.

Fabrication of a bicomponent hybrid orbital prosthesis.

This clinical report describes the management of the retention of an orbital prosthesis in a patient with uncontrolled diabetes. The patient, who underwent left orbital exenteration subsequent to severe mucormycosis, posed a challenge for implant placement and for use of adhesives as a method of retention because of the high likelihood of reinfection. Inaccessibility to severe anatomic undercuts along with their arbitrary block out would have caused diminished retention. As a result, an orbital prosthesis composed of a digitally produced hollow conformer and traditionally produced silicone prosthesis was provided using 3-dimensional imaging and rapid prototyping, with optimum retention.

Correction of cheek biting in a dentate patient.

Postsurgical injury by teeth to oral mucosa (reconstructed by a flap) can lead to ulceration and subsequent infection at the reconstructed site. A prompt intervention by fabricating a specially designed prosthesis to deflect the reconstruction flap away from the occluding teeth has been described for the treatment of cheek biting in the present clinical report.

Correction of microstomia in an edentulous patient.

The problem of small oral aperture is big. Irrespective of the etiology, this problem may be overcome by adjunctive therapies in the form of prosthesis, surgery, or exercise. A patient is described with this problem, which was overcome by revisiting the 3 adjunctive therapies including a commissural stent designed with the patient's edentulous state in mind.

Mini-Implants, Mega Solutions: A Case Series.

Dental implants have evolved as a standard of care for replacement of missing teeth. Though this treatment modality promises a high level of patient satisfaction and success, it cannot be performed in all cases. Apart from medically compromised patients, implant use is also restricted whenever there is limited available bone volume at the edentulous site. An example includes the mandibular incisor, the maxillary lateral incisor region, and other sites with reduced interdental spacing and atrophic edentulous maxillary and mandibular ridges. Bone volume at some of these sites can be increased by suitable augmentation procedure for placement of a regular diameter implant (3.75 to 4.2 mm). But many a times such procedure cannot be undertaken either due to financial constraint, risk of subjecting the patient to additional surgical procedure, added time factor, or guarded prognosis of the grafted site. In such cases, mini-implants can be used. In this case series, mini-implants (2.5 to 3 mm) were used to replace teeth in all mouth quadrants and to retain a mandibular overdenture in a compromised case. The implants served well at all the sites with minimal bone loss and a high level of patient satisfaction. Mini-implants hold the potential to serve as an alternate to regular diameter implants in certain situations. Preferably they should be used in multiples to retain fixed dental prostheses and might serve as an efficient, low-cost solution for retaining overdentures in selected cases.

Comparative evaluation of bonding strength of computer aided machined ceramic, pressable ceramic, and milled metal implant abutment copings and effect of surface conditioning on bonding strength: An in vitro study.

BACKGROUND/PURPOSE: The aim of this study was to compare the shear bond strength of computer aided design/computer aided machined ceramic (CAD/CAM), pressable ceramic, and milled metal implant copings on abutment and the effect of surface conditioning on bonding strength. MATERIALS AND METHODS: A total of 90 test samples were fabricated on three titanium abutments. Among 90 test samples, 30 copings were fabricated by CAD/CAM, 30 by pressable, and 30 by milling of titanium metal. These 30 test samples in each group were further subdivided equally for surface treatment. Fifteen out of 30 test samples in each group were surface conditioned with airborne particle abrasion. All the 90 test samples were luted on abutment with glass ionomer cement. Bonding strength was evaluated for all the samples using universal testing machine at a crosshead speed of 5 mm/min. The results obtained were compared and evaluated using one-way ANOVA with post-hoc and unpaired t-test at a significance level of 0.05. RESULTS: The mean difference for CAD/CAM surface conditioned subgroup was 1.28 ± 0.12, for nonconditioned subgroup was 1.20 ± 0.11. The mean difference for pressable surface conditioned subgroup was 1.18 ± 0.04, and for nonconditioned subgroup was 0.75 ± 0.28. The mean difference for milled metal surface conditioned subgroup was 2.57 ± 0.58, and for nonconditioned subgroup was 1.49 ± 0.15. CONCLUSIONS: On comparison of bonding strength, milled metal copings had an edge over the other two materials, and surface conditioning increased the bond strength.

Rehabilitation of resorbed mandibular ridges using mini implant retained overdentures: A case series with 3 year follow-up.

With the increasing average life expectancy of human beings, the need to cater geriatric patients is ever increasing. Complete dentures are an indispensable tool in this regard. The loose and unstable lower complete denture owing to residual ridge resorption is one of the most common problems faced by edentulous patients. Dental implant retained overdentures have emerged as an efficient treatment modality for such patients. Though useful, not every patient is a suitable candidate to go for conventional implant-borne prosthesis, limitation being the available bone width. In such cases, mini implants may be used for augmenting the retention of the dentures and improving the quality of life of patients. In this case series, rehabilitation of three compromised cases with mini implant retained overdentures have been described wherein patients are experiencing instability of lower denture due to thin resorbed mandibular ridges. In one of the cases, three mini implants placed in A, C, and E position were splinted using a cemented bar to retain the mandibular denture. The other two cases were rehabilitated using unsplinted ball type one piece mini implants placed in A, C, and E position in one case and B and D position in another case. Though splinted bar design should be preferred but the lack of available vertical space precluded the utilization of bar in other two cases. The results were found to be satisfactory with no complications reported during a follow-up period of over 3 years in all the cases.

Comparative evaluation of surface topography of tooth prepared using erbium, chromium: Yttrium, scandium, gallium, garnet laser and bur and its clinical implications.

BACKGROUND: Erbium, chromium: Yttrium, scandium, gallium, garnet (Er, Cr: YSGG) laser has been successfully used in the ablation of dental hard and soft tissues. It has been reported that this system is also useful for preparing tooth surfaces and etching, but no consensus exist in the literature regarding the advantage of lasers over conventional tooth preparation technique. MATERIALS AND METHODS: Labial surfaces of 25 extracted human maxillary central incisors were divided into two halves. Right half was prepared with diamond bur and left half with Er, Cr; YSGG laser and a reduction of 0.3-0.5 mm was carried out. Topography of prepared surfaces of five teeth were examined under scanning electron microscope (SEM). The remaining samples were divided into 4 groups of 10 specimens each based on the surface treatment received: One group was acid etched and other was nonetched. Composite resin cylinders were bonded on prepared surfaces and shear bond strength was assessed using a universal testing machine. RESULTS: The SEM observation revealed that the laser prepared surfaces were clean, highly irregular and devoid of a smear layer. Bur prepared surfaces were relatively smooth but covered with smear layer. Highest bond strength was shown by laser prepared acid etched group, followed by bur prepared the acid etched group. The bur prepared nonacid etched group showed least bond strength. CONCLUSIONS: Er, Cr: YSGG laser can be used for preparing tooth and bond strength value achieved by laser preparation alone without surface treatment procedure lies in the range of clinical acceptability.

Multidisciplinary Rehabilitation in a Case of Congenital Aglossia with Situs Inversus Totalis.

Aglossia is a rare congenital disorder with complete absence of tongue that can also be associated with limb deformities, syndromes and aberrant positioning of the visceral organs. The present case report describes multidisciplinary rehabilitation in a patient with Aglossia Congenita along with dextrocardia, situs inversus, mutilated dentition with a lack of occlusal table and compromised esthetics.

Patient satisfaction with complete dentures fabricated using two neutral zone techniques: a within-subject cross-over pilot study.

Several studies have compared complete dentures fabricated using conventional and neutral zone (NZ) techniques. However, studies comparing patient satisfaction with complete dentures fabricated using swallowing and phonetic NZ techniques are lacking in literature. To compare patient satisfaction with the complete dentures fabricated using the two NZ techniques. To compare the bucco-lingual dimensions of the NZ records obtained with these techniques. Ten completely edentulous subjects dissatisfied with their existing mandibular complete dentures participated in the study. Five subjects first received the swallowing neutral zone (SNZ) dentures and five the phonetic neutral zone (PNZ) dentures. Tissue conditioner was used as the recording material in both the techniques. After having worn the prosthesis for a minimum of 2 months, subjects responded to a questionnaire that measured their perceptions of various factors associated with the prosthesis. The prostheses were then changed and the procedures repeated. Student t test and non-parametric Mann-Whitney tests were used for statistical analysis. Level of statistical significance was set p < 0.05. There was no statistical significant difference in patient satisfaction with the SNZ and PNZ complete dentures for all the variables assessed. Statistical significant difference was observed for majority of the variables when the two NZ dentures were compared with patients' old dentures. The difference in the mean dimensions of the two NZ records was also found to be statistically insignificant except in the maxillary left premolar region. The study indicated that patient satisfaction with the complete dentures fabricated using SNZ technique did not significantly differ from that of the PNZ technique. Data gathered at the final appointment showed that SNZ dentures were preferred by the patients with regards to esthetics, stability, comfort and ability to chew. For ability to speak, mixed preferences were found.

Perception and Attitude of Dental Students Towards Geriatric Care: A Questionnaire-Based Survey.

Introduction Geriatric dentistry concerns the influence of aging and systemic disorders on oral health. Every dental practitioner must comprehensively understand the oral health conditions affecting geriatric patients and the physiological, psychological, and social aspects of aging to deliver holistic care. Methods A cross-sectional survey was undertaken among postgraduate students, interns, and undergraduates in dental colleges across the Delhi National Capital Region (NCR), India. This survey employed a self-administered questionnaire to gauge the attitude of undergraduate and postgraduate students towards elderly patients. Results The study included 312 participants with a mean age of 24.95 years (±2.95 years). The distribution of participants by educational level: Intern: 25.3% (n=79), postgraduate (PG)-1 Year: 16.7% (n=52), PG-2 Year: 9.0% (n=28), PG-3 Year: 9.9% (n=31), undergraduate (UG)-3 Year: 19.2% (n=60), UG-4 Year: 19.9% (n=62). Most respondents strongly agreed on the necessity of being more empathetic and attentive when treating geriatric patients. Similarly, the majority strongly concurred on the differences in treatment and communication required for geriatric patients, underscoring the need for specialized training. Significant differences were observed between undergraduate (UG) and postgraduate (PG) students regarding their confidence in treating geriatric patients, their understanding of geriatric patients' expectations, and their willingness to treat geriatric patients in their future practice, with PG students agreeing on all these aspects. Conclusion Overall, most participants showed a favorable attitude towards elderly patients. However, postgraduates demonstrated a deeper comprehension of the needs of geriatric patients and exhibited greater confidence in their ability to treat them both presently and in future practices. Despite this, there was a recognized need for specialized training. Consequently, there is a call for increased workshops and training sessions focused on geriatric patients.

An electromyographic analysis of orbicularis oris and buccinator muscle activity in patients with complete dentures fabricated using two neutral zone techniques--a pilot study.

PURPOSE: Several studies have evaluated electromyographic (EMG) activity of perioral muscles in patients using unsatisfactory old complete dentures and after the insertion of new clinically acceptable dentures; however, studies evaluating EMG activity of orbicularis oris (OO) and buccinator (BUC) muscles in patients wearing complete dentures fabricated using swallowing (SNZ) and phonetic neutral zone (PNZ) techniques are lacking in the literature. The purpose of this study was to evaluate differences in muscle activity of the superior orbicularis oris (SOO), inferior orbicularis oris (IOO) and BUC muscle during the use of unsatisfactory old complete dentures, in comparison with the satisfactory dentures fabricated using the two neutral zone techniques. MATERIALS AND METHODS: Ten completely edentulous participants dissatisfied with their existing mandibular complete dentures participated in the study. Each patient received two sets of new dentures fabricated using the SNZ and PNZ techniques. Surface EMG activity of the OO and BUC muscles was recorded using a 4-channel Medelec premier plus electromyography machine while the patients still used their old dentures (group A) and with the SNZ (group B) and PNZ (group C) dentures. On the basis of participation in the study, five participants first received the SNZ dentures and five the PNZ type. After having worn the prosthesis for a minimum of 2 months, EMG recordings were repeated for the first set of dentures. The prostheses were then changed and the procedures repeated. The activity of OO and BUC muscles was recorded at rest, while pursing and laughing, and during pronunciation of various syllables. Results are expressed as mean ± SD and as absolute numbers and percentage. ANOVA with appropriate correction (Bonferroni or Tamhane) and Student's t-test were used for statistical analysis. A p-value < 0.05 was taken to indicate a significant difference. RESULTS: There was no statistically significant difference in the mean EMG activity of SOO, IOO, and BUC muscles at rest, or during pursing or laughing among the three groups. No significant difference was observed in the mean EMG activity of SOO and BUC muscle among the groups for all the syllables pronounced. For IOO, a statistically significant difference was observed among the groups for the words "baby" and "cheese." Within-group comparisons of the mean EMG activities of SOO and IOO during pronunciation and pursing showed no significant difference; however, at rest a statistically significant difference was observed in group B. CONCLUSION: OO and BUC muscle activities did not significantly differ, irrespective of the technique used for fabrication of complete dentures.

A modified technique of using digital technology to fabricate surgical obturator in patients with limited mouth opening.

This article presents a digital technique for the fabrication of an immediate surgical obturator for a patient with decreased mouth opening planned for maxillectomy. The amalgamation of pre-operative Cone Beam Computed Tomography (CBCT) data and 3D printing allowed for the fabrication of the immediate surgical obturator without conventional pre-surgical diagnostic impression. The surgical obturator was placed in position intraorally post tumor resection to complete the obturation. The procedure followed led to an accurate fit of the prosthesis without any need for relining during surgery.

3D face scan for fabrication of cranioplast: An applied innovative technique.

Cranial defects are repaired for esthetics, functional, morphological and psychological benefit of the affected patients. Purpose of a cranioplast is to prevent trauma to brain tissue, improve the cranial contour, symmetry and esthetics along with pain reduction. This technique describes the innovative use of a multicamera 3D face scanning software for obtaining a 3D face model of a road traffic accident patient for cranioplast fabrication. Advantage of this technique is that it is quick and easy and allows complete face scan under 10 s.

Neutral zone approach for the rehabilitation of a severely atrophic mandibular ridge: Case report.

Providing a complete denture for a patient with an atrophic mandibular ridge presents a unique challenge for dentists. Retention, stability, and support must be considered when fabricating and fitting a complete denture. This article highlights the use of the neutral zone technique for successful complete denture therapy in a patient with an atrophic mandibular ridge, with special emphasis on the role of coverage of genial tubercles for maximum prosthesis support and stability.

Effectiveness of Vitamin D along with Splint therapy in the Vit D deficient patients with Temporomandibular disorder-A Randomized, double-blind, placebo-controlled clinical trial.

Aim: The purpose of this study is to comparatively evaluate the Vitamin D supplementation and stabilization splint therapy in patients exhibiting temporomandibular disorders (TMD). Settings and Design: The study design was double-blinded, parallel-group, randomized and placebo-controlled trial conducted in patients with low Vitamin D and TMDs, which were allocated to two groups, Study group S + D (Stabilization splint with Vitamin D supplementation) and Control Group S (Stabilization Splint with placebo drug). Subjects and Methods: Thirty-six participants of 18-45 years of age gap with Vitamin D deficiency and TMD were included in the study. Preoperative values of Vitamin D levels in ng/ml, comfort mouth opening (CMO) in mm, maximum mouth opening (MMO) in mm, temporomandibular joint (TMJ) tenderness (grading 0-3), Visual analog scale score (VAS Score 0-10 cm), and total energy (TE) integral values of both left and right TMJ's in Hertz (Hz) were recorded using joint vibration analysis All the values of CMO, MMO, TMJ Tenderness and VAS were recorded at each follow-up at 1st week, 1st month, 2nd month, and 3rd month, respectively. Postoperative Vitamin D levels and TE of both TMJs were recorded at end of 3 months. Statistical Analysis Used: For intergroup comparison, Mann-Whitney U-test and Pearson Chi-square tests were done. For Intragroup comparison, Wilcoxon signed rank test was used for comparison. Results: In Intergroup comparison, a significant difference was seen in CMO, VAS score and MMO (P < 0.05) but not among mean values of TE of right and left TMJ, and Vitamin D levels (P < 0.05). In both groups, there were significant statistical variations in CMO, VAS score, MMO, and TE integral before and after treatment in the right and left TMJs (P < 0.05). Conclusions: The study concludes centric stabilization splint helps in improving symptoms of TMD patients and Vitamin D supplementation provided faster relief in those cases.

Stereophotogrammetric Method for Fabrication of Cranioplast Using Digital Facial Scan Technology - A Case Report.

Rationale: Traumatic brain injury is the most common cause of cranial defects. Cranioplasty is the surgical intervention performed to repair cranial defects. The purpose of a cranioplast is to protect the underlying brain tissues, reduce pain, and improve calvarial contour and symmetry. Patient Concerns: This case report describes the management of an ambulatory aided patient who met with a road traffic accident and had undergone decompressive craniectomy. Diagnosis: Noncontrast computed tomography confirmed the frontal cranial defect and was planned for decompressive craniectomy. Treatment Plan: An innovative multi-camera three-dimensional (3D) face-scanning software (Bellus 3D) was used for facial scanning to obtain a 3D face model and fabrication of 3D model using rich presence technology. Outcomes: The wax pattern was then fabricated on a 3D-prototyped model and a customised polymethylmethacrylate cranioplast was fabricated. Take-Away Lessons: his method with the added advantage of rapid prototyping technology resulted in prosthesis with good aesthetics and better fit.

Comparative Evaluation of Load-Bearing Capacity and Fracture Analysis of PEEK and Zirconia Three-Unit Fixed Dental Prostheses: An In Vitro Study.

PURPOSE: The purpose of this exploratory in vitro study was to compare and evaluate the load-bearing capacity (LBC) of ceramic-veneered zirconia and composite-veneered polyetheretherketone (PEEK) three-unit fixed dental prostheses (FDPs) with and without thermocycling (TC). MATERIALS AND METHODS: The study included 40 samples of three-unit FDPs replacing mandibular first molars. The four groups included were: ceZIR (feldspathic ceramic-layered zirconia), ceZIR TC (feldspathic ceramic-layered thermocycled zirconia), cPEEK (composite-layered PEEK), and cPEEK TC (composite-layered thermocycled PEEK) (n = 10 per group). All frameworks were CAD/CAM milled. Ten PEEK and 10 zirconia samples were subjected to TC (6,000 cycles). All 40 FDP specimens were loaded by applying static load, using a universal testing machine. The maximum load required to fracture the specimens denoted the LBC. The comparison of LBC between the four groups was done by using two-way ANOVA with Tukey's post-hoc analysis (α = .05). RESULTS: There was no statistically significant difference between LBC of cPEEK and ceZIR (P > .001) without thermal aging. LBC values decreased considerably for thermally aged specimens. Statistically significant differences were observed between LBC of cPEEK TC and ceZIR TC (P < .001), cPEEK TC and cPEEK (P < .001), and ceZIR TC and ceZIR (P = .001). On fracture analysis, cPEEK showed delamination failures whereas ceZIR displayed catastrophic connector fractures. CONCLUSION: This comparative evaluation offers preliminary data highlighting substantial depreciation in the LBC of layered PEEK under simulated intraoral conditions, thus raising a question regarding the clinical longevity of layered PEEK multi-unit restorations. In contrast, feldspathic-layered zirconia can be suitable for use in posterior FDPs.