Evaluation of the quality of life of patients with maxillofacial defects after prosthodontic rehabilitation: A cross-sectional study.

Context: Oral cancer surgery leads to hard- and soft-tissue loss which can affect the quality of life of the individuals. Maxillofacial prosthodontics focuses on optimizing the disrupted oral function of individuals whose rehabilitation will serve as a psychosocial therapy. Aim: The aim of this study was to assess the oral health-related quality of life (OHRQoL) after the maxillofacial prosthetic rehabilitation following cancer resection surgery. Settings and Design: The sample comprised 15 oral cancer patients who agreed to maxillofacial prosthesis (MFP) after surgery. Materials and Methods: Oral function and OHRQoL were evaluated pre- and postmaxillofacial prosthetic rehabilitation. The masticatory function, swallowing function, and articulatory function were evaluated. The OHRQoL was evaluated by OHIPJ-14 questionnaire. Descriptive methods such as frequency, percentage, mean, and standard deviation were calculated. Statistical Analysis: Descriptive statistics was used to analyze the results. Results: A statistically significant difference was observed between prescores and postscores of dysphagia score (P = 0.05) and OHIP-J14 score (P = 0.00). No statistically significant differences were evident in perceived chewing ability (P = 0.29) and intelligibility score (P = 0.43). A statistically significant difference was evident in the prescore and postscore of OHIP-J14 subscales: functional limitations (P < 0.05), physical pain (P < 0.05), psychological discomfort (P < 0.05), physical disability (P < 0.05), psychological disability (P < 0.05), and handicap (P < 0.05), before and after maxillofacial prosthetic treatment except for social disability (P > 0.05). Conclusion: OHRQoL significantly improved with maxillofacial prosthetic rehabilitation.

Influence of presence or absence of posts on the failure rates of post endodontic restorations: A systematic review and meta-analysis.

Aim: The study was designed to evaluate the existing evidence on the failure rates of post-endodontic restorations retained with and without post in endodontically treated teeth (ETT). Settings and Design: Preferred Reporting Items for Systematic Reviews and Meta-Analyses- Protocol (PRISMA-P) guidelines were used to formulate the review. Materials and Methods: Randomized controlled trials (RCT's) and prospective clinical studies comparing post endodontic restorations retained with and without post were included. PubMed/Medline, Embase, Cochrane Library and Scopus databases were searched to recognize relevant full-text articles in English language. The quality of the RCT's were evaluated using the Cochrane collaboration tool to assess the risk of bias and reported as having high, low or unclear risk. Random-effects model at a 95% confidence interval was used for the meta-analysis. Statistical Analysis Used: Meta-analyses was performed using the Mantel -Haenszel method31 and risk ratio, with a 95% confidence interval (CI), was estimated for dichotomous data. Random effects model32 was used as the pooling method and 95% confident interval (α = .05 for RR values) in Review Manager (RevMan) [Computer program]. Version 5.4. The Cochrane Collaboration, 2020). Results: Four studies comparing post retained and post free restorations in ETT with a total of 916 restorations were included in the analysis. The total risk ratio was 2.16, (95% CI:1.25 to 3.72). Conclusion: ETT with post retained restorations exhibited significantly lower failure rates compared to restorations without post. Well-designed RCT's are warranted to develop a clinical protocol with respect to post-retained restorations.

Comparative evaluation of flow profile of commercially available vinyl polysiloxane impression materials - An in-vitro study.

Background: Flow characteristics of vinyl polysiloxane (VPS) impression materials are important determinants in the selection of impression materials for the fabrication of accurate indirect restorations. Aims: : The purpose of this study was to determine the flow of three commercially available VPS impression materials at different time intervals using a shark fin device (3M ESPE, Seefeld, Germany). Study Setting and Design: This in-vitro study was carried out at the prosthodontics department of a dental institution. Methods and Material: The height of the shark fin produced by each impression material determined the rate of flow. Statistical Analysis: The data were analysed using one-way analysis of variance (ANOVA) and post-hoc Tukey's test (p-0.05). Results: : Shark fin height of group A VPS impression material was significantly higher at 30 and 120 seconds compared to group B and group C VPS impression materials. Shark fin height produced by group B VPS impression materials at 60 and 90 seconds was significantly higher than the group C VPS impression material but non-significant compared to group A. At 120 seconds, there was no significant difference in the shark fin heights of all the tested materials. Conclusion: All the materials exhibited adequate flow characteristics within clinically acceptable limits.

Rehabilitation of unilateral mastectomy using a hollow breast prosthesis: A clinical case report.

The incidence of breast carcinoma is reportedly the second highest among all carcinomas in Indian women. Depending on the extent of resection, age, general health, and economic condition of the patient, various methods of breast reconstruction using surgery have been reported with success and a superior cosmesis. When the patient is unwilling to opt for surgical reconstruction due to various constraints, an alternative technique must be employed. In such cases, nonsurgical prosthetic reconstruction using maxillofacial silicones is considered the only viable option. This prevents the need for a second surgery and rehabilitates the patient during the decision-making phase for considering a delayed reconstructive surgery. The prosthesis mimics the natural texture, feel, weight, and appearance as its natural counterpart enabling the patient to go about her routine social activities. This case report illustrates an indigenous method of rehabilitation of a unilateral mastectomy case using hollow breast form/prosthesis.

Multidisciplinary Approach for Management of a Patient with Oral Mucosal Malignant Melanoma.

Oral mucosal melanoma is rare and more aggressive than cutaneous melanoma. Hard palate and maxillary alveolar crest are most commonly involved. Multidisciplinary team approach is necessary for successful management of this tumor. The main treatment modality is surgical resection, which usually results in impaired mastication, deglutition, speech, oral competence and significant cosmetic deformity. Here, a rare case of oral mucosal melanoma of mandibular gingiva in a 44-year man is reported, who was treated by en-block mandibular resection followed by adjuvant therapy with high dose interferons (IFN) - 2b. Following two weeks of healing period, prosthetic rehabilitation of the patient was done with an interim removable denture prosthesis, which effectively limited the unfavourable effects of surgery and helped him in resocialisation.

Microbial assessment of dental unit waterlines in an institutional setup in Karnataka, South India.

BACKGROUND AND AIM: Biofilms in dental unit waterlines (DUWLs), suction hoses, and fittings are a potentially significant source of cross-contamination posing significant health risk as these may come into contact with patients during treatment. The purpose of this in vitro study was to identify the spectrum of bacterial flora colonizing the DUWLs and to detect pathogenic microorganisms present in such an environmental niche. MATERIALS AND METHODS: Thirty DUWL samples were collected from in use dental units selected randomly from various clinical departments. Samples were collected from the following devices; 3-in-1 syringe waterline, section of waterline tubing supplying the 3-in-1 syringe, and the air rotor water. The samples were subjected to bacteriological analysis, and all bacterial isolates were tested for their ability to form biofilms. RESULTS: A descriptive analysis of the results obtained was carried out, and it was observed that 7 out of 30 (23.3%) samples collected from DUWL were supplying water of unsatisfactory quality with species of low-pathogenicity bacteria isolated present in significant numbers; four of ten (40%) water supply lines contained bacterial biofilms; and the species with greatest capability to form biofilms were Enterobacter species (spp.). In addition, the results were also subjected to Chi-square test which revealed no statistical difference between the species and the location of collection of samples. CONCLUSION: Within the limitations of this study, it is concluded that DUWLs are not totally free of contamination. Microbial biofilms are a significant source of cross-contamination and cross-infection in the dental clinic environment.

Evaluation of effect of recasting of nickel-chromium alloy on its castability using different investment materials: An in vitro study.

CONTEXT: Castability has been found to be affected by many aspects of the entire casting system. Very few references in dental literature are available regarding recasting of the base metal alloys. AIMS: To evaluate and compare the castability of fresh and reused nickel-chromium alloy and to evaluate the effect of two brands of investment materials on castability of nickel-chromium alloy. SUBJECTS AND METHODS: For the experimental purpose of evaluation of the effect of recasting of nickel-chromium alloy on its castability, different percentages of new and casted alloy (Nickel-chromium alloy-(Wirolloy NB, Type 4 (Ni-67%; Cr-25%; Mo-5%; Si-1.5%; Mn, Nb, B, C each <1%) and two commercial brands of investment materials namely, Deguvest Impact (Degudent; Dentsply Germany) and Bellavest SH (Degudent; Dentsply Germany) was used to obtain 30 samples. Castability value was obtained using Whitlock's formula. Student t-test and one way ANOVA using SPSS 20.0 software was done. RESULTS: The results of this study confirm earlier works that demonstrate that there is no significant difference in castability values of new and recast alloys. In addition, it also demonstrated, there was no difference in castability using Deguvest Impact and Bellavest SH investment materials. CONCLUSIONS: Within the limitations of the study, it was concluded that there was no significant difference found in castability of different percentage combinations of new and once casted alloy using two investment materials. The addition of new alloy during recasting to maintain the castability of nickel-chromium alloy may therefore not be required.

Comparative evaluation of antifungal action of tea tree oil, chlorhexidine gluconate and fluconazole on heat polymerized acrylic denture base resin - an in vitro study.

OBJECTIVE: Candida albicans-associated denture stomatitis is the most common type of denture stomatitis seen in denture wearers. This study evaluates and compares the antifungal action of fluconazole, chlorhexidine gluconate and tea tree oil on heat-polymerised denture base resin, which has been previously contaminated with C. albicans grown in BHI broth. MATERIAL AND METHODS: Seventy-five specimens were immersed in BHI broth previously inoculated with C. albicans and stored for 3 h at 37°C. They were divided into five groups (n = 15): G1: 2% chlorhexidine solution; G2: 100% pure pharmaceutical grade tea tree oil; G3: 65 µg/ml fluconazole solution; C1: specimens not disinfected; C2: specimens not contaminated with Candida. Each specimen was then transferred to individual tubes containing BHI broth and incubated for 24 h. Culture media turbidity was evaluated for absorbance over a period of 14 days using a microplate reader. It was observed that the lower the absorbance, the stronger the antimicrobial action. Statistical analysis was performed (two-way anova and Bonferroni test, p < 0.001). RESULTS: Chlorhexidine and tea tree oil inhibited Candida up to the 14th day, whereas antifungal effect of fluconazole was not significant after the 7th day. CONCLUSION: Tea tree oil and chlorhexidine gluconate are more effective than fluconazole in inhibiting C. albicans growth on heat-polymerised acrylic resin.

Multidisciplinary approach for management of a patient with fibrous dysplasia of maxilla.

Fibrous dysplasia is a non-neoplastic hamartomatous developmental fibro-osseous lesion of bone. Monostotic fibrous dysplasia is more common than the polyostotic form and usually involves jaw bones, ribs and femur. Maxillary lesions may extend to involve the maxillary sinus, zygoma, sphenoid bone and floor of the orbit and require surgical intervention resulting in an acquired defect of the involved site. A multidisciplinary team approach involving an oral pathologist, oral surgeon, oral medicine expert and maxillofacial prosthodontist is required for successful treatment and rehabilitation of such patients. This article describes a case of a patient with fibrous dysplasia of the left maxilla, which was successfully managed by integrating surgical intervention and postoperative rehabilitation, with a surgical obturator and an interim partial denture prosthesis that successfully limited the detrimental effects of surgery, and helped the patient in resocialisation, thereby improving her quality of life.

Prosthodontic status and needs of elderly institutionalized residents in Mangalore: a prospective study.

AIM: The aim of the present study is to assess the prevalence of Kennedy's classification, status of existing prosthodontic appliances if any, awareness of the subjects regarding various treatment options, and treatment needs in a group of elderly institutionalized residents. MATERIALS AND METHODS: The subjects were selected from various old age homes present in Mangalore city, with ages ranging from 60 to 80 years. The subjects were interviewed and examined by a single trained examiner and findings were recorded on a clinical case history report sheet. RESULTS: Kennedy's class I was most prevalent and class IV the least. Among the subjects examined, only 12.4% were wearing prosthesis. Based on the Nevalainen's index and Karslon's index, most of the prosthodontic appliances were found to be in poor condition. 86% of the subjects were in need of prosthodontic treatment. 75% of the subjects interviewed were unaware of the treatment options available. CONCLUSION: The elderly patients living in institutions do not achieve a deserving and satisfactory oral health care. The oral care assistance in institutionalized elderly patients has been an unfulfilled service.

Resilient liners: a review.

Resilient liners when used intelligently are an excellent adjunct in removable prosthodontics. However, currently they have to be best considered as temporary expedients because none of the advocated permanent liners have life expectancy comparable to resin denture base. This article reviews the literature regarding their composition, functions, gelation characteristics, bond strength and influence on denture bases. It also presents their drawbacks and attempts made to extend their longevity. A Medline search was completed for the period from 1986 to 2007, along with a manual search, to identify pertinent English peer-reviewed articles and textbooks.

Dental implications of bisphophonate-related osteonecrosis.

OBJECTIVES: The aim is to explore the current theories about clinical , pathological and dental management of bisphosphonate related osteonecrosis of the jaws. Also discussed are the actions of bisphosphonates, pathogenesis related to the susceptibility of jaws, the predisposing risk factors for the development of bisphosphonate-related osteonecrosis of the jaws (BRONJ) and diagnostic criteria based on the literature review. DISCUSSION: Osteoporosis is a disease that generally affects the mineral status of both cortical and trabecular bone in post menopausal women. Bisphosphonates are a group of drugs that preserve and increase bone mass. Bisphosphonate drugs are classified according to use and method of delivery. The bisphosphonates used for the treatment of osteoporosis are taken orally. Little is known about the side effects and dangers of the long-term use of therapeutic doses of Bisphosphonates. A recent complication reported is osteonecrosis of jaws. The use of IV bisphosphonates for multiple myeloma and metastatic bone diseases suggests that dosage, length of treatment, and route of administration, as well as cofactors such as use of glucocorticoids and immunosuppressive agents, and dental surgery, could all be related to the incidence of BRONJ. This review provides an update on current knowledge about clinical, pathological and management aspects of BRONJ. CONCLUSIONS: Little evidence exists to direct the prosthodontic management of patients with a history of bisphosphonate use. Patients with active osteonecrosis related to bisphosphonate use have reduced tissue tolerance to function with removable prostheses and decreased potential for osseointegration of dental implants. Decisions should be based on clinical judgment tempered by the presenting conditions, medical profile, and patient needs. A better understanding would help in a dental setting to prevent any complication and help to improve the prognosis for those being treated for osteoradionecrosis.Until further evidence emerges regarding management of patients with active bisphosphonate- related osteonecrosis, conservative prosthodontic treatment is reasonable and prudent.

Evaluation of satisfaction with masticatory efficiency of new conventional complete dentures in edentulous patients--a survey.

BACKGROUND: Knowing how patients really feel after treatment is, very often, as relevant as the success rate of the conventional dentures and it can even be the measurement of masticatory function. AIM AND OBJECTIVES: This questionnaire survey aimed to analyse the satisfaction level and masticatory efficiency of patients treated with conventional complete dentures. DESIGN AND SETTING: Thirty edentulous patients were considered in the study. Satisfaction level and masticatory efficiency were analysed based on specific questionnaires for edentulous patients and by a likert rating scale from 0 to 5, at three moments: Prior to treatment (edentulous period), after the insertion of the new dentures and at 30-45 days follow-up. MATERIALS AND METHODS: Thirty patients including 12 male and 18 female patients (mean age 65 years), who voluntarily came for the services. T-test was applied at three different levels. RESULTS: The rehabilitation with conventional complete dentures produced an improvement (p < 0.05) in satisfaction level and masticatory efficiency. CONCLUSION: Thus, those patients who were edentulous previously and dissatisfied with their masticatory ability showed improvement after receiving a new set of conventional complete dentures.

Prosthetic rehabilitation of a patient after partial rhinectomy: a clinical report.

Carcinoma of the nasal vestibule often requires radical surgical excision, which results in total or partial loss of the nose followed by radiation therapy. A noninvasive, cost-effective technique for rehabilitation of a patient with squamous cell carcinoma of the nasal vestibule following partial rhinectomy and radiation therapy using heat-polymerizing clear acrylic resin is presented.

Pin hole nasal prosthesis: a clinical report.

Atrophic rhinitis is a debilitating nasal mucosal disease characterized by foul-smelling discharge of crusts and enlargement of the nasal cavity. Numerous surgical and nonsurgical methods have been advocated for its treatment. This article describes a noninvasive technique for partial occlusion of the dilated nasal cavity in a patient with atrophic rhinitis by use of a pinhole nasal prosthesis made from clear acrylic resin.