Role of Polyetheretherketone in Prosthodontics: A Literature Review.

Implant prostheses and other fixed and removable metal prostheses have led to an increase in demand for the development of new and efficient materials such as high-performance polymers polyetheretherketone (PEEK) over titanium and other metals because of their further complications in the human body. PEEK is a polymer that is nontoxic and has a modulus of elasticity that is comparable to that of human bone. PEEK implants provide benefits over metal implants, such as reducing the stress shielding effect, simple processing, and color resemblance to natural teeth. And it is a fantastic alternative to titanium for dental and orthopedic implants. The current review is undertaken to understand the properties of this PEEK material to weigh its benefits and drawbacks for potential use in dental implants and other prostheses.

A Ring for a Ring Finger: A Case Report on Finger Prosthesis.

The primary use of the hand is to grasp, hold, and manipulate objects. Perhaps the most obvious kind of non-verbal communication is the hand gesture. The most common types of partial hand loss are finger and partial finger amputations. Traumatic injuries, congenital absences, or abnormalities are frequent causes, and they create significant treatment issues. In addition to the acute loss of grab power, the disappearance of fingers may result in significant psychological harm. People who want their fingers replaced frequently have high expectations for how a prosthesis will look. This clinical report illustrates an easy way to keep an acrylic finger prosthetic in place.

Comparative evaluation of the efficacy of customized maxillary oral appliance with mandibular advancement appliance as a treatment modality for moderate obstructive sleep apnea patients-a randomized controlled trial.

BACKGROUND: Obstructive sleep apnea (OSA) is quite common among the adult population, according to recent epidemiological studies. The most frequently suggested alternate treatment for mild to moderate OSA is oral appliances (OA). The purpose of the present study was to assess as well as compare the effectiveness of custom-made maxillary oral appliances against mandibular advancement appliances in the care of individuals suffering from moderate obstructive sleep apnea. METHODS: A prospective interventional research was carried out with 40 participants. Polysomnography (PSG) was done and the participants with an apnea-hypopnea index (AHI) >15-30 were involved in the research. Study participants were randomly split up into two test groups: group I was the "Control Group" (group treated with a mandibular advancement device (MAD), n=20), while group II was exposed to a "customized maxillary oral appliance" (CMOA, n=20). Both groups had reference measures for AHI, blood oxygen saturation (SpO2), oro-nasal airflow via respiratory disturbance index (RDI), and the Epworth Sleepiness Scale (ESS). Appliances were fabricated and delivered to the respective study group participants. PSG was again conducted after a period of 1 and 3 months of appliance delivery and re-evaluation was done for all the parameters and was compared with reference measurements. The facts were analyzed using descriptive and analytical statistical methods. The statistical program utilized in the study was "SPSS (Statistical Package for Social Sciences) Version 20.1." After 1 and 3 months, the statistical significance between the two study groups was assessed at P<0.05. RESULTS: The analysis of mean AHI, SPO2, RDI, and ESS for both test groups manifested statistically significant measures (P<0.001). The study results revealed a statistically significant depletion in mean AHI scores, improvement in mean SPO2 scores, and reduction in mean RDI scores and ESS scores when compared with reference measurements to 1 month, 1 to 3 months, and between reference measurements and 3 months. CONCLUSION: The CMOA was effective in managing moderate OSA and has great therapeutic potential. It can be an option for the MAD for treating patients suffering from moderate obstructive sleep apnea. TRIAL REGISTRATION: The study was registered under Clinical Trials Registry-India and the registration number is CTRI/2020/07/026936 . Registered on 31 July 2020.

A narrative review on techniques of iris replication in an ocular prosthesis.

The disfigurement associated due to the loss of an eye can cause a significant physical and psychological disturbance. Psychological distress among such unfortunate patients can be reduced by providing an artificial eye. Rehabilitating such patients with an ocular defects is the most challenging task for a prosthodontist. The custom-made ocular prostheses are preferred over the prefabricated stock eye shells as it provides intimate contact with the tissue bed, enabling an ideal fit. For an esthetic ocular prosthesis, the precise positioning of an iris is a primary requirement to avoid the squint eye appearance. Various case reports are documented in the literature for centralizing the iris in the prosthetic eye. This review article explores the established methods and techniques for positioning the iris in a custom-made ocular prosthesis.

Effect of Rehabilitation of Completely Edentulous Patients With Complete Dentures on Temporomandibular Disorders: A Systematic Review.

The present study evaluates the effect of rehabilitating completely edentulous patients with complete denture prosthesis on temporomandibular disorders (TMD). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to perform this systematic review, primarily to describe the technique. Manuscripts published between 1965 and December 31, 2021, were searched in the two most common electronic databases, PubMed and Cochrane Library. To find relevant scientific papers on the influence of complete dentures on temporomandibular disorders, an electronic pursuit of peer-reviewed articles confined to the English language and a dental survey were undertaken. Two observers reviewed the abstracts separately and chose five full-text papers that met the inclusion requirements. Due to the heterogeneity of the data provided, a meta-analysis could not be performed. The result of complete dentures on temporomandibular problems was studied in detail in five peer-reviewed papers. The result of the present study concluded that the complete denture could act as a conducive treatment option to the revocation of TMD for elderly edentulous patients.

Comparative evaluation of the efficacy of customized maxillary oral appliance with mandibular advancement appliance as a treatment modality for moderate obstructive sleep apnea patients-protocol for a randomized controlled trial.

BACKGROUND: Obstructive sleep apnea (OSA) is due to the obstruction of the upper airway during sleep. This condition is often associated with multiple symptoms and co-morbidities. There are many treatment options mentioned in the literature to manage OSA, among which interventional option of continuous positive airflow (CPAP) and non-interventional option, i.e., mandibular advancement device (MAD), which is an oral appliance (OA), are the most preferred ones. This study aims to evaluate the efficacy of customized maxillary oral appliances with mandibular advancement devices in moderate OSA patients. METHODS: A prospective interventional study with a randomized controlled trial will be carried out involving 40 participants (sample size), with an apnea-hypopnea index (AHI) > 15-30, recorded on polysomnography (PSG). Study participants will be randomly divided into the following treatment groups: control group or group subjected to mandibular advancement device (MAD, n=20) and second group subjected to customized maxillary oral appliance (CMOA, n=20). Baseline assessment of apnea/hypopnea index (AHI), oxygen saturation in blood, percentage of rapid eye movement, electroencephalogram, electrocardiogram, oro-nasal airflow via a pressure transducer, and Epworth Sleepiness Scale will be done. Then both study group participants will receive their respective appliances. And after one month and three months of delivery of the appliance, all the parameters, i.e., AHI, oxygen saturation in blood, percentage of rapid eye movement, electroencephalogram, electrocardiogram, oro-nasal airflow via a pressure transducer, and Epworth Sleepiness Scale will be re-evaluated and compared with the baseline measurements. Descriptive and analytical statistics will be done. SPSS (Statistical Package for Social Sciences) Version 20.1 will be used as statistical software. The statistical significance between the two groups after one month and three months will be evaluated at p< 0.05. DISCUSSION: We expect, customized maxillary oral appliance to be more efficient in managing moderate OSA, in comparison with MAD. If the hypothesis of the present study is confirmed, then this customized maxillary appliance will be quoted as a "gold standard" for managing moderate OSA. TRIAL REGISTRATION: CTRI/2020/07/026936 Registered 31 July 2020.

Oral appliances for obstructive sleep apnea: Emerging issues, upcoming challenges, and possible solutions.

BACKGROUND: As per the current epidemiological studies, the prevalence of obstructive sleep apnea (OSA) among the adult population is very high. Oral appliances (OAs) have emerged as the most recommended alternative treatment option for mild to moderate OSA. OBJECTIVE: The objective of this article is to propose or develop a new design of OA named "customized maxillary oral appliance (CMOA)," for managing moderate OSA syndrome. METHODS: The design proposed in this article is first of its kind that is fabricated on the maxillary arch. CMOA is developed by combining the principles of the three most popular OAs used in OSA, namely, soft palate lifters, tongue retaining devices, and mandibular advancement devices. CONCLUSIONS: Given the potential impact of OSA on general and mental health and the side effects of existing appliances, there is a need for a new remedy to be introduced in the field of sleep medicine. This novel design can provide a new therapeutic option for patients with moderate OSA.

A method of hollowing the obturator prosthesis and an overview on the pros and cons of the various materials used for hollowing.

Prosthetic rehabilitation of a partial or total maxillectomy with an obturator is the most acceptable treatment option. The hollowing of the obturator prosthesis is beneficial as it reduces the stresses over the underlying and surrounding tissues. A simple technique of fabricating a hollow bulb obturator has been discussed in this article. At the step of the packing of a denture, the hollow wax pattern of the defect area is formed with modeling wax. This hollow wax pattern is filled with water and is allowed to freeze to form an ice block. This ice block is removed from the wax pattern and is interposed between two layers for heat-cured acrylic resin and is then cured. After processing the denture, the water is retrieved by making a small hole in denture base, which is packed after hollowing with a cold cure acrylic resin. A lightweight prosthesis with a uniform thickness was achieved with a readily available and easily retrievable material, i.e., ice.

Management of Fracture Mandible by Open Occlusal Acrylic Splint in Pediatric Patients: A Case Series.

AIM AND OBJECTIVE: The aim of this article is to report the treatment management of fracture mandible in pediatric patients by a simple, noninvasive, and conservative method. Treatment of a pediatric patient with a mandibular fracture is one of the most challenging jobs. In adults, the treatment of the mandibular fracture is a surgical intervention by open reduction and fixation but it is not usual in the case of children due to the anatomy of growing mandible and deciduous teeth, presence of underlying erupting permanent teeth, and incomplete ossification of jawbones. In pediatric patients, the main concern in the treatment of the mandibular fracture is the normal growth and development of mandibular bone. So, in this case series, the treatment of the children who got mandibular fracture were done by a simple, time saving and noninvasive procedure by the fabrication of open occlusal splint retained by circummandibular wiring which did not interfere with the growth and development of mandible. HOW TO CITE THIS ARTICLE: Lodhi T, Patil SB, Bahetwar SK, et al. Management of Fracture Mandible by Open Occlusal Acrylic Splint in Pediatric Patients: A Case Series. Int J Clin Pediatr Dent 2021;14(6):812-815.

An Innovative Method for Iris Positioning in a Prosthetic Eye.

AIM: An apparatus named "laser pointer apparatus" is proposed for accurate iris positioning in a prosthetic eye. BACKGROUND: Loss of an eye leads to significant psychological stress due to functional disability and societal response to the facial disablement. Custom-made eye prosthesis is a good option to rehabilitate such defects. Inaccurately positioned iris in a prosthetic eye results in squint eye appearance leading to poor esthetics and poor psychological impact among such unfortunate patients. TECHNIQUE: A new apparatus called a laser pointer apparatus, which is an assembly of an occlusal plane analyzer, web camera, laser pointer, and software, has been introduced for iris positioning in a prosthetic eye. CONCLUSION: Iris positioning is one of the key steps in fabricating an eye prosthesis. Laser pointer apparatus is a reliable method for iris positioning in a prosthetic eye. CLINICAL SIGNIFICANCE: Positioning the iris to the ideal symmetrical position is a cardinal step in the fabrication of an ocular prosthesis. This article aims to introduce a "laser pointer apparatus" to orient iris in a prosthetic eye objectively to overcome the subjective errors.

Assessment of the Change in Color of Maxillofacial Silicone after Curing Using a Mobile Phone Colorimeter Application.

AIM: To evaluate the change in color of the maxillofacial silicone after curing using a mobile phone colorimeter application. MATERIALS AND METHODS: A two-piece metal mold was fabricated. Twenty five samples were made using M511, maxillofacial silicone. A jig was prepared to hold the mobile phone at a fix distance from the samples. The color was measured for each sample in terms of HSV (hue, saturation, value) with the mobile phone colorimeter application after manipulation and after polymerization of the samples. Data were statistically analyzed using the Student's paired t test and the software used in the analysis was SPSS 22.0 version. RESULTS: The mean difference of hue was 1.32 ± 2.71, with p value 0.053. Mean differences in saturation was 0.72 ± 2.01, with p value 0.066. Mean differences in value were 2.16 ± 3.11, with a p value 0.002. The measure of value showed statistically significant differences (p < 0.05). CONCLUSION: There was a significant change in the value of the color of the maxillofacial silicone after polymerization. CLINICAL SIGNIFICANCE: Increasing the value of the color by 2-3% at the time of manipulation of the maxillofacial silicone with the use of a mobile phone colorimeter application can help the clinician to reproduce the same color in the final prosthesis after curing to achieve a predictable esthetic outcome for a facial prosthesis.

Evaluation of the effect of different surface treatments on the bond strength of non-precious alloy‒ceramic interface: An SEM study.

Background. Dental porcelain has excellent esthetics in combination with biocompatibility and is one of the most commonly used restorative materials. Its low tensile strength remains a major drawback. The porcelain-fused-to-metal restorations have been introduced to increase the fracture resistance of dental porcelain. The aim of this study was to evaluate the effect of different surface treatments on the bond strength of a non-precious alloy to ceramic. Methods. The present cross-sectional observational study was conducted with forty samples of cobalt‒chromium that were fabricated with porcelain interposed between the two metal test pieces. The metal was subjected to combinations of different surface treatments. The samples group A (n=10) were not subjected to any surface treatments. Group B samples underwent sandblasting and surface grinding. Group C samples were subjected to sandblasting, surface grinding and degassing; and group D samples underwent sandblasting, surface grinding, ultrasonic cleaning and degassing. The tensile bond strength was measured in a universal testing machine, and a scanning electron microscope (SEM) was used to obtain images of the samples after surface treatment to determine the surface irregularities and after the debonding of the samples for the type of the bond failure. ANOVA was used for the statistical analysis. Results. The results showed significant variations in the tensile bond strength between the four groups (F=251.05, P=0.000). The SEM images of group A showed no surface irregularities; group C samples exhibited surface irregularities more than those in group B. Group D had the highest surface irregularities. SEM evaluations showed a statistically significant difference in the type of bond failure (P<0.001). Conclusion. Based on the results of this study, it can be concluded that the surface treatments on the metal increased the bond strength of the metal‒ceramic interface significantly. A combination of sandblasting, surface grinding and ultrasonic cleaning, followed by degassing, resulted in the highest tensile bond strength.

Comparative Evaluation of the Effect of Chemical Disinfectants and Ultraviolet Disinfection on Dimensional Stability of the Polyvinyl Siloxane Impressions.

CONTEXT: Infection control is an important concept in the present day practice of dentistry. Disinfection of dental impressions is part of the daily routine in a dental clinics. After disinfection, it is important that impressions remain dimensionally stable. AIM: The purpose of this study was to compare the effect of chemical disinfectants and ultraviolet (UV) disinfection on the dimensional stability of the polyvinyl siloxane impressions. OBJECTIVES: The objective of the study is (1) To evaluate the effect of chemical disinfectant (2% glutaraldehyde and 1% sodium hypochlorite) and UV disinfectant on the dimensional stability of polyvinyl siloxane impression material. (2) Comparative evaluation of the dimensional discrepancy between the cast poured from the polyvinyl impressions material, that is subjected to chemical disinfectant and UV disinfectant to that of cast poured from impressions that were nondisinfected. MATERIALS AND METHODS: A customized tray was fabricated to make impressions. Impressions were divided into four groups, 10 samples were disinfected with 2% glutaraldehyde for 20 min, 10 samples were disinfected with 1% sodium hypochlorite for 20 min, 10 samples were disinfected with UV light for 20 min, and 10 samples were not subjected to disinfection which served as control group. All the samples were poured after 30 min in die stone. Measurements were recorded using traveling microscope of 0.001 accuracy. Statistical analysis used in this study was the one-way ANOVA test. RESULTS: The result showed significant dimensional changes in samples disinfected with 2% glutaraldehyde and 1% sodium hypochlorite, whereas samples disinfected with UV disinfectant unit showed no significant dimensional changes when compared with control group samples. Within the chemical groups, impressions disinfected with 1% sodium hypochlorite showed more discrepancy in the dimensions when compared to the 2% glutaraldehyde disinfected group. CONCLUSIONS: UV light disinfectant can be safely used to disinfect impressions as compared to chemical disinfectants in clinical prosthodontic procedures.

Does Hamulotomy during Palatoplasty Have Any Effect on Hearing Ability in Nonsyndromic Cleft Palate Patients? A Prospective, Single Blind, Comparative Study.

The primary goal of palatoplasty is to achieve a tension-free palatal closure ensuring no postoperative complications. Many surgeons fracture the pterygoid hamulus to minimize tension during palatoplasty. However, this maneuver gained criticism by some authors on the grounds that it may lead to Eustachian Tube dysfunction. Our study intended to figure out the relationship of hamulus fracture with the postoperative state of middle ear in cleft palate children. Fifty consecutive cleft palate patients with an age range of 10 months to 5 years were recruited. All the patients were assigned to either hamulotomy or nonhamulotomy group preoperatively. The patients were subjected to otoscopic examination and auditory function evaluation by brainstem evoked response audiometry (BERA) preoperatively and 1 month and 6 months postoperatively. Otoscopy revealed that the difference in the improvement of middle ear status in both groups was statistically insignificant. Moreover, there was no significant difference in the BERA outcomes of the fracture and nonfracture populations. Complication rate in both groups was also statistically not significant. It can be concluded that hamulotomy does not have any effect on the hearing ability in cleft palate population, so hamulotomy can be performed for tension-free closure during palatoplasty.

Myxoid Chondrosarcoma of Maxilla in a Pediatric Patient: A Rare Case Report.

Myxoid variant of chondrosarcoma is an uncommon potentially lethal malignant tumor which is even rare in pediatric age group. In the present paper, we report one such case of intermediate grade myxoid chondrosarcoma of left side of maxilla in a 12-year-old girl. The present case had a firm, painless, and lobulated growth in premolar-molar region which was associated with bicortical expansion. Maxillofacial imaging showed ill-defined radiolucency with displaced maxillary molars. Osteolytic changes were evident with the alveolus and walls of maxillary sinus. Owing to the age of the patient, surgical excision was selected as the modality of management followed by postoperative radiotherapy. This report encompasses the entire gamut of clinicopathological, radiological, and treatment modalities employed for chondrosarcoma.