Tightening torque of implant abutment using hand drivers against torque wrench and its effect on the internal surface of implant.

AIM: The aim of this study was to compare the torque rendered by a handheld driver and a torque wrench and thereby evaluate its effect on the internal threads of implant. SETTING AND DESIGN: An in-vitro comparison of implant abutment torque using a digital torque gauge. MATERIALS AND METHODS: Thirty participants were randomly selected and were asked to torque two samples of mounted abutment analogs, one using a handheld driver and other with a torque wrench. The hex was then attached to the digital torque gauge to record the amount of torque generated and the recorded values were compared. Simultaneously, impressions of the internal threads of implant were taken using light body putty material before and after torque application. The samples were viewed under a stereomicroscope and the measurement of the initial four threads was compared. STATISTICAL ANALYSIS USED: The data was subjected to statistical analysis using SPSS version 20.0 software. The intergroup comparison was done using one sample t-test, and the internal threads were analyzed using ANOVA statistical analysis. RESULTS: The results obtained showed that the torque generated using a handheld driver was higher (27-43 Ncm) than that of torque wrench (28-35 Ncm). Torque wrench values were within the manufacturer's recommendation. The mean of internal thread changes of the handheld driver and torque wrench was 861.033 mm and 864.350 mm, respectively, showing an insignificant difference. One-way ANOVA test showed P < 0.01 and difference of 11 mm for posttreatment hand torque and 14 mm for posttreatment torque wrench values. CONCLUSIONS: The mechanical torque instrument showed specified torque values as recommended by the manufacturer. Consequently, the internal threads of the implants did not undergo any significant change using hand tightening or using a torque wrench.

Idiopathic Basal Ganglia Calcification: Fahr's Syndrome, a Rare Disorder.

Fahr's syndrome is a rare neurological disorder with varied clinical manifestations. It is characterized by the progressive deposition of calcium in the walls of the blood vessels of basal ganglia and dentate nuclei of the cerebellum in young and middle-aged people. It is important for neurologists, geneticists, psychiatrists, dentists, and other appropriate care specialists to have a thorough knowledge of this syndrome as any of them could be the first person to diagnose the disease. This case report of Fahr's syndrome presents the signs and symptoms of the patient and the treatment for oral conditions were done.

Finite element analysis of stress concentration between surface coated implants and non surface coated implants - An in vitro study.

BACKGROUND: To determine qualitative comparison in stress distribution between surface coated implants and non surface coated implants using 2 different lengths and vertical, oblique, and lateral forces. MATERIAL AND METHODS: 3 dimensional finite element study was carried out at first molar site with 4 surface coated and 4 non surface coated implants using mimic 8.11, solid edge 2004, hypermesh 9.0, and ansys12.1 software. RESULTS: The pattern of stress distribution was almost similar between vertical and oblique loading but varied with lateral loads between surface coated and non surface coated implants. As the length of the implants increased stress concentration had no significant variation between surface coated and non surface coated implants, but had a tendency to increase at the abutment and abutment screw on all 3 forces. CONCLUSIONS: Among the surface coated and non surface implants the pattern of stress distribution was similar signifying that surface coating of implants had no significant role in stress distribution using 3d finite element analysis and within the limitations of this study. Key words:Surface coating, non surface coating, implants, stress and bone.

Evaluation of marginal and internal gaps of metal ceramic crowns obtained from conventional impressions and casting techniques with those obtained from digital techniques.

BACKGROUND: Accuracy in fit of cast metal restoration has always remained as one of the primary factors in determining the success of the restoration. A well-fitting restoration needs to be accurate both along its margin and with regard to its internal surface. AIM: The aim of the study is to evaluate the marginal fit of metal ceramic crowns obtained by conventional inlay casting wax pattern using conventional impression with the metal ceramic crowns obtained by computer-aided design and computer-aided manufacturing (CAD/CAM) technique using direct and indirect optical scanning. MATERIALS AND METHODS: This in vitro study on preformed custom-made stainless steel models with former assembly that resembles prepared tooth surfaces of standardized dimensions comprised three groups: the first group included ten samples of metal ceramic crowns fabricated with conventional technique, the second group included CAD/CAM-milled direct metal laser sintering (DMLS) crowns using indirect scanning, and the third group included DMLS crowns fabricated by direct scanning of the stainless steel model. The vertical marginal gap and the internal gap were evaluated with the stereomicroscope (Zoomstar 4); post hoc Turkey's test was used for statistical analysis. One-way analysis of variance method was used to compare the mean values. RESULTS AND CONCLUSION: Metal ceramic crowns obtained from direct optical scanning showed the least marginal and internal gap when compared to the castings obtained from inlay casting wax and indirect optical scanning. Indirect and direct optical scanning had yielded results within clinically acceptable range.

Acupuncture - An effective tool in the management of gag reflex.

Gagging is of great concern to the dentist as it is a serious impediment during the execution of various dental procedures. The etiology of gagging is multifactorial, and several suggestions have been offered to arrest this reflex, some of which are nonsustainable and does not show the immediate result. Acupuncture has been successfully employed as an adjunct to local anesthesia in dental extractions, pain management and also in the symptomatic management of temporomandibular joint disorders. The author highlights the application of acupuncture in the management of patients with gag reflex during dental procedures and its benefits are reported.

A prosthodontic management of severely resorbed anterior ridge defect - a case report.

The Dental profession has devoted most of its history to restoring the effects of dental disease. The public's interest in Dental health and beauty has become an engine that continues to drive the demand for cosmetic dental procedures. In the past, achieving a beautiful smile required submission to extensive invasive procedures and expensive fixed dental prosthetic restorations. Advancements in restorative material formulations and adhesive technology have expanded such possibilities. Despite many recent advances in aesthetic dentistry techniques and materials, certain cases remain difficult to restore. Replacing missing anterior teeth presents a serious challenge to the clinicians especially with a large ridge defect. Such cases require not only replacement of the missing teeth but also the restoration of the bone defect, aesthetics and phonetics. While the conventional treatment approaches like fixed partial denture or an option of implant may not justify the restoration of the defects. A combination of fixed and removable restoration provides good alternative. The aim and purpose of this case report is to describe a multidisciplinary approach of managing a patient who reported with a similar complaint of missing anterior teeth with anterior ridge defect hoping to get not only her teeth but also her lost smile.

Aesthetic essentiality regained using implant- a case report.

The goal of implant therapy is to provide patients with a predictable, aesthetically and functionally satisfying treatment outcome with a low risk of aesthetic complications. Dental implants have been utilized by mankind for thousands of years, but only recently they have achieved widespread acceptance from the profession. Anterior sites are more likely related to aesthetic expectations and often represent a considerable challenge for involved clinicians and dental technicians, since various local risk factors have the potential to compromise the predictability of the result. In recent years, substantial efforts have been made to increase the appeal of implant therapy by shortening the overall treatment time and minimizing the number of surgical intervention. According to traditional protocol, a 12 month healing after extraction was suggested, but over the past few years alternative approaches have been proposed, such as immediate implant placement at the time of extraction or early implant placement following weeks of soft tissue healing. Common to all of these approaches is the requirement of adequate remaining bone volume. If there is no adequate bone volume, techniques like guided bone regeneration (GBR) are used for ridge augmentation before implant placement. The present case has utilized an endosteal root form implant and the advantage of guided bone regeneration technique in regaining aesthetic demands of the patient.

Rehabilitation of partially eviscerated eye with custom made ocular prosthesis-a case report.

Human eyes are the most precious gift from nature; presence of a pair of eye not only gives expression to life but also adds dignity to the face. The loss of an eye causes disfigurement of the face and causes anxiety, stress and depression in their life. The rehabilitation of patients with congenital or acquired defects of the eye is a challenging job. The aim of the rehabilitation is to restore the patient's normal appearance, comfort along with reasonable functional eye movements. This case report describes the rehabilitation of partially eviscerated eye of the patient with custom made ocular prosthesis.

Correlation of nasal width to inter-canine distance in various arch forms.

Selection of teeth for dentures to provide a aesthetically pleasing appearance is a challenge often encountered. Various anthropometric measurements have been utilised traditionally, which is subjective to each practitioner. Interalar width is one of the routinely used method in the selection of upper anterior teeth. It is based on the premise that the parallel line drawn from the alae of the nose touches the tip of the canine. However this may not hold good for all type of arch forms. This paper finds a correlation between the alar of the nose and the tip of the canine for the various arch forms.