A Comparative Evaluation of Vertical Marginal Gap for Vented and Precemented Cad-Cam Zirconium Copings on Angulated Abutments: An In vitro Study.

Objective: To evaluate vertical marginal gap after cementation of Zr (zirconium) copings with palatal vent, open vent, and precementation technique on angulated abutments resulting from cement entrapment between intaglio surface of copings and angulated abutments. Materials and Methods: Twenty-four angled abutments and 24 CAD-CAM Zr copings were assigned to three groups depending on the type of cementation technique, comprising eight copings with palatal vent, open vent, and no vent, respectively. Vertical marginal gaps between abutment shoulder and coping margin were evaluated at four points: buccal, palatal, mesial, and distal. The readings were statistically analyzed. Results: The average mean value of vertical marginal gap at all sites for Group A with palatal vent was 158.45, for Group B with open vent was 151.84, and for Group C using precementation technique was 163.58. A statistically non-significant difference was seen for values between all sites (P > 0.05) for all groups. Conclusion: The average vertical marginal gap for Group B was comparatively lower compared to Groups A and C.

Clinical Assessment of Immediate Autotransplantation of Mandibular Third Molars: An In Vivo Study.

INTRODUCTION: Transplanting a tooth from one area of the mouth to another is known as autogenous tooth transplantation. It is a great choice for restoring young patients' teeth with developing alveolar bone because it uses the patient's own tooth as the replacement rather than a false one. This study aims to evaluate pain, infection, mobility, resorption, ankylosis, and success rate in the replacement of mandibular non-restorable molars through an immediate autotransplantation of the nonfunctional impacted mandibular third molar. MATERIALS AND METHODS: In this in vivo study, 20 patients between the ages of 22 and 50 were selected. The cases in which the first or second mandibular molar was nonrestorable and had an impacted third molar for transplantation were selected. In all the cases, the nonrestorable molar was extracted and replaced with a nonfunctional, impacted third molar. All the cases were evaluated for pain, infection, mobility, ankylosis, and resorption at the postoperative second week, one month, third month, and six months. The pain was assessed on the visual analog scale (VAS), infection was assessed by the presence of purulent discharges, mobility was assessed on a clinical examination of tooth movements, ankylosis was seen radiographically as the obliteration of the periodontal ligament space, and the absence of the lamina dura and resorption were seen radiographically as radiolucency on the root surface. All the readings were tabulated and statistically analyzed. RESULTS: Pain was seen to be maximal at two weeks and minimum at six months. Infection was not seen at all time intervals. Mobility was reduced with time. There was no significant ankylosis or resorption. Out of the 20 cases, four patients required extractions due to resorption and grade 3 mobility. One patient showed ankylosis. The success rate of the autotransplantation was 75%. Fifteen patients showed well-defined lamina dura without ankylosis or resorption. CONCLUSION: Autotransplantation is a valuable tooth replacement option and more economical, especially when provided with proper case selection.

New design titanium miniplate versus conventional miniplate in treatment of mandibular angle fractures: A comparative study.

Introduction: Mandibular angle fracture (MAF) is the second most common site of all fractures of the mandible with the highest complication rate. Management of MAF has evolved in the past four decades. The purpose of the prospective study was to compare the efficacy of new design titanium miniplate (NDM) with conventional titanium miniplate (CTM) in the treatment of MAF. Objectives: Mouth opening, occlusion, bite force measurement, and radiographs compared preoperatively and first week, first month and third month postoperatively. Materials and Method: Fourteen patients diagnosed with MAF were randomly divided into two groups: Group A (seven patients) was treated with NDM and Group B (seven patients) with CTM. Patients were assessed preoperatively and postoperatively at an interval of one week, one month and three months. Results: Repeated measures ANOVA and Post hoc Tukey test showed a significant increase in bite force and mouth opening for both groups in first and third postoperative months. Unpaired t-test showed slightly better mouth opening in Group B and slightly higher bite force in Group A. Discussion: Both miniplates fulfilled all the study objectives and equally satisfactory healing was seen at the end of third month. NDM offers better stability, rigidity, and anatomic reduction of the fracture with a drawback of difficulty in adaptation and increased operative timing compared to CTM. Hence, we would like to conclude that both miniplates are equally efficient in the treatment of non-comminuted angle fractures with the NDM having upper hand in stability.

Are Multiple Choice Questions for Post Graduate Dental Entrance Examinations Spot On?-Item Analysis of MCQs in Prosthodontics in India.

BACKGROUND: Construction of appropriate test items is a challenge in preparing quality multiple choice questions. Item analysis provides valuable feedback data on validity of multiple choice questions. The present study was conducted to evaluate the difficulty index, discrimination index and distracter efficiency of the items present in the multiple choice questions of post graduate dental entrance examinations. METHODS: A list consisting of 20 MCQs was taken from the entrance exam books of MCQs on an introductory topic and administered to 104 undergraduate students. RESULTS: In the present study 15% of the MCQs related to impression making procedure were difficult with difficulty index (p) less than 30%, 15% were poor discriminators and 55% had at least one non-functional distracter. CONCLUSION: Item analysis of MCQs in post graduate entrance examinations demonstrated low difficulty index, discrimination index and distracter efficiency. Hence, we propose a strong need for faculty training in test constructors and their post validation.

Challenges in Learning Preclinical Prosthodontics: A Survey of Perceptions of Dental Undergraduates and Teaching Faculty at an Indian Dental School.

INTRODUCTION: Preclinical dental education promotes development of competency and expertise before students work on patients, but this phase is devoid of exposure to real patients leading to challenges in teaching-learning. AIM: The aim of this study was to explore the challenges faced by students during the process of learning preclinical prosthodontics. MATERIALS AND METHODS: Two Focus Group Discussions (FGDs) were conducted with two different groups of students and one FGD was held with prosthodontics faculty. The FGDs explored the student's and faculty perceptions on the topics which were difficult for the students to understand and their suggestions on how these topics can be made easier to understand. The discussions were audio taped with prior consent and transcribed. RESULTS: The students and the faculty felt that the subject of prosthodontics is vast, difficult to visualize and also difficult to correlate theory with practical aspects. Lack of clinical exposure coupled with use of conventional methods of teaching were identified as reasons for difficulty in understanding the subject. Both students and faculty members suggested that use of simulation, demonstrations, and videos could augment the learning process for the students. Early clinical exposure will help solve many problems encountered during learning and contribute to a better understanding. CONCLUSION: The students and faculty expressed a "need" for early clinical exposure to enhance the learner's understanding of the preclinical aspects of the subject. The present study highlights the need for change in instruction methods to enhance the learning experiences in preclinical prosthodontics of dental undergraduate students in India.

Lingual Frenectomy in Joubert Syndrome.

AIM: Our aim is to present a case of a rare disorder, such as Joubert syndrome (JS) which required oral surgical intervention under general anesthesia at a very young age to help in achieving normal developmental milestones. BACKGROUND: Ciliopathies are an emerging class of diseases of which JS is a significant member. There have been very few cases of JS with its distinguishing features which have been reported in recent literature. CASE REPORT: We herewith present a case of JS who reported to our unit with a complaint of speech abnormality. Intraoral examination revealed a tongue-tie which was planned for surgical release. As any drugs that interfere with respiratory depression have to be used with utmost care, adequate precautions were taken in this case and the patient was treated under general anesthesia. The tongue-tie was released and associated ham-artomatous outgrowths from the floor of the mouth were also excised. Appropriate postoperative care was taken and the patient was discharged. CONCLUSION: The patient treated by us did not reveal any significant intraoperative or postoperative complications. Treatment of cases of JS required a team effort of multiple dental and medical specialists. Long-term follow-up of such patients is required so that they achieve normal chronological development. CLINICAL SIGNIFICANCE: Joubert syndrome being a rare disorder requires special anesthetic care during any surgical procedure, especially that involving the oral cavity. The need and timing of surgical intervention in such cases should be carefully assessed and appropriate precautions should be taken.

Reinforcement of Aluminum Oxide Filler on the Flexural Strength of Different Types of Denture Base Resins: An In vitro Study.

INTRODUCTION: Acrylic resins have been used extensively for the fabrication of denture bases because of their aesthetic qualities, ease of manipulation and repairability. Flexural fatigue of the denture base has been shown to be a factor in the clinical failure of polymethyl methacrylate resin dentures. Also, the fracture can result from impact, fatigue or degradation of the base material. Hence, there is a need to increase the strength of denture base resins. AIM: To evaluate the effect of reinforcing alumina oxide filler on the flexural strength of different acrylic resins. MATERIALS AND METHODS: A total of 180 acrylic specimens were fabricated, which were divided into three groups self cure acrylic resin (SC), conventional heat cure resin (HC) and high strength heat cure resin (HI). Each group was divided into four subgroups i.e., control group and the specimens of the remaining three groups were reinforced with aluminum oxide (Al2O3) powder by 5%, 10% and 15% by weight. Specimens were stored in distilled water for one week; flexural strength was tested by universal testing machine. Results were analysed by one-way analysis of variance and post-hoc Tukey paired group comparison tests. RESULTS: Flexural strength of SC increased by 9%, 13% and 19%, Flexural strength of HC increased by 8%, 15% and 19% and that of HI increased by 21%, 26% and 29% compared to control group by adding 5%,10% and 15% of alumina filler (p-value <0.001). Addition of 15% of alumina powder to SC showed high flexure strength compared to control group of HC (p-value <0.001). Addition of 10% and 15% of alumina powder to HC showed high flexural strength compared to control group of HI (p-value <0.001). CONCLUSION: Addition of alumina to self cure acrylic resin, conventional heat cure acrylic resin and high strength heat cure acrylic resin increased the flexural strength. Increasing the flexural strength of the acrylic resin base material could lead to more clinical success.

Case-based learning: A study to ascertain the effectiveness in enhancing the knowledge among interns of an Indian dental institute.

OBJECTIVE: Time and again, it has been shown that active learning promotes critical thinking, and this environment has to be fostered in dental education too. Therefore, the present study was carried out with an aim to know the effectiveness of case-based learning (CBL) in enhancing the knowledge of dental interns of a dental institute in India. MATERIALS AND METHODS: This pre-post single-blinded, experimental study was conducted in two sessions on a purposive sample of 45 dental interns who gave informed consent. The interns answered a pretest questionnaire comprising questions related to their knowledge of hyperplastic tissue in complete denture patients. The interns were randomly allocated into three subgroups for thorough discussion. Each group viewed all three parts of a case related to hyperplastic tissue and presented the case in the presence of a facilitator. The facilitator discussed the subject with the three subgroups. A post-test was conducted immediately, and the results were compared with the pretest. The facilitator explained about hyperplastic tissue with an audio-visual aid after the post-test was administered. The perception of interns toward CBL was assessed by a standard questionnaire. RESULTS: On analysis, the comparison of the overall knowledge scores pre- and post-CBL showed a statistically significant increase from 9.8 ± 2.14 to 12.6 ± 1.37 (P < 0.001). CONCLUSION: CBL proved to be effective in enhancing the knowledge of dental interns.

The dental management of troublesome twos: renal tubular acidosis and rampant caries.

Renal tubular acidosis is a group of disorders in which there is metabolic acidosis due to defect in renal tubular acidification mechanism to maintain normal plasma bicarbonate and blood pH. Irrespective of organ system involved, oral cavity often reflects the disease occurring anywhere in the body. Thus congenital chronic renal diseases, causing acid-base disturbances affects development and structure of the teeth. Chronic renal tubular acidosis causes enamel defects, dental caries, oral candidiasis, angular cheilitis, etc. We hereby present an unusual case report of a 4-year-old boy suffering from renal tubular acidosis associated with rampant caries, whose full mouth rehabilitation has been done.

Use of zirconia to restore severely worn dentition: a case report.

The management of tooth wear has been a subject of increasing interest from both preventive and restorative points of view. Severe tooth wear is frequently multifactorial and variable. Successful management is a subject of interest in dentistry. A critical aspect is to determine the occlusal vertical dimension (OVD) and a systematic approach that can lead to a predictable and favorable treatment prognosis. Management of patients with worn dentition is complex and difficult. Accurate clinical and radiographic examinations, a diagnostic wax-up, and determining OVD are crucial. This paper describes the full-mouth rehabilitation of a 47-year-old bruxer with a severely worn dentition.