Troubleshooting in Designing and Fabricating a Hollow Bulb Cast Partial Denture in a Partial Maxillectomy Patient: A Case Report.

The most common complication post COVID-19is mucormycosis. It is an opportunistic infection caused by the fungus mucormycetes which belongs to the order Mucorales. This infection can spread from the oral cavity to the nasal cavity and sometimes also involve the orbit. Surgical resection of the affected region followed by its prosthetic rehabilitation is one of the viable treatment options. In this case report, we will discuss the problems in designing and fabricating a hollow bulb obturator and its solutions.

Prosthetic rehabilitation of mucormycosis patients using DMLS fabricated cast partial denture with semi-precision attachments-A case series.

BACKGROUND: The rehabilitation of maxillectomy defects is a challenging endeavour that necessitates customizing the procedure for each patient. The successful treatment for these patients requires a combined conventional and contemporary treatment options. The high-tech prosthodontic treatment option for these defects and distal extension cases are combining fixed and removable partial dentures with precision/semi-precision attachments. It will enhance retention, stability, esthetics and functional ability of the prosthesis. METHODS: Three post-Covid Mucormycosis patients reported after localised debridement and partial maxillectomy for definitive rehabilitation. For partial Maxillectomy patients, DMLS designed cast partial denture along with semi-precision attachments (Preci-vertix and OT strategy Rhein For patient with localized defect, DMLS designed cast partial denture was planned. For both patients the defect area was kept as hollow cavity (Closed or Open), in order to reduce the weight of the prosthesis. RESULTS AND CONCLUSION: The prosthodontic rehabilitation of these patient can be a simple and economical treatment options and it improves the stomatognathic functions and quality of life of the patient. The major hurdles during rehabilitation are retention and stability as there is no basal seat and hard tissue support. Hence, we tried a combined conventional and digital techniques in order to provide prosthesis with precise fit and accuracy as well as reducing the treatment time and visits of the patients.

Maxillary Cast Partial Denture and Mandibular Implant-Supported Metal-Ceramic Prosthesis With a Split Framework to Compensate for Mandibular Flexure: A Case Report.

The goal of modern dentistry is to restore optimum oral health, function, and comfort for a patient. For an implant-supported fixed prosthesis, these goals cannot be met if the biomechanical factors governing the success of the prosthesis are overlooked. Mandibular flexure is one such factor that needs to be considered, especially when implants are being placed posterior to the interforaminal region. If not, it can lead to problems like increased stress, bone resorption, poor fit of the prosthesis, screw loosening, and patient discomfort. The use of a split-framework prosthesis is one of the measures that could be taken to decrease the stress, ensure a passive fit of the framework, and long-term maintenance of patient comfort and function. This case report describes the oral rehabilitation of a patient using a maxillary cast partial denture and mandibular split framework fixed prosthesis to compensate for mandibular flexure.

Prosthodontic Rehabilitation of a Residual Post-surgical Cleft Defect.

Cleft lip/palate is a common birth defect globally, and the impact of this condition on the dental health of affected individuals can be profound. During intricate rehabilitation of cleft lip and palate patients, the final phase is achieved with definitive prosthodontic treatment. Prosthodontic rehabilitation is often necessary due to missing teeth and the alveolar ridge, malocclusion, residual defects, and the discrepancy between maxillary and mandibular arches. This article presents a case report of a young female patient with residual post-surgical cleft palatal defect having a mobile anterior segment with missing lateral incisors rehabilitated by a cast partial denture. The prosthesis utilized provided improvements in the patient's speech and esthetics but at a low level of cost and ongoing maintenance.

Prosthetic Rehabilitation Following Segmental Maxillectomy Confluent with an Orbital Defect Using a Hollow Orbital Prosthesis Retained Magnetically with an Obturator: A Case Report.

Loss of a sense organ, such as an eye in situations of orbital involvement, or any other bodily part, such as the maxilla or palate, might make one more dependent on others for care and affect how they perceive themselves in society. The prosthetic rehabilitation of large mid-facial defects is a challenging task due to the varied size and shape of the defect. Confluent maxillary and orbital abnormalities are best restored with prosthetic means by creating a comfortable, aesthetically pleasing prosthesis that allows for the restoration of speech, deglutition, and mastication. The retention of any prosthesis is must for it to be successful. The hollow orbital conformer described in this case presentation aids in reducing the weight of the prosthesis, thereby enhancing the retention of the prosthesis. This clinical case presentation highlights the aesthetic and functional rehabilitation using a combined obturator-orbital prosthesis connected using intraoral magnets.

Prosthetic Rehabilitation of a Partially Dentate Patient With a Maxillary Cast Partial Denture and Mandibular Overdenture: A Case Report.

Using natural teeth as denture abutments can significantly slow the progression of residual ridge resorption. The abutments and the denture-bearing areas can share the stress concentration. By providing sensory feedback, occlusal stability loss, aesthetic loss, and compromised mastication, overdentures can help reduce residual ridge resorption. Overdentures have been shown to be effective in reducing residual ridge resorption and increasing retention and stability. When edentulous areas are too large or numerous for the fixed prosthesis and cross-arch stabilization is required, a cast partial denture (CPD) is preferred. The insertion and removal of the denture, as well as regular oral hygiene, are simple procedures. The current case report describes the prosthetic rehabilitation of a partially dentate patient using a maxillary CPD and mandibular overdenture.

Efficacy of porphyrin derivative, Chlorhexidine and PDT in the surface disinfection and roughness of Cobalt chromium alloy removable partial dentures.

AIM: The present study aimed to evaluate the effect of different cleansers and photodynamic therapy (PDT) on disinfection of Co/Cr removable partial denture colonized with C. albicans, S.aureus and S.mutans. MATERIAL AND METHODS: Twenty-five Co/Cr removable partial dentures were constructed. and inoculated by American Type Culture Collection (ATCC) of Candida albicans, S.aureus, and S.mutans in an in-vitro setup. Co/Cr removable partial dentures were randomly allocated into five groups and framework was immersed in 15 mL of contaminated culture medium broth. Based on the cleansing method, disinfected dentures in group 1 were cleansed with porphyrin derivative; group 2 was exposed to 0.12% chlorhexidine digluconate; samples in group 3 and group 4 were subjected to sodium perborate enzyme and citric acid respectively. Through a surface analyzer, the surface roughness of Co/Cr and methacrylate resin was measured in 3 different zones in micrometers before and after disinfection. Two-way ANOVA and Tukey's test was used to analyze the data. Levene test was used to assess the normal distribution of data. Significance level p< 0.05 RESULTS: The results of metal roughness displayed that Co/Cr used as an alloy did not exhibit significant difference when exposed to different chemical disinfectants and photosensitizer (p > 0.05). Similarly, surface roughness (Ra) of heat polymerized acrylic resin using cleansers and PDT demonstrated no significant difference. Intergroup comparison showed that, hematoporphyrin derivative displayed comparable cleansing property against S. aureus, C.albicans, and S. mutans compared to to 0.12% CHX digluconate (p>0.05). The intragroup comparison showed hematoporphyrin derivative and CHX were equally effective against all bacteria (p>0.05). CONCLUSION: CHX digluconate and hematoporphyrin derivative demonstrated high antimicrobial activity against S.aureus, S.mutans, and C.albicans with minimum Ra of an acrylic denture and Co/Cr metallic framework.

Current trends in removable partial prosthodontics education in dental colleges of Pakistan.

OBJECTIVE: The objective of this study was to investigate the current trends in undergraduate teaching of removable partial prosthodontics in various dental colleges of Pakistan. METHODOLOGY: A cross-sectional study was conducted in which a questionnaire was sent by email to head of Prosthodontics department of thirty-one dental institutes of Pakistan. The survey included multiple questions regarding current trends in removable partial prosthodontics education in undergraduate dental colleges. RESULTS: Out of thirty-one questionnaires, twenty-six were completely filled and returned. In 19 (73%) dental colleges, removable partial denture is taught over a period of at least two years of undergraduate education. Students of only six dental colleges fabricate 10-12 removable partial dentures during their Prosthodontic rotation. Lectures and live clinical demonstration for construction of removable acrylic dentures are reported to be carried out in all the dental schools. Simple hinge articulator is the articulator of choice in 22 (84.6%) colleges. Even though twenty-four out of twenty-six colleges (92.3%) teach fabrication of cast partial dentures in lectures, none of the student fabricate these dentures during their Prosthodontic rotation. CONCLUSION: This survey is the first to comprehensively report the teaching practices of removable denture Prosthodontics in undergraduate dental colleges of Pakistan. Faculty of all twenty-six colleges give clinical demonstrations of acrylic partial denture construction before students start working in the dental OPD. Most of the dental colleges report use of similar impression materials and techniques in removable partial denture fabrication. More than 90% of dental colleges teach cast partial dentures theoretically, but their construction is grossly neglected in all the dental colleges. It is important that this skill is taught and practised by students in order to have the necessary skill set, so they can provide comprehensive treatment to partially dentate patients once they graduate.

Attitude of dental professionals toward cast partial denture: A questionnaire survey in India.

AIMS: The use of cast partial dentures (CPDs) has been decreased and its importance has been declined in the teaching curriculum. The purpose of this survey was to evaluate the attitudes of dental professionals toward conditions using CPDs in private practice in India. SETTINGS AND DESIGN: Descriptive survey. MATERIALS AND METHODS: This survey consists of eight close-ended questions concerning the use of CPD by dental professionals practicing in India. The URLs of the questionnaire were shared via E-mail to dentists practicing throughout India, to obtain a response of 384 which is a predetermined sample size. STATISTICAL ANALYSIS USED: Statistical analysis was done using counts and percentages and the results were further analyzed statistically by the Chi-square test. RESULTS: Nearly 42.79% of general dental practitioners (GDPs), 47.26% of prosthodontists, and 9.95% of other specialist dentists responded to the questionnaire. GDPs mostly preferred removable partial dentures (RPDs) (71.87%) and fixed partial dentures (57.22%), whereas prosthodontists preferred mostly implant (60.91%). GDPs mostly preferred flexible dentures (62.42%), whereas prosthodontists preferred CPDs 62.84%. Almost 52.50% of the GDPs mostly raised a cost issue and 63.11% of the prosthodontists had difficulty in adjustment with CPDs. Nearly 63.46% of the dentists told that implant-supported restorations are better options compared to CPDs; still, majority of the dentists (53.23%) were in favor that more importance for teaching CPDs in graduation curriculum should be given. CONCLUSIONS: This survey shows that in India a significant proportion of GDPs (71.87%) preferred RPDs, mostly flexible dentures (62.42%) due to their low cost compared to CPDs. Prosthodontists mostly preferred implants (60.91%) because they are more confident and better trained in these. It is recommended that more importance be given in teaching implants along with CPDs in graduation curriculum so that practitioners can better educate their patients about implants and their advantages over flexible dentures and their utilization in cases where patients are not willing for CPDs.

Evaluation of the effect of ultraviolet light polymerized clear adhesive on shear and tensile bond strength of heat cure denture base resin to the cobalt-chromium retentive minor connector: An in vitro study.

AIM: The aim of this study is to evaluate the efficacy of new material ultraviolet (UV) light polymerized clear adhesive on shear and tensile bond strength of heat cure denture base resin (Polymethylmethacrylate (PMMA)) to cobalt-chromium (Co-Cr) retentive minor connector. SETTING AND DESIGN: Comparative evaluation- In-vitro study. MATERIALS AND METHODS: Sixty samples of Co-Cr plates mimicking minor connectors were fabricated. Thirty samples were coated with new material UV light polymerized clear adhesive and cured under UV light source for 10 min. In gun-metal flask, metal plates were placed in the lower compartment over it. Heat cure acrylic resin was packed in the dough stage with the help of clamps and processed according to the manufacturer's instructions. Samples were kept in artificial saliva for 90 days. Shear and tensile bond strengths were calculated of each sample with a Universal testing machine, and results were statistically analyzed. Type of bond failure was observed for each sample under stereomicroscope. STATISTICAL ANALYSIS USED: Unpaired t test. RESULTS: Tensile bond strength, as well as shear bond strength, showed that 0.93 N and 1.64 N respectively for without application of new adhesive was more as compared to that of samples with the application of new adhesive which is 0.75 N and 1.54 N respectively. Bond failure was found to be an adhesive failure in resin-metal interface. CONCLUSIONS: Excellent bonding seen between the new adhesive and acrylic interface but limited effect on the metal interface. To increase bond strength between metal and resin interface, some surface treatment with the metal surface is needed to increase the bonding of the new adhesive to the metal surface.

Esthetic Clasp Cast Partial Denture.

Denture esthetics as defined by Glossary of prosthodontics terms the effect produced by a dental prosthesis that affects the beauty and attractiveness of the person. [1] Removable partial dentures (RPDs) are the widely accepted and treatment of choice for most cases as it is both effective and affordable. Partially edentulous treatment planning includes both esthetics and masticatory function. A prosthesis that is highly esthetic will improve patient's motivation and acceptance. It is a very wrong notion to expect that patients will tolerate unesthetic partial dentures because good masticatory capability has been achieved. Esthetics plays a vital role in the success of partial dentures, and the length and mobility of the patient's lips play a significant role in achieving it. [2] Patients with short lips or highly mobile lips pose problems as esthetics are compromised because most clasp arms, denture borders, and other components will show when the patient smiles or speaks. [3] RPDs can easily look artificial; hence, special emphasis should aim toward restoring function, phonetics, esthetics with a long-term benefits which requires meticulous attention during fabrication. This case reports is an esthetic clasp designed for a cast partial denture for a young girl for esthetic and function.

Prosthetic Lip with the Retentive Attachment for a Unilateral Cleft Lip Patient: A Clinical Report.

Patients afflicted with congenital cleft lip defect experience disfigured facial esthetics and lack of oral competency that could reduce the speech intelligibility. Rehabilitation of such cosmetic deformities condition often encountered with dental abnormalities becomes the challenge. When surgical treatment is not desired, prosthetic reconstruction turns out to be an economical option. This clinical treatment describes the fabrication of a maxillary lip prosthesis supported by a cast partial denture retained with magnetic attachment in a cleft lip patient. The use of intraoral magnets placed labially on the cast partial denture and on the counterpart of the prosthesis improved the retention. Moreover, the biomedical-grade silicone prosthesis used to blend closely with the patient's skin shade fulfilled the esthetic needs.

Restoring Anterior Aesthetics by a Rotational Path Cast Partial Denture: An Overlooked Technique.

Cast Partial Dentures (CPD) has long been known to restore missing teeth in patients with minimal invasion on hard and soft tissues. Although satisfactory otherwise, the main concern in CPD is the anterior display of metal. Also the technique sensitive lab procedures, together with the esthetic concern have built an iceberg around the frequent utilization of this treatment modality. With the advent of various techniques to get rid of the metallic display, it was predicted to have more CPD's done in the dental arena. But the conceptual technicalities of the procedure took away the limelight from this treatment modality and focused on the fixed prosthodontics. Although feasible in a large number of patients, fixed prosthesis still has areas of restriction. It is here, when we apply our knowledge and skill of esthetic CPD. Esthetic CPD eliminates the metal display by utilizing desirable undercuts. The engaging action of the framework into these undercuts paves way for a rotational motion to seat the remaining prosthesis. Hence dual path of insertion helps eliminating the anterior clasp. In this case report dual path of insertion is discussed for replacing anterior teeth in an old male patient who had mild esthetic concerns. Following the conservative approach of CPD (over FPD) esthetic and restorative treatment was planned with patient's consent.

A multidisciplinary approach to full mouth rehabilitation and solving the dilemma of wriggling dentures- a case report.

A successful management of full mouth rehabilitation demands a multi-disciplinary approach for its long lasting success. The present case report is intended to give an insight into the use of multiple treatment modalities to achieve a balanced, efficient and biomechanically successful prosthodontic treatment with acceptable aesthetics. Treatment of a maxillary and mandibular bilateral distal free end edentulous arch along with upper and lower anterior teeth requires plenty of contemporary and conventional prosthodontic treatment modalities. Management of distal extension situation provides complexity of biomechanical problems due to the three dimensional movements of the distal extension denture. A distal most implant can convert a distal extension RPD from a tooth and tissue supported prosthesis to a tooth and implant supported prosthesis which provides a definite stop thus enhancing the retention and stability of the prosthesis, eliminating the problems often associated with a tooth and tissue supported distal extension RPD. How to cite the article: Nidawani P, Galagali G, Reddy ES, Behera SS. A Multidisciplinary Approach to Full Mouth Rehabilitation and Solving the Dilemma of Wriggling Dentures- A Case Report. J Int Oral Health 2014;6(2):136-40.

A New Approach for Management of Kennedy's Class I Condition Using Dental Implants: A Case Report.

Replacement of multiple missing teeth mainly in the Kennedy's class I and class II condition is a challenge for the clinician and the patient in terms of retention, masticatory efficiency, esthetics, comfort and importantly economics. Here, a case using implants in the distal denture bearing area with ball attachments and fabricating a cast partial denture over it utilizing the best of all benefits has been presented.