Modified Technique to Fabricate a Definitive Closed Bulb Hollow Obturator for Maxillectomy in a Patient Following COVID-Associated Mucormycosis: A Case Report.

Immunocompromised people developed mucormycosis as a result of the COVID-19 outbreak. Antifungal medications, surgical excision of infected tissues, and therapy of underlying metabolic problems are available forms of treatment. Usually, surgery entails completely excising the affected area. The patient is at risk for nasal twang, nasal cavity leaks, and impaired masticatory function because of these anomalies. The obturator prosthesis may form an oro-nasal seal in such problems. Additionally, lowering the prosthesis weight contributes to improved stability and retention. This case report explains a novel flasking technique to lessen the prosthesis weight and a modified impression technique to capture the palatal deformity.

Customizing the Emergence Profile Around an Immediately Loaded Single Implant in the Esthetic Zone: A Case Report.

An optimal esthetic result is essential for an implant-supported restoration in the anterior zone. In the esthetic zone, providing immediate interim restorations following implant surgery has been proposed as a reliable and desirable treatment approach. A well-contoured interim restoration following implant placement minimizes hard and soft tissue changes in the peri-implant zone. This in turn has the potential to enhance the esthetic outcome and, therefore, patient satisfaction. Multiple prosthetic and surgical aspects need to be carefully planned and executed to achieve the intended final result. This is a report describing the steps involved in recontouring the gingiva to achieve an optimal emergence profile following the immediate loading of a single implant in the esthetic zone.

Rehabilitation of Edentulous Arch Using All-on-Four Treatment Protocol: A Case Report.

In edentulous arches, alveolar ridge atrophy after tooth extraction is a common problem that affects patient comfort and quality of life. Implant-supported fixed restorations are a well-proven treatment option for edentulism. The concepts of implant dentistry have developed over time to produce better aesthetics and functional results. To reduce cantilever length and enable prostheses with 12 teeth, the all-on-four technique entails inserting two anterior implants axially and distally orienting two posterior implants. Compared to conventional loading, immediate loading offers various benefits without compromising quality. An instantaneous fixed provisional allows patients immediate function and preserves their quality of life while also promoting a high degree of patient satisfaction in terms of aesthetics, phonetics, mastication, and psychological comfort.

An Innovative Technique of Iris Positioning Using Digital Photographs for Custom Ocular Prosthesis: A Case Report.

Trauma, cancer, and congenital abnormalities are the three main causes of eye loss. A person's personal and professional life is left with functional, aesthetic, and psychological problems when they lose one eye. A customized ocular prosthesis made of heat-cured polymethylmethacrylate can be used to restore an eye defect. Fabrication of the customized ocular prosthesis has multiple steps including scleral plank fabrication, iris positioning, and characterization. This article's primary goal is to explain a novel method for iris positioning for better cosmetic outcomes.

Esthetic Rehabilitation of Partially Edentulous Ridge With Horizontal Bone Augmentation Using the Sausage Technique: A Report of Two Cases.

Bone augmentation techniques have been used in atrophic ridges to attain appropriate bone volume and enable dental implant insertion. By reducing the need for autogenous bone and decreasing morbidity at the donor sites, the use of bone substitutes has improved patient comfort and satisfaction. One of the major challenges in implant dentistry is achieving an optimal esthetic result with implant-supported crowns in the esthetic zone. Multiple prosthetic and surgical aspects need to be carefully planned and executed to achieve the final esthetic result. This is a report describing bone augmentation using the sausage technique and subsequent prosthetic rehabilitation in two cases.

A Case Report on Iris Disk Positioning on a Custom-Made Ocular Prosthesis Using an Adjustable Trial Frame.

Trauma, cancer, and congenital defects may all result in the loss of an eye. This leads to significant emotional and physical challenges in an individual's life. In such cases, cautious preoperative, surgical, and prosthetic planning employing a multidisciplinary approach is essential for effective rehabilitation. Iris positioning is one of the crucial steps in the fabrication of a customized ocular prosthesis. Iris positioning is a technique-sensitive process, hence visual evaluation by itself could not provide reliable results. This case report illustrates a method of iris disk positioning on a custom-made ocular prosthesis using an adjustable trial frame. The advantage of the adjustable mechanism of the adjustable trial frame was utilized here to position the iris on the scleral blank. Since the iris disk on the ocular prosthesis was positioned in symmetry with that of the natural eye, the patient's aesthetics were restored.

Aesthetic treatment planning simplified using digital smile design: A case report.

Digital smile design (DSD) plays an essential role in the planning of aesthetic treatments. However, most digital smile designing software programmes are expensive and require specialised training and skill for effective implementation. This paper illustrates the use of Adobe Photoshop and Microsoft PowerPoint, which are economical and user friendly for planning aesthetics in a clinical case.

Rehabilitation of an Orofacial Cleft through Presurgical Nasoalveolar Molding with a 1-year Follow-up.

Aim: To highlight the effectiveness of Presurgical Nasoalveolar Molding (PNAM) technique and the appliance used prior to the surgical reconstruction of cleft lip and palate in newborns. Background: In underdeveloped and developing countries, babies born with oral clefts, are generally anemic with low birth weight and may be unfit for surgery immediately. Feeding these babies is also difficult as the air leaks through the cleft and they cannot create the suction needed for suckling. Case description: Two newborn babies, presented with unilateral midfacial clefts involving the lip, alveolus and palate. Conclusion: The PNAM appliance enabled breast Feeding while lessening the soft tissue and cartilaginous deformity and allowing surgical soft tissue repair with minor scar formations. Clinical significance: PNAM can reduce the surgical burden and reduce the number of surgical revisions when initiated early. How to cite this article: Ferreira AN, Eswaramurthy P, Aras MA, et al. Rehabilitation of an Orofacial Cleft through Presurgical Nasoalveolar Molding with a 1-year follow-up. Int J Clin Pediatr Dent 2023;16(1):162-165.

Evaluation and comparison of flexural strength, surface roughness and porosity percentage of denture base resins incorporated with Thymoquinone and silver nano-antimicrobial agents-an in vitro study.

Aim: To evaluate and compare the flexural strength, surface roughness and porosity percentage of acrylic denture base material modified with two antimicrobial agents, Thymoquinone (TQ) and Silver nanoparticles (AgNP). Materials and methods: A total of 90 specimens were fabricated and divided into groups A, B and C with 30 specimens each. Of the 30 specimens, 10 specimens measuring 65mmx 10mmx 2.5 mm were used to study the flexural strength, 10 specimens measuring 10 mm × 20 mm × 3 mm to study surface roughness and 10 specimens measuring 10 mm × 20 mm × 3 mm to study porosity percentage. Group A specimens were made of unmodified denture base resin, group B and C were modified with 2.5% AgNP and 1% TQ respectively. The specimens were processed in the conventional manner. A universal testing machine was used to measure flexural strength and a profilometer was used to measure surface roughness. Porosity percentage was evaluated with help of a desiccator. The data obtained was subjected to statistical analyses using One-way ANOVA and the Tukey-post hoc test, with statistical significance at p ≤ 0.05. Results: Addition of 2.5% AgNP and 1% TQ to acrylic denture base resin significantly reduced flexural strength and increased the porosity percentage (p < 0.01) but within clinically acceptable limits. No significant difference was found in the surface roughness between the various groups tested. Conclusions: Heat cured acrylic denture base resins modified with 2.5% AgNPs,1% TQ exhibited clinically acceptable flexural strength and surface properties and could be incorporated into the denture base material as an antimicrobial agent.

Long term antifungal efficacy of silver-zinc zeolite nanoparticles incorporated in two soft denture liners - An in vitro assessment.

Background: There is generally a lack of compliance in patients who report with oral candidiasis, as they are advised to temporarily stop wearing the prosthesis and are prescribed topical antifungals which are generally unpleasant to taste and follow a rigorous schedule. Furthermore, with the alarming evidence of drug resistance, there is a need for an enhanced drug and drug delivery system. The aim of the study was to determine the dose-dependent antifungal efficacy of silver-zinc zeolite nanoparticles (SZZ-NPs) when incorporated in two brands of soft denture liners against Candida albicans. Materials and Methods: A total of 72 samples were made to determine the in vitro antifungal efficacy of SZZ-NPs and fluconazole by measuring the mean inhibition diameter (MID). Two concentrations of SZZ-NPs were compared (0.5%, 2% w/w) with fluconazole 5%w/w which is routinely prescribed. The antifungals were incorporated in two types of commercially available soft denture liners (Visco gel, GC soft denture liner). The MIDs were measured at day 1, day 7, day 15, and day 30. The values obtained (P < 0.001) were analyzed with one-way ANOVA, Tukey's post hoc, and independent t-test. Results: A statistically significant difference (P < 0.001) was noted among all the antifungal agents at all the time intervals tested. The anti-fungal efficacy of SSZ-NPs 2% w/w incorporated in GC soft denture liner was significantly superior (P < 0.001) to all groups tested and it retained its antifungal efficacy even on day 30 (MID: 18.33 ± 2.44). Conclusion: SZZ-NPs 0.5%w/w, 2%w/w, and fluconazole 5%w/w can be incorporated with soft denture liners against C. albicans. Fluconazole 5%w/w is the recommended choice for short-term antifungal efficacy, while SZZ-NPs 2%w/w is recommended when long-term antifungal efficacy is needed. GC soft denture liner was the recommended choice.

Prosthetic rehabilitation of a midfacial defect with magnet-retained intraoral-extraoral combination prosthesis.

It may not be possible to treat large maxillofacial defects by surgical reconstruction alone. Prosthetic rehabilitation is invariably required to restore esthetics and function. Achieving adequate retention, stability, and support in these maxillofacial prostheses is a challenging task. This clinical report describes prosthetic rehabilitation of a midfacial defect following surgical resection of squamous cell carcinoma. The intraoral defect was restored with a maxillary obturator prosthesis with salivary reservoir, and the extraoral defect was restored with magnet-retained facial prosthesis having an acrylic resin framework and an overlying silicone facial prosthesis.

An in vitro study to compare the influence of two different primers on the peel bond strength between a maxillofacial silicone material and an acrylic resin material versus a composite resin material.

Aim: The aim of this study was to evaluate and compare the peel bond strength of an autopolymerizing acrylic resin and a fiberreinforced composite (FRC) resin to a heat temperature vulcanizing maxillofacial silicone (M511) using two different primers. Settings and Design: In vitro - comparative study. Materials and Methods: Autopolymerizing acrylic resin and FRC resin specimens with a dimension of 75 mm (length) ×10 mm (width) × 3 mm (height) were fabricated. A total of 60 samples were split into six categories based on the substructure material and primers (A330G primer and Sofreliner tough primer) used to bond the maxillofacial silicone to the FRC and acrylic resin specimens. In a universal testing machine, the peel bond strength was conducted at a 10 mm/min crosshead speed until bonding failure occurred. Statistical Analysis Used: The t-test, one-way analysis of variance, and the Tukey's honest significant difference (post hoc test) tests were used to statistically assess the values. Results: The Sofreliner tough primer produced the greatest peel bond strength in both the acrylic resin (0.89690 N/mm) and the FRC resin groups (3.19860 N/mm). Adhesive failures predominated in the acrylic resin group regardless of the primer used. The FRC group showed predominantly cohesive failures with both the A330G primer and Sofreliner tough primer. Conclusion: This study suggests that FRC resin combined with Sofreliner tough primer can significantly enhance the peel bond strength.

Survival rates of axial and tilted implants in the rehabilitation of edentulous jaws using the All-on-four™ concept: A systematic review.

Aim: The aim of this review was to evaluate the survival rate of axial and tilted implants in rehabilitation of edentulous jaws using all on four concept. Setting and Design: Systematic Review. Materials and Methods: A literature review was performed in MEDLINE, PubMed Central (PMC), Google scholar, Embase, Cochrane Central Register of Controlled Trials. Hand searches were conducted of the bibliographic of related journals and systematic reviews. A total of 380 articles were obtained from the intial screening process. Of these articles, 25 articles fulfilled the inclusion criteria. The authors performed evaluation of articles independently as well as data extraction and quality assessment. Statistical Analysis Used: Qualitative analysis. Results: The major prosthetic complication was the fracture of the acrylic prosthesis. The mean cumulative survival rate of implants (72-132 months) were 94% to 98%. The prosthesis survival rate (12 months) was between 99% to 100%. The averaged bone loss was 1.3 ±0.4 mm (12-60 months). No Significant difference was found between survival rates of axial and tilted implants nor between maxilla and mandible. Conclusion: All on four concept can be employed successfully in the edentulous patients with resorbed ridges while improving their quality of life and reducing morbidity. However,randomized clinical trials with large sampling size and long term follow up should be incorporated.

An in vitro study to compare the surface roughness of glazed and chairside polished dental monolithic zirconia using two polishing systems.

AIM: To evaluate the efficiency of two commercially available polishing systems in reducing surface roughness of a monolithic zirconia after clinical adjustment and to compare them to glazed zirconia. SETTING AND DESIGN: In vitro study. MATERIAL AND METHODS: This in vitro study was conducted on 25 discs (10mm in diameter and 2mm in thickness) using monolithic zirconia (Ceramill Zolid). From 25 specimens, 5 specimens were randomly selected as the positive control. The remaining discs were abraded for 15 secs with a red band diamond finishing bur using an air rotor handpiece. Then the specimens were randomly divided into 5 equal groups of 5 specimens each. Group 1: Roughened, unpolished and unglazed. Group 2 (Positive Control): Glazed without prior roughening,Group 3: Roughened and polished with eZr polishing kit, Group 4: Roughened and polished with Optra fine ceramic polishing kit and Group 5: Roughened and glazed. The surface roughness (Ra) values (µm) were measured quantitatively by a surface analyzer. The mean values were compared using one-way ANOVA and Post Hoc Test. One specimen of each group was evaluated qualitatively under a scanning electron microscope(SEM) for surface topography. STATISTICAL ANALYSIS USED: One-way ANOVA and Post Hoc Test. RESULTS: The lowest Ra value was found in Group 4-Roughened and polished with Optrafine ceramic polishing kit (Ra=0.47µm) as compared to Group 3-Roughened and polished with eZr polishing kit (Ra=0.49µm) and Group 5-Roughened and glazed (Ra=0.59µm). There was no stastistically significant difference between two polishing systems. SEM analysis of surfaces polished with Optrafine polishing kit revealed smoother and regular morphology as compared to surfaces polished with eZr polishing kit. CONCLUSION: The Optrafine polishing kit created more smoother and uniform surfaces as compared to surfaces polished with eZr polishing kit both quantitatively and qualitatively. Also, lowest surface roughness values were produced by optrafine ceramic polishing kit on monolithic zirconia as compared to glazed monolithic zirconia after their clinical adjustments.Thus Optrafine ceramic polishing kit can be used as alternative to glazing.

Effect of Chemical Disinfectants on the Color Stability of Maxillofacial Silicones: An In Vitro Study.

PURPOSE: To evaluate the effect of chemical disinfection on the color stability of room temperature vulcanizing (RTV) maxillofacial silicone elastomer with and without pigment addition. MATERIALS AND METHODS: Sixty specimens were obtained from a RTV maxillofacial silicone. The specimens were randomly divided into 6 groups according to pigments and disinfectant to be used (n = 10). NP-DW-nonpigmented silicone specimens to be immersed in distilled water (control). NP-S- nonpigmented silicone specimens to be rubbed with an anti-bacterial soap. NP-CHX-nonpigmented silicone specimens to be immersed in chlorhexidine gluconate solution (2%). P-DW-pigmented silicone specimens to be immersed in distilled water (control). P-S-pigmented silicone specimens to be rubbed with antibacterial soap. P-CHX-pigmented silicone specimens to be immersed in chlorhexidine gluconate solution (2%). Disinfection was conducted 6 times a day for 60 days simulating 1 year of usage. Color was evaluated after 60 days (disinfection period) using a reflectance spectrophotometer. Color alterations were calculated by the CIE L∗ a∗ b∗ system. Data were analyzed by t-test, one-way ANOVA, and Tukey test (α = 0.05). RESULTS: NP-S and P-S exhibited the highest color alterations, whereas NP-DW and P-DW the lowest color alterations. CONCLUSION: Disinfection procedures affect the color stability of maxillofacial silicone. Chlorhexidine gluconate solution (2%) can be effectively used as a chemical disinfectant for maxillofacial prostheses. Antibacterial soap produced clinically unacceptable color changes in the silicone, hence is not advisable as a disinfectant.

The Hollow Maxillary Complete Denture: A Simple, Precise, Single-Flask Technique Using a Caramel Spacer.

The success of removable prostheses ultimately depends on a number of factors such as retention, stability, support, esthetics, and masticatory function. Increased intraoral inter-arch distance leads to an increase in the weight of the prosthesis. This may compromise the retention and resistance, which are key for a successful removable prosthesis. Various methods, techniques, and materials have been reported to minimize the weight of a prosthesis. This article describes a simple, unique, precise single-flask technique for the fabrication of a lightweight maxillary prosthesis using caramel as a 3D spacer, which was "indexed" to obtain a uniform thickness of acrylic around the hollow cavity.

Effect of the simulated Indian and Mediterranean climates on the Shore A hardness of maxillofacial silicone.

PURPOSE: The purpose of this study was to assess and compare the effect of the simulated Indian and Mediterranean climates on the Shore A hardness of a commercially available nonpigmented room temperature vulcanizing maxillofacial silicone. MATERIALS AND METHODS: Sixty specimens were fabricated from A-2000 silicone material (Factor II), using a stainless steel mold of dimension 20 mm × 2 mm. The initial Shore A hardness was noted using a digital durometer. Thirty samples were subjected to the simulated Mediterranean climate (Group I), and the remaining thirty samples were subjected to the Indian tropical climate (Group II) in an accelerated weather chamber to simulate 1 year of clinical use. Final Shore A hardness was noted. A one-way ANOVA and Bonferroni post hoc tests were performed for the Shore A hardness at P < 0.05. RESULTS: The mean initial Shore A hardness for both the groups was 24.9833. After accelerated weathering, Group I showed mean Shore A hardness of 33.0000 whereas Group II showed mean Shore A hardness of 38.0000. CONCLUSIONS: The Shore A hardness of Factor II, before and after accelerated artificial weathering, was statistically significant at 0.05 level (P < 0.05). The change in Shore A hardness was greater in the simulated tropical climate group (Group II) as compared to the simulated Mediterranean climate group (Group I) but within clinical limits.

An innovative and simple approach to fabricate a hollow ocular prosthesis with functional lubricant reservoir: A solution to artificial eye comfort.

The loss of an eye is an emotional and psychological setback to the patient. An ocular prosthesis is created to restore the lost anatomical structure and to correct the cosmetic defect. The tear reflexes do not function at optimal levels in anophthalmic sockets which make prosthesis wear uncomfortable. This case report presents an innovative hollow ocular prosthesis with functional lubricant reservoir which upon normal blinking would draw the lubricant from the reservoir through an exit hole which spreads over the prosthesis allowing a comfortable and long duration of prosthesis wear.

Iris Positioning Using a Grid Attached to a Spring Bow for a Custom Ocular Prosthesis.

Eyes are among the first features of the face to be noticed. Loss of an eye due to congenital, traumatic or pathologic aetiologies causes disfigurement and loss of sensory feedback. It leaves a psychological impact on the patient, thus prosthesis should be provided at the earliest to raise the spirits of the afflicted. Iris positioning is one of the important steps in fabricating customized ocular prosthesis. In facial asymmetry cases, comparison of both irises together can be a major disadvantage. This case report illustrates the use of a unique customized frame spring bow assembly to position the iris disk using the established parallelism between inter pupillary line to the horizontal plane.