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A simple technique to fabricate a surgical obturator restoring the defect in original anatomical form.

Vaibhao I SHAMBHARKAR ; Santosh B PURI ; Pravinkumar G PATIL

The Journal of Advanced Prosthodontics.2011;3(2):106-109. doi:10.4047/jap.2011.3.2.106

Oral cancer treatment involves the surgical removal of all or part of the maxilla, leaving the patient with a defect that compromises the integrity and function of the oral cavity. The postoperative restoration of esthetics, deglutition, and speech shortens recovery time in the hospital and expedites the patient's return to the community as a functioning member. The surgical obturator is the proven treatment option in such situations. This article describes a simple technique to fabricate a surgical obturator that restores patient's original dentition and facial and palatal tissue form. The obturator fabricated with this technique utilizes the vacuum formed index of patient's original tissue form and duplicated partly in heat and partly in auto polymerizing acrylic resin. Duplication of the original tissue form helps patient to minimize the immense physiological trauma immediately after the surgical resection. The obturator fabricated with this technique supports soft tissues after surgery and minimizes scar contracture and disfigurement, and thus may have a positive effect on the patients' psychology.
Cicatrix ; Contracture ; Deglutition ; Dentition ; Esthetics ; Hot Temperature ; Humans ; Maxilla ; Maxillofacial Prosthesis ; Mouth ; Mouth Neoplasms ; Polymers ; Vacuum

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Prosthodontic rehabilitation of a patient with bilateral auricular deformity.

Sneha Shivkumar MANTRI ; Ram U THOMBRE ; Daigavane PALLAVI

The Journal of Advanced Prosthodontics.2011;3(2):101-105. doi:10.4047/jap.2011.3.2.101

Maxillofacial prosthodontics is an art and science which provides life like appearance to the person with facial deformity. Maxillofacial prosthetic rehabilitation for acquired defects has become more complex and sophisticated with advancement in techniques and materials. This case report describes the clinical and laboratory procedure for fabricating an auricular prosthesis for a patient with trauma related bilateral auricular deformity. Ear prosthesis was fabricated in two parts taking retention from external auditory canal.
Congenital Abnormalities ; Ear ; Ear Canal ; Humans ; Prostheses and Implants ; Prosthodontics ; Retention (Psychology)

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Full mouth implant rehabilitation of a patient with ectodermal dysplasia after orthognathic surgery, sinus and ridge augmentation: a clinical report.

Mohammad BAYAT ; Mohammad Mohsen KHOBYARI ; Mohsen DALBAND ; Fatemeh MOMEN-HERAVI

The Journal of Advanced Prosthodontics.2011;3(2):96-100. doi:10.4047/jap.2011.3.2.96

An 18-year-old male presented severe hypodontia due to hypohidrotic ectodermal dysplasia was treated with Le Fort I maxillary osteotomy with simultaneous sinus floor augmentation using the mixture of cortical autogenous bone graft harvested from iliac crest and organic Bio-Oss to position the maxilla in a right occlusal plane with respect to the mandible, and to construct adequate bone volume at posterior maxilla allowing proper implant placement. Due to the poor bone quality at other sites, ridge augmentation with onlay graft was done to construct adequate bone volume allowing proper implant placement, using tissue harvested from the iliac bone. Seven implants were placed in the maxilla and 7 implants were inserted in the mandible and screw-retained metal ceramic FPDs were fabricated. The two year follow up data showed that dental implants should be considered as a good treatment modality for patients with ectodermal dysplasia.
Adolescent ; Anodontia ; Ceramics ; Dental Implants ; Dental Occlusion ; Ectoderm ; Ectodermal Dysplasia ; Follow-Up Studies ; Humans ; Inlays ; Male ; Mandible ; Maxilla ; Maxillary Osteotomy ; Minerals ; Mouth ; Orthognathic Surgery ; Sinus Floor Augmentation ; Transplants

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A comparative evaluation of fracture resistance of endodontically treated teeth restored with different post core systems: an in-vitro study.

Chetana S MAKADE ; Ganesh K MESHRAM ; Manjusha WARHADPANDE ; Pravinkumar G PATIL

The Journal of Advanced Prosthodontics.2011;3(2):90-95. doi:10.4047/jap.2011.3.2.90

PURPOSE: To compare the fracture resistance and the mode of failure of endodontically treated teeth restored with different post-core systems. MATERIALS AND METHODS: Root canal treatment was performed on 40 maxillary incisors and the samples were divided into four groups of 10 each. For three experimental groups post space preparation was done and teeth were restored with cast post-core (Group B), stainless steel post with composite core (Group C) and glass fiber post with composite core using adhesive resin cement (Group D). Control group (A) samples were selected with intact coronal structure. All the samples were prepared for ideal abutment preparation. All the samples were subjected to a load of 0.5 mm/min at 130degrees until fracture occurred using the universal testing machine. The fracture resistance was measured and the data were analyzed statistically. The fracture above the embedded resin was considered to be favorable and the fracture below the level was considered as unfavorable. The statistical analysis of fracture resistance between different groups was carried out with t-test. For the mode of failure the statistical analysis was carried out by Kruskal-Wallis test and Chi-Square test. RESULTS: For experimental group Vs control group the fracture resistance values showed significant differences (P<.05). For the mode of failure the chi-square value is 16.1610, which means highly significant (P=.0009) statistically. CONCLUSION: Endodontically treated teeth without post core system showed the least fracture resistance demonstrating the need to reinforce the tooth. Stainless steel post with composite core showed the highest fracture resistance among all the experimental groups. Teeth restored with the Glass fiber post showed the most favorable fractures making them more amenable to the re-treatment.
Adhesives ; Collodion ; Dental Pulp Cavity ; Glass ; Incisor ; Resin Cements ; Stainless Steel ; Tooth

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Resorption of labial bone in maxillary anterior implant.

Young Bum CHO ; Seung Jin MOON ; Chae Heon CHUNG ; Hee Jung KIM

The Journal of Advanced Prosthodontics.2011;3(2):85-89. doi:10.4047/jap.2011.3.2.85

PURPOSE: The purpose of this study was to evaluate the amount of resorption and thickness of labial bone in anterior maxillary implant using cone beam computed tomography with Hitachi CB Mercuray (Hitachi, Medico, Tokyo, Japan). MATERIALS AND METHODS: Twenty-one patients with 26 implants were followed-up and checked with CBCT. 21 OSSEOTITE NT(R) (3i/implant Innovations, Florida, USA) and 5 OSSEOTITE(R) implants (3i/implant Innovations, Florida, USA) were placed at anterior region and they were positioned vertically at the same level of bony scallop of adjacent teeth. Whenever there was no lesion or labial bone was intact, immediate placement was tried as possible as it could be. Generated bone regeneration was done in the patients with the deficiency of hard tissue using Bio-Oss(R) (Geistlich, Wolhusen, Switzerland) and Bio-Gide(R) (Geistlich, Wolhusen, Switzerland). Second surgery was done in 6 months after implant placement and provisionalization was done for 3 months. Definite abutment was made of titanium abutment with porcelain, gold and zirconia, and was attached after provisionalization. Two-dimensional slices were created to produce sagittal, coronal, axial and 3D by using OnDemand3D (Cybermed, Seoul, Korea). RESULTS: The mean value of bone resorption (distance from top of implant to labial bone) was 1.32 +/- 0.86 mm and the mean thickness of labial bone was 1.91 +/- 0.45 mm. CONCLUSION: It is suggested that the thickness more than 1.91 mm could reduce the amount and incidence of resorption of labial bone in maxillary anterior implant.
Bone Regeneration ; Bone Resorption ; Cone-Beam Computed Tomography ; Dental Porcelain ; Florida ; Humans ; Incidence ; Pectinidae ; Titanium ; Tokyo ; Tooth ; Zirconium

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Initial bacterial adhesion on resin, titanium and zirconia in vitro.

Byung Chul LEE ; Gil Yong JUNG ; Dae Joon KIM ; Jung Suk HAN

The Journal of Advanced Prosthodontics.2011;3(2):81-84. doi:10.4047/jap.2011.3.2.81

PURPOSE: The aim of this in vitro study was to investigate the adhesion of initial colonizer, Streptococcus sanguis, on resin, titanium and zirconia under the same surface polishing condition. MATERIALS AND METHODS: Specimens were prepared from Z-250, cp-Ti and 3Y-TZP and polished with 1 microm diamond paste. After coating with saliva, each specimen was incubated with Streptococcus sanguis. Scanning electron microscope, crystal violet staining and measurement of fluorescence intensity resulting from resazurin reduction were performed for quantifying the bacterial adhesion. RESULTS: Surface of resin composite was significantly rougher than that of titanium and zirconia, although all tested specimens are classified as smooth. The resin specimens showed lower value of contact angle compared with titanium and zirconia specimens, and had hydrophilic surfaces. The result of scanning electron microscopy demonstrated that bound bacteria were more abundant on resin in comparison with titanium and zirconia. When total biofilm mass determined by crystal violet, absorbance value of resin was significantly higher than that of titanium or zirconia. The result of relative fluorescence intensities also demonstrated that the highest fluorescence intensity was found on the surface of resin. Absorbance value and fluorescence intensity on titanium was not significantly different from those on zirconia. CONCLUSION: Resin specimens showed the roughest surface and have a significantly higher susceptibility to adhere Streptococcus sanguis than titanium and zirconia when surfaces of each specimen were polished under same condition. There was no significant difference in bacteria adhesion between titanium and zirconia in vitro.
Bacteria ; Bacterial Adhesion ; Biofilms ; Colon ; Diamond ; Electrons ; Fluorescence ; Gentian Violet ; Microscopy, Electron, Scanning ; Oxazines ; Saliva ; Streptococcus sanguis ; Titanium ; Xanthenes ; Zirconium

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The relationship between initial implant stability quotient values and bone-to-implant contact ratio in the rabbit tibia.

In Phill PARK ; Seong Kyun KIM ; Shin Jae LEE ; Joo Hee LEE

The Journal of Advanced Prosthodontics.2011;3(2):76-80. doi:10.4047/jap.2011.3.2.76

PURPOSE: Implant stability quotient (ISQ) values have been supposed to predict implant stability. However, the relationship between ISQ values and bone-to-implant contact ratio (BIC%) which is one of the predictors of implant stability is still unclear. The aim of the present study was to evaluate initial ISQ values in relation to BIC% using rabbit model. MATERIALS AND METHODS: Four New Zealand white rabbits received a total of 16 implants in their tibia. Immediately after implant placement ISQ values were assessed. The measurements were repeated at the time of sacrifice of the rabbits after 4 weeks. Peri-implant bone regeneration was assessed histomorphometrically by measuring BIC% and bone volume to total volume values (bone volume %). The relationships between ISQ values and the histomorphometric output were assessed, and then, the osseointegration prediction model via the initial ISQ values was processed. RESULTS: Initial ISQ values showed significant correlation with the BIC%. The bone volume % did not show any significant association with the ISQ values. CONCLUSION: In the limitation of this study, resonance frequency analysis is a useful clinical method to predict the BIC% values and examine the implant stability.
Bone Regeneration ; Osseointegration ; Rabbits ; Tibia

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Comparative analysis of the clinical techniques used in evaluation of marginal accuracy of cast restoration using stereomicroscopy as gold standard.

Abhishek RASTOGI ; Vikas KAMBLE

The Journal of Advanced Prosthodontics.2011;3(2):69-75. doi:10.4047/jap.2011.3.2.69

PURPOSE: This study assessed the effect of preparation design on marginal adaptation and also compared the sensitivity and specificity of clinical evaluation techniques for marginal accuracy of cast restorations to stereomicroscopy. MATERIALS AND METHODS: Three Ivorine molar teeth of different designs were prepared. (A)-A complete crown preparation with buccal shoulder and beveled finish line. (B)-A complete crown preparation with chamfer finish line. (C)-A three-quarter crown preparation with proximal boxes and beveled finish line. Twenty four castings were prepared with eight castings for each design respectively. Each casting underwent examination with an explorer, disclosing media, and a stereomicroscope. Stereomicroscopy at a value less than or equal to 30 microns was used as a gold standard to evaluate the significance of different designs on marginal adaptation. Chi-square tests of independence and Kruskal-Wallis were used to evaluate the effect of preparation design and compare the agreement between examination methods for detection of marginal gap size of greater than or equal to 30 microns (alpha=.05). Sensitivity and specificity for explorer and disclosing media as compared to stereomicroscope was calculated using statistical formula given by Park. RESULTS: The preparation design did not significantly affect overall marginal adaptation. Examination by explorer and disclosing media at 30 microm revealed 39% and 10.06% sensitivity and 91% and 82% specificity respectively. CONCLUSION: Preparation designs examined in this study did not significantly affect the marginal adaptation of the castings. Commonly used clinical evaluation techniques using explorer and disclosing media appeared to be inadequate for assessment of marginal accuracy.
Crowns ; Molar ; Sensitivity and Specificity ; Shoulder ; Tooth

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Wettability and cellular response of UV light irradiated anodized titanium surface.

Kyou Hwa PARK ; Jai Young KOAK ; Seong Kyun KIM ; Seong Joo HEO

The Journal of Advanced Prosthodontics.2011;3(2):63-68. doi:10.4047/jap.2011.3.2.63

PURPOSE: The object of this study was to investigate the effect of UV irradiation (by a general commercial UV sterilizer) on anodized titanium surface. Surface characteristics and cellular responses were compared between anodized titanium discs and UV irradiated anodized titanium discs. MATERIALS AND METHODS: Titanium discs were anodized and divided into the following groups: Group 1, anodized (control), and Group 2, anodized and UV irradiated for 24 hours. The surface characteristics including contact angle, roughness, phase of oxide layer, and chemical elemental composition were inspected. The osteoblast-like human osteogenic sarcoma (HOS) cells were cultured on control and test group discs. Initial cellular attachment, MTS-based cell proliferation assay, and ALP synthesis level were compared between the two groups for the evaluation of cellular response. RESULTS: After UV irradiation, the contact angle decreased significantly (P<.001). The surface roughness and phase of oxide layer did not show definite changes, but carbon showed a considerable decrease after UV irradiation. Initial cell attachment was increased in test group (P=.004). Cells cultured on test group samples proliferated more actively (P=.009 at day 2, 5, and 7) and the ALP synthesis also increased in cells cultured on the test group (P=.016 at day 3, P=.009 at day 7 and 14). CONCLUSION: UV irradiation induced enhanced wettability, and increased initial cellular responses of HOS cells on anodized titanium surface.
Carbon ; Cell Proliferation ; Humans ; Osteosarcoma ; Titanium ; Ultraviolet Rays ; Wettability

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The effect of ceramic thickness and number of firings on the color of a zirconium oxide based all ceramic system fabricated using CAD/CAM technology.

Vinay Chila BACHHAV ; Meena Ajay ARAS

The Journal of Advanced Prosthodontics.2011;3(2):57-62. doi:10.4047/jap.2011.3.2.57

PURPOSE: Ceramics have a long history in fixed prosthodontics for achieving optimal esthetics and various materials have been used to improve ceramic core strength. However, there is a lack of information on how color is affected by fabrication procedure. The purpose of this study was to evaluate the effects of various dentin ceramic thicknesses and repeated firings on the color of zirconium oxide all-ceramic system (Lava(TM)) fabricated using CAD/CAM technology. MATERIALS AND METHODS: Thirty disc-shaped cores, 12 mm in diameter with a 1 mm thickness were fabricated from zirconium oxide based all ceramic systems (Lava(TM), 3M ESPE, St Paul, MN, USA) and divided into three groups (n = 10) according to veneering with dentin ceramic thicknesses: as 0.5, 1, or 1.5 mm. Repeated firings (3, 5, 7, or 9) were performed, and the color of the specimens was compared with the color after the initial firing. Color differences among ceramic specimens were measured using a spectrophotometer (VITA Easyshade, VITA Zahnfabrik, Bad Sackingen, Germany) and data were expressed in CIELAB system coordinates. A repeated measures ANOVA and Bonferroni post hoc test were used to analyze the data (n = 10, alpha=.05). RESULTS: L*a*b* values of the ceramic systems were affected by the number of firings (3, 5, 7, or 9 firings) (P<.001) and ceramic thickness (0.5, 1, or 1.5 mm) (P<.001). Significant interactions were present in L*a*b* values between the number of firings and ceramic thickness (P<.001). An increase in number of firings resulted in significant increase in L* values for both 0.5 mm and 1.5 mm thicknesses (P<.01, P=.013); however it decreased for 1 mm thickness (P<.01). The a* values increased for 1 mm and 1.5 mm thicknesses (P<.01), while it decreased for 0.5 mm specimens. The b* values increased significantly for all thicknesses (P<.01, P=.022). As the dentin ceramic thickness increased, significant reductions in L* values (P<.01) were recorded. There were significant increases in both a* and b* values (P<.01) as the dentin ceramic thickness increased. CONCLUSION: The number of firings and dentin ceramic thickness have a definite effect on the final color of all ceramic system tested. The mean DeltaE value increased as the dentin ceramic thicknesses increased for zirconium-oxide based all ceramic specimens tested. However, the mean DeltaE values were less than 3.7DeltaE units which is rated as a match in the oral environment.
Ceramics ; Dental Porcelain ; Dentin ; Esthetics ; Fires ; Prosthodontics ; Zirconium

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