Radiotherapy molds: An approach to fabricating facial moulage.

Impression procedures for recording large maxillofacial defects are tedious and difficult because of the unavailability of stock impression trays. This article describes the procedure of fabricating a straightforward facial moulage with predictable accuracy by using a reusable radiotherapy thermoplastic sheet.

Osteonecrosis of the jaw associated with imatinib therapy in myeloproliferative neoplasm: a rare case report.

Medication-related osteonecrosis of the jaw (MRONJ) is a relatively infrequent but very well-known adverse effect of bisphosphonates. This rare complication of bisphosphonates is rarest with the use of certain drugs. Tyrosine kinase inhibitors (TKIs), particularly used in renal cell carcinoma or gastrointestinal tumors as a chemotherapeutic agent, can precipitate this particular medical condition of bone when it is associated with either radiation or bisphosphonates, though, monodrug therapy with TKIs rarely causes MRONJ. This article describes a rare case of necrosis of the jawbone in a patient with a myeloproliferative neoplasm who was receiving the TKI imatinib and had no history of bisphosphonate or radiation therapy to head and neck region.

Evaluation of different visual method used, to enhance communication skills between dental care providers and speech and hearing impaired patients.

PURPOSE: The purpose of this study is to evaluate the efficacy and retentiveness of various communication methods among speech and hearing impaired patients and dental practitioners. MATERIALS AND METHODS: A group of 33 school participants were selected for this study. An experimental task required the participants to follow routine dental instructions in the form of videotape and photographic charts and answer the questionnaire based on visual instructions. School participants were visited two times at an interval of 1 month. Participants were randomly divided into three groups, each consisting of 11 school participants, irrespective of gender and age. Group 1 received visual instructions without showing video and charts, Group 2 received video instructions, and Group 3 received photographic instructions. The questionnaires were assessed immediately and after 1 month. RESULTS: The study results were assessed in terms of improvement in knowledge concerning communication skills and long-term retention of the instructions for 1 month. ANOVA followed by post hoc Tukey test revealed a significant difference between Group 1 and other groups. However, there was no statistically significant difference between Group 2 and Group 3. The paired t-test revealed that there was a significant difference between the two visits in Group 1. However, there was no significant difference between visit 1 and visit 2 in Group 2 and Group 3. CONCLUSION: Health-care workers and patients with special needs like hearing-impaired patients should overcome communication barriers that may hinder proper diagnosis and treatment planning.

Does the size matter? Evaluation of effect of incorporation of silver nanoparticles of varying particle size on the antimicrobial activity and properties of irreversible hydrocolloid impression material.

OBJECTIVES: The main objective of the present in vitro study is to evaluate the antimicrobial activity and properties of irreversible hydrocolloid impression material incorporated with silver nanoparticles of varying size at different concentrations. METHODS: Silver nanoparticles of 80-100, 50-80, 30-50 and 10-20nm size were added to irreversible hydrocolloid impression material at 0.5, 1.0, 2.0 and 5.0wt%. Antimicrobial activity of the silver nanoparticle incorporated irreversible hydrocolloid was measured using disk diffusion method. The gel strength, flow, gelation time and permanent deformation were measured according to American Dental Association specification #18. Data were analyzed using analysis of variation at a confidence interval of 95% (α=0.05). RESULTS: Silver nanoparticles of 80-100nm size have imparted superior antimicrobial activity to the irreversible hydrocolloid in a dose-dependent manner whereas finer nanoparticle size did not exhibit any antimicrobial activity. The addition of silver nanoparticles did not alter the properties of irreversible hydrocolloid at 0.5 and 1.0wt% whereas at higher concentrations significant differences in flow, gelation time and strength were observed. SIGNIFICANCE: The results of the present study indicate that silver nanoparticles of size range 80-100nm are superior in imparting antimicrobial activity to irreversible hydrocolloid compared to finer particle size range.

Effect of comonomer of methacrylic acid on flexural strength and adhesion of Staphylococcus aureus to heat polymerized poly (methyl methacrylate) resin: An in vitro study.

AIMS AND OBJECTIVE: The purpose of the present study was to evaluate and compare flexural strength and Staphylococcus aureus adhesion of heat-activated poly (methyl methacrylate [MMA]) resin modified with a comonomer of methacrylic acid (MAA) and MMA monomer. MATERIALS AND METHODS: Comonomer preparation was done with the addition of varying concentration of MAA (0, 15, 20, and 25 wt %) to the MMA of conventional heat-activated denture base resin to prepare the specimens. Prepared specimens were stored in distilled water at 37°C for 1 day and 1 week before the evaluation of flexural strength and microbial adhesion. Flexural strength was measured using a universal testing machine at a crosshead speed for 2 mm/min (n = 10). Microbial adhesion (colony-forming unit [CFU]) was evaluated against S. aureus using a quadrant streaking method (n = 5). Data were subjected to one-way ANOVA, and the significant differences among the results were subjected to Tukey's HSD test. P < 0.05 was considered statistically significant. RESULTS: Addition of MAA to the MMA monomer was found to significantly reduce the adhesion of S. aureus for all the groups. Reduction of CFU of S. aureus was found be more significant for Group 3 as compared to control, both at 1-day (P < 0.001) and 1-week (P < 0.002) storage in distilled water. However, no statistically significant changes in the flexural strength were observed with the addition of MAA at 1-day (P = 0.52) and 1-week (P = 0.88) time interval. CONCLUSION: Addition of MAA to conventional denture base resin reduced the microbial adhesion without significantly affecting the flexural strength.

Lobule separator prosthesis to prevent adhesion of reconstructed ear lobe.

An adhesion is a band of scar tissue that binds two parts of the tissue together, which develops when the body's repair mechanisms respond to any tissue disturbance, such as surgery, infection, trauma, or radiation. Prevention of unwanted scar bands is of utmost importance to develop esthetic and healthy tissue. This article describes a technique to prevent the adhesion of the surgically reconstructed ear lobule with facial skin, using novel lobule separator prosthesis.

Pneumatic impression: Improving dental arch impression with an inflatable balloon.

PURPOSE: The purpose of this impression technique is to overcome the problem associated with restricted mouth opening in association with high arched palate by employing pneumatic impression technique using latex balloon. METHODS: A stock tray was modified with auto polymerizing acrylic resin. On the modified tray, a latex balloon was attached with aid of cyanoacrylate. The outlet of the balloon was then connected to a clinical sphygmomanometer bulb with the rubber pipe for air passage which would aid in inflating the balloon. The prepared tray assembly was then equipped for recording the impression. An adequate amount of addition polysiloxane impression material, sufficient to cover the entire area of the balloon was loaded onto the tray. The balloon was then inflated with the help of a sphygmomanometer bulb which transferred the air only in one direction. On completion of setting time of the impression material, the air pressure was relieved by deflating of balloon which helped in the easy removal of the impression. The impression was subsequently removed from the oral cavity and disinfected. CONCLUSION: This novel technique was helpful for recording impression in patients presenting with restricted mouth opening and high arched palate.

Antimicrobial activity and properties of irreversible hydrocolloid impression materials incorporated with silver nanoparticles.

STATEMENT OF PROBLEM: Conventional spray and the immersion disinfection of irreversible hydrocolloid impression materials may lead to dimensional changes. PURPOSE: The purpose of this in vitro study was to investigate the antimicrobial activity and properties of irreversible hydrocolloid impression materials incorporated with silver nanoparticles. MATERIALS AND METHODS: The antimicrobial activity and properties of 2 commercially available irreversible hydrocolloid impression materials were evaluated after incorporating varying concentrations of silver nanoparticles. Antimicrobial activity was determined using the disk diffusion method. The gel strength, permanent deformation, flow, and gelation time were measured according to American Dental Association specification #18. Analysis of variance was used to identify the significant differences within and across the groups (α=.05). RESULTS: Adding silver nanoparticles to irreversible hydrocolloid impression materials resulted in superior antimicrobial activity without adversely affecting their properties. Adding silver nanoparticles to Zelgan significantly increased the gel strength compared with the control group, except at 5 wt%. However, the gel strength of Tropicalgin was unaffected except at 5 wt%. An increase in the permanent deformation was found with the incorporation of silver nanoparticles in both Zelgan and Tropicalgin. The flow of Zelgan increased with the incorporation of silver nanoparticles, whereas a decrease in the flow of Tropicalgin was observed at 1 wt% and 2 wt%. An increase in the gelation time of both Zelgan and Tropicalgin was observed with the incorporation of silver nanoparticles. CONCLUSIONS: Based on this in vitro study, silver nanoparticles can be incorporated into irreversible hydrocolloid impression materials as antimicrobial agents without adversely affecting their properties.

Functional and aesthetic rehabilitation of a geriatric patient with cleft palate: a case report.

Cleft palate defect with complete edentulism in elderly patients presents a prosthodontic challenge for complete denture fabrication. Such large defects are very difficult to restore by surgical intervention and have direct consequence on such functions as mastication and speech, on aesthetics, and on the patient's mental attitude. This article describes a case report in which a 76-year-old female patient underwent restoration with a closed hollow bulb obturator for a large cleft palate defect.

Cranioplasty with custom made alloplastic prosthetic implant: A case report.

Cranial defects often occur due to trauma. The treatment of such defects is a challenge to the skill and knowledge of the practitioner. This article presents one such case, where a 15-year-old boy had suffered extensive loss of the right cranium following a road traffic accident. The patient required rehabilitation of the right fronto-temporal cranial anatomy and was managed using a custom made heat polymerized acrylic alloplastic implant.

Three-dimensional orientation of iris in an ocular prosthesis using a customized scale.

The success of an ocular prosthesis depends largely on the correct orientation of the iris disk. Various methods have been put forth to achieve this. This article emphasizes one such simplified method, wherein a customized scale has been used to orient the iris disk mediolaterally, superoinferiorly, and anteroposteriorly in an ocular prosthesis. A scleral wax pattern was fabricated. The customized scale was used to measure the dimension and orientation of the natural iris. These measurements were then transferred to the scleral wax pattern with the customized scale. An iris disk was fabricated using black crayon on the scleral wax pattern according to the measurements. The scleral wax pattern, including the iris disk, was then placed in the eye socket to verify its dimension and orientation. A prefabricated iris disk was modified according to the measured dimensions and transferred to the final scleral wax pattern. The transfer of these dimensions to the definitive prosthesis was achieved successfully, ultimately improving the patient's social and psychological well being.

Fabrication of a surgical splint in an emergency situation: a clinical report.

Fractures involving pediatric jaws most often require a splint to prevent the fragments from being displaced; however, impression making presents a challenge. This article describes the fabrication of a surgical splint over an ideal cast, which is subsequently refitted with a tissue conditioner onto the patient's jaw. The highlight of this technique is the elimination of an impression procedure, thereby reducing clinical and laboratory time and easing pain in the child.

Implant crest module: a review of biomechanical considerations.

The success of dental implants has long been established through various studies with a particular emphasis laid on an implant design. Crest module is that portion of a two-piece metal dental implant, designed to hold the prosthetic components in place and to create a transition zone to the load bearing implant body. Its design, position in relation to the alveolar crest, and an abutment implant interface makes us believe that, it has a major role in integration to both hard and soft tissues. Unfortunately, in most clinical conditions, early tissue breakdown leading to soft tissue and hard tissue loss begins at this region. Early crestal bone loss is usually highest during the first year after placement ranging from 0.9 to 1.6mm and averaged 0.05-0.13 mm in the subsequent years . Various hypotheses have been stated to reason it however, none has been proved convincingly. In light of this, various attempts have been made to overcome this undesirable bone loss, by varying an implant design, the position, surgical protocol, and the prosthetic options. Irrespective of an implant system and designs that are used, crestal bone loss of up to the first thread is often observed. The purpose of this review is to look into the various designs and treatment modalities, which have been introduced into the crest module of an implant body to achieve the best biomechanical and esthetic result.