Comparison of occlusal schemes in complete denture patients

The objective of this study was to compare the masticatory performance with bilateral balanced occlusion and lingualized occlusion in complete denture patients reporting to Armed Forces Institute of Dentistry Pakistan. A randomized control trial study was carried out on sixty edentulous patients. Subjects were divided into two equal groups, A and B by non-probability consecutive sampling method. Group A patients were provided complete dentures with bilaterally balanced occlusion and group B patients were provided complete dentures with lingualized occlusion. Masticatory performance was determined at the 01-month follow-up appointment using Sieving method. Data were analyzed using SPSS 19.0.Results of the study showed that patients with bilateral balance occlusion dentures had superior masticatory performance as compared to ones' with lingualized occlusion. Conclusion made was that bilateral balance occlusal scheme patients were able to masticate properly with ease and comfort and were more comfortable with their prostheses

Preferred methods for the selection of artificial teeth in a complete denture patient in a tertiary care hospital at Rawalpindi

This study was conducted to find the most convenient method for the selection of teeth for complete denture patients between Consultant, Residents and House officers in prosthetic services. A questionnaire was designed specifically prepared and distributed to 45 dentists working in tertiary care hospitals in the twin cities of Rawalpindi and Islamabad. All participants answered questions and responded to the survey. Majority preferred patient's facial form as a guideline in choosing the shape of anterior denture teeth [40%], the most widely used guide in choosing the color of the front teeth was the tone of the patient's skin [48.9%], and more often appearance used in selecting the size of front teeth were the corners of the mouth [35.5%]. Fifty-one percent of dentists prefer to use anatomical teeth for back teeth in prosthesis. Bulk of the participants [97.8%] preferred acrylic resin material for artificial teeth. It can be accomplished as the preferred method to opt for artificial teeth and general dentist in Rawalpindi and Islamabad agree with the approaches by dentists internationally, as evidenced by the data published on the subject

Awareness about prosthodontic treatment for missing natural teeth among patients seen at afid

Loss of teeth significantly impairs oral functions and masticatory efficiency. Due to lack of awareness about importance of prosthodontic replacement, mostly patients do not seek treatment immediately after tooth loss. Patients with different educational and socioeconomic background may have different reasons for not replacing teeth after extraction such as financial issues, lack of time and lack of motivation. The objective of this study was to determine the awareness level about prosthodontic treatment for missing natural teeth among patients seen at prosthodontic department of AFID in Rawalpindi. The study was carried out on 137 subjects over a period of almost six months. Based on the criteria of awareness defined in methodology, 19 patients [13.9%] had low awareness level, 89 [65%] had medium awareness level and 29 [21.2%] had high level of awareness. There was significant association of awareness level with gender [p=0.009], education [p=0.00] and occupation [p=0.001]. It was concluded that patients visiting AFID have medium level of awareness about prosthodontic treatment options. Dentists were the most common source of information for the patients in terms of education about different treatment options available to replace the missing teeth

Knowledge and attitude of patients towards dental implant at armed forces institute of dentistry, Pakistan

Objective: Assessment of the patient knowledge and attitude towards dental Implants at a tertiary care dental hospital

Study Design: A cross sectional descriptive study

Place and Duration of Study: Armed Forces Institute of Dentistry, Rawalpindi from Jan 2014 to Jun 2014

Material and Methods: A survey was conducted on 150 partially dentate male and female patients having age 20 years and above using a self-explanatory questionnaire. Completely dentate and edentulous patients were excluded in study. Age and gender of the patients were noted. Data were analyzed using SPSS 17.0. Frequencies of age, knowledge, sources and limiting factors were calculated

Results: Sixty percent of the patients were aware of dental implants. Dentists were the main sources of information regarding the dental implants followed by friends and relatives. A majority of patients [65%] had objection on the cost of implant therapy. Major disadvantage and deterrent to implant therapy were cost and surgery

Conclusion: The study showed that most of the patients were aware of dental implants. Dentists and electronic advertising media plays an important role in educating patients about dental implants. Cost was a major limitation in provision of dental implants

Clinical evaluation of proximal contact points in fixed prostheses

This cross-sectional study clinically assesses the tightness of proximal contact points of fixed dental prosthesis with natural teeth. Sixty nine [69] patients visiting the Department of Prosthodontics, Armed Forces Institute of Dentists [AFID], Rawalpindi, were included. The crowns, as a single unit or terminal abutment of bridge, prepared and fabricated at the same institute were included. A total of 142 Proximal Contact Points [PCPs] were assessed with the dental floss and categorized as acceptable, loose and tight. Among these, 83 [58.4%] were acceptable, 41 [28.8%] loose and 18 [12.6%] were tight. Out of 142 PCPs, 104 [73.2%] were Porcelain Fused to Metal [PFM] and 38 [26.7%], all metal. Out of 104 PFM crown/FPD PCPs 59 [56.7%] were acceptable, 32 [30.7%] were loose and 13 [12.5%] tight. Out of 38 all metal crown/FPD PCPs 24 [63%] acceptable, 9 [23%] were loose and 5 [13%] were tight. PCPs must be checked for acceptability before cementation. The PCPs of adjacent natural dentition in same patient may serve as guide for assessment

Mind the crown margins

Metal free ceramic restorations have increased in demand due to their superior esthetics and more resemblance to the natural teeth, more so now that metal-free biocompatible options are preferred. Although porcelain fused to metal crowns are also used owing to less tooth structure loss in their preparation, the metal portion shows through the marginal area giving a blue-gray, cyanotic appearance to the tissue. Margins are one of the most important components in the success of a ceramic restoration. ssential prerequisites for the clinical success of an all ceramic restoration includes good esthetics, a high resistance to fracture and perfect marginal fit. A poor marginal design or one that is not prepared well may be a source of plaque accumulation, other than being esthetically unpleasing. Different marginal designs have been proposed and the most acceptable ones for all-ceramic restorations are either the rounded shoulder or the large chamfer margin. A major part of the current literature and research done on this subject falls into two broad categories that are affected by the type of marginal finish line - marginal fit and fracture resistance

Complexity of partial edentulism among patients seen at armed forces institute of dentistry, Rawalpindi

The objective of this study was to determine the frequency of different classes of partially dentate patients reporting to Armed Forces Institute of Dentistry Pakistan on the basis of PDI classification. A cross-sectional study was carried out on five hundred thirty four [534] partially dentate patients of age between 35 to 65 years. Data was collected by taking history, clinical and radiographic exam-ination. A Proforma was filled in by the principal investigator and PDI classification of the patient determined. Out of 534 patients, 92 patients [17.2%] were classified in PDI class I. 212 patients [39.7%] were classified in PDI class II.146 patients [27.3%] were grouped in PDI class III while 84 patients [15.7%] were classified in PDI class IV. Inclusion of PDI classification in everyday practice will be helpful in accurate diagnosis and treatment planning of the patients seeking prosthodontic rehabilitation

Prevalence of post insertion complaints in removable partial denture patients

The objective of this study was to determine the frequency of complaints in patients wearing removable partial dentures reporting at Armed Forces Institute of Dentistry Pakistan. The study included One hundred patients [60 males and 40 females] wearing removable partial dentures for at least 6 months. Details of age, gender, medical history and denture history were obtained. Patients post insertion complaints were recorded. The collected data was statistically analyzed using SPSS v17. The results were estimated statistically at a significance level of P<.05.It was found that 55% of the subjects had complaint of their dentures being loose; 40% complained of ulceration around or under their appliances; 35% of patients had problem of pain and discomfort; 25% reported that they had low masticatory efficacy. 28% of the patients had problems in speech. 10% patients complained of debonded artificial teeth. Pain and soreness, difficulty in mastication and speech, loss of retention, ulcerations and debonding/fracture of artificial teeth are the main post insertion complications in RPD patients. Proper RPD design and patient compliance can help overcome these challenges

Bridging the gap. quality of communication between prosthodontists and lab technicians

This descriptive study was carried out at dental out-patient department of Liaquat medical University Hospital Hyderabad from January 2013 to December 2013. Thirty-five patients wearing auto polymerized [self-cured] fixed partial dentures provided by unqualified and qualified dental practitioners were assessed. Condition of oral health was evaluated on the basis of proper history and clinical examination. Prosthesis condition was also assessed. Oral health of underlying soft and hard tissues was carefully evaluated after removing the prosthesis with the help of slow speed hand piece without jeopardizing oral tissues. It was evident in this study that fixed partial dentures made from auto polymerized [self cure] acrylic resins had adversely affected the oral tissues compelling the patients to visit the qualified dentist for proper treatment of their problems

Effect of career counseling on postgraduate education preferences of dental students

To determine the factors responsible for and the effectiveness of career counselling on postgraduation preferences. Sequential mixed method study. Army Medical College and Armed Forces Institute of Dentistry Rawalpindi Pakistan. Data was collected by means of a questionnaire. In which questions were asked under different themes. All those participating in the survey were being delivered a series of 2 lectures on career counselling, with 1 week gap between the lectures. After that the same questionnaire, containing some additional questions, were filled up by the participants. A total of 100 students/ house officers participated in this study. Eighty eight percent had knowledge about post-graduation programs in dentistry. McNemar's test showed that difference in choice of postgraduation was not significant [p=0.458]. Marginal homogeneity test used for the 1st option of postgraduation before and after counselling session was statistically significant [p=0.046]. Factors affecting the choice of specialty were better chances of getting job 62% [n=62], better chances of earning 84% [n=84] and would be less hectic 71% [n=71] and 78% [n=78] were passionate regarding the choice of specialty. Marginal homogeneity test applied for 1st choice of institution for post-graduation was statistically significant. Fifty nine percent [n=59] participants described low income and no stipend as a major barrier for post-graduation. Ninety two percent [n=92] of participants described that the career counselling session has increased their knowledge and broadened their horizon. Career counselling made statistically significant difference in the choice of specialty before and after the session and it was very effective for participants in selecting their preferences

Pattern of acquired postsurgical unilateral maxillary defects for prosthodontics rehabilitation in patients at AFID

To determine the pattern of acquired postsurgical unilateral maxillary defects [Aramany Class I] for Prosthodontics rehabilitation in patients at AFID. A descriptive study was conducted in the Department of Prosthodontics, Armed Forces Institute of Dentistry from August 2014 to March 2015. A total of 65 acquired unilateral postsurgical maxillary defect patients referred from Oral and Maxillofacial surgery department, with an age ranging between 25-70 years. Only Aramany Class I post-surgical defect patients were included in this study. Out of 65 patients 34 were male and 31 were female. The mean age of patients was 41+6.921 SD. Almost all of the patients 98.46% [n=64] belonged to a poor socioeconomic status. 81.5% [n=53] of the unilateral maxillary defect were on the left side where as 18.5% [n=12] were on the right side. Chi square test used to determine the association of gender with pattern of maxillectomy was not significant [p=0.859]. Logistic regressions wald test used to determine the association of age with maxillary defect was significant [p=0.000]. Within the limitations of this study, the pattern of Aramany Class I post-surgical defect was more prevalent on the left side as compared to the right side and most of the patients belonged to poor socioeconomic status irrespective of the age of patients

Denture hygiene habits among edentulous patients seen at Armed Forces Institute of Dentistry, Rawalpindi

The objective of this study was to determine denture hygiene habits in complete denture patients according to their age and time of dentures reporting at Armed Forces Institute of Dentistry, Rawalpindi. A cross sectional study was carried out on 200 hundred completely edentulous patients between 45 to 65 years wearing complete acrylic dentures. They were further subdivided according to gender [120 males, 80 females] and age groups as 45-55 years [Group I] and 54-65 years [Group II]. Data were collected on a standardized data sheet. A Proforma was filled in by every patient and denture hygiene habits of the subjects were documented. Data collected was analyzed using SPPS 17.0.Out of 200 patients, 65% of the subjects cleaned their dentures once daily. Group I patients who had been wearing dentures since 2 years showed more tendency towards denture cleaning. Patients mostly used water only for denture cleansing. Clinicians should provide proper denture hygiene instructions. Noncompliance of the patients is main reason for poor status of complete dentures seen in the elderly population

Aglossia: a rare case report and review

Aglossia is a rare malformation resulting in the partial development or complete absence of the tongue. It is commonly associated with craniofacial and limb defects [Oromandibular Limb Hypogenesis Syndrome].The etiology is unknown and various theories have been proposed for this. The objective of presenting the case report and literature review is to discuss the clinical presentation, causative factors and possible management strategies of this rare malformation

Selection of Appropriate Artificial Maxillary Central Incisor Size Using Dimensions of Hard Palate

To determine the ratio between width of hamular notches and maxillary central incisors' width at cervical, incisal and contact points. Cross–sectional descriptive study. Department of Prosthodontics, Armed Forces Institute of Dentistry, Rawalpindi from Feb 2010 to Aug 2010. Impressions of the maxillary jaw of 125 subjects were made and casts were obtained. A precise caliper was used to make the measurement ofthe widths of the maxillary central incisors at three different levels; the incisal edge [IW], at the level of interdental contact points [ConW] and in the cervical region [CerW]. The hamular width [HW] was measured between the most mesial demarcation point of the left and the right hamular notches.The ratios between the hard palate width [HW] and maxillary central incisor widths at all the three levels [IW, ConW, CerW] were calculated.Data was analyzed using SPSS 16. Of the125 subjects, 52 [41.6%] were males and 73 [58.4%] were females while mean age of the subjects was 26.56 years. Ratios HW/CerW, HW/IW and HW/ConWwere calculated as 6.08+0.18mm, 5.9+0.17mm and 5.81+ 0.17mm. The HW can be used as a preliminary method for determining the width of the maxillary central incisor

Comparison of patient's satisfaction level with complete dentures fabricated by neutral zone technique and conventional technique

The objective of the study was to compare the satisfaction level of edentulous patients provided with complete dentures that were fabricated by either the neutral zone technique or the conventional technique. For this a quasi experimental comparative study [Phase 2 trial] was carried out at Department of Prosthodontics, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan from September 2006 to February 2008. Sixty edentulous patients were included in the study and randomly placed into two groups. Complete dentures were fabricated for these patients; by the neutral zone technique for Group A and by the conventional technique for Group B. The satisfaction level of patients was assessed after six months of denture insertion with the help of a questionnaire. In Group A, 8 were highly satisfied, 19 fairly satisfied and 3 poorly satisfied while in Group B, 3 were highly satisfied, 16 fairly satisfied and 11 poorly satisfied. Chi-square test revealed a significance of 0.03 [P < 0.05] regarding comparison of patient's satisfaction level in both the study groups. It was concluded that dentures fabricated by neutral zone technique were more stable and functionally better than conventional dentures

Comparison of mean tooth attrition score in psychiatric patients with healthy individuals

The objective of the study was to compare the Mean Tooth Attrition Score in psychiatric patients with depression, with healthy individuals of same age groups. A Case control study was carried out in the Department of Prosthodontics, Armed Forces Institute of Dentistry and Psychiatric Department, Armed Forces Institute of Mental Health, Rawalpindi, from August 2010 to March 2011. Seventy patients were divided into two equal groups, A and B. Group A comprised of 35 psychiatric patients with depression under treatment since one year having minimum ten natural teeth in oral cavity including first molars and incisors selected from Armed Forces Institute of Mental Health while group B comprised of 35 otherwise healthy individuals of same age range reported to AFID for routine dental treatment. They were included by Non probability consecutive sampling method. The patients with history of facial trauma, hormonal disease or neoplasm, having carious or restored molar teeth and malocclusion were excluded from the study. Smith and Knight[1] index with scores ranging from 0 [No loss of enamel] to 4 [Complete loss of enamel] used to measure tooth attrition score of central, lateral incisors and first molars. The data were analyzed with SPSS version 16. In this study, a significant difference between groups for mean tooth attrition score was found. Psychiatric patients with depression and anxiety revealed the highest degree of tooth wear, many of them requiring complex treatment

Comparison of two cooling procedures on linear dimensional change of heat cured acrylic maxillary complete denture base

Certain dimensional changes are known to occur in acrylic resin during or after its processing. These changes hold clinical significance because better adaptation of denture base to oral tissues is related to minimum dimensional changes after processing. This study aimed at the evaluation of linear dimensional changes of maxillary heat cured denture bases after bench cooling and rapid cooling procedure. It was a randomized controlled trial, done in Central Dental Laboratory at Armed Force Institute of Dentistry. 60 heat cured acrylic resin [PMMA], maxillary complete denture bases divided into two equal groups [A and B] of 30 each randomly using a scientific random number table were fabricated bypassing through standard heating cycle and then the flask cooled by bench cooling method and rapid cooling method for 30 each. Linear dimensional changes from point A to B, A to C and B to C were noted. The study sample were considered to be significant with the p-value 0.003, 0.001 and 0.001 respectively. Bench cooling is a preferable technique to improve the mucosal adaptation of the denture base and less dimensional changes

Body mass index before and after provison of complete dentures

Good diet is essential for the development and maintenance of healthy teeth, but healthy teeth are important in enabling the consumption of a varied and healthy diet throughout the life cycle. Toot loss impairs chewing function and may result in the consumption of a limited diet of poor nutritional quality and may impact on diet-related quality of life. To be able to eat better is one of the main reasons for the provision of dental prostheses, the other reasons being aesthetics and speech. The objective of this study was to compare body mass index [BMI] of the patient before and after provision of complete denture therapy in a six months period. Seventy completely edentulous patients were included in this quasi-experimental study with age ranges between fifty five to sixty five years. Body Mass Index [BMI] was calculated at baseline, three and six month interval after provision of complete denture. Within the limitations of this study, no significant differences were found in BMI, before and after provision of complete denture

Effect of mechanical modification of acrylic resin denture teeth bonded to acrylic denture base

Techniques for bonding denture teeth to acrylic resin denture base remains empirical, with little consensus from the literature, among clinicians or among dental laboratories. Despite of this great variation, the data available regarding effectiveness of various methods used are sparse. The study was carried out to compare the effect of different surface treatments of ridge lap area of acrylic resin denture teeth on bond strength of acrylic resin denture teeth with acrylic resin denture base. 180 Maxillary central incisors were divided into 6 groups of 30 each according to surface preparations. First group served as the control with no surface preparation; other groups included horizontal grooves, vertical grooves, diatorics, sand blasting and roughened surfaces. Compressive shear force was applied to incisal edge of each tooth until fracture occurred, the force recorded and teeth visually inspected to determine adhesive or cohesive failure. Significant increase in failure load ranged for diatoric 274 +/- 78N. Significant decrease in failure mode was observed after sand blasting 157 +/- 79N. Remaining groups showed non-significant increase in force required for bond failure

Reasons and pattern of first molar extraction - a study

The aim of this cross sectional prospective study was to determine reasons and patterns of permanent 1[st] molar extraction in patients reporting to oral and maxillofacial surgery department at Armed Forces Institute of Dentistry, Rawalpindi. All patients referred to oral and maxillofacial surgery department for extraction of permanent first molar teeth from 1st of January 2009 till 31[st] of December 2009 were included in the study irrespective of their age and gender. The primary reason of extraction was recorded along with other relevant information. The pattern of extractions of the permanent first molars was also noted. A total of 470 patients were included in the study. Out of these 291 [61.9%] were males [M: F 1.6:1]. Caries was the most common cause with 281 extractions [59.8%] in all age groups in both genders followed by periodontitis, which was responsible for 109 [23.2%] of permanent first molar extractions. Mandibular molars were more frequently extracted [62.7%] as compared to the maxillary molars [37.3%], with the mandibular left molar being the most frequently extracted tooth in the sample population