Journal of Clinical Prosthodontics and Implantology

The Evolving Landscape of Prosthodontics-Enhancing Quality of Life Through Advanced Dentistry

Ponsekar Abraham Anandapandian — 2024-06-08

Post Mucormycosis Rehabilitation By Prosthodontists In Tamil Nadu & Pondicherry: KAP-Questionnaire Based Study

Kanmani Athinarayanan — 2024-05-24

Background: Covid-19 pandemic during 2019 left high mortality rates with mucormycosis (black fungus) as its deadly complication. The spread of black fungus has become global; hence it’s crucial to undertake necessary measures to prevent its spread. Prosthodontists have an inevitable role in the management of mucormycosis and educating the patients regarding the same. The diagnosis of mucormycosis is quite challenging. The treatment should start as quick as possible in order to decrease the death rates. Hence, the knowledge of clinical features and risk factors of mucormycosis is necessary for the prosthodontist in order to provide prompt treatment to the patient.

Materials and methods: A cross-sectional questionnaire based online survey was undertaken amongst 183 Prosthodontists in Tamilnadu and Pondicherry. The questionnaire consisted of 15 questions which evaluated their knowledge, awareness and practice related aspects towards management of postsurgical mucormycosis patients. Statistical analysis was done by using t-test, ANOVA, Pearson and correlation tests. The statistical significance was defined at P < 0.05.

Results: 93% of the study participants were private practitioners in the age group of 25 – 45 years. 106 out of 183 participants had good knowledge about clinical features, prevalent conditions (n=106) and its mode of spread(n=106). They have reported using various prosthesis, grafts and obturators for management of post surgical mucormycosis defects.

Conclusion: Most of the participants were aware about mucormycosis, had reported cases of mucormycosis during Covid-19 and had also employed different methods for prosthetic rehabilitation of patients. However, due to the increase of mucormycosis cases during Covid-19, the practitioners have adopted various methods for rehabilitation. Hollow bulb obturators were found to be the popular mode of rehabilitation. Further research is necessary to develop a standardized protocol for management of post mucormycosis defects.

In Vitro Evaluation Of The Effect Of Different Cleansing Agents On The Shear Bond Of Contaminated Zirconia Ceramics To Resin Cement

Divya Krishnan — 2024-05-24

Aim: The aim of this in-vitro study was to evaluate the effect of different cleansing solutions on the shear bond strength of contaminated zirconia ceramic to resin cement.

Materials and Methods: Fifty zirconia disc (Dental Direkt,YES Germany) of size 10mm x 3mm were fabricated and mounted in self-cure acrylic resin block using a customized jig. The samples (n=10) were grouped based on two cleansing solutions and sub grouped based on two contaminants. Group I (control), neither contaminated nor any cleansing solution used. Group IIA, contaminating with saliva, cleansed with water and Group IIB, contaminating with GC Fitchecker II, cleansed with water. Group IIIA, contaminating with saliva, cleansed with Zirclean and Group IIIB, contaminating with GC Fitchecker II, cleansed with Zirclean. Subsequently fifty composite buttons (5.5mm x 3mm) were fabricated and bonded to the test samples using resin modified glass ionomer cement (Riva Cem,SDI). Thermocycling, shear bond strength, scanning electron microscopy were carried out for all the groups. Statistical analysis was done using independent t test with SPSS software

Results: On comparison it was found that samples contaminated with saliva, cleansed with Zirclean showed a higher mean shear bond strength and the result was statistically significant (P<0.001). Samples contaminated with GC Fitchecker, cleansed with Zirclean showed a higher mean shear bond strength and the result was statistically significant (P<0.001). The result collaborated with SEM analysis of the debonded samples.

Conclusion: Zirclean can be used as an effective surface cleansing solution for zirconia restorations.

Implant Fixture Fracture Related To Angulation Path Compounded By Implant Width

Ashok Balasundaram — 2024-05-24

Accurate implant placement is vital to the proper function and life of not only the implant fixture but also the implant-restoration structural unit. Less than 1% of implant failures occur primarily due to fracture of the implant fixture. Though the principle of implant placement today is prosthetic-driven, proper implant fixture placement is fundamental to the life of the implant-prosthesis unit and includes factors such as selection of key factors such as expertise of dentist or specialist placing the implant fixture, length, and diameter, angulation or path of insertion, length and of implant fixture. Research indicates that among the factors listed, diameter and angulation or proposed path of insertion of the implant fixture play an important role in the long-term stability of the implant fixture.

In this case report, we describe a patient who underwent implant therapy, bilaterally, in the mandible. Implant fixtures were placed in the region of missing tooth #19 and #30 which were previously extracted due to pulpal disease of carious origin. In both cases, a 5.0 mm diameter implant fixture was selected to replace the missing #19 and 30. The implant placed in the #19 region was placed with the ideal angulation and subsequently restored, while the implant fixture placed in the missing #30 location was inserted at an off-angle, then subsequently restored. Three years following restoration, the patient presented with a fractured implant replacing #30. This case report emphasizes the importance of selection of appropriate implant fixture features such as diameter and angulation for the long-term survival of the entire implant-prosthesis unit. As the report would further indicate, in the region of tooth #30, it was difficult to ascertain the cause of implant therapy failure. The case report also underpins the need to pay increased attention to all factors on an individual basis that essentially compound to improve the survivability of the implant-prosthesis unit.

Utilization Of Neutral Zone Technique In Complete Denture Fabrication For A Class III Sagittal Jaw Relation Patient

Leoney Antony, M.D.S,Ph.D — 2024-05-24

Long-term denture wearers have advanced ridge atrophy and atrophy of the musculature of the cheeks and lips and often face challenges associated with decreased mandibular denture stability. This case report highlights the successful implementation of the neutral zone technique in the fabrication of maxillary and mandibular complete dentures to address this issue. Understanding the concept of the neutral zone is essential for achieving optimal denture stability, retention, and speech quality. The steps involved in capturing and utilizing the neutral zone to improve denture stability are thoroughly described. The case exemplifies the effectiveness of the neutral zone technique in overcoming mandibular denture instability for patients with compromised edentulous ridges, resulting in enhanced patient satisfaction, improved oral function and speech.

Prosthodontic Management Of Post Covid Mucormycosis

Santhosh Sathyanarayan — 2024-05-24

Background:

Post covid mucormycosis although very uncommon, came to the limelight after the covid pandemic owing to the decrease in immunity of affected individuals. Post treatment, most of the patients were subjected to physical and mental trauma owing to the aggressive resection of the affected tissues. Patients faced difficulty in swallowing, speech and it affected the esthetics which had a negative impact on the quality of life of patients. Prosthetic management of such patients involves fabrication of maxillofacial prosthesis which replaces the resected tissue thereby restoring normal oral functions.

Aim:

To manage patients affected by post covid mucormycosis prosthetically thereby improving the oral health of the individual.

Case description:

In this article three cases are described which were prosthetically managed with help of obturator, cast partial denture, and hollow denture.

Conclusion:

Prosthetic rehabilitation of patients affected by mucormycosis is quiet complex considering the fact that surgery cannot be planned as per prosthetic requirements. Most of the time prosthodontists are left with minimal structure which would aid in retention, stability and support of denture. Rehabilitation of such patients with implants is a question of debate as more research is required to have clarity regarding the success of implants in mucormycosis affected patients. Conventional treatment with obturator, partial and complete denture is proven to be successful.

Essix Obturator As An Immediate Obturator

Sunantha Selvaraj — 2024-05-24

Background: The fabrication of immediate surgical obturator is known for that the appliance is placed immediate after the surgical procedure. Nevertheless, its design and the material used has not been given much consideration owing to a short duration of usage. However utilization of a immediate surgical obturator has a long-term effect on the patient's tissues and if not fabricated using an appropriate technique and material, the obturator could itself may result in deleterious biological as well as psychological effects on the patient.

Case report: This case report sheds light on suggesting a modification in new material and technique which attempts to obturate the open eradicate or diminish the deleterious effects. This in turn could bring about a more aesthetic outcome, improving the overall quality of life of the patient in the long run.

A Simple Modified Open Tray Implant Impression Technique in a Patient with Fixed Orthodontic Appliance Therapy

Vidyashree V Nandini — 2024-05-24

Background: Implant based restorations are an integral part of orthodontic treatment currently and this combination provides increased treatment options. Making impressions for implant based restorations in subjects undergoing orthodontic treatment is a challenging task.

Aim: This article presents a simple technique to achieve precise impressions utilizing commonly available materials in dental operatory.

Case Description: Patient undergoing orthodontic therapy requiring replacement of missing lateral incisor was planned for implant placement and crown fabrication simultaneously during fixed appliance therapy. A modified open tray implant impression with polyvinyl siloxane was made during the prosthetic phase for successful rehabilitation of the edentulous space in the anterior region.

Clinical Significance: Multidisciplinary approach to treatment is time saving, which includes simultaneous Orthodontic and Prosthodontic procedures. A simple modification of the open tray impression procedure can result in an accurate final cast in the region of interest to overcome the difficulties of impression making in a patient with fixed orthodontic appliance.