Functional and aesthetic rehabilitation using 'all on 4' treatment protocol with intraoral welding.

With the increasing life expectancy and improved quality of life, the conventional prosthodontic removable treatment modalities are being replaced with implant retained fixed prostheses. A full-arch conventional rehabilitation of edentulous ridges requires six to ten dental implants. However, some patients demand fixed implant-supported prostheses inspite of medical conditions and economic concerns. Also in completely edentulous cases, the insufficient bone morphology directs the treatment plan towards alternatives such as cantilever prostheses, short implants or ridge augmentation procedures. These clinical conditions have brought in a quantum shift in treatment planning towards the 'all on 4 protocol' providing immediately loaded fixed prosthesis supported by 4 implants thereby providing optimum and immediate restoration of function and esthetics.

Impact of complete mouth rehabilitation following Pankey Mann Schuyler versus HOBO Philosophy on Oral Health-Related Quality of Life using Oral Health Impact Profile-14: A randomized clinical trial.

Aim: Aim of this in vivo study was to assess the impact of two rehabilitation philosophies namely; Pankey Mann Schuyler (PMS) & Hobo Twin Stage (HOBO) on Oral Health-related Quality of life (OHRQoL) using Oral Health Impact Profile (OHIP 14). Settings and Design: This was a randomized clinical trial. Material and Methods: This study was designed based on the PICOT model. 40 patients were selected who need to undergo complete mouth rehabilitation. The intervention performed was complete mouth rehabilitation therapy and the results were compared with that of no intervention. The outcome was assessed in terms of improvement in mastication, phonetics, esthetics and overall OHRQoL (OHIP-14) over a period of 01 year at intervals of 48 hrs, 01 mon, 6 mon and 12 months. Patients were unaware of the treatment philosophy being used and were given a questionnaire (OHIP-14); at baseline (pre-treatment) and 48 hrs, 1, 6 and 12 months after completion of treatment (post-treatment) to evaluate OHRQoL. The data was collected by independent reviewers blinded to the regimen followed making the participants and the outcome assessors blinded to the procedure. Statistical Analysis: Independent Student's t-test and Chi-Square test were used for analysis. Result: Analysis illustrated significant differences in scores obtained pre-treatment and post-treatment in both groups at 12 months (P < 0.05). At 12 months, OHIP-14 scores showed a mean percentage change of 51% in Group A (PMS); (P = 0.001) and a mean percentage change of 49% in group B (Hobo). Conclusion: Complete mouth rehabilitation therapy for management of generalized attrition or mutilated dentition is a viable and effective treatment option and brings about definitive improvement in Oral Health Related Quality of Life (OHRQoL) and overall health status of an individual.

Microbiome analysis: An emerging forensic investigative tool.

Microbial diversity's potential has been investigated in medical and therapeutic studies throughout the last few decades. However, its usage in forensics is increasing due to its effectiveness in circumstances when traditional approaches fail to provide a decisive opinion or are insufficient in forming a concrete opinion. The application of human microbiome may serve in detecting the type of stains of saliva and vaginal fluid, as well as in attributing the stains to the individual. Similarly, the microbiome makeup of a soil sample may be utilised to establish geographic origin or to associate humans, animals, or things with a specific area, additionally microorganisms influence the decay process which may be used in depicting the Time Since death. Further in detecting the traces of the amount and concentration of alcohol, narcotics, and other forensically relevant compounds in human body or visceral tissues as they also affect the microbial community within human body. Beside these, there is much more scope of microbiomes to be explored in terms of forensic investigation, this review focuses on multidimensional approaches to human microbiomes from a forensic standpoint, implying the potential of microbiomes as an emerging tool for forensic investigations such as individual variability via skin microbiomes, reconstructing crime scene, and linking evidence to individual.

Custom-fabricated nasal conformers and surgical stents in the management of midfacial acid burn injuries: A clinical report.

Acid burn injuries in the midfacial region cause contracture of the skin and nasal aperture, which can lead to nasal airway obstruction. Management of such complicated situations requires a multidisciplinary approach, including prosthetic intervention. This article describes a clinical treatment for fabricating a custom nasal conformer for a 28-year-old man who presented with a history of an acid burn injury leading to obstructed external nares and fusion of the tip and columella of the nose with the philtrum of the upper lip. The prosthesis served the dual function of maintaining the nasal airway passage and preventing the contracture of the graft placed over the upper lip during reconstructive surgery.

Multidimensional evaluation of prosthetically rehabilitated\cranial defects using key behavior change inventory.

Defects of the cranial vault can result from the decompressive craniectomy secondary to trauma, cerebral infections, resection of intracranial processes, or bone invading skin tumors. Reconstruction of the cranial vault not only provides protection and esthetic reasons but also maintains and restores physiological circulatory system of the cerebrum essential for the regulation of intracranial pressure. This paper presents prosthetic rehabilitation of two patients, who suffered head injury resulting in extensive frontoparieto temporal defects that induced symptoms such as headache, fatigue, loss of concentration, loss of memory, and depression. Along with the physical dysfunction and disfigurement, the injury resulted in a deep psychological impact on overall well-being and self-esteem of the patient as well as the close family members. The patients were prosthetically rehabilitated with custom-made heat polymerized polymethyl methacrylate cranial prosthesis and the assessment of postrehabilitation outcome was done using a specific measurement tool; key behaviors change inventory (KBCI) a 64-item questionnaire that evaluates executive, interpersonal, and emotional functioning behaviors following traumatic brain injury. Rehabilitation resulted in the restoration of form, function, and esthetics along with the improvement in psychological status and general health as reflected in KBCI scores posttreatment. Based on the posttreatment scores obtained in the cases under study, it is suggested that KBCI may serve as an important prognostic tool for the assessment of treatment outcomes.

Utility versus futility of facebow in the fabrication of complete dentures: A systematic review.

AIM: The aim of this review was to investigate utility or futility of facebow for fabrication of complete denture prosthesis to maximise clinical efficiency and acceptability of complete dentures. SETTINGS AND DESIGN: Systematic review following PRISMA guidelines. MATERIALS AND METHODS: A study question was designed based on PICOT model which was used to evaluate whether facebow transfer is required or not for fabrication of complete denture prosthesis. An extensive search was carried out manually and using electronic databases such as PubMed-Medline, Cochrane, Google Scholar, and Clinicaltrials.gov. Parameters under review included patient satisfaction, masticatory efficiency, occlusal adjustments, clinician time, stability and retention. Boolean operators, MeSH terms and limiters were applied to develop the search and reach to conclusive studies pertaining to study design. Literature dated between 1950 and 2019 were selected. The data extraction and assessment of the studies was done by two independent investigators. STATISTICAL ANALYSIS USED: No meta-analysis was conducted due to heterogeneity of data obtained. RESULTS: 13690 studies were shortlisted, 13672 were excluded based on title and abstract. By the end of search phase, 07 RCTs were considered relevant. 04 studies concluded comparable/ no differences in outcome with and without use of facebow for fabrication of complete denture prostheses, whereas 03 studies concluded better results without the use of facebow. CONCLUSION: The use of facebow results in fabrication of complete denture prostheses with similar results in terms of clinical efficiency and patient acceptability as compared to simplified techniques using anatomical landmarks. Variations in assessment criteria, non uniform distribution of sample size amongst different clinical trials and subjective questionnaire based criteria are the weaker links in the review. Extensive research and long term standardised studies with objective criteria for assessment are required for comprehensive and conclusive results to establish the need for change in clinical practice.

Forensic odontology: The prosthetic ID.

The term "forensic science" involves forensic (or forensis, in Latin), which means a public discussion or debate. In a more modern context, however, forensic applies to courts or the judicial system. Combine that with science, and forensic science means applying scientific methods and processes to solving crimes. People can be identified by their fingerprints, foot creases, and from traces of their DNA from blood, skin, hair, saliva, and semen by DNA analysis. However, in situations where these records are unavailable or unusable due to the nature of the disaster, the dental records and aids prove to be useful for victim identification. This article aims at highlighting the importance of the dental records and the forensic odontology in the accurate and efficient identification of the conflict victims or deceased to serve as an important adjunct to the forensic medicine in a simplified manner.

Preparation and evaluation of antibacterial potential of Pithecellobium dulce root extract against Gram positive and Gram negative bacteria.

In the present study hexane, benzene, ethyl acetate and ethanol extracts of Pithecellobium dulce root were prepared using soxhlet extractor. The extracts were evaluated for antibacterial activity against one Gram positive (Staphylococcus aureus) and three Gram negative (Acetobacter aceti, Acetobacter aceti, Klebsiella pneumoniae) strains. Disc diffusion method revealed promising antibacterial activity of the extracts prepared in polar solvents (ethyl acetate and ethanol) compared to non-polar solvents (hexane and benzene). Ethanolic root extract was found to be most active against Acetobacter aceti, Staphylococcus aureus, Klebsiella pneumonia and Enterobacter aerogenes bacterial strains. The zone of inhibition of ethanolic root extract against Acetobacter aceti, Staphylococcus aureus, Klebsiella pneumonia and Enterobacter aerogenes bacterial strains was 15.4, 11.0, 19.0 and 13.0 mm, respectively at 100 mg concentration. Ethyl acetate extract also exhibited good antibacterial activity against Entrobacter aerogenes, Klebsiella pneumonia and Acetobacter aceti. The zone of inhibition of ethyl acetate root extracts against Entrobacter aerogenes, Acetobacter aceti and Klebsiella pneumonia was 10.5, 18.0 and 10.0 mm, respectively. The benzene extract showed some activity against Acetobacter aceti with the zone of inhibition 10.0 mm. The antibacterial activity of Pithecellobium dulce root hexane extract was found to be negligible against all the four tested strains of bacteria. These findings suggest that ethanolic and ethyl acetate root extracts of Pithecellobium dulce has potential as effective anti-bacterial agent.

Synthesis and in vitro evaluation of 2-(((2-ether)amino)methylene)-dimedone derivatives as potential antimicrobial agents.

The study was designed with an aim to synthesize a series of 2-(((2-ether)amino)methylene)-dimedone derivatives and evaluate the synthesized compounds for antimicrobial activity. Compound library was synthesized by reaction with alkyl, alkenyl, alkynyl and alicyclic bromo-compounds. Characterization of the synthesized compounds was performed by 1H NMR, 13C NMR and mass spectral techniques. The compounds were evaluated for their antibacterial activity against Gram-positive (Staphylococcus aureus, Bacillus subtilis, Clostridium sporogenes) and Gram-negative bacteria (Pseudomonas aeruginosa, Escherichia coli). The activity of these compounds was also evaluated against fungi (Aspergillus fumigatus, Penicillium chrysogenum, Fusarium oxysporum, Candida albicans) and molds (A. niger and A. oryzae). Broth microdilution method and CLSI guidelines with minor modification were used for the determination of anti-bacterial and antifungal activity, respectively. Although four compounds (4i, 4j, 4k and 4l) showed good antibacterial activity but compound 4k was found to be most active chemotype in the series. Compound 4k was found to be active against S. aureus, B. cereus and B. subtilis bacterial strains at one dilution lower compared to the control ciprofloxacin. Antibacterial activity of compound 4k was comparable to ciprofloxacin against S. pyogenes and M. luteus. The compound 4d, 4e and 4s showed good antifungal and antimold activity compared to other chemotypes. However, in comparison to fluconazole both the compounds showed lower activity. The results merit the antimicrobial promise of the 2-(((2-ether)amino)methylene)-dimedone analogs.

Effect of firing cycle and surface finishing on the sag resistance of long-span metal ceramic framework using base metal alloys-an in vitro study.

BACKGROUND: The search for the ideal restorative material or combination of materials in dentistry is still the subject of modern dental research. In clinical practice, there are increased numbers of ceramo-metal restorations being fabricated which replace multiple missing teeth in a single framework. The literature is scanty with regard to investigations of the 'sag' resistance of base metal alloys commonly used for ceramo-metal restorations and specifically for long-span restorations. An in vitro study was carried out to investigate the effects of surface finishing and simulated porcelain-firing on the sag resistance of long-span ceramo-metal frameworks using base metal alloys. METHOD: Four types of alloys were used. A total of 80 samples were selected for the study and they were divided into four groups of 20 samples each. 'As cast' metal specimens in group I, group II and with surface finishing in group III and group IV. Each test sample was mounted on the sample holding accessory of the custom made thermo mechanical analyser and subjected to three firing cycles. Each sample was evaluated for the sag-related deflection recorded by the dial gauge with an accuracy of 1 µm. The data recorded was subjected to a statistical analysis using unpaired t-test to compare the relative difference in the sag-related deflection values. RESULTS: It was observed that the values for sag-related deflection were significantly less for the 'as cast' samples of all the alloy groups. Nickelchromium (NiCr) and cobaltchromium (CoCr) exhibited value of 19.4 µm and 14.8 µm, respectively. CONCLUSION: Among the four groups of alloys tested, CoCr based alloy exhibited the least amount of sag-related deflection. The results show that the sag-related deflection was less in Co-Cr alloys as compared with the NiCr alloys, still Ni-Cr alloys in fixed dental prostheses frameworks are used due to their desirable physical and chemical properties.