Aesthetic Dentistry - What You Decided and What I Want: Shade Selection

ABSTRACT Objective: To assess the relationship between patients' and dentists' perceptions of shade selection and its impact on satisfaction with the prosthesis. Material and Methods: A single group pre-post study was conducted at the Prosthodontics department of a teaching hospital in India. One hundred ten participants were selected through a systematic random sampling technique with inclusion and exclusion criteria. Patients' attitudes regarding the aesthetics of their maxillary anterior teeth were recorded using a validated questionnaire. Shades for the intended prosthetic crown selected by the dentist and chosen by the patient were recorded separately, and patient satisfaction with the appearance of the final prosthesis was recorded. We used descriptive statistics followed by Pearson's Chi-square test and a binomial logistic regression model for inferential statistics. Results: 109 participant's data were available for final analysis. Patients choose lighter shades than the dentist's selection, which is statistically significant (p=0.000). 73.4% were satisfied with the final prosthesis, and the binomial logistic regression model identified using patient-selected shade for the final prosthesis was significantly associated with patients' satisfaction with the final prosthesis (OR=3.3, p=0.001). Conclusion: The patient's preference should be considered with the dentist's option when selecting a shade to create good esthetics.

Relation between Clinical Oral Dryness Score and Denture Satisfaction among Patients' in a Tertiary Care Centre, India.

INTRODUCTION: Xerostomia is a subjective feeling of dryness commonly seen in elderly populations which impairs the quality of life. Due to loss of lubricating property of saliva the buccal mucosa, tongue and lips tend to stick leading to dry, freckled, ulcerated and sore mucosa which is of major concern to the patient to use complete denture. AIM: The aim of the study was to assess the relation between oral dryness score and denture satisfaction among elderly patients. MATERIALS AND METHODS: A cross-sectional study was conducted in prosthodontics department of a dental institution. Patients wearing dentures for at least six months were invited to participate in study. Visual Analogue Scale (VAS) with scores ranging from 0-100 was used to assess patient's satisfaction and clinical oral dryness score was assessed using the criteria described by Osailan SM et al., with scores ranging from 0-10. Data was analysed with SPSS software (version-20) and Kendall's tau-b correlation was used to determine the relationship between mean denture satisfactions and mean clinical oral dryness scores. RESULTS: A total of 220 participants were included in the study based on inclusion criteria. Mean dryness score of the participants was 1.8±0.6 and mean VAS-score for denture satisfaction was 74.32±21.20 for aesthetics, for chewing ability the mean score was 62.31±19.64 and for phonetics it was 67.82±30.60. Strong negative correlation between VAS-scores and oral dryness scores was observed. CONCLUSION: Clinical oral dryness score is one of the important factors which influence denture satisfaction. Dentist should consider in predicting prognosis.

Evaluation of surface detail reproduction, dimensional stability and gypsum compatibility of monophase polyvinyl-siloxane and polyether elastomeric impression materials under dry and moist conditions.

OBJECTIVES: This in vitro study was designed to compare polyvinyl-siloxane (PVS) monophase and polyether (PE) monophase materials under dry and moist conditions for properties such as surface detail reproduction, dimensional stability, and gypsum compatibility. MATERIALS AND METHODS: Surface detail reproduction was evaluated using two criteria. Dimensional stability was evaluated according to American Dental Association (ADA) specification no. 19. Gypsum compatibility was assessed by two criteria. All the samples were evaluated, and the data obtained were analyzed by a two-way analysis of variance (ANOVA) and Pearson's Chi-square tests. RESULTS: When surface detail reproduction was evaluated with modification of ADA specification no. 19, both the groups under the two conditions showed no significant difference statistically. When evaluated macroscopically both the groups showed statistically significant difference. Results for dimensional stability showed that the deviation from standard was significant among the two groups, where Aquasil group showed significantly more deviation compared to Impregum group (P < 0.001). Two conditions also showed significant difference, with moist conditions showing significantly more deviation compared to dry condition (P < 0.001). The results of gypsum compatibility when evaluated with modification of ADA specification no. 19 and by giving grades to the casts for both the groups and under two conditions showed no significant difference statistically. CONCLUSION: Regarding dimensional stability, both impregum and aquasil performed better in dry condition than in moist; impregum performed better than aquasil in both the conditions. When tested for surface detail reproduction according to ADA specification, under dry and moist conditions both of them performed almost equally. When tested according to macroscopic evaluation, impregum and aquasil performed significantly better in dry condition compared to moist condition. In dry condition, both the materials performed almost equally. In moist condition, aquasil performed significantly better than impregum. Regarding gypsum compatibility according to ADA specification, in dry condition both the materials performed almost equally, and in moist condition aquasil performed better than impregum. When tested by macroscopic evaluation, impregum performed better than aquasil in both the conditions.

An innovative impression technique for fabrication of a custom made ocular prosthesis.

Various impression and fitting techniques have been described in the past for restoring ocular defects. The present article describes a new direct impression technique for recording and rehabilitating ocular defects, by custom-made ocular prosthesis. All the techniques described in the history, mainly concentrated in recording the tissue surface of the defect, which made it difficult to contour the palpebral surface resulting in the poor esthetics of the prosthesis. The present impression technique uses heavy bodied polyvinyl siloxane impression material, which facilitates accurate recording of the tissue surface and the palpebral surface of the defect, resulting in the fabrication of functionally and esthetically acceptable prosthesis.

Comparative Evaluation of Metal-ceramic Bond Strengths of Nickel Chromium and Cobalt Chromium Alloys on Repeated Castings: An In vitro Study.

BACKGROUND: Recasting the base metal alloys is done as a routine procedure in the dental laboratories whenever there is casting failure or to decrease the unit cost of a fixed partial denture. However, this procedure may affect the metal ceramic bond. Furthermore, it is unclear, as to which test closely predicts the bond strength of metal-ceramic interface. The aim was to compare the bond strength of nickel chromium (Ni-Cr) and cobalt chromium (Co-Cr) alloys with dental ceramic on repeated castings using shear bond test with a custom made apparatus. MATERIALS AND METHODS: Sixty metal ceramic samples were prepared using Wiron 99 and Wirobond C, respectively. Three subgroups were prepared for each of the groups. The first subgroup was prepared by casting 100% fresh alloy. The second and third subgroups were prepared by adding 50% of fresh alloy and the remnants of the previous cast alloy. The bond load (N) between alloy and dental porcelain was evaluated using universal testing machine using a crosshead speed of 1 mm/min, which had a 2500-kgf load cell. Mean values were compared using oneway analysis of variance with post-hoc Tukey's test and Student's t-test. RESULTS: The mean shear bond load of A0 (842.10N) was significantly higher than the load of A1 (645.50N) and A2 (506.28N). The mean shear bond load of B0 (645.57N) was significantly higher than the load of B1 (457.35N) and B2 (389.30N). CONCLUSIONS: Significant reduction in the bond strength was observed with the addition of the first recast alloy (A1 and B1) compared with the addition of second recast alloy (A2 and B2). Ni-Cr alloys (664.63N) showed higher bond strengths compared to that of Co-Cr alloys (497.41N). The addition of previously used base metal dental alloy for fabricating metal ceramic restorations is not recommended.

Early prosthetic management of maxillectomy, hemimandibulectomy patient with a lateral mid facial defect: a case report.

Maxillofacial prostheses for acquired defects have become more complex and sophisticated with advances in surgical, physical, and rehabilitative dentistry, but before planning, orofacial structures must be analyzed as to the specific cause and the consequent objectives of rehabilitation. Also retention of facial prostheses is very much challenging. Hence, we are presenting the fabrication of an interim prosthesis obturator and cheek prosthesis to restore the speech, help in deglutition and prevent drooling of saliva.