Prevalence of Osteoporosis and Its Effect on Residual Ridge Resorption in Postmenopausal Females of Rural Central Indian Region.

AIM:  To determine the correlation between body mass index (BMI), bone mineral density (BMD), and residual ridge resorption (RRR) in postmenopausal females and the effect of osteoporosis on RRR. MATERIALS AND METHODS:  A study was conducted with 60 postmenopausal female individuals. BMI was calculated using the weight and height of the patient using a formula. BMD was assessed and graded using a T-score. RRR was determined using the Tallgren method. RESULTS: Most individuals showed a higher BMI (63.33%), which is in the overweight or obese category. BMD was lower in approximately 68.33% of patients, and RRR was significantly higher in about 60% of total patients. CONCLUSION: The higher the BMI values, the lesser the BMD and the higher the RRR.

Revolutionizing Maxillary Rehabilitation: Zygomatic Implants Addressing Severe Alveolar Atrophy.

This case report describes the care given to a 58-year-old male patient with severe upper jaw atrophy. The treatment strategy involved utilizing zygomatic implants in conjunction with endosteal implants to rehabilitate both the maxilla and mandible. Temporary prostheses were used during the healing phase, followed by the fabrication and placement of final prostheses. The utilization of zygomatic implants offers advantages such as immediate stabilization and function without the need for extensive bone grafting. This approach not only reduces treatment time and costs but also enhances patient outcomes. Furthermore, guided surgical techniques are increasingly employed to ensure precise implant placement, optimizing prosthetic support.

Digitalization in Cranial Reconstruction: Revolutionizing Precision and Innovation.

Cranioplasty for cranial defects can be complex and challenging in composite defects. The intricate 3D structure of the craniofacial skeleton poses various difficulties encountered in surgical reconstruction. The continuous progress in computer-aided design and computer-aided manufacturing design, and fabrication technology has led to a growing array of applications for visual analog scale and 3D printing in craniofacial surgery, encompassing preoperative assessment, the creation of cutting guides, and the development of custom implants and stereolithographic models. Within this review, the authors detail the present and developing applications of virtual surgical planning, 3D bioprinting, augmented reality, and virtual reality in craniofacial reconstruction.

Revolutionizing Neurosurgery: The Cutting-Edge Era of Digitally Fabricated Cranial Stents.

Cranial defects are broadly classified as either congenital or acquired. The prevalence of cranial injuries has notably increased, propelled by a heightened emphasis on aesthetics and the demand for skull reconstruction in contemporary society. Consequently, rehabilitation for these defects has also surged. Surgical correction or repair, known as cranioplasty, not only aims at aesthetic rehabilitation but also addresses psychological issues, improving social acceptance and overall performance. Amid evolving trends, the availability of advanced biomedical tools, technologies, and materials empowers surgeons and prosthodontists, leading to improved outcomes in aesthetics and functionality. One noteworthy technique highlighted in this case report involves using bone cement in conjunction with polymethyl methacrylate, adding novelty to the approach. The interdisciplinary management team, consisting of prosthodontists and neurosurgeons, played a pivotal role in improving neurological status and cosmetic outcomes for the patients.

Association of Salivary Cortisol With Anxiety in Type 2 Diabetes Mellitus Patients Before and After Complete Denture Rehabilitation: An In-Vivo Analysis.

Background Complete edentulism negatively impacts emotional, physical, social, and psychological well-being, leading to a decline in quality of life and heightened stress and anxiety. Stressful situations associated with edentulism can elevate cortisol levels, potentially increasing the risk of diabetes. Rehabilitation with complete dentures needs careful evaluation for its impact on general health, considering stress points and systemic effects. This study aimed to assess salivary cortisol levels in type 2 diabetes mellitus patients before and after complete denture rehabilitation, highlighting the intricate relationship between diabetes, cortisol, and the stress response. Methods This is a cross-sectional study centered on individuals with diabetes who were completely edentulous and undergoing evaluation by the outpatient prosthodontic department. Glycated hemoglobin, anxiety levels, and the fabrication of complete dentures were all accomplished with the participants' consent. Patients underwent evaluations before and one month after receiving complete denture rehabilitation. Results An absolute correlation between salivary cortisol levels and anxiety may be established because anxiety levels dramatically decreased during complete denture rehabilitation. Conclusion By learning how the patient's general health is related to their new set of complete dentures and how to correlate that information with dental rehabilitation, professionals can help patients better adapt to their new set of dentures.

Appliances Therapy in Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis.

Obstructive sleep apnea (OSA) is a recurrent partial or complete obstruction of the upper airway during sleep caused by narrowing or collapse of the pharyngeal wall. It leads to microstimulation and oxyhemoglobin desaturation, resulting in sleepiness and loud snoring. OSA negatively affects the cardiovascular system and may contribute to neurocognitive impairment. The aim of this systematic review is to evaluate the effectiveness and efficacy of appliance therapy in obstructive sleep apnea. The effectiveness was assessed by using the Apnea Hypopnea Index (AHI). An electronic search of the Cochrane Library, PubMed, and Google Scholar was conducted between 1998 and 2021. Articles were independently assessed by three reviewers. The quality of a randomised control trial (RCT) is assessed using the Cochrane risk of bias method. The tool GRADE was used to achieve the desired level of confidence for each outcome reported. Several studies used continuous positive airway pressure (CPAP), mandibular advancement devices (MAD), and tongue retention devices (TRD). The meta-analysis included a total of six papers that met the inclusion criteria. Results showed that CPAP significantly improved AHI compared with an oral appliance (random effects: difference in means = 8.40, 95% CI = 7.21 to 9.60). It was also found that oral appliance (OA) therapy significantly improved AHI compared with baseline before appliance therapy (random effects: mean difference = 13.40, 95% CI = 10.87 to 15.93; p.00001). For mild to moderate OSA, CPAP is considered the gold standard. Our meta-analysis of six RCTs found favorable evidence for OSA patients receiving oral devices; however, they were less effective than CPAP. A subgroup analysis found that MAD may be a beneficial treatment for mild to moderate OSA patients who do not respond to CPAP. The findings suggest that oral appliances may be an effective treatment for OSA, especially in patients with mild to moderate OSA.

Quad Zygoma: A Graftless Solution in Post-mucormycosis Maxillectomy.

Mucormycosis, a fungal infection that commonly affects individuals with diabetes and compromised immune systems, often requires surgical excision and debridement. However, this can result in significant defects, posing a challenge for clinicians in terms of reconstruction and rehabilitation. Prostheses, local and regional pedicled flaps with or without bone grafts, and titanium mesh application are available options for maxillary reconstruction. Soft-tissue flaps are not sufficient to provide osseointegrated implants with both bone repair and structural support, which emphasises the quad zygoma's beneficial role in treating maxillary abnormalities. Patients benefit from quad zygoma, which uses zygomatic implants and eliminates the need for subsequent procedures, which shortens the course of treatment and lowers costs. Because zygomatic implants are securely fixed into the zygoma, temporary prostheses can be loaded right away. Then, four to six months later, a fixed prosthesis may be introduced. Clinical results with zygomatic implants often surpass those of bone grafting, representing a potential novel gold-standard approach for the compromised maxilla. This case report details the rehabilitation of post-mucormycosis patients with maxillary defects using quad zygomatic implants. The absence of complications during follow-up, conducted at 15, 30, 45, and 90 days, and subsequently monthly for two years, highlights the success of this approach. Evaluation parameters included soft tissue recovery, infection, wound separation, stability of prosthesis, eating effectiveness, and aesthetic outcomes. The positive outcomes observed at follow-up appointment emphasize the viability and effectiveness of quad zygomatic implants in addressing maxillary defects post-mucormycosis.

Rapid Prototyping in Maxillofacial Rehabilitation: A Review of Literature.

This review focuses on fast prototyping advancements in the field of maxillofacial prosthodontics, as well as the various methods for fabricating maxillofacial prostheses. As of date, the interface and software used for processing and designing maxillofacial prostheses are costlier, atypical for the specific purpose, and only reachable to highly trained dental specialists or computer-aided design (CAD) engineers. This review is a summary of all rapid prototyping trials conducted in the mentioned context of three-dimensional (3D) printing of maxillofacial prostheses, treatment modalities, and future perspectives relating to rapid prototyping in dentistry. We performed a search of relevant articles on Google Scholar and PubMed, which yielded a total of 21 articles for full-text reviews. After excluding some articles based on the exclusion criteria, a review was conducted. This study gives a comprehensive discussion of current issues and future ideas for integrating digital technology with conventional techniques.

Paradigm Shift in Materials for Skull Reconstruction Facilitated by Science and Technological Integration.

The surgical repair of a bone deficiency in the skull caused by a prior procedure or accident is known as cranioplasty. There are various types of cranioplasties, but the majority entail raising the scalp and reshaping the skull using either the original piece of bone from the skull or a specially molded graft created from Titanium (plate or mesh), artificial bone in place of, a stable biomaterial (prefabricated customized implant to match the exact contour and shape of the skull). Cranioplasty, one of the oldest surgical treatments for cranial abnormalities, has undergone several changes throughout the years to discover the best material to improve patient outcomes. Various materials have been utilized in cranioplasty throughout history. As biomedical technology progresses, surgeons will have access to new materials. There is still no agreement on the optimum material, and research into biologic and nonbiologic alternatives is ongoing in the hopes of finding the finest reconstruction material. The materials and techniques used in cranioplasty are covered in this article.

Prosthetic Rehabilitation of a Partially Dentate Patient With a Maxillary Cast Partial Denture and Mandibular Overdenture: A Case Report.

Using natural teeth as denture abutments can significantly slow the progression of residual ridge resorption. The abutments and the denture-bearing areas can share the stress concentration. By providing sensory feedback, occlusal stability loss, aesthetic loss, and compromised mastication, overdentures can help reduce residual ridge resorption. Overdentures have been shown to be effective in reducing residual ridge resorption and increasing retention and stability. When edentulous areas are too large or numerous for the fixed prosthesis and cross-arch stabilization is required, a cast partial denture (CPD) is preferred. The insertion and removal of the denture, as well as regular oral hygiene, are simple procedures. The current case report describes the prosthetic rehabilitation of a partially dentate patient using a maxillary CPD and mandibular overdenture.

Alternative Prosthodontic Therapies: A Multifaceted Approach.

The increasing influence of alternative therapies reflects shifting demands and attitudes in modern society in general. Concerns about the negative impacts and rising expenses of traditional health care are also fueling the hunt for alternatives. Acupuncture, acupressure, homeopathy, Ayurveda, and hypnosis are examples of therapy modalities. Alternative therapies, on the other hand, are currently recommended as a supplement to traditional treatment. Although their efficacy as a standalone therapy is debatable, when used in conjunction with conventional treatment, they can be a valuable addition to the general dentist's therapeutic arsenal. When mainstream medicine cannot give a proper treatment or simply offers symptomatic alleviation for chronic diseases, the patient's desire for alternative therapies rises. This was found to be true for common medical conditions such as back pain and asthma. Surprisingly, patients seek conventional medical practice treatments for dental or oral health issues more frequently in emergencies (i.e., tooth pain or dental decay, temporomandibular joint disorder, periodontal disease, or dry mouth). Cloves and tea tree oil are the two topical or oral herbal or natural products that dental patients utilize most frequently. Furthermore, people worried about getting dental work done may find great benefits from using mind-body techniques.

Enhancing Esthetics in a Complete Denture Patient: Optimizing Results With Different Impression Techniques.

Tooth loss followed by complete denture rehabilitation can have significant psychological and social consequences for patients. Dentures restore a sense of normalcy and allow the sufferer to communicate with others in today's image-conscious world. Chewing discomfort, as well as unfavorable aesthetics and phonetics, are the most common denture complaints. A complete denture patient's prosthetic rehabilitation should never be confined to the replacement of lost teeth; rather, the ultimate goal should be the restoration of oral functions and aesthetics. The article describes a straightforward, cost-effective, practical, and aesthetic strategy for rehabilitating a complete denture patient with resorbed ridge, flabby tissue, and sunken cheeks. Thus, an effort has been made to restore the patient's stomatognathic system. Tooth loss followed by complete denture rehabilitation can have significant psychological and social consequences for patients. Dentures restore a sense of normalcy and allow the sufferer to communicate with others in today's image-conscious world. Chewing discomfort, as well as unfavorable aesthetics and phonetics, are the most common denture complaints. A complete denture patient's prosthetic rehabilitation should never be confined to the replacement of lost teeth; rather, the ultimate goal should be the restoration of oral functions and aesthetics. The article describes a straightforward, cost-effective, practical, and aesthetic strategy for rehabilitating a complete denture patient with resorbed ridge, flabby tissue, and sunken cheeks. Thus, an effort has been made to restore the patient's stomatognathic system.

The Correlation of Mineral Density of Jaws With Skeletal Bone and Its Effect on Implant Stability in Osteoporotic Patients: A Review of Patient-Based Studies.

Osteoporosis has been an enigma in terms of the administration of implant therapy. It has been implicated as a cause of implant failure as it directly affects the quality of the bone. The diagnosis of osteoporosis is mainly done by measuring skeletal bone mineral density (BMD). During implant therapy, the BMD of jaws can be evaluated on routine orthopantomogram (OPG) or cone beam CT (CBCT). The various advantages of CBCT include establishing a correlation between skeletal bone density and bone density of jaws and estimating its effect on implant stability in osteoporotic patients, which in turn will help in determining the prognosis of the implant in osteoporotic patients. This review is a summary of all patient-related studies conducted in the mentioned context of implant placement in patients with osteoporosis, treatment modalities, and prognosis. We performed a search of relevant articles on Google Scholar, PubMed, and Cochrane, which yielded a total of 25 articles for full-text reviews. After excluding some articles based on the exclusion criteria, a review was conducted along with a pilot study on implant placement in osteoporotic patients. Regional bone density can be a helpful parameter in predicting primary implant stability and it can be a useful indicator of skeletal BMD. With a careful evaluation of BMD, dental implants can be placed in patients with osteoporosis with a better prognosis for the treatment.

Assessment of Bone Mineral Density in Type 2 Diabetes: A Cone Beam Computed Tomography (CBCT) Study.

Introduction The main purpose of the study was to assess and compare bone mineral density (BMD) at prospective implant sites in the mandible in type 2 diabetes mellitus (T2DM) and non-diabetic patients using cone beam computed tomography (CBCT). Material and methodology A total of 40 patients were included in this type of cross-sectional study. They were divided into two groups, A and B, according to their haemoglobin A1c values. Group A consisted of patients with HbA1c between the range of 6.1%-8% and group B had patients with no history of T2DM. CBCT scans were made of the mandibular arches of both the patients to evaluate the BMD at lingual and buccal cortical plates and the trabecular regions in two successive slices with the assistance of PlanMeca Romexis software (PlanMeca Romexis®, Helsinki, Finland). The Shapiro-Wilk test was used to determine the normality of continuous data. The Mann-Whitney U test was used to compare the groups. Results There were no differences that were statistically significant between the two cohorts according to the Mann-Whitney U test at buccal cortical plate points 1 and 2. However, the diabetes group's mean bone density at implant sites-A, B, C, D, and E at trabeculae points 1 and 2 was considerably (7p>0.001) lower than the non-diabetic groups. The mean bone density of the diabetes group was marginally but significantly (p=0.009) lower than the non-diabetic group at lingual cortical plates. Conclusion Individuals with type 2 diabetes mellitus show significantly lower bone mineral density in the lingual cortical plate and trabecular region, however, implant therapy can be performed with certain mentioned guidelines in such regions. In the buccal cortical region, the bone mineral density is seen to be unaffected.

The Effect of Structured Education Training Program on Oral Health Awareness Among School-Going Children of Central India: A Cross-Sectional Study.

Background In order to curb the ever-increasing load of diseases related to the oral cavity, there is a call for generating organized school-based oral health education and training programs. It is proposed that there will be an emphasis on the primary care of oral health of school-going children proven, which is often neglected. This will be beneficial for the early detection, intervention and thus prevention of further debilitating conditions of the pathologies pertaining to the oral cavity with the assistance of the structured program suggested in this article. Aim The aim of the study was the evaluation of oral health programs for oral health awareness and knowledge among school-going children in the Central India region. Settings and design This is a cross-sectional study with measurements before and after the implementation of the oral care program.  Materials and methods This cross-sectional study, approved by the Institutional Ethical Committee, Datta Meghe Institute of Medical Sciences, Wardha, has been done according to the STROBE (Strengthening the Reporting of Observational studies in Epidemiology) checklist. A study based on certain questions was carried out amongst the school-going children of Central India, especially the Vidarbha region. A total of 250 school-going children were enrolled in the study. A survey based on a questionnaire was carried out among the study participants in the age group of 12-16 years of age, which consisted of questions pertaining to knowledge of oral health and hygiene maintenance. The program consisted of presentation slides, role-plays, and demonstrations for inculcating the knowledge. Result A total of 200 study participants responded to the questionnaire. Overall, the baseline mean score of knowledge with scale was 2.80 ± 1.73 SD, which after the intervention was observed to be 10.70 ± 0.54 SD, which showed an increase. There was an aptly 60.4% increase in test scores related to oral health after the specific oral health inculcation program based on questionnaire execution which was statistically significant (p<0.001). Conclusion A properly constructed school children-based oral health education and training program induces better results in the oral health-related comprehension of students.