Wettability of 3 different artificial saliva substitutes on heat-polymerized acrylic resin.

STATEMENT OF PROBLEM: The prosthodontic problems faced by a patient with xerostomia are of great concern. To aid in retention, artificial saliva substitutes should exhibit good wettability on the denture base. PURPOSE: The purpose of this in vitro study was to evaluate the wettability of 3 different artificial saliva substitutes on heat-polymerized acrylic resin and to compare these properties with natural saliva and distilled water. MATERIAL AND METHODS: A total of 150 heat-polymerized acrylic resin specimens were prepared with 25×15×2 mm dimensions. The specimens were divided into 5 groups (n=30): human saliva, distilled water, Aqwet, Mouth Kote, and Stoppers 4. The advancing and receding contact angle values were measured by using a goniometer, and the contact angle hysteresis and equilibrium angle were calculated. One-way ANOVA and the Bonferroni multiple comparisons test were performed to determine the difference between contact angle values among the groups (α=.05). RESULTS: The means of the 5 groups differed significantly (P<.05). The comparison between human saliva and Aqwet showed no significant difference for advancing contact angle, receding contact angle, contact angle hysteresis, or equilibrium contact angle, while comparison between the remaining groups indicated statistically significant (P<.05) results. All 3 saliva substitutes used in this study (Aqwet, Mouth Kote, and Stoppers 4) had significantly better wetting properties than distilled water. CONCLUSIONS: Human saliva had the lowest advancing, receding, and equilibrium contact angle values and the highest angle of hysteresis on heat-polymerized acrylic resin. Aqwet had better wetting ability than the other artificial salivary substitutes tested and was comparable to the human saliva on heat-polymerized acrylic resin. All saliva substitutes have better wetting properties than distilled water.

Reorientation simplified: a device for recording and reproducing the path of insertion for removable partial dentures.

AIM: The record of path of insertion on the dental cast is part of the dentist's work authorization to the dental laboratory technician. The path of insertion record enables the dental technician to replace the cast on a surveyor in the same position that the dentist selected. Analysis of factors that influence the path of insertion should determine a path of insertion that will reduce the potential for dislodgement and promote stability of removable partial denture (RPD). MATERIALS AND METHODS: The recording of the relation of a cast to a dental surveyor and the transfer of this relationship to the dental laboratory may be done by tripodization, by scoring the base of the cast, or by cementing a reference pin on the cast. CONCLUSION: Recording the established path of insertion can be difficult when the procedure uses a cemented pin and the casts are mounted in an articulator. This article describes a procedure for innovative dowel pin and sleeve device to record the path of insertion of RPDs, which serves the same purpose as the cemented pin but can be easily removed and replaced.

Esthetic rehabilitation of discolored anterior teeth with porcelain veneers.

The common man is bombarded by the media extolling the virtues of "the perfect smile." In the 21(st) century of esthetic dentistry, fractured, malformed, malposed, and discolored teeth can be changed and restored to highly desirable form due to introduction of wide range of esthetic materials and techniques. Porcelain veneers is a conservative method of restoring the appearance of discolored, pitted teeth, and teeth with diastemas that provide extremely good esthetic results. A 21-year-old female patient with staining in anterior teeth had reported to the Department of Prosthodontics for esthetic rehabilitation. The patient was treated with porcelain veneers on maxillary anterior teeth. The patient was satisfied with the enhanced esthetic appearance.

Simplifying cleft surgery by presurgical nasoalveolar molding (PNAM) for infant born with unilateral cleft lip, alveolus, and palate: a clinical report.

PATIENT: A 2-day-old female infant with complete unilateral cleft lip, alveolus, and palate (left side) was presented to the Department of Prosthodontics, Government Dental College and Hospital, Nagpur for evaluation and treatment with presurgical nasoalveolar molding (PNAM) prior to surgical intervention. DISCUSSION: The alignment of the alveolar segments creates the foundation upon which excellent results of primary lip and nasal surgery are dependent in the repair of the cleft lip, alveolus, and palate patient. Presurgical infant orthopedics has been employed since the 1950s as an adjunctive neonatal therapy for the correction of cleft lip and palate. One of the problems that the traditional approach failed to address was the deformity of the nasal cartilages and the deficiency of columella tissue in infants with unilateral and bilateral cleft lip and palate. The purpose of this article is to illustrate the step-by-step fabrication process of the PNAM prosthesis used to direct growth of the alveolar segments, lips, and nose in the presurgical treatment of cleft lip and palate. CONCLUSION: As a result, the primary surgical repair of the lip and nose heals under minimal tension, thereby reducing scar formation and improving the esthetic result. Frequent surgical intervention to achieve the desired esthetic results can be avoided by PNAM.

Presurgical nasoalveolar molding (PNAM) for a unilateral cleft lip and palate: a clinical report.

Cleft lip and palate deformity is a congenital defect of the middle third of the face. Incidence varies from 1:500 to 1:2500 live births. Etiology depends upon hereditary and environmental factors. Restoration of these defects is important not only for functional and esthetic reasons, but also because there may be a positive psychological impact for the patient and parents. The goal of primary closure of the lip for unilateral cleft lip is to ensure a normal and symmetrical lip and nose. Presurgical infant orthopedics has been employed since the 1950s as an adjunctive neonatal therapy for the correction of cleft lip and palate. Presurgical nasoalveolar molding (PNAM) represents a paradigm shift from the traditional methods of presurgical infant orthopedics. PNAM consists of active molding of the alveolar segments as well as the surrounding soft tissues. This clinical report describes a new approach of PNAM therapy for an infant with complete unilateral cleft lip and palate showing significant reduction in cleft defect size and improved contour and topography of deformed surrounding soft tissues.

Candida colonisation and the efficacy of chlorhexidine gluconate on soft silicone-lined dentures of diabetic and non-diabetic patients.

OBJECTIVES: The aim of this study was to evaluate Candida colonisation in the dentures with silicone soft liner in diabetic and non-diabetic patients and to assess the antifungal efficacy of chlorhexidine gluconate on Candida colonies. MATERIALS AND METHODS: Thirty patients with resorbed ridges, fifteen each in the diabetic and non-diabetic group, were selected. The mandibular denture of each patient was lined with heat-polymerised silicone resilient liner. Patients were instructed to clean the dentures with soap water and brush. Samples from the fitting surface of mandibular dentures were collected at 15, 21 and 30 days. Subsequently, samples were collected at 15, 21 and 30 days, after cleaning the dentures with a detergent solution of 4% chlorhexidine gluconate, and incubated for the evaluation of Candida growth. These data were subjected to statistical analysis by Mann-Whitney U-test. RESULTS: Normal oral flora in diabetics and non-diabetics showed no difference (p > 0.05). The density of colonies increased after 21 and 30 days in diabetic patients (p < 0.05). Number of Candida colonies significantly reduced in both the groups after 21 and 30 days of cleaning the dentures with 4% chlorhexidine gluconate (p < 0.05). CONCLUSION: Dentures with silicone resilient liner exhibit increased Candida growth in diabetic patients. Four per cent chlorhexidine gluconate solution effectively disinfects these dentures.

Multidisciplinary approach for restoring function and esthetics in a patient with amelogenesis imperfecta: a clinical report.

Amelogenesis Imperfecta (AI) is a genetically determined and enamel mineralization defect reported, depicted as "Hereditary brown teeth." AI is characterized as a clinical entity and its clinical manifestations, histological appearance, and genetic pattern are characterized by their heterogeneity. The need for prosthodontic management of this group of patients varies. Some patients need oral hygiene instructions only, whereas others need extensive dental treatment that includes composite restorations, metal ceramic crowns, all ceramic crowns, porcelain veneers. A 20-year-old male patient presented with sensitive, discoloured, and mutilated teeth, with a decreased vertical dimension of occlusion. The 4-year recall examination revealed no pathology associated with the full mouth rehabilitation, and the patient's aesthetic and functional expectations were satisfied. The rehabilitation included all-ceramic crowns on anterior teeth and metal-ceramic crowns on posterior teeth following endodontic treatment and a crown-lengthening procedure for eliminating tooth sensitivity, improving the aesthetics and occlusion, and for restoring function.

In vitro comparative evaluation of the effect of two different fiber reinforcements on the fracture toughness of provisional restorative resins.

BACKGROUND: Fracture of provisional fixed partial denture (FPD) may jeopardize the success of provisional prosthodontic treatment phase and cause patient discomfort. AIM: The aim of this study was to compare the fracture toughness of the Polymethyl Methacrylate (PMMA) resin and Bis-Acryl Composite (BAC) resin reinforced with the Polyethylene and Glass fibers. MATERIALS AND METHODS: Three groups (N=10) of each of the two materials were prepared for the fracture toughness test. Two groups had the different reinforcements and group without reinforcement served as the control. The mean fracture toughness (MPa.m½ ) was compared by One-way ANOVA, followed by the Scheffe analysis. Fracture toughness between fiber-reinforced PMMA and BAC resin was compared by the independent samples t test. RESULTS: For the controls, the fracture toughness for PMMA resin (0.91) was significantly lower than for the BAC resin (1.19). Glass fiber reinforcement produced significantly higher fracture toughness for both, PMMA (1.48) and BAC (1.82) resin, but the Polyethylene fibers did not (0.95 for PMMA and 1.23 for BAC resin). Among the reinforced groups, Silane impregnated Glass fibers showed highest fracture toughness for the BAC resin (1.82). CONCLUSION: Of two fiber reinforcement methods evaluated, Glass fiber reinforcement for the PMMA and BAC resin produced highest fracture toughness. CLINICAL IMPLICATIONS: On the basis of this in--vitro study, the use of Glass and Polyethylene fibers tested may be an effective way to reinforce resins used to fabricate fixed provisional restorations.

The effect of different fiber reinforcements on flexural strength of provisional restorative resins: an in-vitro study.

PURPOSE: The aim of this study was to compare the flexural strength of polymethyl methacrylate (PMMA) and bis-acryl composite resin reinforced with polyethylene and glass fibers. MATERIALS AND METHODS: Three groups of rectangular test specimens (n = 15) of each of the two resin/fiber reinforcement were prepared for flexural strength test and unreinforced group served as the control. Specimens were loaded in a universal testing machine until fracture. The mean flexural strengths (MPa) was compared by one way ANOVA test, followed by Scheffe analysis, using a significance level of 0.05. Flexural strength between fiber-reinforced resin groups were compared by independent samples t-test. RESULTS: For control groups, the flexural strength for PMMA (215.53 MPa) was significantly lower than for bis-acryl composite resin (240.09 MPa). Glass fiber reinforcement produced significantly higher flexural strength for both PMMA (267.01 MPa) and bis-acryl composite resin (305.65 MPa), but the polyethylene fibers showed no significant difference (PMMA resin-218.55 MPa and bis-acryl composite resin-241.66 MPa). Among the reinforced groups, silane impregnated glass fibers showed highest flexural strength for bis-acryl composite resin (305.65 MPa). CONCLUSION: Of two fiber reinforcement methods evaluated, glass fiber reinforcement for the PMMA resin and bis-acryl composite resin materials produced highest flexural strength. CLINICAL IMPLICATIONS: On the basis of this in-vitro study, the use of glass and polyethylene fibers may be an effective way to reinforce provisional restorative resins. When esthetics and space are of concern, glass fiber seems to be the most appropriate method for reinforcing provisional restorative resins.

Presurgical nasoalveolar moulding for a unilateral midfacial cleft: A case report.

Although surgical correction remains the mainstay of treating unilateral/bilateral cleft lip and/or palate deformities, some inadequacies still remain like scarring of the nasolabial complex, multiple interventions to achieve desired results, etc. Presurgical nasoalveolar moulding consists of selective repositioning by active moulding of the alveolar segments as well as the surrounding soft tissue. Clinical case of unilateral mid-facial cleft treated by the same, showed significant reduction in the defect size and improved contour of the columella-philtrum region for superior postsurgical esthetics.

Functionally generated amalgam stops for single complete denture: a case report.

Single complete denture opposing natural dentition is a common occurrence in clinical practice. This article reports a case of a single complete denture with a technique of occlusal refinement by functionally generated amalgam stops condensed in prepared resin teeth after initial balancing of the denture with semi-adjustable articulator. This technique provides intimacy of contact in all excursions by carving the amalgam in plastic stage. Amalgam stops improve the efficiency of the resin teeth. Dentures fabricated using this technique require fewer and simpler post-insertion adjustments.