Restoration of large cranial defect for cranioplasty with alloplastic cranial implant material: a case report.

Cranial defects result either from trauma or after intentional osteocraniotomies or external decompression craniectomies. These defects occur most frequently during wartime, but their incidence during peacetime, as a result of accident or disease, makes knowledge of cranioplasty useful to the interested practitioner. Most cranial defects will have some variable proportion of cosmetic and mechanical aspects, and the decision regarding cranioplasty must be influenced by the patient's age, prognosis, activity level and the specific conditions of the scalp and calvarium. This case report is oriented towards post-traumatic restoration of large cranial defect with alloplastic heat-cure poly methyl methacrylate resin material.

Influence of Life Style Factors on Oral Potentially Malignant and Malignant Disorders: A Cross Sectional Study.

The incidence of oral cancer has risen in the past decades and is usually recognised when symptomatic and at a late stage. A premalignant lesion is like smoldering volcano, which if not taken care of, may erupt, often with disastrous consequences. Early detection is therefore very important to reduce morbidity and mortality. A descriptive cross-sectional study was done to assess the prevalence, clinical presentation, and association of various addiction habits in the patients who presented with potentially malignant and malignant lesions of the oral cavity in outdoor clinics of ENT and HNS department of a tertiary care center in Jaipur (Rajasthan). 351 patients of different oral mucosal lesions were examined from August 2019 to January 2020 among which 173(49.2%) patients of potentially malignant and malignant lesions comprise the study group. Clinical findings and detailed history including addiction habits with frequency and duration were noted. Cytological and histopathological examinations were done to conclude the diagnosis. Out of 173 patients of the study group, 146(84.4%) were diagnosed with potentially malignant lesions (PMLs) and 27(15.6%) with malignant lesions (MLs). The most prevalent PML was Oral submucous fibrosis (23%) followed by leukoplakia (7.6%). The most common involved site was buccal mucosa (45.0%) followed by the tongue (26.5%). Tobacco consumption was the most prevalent addiction habit (80%) in the study group. High prevalence of tobacco abuse in patients with potentially malignant and malignant lesions suggested a strong relationship between two. It necessitates adequate awareness in the general population as well as early detection and management of these lesions by an expert Otolaryngologist.

Alteration of Smell and Taste Sensations in Covid-19 Positive Patients: A Prospective Cohort Study in Western India.

Loss/alteration of Smell and taste sensation is common in CoViD-19 infection. We conducted present study to find out the frequency, onset and severity of these lost sensations and their recovery in mild, moderate and severe COVID 19 positive patients in our setup. A questionnaire based study on 574 COVID-19 positive patients admitted in a dedicated COVID hospital between September-November, 2020 were followed up until their sensations recovered completely or maximum for two months. Fever was the most common symptom reported. Loss of smell and taste sensation is seen in 200 (34.84%) and 269 (46.86%) patients respectively; 163 (28.4%) developed both. Males were affected significantly more than females (p = 0.030 and 0.027). Approximately 1/4th patients [49 (24.5%) and 55 (20.45%)] reported loss of smell and taste sensation as their first symptom. Most common taste sensation lost was salty 191 (71.0%). Loss of smell sensation is seen maximally in mild cases and the difference among mild, moderate and severe cases is statistically significant (p = 0.00001); while the difference in loss of taste among all three grades of severity is statistically insignificant (p = 0.0770). Most of the patients [smell (142; 71%) and taste (198; 73.6%)] recovered after 2 weeks of onset of lost sensations while 96.5% (193/200) and 98.1% (264/269) patients reported complete recovery of smell and taste sensations after two months of onset. Present study shows that high percentage of COVID-19 positive patients develop loss of either one or both of smell and taste sensations but recovery is fast and complete in most of them.

Modern trends in modeling of extra-oral defects.

Maxillofacial prostheses are usually fabricated on the basis of conventional impressions and techniques. The extent to which the prosthesis reproduces normal facial morphology depends on the clinical judgment and skill of the individual fabricating the prosthesis. Recently, as a result of advances in technology, various computer-aided design and manufacturing techniques have been successfully introduced for the automated fabrication of maxillofacial prostheses. These systems are able to provide more consistently accurate reproduction of facial morphology.

Recreating an esthetically and functionally acceptable dentition: a multidisciplinary approach.

Patients today demand a youthful, attractive smile with comfortable functional acceptance. The complete oral rehabilitation of patients with a functionally compromised dentition frequently involves a multidisciplinary approach and presents a considerable clinical challenge. To a great extent, proper patient selection and careful interdisciplinary treatment planning, including acknowledgment of the patient's perceived needs, reasons for seeking services, financial ability, and socioeconomic profile, can govern the predictability of successful restorations. This clinical report describes a successful interdisciplinary approach for the management of a severely worn dentition with reduced vertical dimension of occlusion. Treatment modalities included periodontal crown lengthening procedures, endodontic treatment followed by post and core restorations, and prosthetic rehabilitation for severe tooth surface loss and reduced vertical dimension of occlusion comprising metal-ceramic restorations in esthetic zones and full-metal restorations in posterior regions.

A comparative study to evaluate the discrepancy in condylar guidance values between two commercially available arcon and non-arcon articulators: a clinical study.

AIM: The purpose of this study was comparative evaluation of sagittal condylar values of arcon and non-arcon articulators with cephalometric readings and to determine the amount of discrepancy in sagittal condylar guidance values between arcon and non-arcon articulators using same protrusive record. MATERIALS AND METHODS: Twenty subjects in the age group of 19-35 years, free from temporomandibular joint dysfunction, and occlusal disharmony, with healthy dentition participated in the study. Hanau H2 (non-arcon type) and Hanau Wide-Vue (arcon type) articulators were programmed for sagittal condylar guidance values using the same protrusive record made in polysiloxane bite registration material with edge to edge degree of protrusion. The resultant values for both the articulators on either side were compared with values obtained from tracing of digital lateral cephalogram using Kodak Dental imaging Window software 6.6.3.0-C program. The tabulated data were subjected to statistical analysis, ANOVA (Fishers 'F' test) for group comparison, Tukey's HSD test for inter-comparison, student's unpaired 't' test for intra-group comparison, and level of significance (P) was calculated using the same. RESULTS: The mean sagittal condylar guidance values of the three different groups were found to be very highly significant (P=0.001) and highly significant (P=0.002) on the right and left sides respectively. There was a very highly significant difference (P=0.001) and highly significant difference (P=0.003) between the arcon and non-arcon group on the right and left side respectively. No significant difference was found between the arcon and cephalometric group (P=0.284 right, P=0.853 left) and a statistically significant difference was found between the non-arcon and cephalometric group (P=0.049 right, P=0.015 left). On intragroup comparison there was no statistically significant difference in sagittal condylar values on the right and left sides. CONCLUSION: The mean difference in the sagittal condylar guidance values obtained from non-arcon and arcon articulators shows a low level of reproducibility, and no significant difference found in mean sagittal condylar values obtained from arcon articulator and cephalometric tracings indicates replication of sagittal condylar guidance value from image of articular eminence.

Prosthetic rehabilitation of large nasal septal defect with an intranasal stent: a clinical report.

Nasal septal perforation is a common complication of many nasal diseases such as congenital, infectious, trauma, and iatrogenic, and rarely may occur as a complication of systemic diseases, etc. The symptoms of uncorrected nasal septal perforations include crusting, epistaxis, difficulty in breathing, nasal twang in speech, postnasal discharge, foul-smelling, rhinorrhea, and hyposmia. Large nasal defects cannot be closed by hard acrylic resin nasal septal obturators because of the problems in access and path of insertion. However, obturation can be achieved by fabrication of a nasal stent that engages one of the nasal cavities. This clinical report describes prosthetic management of a patient with large nasal septal defect following septal surgery complication with an intranasal heat-processed acrylic resin stent. The stent is rendered patent for comfortable breathing, improves speech, is esthetically acceptable, dense and hygienic. These nasal stents indirectly separate the two nasal cavities with effective obturation of large nasal septal defects.