Magnetic resonance imaging investigations in patients with metallic dental prosthesis: "The associated dilemma for medical fraternity and the dentist's role".

Background: Interdisciplinary referrals for dental examination in hospital setups are common before radiotherapy, kidney transplants, or magnetic resonance imaging (MRI). The patients who walk in could be random patients with metallic or porcelain-fused-to-metal prostheses done elsewhere but might require an opinion before the MRI. This leaves quite a responsibility on the consulting dentist to green signal the procedure. There is a lack of evidence in the literature, to confirm the absence of any untoward consequence during such MRI, which might leave the dentist in dilemma. Dental materials' magnetic behavior raises concern regarding whether they are 100% nonferromagnetic; furthermore, the examining dentist might be unaware of the metal used (Co-Cr, Ni-Cr, or trace elements). Clinicians may also come across full-mouth rehabilitated patients with multiple crown-bridge prostheses or metallic superstructure for implant prostheses. Research in the area leaves many unanswered questions because most studies have evaluated artifacts during MRI and are in vitro. Titanium is considered to be safe due to its paramagnetic behavior, whereas the literature does not rule out the probability of dislodgment of other porcelain fused to metal (PFM) prostheses. Due to less reported literature there exists dilemma to ascertain MRI in these patients. An online Google Search, PubMed, and gray literature portray the ambiguity associated with metal and PFM crowns and their magnetic behavior during MRI. Most studies were associated with the artifacts caused during MRI and methods of reducing them under in vitro situations. The concern for dislodgment has also been expressed in a few reports. Technique: Certain steps of a pre-MRI checkup and an innovative technique have been discussed to assure patient safety during the MRI. Conclusion: The technique explained is inexpensive and a quick aid that can be executed before the investigation. Clinical and Research Implications: There is a need to study and understand the magnetic behavior of Co-Cr and Ni-Cr crowns in the presence of various MRI strengths.

Choosing the denture occlusion - A Systematic review.

AIM: The aim of the study is to acquire evidence for the choice of occlusion with anatomic/modified anatomic teeth in complete denture prosthesis. SETTINGS AND DESIGN: Systematic review following PRISMA guidelines. MATERIALS AND METHODS: The study reviewed original articles on various occlusal schemes bilateral balance occlusion (BBO), lingual occlusion (LO), Canine guided occlusion (CG), posterior group function occlusion (PGFO) have been applied to the complete dentures and were analyzed for the objective or subjective or both evaluations. The data were collected in standard format with the needed information such as year of publication, type of study, occlusal schemes compared, test methodology used, sample size for experiment and control, assessment of retention, stability, and other factors which determine the quality of life and period of follow-up. The risk of bias was calculated using tools RoB2.0 and robvis. At all stages, the inclusion and exclusion of studies were discussed among the reviewers. STATISTICAL ANALYSIS USED: Due to the heterogeneity in the data of the included studies no statistical analysis was used. RESULTS: Of the 1896 articles screened only 17 studies were included in the systematic review. These were discussed amongst the reviewers regarding the various occlusion schemes used. The subjective and objective criteria used in the studies was tabulated separately. They were then analyzed for the risk of bias using the robvis 2 tool. CONCLUSION: No scheme is more superior to the other with the anatomic tooth forms. The use of alternative unbalanced schemes produces a similar satisfactory clinical outcome. The ridge classification also has a significant role to play in the preference for an occlusal scheme.

Digitization and its futuristic approach in prosthodontics.

Digitization has become part and parcel of the contemporary prosthodontics with the probability of most of the procedures being based on the digital techniques in near future. Let us think of X-rays or photographs, making impressions, recording jaw movements or fabricating prosthesis, educating and training new dentists or patient motivation for practice build up, all has become digital. CAD-CAM has revolutionized not just the ceramic technology but has also been used for the CAD-CAM implant surgeries, maxillofacial prosthesis and diagnostic splints. Today a practicing dentist needs to be abreast with the latest but with the technology changing so fast, this poses a great challenge. There is endless scope of digitisation and technology in prosthodontics- let it be in the clinical and lab procedures like use of CAD-CAM technology, stereolithography, rapid prototyping, use of virtual articulators and digital face bows, digital radiographs, or in the field of training, education and research by the use of virtual patient programs, dental softwares, optoelectronic recording of jaw motion, digital instron machine, retention testing device, audiovisual aids,… the list will remain endless. The article reviews those various aspects of prosthodontics where digitization has modified the conventional procedures. For discussion they have been considered under the educational aspect, diagnostics, treatment procedures, prosthesis fabrication and lastly the research and futuristic development. The day is not far when remote sensing robotic devices would be performing the restorations under the command and surveillance of the master-the dentist without his immediate presence.

Evaluation of certain dentofacial characteristics as predisposing factors in patients with myofacial pain dysfunction syndrome.

Though a multifactorial etiology has been comprehensively documented in the literature over the years for temporomandibular joint (TMJ) disorder, none of the theories give a total explanation of all aspects of the syndrome. The aim of this study was to evaluate face form and certain occlusal parameters as relevant factors in the degree of dysfunction of the Temporomandibular joint. One hundred and three patients suffering from TMJ dysfunction attending the Out Patient Department of Dr R. Ahmed Dental College over a period of 2 years were clinically examined and subsequently tabulated and compared with the degree of dysfunction to analyze any correlation between them. The data were statistically analyzed by the student t test and χ(2) test to assess the significance of the dysfunction in relation to the various parameters examined. The study indicated a positive relationship between the degree of dysfunction of the TMJ to the face form and certain other attributes.