Effect of calcium and Vitamin D supplementation on residual ridge resorption in edentulous patients: An open-label randomized study.

AIM: Complete dentures (CDs) are fabricated to rehabilitate the edentulous. Severe residual ridge resorption (RRR) compromises CD functionality, adversely affecting function, appearance, systemic health, and quality of life. SETTINGS AND DESIGN: The purpose of this study was to assess the benefit, if any, of calcium and Vitamin D supplementation on the rate of RRR. Retarding RRR would improve treatment prognosis and make CD fabrication less demanding. MATERIALS AND METHODS: This longitudinal, parallel, open-label randomized study was conducted in the Department of Prosthodontics of the institute. One hundred and fifty edentulous subjects underwent bone mineral density (BMD) assessment followed by CD fabrication to measure RR height and width with computerized tomographic (CT) scans. Subjects were randomized to oral supplementation group - S, given combined Vitamin D and calcium daily, and nonsupplementation group - NS. Subjects from both the groups were followed up with repeat BMD test and CT scan after 12 months. Mean BMD, RR height and width, and RRR values were collected, analyzed, and compared for the two groups using STATA 17. STATISTICAL ANALYSIS USED AND RESULTS: Baseline mean T-score, RR height, and RR width were - 1.84, 22.30 mm, and 4.25 mm, respectively, for the sample. In both Groups S and NS, a statistically significant decrease in mandibular RR height (P = 0.000 for both) and width (P = 0.027 and 0.003, respectively) was observed at 1-year follow-up. There was a statistically insignificant difference between Groups S and NS for mean BMD, T-score, RR height and width, and RRR at both baseline and 12-month follow-up. One-year RRR rate for Group S (1.30 mm) was insignificantly lesser than for group NS (1.33 mm). CONCLUSION: Short-term oral calcium and Vitamin D supplementation was ineffective in reducing RRR and improving BMD.

Alarm Signals to Postpone Feeding Plate Fabrication and Nasoalveolar Molding.

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Mechanical failures of dental implants and supported prostheses: A systematic review.

Purpose: Though, mechanical dental implant and supported prosthesis failures are considered significant, a comprehensive evaluation is lacking. A systematic review analyzing different aspects related to such failures was therefore done. Methods: - Electronic search was carried out in PubMed/MEDLINE and Cochrane Library for articles published between 1981 and 2021. Articles were selected using predefined criteria. Data extraction was based on mechanical complications associated with dental implants, prosthetic implant failures, survival rate of implants, mechanical failure of implants placed in the maxilla and mandible, and mechanical complications associated with implant supported over dentures. Quality of included studies was assessed. Meta-analysis for heterogenicity testing, publication bias and implant failure assessment was conducted using MedCalc® Statistical Software version 19.7. Results: - Eighteen retrospective and prospective studies were included following PRISMA guidelines. Mechanical complications were more in the initial 9 years but reduced later. Abutment screw loosening was one of the more common mechanical complications (16.21%). Maxillary implant failure was greater compared to mandibular implant failure with an odds ratio of 4.66 (95% CI -3.21- 6.75). Failure of implant supported overdentures due to mechanical complications were 3% in the fixed effect, and 2.9% in the random effect model (P < 0.05). The overall prevalence of mechanical failure was between 5.6% and 7.7% (P < 0.05). Conclusion: Mechanical failures of implant and supported prosthesis have similar prevalence to biological and esthetic failures, and therefore need to be given due credence. Identifying specific factors contributing to such failures can help reduce incidence.

Half sphere and single clip-bar retained implant supported silicone auricular prosthesis.

Implant supported auricular prosthesis can be retained by several mechanical means, one of them being the Hader bar and clip system. Conventionally two or more rider clips are used. This technique describes a modified Hader bar design to maintain retention while eliminating the requirement of a second clip, significantly bringing down cost.

Clinical Outcomes of Titanium Zirconium and Titanium Dental Implants under Immediate Functional Loading in Posterior Mandibular Region.

BACKGROUND: Studies comparing the clinical performance of titanium zirconium (Ti-Zr) and titanium (Ti) dental implants subjected to immediate loading in the posterior mandibular region where occlusal forces are higher are sparse in the current literature. Hence, the study aimed to evaluate and compare the clinical outcomes of Ti-Zr and Ti dental implants under immediate functional loading in the mandibular posterior region. METHODS: Forty participants fulfilling the predetermined selection criteria were randomly grouped based on dental implant used; Titanium zirconium (Ti-Zr):20, and Titanium (Ti):20. Dental implants were placed through a standard full-thickness mucoperiosteal flap approach and loaded immediately fulfilling the principle of implant protective occlusion. Clinical parameters including crestal bone loss (CBL), modified plaque index (MPI), probing depth (PD) and modified sulcular bleeding index (MSBI) were measured at baseline and follow-up visits (4, 8, and 12 months). Obtained data were compared with standard tests such as the t-test, Chi-square test, and Mann-Whitney U test. RESULTS: On intergroup comparison, CBL was more in the Ti-Zr group as compared to the Ti group at 4 months (0.72 ± 0.16 mm versus 0.70 ± 0.13 mm), but it was less at 8 months (1.08 ± 0.16 mm versus 1.13 ± 0.13 mm) and 12 months (1.19 ± 0.17 mm versus 1.24 ± 0.12 mm) but the difference was not statistically significant (P > 0.05). Mann-Whitney test also revealed no statistically significant difference in MPI, PD and MSBI at 4 months, 8 months and 12 months recall (P > 0.05). CONCLUSIONS: CBL and periodontal parameters of Ti-Zr dental implants were found similar to Ti dental implants under immediate loading in the posterior mandibular region. However, further studies are needed to determine its long-term efficacy and cost-effectiveness.

A study to evaluate psychological and occlusal parameters in bruxism.

PURPOSE: To evaluate the role of anxiety/depression and occlusal factors in bruxism using Hospital Anxiety and Depression Scale and T-Scan III respectively. METHODS: The present case control study was comprising of a group of thirty patients with bruxism (Group Br) and 30 healthy individuals as control group (Group NBr). Subjects were selected from outdoor patients visiting the dental unit with the chief complaint of wearing off/sensitivity of all the teeth due to habitual grinding. The cases were selected by using the diagnostic criteria as given by the American Academy of Sleep Medicine (AASM). Further based on similarities of age and gender, controls were selected. Tooth wear index was recorded using an index given by Ekfeldt et al. Hospital Anxiety and Depression Scale (HADS) questionnaire was administered to both the groups to evaluate anxiety and depression. Recording of occlusal parameters in both the groups was done digitally by using T-Scan III. Statistical analysis was done by using student's t-test, chi square test and Mann Whitney U test. RESULTS: Group Br had significantly greater mean tooth wear index (22.24 ± 11.5) than group NBr (5.17 ± 3.30). Group Br had significantly higher anxiety (9.03 + 1.87/7.17 + 1.82) and depression scores (8 + 1.93/6.17 + 1.23) as compared to NBr. The disclusion time of group Br was 0.652 ± 0.749 and that of group NBr was 0.247 ± 0.289 (p = 0.008). CONCLUSIONS: Subjects with higher level of anxiety, depression and increased disclusion time may have greater predilection towards suffering from bruxism (p < 0.05).

Guide flange Prosthesis for management of hemimandibulectomy.

Guide flange is given to patients who have undergone surgical hemi/segmental/subtotal mandibulectomy due to various reasons (leading cause being squamous cell carcinoma), with resultant mandibular deviation. If procedures such as secondary osseous grafting are planned, the clinician has to wait for healing of the graft, lesion, or radiotherapeutic effects to abate. Only after the healing of the graft, a definitive prosthesis can be planned. During this time lag, prosthesis must be given to the patient to correct mandibular deviation on account of unilateral muscle pull. Furthermore, in certain cases, a definitive prosthesis has to be put on hold due to failure of bone grafting or when the patient is not willing for a second surgery. This report describes the fabrication of such a mandibular guide flange prosthesis.

RDD2020: An annotated image dataset for automatic road damage detection using deep learning.

This data article provides details for the RDD2020 dataset comprising 26,336 road images from India, Japan, and the Czech Republic with more than 31,000 instances of road damage. The dataset captures four types of road damage: longitudinal cracks, transverse cracks, alligator cracks, and potholes; and is intended for developing deep learning-based methods to detect and classify road damage automatically. The images in RDD2020 were captured using vehicle-mounted smartphones, making it useful for municipalities and road agencies to develop methods for low-cost monitoring of road pavement surface conditions. Further, the machine learning researchers can use the datasets for benchmarking the performance of different algorithms for solving other problems of the same type (image classification, object detection, etc.). RDD2020 is freely available at [1]. The latest updates and the corresponding articles related to the dataset can be accessed at [2].

Spectacle Cord-retained Oculo-Orbital Prosthesis.

Retention of an orbital prosthesis plays a key role in treatment success and patient acceptance as does aesthetics. Though numerous retentive aids are available such as implants, adhesives, etc, the cost, surgical aspect, difficulty of use and allergic potential may compromise efficiency. This report describes the case of an 11-year post-enucleation poor retinoblastoma patient, in whom an unfavourable defect leads to a major prosthetic challenge (from point of view of retention and camouflage). This report describes a simple, economical, and user-friendly approach to obtain satisfactory retention and camouflage for such patients with spectacle cords and customised spectacles. Key Words: Oculo-orbital prosthesis, Spectacle, Cord.

A randomized clinical study to compare implant stability and bone loss using early loading protocol in two implant systems with different design.

Aims: The study compared changes in implant stability and bone loss of implants with different designs using early loading at 6 weeks. Setting and Design: In vivo-comparative study. Materials and Methods: Forty subjects were selected and divided randomly by sealed envelope method in Group X and Group A for early loading for missing single posterior tooth in mandible. Implants in Group X had flared crest module and buttress thread design, whereas implants in Group A had parallel crest module and V-shaped thread design. All subjects were evaluated by Ostell for implant stability at the interval of baseline, 6 weeks, 3 months, and 6 months. ImageJ software was used for measurement of crestal bone loss in intraoral periapical radiographs at the interval of 6 weeks, 3 months, and 6 months. Statistical Analysis Used: Unpaired t test, repeated ANOVA, Tukey post hoc test. Results: The mean bone loss values of Group X at predetermined interval were 1.51 ± 0.20 mm, 2.11 ± 0.21 mm and 2.13 ± 0.21 mm. The mean bone loss values of Group A were 1.79 ± 0.16 mm, 2.92 ± 0.23 mm and 2.95 ± 0.23 mm. The mean bone loss was statistical significant (P < 0.05) at 6 weeks, 3 months and 6 months. It was highly significant in Group A at 6 months (P < 0.001). Conclusions: It was concluded that Group X implants design showed better implant stability and less bone loss when compared to Group A implants design.

Mechanically retained functional prosthetic rehabilitation of partial lip necrosis: A rare clinical report.

Prosthetic rehabilitation plays a crucial role in restoring patients with facial defects to normalcy. Although comprising a small proportion, lip defect plays a pivotal role in drastically diminishing the quality of life of the patient, both functionally and socially, with dwindling confidence and self-esteem. Patients may experience speech impairment, uncontrolled drooling, and unesthetic appearance. In addition, constant exposure of tissues to air leads to drying and crusting of lips. This rare case report of a patient with partial lip necrosis describes her functional, mechanically retained prosthetic rehabilitation, which improved phonetics, esthetics, and function without the need of additional retentive features, increasing convenience and ease of use by the patient and at the same time cutting down cost.

Technique to prevent fracture of a partial auricular prosthesis mold.

One of the difficulties faced during the essential and demanding step of fabricating a mold for a partial auricular prosthesis is the fracture of its most elevated part, which engages the remnant concha and triangular fossa region, because of the presence of excessive convolutions and undercuts. This technique describes a 4-part mold for a partial auricular prosthesis in which the most elevated portion is poured separately, thereby preventing mold fracture.

A Pilot Study to Determine the Effect of Three Months of Oral Appliance Therapy using a Mandibular Advancement Device on HbA1c in Subjects with Type 2 Diabetes Mellitus and Obstructive Sleep Apnea.

PURPOSE: Continuous positive air pressure (CPAP) is recommended for obstructive sleep apnea (OSA) with type 2 diabetes mellitus (T2DM) but cost and compliance are major barriers. A mandibular advancement device (MAD) may be an economical, feasible alternative to CPAP. Various studies have been published to recommend MAD as an alternative to CPAP for OSA, but not regarding its efficacy for patients having OSA as well as T2DM. This study aims to objectively and subjectively evaluate oral appliance therapy using a MAD in patients having OSA as well as T2DM. MATERIALS AND METHODS: Patients who visited the hospital clinic having OSA as well as T2DM were recruited. After giving informed consent, participants were divided into three equally sized groups of three grades of OSA (mild, moderate, severe) on the basis of a polysomnography report and were given intervention of MAD at 50% of maximum mandibular protrusion and 20% of maximum interincisal opening. Objective outcomes were HbA1c level and apnea hypopnea index score (AHI). Subjective outcomes were Epworth Sleepiness Scale (ESS) and the Berlin Questionnaire. All outcomes were assessed before and after 3 months of intervention. RESULTS: A statistically significant difference was seen in all outcomes after intervention with MAD (p < 0.01) in all groups except HbA1c level in participants having severe OSA. CONCLUSION: MAD may be recommended in patients having OSA as well as T2DM. This study provides evidence to inform health care workers about possible use of MAD in OSA with T2DM.

Nonimplant, Nonadhesive Overlay Approach to Retain a Partial Auricular Prosthesis.

Partial auricular prosthesis fabrication presents a more complex challenge than complete ear fabrication, with added aspects of merging/camouflaging a larger prosthetic marginal area, pattern try-in, and compromised retention. Better alternatives are excision of the remnant ear to make an implant-retained complete ear prosthesis or surgical reconstruction of the missing ear portion. Both need additional surgery/ies and expenses, neither of which may be acceptable to the patient. This report describes a prosthesis fabrication approach for such patients. This approach does not require implants or adhesives for retention. Issues of marginal camouflage and pattern trial were also addressed satisfactorily.

Rehabilitation of a Complex Oro-Facial Defect by Modified Prosthetic Approach.

Loss of part of the face is associated with physical disability, social isolation and immense psychological trauma. Proper rehabilitation of such a patient is a challenging yet satisfying task for a maxillofacial prosthodontist. Facial prostheses are commonly fabricated of silicone because of many favorable properties, though it predisposes to fungal growth.This report is of a patient with history of uncontrolled diabetes and associated invasive fungal infection, leading to a complex oro-facial defect, which was rehabilitated successfully with a silicone facial prosthesis lined by a material more resistant to fungal growth along with a cast partial obturator. Other design and procedural modifications were also made to suit the needs of the case. Wise selection of materials, keeping in mind the properties of materials, is important in successful rehabilitation.

Color matching in facial prosthetics: A systematic review.

Color matching to the surrounding skin is extremely important in patients wearing maxillofacial prostheses. It is of utmost importance to know the different techniques of color matching and coloring in maxillofacial prostheses. The purpose of this study is to review the literature data with regard to color matching in maxillofacial prosthetics. An electronic search of peer review restricted to English language dental literature was conducted to identify the relevant scientific article on color matching and coloring in maxillofacial prostheses. The publication year was up to December 2015 so that the search could include all the articles provided in that particular database. Two independent observers independently read the abstracts and later preselected full-text articles. A full-text review was carried out only for 15 articles. Out of the 15 articles, 7 were related to coloring using tinting, spraying, milling, and use of commercial cosmetics. Three studies were related to shade matching in maxillofacial prostheses. Two studies conducted the measurement of color in maxillofacial prostheses. Only one study had explained color and its relevance in maxillofacial prosthetics. Only one study was done for reproducing silicone shade guide matching Indian skin color. In addition, a single pilot study was done to measure facial skin and lip color in a human population sample stratified by race, gender, and age. Currently, there is no evidence discussing the best technique available for perfectly matching the color for the fabrication of maxillofacial prostheses. However, the latest instruments such as spectrophotometer and colorimeters are believed to have improved efficiency in matching the color.