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July-September 2009 Volume 9 | Issue 3
Page Nos. 119-178
Online since Wednesday, October 14, 2009
Accessed 43,377 times.
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EDITORIAL |
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From the Secretary's Desk |
p. 119 |
V Rangarajan DOI:10.4103/0972-4052.57079 |
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REVIEW ARTICLE |
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Critical evaluation of methods to record centric jaw relation  |
p. 120 |
Sanjay Bansal, Jayant Palaskar DOI:10.4103/0972-4052.57080 Centric relation is the most difficult, yet, most important step in treating edentulous patients with complete dentures. However, a review of dental literature reveals that the philosophies and methods to make the actual registration vary greatly. It is generally agreed that centric relation records can be grouped into four categories- direct checkbite (interocclusal) recordings, graphic recordings (intra-oral and extra-oral), functional recordings, and cephalometrics. This article discusses the pros and cons of the various methods and techniques of recording centric jaw relations. However, the skill of the dentist and cooperation of the patient are probably the most important factors in securing an accurate centric relation record. |
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ORIGINAL ARTICLES |
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Dynamic visco-elastic analysis of silicone maxillo-facial prosthetic material using custom-made dynamic visco-elastometer and LASER measuring device |
p. 127 |
Alka Gupta, Deshraj Jain, Kartikey Tripathi, AG Bhujle DOI:10.4103/0972-4052.57081 Purpose : The dynamic mechanical properties of silicone maxillo-facial prosthetic material are very important for the successful rehabilitation of patients with facial defects. Moreover, it is equally important to determine these properties under conditions similar to those observed in the natural movement of facial tissues. This study evaluates the dynamic mechanical properties of silicone maxillo-facial prosthetic material using the classical Torsional pendulum method and high precision laser based measurement system. Materials and Methods : Five commercially available silicone maxillofacial prosthetic materials A-2002, A-2186, A-VST-50, A-588V-1and MDX4-4210 were taken as sample in the form of cylinders measuring 8X80 mm. A custom-made dynamic visco-elastometer was used to determine the Storage modulus, Loss modulus and Loss tangent over a frequency range of 0.5 to 1.0 Hertz at 37Celsius. Results : A-VST-50, A-588V-1 had low loss tangent (P less than 0.05), further they had lower storage modulus than other tested material, which is an added advantage over MDX4-4210 and A-2186. At all test frequencies A-2002 was found to have the highest loss modulus as well as the highest loss tangent (damping factor) among all the five kinds of material tested (P less than 0.05) which indicates its slow response to load but large capacity to absorb energy. Conclusion : Custom-made dynamic visco-elastometer has proved to be reliable, low cost and a convenient instrument to evaluate silicone maxillo-facial prosthetic material. No single material was found to have all the desirable dynamic mechanical properties necessary for maxillo-facial prosthesis applications. Therefore, layering of two or more such kind of materials is recommended to achieve desirable properties. |
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Comparison of residual monomer content and flexural strength of two auto-polymerizing reline resins subjected to microwave post-polymerization treatment |
p. 136 |
Padmakar S Patil, Ramesh Chowdhary, Rashmi B Mandokar DOI:10.4103/0972-4052.57082 Statement of Problem : Microwave post-polymerization has been suggested as a method to improve the flexural strength of auto-polymerizing denture relines resin. However, the effect of microwave post-polymerization on residual monomer content and its influence on flexural strength has not been investigated. Purpose : This study analyzed the effect of microwave post-polymerization on the residual monomer content and its influence on the flexural strength of two auto-polymerizing reline resins (Kooliner and Denture Liner) and compared its flexural strength. Materials and Methods : For each material, 70 specimens (64x10x3.3 mm) were polymerized according to manufacturer's instructions and divided into seven groups (n is equal to 10). Control group specimens remained as processed. Before testing, the specimens were subjected to post-polymerization in a microwave oven using different power (550 and 650W) and time (three, four and five minutes) settings. The specimens of each group were then manually ground into fine powder and samples extracted from the specimens using reflux method. The samples were then subjected to gas chromatography for residual monomer determination in area%. The specimens were subjected to three-point bending device with a span of 50mm and crosshead speed of 5mm/min and flexural strength was determined in MPa. Data analysis included Student 't' Test and One-way analysis of variance. Results : For Kooliner and Denture Liner reline resin, the residual monomer content decreased and the flexural strength increased significantly with the application of microwave irradiation using different time/power combinations. The specimens with the lowest residual monomer content were the similar specimens which presented with the highest flexural strength. Conclusion : Microwave post-polymerization irradiation can be an effective method to increase the flexural strength of Kooliner (at 550 W for 5 mins) and Denture Liner (at 650 W for 5 mins) by reducing the residual monomer content by further polymerization at free radical sites. The Kooliner reline resin had superior flexural strength compared to Denture Liner reline resin. |
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Relationship of anatomic landmarks with occlusal plane |
p. 142 |
Rubina Gupta, Himanshu Aeran, SP Singh DOI:10.4103/0972-4052.57083 Purpose : Evaluation of relationship between various anatomical landmarks and the occlusal plane in the natural dentition that could be used for establishing the occlusal plane in complete dentures. Methods : The study comprised of 100 dentulous subjects with all healthy permanent teeth in normal arch form and alignment. Three instruments were custom-made for the purpose : the occlusal plane analyzer to check the parallelism of the ala-tragus lines,and the interpupillary line, the buccinator groove relator and the level analyzer for the level of the linea alba buccalis with the occlusal plane. For the retromolar pad area a metallic scale was used. Results : Within limitations of this study, it was observed that, only 13% subjects showed occlusal plane parallel to the interpupillary line. The posterior reference point of Camper's line was middle point for 72% of males and superior point for 80% of females. Intraorally, 68% of subjects have the occlusal plane at the same level as that of buccinator groove and 77% of the subjects had the occlusal plane at the middle one-third of retromolar pad area. Interpretation and Conclusions : It was concluded that: the occlusal plane is parallel to Camper's plane posterior reference point as the superior point of tragus in females and middle point in males. The occlusal plane is not generally parallel to the interpupillary line. Intra-orally, the level of buccinator groove is reliable, while variations in retromolar pad area make it an unreliable landmark for orienting the occlusal plane. |
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Complete denture fractures: A clinical study
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p. 148 |
Amit V Naik DOI:10.4103/0972-4052.57084 The main purpose of the study was to determine the causes for the fracture of complete dentures of patients reporting to the Department of Prosthodontics, Teerthanker Mahaveer Dental College, Moradabad, Uttar Pradesh, India. Data collected from 200 patients reported for repair of their complete dentures. Data was collected from patients, aged between 30 to 80 years (mean 55 plus/minus 25 years), from both the genders. Investigations were done on factors causing the fracture. After the analysis it was observed that the ratio of fracture of upper to lower denture was 1:3. Most fractures were common among males (55%). The most common reason being accidental dropping of the denture in case of the lower and improper fit and stability of the denture, improper arrangement and occlusion of the teeth for the upper one. Midline fracture was the most common site of fracture (60%). After analysis, the causes for the fracture were divided into material factors and clinical/ technical factors. It was concluded that the after denture delivery, instructions of denture care were required to reduce mishaps, proper principles of denture construction were required for mechanical advantage of the denture - balanced occlusion, removal of interferences, reduction of stress concentration areas, etc has to be followed. The use of high impact acrylics and strengthened acrylic along with methods increasing fracture toughness of the conventional acrylic dentures are to be used. |
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CLINICAL REPORTS |
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Innovative technique for fabrication of hand prosthesis |
p. 151 |
Satheesh Kumar, Ravindra C Savadi, M Srinivasan, Preeti Satheesh DOI:10.4103/0972-4052.57085 A precisely fitting hand prosthesis can improve function by restoring normal length, maintaining sensitivity through a thin lamina, protecting a sensitive stump and transmitting pressure and position sense. Although implant hand prosthesis has a superior outcome, due to economic factors, it may not be advisable in all patients. This article focuses on an innovative method of fabricating 'hollow' glove type of hand prosthesis which aims to reduce the weight and thereby the cost of prosthesis. It also enables us to color match the dorsal and ventral surfaces separately so that the prosthetic form, coloration and texture be as indiscernible as possible from the surrounding tissues. |
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Oral rehabilitation of a hypohidrodotic ectodermal dysplasia patient: An unusual prosthetic problem |
p. 156 |
Sanjay Prasad, Tapan K Giri DOI:10.4103/0972-4052.57086 The aim of this clinical report is to describe the prosthodontic management of a young boy aged 7 years affected by ectodermal dysplasia (ED). Dental treatment can vary depending on the severity of the disease (tooth size, morphology, and the amount of available alveolar bone). New technologies, such as adhesive dentistry, overdenture, and complete denture represent some of the options in the management of the rehabilitation of the patient affected by ED. The conical shaped central incisor was modified using composite resin followed by complete denture. Prosthodontic and restorative treatment was provided for the psychological and social comfort of the young patient. |
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Prosthetic rehabilitation of patient with immediate implant placement |
p. 160 |
Sandeep Kumar, Giridhar Kamath, Seema Gupta DOI:10.4103/0972-4052.57087 The use of immediate postextraction implants presents several advantages in terms of reduction of surgical steps and time required to conclude the therapy. Particularly important is the possibility to minimize bone loss that otherwise would occur in the physiologic healing of the alveolus. Immediate implant placement has helped solve issues with regard to bone quality, quantity and esthetics and also treatment time, as opposed to delayed implant placement. Here, a case report has been presented in which immediate extraction Frialet implant has been placed in mandibular premolar region. |
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Full mouth rehabilitation of a severely worn out dentition to functional harmony |
p. 164 |
Chethan Hegde, D Prasad Krishna, Sunil J Jacob, Manoj Shetty DOI:10.4103/0972-4052.57088 Patients with severe tooth wear may require extensive restorative procedure to achieve appropriate function, esthetics, and comfort. Occlusal rehabilitation requires a correlation of biologic factors, mechanical principles, and esthetic requirements with treatment procedures. A combination of new generation materials, along with improved clinical procedures, works in tandem to produce an esthetic, long-lasting, and functional outcome, satisfying both the clinician as well as the patient. This clinical report describes the full mouth rehabilitation of a severely worn out dentition in functional harmony with the stomatognathic system. Twin-stage procedure was adopted to produce definite amount of disocclusion during eccentric movements. |
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Velopharyngeal obturator in partially edentulous patient |
p. 167 |
Rajesh Shetty, Kamalakanth K Shenoy, Makham Gangaiah DOI:10.4103/0972-4052.57089 Congenital large intraoral defects are amenable to prosthodontic rehabilitation as surgical procedure alone cannot restore the function of residual palatal tissues. This study presents the case report of a partially edentulous patient with congenital cleft palate (Veau's Class III). The procedure for fabrication of definitive velopharyngeal obturator attached to conventional removable partial denture is described. |
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Simplified technique for fabrication of custom ocular tray and making ocular impression |
p. 171 |
RB Hallikerimath, K Preethi, Sunil Dhaded DOI:10.4103/0972-4052.57090 Prosthetic rehabilitation of an ocular defect can be successfully achieved with stock eye by using well fitting ocular tray and a proper impression technique. The tissue adaptation of stock prostheses can be improved by making an accurate impression of an ophthalmic socket using custom ocular tray. This article presents a technique for the fabrication of custom ocular tray and procedure for making impression of eye socket using the same. |
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Altered cast technique for management of large maxillary defects |
p. 175 |
GN Anandakrishna DOI:10.4103/0972-4052.57091 Restoring defects of acquired causes in the maxilla presents an unique challenge to the prosthodontist due to the sheer size and anatomic nature of the defect itself. Since most of the maxillary defects are intraoral in nature, the prosthodontist should decide on the extent of the defect that can be restored. Recording, fabricating, inserting and removing the prosthesis is limited by mouth opening and undercuts present. The conventional techniques of impression making of large maxillofacial defects have inherent deficiencies as the visualization of the amount of extension that can be worn or inserted by the patient comfortably is difficult and also; due to limited mouth opening, custom fabricated trays can be quite difficult to insert. These difficulties can be circumvented by using altered cast technique. This article describes the technique of fabricating prosthesis for large maxillary defect using altered cast technique.
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