Varun Baslas

Oral appliances: A successful treatment modality for obstructive sleep apnea category

Sir, I have read two articles published in your esteemed journal (obstructive sleep apnea [OSA] and metabolic disorders. 2006;8:51‐52 and OSA: Diagnosis and Treatment in an Endocrine Clinic. 2006;8:53‐55) with great interest. Both of them are very informative and provide immense knowledge about OSA. It is very true that OSA has implications beyond disturbed sleep and yet this disorder remains undiagnosed in a substantial portion of the population especially in developing countries like India. Sir, I would like to bring to your kind notice that although continuous positive airway pressure (CPAP) remains to the gold standard treatment modality for OSA, oral appliances are now gaining popularity.

Lock and key cast metallic sectional denture: a revised approach for oral rehabilitation of a patient with microstomia

Microstomia is a common occurrence in clinical practice that may hinder the conventional prosthetic treatment of edentulous patients. Oral augmentation exercises to increase the vertical opening and sectional or collapsible dentures have been described in the past, which have their own drawbacks and limitations. The present article highlights a new approach for rehabilitation of a patient with microstomia with cast lock and key attachments leading to greater ease for both the patient and the clinician. The chief advantage of this technique is the simple fabrication procedure and the reduction in the denture base thickness, providing a larger intraoral space and thus better comfort to the patient, overcoming the shortcomings of previously described sectional denture bases.

A Pilot Study to Determine the Effect of Three Months of Oral Appliance Therapy using a Mandibular Advancement Device on HbA1c in Subjects with Type 2 Diabetes Mellitus and Obstructive Sleep Apnea: OSA with Type II Diabetes Mellitus

PURPOSE Continuous positive air pressure (CPAP) is recommended for obstructive sleep apnea (OSA) with type 2 diabetes mellitus (T2DM) but cost and compliance are major barriers. A mandibular advancement device (MAD) may be an economical, feasible alternative to CPAP. Various studies have been published to recommend MAD as an alternative to CPAP for OSA, but not regarding its efficacy for patients having OSA as well as T2DM. This study aims to objectively and subjectively evaluate oral appliance therapy using a MAD in patients having OSA as well as T2DM. MATERIALS AND METHODS Patients who visited the hospital clinic having OSA as well as T2DM were recruited. After giving informed consent, participants were divided into three equally sized groups of three grades of OSA (mild, moderate, severe) on the basis of a polysomnography report and were given intervention of MAD at 50% of maximum mandibular protrusion and 20% of maximum interincisal opening. Objective outcomes were HbA1c level and apnea hypopnea index score (AHI). Subjective outcomes were Epworth Sleepiness Scale (ESS) and the Berlin Questionnaire. All outcomes were assessed before and after 3 months of intervention. RESULTS A statistically significant difference was seen in all outcomes after intervention with MAD (p < 0.01) in all groups except HbA1c level in participants having severe OSA. CONCLUSION MAD may be recommended in patients having OSA as well as T2DM. This study provides evidence to inform health care workers about possible use of MAD in OSA with T2DM.

Use of natural anterior maxillary teeth in immediate removable partial denture: An old technique revisited

Maxillary anterior teeth play an important role in esthetics, speech, smile, and self-esteem of an individual. Although a clinician can restore missing teeth with artificial teeth, the importance of natural teeth in patients overall personality cannot be ignored. The present article elucidates a technique for fabrication of immediate removable partial denture prosthesis using natural teeth to enhance esthetics and confidence of the patient.

A revised technique for fabrication of hollow mandibular denture: A solution to severely resorbed residual ridge

Purpose: Prosthodontic rehabilitation of elderly patients with severely resorbed ridges is difficult due to compromised ridge height, increased inter-arch distance and altered insertion of associated jaw muscles. Planning dentures in such cases often require dentures that are lightweight to reduce the risk of further ridge resorption, which could otherwise complicate the situation. The purpose of the present technique is to fabricate a light weight lower denture by a revision of previously described technique in the literature. Materials and Methods: This article elucidates a simple technique for the fabrication of lightweight denture (hollow denture) in elderly patients with severely resorbed mandibular ridge. The minimum thickness of denture base acrylic resin for structural durability is ensured by a wax shim of 2 mm. The adequate hollow space indenture for optimal weight reduction is created by condensation silicone impression material. Conclusion: Condensation silicone putty material can be successfully used as a spacer for hollow dentures to combat severe ridge resorption.

Basic principles of rehabilitation for lost eye: A dentist's perspectives

Various maxillofacial prostheses are made from materials used in dentistry. The treatment of the patient who loses one or both eyes is a challenging task for the clinician. A multidisciplinary approach is required to fulfill the needs and expectations of an anophthalmic patient. Dentists are now playing a major role in this regard as they are more familiar with the materials used for artificial eyes. Ocular prosthesis is an artifi cial replacement of the eye. The article describes the overall management and treatment of an anophthalmic patient, followed by a procedure for an easy fabrication of a custom-fi tocular prosthesis.

A technique for using short term soft liners as complete dentures final impression material

Tissue conditioners can be used to condition abused tissues, record functional impressions, make temporary relining for surgical splints and obturators, and for other clinical applications, mainly because of their specific viscoelasticity. Their function in complete denture fabrication is debatable but their use as a functional impression material has been proved. The present article describes a technique for using tissue conditioners as functional impression materials. Correct method of usage, manipulation, specific properties as impression materials and precautions in different situations for obtaining accurate impressions has been highlightened.

Obstructive Sleep Apnea: Coexistence with Thyroid Dysfunction and Diabetes Mellitus

Chief Editor Dr. Ashok Vaidya and . Printed and published by Medknow Publications and Media Pvt. Ltd. on behalf of All India Association of Advancing Research In Obesity, and printed at Nikeda Art Prints Pvt. Ltd, Bhandup, Mumbai and published at B5-12, Kanara Business Centre, Ghatkopar, Mumbai, India.Co-chief Editor Dr. Ramen GoelEditorial OfficeC/o Dr Ashok Vaidya and Dr Rama Vaidya, 102,Vasudha Clinic, Madhuvan C.H.S., Saraswati Road, Santacruz (W), Mumbai 400054, India. E-mail: editor.jomr@gmail.com

A multidisciplinary approach for rehabilitation following ocular trauma

Ocular trauma is a very common incidence that occurs in up to 67% of patients with maxillofacial trauma. It results in life-long agony of not being like others with two eyes, which can see and admire the nature’s beauty. This article reports on a case of a 23-year-old male patient with phthisis bulbi, resulting from ocular trauma. The patient was rehabilitated aesthetically by fabrication of custom-made ocular prosthesis for his traumatically injured right eye. The patient was pleased with the aesthetic outcome, comfort, and mobility offered by the custom ocular prosthesis. There were no complications with regard to health of underlying residual ocular tissues and there was no need of relining of the prosthesis at 6 month recall appointment. Rehabilitation of patients with ocular trauma requires a multidisciplinary approach involving ophthalmologist, psychologist, and skilled maxillofacial prosthodontist. Custom-made ocular prosthesis fitted over the phthisical globe seems to be a highly positive, logical, noninvasive, and beneficial approach to increase mobility to the prosthesis, improve the cosmetic appearance and psychological well-being of the patient.

A multidisciplinary approach for ocular rehabilitation following surgical treatment of retinoblastoma: One year follow-up

Retinoblastoma is a highly malignant neoplasm. Most of the cases are usually advanced at the time of detection, requiring enucleation to salvage the childs life. Just treating the patient for cancer is not enough; the cosmetic rehabilitation of these patients is equally important and it should always be an integral part of their treatment, to help them re-integrate in the aesthetic conscious society. Rehabilitating such patients require a multidisciplinary approach involving the combined and timely efforts of an ophthalmologist, paediatric oncologist and a skilled maxillofacial prosthodontist. This paper presents a case of 3½-year-old girl who had enucleation of her right eye due to retinoblastoma along with chemotherapy and radiotherapy at the age of 3 years. The patient was recalled regularly for follow-up at 3 month intervals for ophthalmic examinations and she was rehabilitated cosmetically with customised ocular prosthesis during the various stages of her developmental growth.