Improved Fabrication of Implant Retained Auricular Prosthesis with Digital Technologies.

A 28-year-old male patient came to the prosthodontics department seeking replacement for his congenital defect left ear. With the use of digital technology, a silicone implant supported bar retained auricular prosthesis that is an exact match in size, shape, and orientation to the existing contralateral ear was made.

Opacifiers on color stability of maxillofacial silicone under aging and Indian weathering conditions: An in vitro study.

STATEMENT OF PROBLEM: Resistance to long-term color change is a desirable property for facial prosthetic elastomers. Evidence for the color stability of maxillofacial silicones under aging and hot and humid Indian weathering conditions is lacking. PURPOSE: The purpose of this in vitro study was to evaluate the effect of adding opacifiers on the color stability of maxillofacial silicone under human aging and Indian weather conditions. MATERIAL AND METHODS: A total of 93 specimen disks were obtained from the A-2186, platinum-based, room-temperature vulcanized, maxillofacial silicone elastomer by using a Ø30×6-mm stainless-steel die. The specimens were divided into 3 main groups (n=30), C (control), T (titanium dioxide), and B (barium sulfate), and 1 additional specimen (n=1) from each group was stored in a closed box and further subgrouped as outdoor weathering (COut, TOut, BOut), acidic perspiration (CAcid, TAcid, BAcid), sebum (CSebum, TSebum, BSebum) (n=10), and visual comparison (CVis, TVis, BVis) (n=1). Baseline L∗, a∗, b∗ values were recorded by using a spectrophotometer and visual perception. The specimens were subjected to human and extraoral aging conditions, and the values were recorded again after 6 months. Data were analyzed statistically by using analysis of variance (ANOVA) and post hoc analysis with the Tukey post hoc test. RESULTS: In group C, the mean color change for COut was 3.69 ±0.49; CAcid, 3.58 ±0.68; and CSebum, 7.53 ±0.22 (P<.001). In group T, the mean color change for TOut was 2.60 ±0.24; TAcid, 2.35 ±0.13; and TSebum, 4.91 ±0.44 (P<.001). In group B, BOut was 1.59 ±0.28, BAcid was 1.46 ±0.28, and BSebum was 4.03 ±0.71 (P<.001). The specimens containing barium sulfate showed the maximum color stability. The least color stability was observed in all specimens exposed to sebum solution and was significantly different (P<.001) from the outdoor weather and acidic perspiration specimens. Visually perceivable color changes were observed in specimens exposed to the sebum solution. CONCLUSIONS: The addition of titanium dioxide and barium sulfate as opacifiers resulted in clinically acceptable color change when exposed to outdoor weathering and acidic perspiration but not in sebum solution.

Satisfaction in conventional acrylic complete denture patient with and without denture liners - a systematic review.

To make a new complete denture, a series of steps is needed, and it is a time-consuming process. Which is not possible in every patient due to financial and medical reasons. The old denture can be relined by denture liners in less clinical and laboratory steps and can successfully increase the efficiency of ill-fitting dentures however, patient satisfaction with denture liners is doubtful. This systematic review was organized from the preferred reporting items for systematic reviews' checklist, and the methods were registered on the international prospective register of systematic reviews (PROSPERO- CRD42020210227). The main systematic review is to assess satisfaction in convectional acrylic complete denture with or without denture liners. Search engines such as PubMed, Science Direct, Cochrane, Ovid, and Google Scholar were used to extract information. The risk of bias was measured with the help of the Cochrane collaboration tool. Initially we found 1711 articles out of which 6 were finalised as per PICO criteria. Patient satisfaction was evaluated by using a visual analogue scale and questionnaire method, which shows denture liners group has more patient satisfaction. Acrylic denture liner and silicon denture liner shows better patient satisfaction compared to the conventional acrylic denture. Among denture liners, there is no significant difference.

Effect of Ball and Bar Attachment Type on Patient Satisfaction Using Two-Implant-Retained Mandibular Overdenture: A Crossover Randomized Clinical Trial.

Background: Considering the two-implant-retained overdenture as a first treatment of choice for edentulous mandible, patients using the overdentures need to be satisfied with the type of attachment used. The purpose of this study was to determine level of patient satisfaction with two-implant-retained mandibular overdentures opposing conventional maxillary complete denture using ball-socket and bar-clip attachments. Materials and Methods: In this within-subject crossover randomized clinical trial, total 20 edentulous patients were given conventional complete dentures for 3 months to use. All completed a satisfaction questionnaire before implant placement. They were randomly assigned to receive an overdenture retained by either ball or bar attachment. After 3 months satisfaction questionnaires were repeated, and crossover was done by changing the attachments. After use of 3 months of alternate attachments, patients were asked to complete the final questionnaires and asked to choose their preferred type. The patient satisfaction scores were recorded after using 3 months of conventional complete denture, 3 months of first attachment and 3 months of second attachment. Data were analyzed using Wilcoxon signed rank test. The P values were adjusted using Bonferroni multiple testing correction, and P < .05 were considered as statistically significant. Results: There was no significant difference in patient satisfaction between ball and bar attachments. However, patient satisfaction improved significantly between baseline and either-attachment-retained prosthesis. At the end of the comparative crossover experiment, 11 patients voted for the ball attachments and 9 for the bar attachments, thereby indicating them as their preferred attachments. Conclusions: Among ball and bar attachment, there was no statistically significant difference in satisfaction scores. Neither ball nor bar attachment was chosen as a preference over the other.

The color stability of maxillofacial silicones: A systematic review and meta analysis.

Aim: This systematic review aims to identify and interpret results of studies that evaluated the changes in the color stability of maxillofacial prosthetic materials due to chemical instability of silicones and pigments and the effect of exposure to environmental conditions and aging factors on the same. Settings and Design: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA). Materials and Methods: Relevant articles written in English only, before November 15, 2019, were identified using an electronic search in the PubMed/Medline conducted to identify pertinent articles. The relevancy of the articles was verified by screening the title, abstract, and full text, if they met the inclusion criteria. A total of 42 articles satisfied the criteria, from which data were extracted for qualitative synthesis. This review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO registration number CRD42019124562). Statistical Analysis Used: Since considerable data heterogenicity was present in all studies except the ones on incorporation of TiO2 for which meta-analysis using random effects model was performed. Results: The database search resulted in 234 studies, of which 202 articles were excluded due to lack of relevance, duplication, and unavailability of data. The remaining 32 fulltext articles were assessed for eligibility, out of which 2 articles were excluded. Twelve articles were yielded by manual search. A total of 42 studies were included in the present systematic review. Due to heterogeneous data, meta-analysis could be only carried out with the effect of TiO2 nano particle on color stability. Conclusions: Although there has been extensive amount of research in this field, an ideal maxillofacial silicone exhibiting good color stability in various human and environmental aging conditions is yet to be identified. Human and environmental aging conditions have an adverse effect on the color stability and addition of TiO2 nano particle seems to improve the same.

Comparative evaluation of three types of denture base materials with saliva substitute before and after thermocycling: An in vitro study.

STATEMENT OF PROBLEM: Xerostomia refers to the decrease in the quality and quantity of saliva. In denture wearers, xerostomia affects the retention of the denture because of lack of wettability of the denture base. However, which denture base resin materials are best wetted by artificial salivary substitutes is unclear. PURPOSE: The purpose of this in vitro study was to determine the wetting properties of 3 different commercially available denture base resin materials with artificial salivary substitute by using contact angle measurements and to compare these properties before and after thermocycling. MATERIAL AND METHODS: A total 120 specimens were fabricated with 3 different denture base materials (n=40): heat-polymerized polymethylmethacrylate (DenTek), injection-molded nylon polyamide (Valplast), and microwave polymerized (VIPI WAVE). The advancing and receding contact angles were measured with a goniometer by using the WinDrop++ software program. The contact angle hysteresis was calculated from the advancing and receding contact angles values. The same specimens were subjected to thermocycling to measure the advancing and receding contact angles values. The comparative evaluation was carried out before and after thermocycling. RESULTS: The mean ±standard deviation contact angles of the microwave-polymerized material were (62.40 ±1.21 degrees) advancing contact angle, (32.12 ±0.66 degrees) receding contact angle, and (30.28 ±1.40 degrees) contact angle of hysteresis. It was followed by the injection-molded nylon polyamide material, whose mean ±standard deviation contact angle values were (68.57 ±1.72 degrees) advancing contact angle, (43.02 ±1.39 degrees) receding contact angle, (26.27 ±2.05 degrees) contact angle hysteresis and high impact strength heat-polymerized polymethylmethacrylate material, whose mean ±standard deviation contact angle values were (69.81 ±0.16 degrees) advancing contact angle, (41.90 ±1.02 degrees) receding contact angle, and (27.91 ±0.97 degrees) contact angle hysteresis. The statistical analysis showed significant differences among contact angle values of the microwave-polymerized material as compared with the heat-polymerized polymethylmethacrylate and injection-molded nylon polyamide materials (P<.001). CONCLUSIONS: The microwave-polymerized material showed better wettability with artificial saliva substitute than heat-polymerized polymethylmethacrylate and injection-molded nylon polyamide.

A Systematic Review to Evaluate Knowledge, Attitude, and Practice Regarding Biomedical Waste Management among Dental Teaching Institutions and Private Practitioners in Asian Countries.

OBJECTIVE: The objective of this study was to assess knowledge, attitude, and practices among dental teaching institutions and private practitioners in Asian countries. MATERIALS AND METHODS: Systematic review of observational studies on BMW management was conducted. We searched the following electronic bibliographic databases: PubMed/MEDLINE and Google Scholar. Manual search was carried out for similar topics in the National Medical Library, New Delhi. In addition, the bibliographies were manually searched. There was no disagreement between the two reviewers. This review was reported and conducted in step with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Only studies written in English and published until November 2019 were included. This review was registered in International Prospective Register of Systematic Reviews (PROSPERO registration number is CRD42019124900). RESULTS: In this review, of 678 articles, 24 articles met inclusion criteria. Available scientific studies showed that knowledge regarding BMW management guidelines varied from 33% to 100% among dentists. Most of the studies reported that knowledge and practice regarding segregation of BMW was limited. Most of the study subjects were aware of hazardous effects of amalgam and had amalgam separator. Studies done in Chennai and Karnataka, approximately one-third dentists were not following BMW guidelines for sharp management and most of them were disposing of sharps in general waste bins. CONCLUSION: On the basis of the current evidence and data extracted from the various databases, it can be concluded that knowledge regarding BMW management guidelines among dentists is inadequate and practice regarding the same is poor. Regular training sessions and Continuing Dental Education (CDE) on BMW management guidelines and updates need to be organized for improvement of knowledge and practice regarding BMW among dentists.

Evaluation of the educator's portfolio as a tool for self-reflection: Faculty perceptions.

Background: Preparing a teaching portfolio to document educational expertise has shown to be useful for both promotion and to stimulate faculty development. This article describes a study of the effectiveness of the Educator's Portfolio (EP) as a stimulus for faculty reflection about educational practice. Methods: A sensitizing session of thirty faculty from medical, dental, and physiotherapy colleges on the same campus was conducted; faculty members were asked to complete and submit their EPs. Out of 30 members, 25 responded (83%). Semi-structured interviews of 25 faculties who prepared EPs were conducted, and a qualitative content analysis of the resulting protocols was completed to determine how the EP development process had promoted their reflection on education. Results: All the 25 faculty members indicated that reflection about education had occurred. Four categories of reflection emerged, namely, (a) lack of understanding regarding how to categorize their work; (b) lack of evidence of the effectiveness of educational activities; (c) reformulating educational practice; and (d) source of motivation and self-regulation. Discussion: The findings indicate that EP preparation serves as a tool for reflection on educational practice, which promotes faculty development.

Comparative evaluation of diametral tensile strength of phosphate-bonded investment (ringless) material by using air-drying method, conventional hot air oven, microwave oven, and combination of microwave and conventional oven: An in vitro study.

AIM: This study evaluated and compared the diametral tensile strength (DTS) of phosphate-bonded investment (PBI) material (ringless) used in removable cast partial denture fabrication. SETTINGS AND DESIGN: Comparative - Invitro study. MATERIALS AND METHODS: The PBI material, Wirovest used in this study was subjected to four different drying methods. A total of 80 specimens were prepared in a cylindrical form; 20 specimens were air dried for 2 h, 20 specimens were dried in a conventional oven at 230°C for 1 h, 20 specimens were dried in microwave oven at 600 W for 10 min, and remaining 20 specimens were dried first in microwave oven and then in conventional oven. The dried specimens were tested at 2-h interval for diametral compression at a crosshead speed of 0.5 cm/min. STATISTICAL ANALYSIS USED: Pairwise analysis. RESULTS: The microwave drying technique and drying by combination method resulted in greater DTS, respectively. CONCLUSION: Within the limitation of this study, PBI specimens dried in microwave oven at 600W for 10 min increased the diametral strength and are also a time-saving procedure.

Comparative evaluation of three gingival displacement materials for efficacy in tissue management and dimensional accuracy.

AIM: Displacement of gingiva is essential for obtaining accurate impressions for the fabrication of fixed prostheses, particularly when the finish line is at or within the gingival sulcus. Various newer impression materials have been introduced to achieve gingival displacement while recording the impressions. A comparative evaluation of these new gingival displacement materials was deemed necessary for efficacy in tissue management and dimensional accuracy. MATERIALS AND METHODS: Ten individuals were selected according to the inclusion and exclusion criteria for gingival displacement using retraction cord impregnated with aluminum chloride and two polyvinyl siloxane impression materials (Aquasil and NoCord VPS impression system) according to Latin block design. Intraoral scanner and Vernier caliper were used to study and compare the dimensional accuracy of each die obtained following which the dies were sectioned and evaluated under optical microscope with image analyzer to measure the amount of gingival retraction. RESULTS AND CONCLUSION: Statistical analysis showed that the amount of gingival retraction obtained by using retraction cord impregnated with aluminum chloride as gingival retraction agent was maximum as compared to NoCord followed by Aquasil. All three gingival displacement techniques could produce gingival displacement >0.2 mm which is the optimum amount of retraction required for impression making. All the three materials are found to be dimensionally accurate.

A Novel Mobile App for Oral Cancer Awareness amongst General Population: Development, Implementation, and Evaluation.

AIM: To develop a mobile app for education and screening regarding oral cancer in the general population. MATERIALS AND METHODS: A mobile app titled Prayaas-Oral Cancer Prevention, Treatment, and Rehabilitation was designed and developed to be installed on a basic mobile handset with or without internet. It was aimed for the common public, patients as well as healthcare providers. The contents included all information in the pictorial format as well as videos regarding oral cancer awareness, tobacco de-addiction, self-oral examination, various surgeries, and rehabilitation options. It was pilot tested in 50 factory workers of rural set-up. Participants' feedback was recorded using a self- report questionnaire. RESULTS: Overall feedback was very positive, they found the app easy to operate, enhancing knowledge regarding oral cancer and they recommended this to be used for the general population. CONCLUSIONS: Within limitations of this pilot study, it can be inferred that mobile technology can be successfully used to reach out to bottom of the pyramid population residing in inaccessible rural population for creating public health issues such as oral cancer. CLINICAL SIGNIFICANCE: Oral cancer is preventable through risk factor intervention especially tobacco de-addiction. The self- oral examination can be a very critical factor in early diagnosis of oral cancer. Access to care is a major issue in our country owing to low levels of education, lower income and exposure to risk factors such as tobacco. The fact that today there is widespread use of mobile technology by people belonging to all socioeconomic groups can be harnessed for this public health awareness initiative. This app can be used as a tool for patient education for prevention as well as early detection of oral cancer, both of which can be key to reduce oral cancer morbidity and mortality in India.

Comparative Evaluation of Water Sorption of Heat-Polymerized Polymethyl Methacrylate Denture Base Resin Reinforced with Different Concentrations of Silanized Titanium Dioxide Nanoparticles: An In vitro Study.

STATEMENT OF PROBLEM: Polymethyl methacrylate (PMMA) is the most regularly used material in denture fabrication. Water sorption of denture base PMMA denture base resin has negative effects on physical properties, may lead to harmful tissue reactions in patients, and also has detrimental effects on color stability of the denture base. PURPOSE: The purpose of this study was to evaluate the effect on water sorption of heat-cured PMMA denture base material after incorporation of 1%, 3%, and 5% by weight of silanized titanium dioxide (TiO2) nanoparticles. MATERIALS AND METHODS: For preparation of test samples, TiO2 nanoparticles (PCode: 700339, Sigma-Aldrich, USA) were coated with a layer of trimethoxysilylpropylmethacrylate (PCode: 440159, Sigma-Aldrich, USA) before sonicated in monomer (MMA) (DPI Heat Cure) with the percentages 1%, 3%, and 5% by weight; after sonication, it was mixed with PMMA powder using conventional denture fabrication procedure. Then, we prepared total 40 samples for study; 10 samples for each four groups, i.e. that is one control group and three experimental groups. The first group was prepared from PMMA without addition of TiO2 nanoparticles (control group), the second group with the addition of 1 wt% TiO2 nanoparticles, the third group with 3 wt% TiO2 nanoparticles, and the fourth one with 5 wt% TiO2 nanoparticles (experimental groups). Water sorption test was then conducted on each sample. RESULTS: Each group was evaluated for water sorption test, and it was found that increasing the wt% of nanoparticles, there was a significant decrease in water sorption of denture base resin from 1.74 to 1.46 mean wt%. P value suggested that the difference of mean percent increase across all groups was statistically significant with P = 0.034. CONCLUSION: The maximum decrease in water sorption was observed in denture base resin incorporated with 5 wt% TiO2 nanoparticles.

Evaluation of relationship between nutritional status and oral health related quality of life in complete denture wearers.

INTRODUCTION: The prevalence of malnutrition increases with old age, especially in developing countries like India, and it is the most common cause of morbidity and mortality, because of many factors out of which dentate status is one. AIM AND OBJECTIVE: The aim of this study is to evaluate and determine the effect of nutritional status and dietary intake on the oral health-related quality of life (OHRQOL) of elderly edentulous complete denture-wearing patients and to know whether elderly complete denture wearers have a higher risk of malnutrition. The objective was to assess the need to include dietary and nutritional counseling during prosthodontic rehabilitation of elderly edentulous patients. MATERIALS AND METHODS: A cross-sectional study was conducted among 200 elderly denture-wearing patients above 60 years of age from Nagpur, Maharashtra. Mini-Nutritional Assessment (MNA) questionnaire was used to assess nutritional status, and Geriatric Oral Health Assessment Index (GOHAI) questionnaire was used to determine the OHRQOL of these patients. Descriptive statistics were used to analyze data using SPSS version 21 (SPSS Inc., Chicago, IL, USA). RESULTS: Among the assessed participants, nearly 95% of them had total scores of GOHAI between 12 and 57 which require "needed dental care." As per MNA, 10.5% had adequate nutrition, 70% were at risk of malnutrition, and remaining 19.5% of participants were malnourished. There was a significant correlation between GOHAI and MNA scores. CONCLUSION: Low nutritional status was associated with the poor OHRQOL among the elderly. A strong association was found between mean GOHAI and MNA scores and thereby nutritional status and OHRQOL. The use of conventional dentures increases the risk of malnutrition in the elderly due to inability to eat and chew food properly. Dietary analysis and counseling should be strictly incorporated into geriatric treatment planning during prosthetic rehabilitation.

Effect of Repeated Microwave Disinfection on the Surface Hardness of a Heat-Cured Denture Base Resin: An In vitro Study.

STATEMENT OF THE PROBLEM: Disinfection of complete dentures is very crucial to prevent cross-contamination and infection. Microwave disinfection is a quick, easy, and effective means to disinfect dentures. However, the effect of repeated microwave cycles on the surface hardness property of heat-cured polymethyl methacrylate (PMMA) resin is not known. MATERIALS AND METHODS: A total of 60 samples of heat-cured PMMA resin were fabricated for surface hardness. Each group was divided into four groups, according to the number of microwave cycles (MWC) applied for disinfection: control group (no disinfection) 0MWC, 1MWC group, 3MWC group, and 5MWC group. RESULTS: No significant change on the surface hardness of a heat-cured denture base resin on repeated microwave disinfection. CONCLUSION: The repeated microwave disinfection showed statistically nonsignificant change on the surface hardness of the PMMA resin. Microwave disinfection can be safely used in regular practice to avoid cross-contamination and can also be suggested to patients for the regular denture hygiene.

An In Vitro Study to Evaluate and Compare the Flow Property of Different Commercially Available Zinc Oxide Eugenol Impression Materials.

INTRODUCTION: Impression making is one of the most important steps in prosthodontic rehabilitation of edentulous patients. Zinc oxide eugenol (ZOE) impression paste is the most commonly used material for complete denture wash impression due to its cost-effectiveness and ease of manipulation, while providing the advantage of ability to record fine minute tissue details. Rheological property like flow is a critical factor influencing the success of any impression material, especially in intraoral conditions. Therefore, with so many brands of commercially available impression materials flooding the markets, the aim of this study was to evaluate and compare the flow property of four commercially available ZOE impression materials under simulated intraoral condition. MATERIALS AND METHODS: The testing method used was according to the American Dental Association (ADA) specification no. 16 for ZOE impression pastes. RESULTS: At room temperature, maximum flow was seen with Denzomix followed by Dental Product of India (DPI), Neogenate, and Cavex in descending order, respectively, at 30 s, 1 min, and 10 min of load application. At 37°C in saliva, maximum flow was seen with Denzomix followed by Neogenate, DPI, and Cavex in descending order, respectively, at 30 s, 1 min, and 10 min of load application. Of the four ZOE impression pastes, only the flow of Cavex was considerably less than ADA specified value. INTERPRETATION AND CONCLUSION: Results obtained from this study showed that there is considerable variation in the flow values of different commercially available ZOE impression materials. Change in temperature and presence of saliva had a significant influence on the flow of ZOE impression materials.

Knowledge and attitude about relining of complete dentures in clinical practice: A cross-sectional study.

BACKGROUND: Residual ridge resorption is crucial sequelae of tooth loss. Complete dentures are the most common way of rehabilitating edentulous patients. However, with continuing residual ridge resorption, dentures tend to become loose and unstable causing discomfort, chewing disability, and speech problems. Denture relining is an economical means of improving a denture's stability and retention. An understanding of the clinical indications and limitations of these materials and procedures is crucial for clinical success. AIM AND OBJECTIVE: The purpose of this survey was to assess knowledge, attitude, and practice in relining dentures among dental practitioners. MATERIALS AND METHODS: The cross-sectional survey was conducted using a validated questionnaire on 200 (n = 200) dental practitioners in Nagpur city, Maharashtra. Data analysis was done using proportion test with SPSS EPI INFO software. RESULTS: Although all 200 practitioners were aware of the relining procedure and were routinely carrying out the procedure in their dental clinics, 50% of the practitioners were unaware of the correct relining step by step procedure and were also not sure about the antimicrobial properties of the relining material available in the market. CONCLUSION: Awareness and scientific knowledge about the relining materials and procedure should be enhanced within general dental practitioners through CDE program and workshops. Steps should be taken to include relining procedure as a part of undergraduate clinical curriculum as well as internship program.

Evaluation of the role of skull anthropometry for complete denture teeth selection: A cross-sectional study.

BACKGROUND: Success of complete denture treatment lies in the ability to make it indiscernible from the natural. The selection of the six maxillary anterior teeth is of utmost importance as it contributes most to denture esthetics. Although various techniques and methods to determine the width of maxillary anterior teeth and its relation to various body measurements were done, the simple technique of using circumference of head has been less documented, specifically for Indian population. AIMS AND OBJECTIVE: The aim of this study was to determine whether a relationship exists between the widths of the upper six anterior teeth to head circumference and the objective was to decide whether head circumference can be used as a deciding criterion to select size of maxillary anterior teeth for Central Indian population. MATERIALS AND METHODS: This study was done on 300 people who included 135 males and 165 females. The circumference of head (A) and the combined width of the six anterior maxillary teeth (B) were measured and the ratio of A: B was determined. RESULTS: EPO Info software version 6 was used to derive the statistical analysis with unpaired Student's t-tests. In male students, the mean of the ratio between the head circumferences to the combined widths of the anterior maxillary teeth was 10.14:1. In female students, the mean of the ratio between the head circumferences to the widths of the anterior maxillary teeth was 10.09:1. The average circumference of head to mesiodistal width of six anterior teeth ratio was concluded to be 10. CONCLUSION: Within the limitations of this study, the results suggest that head circumference divided by 10 can be used to select a teeth set with the resulting value as the combined mesiodistal width of six anterior teeth. This can be used as a starting point for determining the width of the anterior maxillary teeth for edentulous patients, which can be further confirmed with the esthetic appearance and with other facial measurements.

Impact of interprofessional education module on attitudes of health-care providers involved in maxillofacial rehabilitation: A cross-sectional study.

PURPOSE: Rehabilitation of maxillofacial deformities is a challenging task because it involves not only a lot of skills and expertise but also many disciplines working in unison for optimum outcome. However, more often than not a prosthodontist is not a member of tumor board and consulted after surgery which affects the prognosis of the rehabilitation adversely. There was a perceived need to create awareness among referring surgeons and physicians, and interprofessional education (IPE) initiatives were deemed necessary to improve this collaboration. METHODOLOGY: Four-hour IPE module was developed involving residents and faculty from three disciplines. The change in attitudes was evaluated quantitatively using Attitudes toward Health Care Teams questionnaire both before and after the module. Semi-structured interviews with selected participants provided the qualitative feedback. RESULTS: The questionnaire consisted of 14 questions answered on 5-point Likert scale (1-5). The mean score of pretest was 44.2 and of posttest was 49.1. Difference was statistically significant (P < 0.05). Higher score indicates better attitude. CONCLUSION: A brief IPE program can improve interprofessional attitudes and collaborative behavior of health-care professionals involved in maxillofacial rehabilitation. It enables the professionals to understand interact and share viewpoints regarding most critical issues faced by them and find solutions to achieve best possible patient care.

An evaluation of patient's decisions regarding dental prosthetic treatment.

INTRODUCTION: For fabricating dental prostheses that meet patients' demands and have good longevity and function, appropriate treatment planning and decision-making are required. Therefore, not only technical skills and clinical judgment of the dentist are needed, but also patients' attitude toward treatment plays a critical role in posttreatment satisfaction. AIM: The aim of this study is to investigate the factors affecting decision-making and the selection of dental prosthesis by the patients. MATERIALS AND METHODS: A cross-sectional survey to determine patients' attitudes about replacement of teeth was conducted. This survey was performed with the help of a prevalidated questionnaire, which contained the demographic data of every patient, whether or not they accept the treatment plan proposed by the dentist, and a close-ended multiple choice question stating the reasons cited by them if they decline the proposed treatment plan. RESULTS: The data were subjected to statistical analysis by Chi-square test at a significance level of P < 0.05. A relationship between the demographical information such as age, gender, educational status, marital status, and monthly income of each patient and the single best reason opted by them to not undergo the proposed treatment plan was established. CONCLUSIONS: In the sample of population studied, most of the patients declined the proposed treatment plan and accepted the alternate one. High expenditure is the most common reason for this rejection.

Evaluation of adhesive bonding of lithium disilicate ceramic material with duel cured resin luting agents.

PURPOSE: The purpose of this vitro study was to comparatively evaluate the adhesive bonding of dual cured resin luting agents with lithium disilicate ceramic material. MATERIALS AND METHODS: Porcelain laminate veneers were prepared with lithium disilicate ceramic material i.e. IPS Empress II( E-Max Press). These laminates were bonded with RelyX ARC, Panavia F 2.0, Variolink II, Duolink and Nexus NX3.The porcelain laminates were etched with 9.6% hydrofluoric acid (Pulpdent Corporation) for one minute, washed for 15 sec with three way syringe and dried for 15 sec with air syringe. The silane (Ultradent) was applied with the help of applicator tip in a single coat and kept undisturbed for one minute. The prepared surfaces of the premolars were treated with 37% phosphoric acid (Prime dent) for 15 sec, thoroughly rinsed and dried as per manufactures instructions. The shear bond test was carried out on all samples with the Universal testing machine (Instron U.S.A.) The scanning electron microscopic study was performed at the fractured interface of representative samples from each group of luting agents. RESULT: In this study, the highest value of shear bond strength was obtained for NEXUS NX3 and the lowest for VARIOLINK II. CONCLUSION: The difference in bond strength can be interpreted as the difference in fracture resistance of luting agents, to which shearing load was applied during the shear bond strength test. It is inferred from this study that the composition of the luting agent determines the adhesive characteristics in addition to surface treatment and bonding surface area.