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Table of Contents
October-December 2015
Volume 15 | Issue 4
Page Nos. 291-394
Online since Monday, December 14, 2015
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EDITORIAL
Virtual articulators and virtual facebow transfers: Digital prosthodontics!!!
p. 291
Shilpa Shetty
DOI
:10.4103/0972-4052.171825
PMID
:26929529
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REVIEW ARTICLES
Relationship between removable prosthesis and some systemics disorders
p. 292
Pierre Le Bars, Alain Ayepa Kouadio, Justin Koffi N'goran, Zahi Badran, Assem Soueidan
DOI
:10.4103/0972-4052.171828
PMID
:26929530
This article reviews the dental literature concerning the potential impact of the removable prosthesis (RP) on the health status of patients with certain systemic diseases. Literature was surveyed using Medline/PubMed database resources, as well as a manual search, up to 2015 to identify appropriate articles that addressed the aim of this review. The research used keywords about associations between RP and six pathologies: Human immunodeficiency virus infection, diabetes mellitus, pulmonary diseases, gastric-
Helicobacter pylori
, cancer, and cardiovascular diseases. Analysis of literature showed that in patients with dentures having one or more of the six general conditions listed,
Candida albicans
organism is more frequently found in the oral flora compared to healthy denture wearer. Although causality has not been established and pending further research on this topic, the hygienic practices necessary to minimize the risk of numerous pathologies should be strengthened in the case of these patients, all the more in the presence of physical or psychological disability. The relationship between the general diseases and increasing of oral candidiasis denture patients is not explained. Therefore, attention to oral hygiene and professional care for removing
C. albicans
may be beneficial in these medically compromised patients.
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Burning mouth syndrome: Current concepts
p. 300
Cibele Nasri-Heir, Julyana Gomes Zagury, Davis Thomas, Sowmya Ananthan
DOI
:10.4103/0972-4052.171823
PMID
:26929531
Burning mouth syndrome (BMS) is a chronic pain condition. It has been described by the International Headache Society as "an intra-oral burning or dysesthetic sensation, recurring daily for more than 2 h/day for more than 3 months, without clinically evident causative lesions." BMS is frequently seen in women in the peri-menopausal and menopausal age group in an average female/male ratio of 7:1. The site most commonly affected is the anterior two-thirds of the tongue. The patient may also report taste alterations and oral dryness along with the burning. The etiopathogenesis is complex and is not well-comprehended. The more accepted theories point toward a neuropathic etiology, but the gustatory system has also been implicated in this condition. BMS is frequently mismanaged, partly because it is not well-known among healthcare providers. Diagnosis of BMS is made after other local and systemic causes of burning have been ruled out as then; the oral burning is the disease itself. The management of BMS still remains a challenge. Benzodiazepines have been used in clinical practice as the first-line medication in the pharmacological management of BMS. Nonpharmacological management includes cognitive behavioral therapy and complementary and alternative medicine (CAM). The aim of this review is to familiarize healthcare providers with the diagnosis, pathogenesis, and general characteristics of primary BMS while updating them with the current treatment options to better manage this group of patients.
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ORIGINAL ARTICLES
Evaluation and comparison of the effect of different surface treatment modifications on the shear bond strength of a resin cement to titanium: An
in vitro
study
p. 308
Tahsin Mansur Veljee, CS Shruthi, R Poojya
DOI
:10.4103/0972-4052.161072
PMID
:26929532
The purpose of this study was to evaluate and compare the effect of grit blasting, chemical treatment, and application of alloy primer combinations on the shear bond strength (SBS) of a self-cure resin cement to titanium surface.
Materials and Methods:
Fifty cast commercially pure titanium discs (9 mm × 2 mm) were divided into five groups (
n
= 10), which received the following surface treatments: Control group (no surface treatment), group 1 (grit blasting using 110 µm Al
2
O
3
particles and application of alloy primer), group 2 (grit blasting using 110 µm Al
2
O
3
particles and chemical treatment using 1N HCl), group 3 (chemical treatment using 1N HCl and application of alloy primer), and group 4 (Grit blasting using 110 µm Al
2
O
3
particles, chemical treatment using 1N HCl and application of alloy primer). Superbond C and B resin cement was applied to the treated titanium surfaces including controls. SBSs were determined after thermocycling for 5000 cycles. Data (megapascal) were analyzed by ANOVA and Bonferroni test.
Results:
Group 4 (grit blasting using 110 µm Al
2
O
3
particles, chemical treatment using 1N hydrochloric acid, and application of alloy primer) produced the highest bond strength followed by group 1, group 3, group 2, and the control group which showed the least bond strength.
Conclusion:
(1) Air-abrasion with alumina particles increases the micromechanical retention of the resin to titanium. (2) The alloy primer promotes wettability, which increases the adhesive bonding of resin cement to titanium. (3) Chemical treatment using hydrochloric acid effectively pretreats the titanium surface thereby increasing the SBS values.
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A comparative evaluation of the reliability of three methods of assessing gingival biotype in dentate subjects in different age groups: An
in vivo
study
p. 313
Sarfaraz Memon, Jayanti R Patel, Rajesh Sethuraman, Ravi Patel, Himanshu Arora
DOI
:10.4103/0972-4052.171830
PMID
:26929533
Introduction:
In the modern competitive society, a pleasing appearance often dictates the difference between success and failure in both our personal and professional lives. Evaluation of gingival biotype is very important from the start of treatment plan to the final restorative placement to provide excellent esthetics.
Materials and Methodology:
For the study, subjects were divided into 4 groups of different ages, from 20-30, 31-40, 41-50 and 51-60 years. 30 subjects (15 men and 15 women) were selected in each group for the study. Examination of the thickness of Gingival Biotype was done in 3 different ways; - Direct visual, William's Graduated Probe and Using modified wax caliper.
Results:
The McNemar test showed statistically significant differences in the way gingival biotype was identified when comparing visual assessment with assessment using direct measurement (
P
< 0.001). And there was no statistically significant difference when assessment using a periodontal probe was compared to direct measurement (
P
< 0.676). There is no correlation for the Biotype among the different age groups.
Conclusion:
Gingival biotype identification by visual assessment is statistically significantly different from assessment with direct measurement. Gingival biotype identification by assessment with a periodontal probe is not statistically significantly different from direct measurement.
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Comparative evaluation of bond strength of all-metal crowns with different luting agents after undergoing various modes of surface treatments: An
in-vitro
study
p. 318
Shivam Singh Tomar, Jayanta Bhattacharyya, Soumitra Ghosh, Preeti Goel, Samiran Das, Kaplia Chakarvarty
DOI
:10.4103/0972-4052.161557
PMID
:26929534
Aim:
This study includes a comparative evaluation of the various surface treatments of the intaglio surface of crowns in combination with various luting agents for maximal retention.
Materials and Methods:
Totally, 150 dies of a standard complete crown preparation were fabricated. Wax pattern with a loop on the occlusal surface was prepared on each die using standard procedures, and then crowns were cast with nickel-chromium alloy. These crowns were randomly divided into five groups as per the surface of the intaglio surface of the metal copings. The crowns in each group were again subdivided randomly into three groups as per the luting agents used resin-modified glass ionomer cement, glass ionomer cement, and zinc phosphate cement. Retention was measured (MPa) by separating the metal crowns from the metallic die under tension on a Universal testing machine.
Statistical Analysis Used:
The data were recorded and statistically analyzed using one-way analysis of variance followed by Tukey's test.
Results:
The retention differed both with surface treatment and type of luting agents. Untreated group showed the least bond strengths < sandblasting with 50 µm alumina < sandblasting with 50 µm alumina with ultrasonic cleaning < sandblasting with 110 µm alumina < sandblasting with 110 µm alumina along with ultrasonic cleaning. For luting agents, glass ionomer cement showed least bond strength because there was no chemical bonding present between metal crown and metallic die, followed by zinc phosphate cement and maximum bond strength were found for resin-modified glass ionomer cement.
Conclusion:
Among all types of surface treatments used in this study, maximum bond strength was yielded by sandblasting with 110 µm alumina + ultrasonic cleaning and the best luting agent was resin-modified glass ionomer cement.
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Evaluation of Hanau's formula in determination of lateral condylar guidance: A clinical research study
p. 326
Sanjay Vasant Bhawsar, Ashlesha Subhash Marathe, Sadekh Abdul Ansari
DOI
:10.4103/0972-4052.161566
PMID
:26929535
Statement of Problem
: The accuracy and reliability of the methods used for programming the semi-adjustable articulators determine the accuracy in occlusion. The current recommended average settings using the Hanau's formula commonly used by clinicians is questionable, and thus reassessment is needed. This study was carried out to evaluate and compare the lateral condylar guidance: (1) Using the Hanau's formula and the computerized jaw tracking device (Kinesiograph). (2) On the right and left sides using both these methods.
Materials and Methods
: A total of 20 completely edentulous patients (14 male and 6 females) within 40–60 years of age were selected. Jaw relation was recorded followed by face bow transfer. Extraoral Gothic arch tracing was recorded; three protrusive records were obtained and condylar guidance was calculated. Lateral condylar guidance was then calculated using Hanau's formula, followed by the computerized jaw tracking device. A comparative evaluation was done of the obtained values. The same investigator worked with each of the study participants for the purpose of standardization.
Results
: The lateral condylar guidance values obtained using the Hanau's formula ranged from 14 to 17° while those obtained using the computerized K7 jaw tracking device ranged from 8 to 40°. Bennett angle values, obtained using the jaw tracking device and Hanau's formula showed statistically significant differences (
P
< 0.05) using paired
t
-test (at 95% confidence interval). Bennett angle values of the right and left sides found using the Hanau's formula were almost similar. Difference in the Bennett angle values of the right and left sides were found using the jaw tracking device. However, this difference was not statistically significant (
P
> 0.05).
Conclusion
: Based on the results, dentist and dental technicians should consider reassessing the current recommended average settings and use of the Hanau's formula for programming the semi-adjustable articulators.
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Comparative evaluation of craniofacial anthropometric measurements in Indian adult patients with and without obstructive sleep apnea: A pilot study
p. 331
Abhishek Dubey, Snehal Upadhyay, Somil Mathur, Surya Kant, Balendra Pratap Singh, Rakesh Makwana
DOI
:10.4103/0972-4052.161567
PMID
:26929536
Aims
: The study aimed to compare the craniofacial features of North Indian patients suffering from obstructive sleep apnea (OSA) to that of normal North Indian population.
Materials and Methods:
Selected 25 North Indian subjects (age: 18–65 years) were divided into two groups (OSA group [
n
= 14] and non-OSA group [
n
= 9]) according to the results of full night polysomnographic sleep study. Body mass index (BMI), neck circumference (NC), and lateral cephalograms were recorded for each subject in both groups and total 22 parameters of craniofacial anthropometric features were measured on lateral cephalograms for each subject. The differences in BMI, NC, and craniofacial features between the OSA and non-OSA groups were compared statistically.
Results
: Independent sample
t
-test was used to compare the differences between OSA group and non-OSA group. The results showed that the BMI, NC, bulk of tongue (tongue length, tongue height, and tongue area) and length of the soft palate (PNS-U) were significantly higher in OSA group. OSA group was also found to have inferior positioning of hyoid bone (MP-H, ANS-H, PNS-H, ANS-Eb), narrower superior and middle airway space (SPAS and MAS), antero-inferior positioning of mandible (Gn-C3, ANS-Me, SNB, N-Me) and lower cranial base flexure angle (N-S-Ba).
Conclusion
: Craniofacial features, which play an important role in the pathophysiology of OSA, differ significantly between North Indian patients suffering from OSA and normal North Indian population.
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Maxillomandibular relationship record for implant complete mouth rehabilitation with elastomeric material and facial surface index of existing denture
p. 337
Pravinkumar G Patil, Smita Nimbalkar-Patil
DOI
:10.4103/0972-4052.161568
PMID
:26929537
Introduction:
The maxillomandibular relationship (MMR) record is a critical step to establish the new occlusion in implant supported complete mouth rehabilitation. Using patients existing denture for recording the MMR requires implant definitive cast to be modified extensively to completely seat the denture (with unaltered flanges) on it. This may influence the correct seating of the denture on the implant definitive cast causing faulty recording of the MMR.
Materials and Method:
Elastomeric record bases, reinforced with the resin framework, are fabricated and relined with the light body elastomeric material when all the healing abutments are in place. The MMR is recorded with these elastomeric record bases using vacuum formed facial surface index of the occluded existing dentures as a guideline.
Results:
The elastomeric record bases with facial surface index of the existing dentures can allow clinicians to record MMR records without removing the healing abutments from the mouth with acceptable accuracy. This can save chair-side time of the procedure. The record of facial surfaces of existing complete denture in the form of vacuum formed sheet helps to set the occlusal vertical dimension.
Conclusion:
Use of facial surface index together with the elastomeric record bases can be the useful alternative technique to record the MMR in patients with implant supported full mouth rehabilitation. Further study is required to prove its routine clinical utility.
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Perception and knowledge of dental interns toward interdepartmental coordination for successful prosthodontic treatment: A pilot study
p. 342
Kamal Shigli, Pradnya Kakodkar, Neha Agrawal, Mamata Hebbal, Dayanand Huddar, M Vikneshan
DOI
:10.4103/0972-4052.161570
PMID
:26929538
Background:
The graduating dentist should be trained in providing treatment utilizing the interdisciplinary approach because of the rapid advancements and increase in patient expectations, which demands for collaboration between the different specialists.
Purpose:
A pilot study was undertaken with an aim to assess the perception and knowledge of dental interns toward interdepartmental coordination for successful prosthodontic treatment.
Subjects and Methods:
Dental interns from two dental colleges in Sangli (India) participated in the study. A 24-item self-administered, structured closed-ended questionnaire was used to collect the data. Four questions assessed the perception and 20 questions assessed the knowledge, which were based on the four domains viz.: General, Endodontics, Orthodontics, and Prosthodontics. They were framed from case scenarios reporting to the Department of Prosthodontics, which required interdepartmental consultation. The questionnaire was validated before its application and reliability were also assessed. The final score for each question was calculated based on the correct responses. Descriptive analysis was calculated using the frequencies, percentages, and mean values by using SPSS 16 software.
Results:
Among 117 interns who participated in the study, 79.5% reported that they lacked training in an interdisciplinary approach. Approximately, 96% reported that the curriculum should be designed to include interdisciplinary training. Nearly, 88% reported that specialist from different specialty should be posted in one interdisciplinary department. Around 60% reported that they did not have the confidence of treating the patient as a whole. When the overall mean scores were considered, the highest scores were obtained for the general domain (95.3) and the lowest for the prosthodontic domain (83.6).
Conclusion:
The dental interns perceived that they lacked training in interdisciplinary approach, and the curriculum should include interdisciplinary training.
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In vitro
and
in vivo
evaluation of carbonate apatite-collagen scaffolds with some cytokines for bone tissue engineering
p. 349
Sherman Salim, Maretaningtias Dwi Ariani
DOI
:10.4103/0972-4052.171821
PMID
:26929539
Background:
Collagen is regarded as one of the most useful biomaterials. We tried to combine collagen and carbonate apatite (CA) with some cytokines in order to enhance bone formation ability. In this study, we found that CA-collagen sponge (CA-CS) was a possible candidate of newly graft material for bone formation.
Materials and Methods:
CA-CS was fabricated by the following procedure. One wt% of pig hide collagen solution (Nippon Meat Packers. Inc., Tokyo, Japan) was neutralized with 0.1 N NaOH, and then mixed immediately 243 mg apatite powder with 0.06 M carbonate contents. After centrifugation at 1500 rpm for 10 min, excess water was removed, and the mixture was packed into Teflon molds (5.0 mm × 2.0 mm). Each 10 µg of basic fibroblast growth factor (bFGF) and recombinant human bone morphogenetic protein-2 (rh-BMP2) were involved in these sponges. Then these scaffolds frozen at −80°C for 2 h and dried in a freeze dry machine for 24 h. CA-CS without cytokines were also prepared as a control. Mouse osteoblast-like cell (MC3T3-E1) proliferations in these scaffolds were investigated by 3-day
in vitro
cell culture using MTT assay examination. Ten New Zealand rabbits (weight: 3–3.5 kg) were used in this
in vivo
study. After 3 weeks of placement, the scaffolds, rabbits were sacrificed, and bone formation in the sockets was evaluated histologically and histomorphometrically.
Results and Conclusion:
By histological observation and measurement of bone area ratio, CA-CS with cytokines showed higher bone formation ability (bFGF/CA-CS: 50.7 ± 7.3%, rh-BMP2/CA-CS: 54.2 ± 5.0%) than other groups. From the limited results of this study, it is suggested that CA collagen scaffolds with some cytokines may become an attractive scaffold for bone regeneration.
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A clinical study to compare between resting and stimulated whole salivary flow rate and pH before and after complete denture placement in different age groups
p. 356
BC Muddugangadhar, Rajashekar Sangur, IV Rudraprasad, DB Nandeeshwar, BH Dhanya Kumar
DOI
:10.4103/0972-4052.164907
PMID
:26929540
Purpose:
This study compared the flow rate and pH of resting (unstimulated) and stimulated whole saliva before and after complete denture placement in different age groups.
Materials and Methods:
Fifty healthy, non-medicated edentulous individuals of different age groups requiring complete denture prostheses were selected from the outpatient department. The resting (unstimulated) and stimulated whole saliva and pH were measured at three stages i.e.,
Before complete denture placement;
Immediately after complete denture placement; and
After 2 to 3 months of complete denture placement.
Saliva production was stimulated by chewing paraffin wax. pH was determined by using a digital pH meter.
Results:
Statistically significant differences were seen in resting(unstimulated) and stimulated whole salivary flow rate and pH obtained before, immediately after, and after 2 to 3 months of complete denture placement. No statistically significant differences were found between the different age groups in resting (unstimulated) as well as stimulated whole salivary flow rate and pH.
Conclusion:
Stimulated whole salivary flow rates and pH were significantly higher than resting (unstimulated) whole salivary flow rates and pH obtained before, immediately after, and after 2 to 3 months of complete denture placement. No age related variations in whole salivary flow rate and pH were observed in healthy, non-medicated individuals.
Clinical Implications:
The assessment of salivary flow rate, pH in different age groups is of prognostic value, which is an important aspect to be considered in the practice of removable prosthodontics.
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Evaluation of flexural strength and color stability of different denture base materials including flexible material after using different denture cleansers
p. 367
Vrinda R Shah, Darshana Nilesh Shah, Chirag J Chauhan, Paras J Doshi, Ashish Kumar
DOI
:10.4103/0972-4052.164908
PMID
:26929541
Aims:
Present study aimed at evaluating the colour stability and flexural strength of flexible denture base materials (Valplast) and Polymethyl methacrylate (PMMA) denture base material (Meliodent) processed by two different methods (Injection moulding and compression moulding) after immersing them in three different denture cleansers with acidic, basic and neutral PH.
Methods and Materials:
Total 120 specimens (65 × 10 × 3 mm3), 40 specimens of each material (Valplast, Meliodent compression moulding and injection moulding) were immersed in denture cleansers having different PH; Valclean (Acidic), Clinsodent (Basic) and Polident (Neutral) as well as Distilled Water. Color changes were measured with a spectrophotometer after 1 month, 3 months and 6 months of immersion cycle. A flexural 3-point bending test was carried out by using an Instron universal testing machine after 6 months of soaking.Data were analyzed using SPSS software
Results:
Maximum effect on colour stability was noted with Clinsodent followed by Valclean. Least color changes were observed after immersion in Polident. Colour difference was increased significantly as the immersion time increased. For both Meliodent and Nylon resins, statistically significant change in flexural strength occurred with immersion in all denture cleansers. Clinsodent has greater effect as compared to Valclean and Polident.
Conclusions:
Polident and Valclean can be safely used as denture cleanser for both nylon and acrylic resin denture base materials as far as colour stability and flexural strength both are concerned.
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Evaluation of the surface roughness of three heat-cured acrylic denture base resins with different conventional lathe polishing techniques: A comparative study
p. 374
Duggineni Chalapathi Rao, N Kalavathy, HS Mohammad, A Hariprasad, C Ravi Kumar
DOI
:10.4103/0972-4052.164910
PMID
:26929542
Purpose:
Surface roughness promotes adhesion and colonization of denture plaque. Therefore, it is important to know the effects of polishing and finishing on the surface roughness of various acrylic resin materials.
Objectives:
To evaluate and compare the effects of different conventional lathe polishing techniques on heat cured acrylic resins in producing surface roughness.
Materials and Methods:
Three different commercially available heat-cured acrylic resin materials namely DPI, Meliodent and Trevalon Hi were selected. 30 Specimens of each acrylic material (30 x 3 = 90, 10 x 60 x 2mm) were prepared and divided into 5 groups, each group consisted of 6 Nos. of specimens per material(6x3=18) and were grouped as Group A(unfinished), Group B (finished), Group C (Polishing Paste), Group D (Polishing Cake) and Group E (Pumice and Gold rouge). The resulted surface roughness (µm) was measured using Perthometer and observed under Scanning Electron Microscope. The values obtained were subjected statistical analyses.
Results:
Among the materials tested, better results were obtained with Trevalon Hi followed by Meliodent and DPI. Among the polishing methods used, superior results were obtained with universal polishing paste followed by polishing cake; Pumice and Gold rouge. Although Pumice and Gold rouge values produced greater roughness value, they were well within the threshold value of 0.2 mm.
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EVIDENCE SUMMARY
Intervention for replacing missing teeth: Alveolar ridge preservation techniques for dental implant site development - evidence summary of Cochrane review
p. 381
Srinivasan Jayaraman
DOI
:10.4103/0972-4052.171824
PMID
:26929543
The Cochrane reviews have transparent reporting of the methodology to clarify the reader the methods used for writing the review; hence, each review becomes a large volume of scientific literature. This evidence summary of the Cochrane review published in 2015 for the question, what are the clinical effects (preservation of both width and height of bone, esthetic outcomes, complications, and failure of implant) for different alveolar ridge preservation techniques (ARP) and materials used in patients planning implant placement following extraction after 6 months follow-up. This review provides evidence for efficacy of different ARP techniques, materials, and superiority of one over the other. It also tries to settle the controversy of timing of placement of implant after grafting. Of the 8 included studies from 50, two trials provide moderate evidence for xenografts versus extraction favoring xenografts in preserving the width and height of bone by 1.97 mm (2.48–1.46) and 2.60 mm (3.43–1.76), respectively in pooled estimates of meta-analysis. Using different material, five-trial were found; of which, two trials provide moderate evidence for alloplast versus xenografts favoring alloplast in preserving the width by 0.44 mm (0.90–0.02) and low-grade evidence for height of bone by 0.35 mm (0.86–0.16) in pooled estimates of meta-analysis. There is a paucity of randomized controlled trial to address other primary and secondary outcomes addressed in this review.
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CASE REPORTS
Posterior open occlusion management by registration of overlay removable partial denture: A clinical report
p. 386
Saeid Nosouhian, Amin Davoudi, Mohammad Derhami
DOI
:10.4103/0972-4052.171822
PMID
:26929544
This clinical report describes prosthetic rehabilitation of posterior open bite relationship in a patient with several missing teeth and skeletal Class III malocclusion. Primary diagnostic esthetic evaluations were performed by mounting casts in centric relation and estimating lost vertical dimension of occlusion. Exclusive treatments were designated by applying overlay removable partial denture with external attachment systems for higher retentions.
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Prosthetic rehabilitation of a total laryngectomy patient
p. 390
Pulkit Jain, Amit Siwach, Gurleen Arora, Richa Agarwal
DOI
:10.4103/0972-4052.164912
PMID
:26929545
The fundamental objective in restoring a defect created after total laryngectomy with a custom made silicone prosthesis is to enable the patient to cope better with the difficult process of rehabilitation after a major surgery has been performed. A cosmetically acceptable prosthesis that reproduces the color and form and allows the patient to return to his/her accustomed lifestyle. A sequence of steps for construction of custom-made laryngeal prosthesis is outlined in this case report using the readily available materials and method which any prosthodontist can readily understand and deliver.
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© The Journal of Indian Prosthodontic Society | Published by Wolters Kluwer -
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Online since 23
rd
March, 2015