Management of Denture Infection with Phytomedicine.

Natural teeth are an integral part of the masticatory system. Absence of dentition subjects the individual to compromised oral function, facial appearance and phonetics. Rehabilitation with dental prosthesis is imperative to restore form and masticatory activity. Currently, fabrication of removable and fixed prosthesis has become most predictable. Nonetheless, there is an increased prevalence of oral stomatitis observed over the years in edentulous individuals wearing removable dentures. Amongst the many pathogens that cause denture infections, Candida albicans is assumed to be the most virulent opportunistic agent. Different methods, such as mechanical, chemical, chemicmechanical, and pharmacological are tried to fight such infections. Regardless of various management strategies developed to treat denture stomatitis, the research continues to evolve the most optimal one. Improper oral and or denture hygiene maintenance, surface irregularities on denture, persistence of xerostomia and associated systemic illness pose risk for exaggeration of the disease. In extreme conditions, the development of aspiration pneumonia in geriatric patients is considered a threat to both dental and medical specialists. Therapeutic administration of synthetic anti-microbial drugs, along with meticulous oral hygiene maintenance are recommended protocols till date. However, limitations such as antibiotic resistance, side effects, counter drug reactions, cost of the medicaments predispose to origin of natural herbal products to treat denture stomatitis. Vast array of plant products are studied in previous literature, yet no definitive edge of one over the other is proven. This article intends to provide a mini-review on the different organic plant materials, also called as phytomedicines used for the treatment of candida associated denture stomatitis (CADS).

Finite element stress analysis of Aramany class I maxillectomy defect with single- and two-piece closed bulb obturators.

AIM: To evaluate the stress on the surrounding structures of Aramany class I maxillectomy defect restored with different obturator prostheses. METHODS AND RESULTS: Definitive three-dimensional (3D) finite element (FE) model of Aramany class I defect rehabilitated with single- and two-piece closed bulb obturator prostheses was constructed based on patient computed tomography (CT) using a software. Unilateral defect restored with tripodal design single-piece closed bulb obturator was used as FE model 1- and two-piece magnet retained closed bulb obturators as FE model 2. Finite element analysis (FEA) with three different load (150 N, 200 N and 250 N) applications was used to calculate the equivalent von Mises stress. A least stress value of 62.28 MPa was observed in two-piece closed bulb design with 150 N force, and highest stress value of 104.15 MPa was observed in single-piece obturator with application of 250 N force. CONCLUSION: Minor difference in stress distribution pattern was observed between single-piece obturator and two-piece obturator, and stress value was comparatively lesser in two-piece than single-piece obturator. The stress pattern, distribution and numerical values increased with increase in magnitude of forces. More stress was observed on the lateral slopes of obturator closer to defect than in other areas of the obturator.

Retention of removable complete dentures made with different posterior palatal seal techniques and oral health quality of life: A clinical study.

STATEMENT OF PROBLEM: How different methods of recording posterior palatal seal affect removable complete-denture retention and oral health quality of life is unclear. PURPOSE: The purpose of this clinical study was to compare the retention and oral health quality of life (OHIP-14) between conventional and arbitrary posterior palatal seal techniques in participants with removable complete dentures. MATERIAL AND METHODS: Edentulous patients were recruited according to definitive criteria. The participants were randomly divided into conventional and arbitrary seal. After the delivery of the denture, the retention was evaluated with a force gauge dynamometer and at 3, 6, 9, and 12 months. Denture satisfaction was evaluated with the OHIP-14 questionnaire. Data were statistically analyzed by using the t test and repeated measure ANOVA (α=.05). RESULTS: The mean ±standard deviation values (N) for conventional seal at 0, 3, 6, 9, and 12 months by dynamometer in the anterior region ranged from 4.73 ±0.78 to 4.90 ±0.81 and in the posterior region between 5.07 ±0.84 and 5.31 ±0.99. Dynamometer values for arbitrary seal in the anterior region were from 4.56 ±0.77 to 4.88 ±0.81, and in the posterior, it varied between 4.74 ±0.74 and 5.15 ±0.81. Force gauge values (N) for conventional and arbitrary seal were in the range of 18.35 ±2.84 to 20.69 ±3.89. The general mean ±SD OHIP-14 was higher for the conventional seal at 3.12 ±0.25 than for the arbitrary seal at 2.73 ±0.23 The difference between the conventional and arbitrary seal techniques was not statistically significant (P>.05) CONCLUSIONS: No significant difference in complete denture retention was detected between the 2 posterior palatal seal techniques. Oral health quality of life was higher with the conventional seal technique.

Evaluation of Psychological Stress Marker in Partially Edentulous Indian Adults Restored with Fixed Dental Prosthesis - A Prospective Cohort Study.

BACKGROUND: Clinical studies have established mastication as a stress relaxation behavior in humans. Absence of teeth compromises mastication, increasing psychologic stress in individuals depicted by many physiologic changes in body. Quantitative level of psychologic stress bio-markers serve as indicators of underlying physical ailment. Lesser literatures are available in determining the role of alpha amylase stress bio marker in partially edentulous clinical situations. AIM: The purpose of this clinical study was to evaluate the levels of salivary alpha-amylase (sAA) stress biomarker in partially edentulous subjects before and after restoration with fixed dental prosthesis. MATERIAL AND METHODS: Forty partially edentulous patients with missing mandibular first molar were selected for this study. Two questionnaires, state trait anxiety inventory (STAI) and perceived stress scale (PSS) was used to evaluate stress and anxiety levels of participants. The recruited participants were treated with metal ceramic fixed dental prosthesis (FDP). A visual analog scale (VAS) was used to determine the patient satisfaction .Unstimulated salivary samples were collected preoperative, 3rd and 6th month post FDP placement. Level of sAA was estimated. Data obtained in the form of mean ± SD was subjected to statistical analysis using paired sample t-test (α=.05). RESULTS: The salivary alpha amylase level was highest with mean of 36.73 µM/min/mg ptn before restoration with FDP. In the third month after prosthesis placement, the enzyme values decreased to16.62 µM/min/mg ptn and least value of 8.58 µM/min/mg ptn was detected in sixth month (P < 0.05). CONCLUSION: The salivary alpha amylase stress biomarker decreased after tooth replacement with FDP.

A salivary sensor for the management of xerostomia in edentulous patients.

This article describes a method for managing xerostomia in edentulous patients with a newly developed salivary sensor. A micropressure sensor unit with a capsule to hold artificial salivary substitute was built into the dental prosthesis. This sensor prosthesis can help patients overcome mouth dryness, improves patient comfort, and aids in retention of the prosthesis.

Correlation between Visible Length of the Iris and the Length of the Maxillary Central Incisor Using Digital Image Analysis- A Pilot Study.

INTRODUCTION: Complete denture therapy is one such modality where science and art goes hand in hand. Selection of artificial teeth for completely edentulous patients is not easy in the absence of pre extraction records, because till date concrete guidelines do not exist. AIM: The purpose of this study was to determine if a correlation existed between the visible length of the iris and the length of the maxillary central incisor to potentially provide a guide for teeth selection. MATERIALS AND METHODS: A total of 20 Indian dental students consented to participate in the pilot study. Standardized digital images of the face revealing the eyes and component of teeth on smiling was captured using a digital camera. The digital measurements of the visible iris length (medial aperture height, tangential to iris) and the length of the maxillary central incisor from the zenith to the incisal edge were analysed using Adobe Photoshop creative cloud software. The data was statistically evaluated and results were tabulated. Karl Pearson's Coefficient of Correlation was utilized to detect if any association existed between the two variables. RESULTS: The mean value of length of central incisor was 10.39 mm and the mean value of the visible length of iris was found to be 12.9 mm. A Pearson correlation analysis revealed an r-value <0.3 indicating minimal association between the two variables with a p-value >0.01 (.322). CONCLUSION: On inference, the correlation between the visible iris length and that of maxillary central incisor were unable to produce a strong positive statistical association. However, an association factor between the two has been obtained. Deduction of 2.5 mm from the dimension of visible iris length will help in attaining the length of artificial maxillary central incisor tooth.

Power spectrum density analysis for the influence of complete denture on the brain function of edentulous patients - pilot study.

PURPOSE: This pilot study was to find the influence of complete denture on the brain activity and cognitive function of edentulous patients measured through Electroencephalogram (EEG) signals. MATERIALS AND METHODS: The study recruited 20 patients aged from 50 to 60 years requiring complete dentures with inclusion and exclusion criteria. The brain function and cognitive function were analyzed with a mental state questionnaire and a 15-minute analysis of power spectral density of EEG alpha waves. The analysis included edentulous phase and post denture insertion adaptive phase, each done before and after chewing. The results obtained were statistically evaluated. RESULTS: Power Spectral Density (PSD) values increased from edentulous phase to post denture insertion adaption phase. The data were grouped as edentulous phase before chewing (EEG p1-0.0064), edentulous phase after chewing (EEG p2-0.0073), post denture insertion adaptive phase before chewing (EEG p3-0.0077), and post denture insertion adaptive phase after chewing (EEG p4-0.0096). The acquired values were statistically analyzed using paired t-test, which showed statistically significant results (P<.05). CONCLUSION: This pilot study showed functional improvement in brain function of edentulous patients with complete dentures rehabilitation.