A Case Report on Iris Disk Positioning on a Custom-Made Ocular Prosthesis Using an Adjustable Trial Frame.

Trauma, cancer, and congenital defects may all result in the loss of an eye. This leads to significant emotional and physical challenges in an individual's life. In such cases, cautious preoperative, surgical, and prosthetic planning employing a multidisciplinary approach is essential for effective rehabilitation. Iris positioning is one of the crucial steps in the fabrication of a customized ocular prosthesis. Iris positioning is a technique-sensitive process, hence visual evaluation by itself could not provide reliable results. This case report illustrates a method of iris disk positioning on a custom-made ocular prosthesis using an adjustable trial frame. The advantage of the adjustable mechanism of the adjustable trial frame was utilized here to position the iris on the scleral blank. Since the iris disk on the ocular prosthesis was positioned in symmetry with that of the natural eye, the patient's aesthetics were restored.

Rehabilitation of an Orofacial Cleft through Presurgical Nasoalveolar Molding with a 1-year Follow-up.

Aim: To highlight the effectiveness of Presurgical Nasoalveolar Molding (PNAM) technique and the appliance used prior to the surgical reconstruction of cleft lip and palate in newborns. Background: In underdeveloped and developing countries, babies born with oral clefts, are generally anemic with low birth weight and may be unfit for surgery immediately. Feeding these babies is also difficult as the air leaks through the cleft and they cannot create the suction needed for suckling. Case description: Two newborn babies, presented with unilateral midfacial clefts involving the lip, alveolus and palate. Conclusion: The PNAM appliance enabled breast Feeding while lessening the soft tissue and cartilaginous deformity and allowing surgical soft tissue repair with minor scar formations. Clinical significance: PNAM can reduce the surgical burden and reduce the number of surgical revisions when initiated early. How to cite this article: Ferreira AN, Eswaramurthy P, Aras MA, et al. Rehabilitation of an Orofacial Cleft through Presurgical Nasoalveolar Molding with a 1-year follow-up. Int J Clin Pediatr Dent 2023;16(1):162-165.

Effect of Chemical Disinfectants on the Color Stability of Maxillofacial Silicones: An In Vitro Study.

PURPOSE: To evaluate the effect of chemical disinfection on the color stability of room temperature vulcanizing (RTV) maxillofacial silicone elastomer with and without pigment addition. MATERIALS AND METHODS: Sixty specimens were obtained from a RTV maxillofacial silicone. The specimens were randomly divided into 6 groups according to pigments and disinfectant to be used (n = 10). NP-DW-nonpigmented silicone specimens to be immersed in distilled water (control). NP-S- nonpigmented silicone specimens to be rubbed with an anti-bacterial soap. NP-CHX-nonpigmented silicone specimens to be immersed in chlorhexidine gluconate solution (2%). P-DW-pigmented silicone specimens to be immersed in distilled water (control). P-S-pigmented silicone specimens to be rubbed with antibacterial soap. P-CHX-pigmented silicone specimens to be immersed in chlorhexidine gluconate solution (2%). Disinfection was conducted 6 times a day for 60 days simulating 1 year of usage. Color was evaluated after 60 days (disinfection period) using a reflectance spectrophotometer. Color alterations were calculated by the CIE L∗ a∗ b∗ system. Data were analyzed by t-test, one-way ANOVA, and Tukey test (α = 0.05). RESULTS: NP-S and P-S exhibited the highest color alterations, whereas NP-DW and P-DW the lowest color alterations. CONCLUSION: Disinfection procedures affect the color stability of maxillofacial silicone. Chlorhexidine gluconate solution (2%) can be effectively used as a chemical disinfectant for maxillofacial prostheses. Antibacterial soap produced clinically unacceptable color changes in the silicone, hence is not advisable as a disinfectant.

Customized Cheek Plumper with Friction Lock Attachment for a Completely Edentulous Patient to Enhance Esthetics: A Clinical Report.

Prosthetic rehabilitation of a completely edentulous patient should never be restricted to the replacement of missing teeth. The ultimate aim of complete denture treatment should be restoration of the full range of oral functions and esthetics. Slumped cheeks are always a concern for esthetically demanding complete denture patients. This article describes a simple, scientific, cost-effective technique to improve facial esthetics in a completely edentulous patient with the help of a cheek plumper. The technique used here implements the concept of neutral zone to precisely determine the amount of space available for the cheek plumper. The simple friction lock attachments that retained the cheek plumpers on the prosthesis were also fabricated after determining the space available in the appropriate areas. Thus an effort was made to keep the cheek plumpers unobtrusive yet effective to ensure complete integration of the prosthesis into the stomatognathic system.

The Hollow Maxillary Complete Denture: A Simple, Precise, Single-Flask Technique Using a Caramel Spacer.

The success of removable prostheses ultimately depends on a number of factors such as retention, stability, support, esthetics, and masticatory function. Increased intraoral inter-arch distance leads to an increase in the weight of the prosthesis. This may compromise the retention and resistance, which are key for a successful removable prosthesis. Various methods, techniques, and materials have been reported to minimize the weight of a prosthesis. This article describes a simple, unique, precise single-flask technique for the fabrication of a lightweight maxillary prosthesis using caramel as a 3D spacer, which was "indexed" to obtain a uniform thickness of acrylic around the hollow cavity.

A Novel Universal Cementation Technique for Implant-Supported Crowns with Subgingival Margins.

Restoration of implant crowns with subgingival margins has always been a challenge. If done precisely it leads to better treatment outcomes and prognosis. An incorrect technique and improper execution of the luting procedure are known to cause a high incidence of peri-implant disease due to incomplete elimination of the luting agent. Deep subgingival abutment margins are difficult to recognize, and cement removal in these cases becomes complicated if the sulcus depth is greater than 3 mm. Irrespective of the type of instrument used to remove the excess cement, scratches on the abutment and some cement remnants are consistently noticed. Therefore elimination of excess luting agent before the prosthesis is inserted intraorally is considered an effective technique to prevent complications due to excess luting agent. This article presents a chairside universal technique for cementation of implant crowns on abutments with deep subgingival margins. This technique attempts to minimize the amount of excess cement in peri-implant tissue.

Salivary reservoir designs for patients with xerostomia: a review

Aim: The present paper aims to review the literature available on various approaches to salivary reservoir designs, the functional aspects, cleansibility, type of attachments used, and different techniques used for the fabrication of salivary reservoirs in patients suffering from xerostomia. Material and Methods: A search in the National Library of Medicine's Pub Med database, Google search and Science Direct was performed to include all case reports and reviews on prosthodontic rehabilitation of dentulous/partially edentulous/edentulous patient with xerostomia. Results: Out of the 35 articles found in the database search, 18 articles were included based on the designs they adopted for fabrication of salivary reservoirs. Conclusions: The various designs available in literature enable an operator to choose the most suitable reservoir design based on specific patient requirements. Innovations in reservoir design promise a more customized prosthesis for every patient. Further research and innovation will enable increasingly efficient salivary substitute delivery systems for the xerostomic patient.

The role of nasendoscopy in the fabrication of a palatopharyngeal obturator - a case report.

Defects confined to the hard palate can be managed with relative ease because it is a static shelf creating oro- nasal separation. Since the soft palate is a dynamic separator between the oral and nasal cavities, defects involving the soft palate require careful consideration. Instrumental visualization methods can aid the fabrication of obturators in patients with such defects and prevent problems of under or over obturation. This case report presents the prosthodontic management of a patient with a Veau class II cleft palate using a palatopharyngeal obturator in order to re-establish normal functions of deglutition and speech. Nasendoscopy was used as an adjunctive procedure to assess velopharyngeal function with the prosthesis.

Tooth Supported Overdenture Retained with Custom Attachments: A Case Report.

Overdenture is a favored treatment modality for elderly patients with few remaining teeth. Roots maintained under the denture base preserve the alveolar ridge, provide sensory feedback and improve the stability of the dentures. Furthermore, the use of copings and precision attachments on the remaining teeth enhances the retention of the denture. This clinical report describes a novel method of fabricating a tooth supported overdenture retained with custom made ball attachments using orthodontic separators as a female component. Customized ball attachments with orthodontic separators are a simple and cost effective alternative treatment to the use of prefabricated attachments for enhancing the retention of tooth supported overdentures.

Repair of fractured abutment teeth under pre-existing crowns: an alternative approach.

This article describes a technique for repair of abutment tooth which fractured during removal of a provisional restoration before bisque trial. The technique uses plastic templates to fabricate new composite core foundation for the existing crowns. This technique helps the dentist to rebuild the core in a single appointment.

A comparison of the accuracy of patterns processed from an inlay casting wax, an auto-polymerized resin and a light-cured resin pattern material.

BACKGROUND: Traditionally, inlay casting waxes have been used to fabricate patterns for castings. Newer resin pattern materials offer greater rigidity and strength, allowing easier laboratory and intraoral adjustment without the fear of pattern damage. They also claim to possess a greater dimensional stability when compared to inlay wax. AIMS: This study attempted to determine and compare the marginal accuracy of patterns fabricated from an inlay casting wax, an autopolymerized pattern resin and a light polymerized pattern resin on storage off the die for varying time intervals. MATERIALS AND METHODS: Ten patterns each were fabricated from an inlay casting wax (GC Corp., Tokyo, Japan), an autopolymerized resin pattern material (Pattern resin, GC Corp, Tokyo, Japan) and a light-cured resin pattern material (Palavit GLC, Hereaus Kulzer GmbH, Germany). The completed patterns were stored off the die at room temperature. Marginal gaps were evaluated by reseating the patterns on their respective dies and observing it under a stereomicroscope at 1, 12, and 24 h intervals after pattern fabrication. RESULTS: The results revealed that the inlay wax showed a significantly greater marginal discrepancy at the 12 and 24 h intervals. The autopolymerized resin showed an initial (at 1 h) marginal discrepancy slightly greater than inlay wax, but showed a significantly less marginal gap (as compared to inlay wax) at the other two time intervals. The light-cured resin proved to be significantly more dimensionally stable, and showed minimal change during the storage period. CONCLUSION: The resin pattern materials studied, undergo a significantly less dimensional change than the inlay waxes on prolonged storage. They would possibly be a better alternative to inlay wax in situations requiring high precision or when delayed investment (more than 1 h) of patterns can be expected.

Understanding the psychology of geriatric edentulous patients.

OBJECTIVE: This article focuses on understanding our older patients who require complete prosthodontic care. By breaking down the patient psychology to its component parts, it is easier to obtain a clear picture of this special cohort of patients. Considering the increase in number of geriatric edentulous patients, this knowledge will help the dentist serve the geriatric population better. BACKGROUND: The role of psychology and personality in complete denture treatment is well documented. The geriatric patient who needs complete dentures has a psychological aspect that needs consideration. Although significant, these aspects may sometimes be ignored or considered irrelevant. MATERIALS AND METHODS: A review of relevant literature was carried out to obtain data on the psychology and personality of geriatric, complete denture patients and their behavioural changes. The obtained data was filtered and condensed to provide a short but comprehensive look at the geriatric edentulous patient's psychology. CONCLUSION: When handling geriatric edentulous patients, the dentist must be confident of addressing and managing the psychology of these patients. A thorough understanding of the geriatric mental state thus becomes important and significant for the clinician.

Chlorhexidine allergy due to topical application.

Chlorhexidine is commonly used in dentistry in various forms. Allergic reactions to chlorhexidine of both immediate and delayed type have been reported. Although the incidence is low there may be severe manifestations in some patients. This report presents a case of allergy to chlorhexidine following topical application.

Customised attachments retained cheek plumper prosthesis: a case report.

Emphasis on facial esthetics has become an integral part of dental treatment. Prosthetic rehabilitation of a completely edentulous patient no longer confines to only replacement of missing teeth. Patients are increasingly demanding improvement in esthetics at the end of treatment. Slumped or hollow cheeks can add years to a person's age. This article has described a simple, effective and noninvasive treatment alternative to improve facial appearance in a completely edentulous patient with hollow cheeks by making use of detachable plumper prosthesis using customised attachments.

Custom sectional impression trays with interlocking type handle for microstomia patients.

Making impressions in microstomia patients is often cumbersome. A modification of standard impression procedure is often necessary while treating such patients. This article describes the fabrication of a custom sectional impression tray with interlocking type of a handle for definitive impression procedures in a microstomia patient.