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Sensory disturbances in the inferior alveolar nerve (IAN) prior to treatment can be attributed to various factors, including the site, type of fracture, and fracture displacement. Therefore, it is of interest to assess the incidence of inferior alveolar nerve injuries associated with mandibular fractures before and after surgical treatment. Group A consisted of patients with inferior alveolar nerve paresthesia before treatment, while Group B consisted of patients with inferior alveolar nerve paresthesia after treatment. A significant difference was observed between the two groups, with a p-value of 0.031 (p <0.05) with the overall incidence of IAN deficit was 57.33% before treatment and 61.33% after treatment. These findings highlight the importance of promptly identifying and managing IAN injuries to minimize long-term consequences.
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Introduction Complete loss of natural teeth severely compromises the masticatory efficiency of geriatric patients and directly affects their general health. Biofunctional prosthetic system (BPS) has been developed as an alternate method of denture fabrication to match the higher expectations of patients. Studies comparing BPS dentures with injection-molded conventional complete dentures (IM-CCD) are lacking. Our study aimed to compare the masticatory efficiency and patient satisfaction of BPS dentures with IM-CCD. Methods This trial was designed as a randomized, prospective, single-center, double-blinded study with two parallel arms (BPS group and IM-CCD group) having an equal allocation (1:1). Completely edentulous patients aged 45-80 who visited our outpatient department between January and August 2018 were screened and enrolled according to our inclusion and exclusion criteria. Random sequence generation was done using an online randomization program. Allocation concealment was done using sequentially labeled opaque envelopes. The participants and the outcome assessors were blinded. A single operator performed all the clinical procedures in both groups under the guidance of the instructor. The age and gender of the patients were recorded for demographic data at baseline. Primary outcomes were assessed six weeks after denture insertion. The number of denture adjustments required during the first six weeks after denture delivery was recorded as the secondary outcome. Masticatory efficiency was evaluated by the volumetric single-sieve method. An abbreviated version of the Oral Health Impact Profile questionnaire for edentulous patients (OHIP-EDENT) was used for patient satisfaction scores. The total OHIP-EDENT score was calculated by adding all the responses to the 19 questions (ranging from 0 to 38). Individual domain scores were calculated by adding the response to all the questions in that domain. All the data obtained were tested for normality using the Kolmogorov-Smirnov test. Data were analyzed using either unpaired Student's T-test or Mann-Whitney U test for normal and non-normal data, respectively. The gender characteristics of the sample were compared using Chi-Square test. Results Two patients in the IM-CCD group and one patient in the BPS group were lost to follow-up. Hence only the secondary outcome data were analyzed for these patients. Primary outcome data of patients who were lost to follow-up were excluded from the analysis. No significant differences (p>0.05) were found between the two groups for age and gender characteristics of the samples. Masticatory efficiency for both peanut and carrot was found to be significantly higher (p<0.05) in the BPS group than in the IM-CCD group. No significant differences (p>0.05) in the mean scores were observed between the two groups for total OHIP-EDENT scores or the individual domain scores. No significant differences (p>0.05) were observed between the groups for the number of denture adjustments done. Conclusion Within the limitations of the trial, it can be concluded that the BPS dentures significantly improved the masticatory efficiency for both hard (carrots) and soft (peanuts) foods compared to the IM-CCD. However, there was no difference between the masticatory-related complaints domain scores between the two dentures. No significant differences were found between BPS dentures and IM-CCD with respect to overall patient satisfaction scores or post-insertion denture adjustments.
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This report details the successful prosthetic rehabilitation of a 25-year-old male patient with Papillon Lefèvre Syndrome (PLS) using an implant-supported hybrid prosthesis. Six implants were placed in the maxilla, and four were placed in the mandibular arch. All implants were inserted axially (non-tilted) and were planned to be loaded after a healing period of 6 months. One implant failed due to graft loss during the healing phase, which was removed and the remaining implants were restored with a hybrid prosthesis after 6 months, using the delayed loading protocol. The patient was followed-up for four years and all the remaining implants successfully integrated and remained fully functional during this period. The prosthesis significantly improved the functional, aesthetic, and psychological well-being of the patient. This case report is the first of its kind to use only four axially placed implants for rehabilitation of a PLS patient with a successful four-year follow-up.
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PURPOSE: There has been less focus on methods to improve the clinical performance of partial veneer crowns. In this study, we wanted to explore the potential of two new surface treatment modalities (laser etching and spark erosion) for improving the longevity of partial veneer crowns. MATERIAL AND METHODS: Conventional partial veneer crown preparation was done on 90 extracted premolars by a single operator. All the samples used in the study were divided into three groups. Group A were samples to be treated by sandblasting alone, Group B were samples to be treated by sandblasting followed by laser etching, and Group C were samples to be treated by sandblasting followed by spark erosion. Each group consisted of two Sub Groups: Sub Group I-Retention test group, Sub Group: II-Resistance test group. The prepared teeth were randomly allotted to the three groups and subgroups using lot method. Partial veneer crown copings were fabricated for testing retention and resistance. Castings in each subgroup were luted with resin cement to their respective tooth preparations. Retention and resistance testing of samples were done with the use of an Instron Universal testing machine. RESULTS: The two surface treatments, laser etching and spark erosion (Groups B and C) of metal copings significantly improved the retention and resistance compared to sandblasted surfaces alone (P ≤ 0.05). Retention and resistance of copings which were sandblasted and spark eroded (Group C) were found to be highest among the three groups (P ≤ 0.05). CONCLUSION: Within the limitation of this study, it can be concluded that the combination of spark erosion and sandblasting significantly improves the retention and resistance values of partial veneer crown. This study helps to provide better knowledge about the surface treatment required for success of partial veneer crowns.
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Recasting of the casting alloys affects the composition and elemental release which may have cytotoxic effect different from the pure alloy in the surrounding tissues. An Invitro study was conducted to investigate the elemental release and their cytotoxic effects from commercially available Ni-Cr dental casting alloys, commonly used for fabricating fixed partial dentures. Three Ni-Cr alloys [Wiron 99(A), Ceramet (B), and Hi Nickel CB (C)] were tested. Alloy specimens (disks 3 × 5 mm) were casted and grouped as follows: Group I (A(1)/B(1)/C(1)): 100% pure alloy; Group II (A(2)/B(2)/C(2)): 50% new with 50% recast; and Group III (A(3)/B(3)/C(3)): 100% recast. Disks of each alloy type from each group were transferred to Dulbecco's modified eagle medium and left for 3 days at 37°C in an atmosphere of 5% CO(2). Ni, Cr, Co, Cu and Mo elemental release from metal alloys into culture medium was investigated using Inductively Coupled Plasma Mass Spectrometry. Cytotoxicity was tested using mouse fibroblast cells and MTT Assay. Controls consisted of 6 wells containing cells with no alloy specimens. Data were analyzed by two-way analysis of variance followed by t-test. The total amount of elements released in parts per billion for various casting groups were Group I, A(1)-6.572, B(1)-6.732, C(1)-8.407; Group II, A(2)-22.046, B(2)-26.450, C(2)-29.189; Group III, A(3)-84.554, B(3)-88.359, C(3)-92.264. More amounts of elements were released in Hi Nickel CB than Ceramet and Wiron 99 in all the three test groups. Percentage of viable cells from MTT analysis were Group I, A(1)-62.342, B(1)-61.322 C(1)-60.593, Group II, A(2)-58.699, B(2)-56.494, C(2)-52.688, Group III, A(3)-53.101, B(3)-52.195, C(3)-47.586. The viable cells present in the culture media were more in Wiron 99 than Ceramet and Hi Nickel CB. Elemental release increased with amount of recast alloy. Amongst the three alloys tested Hi Nickel CB had significantly higher elements released compared to Ceramet and Wiron 99 in 100% pure alloys, 50% recast and 100% recast alloys. Wiron 99 showed least element release in 100% pure alloy, 50% recast and 100% recast specimens. 100% pure alloys of all three alloys are less cytotoxic, but their cytotoxicity is more on 50% and 100% re-casted alloys. Out of all three variations of casting Wiron 99 was least cytotoxic, followed by Ceramet and Hi Nickel CB. Recasting of alloys significantly increased the elements released and their cytotoxicity.
