Comprehensive Approach for Rehabilitation of a Completely Edentulous Patient: A Case Report.

Complete edentulism poses significant challenges to oral function, esthetics, and overall quality of life. The use of complete dentures remains a cornerstone in rehabilitating such patients and restoring masticatory function, phonetics, and facial esthetics. However, to improve patients' function, it is important to restore the stomatognathic system. The rehabilitation process begins with a thorough assessment of the patient's oral health status, including evaluation of the remaining supporting structures and the surrounding soft tissues. Impressions and jaw relation records are meticulously obtained to ensure accurate denture fabrication. Proper denture retention, stability, and occlusion are crucial for successful rehabilitation. Beyond functional aspects, attention to esthetics plays a pivotal role in patient satisfaction and acceptance of complete dentures. Customization of denture teeth in terms of shape, shade, and arrangement is essential to achieve natural-looking smiles and facial harmony. Complete dentures remain a valuable treatment modality for the comprehensive rehabilitation of completely edentulous patients. Through a combination of meticulous treatment planning, advanced techniques, and patient-centered care, we can achieve successful outcomes in restoring oral function and thus improving the overall quality of life for such patients. Thus, this case report outlines a simple, economical, and useful rehabilitation plan for a patient with an edentulous maxillary and mandibular arch with flabby tissue and a resorbed mandibular ridge.

Balancing Function and Proprioception: A Case Report Featuring Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM)-Fabricated Marburg Denture System.

The ultimate purpose of a partial prosthetic denture is to protect the rest of the teeth as their discarded functionality is being put back together. A Marburg double crown is a form of retainer that works well by providing splinting action between many abutment teeth as well as retention and support. Compared to traditional clasp-retained removable partial dentures (RPDs), the Marburg double crown transfers load to the abutment teeth's long axis. The Marburg double crown system fabricated efficiently using the computer-aided design/computer-aided manufacturing (CAD/CAM) system for treating partially edentulous patients is highlighted in this case report.

Full Mouth Rehabilitation With All-on-Six Concept With Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) Milled Bar Retained Zirconia Prosthesis.

Full-mouth rehabilitation, also known as full-mouth reconstruction or restoration, is the comprehensive process of restoring and rehabilitating the function, aesthetics, and health of all teeth in the upper and lower jaws. This involves a multidisciplinary approach, addressing issues such as occlusion (bite), tooth wear, tooth loss, and periodontal (gum) health to achieve optimal dental function and appearance. This treatment provides a stable and reliable solution for dental problems associated with the complete or partial loss of dental elements. This case report discusses the management of a 72-year-old male patient who came with a chief complaint of decayed, missing, and mobility of his teeth. His medical history included drug-regulated diabetes and chronic periodontitis, which remained a reason behind his deteriorating dental health. The treatment plan encompassed a comprehensive approach, starting with the full-mouth extraction and progressing to the placement of six implants in both the mandibular and maxillary arches for complete restoration. After allowing eight weeks for healing, the impressions for the implants were recorded with the polyvinyl siloxane material. The case demonstrates the application of the all-on-six concept; whereby full arch rehabilitation is possible with the strategic placement of six implants. By employing the latest in advanced computer-aided design/computer-aided manufacturing (CAD/CAM), a zirconia prosthesis that was retained on a milled bar was fabricated-yielding a very high degree of accuracy and excellent aesthetics in the restoration. Restorations with zirconium were done, as it is excellent in aesthetics and functioning. This article considers the importance of precision planning, correct implant placement, and advances in dental science and technology. Most importantly, the conclusion that can be drawn is that the end outcome of total rehabilitation with all-on-six should not only be an affirmation that difficult cases can be managed very well but also the patient's quality of life is improved by using the latest dental procedures.

Crafting Confidence: A Comprehensive Case Study of Full-Mouth Reconstruction Utilizing Implant-Supported Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) Zirconia Restorations.

A 67-year-old male patient reported to the department with a chief complaint of tooth mobility. The patient presented with a medical history of diabetes for which he was on medication, and he also reported a history of chronic periodontitis. After a thorough assessment of the patient, a proper treatment plan was designed, which included full-mouth rehabilitation, prior to which the patient was advised full-mouth extraction. Six implants were inserted into the mandibular and maxillary arches as part of the treatment. After the implant was placed, zirconia was the preferred choice for the restoration because of its superior aesthetic results. Polyvinyl siloxane impression material was used to make implant impressions after an eight-week healing period. The case report provides the technique for the current approach to full-mouth rehabilitation with all six concepts of implant placement. In these situations, it is crucial to plan and insert implants correctly and adhere to the entire treatment plan. Restorations were performed using the latest computer-aided design/computer-aided manufacturing (CAD/CAM) technologies for a more aesthetically pleasing result. The case study highlights the significance of meticulous preparation and implementation for the accomplishment of successful full-mouth rehabilitation.

Troubleshooting Vaginal Stents: A Critical Review of Common Problems and Solutions.

This review aims to examine the use of vaginal stents in clinical practice, specifically for treating vaginal agenesis and related complications and problem associated with vaginal stents. Vaginal agenesis, also known as Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, is a congenital disorder characterized by the uterus not developing or developing only partially. Vaginal stents are medical devices that preserve the structural integrity and patency of the vaginal canal after trauma or surgery. They play an important part in gynecological treatments such as post-radiation therapy, reconstructive surgery, and vaginal stenosis management. The review also discusses the primary applications of vaginal stents, such as preventing adhesions, healing mucosa, and maintaining patency. It also investigates frequent concerns associated with stent use, such as complications and the need for better designs. Vaginal stents are essential in a variety of therapeutic settings, providing major benefits in maintaining vaginal tissue and function. However, their use is fraught with complications, including the risk of infection, discomfort, and the possibility of inappropriate placement.

Aesthetic and Functional Rehabilitation for Dentogingival Asymmetry Using Zirconia Restorations.

In an effort to improve dentogingival aesthetics, scientific research has been developing non-surgical techniques and dental restorative materials. A 45-year-old female reported to the hospital with a complaint of an unpleasant aesthetic in the anterior region of the maxilla. She has an irregular contour of the gingiva in her anterior region and no temporomandibular problems. There is a history of trauma, but she did not take any treatment for it, which caused discolouration. Plaque index was retained by the surface roughness. Due to this reason, the patient's appearance, self-esteem, and quality of life have decreased. The purpose of this case is to provide a system-based clinical example of oral rehabilitation for anterior teeth. The patient didn't like the way she looked, and hence aesthetic and functional rehabilitation was planned. Treating the dentogingival asymmetry was the first step in the therapeutic approach. An in-ceram zirconia permanent porcelain metal-free crown was positioned after the temporary crowns were cemented into place. It should be mentioned that in clinical situations, the integration of periodontal and prosthetic treatment is crucial. Additionally, it is stated that the in-ceram zirconia system can produce satisfactory results when applied appropriately. For the main anterior teeth, zirconia crowns have offered an alternate treatment option that addresses aesthetic concerns and facilitates the installation of extra-coronal restorations. This article describes a case involving the aesthetic and functional restoration of severely damaged maxillary incisors using zirconia crowns.

Influence of Crown Height and Width on Marginal Bone Loss and Long-Term Stability of Dental Implants: A Systematic Review.

Still, a major focus of research in implantology is how crown height and width affect marginal bone loss (MBL) and the long-term durability of dental implants. Maximizing the success of implants and lowering problems depends on an awareness of these elements. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, this systematic review searched pertinent studies across several databases using keywords unique to databases. Studies on MBL and long-term implant stability evaluated in the review included those on crown height and width, horizontal and vertical cantilevers, and prosthesis dimensions. In the chosen studies, we found that both implant success and crestal bone loss were greatly influenced by crown height and width. Particularly in the posterior sections, horizontal cantilevers were connected to both increasing MBL and mechanical problems. Vertical cantilevers also affected MBL; however, their impacts were more obvious in circumstances with greater crown heights. Greater prosthesis widths, especially in the mandibular molar area, were linked to higher MBL. Bone density and insertion torque (IT) were the main determinants of MBL, more than the primary implant stability quotient. Early MBL was influenced by abutment height, mucosal thickness, and implant insertion depth; bone levels stabilized six months later. Short implants allow single crowns to be supported, but in some cases, a higher failure rate was seen. The success and stability of dental implants were found to be mostly dependent on crown height, width, and cantilever design. MBL and long-term stability are greatly influenced by horizontal and vertical cantilevers, which calls for careful design and planning. With specific care for bone density, IT, and early MBL stabilization, both short and standard implants can produce equivalent results. These results highlight the need for customized treatment plans to maximize implant success and lifetime.

Rehabilitation of an Ocular Defect Using a Custom Ocular Prosthesis in a Pediatric Patient.

It is a well-known saying that the eyes are "windows to the soul." The absence or loss of any facial part, particularly the vision, can lead to severe physical as well as emotional trauma. Losing any part of the face causes the patient societal, physical, and psychological anguish. An ocular prosthesis aims to improve social acceptance and boost self-confidence by restoring the facial appearance. A pediatric dental specialist should be a part of the maxillofacial prosthesis team since maxillofacial prosthetic rehabilitation in young children can be challenging, especially with the less cooperative ones. The following case report describes these challenges in relation to a 5-year-old boy who had his eye enucleated due to trauma. The purpose of the case was to provide custom-built, acrylic ocular prostheses in as comfortable and atraumatic manner as possible by the maxillofacial prosthetic team. How to cite this article: Bansod AV, Pisulkar S, Beri A, et al. Rehabilitation of an Ocular Defect Using a Custom Ocular Prosthesis in a Pediatric Patient. Int J Clin Pediatr Dent 2024;17(4):479-482.

Revolutionizing Maxillary Rehabilitation: Zygomatic Implants Addressing Severe Alveolar Atrophy.

This case report describes the care given to a 58-year-old male patient with severe upper jaw atrophy. The treatment strategy involved utilizing zygomatic implants in conjunction with endosteal implants to rehabilitate both the maxilla and mandible. Temporary prostheses were used during the healing phase, followed by the fabrication and placement of final prostheses. The utilization of zygomatic implants offers advantages such as immediate stabilization and function without the need for extensive bone grafting. This approach not only reduces treatment time and costs but also enhances patient outcomes. Furthermore, guided surgical techniques are increasingly employed to ensure precise implant placement, optimizing prosthetic support.

Striving for Excellence: Fabrication of Complete Denture in a Patient With Flabby Ridges Using Specialized Impression Technique.

Tissue growth across the ridges is a typical clinical feature in the mandibular and maxillary arches. This excess tissue is known as flabby ridges. The mobile tissue may be distorted throughout the impression-making process due to the forces applied. The chewing forces will displace the denture if it is not adequately maintained, which will eventually cause the denture to lose its stability, support, and retention. The particular impression technique promoted accurately documenting flabby ridges. Several strategies, including implant therapy, balanced occlusal load distribution, surgical management, and special impression techniques, can be used to treat removable dentures with "flabby ridges." This case study demonstrates the method for constructing a complete denture in a patient with flabby ridges using a specialized impression technique. This impression technique helps to record flabby tissue with minimal displacement, improving the stability, support, and retention of complete dentures.

Rapid Smile Restoration: Basal Implants for the Edentulous Mandible With Immediate Loading.

In the significant atrophic jaws, it is difficult to place dental implants since there is a qualitative and quantitative shortage of future implant beds. Basal implants, also known as cortical or bicortical implants, offer a viable alternative for dental rehabilitation in patients with significant alveolar bone loss. These implants are anchored in the dense basal bone, providing immediate stability and allowing for immediate loading, thereby reducing overall treatment time and eliminating the need for extensive bone grafting procedures. This case report demonstrates the efficacy of basal implants in providing immediate functional and aesthetic restoration for patients with significant alveolar bone loss, by describing a 49-year-old patient who presented with severe alveolar ridge resorption, making traditional implant placement unfeasible. Basal implants were successfully placed, and an immediate prosthesis was delivered, resulting in excellent functional and aesthetic outcomes.

Rehabilitation of the Surgical Defect Secondary to Mucormycosis With a Definitive Obturator: A Case Report.

Neglect initially starts as an infection, evolving into a disease. During the COVID-19 pandemic, lifestyle changes and disturbed food intake have weakened immune systems, making individuals more susceptible to secondary infections. Mucormycosis poses a significant threat, especially during the COVID-19 pandemic when immune systems may be compromised. The impact of the disease extends beyond physical health, affecting psychological and social well-being due to the challenges, such as difficulties in mastication, speech, and swallowing post-surgery. The mention of maxillectomy highlights the severe nature of some cases, necessitating surgical intervention to remove the affected tissue. Anatomical and functional losses following surgical excision of the maxilla and surrounding tissues need to be recovered as soon as possible. After surgery, prostheses can and should be used to restore speech, mastication, and deglutition - three essential physiological activities. Thus, a patient's treatment approach should include prosthetic planning before surgical intervention and rehabilitation after the surgery. If they are carefully handled at the moment of surgery, the overall continuity created by maxilla resection includes at least the oral, nasal, and maxillary sinus cavities, which may prove to be a useful future location for prosthesis retention. As a result, the prosthodontist's role becomes crucial in assisting the surgeon in taking all necessary precautions that are beneficial to the patient.

Digitalization in Cranial Reconstruction: Revolutionizing Precision and Innovation.

Cranioplasty for cranial defects can be complex and challenging in composite defects. The intricate 3D structure of the craniofacial skeleton poses various difficulties encountered in surgical reconstruction. The continuous progress in computer-aided design and computer-aided manufacturing design, and fabrication technology has led to a growing array of applications for visual analog scale and 3D printing in craniofacial surgery, encompassing preoperative assessment, the creation of cutting guides, and the development of custom implants and stereolithographic models. Within this review, the authors detail the present and developing applications of virtual surgical planning, 3D bioprinting, augmented reality, and virtual reality in craniofacial reconstruction.

Revolutionizing Neurosurgery: The Cutting-Edge Era of Digitally Fabricated Cranial Stents.

Cranial defects are broadly classified as either congenital or acquired. The prevalence of cranial injuries has notably increased, propelled by a heightened emphasis on aesthetics and the demand for skull reconstruction in contemporary society. Consequently, rehabilitation for these defects has also surged. Surgical correction or repair, known as cranioplasty, not only aims at aesthetic rehabilitation but also addresses psychological issues, improving social acceptance and overall performance. Amid evolving trends, the availability of advanced biomedical tools, technologies, and materials empowers surgeons and prosthodontists, leading to improved outcomes in aesthetics and functionality. One noteworthy technique highlighted in this case report involves using bone cement in conjunction with polymethyl methacrylate, adding novelty to the approach. The interdisciplinary management team, consisting of prosthodontists and neurosurgeons, played a pivotal role in improving neurological status and cosmetic outcomes for the patients.

Pulpotomy for the Management of Irreversible Pulpitis in Mature Teeth.

Strict protocols for evaluating the pulp's preoperative state should be developed, along with a new classification scheme for the different pulp states, as case selection plays a major role in the effectiveness of adult pulpotomy. In this case report, a male patient, age 15, who had a carious lower left first molar underwent pulpotomy. The pulp's initial state was ascertained by pulse oximetry, electric pulp testing (EPT), and cold testing. The final diagnosis was symptomatic irreversible pulpitis. A 12-month follow-up period following the placement of mineral trioxide aggregate (MTA) (MTA Angelus Angelus, Londrina, Brazil; Clinician's Choice, New Milford, CT) and tooth-colored composite restoration revealed no visible anomalies in the postoperative radiographs, and the tooth remained functional and free of symptoms.

Association of Salivary Cortisol With Anxiety in Type 2 Diabetes Mellitus Patients Before and After Complete Denture Rehabilitation: An In-Vivo Analysis.

Background Complete edentulism negatively impacts emotional, physical, social, and psychological well-being, leading to a decline in quality of life and heightened stress and anxiety. Stressful situations associated with edentulism can elevate cortisol levels, potentially increasing the risk of diabetes. Rehabilitation with complete dentures needs careful evaluation for its impact on general health, considering stress points and systemic effects. This study aimed to assess salivary cortisol levels in type 2 diabetes mellitus patients before and after complete denture rehabilitation, highlighting the intricate relationship between diabetes, cortisol, and the stress response. Methods This is a cross-sectional study centered on individuals with diabetes who were completely edentulous and undergoing evaluation by the outpatient prosthodontic department. Glycated hemoglobin, anxiety levels, and the fabrication of complete dentures were all accomplished with the participants' consent. Patients underwent evaluations before and one month after receiving complete denture rehabilitation. Results An absolute correlation between salivary cortisol levels and anxiety may be established because anxiety levels dramatically decreased during complete denture rehabilitation. Conclusion By learning how the patient's general health is related to their new set of complete dentures and how to correlate that information with dental rehabilitation, professionals can help patients better adapt to their new set of dentures.

Quantitate evaluation of photogrammetry with CT scanning for orbital defect.

Facial deformities can be caused by cancer, tumours, trauma, infections, congenital or acquired defects and may lead to alteration in basic functions such as communication, breathing, and mastication and aesthetic thereby affecting quality of life. Traditional processes for manufacturing maxillofacial prostheses involve complicated, time-consuming and tedious processes for the patient and the operator. Impression of the defect area, which is the one of the crucial step in fabrication of prosthesis, is the longest and most difficult process as it requires a long contact with the patient. The digital revolution is now changing the landscape of prosthetic production and making the impression making procedure simpler. Digital technology reduces patient chair side time by providing more accurate display data in less time (3-5 min) than traditional methods. Digital impressions eliminate the need for bulky impression materials and provide a more comfortable patient experience.

Appliances Therapy in Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis.

Obstructive sleep apnea (OSA) is a recurrent partial or complete obstruction of the upper airway during sleep caused by narrowing or collapse of the pharyngeal wall. It leads to microstimulation and oxyhemoglobin desaturation, resulting in sleepiness and loud snoring. OSA negatively affects the cardiovascular system and may contribute to neurocognitive impairment. The aim of this systematic review is to evaluate the effectiveness and efficacy of appliance therapy in obstructive sleep apnea. The effectiveness was assessed by using the Apnea Hypopnea Index (AHI). An electronic search of the Cochrane Library, PubMed, and Google Scholar was conducted between 1998 and 2021. Articles were independently assessed by three reviewers. The quality of a randomised control trial (RCT) is assessed using the Cochrane risk of bias method. The tool GRADE was used to achieve the desired level of confidence for each outcome reported. Several studies used continuous positive airway pressure (CPAP), mandibular advancement devices (MAD), and tongue retention devices (TRD). The meta-analysis included a total of six papers that met the inclusion criteria. Results showed that CPAP significantly improved AHI compared with an oral appliance (random effects: difference in means = 8.40, 95% CI = 7.21 to 9.60). It was also found that oral appliance (OA) therapy significantly improved AHI compared with baseline before appliance therapy (random effects: mean difference = 13.40, 95% CI = 10.87 to 15.93; p.00001). For mild to moderate OSA, CPAP is considered the gold standard. Our meta-analysis of six RCTs found favorable evidence for OSA patients receiving oral devices; however, they were less effective than CPAP. A subgroup analysis found that MAD may be a beneficial treatment for mild to moderate OSA patients who do not respond to CPAP. The findings suggest that oral appliances may be an effective treatment for OSA, especially in patients with mild to moderate OSA.

The Good Old Masserann Technique for the Retrieval of a Separated Instrument: An Endodontic Challenge.

Instrument separation is one of the most upsetting endodontic errors, and it can occur at any time during root canal surgery. A broken file causes a metallic restriction in the root canal and makes it difficult to clean and shape the instrument effectively, thereby making the prognosis questionable. Hence, such a fragment should be properly retrieved when it becomes difficult to bypass it. A variety of techniques and tools are utilized for instrument recovery; however, most of them are expensive, difficult to master, and technique-sensitive. One such tool for orthograde removal of intracanal metallic obstacles is the Masserann kit. We discuss a case involving file removal from the maxillary premolar by using the Masserann technique.

Quad Zygoma: A Graftless Solution in Post-mucormycosis Maxillectomy.

Mucormycosis, a fungal infection that commonly affects individuals with diabetes and compromised immune systems, often requires surgical excision and debridement. However, this can result in significant defects, posing a challenge for clinicians in terms of reconstruction and rehabilitation. Prostheses, local and regional pedicled flaps with or without bone grafts, and titanium mesh application are available options for maxillary reconstruction. Soft-tissue flaps are not sufficient to provide osseointegrated implants with both bone repair and structural support, which emphasises the quad zygoma's beneficial role in treating maxillary abnormalities. Patients benefit from quad zygoma, which uses zygomatic implants and eliminates the need for subsequent procedures, which shortens the course of treatment and lowers costs. Because zygomatic implants are securely fixed into the zygoma, temporary prostheses can be loaded right away. Then, four to six months later, a fixed prosthesis may be introduced. Clinical results with zygomatic implants often surpass those of bone grafting, representing a potential novel gold-standard approach for the compromised maxilla. This case report details the rehabilitation of post-mucormycosis patients with maxillary defects using quad zygomatic implants. The absence of complications during follow-up, conducted at 15, 30, 45, and 90 days, and subsequently monthly for two years, highlights the success of this approach. Evaluation parameters included soft tissue recovery, infection, wound separation, stability of prosthesis, eating effectiveness, and aesthetic outcomes. The positive outcomes observed at follow-up appointment emphasize the viability and effectiveness of quad zygomatic implants in addressing maxillary defects post-mucormycosis.