Corneal diseases are among the major causes of global blindness, secondary to cataract. osteo-odonto keratoprosthesis (OOKP) is the ideal treatment for patients with end-stage inflammatory corneal diseases where a portion of tooth along with bone is used to support an optical cylinder to restore vision in such patients. OOKP surgery requires multidisciplinary approach involving dentists, ophthalmologists, and radiologists. Very less is known in dentistry about the role of the periodontium in the field of ophthalmology. This paper highlights OOKP indications, contraindications, surgical procedure, role of oral structures, advantages, and limitations.

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Aim: The accuracy of a dental impression is determined by two factors: “trueness” and “precision.” The scanners used in dentistry are relatively new in market, and very few studies have compared the “precision” and “trueness” of intraoral scanner with the extraoral scanner. The aim of this study was to evaluate and compare accuracy of intraoral and extraoral digital impressions. Materials and Methods: Ten dentulous participants (male/female) aged 18–45 years with an asymptomatic endodontically treated mandibular first molars with adjacent teeth present were selected for this study. The prepared test tooth was measured using a digital Vernier caliper to obtain reference datasets. The tooth was then scanned using the intraoral scanner, and the extraoral scans were obtained using the casts made from the impressions. The datasets were divided into four groups and then statistically analyzed. The test tooth preparation was done, and dimples were made using a round diamond point on the bucco-occlusal, mesio-occlusal, disto-occlusal, and linguo-occlusal lines angles, and these were used to obtain reference datasets intraorally using a digital Vernier caliper. The test tooth was then scanned with the IO scanner (CS 3500, Carestream dental) thrice and also impressions were made using addition silicone impression material (3M™ ESPE) and dental casts were poured in Type IV dental stone (Kalrock-Kalabhai Karson India Pvt. Ltd., India) which were later scanned with the EO scanner (LAVA™ Scan ST Design system [3M™ ESPE]) thrice. The Datasets obtained from Intraoral and Extraoral scanner were exported to Dental Wings software and readings were obtained. Repeated measures ANOVA test was used to compare differences between the groups and independent t-test for comparison between the readings of intraoral and extraoral scanner. Least significant difference test was used for comparison between reference datasets with intraoral and extraoral scanner, respectively. A level of statistical significance of P < 0.05 was set. Results: The precision values ranged from 20.7 to 33.35 μm for intraoral scanner and 19.5 to 37 μm for extraoral scanner. The mean deviations for intraoral scanner were 19.6 μm mesiodistally (MD) and 16.4 μm buccolingually (BL) and 24.0 μm MD and 22.5 μm BL for extraoral scanner. The mean values of the intraoral scanner (413 μm) for trueness were closest to the actual measurements (459 μm) than the extraoral scanner (396 μm). Conclusion: The intraoral scanner showed higher “precision” and “trueness” values when compared with the extraoral scanner.

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Aim: An attempt is made to investigate clinical efficacy of cord, paste system, and a strip gingival retractile materials. This study aims to evaluate and compare the gingival retraction efficacy of retraction strip along with conventional retraction cord and paste system. Material and Methods: This in vivo experimental study was carried out on 30 patients. Three different gingival retraction systems were used to evaluate the amount of vertical and lateral displacement. Based on selection criteria, 30 individuals requiring fixed dental prosthesis with respect to mandibular first molar were selected. Tooth preparation for metal ceramic restoration with subgingival finish line was performed. Gingival displacement was accomplished with ultrapak cord, merocel strip, and magic foam cord immediately, 7 and 14 days after the tooth preparation, respectively. The amount of gingival displacement in vertical and lateral directions was measured at mesiobuccal, midbuccal, and distobuccal regions of the prepared tooth. The vertical retraction was measured intraorally by using digital vernier caliper, and postgingival displacement impression was used to measure lateral gingival retraction. Stereomicroscopic images of impression under ×10 resolution were transferred to image analyzer to measure the lateral displacement. The obtained data analyzed in one-way ANOVA and Bonferroni test were used to determine the significant difference at P < 0.05 level. Results: ANOVA test showed the significant difference between the materials tested with respect to the mean vertical and lateral gingival retraction (P = 0.001). Multiple comparisons by Bonferroni test revealed a significant difference in vertical and lateral displacement among the materials tested. Conclusions: Merocel strip provided the maximum amount of vertical and lateral tissue displacement, followed by ultrapak cord and least with magic foam cord which was statistically significant.

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Aim: Immediate loading protocol, in recent times, has gained popularity as it has not only shortened the treatment time but also resulted in enhanced patient satisfaction. The aim of this study was to evaluate and compare the effectiveness of immediate implant loading protocol over conventional implant loading protocol with respect to peri-implant bone loss. Materials and Methods: Twenty patients selected for this study were divided into two groups. In Group I patients, implants were immediately loaded, whereas in Group II, they were loaded with conventional loading protocol. Peri-implant bone loss was measured and compared using intraoral periapical radiographs with the grid at the time of implant loading, 1, 3, and 6 months after implant loading. Results: Change in radiographic bone loss in both the groups was found to be statistically significant when baseline was compared to 1, 3, and 6 months, but the difference in the bone loss between Group I and II was not found to be statistically significant. Conclusion: No statistically significant difference was observed in the crestal bone loss on comparison of immediate loading to delayed loading protocol. Clinical Significance: After achieving good primary stability, immediate-loaded implants can be used for the benefit of the patients as it reduces the period of edentulism.

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Aim: The purpose of this study was to compare the marginal and internal adaptation of cobalt-chromium (Co-Cr) copings fabricated from conventional wax pattern, three-dimensional (3D)-printed resin pattern, and laser sintering technique. Materials and Methods: A total of thirty copings were made, out of which ten copings were made from 3D-printed resin pattern (Group A), ten from inlay wax pattern (Group B), and ten copings were obtained from direct metal laser sintering (DMLS) technique (Group C). All the thirty samples were seated on their respective dies and sectioned carefully using a laser jet cutter and were evaluated for marginal and internal gaps at the predetermined areas using a stereomicroscope. The values were then analyzed using one-way ANOVA test and post hoc Bonferroni test. Results: One-way ANOVA showed lowest mean marginal discrepancy for DMLS and highest value for copings fabricated from inlay wax. The values for internal discrepancy were highest for DMLS (169.38) and lowest for 3D-printed resin pattern fabricated copings (133.87). Post hoc Bonferroni test for both marginal and internal discrepancies showed nonsignificant difference when Group A was compared to Group B (P > 0.05) and significant when Group A was compared with Group C (P < 0.05). Group B showed significant difference (P < 0.05) when compared with Group C. Conclusion: Marginal and internal discrepancies of all the three casting techniques were within clinically acceptable values. Marginal fit of DMLS was superior as compared to other two techniques, whereas when internal fit was evaluated, conventional technique showed the best internal fit.

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Purpose: The purpose of this study is to compare the effect of implant-abutment connections, abutment angulations, and screw lengths on screw loosening (SL) of preloaded abutment using three dimensional (3D) finite element analysis. Materials and Methods: 3D models of implants (conical connection with hex/trilobed connections), abutments (straight/angulated), abutment screws (short/long), and crown and bone were designed using software Parametric Technology Corporation Creo and assembled to form 8 simulations. After discretization, the contact stresses developed for 150 N vertical and 100 N oblique load applications were analyzed, using ABAQUS. By assessing damage initiation and shortest fatigue load on screw threads, the SL for 2.5, 5, and 10 lakh cyclic loads were estimated, using fe-safe program. The obtained values were compared for influence of connection design, abutment angulation, and screw length. Results: In straight abutment models, conical connection showed more damage (14.3%–72.3%) when compared to trilobe (10.1%–65.73%) at 2.5, 5, and 10 lakh cycles for both vertical and oblique loads, whereas in angulated abutments, trilobe (16.1%–76.9%) demonstrated more damage compared to conical (13.5%–70%). Irrespective of the connection type and abutment angulation, short screws showed more percentage of damage compared to long screws. Conclusions: The present study suggests selecting appropriate implant-abutment connection based on the abutment angulation, as well as preferring long screws with more number of threads for effective preload retention by the screws.

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Purpose: To evaluate the surface roughness of bis-acrylic and acrylic resins submitted to different methods of polishing. Materials and Methods: Fifty samples of each provisional restorative material (Structur 2, Protemp 4, Duralay, and Dencrilay) were fabricated (10 mm × 2 mm) and divided into five groups (n = 10): (1) positive control group – polyester strip; (2) negative control – unpolished; (3) abrasive tips (Exa-Technique-Edenta); (4) goat hair brush and diamond polishing paste; and (5) silicone tips (Enhance). Each material was mixed and polymerized according to manufacturer's instructions. The parameter evaluated was the arithmetic mean of the surface roughness (Ra) determined using the rugosimeter SJ 301 (Mitutoyo, Japan). The data were analyzed with two-way analysis of variance (post hoc Tukey's test) (P < 0.05). Results: The lowest surface roughness values (0,22–0,90 μm) were observed in the Group 4 – goat hair brush and diamond paste, while the highest values (1,17–1,44 μm) were found in the Group 5 – silicone tips (enhance), with statistically significant differences between them, except for Dencrilay acrylic resin. There was statistically significant difference between bis-acrylic and acrylic resins in the Groups 1, 2, and 4. Conclusions: Within the limitations of this study, it was concluded that the most effective polishing system was the goat hair brush with diamond paste for both bis-acrylic and acrylic resins. The bis-acrylic resins exhibited significantly smoother surfaces than the acrylic resins.

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Statement of Problem: Heat cure acrylic resin material with reduced monomer content is generally recommended for clinical usage as it leads to improved mechanical, physical, and biocompatibility properties. Aims and Objective: The purpose of the present study was to evaluate and compare the amount of the residual monomer in the conventional and three different groups of deep-frozen heat cure polymethylmethacrylate (PMMA) acrylic resin. Materials and Methods: Totally 40 Specimens of heat cure PMMA acrylic resin (DPI India) (10 conventional heat cure and 30 deep frozen) were made using two disc-shaped stainless steel molds and invested into type II dental stone using compression molding technique. Each group contained 10 specimens (n = 10). Group 1: Control group of conventional polished PMMA specimen stored in water for 24 h at +37°C (10 specimens), Group 2: Deep frozen unpolished PMMA (10 specimens), Group 3: Deep frozen polished PMMA (10 specimens), and Group 4: Deep frozen polished PMMA specimen stored in water for 24 h at +37°C (10 specimens). Amount of the residual monomer content in all the specimens was measured using high-performance liquid chromatography. Data were analyzed using One-Way Analysis of Variance and multiple comparison Tukey's post hoc test (α = 0.05). Results: Least residual monomer content was found in Group 4 (0.12 wt%) followed by Group 3 (0.19 wt%), Group 2 (0.23 wt%), and Group 1 (0.26 wt%). Statistically significant difference (P < 0.05) was found in residual monomer content for all the four groups tested. Post hoc test for intergroup comparison also showed a significant difference between groups. Conclusion: The amount of the residual monomer was found to be least in deep-frozen polished PMMA specimen stored in water for 24 h at +37°C (Group 4). Thus, it can be concluded that deep freezing, polishing, and storing in water can reduce the residual monomer content.

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Myogenous temporomandibular disorder (TMD) is the most common type of nonodontogenic pain. The diagnosis is often elusive since diagnosing such conditions often requires a more comprehensive patient assessment. At present, there is no simple one-step diagnostic test to help render a definitive diagnosis of myogenous TMD pain. The twin-block injection can serve as a diagnostic aid to facilitate diagnosis of such myogenous TMD. The twin-block injection blocks the innervation to both the temporalis and masseter muscles, the two most common sources of referred pain to the teeth. This article reviews the twin-block technique along with a case report illustrating its potential role in the diagnosis and management of myogenous TMD pain of masseteric and temporalis origin.

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Purpose: One of the crucial requirements for the success of implants is to achieve good stability. Two well-accepted quantitative methods to assess implant stability, the insertion torque value (ITV), and resonance frequency analysis (RFA) can be a valuable adjunct to radiological and clinical examination. This study was conducted to assess the relationship between ITVs and implant stability quotient (ISQ) and its influence on timing of functional implant loading, as well as to determine the effect of some of the factors on the stability of implants. Materials and Methods: Forty implants were inserted in 37 patients in the posterior mandibular region according to conventional protocol and allowed to heal by placing a healing abutment at the time of placement. For each implant, ITV was measured at the time of the implant placement by manual torque wrench (Nobel Biocare), and the ISQ value was measured by using resonance frequency analyzer (Osstell-ISQ; Integration Diagnostics) at the baseline levels, 3^rd week, 7^th week, 11^th week, and 15^th week interval. Results: The correlation between ITV and ISQ was found to be moderately positive and significant (r = 0.399) (P = 0.000). The correlation of ITV value at baseline and ISQ values recorded at the subsequent weeks was also found to be statistically significant at week 3 (r = 0.376) (P = 0.000) and week 7 (r = 0.327) (P = 0.000). Conclusion: It can be concluded from this study that there is a positive and statistically significant correlation between the ITV and ISQ values.

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Background: Residual ridge resorption is crucial sequelae of tooth loss. Complete dentures are the most common way of rehabilitating edentulous patients. However, with continuing residual ridge resorption, dentures tend to become loose and unstable causing discomfort, chewing disability, and speech problems. Denture relining is an economical means of improving a denture's stability and retention. An understanding of the clinical indications and limitations of these materials and procedures is crucial for clinical success. Aim and Objective: The purpose of this survey was to assess knowledge, attitude, and practice in relining dentures among dental practitioners. Materials and Methods: The cross-sectional survey was conducted using a validated questionnaire on 200 (n = 200) dental practitioners in Nagpur city, Maharashtra. Data analysis was done using proportion test with SPSS EPI INFO software. Results: Although all 200 practitioners were aware of the relining procedure and were routinely carrying out the procedure in their dental clinics, 50% of the practitioners were unaware of the correct relining step by step procedure and were also not sure about the antimicrobial properties of the relining material available in the market. Conclusion: Awareness and scientific knowledge about the relining materials and procedure should be enhanced within general dental practitioners through CDE program and workshops. Steps should be taken to include relining procedure as a part of undergraduate clinical curriculum as well as internship program.

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Background: Tooth extraction will provoke changes in alveolar bone morphology and dimensions. Postextraction bone resorption can lead to significant problems for restorative dentistry. Therefore, the extracted tooth socket needs to be preserved to reduce alveolar ridge bone resorption. This research aimed to analyze the expression and levels of osteocalcin, collagen 1, and osteoblasts in extracted tooth sockets filled with a combination of mangosteen peel extract and demineralized freeze-dried bovine bone xenograft (DFDBBX). Material and Methods: Fifty-six Cavia cobaya, whose lower left incisors had been extracted, were divided into eight groups according to the substance used to fill their sockets on days 7 and 30, Poly ethylene glycol, DFDBBX, mangosteen peel extract, or a combination of mangosteen peel extract and DFDBBX. This research was conducted in several stages; the application of mangosteen peel extract combined with graft material was performed as the form of tooth extraction socket preservation. The C. cobaya rats were subsequently examined by immunohistochemical methods to measure osteocalcin and collagen 1 expressions, whereas histological examination was conducted to calculate the number of osteoblasts in accordance with the duration of the research. Results: On days 7 and 30, the group treated with a combination of DFDBBX and mangosteen peel extract which had the highest expression and levels of osteocalcin, collagen 1, and osteoblasts. Conclusion: The administration of mangosteen peel extract combined with DFDBBX as a means of tooth extraction socket preservation can increase osteocalcin and collagen 1 expression. Consequently, osteoblasts as a means of alveolar bone regeneration will increase in number.

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Background: The presence of the dental papilla is critical to achieve esthetics in a single tooth implant restoration. Aim: The purpose of this study was to determine if there were differences in the papilla fill between implant and teeth comparing immediate implant placement and provisionalised single tooth implant restorations with delayed implant placement and provisionalised single tooth implant restorations. The papilla fill in these two groups was evaluated using the Jemt papilla index. Results: It was seen that there was no statistically significant difference seen in the volume of the papilla between both the groups. There was a statistically significant difference seen in both the groups on the distal and mesial side from the initial stage go the follow up period of 10 days, 3 months and 6 months. Conclusion: The interpretation of clinical papilla is a difficult task since many different clinical situations can be encountered while studying single tooth implant restorations. The single tooth implant restoration is a specific entity; the distance between the mesial and the distal side of one implant is never the same. Therefore the present study analysed the papilla as a unit and focused on the vertical fill related to the implant and adjacent teeth.

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Statement of Problem: In clinical situations, short implant abutments create lack of retention with overlying cemented prosthesis. Aims: The aim of this study is to evaluate the impact of different surface treatments on the retention of implant-supported cement-retained bridge with short implant abutments. Materials and Methods: Six straight Adin implant abutments of similar sizes (3 mm diameter × 3 mm height) were selected. All were divided into three groups (n = 2): with circumferential grooves and sandblasting (G + SB), with a circumferential groove and bur modification (G + B) and third one taken as control. The framework simulating three-unit bridge was casted in each group. A total of 30 such frameworks (10 for each group) were fabricated. Each casting was cemented with a zinc phosphate cement (Dentsply). The cemented frameworks were then being stored in 100% humidity at 37°C for 24 h. Retention tests were conducted with a universal testing machine (5 mm/min), and retentive forces were recorded. Data were subjected to one-way analysis of variance, Tukey's honestly significant difference test, (α = 0.05). Results: For the first group, retentive value increased by 619.30 N, the second group increased the retention by approximately 749.80 N (P < 0.001). The null hypothesis was rejected, the abutments with G + B showed significantly higher retention, than the G + SB and control group (F = 15.95, df = 29, P < 0.001). Conclusion: The addition of G + B to implant abutments significantly increased the retention of cement-retained frameworks. For long-term prognosis of the prosthesis; G + B modification can be a better option as compared to G + SB.

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