Apical and lateral accuracy of intraradicular impressions made using the indirect and direct technique at three different locations: A comparative in vitro analysis.

Background: There is limited literature available comparing the accuracy of intraradicular impressions made with a novel hybrid impression material using the indirect and direct technique at three different locations. Materials and Methods: For this comparative in vitro analysis, postspace was prepared in 15 recently extracted teeth and impressions made with vinyl polysiloxane, polyether (PE), vinyl polyether silicone (VPES), and pattern resin. Postpatterns obtained were re-seated on the teeth and longitudinally sectioned. A binocular microscope was used to measure apical and lateral discrepancies at three locations (L1, L2, and L3). L1 at the postcore junction, L2 at the middle of the post space, and L3, 2 mm short of the apical end. The data obtained were statistically analyzed using the Statistical Package for the Social Sciences (SPSS) software. One-way analysis of variance (ANOVA) (intergroup) followed by Tukey's post hoc test with P ≤ 0.05 was used. Results: The one-way ANOVA noted a highly significant difference at the apical location. Pattern resin had the highest apical discrepancy (151.93 ± 8.59 µm), whereas the lowest was with vinyl PE silicone (140.31 ± 11.46 µm). At L1, the highest discrepancy was seen with pattern resin (32.09 ± 2.31 µm), whereas the lowest was with the addition silicone (31.94 ± 2.54 µm). At L2, addition silicone (32.88 ± 2.81 µm) showed the highest discrepancy, whereas the lowest was with vinyl PE silicone (30.5 ± 8.79 µm). The PE group had the highest mean at the L3 location (31.38 ± 3.46 µm) and the lowest was with vinyl PE silicone (30.93 ± 2.25 µm). At all lateral locations, no significant difference was noted. Tukey's post hoc comparison showed a significant difference between pattern resin and VPES (11.62 µm) followed by pattern resin and addition silicone (11.47 µm) apically. Conclusion: The indirect technique using VPES or addition silicone is more accurate than the direct technique at the apical location.

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.

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.

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.

Nanomaterials and their application in prosthodontics: A review

Objectives: The objective of this paper is to review the available literature on the novelties and applications of nanomaterials in Prosthodontics. Data and Sources: 125 articles were retrieved which included reviews and studies on various nanomaterials used in Dentistry especially Prosthodontics after Gray literature search, cross references and electronic database search in PubMed, MedLine and Google search using the following key words- Nanomaterials, Nanotechnology, Prosthodontics, Dentistry, Applications Study selection: 74 articles were selected and reviewed as they met the selection criteria. Conclusion: Within the scope of this review, reported literature showed that the emerging science of nanotechnology in Dentistry especially in the field of Prosthodontics has triggered growing interest in the potential applications and benefits compared to the conventional materials in use. The latest research progress on the applications of nanomaterials used in Prosthodontics was reviewed with detailed description, keeping in mind the limitations like challenges faced and the health implications.

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.

Shade Guide for the Fabrication of Acrylic Denture Based on Mucosal Colour.

This article highlights the use of a simple and convenient shade guide system which not only helps in choosing the shade tab that matches with the colour of the mucosa, but, also helps in the fabrication of the precise shade of acrylic resin for making the denture. The shade guide is fabricated by mixing specified quantities of various colours of acrylic polymer in order to obtain various shade tabs. The method for fabrication of the shade guide and the clinical procedure has been discussed.

Ocular prosthesis incorporating IPS e-max press scleral veneer and a literature review on non-integrated ocular prosthesis.

The article highlights a new method for the fabrication of an ocular prosthesis by the incorporation of a ceramic scleral veneer. The steps of fabrication include impression making, wax try-in, performing a "cut-back" on a selected stock eye, insertion of the IPS e-max press scleral veneer, finishing and insertion. It also includes a detailed review on non-integrated ocular prostheses.

Three-dimensional finite element analysis of the stress distribution pattern in a mandibular first molar tooth restored with five different restorative materials.

INTRODUCTION: Badly broken or structurally compromised posterior teeth are frequently associated with crown/root fracture. Numerous restorative materials have been used to fabricate indirect full-coverage restorations for such teeth. This study aims to evaluate and compare the effect of restorative materials on the stress distribution pattern in a mandibular first molar tooth, under varying loading conditions and to compare the stress distribution pattern in five commonly used indirect restorative materials. MATERIALS AND METHODS: Five three-dimensional finite element models representing a mandibular first molar tooth restored with crowns of gold, porcelain fused to metal, composite (Artglass), alumina-based zirconia (In-Ceram Zirconia [ICZ]), and double-layered zirconia-based materials (zirconia core veneered with porcelain, Lava) were constructed, using a Finite Element Analysis Software (ANSYS version 10; ANSYS Inc., Canonsburg, PA, USA). Two loading conditions were applied, simulating maximum bite force of 600 N axially and normal masticatory bite force of 225 N axially and nonaxially. RESULTS: Both all-ceramic crowns allowed the least amount of stress distribution to the surrounding tooth structure. In maximum bite force-simulation test, alumina-based all-ceramic crown displayed the highest von Mises stresses (123.745 MPa). In the masticatory bite force-simulation test, both all-ceramic crowns (122.503-133.13 MPa) displayed the highest von Mises stresses. CONCLUSIONS: ICZ crown displayed the highest peak von Mises stress values under maximum and masticatory bite forces. ICZ and Lava crowns also allowed the least amount of stress distribution to the surrounding tooth structure, which is indicative of a favorable response of the underlying tooth structure to the overlying full-coverage indirect restorative material. These results suggest that ICZ and Lava crowns can be recommended for clinical use in cases of badly damaged teeth.

A Unique Flask Design for Processing Cranial Prosthesis Using Heat Cured Acrylic - A Case Report.

In a 30 year old male patient, the absence of a cranial bone fragment had left the brain covered only by dura mater, subcutaneous tissue and scalp, resulting in aesthetic and functional impairment. A prosthetic replica of the bone fragment made of PMMA (Polymethylmethacrylate) was fabricated using a unique flask design that consisted of a medium sized stainless steel instrument tray with lid, four large headed screws and a C clamp, since the prosthesis was too big to be invested in a conventional flask.

Comparative evaluation of border molding using two different techniques in maxillary edentulous arches: A clinical study.

PURPOSE: The aim of this in vivo study was to compare the single-step border molding technique using injectable heavy viscosity addition silicone with sectional border molding technique using low fusing impression compound by evaluating the retention of heat cure trial denture bases. MATERIALS AND METHODS: Ten completely edentulous patients in need of prostheses were included in this study. Two border molding techniques, single-step (Group 1) and sectional (Group 2), were compared for retention. Both border molding techniques were performed in each patient. In both techniques, definitive wash impression was made with light viscosity addition silicone. The final results were analyzed using paired t-test to determine whether significant differences existed between the groups. RESULTS: The t-value (3.031) infers that there was a significant difference between Group 1 and Group 2 (P = 0.014). The retention obtained in Group 2 (mean = 9.05 kgf) was significantly higher than that of Group 1 (mean = 8.26 kgf). CONCLUSION: Sectional border molding technique proved to be more retentive as compared to single-step border molding although clinically the retention appeared comparable.

An Innovative and Simple Technique of Hollow Maxillary Complete Denture Fabrication.

Prosthetic rehabilitation of severely atrophic ridges has always been an ordeal for the clinician due to decreased support, stability and retention. Because of severe resorption the restorative space between maxillary and mandibular residual ridges is increased. Rehabilitation in such cases may result in increased height and weight of the prosthesis further compromising its retention and stability. This in turn overloads the underlying hard and soft tissues exacerbating ridge resorption so, in order to break this vicious cycle, the weight of the prosthesis needs to be reduced which can be achieved by making hollow prosthesis. This article describes a novel technique of fabricating a hollow maxillary complete denture.

Immediate dentin sealing for indirect bonded restorations.

PURPOSE: The aim of this article is to review available literature on the clinical procedure of immediate dentine sealing for indirect bonded restorations. STUDY SELECTION: More than 40 articles reporting the technique, studies, outcomes, etc. were reviewed after PUBMED/MEDLINE search, most of them addressing the specific situation of dentin bonding for indirect restorations. RESULTS: It is known that tooth preparation for indirect bonded restorations can result in significant dentin exposures. Immediate application and polymerization of the dentin bonding agent to the freshly cut dentin, prior to impression making is therefore recommended by some authors. Literature indicates that this procedure, immediate dentine sealing (IDS), appears to achieve improved bond strength, fewer gap formations, decreased bacterial leakage, and reduces post-cementation sensitivity. This rational approach to adhesion is also reported to have a positive influence on tooth structure preservation, patient comfort, and long term survival of indirect bonded restorations. CONCLUSION: In the extensive literature regarding advantages of using IDS technique significant differences have been shown when compared to Delayed Dentine Sealing. Although more research is required in this field, presently there are NO scientific reasons not to recommend IDS in routine practice.

Surgical excision and contoured custom made splint to treat helical keloid.

Helical keloids are difficult to treat as surgical excision requires effective compression of the operative scar to prevent recurrence while retaining the contour and elasticity of the helix. The authors fabricated a conforming custom made post-operative splint from a commonly used dental material. Splints could be fabricated in both pre-operative and post-operative stage.