Acquired and congenital defects of the face create an unfortunate condition for an individual. For the individual to lead a comfortable life requires facial rehabilitation, thus a reassessment of materials used in the field of maxillofacial prosthesis seems desirable. The materials have traveled a long way from wood, wax, primitive metal, leather, rubber, etc. to the latest biomedical material such as polymers. While the new materials have exhibited some excellent properties they have also exhibited some frustrating deficiencies. We still are in search of a material comprising all the ideal properties so as to best restore a maxillofacial defect.

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Edentulousness falls in a special category among the various conditions of dental origin. Tooth loss is the dental equivalent of mortality. A simple estimation of the proportion of the partial edentulous persons is a rough indication of the prevalence of dental diseases and the success or failure of dental care. The epidemiological features of partial edentulousness of one community or one village can be evaluated on the basis of a cross-sectional house-to-house survey. In this study a cross-sectional house-to-house survey was carried out at Herga village of Udupi District, Karnataka, India. The aim of this study is to evaluate the epidemiological features of partial edentulousness in the age group of 35-44 years in a rural population based on the Kennedy classification. Chi-square test was conducted and results were obtained and P value < 0.05 was considered statistically significant.

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Background: Acrylic resin bases attract stains and odor producing organic and inorganic deposits. The use of chemical denture cleanser soaks is the most popular method of denture cleansing. Aim: To compare the efficacy of 2 different denture cleansers in removing tea, coffee, turmeric and paan stains from heat cured clear acrylic resins. Materials and Methods: Two hundred heat cured clear acrylic samples were prepared. The samples were divided into four groups and stored in tea, coffee, turmeric and paan at 37°C for 10 days. Stained samples were subjected to immersion in the commercially available denture cleansers sodium perborate (Clinsodent), sodium hypochlorite (VI-Clean) and distilled water (control). Optical density (OD) values were measured before and after 20 minutes and 8 hours of immersion in the cleansers. The data were analyzed statistically using Fischer's test (one way ANOVA) and multiple comparisons were done by Bonferroni test. Results: Both Clinsodent and VI-clean were found to be least effective in removal of coffee stains and best for removing turmeric stains. Conclusion: It is necessary for the dental professional to ensure that the denture wearing public knows how to select the appropriate denture cleanser so as to improve denture home care protocol.

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Severe resorption of the mandibular alveolar ridge contributes to instability and discomfort of the conventional acrylic resin dentures. Alveolar ridge resorption may be corrected, in part, by various surgical techniques. But when surgery is not feasible, the need for a mandibular denture that is strong, stable and functional can be met by a metal-based denture. This article describes the clinical and laboratory procedures to incorporate a metal frame at a pre-determined, controlled position within the prosthesis. This procedure provides not only stability and strength but also ensures space for a resilient liner.

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Context: The design of a fixed partial denture (FPD) is very important to reduce the stresses generated over the supporting tissues. The connector area needs specific conditions due to biological and esthetic demands, and must be well assessed especially in the posterior regions. Aims: To make a stress analysis of a titanium cantilever fixed partial denture executed with the CAD-CAM system Everest®Kavo, in order to optimize the design of the structure, considering the shape and connector's area. Materials and Methods: A finite element analysis mesh was constructed after post-processing the CAD-CAM design. This mesh was submitted to 500 N load to assess the stress distribution within the cantilever (molar) connector. To optimize the design of this connector, a simplified model was created and a stress analysis was done with the software Solidworks®, by modifying the connector's shape and the load. Results: The stress values obtained were of 1.8 GPa, 6.5 times higher than titanium yield tensile strength. The stress analysis in the simplified model revealed lower stresses with an elliptical connector (994 MPa), or a 1 mm fillet (812 MPa). Lower loads suggested lower stresses of 540 MPa (125 N load) and 174 MPa (50 N load). Conclusions: Cantilever titanium connectors with 5.28 mm2 area are insufficient to withstand 500 N loads in a molar size cantilever, but may support normal physiologic loads of 50 N. The connectors should be more elliptical than circular to better withstand vertical loads, and the CAD software should permit the design of fillets in the connector/abutment surface. Future studies should evaluate the size of this fillet.

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This study compared the recorded interocclusal relationships produced using commonly used materials, determining which material accurately provides records of the interocclusal relationship for remounting. Ten occlusal registration materials were used in this study. Maxillary and mandibular casts were mounted on an articulator in maximum intercuspation. The interocclusal relationship was recorded with each specimen under a constant weight. Remounting of the mandibular cast was accomplished with the interocclusal record. The record was removed and the interocclusal contact recorded using occlusal indicator wax. The penetration of contacts was counted. This process was repeated using three specimens for each of the 10 materials used and measured. A standard deviation analysis was done on the number of penetration contacts. Stone interocclusal records were the most accurate material for occlusal registration. Wax wafer interocclusal records were the least accurate material. Clinical Application: This study suggests that the choice of material used for occlusal registration should be based on the expected time interval between occlusal registration and mounting of casts. If the mounting is expected immediately following the interocclusal registration, bite stone is the material of choice for occlusal registration. When a delay is expected between occlusal registration and mounting of the casts, non-eugenol zinc oxide may be chosen as the registration material.

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Prosthetic rehabilitation with surgical obturator for total maxillectomy patients is a challenging job because of the lack of normal hard and soft tissue support. In such cases the obturator can be retained with a spring-retained appliance if mandibular dentition is normal. A patient (treated with total maxillectomy) was rehabilitated with a new spring-retained surgical obturator. The spring used in this type of appliance is made up of 23-gauge stainless steel orthodontic wire which incorporates four coils. The spring is simple in design, applying light, clinically acceptable seating force, easily cleansable and causing no soft tissue irritation.

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The rehabilitation of patients with acquired defects of the maxilla is a challenge in terms of re-establishing oronasal separation. In most patients these goals are met by means of prosthetic rehabilitation with an obturator prosthesis. Prosthetic rehabilitation can be achieved satisfactorily if all facets of treatment planning and design consideration are taken well into account prior to the rehabilitation process. In many cases effective obturation is achieved but in the relative majority, the prosthesis is usually rejected by the patient as being non-retentive and the outcome is a failure. So, making the prosthesis hollow and the placement of attachments can have a dramatic effect on the stability and retention of the obturator prosthesis in partially dentulous maxillectomy patients. This paper describes a clinical case of post maxillectomy due to adenocystic carcinoma, rehabilitated with the hollow bulb obturator stabilized with Dalla Bona type of radicular attachment.

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In patients with a defective maxillo-mandibular complex, the foremost challenge in achieving an accurate centric or eccentric record is the sheer irregularity and non-repeatability of the movements of the mandible. As a result, mandatory clinical procedures like jaw relations, intra or extra-oral tracings and interocclusal records are made complicated, and the accuracy of such records, questionable. Hence every maxillofacial patient must be considered on an individual basis and rehabilitation procedures customized to suit the clinical situation, rather than strictly adhering to theoretical principles. This involves procedures like customizing the record bases, occlusal schemes and individualized training regimens for these patients, along with some modifications in the existing articulators. One such modified articulator is presented here.

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Amelogenesis imperfecta has been described as a complex group of hereditary enamel defects that disturbs the enamel structure and exists independent of any related systemic disorder. A 24-year-old male patient presented with discolored and hypersensitive teeth. The aim of the treatment was to reduce dental hypersensitivity and restore esthetics and masticatory function. The maxillary and mandibular teeth were prepared and metal ceramic crowns were cemented on the prepared teeth. The final treatment result provided the patient with improved dental esthetics and functional efficiency that enhanced his self-image.

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Amelogenesis Imperfecta (AI) is a group of hereditary defects of enamel, unassociated with any other generalized defects. Al results in poor development or complete absence of the enamel of the teeth caused by improper differentiation of the ameloblasts. This report describes the diagnosis and treatment of a young male patient with AI using contemporary restorative strategies. Initially, the tooth surfaces were treated with a professional cleaning along with conservative restorative treatment. Later, full mouth rehabilitation with metal-ceramic crowns was done. The treatment resulted in improved function, esthetics and self-confidence of the patient.

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Generalized diminished root is a rare condition leading to early loss of teeth. This report describes the diagnosis and treatment of a 20-year-old short-stature male patient suffering from unusual generalized short roots associated with microdontia, taurodontism of the posterior teeth and multiple dens invaginatus, who had lost several teeth due to spontaneous exfoliation.

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Retention is one of the most important considerations in fabricating a successful facial prosthesis. This article presents a technique using two acrylic resin extensions to provide more retention for a nasal prosthesis.

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