Showing papers in "The Journal of Indian Prosthodontic Society in 2020"
TL;DR: While the accuracy of IOS systems appears to be promising and comparable to conventional methods, they are still vulnerable to inaccuracies.
Abstract: Intraoral scanners (IOSs) are used for capturing the direct optical impressions in dentistry. The development of three-dimensional technology and the trend of increasing the use of IOSs in dental office routine lead to the need to assess the accuracy of intraoral digital impressions. The aim of this review was to assess the accuracy of the different IOS and the effect of different variables on the accuracy outcome. An electronic search using PubMed with specific keywords to obtain potential references for review. A search of MEDLINE (PubMed) identified 507 articles. After title and abstract screening, 412 articles were excluded for not meeting the inclusion criteria and discarding duplicate references. Ninety-five articles were followed for full screening; only 24 articles were included in the final analysis. The studies indicated a variable outcome of the different IOS systems. While the accuracy of IOS systems appears to be promising and comparable to conventional methods, they are still vulnerable to inaccuracies.
26 citations
TL;DR: It can be concluded that active wavefront sampling is more accurate than the other intraoral scanning technology employed by commercial scanners.
Abstract: Background: Intraoral scanner (IOS) is a medical device used for capturing direct optical impressions and composed of a handheld camera (hardware), a computer and software. Digital impressions by intraoral scanning have become an increasingly popular alternative to conventional impressions. The aim of this systematic review is to assess the studies regarding the various available technologies for IOS and evaluate the most accurate IOS system for cases with multiple implants and identify the factors that can influence its accuracy. Materials and Methods: A comprehensive electronic search was done in online databases, 'Pubmed', 'Google Scholar' and 'Cochrane' based on pre-determined eligibility criteria. In-vitro studies, In-vivo studies and Randomized controlled trials assessing the accuracy of intra-oral scanner technology were selected after thorough screening. The search strategy covered all studies published until February 2019 and yielded a total of 11 articles out of which 8 studies were determined to fulfil the inclusion criteria and were selected for this review. Data extraction from the included studies was conducted by the primary author and reviewed by the second author. Results: The information collected included sample size and population, study design, intervention, scanning methods, comparisons and outcome measures. 5 out of 8 included studies compared the distance deviation of the acquired scans from the true values while the remaining 3 studies gave trueness and precision values as the outcome variables. A forest plot on scanner precision displayed slightly higher precision levels in the TRIOS scanner compared to the other intraoral scanners. Conclusion: Despite the limitations this study, it can be concluded that active wavefront sampling is more accurate than the other intraoral scanning technology employed by commercial scanners.
24 citations
TL;DR: The VES spectrophotometer reported the highest accuracy, reliability, and repeatability in shade selection followed by photo colorimetric method, which indicates a statistically significant difference between the treatment and control groups.
Abstract: Aim: To evaluate the methods of the dental shade selection and provide a summary of different factors affecting the shade selection. Design and Setting: The systematic review and meta-analysis. Materials and Methods: The electronic search of the peer-review articles between 2002 and 2018 was carried out the by using the PRISMA guidelines. A total twenty-one studies related to the visual shade methods, instrumental shade methods, and the factors affecting the shade selections was evaluated. The search strategy was based on the PICOS framework. Statistical Analysis: There was statistically significant heterogeneity (Q = 1038.1518, df = 20, and P Result: The review evaluated the 21 studies of tooth colour science that met with the inclusion criteria and search criteria. The meta-analysis of the 21 combined studies reported acceptable homogeneity (i2 = 98%) which indicates a statistically significant difference between the treatment and control groups. Conclusion: The VES spectrophotometer reported the highest accuracy, reliability, and repeatability in shade selection followed by photo colorimetric method. The Vita 3D master shows more consistent results in repetitive shade selection. Knowledge and training of the shade selection protocol are necessary for proper shade matching
23 citations
TL;DR: Evaluated studies pointed toward the beneficial effects of CGF in implant treatment, and CGF was seen to promote osseointegration and enhance bone regeneration, which seem promising.
Abstract: In the era of evidence based dentistry, a well-documented consolidated data about improvements in dentistry is a necessity. Concentrated growth factor (CGF) is an emerging trend in periodontology and now in implant dentistry. Various studies have been published in the literature evaluating the effect of CGF on implant osseointegration, implant stability, survival rate, sinus augmentation, and peri-implant defects. However, no systematic review has yet been documented. The present systematic review, being first of its kind, aimed to evaluate the potential outcomes of employing CGF in implant treatment. A literature search was carried out in PubMed and Google scholar for articles published between 2001 and 2019, with various keywords such as "CGF," "dental implant," "bone regeneration," "CGF," and "osseointegration." The screening of studies was done according to PRISMA guidelines. A total of eleven studies were included in this review. Majority of the included studies pointed toward the beneficial effects of CGF in implant treatment. CGF was seen to promote osseointegration and enhance bone regeneration. Although more clinical studies are required to validate the potential merits of CGF in the long run, the preliminary results seem promising.
16 citations
TL;DR: The primary stability of implant placed using OD drills was found to be slightly higher than implant placed with traditional drilling; however, there was no statistical significance (P > 0.05) in implant stability between the traditional drilling and OD drilling.
Abstract: Aim: The present study was done to evaluate and compare the stability of the implant and the loss of crestal bone in the implants placed using OD drilling and traditional drilling technique. Setting and Design: In vivo-comparative study. Materials and Methods: A total of 20 implants were placed in the anterior maxilla, and the patients were divided into two groups. In Group I, the implants were placed using traditional drilling technique, and in Group II, implant placement was done using OD drilling technique. Primary stability was measured in both the groups at baseline (immediate postoperative), and at an interval of 6 months, while crestal bone levels were measured at baseline, 6, and 8 months. Statistical Analysis Used: The data obtained were subjected to unpaired t-test to make intergroup comparisons, while one-way ANOVA F-test was used to make intragroup comparisons. Results: The primary stability of implant placed using OD drills was found to be slightly higher than implant placed with traditional drilling; however, there was no statistical significance (P > 0.05). When the data obtained for crestal bone levels were statistically analyzed, no significant difference between the two groups was obtained (P > 0.05). Conclusion: Within the limitations of this study following conclusions were drawn: there was no statistically significant difference in implant stability between the traditional drilling and OD drilling (P
13 citations
TL;DR: The completely edentulous individuals with atrophic posterior alveolar ridges can be rehabilitated successfully with improved biting force and chewing efficiency by All-on-four treatment concept.
Abstract: Aim To compare and evaluate biting force and chewing efficiency of all-on-four treatment concept, implant-supported overdenture, and conventional complete denture. Settings and design Invivo - comparative study. Materials and methods A total of 12 edentulous patients were included in the study and conventional complete dentures were fabricated. Patients were divided into two groups. In Group 1, complete dentures were replaced with implant-supported overdenture, and in Group 2, complete dentures were replaced with hybrid denture supported by all-on-four treatment concept. The biting force was assessed using a bite force sensor and electromyographic recordings were made by electromyogram for masticatory muscles when chewing three different consistencies of foods. Statistical analysis used The data was statistically analyzed using software SPSS version 22.0. Paired t-test was used for intra-group comparison and unpaired t-test was used for intergroup comparison. Results The difference in biting force and chewing efficiency for all-on-four treatment concept was statistically significant for overdenture and complete denture. The highest biting force and chewing efficiency were observed for all-on-four treatment concept, followed by implant-supported overdenture and complete denture. Conclusion The study concluded that the completely edentulous individuals with atrophic posterior alveolar ridges can be rehabilitated successfully with improved biting force and chewing efficiency by All-on-four treatment concept.
13 citations
TL;DR: The ball and locator attachments excellently perform in terms of survival rate, tissue response, and patient satisfaction as well as low for magnetic attachment.
Abstract: Aim: To evaluate the survival rate, tissue response, and patient satisfaction of different attachments used in implant overdenture. Settings and Design: Systematic Review and Meta-analysis. Materials and Methods: Electronic search of peer-review articles published between 2001 and 2019 assessing the attachments used for implant-supported overdentures was done according to PRISMA Guidelies. The review evaluated sixteen articles related to survival of the attachments, the reaction of the soft and hard tissues along with repair and maintenance of the attachments, and overall performance of the overdenture attachments. Statistical Analysis Used: There is statistically significant heterogeneity (Q =374.7403, df = 15, and P Result: The review evaluated the 16 articles that met with the inclusion and search criteria. The studies were the combination of bar and ball attachments and their subtypes, magnetic and bar attachments, and locator in combination with other attachments. The meta-analysis of combined 16 studies reported acceptable heterogeneity among 16 studies (I 2 = 96%) and reported to be statistically significant (P Conclusion: The survival rate of attachments was in the range of 95.8%–97.5% for bar, 96.2%–100% for ball, 90%–92% for magnet and locator attachments were in the range of 97% after a mean follow-up period of 3 years. The bar attachments reported moderate tissue reaction in the form of mucosal changes, gingival inflammation, and bone resorption. The locator attachments require higher maintenance and repair. The magnetic attachments produce higher bone resorption and readily displace under functional force. Patient satisfaction and compliance was higher for ball, locator, and bar attachments as well as low for magnetic attachment. Thus, the ball and locator attachments excellently perform in terms of survival rate, tissue response, and patient satisfaction.
12 citations
TL;DR: The use of a flexible silicone obturator for the treatment of a 34-year-old patient with partial maxillectomy due to osteosarcoma of the maxilla with retention by “snug fit” from the defect site.
Abstract: Prosthodontic management of palatal defect is fundamental to close patient's oronasal communication and improve masticatory function, phonetics, esthetics, and comfort. Maxillary defects are the direct consequence of the surgical treatment of malformations, neoplasms, or trauma. The primary goal of an obturator is to close palatal defects after maxillectomy and to improve speech and masticatory function. This clinical report describes the use of a flexible silicone obturator for the treatment of a 34-year-old patient with partial maxillectomy due to osteosarcoma of the maxilla. A conventional cast partial denture with a hollow bulb made in acrylic was given as a definitive obturator initially, which was not comfortable for the patient. Alternatively, a new technique of fabrication of obturator with silicone to close palatal defect was decided to establish an acceptable phonetics, comfort, speech, and function for the patient. This silicone obturator gets retention by "snug fit" from the defect site.
11 citations
TL;DR: CAD-on crowns were found to have significantly higher fracture resistance and cyclic fatigue resistance properties than hand-layered zirconia crowns.
Abstract: Aim: This in vitro study was to compare the fracture resistance and cyclic fatigue resistance of hand-layered zirconia crowns and computer-aided design (CAD)-on crowns (lithium disilicate with zirconium oxide). Settings and Design: Comparative -Invitro study design. Materials and Methods: All ceramic crown preparation was done on a mandibular molar ivorine tooth, impression made, and duplicated. Twenty hand-layered zirconia crowns and twenty CAD-on crowns were fabricated using CAD/computer-aided manufacturing (CAD/CAM) technique. All crowns were cemented to their respective dies using resin cement for evaluating fracture resistance and cyclic fatigue resistance using universal testing machine. Statistical Analysis Used: Independent samples t-test, Mann–Whitney U-test, and Shapiro–Wilk test were used. Results: The mean fracture resistance of CAD-on crowns (2660.50 ± 501.303 N) was significantly more than that of hand-layered zirconia crowns (1963.60 ± 452.895 N) (independent samples t-test, P Conclusion: CAD-on crowns were found to have significantly higher fracture resistance and cyclic fatigue resistance properties than hand-layered zirconia crowns.
10 citations
TL;DR: Optrafine ceramic polishing kit can be used as alternative to glazed monolithic zirconia after clinical adjustment and created more smoother and uniform surfaces as compared to surfaces polished with eZrPolishing kit both quantitatively and qualitatively.
Abstract: Aim To evaluate the efficiency of two commercially available polishing systems in reducing surface roughness of a monolithic zirconia after clinical adjustment and to compare them to glazed zirconia. Setting and design In vitro study. Material and methods This in vitro study was conducted on 25 discs (10mm in diameter and 2mm in thickness) using monolithic zirconia (Ceramill Zolid). From 25 specimens, 5 specimens were randomly selected as the positive control. The remaining discs were abraded for 15 secs with a red band diamond finishing bur using an air rotor handpiece. Then the specimens were randomly divided into 5 equal groups of 5 specimens each. Group 1: Roughened, unpolished and unglazed. Group 2 (Positive Control): Glazed without prior roughening,Group 3: Roughened and polished with eZr polishing kit, Group 4: Roughened and polished with Optra fine ceramic polishing kit and Group 5: Roughened and glazed. The surface roughness (Ra) values (μm) were measured quantitatively by a surface analyzer. The mean values were compared using one-way ANOVA and Post Hoc Test. One specimen of each group was evaluated qualitatively under a scanning electron microscope(SEM) for surface topography. Statistical analysis used One-way ANOVA and Post Hoc Test. Results The lowest Ra value was found in Group 4-Roughened and polished with Optrafine ceramic polishing kit (Ra=0.47μm) as compared to Group 3-Roughened and polished with eZr polishing kit (Ra=0.49μm) and Group 5-Roughened and glazed (Ra=0.59μm). There was no stastistically significant difference between two polishing systems. SEM analysis of surfaces polished with Optrafine polishing kit revealed smoother and regular morphology as compared to surfaces polished with eZr polishing kit. Conclusion The Optrafine polishing kit created more smoother and uniform surfaces as compared to surfaces polished with eZr polishing kit both quantitatively and qualitatively. Also, lowest surface roughness values were produced by optrafine ceramic polishing kit on monolithic zirconia as compared to glazed monolithic zirconia after their clinical adjustments.Thus Optrafine ceramic polishing kit can be used as alternative to glazing.
9 citations
TL;DR: The ZP represents a viable alternative to the cast metal post during the esthetic restoration of endodontically treated anterior teeth and shows no significant correlation between the post systems and post length on the fracture resistance.
Abstract: Aim: Post-and-core restorations require sufficient length of the post for retention of the prosthesis and root strength. The effect of different lengths of prefabricated zirconia posts (ZPs) on the fracture strength of endodontically treated teeth needs evaluation. Hence, the aim of this study was to evaluate the in vitro fracture resistance of endodontically treated incisors restored with ZP, glass-fiber (GFP), and cast posts (CP) of different lengths. Settings and Design: Comparative in-vitro study. Materials and Methods: Sixty extracted incisors were endodontically treated, tooth preparations were carried out, and the impression of the coronal portion of each prepared tooth was made using polyvinyl siloxane impression material loaded in copper tubes. The coronal portion of each tooth was removed, maintaining a 2 mm ferrule. The teeth were restored with one of the three posts: CPs, GFP, or ZPs, with intraradicular lengths of either 6 or 8 mm (n = 10). The CP and core patterns were fabricated using post space impressions and core buildup and cast using Nickel–Chromium alloy. After composite resin core buildup of GFP and ZPs treated teeth using the previously made copper tube impressions, the teeth were loaded to fracture in an oblique direction in the universal testing machine. Statistical Analysis Used: Data were analyzed using two-way ANOVA and Tukey–Kramer tests (α = 0.05). Results: The highest and lowest values of fracture resistance were reported with ZP8 and GFP6 groups, respectively. There was no significant difference in fracture resistance between the posts of length 6 mm and 8 mm in CP, GFP, and ZP groups. There was no significant difference (P = 0.953) in fracture resistance between CP (284.8 N) and ZP (258.31 N) groups, while the GFP group (160.61 N) had a significantly lower value of fracture resistance than the CP and ZP groups. Two-way ANOVA test for fracture resistance of the post systems and post lengths showed that there was no significant correlation between the post systems and post length on the fracture resistance. There was a greater percentage of favorable fractures in GFP and ZP groups (65% each), than the CP group (20%). Conclusion: For the post systems tested, extending the post length does not significantly increase the fracture resistance of the restored teeth. The ZP represents a viable alternative to the cast metal post during the esthetic restoration of endodontically treated anterior teeth.
TL;DR: The following conclusions were drawn that the PEEK crowns demonstrated its capability to produce quality prostheses that were rated satisfactory with a relatively low rate of fracture over the relative mean period of one year.
Abstract: Aim: The aim of this study was to evaluate the clinical performance and patient satisfaction of PEEK Crowns. Setting and Design: In-vivo longitudinal pilot study. Materials and Method: 20 PEEK crowns were placed in 20 patients. 11 were placed in the maxilla and 9 were placed in the mandible. All procedural steps were performed by the same operator. The teeth were prepared with a chamfer finish line of 0.8 to 1 mm. The crowns fabricated were luted using resin cement. Using Modified Ryge's Criteria, the crowns were examined for anatomic form, marginal integrity, surface roughness, restoration staining, marginal discoloration and color match at a time interval of 1 week, 1 month, 3 months, 6 months, one year. Patient satisfaction was also evaluated at the same interval using a questionnaire. Statistical Analysis Used: The data collected was evaluated using fisher's exact test. Results: Based on modified Ryge's criteria, almost 90% of the crowns were rated satisfactory. Fracture was registered in only one crown. Slight chipping off was seen in two crowns. No significant difference was seen in any other factors assessed. Slight variation was seen in the periodontal status of 3 patients. Conclusion: Within the limitations of this study the following conclusions were drawn that the PEEK crowns demonstrated by the use of Modified Ryge's Criteria, its capability to produce quality prostheses that were rated satisfactory with a relatively low rate of fracture over the relative mean period of one year.
TL;DR: It can be concluded that mandibular implant placement is associated with a considerable risk of neurosensory disturbance and clinicians must take necessary precautions to avoid such complications.
Abstract: Aim: Implantology has been widely accepted as the mainstay treatment for rehabilitating complete and partial edentulism. However, it is associated with some failures and complications, the most concerning being neurosensory disturbance. Although neurosensory disturbance has been extensively studied, the incidence and cause remains largely variable. Thus, the aim of this systematic review and meta-analysis was to evaluate the incidence, distribution, and recovery rate of neurosensory disturbance. Settings and Design: This systematic review was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. A structured literature review was conducted using the following databases: PubMed, Science Direct, Cochrane, Ovid, and Google Scholar for reports related to neurosensory disturbance experienced after implant placement in the mandible. Statistical Analysis Used: Incidence and recovery rate for 100 person-years was calculated using the Poisson regression model. The risk difference of incidence between anterior and posterior implants was calculated with a random effects model. Results: Electronic database search yielded 1589 articles; a total of nine articles were selected for the meta-analysis. The risk of neurosensory disturbance was estimated at 13.50/100 person-years (95% confidence interval (CI): 10.98–16.03), with a greater risk with anteriorly placed implants: −0.02 (95% CI: −0.21–0.16) (P = 0.05). The overall recovery rate was estimated at 51.30/100 person-years (95% CI: 31.2–71.4). Conclusions: Within the limitations of the study, it can be concluded that mandibular implant placement is associated with a considerable risk of neurosensory disturbance. A large proportion of these patients present with spontaneous recovery; however, clinicians must take necessary precautions to avoid such complications. More randomized controlled trials are required to quantify the effect of factors leading to altered sensation during implant placement.
TL;DR: It can be concluded that addition of nanoparticles at various concentrations may improve the physical and mechanical properties and color stability of the prosthesis made from the silicone elastomers.
Abstract: Aim: The aim of this systematic review was to evaluate the effect of addition of various nanoparticles into maxillofacial silicone elastomer on color stability and mechanical and biological properties of the silicone elastomer.
Settings and Design: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines(PRISMA).
Materials and Methods: The electronic database search in MEDLINE/PubMed was based on population (silicone elastomer), intervention (nanoparticles), comparison (unreinforced silicone elastomer with nanoparticle-reinforced silicone elastomer), outcome (color stability and mechanical, physical, and biological properties), i.e., PICO framework. The key words used are (”maxillofacial silicone” OR “silicone elastomer” OR “facial silicone”) AND (”nanoparticles” OR “Nano-oxides”) AND (”colour stability” OR “Hardness,” “tensile strength” OR “tear strength” OR “antifungal activity”).
Results: The database search resulted in 2099 studies, of which 2066 articles were excluded as they were irrelevant, duplicates, and data were not available. The remaining 33 full-text articles were assessed for eligibility, out of which 2 articles were in Chinese language, 3 articles were thesis documents, and 8 were review articles. A total of 12 articles were excluded and the remaining 20 articles were included. One article was yielded by hand search of references of included studies. A total of 21 studies were included in the present systematic review. Conclusion: With the available evidence in the literature, it can be concluded that addition of nanoparticles at various concentrations may improve the physical and mechanical properties and color stability of the prosthesis made from the silicone elastomers.
TL;DR: The use of undersized drilling has proven advantageous for increasing initial implant stability in the low-density bone, and although the PIS may be lower, the secondary implant stability is found to be correlated to acceptable values.
Abstract: Aim: The aim of this study is to assess the influence of different implant placement techniques to improve primary implant stability (PIS) in the low-density bone. Materials and Methods: Citations published in English and those available in full text were searched from electronic databases (PubMed and Google Scholar) from the year 2000–2017 by which 75 manuscripts were revealed. After applying inclusion and exclusion criteria, seven were selected for the present review. The whole process was conducted by the following preferred reporting items for systematic reviews and meta-analyses guidelines. Results: The measurement of primary stability showed significant correlations with different bone densities and with implant outcome; however, these two parameters have not been investigated at the same time frequently. Of the seven manuscripts, three discussed standard drilling protocol, two used undersized drilling, one used guided drilling, and one compared standard drilling with undersized drilling. Several intraoperative methods of jaw bone-density assessment were reported, and resonance frequency analysis, periotest, and insertion torque values were used to quantify PIS. Conclusion: The use of undersized drilling has proven advantageous for increasing initial implant stability in the low-density bone. Although the PIS may be lower, the secondary implant stability is found to be correlated to acceptable values.
TL;DR: Laser treatment as an adjunctive therapy or monotherapy in peri implantitis does not show any superior effects than conventional measures as per evidence, however, cases with peri implants mucositis have shown far more promising results with laser therapy compared to conventional procedures.
Abstract: Aim: Peri implant diseases lead to pathological changes in the peri implant tissues and loss of osseointegration. The purpose of this analysis is to evaluate the effect of various lasers and photodynamic therapy (PDT) on peri implant diseases compared to conventional procedures. Setting and Design: This meta analysis was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines. Materials and Methods: A systematic search of the electronic databases such as PubMed, ICTRP, CT.gov, Embase, and Cochrane Library was done additional to manual search of peer review article on peri-implant diseases. Eleven randomized control clinical trials were included in which laser therapy and PDT were used as an interventional procedure. Results and Statistical Analysis Used: Review Manager 5.03 (RevMan, Nordic Cochrane Center, Copenhagen, Denmark), and random effects model were used to assess mean difference (MD). Bivariate differential mean statistic was used in intergroup estimate with 95% confidence interval (CI). I2 test statistics was applied for heterogenity and P Conclusion: Laser treatment as an adjunctive therapy or monotherapy in peri implantitis does not show any superior effects than conventional measures as per evidence. However, cases with peri implant mucositis have shown far more promising results with laser therapy compared to peri implantitis.
TL;DR: It seems as if the usage of PPI has a detrimental effect on the success of dental implants, and there is a need to conduct well-designed, prospective, randomized clinical trials with balanced confounding factors to derive a proper conclusion.
Abstract: Aim: The present systematic review aims to determine the evidence on the impact of proton pump inhibitors (PPIs) on dental implants. Settings and Design: This secondary qualitative and quantitative research was done using a pre-specified question and inclusion criteria. Materials and Methods: A systematic search was conducted in electronic databases such as PubMed, Ovid, and Cochrane. All the studies that assessed the effect of PPIs on dental implants were included, irrespective of the design. Literature review, letter to editors, short commentaries, and opinion articles were excluded. Results and Statistical Analysis Used: A total of three publications fulfilled the inclusion criteria. All these included articles were retrospective cohort studies; the methodological quality was assessed using Newcastle–Ottawa scale. A total of 452 implants were placed in 149 PPI users, whereas 6798 were positioned in 2241 nonusers. Of these, 43 and 212 implants failed in users and nonusers, respectively (odds ratio: 2.91, 95% confidence interval: 2.06–4.11). The meta-analysis was performed using the statistical software Review Manager, and a fixed-effect model was used to obtain the odds ratio. The success rate of implants based on age, gender, smoking, and bone augmentation could be combined only from two studies, which revealed a considerable effect of these factors. Conclusion: As far as the available evidence is considered, it seems as if the usage of PPI has a detrimental effect on the success of dental implants. This influence needs justification as none of the included studies segregated the data based on confounding factors. Hence, there is a need to conduct well-designed, prospective, randomized clinical trials with balanced confounding factors to derive a proper conclusion.
TL;DR: The antimycotic activity of M. alternifolia, C. nucifera, and A. indica mixed with the Visco-gel tissue conditioner can be used as an alternative therapy for denture stomatitis.
Abstract: Aim: The search for alternative therapies for oral candidiasis is a necessity and the use of medicinal plants seems to be one such promising solutions. Incorporation of phytotherapeutic agents, Azadirachta indica (neem oil), Melaleuca alternifolia oil (tea tree oil), and Cocos nucifera oil (coconut oil), were tested for their efficacy as antifungal agents against Candida albicans. Next, the efficacy of these three antifungal agents when incorporated in a soft relining material at minimum inhibitory concentration (MIC) was evaluated. Settings and Design: Evaluative - In-vitro study design. Materials and Methods: The MIC against C. albicans ATCC 24433 was calculated for M. alternifolia oil, A. indica oil, and C. nucifera oil using the broth microdilution method. Based on the preliminary screening results for MIC, tissue conditioner samples were prepared to evaluate the zone of inhibition (ZOI) and MIC. Antifungal activity of the MIC of the three oils was assessed and compared by measuring the mean ZOI. Antifungal activity of the three oils was assessed using one-way analysis of variance (ANOVA) and post hoc test. Statistical Analysis Used: Oneway ANOVA and post hoc Tukey honestly significant difference test. Results: Inhibition against C. albicans was exhibited when 20% v/v, 25% v/v, and 15% v/v of C. nucifera oil, M. alternifolia oil, and A. indica oil were used, respectively. The results of ANOVA and post hoc test at the end of 48 h and 7 days suggested that all three oils were significantly different from each other (P = 0.000) and A. indica/neem oil with 15% concentration had the best antifungal activity at the end of 48 h and 7 days. Conclusion: The antimycotic activity of M. alternifolia, C. nucifera, and A. indica mixed with the Visco-gel tissue conditioner can be used as an alternative therapy for denture stomatitis.
TL;DR: No scheme is more superior to the other with the anatomic tooth forms in complete denture prosthesis and the use of alternative unbalanced schemes produces a similar satisfactory clinical outcome.
Abstract: Aim: The aim of the study is to acquire evidence for the choice of occlusion with anatomic/modified anatomic teeth in complete denture prosthesis. Settings and Design: Systematic review following PRISMA guidelines. Materials and Methods: The study reviewed original articles on various occlusal schemes bilateral balance occlusion (BBO), lingual occlusion (LO), Canine guided occlusion (CG), posterior group function occlusion (PGFO) have been applied to the complete dentures and were analyzed for the objective or subjective or both evaluations. The data were collected in standard format with the needed information such as year of publication, type of study, occlusal schemes compared, test methodology used, sample size for experiment and control, assessment of retention, stability, and other factors which determine the quality of life and period of follow-up. The risk of bias was calculated using tools RoB2.0 and robvis. At all stages, the inclusion and exclusion of studies were discussed among the reviewers. Statistical Analysis used: Due to the heterogeneity in the data of the included studies no statistical analysis was used. Results: Of the 1896 articles screened only 17 studies were included in the systematic review. These were discussed amongst the reviewers regarding the various occlusion schemes used. The subjective and objective criteria used in the studies was tabulated separately. They were then analyzed for the risk of bias using the robvis 2 tool. Conclusion: No scheme is more superior to the other with the anatomic tooth forms. The use of alternative unbalanced schemes produces a similar satisfactory clinical outcome. The ridge classification also has a significant role to play in the preference for an occlusal scheme.
TL;DR: Marginal adaptation of FDPs fabricated using the digital and conventional impressions method was within the clinically acceptable limits, however, more robust clinical trials need to be conducted with large sample size to validate the conclusions.
Abstract: Aim: The aim of this systematic review was to investigate the marginal adaptation of three or four unit fixed dental prosthesis (FDP) fabricated with digital impression techniques to those fabricated using any other impression technique. Settings and Design: Database/electronic searches were conducted till August 2019 in PUBMED-MEDLINE, SCOPUS, and Cochrane library. To identify published articles, multiple keywords were used to develop a search strategy in various combinations. Manual searching of articles was also done. Clinicaltrials.gov.in WHOICTRP and CTRI websites were also searched. Two independent reviewers (TP and VK) assessed eligibility for inclusion, extracted data, and assessed quality using the Cochrane risk of bias tool. Results: Database search identified 497 citations and four citations through manual search. After removing duplicates and going through abstracts, 23 articles were perused for full-text screening. Two articles met the inclusion criteria; characteristics were described qualitatively, with two studies having overall low risk of bias. Conclusions: Marginal adaptation of FDPs fabricated using the digital and conventional impressions method was within the clinically acceptable limits. However, more robust clinical trials need to be conducted with large sample size to validate the conclusions.
TL;DR: The hypothesis that the presence of dentures improve oral sterognostic ability and masticatory efficiency is supported.
Abstract: Aim: The aim of the present study was to evaluate the improvement in oral stereognostic ability, masticatory efficiency, and difference in salivary flow rate in nonexperienced denture wearers, before, after, and 6 months after rehabilitation with complete dentures.
Settings and Design: Invivo – Observational study.
Materials and Methods: Seventy edentulous subjects were selected who came for rehabilitation with complete dentures for the first time. The study was conducted in three stages–before denture insertion, after denture insertion, and 6 months after denture insertion. Oral stereognostic ability was evaluated by asking the subjects to identify six heat cured acrylic resin samples by oral manipulation without seeing it. The unstimulated salivary flow rate was estimated by measuring the time taken to collect 5 ml of the whole saliva. Masticatory efficiency of the subjects was assessed with the help of preweighed chewing gums. The chewing gums were desiccated after the chewing strokes and weighed again.
Statistical Analyses Used: Data were tabulated and analyzed statistically using pairedt-test, one-way ANOVA test, and the post hoc test.
Results: Oral stereognostic ability increased immediately on insertion of complete dentures and was still higher 6 months post insertion of dentures. Comparison of the means of masticatory efficiency after denture insertion and 6 months after denture usage gave highly significant values (p<0.001). The salivary flow which increased immediately following denture insertion returned to almost normal 6 months after denture insertion.
Conclusion: The study support the hypothesis that the presence of dentures improve oral sterognostic ability and masticatory efficiency.
TL;DR: The 45° tilt induced higher stress values at the bone-implant interface, especially in the distal aspect, than the other 2 tilts analyzed, which increased with increased cantilever length which was further influenced by thedistal implant tilt and the quality of the bone.
Abstract: Aim: The aim of this work was to evaluate stress distribution on implants in All-on-Four situation with varying distal implant angulations (30°,40°,45°) and varying cantilever lengths (4 mm, 8 mm, 12 mm, 16 mm) in atrophic maxilla using finite element analysis. Setting and Design: A in vitro study, finite element analysis. Materials and Methodology: Three-dimensional finite element model of an edentulous maxilla restored with a prosthesis supported by four implants was reconstructed to carry out the analysis. Three different configurations, corresponding to 3 tilt degrees of the distal implants (30°, 40°, and 45°) were subjected to 4 loading simulations. Statistical Analysis Used: The results of the simulations obtained were evaluated in terms of Von Mises equivalent stress levels at the bone-implant interface. Result: From a stress-level viewpoint, the 45° model was revealed to be the most critical for peri-implant bone. In all the loading simulations, the maximum stress values were always found at the neck of the distal implants. With increasing distal implant tilt, cantilever length reduces depending on the quality of bone. At 30° angulation of distal implant a maximum cantilever length of 16 mm may be given if the quality of bone is D3 but only 8 mm cantilever may be recommended if bone quality is D4. At 40° angulation, 16 mm in D3 bone and 0 mm in D4 bone whereas at 45° angulation, it reduces to 12 mm in D3 bone and no cantilever is recommended with D4 bone. Conclusion: The 45° tilt induced higher stress values at the bone-implant interface, especially in the distal aspect, than the other 2 tilts analyzed. Stress values increased with increased cantilever length which was further influenced by the distal implant tilt and the quality of the bone.
TL;DR: Two-implant-retained overdentures are more expensive but cost-effective than the conventional complete dentures, but there is a lack of long-term data on aftercare cost and survival rate of mini-implants.
Abstract: Aim The aim of this study was to examine systematically the data published on the cost and cost-effectiveness of mandibular two-implant-retained overdentures compared to other removable prosthodontic treatment options for edentulous mandible. Settings and design It is a systematic review which analyses the available data from the prospective and retrospective studies and randomized clinical trials to find out costs and cost effectiveness of different removable treatment modalities for completely edentulous mandible. The study protocol was decided according to PRISMA guidelines. Materials and methods The search was limited to English literature only and included an electronic search through PubMed Central, Cochrane Central Register of Controlled Trials, and complemented by hand-searching. All clinical trials published up to August 2019 were included (without any starting limit). Two independent investigators extracted the data and assessed the studies. Statistical analysis used No meta-analysis was conducted because of the high heterogeneity of data. Results Out of the initial 509 records, only nine studies were included. The risks of bias of individual studies were assessed. Six studies presented data on cost and cost analysis only. The rest three articles provided data on cost-effectiveness. The overall costs of implant overdentures were higher than the conventional complete dentures. However, implant overdentures were more cost-effective when compared to conventional complete dentures. Single-implant overdentures are also less expensive than two-implant overdentures. Overdentures supported by two or four mini-implants were also reported as more cost-effective than conventional two-implant-supported overdentures. Conclusions Two-implant-retained overdentures are more expensive but cost-effective than the conventional complete dentures. Two- or four-mini-implant-retained overdentures are less expensive than two-implant-retained overdentures, but there is a lack of long-term data on aftercare cost and survival rate of mini-implants. Single-implant overdentures are also less expensive than the two-implant-retained overdentures. The differences of the aftercare costs of different attachment systems for implant overdentures were not significant. There is a need of further studies on comparative cost-effectiveness of different types of implant overdentures.
TL;DR: Although MOF and MMF are both important and effective factors in the success of prosthetic restorations, one cannot be expected by the other and both should be considered in the treatment plan separately.
Abstract: Aim The narrowing of the mandible during opening and protrusion movements is defined as median mandibular flexure (MMF). MMF is caused by the attachment of mandibular muscles; therefore, it can be assumed that a greater amount of maximum occlusal force (MOF) may cause more flexion and could affect the survival of dental and implant restorations. The purpose of this study was to evaluate any relationship between MOF and MMF in a sample of adults. Settings and Design In vivo - comparative study. Materials and Methods In this descriptive, cross-sectional, nondirectional study, a sample of 90 volunteers were recruited (45 men and 45 women). MOF was measured by applying the strain gauge receptor to the first molar region, and MMF was measured by calculating the variation in the intermolar distance by a digital caliper with an accuracy of 0.01 mm using an impression and resulted in the stone cast during the maximum opening and closed-jaw positions. The body mass index (BMI) also was calculated. Statistical Analysis Data were analyzed using the SPSS software (version 23) inferential and descriptive statistics, linear regression, and Pearson correlation coefficient. P < 0.05 was considered statistically significant. Results There was no statistically significant relationship between MOF and MMF (P = 0.78), but there was a significant association between MOF and BMI (P < 0.001, r = 0.475) and gender. Conclusion Although MOF and MMF are both important and effective factors in the success of prosthetic restorations, one cannot be expected by the other and both should be considered in the treatment plan separately.
TL;DR: It is recommended that more importance be given in teaching implants along with CPDs in graduation curriculum so that practitioners can better educate their patients about implants and their advantages over flexible dentures and their utilization in cases where patients are not willing for C PDs.
Abstract: Aims: The use of cast partial dentures (CPDs) has been decreased and its importance has been declined in the teaching curriculum. The purpose of this survey was to evaluate the attitudes of dental professionals toward conditions using CPDs in private practice in India. Settings and Design: Descriptive survey Materials and Methods: This survey consists of eight close-ended questions concerning the use of CPD by dental professionals practicing in India. The URLs of the questionnaire were shared via E-mail to dentists practicing throughout India, to obtain a response of 384 which is a predetermined sample size. Statistical Analysis Used: Statistical analysis was done using counts and percentages and the results were further analyzed statistically by the Chi-square test. Results: Nearly 42.79% of general dental practitioners (GDPs), 47.26% of prosthodontists, and 9.95% of other specialist dentists responded to the questionnaire. GDPs mostly preferred removable partial dentures (RPDs) (71.87%) and fixed partial dentures (57.22%), whereas prosthodontists preferred mostly implant (60.91%). GDPs mostly preferred flexible dentures (62.42%), whereas prosthodontists preferred CPDs 62.84%. Almost 52.50% of the GDPs mostly raised a cost issue and 63.11% of the prosthodontists had difficulty in adjustment with CPDs. Nearly 63.46% of the dentists told that implant-supported restorations are better options compared to CPDs; still, majority of the dentists (53.23%) were in favor that more importance for teaching CPDs in graduation curriculum should be given. Conclusions: This survey shows that in India a significant proportion of GDPs (71.87%) preferred RPDs, mostly flexible dentures (62.42%) due to their low cost compared to CPDs. Prosthodontists mostly preferred implants (60.91%) because they are more confident and better trained in these. It is recommended that more importance be given in teaching implants along with CPDs in graduation curriculum so that practitioners can better educate their patients about implants and their advantages over flexible dentures and their utilization in cases where patients are not willing for CPDs.
TL;DR: There is no evidence in the form of a systematic review of the available literature discussing the best technique available for perfectly matching the iris positioning, however, the latest techniques making use of digital technology such as digital photography, is believed to be more precise for iri positioning in the ocular prosthesis.
Abstract: Aim: To evaluate different methods, techniques, and concepts documented in the literature to assess iris positioning accurately to the related dimensions needed to effectuate maxillofacial rehabilitation of ocular prosthesis. Settings and Design: This systematic review was conducted as per the PRISMA guidelines which is the most opted reporting protocol. Materials and Methods: Two electronic databases PubMed and Cochrane Library) were searched for manuscripts published from 1969 till September 30, 2019. An electronic search (of peer review restricted to English language dental literature was conducted to identify the relevant scientific article on iris positioning in maxillofacial prostheses. Two observers independently read the abstracts and selected 17 full text articles fulfilling the inclusion criteria. Statistical Analysis Used: No meta-analysis was conducted due to heterogeneity of data obtained. Results: All the 17 documented articles related to determination of the iris positioning to perform maxillofacial prosthetic rehabilitation depicting the use of a strip of plastic template, a Boley's gauge, a millimeter ruler, a pupillometer, window light, an ocular locator with fixed caliper, inverted anatomic tracings, a transparent graph grid were reviewed systematically. Conclusion: Currently, there is no evidence in the form of a systematic review of the available literature discussing the best technique available for perfectly matching the iris positioning. However, the latest techniques making use of digital technology such as digital photography, is believed to be more precise for iris positioning in the ocular prosthesis.
TL;DR: No statistically significant difference was observed in crestal bone loss between conventional and diode laser technique in an edentulous mandible involving placement of two implants in mandible following the comparison of two different techniques for second-stage surgery.
Abstract: Aim: This study aims to evaluate and compare the crestal bone levels around implants as influenced by conventional and diode laser during second-stage surgery in an edentulous mandible using cone beam computed tomography (CBCT) and digital radiography (DR). Settings and Design: A split-mouth in vivo prospective study on edentulous patients involving placement of two implants in mandible followed by the comparison of two different techniques for second-stage surgery. Materials and Methods: The study was undertaken to evaluate the crestal bone change around 16 implant sites distributed in two groups (eight implants each) following two methods during second-stage surgery, i.e., Group 1 - Conventional second stage and Group 2 - Diode laser. Measurements were made on two sides (mesial and distal) using intraoral periapical and four sides (labial, lingual, mesial, and distal) using CBCT scans for both groups. These measurements were conducted at two time intervals for both, i.e., immediately after implant loading and twenty 4 weeks after implant loading. The values obtained were subjected to statistical analysis. Statistical Analysis Used: The normality of data was checked by Shapiro–Wilk's test. Intragroup comparison was compared using independent t-test by post hoc comparison by Bonferroni method (P Results: Crestal bone loss at the time of loading for Group 1 evaluated by CBCT was 0.950 ± 0.988 while after 24 weeks of loading, it was 1.388 ± 0.576. For Group 2, mean crestal bone loss was 1.200 ± 0.925 at the time of loading, and after 24 weeks, it was 1.512 ± 0.674. Crestal bone loss at the time of loading for Group 1 evaluated by DR was 1.075 ± 0.849 while after 24 weeks of loading, it was 1.562 ± 0.480. For Group 2, mean crestal bone loss was 1.162 ± 0.833 at the time of loading and after 24 weeks, it was 1.700 ± 0.498. Conclusions: In the present study, no statistically significant difference was observed in crestal bone loss between conventional and diode laser technique.
TL;DR: Investigation of the antimicrobial potential of irreversible hydrocolloid impression material manipulated using chitosan impregnated solution at various time intervals showed significant antimicrobial activity in 10 minutes, which resulted in superior antimacterial activity.
Abstract: Aim To evaluate the antimicrobial potential of irreversible hydrocolloid impression material manipulated using chitosan impregnated solution at various time intervals. Setting and design Evaluative invivo study design. Materials and methods Maxillary impressions made for 20 dentulous volunteers using irreversible hydrocolloid impression material manipulated using distilled water as control and using 1% chitosan impregnated solution as test group using stock metal trays with one-week interval. Bacterial samples were collected using dry sterile cotton swab in the mid-palatal region at the time intervals of 0, 10, 20 minutes. Bacterial swabs were inoculated on nutrient agar media and incubated at 37° C for 24 hours. Bacterial colonies were counted with the aid of colony counter. Statistical analysis used The resultant data was subjected to statistical analysis using repeated measures ANOVA and independent t test. Results Adding water soluble chitosan to irreversible hydrocolloid impression material resulted in superior antimicrobial activity. With the passage of time there was a significant decrease in the microbial colony count upto 10min (p=0.016). However, the rate of decrease of microbial colony count was statistically insignificant between the samples collected at 10 and 20 min. Conclusion Incorporation of water soluble chitosan to irreversible hydrocolloid impression material showed significant antimicrobial activity in 10 minutes.
TL;DR: The association with metal components seems to be an alternative to increase the success of NMCDs by combining esthetics and biomechanical principles of conventional removable partial dentures.
Abstract: The aim was to discuss the indications, contraindications, advantages, and disadvantages of Nonmetal clasp dentures (NMCDs), as well as the most relevant properties of its constituent materials. A search was conducted using the keywords: "nonmetal clasp dentures," "thermoplastic resin," "flexible resin removable partial denture," "polyamide," and "nylon" in databases PubMed/Medline, Lilacs, SciELO, and textbooks between 1955 and 2020. Theses and texts without reliable sources of publication were excluded. Once the analysis instruments were determined, the data were analyzed and discussed. NMCDs present high flexibility, easy adaptation to the abutments, color compatibility and biocompatibility with the oral mucosa, and absence of visible metal clasps. However, they need laboratory relining, grinding, and polishing, do not have criteria for its planning, become rougher and stained over time, and are able to traumatize supporting tissues. The association with metal components seems to be an alternative to increase the success of NMCDs by combining esthetics and biomechanical principles of conventional removable partial dentures. The lack of long-term clinical studies makes the professionals to rely solely on previous experiences or on the manufacturers' recommendations. It suggested that NMCDs must be indicated with caution when not used temporarily.
TL;DR: There was an overall positive correlation between TL and VDR in patients with and without orthodontic treatment and the regression equations presented in this article could help clinicians in their clinical practice and researchers to conduct future trials.
Abstract: Aim A variety of anthropometric techniques have been proposed to determine the correct vertical dimension of occlusion. However, none have reported correlating thumb length (TL) with vertical dimension at rest (VDR). This study aimed to correlate the VDR to measurements of the thumb in a multi-national, multi-centric trial in participants with and without orthodontic treatment and establish a regression equation for each region. Settings and Design A cross-sectional multi-national, multi-centric correlation trial. Materials and Methods A cross-sectional study was conducted in India and Malaysia with a total of 688 participants. Measurements of thumb and VDR were obtained using a modified Willi's gauge using a standard operating procedure. Statistical Analysis Used Pearson's correlation coefficient was calculated to determine the correlation between TL and VDR. A multiple linear regression was done to correlate VDR from gender, orthodontic treatment, and length of thumb. Results Correlation coefficient between TL and VDR in patients with orthodontic treatment was 0.829 and 0.774 in patients without orthodontic treatment. The correlation between TL and VDR in patients with orthodontic treatment in North India was 0.484, P = 0.010 and Malaysia was 0.946, P < 0.001. There were significant correlations between TL and VDR in patients without orthodontic treatment in all regions (P < 0.001). Regression equations were obtained for different ethnic groups for calculating the VDR. Conclusion There was an overall positive correlation between TL and VDR in patients with and without orthodontic treatment. The regression equations presented in this article could help clinicians in their clinical practice and researchers to conduct future trials.