Acrylic Prosthesis Research Articles

Geniş Maksiller Rezeksiyonu Olan Hastalarda Yeni Tedavi Yaklaşımları

Prosthetic treatment of the maxillectomy cases are difficult due to the problems to perform sufficient retention, stability and aesthetic. Separation of the oral and nasal passages, impairment of mastication, esthetic and phonetic problems are the main goals of treatment. In this study, the prosthetic treatment of the subtotal maxillectomy patient, who is diagnosed with adenoid cystic carcinoma was described. A patient-specific obturator was fabricated for problems regarding to reduced crest support stabilization and retention. The retention was obtained by certain parts of the obturator, one which is actively engaged to the defect undercuts and one which was designed for the limited opening of the patient's mouth. A latex tube was used for retention which was ligatured, using a 0.1 mm orthodontic wire, around a neighboring bulb portion which suits the defective undercut region. Due to the limitation of mouth opening, the obturator is designed to have a short bulb extension which is attached to the acrylic prosthesis base.

Metal-Ceramic and Polyether Ether Ketone-Composite Maxillary Fixed Prosthesis Supported by Four Implants and Opposed by Removable Distal Extension Partial Dentures: A Comparative Study of Clinical and Prosthetic Outcomes.

This study aimed to evaluate clinical and prosthetic outcomes of metal-ceramic and polyether ether ketone (PEEK) fixed prostheses supported by four maxillary implants and opposed by distal extension removable partial dentures. Thirty participants with edentulous maxillary and distal extension mandibular ridges received four implants according to the All-on-4 treatment concept. The implants were immediately loaded by fixed acrylic prostheses. After 6 months, patients received either metal frameworks covered with porcelain teeth (metal group) or PEEK framework veneered with composite teeth (PEEK group). Plaque Index (PI), Gingival Index (GI), pocket depth (PD), implant stability quotient (ISQ), peri-implant marginal bone loss (MBL, using digital periapical radiographs), and implant survival were measured at baseline, 1 year, and 3 years. Prosthetic complications were measured on the patient and implant levels after 3 years. No implant failures occurred after insertion of the definitive prosthesis, and the implant survival rate was 100% in both groups. PI, GI, PD, ISQ, and MBL increased significantly with time. The most frequent complications were veneer fracture for the PEEK group and prosthetic screw loosening for the metal group. The metal group showed significantly higher PI, PD, and MBL than the PEEK group after 3 years. PEEK was associated with significantly higher veneer fracture than metal, while metal was associated with significantly higher prosthetic screw loosening than PEEK. Within the limitations of this study, the PEEK framework veneered with composite may be a suitable alternative to a metal porcelain prosthesis for All-on-4 implant rehabilitation in patients with maxillary edentulous arches opposed by distal extension mandibular ridges, as it was associated with favorable clinical and prosthetic outcomes after 3 years. However, it was associated with an increased rate of veneer or artificial gingiva fracture.

Custom-made Ocular Prosthesis for Rehabilitation of Missing Parts of the Face: A Case Report

Background. Eyes are an important component of the face and vital organs of vision. Eye loss can be caused by congenital defects, trauma, or tumor. Loss of an eye produces physical abnormalities that pose a psychological burden on the patient, as well as visual function damage. An ocular prosthesis is an artificial maxillofacial prosthesis to replace the lost eye.
 Case summary. A 54-year-old man consults at the Prosthodontics Specialist Universitas Airlangga Dental Hospital for an eye prosthesis. The patient did not have the right eyeball since birth. Soft tissue around the eye is normal, including the palpebral muscles.
 Case management. An impression was made using a custom tray and alginate in the defect area, followed by filling the impression with gypsum type 3 to get a working model, from which a wax model is made and adjusted to the patient. After that, sclera and ocular acrylic prostheses are made on the basis of an adjusted wax model. The prosthesis is then polished and colored according to the contralateral eye. Then the prosthesis is delivered to the patient.
 Conclusion. The hollow custom-made eye prosthesis can be considered in the treatment of anophthalmia. It is able to improve the patient's psychological and emotional status.

IMMEDIATE AESTHETIC REHABILITATION OF A FRACTURED ANTERIOR TOOTH BY USING THE NATURAL TOOTH AS A PONTIC: AN INNOVATIVE TECHNIQUE

Sudden tooth loss in the esthetic zone of the maxillary or mandibular anterior region can be due to dental trauma, endodontic failure, extensive root resorption, or advanced periodontal disease. The treatment options for replacing the missing tooth can vary between removable temporary acrylic prosthesis, Resin-bonded bridges, Traditional metal, and ceramic fixed partial denture, and implant-supported prosthesis. Irrespective of the final treatment, the first line of management would be to provisionally restore the patients esthetic appearance at the earliest, while functionally stabilizing the compromised arch. Using the patients own natural tooth as a pontic offers the benefits of being the right size, shape, and color and provides exact repositioning in its original intraoral three-dimensional position. The abutment teeth can also be preserved with minimal or no preparation, thus keeping the technique reversible, and can be completed at the chairside thereby avoiding laboratory costs.

Computer guided flapless versus Free hand flap surgery for implants supporting All-on-4 fixed prosthesis in atrophied mandible. One year clinical and radiographical results of a randomized trial.

Aim: The purpose of this study was to evaluate clinical and radiographical outcomes of computer guided flapless versus Free hand flap surgery for implants used to anchor All-on-4 fixed prosthesis in atrophied mandible. Materials and methods: Twelve completely edentulous patients with atrophied mandibular ridges were randomly assigned into two groups Group1 (Free hand flap surgery, control): received 4 implants using the All on four protocol and free hand flap surgery and metal guide. Group2 (computer guided flapless surgery, study): received 4 implants using computer guided flapless surgery and stereolithographic surgical guide. Implants were immediately loaded by acrylic prosthesis then full arch ceramometal fixed prosthesis was used as a final restoration. Plaque Index, Gingival Index, pocket depth, stability of the implants, and crestal bone loss were evaluated at baseline, 3, 6 and 12 months after loading. Results: The survival rate of the implants was 95.8% and 91.7% for group 1 and group 2. For both groups, implant stability significantly decreased from insertion to 3 months, and increased again at six months. For both techniques, crestal bone loss significantly increased with time. For all time intervals, flap group showed significant higher plaque index, gingival index, probing depth and crestal bone resorption than flapless group. Conclusion: Within the limits of this short-term randomized trial regarding the small sample size, computer guided flapless approach may be recommended for all on four implant rehabilitation of edentulous mandibles than conventional flap surgical approach as it was associated with favorable clinical and radiographical peri-implant parameters.

All on four fixed prostheses versus implant overdentures for management of edentulous maxilla opposing mandibular 2- implant assisted overdentures

Purpose: This study aimed to compare two treatment modalities; All on four fixed prostheses and locator retained overdentures; to rehabilitate patients having problems associated with edentulous maxilla opposing mandibular implant assisted overdentures. Materials and methods: Ten patients complaining from looseness and instability of their maxillary dentures that oppose mandibular 2-implant-retained overdentures were randomly divided into 2 groups: Group I included 5 patients who received four implants according to the All-on- four Concept (2 parallel middle implants and 2 posterior implants with distal inclination). Implants were immediately loaded with fixed acrylic prosthesis, then after 6 months the prosthesis was replaced with fixed ceramometal restoration, Group II, included 5 patients who received four implants that were immediately loaded with Locator retained maxillary overdentures using new maxillary dentures. Clinical (plaque index (PI), gingival index (GI), probing depth (PD) and implant stability (IS)) and radiographic (marginal bone loss (MBL) outcomes were recorded at baseline (T0), 6 (T6) and 12 (T12) month after prosthesis insertion.

Comparison of the Masticatory Force (with 3D Models) of Complete Denture Base Acrylic Resins with Reline and Reinforcing Materials.

The reinforcement of acrylic denture base remains problematic. Acrylic prosthesis fractures are commonly observed in prosthodontic practice and have not been reliably resolved. This study compared the resistance to masticatory force of acrylic bases of removable complete conventional prosthesis in 3D upper models. Forty acrylic base test specimens containing two types of reinforcement meshes (20 with glass fiber meshes (FIBER-FORCE®- Synca, Bio Composants MédicauxTM, Tullins, France), 20 with metal meshes (DENTAURUM®-Ispringen, Germany)), 20 with a conventional PMMA acrylic base (LUCITONE 199®-Dentsply Sirona, York, PA, USA), and 20 using a permanent soft reline material (MOLLOPLAST-B®-DETAX GmbH & Co. KG, Ettlingen, Germany) were tested—a total of 80 specimens. Half of the specimens were made for a low alveolar ridge and half for a high alveolar ridge. The data were analysed using one-way analysis of variance and Student’s t-test for independent test specimens. In the high-alveolar-ridge group, the prosthesis reinforced with the glass fiber mesh was the most resistant to fracture, while in the low-alveolar-ridge group, the non-reinforced prosthesis showed the highest resistance masticatory force. Prostheses with the permanent soft reline material showed the lowest resistance to fracture in both high and low-alveolar-ridge groups. The results show that the selection of the right reinforcement material for each clinical case, based on the height of the alveolar ridge, may help to prevent prosthesis fractures.

Efficacy of Natural Tooth Pontic in Periodontally Compromised Patients: A Systematic Review

Periodontitis is a major concern for the dentist because the destruction of periodontal fibers causes mobility of teeth and eventually leads to tooth loss. Conventional techniques like removable temporary acrylic prosthesis, or resin-bonded bridges hold their own disadvantages and a fixed prosthesis may worsen the existing condition. Natural tooth pontic (NTP) in such cases may be advantageous in terms of esthetics and patient satisfaction along with cost effectiveness. Hence, the aim of this review was to evaluate the efficacy of NTP in periodontally compromised patients. Electronic search on data sources such as PubMed and Google scholar along with hand searching of the articles was done in institutional library. All case reports and case series were included in English language published till October 31, 2019, were included. After applying inclusion and exclusion criteria, ten articles were selected for the present review. The whole process was conducted by following the Preferred Reporting Items for Systematic Reviews guidelines. Our review noted that all the patients were satisfied with the appearance of the tooth and also comfortable in maintaining the oral hygiene as these pontics had a ridge lap design. Survival rate was 100% except for the case series which reported a survival rate of 75% while few others did not report anything since no follow-up was conducted. Overall NTP was well accepted by the patients. NTP can be of a great option as prosthesis in the patients with compromised periodontium. Patient's positive satisfaction, cost viability, and accomplishment of appearance in the esthetic zone of the oral cavity make this strategy as a valuable treatment option.

Severe osteolysis and periprosthetic femoral fracture 45\u2009years after acrylic hemiarthroplasty of the hip: a case report

BackgroundHip arthroplasty using acrylic prosthesis was once conducted; however, it has now been abandoned because of early breakages and wear of material. Therefore, complications or revision surgeries due to the use of acrylic prostheses are becoming rare.Case presentationA 76-year-old woman presented with a sudden onset of severe pain in her left femur while walking. Radiographs revealed severe osteolysis and periprosthetic femoral fracture 45 years after the initial hemiarthroplasty using an acrylic prosthesis. We performed a Girdlestone resection arthroplasty by removing the prosthesis and fixing the fracture site using an intramedullary nail and metal plate. The patient was pain-free in her hip and leg 2 years and 9 months after the surgery. Although she walked with a cane or crutches, no postoperative complications were observed.ConclusionsThe combined use of an intramedullary nail and plate fixation with resection arthroplasty could offer acceptable results for patients with severe osteolysis and periprosthetic fracture after femoral head replacement using an acrylic prosthesis. Our report seems relevant because it not only reminds us of the significant steps made in the development of modern total hip arthroplasty; it also highlights one of the surgical options for severe osteolysis and periprosthetic fracture of the hip.

Six-year clinical outcomes of implant-supported acrylic vs. ceramic superstructures according to the All-on-4 treatment concept for the rehabilitation of the edentulous maxilla

The aim of the current study was to document the long-term clinical results of the use of two prosthetic techniques for the rehabilitation of completely edentulous maxillae according to the “All-on-Four” concept: Fixed, screw-retained prosthesis mounted on a chrome-molybdenum framework with (1) metal-ceramic veneers and (2) Acrylic prosthesis with acrylic resin prosthetic teeth. A total of 34 patients were assigned to subgroups according to their own preference of the superstructure type (ceramics [n: 17] or acrylic resin [n: 17]). Prosthetic complications, marginal bone loss, plaque accumulation, bleeding on probing, bite force and oral-health-related quality of life were assessed over a period of 6 years. Marginal bone loss around implants of the ceramic group remained well within the limits for ‘success’, as defined by the 2007 Pisa consensus over the time (1.43 ± 0.35 mm). However, marginal bone loss was significantly more pronounced around the implants in the acrylic group (2.15 ± 0.30) and the difference between two groups was statistically significant (p: 0.00). Bleeding on probing and plaque accumulation showed also positive correlation with marginal bone loss. Both acrylic and ceramic suprastructures appeared to be equivalent after 6 years; however, ceramic suprastructures revealed superior clinical results in terms of bone loss and plaque accumulation. Current study determines the long-term clinical outcomes of different prosthetic management alternatives in All-on-Four and aids to increase dental professionals’ ability to meet the patients’ expectations.

THE EFFECT OF RETENTION FORMS ON ACRYLIC BASE SURFACES ON ADHESIVE STRENGTH OF DENTURE RELINER MATERIALS

Background: Acrylic prosthesis that are used for a long time are often not sticky anymore and easy off. Treatment that can be done is relining, which is resurfacing with new material addition to prosthesis surface in contact with mucosa. One of materials used is denture reliner made of acrylic material (heat and self cured acrylic). The successful use of this reliner material depends on the retention of acrylic base surface. There is some retentions namely bur strokes, ethyl acetate and Al2O3 sandblast. Purpose: To determine effect of retention in form of bur strokes, Ethyl Acetate and Al2O3 sandblast on acrylic bases surface on adhesive strength of reliner denture material. Method: Research using samples in form of acrylic blocks with a length of 80mm, a large block width of 10 x10 mm and small block of 10 x 8 mm, reliner material thickness is 3 mm. Total of 64 samples were divided into 2 groups based on reliner materials (heat and self) and each group was divided into 4 groups based on treatment (control, bur stroke, ethyl acetat and Al2O33 sandblast). All samples were subjected to tensile test using UTM to obtain tensile strength values. Result: Heat CA tensile strength value was greater than self CA and the two groups were significantly different (p<0.05), while lowest tensile strength value in control group followed by ethyl acetate and largest value in Al2O3 sandblast and almost all groups were significantly different (p<0.05). Conclusion: Heat CA is more adhesive than self CA and retention on acrylic surface is proven to be effective in increasing adhesive strength of acrylic surface against denture reliner.

EVALUATION OF IMPACT STRENGTH OF HEAT CURE ACRYLIC RESIN REINFORCED WITH NYLON FIBER MESH WITH AND WITHOUT PRESTRESSING (IN VITRO STUDY)

INTRODUCTION: Acrylic resin prostheses are liable to high levels of forces due to their frequent removal by patients and accidental slippage. Hence, the impact strength of acrylic denture base material is of major significance in providing long-term functional prostheses.OBJECTIVES: The aim of this study was to evaluate the reinforcing effect of prestressed nylon fiber meshwork and the specimen thickness increase on the impact strength of heat cure acrylic resin.MATERIALS AND METHODS: 72 specimens were divided into 3 groups (I, II and III) which were heat cure acrylic resin (control), Nylon mesh reinforced acrylic resin and prestressed-nylon mesh reinforced acrylic resin. Each group was formed of 24 specimens, which were further subdivided into 3 subgroups (A, B and C) of different dimensions; 75 mm × 10 mm × 3 mm and 75 × 10 × 4 mm and 75 x 10 x 5 mm. Thus, the specimens were divided into 9 experimental subgroups (n=8 per subgroup). A Charpy’s impact tester was used to measure the impact strength of acrylic resin. The data were analyzed using Anova-test (p≤0.05).RESULTS: The mean impact strength of groups II and III was higher than the control group I impact strength. The difference between the reinforced groups and control group was statistically significant for all specimen thicknesses.CONCLUSIONS: The impact strength of heat cure acrylic resin was increased by the incorporation of nylon fiber mesh whether prestressed or not.

Evaluation of implant properties, safety profile and clinical efficacy of patient-specific acrylic prosthesis in cranioplasty using 3D binderjet printed cranium model: A pilot study

There exists a significant demand to develop patient-specific prosthesis in reconstruction of cranial vaults after decompressive craniectomy. we report here, the outcomes of an unicentric pilot study on acrylic cranial prosthesis fabricated using a 3D printed cranium model with its clinically relevant mechanical properties. MethodsThe semi-crystalline polymethyl methacrylate (PMMA) implants, shaped to the cranial defects of 3D printed cranium model, were implanted in 10 patients (mean age, 40.8 ± 14.8 years). A binderjet 3D printer was used to create patient-specific mould and PMMA was casted to fabricate prosthesis which was analyzed for microstructure and properties. Patients were followed up for allergy, infection and cosmesis for a period of 6 months. ResultsAs-cast PMMA flap exhibited hardness of 15.8 ± 0.24Hv, tensile strength of 30.7 ± 3.9 MPa and elastic modulus of 1.5 ± 0.1 GPa. 3D microstructure of the semi-crystalline acrylic implant revealed 2.5–15 µm spherical isolated pores. The mean area of the calvarial defect in craniectomy patients was 94.7 ± 17.4 cm2. We achieved a cranial index of symmetry (CIS -%) of 94.5 ± 3.9, while the average post-operative Glasgow outcome scale (GOS) score recorded was 4.2 ± 0.9. Conclusions3D printing based patient-specific design and fabrication of acrylic cranioplasty implant is safe and achieves acceptable cosmetic and clinical outcomes in patients with decompressive craniectomy. Our study ensured clinically acceptable structural and mechanical properties of implanted PMMA, suggesting that a low cost 3D printer based PMMA flap is an affordable option for cranioplasty in resource constrained settings.

Facial rehabilitation with implant-retained nasal prosthesis of acrylic resin: a case report

ABSTRACT The objective of this study was to report a clinical case of facial rehabilitation with an acrylic implant-retained nasal prosthesis after partial rhinectomy resulting from the resection of a basal cell carcinoma in the patient, a 53-year-old Caucasian, normosystemic, professional cowboy. After clinical examination and in possession of computed tomography images, surgery was performed for the placement of conventional dental implants in the premaxillary region (left side). After the surgery, a three-month period of waiting was observed to allow osseointegration of the implants. Later, the nasal prosthesis was prepared, and at the end of treatment, this presented satisfactory peripheral adaptation, retention and esthetics. The patient has returned for follow-up every 6 months, regarding analysis of the prosthesis color, peri-implant health, hygiene, and exchange of the magnets and relays when necessary. The authors concluded that this therapy may be well indicated in patients with partial and total nasal defects, provided that there is correct planning and execution of the surgical, clinical and laboratory phases.

Survival rates of axial and tilted implants in the rehabilitation of edentulous jaws using the All-on-four™ concept: A systematic review.

Aim:The aim of this review was to evaluate the survival rate of axial and tilted implants in rehabilitation of edentulous jaws using all on four concept.Setting and Design:Systematic Review.Materials and Methods:A literature review was performed in MEDLINE, PubMed Central (PMC), Google scholar, Embase, Cochrane Central Register of Controlled Trials. Hand searches were conducted of the bibliographic of related journals and systematic reviews. A total of 380 articles were obtained from the intial screening process. Of these articles, 25 articles fulfilled the inclusion criteria. The authors performed evaluation of articles independently as well as data extraction and quality assessment.Statistical Analysis Used:Qualitative analysis.Results:The major prosthetic complication was the fracture of the acrylic prosthesis. The mean cumulative survival rate of implants (72-132 months) were 94% to 98%. The prosthesis survival rate (12 months) was between 99% to 100%. The averaged bone loss was 1.3 ±0.4 mm (12-60 months). No Significant difference was found between survival rates of axial and tilted implants nor between maxilla and mandible.Conclusion:All on four concept can be employed successfully in the edentulous patients with resorbed ridges while improving their quality of life and reducing morbidity. However,randomized clinical trials with large sampling size and long term follow up should be incorporated.

Biological and prosthetic complications of cantilevered and non-cantilevered fixed hybrid metal acrylic prostheses used for vertical and inclined implants in atrophied mandible. A randomized clinical trial.

Aim: This study aimed to evaluate biological and prosthetic complications of cantilevered and non-cantilevered fixed hybrid metal acrylic prostheses used for vertical and inclined implants in atrophied mandible. Materials and Methods: Eight completely edentulous individuals will be classified into 2 groups randomly: 1) Group I (cantilevered prosthesis, n=4): patients received 4 vertical implants parallel to each other’s in the interforaminal area and cantilevered metal acrylic prosthesis, 2) Group II (non-cantilevered prosthesis, n=4): patients received 4 implants (2 parallel anterior implants and 2 posterior implants inclined 30odistally) and non-cantilevered metal acrylic prosthesis. Biological and prosthetic complications were measured after one year from prosthesis insertion. Results: There was no significant difference in implant failure, implant survival, pain, swelling, abscess, fistula formation, peri-implantitis, peri-implant mucositis, bleeding on probing between groups. The non-cantilevered group showed significantly higher pocket depth than the cantilevered group. The cantilevered group showed significantly higher bone loss than the non-cantilevered group. There were no prosthesis fractures, cylinder fracture, abutment fracture, and prosthetic screw fracture occurred in both groups. There was no difference in teeth wear, teeth fracture, and gingival fracture between groups. The cantilevered group showed a significantly higher crown fracture, abutment screw, and prosthetic loosening than the non-cantilevered group. Conclusion: Both cantilevered and non-cantilevered fixed hybrid metal acrylic prostheses can be used successfully for vertical and inclined implants respectively in atrophied mandible with favorable biologic and prosthetic outcomes after one year.

Histomorphometric Analysis of Osseointegrated Grade V Titanium Mini Transitional Implants in Edentulous Mandible by Backscattered Scanning Electron Microscopy (BS-SEM)

The purpose of this study is to assess the use of grade V titanium mini transitional implants (MTIs) immediately loaded by a temporary overdenture. For this, a histomorphometric analysis of the bone area fraction occupancy (BAFO) was performed by backscattered scanning electron microscopy (BS-SEM). Four female patients were submitted to surgery in which two MTIs were installed and immediately loaded with a temporary acrylic prosthesis. During the same surgery, two regular diameter implants were placed inside the bone and maintained without mechanical load. After 8 months, the MTIs were extracted using a trephine and processed for ultrastructural bone analysis by BS-SEM, and the regular-diameter implants were loaded with an overdenture device. A total of 243 BAFOs of MTIs were analyzed, of which 94 were mainly filled with cortical bone, while 149 were mainly filled with trabecular bone. Bone tissue analysis considering the total BAFOs with calcified tissues showed 72.13% lamellar bone, 26.04% woven bone, and 1.82% chondroid bone without significant differences between the samples. This study revealed that grade V titanium used in immediately loaded MTI was successfully osseointegrated by a mature and vascularized bone tissue as assessed from the BAFO.

A fixed reconstruction of fully edentulous patients with immediate function using an apically tapered implant design: a retrospective clinical study

BackgroundImmediate function has become an accepted treatment modality for fixed restorations in completely edentulous jaws. It is known that implant microtopography (surface) may enhance osseointegration, while implant macrotopography (macrodesign) plays an important role in primary stability in the patient requiring an immediate loading. The aim of this retrospective study was to evaluate the clinical and radiographic outcomes of the edentulous subjects treated with narrow and/or regular diameter, which placed and loaded immediately.MethodsForty-two consecutive patients received 171 implants, including regular and narrow diameter implants (NDIs). Each jaw, 19 mandibles and 24 maxillae, was treated with a fixed-full arch prosthesis according to the Straumann® Pro Arch concept. The majority (95%) of the restorations were supported by four implants, of which the posterior two implants were tilted. A provisional functional acrylic prosthesis was delivered on the day of surgery. All patients were followed up to 55 months. Cumulative survival rate was determined using Kaplan-Meier analysis. Radiological measurement of marginal bone level was performed.ResultsThe overall follow-up time for survival rate was up to 55 months. Four implants (3 implants in maxilla, 1 implant in mandible) were lost, resulting in an overall cumulative implant survival rate of 97.7%. Implant survival rate in the axial and tilted implants was not statistically significant. The mean of interproximal marginal bone loss was 0.15 mm after 24 months. Good soft tissue health was observed in almost 99% of patients. The final prosthesis survival rate was 100%.ConclusionsThe results of this retrospective pilot study indicated that total edentulous patients requiring an immediate implant placement and loading can be successfully treated with this implant design. The improved mechanical properties of these implants might give a more conservative treatment option for the jaws showing a severe horizontal alveolar bone resorption.

Prosthodontic Rehabilitation of Missing Dentition Using Multi Unit Precision Attachment Hybrid Overdentures–Clinical Report of Two Patients

Prosthodontic rehabilitation of a patient with terminal dentition is very challenging. Any conservative treatment that can delay or eliminate future prosthodontic problems should be considered. Complete and partially edentulous patients are generally unsatisfied due to the inherent instability of dentures during functional and parafunctional movements which results due to the lack of adequate supporting hard and soft tissues. Inspite of rapid development and good success rate in the field of implantology, preservation of remaining natural teeth or roots is more desirable which supports Devan’s dictum. Overdenture is a complete or partial denture prosthesis supported partly by soft tissues and partly by retained natural teeth or its roots or implants. Overdenture increases the retention, stability and support, improves the masticatory efficiency, preserves the alveolar bone and muscular patterns and preserves sensory receptors within the periodontal ligament which increases manipulative skills in handling the denture. Retention and stability of overdentures can be improved by attachments or magnets. Fixed partial denture is not an option when there is no distal abutment. The solution of such a critical situation is to give combined or hybrid prosthesis. A combined prosthesis carries the advantage of fixed removable prostheses without surgical intervention, where an acrylic prosthesis is retained with an extra coronal attachment to tooth. This paper presents a twin patient report of rehabilitation of a mandibular and maxillary terminal dentition with a combined prostheses of acrylic retained by extra coronal precision attachment system (Rhein 83, Italy)

Prosthetic rehabilitation of a patient with an ocular defect using a simplified approach: A case report

The disfigurement associated with eye loss can cause significant physical and emotional disturbance. Cosmetic rehabilitation with custom made prosthesis gives such individuals professional and social acceptance and alleviates problems. A case of a custom-made ocular acrylic prosthesis is presented here, which had acceptable fit, retention and esthetics.