Management of temporomandibular joint disorders requires a multifaceted approach. Splint therapy is one among the preferred treatment modalities. There are various schools of thought pertaining to splint therapy which is often challenging to both dentists and patients. Hence a thorough knowledge regarding splints and its application proves to be of great importance in proper treatment planning. Occlusal splint therapy is a non- invasive, reversible and conservative type of treatment recommended for parafunctional habit, unstable occlusion, stress related pain symptoms, occlusal interferences, in extensive restorative treatment and also other masticatory muscle disorders. Its function has been proved to reduce appropriate symptoms by altering the occlusal equilibrium, distributing forces associated with parafunctional activities and normalizing periodontal ligament proprioception. This article enumerates various aspects of splint therapy such as types of splints, their uses, functions, design, fabrication and its modification with a clear insight on the physiologic and therapeutic effects of various splints. This knowledge gives way to the selection, designing and application of a specific occlusal splint which would help in achieving appropriate and successful treatment planning for the patient.
One of the major reason for a successful denture treatment is a good impression and the cast made out of it. It’s a well known fact, that the denture can only be as good as the impressions made. Therefore, attention to every detail and depth of the impressions plays a pivotal role for a successful clinical result, for which border moulding is an essential procedure for the same. Impressions convey operator’s extent of knowledge, understanding and the clinical results that can follow. A combination of a sound knowledge, along with acquired skill, experience, and patience can result in a successful and aesthetic prosthesis with adequate retention, stability and support with minimal post placement corrections. This article gives an insight into the necessary requisites to be followed during border moulding and secondary impression in making of a successful complete dentures.
Purpose: In spite of many advances in the field of prosthetic dentistry, the choice of whether to treat and retain a grossly compromised tooth or to extract and replace with an implant is debatable. Alveolar bone preservation is one of the main criteria to select the treatment option. This is directly affected by the stress generated in the cortical bone under variable loads and is therefore, relevant. Materials and methods:Two three-dimensional finite element models were generated in relation to maxillary second premolar using ANSYS software. Model-I was parallel-tapered titanium implant with screw-retained titanium abutment and porcelain fused to metal (PFM) crown. Model-P was fiber post and composite resin core with PFM crown. Luting cement was resin cement. Both the models were surrounded by homogeneous and isotropic cortical and cancellous bone, and were subjected to variable loads of 300, 400, and 500 N in axial (0°) and nonaxial (15°, 45°) directions. Results: Stress in the cortical bone in megapascal (MPa) inModel-I/Model-P when subjected to variable loads in newtons (N) in axial direction was 300 N -37.6 MPa/47.3 MPa; 400 N -50.2 MPa/63.0 MPa; 500 N -62.7 MPa/63.0 MPa. 15°-300 N -68.5 MPa/65.9 MPa; 400 N -91.3 MPa/87.9 MPa; 500 N -114.2 MPa/87.9 MPa. 45° -300 N -136.3 MPa/88.9 MPa; 400 N -181.8 MPa/118.5 MPa; 500 N -227.2 MPa/118.5 MPa. Conclusion:Within the limitation of this study, it was concluded that on axial loading, both the treatment modalities showed no significant difference, but on nonaxial loading, the cortical bone in the implant model showed to have considerably higher stress than post core-treated tooth model. Hence, given a choice, this study favors retaining and restoring a compromised tooth with post core and crown rather than extracting and replacing with an implant.
Management of multiple impacted teeth in a nonsyndromic patient is a unique challenge especially if the condition involves the entire permanent dentition. A 36-year-old male patient reported to us with a complaint of loose upper and lower complete dentures. On radiographic examination all the permanent upper and lower teeth were impacted. The medical history and examination was not suggestive of any syndrome or metabolic disorder. The treatment plan to remove all the impacted teeth and place zygomatic implants in the maxilla with multiple implants to give a fixed prosthesis in the maxilla and mandible was carried out.
The disfigurement caused by loss of any part of the body is often a psychologically damaging experience for the patient. To gain improved fit and intimate tissue adaptation of the prosthesis, an accurate impression and fitting technique is necessary. This article reviews various impression techniques that can be used in clinical practice as and when need arises.
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