The effect of post-core and ferrule on the fracture resistance of endodontically treated maxillary central incisors.

AIM: To evaluate the effect of post reinforcement, post type and ferrule on the fracture resistance of endodontically treated maxillary central incisors. MATERIALS AND METHODS: Sixty central incisor teeth were selected and grouped into six groups, viz. A, B, C, D, E, and F, each consisting of 10 specimens. Group A specimens were not subjected to any restorative treatment. Group B specimens were endodontically treated and crowned. Specimens of groups C and D were restored with custom cast post and core. Specimens of groups E and F were treated with prefabricated titanium post and composite core. Specimens of groups C and E were restored with porcelain-fused metal (PFM) crown having 2 mm ferrule. Specimens of groups D and F were restored with PFM crown having no ferrule. All the specimens were subjected to load (newton, N) on the lingual surface at a 135 degree angle to the long axis with a universal testing machine until it fractured. The fracture load and mode of fracture of each specimen were noted. One-way analysis of variance with Tukey honestly significant difference procedure was employed to identify the significant difference among the groups at 5% level (P < 0.05). RESULTS: There were significant differences among the six groups studied (P < 0.0001). The highest fracture strength was recorded with specimen of group C (1376.7 N). There were significant differences between groups A and D versus groups B, E, and F. There were no significant differences between groups B, E, and F. Cervical root fracture was the predominant mode of failure in all the groups except group A. CONCLUSION: The results showed that endodontically treated teeth restored with custom cast post core were as strong as the untreated group. Teeth restored with custom cast post core were better resistant to fracture than teeth restored with prefabricated titanium post and composite core. Ferrule is more important in custom cast post core than in prefabricated post and composite core.

Clinical assessment of primary stability of endosseous implants placed in the incisor region, using resonance frequency analysis methodology: an in vivo study.

AIM: To evaluate the effect of immediate loading on the primary stability of endosseous implants placed in the anterior incisor region by mapping the stability, using resonance frequency analysis, over a period of time. MATERIALS AND METHODS: A total of eight implants (Zimmer Screw-Vent) were placed in four patients. The Osstell resonance frequency analyzer was used to determine the primary stability at baseline (day 1), 15 th day, 30 th day, 60 th day, and 90 th day for each of the eight implants. Analysis of data was done using SPSS (Statistical Package for Social Science; version 4.0.1). RESULTS: All implants showed adequate initial stability at baseline with an ISQ > 50. Implant nos. 1, 3, 4, 7, and 8 showed a high initial stability at baseline (ISQ > 65), following which a decrease in the stability was recorded during the 15 th day, 30 th day, and 60 th day. By the 90 th day, the stability values were nearly equivalent to those obtained at baseline. The highest mean stability value was recorded on the day of implant placement. The lowest mean stability recording was obtained on the 30 th day after implant osteotomy. By the 90 th day, the mean stability value was nearly equivalent to that obtained at baseline. CONCLUSIONS: Within the limitations of this study, it can be concluded that immediate loading of implants placed in the maxillary and mandibular incisor region does not seem to have an adverse effect on the osseointegration of implants, which achieved a high primary stability. The use of the resonance frequency analyzer as a tool to monitor the variation in the stability of the implants over a period of time has been validated.

Prosthetic management of a patient with Treacher Collins syndrome.

Treacher Collins syndrome encompasses a group of closely related defects of the head and neck. It is a rare syndrome characterized by bilaterally symmetrical abnormalities derived from the first and second brachial arches and the nasal placode. It is an autosomal dominant disorder and its occurence ranges from 1 in 25,000 to 1 in 50,000 live births. The facial appearance of these patients can be improved by either surgical or prosthetic rehabilitation. In this case report we are presenting the features of a 13-year-old boy with Treacher Collins syndrome. A multidisplinary approach was followed in managing the situation. The various treatment options and the steps involved in making an auricular prosthesis are also discussed.

Prosthetic rehabilitation of individuals with ectodermal dysplasia.

Ectodermal dysplasia is a genetic disorder commonly affecting the development of teeth. The quality of life of the affected individuals can be improved by a multidisciplinary approach to the treatment plan. The treatment may include removable, fixed, implant-supported prostheses, or a combination of these options. This case report describes in detail the diagnosis and treatment of two such individuals using removable overdentures.