Kunwarjeet Singh

Flexible thermoplastic denture base materials for aesthetical removable partial denture framework.

Conventional fixed partial dentures, implant supported Fixed Partial Dentures (FDPs) and removable partial dentures are the most common treatment modalities for the aesthetic and functional rehabilitation of partially edentulous patients. Although implants and FDP have certain advantages over removable partial dentures, in some cases, removable partial dentures may be the only choice which is available. Removable cast partial dentures are used as definitive removable prostheses when indicated, but location of clasps may affect aesthetics. So, when patient is concerned about aesthetics, flexible partial dentures which is aesthetically superior to flipper and cast partial dentures, may be considered. But for the success of flexible removable partial denture, proper diagnosis, treatment planning and insertion technique of this prosthesis is very important, which have been thoroughly described in this article.

Palateless custom bar supported overdenture: A treatment modality to treat patient with severe gag reflex

OBJECTIVE To suggest a custom bar supported overdenture treatment modality for prosthodontic management of patients with severe gag reflex. BACKGROUND Some patients have a severe gag reflex and cannot tolerate conventional maxillary complete dentures with maximum palatal coverage and extensions of all borders. The condition further gets complicated in patients suffering from respiratory problems along with severe gag reflex. Severe gagging acts as a barrier to treat such patients with accepted clinical procedures and prevent patients from wearing the prosthesis. By saving some of the remaining natural teeth and fabricating, a horse shoe shape palateless simple tooth or bar supported overdenture can be successfully used for treating such patients. MATERIALS AND METHODS The remaining maxillary right and left canines were prepared with the tapered round end diamond bur to receive copings of custom bar after intentional root canal treatment of same teeth. Impression was made with light body and putty of the polyvinyl siloxane elastomer with double step putty wash technique. Impression was poured with die stone. Wax pattern of copings with bar was fabricated with inlay wax which was invested and casted. After retrieving the bar, it was finished and its fit was evaluated. The coping-bar assembly was finally cemented with the glass ionomer cement. Palateless overdenture was fabricated by conventional technique used for the fabrication of complete denture. CONCLUSION Palateless custom bar supported overdenture procedure can be successfully used for the management of patients with severe gag reflex with improved denture retention, stability, chewing efficiency and comfort of the patient.

Prevention of trauma to soft tissues from opposing dental implants in completely edentulous patients

OBJECTIVE To suggest a technique to prevent trauma of the edentulous ridge from opposing dental implants when prosthesis kept out during night. BACKGROUND In modern dentistry, implant-supported overdentures are commonly fabricated to minimise the problems associated particularly with mandibular conventional removable denture such as the lack of retention or stability, decreased chewing efficiency, difficulties in speech and soft tissue abrasion. The patients wearing two implant-retained overdentures that are mainly soft tissues supported-implant-retained overdentures are advised to keep prosthesis out of the oral cavity during night to allow the tissues to rest and remain healthy. Few of such patients might complaint about trauma of the opposing soft tissues by the dental implants when prosthesis is kept out. MATERIALS AND METHODS A thermoplastic resin mouthguard was fabricated by adapting the modelling wax over the abutments on the master cast from thermoplastic resin sheets. The wax was removed and guard was filled with chemically cure permanent silicone soft liner and immediately placed in the patient mouth. CONCLUSION The trauma caused by dental implants to the opposing edentulous ridge was effectively managed by soft thermoplastic resin mouthguard filled with permanent silicone soft liner.

A Conservative Treatment Approach to Replacing a Missing Anterior Tooth

An implant-supported crown or conventionally fixed partial denture is the most common treatment modality to replace a missing anterior tooth but a more conservative approach, with a fiber reinforced composite resin FPD, can be used to replace a missing anterior tooth in young patients or when the patient does not agree for an implant, or conventional FPD or RPD therapy. It is an esthetic, conservative single sitting chairside procedure which can be used as a definitive treatment alternative in certain clinical situations for esthetic and functional replacement of a missing anterior tooth. To achieve desirable results, putty matrix was used for proper positioning of the pontic during direct fabrication of FRCFPD.

Bilateral radix entomolaris with primary and permanent mandibular first molars

Dental practitioners should be aware of the morphological dental anomalies like additional roots; their location, incidence and associated unusual root canal morphology. They should also carefully interpret the intraoral radiographs so that such anomalies do not go unnoticed.

Prevention of trauma to edentulous ridge from opposing natural teeth

OBJECTIVE To suggest a technique to prevent trauma of the edentulous ridge from opposing natural or restored teeth. BACKGROUND The prevalence of the condition where one edentulous arch opposes a natural or restored dentition is quite common. In most of cases, the maxillary arch is completely edentulous and either all teeth or only anterior teeth are present in the mandibular arch. These remaining teeth may continuously cause trauma to the opposing edentulous ridge during the night when a removable prosthesis is kept out of the mouth. MATERIALS AND METHODS A thermoplastic acrylic resin mouthguard was fabricated on a cast of the remaining teeth dentition. CONCLUSION This article presents a simple and inexpensive procedure to prevent self-induced trauma of the edentulous ridge from opposing natural teeth by using a thermoplastic acrylic resin mouthguard.

An Innovative Wire Impression Technique of Highly Resorbed Mandibular Ridge

Rehabilitation of a highly resorbed mandibular ridge can be a difficult and challenging one. Making an impression with available stock trays, even after modification is difficult in case of extremely resorbed ridges. In such cases, an innovative technique of making impression with properly adapted wire and silicone putty can be used to make a proper impression to achieve maximum retention and stability. This article describes an impression technique of highly resorbed mandibular ridge using an orthodontic wire, to gain maximum retention and stability.

A Comparison of Properties of Restorative Composite Resins Cured withQuartz Tungsten Halogen (QTH) and Light Emitting Diode (LED) LightCuring Units: An Invitro Study

Purpose: The aim of the present study was to compare the different properties of restorative composite resin cured for specific period of time with conventional quartz tungsten halogen and light emitting diode light curing units. Material and methods: Sixty specimens of standard dimensions (4mm in diameter and 8mm in length) were made from transparent polyester sheets. The specimens were divided into three groups and each specimen was filled with light cure composite resin (Esthet X, Dentsply) and cured with QTH and LED light curing units for 40 seconds. The comparative evaluation of compressive strength, surface hardness and depth of cure were done with Instron machine, Vickers hardness testing machine and standardized scrapping methods described in the ISO standard for resin based composite, ISO 4049: 2000, respectively. Results: Statistical analysis of the data demonstrated a significant difference (p 0.05) in the surface hardness at the illuminated surface of the composite resin cured with QTH and LED light curing units. Conclusion: Careful selection of the light emitting diode light curing units having intensity equal or greater than conventional quartz tungsten halogen light curing units is very important to achieve desirable results, keeping in mind the certain advantages of LED as compared to QTH for the polymerization of composite resin

Tooth Implant an Alternative to Failed Implant Supported Prosthesis in aSmoker

Chronic smoking can lead to failure of Osseo integration due to decrease in local blood flow and failure of cell proliferation by by-products of smoking. This along with immediate failure of a malpositioned implant, devitalization of adjacent tooth necessitating a call for endodontic treatment or the fracture of the adjacent tooth due to malpositioned implant, fracture of the prosthesis due to incomplete seating and occlusal discrepancies have a tremendous impact on the psyche of the patient. Some of them show reluctance to functional rehabilitation with implant supported prosthesis posing a tough challenge to the restorative dentist. A good alternative in such cases would be to save some of the natural teeth and place a precision stud attachment in the canal of selected teeth, which will act like a tooth implant, providing retention and stability similar to implant supported prosthesis.

Fabrication and relining of dentures with permanent silicone soft liner: A novel way to increase retention in grossly resorbed ridge and minimize trauma of knife edge and severe undercuts ridges

The aim of this study is to suggest a technique to improve the retention of the prosthesis in grossly resorbed ridge and minimize the trauma of thin, atrophic knife edge ridge with severe undercuts. Significant numbers of patients seek treatment for edentulism throughout the world. In the current scenario, implant retained/supported prostheses have been considered a standard of care for rehabilitation of completely edentulous patients, but still this treatment modality is out of reach of many patients due to economic factor. In such patients, conventional removable complete dentures are considered for functional rehabilitation. However, in some of the patients with grossly resorbed ridges and knife edge ridges or ridges with severe undercuts, these prostheses have compromised retention and also continuously causes trauma to knife edge ridges and mucosa covering the undercuts during insertion and removal of the prosthesis thereby reducing the compliance of the patient. By incorporating, a layer of resilient permanent silicone soft liner on the tissue surface of a new or old denture is a novel way to reduce the trauma of thin and severe undercut ridges and also improve the retention of the prosthesis. This study described the successful functional rehabilitation of three completely edentulous patients with grossly resorbed, thin knife edge, and severe undercut mandibular ridges with permanent silicone soft liner. Permanent silicone soft liner act as a shock absorber, helps in equal dissipation of occlusal stresses, maintains an intimate contact with the underlying tissues and compressed during function thereby increasing retention and minimizing trauma by preventing a direct contact of hard denture base with compromised tissues.