Kamalakanth Shenoy

Ocular impressions: An overview

The making of an ocular prosthesis after enucleation of the eye or the making of a cover shell prosthesis following evisceration requires an impression of the remaining ocular tissues. An accurate impression of these tissues facilitates a close adaptation of the custom prosthesis to the tissue bed, resulting in better potential for movement. This article reviews various ocular impression techniques as proposed by various authors.

Infection control in the prosthodontic laboratory

Although a lot of importance is given to infection control in the dental clinic, it is usually overlooked in the laboratory. This article reviews the various issues of infection control in the dental, especially the prosthodontic laboratory.

Techniques for Evaluating the Fit of Removable and Fixed Prosthesis

The importance of an accurately fitting fixed prosthesis or a removable prosthesis is essential for the success of the restoration. Ill-fitting prosthesis may cause mechanical failures of the prosthesis, implant systems, or biologic complications of the surrounding tissue. There are several causes related to improper seating of the prosthesis. Some of which can be corrected and the others need to be repeated. Hence the clinician must carefully evaluate the adaptation of the prosthesis using the clinical techniques and combination of the available materials and evaluation methods to optimize the fit of prosthesis. This article reviews the various clinical methods that have been suggested for evaluating the fit of the fixed and removable prosthesis.

Occlusal Plane Location in Edentulous Patients: A Review

Occlusal plane orientation is an important factor in the construction of a complete denture. Occlusal plane could be oriented using landmarks in the mandibular arch as well as in the maxillary arch. In the mandibular arch there are few landmarks which could be used to orient the occlusal plane like the retromolar pad, corner of the lips (lower lip length) whereas the maxillary arch has a number of landmarks, of which the ala-tragal line is the most commonly used and the same being the most controversial. In the following article different landmarks and its accuracy for orientating the occlusal plane in an edentulous subject as studied by various authors has been discussed.

Short implants: A new dimension in rehabilitation of atrophic maxilla and mandible

Insufficient alveolar bone height is a common clinical situation encountered more in the posterior jaws. Advanced surgical procedures such as bone grafting, sinus lifting, and nerve repositioning are required to overcome this condition and make implant treatment possible for such patients. Prolonged healing period, increased morbidity, and longer duration of the implant treatment accompanies these procedures. Short implants are considered as a viable alternative in patients with reduced alveolar bone height to avoid more invasive surgical procedures. They simplify the implant treatment, reduce patient morbidity, shorten the duration of treatment, and make it less expensive. In the past, when machined implants were used, rehabilitation with short implants showed increased failure rate in comparison to longer implants. With the improvements in the surface topography of implants, which increase the bone implant contact, and use of adapted surgical protocols similar survival rates as that of regular implants have been reported even with short implants. Various methods to increase the functional surface area and decrease the stress on the prosthesis have greatly contributed to the increased success rate of short implants. Clinical Relevance to Interdisciplinary Dentistry Successful outcome of implant treatment depends on the coordinated efforts of various specialties Proper technique of implant placement by the surgeon and prior planning of the prosthesis by the prosthodontist is essential Maintenance and periodic evaluation of periodontal health are necessary.

Dentures in forensic identification: A simple and innovative technique

Identification is an essential requirement of any medico legal investigation because a wrong identity may pose a problem in delivering justice. The dental profession has long acknowledged the importance of placing identification marks on dentures. If we go through the literature, we would find many methods to label a denture but none till date fulfils all the requirements of American Dental Association (ADA). This article describes a radiographic technique wherein a lead foil with patient details is sandwiched between two layers of resin during the processing of the denture. Moreover the following method has proved to be simple, easy, quick, durable and cosmetically acceptable fulfilling all the requirements of ADA.

A comparative evaluation of effect on water sorption and solubility of a temporary soft denture liner material when stored either in distilled water, 5.25% sodium hypochlorite or artificial saliva: An in vitro study.

Introduction: Soft denture liners have a key role in modern removable prosthodontics since they restore health to inflamed and abused mucosa by redistribution of forces transmitted to the edentulous ridges. The most common problems encountered using soft denture liners are water sorption and solubility when in contact with saliva or storage media. These problems are associated with swelling, distortion, support of Candida albicans growth, and stresses at the liner/denture base interface that reduces the bond strength. Objective: To evaluate the water sorption and solubility of commercially available acrylic based self cure soft denture lining material (GC RELINE™ Tissue Conditioner) after immersion in three different storage media (distilled water, Shellis artificial saliva, 5.25% sodium hypochlorite disinfectant solution) at time interval of 4, 7, 11, and 15 days. Material and Methods: The study involved preparation of artificial saliva using Shellis formula. A total 45 standardized samples of the material (GC RELINE™) were prepared in disk form (15 mm in diameter and 2 mm in thickness). The study was divided into three groups with storage in Control (distilled water), Shellis artificial saliva, and 5.25% sodium hypochlorite. Samples were dried in a desiccator and weighed in the analytical balance to measure the initial weight (mg/cm2) of the disks (W1). The first groups (15 samples) were placed in 30 ml distilled water (Group A) at 37ºC, second group 30 ml of artificial saliva (Group B) and third group in 5.25% sodium hypochlorite (Group C). Disks were removed from disinfectant after 5 min and placed in 30 ml distilled water. On days 4, 7, 11, and 15, all samples were removed from their containers and reweighed to measure the weight (mg/cm2) of the disks after sorption (W2). The solubility was measured by placing the disks back in the desiccator after each sorption cycle and drying them to constant weight in the desiccator. These values were weight after desiccation (W3). Water sorption and solubility was calculated: 1. Sorption (mg/cm2) = (W2−W1)/Surface area 2. Solubility (mg/cm2) = (W1−W3)/Surface area. Statistical Analysis: Statistical Analysis was done using one way analysis of variance and the intercomparison between each group was done using Tukeys honestly significance difference (HSD) test. Results: Within the limitations of this study it was concluded that water sorption of the GC RELINE™ soft denture liner material was highest in distilled water followed by 5.25% sodium hypochlorite and least in Shellis artificial saliva at 4, 7, and 11 day interval. However, on the 15th day, the results showed maximum water sorption in 5.25% sodium hypochlorite followed by distilled water and least in artificial saliva. The results on solubility showed highest solubility of GC RELINE soft denture liner in artificial saliva followed by distilled water and least in 5.25% sodium hypochlorite at 4, 7, 11, and 15 day interval. Discussion: The least water uptake of the soft liner in artificial saliva was due to its ionic properties and supports the theory that water uptake of these materials is osmotically driven. However, the solubility was highest in artificial saliva since it is a mix of various salts and other additives, so there is a possibility of interaction with soft denture lining material.

Position of Occlusal Plane in Dentate Patients with Reference to the Ala-Tragal Line Using a Custom-Made Occlusal Plane Analyzer.

PURPOSE The purpose of this study was to determine which of the three positions on the tragus, (superior, middle, inferior) when joined with the ala of the nose for the ala-tragal line was most parallel to the natural occlusal plane in dentate patients. MATERIAL AND METHODS This study was carried out on 500 individuals, selected randomly and who agreed to participate in the study. A custom-made occlusal plane analyzer was used to check the parallelism between the ala-tragal line and the occlusal plane. The tragus was divided into three parts: superior, middle, and inferior. The instrument was placed in the participants mouth, and the posterior points on the tragus were determined. RESULTS For the 500 dentate participants in this study, the most common location of the posterior point on the tragus was the inferior part of the tragus (50.8%). The second most common location of the tragus was the middle part (24.7%), followed by the superior location (12.1%). CONCLUSION The results of this study indicated that the occlusal plane was found parallel to a line joining the ala of the nose and the inferior part of the tragus in a slight majority of the participants.

Anterior loop connector fixed partial denture: A simple solution to a complex prosthodontic dilemma

Drifting of teeth into the edentulous area may reduce the available pontic space; whereas a diastema existing before an extraction may result in excessive mesio-distal width to the pontic space. Although rarely used, loop connectors are sometimes required to address this problem of excessive mesio-distal width pontic space. The loop may be cast from sprue wax that is circular in cross section or shaped from platinum-gold-palladium (Pt-Au-Pd) alloy wire. Loop connectors offer a simple solution to the above mentioned dilemma, involving an anterior edentulous space albeit with the maintenance of the diastema. This article describes the procedure for the fabrication of a loop connector fixed partial denture to restore an excessively wide anterior edentulous space in a patient with existing spacing between all the maxillary anterior teeth.

The selective pressure maxillary impression: A review of the techniques and presentation of an alternate custom tray design

An impression in complete dentures is the first step in the fabrication of the complete denture prosthesis. Various theories have been proposed by different authors as to how to achieve an optimum impression in different ways. Among them the most accepted is selective pressure theory, which was advocated by Carl O Boucher. In the last few decades many authors have interpreted Bouchers selective pressure in various ways making it more complicated and difficult to follow. But all the authors proposed their concepts based on the available information of the underlying functional and histologic anatomy during their time. This article reviews the various ways of achieving selective pressure as seen by different authors and also includes a custom tray design to achieve selective pressure, which is based on the newer concepts of the stress bearing and relieving areas in the maxillary edentulous impression procedures.