Endodontic and post-endodontic management of a fused molar.

Treatment of fused teeth needs special care and attention to the bizarre anatomy. This paper describes root canal treatment of a fused carious tooth presenting with apical periodontitis. It is a rare case of fusion of the mandibular second molar with a paramolar. There is no literature regarding placement of crown over endodontically treated fused teeth. In this case, the fused teeth were endodontically treated and restored by a porcelain fused to metal crown.

A comparison of stress distribution and flexion among various designs of bar attachments for implant overdentures: a three dimensional finite element analysis.

CONTEXT: Bar overdentures are popular choices among clinicians worldwide but configurations that provide an optimal biomechanical distribution of stress are still debatable. AIMS: To compare the stresses and elastic flexion between implant supported bar overdentures in various configurations using finite element analysis. SETTINGS AND DESIGN: A CAT scan of a human mandible was used to generate an anatomically accurate mechanical model. MATERIALS AND METHODS: Three models with bars and clips in three different configurations were constructed. Model 1 had a single bar connecting two implants, Model 2 had three bars connecting all the four implants, and Model 3 had two bars connecting the medial and distal implants on the sides only. The models were loaded under static conditions with 100N load distributed at the approximate position of the clip. The mandibular boundary conditions were modeled considering the real geometry of its muscle supporting system. Maximum von Mises stress at the level of the bar and at the bone implant interface were compared in all three models. The flexion of mandible and the bar was also compared qualitatively. STATISTICAL ANALYSIS USED: The analyses were accomplished using the ANSYS software program and were processed by a personal computer. Stress on these models was analyzed after loading conditions. RESULTS: Qualitative comparisons showed that stress at the level of the bar and at the bone implant interface were in the following order: Model 1> Model 3> Model 2. The flexion of the mandible and the bar were in the following order: Model 2 > Model 1 > Model 3. CONCLUSIONS: Four implant bar systems connected by bars on the sides only is a better choice than two implant bar systems and four implant bar systems with bars connecting all four implants.

Prosthetic rehabilitation of edentulous mandibulectomy patient: a clinical report.

Segmental resection of the mandible commonly results in deviation of the mandible to the defective side. The amount of deviation depends on the amount of hard and soft tissue involvement, the method of surgical site closure, the degree of impaired tongue function, the number of remaining teeth and the extent of loss of sensory and motor innervations. Prosthodontic treatment along with physical therapy may be useful in reducing mandibular deviation and improving masticatory efficiency. This clinical report describes the use of two rows of nonanatomic teeth on the unresected side. This provided a broader occlusal table and improved masticatory efficiency in our edentulous madibulectomy patient.