Aim: The aim of this review was to evaluate the survival rate of axial and tilted implants in rehabilitation of edentulous jaws using all on four concept. Setting and Design: Systematic Review. Materials and Methods: A literature review was performed in MEDLINE, PubMed Central (PMC), Google scholar, Embase, Cochrane Central Register of Controlled Trials. Hand searches were conducted of the bibliographic of related journals and systematic reviews. A total of 380 articles were obtained from the intial screening process. Of these articles, 25 articles fulfilled the inclusion criteria. The authors performed evaluation of articles independently as well as data extraction and quality assessment. Statistical Analysis Used: Qualitative analysis. Results: The major prosthetic complication was the fracture of the acrylic prosthesis. The mean cumulative survival rate of implants (72-132 months) were 94% to 98%. The prosthesis survival rate (12 months) was between 99% to 100%. The averaged bone loss was 1.3 ±0.4 mm (12-60 months). No Significant difference was found between survival rates of axial and tilted implants nor between maxilla and mandible. Conclusion: All on four concept can be employed successfully in the edentulous patients with resorbed ridges while improving their quality of life and reducing morbidity. However,randomized clinical trials with large sampling size and long term follow up should be incorporated.

Aim: Recording the maxillomandibular relationship is important in various prosthodontic treatments. Evidence of face-bow transfer resulting in improved outcome is conflicting. Hence the objective of this study is to determine the use of face-bow transfer in prosthodontics. Settings and Design: Systematic review based on PRISMA guidelines. Materials and Methods: A protocol was developed prior, which covered all aspects of the review. The databases explored were MEDLINE database, ScienceDirect, and Cochrane collaboration library. The PICO model included participants who received a complete denture/partial denture prosthesis. Intervention was the use of the face-bow device. Comparator was prosthesis made with a simple procedure of not using a face-bow device for prosthodontic rehabilitation. Outcomes were patient satisfaction with dentures, the stability of the dentures, esthetics, and time taken for clinical and laboratory procedures. Only randomized clinical trials were included in this study. The methodological quality of the studies was assessed according to the Cochrane risk of bias tool. Statistical Analysis Used: Qualitative analysis. Results: A total of 144 articles were identified. On excluding 4 duplicates and screening the title and abstracts of the rest of the records based on exclusion criteria only 15 studies were selected for review. Conclusions: The use of the face-bow did not yield superior results for the quality of the prosthesis. Therefore, there is no evidence for the utility of face-bow transfer in complete denture treatment. However, no inference could be drawn for its utility in partial denture prosthodontics as there was no study to draw an inference.

Aim: To systematically review the available literature on full mouth rehabilitation of the worn out dentition to help the clinician to choose a suitable philosophy to treat an individual Turner and Missirlian classification. Settings and Design: Systematic review following PRISMA guidelines. Materials and Methods: The electronic search engine explored for relevant published studies from the earliest available date, from January 1960 till October 2018. Search terms included were “full mouth rehabilitation OR occlusion OR philosophies of full mouth rehabilitation OR oral rehabilitation OR Pankey Mann Schuyler philosophy OR Hobo Twin stage OR Hobo Twin Table OR worn out dentition OR Turner and Missirlian classification”. All collected studies were analyzed and a total of 54 articles and 2 hand searches were extracted, among which 32 articles were selected for the systematic review. Of these 32 articles, 8 were original research studies, 23 case reports and 1 study which comprised 3 case reports were incorporated. Hence, a total of 26 case reports were considered for this systematic review based on CAse REport guidelines. Statistical Analysis Used: Qualitative analyisis. Results: Among 26 case reports, 15 cases (57.69%) were treated by Pankey Mann Schuyler philosophy, 2 cases (7.69%) by Hobo twin table and 9 cases (34.61%) by Hobo twin stage philosophy. 21 out of 26 cases were introduced for category no. 1 (80.76%) and 4 cases for category no. 2 (15.38%) and only 1case presented for category no.3 (3.84%) of Turner and Missirlian classification. Conclusion: No philosophies are universally applicable. Although the most commonly used philosophy is Pankey Mann Schuyler. Hobo Twin stage philosophy is the second most commonly used followed by Hobo Twin table. Maximum patients with worn out dentition are grouped under category no.1 of Turner and Missirlian classification system. Maximum cases of this category are treated by Pankey Mann Schuyler's philosophy.

Aim: The purpose of systematic review and meta-analysis was to compare the efficacy of short implant versus conventional long implant with sinus graft in patients rehabilitated for posterior atrophic maxilla. Setting and Design: Systematic review and meta analysis. Materials and Methods: Electronic searches were conducted in Pub Med, Embase, and Medline with supplemented by manual search up to December 2019. The randomized controlled trial (RCTs) comparing short implant (<8.5 mm) and long implant (>8.5 mm) with sinus graft were included. (Prospero CRD42020186972). Statistical Analysis Used: Random-effect model, fixed-effect model, A funnel plot and the Egger's test. Results: Twenty-two Randomized controlled trials (RCTs) were assessed with 667 patients and 1595 implants (short implant:767, Long implant:835). No significant difference of implant survival rate was recorded for short and long implant (at patient level: RR: 1.01, 95% CI = 0.52-2.0, P = 0.87, I² = 0%, at implant level RR = 1.09, 95% CI = 0.6-2.0, P = 0.7, I² = 0%). Similarly marginal bone resorption was reported no difference for short and long implant (MD = 0.16. 95% CI: -0.23 = -0.08, P = 0.00, I2 = 74.83%). Biological complications were marginally higher for long implant (RR = 0.48, 95% CI = 0.23-0.8, P = 0.13, I² = 29.11%). and prosthetic complications were marginally higher for short implants (RR=1.56, 95% CI=0.85-3.15, P = 0.43, I² = 0%). Conclusion: There was no significance difference in implant survival rate and marginal bone resorption recorded for both the short implant and long implant with sinus graft, in the patients rehabilitated with posterior atrophic maxilla. Hence, short implant is a suitable alternative to long implant with sinus graft, for the rehabilitation posterior atrophic maxilla.

Aim: To compare the rise in temperature using trephines over conventional ones during bone site preparation. Setting and Design: An-vitro, evaluative study Materials and Methods: Twenty implant sites were prepared using pilot drill up to depth of 10 mm on bovine femoral bone. In first part, no irrigation was used. Five sites were prepared using conventional drill of 2.8 mm, and other five were prepared with help of trephine drills. On completion of each drill, infrared thermometer was used to measure temperature on both the drill tip and the shaft. The same procedure was repeated with bone immersed in saline. Statistical Analysis Used: Student t test was used to evaluate the significance of difference. Result: Study showed that the temperature rise at drill tip was significantly higher for trephine drill (52.98 ± 1.67 °C) than conventional drills (48.20 ± 0.67 °C), however the temperature difference in trephine and conventional drills was statistically insignificant. Conclusion: The temperature increase was more distributed in conventional drills than trephine. Copious irrigation is thus mandatory for trephine drills. Intermittent drilling is preferred with conventional drills.

Aim: The objective is to evaluate the effect of shades of monolithic zirconia on the microhardness and sorption/solubility of the underlying two dual-cured resin types of cement. Materials and Methods: Eighty samples of two dual-cured resin cement discs were polymerized under 60 monolithic zirconia discs in three shades and directly activated resin discs of cement were used as the control group (n = 10). After 24 h storage at 37°C in an incubator, Vickers microhardness and the sorption and solubility were measured. Statistical Analysis Used: Two-way ANOVA , one-way ANOVA, Independent t-test, Tukey's honestly significant difference, and Tamhane's T2 tests. Results: The mean microhardness of the Variolink N resin cements were significantly higher than Panavia SA ones (P < 0.001). Furthermore, Variolink N cements exhibited lower sorption/solubility than Panavia SA resin cements (both P < 0.05). The ceramic shade had a significant influence on the microhardness of both cements (P < 0.001) but had no significant effect on the sorption/solubility of resin cements (P > 0.05). Conclusion: Interposition of monolithic zirconia decreases the microhardness of resin cement especially Panavia SA. In Variolink N, by increasing the chroma saturation of ceramics, the microhardness decreased, however in Panavia SA, it was altered by the shades, but not in a specific pattern. For both cements, there were no statistical differences between the sorption/solubility of samples photo-cured under different shades. There was a reverse correlation between microhardness and water sorption/solubility of both cements.

Aim: To evaluate the microleakage of metallic copings luted with three different commercially available luting cements. Setting and Design: Comparative evaluation in vitro study. Materials and Methods: Thirty replicas of abutment analog were milled and divided into 3 groups. Nickel chromium copings were fabricated; marginal gap was evaluated with optical microscope and luted with Zinc Oxide Non Eugenol cement, Zinc Polycarboxylate cement and Zinc Phosphate cement. After Thermocycling, cemented specimens were placed into 0.5% aqueous solution of basic fuchsin solution for 24 hours for dye penetration. Copings were longitudinally sectioned and microleakage scores were evaluated. Statistical Analysis Used: Kruskal-Wallis analysis of variance (ANOVA) followed by Chi-Square test. Pairwise comparison of groups with Mann Whitney U test. Result: Mean microleakage score was least for Zinc Phosphate cement (1.075 ± 0.85) followed by Zinc Polycarboxylate cement (1.80± 0.23) and most for Zinc Oxide Non Eugenol (2.1± 0.37). The results of the study were statistically significant, P < 0.05. Conclusions: Within the limitations of the study, it was found that all cements exhibited certain amount of microleakage. Zinc Phosphate cement exhibited a mean microleakage score that was significantly lower than Zinc Oxide Non Eugenol cement and Zinc Polycarboxylate cement. When microleakage scores of Zinc Oxide Non Eugenol cement and Zinc Polycarboxylate cement were compared, the difference was found to be insignificant indicating that microleakage in these cements is similar.

Aim: To evaluate anxiety in patients undergoing complete denture treatment. Settings and Design: The most overlooked factor during complete denture treatment is the patient's anxiety regarding the treatment. The awareness amongst dentists regarding such anxiety and its effects on the complete denture treatment is important to form a proper communication channel through which measures to ease this anxiety can be formulated and implemented. Materials and Methods: A valid pre-structured questionnaire of 10 questions was presented to the patients desirous of receiving complete dentures after obtaining an informed consent. The questionnaire for the survey was filled and collected from 500 patients receiving complete denture treatment. Statistical Analysis Used: Descriptive statistics. Results: Reasons inducing anxiety included: materials used – 359 (71.8%), sight of instruments – 71 (14.2%), dental chair – 66 (13.2%), airotor – 4 (0.8%), denture breakage – 225 (45.0%), ill-fitting prostheses – 153 (30.6%), repeated removal and insertion of dentures 104 (20.8%), swallowing the denture 19 (3.8%). Factors aggravating anxiety included: gagging while impression making – 298 (59.6%), mouth fullness – 122 (24.4%), swallowing the impression material – 61 (12.2%), breathlessness – 20 (4%). 422 (84.4%) patients indicated comfort with the procedure being explained beforehand, 429 (85.8%) patients indicating more so in a language understood by them. Conclusion: There is a greater need that the patient's expectations be understood and their doubts, concerns and fears be lessened by proper communication. Proper understanding of patient's mental attitude will help us improve the approach of dentists towards complete denture treatment in a more patient friendly way.

Aims: The study compared changes in implant stability and bone loss of implants with different designs using early loading at 6 weeks. Setting and Design: In vivo-comparative study. Materials and Methods: Forty subjects were selected and divided randomly by sealed envelope method in Group X and Group A for early loading for missing single posterior tooth in mandible. Implants in Group X had flared crest module and buttress thread design, whereas implants in Group A had parallel crest module and V-shaped thread design. All subjects were evaluated by Ostell for implant stability at the interval of baseline, 6 weeks, 3 months, and 6 months. ImageJ software was used for measurement of crestal bone loss in intraoral periapical radiographs at the interval of 6 weeks, 3 months, and 6 months. Statistical Analysis Used: Unpaired t test, repeated ANOVA, Tukey post hoc test. Results: The mean bone loss values of Group X at predetermined interval were 1.51 ± 0.20 mm, 2.11 ± 0.21 mm and 2.13 ± 0.21 mm. The mean bone loss values of Group A were 1.79 ± 0.16 mm, 2.92 ± 0.23 mm and 2.95 ± 0.23 mm. The mean bone loss was statistical significant (P < 0.05) at 6 weeks, 3 months and 6 months. It was highly significant in Group A at 6 months (P < 0.001). Conclusions: It was concluded that Group X implants design showed better implant stability and less bone loss when compared to Group A implants design.

Aim: The purpose was to evaluate the morphological variations of the condyle in patients presenting with myalgia associated with and without clicking of temporomandibular joint (TMJ) and its possible effect on the contour and height. Setting and Design: Cross sectional study. Material and Methods: A total of 60 patients comprising of 20 patients with myalgia, 20 patients with myalgia associated with clicking of TMJ, and a control group of 20 patients without any signs and symptoms of temporomandibular disorder were selected for purpose of the study. Using a digital panoramic radiograph, the contour of the condyle was evaluated for shape, condylar height (CH), and condylar asymmetry. Statistical Analyses Used: Chi-square test, One- way ANOVA. Results: Rounded contour of the condyle was the most prevalent shape of the condyle amongst the three groups. There was a significant decrease in mean right and left CH in subjects with myalgia (0.71 cm and 0.73 cm) and subjects with myalgia associated with clicking (0.65 cm and 0.62 cm) compared to control group subjects. There was also an increase in the mean asymmetry index in subjects with myalgia presenting with clicking (2.362 ± 1.4) and without clicking (1.388 ± 2.1) (P < 0.05). Conclusion: Within the limitations of the current study, round contour of the condyle is the most common variant. Subjects with myalgia showed a significant reduction in condyle height. Condyle contour, height, and asymmetry may not predispose the joint for clicking.

Aim: The aim of the study was to evaluate the effect of dentist's communication skills and patient's psychological factors in predicting denture satisfaction and quality of life. Settings and Design: Cohort study. Materials and Methods: Patient-related variables were obtained using questionnaires in both pre- and post-intervention phases. In addition to this, in preintervention phase, lacunae in doctor–patient communication were obtained. Based on this, the postgraduates were trained in relevant communication skills required during complete denture treatment. In postintervention phase, the postgraduates were again followed up for continuation or decay of skills. Statistical Analysis: Mixed-mode approach - quantitative and qualitative analysis. Results: Both groups were similar in psychological parameters, personality domains, denture quality and quality of life at baseline. However, there was significant difference in denture satisfaction (P < 0.001) in both the groups. In the experimental group, denture satisfaction was more (80.4%) and quality of life had improved from baseline to 3 months (P = 0.000). Denture satisfaction was associated with self-efficacy (P = 0.002) and the communication skills of the dentist (P = 0.000). Quality of life was associated with the conscientiousness domain of personality (P = 0.049) and the communication skills of the dentist (P < 0.05). Conclusion: Satisfaction and quality of life with dentures were associated with self-efficacy, conscientiousness domain and the communication skills of the dentist. Denture satisfaction can be predicted by dentist communication skills. Therefore, training in communication skills for complete denture patient management and assessment of the psychological profile of the patient could contribute to the effective patient-centered practice to avoid patient dissatisfaction.

Aim: The purpose of the study was to evaluate the frictional resistance and the vertical force required to achieve the frictional resistance for different length and designs of extracoronal attachments used in fixed partial denture (FPD). Setting and Design: Finite element analysis. Materials and Methods: Four different designs and five different lengths (3 mm, 3.5 mm, 4 mm, 4.5 mm, and 5 mm) of extracoronal attachments for FPD were selected from different manufacturers. Three-dimensional models of all the samples were simulated using Catia V5 software. The properties were incorporated to the software to simulate the clinical conditions. The frictional resistance and the vertical force required to achieve frictional resistance were analyzed using ANSYS workbench 15.0 finite element software. Statistical Analysis Used: ANOVA and Tukey's post hoc test. Results: The mean microhardness of the Variolink N resin cements were significantly higher than Panavia SA ones (P < 0.001). Variolink N cements exhibited lower sorption/solubility than Panavia SA resin cements (P < 0.05). The ceramic shade had a significant influence on the microhardness of both cements (P < 0.001) but had no significant effect on the sorption/solubility of resin cements (P > 0.05). Conclusion: Interposition of monolithic zirconia decreases the microhardness of resin cement especially Panavia SA. The microhardness decreased in Variolink N with the increase in the chroma saturation of ceramics. However, in Panavia SA, it was altered by the shades. For both cements, there were no statistical differences between the sorption/solubility. There was a reverse correlation between microhardness and water sorption/solubility of both cements.