Gunshot injuries to the face can have serious aesthetic, functional, and psychological consequences. The incapacitating nature of maxillofacial defects makes reconstruction of the maxilla and mandible challenging, owing to multiple surgeries and extensive rehabilitation phase. Outcome of prosthodontic treatment is one of the important parameters by which a patient measures the success of rehabilitation. A 5-year follow-up of comprehensive surgical and prosthodontic reconstruction of a gunshot injury using dental implants is described. This case report illustrates the contribution of immediate dental implants with proper oral hygiene follow-up as an effective treatment modality in restoring a patient to near normal function and aesthetics.
Strength and biocompatibility of any restoration is an important criterion for success and function of any prosthesis. Despite the high fracture resistance of traditional metal ceramic crowns, limitations are imposed by esthetic concerns. The objective of this study is to determine whether zirconium dioxide or nickel chromium copings had better strength when used with two resin based luting cements namely RelyX U100 and Variolink II. Materials and Methods: A total of 40 copings were fabricated, of which 20 were zirconium oxide copings made using CAD/CAM technology. The remaining 20 were nickel-chromium copings obtained using Lost Wax technique. Two resin cements were selected i.e, RelyX U100 universal selfadhesive resin luting cement (RelyXTM U100, 3M ESPE, Sumaré, SP, Brazil) and Variolink II resin luting cement (Ivoclar Vivadent, Schann, Liechtenstein). These cements were mixed and luted on the copings. The copings were seated onto the steel die using finger pressure for 1 minute and placed under a 2.2 kg standard load for 15 minutes. A compressive load was applied through a 1/8-inch diameter hardened steel sphere attached to the moving head of universal testing machine (LR 50K, Lloyds instruments, UK). Load was applied at a crosshead speed of 0.5 mm per minute until fracture occurred. Results: It was found that Nickel-Chromium yielded a higher fracture load compared to Zirconia and the difference in mean fracture load between them was found to be statistically significant (P<0.001). The Copings are found to be a significant factor influencing fracture load. No statistically significant difference was observed between RelyX and Variolink II cements (P>0.05). Slightly higher mean fracture load was recorded in Variolink II compared to RelyX.
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