Closed-mouth Technique Research Articles

Comparison Of Different Methods Of Controlling Pain During Debonding Of Orthodontic Brackets.

To compare the efficacy of finger pressure and plastic wafers in terms of pain control during debonding. This cross sectional study was conducted at the Department of Orthodontics, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from January to June 2020, and comprised patients of either gender aged 13-21 years who had completed fixed orthodontic treatment with 0.022 brackets of Roth prescription and required debonding. The patients was divided into two equal groups. In group A, teeth were stabilised with finger pressure with cotton between the finger and teeth, and then debonding was done using open mouth technique. In group B, teeth were stabilised using a plastic wafer between maxillary and mandibular teeth, and then debonding was done using closed mouth technique. Pain was assessed using a visual analogue scale VAS. Data was analysed using SPSS 23. Of the 110 patients, each of the 2 groups had 55(50%) subjects. Overall, there were 35(32%) males and 75(68%) females. The mean age of the sample was 16±2.4 years. Mean pain scores among the males was 32.0±7.68 compared to 34.067±12.59 among the females (p>0.05). Subjects in group B had significantly less pain than those in group A (p<0.05). Plastic wafer was found to be more effective in terms of controlling pain during debonding compared to finger pressure.

Integration of an intraoral scan and a conventional impression for fabricating complete dentures for a patient with flabby tissues

Inflammatory movable tissues in the maxillary anterior region are the result of excessive stimulation of the anterior alveolar ridge, as the maxillary denture habitually rotates anteriorly and upward during mastication. The pressure required for a functional impression makes it difficult to obtain the accurate anatomy of the inflamed mucosal tissues. An intraoral scanner can be used to record the movable tissues in an immobile state. However, for removable dentures, the oral scanner is limited by the difficulty in evaluating the denture borders or the posterior palatal seal area accurately. The fabrication of a complete denture by combining the use of an oral scanner to capture an anatomic impression without exerting pressure on the maxilla, including the movable tissues, and a traditional functional impression using the closed-mouth technique is described.

Patients' mouth opening as a factor for discomfort during maxillary buccal infiltration anesthesia: A randomized clinical trial and survey of opinion

Introduction: The aim of the study was to investigate (a) whether patients' mouth opening influenced their discomfort during maxillary buccal infiltration (MBI) anesthesia and (b) whether dentists preferred their patients' mouth opened during MBI or closed.Materials and Methods: The protocol of this study was registered in ClinicalTrials.gov (NCT03921190). In this parallel equivalence randomized clinical trial, 120 American Society of Anesthesiologists I or II adult patients with a maxillary posterior tooth diagnosed with irreversible pulpitis and normal apical tissues and scheduled for root canal treatment were included and randomly divided into two groups using a coin toss; Group A (n = 56) received MBI with an open mouth, while Group B (n = 64) were injected using a closed-mouth technique. Patients with psychological disorders, soft-tissue abnormalities, tenderness to palpation, or percussion, and those who used analgesics 12 h before the appointment were excluded. Patients rated their discomfort during needle penetration, cheek retraction, and their overall discomfort using a standard 100 mm visual analog scale (VAS). Furthermore, 50 practicing dentists assessed (on a standard 100 mm VAS) the visibility of the injection site and ease of cheek retraction during MBI using either technique and chose their preferred technique. Data were analyzed using the Student's t, independent sample t, and the Chi-square tests.Results: The mean discomfort experienced in Groups A and B were 32.4 and 31.6 upon needle penetration (P = 0.84), 28.9 and 18.9 upon cheek retraction (P < 0.001) and 32.6 and 25.0 throughout the injection procedure (P < 0.001), respectively. Out of 48 dentists who returned the completed forms, 38 dentists reported that they preferred the closed-mouth technique for MBI (P < 0.001).Conclusions: The closed-mouth technique of MBI anesthesia results in less patient discomfort and improved visibility.

Three-dimensional comparative evaluation of articular disc position and other temporomandibular joint morphology in Class II horizontal and vertical cases with Class I malocclusion.

To evaluate and compare articular disk position, condylar position, and joint spaces in Class II vertical, Class II horizontal, and Class I cases. The purpose was to assess the potential for development of temporomandibular disorders (TMDs) in the three groups. A sample of 75 cases, 25 cases in each group of Class I, Class II vertical, and Class II horizontal, were selected based on inclusion and exclusion criteria. Magnetic resonance imaging (MRI) assessments were made with a 1.5-Tesla basic system with a closed-mouth technique for evaluating articular disk position in the sagittal and transverse planes, condylar position, and joint spaces in the sagittal plane. Philips 3.0 software was used to analyze the MR images. There was evidence of alterations in the temporomandibular joint (TMJ) morphology in both Class II vertical and Class II horizontal cases, with maximum discrepancy in Class II vertical cases. MRI evaluation suggested a tendency for antero-medial disk displacement with anteriorly positioned condyles in Class II vertical cases. The discrepancy was milder in the Class II horizontal group. Class II vertical cases are more susceptible to the development of TMDs and should be subjected to TMJ evaluation before starting any orthodontic treatment to intercept and prevent a mild asymptomatic TMD from developing into a more severe form. Class II vertical cases should be subjected to MRI evaluation before starting any orthodontic treatment.

Should Maxillary Buccal Infiltration Anesthesia be Given in a Closed Mouth Technique?

Should Maxillary Buccal Infiltration Anesthesia be Given in a Closed Mouth Technique?

Evaluation of different impression techniques for indirect e-max fixed dental prostheses. Randomized clinical trial

IntroductionNowadays, it is a new era in prosthetic dentistry, due to the use of digital impressions and new digital computer-aided methods for designing and manufacturing computer-aided design/computer-aided manufacturing (CAD/CAM). Now, we are trying to change all the old traditional methods to have better results. Some studies found that there is no significance between the overall survivals of the tooth supported and implant CAD CAM fabricated prostheses. In addition, there is no difference in accuracy. Making single crowns or short span bridges can be done efficiently with digital impressions. In addition, it was found that digital impressions could be more reproducible. Materials and methodsThis randomized clinical study evaluated three impression techniques. Ten participants demanding three units all-ceramic bridges were involved in the study. The inclusion criteria were from 18 to 60 years group age; the patient should have plaque score and bleeding score <25%, with good periodontal state, with one missing tooth in need to three units fixed dental prosthesis, with sound or properly restored neighboring and opposing teeth. Sequencing of the different impression techniques investigate is determined according to computer-generated randomization list. The sequence of the different impression techniques was concealed by sealed envelopes until the date of the participant clinical visit. Three operators (R.A, M.M, and R.G.) Performed the impressions. ResultsAlmost 50% of the participants were male and the rest were female, with mean age 37.3 from range (from 20 to 50). Impressions were made to abutments of three units bridges. The mean of the procedure time ± SD was 336 ± 9.4 s for closed mouth technique impressions, 557 ± 8.2 s for the single-step traditional metal tray technique, and 397 ± 8.6 s for the Omnicam [Table 1]. ConclusionsIt was found in our research that the closed mouth technique is the fastest, with best patient acceptance and best operator easiness evaluation followed by the digital procedures, which are preferred over the conventional trays as approved by the previous studies in the literature.

Complete denture rehabilitation of edentulous patient with severe alveolar bone resorption using mandibular suction denture with closed mouth technique: a clinical report

Complete denture rehabilitation of edentulous patient with severe alveolar bone resorption using mandibular suction denture with closed mouth technique: a clinical report

Evaluation of different impression techniques for indirect E-max fixed dental prostheses. Randomized clinical trial

Background: Assessment of optical in comparison to traditional impressions is needed. The goal of this research is evaluating optical and traditional impressions regarding time, participant, and operators' preference. Materials and Methods: One optical and two traditional impressions were made in ten participants randomly. Optical scanner used is Omnicam of Cerec; traditional impression used closed mouth tray and other used one-step traditional tray. Time taking impression and occlusal relationship registration were evaluated. Participants and operators feeling about easiness of procedure were evaluated using visual analog scales. Paired t-test was applied detecting differences. Results: Mean time ± standard deviation was 336 ± 9.4 s using traditional closed mouth technique, 557 ± 8.2 for single step, and 397 ± 8.6 s for Omnicam. Timing of closed mouth technique was significantly lower than single-step and optical impression. Participant's assessment (very uncomfortable = 0 and comfortable = 100) measured 68 ± 9.7 for closed mouth, 79 ± 9.4 for optical, and 59 ± 9.7 for the single-step technique. There was statistical significance between differences except between closed mouth and single-step techniques; differences between them were not significant. Operators assessment (simple = 0 and very difficult = 100) was 21 ± 9.5 for closed mouth, 62 ± 9.2 for optical, and 46 ± 11.2 for single-step technique. There was statistical significance between the differences. Conclusions: Closed mouth took less time than optical and the single-step technique. Regarding comfort of participant, optical impression was the best. Operator's assessment favored optical impressions most as being the easiest.

Fabrication of complete denture using Centric tray and closed mouth technique for edentulous patient

Fabrication of complete denture using Centric tray and closed mouth technique for edentulous patient

Randomized controlled within-subject evaluation of digital and conventional workflows for the fabrication of lithium disilicate single crowns. Part I: digital versus conventional unilateral impressions

Statement of problemTrials comparing the overall performance of fully digital and conventional workflows in reconstructive dentistry are needed. PurposeThe purpose of the first part of this randomized controlled clinical trial was to determine whether optical impressions produce different results from conventional impressions with respect to time efficiency and patient and operator perceptions of the clinical workflow. Material and methodsThree digital impressions and 1 conventional impression were made in each of 10 participants according to a randomly generated sequence. The digital systems were Lava COS, iTero, and Cerec Bluecam. The conventional impression was made with the closed-mouth technique and polyvinyl siloxane material. The time needed for powdering, impressions, and interocclusal record was recorded. Patient and clinician perceptions of the procedures were rated by means of visual analog scales. The paired t test with Bonferroni correction was applied to detect differences (α=.05/6=.0083). ResultsThe mean total working time ±standard deviation amounted to 260 ±66 seconds for the conventional impression, 493 ±193 seconds for Lava, 372 ±126 seconds for iTero, and 357 ±55 seconds for Cerec. The total working time for the conventional impression was significantly lower than that for Lava and Cerec. With regard to the working time without powdering, the differences between the methods were not statistically significant. The patient rating (very uncomfortable=0; comfortable=100) measured 61 ±34 for conventional impression, 71 ±18 for Lava, 66 ±20 for iTero, and 48 ±18 for Cerec. The differences were not statistically significant. The clinician rating (simple=0; very difficult=100) was 13 ±13 for the conventional impression, 54 ±27 for Lava, 22 ±11 for iTero, and 36 ±23 for Cerec. The differences between the conventional impression and Lava and between iTero and Lava were statistically significant. ConclusionsThe conventional impression was more time-effective than the digital impressions. In terms of patient comfort, no differences were found between the conventional and the digital techniques. With respect to the clinician perception of difficulty, the conventional impression and the digital impression with iTero revealed more favorable outcomes than the digital impression with Lava.

CLINICAL AND RADIOGRAPHIC EVALUATION OF SOFT-LINER ATTACHMENT FOR BAR/IMPLANT RETAINED MAXILLARY OVERDENTURES. A ONE YEAR PROSPECTIVE STUDY

Aim of the study: This study aimed to evaluate clinical and radiographic outcome of soft-liner attachment for bar/implant retained maxillary overdentures after one year. Materials and methods: Six completely edentulous patients (3 males and 3 females) complained from lack of stability and insufficient retention of their maxillary dentures received 4 implants in the anterior part of the maxilla (2 at canine areas and 2 at 2nd premolar areas) using the standardized two-stage submerged surgical protocol. Six months after surgery, implants were connected with a resilient bar with 2 short distal cantilevers of 7mm length. The fitting surfaces of maxillary dentures were lined with auto polymerized addition silicone resilient liner which is used as a female housing over the bar using closed mouth technique. Plaque Index (PI), Bleeding Index (BI), and Gingival Index (GI), Probing depth (PD), Implant stability (ISQ) and Marginal bone loss (MBL) were evaluated at time of overdenture insertion T0, 6 months after overdenture insertion (T6) and 12 months after overdenture insertion (T12). Results: None of the implants failed after one year follow-up resulted in 100% survival rate. There was no significant difference in PI, GI, BI between observation times. Both PD and MBL increased significantly with time. ISQ decreased significantly at T6 and increased again at T12. There was a significant positive correlation between MBL and PD only. Conclusion: Soft liner attachments for cantilevered bar-implant retained maxillary overdentures are associated with good peri-implant soft tissue health, good implant stability and minimal marginal bone loss after one year.

Closed mouth method with dynamic and muco compressive impression on upper and lower jaw flat ridges for aid full denture retention

A patient with flat ridge difficult to have retentive complete denture. The aim of this paper is to describe the combination of impression using closed mouth technique with dynamic and muco compressive material. In this case, the combination technique of dynamic impressive material and muco compressive material with closed mouth method on patient with upper and lower jaw flat ridges. The patient has made complete denture 10 times but not satisfied. The treatment of upper and lower flat ridges using this technique resulted retentive, stable and comfortable denture.

The fixed/detachable implant provisional prosthesis.

Interim modification and management of a complete denture following surgical uncovering of dental implants can be time-intensive and may fail to provide adequate patient benefit until the definitive prosthesis can be completed. Inadequate interim management can result in functional and tissue difficulties. Modification of the conventional complete denture to a fixed/detachable provisional prosthesis in a one-stage procedure provides the patient an opportunity to experience a fixed prosthesis. The incorporation of fixed, provisional cylinders to the existing denture base using autopolymerizing acrylic resin with a closed-mouth technique is described. The peripheral regions are reduced and the distal extension shortened to resemble a fixed/detachable prosthesis. This conversion technique can provide patient satisfaction and comfort until delivery of the definitive prosthesis. Esthetic concerns, home care problems, or patient difficulties with the provisional prosthesis can be rectified in the final prosthesis.

Metered-Dose Inhalers: Mouth Open or Closed?-Reply

In Reply. —We agree with Dr Newman that the open-mouth or spacer technique is an effective method of using an MDI; however, we disagree with the description of the closed-mouth technique as being incorrect. In a review of MDIs in asthma treatment, Tinkelman et al 1 stated that both open- and closed-mouth techniques have

An evaluation of the closed mouth mandibular block technique

This randomised double-blind study compared the efficacy of the closed-mouth and the conventional mandibular block injection techniques in 200 patients requiring anaesthesia for tooth extractions. Results showed the success rate of inferior alveolar nerve anaesthesia with a single injection to be 97% in the conventional group, and 79% in the closed-mouth group. Within 5 min after the injection, 87% of the conventional group as compared with 55% of the closed-mouth group had lip numbness. The conventional and closed-mouth techniques, respectively, yielded 22% and 2% positive aspirations. Long buccal nerve anaesthesia during the closed-mouth injection was achieved in 71% of cases. Both techniques produced similar pain responses, as well as changes in blood pressure and pulse rate. The closed-mouth injection technique produced a greater variety of unexpected symptoms than the conventional. It was concluded that the conventional technique was more effective in blocking the inferior alveolar nerve, and was also faster in producing anaesthesia, but yielded more positive aspirations than the closed-mouth technique.

Three-dimensional analysis of maxillary denture displacement during reline impression procedure

The contourmeter was used to determine quantitatively the denture displacements caused by various impression materials and techniques during the relining of a maxillary denture. This study indicated the following conclusions. Tissue-conditioning material used with closed-mouth impression technique or light-bodied polysulfide used with either open- or closed-mouth technique caused the least denture displacement in the three dimensions when compared with regular-bodied polysulfide or zinc oxide and eugenol impression materials. Comparing the same impression materials used with either open- or closed-mouth technique showed no significant difference in maxillary denture displacements. A relined complete denture should be remounted on the articulator and the occlusion refined to eliminate occlusal mismatches resulting from three-dimensional denture displacements during relining.

Double arch impressions for simplified restorative dentistry

Use of a double arch, closed-mouth technique as described in this article enables dentists to obtain cast and die placement in centric occlusion in a single step. Complete closure of the teeth is mandatory for registering the interocclusal relationship correctly. The accuracy of the interocclusal relationship is more likely because of the decreased number of steps in the technique. Several different trays are available for the double arch impression technique. The more rigid trays buttress the impression material and reduce the possibilities of distortion in the final impression. Several variations in the double arch impression technique are possible, and tray selection is dependent on the demands of each patient.

Intraoral spread of the antimicrobial effect of a chlorhexidine gel.

The aim of the study was to determine the range of the antimicrobial effect of Hibitane Dental Gel (ICI, Macclesfield, England), containing 1% chlorhexidine, when used as a dentifrice while brushing. A standard toothpaste with no claim for antibacterial activity (Pepsodent) was used as a control. Twenty-four dental students brushed their teeth during two 4-day periods using the closed mouth technique, i.e. they kept their teeth tightly clenched and brushed only the facial tooth surfaces twice daily. Before and after each test period the lingual and linguomesial surfaces of the mandibular teeth were scored for clearly visible plaque. The facially applied chlorhexidine gel had no more effect on plaque growth lingually than the standard toothpaste which was used as control. The lack of effect of the gel was suggested to be due to an insufficient spread and penetration capacity of its antimicrobial component.