An in vitro study to compare the surface roughness of glazed and chairside polished dental monolithic zirconia using two polishing systems.

AIM: To evaluate the efficiency of two commercially available polishing systems in reducing surface roughness of a monolithic zirconia after clinical adjustment and to compare them to glazed zirconia. SETTING AND DESIGN: In vitro study. MATERIAL AND METHODS: This in vitro study was conducted on 25 discs (10mm in diameter and 2mm in thickness) using monolithic zirconia (Ceramill Zolid). From 25 specimens, 5 specimens were randomly selected as the positive control. The remaining discs were abraded for 15 secs with a red band diamond finishing bur using an air rotor handpiece. Then the specimens were randomly divided into 5 equal groups of 5 specimens each. Group 1: Roughened, unpolished and unglazed. Group 2 (Positive Control): Glazed without prior roughening,Group 3: Roughened and polished with eZr polishing kit, Group 4: Roughened and polished with Optra fine ceramic polishing kit and Group 5: Roughened and glazed. The surface roughness (Ra) values (µm) were measured quantitatively by a surface analyzer. The mean values were compared using one-way ANOVA and Post Hoc Test. One specimen of each group was evaluated qualitatively under a scanning electron microscope(SEM) for surface topography. STATISTICAL ANALYSIS USED: One-way ANOVA and Post Hoc Test. RESULTS: The lowest Ra value was found in Group 4-Roughened and polished with Optrafine ceramic polishing kit (Ra=0.47µm) as compared to Group 3-Roughened and polished with eZr polishing kit (Ra=0.49µm) and Group 5-Roughened and glazed (Ra=0.59µm). There was no stastistically significant difference between two polishing systems. SEM analysis of surfaces polished with Optrafine polishing kit revealed smoother and regular morphology as compared to surfaces polished with eZr polishing kit. CONCLUSION: The Optrafine polishing kit created more smoother and uniform surfaces as compared to surfaces polished with eZr polishing kit both quantitatively and qualitatively. Also, lowest surface roughness values were produced by optrafine ceramic polishing kit on monolithic zirconia as compared to glazed monolithic zirconia after their clinical adjustments.Thus Optrafine ceramic polishing kit can be used as alternative to glazing.

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.

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.

Effect of the simulated Indian and Mediterranean climates on the Shore A hardness of maxillofacial silicone.

PURPOSE: The purpose of this study was to assess and compare the effect of the simulated Indian and Mediterranean climates on the Shore A hardness of a commercially available nonpigmented room temperature vulcanizing maxillofacial silicone. MATERIALS AND METHODS: Sixty specimens were fabricated from A-2000 silicone material (Factor II), using a stainless steel mold of dimension 20 mm × 2 mm. The initial Shore A hardness was noted using a digital durometer. Thirty samples were subjected to the simulated Mediterranean climate (Group I), and the remaining thirty samples were subjected to the Indian tropical climate (Group II) in an accelerated weather chamber to simulate 1 year of clinical use. Final Shore A hardness was noted. A one-way ANOVA and Bonferroni post hoc tests were performed for the Shore A hardness at P < 0.05. RESULTS: The mean initial Shore A hardness for both the groups was 24.9833. After accelerated weathering, Group I showed mean Shore A hardness of 33.0000 whereas Group II showed mean Shore A hardness of 38.0000. CONCLUSIONS: The Shore A hardness of Factor II, before and after accelerated artificial weathering, was statistically significant at 0.05 level (P < 0.05). The change in Shore A hardness was greater in the simulated tropical climate group (Group II) as compared to the simulated Mediterranean climate group (Group I) but within clinical limits.

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.

An innovative and simple approach to fabricate a hollow ocular prosthesis with functional lubricant reservoir: A solution to artificial eye comfort.

The loss of an eye is an emotional and psychological setback to the patient. An ocular prosthesis is created to restore the lost anatomical structure and to correct the cosmetic defect. The tear reflexes do not function at optimal levels in anophthalmic sockets which make prosthesis wear uncomfortable. This case report presents an innovative hollow ocular prosthesis with functional lubricant reservoir which upon normal blinking would draw the lubricant from the reservoir through an exit hole which spreads over the prosthesis allowing a comfortable and long duration of prosthesis wear.

Comparative evaluation of border molding using two different techniques in maxillary edentulous arches: A clinical study.

PURPOSE: The aim of this in vivo study was to compare the single-step border molding technique using injectable heavy viscosity addition silicone with sectional border molding technique using low fusing impression compound by evaluating the retention of heat cure trial denture bases. MATERIALS AND METHODS: Ten completely edentulous patients in need of prostheses were included in this study. Two border molding techniques, single-step (Group 1) and sectional (Group 2), were compared for retention. Both border molding techniques were performed in each patient. In both techniques, definitive wash impression was made with light viscosity addition silicone. The final results were analyzed using paired t-test to determine whether significant differences existed between the groups. RESULTS: The t-value (3.031) infers that there was a significant difference between Group 1 and Group 2 (P = 0.014). The retention obtained in Group 2 (mean = 9.05 kgf) was significantly higher than that of Group 1 (mean = 8.26 kgf). CONCLUSION: Sectional border molding technique proved to be more retentive as compared to single-step border molding although clinically the retention appeared comparable.

An Innovative and Simple Approach to Functional Salivary Reservoir Fabrication.

Saliva is a valuable oral fluid that is often taken for granted. Impaired salivary function is a major and a debilitating sequela of radiation treatment for patients with head and neck cancer. It can persist for years and thereby increases the risk of oral infection significantly. Moreover, it has a notably negative impact on the quality of life of such patients. To help overcome this problem, a number of techniques have been proposed for incorporating a reservoir containing salivary substitute into a removable prosthesis. A new design for a functional salivary reservoir is presented here. This design is simple to construct and easily maintained by the wearer. Details of its design, construction, and other potential advantages are presented.

A Review on Denture Marking Systems: A Mark in Forensic Dentistry.

"Identification through forensic science is an art of giving the corpse a name A real life detective work that would put even Sherlock Homes to shame." Forensic dentistry deals with proper handling and examination of dental evidence and proper evaluation and presentation of dental findings in interest of justice. The Prosthodontists are playing a very important role in forensic dentistry as they are concerned with fabrication of various prosthesis which can serve as an important tool for identification. Identification is essential requirement of any medico-legal investigation because a wrong identity may pose a problem in delivering justice. This article describes the different methods for identification/marking of the complete dentures, removable partial dentures and fixed partial dentures and the importance of denture marking in forensic investigatory purposes. The PubMed, Ebsco and Google search engines were used to gather the articles.

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.

The Ocular Prosthesis: A Novel Technique Using Digital Photography.

Loss of an eye can cause a significant psychological and emotional disturbance to any patient. An ocular prosthesis helps to re-establish the physical and mental well-being of the patient. This article describes a novel technique along with a case report for fabricating a predictable, esthetic and well-fitting custom-made ocular prosthesis in an attempt to avoid costly and time consuming procedures that may be required in other methods.

Customizing the Emergence Profile Around an Immediately Loaded Single Implant in the Esthetic Zone: A Case Report.

An optimal esthetic result is essential for an implant-supported restoration in the anterior zone. In the esthetic zone, providing immediate interim restorations following implant surgery has been proposed as a reliable and desirable treatment approach. A well-contoured interim restoration following implant placement minimizes hard and soft tissue changes in the peri-implant zone. This in turn has the potential to enhance the esthetic outcome and, therefore, patient satisfaction. Multiple prosthetic and surgical aspects need to be carefully planned and executed to achieve the intended final result. This is a report describing the steps involved in recontouring the gingiva to achieve an optimal emergence profile following the immediate loading of a single implant in the esthetic zone.

Modified Technique to Fabricate a Definitive Closed Bulb Hollow Obturator for Maxillectomy in a Patient Following COVID-Associated Mucormycosis: A Case Report.

Immunocompromised people developed mucormycosis as a result of the COVID-19 outbreak. Antifungal medications, surgical excision of infected tissues, and therapy of underlying metabolic problems are available forms of treatment. Usually, surgery entails completely excising the affected area. The patient is at risk for nasal twang, nasal cavity leaks, and impaired masticatory function because of these anomalies. The obturator prosthesis may form an oro-nasal seal in such problems. Additionally, lowering the prosthesis weight contributes to improved stability and retention. This case report explains a novel flasking technique to lessen the prosthesis weight and a modified impression technique to capture the palatal deformity.

An Innovative Technique of Iris Positioning Using Digital Photographs for Custom Ocular Prosthesis: A Case Report.

Trauma, cancer, and congenital abnormalities are the three main causes of eye loss. A person's personal and professional life is left with functional, aesthetic, and psychological problems when they lose one eye. A customized ocular prosthesis made of heat-cured polymethylmethacrylate can be used to restore an eye defect. Fabrication of the customized ocular prosthesis has multiple steps including scleral plank fabrication, iris positioning, and characterization. This article's primary goal is to explain a novel method for iris positioning for better cosmetic outcomes.

Rehabilitation of Edentulous Arch Using All-on-Four Treatment Protocol: A Case Report.

In edentulous arches, alveolar ridge atrophy after tooth extraction is a common problem that affects patient comfort and quality of life. Implant-supported fixed restorations are a well-proven treatment option for edentulism. The concepts of implant dentistry have developed over time to produce better aesthetics and functional results. To reduce cantilever length and enable prostheses with 12 teeth, the all-on-four technique entails inserting two anterior implants axially and distally orienting two posterior implants. Compared to conventional loading, immediate loading offers various benefits without compromising quality. An instantaneous fixed provisional allows patients immediate function and preserves their quality of life while also promoting a high degree of patient satisfaction in terms of aesthetics, phonetics, mastication, and psychological comfort.

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.

Esthetic Rehabilitation of Partially Edentulous Ridge With Horizontal Bone Augmentation Using the Sausage Technique: A Report of Two Cases.

Bone augmentation techniques have been used in atrophic ridges to attain appropriate bone volume and enable dental implant insertion. By reducing the need for autogenous bone and decreasing morbidity at the donor sites, the use of bone substitutes has improved patient comfort and satisfaction. One of the major challenges in implant dentistry is achieving an optimal esthetic result with implant-supported crowns in the esthetic zone. Multiple prosthetic and surgical aspects need to be carefully planned and executed to achieve the final esthetic result. This is a report describing bone augmentation using the sausage technique and subsequent prosthetic rehabilitation in two cases.

Prosthodontic Rehabilitation of a Completely Edentulous Patient by Salvaging Ailing Implants Using a Bar Retained Over Denture: A Case Report.

Patients who are edentulous experience challenges with their dentures, especially the mandibular ones. The primary concerns of these patients include reduced chewing efficiency, instability, and loss of retention. With the advancement of implants and prosthetic options, these concerns can be addressed by resorting to implant-supported fixed and removable prostheses. The impetuous use of dental implants to solve these issues leads to inadvertent failures in the treatment undertaken. Improper planning of cases leads to prosthesis breakage and implant failures leaving the patient dissatisfied. One such case of rehabilitation of a completely edentulous over-denture patient with ailing implants is described in this clinical report.

Aesthetic treatment planning simplified using digital smile design: A case report.

Digital smile design (DSD) plays an essential role in the planning of aesthetic treatments. However, most digital smile designing software programmes are expensive and require specialised training and skill for effective implementation. This paper illustrates the use of Adobe Photoshop and Microsoft PowerPoint, which are economical and user friendly for planning aesthetics in a clinical case.