Customizing the Emergence Profile Around an Immediately Loaded Single Implant in the Esthetic Zone: A Case Report.

An optimal esthetic result is essential for an implant-supported restoration in the anterior zone. In the esthetic zone, providing immediate interim restorations following implant surgery has been proposed as a reliable and desirable treatment approach. A well-contoured interim restoration following implant placement minimizes hard and soft tissue changes in the peri-implant zone. This in turn has the potential to enhance the esthetic outcome and, therefore, patient satisfaction. Multiple prosthetic and surgical aspects need to be carefully planned and executed to achieve the intended final result. This is a report describing the steps involved in recontouring the gingiva to achieve an optimal emergence profile following the immediate loading of a single implant in the esthetic zone.

Esthetic Rehabilitation of Partially Edentulous Ridge With Horizontal Bone Augmentation Using the Sausage Technique: A Report of Two Cases.

Bone augmentation techniques have been used in atrophic ridges to attain appropriate bone volume and enable dental implant insertion. By reducing the need for autogenous bone and decreasing morbidity at the donor sites, the use of bone substitutes has improved patient comfort and satisfaction. One of the major challenges in implant dentistry is achieving an optimal esthetic result with implant-supported crowns in the esthetic zone. Multiple prosthetic and surgical aspects need to be carefully planned and executed to achieve the final esthetic result. This is a report describing bone augmentation using the sausage technique and subsequent prosthetic rehabilitation in two cases.

Aesthetic treatment planning simplified using digital smile design: A case report.

Digital smile design (DSD) plays an essential role in the planning of aesthetic treatments. However, most digital smile designing software programmes are expensive and require specialised training and skill for effective implementation. This paper illustrates the use of Adobe Photoshop and Microsoft PowerPoint, which are economical and user friendly for planning aesthetics in a clinical case.

Customized Cheek Plumper with Friction Lock Attachment for a Completely Edentulous Patient to Enhance Esthetics: A Clinical Report.

Prosthetic rehabilitation of a completely edentulous patient should never be restricted to the replacement of missing teeth. The ultimate aim of complete denture treatment should be restoration of the full range of oral functions and esthetics. Slumped cheeks are always a concern for esthetically demanding complete denture patients. This article describes a simple, scientific, cost-effective technique to improve facial esthetics in a completely edentulous patient with the help of a cheek plumper. The technique used here implements the concept of neutral zone to precisely determine the amount of space available for the cheek plumper. The simple friction lock attachments that retained the cheek plumpers on the prosthesis were also fabricated after determining the space available in the appropriate areas. Thus an effort was made to keep the cheek plumpers unobtrusive yet effective to ensure complete integration of the prosthesis into the stomatognathic system.

The Hollow Maxillary Complete Denture: A Simple, Precise, Single-Flask Technique Using a Caramel Spacer.

The success of removable prostheses ultimately depends on a number of factors such as retention, stability, support, esthetics, and masticatory function. Increased intraoral inter-arch distance leads to an increase in the weight of the prosthesis. This may compromise the retention and resistance, which are key for a successful removable prosthesis. Various methods, techniques, and materials have been reported to minimize the weight of a prosthesis. This article describes a simple, unique, precise single-flask technique for the fabrication of a lightweight maxillary prosthesis using caramel as a 3D spacer, which was "indexed" to obtain a uniform thickness of acrylic around the hollow cavity.

A Novel Universal Cementation Technique for Implant-Supported Crowns with Subgingival Margins.

Restoration of implant crowns with subgingival margins has always been a challenge. If done precisely it leads to better treatment outcomes and prognosis. An incorrect technique and improper execution of the luting procedure are known to cause a high incidence of peri-implant disease due to incomplete elimination of the luting agent. Deep subgingival abutment margins are difficult to recognize, and cement removal in these cases becomes complicated if the sulcus depth is greater than 3 mm. Irrespective of the type of instrument used to remove the excess cement, scratches on the abutment and some cement remnants are consistently noticed. Therefore elimination of excess luting agent before the prosthesis is inserted intraorally is considered an effective technique to prevent complications due to excess luting agent. This article presents a chairside universal technique for cementation of implant crowns on abutments with deep subgingival margins. This technique attempts to minimize the amount of excess cement in peri-implant tissue.

Comparative evaluation of border molding using two different techniques in maxillary edentulous arches: A clinical study.

PURPOSE: The aim of this in vivo study was to compare the single-step border molding technique using injectable heavy viscosity addition silicone with sectional border molding technique using low fusing impression compound by evaluating the retention of heat cure trial denture bases. MATERIALS AND METHODS: Ten completely edentulous patients in need of prostheses were included in this study. Two border molding techniques, single-step (Group 1) and sectional (Group 2), were compared for retention. Both border molding techniques were performed in each patient. In both techniques, definitive wash impression was made with light viscosity addition silicone. The final results were analyzed using paired t-test to determine whether significant differences existed between the groups. RESULTS: The t-value (3.031) infers that there was a significant difference between Group 1 and Group 2 (P = 0.014). The retention obtained in Group 2 (mean = 9.05 kgf) was significantly higher than that of Group 1 (mean = 8.26 kgf). CONCLUSION: Sectional border molding technique proved to be more retentive as compared to single-step border molding although clinically the retention appeared comparable.

An Innovative and Simple Technique of Hollow Maxillary Complete Denture Fabrication.

Prosthetic rehabilitation of severely atrophic ridges has always been an ordeal for the clinician due to decreased support, stability and retention. Because of severe resorption the restorative space between maxillary and mandibular residual ridges is increased. Rehabilitation in such cases may result in increased height and weight of the prosthesis further compromising its retention and stability. This in turn overloads the underlying hard and soft tissues exacerbating ridge resorption so, in order to break this vicious cycle, the weight of the prosthesis needs to be reduced which can be achieved by making hollow prosthesis. This article describes a novel technique of fabricating a hollow maxillary complete denture.

Immediate dentin sealing for indirect bonded restorations.

PURPOSE: The aim of this article is to review available literature on the clinical procedure of immediate dentine sealing for indirect bonded restorations. STUDY SELECTION: More than 40 articles reporting the technique, studies, outcomes, etc. were reviewed after PUBMED/MEDLINE search, most of them addressing the specific situation of dentin bonding for indirect restorations. RESULTS: It is known that tooth preparation for indirect bonded restorations can result in significant dentin exposures. Immediate application and polymerization of the dentin bonding agent to the freshly cut dentin, prior to impression making is therefore recommended by some authors. Literature indicates that this procedure, immediate dentine sealing (IDS), appears to achieve improved bond strength, fewer gap formations, decreased bacterial leakage, and reduces post-cementation sensitivity. This rational approach to adhesion is also reported to have a positive influence on tooth structure preservation, patient comfort, and long term survival of indirect bonded restorations. CONCLUSION: In the extensive literature regarding advantages of using IDS technique significant differences have been shown when compared to Delayed Dentine Sealing. Although more research is required in this field, presently there are NO scientific reasons not to recommend IDS in routine practice.

Salivary reservoir designs for patients with xerostomia: a review

Aim: The present paper aims to review the literature available on various approaches to salivary reservoir designs, the functional aspects, cleansibility, type of attachments used, and different techniques used for the fabrication of salivary reservoirs in patients suffering from xerostomia. Material and Methods: A search in the National Library of Medicine's Pub Med database, Google search and Science Direct was performed to include all case reports and reviews on prosthodontic rehabilitation of dentulous/partially edentulous/edentulous patient with xerostomia. Results: Out of the 35 articles found in the database search, 18 articles were included based on the designs they adopted for fabrication of salivary reservoirs. Conclusions: The various designs available in literature enable an operator to choose the most suitable reservoir design based on specific patient requirements. Innovations in reservoir design promise a more customized prosthesis for every patient. Further research and innovation will enable increasingly efficient salivary substitute delivery systems for the xerostomic patient.

Preoperative intraoral evaluation of planned fixed partial denture pontics using silicone putty.

A preoperative visualization and evaluation of fixed partial denture (FPD) pontics in the anterior dentition is necessary for both the patient and the dentist. Such an evaluation allows patients to decide whether the esthetic and functional parameters of the restoration meet their requirements and expectations. To facilitate such an assessment, a method that allows stable intraoral positioning of the pontics is required. This article describes a technique to achieve this in a simple and effective way before the abutments are prepared. In addition, it also allows the operator to modify the pontics intraorally for esthetics and later incorporate the same pontics into the interim prosthesis. The integration of this pretreatment pontic evaluation procedure into FPD restorations assures better results and patient satisfaction.

Understanding the psychology of geriatric edentulous patients.

OBJECTIVE: This article focuses on understanding our older patients who require complete prosthodontic care. By breaking down the patient psychology to its component parts, it is easier to obtain a clear picture of this special cohort of patients. Considering the increase in number of geriatric edentulous patients, this knowledge will help the dentist serve the geriatric population better. BACKGROUND: The role of psychology and personality in complete denture treatment is well documented. The geriatric patient who needs complete dentures has a psychological aspect that needs consideration. Although significant, these aspects may sometimes be ignored or considered irrelevant. MATERIALS AND METHODS: A review of relevant literature was carried out to obtain data on the psychology and personality of geriatric, complete denture patients and their behavioural changes. The obtained data was filtered and condensed to provide a short but comprehensive look at the geriatric edentulous patient's psychology. CONCLUSION: When handling geriatric edentulous patients, the dentist must be confident of addressing and managing the psychology of these patients. A thorough understanding of the geriatric mental state thus becomes important and significant for the clinician.