Aditi Nanda

Correction of microstomia in an edentulous patient.

The problem of small oral aperture is big. Irrespective of the etiology, this problem may be overcome by adjunctive therapies in the form of prosthesis, surgery, or exercise. A patient is described with this problem, which was overcome by revisiting the 3 adjunctive therapies including a commissural stent designed with the patients edentulous state in mind.

Acrylic cranial implant: an alternative vector in management of cranial defect.

In a pediatric patient with cranial defect, in order to replace the missing portion of the cranium, an acrylic cranial implant was fabricated prior to the surgical procedure. The primary aim was to fabricate this cranial implant prior to the surgical procedure and with optimum fit. A customized hand-sculpted acrylic cranial implant fabricated by lost wax technique was made prior to the surgery and with adequate precision. The prefabricated cranial implant was used by neurosurgeons on the patient in order to restore the continuity of bone (by the acrylic cranioplast) over the cranial defect, improving the aesthetics and more importantly providing protection to the vital neural tissue. Though with recent advancements (like computer-aided design and manufacturing, and rapid prototyping), rapidity and precision can be achieved in the fabrication of cranial prosthesis, yet most of the apparatus may not be amenable in every setup and may not be affordable by all patients. A simple, operator-friendly technique which acquires satisfactory precision has been described for a patient much in need. Optimal postoperatory results were attained.

An electromyographic study to assess the minimal time duration for using the splint to raise the vertical dimension in patients with generalized attrition of teeth.

BACKGROUND To investigate the effect of restoration of lost vertical by centric stabilizing splint on electromyographic (EMG) activity of masseter and anterior temporalis muscles bilaterally in patients with generalized attrition of teeth. MATERIALS AND METHODS EMG activity of anterior temporalis and masseter muscle was recorded bilaterally for 10 patients whose vertical was restored with centric stabilizing splint. The recording was done at postural rest position and in maximum voluntary clenching for each subject before the start of treatment, immediately after placement of splint and at subsequent recall visits, with splint and without the splint. RESULTS The EMG activity at postural rest position (PRP) and maximum voluntary clench (MVC) decreased till 1 month for both the muscles. In the third month, an increase in muscle activity toward normalization was noted at PRP, both with and without splint. At MVC in the third month, the muscle activity without splint decreased significantly as compared to pretreatment values for anterior temporalis and masseter, while with the splint an increase was seen beyond the pretreatment values. CONCLUSION A definite response of anterior temporalis and masseter muscle was observed over a period of 3 months. This is suggestive that the reversible increase in vertical prior to irreversible intervention must be carried out for a minimum of 3 months to achieve neuromuscular deprogramming. This allows the muscle to get adapted to the new postural position and attain stability in occlusion following splint therapy.

Principles of occlusion in implant dentistry

Dental implants require different biomechanical considerations from natural teeth. Also, with one of the criteria for long-term implant success being “occlusion,” it becomes imperative for the clinician to be well versed with the different concepts when rehabilitating with an implant prosthesis. All endeavors must be made to reduce the overload and noxious forces on implants during mandibular movements. The occlusal rehabilitation schemes for implant-supported prostheses are derivatives of the occlusal scheme for natural dentition. The implant-protected occlusion (IPO) scheme has been designed to ensure the longevity of both prosthesis and implant. The article reviews the concepts of IPO and their applicability in different clinical scenarios.

Checking the cheek bite injury: fabrication of an interim cheek guard appliance.

Among the various sequelae associated with the treatment of oral carcinoma (both surgical and radiotherapy), the two conditions that can be of serious concern are reduced mouth opening and mucositis. The limited mouth opening can lead to entrapment of buccal mucosa in between teeth during the chewing cycle, which in turn can lead to further injury of the mucosa. A simple method has been described by the authors to prevent the cheek bite by fabrication of a cheek guard appliance. Favorable results were seen within a few days after insertion of the appliance.Among the various sequelae associated with the treatment of oral carcinoma (both surgical and radiotherapy), the two conditions that can be of serious concern are reduced mouth opening and mucositis. The limited mouth opening can lead to entrapment of buccal mucosa in between teeth during the chewing cycle, which in turn can lead to further injury of the mucosa. A simple method has been described by the authors to prevent the cheek bite by fabrication of a cheek guard appliance. Favorable results were seen within a few days after insertion of the appliance.

Light Is Right—Various Techniques to Fabricate Hollow Obturators

Management of malignancies and abnormal growths in maxillary sinus often include ablative surgeries. The closure of the resulting anatomical defect can be achieved with an obturator prosthesis. Reduction in weight of the obturator is an important consideration in improving the retention and stability of the prosthesis. Hollowing the bulb of the obturator (extension of the prosthesis into the defect) is an effective method of reducing the weight of the prosthesis. Such obturators can be one piece or two pieces. Of the many methods to make an obturator hollow, four techniques are described here. Along with the pros and cons of each, the method of fabrication is detailed as well. It is the discretion of the operator to apply these techniques aptly for fabrication of either an interim or a definitive prosthesis.

Prosthetic rehabilitation of resected orbit in a case of mucormycosis

The design of orbital prosthesis to rehabilitate patients with orbital exenteration depends on the underlying clinical condition, material chosen for prosthesis, method of retention of the prosthesis, and and preference of the patient. Rehabilitation of a patient with orbital exenteration due to mucormycosis has been described by fabricating a prosthesis that used polymethyl methacrylate (to fabricate a conformer) and silicone material (to fabricate prosthetic superstructure). The two-component prosthesis was designed to attain dual mechanical retention using an anatomic undercut (conformer) and manually created mechanical undercut (prosthetic superstructure). The objective was to maintain the biological health of the underlying postsurgical tissue, longevity of the prosthesis, optimal esthetics, and adequate retention.

Cameo surface recording in complete denture fabrication using transcutaneous electrical nerve stimulation: A clinical report

Severe bone loss in patients with complete edentulism poses a treatment challenge. In fabricating a denture, the stability of the prosthesis must be enhanced by recording the cameo surface within the confines of the physiological position of the cheek and tongue muscles (the neutral zone) and by shaping it accordingly. The treatment of a patient with a completely edentulous maxillary arch and severe maxillary anterior bone loss is described. The cameo surface was recorded within the physiological limits during the fabrication of a complete denture by using transcutaneous electrical nerve stimulation (TENS).

Interprofessional education: A reform plan for collaborative

Health‐care professionals come across several situations on a routine basis, wherein the lack of collaboration between different health professions is apparent. The focus of this paper is on revealing the effect of lack of interprofessional collaboration on the quality of patient care and safety of the patient. One example of the situation where interdisciplinary role can be beneficial is the association of severe advanced periodontitis and the occurrence of cardiovascular diseases. It is a possibility that poor oral hygiene and oral health neglect if altered during early stages of disease may lead to arrest of problems associated with cardiovascular problems.

Technique for adapting a spacer for a custom impression tray

A method of adapting a spacer for the custom trays used to make a definite impression for complete dentures is presented. The technique can be used under a variety of conditions and offers several advantages.