Aim: The aim of this systematic review is to evaluate the survival rate of dental implant placed using different maxillary sinus floor elevation techniques. Setting and Design: PRISMA guidelines were used for this systematic review and meta-analysis. Materials and Methods: Relevant articles were searched from Medline, PubMed, Google Scholar, ScienceDirect, and Cochrane trials. Articles published in English language were selected. Hand search was further conducted. For risk of bias, two tools were used, i.e., Cochrane tool for randomized controlled trials (RCTs) and new castle Ottawa quality assessment tool for non-RCTs. Statistical Analysis: For statistical meta-analysis RevMan 5.4 software was used. Results: Seventeen studies were finalized. All studies were included in the meta-analysis to check the implant survival rate. There is no statistical difference between direct and indirect techniques, and forest plot was derived for direct approach (P = 0.688, 95% confidence interval [CI] 0.9691) and for indirect approach (P = 0.686 and 95% CI 0.970). Conclusion: There is no statistically significant difference in the survival rate of implant placed using direct or indirect sinus lift approach procedures. Hence, the technique is selected as per the indications given for each direct and indirect procedure.

Aim: Accurate fit of the abutment to the implant is required for the uniform load distribution throughout the assembly. The study aims to compare the marginal misfit of titanium stock abutments with the cobalt-chromium (CoCr) customized abutments fabricated with the different manufacturing processes in internal hex implant-abutment connection using an appropriate scanning technique. Setting and Design: In vitro comparative study. Materials and Methods: A total of 40 abutments were included in the study. Ten titanium stock abutments were used as control (Group CN) and 30 CoCr abutments were fabricated and taken as the test group. Stock abutments were scanned and from obtained images test group abutments were fabricated as follows: Ten cast abutments (Group CA), 10 sintered abutments (Group SA), and 10 milled abutments (Group MA). Endosseous implanst having internal hex connections were matched with 10 stock abutments and 30 customized CoCr abutments. Implants were mounted in a clear epoxy resin block and the abutments were then fitted onto the implants with a torque of 30Ncm. The marginal discrepancy at implant-abutment connections was measured with confocal laser scanning microscope. Statistical Analysis Used: One-way ANOVA and Tukey's post hoc test was done for statistical analysis. Results: One-way ANOVA revealed a significant difference in marginal misfit of abutments. The mean marginal misfit was lowest for stock abutments (0.35 ± 0.009 μm). Among the customized abutments, the mean marginal misfit was highest for cast abutments (2.44 ± 0.445 μm) followed by sintered abutments (1.67 ± 0.232 μm) and least for milled abutments (0.65 ± 0.041 μm). A significant difference was found in marginal misfit with cast abutments and sintered abutments when compared to stock abutments (P < 0.001). The difference in marginal misfit was insignificant between stock abutments and milled abutments (P = 0.052). Conclusion: Difference in marginal misfit exists between the titanium stock abutments and customized CoCr abutments. Among the customized abutments, milled CoCr abutments have the least marginal discrepancy and cast CoCr abutments have a maximum marginal discrepancy. Milled CoCr abutments can be used as an alternative to titanium stock abutments.

Aims: The goal of this study was to analyze the bacterial microleakage following two methods (heat vs. rotary) of postspace preparation after two-time intervals (immediate vs. 1 week later). Setting and Design: In vitro-comparative study. Materials and Methods: Eighty-two single-rooted teeth were decoronated at the cementoenamel junction. Root canals were prepared using rotary files. After root canal obturation, specimens were randomly allocated to 4 experimental groups based on the method of postspace preparation (heat or peeso reamer) and time interval (immediate or 1 week later) (n = 18). Group 1: Peeso reamer-immediate, Group 2: Heat-immediate, Group 3: Peeso reamer-1 week later, Group 4: Heat-1 week later. 10 specimens were considered as positive and negative controls (n = 5 each). Custom-made dual-chamber devices were used to appraise the bacterial microleakage for 60 days. Statistical Analysis Used: Data were analyzed with Chi-Square and Log-Rank tests and Cox regression. Results: All through the experimental period, there was no significant difference (P = 0.41) between the studied groups. Groups 2 and 4 had the highest microleakage and the lowest survival rate (55.56% ± 11.71%). Group 1 showed the lowest microleakage and the highest survival rate (77.8% ± 9.80%). Conclusions: The applied techniques for postspace preparation and the time intervals (neither independently nor simultaneously) showed no significant difference in the field of bacterial leakage.

Aim: The present study aimed to evaluate on a comparative basis the vertical marginal fit between conventionally casted, direct metal laser sintered (DMLS), and milled computer-aided design/computer-aided manufacturing (CAD-CAM) one-piece metal framework supported by five implants using one-screw test and screw resistance test. Settings and Design: This is an in vitro study. Materials and Methods: Five implants were placed parallel to one other in a Styrofoam master model. A total of 30 implant-supported screw-retained superstructures were manufactured using three techniques, i.e., conventionally casted, milled, and sintered. To evaluate the vertical marginal discrepancy, screw resistance test, and one-screw test were used, and measurements were made using a stereomicroscope. Statistical Analysis Used: The data was analysed using two statistical tests, i.e., ANOVA and the post hoc Bonferroni test. Results: On evaluating the frameworks using one-screw test, the mean vertical misfit value at the terminal implant for the control group was 292.58 ± 15.46μm, for conventionally casted framework 398.41 ± 21.13 μm, for DMLS 343.44 ± 24.73 μm, and for CAD-CAM was 304.03 ± 14.23 μm, whereas the average misfit values at four implants on applying screw resistance test were 1268.65 ± 84.24 (control), 1774.88 ± 67.70 (casted), 1508.02 ± 62.19 (DMLS), and 1367.29 ± 81.87 (CAD-CAM). The average misfit values on two implants using screw resistance test were 635.02 ± 57.33 for the control group; for conventionally casted, it was 879.75 ± 35.93; for (DMLS) framework, it was 761.51 ± 32.85; and for milled CAD-CAM framework, it was 687.07 ± 42.17 μm. Conclusion: The mean vertical marginal discrepancy, when compared with control, was least in milled CAD-CAM frameworks, followed by sintered DMLS and conventionally casted frameworks. Hence, according to the present study, CAD/CAM technique is recommended to achieve maximum marginal fit in full mouth screw-retained implant-supported FDPs.

Aim: The aim of this study was to compare the function and coordination of masticatory muscles for patients with two implant-supported mandibular overdenture (ISOD) with that of conventional complete dentures (CCD) using surface electromyography (sEMG). The objectives were to assess the muscle activity (efficiency) and clinical outcome after the transition of CCD patients to ISOD. Setting and Design: This was a crossover study. Materials and Methods: This clinical trial was conducted in the department of prosthodontics. A total of 15 patients (nine males and six females) were assessed using sEMG. In each patient, a total of four surfaces were examined above the following muscles – right and left masseter and right and left temporalis muscles. The electromyography readings were recorded to assess muscle activity during Clenching, cotton roll clenching, and chewing. The readings were recorded first for CCD and then for ISOD (after installing attachments). Statistical Analysis Used: Data analysis was done using independent t-test and one-way ANOVA. Results: Mean muscular activity of masseter during clenching, cotton roll clenching, and chewing for patients with ISOD (44.3 ± 11.2 μV, 41.1 ± 13.4 μV, and 45.2 ± 17.5 μV) was higher than CCD (26.0 ± 11.3 μV, 22.6 ± 9.7 μV, and 24.2 ± 9.5 μV). The mean muscular activity of temporalis during clenching, cotton roll clenching, and chewing was also higher with ISOD (47.9 ± 11.2 μV, 45.6 ± 11.9 μV, and 51.0 ± 14.4 μV) than CCD (31.0 ± 12.2 μV, 29.7 ± 15.3 μV and 31.9 ± 14.2 μV). No statistically significant result was found between masseter and temporalis muscle activity on both sides (P < 0.05), indicating symmetrical activity on both the sides. Conclusion: Two-ISODs prove to be a better and efficient treatment modality in rehabilitating edentulous patients as it enhances retention and also increases masticatory muscle activity and chewing efficiency.

Aims: The study aims to find out the best possible method of cleaning the removable partial denture (RPD) by evaluating the Candida count limiting ability in RPD users using three different cleaning methods. Settings and Design: The present study is randomized controlled trial. Three groups were formed with 20 participants in each. The groups were Group 1 RPD cleansing done using sterile saline and denture brush (negative control group), Group 2 RPD cleansing done using soap and denture brush and Group 3 RPD cleansing done using denture cleansing tablet and denture brush. Materials and Methods: A baseline data and 15 days' postinsertion data of Candida count was recorded using swab collection, from the RPDs given. The swab was collected, cultured, and incubated using standard methods. Once Candida was identified using Sabouraud's dextrose agar, Candida albicans was further confirmed using germ tube test and cornmeal agar. Statistical Analysis Used: The analysis was done using SPSS software (IBM Corp. Released 2010. IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY: IBM Corp.). Paired t-test, was used to compare the number of colonies pre and postintervention. The difference between the groups was analyzed using one-way analysis of variance (ANOVA) and Tukey's post hoc analysis. Results: The comparison of baseline data and postintervention data within each group using paired t test demonstrated statistically significant values; P = 0.046 and 0.000 in Group 2 and 3 respectively. The difference between the Candida colonies in three different groups after the intervention (15 Days) was analyzed using analysis of variance and found to be statistically significant with P = 0.004. Tukey's post hoc analysis was used to analyze the difference between the groups. It was concurred that there was a statistically significant difference between all three groups, but the difference in the mean was highest between the Group 1 and 3 (1210.99). Conclusion: Within the limitations of the study, it is concluded that the use of denture cleansers and brush on a daily basis would actively reduce the number of C. albicans colony formation in RPD and thereby improve the overall health of denture wearer.

Aim: The present study was conducted to evaluate differences in Oral Health-Related Quality of Life (OHRQoL) in denture wearers based on psychological classification and patient satisfaction. Settings and Design: A prospective study. Materials and Methods: 284 patients, aged 30 years and above who fulfilled the eligibility criteria were recruited. Participants answered the OHIP – EDENT questionnaire at the time of denture insertion and 6 months later. Psychological categorization was based on MM House classification. Patient satisfaction was graded from totally satisfied to not very satisfied. Statistical Analysis Used: SPSS 23 version was used for analyzing descriptive and inferential statistics. ANOVA was used to find significant differences for OHRQoL based on psychological classification and patient satisfaction. Before and after intervention analysis was assessed using student 't' test. Results: Philosophical and exacting patients had better adaptation to dentures than the hysterical and indifferent class of denture wearers. Totally satisfied and very satisfied patients with dentures had lesser mean scores as against the other categories which was significant in all domains suggesting better. Overall, OHIP – EDENT score decreased from 20.253 ± 12.466 to 17.168 ± 14.143, which were significant at P =0.043, thus showing an improvement after a 6 month follow up. Conclusions: Psychological attitude of denture wearers must be considered by the prosthetic specialist for effective adaptation and acceptance by the edentulous patient.

Aim: The purpose of this study is to evaluate the retention effectiveness of Molloplast B as a female attachment compared to O rings' in implant supported overdentures. Settings and Design: This systematic review and meta-analysis was evaluated using the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Materials and Methods: Sixteen female part models were divided into two groups: eight female parts made with O ring (Group A) and eight female parts made with Molloplast B (Group B). All of the models were soaked in artificial saliva for 24 h, then, their retention force was measured in Newton using a Universal mechanical testing machine, initially, after 500, after 1000, and after 1500 of loading and dislodging cycles. Statistical Analysis Used: The statistical analysis was conducted by using one way ANOVA test and Bonferroni test. SPSS Software (SPSS, Version 27, IBM Co., Chicago, IL, USA). Results: After 1500 loading and dislodging cycles, Group B has the highest mean retention force (4.09), followed by Group A, which has a mean retention force of 3.73. Conclusion: Molloplast B with a 2.7 mm diameter ball attachment lost the least amount of retention force after 1500 loading and dislodging cycles.

Aim: The aim of this study was to investigate the combined effect of ceramic material, ceramic thickness, and implant abutment background to the final color of restorations. Settings and Design: This was a comparative in vitro study. Materials and Methods: Three different types of monolithic and porcelain-veneered zirconia disc-shaped specimens (Prettau Anterior, VITA YZ ST, and VITA YZ HT) were prepared in A3 shade with two different thicknesses (1 mm and 1.5 mm) (n = 10). Each zirconia material was made of 4-mm thickness as a control specimen of each monolithic zirconia type, and 4-mm thick veneering ceramic (VITA VM9 Base Dentine) was made as a control for veneered zirconia groups. Three simulated implant abutments were fabricated from titanium, white-shaded and yellow-shaded zirconia. The zirconia specimens were placed on different abutment backgrounds, and the color difference (ΔE) between experimental and control specimens was measured. Statistical Analysis Used: The three-way ANOVA and the Scheffé test were used for data analysis (α = 0.05). Results: The mean ΔE values between two thicknesses were significantly different in every background for all zirconia materials. The ΔE values of zirconia specimens on yellow zirconia were lower than those of other abutments. The clinically acceptable ΔE value (ΔE <3) was found in some monolithic zirconia specimens on white-shaded and yellow-shaded abutments, while the ΔE value is approximately 3 or less in all 1.5-mm thick porcelain-veneered zirconia groups. Conclusions: Different zirconia materials on implant abutments affected the final color of restorations. To achieve satisfactory color, the minimum thickness of zirconia restorations should be at least 1.5 mm on yellow zirconia abutment.

Aim: Evaluate the accuracy between the intraoral and extraoral scanning regarding the three dimensional (3D) deviation and distances between the implants, through 2 scanning methods. Settings and Design: An in vitro study. Materials and Methods: An edentulous mandibular model was used to install four implants and abutments, recommending 6 distances between the implants. Scans were performed using an intraoral (SI) and extraoral (SE) scanner for each studied group: Scanning with the scan bodies (SB) and device (SD) (n = 10). The files were imported into a surface evaluation program to assess 3D deviations and measure distances between implants. Statistical Analysis: Precision was assessed as the difference between files (Kruskal–Wallis test), while trueness was assessed from the difference between scans, applying the Wilcoxon and Mann–Whitney test. Results: As for the 3D deviations, SI showed accuracy, for the faces and positions of the implants in relation to the SE, in both scanning methods (P < 0.05). Regarding the capture of distances between implants, the SD scan obtained better trueness than the SB group (P < 0.05). Conclusion: We concluded that the type and scanning methods used did not influence the 3D deviations, while for distances, scanning with the device had better trueness.

Aim: The aim of the study was to compare the efficiency of three denture cleansers (Valclean, Polident and Clinsodent) in removal of turmeric stains from flexible denture base resins. Settings and Design: In vitro – comparative study. Materials and Methods: A total of 45 specimens of flexible denture base resins were fabricated and subjected to baseline colour measurements using spectrophotometer. Specimens were stained with turmeric and colour measurements of stained specimens were made. All the stained specimens were divided into three groups (n = 15) for removal of stains with three denture cleansers: Valclean, Polident, Clinsodent and colour measurements of cleansed specimens were made. The colour measurements (ΔE) values obtained were collected and statistical analysis was done. Statistical Analysis Used: One-way ANOVA (Analysis of Variance), Tukey's post hoc test. Results: One way ANOVA test revealed that the mean colour difference of three groups were statistically different with P value < 0.001. A further Tukey post hoc test revealed that the Valclean group had lesser mean scores than Polident and Clinsodent group. Conclusion: It was concluded that Valclean showed statistically significant greater stain removal efficiency than Polident followed by Clinsodent.

Midfacial defects are defined as congenital or acquired defects in the horizontal plane at the middle third of the face and communicate with intraoral maxillary defects. These defects lead to speaking difficulty, difficulty in saliva control and deglutition, mastication, and esthetics. Prosthetic rehabilitation of such defects with maxillofacial prosthesis is a challenging task. Maxillary defects with bilateral undercuts present are common. This case report explains to achieve retention by engaging the bilateral undercuts with the desired path of insertion and obtaining adequate retention of these prostheses. This clinical case report presents prosthetic rehabilitation of a mid-facial defect involving one orbit and the premaxilla region with the help of silicone orbital prostheses and magnets along with an expansion device. This dramatically improved the patient's speech, mastication, deglutition, esthetics, and self-confidence.

Unfortunate loss or absence of an ear has a far-reaching impact on an individual psyche. Auricular defects are seen commonly due to trauma, congenital abnormalities, and malignancies which result in disfigurment of the pinna. Rehabilitation of an auricular defect with a custom-made auricular prosthesis improves social acceptance and self-confidence in an individual. Auricular defects present reconstructive challenges, especially if they are bilateral. Surgical reconstruction provides effective results for defects; however, for some patients, surgical intervention is contraindicated. This case report describes an innovative technique to rehabilitate patients with auricular defects with mixed hearing loss and bilateral microtia using a multidisciplinary approach. The patient was provided with a functional auricular prosthesis. The prime purpose of the treatment rendered was to restore the lost auricular structure to the patient's satisfaction comfortably and cost-effectively. An early rehabilitation promotes physical as well as psychological healing of the patient.

Treatment of pediatric patients with partial anodontia is a challenge requiring interdisciplinary approach. Growth period, reduced vertical dimension, microdontia, and unacceptable esthetics present difficulties at various stages of prosthetic rehabilitation. Congenital absence of teeth impairs the nutritional status of the growing child and causes a psychological setback. This article describes the prosthetic management of a patient suffering from partial anodontia done over a period of 10 years. Considering the age and psychological and financial requirements of the patient, removable and fixed prostheses were fabricated at different phases of the treatment. The ultimate aim was restoration of function, improvement of esthetics, and overall psychological upliftment of the patient which was achieved by maxillary metal ceramic bridge and mandibular implant retained hybrid prosthesis.