Final Impression Research Articles

Acrania-exencephaly-anencephaly sequence

Acrania–exencephaly–anencephaly sequence is rare forms of neural tube defects. The progression is from a relatively normal-appearing exposed brain due to an absent cranium called as acrania, to an amorphous brain mass term as exencephaly. We present a case of 20 years female, nonconsaguinous marriage, G1P0A0 having amenorrhea since 3 months. On ultrasonography, a single fetus of gestational age of about 15 weeks gestation showed congenital malformation- acrania with exencephaly. Final impression on fetal autopsy given was acrania–exencephaly with deformed brain, ill-formed cervical C1, 2 spine, bilateral pulmonary immaturity- Grade II with pulmonary congestion and hemorrhage. We are presenting this rare fetal anomaly of acrania–exencephaly–anenecephaly sequence for its clinical, radio imaging, and fetal autopsy findings.

A Comparison of Undergraduate Prosthodontic Teaching of Removable Partial Dentures in Saudi Arabian Dental Colleges with North American and Turkish Dental Schools.

ABSTRACTObjectives:To meet the needs of society, it is obligatory to provide standardized skill training to undergraduate students in dental colleges. Surveys related to teaching curriculum are valuable means to evaluate education across the country. The aim of this study was to find the trends in the undergraduate teaching curriculum, by determining the differences in the teaching methods and principles of fabrication of removable partial dentures in dental colleges in Saudi Arabia and to compare these with the curriculum of North American dental schools and Turkish dental schools.Materials and Methods:An online survey was conducted in 23 dental colleges of Saudi Arabia. Descriptive data analysis was performed to synopsize the information.Results:Eighteen out of 23 (78.23%) dental colleges of Saudi Arabia answered the questionnaire; 88.9% of the colleges follow the practice of using custom trays for making final impressions; and 44.4% of the colleges use only polyvinyl siloxane for making final impressions. Semiadjustable articulators were commonly used for mounting study casts (61.1%) and master casts (66.6%). An in-house production laboratory is present in 72.2% of the colleges. Cobalt–chromium alloy is used in 94.4% of the colleges for the framework. A set protocol for postinsertion adjustment visits is followed in 94.4% of the colleges.Conclusions:Dental colleges of Saudi Arabia have similar standards of removable partial denture education at the undergraduate level, with variations in a few aspects. Removable partial denture teaching programs of Saudi Arabian dental colleges are comparable to similar programs in dental schools of the United States and Turkey.

Effect of freshly placed core buildup composites on setting of silicon impression materials.

Aim:The aim is to study the effect of freshly placed composite build-ups on setting of additional silicone impression materials.Settings and Design:In vitro - experimental study.Materials and Methods:Three composite materials; Build-It™ F. R™, Filtek™ Bulk Fill flow and Filtek™ Z350 and three light-bodied additional silicone impression materials; Elite HD+, Aquasil LV Ultra and Express™ were used. Cylindrical-shaped specimens were made of each material (diameter 15 mm and height 10 mm). The silicone specimens were brought into contact with the composite specimens, which were either freshly cured (9 groups, n = 90) or cured and then stored in normal saline for 1 week (9 groups, n = 90). Shore A hardness (SAH) scores of silicone surfaces were recorded following the ASTM D2240-5 standards for shore A Durometer testing. Six measurements were made per each silicone surface and medians were calculated. Kruskal–Wallis and Mann–Whitney tests (SPSS v20) were used to check statistical significant differences between all groups and paired comparisons, respectively (P < 0.05).Statistical Analysis Used:Kruskal-Wallis and Mann-Whitney tests.Results:The SAH scores of additional silicones in direct contact with freshly placed composites were significantly less than SAH scores of additional silicones in direct contact with composites specimens aged for 1 week in 7 out of 9 combinations (P < 0.05). Only when Express™ and Elite HD+ were applied over freshly placed Filtek™ Bulk Fill flow, the SAH scores difference was not statistically significant to SAH scores of matching combinations applied after 1 week of composite storage.Conclusions:Freshly placed composite might affect setting of additional silicone impression materials. Dentists should carefully assess final impression on areas of prepared teeth that have received composite fillings recently.

Fabrication of a customized impression metal jig for an implant-supported overdenture with a milled bar

The use of computer-aided design/computer-aided manufacturing technology simplifies the laboratory and clinical steps for the fabrication of implant prostheses. It also reduces additional costs for the prosthetic components and technical procedures. This article describes a modified impression technique using an impression metal jig to enhance the accuracy of final impression and also to eliminate the need for the try-in of resin pattern of the milled bar.

Modified impression technique for patient with microstomia

Routine custom trays are difficult to use to make impressions for patients with microstomia. Several types of split custom trays have been introduced to accommodate these situations. A method of fabricating mandibular and maxillary sectional special trays and impression technique for a patient with small oral opening is described. Sectional maxillary and mandibular custom trays can enhance its stabilization during border molding and final impression making. Thus it helps in fabricating a better fitting complete denture for such patients and also makes the impression procedure easy for patient with limited opening as the tray can easily be inserted in two pieces. Keywords: Impression, Microstomia, Sectional custom tray.

Comparative Analysis of the Effect of Border Molding Using Different Molding and Final Impression Materials on the Retention of Complete Denture Bases

Aim : It is for comparing the retention of complete denture bases made by border molding using the low fusing compound and putty type condensation silicon by using metallic zinc- oxide eugenol and medium body condensation silicon as final impression material.. Subjects and Methods: the study was carried out on 20 patients , the selected was completely edentulous with well-developed ridge four dentures for each patient was fabricated :( Group A):border molding with green stick compound and final impression with zinc oxide eugenol(Group B): border molding with green stick compound and medium body rubber base as a final impression(Group C): border molding with putty type and medium body condensation silicon as a final impression materials(Group D): border molding with putty type condensation silicon and medium body rubber base as a final impression. Results: Statistically significant results were in complete denture obtained from putty type border molding and medium body condensation silicon final impression, while the least values obtained from green stick border molding and zinc oxide eugenol final impression. Conclusion: Based on the favourable results of this study , it can summarized that the complete denture obtained from putty type and medium body condensation silicone more retentive than other complete dentures obtained from other border molding and final impression materials.

Observational Study to Evaluate the Clinical Efficacy of Thermalytix for Detecting Breast Cancer in Symptomatic and Asymptomatic Women.

PURPOSETo evaluate the sensitivity and specificity of Thermalytix, an artificial intelligence–based computer-aided diagnostics (CADx) engine, to detect breast malignancy by comparing the CADx output with the final diagnosis derived using standard screening modalities.METHODSThis multisite observational study included 470 symptomatic and asymptomatic women who presented for a breast health checkup in two centers. Among them, 238 women had symptoms such as breast lump, nipple discharge, or breast pain, and the rest were asymptomatic. All participants underwent a Thermalytix test and one or more standard-of-care tests for breast cancer screening, as recommended by the radiologists. Results from Thermalytix and standard modalities were obtained independently in a blinded fashion for comparison. The ground truth used for analysis (normal or malignant) was the final impression of an expert clinician based on the symptoms and the available reports of standard modalities (mammography, ultrasonography, elastography, biopsy, fine-needle aspiration cytology, and so on).RESULTSFor the 470 women, Thermalytix resulted in a sensitivity of 91.02% (symptomatic, 89.85%; asymptomatic, 100%) and specificity of 82.39% (symptomatic, 69.04%; asymptomatic, 92.41%) in detection of breast malignancy. Thermalytix showed an overall area under the curve (AUC) of 0.90, with an AUC of 0.82 for symptomatic and 0.98 for asymptomatic women.CONCLUSIONHigh sensitivity and high AUC of Thermalytix in women of all age groups demonstrates the efficacy of the tool for breast cancer screening. Thermalytix, with its automated scoring and image annotations of potential malignancies and vascularity, can assist the clinician in better decision making and improve quality of care in an affordable and radiation-free manner. Thus, we believe Thermalytix is poised to be a promising modality for breast cancer screening.

Reporting the Presence of Coronary Artery Calcium in the Final Impression of Non-gated CT Chest Scans Increases the Appropriate Utilization of Statins.

BackgroundCoronary artery calcium (CAC) scoring based on gated non-contrast cardiac computed tomography (CT) is a validated risk marker of major adverse cardiovascular events (MACE). Reporting of CAC on non-gated CT chest (NGCT) scans and the impact on medical therapy is not well studied.MethodsA retrospective cohort of 5,043 NGCT scans was reviewed for the presence of CAC. The radiology report was reviewed to determine whether CAC was mentioned in either the body of the report or the final impression. Electronic medical records (EMR) were abstracted for baseline demographics, cardiovascular (CV) risk factors, lipid-lowering agents, and aspirin (ASA) prior to and after NGCT.ResultsCAC was present in 63.0% of NGCT scans. Of these scans, CAC was mentioned in the body of the report in 81.6% of studies. Conversely, CAC was mentioned in the final impressions in only 15.1% of these scans. Amongst patients with CAC, initiation of a statin in treatment-naive patients was more common when CAC was mentioned in the final impression versus the body only (12.3% vs. 4.9%, p=0.001) despite the fact that baseline utilization of statins in this cohort was higher (71.1% vs. 64.1%, p=0.005). Initiation of a statin in treatment-naive patients had a trend towards significance when CAC was mentioned in the body of the report versus not reported (4.9% vs. 2.62%, p=0.142). Reporting of CAC in the final impression significantly increased the initiation of ASA in treatment-naive patients (9.52% vs. 4.33%, p=0.033). Reporting of CAC in either the final impression or the body of the report did not affect the initiation of non-statin lipid-lowering therapies in patients with CAC.ConclusionThe inclusion of CAC in the final impression of NGCT radiology reports positively impacts the appropriate initiation of statin and aspirin therapy in treatment-naive patients. Universal adherence to a standardized reporting system for the presence of CAC on NGCT should be considered to improve the initiation of guideline-directed medical therapy.

A rare case of Scwannoma at carotid space of neck region mimicking as Paraganglioma.

This is a case of carotid body tumour at right side of neck region with initially diagnosed as paraganglioma. A 22 year old female patient with an history of pain and swelling at right side of neck region with intermittent headache difficulty during deglutination. Patient has taken medication for pulmonary kochs for 8 months. Now presented with the mentioned complaints with a swelling at right side swelling at neck region. The features and the correlation with MRI report diagnosed as paraganglioma and then on Histopathologic examination showed a tumour mass composed of two different areas admixed with each other either alternatively or diffusely. The final pathological impression was Neurilemmoma (Schwannoma).The diagnosis was definitive with no evidence of paraganglioma.

Film Costume as a Visual Narrative Element

This research is an attempt to try to define the semiotic elements of film costumes that result with certain final feelings of the viewer. Looking through the semiotic theory of both Roland Barthes and Walter Benjamin and the specifics of (theatre and) film costume as a means of influencing the viewer and his/her thoughts, feelings and overall catharsis, the identity of a certain film has been set through an analysis of various elements. Furthermore, it has been noticed that psychological results by one observing a film can be various and lean more on known philosophical and psychological tendencies i.e. Freud’s theories or the ones of M. Merleau-Ponty or Lacan. To make it less verbatim, the example for the analysis that has been chosen is the 1982 science fiction film Bladerunner directed by Ridley Scott. With surreal messages and multi-layered meanings of its visual and audio presentation, it seemed like a perfect starting point for the research of the subconscious mind of the viewer. Finding a non-invasive approach to viewer’s impression, the costume itself could be observed both independently and in correlation with other film elements. By combining the results of all film levels via a visual psychological test by Robert Plutchik, known as Plutchik’s wheel of emotions, it is plain to see that a final impression still lies in a personal analysis. We find a prevalence of certain thoughts that lead the viewer to change his/her perception and, ultimately, to catharsis.

Comparative evaluation of retentive strength of polyvinyl siloxane impression materials to custom tray using different tray adhesives: An In Vitro study

The retentive strength of the impression material to the impression tray is an important factor that can affect the quality of the final impression. Separation of the impression from the tray or tearing of the impression while removing from the mouth could be one of the reasons for distortion. It is imperative to know the most effective tray adhesive which can be used with different brands of rubber-based impression material. So, this study was directed to compare the different tray adhesives that can be effectively used in our day-to-day clinical practice.

3D Digital Impression Systems Compared with Traditional Techniques in Dentistry: A Recent Data Systematic Review.

The advent of new technologies in the field of medicine and dentistry is giving improvements that lead the clinicians to have materials and procedures able to improve patients’ quality of life. In dentistry, the last digital techniques offer a fully digital computerized workflow that does not include the standard multiple traditional phases. The purpose of this study is to evaluate all clinical trials and clinical randomized trials related to the digital or dental impression technique in prosthetic dentistry trying to give the readers global information about advantages and disadvantages of each procedure. Data collection was conducted in the main scientific search engines, including articles from the last 10 years, in order to obtain results that do not concern obsolete impression techniques. Elsevier, Pubmed and Embase have been screened as sources for performing the research. The results data demonstrated how the working time appears to be improved with digital workflow, but without a significant result (P = 0.72596). The papers have been selected following the Population Intervention Comparison Outcome (PICO) question, which is related to the progress on dental impression materials and technique. The comparison between dentists or practitioners with respect to classic impression procedures, and students open to new device and digital techniques seem to be the key factor on the final impression technique choice. Surely, digital techniques will end up supplanting the analogical ones altogether, improving the quality of oral rehabilitations, the economics of dental practice and also the perception by our patients.

A Customized Impression Technique for Highly Placed Mal-Aligned Implant for a Hybrid Over Denture Patient: A Case Report

A hybrid implant denture is a fixed prosthesis over a metal framework and engaged by screws into the implant abutments. The anterior and posterior part of a mandibular hybrid denture is rigid on implants. Implant supported hybrid prosthesis provide satisfactory results on the mastication, esthetics and phonetics. This article describes a customized impression technique for highly mal aligned placed implants for hybrid implant denture. The total of five implants was present in the mandibular arch. Author advocates surveying of mal aligned implant analogue cast. The current technique depicts a customized resin impression tray with open border at two sites that concomitant at highly mal aligned implant position (canine region). Technique also uses the hard elastic chain for splinting of impression analogue. Final impression is recorded with single putty wash technique with polyvinyl siloxane elastomeric material. Although, technique is quite clinical sensitive. Asserting over this technique, it eliminates the use of transmucosal or multi unit abutments. This advocated technique is also economical for both clinician and patient. Impression was quite satisfactory.

ANALYSIS OF THE RECEPTIONIST SERVICE QUALITY ON GUEST SATISFACTION AT HARPER KUTA HOTEL

This research is based on the importance of the role of the receptionist as a brand image of a hotel in terms of first impressions and final impressions for guests who stay overnight. Services provided to guests are expected to be able to meet expectations or even exceed them. This research is intended to measure and analyze the quality of receptionist services to guest satisfaction at Harper Kuta Hotel, using servqual method to check the gap both partially, simultaneously. By using servqual which is used as 16 indicators X, against the Overall of Guest Satisfaction, Customer Loyalty. The average expectation of respondents is 3.60 while the average perception is 3.52. Respondents were determined by random sampling method and with the method of determining the number of samples using the Slovin method, the number of respondents was 99 respondents. The data analysis technique used is validity test, reliability test, servqual method and data processing using SPSS 25 software to analyze multiple linear regression. Based on the results of data processing obtained 3 positive indicators, namely the infrastructure supporting the receptionist is adequate, the receptionist provides services professionally, the receptionist provides general information correctly and updates. While other variables produce negative gaps that have an adverse effect.

Development and usability of a Hands-On Assessment Tool for Child Health: The HATCH.

To develop a comprehensive, hands-on assessment tool for assessing health in children under five in underserved regions. Methodological study design and usability testing were used. Eight nurses working at two health posts and 261 children under five living in the migrant villages participated in the study. The developed tool was evaluated using 10 items of a questionnaire based on the honeycomb model of Morville (2004). Community nurses administered the questionnaire then followed with a focus group interview after completing a child health exam using the developed tool. Data were collected during July 2017. The Hands-on Assessment Tool for Child Health is composed of developmental screening, identification of risk factors and clinical signs, growth measurement, diagnostic tests and interpretation of each subdomain, and final impressions. Management strategies include parent education, resource networking, referral to a paediatrician, and follow-up plans. Usability testing revealed high scores on the facets "valuable," "useful," "desirable," and "findable." Considering the demand for hands-on tools in underserved regions, the developed tool can provide nurses with resources for competent management of child assessment, interpretation, and nurses' intervention strategies, fortified with clinical judgement processes.

Smile Design pada Penutupan Diastema Menggunakan Veneer Porselin pada kasus Protrusif (Laporan Kasus)

Background: Value of the appearance of one’s teeth has taken on a greater importance in today’s society. Several Choices of treatment are available to treat the problems arising in the zone of high esthetic sensitivity. Each treatment offers some advantages and disadvantages. The use of porcelain laminate veneers to solve esthetic and functional problems has been shown to be a valid management option especially in the anterior esthetic zone. Smile design is a scientific principal that can help operators to achieve esthetic goals. This case report discussed a patient with diastema in the anterior region with protrusive dental position. The patient was treated with porcelain laminate veneers in the anterior teeth for diastema closure. Objective: This case report was written to bring forward the proper and successful management in esthetic treatment of anterior maxilla in protrusive dental position case. Case and management : A 37 year-old female patient complained of diastema in anterior teeth and feels uncomfortable with her condition. She was unhappy with the appearance of her teeth and restrained herself from smiling due to self-consciousness. On examination, diastemas were found in her maxillary and mandibular anterior region. Smile Design was applied in this patient, and it was decided to use porcelain laminate veneer. The tooth preparation was kept in enamel at a depth of 0.5 mm using a depth cutting diamond and a tapered diamond 1 mm in diameter. 0.25 mm chamfer was maintained in the cervical region The chamfer finish lines were at the level of gingival margin. Gingival retraction procedure was performed prior to final dental impression using a double impression technique. Cementation was done after final evaluation of both aesthetic and function. Conclusion: Esthetic management in diastema closure using simple smile design can be done by using porcelain laminate veneers which give satisfactory result.

To evaluate the effect of storage temperature on the linear dimensional accuracy of delayed and repeat pours of two addition silicone impression materials

Background: Addition silicone elastomers are the most commonly used impression materials for making final impression for fixed partial dentures, implants, and removable partial dentures. The dimensional stability and accuracy of addition silicone impression material is influenced by the storage time, temperature, and repeat pour. Aim and Objectives: The aims and objectives of this study were to evaluate the accuracy of two different types of addition silicone elastomeric impression materials, stored at different temperatures; to evaluate the accuracy of two different types of addition silicone elastomeric impression materials after delayed and repeated pour; and to compare the linear dimensions of two different types of addition silicone elastomeric impression materials with a control die. Materials and Methods: A machined standard steel master die and a metal custom impression tray were made for making a final impression of machined standard steel master die. The final impression was made by using two different brands of addition silicone impression materials (Aquasil™ Ultra Impression material, Dentsply/Caulk, Milford, DE, USA, and 3M™ ESPE™). Double-step putty light-body impression technique was used for making the final impression. In this manner, a total of eighty impressions were made, and they were divided into two groups namely Group I and Group II. To study the effect of delayed pours and storage temperature, the two groups were further divided into four subgroups, with ten impressions each. All the ten impressions of each subgroup were stored in an acrylizer at 40°C, −10°C for 24 h, −2°C for 48 h, and 0°C for 1 week inside a refrigerator in sealed plastic bags before being poured with type IV dental stone. To study the effect of repeat pours on the accuracy of stone casts, all the ten impressions of each subgroup were immediately re-poured with type IV die stone after the removal of the first set of casts. Thus, again a fresh set of eighty casts were obtained having forty casts to each group. Results: When the impressions were stored in the acrylizer at 40°C, −10°C for 24 h, −2°C for 48 h, and 0°C for 1 week, the addition silicone impression materials did not show any significant change when compared to the control samples. Conclusion: Both the types of addition silicone elastomeric impression materials maintained their accuracy after delayed pours and repeat pours. Storing impressions under different conditions caused no adverse effect upon the accuracy of both types of addition silicone elastomeric impression materials. There was no significant change in the dimensions of stone casts obtained from both impression materials as compared to the dimensions of the master die. Even though if the addition silicone impression material is delayed, i.e. poured up to 1 week, repeat poured, and exposed from − 10°C to 40°C, the linear dimensional accuracy will not be adversely affected.

The Effect of Simultaneous Application of Transcutaneous Electrical Nerve Stimulation (TENS) on Specific Lumbar and Acupuncture Points on Labour Pain Relief: A Randomised Clinical Trial

Introduction: Labour pain is among the most challenging experiences a woman could face during life. Non Pharmacological modalities like Transcutaneous Electrical Nerve Stimulation (TENS) are rather new methods, introduced for relieving this pain. Aim: To investigate the effect of concurrent use of TENS application on the labour pain relief. Materials and Methods: This is a double-blind randomised clinical trial study where, a total of 104 eligible pregnant women qualified for normal vaginal delivery. They were randomly divided into four groups treated with Lumbar-TENS or Acupuncture points-TENS as A: both inactive (placebo group), B: Active Acupuncture points TENS, C: Active Lumbar TENS and D: both active. TENS was applied on four points of toraco-lumbo sacral, while Acupuncture points-TENS was applied on Hegu and Sanyinjiao points. The pain scores were evaluated by Visual Analogue Scale (VAS) criteria, four times during the study for each individual. A questionnaire was used to evaluate the final impression of the subjects about the TENS method. The groups were compared using chi-square or Kruskal Wallis test. The trend of pain score over the study time points were assessed using Generalised Estimating Equation (GEE). Results: The mean age of the women were 27.86±5.92 years. There were no significant differences between the groups based on the pain scores over the study periods (p-value=0.588). There was a statistically significant difference between groups for satisfaction about the procedure and the placebo group had the lowest rate of tendency to reuse TENS at the future Labour (74%) compared to the other three groups (93-100%) (p-value=0.046). Conclusion: Lumbar or Acupuncture points-TENS had no significant relieving effects on Labour pain among the participants.

A Novel Functional Swallow Method to Establish the Posterior Palatal Seal during the Maxillary Edentulous Final Impression: A Case Report

To propose an alternate, r eliable, and easy-to-use functional swallow method for establishing the posterior palatal seal. Accurate r egistration of the posterior palatal seal is crucial to the success of the maxillary complete denture. The conventionally used functional "Ah" technique may not be r eliable at times to record the posterior palatal seal, hence compromising the retention of the maxillary complete denture. Case description and technique: A 70-year-old female patient requiring complete dentures presented with an unusually tense soft palate during the phase of posterior palatal seal development. The soft palate did not relax and remained in a superior position when the "Ah" functional method was used to record the seal. The posterior palatal seal area could not be compressed sufficiently during border molding, preventing the formation of an adequate seal. Hence, a new functional technique was devised to relax and displace the soft palate for developing an effective seal. This case report describes a novel and reliable method of displacing the posterior palatal seal area with a low-fusing compound by utilizing the patient's functional swallow position. The functional swallow method can be used effectively as an alternative and reliable method to obtain a consistent posterior palatal seal. The functional swallow method of developing the posterior palatal seal is simple, less demanding on the clinician, and can save chairside time. It also helps in an easy transfer of the demarcated posterior palatal seal area to the custom tray. The method lets the dentist be in charge of developing the seal rather than relying on the arbitrary cast scrapping by the technician. Also, the seal can be achieved by employing commonly used materials.

Clinical Evaluation of Maxillary Arch Complete Denture Impressions Made by Undergraduate Students in a Dental College

Introduction: An accurate impression is the foundation of denture fabrication process thus a practitioner should be aware of the possibility of including errors during this procedure. Time spent in making a good impression will reduce the time required in adjusting the final prosthesis as well as make it more comfortable for the patient in accepting the prosthesis.&#x0D; Materials and Methods: Maxillary arch final impressions made by undergraduate dental students on 106 edentulous patients were evaluated. The impressions were assessed on the basis of criteria’s like errors on mixing, flow, tray positioning, presence of voids, creases/irregularities, exposure of tissue stops and extension at posterior border. The data’s collected were analyzed for the frequency of occurrence and distribution of each type of errors.&#x0D; Results: It was found that 97.2% of students performed at least one detectable error during making of maxillary arch final impression. The number of errors made by students ranged from single to as much as seven errors in one impression. The most common error was lack of exposure of all tissue stops followed by presence of voids and creases/irregularities on impression surface.&#x0D; Conclusion: There is high possibility of including errors while making maxillary arch final impression by undergraduate dental students. The study highlights the need to explore novel techniques of clinical demonstrations and teaching important concepts to learning students. The inclusion of more pre-clinical exercises in undergraduate curriculum relating to manipulation of dental materials may improve skills of students in making accurate edentulous impressions.