ABSTRACT
STATEMENT OF PROBLEM: Changes in the oral microbiota of new complete denture wearers are the main cause of oral candidiasis. The drawbacks associated with traditional antimycotic therapies, especially drug resistance, have led to the search for potent therapeutic and prophylaxis agents with less harmful effects, including probiotics. However, investigation of the prophylaxis and preventive effects of probiotics on new complete denture wearers are lacking. PURPOSE: The purpose of this randomized clinical trial was to assess the prophylactic efficiency of multistrain probiotics (Lactobacillus and Bifidobacterium) in combating oral candidiasis in new complete denture wearers. The Candida relapse after 4 weeks of intervention cessation was also evaluated. MATERIAL AND METHODS: A total of 50 new maxillary and mandibular complete denture wearers with asymptomatic detectable levels of Candida were enrolled. The participants in the probiotics group received a daily dose of probiotic lozenges for 8 weeks versus placebo tablets taken by those in the placebo group. Collected mouth-rinse samples were microbiologically assessed to count Candida colonies and identify different species at different time intervals: baseline, 2 weeks after denture delivery, 4 and 8 weeks after the beginning of intervention, and 4 weeks postintervention follow-up. Data were assessed by performing the Shapiro-Wilk test to check the normality of the colony count, while the difference in the colony count between timelines was analyzed using the Freidman test followed by multiple comparison tests (α=.05). RESULTS: Two weeks after denture delivery, the Candida load had not risen significantly from the baseline count (P>.05). After the intervention, the probiotics had reduced the Candida count significantly in the fourth week and in subsequent follow-up periods, with the highest decrease observed in the eighth week, recording a median count of (0.00) compared with (2.74) at the baseline level (P<.001). Furthermore, in assessing the differential count of Candida species, a noteworthy decrease was found in the level of the most prevalent Candida albicans in the eighth week, with a relapse noticed in the twelfth week of posttreatment follow-up. CONCLUSIONS: Probiotic lozenges had antimycotic efficiency in asymptomatic new complete denture wearers, with short-term extended preventive effects after intervention cessation.
ABSTRACT
This article describes a newly designed Prosthetic Auricular Guide (PAG) that allows for accurate planning and positioning of both the auricular implants and the prosthetic auricle. The design aims to provide a cost-effective guiding device for more esthetic ear prostheses which is the patient's main concern. Along with determining the best clinically accepted position of the ear, the device can be used while taking CBCT which allows for the integration of the clinically approved position with the remaining bone for accurate planning of implant positions. Furthermore, the device can be fixed during surgery for accurate transmission of the planned position. The device is also adjustable making it suitable for all patterns of auricular defects, different ages, and even for patients with asymmetric faces.
Subject(s)
Dental Implants , Ear Auricle , Plastic Surgery Procedures , Humans , Prosthesis Implantation , Ear, External/surgery , Ear Auricle/surgeryABSTRACT
Skin overgrowth is a complication that hinders bone-anchored prosthetic ear rehabilitation. In order to accurately transfer the healing skin for prosthetic reconstruction, this article introduces a custom-made autopolymerizing acrylic resin auricular cap (button) through indirect pick up of the metal housing. The caps are secured during the healing stage to shape the skin, preventing surgical edema, swelling, and skin overgrowth in patients suffering from keloid reactions from covering the implant abutments. Since skin height and form are changeable, the caps can be relined directly or indirectly if greater skin compression is required. Moreover, these custom-made caps can be utilized during prosthetic silicone ear fabrication to retain the metal housing.
ABSTRACT
STATEMENT OF PROBLEM: Computer-aided design and computer-aided manufacturing (CAD-CAM) milled titanium bars have shown good clinically acceptable passive fit and definitive marginal fit; however, investigations into the passive fit and definitive marginal fit of prefabricated CAD-CAM milled titanium bars are lacking. PURPOSE: The purpose of this in vitro study was to compare and evaluate the passive fit and definitive marginal fit of prefabricated and conventional CAD-CAM milled titanium bars. MATERIAL AND METHODS: A total of 10 polyurethane radiopaque anatomic completely edentulous mandibular models had implants (Biohorizons) placed in the left and right canine and second premolar positions using a 3-dimensionally printed fully guided surgical guide. For the conventional bars, impressions were made, and casts were scanned and exported to a software program (exocad 3.0). For the prefabricated bars, the surgical plans were exported from the software program directly. The Sheffield test was used to evaluate the passive fit of the bars, and marginal fit was evaluated with a scanning electron microscope at ×50 magnification. The Shapiro-Wilk test was used to determine that the data were normally distributed; the data are presented using mean and standard deviation. Group comparisons were made with the independent t test (α=.05). RESULTS: The passive and marginal fit of the conventional bars was better than that of the prefabricated bars. The mean ±standard deviation values for passive fit were 75.2 ±13.7 µm for conventional bars and 94.7 ±16.0 µm for prefabricated bars (P<.001). A statistically significant difference (P<.001) was also found between the marginal fit of the conventional bars 18.7 ±6.1 µm and the prefabricated bars 56.3 ±13.0 µm. CONCLUSIONS: Conventional CAD-CAM milled titanium bars had a better passive and marginal fit than prefabricated CAD-CAM milled titanium bars; however, both had clinically acceptable passive fit ranging from 75.2 to 94.7 µm and definitive marginal fit ranging from 18.7 to 56.3 µm.
