Satheesh B Haralur

Effect of alginate chemical disinfection on bacterial count over gypsum cast

PURPOSE To evaluate the efficacy of sodium hypochlorite (1 : 10) and iodophor disinfectants on alginate impressions along with their effect on the survived bacterium count on the gypsum cast. MATERIALS AND METHODS Four alginate impression on each dentate patients were made, of which Group I were not washed or disinfected, Group II impressions were merely washed with water, Group III were disinfected by spraying with sodium hypochlorite (1 : 10), Group IV were disinfected with iodophor (1 : 213). Gypsum cast (type III) were made from all the impression. Impressions and gypsum cast were swabbed in mid palatal region for bacterial culture. Bacterial colony counting done after 3 days of incubation at 37℃ in blood agar media. The data obtained was analyzed by one way ANOVA test at a significant difference level of 0.05. RESULTS Group I and Group II showed significantly more bacteria compared to Group III and Group IV. Bacterial colonies on the alginate impression and gypsum cast in group disinfected with Sodium hypochlorite (1 : 10) were 0.18, 0.82 respectively compared to group treated with iodophor (1 : 213). There was an increase in bacterial count on dental cast compared to source alginate impressions. CONCLUSION Sodium hypochlorite (1 : 10) was found to be better disinfectant for alginate impression. There was an indication of increase in number of bacteria from alginate impression to making of dental cast. Additional gypsum cast disinfectant procedures need to be encouraged to completely eliminate cross infection to dental laboratory.

Evaluation of efficiency of manual polishing over autoglazed and overglazed porcelain and its effect on plaque accumulation.

PURPOSE The aim of this study was to evaluate the efficiency of manual polishing over autoglazed and overglazed porcelain and their effect on plaque accumulation. MATERIALS AND METHODS Thirty-six porcelain discs were fabricated out of which 18 each was subjected for autoglazing and overglazing. Half surface of the discs was left intact; the remaining half was roughened with medium grit diamond bur. Roughened surfaces were repolished by porcelain polishing kits (Shofu, DFS, Eve). All the surfaces were evaluated by the perthometer and SEM. Six discs from each sample were placed in human volunteers mouth for 72 hours to evaluate the plaque accumulation. Acquired data was subjected to ANOVA comparative evaluation. RESULTS Roughened surfaces had average roughness value of 2.88±0.1935 µm. The repolished surfaces by porcelain correction kits Shofu, DFS and Eve, average roughness value reduced to 0.6250±0.1036, 0.9192±0.0953, 0.9017±0.1305 respectively. Autoglazed and overglazed surfaces showed the mean roughness value (Ra) of 0.4217±0.0685, 0.3450±0.0729. SEM study showed the improved surfaces when subjected for polishing. Plaque accumulation percentage was the highest on roughened surface (93.83±6.2552%), followed by porcelain discs polished by commercial kits. Autoglazed surfaces found to be the best surfaces with the least plaque accumulation (0.5237±0.4209%). CONCLUSION All the polishing kits used in the study reduced the average roughness by approximately 77%. Corrected porcelain surfaces should ideally be reglazed, alternatively, polish the surfaces before final cementation.

Clinical Strategies for Complete Denture Rehabilitation in a Patient with Parkinson Disease and Reduced Neuromuscular Control

The dentist has a large role in geriatric health care for the ever increasing elder population with associated physical and neurological disorders. The Parkinson disease is progressive neurological disorder with resting tremor, bradykinesia, akinesia, and postural instability. The psychological components of disease include depression, anxiety, and cognitive deficiency. Poor oral hygiene, increased susceptibility for dental caries, and periodontal diseases predispose them to early edentulism. The number of Parkinson affected patients visiting dental clinic seeking complete denture is growing. This case report explains the steps involved in the complete denture rehabilitation of Parkinson patient. The effective prosthesis will help in alleviating functional, aesthetic, and psychological disabilities of the patient.

Use of CAD/CAM in Esthetic Restoration of Badly Decayed Tooth

Proper, intelligent use of materials and technology should be utilized for the benefit of the patient. This case report presents a patient with a badly broken premolar tooth demanding high esthetic all-ceramic restoration. Following multiple procedure tooth was restored with zirconia all ceramic restoration. Multiple procedures to save a tooth are a really worthy, in the interest of patients. Use of zirconia and CAD-CAM will help in saving many compromised tooth even in high-stress regions. This provides the patient a chance to have restorations, which are biomechanically superior in addition to being pleasing esthetically.

Influence of remaining dentin wall thickness on the fracture strength of endodontically treated tooth.

Background: Remaining dentin wall thickness may influence the fracture resistance of tooth. Aims: To investigate the effect of various coronal dentin wall widths on the fracture strength of root canal treated teeth. Materials and Methods: Fifty recently extracted single canal mandibular premolars were used for the study. Ten unrestored teeth were used as control (Group 1); remaining teeth were root canal treated and divided into four groups (n = 10). The Groups 2a, 2b and 3a, 3b were having 2.5 mm, 1.5 mm remaining dentin with and without post, respectively. The samples fracture resistance was tested under the universal testing machine. The data were analyzed with one-way ANOVA and post-hoc Tukey test for comparative evaluation. Results: The mean fracture strength observed in Group 1 was (29.75 Mpa) followed by Group 2a (28.97 Mpa), Group 2b (27.70 Mpa), Group 3a (23.39 Mpa), and Group 3b (16.38 Mpa). There was no statistically significant difference between control and Groups 2a and 2b with P > 0.05. The post contributed significantly for fracture resistance in Group 3a. Conclusion: The endodontic post is not required in root canal treated teeth >2.5 mm coronal dentin wall width while the post is essential for a tooth with <1.5 mm dentin wall width to improve fracture resistance.

Replacement of Missing Anterior Teeth in a Patient with Temporomandibular Disorder

The loss of anterior teeth leads to extreme psychological trauma, along with functional and esthetic debilitations. Healthy anterior teeth play an important role of protecting the posterior teeth during excursive mandibular movement. Loss of anterior teeth induces posterior interference with extended disocclusion time. Posterior disocclusion is critical to remove the harmful force on the teeth temporomandibular joint and eliminate muscle hypertonicity. Occlusal interference is considered as contributing factor to temporomandibular disorder (TMD) symptoms. Prosthesis design should eliminate deleterious tooth contacts. Establishing optimum anterior guidance is a key to establishing harmonious functional occlusion in addition to the correction of the esthetic and phonetic disabilities. This case report explains the steps involved in the rehabilitation of the TMD patient with loss of maxillary anterior teeth.

Maxillofacial prosthesis in a palliative care for terminally ill patient with squamous cell carcinoma

It is the god given right of every human being to appear human. – Ernest L. DaBreo. A 55-year-old man with combined surgical and radiation therapy for buccal mucosa required the prosthetic rehabilitation for full thickness facial cheek defect. Apart from the aesthetics concerns, he had several oral debilities like difficulty in speaking, eating and swallowing. Though the carcinoma is known for high rates of morbidity and mortality, it is an obligation of a prosthodontist to help the patient to have a dignified and normal social life for their remaining lifespan. Palliative dental cares main focus is to re-establish the quality of the remaining life, in addition to the alleviation of physical and psychological suffering of the far-advanced disease patients. This case report summarises the importance of maxillofacial prosthesis in a postoperative malignancy and palliative care.

The Effect of Accelerated Aging on the Colour Stability of Composite Resin Luting Cements using Different Bonding Techniques

INTRODUCTION The main criterion of successful aesthetic restoration is to match the colour of the adjacent teeth. Porcelain laminate veneer is widely practiced indirect restoration in the contemporary aesthetic dentistry. The underlying luting cement colour influences the final outcome of the thin, translucent veneer shade. Hence, colour stability of luting cement is important criteria during their selection. AIM The objective of the study was to assess the colour stability of the different dentin bonding techniques in composite resin luting cements. MATERIALS AND METHODS A total of forty intact, non carious teeth were prepared to receive Porcelain Laminate Veneers (PLV). The lithium disilicate PLV were fabricated, and fitting surface was conditioned with 5% hydrofluoric acid and silane application. According to the bonding technique employed for the cementation of the PLV, the teeth samples were randomly divided into the four groups of ten each. The Group I and Group II samples were conditioned with etch and wash; the polymerization of resin was accomplished with the dual cure for Group I and light cure for Group II. The Group III and Group IV samples were conditioned with self-etch and self-adhesive technique correspondingly. The teeth shade was recorded in similar locations with a spectrophotometer before and after subjecting them to the accelerated ageing process. The ageing process included the thermocycling process in water between 5°C and 55°C for 5000 cycles followed by 100 hours xenon light exposure. The data were analysed with SPSS 19.0 by ANOVA and LSD post-hoc comparison. RESULTS The higher mean colour change was observed in Group I sample (etch washdual cure) with a ∆E value of 2.491. The ∆E value for Group II (etch wash-light cure) and Group III (selfetch) was 1.110 and 2.357 respectively. The lowest mean colour change was observed in Group IV (self-adhesive) with ∆E at 0.614. Statistical analysis showed significant differences between Group IV and Group I; Group IV and Group III with p<0.05. CONCLUSION The self-adhesive and etch-wash light cure luting cements were found to be less susceptible for colour changes due to accelerated ageing.

Influence of Functional Clinical Temperature over Compressive Strength and Diametral Tensile Strength of Various Luting Cements.

Objective: To estimate the effect of temperature over the physical properties of commonly used luting cements. Material and Methods: The two set of cylindrical shaped cement samples measuring 12mm X 6mm and 4mm X 8mm were fabricated from non-eugenol zinc oxide, glass ionomer, zinc phosphate, Zinc polycarboxylate, resin cements. These two sets of samples were utilized to test compressive and diametral tensile strength respectively. Forty cement samples from each mold were fabricated and distributed between 14, 22, 37 and 55 0 C (N=10). The samples were tested under universal testing machine, and data subsequently analyzed using One-way ANOVA and Tukey multiple comparisons statistical methods at p > 0.05. Results: The higher temperature resulted in noticeable reduction in the compressive strength of non-eugenol -zinc oxide, Zinc-phosphate, Zinc poly carboxylate cements. The highest compressive strength was recorded for non-eugenol zinc oxide (8.08 Mpa) at 37 0 C, Zinc phosphate (91.01Mpa) at 14 0 C, and for zinc polycarboxylate (83.06 Mpa) at 37 0 C. The comparative values for respective cements at 55 0 C were 6.40Mpa, 59.80Mpa, and 52.88 Mpa. The higher temperature had insignificant effect on the compressive strength of glass ionomer cement, while composite resin cement indicated minor deterioration. Conclusion: The relative mouth temperature influences the physical properties of the luting cements.

An Anthropometric Study of Cranio-Facial Measurements and Their Correlation with Vertical Dimension of Occlusion among Saudi Arabian Subpopulations

BACKGROUND: Determining and restoring physiological vertical dimension of occlusion (VDO) is the critical step during complete mouth rehabilitation. The improper VDO compromises the aesthetics, phonetics and functional efficiency of the prosthesis. Various methods are suggested to determine the accurate VDO, including the facial measurements in the clinical situations with no pre-extraction records. The generalisation of correlation between the facial measurements to VDO is criticised due to gender dimorphism and racial differences. Hence, it is prudent to verify the hypothesis of facial proportion and correlation of lower third of the face to remaining craniofacial measurements in different ethnic groups. The objective of the study was to evaluate the correlation of craniofacial measurements and OVD in the Saudi-Arabian ethnic group. METHODOLOGY: Total of 228 participants from Saudi-Arabian Ethnic group were randomly recruited in this cross-sectional study. Fifteen craniofacial measurements were recorded with modified digital Vernier callipers, and OVD was recorded at centric occlusion. The obtained data were analysed by using the Spearman’s correlation and linear regression analysis. RESULTS: The Mean OVD in male participants was higher (69.25 ± 5.54) in comparison to female participants (57.41 ± 5.32). The craniofacial measurement of Exocanthion-right labial commissure and the Mesial wall of the right external auditory canal-orbitale lateral had a strong positive correlation with VDO. The strong correlation was recorded with a trichion-upper border of right eyebrow line and trichion-Nasion only in males. Meanwhile, the length of an auricle recorded the positive correlation in female participants. CONCLUSIONS: Being simple and non-invasive technique, craniofacial measurements and linear equations could be routinely utilised to determine VDO.