Innovative two-part impression technique for an extensive maxillary defect

Patients reporting with large maxillary defects pose great difficulty in prosthodontic practice. After thorough history and clinical examination, prosthetic rehabilitation of these patients usually starts with an impression. In such cases conventional single step impression technique solely may not give the desired results. If the defect is of large size then impression making becomes difficult and complicated procedure. Therefore, conventional impression technique can be modified according to the needs and requirements. This report describes a modified and innovative technique of making impression in two parts, which can be withdrawn from mouth in two segments and easily reoriented outside the mouth

Diabetes mellitus patients; immediate dentures

Objectives: To observe Quality of Life [QoL] in diabetes mellitus patients after fabrication of immediate dentures

Setting: Department of Prosthodontics in Hamdard University Dental Hospital, Karachi

Period: Two years from October 2011 to September 2013

Methodology: Thirty patients with established diagnoses of diabetes mellitus reported. In this study by purposive non-probability sampling technique. In this study patients were selected, male and female patients were 24 and 6 respectively with the age range of 22- 74 years. After getting consent Questions mention in OHIP-14 were asked from the patients on 1[st] visit and 2 months later after fabrication of immediate denture to assess the QoL of in these patients. Data was obtained after using SPSS-version 19. For analysis Wilcoxon Signed Ranks Test was applied to get results. Probability level of P

Results: There was marked improvement in different domains of QoL in diabetes mellitus patients after fabrication of immediate dentures, most of the patients were pleased with their prosthesis. Three patients had complained of pain on buccal side which was corrected by trimming the overextended flange of their denture. All patients had improvement in phonetics [P value 0.01], better choice of food [P value 0.00], eating ability [P value 0.01], decrease embarrassment [P value 0.08] and self-assurance [P value 0.025]. However, effect of immediate denture on variable like tension was not advantageous having P-value of 0.157

Conclusion: By fabrication of immediate dentures to diabetes mellitus patients, QoL can be markedly improved in such patients

Achievement of retention in maxillary obturators

The study was done to evaluate various means of retention in fabrication of maxillary obturators. It was a descriptive study and it was carried out at Hamdard University Dental Hospital, Karachi. It was spread over three years from August 2010 to July 2013. Twenty eight patients formed the study group. Age ranged from 03-78 years. Twenty were males and eight females. Five of them had already used obturator. After taking consent, they were asked to fill a specially designed Proforma .Thus all required information was obtained. All patients were provided with maxillary obturators. Interim obturator was fabricated for 46% patients, while surgical and definitive obturators were made for 29% and 25% patients respectively. In 24 patients conventional means of retentions like clasp, indirect retainer, utilization of retentive under cuts, proper extension of prosthesis were used. In three patients implant supported obturator were fabricated while in one patient magnets were used. Utilization of various means of retention bring better compliance in maxillary defect patients

Continued linear setting expansion in two proprietary type IV dental stones

Objective: To report linear setting expansion of two commercially available type IV dental stones at various time periods

Methodology: An Analytical study design conducted from December to June 2006 involving 60 stone casts poured in impressions of a machined brass model. After an elapse of a post-mixing and pouring period of 2 hours, the initial linear setting expansion as observed between chosen reference points on each cast was made using travelling microscope. On each cast, further observations and recordings of the linear expansion between reference points, were also made at test periods of 24, 48, 72, 96, 120 and 168 hours

Results: Generally, linear setting expansion continued over the test periods with the highest expansion values at 168 hours on some casts. Expansion reached at peak value for casts poured in Silky Rock at the 96 hours test period as compared to 120 hours in those made in GC Fuji Rock stone. In case of GC Fuji Rock, 44.8% of the overall expansion occurred by the test period of 2-hours as compared to 76.7% in case of Silky Rock. Furthermore, the observed values for the setting expansion at the 2-hours test period were different from those provided by the manufacturers and for one product were significantly different

Conclusion: Considering the observed varying setting behavior of the test stones and its deviation from the manufacturers provided data and the many available ones for dental application, the importance of continued research in the in the area is highlighted

Comparison of psychomotor performance in subjects with congenital tooth agenesis to those with normal dentition

Objective: To compare oral psychomotor performance in subjects with congenital tooth agenesis to control subjects having normal full complement of teeth

Study Design: It was a cross sectional comparative study

Place and Duration: This study was conducted in the Department of Prosthodontics, de' Montmorency College of Dentistry/ Punjab Dental Hospital, Lahore Pakistan from June 15[th], 2006 to December 14[th], 2006

Patients and Methods: Forty subjects with diagnosed tooth agenesis were selected using purposive, non-probability technique. Forty other subjects with normal complement of teeth were also selected as a control group. These were dental students of third and final year. Oral psychomotor performance scores were calculated using specific test samples for both groups. Results were analyzed and compared using descriptive statistical analysis protocol

Results: Intra oral psychomotor performance time scores were higher in subjects with tooth agenesis 133.7 +/- 36.8 as compared to 72.7 +/- 32.7 in control group p value < 0.01] t value 7.8]. It confirms that the affected subjects had some difficulty in perceiving and then in giving proper intra oral psychomotor response. Mean values and standard deviation were calculated for age, whereas frequency in percentage was calculated for gender and severity of the tooth agenesis state. These groups were compared for any significant differences in the oral psychomotor ability scores using t-test

Conclusions: Intra oral psychomotor performance was impaired in subjects with tooth agenesis as compared to those with normal set of dentition

Xeroderma pigmentosum with melanoma of face and its prosthetic management

Xeroderma pigmentosum is a rare genetic disorder, characterized by cutaneous, ocular and neurological symptoms. Squamous cell carcinoma and melanoma are also its secondary characters. This case report is about maxillofacial prosthetic management of a 10 years old child presented with xeroderma pigmentosum. The nose of the patient was excised surgically due to melanoma. This case report elaborates the role of prosthodontist and the whole procedure of constructing the nasal prosthesis via conventional technique by using the patient's sibling nasal form as template. Regular follow up revealed marked improvement in esthetics, function and ultimately patient's quality of life

simple and quick technique of fabricating a space maintainer for avulsed primary maxillary incisors

Traumatic injuries to primary teeth are very common. A properly designed/ fixed space maintainer not only preserves arch length but also reduces the psychological trauma, speech problems and prevents the development of tongue thrusting habits. As, it is difficult while operating in such young patient's mouth, this article describes a simple technique to quickly fabricate a space maintainer for avulsed primary maxillary incisors

Evaluation of oral function after removable partial denture therapy

This study aimed to evaluate the oral function after removable partial denture therapy from patients perspective. It was a descriptive case series. One hundred and ten partially dentate subjects were studied in the Department of Prosthodontics, de, Montmorency college of dentistry, Lahore. All the subjects were given oral health impact profile -14 questionnaire before and one month after provision of removable partial denture. Before and after treatment responses were recorded on 5 point Lickert scale. The post treatment scores were compared with pretreatment baseline scores and improvement in oral functional problems were assessed. 96% of study subjects had problems in pronouncing words, which persisted in 56% of the subjects after using removable partial denture. 94% of the study group had taste problems before removable partial denture treatment, which improved in 50% of study population after therapy. This suggested that removable partial dentures had a positive impact on oral function in almost half of the population. Lack of improvement in remaining group can be attributed to lack of education and awareness which was responsible for negative attitude of these patients towards removable partial dentures

Fabrication of an acrylic interim denture employing two-part impression technique for distal extension bases - Kennedy class 1 with modifications

Impression procedure forms the basis of a successful Removable Partial Denture however, in distal extension bases the residual ridge must be recorded in functional form and the remaining natural teeth in an anatomic form. Zinc oxide eugenol impression paste is a material of choice for functional impression whilst irreversible hydrocolloid is suitable for an anatomic impression. Therefore two-part impression technique is a suggestive impression technique that enables the operator to make an impression utilizing two different types of impression materials loaded in two different trays, one of which is a special tray and other a stock tray, so as to control the differential support predicament

Attitude of dental students towards elderly

The aim of this study was to assess the attitude of dental students towards elderly patients. This increased the awareness of the need of the geriatric dental education within the undergraduate dental curriculum, which is the pressing need for today. The study was carried out at the de,Montmorency College of Dentistry, Lahore-Pakistan. It was a descriptive cross sectional study. Study sample comprised of sixty final year students. Attitude of students towards elderly was measured using a self administered questionnaire consisting of ROZENCRANZ AND MCNEVIN AGING SEMENTIC DIFERENTIAL SCALE. Students attitude was found to be very positive towards elderly patients as they showed a strong desire to work with elderly patients. This showed that the future geriatric dentistry is not towards a decline in Pakistan as compared to negative attitudes of students in the developed countries

Disinfection of irreversible hydrocolloid impression material: effect on linear dimensional stability

The dental impressions contaminated with saliva and/or blood must be considered source of infection, with the potential of transmitting disease to the dentists, auxiliary personnel and laboratory technicians. The cross infection control measures must follow while handling these impressions or casts without compromising on their dimensional stability. The objective of this study was to evaluate the linear dimensional stability of irreversible hydrocolloid [alginate] when it is disinfected with 0.5% NaOCl by immersion and incorporation methods. This was Quasi Experimental study. One-hundred-seventeen [117] impressions were made out of which Fifty-seven [57] were not included in the study. Impressions were made by non-probability purposive sampling technique. Casts were made from the impressions. Measurements of the casts at three specific points were carried out using measurement guiding template through screw gauge and were recorded. In this study Sodium Hypochlorite 0.5% was used as disinfectant material for irreversible hydrocolloid. Immersion disinfection of irreversible hydrocolloid in 0.5% Sodium Hypochlorite showed statistically significant effect on its linear dimensional stability [p<0.05]. On the other hand, incorporation of Sodium Hypochlorite 0.5% in irreversible hydrocolloid as a water substitute was not practical, as it resulted in detachment of material from the impression tray. Disinfection of irreversible hydrocolloid by immersion method results in linear dimensional instability of the material and by incorporation method it is not possible

Rehabilitation of a large maxillo-facial defect using acrylic resin prosthesis

Large facial defects require definitive surgical reconstruction. However, at times such reconstruction is not possible due to extensive loss of tissues that can not be corrected by surgery alone. In this case, prosthetic restoration of lost facial tissues was carried out. Introduction of newer material which gives life-like appearance to such prosthetic restoration e.g. silicone and poly-ether rubbers, and use of implants to retain these prosthesis have given a new dimension to rehabilitation of such patients. This report presents a case of prosthetic rehabilitation of extensive extra oral defect due to basal cell carcinoma of cheek, using acrylic resin material

Comparison of maxillary anterior teeth width in natural and artificial dentition

This study characterizes the distribution of the mesiodistal widths of 6 maxillary anterior natural teeth [NMAT] for comparison with the widths of the most commonly used artificial denture teeth moulds [AMAT]. The width of the six maxillary anterior teeth was measured on a curve defined by the facial surfaces of the teeth. 280 casts of dentate subjects [140 men and 140 women] were measured. The width of the maxillary anterior natural teeth was compared to that of 5 different brands of commonly used artificial denture teeth moulds. The mean +/- standard deviation [SD] width of the six anterior teeth for men and women [54.09 +/- 2.5 mm and 52.08 +/- 2.8 mm, respectively] differed significantly [P < .001], 35% of the women and 51% of men had anterior teeth that measured 53 mm or wider. In contrast, the mean width of the most widely used artificial maxillary denture teeth [Welbite] is 45 mm while 45.3 for all 98 AMAT moulds. Of the 98 AMAT moulds available, only 4 have a width between 51- 53.4 mm, two of them from Yamahachi and one each from Shofu and Ivoclar. These findings suggest an acute shortage of AMAT moulds in sizes above 50mm. The lack of physiologically sized tooth molds could be one reason for the inappropriate selection of comparatively small maxillary denture teeth

Maxillofaciqal rehabilitation of a large cleft palate using fixed-removable prosthesis

Maxillofacial defects either congenital or acquired, lead to a marked loss of both the functional efficiency and aesthetic profile of the affected individuals. Plastic surgery and tissue reconstruction is the treatment of choice. However, in certain clinical scenarios, removable and/or fixed obturator prosthesis can be the only option available. The management of these critical cases should be planned after a detailed investigation and diagnosis, evaluation of the subject's expectations and demands, socioeconomic status, available technical facilities and utilization of a multi-disciplinary team approach. This report discusses the intra oral rehabilitation of a complete, unilateral cleft palate along with dento-alveolar rehabilitation. A fixed-removable prosthesis was provided to gain functional as well as aesthetic results without extensive surgical correction

Management of diabetes mellitus patients in prosthodontics

Diabetes Mellitus is a nutritional metabolic disorder characterize by various oral and systemic problems. These patients when referred to dentist or prosthodontist for the provision of prosthetic treatment require multidisciplinary approach. In this article special focus is emphasized on the various factors important factors to be kept in mind when providing prosthodontic treatment for such patients

Oral stereognostic ability in hypodontia patients

Hypodontia is congenital absence of one or more, but not all, of the normal complement of teeth. It is one of the most frequent alterations of human dentition. Hypodontia either alone or association with craniofacial developmental disorders can pose speech and masticatory dysfunctions along with aesthetic and functional problems. Oral Stereognostic ability can be used to diagnose and predict the prognosis of different treatment modalities in hypodontia patients. To compare oral Stereognostic ability in hypodontia patients with those having normal dentition. Case Control study, conducted in the Department of Prosthodontics, de'Montmorency College of Dentistry/ Punjab Dental Hospital, Lahore, Pakistan. Forty hypodontia subjects were selected. Forty dental students of third and final year with normal dentition were selected as controls. Oral Stereognostic ability scores were calculated using specific test samples for both groups. This study showed that oral Stereognostic ability scores were reduced in hypodontia subjects with a significant p value<0.001. It confirms that hypodontia subjects had some difficulty in perceiving the intra oral objects. Oral Stereognostic ability was impaired in hypodontia subjects; correction at early age might improve the case

Rehabilitation of a large midfacial defect using silicone based maxillofacial prosthesis

Maxillofacial defects always pose a restorative challenge to plastic surgeons and maxillofacial prosthodontics. Surgical reconstruction of large facial defects is not possible at times due to extensive loss of tissues. In such cases, restoration of facial tissues can be done using maxillofacial prosthetics. Introduction of newer materials like silicones, poly ether rubbers and use of implants to retain these prostheses have provided a new hope for the rehabilitation of such patients. A case of prosthetic rehabilitation of lost facial structures as a result of chemical burns is presented and also compares the prostheses fabricated using acrylic resins and silicone materials

Application of tissue conditioner reduces candida colonies count in patients with denture related stomatitis

Some 50% patients wearing complete dentures [CD] develop denture related stomatitis [DRS]. Candida albicans are the predominant infective organisms causing DRS. Several approaches have been recommended to treat DRS in elderly but the outcome is unpredictable because of poor patients' compliance. The effect of the application of tissue conditioner, on Candida albicans colonies reduction in DRS patients. This was an interventional, Quasi Experimental study of one year duration from January 2007 to December 2007. Using a purposive convenience sampling technique, 36 DRS patients wearing maxillary CDs were selected. In each subject, a layer of a polymeric resin based tissue conditioning material was applied to the fitting surface of their maxillary complete denture. Comparison of candida colonies counts was made that were cultivated from swabs obtained from the palatal mucosa of patients before and 3 days after the application of the tissue conditioner. The reduction in the number of Candida colonies on the palatal mucosa was significant [p<.05]. Treatment of DRS with tissue conditioner was effective against Candida albicans especially in non-compliant patients

Hypodontia and microdontia associated with hereditary ectodermal dysplasia

Hypodontia and associated conditions like Hereditary Ectodermal Dysplasia [HED] and microdontia markedly influence on physical, functional and psychosocial maturation of the affected individuals. Thorough evaluation, proper counseling and careful treatment planning employing a multidisciplinary approach are keys to a successful, long-term management. This case report describes the prosthodontic management of a young man with hypodontia and microdontia

Gagging and its management

Gagging is a normal protective reflex to prevent foreign bodies entering the trachea. Some individuals are more prone towards gagging. Various local and systemic factors such as alcoholism, gastrointestinal reflux and foreign bodies irritating soft palate or choking the oro-pharyngeal region can trigger this reflex. In this paper various techniques to prevent gagging during dental treatment are discussed