Prosthetic rehabilitation of intraoral defects in patients with rhino-orbital-cerebral-mucormycosis: A systematic review.

AIM: This study aimed to systematically review the frequency and type of intraoral prosthetic rehabilitation in patients with rhino-orbital-cerebral-mucormycosis (ROCM). SETTINGS AND DESIGN: Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. MATERIALS AND METHODS: An electronic search was conducted in databases including PubMed, Web of Science, Scopus, and Google Scholar. Case reports that documented prosthetic rehabilitation following surgery in patients with ROCM were included. This review was registered under the International Prospective Register of Systematic Reviews CRD42021262284. Assessment of the quality of the included studies was done using the Joanna Briggs Institute Critical Appraisal Checklist for Case reports, which comprised of an eight-item checklist. The recorded observations were organized and subjected to analysis. STATISTICAL ANALYSIS USED: Qualitative analysis was used. RESULTS: Among the 25 case reports, type IId defect was the most common. Three types of prosthetic treatments were rendered, with the obturator being the most common choice of rehabilitation, followed by implant-retained obturator overdenture and fixed implant-supported prosthesis. Patients undergoing implant-based rehabilitation exhibited a 100% survival rate for implants, with follow-up periods spanning from 6 months to 3 years. No prosthetic complications were reported in any of the included case reports. CONCLUSIONS: The prevailing defect type identified was IId (48%), while the treatment of choice most frequently employed was an obturator (84%). However, with limited evidence available at present, further research is required to draw more definitive conclusions.

Comparative evaluation of masticatory efficiency, clinical performance, and patient satisfaction of single implant-retained mandibular overdenture versus conventional complete denture: A prospective in vivo study.

AIM: The aim of this within-subject prospective clinical study was to investigate the scope of single implant mandibular overdenture by assessing its masticatory efficiency, clinical performance, and patient satisfaction compared to conventional complete dentures. SETTINGS AND DESIGN: Prospective In Vivo Study. MATERIAL AND METHODS: This prospective in vivo study was conducted in the Department of Prosthodontics and Crown and Bridge, Christian Dental College, Ludhiana. A total of 12 completely edentulous patients received a single implant in the mandibular anterior midline region. After the healing period, the conventional maxillary and mandibular dentures were fabricated. 15 days post insertion of the conventional dentures, patients were evaluated for masticatory efficiency, clinical performance including retention and stability, and patient satisfaction. To evaluate the masticatory efficiency blue raspberry and original pink "Hubba Bubba tape gum" were used as a test food. Colorimetric analysis was done to assess variance of hue. To assess clinical performance, retention, and stability of the mandibular denture was recorded using a digital force gauge and was tabulated as per CU-modified Kapur's criteria. OHIP-14 index was used to assess patient satisfaction. After evaluation of the parameters of conventional dentures, the denture was converted into an implant-retained mandibular denture by chairside conversion with locator attachments. 15 days post-implant loading, parameters of the implant retained mandibular overdenture were assessed again followed by statistical analysis. STATISTICAL ANALYSIS USED: The masticatory efficiency was assessed using a paired t-test. The patient satisfaction was sequentially assessed with Wilcoxon signed rank test and thereafter paired t-test was used to compare between conventional complete denture and overdenture. Clinical performance was assessed using the Wilcoxon signed rank test. RESULTS: The masticatory efficiency of single implant mandibular overdenture was higher than that of conventional complete dentures. The clinical performance of the overdenture was higher than that of the conventional denture. Stability being a time-dependent parameter might need longer follow-ups for further conclusions. Patient satisfaction with single implant retained overdenture was significantly higher than conventional complete dentures. CONCLUSION: Single implant mandibular overdenture has improved masticatory efficiency, clinical performance, and patient satisfaction compared to conventional complete dentures.

Digital superimposition of scans for recording and transferring vertical relation from provisional restorations when rehabilitating worn-out dentition: A dental technique.

Excessive wear of the natural dentition results in the loss of tooth anatomy and the vertical dimension of occlusion (VDO) which may necessitate full mouth rehabilitation. Successful full-mouth rehabilitation with increased VDO requires accurate recording and transfer of the newly raised VDO with provisional restorations. Conventional bite registration can incur errors during the recording and transfer of vertical dimensions. This article introduces a digital approach-the superimposition of scans using an intraoral scanner (IOS) to transfer VDO, occlusion, and aesthetic data from provisional restorations for designing and fabricating indirect restorations in the management of worn-out dentition.

Computer-aided design software-enabled preclinical prosthodontic training: A digital education technique.

The prosthodontics preclinical training modules involve textbook-based two-dimensional (2D) ideal images and practicing on manikin models to emulate ideal tooth preparations and teeth arrangements. Relying solely on 2D images as objectives for preclinical exercises limits the trainee's creative skills to instructions of textbooks and clinical instructions received. With advancements in digital dentistry, dental trainees should have early exposure to the three-dimensional (3D) rendering of ideal preclinical objectives. A dental education technique using computer-aided design software and smartphones is described that will allow 3D rendering of ideal prosthodontic training assignments allowing early exposure to digital dentistry for dental training students.

Surface trueness and precision of interim restorations fabricated by digital light processing and CAD-CAM milling systems.

STATEMENT OF PROBLEM: The development of digital dental technologies has enabled clinicians to use additive and subtractive manufacturing techniques to fabricate interim restorations. However, knowledge of the trueness and precision of such restorations fabricated using digital light processing (DLP) and computer-aided design and computer-aided manufacturing (CAD-CAM) methods is limited. PURPOSE: The purpose of this in vitro study was to assess and compare the accuracy of interim crowns fabricated using DLP and CAD-CAM methods. MATERIAL AND METHODS: A typodont mandibular first molar was prepared for a ceramic crown, and a digital scan (Medit T500) was obtained to design interim crowns by using the CAD software program. The CAD data were designated as the reference data. A total of 20 crowns were fabricated by DLP and CAD-CAM technology. The fabricated interim crowns were further scanned using a laboratory scanner and were superimposed with the CAD data by using a 3-dimensional (3D) point cloud assessing software program (CloudCompare) for the evaluation of trueness and precision. Root mean square values (RMS) were obtained for the evaluation of discrepancies. The Student t test was used to compare data as the Shapiro-Wilk test confirmed the normal distribution. RESULTS: RMS values for the trueness values of the external and intaglio surfaces of the 3D printed and milled interim crown displayed no statistically significant differences (P>.05). Precision for the external surface reported significance (P<.05), whereas that for the intaglio surface reported no significance (P>.05). CONCLUSIONS: The accuracy of interim crowns fabricated by using DLP was comparable with that of milled crowns. Both manufacturing systems produced a true reproduction of the CAD. As for precision, the external surface of the DLP interim crown was statistically different from that of the milled group as it relates to the CAD.

Three-dimensional finite element analysis of zygomatic implants for rehabilitation of patients with a severely atrophic maxilla.

STATEMENT OF PROBLEM: Stresses applied to zygomatic implants have been determined to be transferred mainly to the zygomatic bone; however, consensus regarding the stress distribution pattern in the bone surrounding zygomatic implants has not yet been reached. PURPOSE: The purpose of this 3-dimensional (3D) finite element analysis (FEA) study was to visually compare the stress distribution pattern in 2 different zygomatic implant treatment modalities and evaluate the effect of masseter musculature involvement. MATERIAL AND METHODS: A 3D FEA craniofacial model was constructed from the computed tomography (CT) data of a selected patient with a severely atrophic edentulous maxilla. Modeled zygomatic and conventional implants were inserted into the craniofacial model supporting a prosthesis superstructure. Two types of treatment were considered in the study: 2 zygomatic implants placed bilaterally or 2 zygomatic implants placed in conjunction with at least 2 conventional implants at the anterior maxilla. The models were loaded with a vertical force of 150 N, a lateral force of 50 N, and a distributed occlusal force of 300 N applied to the insertion area of the masseter muscle. The stresses on and deformations of the bones and implants were then observed and compared with and without the involvement of the musculature component. RESULTS: The stresses were distributed efficiently along the vertical and horizontal facial buttresses, as in the dentate skull; however, a difference in distribution pattern was observed when the models were loaded without applying the muscle component. The maximum deformation of bones surrounding the implants occurred in the abutment connection of the conventional anterior implant in the model with an additional conventional anterior implant. CONCLUSIONS: The FEA revealed the stresses were distributed efficiently along the vertical and horizontal facial buttresses, as in the dentate skull. However, the stresses in both models were concentrated in the zygomatic bone when incorporating the muscle component. Therefore, incorporating muscular force into FEA studies could affect the analysis result.

A smartphone application with a gray card for clinical shade selection: A technique.

Shade selection is an inherently complex procedure, and its accurate reproduction in the definitive restoration involves an in-depth understanding of color science and its effective communication with the dental laboratory technician. A technique is presented that uses a smartphone application (Snapseed; Google LLC) and a gray card for clinical shade selection.

A User-Friendly Technique for Replacing Nylon Inserts of a Locator Attachment.

Rehabilitation of edentulous patients with implant-supported overdentures has gained prominence over the use of conventional dentures because of the improved quality of life it provides patients. Various attachment systems are available that facilitate the insertion and removal of prostheses, and among them, the Locator attachment system has become popular due to its self-aligning property, simplicity of use, and minimal space requirement of male inserts within the denture. However, the loss of retention of nylon inserts over time requires their removal from the metal housing and subsequent replacement. This article describes an easy alternative technique for replacing the nylon inserts in the denture cap using a simple dental explorer and mirror head.

Rehabilitation of the severely resorbed maxilla by using quad zygomatic implant-supported prostheses: a systematic review and meta-analysis.

STATEMENT OF PROBLEM: Quad zygomatic implants have been used as a treatment option for patients with a severely resorbed maxilla. However, data on the average rate of success of the prosthesis, survival of the zygomatic implants, and associated complications are sparse. PURPOSE: The purpose of this systematic review and meta-analysis was to assess prosthetic and zygomatic implant success of treating severe maxillary resorption with prostheses supported by 4 zygomatic implants, with an additional review on potential complications. MATERIAL AND METHODS: A comprehensive search of studies published in English between January 2001 and December 2020 was performed in the PubMed, OVID, EBSCO, and EMBASE databases according to the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42021219468). The population, intervention, comparison, and outcome (PICO) question was "What is the effectiveness of oral rehabilitations using only 4 zygomatic implants placed in severely resorbed maxillae?" The search results were subjected to a systematic review for articles reporting prosthetic success and zygomatic implant survival. Prosthetic success was analyzed by using a fixed-effects inverse-variance model. The random-effects model was adopted for meta-analysis as moderate heterogeneity was identified among studies that reported implant survival in quad zygoma treatments. The quality of publications was appraised by using the Critical Appraisal Skills Program (CASP) checklists. RESULTS: Of the 82 titles, 7 studies that met the inclusion criteria without an overlap of patient cohorts were quantitatively analyzed for the average rate of prosthetic success and implant survival. All prostheses in the aggregated studies were immediately loaded with acrylic resin interim prostheses replaced by a definitive prosthesis, which consisted of overdentures retained by bar splinting (n=2), metal bar-reinforced prostheses (n=2), fixed screw-retained acrylic resin prostheses (n=34), and screw-retained titanium prostheses with ceramic or acrylic resin teeth (n=75). Technical complications of zygomatic implants included mobility associated with a machined surface and fracture of the abutment screw. The most common prosthetic complications reported were fracture of the definitive prosthesis and loss of the interim prosthesis subsequent to the failure of at least 1 zygomatic implant. The results showed that prostheses supported by quad zygoma implants displayed an overall success of 100% (CI=95%, I2=0.00%, P=.850), whereas zygomatic implants showed a survival rate of 98% (CI=95%, I2=60.48%, P=.040) with minimal implant failures and few complications. CONCLUSIONS: Although the data analysis showed favorable results for rehabilitating severely resorbed maxillae by using quad zygoma with high prosthetic success and high implant survival rate, further long-term clinical studies are required to strengthen the evidence. However, potential implant and prosthetic complications should be considered while planning this treatment approach.

A 10-year (2010 to 2019) scientometric analysis of prosthodontic journals based on SCImago Journal and Country Rank indicators.

STATEMENT OF PROBLEM: Scientometrics is the study of measuring and analyzing scholarly literature. Scientometric analysis to determine the impact of prosthodontic journals on scientific contributions is lacking. PURPOSE: The purpose of this analysis was to compare the quality of prosthodontic journals based on performance indicators over 10 years (2010 to 2019). MATERIAL AND METHODS: The SCImago Journal and Country Rank portal was used to identify various prosthodontic journals under the subject of dentistry. Seven journals publishing in the English language with "Prosthetics" and "Prosthodontics" in the title were identified and analyzed. The statistical analyses of the scientometric indicators for the 7 highest-ranked journals were performed with 1-way analysis of variance (ANOVA) and the Tukey post hoc tests (α=.05). RESULTS: The absolute SCImago journal rank (SJR) was highest at various time periods for the Journal of Prosthetic Dentistry (JPD), International Journal of Prosthodontics (IJP), and Journal of Prosthodontic Research (JPR). The JPD and IJP scored higher SJR than other journals during this period (P<.05). The mean cites per document and the h-index were highest for JPD (P<.05). CONCLUSIONS: Scientometric tools enable the evaluation of journal performance to aid researchers when choosing a journal to which to submit their work. Analysis of the 7 prosthodontic journals revealed the performance of various journals and gives an insight into the journal characteristics for future researchers who wish to submit their scholarly work.

Are YouTube videos on complete arch fixed implant-supported prostheses useful for patient education?

STATEMENT OF PROBLEM: Complete arch fixed implant-supported prostheses have gained substantial popularity as a treatment option for patients with edentulism or a failing dentition. While YouTube is a leading source of health-related information videos, the usefulness and quality of videos on YouTube about complete arch fixed implant-supported prostheses are unclear. PURPOSE: The purpose of this study was to evaluate the quality of videos on complete arch fixed implant-supported prostheses and assess their usefulness for the general population as an educational resource. MATERIAL AND METHODS: An electronic search for "complete arch fixed treatment using dental implants" was conducted on YouTube on October 10, 2021. The videos in English with a duration between 4 and 20 minutes were considered for the analysis. A total of 89 videos were subjected to quantitative analysis by using a usefulness score. Additionally, to evaluate video quality, 5-point global quality scale (GQS) criteria were applied. A 1-way analysis of variance (ANOVA) was used to compare mean scores among different subgroups. The Pearson correlation analysis investigated the relationship among the usefulness score, GQS score, and video demographics, which include video content, source, type (academic or nonacademic), total views, and upload days (the days since the video was uploaded to YouTube) (α=.05). RESULTS: The mean number of views for the 89 selected videos was 193 321 with a mean daily upload of 1241. The mean ±standard deviation usefulness score was 1.55 ±1.35, with 78.7% of the videos rated poor, 20.2% moderate, and 1.1% excellent. The majority of videos included procedures involved (44.9%) and advantages (41.9%), and the least discussed topics were contraindications (7.9%) and prognosis and survival (6.7%). The GQS scoring had a mean score of 1.98 ±0.78 out of a total score of 5. While statistically significant differences were not found among the video source, total views or upload days, and usefulness score (P>.05), significant differences were found between the type of videos and usefulness score (P<.001). CONCLUSIONS: The majority of videos on complete arch fixed implant-supported rehabilitation were rated as poor in usefulness for patient education. Quality videos on implant-supported fixed rehabilitation were lacking on YouTube (GQS score <1.50), with most videos consisting of marketing or promotional content rather than unbiased educational information.