The Accuracy of Casts Obtained Using Different Impression Techniques and Impression Materials in Combined Parallel and Angulated Implants: An In Vitro Study.

Aim The aim of this in vitro study was to evaluate and compare the accuracy of casts made from two elastomeric impression materials (polyvinyl siloxane (PVS) and vinylsiloxanether (VSE)) using different impression techniques on parallel and angulated implants. Materials and methods The reference model was fabricated using auto-polymerizing acrylic resin on which three implant analogs were placed of which two were parallel to each other and the third at 20-degree mesial angulation. A total of 60 impressions were made of which 30 were by using PVS and 30 by VSE. For each material, 10 impressions were made by closed tray technique, 10 by open tray technique and 10 by open tray with sandblasting and adhesive coating of the impression copings technique. The inter-analog distances of the casts obtained were evaluated and compared with the reference model by a vision measuring machine. Data were analyzed using analysis of variance (ANOVA), Tukey's Honest Significant Difference (HSD) post hoc and independent samples t-test. Results When the inter-analog distances of the duplicate casts were compared with the reference model, the mean error rates for parallel implants decreased in the order of closed tray technique, open tray technique and open tray with sandblasting and adhesive coating of the impression copings technique for both PVS and VSE impression materials. Similarly, the same order was observed for angulated implants for both impression materials. Using the closed tray technique, there was no statistically significant difference in the accuracy of the cast between the two materials for parallel implants (P = 0.525) and also no significant difference between the two materials for angulated implants (P = 0.307). Similarly, there was no statistically significant difference in the accuracy of the cast between the two materials for parallel implants (P = 0.455) and also no significant difference between the two materials for angulated implants (P = 0.519) using the open tray technique. Whereas for the open tray with sandblasting and adhesive coating of the impression copings technique, VSE produced a more accurate cast than PVS for parallel implants and was statistically significant (P = 0.033); however, there was no significant difference between the two materials for angulated implants (P = 0.375). Conclusion For parallel implants, VSE by an open tray with sandblasting and adhesive coating of the impression copings technique produced a more accurate cast than PVS. For angulated implants, there was no significant difference between the two materials and it was only the technique that significantly affected the accuracy of the cast.

An Aesthetic and Economic Approach of Smile Designing for a Patient With Dentinogenesis Imperfecta: A Rare Case Entity.

This is a case report presenting a female patient in her twenties suffering from severely stained, unaesthetic, and worn-out teeth since her childhood. It was a major aesthetic and functional concern for her. This clinical presentation describes the prosthetic rehabilitation of a patient with generalized discolored and worn-out teeth to have enhanced aesthetics and masticatory function of the patient. This is a referred case of dentinogenesis imperfecta- II (DGI-II) from the Department of Oral Medicine and Radiology and Oral Pathology, as diagnosed by them after a thorough clinical, radiographical, and histopathological examination. DGI is a disorder of teeth characterized by discoloration and rapid wear and belongs to a group of disorders of the development of teeth. Due to the rapid wear and generalized intrinsically stained and discolored teeth, there is a loss of vertical dimension of occlusion (VDO) and an unesthetic look of the patient respectively. Therefore, the main objective of the case report is to re-establish the aesthetic and regain the VDO and functionality of the damaged teeth using the Pankey Mann Schuyler philosophy in which the first anterior teeth were rehabilitated with porcelain fused to metal (PFM) crowns based on aesthetics and phonetics of the patient. This was followed by posterior PFM crowns based on Broadrick's flag analysis for posterior occlusal plane determination and centric occlusion.

Pankey Mann Schuyler Philosophy-Based Prosthetic Rehabilitation for an Amelogenesis Imperfecta Patient: A Case Report.

This clinical case report presents the prosthetic rehabilitation of a 23-year-old male patient with generalized discolored and worn-out teeth, which were of aesthetic and functional concern. In collaboration with the Department of Oral Medicine and Radiology and Oral Pathology, this clinical condition was diagnosed as amelogenesis imperfecta (AGI). AGI is a genetic odontological disorder that is an epithelial derivative of the developed tooth bud with enamel malformation. AGI typically affects both deciduous and permanent teeth. Patients generally have aesthetic complaints and compromised chewing efficiency with loss of vertical dimension. Prosthetically rehabilitating an AGI patient is a multidisciplinary approach to regain aesthetics, phonetics, and mastication. This article describes the full mouth rehabilitation, following the Pankey Mann Schuyler philosophy, of the patient with AGI involving all teeth. Full mouth rehabilitation was planned to restore aesthetics, phonetics, and mastication in four phases. First was prosthetic rehabilitation of the mandibular anterior teeth, followed by the maxillary anterior, mandibular posterior, and, finally, maxillary posterior teeth.

Finger Prosthesis: An Economic and Esthetic Approach.

Fabrication of prosthetic fingers is more of an art than a science. The prosthetic finger must match the missing fingers or digits to such an extent to have a natural aesthetic look for the patient. This would build up the patient's confidence and prevent unwanted attraction by others. A patient, 47 years old, reported the loss of the middle finger of the right hand. The loss of the right middle finger was till the first phalanx, and it was distorted till the second phalanx. The patient wanted to have a natural look at his hand. Alginate impressions of the patient's amputated finger and the donor's relevant matching fingertip were made. A waxed prosthesis pattern was fabricated with the donor's fingertip. A wax trial was done in the patient, and was flasked. A heat cure acrylic was intrinsically painted with acrylic paint color to match the adjacent finger's skin tone, followed by packing these in the dewaxed mold, processed, trimmed, finished, and polished. This case report describes a method of obtaining or enhancing retention of the prosthetic finger by adopting a customized finger ring on the master cast and also customizing the prosthesis in the clinical rest position to have the aesthetic appearance in the resting condition of the palms and fingers. This method is cheaper and very easy to be adopted for affected people.

Aesthetic essentiality regained using implant- a case report.

The goal of implant therapy is to provide patients with a predictable, aesthetically and functionally satisfying treatment outcome with a low risk of aesthetic complications. Dental implants have been utilized by mankind for thousands of years, but only recently they have achieved widespread acceptance from the profession. Anterior sites are more likely related to aesthetic expectations and often represent a considerable challenge for involved clinicians and dental technicians, since various local risk factors have the potential to compromise the predictability of the result. In recent years, substantial efforts have been made to increase the appeal of implant therapy by shortening the overall treatment time and minimizing the number of surgical intervention. According to traditional protocol, a 12 month healing after extraction was suggested, but over the past few years alternative approaches have been proposed, such as immediate implant placement at the time of extraction or early implant placement following weeks of soft tissue healing. Common to all of these approaches is the requirement of adequate remaining bone volume. If there is no adequate bone volume, techniques like guided bone regeneration (GBR) are used for ridge augmentation before implant placement. The present case has utilized an endosteal root form implant and the advantage of guided bone regeneration technique in regaining aesthetic demands of the patient.