A lot of clinical questions are answered by combining our intuition, training and clinical experience, which may or may not be based on scientific evidence. This type of learning that relies heavily on clinical experience and information learned in dental schools or from colleagues, can lead to inappropriate treatment outcomes. Evidence-based dentistry attempts to answer clinical questions based on a critical review of the most sound scientific evidence available combined with one's clinical experience and scientific knowledge.

The making of an ocular prosthesis after enucleation of the eye or the making of a cover shell prosthesis following evisceration requires an impression of the remaining ocular tissues. An accurate impression of these tissues facilitates a close adaptation of the custom prosthesis to the tissue bed, resulting in better potential for movement. This article reviews various ocular impression techniques as proposed by various authors.

An impression in complete dentures is the first step in the fabrication of the complete denture prosthesis. Various theories have been proposed by different authors as to how to achieve an optimum impression in different ways. Among them the most accepted is selective pressure theory, which was advocated by Carl O Boucher. In the last few decades many authors have interpreted Boucher's selective pressure in various ways making it more complicated and difficult to follow. But all the authors proposed their concepts based on the available information of the underlying functional and histologic anatomy during their time. This article reviews the various ways of achieving selective pressure as seen by different authors and also includes a custom tray design to achieve selective pressure, which is based on the newer concepts of the stress bearing and relieving areas in the maxillary edentulous impression procedures.

The development of sophisticated surgical techniques and procedures in the past decade has greatly enhanced the rehabilitation of congenital cleft palate patients. However, some of these patients may present oral and / or systemic factors contraindicating surgical intervention. In addition, since total elimination of surgical failure has not yet become a reality, there exists a patient population for whom rehabilitation must be approached with the help of a prosthodontist. The function of a prosthodontist is to restore the basic vital functions of mastication, deglutition and speech production. To accomplish this, the prosthodontist is most concerned with the preservation of residual teeth, the health of the periodontium, the physiology of residual soft palate musculature and the activity of the anatomic structures identified with the palatopharyngeal sphincters. This article provides an overview of palatopharyngeal incompetence.

The health of the surrounding hard and soft tissues is important for the optimal functioning of the natural dentition. The dentist plays a positive role in maintaining the health of the diseased oral tissues if a careful and meticulous diagnosis, treatment planning and treatment procedures are carried out. On the other hand, the dentist may be incriminated in perpetuating damage to the tissues as a result of injudicious / careless dental therapy. This article is a review on the implications of common dental procedures for the periodontium.

More than 80% of India lives in villages, who in contrast to their urban counterparts, are mostly illiterate and ignorant. The educated few migrate from rural to urban areas for money and better opportunities. For similar reasons, dentists prefer to settle in the urban scene. The obvious sufferers of this situation are the rural aged. The purpose of this study therefore, was to identify the prosthodontic need, the degree of its fulfillment, awareness of the need and reasons for unfulfilled need in this Indian rural aging subpopulation. The study area consisted of a group of six villages collectively known as 'Sarora' situated in district Lucknow, Uttar Pradesh, India. The study population was divided on the basis of age, sex, education and economic status in order to facilitate comparisons. Interviews and clinical examination were the tools of the study. The collected data was then subjected to statistical analysis. The edentulous study population comprised 10.1% of the total study population of which 73.1% had never visited a dentist. The dentulous and the partially dentulous populations comprised 11% and 96.5% of the study population respectively and the latter was found to have unfulfilled prosthodontic need. It was concluded that outreach programs are essential to improve the condition of the rural aging population.

Statement of Problem : Interocclusal recording materials should have good dimensional stability for precise articulation. Purpose :The aim of this in vitro study was to evaluate and compare the dimensional stability of three types of interocclussal recording materials at various time intervals. Materials and Methods : The materials used in the study were polyvinylsiloxane (Virtual), zinc oxide eugenol paste (Superbite) and Bite registration wax (Alumax). The test was carried out using a mold of the American Dental Association (ADA) specification No. 19. A total of 30 samples were made with each group consisting of ten samples. The samples were measured using an optical microscope with a micrometer provision. The measurements were made at time intervals of 1, 24, 48 and 72 hrs. Results : Five readings were taken for each sample at each time interval and the mean was considered to measure the dimensional change by comparing with that of the original measurement in the die. The results obtained were statistically analyzed using a one-way analysis of variance (ANOVA) and Tukey-(Honestly Significant Differences) HSD test. The mean percentage dimensional change at various time intervals: I) Group A 1 h-0.22%, 24 h-0.48%, 48 h-0.66%, 72 h-0.79%; II) Group B 1 h-0.58%, 24 h-0.93%, 48 h-1.23%, 72 h-1.46% III) Group C 1 h-0.44%, 24 h-0.60%, 48 h-0.77%, 72 h-1.07%, respectively. Group A was dimensionally the most stable of the three groups followed by Group C and then Group B. Conclusion : Dimensional stability is influenced by both the "material" and "time" factors and is found to decrease as the time factor increased. Polyvinylsiloxane (Virtual, Group A) was dimensionally the most stable followed by zinc oxide eugenol paste (Superbite, Group C) and then Bite registration wax (Alumax, Group B).

The aim of this study was to evaluate shear bond strength between the Nickel-Chromium (Ni-Cr) alloy and composite veneer resin after different surface treatments using two different materials. Preparation samples (120) were equally divided into two categories on the basis of resin used: Category A: Consists of 3M resin Category B: Consists of solidex resin Load was applied in kilogams (kg) and recorded at the point of bonding failure. Shear bond strength was evaluated as failure load divided by specified area on the bonding surface of samples in terms of pressure units-MegaPascals (Mpa). Two way ANOVA (Analysis of variance) and Student's t-test for intergroup comparison were used for statistical analysis. Results revealed that the mean shear bond strength was higher for all groups of Solidex when compared with 3M. This study concluded that sandblasting the metal surface with 60 m alumina followed by acid etching and the application of the primer and adhesive along with the composite veneer resin gives higher shear bond strength at the Ni-Cr alloy and composite resin interface

Myofascial pain dysfunction syndrome is the most common temporomandibular joint disorder (TMD). It is a stress-related disorder and its incidence is on the rise in this present day stressful lifestyle. Temporomandibular joint kinematics requires strict harmony between the dentition and the muscle action for normal functioning of the masticatory apparatus to take place. An accurate diagnosis is the first step in the management of any TMDs and this process cannot be abridged. This paper highlights an easy method of designing and functioning of a device can be used for diagnosing the relationship of the noxious occlusion to tenderness in the lateral pterygoid muscle and other muscles of the mastication. Along with this it can be used to relieve the ischemic muscle tenderness, may be used as a positioning device for the registrations of physiologic interocclusal relations and to help eliminate the dysfunctional articular clicks.

The ideal properties of a complete denture are adequate rigidity on the polished surface to bear masticatory forces and at the same time, flexibility and softness on the tissue surface for proper and even distribution of the masticatory forces. The problem with a conventional denture is that on its tissue surface, the denture is rigid leading to uneven distribution of load. This drawback even worsens in the case of flabby, atrophic and unemployed ridges with excessive bone resorption. Various methods and materials have been used to give a cushioning effect to the tissues when dentures are actually in use including liquid-supported dentures. The complete denture is designed so that the base is covered with a preshaped, closed fitting, flexible, foil. This technique allows continued adaptation of the denture to the mucosa in the resting and functional states. A complete denture will not have a good prognosis if it violates the foundation on which it rests. Liquid-supported dentures eliminate the main disadvantages encountered due to rigid denture base materials thereby providing proper retention, stability, support and comfort to the patient.

Rehabilitation in patients with facial defects requires a multidisciplinary approach involving a head and neck surgeon, a maxillofacial prosthodontist and a reconstructive surgeon. Extra-oral prosthetic rehabilitation complements reconstructive surgery in patients with facial defects especially- in our set-up where economic factors are a major consideration for the patient. We discuss a case of facial injury as a result of a bear attack for which an extra-oral facial prosthesis was applied to the patient at a fraction of the cost of reconstructive surgery.

Maxillofacial trauma refers to any injury to the face or jaw caused by physical force, the presence of foreign objects, animal or human bites or burns. Animal bites to the face are generally caused by the attacks of mammals like dogs, donkeys, bear and wolf. Since an individual's self-image and self-esteem are often derived from his or her own facial appearance, any injury affecting these features requires particular attention. We present here a case of prosthetic rehabilitation for destructed nasal cartilage caused by a bear bite. The patient was treated with a nasal prosthesis made with acrylic resin, which provided acceptable esthetics and psychological benefit to the patient. Spectacle glasses helped to retain the prosthetic nose.