Prosthodontic rehabilitation of patients with a unilateral subtotal maxillectomy using a customised subperiosteal zygomatic implant: a post-COVID-19 mucormycosis.

Restoring the maxillary resection defect involving the alveolar process, the hard and soft palate and the paranasal sinuses in terms of phonetics, mastication and deglutition is more challenging, especially with young patients with aesthetic concerns.This case report describes the prosthodontic rehabilitation of a young patient with a unilateral subtotal maxillectomy due to post-COVID-19 mucormycosis. A patient-specific subperiosteal implant was planned to rehabilitate the patient's bony defect. Using postsurgical CT, a customised subperiosteal titanium framework was fabricated by the direct metal laser sintering method using grade IV titanium alloy. The fabricated framework was implanted over the patient's zygomatic anatomic contour. Three months later, the patient-specific implant was unveiled to the oral cavity, an open-tray impression was made and the fixed implant prosthesis was fabricated.This case report opens a new realm of rehabilitation for severely compromised maxillary bony defects and impaired oral functioning with no other viable conventional reconstruction options.

Comparative evaluation of masticatory efficiency in various facial forms of dentate and rehabilitated complete denture patients.

PURPOSE: To evaluate the masticatory efficiency in various facial forms of dentate and rehabilitated complete denture patients. MATERIALS AND METHODS: A total of 60 subjects were selected for the study based on the inclusion criteria. Out of which 30 subjects belong to the dentate group (D) and 30 subjects belong to the completely edentulous group rehabilitated with conventional complete denture (CECD). They were sub-grouped as brachyfacial, mesofacial, and dolichofacial facial form using facial index measurement and cephalometric analysis. After which they had undergone masticatory efficiency test using spectrophotometric analysis using diluted expectorate of chewed natural test food beetroot (10, 15 and 20 strokes). Mean of absorbance value obtained was considered as mean masticatory efficiency. From which average masticatory efficiency percentage was determined using masticatory efficiency percentage equation and considered as the masticatory efficiency of that particular subject. RESULTS: Statistical analysis reveals that among dentate subject (D) group, brachyfacial subjects exhibited highest masticatory efficiency (70.9 ± 12.64 %) followed by mesofacial (60.6 ± 10.66 %) and dolichofacial (34.3 ± 10.81%) subjects. Similarly in completely edentulous subjects rehabilitated with conventional complete denture (CECD), brachyfacial (52.7 ± 8.11%) subgroups, mesofacial (42.3 ± 6.52%) and dolichofacial (29.3 ± 7.76 %). CONCLUSION: Along with other determinant factors, facial form also plays an influential role on masticatory efficiency. Brachyfacial subjects exhibited highest masticatory efficiency followed by mesofacial and dolichofacial subjects among both the study groups.

Knowledge, Attitude, and Practice of Patients toward Dental Implants in Need of Prosthodontic Rehabilitation.

Background: Our goal in conducting this study was to see how well-informed patients are about dental implants as a method of prosthodontic rehabilitation. Materials and Methods: "In this cross-sectional study, 500 new dental students were asked questions using a pre-made, self-administered questionnaire. A pilot study was carried out to verify the reliability of the survey instrument. Analysis of the data was performed in SPSS 16 (SPSS). We used the P 0.05 thresholds for the Student's T-test and the ANOVA to determine statistical significance." Results: In all, there were 500 people involved: 320 men and 180 women. The media and dentists were the two most common places to learn about implants, and as patients received more information, they became more informed consumers. Many people put off getting therapy because of how expensive it is. Conclusion: Only a small percentage of individuals had implants, and more than half knew nothing about them. This finding also highlighted the need of educating patients more thoroughly on this therapy option. As a result, the public has to be educated about oral health and implants in order to adopt a more favorable perspective.

Knowledge, attitude and preparedness to combat COVID-19 infection among dental professionals: A student-centric pilot study.

Background: In the COVID-19 age, attempts are being made to raise student awareness and improve best practices to contain the outbreak. Methodology: The target population was interns and 3rdyear undergraduate students from JSS Dental College and Hospital, Mysuru. COVID-19 knowledge, awareness and attitude of the students and interns and the preparedness to tackle the current COVID 19 pandemic were assessed. Results: 120 respondents responded via a contented validated self-administered questionnaire with regard to knowledge, attitude and practices and preparedness to address the COVID 19 pandemic by undergraduates and interns. The student participants irrespective of their years into practice were aware of the guidelines being issued by Health care authorities and to address the COVID 19 pandemic. Among the respondents, 57.5% were 3rd year dental students and 42.5% were interns. Regarding knowledge about COVID infection, 42.9% (3rd year students) and 57.1% of the interns were aware of the recent developments, 34.1% of the III year students were aware of the safe distance to be maintained between patients, 42.4% of the students and 57.6% of interns were aware of the authority to be contacted with suspected COVID 19 infections. The participants were also aware of the vaccine trial which was conducted. Most of the respondents (64.3% of the students and 78.6% of the interns) were aware of fumigation in clinical or high-contact areas on a daily basis and biweekly in nonclinical areas. Conclusions: The results suggest a strong need to encourage the current training program among students in health care-related fields.

Influence of T-scan System on Occlusion Correction of Implant Supported Prostheses: A Systematic Review.

AIM: To systematically evaluate the literature evidence regarding the suitability of the T-scan occlusal system for implant supported prostheses. MATERIALS AND METHODS: A thorough bibliographic search was conducted on PubMed, Google Scholar, Cochrane library, Web of Science, EMBASE, and Scopus to collect relevant articles published from January 1, 2008 to August 30, 2021, using a combination of the following words:"T-scan," "Implant supported prostheses," and "dental implant" according to the PRISMA guidelines for the focused research question constructed using the PICO criteria. Randomized control trials, prospective studies, retrospective studies on the use of T-scan system in implant-supported prostheses reported in English language were included in the study. RESULTS: This review consisted of 17 studies and 359 patients rehabilitated with 1,126 implants. In 3 studies, removable types of prostheses were given over implants, and in 14 studies, fixed types of prostheses were given. Nine studies determined the percentage of occlusal force magnitude and occlusion time sequence. Three studies measured the localization of the occlusion center. T-scan was used in two studies to measure the amount of gingival crevicular fluid after occlusal adjustment. The follow-up period ranged from 6 months to 2 years or more. CONCLUSION: T-scan proved with better results than other occlusal analysis indicators in terms of occlusion measurement, clinical execution, quantify the location and contact timing, and occlusion in 3D with more precision. CLINICAL SIGNIFICANCE: T-scan occlusal analysis system is widely used in dentistry and there is an increase in the number of studies, so a systematic review evaluating and comparing results is warranted.

Re-evaluation of interarch space determination in fully dentate adults with different facial forms: A clinical study.

AIM: The aim is to determine the average inter-arch space of fully dentate subjects at rest and at occlusion with different facial forms. MATERIALS AND METHODS: Fifty subjects each of three groups of facial form, square, taper, and oval facial with a complete set of maxillary and mandibular arch teeth with average age from 25 to 40 years were included in this study. An equal number of male and females were included in all the groups. Vertical height at rest and at occlusion was recorded in every subject of the all the three groups using a prescribed procedure, and freeway space (FWS) was measured. RESULTS: The collected data were statistically evaluated, and it showed the mean and median for each facial form subjects, square facial form (3, 2.32), taper facial form (2.62, 2), and ovoid facial form (2.68, 2), respectively. No significant difference between any of the readings (P < 0.05). However, 9% of the individuals showed the FWS range of 5-6 mm. The lowest and highest FWS measurements were 1 and 7 mm, respectively. One more significant factor is that majority (56%) of the square facial form subjects showed FWS range of 3-4 mm. CONCLUSION: The conclusions were drawn, to understand the average inter-arch space in various facial forms, which was more than 3-4 mm.

Influence of different abutment diameter of implants on the peri-implant stress in the crestal bone: A three-dimensional finite element analysis--In vitro study.

PURPOSE OF THE STUDY: The study was designed to evaluate and compare stress distribution in transcortical section of bone with normal abutment and platform switched abutment under vertical and oblique forces in posterior mandible region. MATERIALS AND METHODS: A three-dimensional finite element model was designed using ANSYS 13.0 software. The type of bone selection for the model was made of type II mandibular bone, having cortical bone thickness ranging from 0.595 mm to 1.515 mm with the crestal region measuring 1.5 mm surrounding dense trabecular bone. The implant will be modulated at 5 mm restorative platform and tapering down to 4.5 mm wide at the threads, 13 mm long with an abutment 3 mm in height. The models will be designed for two situations: (1) An implant with a 5 mm diameter abutment representing a standard platform in the posterior mandible region. (2) An implant with a 4.5 mm diameter abutment representing platform switching in the posterior mandible region. Force application was performed in both oblique and vertical conditions using 100 N as a representative masticatory force. For oblique loading, a force of 100 N was applied at 15° from the vertical axis. von Mises stress analysis was evaluated. RESULTS: The results of the study showed cortical stress in the conventional and platform switching model under oblique forces were 59.329 MPa and 39.952 MPa, respectively. Cortical stress in the conventional and platform switching model under vertical forces was 13.914 MPa and 12.793 MPa, respectively. CONCLUSION: Results from this study showed the platform switched abutment led to relative decrease in von Mises stress in transcortical section of bone compared to normal abutment under vertical and oblique forces in posterior mandible region.