Reclaiming the Smile: Full Mouth Rehabilitation of a Generalized Attrition Patient Using the Hobo Twin-Stage Technique.

This clinical report details the successful rehabilitation of a 63-year-old male patient with severe tooth wear, a reduced vertical dimension of occlusion, and esthetic concerns. The Hobo twin-stage procedure addressed these issues while improving the patient's oral health and quality of life. After ensuring adequate oral hygiene, the treatment began with scaling and root planning, followed by diagnostic impressions. An occlusal splint was fabricated, followed by a diagnostic wax-up and tooth preparation. Full-arch impressions of prepared teeth were made using the addition of silicon elastomeric impression material, and chairside provisional crowns were fabricated. The working casts were mounted on a semi-adjustable articulator, and the metal copings were tried on before being built up in porcelain. The patient achieved successful outcomes and expressed satisfaction with the treatment. The Hobo twin-stage technique and porcelain-fused-to-metal crowns can be viable approaches for restoring the teeth's form and function while enhancing the patient's oral health and esthetics. However, regular follow-up appointments and good oral hygiene maintenance are essential for the long-term success of the treatment.

Evaluation of clinical and radiographic outcome of friction fit conical abutment system in implant-supported dental prostheses: An in vivo study.

Aim: The purpose of this clinical study was to analyze the clinical feasibility of friction fit conical abutment system in implant-supported fixed dental prostheses as an alternative to cement and screw retention. Settings and Design: This was an in vivo longitudinal study. Materials and Methods: A total of 10 prostheses were designed as 3- or 4-unit fixed dental prostheses supported by two implants. All the subjects selected were evaluated for pocket probing depth (PPD) and marginal bone loss at the time of implant placement (T1), at the time of placement of friction fit prostheses (T2), and 12 months after placement of friction fit prostheses (T3). Marginal bone loss at T2 and T3 was measured with respect to bone levels at T1 and T2, respectively. The patient satisfaction was assessed at T2 and T3 using FDI clinical criteria and scoring system (modified by Monaco et al.). Statistical Analysis Used: Shapiro-Wilk test was employed to test the normality of data. Paired sample t-test was performed for quantitative variables. Results: A total of twenty implants were inserted in ten partially edentulous spaces; the average patient age was 50.2 years. No significant difference was seen between T2 and T3 for PPD. Comparison of marginal bone loss using paired t-test showed a statistically highly significant difference at T2 and T3 with higher value at T2. No prostheses were dislodged during postprosthetic follow-up. The survival rate was 100% for both the abutments and implants. No change in surface luster was observed 12 months following prosthetic rehabilitation in any case. No prostheses or framework fracture was reported and all patients were satisfied with the prosthesis received. Conclusions: Friction fit conical abutment system can act as a novel approach for the retention of implant-supported fixed dental prostheses.

Guidance Prostheses for Partial Mandibulectomy Patients: A Case Series.

This case series discusses the fabrication of guidance prostheses (GPs) for patients who presented to the Department of Prosthodontics with marked mandibular deviation, resulting in facial disfigurement and deranged occlusion. These GPs guide the mandible to the unresected side to achieve stable occlusion. This case series included three approaches to reducing mandibular deviation: a maxillary guidance ramp, a mandibular guidance prosthesis, and a twin occlusal appliance. These approaches were used in conjunction with a well-planned mandibular exercise regimen. The earlier mandibular guidance therapy is started, the better the outcome. GPs are used until good occlusal relationships and proprioception are restored. These GPs can be discarded or used occasionally once a good occlusal relationship has been achieved.

A Comparative Evaluation of Digital Radiography and Ultrasound Imaging to Detect Periapical Lesions in the Oral Cavity.

Purpose This study evaluates the efficacy of digital radiography and ultrasound (USG) for the distinction between periapical cysts and granulomas, determines the nature and extent of the periapical lesion, visualizes the lumen of the lesion, assesses its size, content, and vascularity. Material and Methods Thirty patients, ages 18 to 40, with well-defined periapical radiolucencies on maxillary or mandibular teeth, indicated for the extraction or periapical surgery, underwent digital radiography examination using the paralleling technique, followed by USG examination. A sonologist evaluated the lesions' size, echogenicity, and vascular content. The diagnosis was compared to histopathological examinations of tissues obtained through extraction or periapical surgery. Results The diagnostic value of USG compared to the histopathological diagnosis of the periapical cyst was greater than that of the radiographic diagnosis, with an ultrasonographic diagnostic sensitivity (SN) value of 60% and a radiographic diagnostic SN value of 40%, respectively. The diagnostic value of USG imaging against the histopathological diagnosis of periapical granuloma was slightly lower than that of digital radiography, with an SN value of 72.2% for USG and 83.33% for digital radiography. However, the specificity (SP) value and precision of USG imaging were superior to those of digital radiographic diagnosis. USG imaging and radiographic diagnosis had 58.33% and 50% SP values, respectively. In cases of periapical abscess, the diagnostic values of USG against histopathological diagnosis were lower than those of radiographic diagnosis, which had an SN value of 100%. Conclusion USG with color doppler is a more effective tool than digital radiography for diagnosing periapical lesions. The echo structure of the lesions and the presence of vascularity on USG with color doppler correlated with histopathology better than the radiological diagnosis.

Full Mouth Rehabilitation Using the Twin Stage Procedure in a Patient with Amelogenesis Imperfecta: A Case Report.

Amelogenesis imperfecta (AI) refers to a group of inherited odontological disorders that alter enamel formation. The AI variant is based on the primary enamel defect, classified as hypoplastic type I, hypo maturation type II, hypo calcification type III, and hypo maturation type IV. AI is commonly linked with the loss of the normal occlusal plane, the loss of the vertical dimension of occlusion (VDO), and impaired functions and esthetics. This case report describes the Hobo and Takayama twin-stage procedure for the rehabilitation of a patient with hypoplastic AI.

Comparative Evaluation of the Clinical Efficacy of Four Different Gingival Retraction Systems: An In Vivo Study.

INTRODUCTION: There are numerous gingival retraction systems available on the market. This study aimed to evaluate the clinical efficacy of four gingival retraction systems, namely, impregnated retraction cord, gingival retraction capsule, retraction paste, and polyvinyl acetate strips. METHODS: A total of 20 people were chosen for the study, and 100 specimens were collected. The specimens were classified into five groups based on the materials used for gingival displacement. On the first day, a baseline impression without gingival displacement was made. Afterward, impressions were made with any of the following four gingival retraction systems: impregnated retraction cord (SURE-Cord® Plus; Sure Dent Corporation, Jungwon-gu, South Korea), retraction capsule (3M ESPE astringent retraction paste capsule; 3M Corporation, St. Paul, MN), retraction paste (Traxodent® Hemodent® Paste Retraction System; Premier Dental Co., Plymouth Meeting, PA) and polyvinylacetate strips (Merocel; Merocel Co., Mystic, CT), with a 14-day interval between each system. The amount of gingival displacement was measured using an optical microscope as the distance from the tooth to the gingiva crest in a horizontal plane. RESULTS:  All experimental groups had higher gingival displacement than the control group (P < 0.01). Among the experimental groups, polyvinyl acetate strips had the highest gingival displacement value (541.65 µm), followed by impregnated retraction cord (505.37 µm), retraction capsule (333.57 µm), and retraction paste (230.63 µm). CONCLUSION:  Within the limits of this in vivo study, significant differences in horizontal gingival displacement were discovered among the four evaluated systems. The horizontal displacement requirements of 200 µm were exceeded by all four systems. The maximum value for gingival displacement was found in polyvinyl acetate strips (Merocel), followed by impregnated retraction cord (SURE-Cord), and retraction capsule (3M ESPE), and the lowest value was found in retraction paste (Traxodent).

Microstrain Analysis of Selective Pressure Techniques for Mandibular Complete Denture Impression: An In Vivo Study.

Aim The present in vivo study was undertaken for microstrain analysis of the selective pressure impression technique using strain gauges in mandibular complete denture impression. Methodology Ten completely edentulous patients undergoing complete denture treatment were selected for the study. For each patient, mandibular casts were made, and two custom trays were fabricated on the mandibular cast. These mandibular trays were divided into two groups: those with mandibular impressions made in the custom tray with the use of a spacer (MST) and those without a spacer (MWS). For each patient, a primary impression was made by using an impression compound. After that, the primary cast was obtained, and the custom tray was fabricated by using auto polymerizing resin. Then strain gauges were attached to the particular areas of the tray. The customized tray with zinc oxide eugenol impression material was seated in the patient's mouth for the final impression. The strain produced during impression making at different areas was recorded by a multi-channel (six) strain amplifier and data logger (8-channel digital strain indicator NIC, Jaipur, India). The data obtained were subjected to statistical analysis using an independent t-test (for quantitative data within two groups). The level of significance was set at p=0.05 (p<0.05-significant, p<0.01-highly significant, p<0.0001-very highly significant). Results The comparison of the percentage of microstrain produced at the relief area with and without spacer tray design showed a statistically significant (p=0.001) result with a greater number of percentages of microstrain among those without spacers (94.19) than with spacer (72.09) tray design. Conclusion The use of a tray with relief for selective pressure impression of an edentulous mandible resulted in a desirable pressure distribution at the alveolar crests and buccal shelves.

Influence of surface modification of titanium implants on improving osseointegration: An in vitro study.

STATEMENT OF PROBLEM: The effect of aging and the surface treatment of implants on osseointegration needs to be evaluated. PURPOSE: The purpose of this in vitro study was to evaluate the effects of aging and the surface treatment of titanium with ultraviolet (UV) radiation and fibroblast growth factor (FGF) on hydrophilicity and cell growth and thus on osseointegration. MATERIAL AND METHODS: A total of 28 specimens were divided into 2 groups to measure hydrophilicity (n=14) and cell growth (n=14). Each group was further divided into 4 groups according to surface modification. These include the control group (CG) (nascent specimens), aged group (AG) (nascent specimens aged for 4 weeks), photofunctionalized group (PG) (aged specimens UV-A treated), and mimed group (MG) (aged specimens UV-A and FGF2 treated). The PG and MG specimens were treated with UV-A light for 40 minutes. The biomimetic surface modification was performed for MG. Hydrophilicity was measured by using the contact angle in relation to the surface of titanium disks with the help of a drop shape analyzing device (KRUSS), and cell growth was measured by calculating the number of stem cells per cm2 with the help of a scanning electron microscope (SEM). The data obtained were subjected to statistical analysis with a statistical software program (α=.05). RESULTS: The lowest contact angle values were found in PG (13.52 ±0.90 degrees) and the highest in AG (70.54 ±1.72 degrees). The highest number of cells per cm2 (2880 ±99.33) were found for MG, and the lowest number of cells per cm2 (760 ±9.17) for AG. CONCLUSIONS: Aging decreased the hydrophilicity and cell adhesion, migration, and growth on the titanium surface. UV treatment improved the hydrophilicity, cell adhesion, migration, and growth for both CG and AG. FGF2 treatment increased the cell adhesion, migration, and growth for CG, AG, and PG.