Evaluation of positional accuracy in multiple implants using four different splinting materials: An in vitro study.

BACKGROUND: Prosthesis misfit plays an important role in complications such as occlusal and abutment screw loosening and fracture in implant restorations. Reproducing the intraoral relationship of implants through impression procedures is the first step in achieving an accurate, passively fitting prosthesis to ensure maximum accuracy. Hence, splinting of multiple implants with most accurate material may be a valid option. CONTEXT: The results of splinting multiple implants are always inconsistent, and there is limited literature available to compare the accuracy of impression techniques as well as materials. In such situation, more and more studies have to be done to prove the efficacy and accuracy of each splinting materials. AIM: The aim of the study was to evaluate the positional accuracy in multiple implants using acrylic resin, pattern resin, flowable composite, and bite registration paste. SUBJECTS AND METHODS: An acrylic resin model was fabricated into which four implant analogs placed. The copings attached were splinted with dental floss onto which acrylic resin was added, which was sectioned and rewelded (Group A). Similarly, pattern resin, flowable composite, and bite registration material were added which were considered as Group B, C, and D, respectively. Impressions were made in vinyl polysiloxane and analogs were attached. The casts retrieved from each group were analysed for the positional accuracy of implants. STATISTICAL ANALYSIS: One-way ANOVA was done to analyze the significant difference between the four implant analogs of each group with the master model. The confidence interval was also calculated to assess the accuracy. RESULTS: It was observed that all materials are equally effective for the accurate reproduction of implant positions. There was no significant difference between the centroids of implant analogues of master model and the mean of interimplant distance 1 and 2, 1 and 4, 3 and 4 and 2 and 4 in each group. The P-values were >0.05. The accuracy of splinting materials were analysed and it showed that splinting with flowable composite (Group C) as well as bite registration paste were in par with the conventionally used materials like pattern resin and acrylic resin. CONCLUSIONS: Results showed that flowable composite as well as bite registration material can be recommended as splinting material of choice for multiple implant cases, as these exhibited similar results like other groups (pattern resin and acrylic resin) which are conventionally used.

Prosthetic rehabilitation in neurosurgical cranioplasty.

The defects of the skull cause mechanical vulnerability of the brain, esthetic disfigurement, and transmission of vibrations and pulsation of the brain. Subsequent cranioplasty may be required to compensate for the defect and to alleviate various signs and symptoms. When long-term outcome of biomaterial use in pediatric cases is limited, alloplastic cranioplasty in adults are supported by several large case series. This case report narrates cranioplasty using titanium alloplastic implant material.

Ureteral Reflux into an Ectopic Upper Moeity of a Duplex Kidney from the Bladder Neck with Distal Ureteral Pseudodiverticulum Formation.

Urinary incontinence is a condition causing significant psychological trauma and affects the quality of life of the affected individual. Though common causes of urinary incontinence of non-traumatic aetiology in young adults include detrusor instability and congenital conditions like meningomyelocoele, an ectopic ureter is an important surgically correctable cause of urinary incontinence. The cause of incontinence in an ectopic ureter is insertion of the ureter distal to the internal urethral sphincter. The authors describe a case report of an ectopic ureter arising from a duplex moiety with poor renal function using multiple modalities. This highlights the utility of multiple modalities in arriving at an accurate diagnosis, with adequate clinically useful information. In this case, the formation of a pseudo-diverticulum resulted in diagnostic confusion.

A case report of racemose pattern of intracranial tuberculoma with brain stem and hypophyseal involvement developing paradoxically during treatment.

Tuberculosis involving the central nervous system, a source of considerable morbidity and mortality, forms 5-10% of the disease burden associated with tuberculosis. Central nervous system tuberculosis may present as meningitis, tuberculoma, abscesses, cerebritis or miliary tuberculosis. The most common site of tuberculoma has been reported to be at the grey-white matter junction and the periventricular region. They may even be found in the epidural, subdural and subarachnoid spaces, and the brain stem, with the rarer sites of involvement being the cavernous sinus, sella turcica, hypophysis, hypothalamus, sphenoid sinus and the mastoid air cells. Although tuberculosis is very common in developing countries, with the increasing prevalence of immunosuppression owing to human immunodeficiency virus and patients surviving chemotherapy or organ transplantation, the incidence of tubercular infections has been rising in developed countries. The authors report a case of intracranial tuberculosis in a human immunodeficiency virus-negative patient, who underwent incomplete treatment for tubercular peritonitis and presented with unilateral ptosis. Tuberculous involvement was noted in a racemose pattern in the subarachnoid space, cavernous sinuses, suprasellar cistern and parasellar region. To the best of our knowledge, the term racemose pattern of tuberculoma has not been described before, while about 10 cases of tuberculoma involving the cavernous sinuses have been reported in the literature. Furthermore, the racemose pattern of tuberculosis in the subarachnoid space, as well as involvement of the cavernous sinus, hypothalamus, pituitary and the cisterns, developed paradoxically after initiation of antitubercular chemotherapy.