A Case Report on Implant-Supported Telescopic Prosthesis-A Gerodontic Enhancement.

One of the most challenging and demanding endeavors in the field of prosthodontics is the rehabilitation of an edentulous mandible. Implants have been used to support mandibular or maxillary prosthetic rehabilitation. Advantages of using implants are increased retention, increased chewing ability, and also easy access to oral hygiene procedures. For decades, the use of telescopic and conical crowns are in practice to connect natural teeth and not many cases have been reported in the literature of telescopic crowns placed on implants to support the prosthesis. Telescopic crowns provide the best possible distribution of force to the abutment teeth and can improve the patient's oral health-related quality of life. The use of telescopic crowns as attachments for implant-supported overlying prostheses may be a viable treatment option for edentulous mandible. The functional and the aesthetic enhancement by telescopic retainers are favorable features for many challenging situations. This case report discusses a 60-year-old male, who reported to the department of prosthodontics with three implants and two bi-cortical screws that were placed in a completely edentulous mandibular arch by a private practitioner one year back and this situation was prosthodontically managed by us with an implant-supported telescopic removable prosthesis.

Evaluation and Comparison of the Effects of Persulfate Containing and Persulfate-free Denture Cleansers on Acrylic Resin Teeth Stained with Cigarette Smoke: An In Vitro Study.

Problem statement and aim  The esthetics of the complete denture primarily depend upon the color of the denture teeth; however, there are situations where the teeth are subjected to extrinsic and intrinsic stains and discolor over time. The purpose of the study was to investigate the effects of smoking and two different denture cleaners on the color stability of the denture teeth. Material and methods Commercially available maxillary anterior teeth made up of acrylic resin were selected for the study and were divided into two groups (n=10): persulfate-free denture cleanser and persulfate containing denture cleansers. The acrylic teeth were set in the smoke chamber with a distance to absorb the smoke equally from the cigarette. The smoke was released for 10 minutes, and the results are observed by the spectrophotometer. Results All the values were collected after the 21st day, and data were analyzed with the SPSS software. It was found that denture cleansers with persulfate are effective on color stability.  Conclusions Even though the persulfate containing denture cleansers are injurious to health, they can be recommended to the smokers with clear instructions of use. However, for non-smokers, persulfate-free denture cleansers are preferred over the persulfate containing denture cleansers.

Effect of Different Crown Materials on the InterLeukin-One Beta Content of Gingival Crevicular Fluid in Endodontically Treated Molars: An Original Research.

INTRODUCTION: Crown materials used in fixed prosthodontics come into close and prolonged contact with the gingiva. OBJECTIVE: The purpose of this study was to evaluate the effect of different crown materials on the interleukin-one beta (IL-1ß) content of the gingival crevicular fluid and to study which crown material causes the highest inflammation on the marginal gingiva on a biochemical basis. MATERIALS AND METHODS: Twenty patients with single endodontically treated tooth were examined. Contralateral teeth were taken as controls. The crown materials in contact with the marginal gingiva were divided into three groups: Group 1- metal, Group2- ceramic, Group 3-zirconia. The collected data were analyzed with International Bibliography of the Social Sciences (IBSS). Statistical Package for the Social Sciences (SPSS) Statistics software 23.0 (IBM Corp, Armonk, New York). All assay procedures were carried out and the results of the collected samples were calculated using the ELISA-AIDTM technique. RESULTS: Multiple comparisons using one-way analysis of variance (ANOVA) between the materials on day zero, 45th and 90th day was highly significant with p=0.0005. Pairwise comparison using Tukey's honest significant difference (HSD) posthoc test was also highly statistically significant with p= 0.0005 except for ceramic & zirconia which were significant at p=0.04 on the 90th day. Multiple comparison using repeated measure of ANOVA with Bonferroni correction between day zero, 45th and 90th day was found to be statistically significant only for zirconia (p=0.002). CONCLUSION: This study was conducted to evaluate the effect of different crown materials on the amount of marginal gingival inflammation by measuring the IL-1ß content in gingival crevicular fluid (GCF). At the end of the three-month analysis, it was seen that the zirconia crowns exhibited the least marginal gingival inflammation.

Improvised Neutral Zone Technique in a Completely Edentulous Patient with an Atrophic Mandibular Ridge and Neuromuscular Incoordination: A Clinical Tip.

Resorption of mandibular ridges is a multifactorial and biomechanical disease that is chronic, progressive, irreversible, and cumulative leading to loss of sulcular depth, vertical dimension loss, and decreased lower facial height. Some common neurological, hormonal, and metabolic disorders affect the adaptability of dentures, and this can be diagnosed by a trained prosthodontist with proper history-taking and clinical examination.The denture becomes passive due to complex neuromuscular control and causes difficulties in impression-making, mastication, and swallowing, which in turn leads to loss of retention and stability in complete dentures. Hence, residual ridge resorption becomes a challenging scenario for a clinician during fabrication of complete dentures. The neutral zone concept plays a significant role in overcoming these challenges. The neutral zone is the area where the outward forces from the tongue are neutralized or nullified by the forces of the lips and cheeks acting inward during functional movements.The neutral zone technique is an alternative approach for the construction of lower complete dentures. It is most effective for dentures where there is a highly atrophic ridge and history of denture instability. The technique aims to construct a denture that is shaped by muscle function and is in harmony with the surrounding oral structures. The technique is by no means new, but it is a valuable one. It is rarely used because of the extra clinical step involved and its complexity. Complete and partial denture failures are often related to non-compliance with neutral zone factors. Thus, the evaluation of the neutral zone is an important factor. Increased retention and stability with reduced chairside time are the salient features of this new approach to any clinically challenging situation in complete dentures.This clinical report describes a modification of the conventional neutral zone technique using improvised procedures to minimize chairside visits for a patient with an atrophic mandibular ridge and neuromuscular incoordination.

Split Hollow Bulb Obturator to Rehabilitate Maxillary Defect: A Case Report.

The rehabilitation of a maxillectomy patient involves meticulous treatment planning and designing. Lack of retention and facial support and limited mouth opening are the major issues that lead to functional and psychological trauma in post-maxillectomy patients. The successful rehabilitation of a maxillary defect includes restoring the function, esthetics, and a complete obturation of the defect, enabling the patient to feed without nasal regurgitation. This case report describes the fabrication of an obturator with a modified design, namely a split-antral hollow bulb obturator and oral part that is retained with a ball attachment, for a patient with right-side acquired maxillary defect due to recurrent myxoma. The primary advantage of this modification is enhanced facial support and a self-retentive antral obturation that improved the quality of life of the patient after an extensive maxillectomy.