Evaluation of the effect of chemical disinfection and ultraviolet disinfection on the dimensional stability of polyether impression material: an in-vitro study.

BACKGROUND: Various methods, chemical and physical, disinfect dental impressions. Common chemicals include 1% Sodium Hypochlorite and 2% glutaraldehyde, while UV radiation is a prevalent physical method. Few studies compare their effects on dimensional stability in polyether impressions. This study aims to assess such stability using different disinfection methods. Therefore, this study was planned to evaluate the dimensional stability of polyether impression material using different disinfection methods. METHODS: This in vitro study compared the effects of chemical disinfectants (1% Sodium Hypochlorite and 2% glutaraldehyde) and UV irradiation on the dimensional stability of polyether impression material. Groups A, B, C, and D, each with ten samples (N = 10), were studied. Group A was untreated (control). Group B was treated with 2% glutaraldehyde for 20 min, Group C with 1% Sodium Hypochlorite for 20 min, and Group D with UV rays for 20 min. A pilot milling machine drill was used to make four parallel holes labeled A, B, C, and D in the anterior and premolar regions from right to left. After sequential drilling, four implant analogs were positioned using a surveyor for accuracy. Ten open-tray polyether impressions were made and treated as described in the groups, followed by pouring the corresponding casts. Distortion values for each disinfection method were measured using a coordinate measuring machine capable of recording on the X- and Y-axes. RESULTS: A comprehensive analysis was conducted using the one-way ANOVA test for distinct groups labeled A, B, C, and D, revealing significant differences in the mean distances for X1, X2, X4, X5, and X6 among the groups, with p-values ranging from 0.001 to 0.000. However, no significant differences were observed in X3. Notably, mean distances for the Y variables exhibited substantial differences among the groups, emphasizing parameter variations, with p-values ranging from 0.000 to 0.033. The results compared the four groups using the one-way ANOVA test, revealing statistically significant distance differences for most X and Y variables, except for X3 and Y4. Similarly, post-hoc Tukey's tests provided specific pairwise comparisons, underlining the distinctions between group C and the others in the mean and deviation distances for various variables on both the X- and Y-axes. CONCLUSIONS: This study found that disinfection with 1% sodium hypochlorite or UV rays for 20 min maintained dimensional stability in polyether impressions.

A Lab-Based Study to Assess the Surface Roughness of Various Investments: An Original Research.

Introduction: Surface roughness of the crowns is dependent on the pattern material used for the making as well as the procedure of investing. The study was aimed to examine the impact of various pattern materials and investment procedures on the surface roughness of nickel-chromium alloy raw castings. Materials and Methods: An in-vitro study was piloted at a tertiary care hospital. Eighty samples of inlay wax and pattern resin were divided equally. They were invested in phosphate-bonded investment material and kept under normal atmospheric pressure as well as invested under a pressure of 3 bars. The surface roughness was calculated with a Profilometer. The values obtained were compared using statistical tools keeping P < 0.05 as significant. Results: Lowest surface roughness was seen for the wax pattern invested under positive pressure. While the highest was seen for the resin patterns invested at room pressure. A significant variance between the wax 1 and wax 2 (P < 0.01); as well as between the wax 2 vs. Resin 2 specimens (P < 0.01) was noted. Conclusions: Wax patterns can be suggested as the material and method of choice because they showed the least amount of surface roughness when placed under pressure. Resin patterns when invested under pressure can also be suggested as an alternate as they also exhibited similar surface roughness as that of the wax.

Finite element analysis of stress distribution on residual root structure in socket shield procedure following immediate dental implant placement: an in vitro study.

BACKGROUND: The success of implants in the socket shield technique relies on stress experienced by root fragments within the socket. Although there is no consensus on optimal root fragment thickness, varying thicknesses and dynamic implant placement induce stress in various directions and degrees. This study aimed to assess biomechanical response and stress distribution across different root fragment thicknesses in the socket shield procedure. METHODS: This in vitro study was conducted to assess and compare the stress distribution on residual root structures of varying thicknesses positioned within the labial aspect of the maxillary incisor socket during immediate implant placement of standard dimensions. The procedure involved applying an insertional torque of 40 Ncm, and the analysis was conducted using finite element analysis software. RESULTS: Utilizing the Numerical Technique with Abaqus software for explicit dynamics, von Mises stress and principal strain were analyzed on the root structure and bone under nonlinear contact conditions during implant torque application. For Model A, a loading torque of 40 Ncm was applied vertically on the implant, along with a horizontal force of 20 N on the root structure and bone. Results indicated maximum stress of 12.68 MPa on the root structure with a thickness of 0.5 mm and 5.61 MPa on the bone, with principal strains of 6.82E-03 and 4.10E-03, respectively. In Model B, with a root structure thickness of 1.0 mm, the maximum stress increased to 19.70 MPa, while the bone stress rose to 9.51 MPa, with principal strains of 1.03E-02 and 6.09E-03. Model C, with a root structure thickness of 1.5 mm, exhibited a maximum stress of 21.58 MPa on the root and 10.12 MPa on the bone, with principal strains of 1.16E-02 and 6.10E-03. Lastly, in Model D, with a root structure thickness of 2.0 mm, the maximum stress on the root structure and bone escalated to 28.74 MPa and 11.38 MPa, respectively, with principal strains of 1.55E-02 and 8.31E-03. CONCLUSIONS: As the thickness of the shield increases (ranging from 0.5 to 2 mm) in socket shield procedures with immediate implant placement, both stress on the root fragment and bone and principal micro-strain escalate. However, employing a shield thickness within the range of 0.5 to 2 mm does not lead to any adverse stress generation on the residual root fragment. However, for enhanced safety, it is recommended to restrict the maximum diameter and extension of the root fragment to 1.5 mm when considering implant sizes and socket diameter for the socket shield technique.

The effectiveness of botulinum toxin for temporomandibular disorders: A systematic review and meta-analysis.

OBJECTIVE: The current body of research on utilizing botulinum toxin (BTX) to manage temporomandibular disorders (TMDs) has not yet yielded definitive conclusions. The primary objective of this study was to determine the effectiveness of BTX in pain reduction for TMDs compared to placebo and other treatments. The secondary outcomes evaluated were adverse events, maximum mouth opening, bruxism events, and maximum occlusal force. MATERIALS AND METHODS: A literature search was performed on PubMed, Dimension Publication, Scopus, and Google Scholar. The RoB 2 tool was used for quality assessment. The mean differences in pain scores were estimated to measure the effect of BTX on pain reduction. For adverse events, the risk ratio for the incidence of side effects was calculated. RESULTS: Two hundred and sixty non-duplicate articles were identified; however, only 14 RCTS were included in this review. The total study population included 395 patients. The overall risk of bias showed a low to moderate quality of evidence. Results from 6 studies were reported only narratively; four studies were used for meta-analysis on pain reduction, and five were used for meta-analysis on adverse events. The control used in the meta-analysis was placebo injections. Results of the meta-analysis for pain reduction were statistically insignificant for the BTX group with mean differences at MD = -1.71 (95% CI, -2.87 to -0.5) at one month, -1.53 (95% CI, -2.80 to -0.27) at three months, and -1.33 (95% CI, -2.74 to 0.77) at six months. This showed that BTX treatment was not significantly better than placebo for a reduction in pain scores at 1, 3, and 6 months. Regarding safety, the placebo group showed a relative risk of 1.34 (95%CI, 0.48-6.78) and 1.17 (95%CI, 0.54-3.88) at 1 and 3 months respectively. However, the risks were not statistically significant. There was also no difference in the effectiveness of BTX compared to placebo and other treatments for maximum mouth opening, bruxism events, and maximum occlusal force. CONCLUSION: BTX was not associated with better outcomes in terms of pain reduction, adverse events, maximum mouth opening, bruxism events, and maximum occlusal force. More high-quality RCTs are needed to better understand this topic.

Comparative analysis of different types of occlusal splints for the management of sleep bruxism: a systematic review.

BACKGROUND: Sleep bruxism is a prevalent condition in dentistry practice, characterized by involuntary grinding or clenching of the teeth during sleep. Several therapies, including occlusal splints, have been used to manage sleep bruxism and temporomandibular disorders, including occlusal splints. This study aimed to compare the effectiveness of different occlusal splints in managing sleep bruxism. METHODS: The PICO framework encompasses the characterization of the population, intervention, comparison, and pertinent outcomes. A comprehensive and systematic literature review was conducted on PubMed, Scopus, and Google Scholar to identify grey literature. The search specifically targeted scientific studies published before September 20, 2023. The Cochrane Collaboration Risk of Bias Tool assessed the accuracy of the included Randomized Control Trials (RCTs). The modified Newcastle-Ottawa Scale assessed non-randomized studies. Data were systematically extracted, synthesized, and reported thematically. RESULTS: Out of the total of 808 articles that were evaluated, only 15 articles were found to meet the specified inclusion criteria. Adjustable splints, such as full-occlusion biofeedback splints, were more effective in reducing sleep bruxism episodes, improving patient-reported symptoms, and enhancing overall well-being. The impact of different occlusal sprints on electromyographic activity varies, and potential adverse effects should be considered individually. CONCLUSIONS: This review provides valuable insights into the effectiveness of occlusal splints in managing sleep bruxism. The results of this study indicate that occlusal splint therapy is a viable treatment approach for sleep bruxism.

The flexural strength of 3D-printed provisional restorations fabricated with different resins: a systematic review and meta-analysis.

BACKGROUND: Three-dimensional (3D) printing technology has revolutionized dentistry, particularly in fabricating provisional restorations. This systematic review and meta-analysis aimed to thoroughly evaluate the flexural strength of provisional restorations produced using 3D printing while considering the impact of different resin materials. METHODS: A systematic search was conducted across major databases (ScienceDirect, PubMed, Web of Sciences, Google Scholar, and Scopus) to identify relevant studies published to date. The inclusion criteria included studies evaluating the flexural strength of 3D-printed provisional restorations using different resins. Data extraction and quality assessment were performed using the CONSORT scale, and a meta-analysis was conducted using RevMan 5.4 to pool results. RESULTS: Of the 1914 initially identified research articles, only 13, published between January 2016 and November 2023, were included after screening. Notably, Digital Light Processing (DLP) has emerged as the predominant 3D printing technique, while stereolithography (SLA), Fused Deposition Modeling (FDM), and mono-liquid crystal displays (LCD) have also been recognized. Various printed resins have been utilized in different techniques, including acrylic, composite resins, and methacrylate oligomer-based materials. Regarding flexural strength, polymerization played a pivotal role for resins used in 3D or conventional/milled resins, revealing significant variations in the study. For instance, SLA-3D and DLP Acrylate photopolymers displayed distinct strengths, along with DLP bisacrylic, milled PMMA, and conventional PMMA. The subsequent meta-analysis indicated a significant difference in flexure strength, with a pooled Mean Difference (MD) of - 1.25 (95% CI - 16.98 - 14.47; P < 0.00001) and a high I2 value of 99%, highlighting substantial heterogeneity among the studies. CONCLUSIONS: This study provides a comprehensive overview of the flexural strength of 3D-printed provisional restorations fabricated using different resins. However, further research is recommended to explore additional factors influencing flexural strength and refine the recommendations for enhancing the performance of 3D-printed provisional restorations in clinical applications.

Attenuation of orthodontically induced inflammatory root resorption by using low-intensity pulsed ultrasound as a therapeutic modality- a systematic review.

Ultrasound is an effective tool for both diagnostic and therapeutic applications. As an imaging tool, ultrasound has mostly been used for real-time noninvasive diagnostic imaging. As ultrasound propagates through a material, a reflected radio-frequency (RF) signal is generated when encountering a mismatch in acoustic impedance. While traditionally recognized for its diagnostic imaging capabilities, the application of ultrasound has broadened to encompass therapeutic interventions, most notably in the form of Low-Intensity Pulsed Ultrasound (LIPUS). Low-Intensity Pulsed Ultrasound (LIPUS) is a form of mechanical energy transmitted transcutaneously by high-frequency acoustic pressure waves. The intensity of LIPUS (30 mW/cm2) is within the range of ultrasound intensities used for diagnostic purposes (1-50 mW/cm2) and is regarded as non-thermal, non-destructive, permeating living tissues and triggering a cascade of biochemical responses at the cellular level. The LIPUS device produces a 200 µs burst of 1.5 MHz acoustic sine waves, that repeats at a modulation frequency of 1 kHz and provides a peak pressure of 30 mW/cm2. Low-intensity pulsed ultrasound (LIPUS) forms one of the currently available non-invasive healing-enhancing devices besides electro-stimulation (pulsed electro-magnetic field, PEMF). This modality has been leveraged to enhance drug delivery, expedite injury recovery, improve muscle mobility, alleviate joint stiffness and muscle pain, and enhance bone fracture healing. Although LIPUS has been embraced within various medical disciplines, its integration into standard dental practices is still in its nascent stages, signifying an unexplored frontier with potentially transformative implications. Low-intensity pulsed ultrasound (LIPUS) has emerged as an attractive adjuvant therapy in various dental procedures, such as orthodontic treatment and maxillary sinus augmentation. Its appeal lies in its simplicity and non-invasive nature, positioning LIPUS as a promising avenue for clinical innovation. One particular area of interest is orthodontically induced inflammatory root resorption (OIIRR), an oftenunavoidable outcome of the orthodontic intervention, resulting in the permanent loss of root structure. Notably, OIIRR is the second most common form of root resorption (RR), surpassed only by root resorption related to pulpal infection. Given the high prevalence and potential long-term consequences of OIIRR, this literature review seeks to evaluate the efficacy of LIPUS as a therapeutic approach, with an emphasis on assessing its capacity to reduce the severity of OIIRR to a level of clinical significance. To conduct this systematic review, a comprehensive automated literature search was executed across multiple databases, including MEDLINE, Embase, PsycINFO, Web of Knowledge, Scopus, CINAHL, LILACS, SciELO, Cochrane, PubMed, trials registries, 3ie, and Google Scholar. Both forward and backward citation tracking was employed, encompassing studies published from database inception through January 2009 to April 2023. The review focused on randomized controlled trials (RCTs) that specifically evaluated the effects of low-intensity pulsed ultrasound therapy on orthodontically induced inflammatory root resorption (OIIRR), without restrictions of publication date. A stringent selection criterion was applied, and only studies demonstrating high levels of statistical significance were included. Ultimately, fourteen studies met the inclusion criteria and were subjected to further analysis. The overall quality of the included randomized controlled trials (RCTs) was rigorously assessed utilizing the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. This analysis revealed certain methodological limitations that posed challenges in drawing definitive conclusions from the available evidence. Despite these constraints, the review offers invaluable insights that can inform and guide future research. Specifically, it delineates recommendations for targeted populations, necessary interventions, appropriate outcome measures, suitable study designs, and essential infrastructure to facilitate further investigations. The synthesis of these insights aims to enhance the development and application of low-intensity pulsed ultrasound therapy within the field of dentistry, thereby contributing to improved patient outcomes.

Analysis of modified palatal surface for better speech in edentulous patients: A clinico-analytical study.

BACKGROUND: Phonetics with mechanics and aesthetics are considered cardinal factors contributing to the success of complete dentures. OBJECTIVE: The aim of the current study was to evaluate the changes in speech in complete denture patients with and without palatal surface changes. METHODS: The data collected for the study involved completely edentulous Patients (n= 80). Patients were divided into two groups. Group A: Up to 50 years (n= 40); Group B: Above 50 years (n= 40) (including male and female). Each group was further divided into four subgroups for speech analysis-without dentures (A1/B1); with conventional dentures (A2/B2); dentures with a palatogram (A3/B3) and dentures with palate sandblasted (A4/B4). The speech sounds of all patients were evaluated for pitch and intensity using a spectrophotogram (Praat software) and Likert scale. The data so obtained from the quantitative and qualitative analysis were statistically analysed through one-way ANOVA, unpaired student's t-test, and Pearson correlation coefficient. Qualitative analysis was done with the Mann-Whitney U test. RESULTS: The maximum mean value of the pitch and intensity in Groups A and B was subgroup A3 (Palatogram) 190.37 ± 21.50 and 77.07 ± 7.58, B3 (Palatogram) 190.87 ± 24.36 and 75.33 ± 8.12. When comparing Groups A [A1, A2, A3, A4] and B [B1, B2, B3, B4] on the basis of pitch and intensity, a statistically insignificant value was found. No changes in speech sounds (pitch and intensity) were observed in terms of age. Both quantitative and qualitative analysis results showed that speech sounds in the patients with palatogram, had the highest pitch and intensity and were most clear to the listener and there were statistically significant differences from other groups. CONCLUSION: Speech was better in palatogram-based dentures in comparison to a sandblasted denture, conventional denture and without denture in terms of qualitative and quantitative analysis. The physiologic nature of the palatogram fabrication technique produces the palatal part of the denture more compatible with the tongue, thus producing better speech.

Challenges of E-Learning: Behavioral Intention of Academicians to Use E-Learning during COVID-19 Crisis.

The COVID-19 crisis demanded that all educational activities should be performed virtually to follow social distancing guidelines. Therefore, there was a need to perform a research study to assess the effects of external factors on the perceived usefulness, ease of use of e-learning, and the further effect of these perceptions on attitude and intent to use e-learning by using the technology acceptance model (TAM) among academicians at higher education institutions in the Kingdom of Saudi Arabia. METHODS: A cross-sectional study was conducted, and data were collected from 263 academicians across Saudi Arabia through an online survey questionnaire using a non-probability purposive sampling technique and analyzed and tested using the SPSS and Smart PLS software. RESULTS: This study found that self-efficacy was positively associated with perceived usefulness at ß = 0.143 and p < 0.05, but it had no association with perceived ease of use at ß = 0.057 at p > 0.05. System accessibility had a significant and positive relationship with perceived usefulness and perceived ease of use at ß = 0.283, ß = 0.247, and p < 0.01, respectively. Self-efficacy had a positive effect on perceived usefulness, whereas the subjective norm had no relationship with perceived usefulness and perceived ease of use at ß = -0.065 and ß = -0.012 at p > 0.05, respectively. Perceived ease of use and perceived usefulness were positively related to attitude towards use, which has a significant influence on intention to use e-learning. CONCLUSION: Perceived ease of application is the most significant factor (ß = 0.556) in developing the attitude among academicians to practice e-learning, followed by perceived usefulness (ß = 0.262). Moreover, it can be concluded that system accessibility has a stronger influence on developing perception among academicians about the expediency and ease of application of e-learning than self-efficacy.

Clinical Trial to Assess Physiology and Activity of Masticatory Muscles of Complete Denture Wearer Following Vitamin D Intervention.

Background and Objectives: Little information is available on the role of Vitamin D as a micro-nutrient deficiency with masticatory muscle efficiency and its effect on the function of removable prosthesis. The aim of this study was to evaluate the role of vitamin D on masticatory muscle activity among completely edentulous patients and its effect on the retention of removable complete dentures (RCDs). Materials and Methods: A non-randomized clinical control trial was conducted on completely edentulous patients (60.53 ± 7.01 years) in the Indian population between 2017 and 2019. Subjects were evaluated for temporomandibular disorders according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Serum Vitamin D (S Vit D) levels, Ultrasonography (USG), and surface Electromyography (sEMG) readings of the masseter muscle were recorded at enrolment (Level 0), after 3 months of Vitamin D therapy (Level 3), and after consecutive 3 months of maintenance therapy, i.e., after 6 months from baseline (Level 6). The fabrication of new RCDs was done for all after the enrolment, and the retention of RCDs was assessed by asking a question regarding denture retention and asking respondents to mark their satisfaction on a 5-point Likert scale. Data were analysed using ANOVA, Paired'-test and Pearson correlation coefficients. A p-value less than 0.05 indicated a statistically significant association. Results: Between enrolment and a six-month follow-up, S Vit D levels showed an increase from 16.03 ± 5.68 ng/mL to 31.35 ± 9.28 ng/mL, showing an increase of 15.32 ± 9.38 ng/mL (95.57% rise). Statistically significant values were observed for USG and sEMG. Conclusions: Results showed that S Vit D affects masticatory muscle activity by improving its thickness and boosting its tonicity. Healthy muscles assist in the retention of RCDs, consequently aiding in mastication, speech, and phonetics, hence improving patient satisfaction. Clinical implication: Acknowledging the fact that the prevalence of Vitamin D deficiency is worldwide. We suggest Vitamin D therapy as a nutritional intervention among the elderly completely edentulous population, following dietary counselling, and consider Vitamin D therapy to be an adjunct to nutritional counselling for improving masticatory muscle activity and efficiency, which aids in RCD retention and stability. Consequently, improving oral health-related quality of life for individuals.

Comparison of Microleakage in Nanocomposite and Amalgam as a Crown Foundation Material Luted with Different Luting Cements under CAD-CAM Milled Metal Crowns: An In Vitro Microscopic Study.

Microleakage is a persistent problem despite advancement in materials and techniques in fixed prosthodontics. This leads to the importance of sound crown foundation material and luting agents used to maintain the marginal seal. The literature is deficient with studies, comparing microleakage under various crown foundation materials and luting agents, especially with CAD-CAM (computer-aided design and computer-aided manufacturing) metal crowns. This study was aimed to compare microleakage in a nanocomposite/dentinal bonding agent and amalgam/cavity varnish as crown foundation materials luted with two different luting cements: resin-reinforced glass ionomer cement and self-adhesive resin cement, under both dry and contaminated conditions. A hundred intact, caries-free human molars were prepared to receive crown foundation material and extra coronal restorations. Amalgams with cavity varnish and nanocomposites with dentinal bonding agent in both ideal and contaminated conditions were used as crown foundation materials. After restoration, each sample was cemented with a CAD-CAM milled metal crown using two different luting agents-resin-reinforced glass ionomer cement and self-adhesive resin cements both in ideal and contaminated conditions. Cementation was followed by thermocycling of samples, immersion in erythrosine B dye, embedding in clear auto polymerizing acrylic resin and sectioning to evaluate microleakage using stereomicroscope. The mean microleakage between different luting cements on the experimental side of the facial surface was 137.64 µm and 211.01 µm for resin-reinforced GIC and for self-adhesive resin cement was 119.78 µm and 150.42 µm, under ideal and contaminated condition, respectively. There was a significant difference in mean micro-leakage between different crown foundation material and cement groups used in the study. The composites and amalgam, both when used as crown foundation material and luted with use of technically advanced CAD-CAM metal crown with self-adhesive resin cement (in both ideal or contaminated condition), showed less microleakage than in resin-reinforced glass ionomer cement. Overall, the self-adhesive resin cement showed comparatively reduced microleakage in all combinations with different crown foundations. Thus, this combination can be used in daily clinical practice to provide better protection from further decay.

Analysis of surface conditioning methods on core-veneer bond strength of CAD/CAM zirconia restorations.

BACKGROUND: The increased strength of zirconia has resulted in its widespread application in clinical dentistry. Nevertheless, the fracture of veneering porcelains remains one of the key reasons of failure. OBJECTIVE: The objective of this study was to compare and analyze the influence of surface conditioning methods on the core-veneer bond strength of zirconia restorations. METHODS: Thirty specimens of zirconia core with sizes 10 × 5 × 5 mm were layered with porcelain of sizes 5 × 3 × 3 mm. On the basis of different surface conditioning methods, four groups were made: Group I: abrasion with airborne alumina particles of 110 µm size, Group II: sandblasting with silica coated alumina particles of 50 µm in size, Group III (modified group): alteration with a coating of zirconia powder prior to sintering, and Group IV (control group): metal core specimens. The shear force of all specimens was tested using a universal testing machine with a 0.5 mm/min crosshead speed. One-way analysis of variance (ANOVA) and Tukey's post hoc pair wise comparison (p= 0.05) were performed to analyze the shear bond strength. A scanning electron microscope was used to assess the fractured specimens. RESULTS: A statistically significant difference was noted between the groups. The mean value of shear bond strength was 40.25 MPa for Group I, 41.93 MPa for Group II, 48.08 MPa for Group III and 47.01 MPa for Group IV. CONCLUSIONS: The modified zirconia group and control group demonstrated a significantly higher mean bond strength than that of Group I, where airborne particle abrasion was used. The scanning electron microscope showed that cohesive fracture in the porcelain veneers was the main problem of failure in altered zirconia. The modified zirconia specimens in Group III demonstrated significantly improved values of shear bond strength.

Does the quality of residual alveolar bone apical to a periodontal lesion beneath the maxillary sinus play a vital role in preventing the extension of periodontal disease to maxillary sinus? A CBCT-assisted retrospective study.

BACKGROUND: The mucous membrane of the maxillary sinus is sensitivis susceptible to infection or inflammation adjacent to it, which may contribute to mucous membrane thickening (MMT). Residual alveolar bone quality (RABQ) is considered a quality of the remaining bone apical to periodontal defect adjoining to the floor of the maxillary sinus. OBJECTIVE: The current study aimed to analyze the minimum RABQ to prevent the extension of periodontal pathology from reaching maxillary sinus using cone-beam computed tomography (CBCT). METHODS: In this retrospective observational study, 240 sinus exposure CBCT records of 146 patients were evaluated. Patients with at least one sinus exposure were included. RABQ and MMT were calculated using CBCT inbuilt tools. RABQ was divided into four groups based on gray scale values (GSV). Statistical analysis was performed using one way ANOVA and independent sample t-tests. Correlation was completed applying Pearson's correlation coefficient. RESULTS: A significant difference (p< 0.05) was observed between the MMT values of the four RABQ groups. Inverse correlation was observed between mean MMT and GSV values. Mean MMT was higher than pathological MMT range (> 2 mm), with significant differences in groups A and B, where mean GSV values are less than 500. Mean GSV greater than 500 in groups C and D show non-pathological MMT. Prevalence of MMT is 91.4% if GSV is < 500 and 7.5% if GSV is > 500. CONCLUSIONS: Our study suggests that MMT is present if RABQ has GSV values < 500. Maxillary sinusitis and its etiology from periodontal pathology can be excluded based on RABQ adjoining periodontal lesion. Early detection and prompt treatment along with appropriate regenerative protocols can be performed to increase the RABQ. Further microbiological investigation is required to support the present results.

Predoctoral dental implant education techniques-students' perception and attitude.

PURPOSE: Dental implant (DI) therapy is in high demand and can only be rendered efficiently to graduating dentists by effective teaching methodologies. This study aimed to assess the perceptions and attitudes of dental graduates towards predoctoral DI education techniques and rehabilitation by DI. METHODS: A total of 26 well-structured questionnaires were distributed to 120 final-year students. Modified advanced teaching methodologies such as e-learning, small-group teaching-problem-based learning (SGT-PBL), and team-based learning were implemented for teaching DI. Its effects were assessed using a questionnaire set: the first section (DI Rehabilitation) with 12 questions and the second (DI teaching methods) with 14 questions. Statistical analysis was done using the Chi-square test, and a P-value < 0.05 was considered statistically significant. RESULTS: The response rate was 95.83%. Seventy-five percent of the students recommended DI for patients, and 78% of them agreed to it themselves. On comparing teaching methods for DI, on and before level 12, small-group teaching (PBL) was significantly at a higher proportion (P = 0.002), followed by seminars (P < 0.001). Students preferred small-group teaching PBL (60%), followed by e-learning (15%) and demonstration (10%). Ninety-two percent of the students agreed that DI is an important subject in the "bachelor of dental surgery" (BDS) program, but 78% of them felt that time was insufficient to complete the DI syllabus. CONCLUSIONS: The modified teaching methodologies used at level 12 for teaching DI enhanced students' interest and knowledge. The SGT-PBL teaching method was the most preferred. It is recommended that dental implantology topics should be started early in the undergraduate curriculum, and the topics should be widely divided throughout BDS.

Variations in the Compressive Strength of a Die Stone with Three Different Sulfates at Eight Different Concentrations: An In Vitro Study.

AIM: The present study aimed to evaluate the alteration in the compressive strength (CS) of the die stone with three different sulfate salt additives, each at eight various concentrations. MATERIALS AND METHODS: The specimens were prepared at specific dimensions (length: 2.5 cm and diameter: 2.5 cm) divided into three test groups based on the type of sulfate additives used [potassium sulfate (K2SO4), zinc sulfate (ZnSO4·H2O), and manganese sulfate (MnSO4·H2O)] and one control group, without any additives. Again, each group was divided into eight subgroups based on concentration of sulfates (ranging from 0.2% to 4%). A total of 375 specimens were tested. CS (in MPa) was evaluated after 72 hours of drying time, using an universal testing machine. STATISTICAL ANALYSIS: A one-way analysis of variance (ANOVA) was used for intergroup comparisons. Individual comparisons were done using the post hoc Tukey HSD analysis. RESULTS: All the three additives at all the concentrations have shown an inferior resistance to compressive forces when compared to the standard specimen. However, the least mean CS was observed at 0.8% of MnSO4 (10.95 MPa) and the highest was at 1% K2SO4 (25.28%). A highly significant difference (p < 0.001) was observed among the concentrations in all the three groups (K2SO4, MnSO4, and ZnSO4 groups) and F values were derived as 69.84, 24.29, and 130.52, respectively. At each concentration, comparisons between the groups have shown a significant difference (p < 0.05) at almost all concentrations. CONCLUSION: The CS of die stone is shown to be decreased with an increase in all three types of sulfate additives when compared to the control specimen. CLINICAL SIGNIFICANCE: Die stone is an often used gypsum material in the field of dentistry. Compressive strength of the die stone is crucial in prosthetic dentistry; chemical additives such as sulfate salts may increase the CS such that the die stone can withstand clinical and laboratory handling forces. How to cite this article: Vyas R, Vaddamanu SK, Gurumurthy V, et al. Variations in the Compressive Strength of a Die Stone with Three Different Sulfates at Eight Different Concentrations: An In Vitro Study. J Contemp Dent Pract 2019;20(11):1297-1306.

An esthetic modification of a nasal conformer.

Facial contractures caused by burns can collapse the nasal aperture and lead to airway obstruction. Management in such situations requires surgical and prosthetic intervention. Prosthetically, although a nasal conformer is the treatment of choice, even a well-fabricated nasal conformer may be esthetically unappealing and require an aid for enhanced retention. Expensive implant-aided conformers are not always a viable option. This article introduces a technique for fabricating a nasal conformer that is both esthetically appealing and cost-effective. The technique is illustrated by the treatment of a 12-year-old girl who presented with a history of burn injuries leading to nasal contracture that was effectively managed with this concept.

Assessment of Fracture Resistance Capacity of Different Core Materials with Porcelain Fused to Metal Crown: An in vitro Study.

Aim: The aim of the study was to evaluate the capacity to resist fracture in different core buildup materials with porcelain fused to metal (PFM) crown. Materials and methods: Totally, 45 mandibular single rooted first premolars were collected, which were sound along with similar shape and size. The teeth were sectioned at 15 mm above the root apex sparing the sound tooth structure. The teeth were endodontically treated with the crown-down technique using nickel-titanium (NiTi) instrumentation. The specimens were randomized into three groups as per the core materials used and were labeled accordingly. Group I consisted of dual-cured composite resin, group II consisted of glass ionomer reinforced with resin, and group III consisted of Miracle mix. Universal loading machine is used for measuring the compres-sive load applied to fracture the tooth. Results: The mean value of compressive strength was maximum in the dual cured composite resin (598.42 ± 22.64) followed by glass ionomer reinforced with resin (478.88 ± 26.74) and Miracle mix (442.16 ± 30.10). The results showed a significant difference statistically within the core materials used with p < 0.05. The results from the Tukey's post hoc test of multiple comparisons between dual-cured composite resin vs glass ionomer reinforced with resin, dual-cured composite resin vs Miracle mix, and glass ionomer reinforced with resin vs Miracle mix showed a highly statistical difference with p < 0.05, which is significant. Conclusion: This in vitro study showed that the dual-cured composite resin had maximum resistance to fracture compared with other core buildup materials on teeth which were endodonti-cally treated. Clinical significance: Restoration of a tooth which is structurally compromised is a tricky job for all the dentists. Restoring it with a proper core buildup material with adequate fracture resistance makes the tooth structure stable. The core material should be able to resist all types of occlusal forces and to distribute it equally within the tooth structure. Keywords: Core buildup, Crowns, Endodontically treated teeth, Fracture resistance.

Rehabilitation of Nose following Chemical Burn Using CAD/CAM Made Substructure for Implant Retained Nasal Prosthesis: A Clinical Report.

Insufficient knowledge of medical chemicals and their improper use have destructive effects. Accidental exposure to chemicals on facial tissue may result in large facial defect. For ages the tradition of piercing nose is common but improper use of unknown chemical for piercing has deleterious effect. Mostly rhinectomy defects are acquired caused by trauma or malignant diseases. Prosthetic rehabilitation is the preferred treatment of choice for any large rhinectomy defects as medical and surgical interventions are ineffective in developing esthetics. Main concern with the prosthesis for such defects is retention. This article describes rehabilitation of a patient with large size nasal defect created by chemical burn in childhood during piercing. Implant retained customized silicone nasal prosthesis was fabricated using simple O-ring attachments and innovative modified polyamide acrylic resin substructure acting as skeleton.