As a dentist our main aim should be prevention which not only includes prevention of caries and or periodontal disease but also prevention of residual alveolar bone loss after teeth are extracted. Today with greater stress on preventive measures, the dental profession has expanded this preventive concept into Prosthodontics. Preventive Prosthodontics emphasizes the importance of any procedure that can delay or eliminate the future Prosthodontic problem and stop further progression of oral disease and prevent the loss of remaining tissues. The Residual Ridge Resorption (RRR) is an inevitable consequence of tooth loss and denture wearing. Severe RRR gradually results in increased interarch distance, significant horizontal discrepancy between edentulous ridges, occurrence of flabby displaceable tissues in the denture bearing area and other sequelae. Prosthetic rehabilitation in these patients can be challenging. The conventional complete denture fabrication in such cases may further compound the poor denture bearing ability of the tissues and lead to decreased retention, stability and support which may result in psychological problems and social isolation. This case report emphasizes the importance of preventive concepts in every step of complete denture fabrication to offer a long serviceable prosthesis without any significant complications and compromise.
Current concept of complete denture rehabilitation is more concentrated on the harmonization between the artificial and natural tissues. In certain cases with sunken cheeks, patients need extra support to the dentures. Sunken cheeks are best restored using cheek plumper or cheek lifting appliances. Conventional cheek plumper appliances have issues such as increased weight, hampering the denture retention and muscle fatigue in patients. So, to overcome all these difficulties, literature reported various modifications in fabrication and designing of a cheek plumper prosthesis. The present case report describes the outcomes of a modified check plumper appliance in a completely edentulous patient with sunken cheeks. Cheeks play a crucial role in facial aesthetics due to their extreme visibility.1 the form of the cheeks is determined by the teeth, ridges and contour of the dentures, especially when restoring a completely edentulous patient. During the due course of life, patients experience concaving and hollowing of the cheeks due to extraction of posterior teeth, thinning of tissues due to ageing or weight loss.1 Prosthodontic rehabilitation should not only aim at restoring and replacing the missing teeth, but also restore the facial support. Conventional procedures fulfill the requirements in most of the cases. But, in cases with sunken cheeks, patients need extra support to the dentures. Sunken cheeks are best restored using cheek plumper or cheek lifting appliances. Use of cheek plumper prosthesis in maxillofacial prosthodontics is well documented in the previous literature.2, 3, and 4 Usually denture flanges provide support to the perioral musculature but they fail to mimic the fullness of the cheeks. So, cheek plumper helps in providing a necessary support to the cheeks and thereby enhancing the aesthetics. Usually, cheek plumpers can be un-detachable or conventional type and detachable cheek plumpers. 5 A conventional one is single unit prosthesis with a supporting extension near premolar or molar region. The major disadvantages with un-detachable cheek plumpers are increased weight hampering the retention, difficulty during denture insertion, muscle fatigue and cannot be used in patients with limited mouth opening.6 To overcome the above mentioned problems, the cheek plumper used in the present case was innovated in two aspects. One was the usage of magnet retained attachments for the flanges and the other was to decrease the overall weight of the denture by hollowing the cheek plumper, increasing the retention. The present case report is innovative as compared to the previous literature. None of the case reports have used the hollowing technique for plumpers which attributes to additional decrease in the weight of the denture. The present case report highlights the outcome of a modified check plumper appliance in a completely edentulous patient with sunken cheeks.
Introduction: The success of prosthodontic procedures can be accurately determined by the exact replication of the patient’s condylar path using a semi-adjustable articulator. It allows the clinician to determine the morphology of the occlusal surfaces in relation to the condylar pathway during mandibular movements. If condylar guidance is not exactly registered, it might result in occlusal interferences during movements of the mandible and lengthen chairside adjustment time, which is inconvenient for the patient and dentist.Materials and methods: A total of 20 dentulous patients from 20 to 30 years of age group attending the department of prosthodontics at Sibar institute of dental sciences were selected for the study. Alu wax and jet bite were used to obtain the protrusive interocclusal record (PIR). Protrusive records were then used to program the semi-adjustable articulator to obtain HCGA values on both sides. Using the same protrusive records CBCT radiograph was taken. Radiographic images were traced on tracing paper and HCGA values were measured using Frankfort’s horizontal reference line (the line connecting porion and orbitale) and the mean curvature line (most-superior and most-inferior points of the curvatures) on both sides using a protractor. The data were analyzed by paired sample t-tests and Pearson’s correlation tests.Results: There was no significant difference between the right and left sides in the clinical and radiographic methods using Alu wax PIR. In the clinical method utilizing jet bite PIR, the right side had significantly higher HCGA values than on the left side. On CBCT, no such differences were found.Conclusion: CBCT horizontal condylar guidance angle values were higher than those obtained using the clinical method by using both records. Values obtained from both the methods, i.e., protrusive interocclusal record and cone-beam computed tomography, were compared and correlated.
The endodontic treatment of maxillary molar with an aberrant root canal morphology can be diagnostically and technically challenging.1 Unusual root canal morphology in multirooted teeth is a constant challenge for diagnosis and successful endodontic treatment. Presence of extra canals, lateral canals, deltas is commonly encountered.2 This case report is presented to illustrate and describe the endodontic treatment of maxillary first molar with an unusual morphological variation of palatal root. The palatal root had two canals that appeared to unite in the apical third of the canal. How to cite this article Prabha MV, Sinha S, Kumar SVK, Haragopal S. Maxillary Molar with Two Palatal Canals. J Contemp Dent Pract 2012;13(6):905-907.
Introduction: Any implant treatment must begin with successful implant integration. The effectiveness of implant osseointegration is determined by various factors, including implant design, implant diameter and density, and surgical technique. Osseointegration is dependent on implant design. Aim: To assess the primary stability of tapered and cylindrical implants by using Resonance Frequency Analysis (RFA) and Insertion Torque Values (ITV). Materials and Methods: This in-vivo, prospective clinical study was conducted in the Department of Prosthodontics at Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India in the month of November 2019. Twenty patients were selected for the study. Tapered Bioline implants (Bioline Dental GmbH & Co. KGGermany) were spaced in 10 patients (group 1) and cylindrical Bioline implants (Bioline Dental GmbH & Co. KG-Germany) in the other 10 patients (group 2). For both implant designs, primary stability was assessed immediately after implant placement using RFA by Osstell Mentor and ITV by a torque wrench. KolmogorovSmirnov test, Shapiro-Wilk test were used for checking normality. Mann Whitney U test, Independent t tests, Spearman correlation tests were done by using software Statistical Package for Social Sciences (SPSS) Version 23.0. Results: The mean ISQ (Implant Stability Quotient) for tapered implants was 76.6±2.3, and for cylindrical implants mean ISQ is 59.75±4.2 (p-value <0.001). The mean ITV for tapered implants was 43.5±2.58 Ncm, and for cylindrical implants, the mean ITV was 33±4.21 Ncm (p-value <0.001). The correlation between ITV and RFA was 0.928 which was highly significant (p<0.001**). Conclusion: Within the scope of this investigation, tapered implants showed better primary stability than cylindrical-shaped implants as determined by ISQ and insertion torque values. ITV and ISQ values showed a positive correlation in determining the primary stability of implants.
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