The effect of bioelectric and manual impressions on quality of complete dentures and quality of life: A cross over pilot study.

Purpose: To compare the quality of complete dentures and quality of life of participants rehabilitated by using TENS (Transcutaneous electric nerve stimulation) facilitated impression making with manual impressions. Material and methods: Ten completely edentulous participants were enrolled in the crossover, pilot study. Participants were randomized in 2 groups. Five participants in each group were rehabilitated by dentures fabricated with TENS facilitated definitive impression technique (group T) and conventional impression technique (group C). In group T, Bioelectric border molding was done for the participants, that uses electric stimulation of the nerves supplying the muscles. In group C, incremental border molding using modeling plastic impression compound was carried out. Participants in each group used the dentures for 3 months. After 3 months, OHIP-EDENT questionnaire responses were obtained from the participants to observe the oral health related quality of life. A dental specialist recorded denture quality by Kapur scoring criteria. After one month wash period, the treatment was swapped between the groups. OHIP-EDENT scores and Kapur score were recorded for the alternate dentures after 3 months of use. Descriptive analysis was followed by Mann Whitney test to compare the overall scores between group T and group C for OHIP-EDENT, the scores for individual domains of OHIP-EDENT, and Kapur score for denture evaluation (α = 0.05). Results: The overall OHIP-EDENT scores within each domain were less in group T when compared with the scores in group C and Kapur score for group T was more than group C. The difference was statistically significant i.e. P = 0.002 & 0.003 respectively. Conclusions: Less OHIP-EDENT scores in group T imply better perception of quality of life of individuals due to better performance of stomatognathic system. The higher Kapur scores in group T signifies better quality of dentures when TENS was used for definitive impression making.

Comparison of Soft Tissue Volumetric Changes and Pink Esthetics After Immediate Implant Placement with Socket Shield and Conventional Techniques: A Randomized Controlled Trial.

PURPOSE: To compare volumetric changes in buccal soft tissue and pink esthetic scores after immediate implant placement performed with a socket shield technique (SST) or the conventional technique (CT). MATERIALS AND METHODS: This parallel-arm, randomized controlled trial included 22 participants requiring replacement of a single maxillary incisor with an immediate implant. Immediate implants were placed via either the SST or the CT, with patients randomly allocated to one of the two groups. All implants underwent an immediate loading protocol. Definitive crowns were placed 6 months after implant placement. Scans of casts were recorded with a digital white light scanner before implant placement and at the end of 12 months. Volumetric changes to soft tissues on the buccal aspect were assessed by superimposition of the scanned cast. Esthetic evaluation of the soft tissue was done by evaluating the pink esthetic score (PES) before implant placement and 6 and 12 months after implant placement. Statistical analysis of the data was performed using statistical software (Stata 16.0, StataCorp). RESULTS: The mean volumetric change in buccal soft tissues at the end of 12 months in the SST group was -0.1520 ± 0.86 mm, and in the CT group, it was -0.643 ± 0.35 mm. The difference was statistically significant (P = .001). Higher PES was observed in the SST group at all time intervals. The difference was statistically significant at 6 months (P = .001) and 12 months (P = .007). CONCLUSIONS: The results of this study showed less volumetric changes in buccal soft tissues and higher PES when the SST is used rather than the CT.

Comparison of soft tissue volumetric changes and pink aesthetics in immediate implant placement by socket shield and conventional technique: A randomized controlled trial.

PURPOSE: The purpose of this study was to compare soft tissue volumetric changes on buccal aspect and pink aesthetics score in immediate implant placement by socket shield and conventional technique. MATERIAL AND METHODS: This parallel-arm, randomized controlled trial included 22 participants requiring replacement of single maxillary incisor by immediate implant placement. Immediate implants were placed with socket shield technique (SST) and conventional technique (CT) in respective two groups after randomization. All implants were immediately loaded by immediate loading protocol. Definitive crowns were placed 6 months after implant placement. Scans of casts were recorded by using a digital white light scanner before implant placement and at the end of 12 months. Volumetric soft tissue changes on the buccal aspect was assessed by the superimposition of scanned cast. Esthetic evaluation of soft tissue was done by using pink esthetic score (PES) before implant placement, 6 months, and 12 months after implant placement. Statistical analysis of the data was performed using statistical software (Stata 16.0; Stata Corp LLC). RESULTS: The mean soft tissue volumetric change on the buccal aspect at the end of 12 months in the SST group was -0.1520 ±0.86 mm, and in the CT group was -0.643 ±0.35 mm and the difference was statistically significant (P=.001). Higher PES was observed in the SST group when compared to the CT group at all time intervals. The difference was statistically significant at 6 months (P=.001) and 12 months (P=.007). CONCLUSIONS: The results of the study show less volumetric change on the buccal aspect and higher PES in SST when compared to CT. Int J Prosthodont 2023. doi: 10.11607/ijp.8063.

Osteogenic markers in peri-implant crevicular fluid in immediate and delayed-loaded dental implants: A randomized controlled trial.

INTRODUCTION: The study evaluates the levels of matrix metalloprotease-8 (MMP-8), and Cathepsin-K (CatK) in peri-implant crevicular fluid (PICF) among patients with immediate loaded (IL) and delayed-loaded (DL) implants at different time points to know the inflammation and osteogenic status. METHODS: The study population consisted of two groups (n = 25, each group) with a mean age of 28.7 ± 3.5 years, and PICF was collected. MMP-8 and CatK levels were quantified through ELISA. RESULTS: We observed the concentrations of inflammatory markers (MMP-8 and CatK) at three time points in the IL and DL groups. The mean concentration of MMP-8 in the IL group was 9468 ± 1230 pg/mL, 5547 ± 1088 pg/mL, and 7248 ± 1396 pg/mL at 2 weeks, 3 months, and 12 months, respectively; while in the DL group was 10 816 ± 779.7 pg/mL, 9531 ± 1245 pg/mL, and 9132 ± 1265 pg/mL at 2 weeks, 3 and 12 months, respectively. The mean concentration of Cat-K in the IL group was observed at 422.1 ± 36.46 pg/mL, 242.9 ± 25.87 pg/mL, and 469 ± 75.38 pg/mL at 2 weeks, 3, and 12 months, whereas in the DL group was 654.6 ± 152.9 pg/mL, 314.7 ± 28.29 pg/mL, and 539.8 ± 115.1 pg/mL at 2 weeks, 3 months and 12 months, respectively. CONCLUSION: In this study, the levels of CatK and MMP-8 levels decline at 12 months in both groups, and the IL group shows lower values compared to the DL group; however, no significant changes were observed after analyses were adjusted for multiple comparisons (p > 0.025). Therefore, there is not much difference observed in the inflammation process between immediate and delayed loading. (Clinical trial identifier: CTRI/2017/09/009668).

Effect of rehabilitation by using the shortened dental arch concept on the thickness of the masseter muscle and occlusal force: A pilot study.

STATEMENT OF PROBLEM: Knowledge of the effect of a shortened dental arch on masseter muscle thickness and occlusal force is sparse but could help clinicians understand how a shortened dental arch might affect the stomatognathic system. PURPOSE: The purpose of this pilot clinical study was to evaluate and compare the masseter muscle thickness and occlusal force of participants rehabilitated by using a shortened dental arch with matched completely dentate individuals. MATERIAL AND METHODS: Twelve partially edentulous participants with a minimum of 1 posterior occluding pair on each side of the arch were enrolled in the study. The mandibular arch of these participants was rehabilitated by using a single posterior mandibular implant crown (group S). The maxillary arch of all participants in group S was intact. Masseter muscle thickness (cm) and occlusal force (N) were recorded before (T1) and 6 months after implant rehabilitation (T2) for each participant. Twelve participants were selected as controls (group C). They were matched for age, sex, height, and weight with group S and evaluated for masseter muscle thickness and occlusal force. Masseter muscle thickness was evaluated by using ultrasonography during the rest position and maximum volumetric clenching. Occlusal force was measured with an occlusal force measuring appliance. All recordings were done for the left and right sides of the arch. Descriptive analysis was followed by comparison between groups and within group S by using the paired t test (α=.05). RESULTS: Higher masseter muscle thickness and higher occlusal force were observed in group C than in group S before and after rehabilitation. An increase in masseter muscle thickness in the rest position and in maximum volumetric clenching was observed within group S after rehabilitation. Before rehabilitation, a difference in the masseter muscle thickness between group S and group C was statistically significant for the left side at the rest position (P=.017) and during maximum volumetric clenching (P=.016). After rehabilitation, the difference between group S and group C was not statistically significant for masseter muscle thickness at the rest position (P=.890 for right side and P=.555 for left side) and during maximum volumetric clenching (P=.109 for right side and P=.755 for left side). The difference in occlusal force between group S and group C was statistically significant for the right side and left side (P<.001) before rehabilitation and statistically not significant after rehabilitation (P=.161 for the right side and P=.134 for the left side). CONCLUSIONS: Rehabilitation following the concept of a shortened dental arch increased masseter muscle thickness and occlusal force in partially edentulous individuals, making the masseter muscle thickness and occlusal force comparable with those of a completely dentate arch.

Prospective Clinical Pilot Study to Evaluate the Effect of Prosthodontic Rehabilitation on Psychological Status and Quality of Life in Maxillectomy Patients: An Indian Experience.

Abstract: The purpose of the study was to assess psychological status (PS) and quality of life (QOL) before surgical resection of maxilla (T0), 2 weeks after resection (T1), 2 weeks after use of intermediate obturator (T2), before (T3) and 12 weeks after use of definitive obturator (T4). 20 participants, planned for resection of maxilla and subsequent prosthodontic rehabilitation were enrolled. Assessment was done using Hospital Anxiety and Depression Scale (HADS) (HADS-A: anxiety and HADS-D: depression) for PS, World Health Organization Quality of Life BREF (WHOQOL-BREF) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire- Head and Neck Module (EORTC QLQ- H&N35) for QOL, and obturator functioning scale (OFS) for obturator functioning. Six cases were dropped out. Highest HADS-A score was observed presurgically (18.7 ± 1.1) and highest HADS-D score at T1 (18.5 ± 1.8). After rehabilitation, HADS-A and HADS-D decreased significantly (P < 001). Least WHOQOL-BREF score was observed at T1, followed by a consistent, significant rise after rehabilitation at all time intervals (P < 001). Highest EORTC QLQ-H&N 35 score was observed at T1, with significant reduction (P < 0.001) after rehabilitation for all questions, except those related to sexual wellness (P = 1). Highest OFS were observed at T2 (3.1 ± 10.3) and least at T4 (1.9 ± 0.2). QOL and PS decline after maxillectomy. Patient education and rehabilitation with obturator leads to improvement in QOL and PS probably due to restored oral functions, and improved health of soft tissue. Both parameters improved with enhanced obturator quality and time. Registration at Clinical Trials Registry - India ICMR-NIMS: Reg. No. CTRI/2018/04/013164 http://ctri.nic.in/Clinicaltrials/regtrial.php?modid=1&compid=19&EncHid=67729.89030.

A long-term nutritional assessment of maxillary cancer patients undergoing prosthodontic rehabilitation after surgery: A longitudinal study.

Purpose: To evaluate the nutritional status (NS) of patients planned for maxillectomy and prosthodontic rehabilitation using three nutritional assessment methods. Methods: This longitudinal study enrolled 18 planned maxillectomy patients following the inclusion and exclusion criteria. NS was evaluated at five stages: before surgery (S0), 2 weeks after surgery (S1), 3 months after insertion of intermediate obturator (S2), just before fabrication of definitive obturator (S3), and 3 months after insertion of definitive obturator (S4) using two nutritional assessment tools i.e. Patient Generated -Subjective Global Assessment (PG-SGA) &Nutritional risk index (NRI); and body composition indicators i.e. body mass index (BMI), fat free mass (FFM), total body water (TBW), skeletal muscle mass (SMM) and skeletal muscle mass index (SMMI).To determine the changes in patient's nutritional status among different time points Repeated Measure ANOVA with Bonferroni post hoc adjustments was used. Results: Out of 18 patients, 12 were completed the study. NS of maxillectomy patients deteriorates significantly (p < .05) till stage S2. At S3, significant improvement occurred as compared to stage S2, but it remained significantly less than pre-surgical level. However, at stage S4, all parameters were statistically comparable to S0 (p > .05) except for PG-SGA (p < .001) and SMM (p = .044). Conclusion: NS of maxillectomy patients worsen post surgically due to surgical morbidity and adverse effects of radiotherapy (RT) but improves with post-surgical healing, resolution of sequel of RT and improved oral function due to well-adapted obturator prosthesis.

Comparative Evaluation of Load-Bearing Capacity and Fracture Analysis of PEEK and Zirconia Three-Unit Fixed Dental Prostheses: An In Vitro Study.

PURPOSE: The purpose of this exploratory in vitro study was to compare and evaluate the load-bearing capacity (LBC) of ceramic-veneered zirconia and composite-veneered polyetheretherketone (PEEK) three-unit fixed dental prostheses (FDPs) with and without thermocycling (TC). MATERIALS AND METHODS: The study included 40 samples of three-unit FDPs replacing mandibular first molars. The four groups included were: ceZIR (feldspathic ceramic-layered zirconia), ceZIR TC (feldspathic ceramic-layered thermocycled zirconia), cPEEK (composite-layered PEEK), and cPEEK TC (composite-layered thermocycled PEEK) (n = 10 per group). All frameworks were CAD/CAM milled. Ten PEEK and 10 zirconia samples were subjected to TC (6,000 cycles). All 40 FDP specimens were loaded by applying static load, using a universal testing machine. The maximum load required to fracture the specimens denoted the LBC. The comparison of LBC between the four groups was done by using two-way ANOVA with Tukey's post-hoc analysis (α = .05). RESULTS: There was no statistically significant difference between LBC of cPEEK and ceZIR (P > .001) without thermal aging. LBC values decreased considerably for thermally aged specimens. Statistically significant differences were observed between LBC of cPEEK TC and ceZIR TC (P < .001), cPEEK TC and cPEEK (P < .001), and ceZIR TC and ceZIR (P = .001). On fracture analysis, cPEEK showed delamination failures whereas ceZIR displayed catastrophic connector fractures. CONCLUSION: This comparative evaluation offers preliminary data highlighting substantial depreciation in the LBC of layered PEEK under simulated intraoral conditions, thus raising a question regarding the clinical longevity of layered PEEK multi-unit restorations. In contrast, feldspathic-layered zirconia can be suitable for use in posterior FDPs.

Comparative Evaluation of Osteocalcin in Peri-implant Crevicular Fluid and Radiographic Bone Loss in Immediate Loading and Delayed Loading Protocols: A Preliminary Split-Mouth Randomized Controlled Trial.

PURPOSE: To compare osteocalcin and crestal bone loss in implants placed under an immediate loading (IL) compared to a delayed loading (DL) protocol. MATERIALS AND METHODS: This preliminary, split-mouth, randomized controlled trial included 14 participants who required replacement of both mandibular first molars opposing a completely dentate maxillary arch. Two implants were placed in each participant. According to the split-mouth randomization method, a temporary crown was used for the IL protocol and a healing abutment was used for the DL protocol in each participant. Definitive crowns were cemented 3 months after implant placement. Osteocalcin levels were determined using ELISA, and crestal bone loss was evaluated using radiographs at 2 weeks, 3 months, and 12 months after implant placement. RESULTS: The mean osteocalcin level was significantly higher with IL than DL at each point (P < .001), with 95% CI of -262.89 to -439.10 (2 weeks); -238.02 to -375.98 (3 months); and -83.24 to -211.61 (12 months). Higher crestal bone loss was observed in IL when compared to DL implants at 2 weeks (P = .458, 95% CI: -0.10 to 0.21). Less crestal bone loss was observed with IL than DL at 3 months (P = .935) and 12 months (P = .42). CONCLUSION: Osteocalcin levels increased in both IL and DL implants, but higher levels were observed with IL. Higher crestal bone loss was observed with IL during the initial stages of treatment only.

High-dose-rate remote brachytherapy for metachronous second primary carcinoma of soft palate by iridium 192 isotope in an afterload surface mold.

Conservative management of metachronous second primary carcinoma of head and neck is preferred in order to preserve form and function. The purpose of the case report is to describe the treatment of metachronous second primary carcinoma of soft palate by high-dose-rate, remote, afterload brachytherapy. The brachytherapy was done in remote settings by afterloading Iridium 192 isotope carried through a custom fabricated surface mold. The mold enabled good adaptation, stability, and repeatable positioning of the radiation source at each treatment session of fractionated brachytherapy offering consistent dosimetric advantage through a single dosimetry calculation. Collaborative efforts of radiation oncologist and prosthodontist ensured conservative treatment in outpatient set up with minimal adverse effects.

Influence of Thermocycling and Surface Treatments on the Flexural Strength of Denture Base Resin: An In Vitro Study.

AIM: The purpose of this study was to evaluate the flexural strength of heat polymerized denture base resin after thermocycling and different surface treatments done prior to repair or relining. MATERIALS AND METHODS: In this in vitro study, 80 specimens were made with heat-polymerized denture base resin and thermocycled (500 cycles between 5 and 55 °C). The specimens were divided in four groups based on different types of surface treatment: group I (control group: without surface treatment), group II (chloroform for 30 seconds), group III [methyl methacrylate (MMA) for 180 seconds], and group IV (dichloromethane for 15 seconds). The flexural strength was assessed using a Universal testing machine with three-point bending test. The obtained data were subjected to statistical analysis using one-way ANOVA and post-hoc tests. RESULTS: The values of average flexural strength of denture base resin measured were as follows: group I: 111.1 MPa, group II: 86.9 MPa, group III: 73.1 MPa, and group IV: 78.8 MPa. Groups II and IV possessed superior flexural strength than group III. The maximum values were observed with the control group. CONCLUSION: The flexural strength of heat-polymerized denture base resin gets affected by different surface treatments done prior to relining procedures. Lowest flexural strength was obtained when treated with MMA monomer for 180 seconds as compared to the other etchants used. CLINICAL SIGNIFICANCE: Prior to denture repair procedures, operators must choose the chemical surface treatment judiciously. It should not affect the mechanical properties such as flexural strength of denture base resins. Reduction in flexural strength of polymethyl methacrylate (PMMA) denture base can predispose the prosthesis to deteriorated performance when in function.

Stress distribution and patient satisfaction in flexible and cast metal removable partial dentures: Finite element analysis and randomized pilot study.

PURPOSE: To compare stress distribution in polyacetyl based flexible RPD (FRPD) with cast metal RPD (CRPD) by using three-dimensional finite element analysis (FEA) and patient satisfaction by using OHIP-14 questionnaire in participants with Kennedy's class I partially edentulous mandibular arch rehabilitated with CRPD and FRPD. MATERIAL AND METHODS: For FEA, 3D models of Kennedy's class I partially edentulous mandibular arch, CRPD in chrome-cobolt alloy, and polyacetyl based FRPD were geometrically modelled and subjected to a vertical load of 100 â€‹N bilaterally. The in vivo comparison of satisfaction was assessed by enrolling 22 participants with Kennedy's class I partially edentulous mandibular arch. After randomization, 11 participants were rehabilitated by CRPD (group C), and 11 participants by polyacetyl based FRPD (group F). OHIP-14 questionnaire in Hindi language was filled at 1 week and 1 year after denture insertion. RESULTS: Von Mises stress distribution in CRPD was maximum in mesial rest seat of the primary abutment (100 â€‹MPa) and minimum for edentulous ridge (7 â€‹MPa on bone and 6 â€‹MPa on mucosa). Von Mises stress distribution for polyaccetyl based FRPD was maximum in ridge (25 â€‹MPa) and minimum in periodontal ligament of the second premolar (3 â€‹MPa). Patient satisfaction in group F was significantly more than in group C at end of 1 year (P â€‹= â€‹.0158). CONCLUSION: FRPD is useful in periodontally compromised abutment teeth and CRPD in resorbed ridge conditions. Patient satisfaction is more with polyacetyl based flexible RPD when compared with cast metal RPD at the end of 1 year.

Comparison of ridge resorption and patient satisfaction in single implant-supported mandibular overdentures with conventional complete dentures: A randomised pilot study.

PURPOSE: To compare ridge resorption (RR) and patient satisfaction in single implant-supported mandibular overdentures (SIMO) with conventional complete dentures (CCD) over a period of one year. MATERIAL AND METHODS: This prospective, randomized trial enrolled 30 completely edentulous participants following inclusion and exclusion criteria. The study was completed by 28 participants. Rehabilitation of 14 participants was done by using SIMO (group I) and CCD (group C) each according to randomization chart. For both the groups, RR was computed in millimeters from residual ridge height measured by using orthopantogram at 6 months (T1), 9 months (T2), and 12 months (T3) at 3 anatomic locations: maxillary posterior (L1), maxillary anterior (L2), and mandibular posterior (L3). Patient satisfaction was evaluated by using Geriatric Oral Health Assessment Index Hindi version (GOHAI-Hi) at 1week and 12 months after denture delivery. RESULTS: At 12 months, minimum RR was observed at L2 of group I (0.62 â€‹± â€‹0.20 â€‹mm) and maximum RR was observed at L3 of group C (1.04 â€‹± â€‹0.15 â€‹mm). Comparison of ridge resorption between group I and group C was statistically significant at T3 (P â€‹= â€‹.001 for L1, P â€‹= â€‹.006 for L2, and P â€‹= â€‹.028 for L3). At T3, in group I, RR was more at L3 than L2 region (P â€‹= â€‹.011) and L1 region (P â€‹= â€‹.015). Statistically significant difference of GOHAI-Hi scores was observed between group I and group C at end of 12 months (P â€‹= â€‹.003). CONCLUSIONS: SIMO cause less RR and higher patient satisfaction as compared to CCD and can be recommended with higher predictability of success than CCD.

Cranioplast fabrication in a comatose patient: A clinical report.

Cranioplasty may be necessary after decompressive craniectomies to aid in the restoration of the esthetic, morphological, functional, and psychosocial stability of those affected. This clinical report describes the management of a comatose road traffic accident victim with a history of autogenous cranial implant failure after decompressive craniectomy. The challenges posed by the nonambulatory state of the patient and his inability to follow commands were overcome by using reverse engineering and rapid prototyping to fabricate a 3D patient-specific polymethylmethacrylate cranial implant. A digital evaluation technique with grids as measuring tools was successfully implemented in the patient's absence. The use of a custom clamp flask aided in the accommodation and subsequent investing, dewaxing, and polymerization of the carved cranial wax pattern. As a result, a custom cranioplast with optimum marginal fit, acceptable contour, adequate thickness, and reduced surgical duration of placement was obtained through a successful combination of conventional and digital techniques.

Evaluation of the wear of glazed and polished zirconia crowns and the opposing natural teeth: A clinical pilot study.

STATEMENT OF PROBLEM: Clinical studies on the wear properties of different zirconia surfaces are lacking. Selecting a surface that causes and undergoes minimal wear will help improve clinical outcomes. PURPOSE: The purpose of this clinical study was to evaluate and compare the wear over 1 year use of glazed zirconia (GZ) and polished zirconia (PZ) crowns opposing natural enamel and the wear of natural enamel opposing PZ and GZ crowns. MATERIAL AND METHODS: This prospective, split mouth, randomized clinical trial included 14 participants requiring complete coverage crowns on first molars, bilaterally, in a completely dentate mandibular arch. GZ and PZ crowns were cemented according to a randomization chart. Polyvinyl siloxane impressions were made immediately and 1 year after the cementation of the crowns. The respective casts were scanned by using a 3D scanner and a software program to measure the amount of linear wear of zirconia crowns and opposing natural teeth. Wear was observed in 8 groups: PZ crowns, GZ crowns, natural enamel opposing natural enamel in the molar and premolar regions (NE-M and NE-PM), natural enamel opposing PZ crowns in the molar region (NE-PZ-M), natural enamel opposing GZ crowns in the molar region (NE-GZ-M), natural enamel opposing PZ crowns in the premolar region (NE-PZ-PM), and natural enamel opposing GZ crowns in the premolar region (NE-GZ-PM). A descriptive analysis was followed by comparison between groups by using a repeated-measure ANOVA with post hoc adjustments (α=.05). RESULTS: The mean wear (µm) observed was as follows (in ascending order): PZ crowns (13 ±3), NE-PM (13 ±1), GZ crowns (27 ±9), NE-M (34 ±3), NE-PZ-PM (44 ±18), NE-PZ-M (63 ±22), NE-GZ-PM (69 ±21), NE-GZ-M (113 ±33). Wear of GZ and PZ crowns was less than wear of NE-M. The difference was statistically significant when comparing PZ with NE-M (P<.001, CI=-17 to -24). Wear of NE-GZ-M and NE-PZ-M was higher than wear of NE-M, with a statistically significant difference (P<.001, CI=-49 to -107 and P =.004, CI=-8 to -49, respectively). Wear of NE-GZ-M was more than that of NE-PZ-M, and the difference was statistically significant (P<.001, CI=-68 to -32). Wear of NE-PZ-PM and NE-GZ-PM was also more than the wear of NE-PM, and the difference was statistically significant (P<.001, CI=-17 to -43 and P<.001, CI=-39 to -70). CONCLUSIONS: PZ and GZ crowns wear substantially with time, with lesser wear observed in PZ crowns. PZ and GZ crowns also cause more wear in opposing natural enamel than natural enamel antagonists, with the highest wear caused by GZ crowns.

Leadership in academic dentistry.

The transformational changes occurring in academic dentistry are a response to many, different innovations as well as new demands, challenges, pressures and expectations. Despite dental schools and clinical academic centres having responded to rapid, multifaceted change, the ever increasingly complex and changing nature of oral healthcare provision, together with the growing body of evidence on the impact of oral health on general health and wellbeing at all ages, requires academic dentistry to redouble its efforts to remain fit for future purpose. Central to success in this demanding quest is strong, visionary leadership.

Leadership in recruiting and retaining talent in academic dentistry.

A major challenge for leaders in academic dentistry is the recruitment and retention of talented individuals. Six aspects of this challenge are considered - spotting, recruiting, developing, managing and mentoring, retention and 'letting go' talent. Skills in this important aspect of leadership can be learnt and acquired, thereby building capacity to build and retain effective academic teams.

Prosthetic rehabilitation of resected orbit in a case of mucormycosis.

The design of orbital prosthesis to rehabilitate patients with orbital exenteration depends on the underlying clinical condition, material chosen for prosthesis, method of retention of the prosthesis, and and preference of the patient. Rehabilitation of a patient with orbital exenteration due to mucormycosis has been described by fabricating a prosthesis that used polymethyl methacrylate (to fabricate a conformer) and silicone material (to fabricate prosthetic superstructure). The two-component prosthesis was designed to attain dual mechanical retention using an anatomic undercut (conformer) and manually created mechanical undercut (prosthetic superstructure). The objective was to maintain the biological health of the underlying postsurgical tissue, longevity of the prosthesis, optimal esthetics, and adequate retention.