Habib Ahmed Alvi

Effect of complete dentures on craniofacial growth of an ectodermal dysplasia patient: a clinical report.

The aim of this clinical report was to observe the effect of complete dentures on craniofacial growth and development of an ectodermal dysplasia (ED) patient. A complete anodontia patient diagnosed with ED was successfully rehabilitated with conventional complete dentures at the ages of 5, 8, and 10 years. Three sets of complete dentures were made with age-appropriate denture teeth and a bilaterally balanced lingualized occlusal scheme. Periodic follow-up and adjustment when needed was done to maintain proper oral function and esthetics. Serial cephalometric analysis exhibited a marked restriction of forward growth at the anterior nasal spine (ANS) point between 5 and 10 years of age, although there was little change from average in the anteroposterior length of the mandibular body and the height of the mandibular ramus. So, while maxillary growth was reduced, mandibular growth did not significantly change. Cast analysis showed that the increase in arch length was greater than in arch width for both the maxilla and mandible. There was little increase in alveolar ridge height in the anterior region but a considerable increase in the height of the alveolar ridge in the middle and the posterior region. Our findings concluded that the absence of teeth did not affect the growth of the jaws, and it is probable that the denture flange did not arrest the jaw growth, but rather improved the masticatory function by providing good denture stability and retention.

A Simplified Approach for Placing the Iris Disc on a Custom Made Ocular Prosthesis: Report of Four Cases

This case report describes a series of four cases of different age group, in which a simplified approach was applied for positioning the iris disc on a custom made ocular prosthesis. For each of the patient, a pre-fabricated eye was selected; whose iris and pupil closely matched that of the natural eye. This was duplicated for use as a tray in impression procedure. Iris portion of the stock eye was trimmed out and oriented on the cast according to previously transferred pupillary mark. This stock eye-wax pattern combination was tested in the eye socket, modified accordingly and finally cured in transparent heat cured acrylic resin. The technique to fabricate ocular prosthesis in present case reports modifies pre-fabricated eye prosthesis to a custom-made fit and aesthetics. This helped us to overcome the disadvantages of poor fit, inadequate movement and complex painting procedure and technique involved in making a custom-made ocular prosthesis. It can be concluded that close adaptation of the custom-made ocular prosthesis to the tissue bed provides maximum comfort and restores full physiologic function to the accessory organs of the eye.

Call for detection of osteoporosis in India-can a dentist help?

Sir, Apropos the editorial recently published on call for action for osteoporosis in India.[1] Varthakavi et al. have rightly mentioned that we are lagging far behind in terms of diagnosis of osteoporosis; reasons being limited access and availability of dual energy X‐ray absorptiometry (DXA) machines and increased cost of DXA scan. Since osteoporosis is preventable, diagnostic techniques are of major importance.[2] Osteoporosis is characterized as a significant age‐related deficiency in bone mass with a potential for structural failure, affects a large portion of the elderly population. Besides the persisting systemic bone loss, oral manifestations such as alveolar ridge resorption, tooth loss, periodontal disease and oral bone loss could also be associated.[3] This letter proposes that dentist can play a role of importance in cost‐effective and accessible screening of osteoporosis.

Removable partial denture with molar uprighting spring: an innovative hybrid appliance.

PATIENT A 45-year-old female patient with need of fixed replacement of her missing teeth which were lost long time before. Posterior teeth were severally tipped bilaterally in the edentulous space. Hybrid removable partial denture with molar uprighting spring was fabricated for molar uprighting on both side tilted molars. After 3 month and 15 days of treatment with hybrid appliance the molar abutment were uprighted for fabrication of fixed partial dentures. DISCUSSION The objective in molar uprighting is ideal positioning of the molar which will eventually become an abutment tooth for a fixed prosthesis. The ideal position will provide an optimal periodontal environment for the molar. The prosthodontic advantages of molar uprighting via distal tipping include an improved line-of-draw if a FPD is being constructed. Concept of designing of appliances was based on our basic knowledge of forces for uprighting the tooth along with maintaining the function during the treatment period. Another advantage of this appliance was that it prevented supra eruption of opposing teeth during the period when the molar was being uprighted. CONCLUSION Uprighting of tilted molar is extremely beneficial for long term success of fixed denture prosthesis by using hybrid appliances in very short period of treatment without hampering the function of the patient during the treatment period which is very economical as well.

Crestal Bone Loss under Delayed Loading of Full Thickness Versus Flapless Surgically Placed Dental Implants in Controlled Type 2 Diabetic Patients: A Parallel Group Randomized Clinical Trial

PURPOSE To compare crestal bone loss around dental implants using a delayed loading protocol. Bone loss was compared in patients following conventional full thickness flap and flapless surgery in controlled type 2 diabetic patients. MATERIALS AND METHODS Eighty-eight type 2 diabetic patients satisfying predetermined inclusion and exclusion criteria were selected for this single center, parallel group study after obtaining institutional review board approval and informed consent. These patients were randomly divided into two groups. Group I consisted of patients undergoing full thickness flap surgery for implant placement, and group II consisted of patients undergoing flapless surgery for implant placement. The mean age, duration of diabetes, glycosylated hemoglobin levels, and male-to-female ratio in both groups were matched and compared statistically. Dental implants were placed followed by delayed loading (4 months) in both groups. Crestal bone loss was assessed with intraoral periapical radiographs with the help of computer software (DBSWIN viewer). Actual implant length acted as the radiographic index, and implant-abutment junctions were used as a reference point for all measurements. Mesial and distal bone levels at baseline, 6, and 12 months post implant placement of the two groups were determined. Mesial and distal crestal bone loss from baseline to 6 and 12 months were calculated and compared with Tukey test using SPSS v15.0 statistical analysis software. RESULTS Tukey test revealed similar (not statistically different) mean mesial crestal bone loss between the two groups after 6 months (0.47 ± 0.08 mm vs. 0.36 ± 0.13 mm, p = 0.576) and after 12 months (1.56 ± 0.25 mm vs. 1.50 ± 0.22 mm, p = 0.891). The mean distal bone loss resulting between the two groups was not statistically different at 6 months (0.44 ± 0.08 mm vs. 0.35 ± 0.12 mm, p = 0.687) and at 12 months (1.57 ± 0.23 mm vs. 1.61 ± 0.22 mm, p = 0.947). CONCLUSIONS The results of this clinical randomized control trial indicated that in controlled type 2 diabetic patients, levels of crestal bone loss around dental implants placed following conventional full thickness flap surgery was comparable to crestal bone loss around dental implants placed with the flapless surgical technique. More clinical studies are required regarding controlled type 2 diabetics with larger sample sizes, for long time periods to obtain more predictable results.

Management of mandibular deviation after mandibulectomy by simplified approach

Unfavourable sequelae from mandibular surgeries include malocclusion and temporomandibular joint dysfunction. The management of the situation before these complications arise is largely based on experience. This report presents a case where mandibular deviation is decreased through an additional row of teeth in the maxillary removable partial denture, and by decreasing scar contracture in the surgical site by means of a simple exercise.

Novel registration technique to register neutral zone

INTRODUCTION The three dimensional volume of complete dentures optimally occupies an edentulous space that is substantial, in the light of the progressive changes that accompany edentulism and functional dynamics. The paper discusses current knowledge of neutral zone registration and presents a novel technique for this registration. MATERIAL AND METHODS Fabricate maxillary and mandibular occlusal rims over conventional record bases using high fusing impression compound. Register the maxillary and mandibular neutral zone separately by swallowing method and after try in of complete denture; remove the wax apical to the tooth surfaces and recording will be completed with putty and light body impression material. RESULTS Complete dentures are a biomechanical device that must be designed in harmony with normal neuromuscular function to get stability and proper function. Improper teeth positioning and polished surface contour will result in compromised stability of denture. CONCLUSIONS This article describes a preview of facio-lingual positioning of denture teeth along with a novel approach of recording the neutral zone with an elastomeric impression material.

Fabrication of custom made eye prosthesis for anophthalmic paediatric patients: 2 case reports

The loss of an eye is an emotional and psychological setback to the patient. After enucleation, evisceration or exenteration of the eye, the goal is to replace the missing tissues with an artificial prosthesis and restore the facial symmetry and normal appearance of the anophthalmic patient. In case of pediatric patients, the team approach of the ophthalmologist, the maxillofacial prosthodontist and pedodontist are required to rehabilitate the ocular defect, that improves not only the patients comfort and cosmesis as well as maintain the near symmetrical bony orbital wall and eyelid development. This article illustrates two different cases of pediatric patients where the eye was surgically removed and ocular prosthesis was fabricated. Clinical Relevance to Interdisciplinary Dentistry A few case reports are mentioned in literature for prosthetic rehabilitation of anophthalmic pediatric patients. The presented case reports stressed the use of custom made eye prosthesis than prefabricated one for pediatric patients. As patient grows, the size of eye socket changes, hence periodic enlargement of the prosthesis is necessary for a growing child to aid in the normal development of the lids and the soft tissue lining the orbital bone. The custom made prosthesis can be adjusted whether needed at recall visits. The presented technique is simple and less time consuming. This technique is least depended upon artistic ability of dentist.

A multidisciplinary approach for ocular rehabilitation following ophthalmomalacia in a paediatric patient

The traumatic loss of an eye is not just the loss of an essential sense organ. It results in life-long agony of not being like others with two eyes, which can see and admire the nature’s beauty. As young patients are quite sensitive to peer pressure and for them, the greatest challenges are in the terms of identity and social acceptance, so, early rehabilitation is must in such patients. This article reports on the rehabilitation of a 13-year boy with custom ocular prosthesis for his traumatically injured left eye. The custom made ocular prosthesis fitted over the patient’s left eye with ophthalmomalacia, successfully restored the patient’s aesthetics and improved his social acceptance thereby, improving his quality of life.