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Implant Fixture Fracture Related To Angulation Path Compounded By Implant Width

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.

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Prosthodontic Management Of Post Covid Mucormycosis

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.

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

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.

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

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.

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Comparison of Commercially available denture teeth with available natural teeth dimensions among genders

Background: Selecting the artificial teeth is an art, every prosthodontist should learn the art to fulfill the esthetic and functional requirement of the patient. It gives a pleasing, expressive and confident life to the patient. Aim: To compare the dimensions of natural maxillary and mandibular anterior and posterior teeth with the dimensions of three commercially available denture teeth such as Acryrock,Biorock and Ivoclar Vivadent along with gender consideration. Materials and Methods: The length and width of the natural anterior and posterior teeth from dentate casts of 23 males and 77 females were examined by a single examiner using a digital vernier caliper on a straight line and using a flexible ruler . These dimensions were also measured in three denture teeth mold charts: Acryrock, Biorock, Ivoclar vivadent. The dimensions thus obtained are compared between the three systems of artificial teeth and natural teeth for selecting the best system of artificial teeth for complete denture prosthesis. Results: This present study concludes that the width of available natural maxillary anterior teeth matches with the dimensions of all the three commercially available denture teeth such as Ivoclar Vivadent, Acryrock, Biorock. But the mandibular anterior and posterior teeth of maxillary and mandibular dentate cast dimensions were matching only with the Ivoclar vivadent teeth set irrespective of the genders. Conclusion: From this study, the determination of the size of anterior and posterior artificial teeth using the natural teeth dimensions for fabrication of complete denture prosthesis was proved statistically and mathematically.

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