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AIM: Assessment of occlusion changes during laboratory phase of relining is essential to evaluate the occlusal discrepancies that could get incorporated in the denture with the use of different relining materials. Since the long term stability and functional success of the denture is heavily influenced by occlusion, an In-vitro study to assess these changes after relining is warranted. The aim of the study is to evaluate the changes in occlusion during laboratory phase of relining procedure. SETTINGS AND DESIGN: This is an in vitro study with a total of 30 specimen. MATERIALS AND METHODOLOGY: A total of 30 maxillary standardized dentures were fabricated after mounting on a semi adjustable articulator. These samples will be divided into three groups based on the relining material used (Autopolymerizing resin, Heat-cure resin, Tissue conditioner). The vertical dimension, Centric contact points and eccentric contact points were measured before and after relining. STATISTICAL ANALYSIS USED: The variables were tested to see if they had a normal distribution using the Shapiro-Wilk test. Parametric distribution was seen for ECP leading to further comparison using one way analysis of variance (ANOVA). Non-parametric distribution was found while testing the VD, CCP leading to adoption of Kruskal-wallis test for comparison of groups. Dunn Bonferroni test was done for VD since results were significant. RESULTS: The results of this in-vitro study showed statistically significant difference with respect to change in vertical dimension in all groups pre and post relining (P = 0.005). The centric contact points showed lesser variation in position when comparing the pre to the post relining phase with the use of autopolymerising resins, whereas heat cure resins and tissue conditioners showed statistically significant difference in the centric point contacts post relining. No statistically significant changes were seen in eccentric occlusion post relining in all groups. Tissue conditioners showed minimum mean changes in eccentric contacts. CONCLUSION: Within the limitations of this study, the use of autopolymerising resins depicted the most stable results with respect to occlusion, for relining of dentures.

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Aims: The aim of this study was to assess the impact of prosthodontic rehabilitation on glycemic and lipid control in functionally and completely edentulous patients with diabetes. Setting and Design: An in vivo study conducted with the intention of studying the potential link between edentulism and impaired masticatory efficiency with the nutritional status in diabetic patients. Materials and Methods: A total of 20 diabetic patients based on the inclusion criteria were selected. They were rehabilitated using a removable prosthesis, and observations were made across three parameters - glycosylated hemoglobin (HbA1C), serum cholesterol (S col), and serum protein (SP) at three stages - baseline, 3 months, and 6 months posttreatment. This was done to gauge the impact of the prosthetic rehabilitation on their health due to an increased masticatory efficiency potentially causing changes in dietary patterns. Statistical Analysis Used: •Inter group comparison (>2 groups) was done using one way ANOVA followed by pair wise comparison using post hoc test. •Intra group comparison was done using repeated measures ANOVA (for>2 observations) followed by post Hoc test. For all the statistical tests, P < 0.05 was considered to be statistically significant, keeping α error at 5% and ß error ati20%, thus giving a power to the study as 80%. Results: Hba1c at the baseline had a mean value of 8.04%, which reduced to 7.87% at the 3-month stage and 7.38% at the 6-month stage. S col at the baseline had a mean of 151.6 mg/dL; at the 3-month follow-up, it was 166.5 mg/dL, and at the 6-month follow-up, it was 173.95 mg/dL. SP had a mean baseline value of 6.38 mg/dL, which progressed to 6.67 mg/dL at the 3-month stage and 6.97 at the 6-month stage. Conclusion: Within the limitations of this study, it can be concluded that after 6 months of prosthetic rehabilitation in edentulous/functionally edentulous patients: There was a reduction in HbA1c (8.04%-7.38%); however, it was found to be statistically insignificant at that stage There was an increase in S col (151.6 mg/dL-173.95 mg/dL); it was found to be statistically significant There was an increase in SP (6.38 mg/dL-6.97 mg/dL); however, it was found to be statistically insignificant at that stage.

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PURPOSE: A Comparison of Occlusal Schemes with Condylar Inclination and Anterior Guidance in Dentate Individuals Methods. Twenty-six dentate patients between the ages of 18 to 30 of Indian Origin with canine-guided occlusion and 26 patients with group function occlusion were included in the study. The School of Articulator Munich (SAM) Axioquick system was used to assess the condylar guidance and eccentric tracings of the patients. For analyses, Student's t-test was used. For quantitative data, the mean and standard deviation were calculated. For all the statistical analysis the probability of type-I error of 0.05 was considered statistically significant. RESULTS: The mean condylar guidance for canine guided and group function occlusion on the right side was 38.4 ±12.7 and 30.5 ±12.5 and on the left side was 36.5 ±13.0 and 27.5±12.0 degrees with statistically significant difference [P value: 0.01]. The condylar guidance, incisal guidance, Bennett angle, protrusion, left lateral, right lateral, and left and right lateral angles were analyzed statistically between the two types of occlusions. The results showed a statistically significant difference between the two groups for all parameters except right condylar guidance. Furthermore, all the parameters were higher in canine guided occlusion group over group function occlusion. CONCLUSIONS: Within the study limitations, it was concluded that the condylar guidance was steeper in canine guided occlusion than in group function occlusion. The eccentric parameters were steeper in canine guided occlusion than in group function occlusion. CLINICAL SIGNIFICANCE: This study showcases that the condylar guidance might not play a major role in determining the occlusal scheme but, the incisal guidance determines the occlusal scheme predominantly in class 1 occlusion patients.

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Cleft lip and palate are the most common orofacial anomalies affecting the quality of life of an individual. Bilateral cleft lip and palate are the most difficult to treat due to missing premaxilla, and removable prosthesis is the only treatment in such situations to satisfy esthetics, function, and phonetics. In this case report, we have discussed a novel technique of rehabilitating a bilateral cleft palate patient with a fixed hollow prosthesis that would replace the missing hard and soft tissue, yet is light weighed. This unique prosthetic solution could set a new standard of treatment in a seemingly compromised situation.

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BACKGROUND: Dental implants have become a popular alternative in the oral and maxillofacial rehabilitation after the introduction of the concept of osseointegration. A poor density bone can negatively influence the bone to implant contact (BIC) and delay osseointegration. Various osteotomy techniques and drilling procedures have been used to increase stability in low-density bone. But they have been associated with limitations such as trauma to the surrounding bone and difficulty in controlling the technique. Osseodensification has recently been developed. Densifying burs are specifically designed burs which help in preserving the bone by condensing the bone by rotating in the noncutting direction. MATERIALS AND METHODS: Split-mouth study was conducted on a total of 10 patients wherein implants were placed in the same patient bilaterally in maxillary posterior region where the left maxillary posterior region received implants through sequential osteotomy technique and the right maxillary posterior region received implants through a series of new multifluted tapered burs (Densah™). A cone-beam computed tomography (CBCT) was taken preoperatively, immediately after implant placement, and 3 and 6 months after implant placement. The bone density and crestal bone levels were measured. Results were analyzed by student's paired "t" test and Man-Whitney U test. RESULTS: There is no statistical difference between the levels of the crestal bone between an osseodensified site as compared to a conventional osteotomy site. The width of the residual bone increases after osseodensification and remains in the increased dimension for 3 months and continues at 6 months. Thus, it can be concluded that osseodensification leads to bone expansion. CONCLUSION: The radiographic bone density adjacent to the implant is significantly increased after ossedensification and the bone there remains relatively dense over a period of 6 months aiding in a primary stability and eventual good osseointegration.

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Aims: This study aimed to evaluate the combined influence of condylar and incisal guidance in canine-guided and group function occlusal schemes. Settings and Design: In vivo - Cross sectional study. Materials and Methods: A total number of 88 subjects were selected and classified into two groups: 44 subjects with canine guided and 44 subjects with group function occlusal schemes. Condylar and incisal guidance tracings of both the groups were recorded using SAM AXIOQUICK RECORDER (School Articulator Munich) and evaluated. Statistical Analysis Used: Kolmogorov-Smirnov test and Shapiro-Wilk test were employed to test the normality of data. Independent sample t-test and Mann-Whitney U-test was performed for quantitative variables. Results: The condylar and incisal guidance among canine-guided individuals was 31.38 ± 12.01 and 55.83 ± 14.04, respectively, while in group function individuals, it was 29.44 ± 12.65 and 43.74 ± 20.27. Conclusions: Within the limitations of the present study, condylar guidance was similar in subjects with both schemes of occlusion, whereas steeper incisal guidance was noticed in canine-guided individuals as compared to group function.

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BACKGROUND: The "All-on-four" concept for treatment of edentulous arches incorporates four implants that are placed in between mental foramina in the mandible. The prosthetic framework is an important parameter in stress/strain concentration at the implants, prosthesis, and the underlying bone. Materials such as titanium, zirconia, and carbon fibers have been used for fabrication of framework in the past. The aim of this study was to analyze the effect of framework materials in the "All-on-four" implant system. MATERIALS AND METHODS: Finite element three-dimensional (3D) model of edentulous mandible was simulated using a computerized tomographic scan data of an edentulous patient. Threaded implants were replicated along with the abutments using 3D modeling software and the framework was designed and simulated using material properties of titanium, zirconia, and polyetheretherketone (PEEK). Axial and nonaxial load of 200 N was applied at the abutment region of right distal implants. The computer-generated numerical values were tabulated and analysed by ANSYS software. RESULTS: Principal strain, von Mises stress and micromotion were assessed in the peri-implant bone region to evaluate its stress condition. Zirconia framework showed the least stress/strain values at axial and oblique loading. Maximum strain values were seen at the PEEK framework material. Zirconia framework in all models showed the least micromotion/displacement. CONCLUSION: The stress distribution pattern at implant-bone interface was influenced by the framework material used. The framework material, loading site, and direction of forces influenced the stresses and displacement at the bone-implant interface.

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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.

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An accurate diagnostic and interdisciplinary approach is essential for obtaining suitable, conservative, and predictable results in areas with high esthetic demand. Patients reporting with an improper prosthesis that has a black triangle pose a challenge for soft-tissue esthetic rehabilitation. Re-restoration of such cases with conventional fixed prosthesis would be undesirable due to imbalance in pink and white esthetics. This case report describes an interdisciplinary approach to maintain the existing midline diastema and correction of black triangle in the interproximal area between abutment and pontic in the esthetic zone. Minimally invasive vestibular incision subperiosteal tunneling access technique with connective tissue graft was planned for reconstructing the interdental papilla, followed by prosthetic rehabilitation of edentulous site with fixed partial denture using loop connector design to maintain the midline diastema. Postoperative result showed a comprehensive, pink and white rehabilitation to meet the patient's esthetic demand.

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OBJECTIVES: : This study is aimed to evaluate and compare the effect of moist heat fomentation therapy with ultrasound therapy in patients with the masticatory myalgia. MATERIALS AND METHODS: The study was conducted on 42 patients with masticatory myalgia, dividing them into two groups; Group A (21 patients), received moist heat therapy and Group B (21 patients), received ultrasound therapy for seven effective days. Prior and after the treatment the numeric rating scale (NRS) and the electromyography (EMG) scores were recorded and compared. The observations were analyzed clinically and statistical support was taken to assess the NRS and EMG data. RESULTS: Irrespective of the groups, patients testified a significant reduction in pain after the treatment. From the EMG readings; even though the standard deviation for each group was varied considerably, EMG recorded an improved muscle activity. Statistical analysis was used to assess and identify the best treatment methodology between the two modalities. CONCLUSION: From the statistical analysis, it is concluded that, though both the therapies had significantly reduced the symptomatic response, it is moist heat fomentation that improved muscle activity both statistically and clinically in comparison to ultrasound.

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BACKGROUND: Augmentation of the maxillary sinus increases the lost height of ridge in the posterior maxilla. Bony convolutions from the floor of the sinus called septa may be encountered during the procedure and significantly impact the outcome of the procedure. MATERIALS AND METHODS: For this retrospective study, 120 cone-beam computed tomography (CBCT) scans were collected from the archives of the department of oral radiology in the time period between January 2016 and August 2018. Planmeca Romexis® software version 3.2.7 was used to check for the incidence, and then among the septa, plane of orientation, location with respect to the wall of the sinus, and in terms of relation to tooth were examined. The average height and average width of all the septa were measured using a measuring tool in the software. RESULTS: Thirty-five of the total 88 patients showed septa in 40 sinuses, in which 36 sinuses showed one septum and 4 sinuses showed 2 septa. Forty-one septa were located on the floor of the sinus in the frontal orientation and 3 septa were located on the lateral wall of the sinus in the axial orientation. The mean height and mean width of the 41 septa on the floor of the sinus were 5.72 mm and 3.47 mm, respectively. The mean height of septa found on the lateral wall of the sinus was 5.59 mm. CONCLUSION: Septa had a higher tendency to be in bucco-palatal direction and on the floor of the sinus and frequent occurrence in the region of molars. A thorough prediagnostic evaluation using CBCT is necessary prior to sinus augmentation procedures.

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AIM: There is an increased awareness for aesthetically pleasing restorations among patients in current practice. Due to variability in the natural tooth colour, shade selection becomes an intricate procedure. The aim of this study is to determine which of the three named methods is more accurate for shade selection in aesthetic dentistry. MATERIALS AND METHODS: Two VITAPAN classical shade guides were used for this study. Nine shades were selected from the first shade guide (A1, A2, A3.5, B1, B2, B3, C1, C2, C3) and the number was concealed. Ten selected participants were asked to identify each concealed shade with the second shade guide. Canon 5D camera with ISO 200, shutter speed 1/100 sec, F22 was used for capturing images of the second shade guide. Photoshop CS3 Software was used for developing the digital shade guide. The participants were asked to match the shades from the first shade guide with the prepared digital shade guide. The third photographic shade guide was prepared using a polarised filter on the Canon 5D camera with the same settings. The participants were asked to match shades with the prepared photographic shade guide. RESULTS: Total observations made during the study were 270. Cross table statistical analysis (Chi-square test) done using SPSS 20.0 showed statistically significant difference between conventional and digital photography (P = 0.049). Analysis between digital photography and polarizing filter photography did not reveal a significant association (P = 0.181). CONCLUSION: Digital photographic method was most accurate among the three shade selection methods. It can be used to obtain aesthetic results.

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BACKGROUND: The objective of the study was to estimate the fluoride content in regular food items available, including fish, in a coastal area of the South Karnataka state of India. MATERIALS AND METHODS: Fish and food samples were collected from a local market, i.e., Deralakatte, Mangalore of Karnataka State, India. Commonly consumed different species of fish (eight types are included in the study) and popular food items (twelve types) were collected through a random sampling strategy and then processed for the study. The flesh and bones of fish were separated from individual fish. Samples of flesh, bones, and food (nonfish, vegetarian food consumed by a proportion of Karnataka population) were homogenized separately, dried, and the pH of the processed samples was adjusted to neutrality (pH 7.0). Fluoride anion was determined using a fluoride ion selective electrode (ISE, Nico2000 Ltd., UK). Although the ingredients of the different fish and food items explored differed, the same processing technique and analytical laboratory bench-work procedure were performed for each sample, i.e., as per published research elsewhere. This ensured the accurate estimation of fluoride for each food item. RESULTS: Concentrations of fluoride in foods (Nonfish, vegetarian food) was estimated to ranging from 0.85 to 7.09 ppm and that in fish samples ranged from 1.45 to 2.30 ppm. The highest concentration was estimated 3.16 ppm in Rohu fish flesh, and 7 ppm in rava dosa (a vegetarian food). CONCLUSION: In conclusion, the Rohu (Labeo rohita) fish species were found to contain higher concentrations of bone fluoride. Fluoride determined in fish flesh was also high in concentration 2.28 ppm. Among the regular food items, rava dosa (a thin and crispy crepe made from rava and rice flour) preparation has a higher level of fluoride. These values would provide valid information regarding the future development of recommended dietary allowance strategy for a population.

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CONTEXT: This study was done to determine the level and type of microbial contamination present on the surface of various dental laboratory equipment and laboratory attire and to determine the antibiotic susceptibility pattern of these isolated pathogens. SUBJECTS AND METHODS: The samples were divided into following groups: six groups of dental laboratory equipment (articulators, facebow, fox plane, polishing buff, micromotor handpiece, and surveyors) and dental attire of laboratory technicians and students. A total of 33 swabs were collected from each dental laboratory equipment, namely, articulators, facebow, fox plane, polishing buff, micromotor handpiece, and surveyors. The dental laboratory attire of students and dental technicians were analyzed separately. The swabs were collected from the laboratory attire at the end of the week, and they were washed once a week and at the beginning of the week. The groups are Group 1 - dental laboratory attire (students), Group 2 - dental laboratory attire (technicians), Group 3 - polishing buff, Group 4 - facebow, Group 5 - surveyor, Group 6 - fox plane, Group 7 - articulator, and Group 8 - micromotor handpiece. The moistened swabs were inoculated into the broth and subcultured on to the MacConkey Agar plates, and then incubated aerobically at 37°C for 24 h. The organisms were identified based on colony morphology, Gram staining, and standard biochemical tests. The antibiotic susceptibility patterns of the isolated organisms were done according to the CLSI guidelines. The collected data were statistically analyzed. STATISTICAL ANALYSIS USED: The data collected were entered into a Microsoft Excel Spreadsheet and analyzed using IBM SPSS Statistics, Version 22 (Armonk, NY, IBM Corp.). The frequency and mean standard deviation of the samples were analyzed using Fisher's exact value test. Percentage of resistance among the isolates to different antimicrobials was also determined. RESULTS: The microorganisms isolated were Staphylococcus aureus, Escherichia coli, coagulase-negative Staphylococcus, Pseudomonas, Klebsiella, nonfermenting Gram-negative bacteria, and Bacillus species. The mean microbial levels in dental laboratory attire were more (5 log10 colony-forming units [CFU]) compared with dental equipment (3 log10 CFU-4 log10 CFU). Furthermore, most of the isolated organisms showed increased antimicrobial resistance. CONCLUSION: Majority of the isolated organisms were not a part of the normal oral microflora and are capable of causing various diseases. The increased resistance to the antimicrobials showed by the isolated organisms proves that there are increased chances of multiresistant organisms to occur in the future.

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This study was undertaken to compare the bone density in nondiabetic and controlled type II diabetes patients using spiral computed tomography. A group of 40 edentulous men, comprising of 20 nondiabetics and 20 controlled type II diabetics between the ages of 50-65 years, were enrolled in the study. Glycemic control of the diabetic patients was assessed by glycosylated hemoglobin level. The controlled diabetic group had an HbA1c level between 6.1-8%. A radiographic stent was prepared by using chemically cured resin. Bone densities at trabecular, buccal, and lingual cortical regions of maxillary and mandibular edentulous arches were measured by a tomography machine. Mean bone density measurements were recorded in Hounsfield units. The data thus obtained from 10 sites of maxillary and mandibular arches were tabulated and analyzed using SPSS statistical software. This study showed no significant changes in bone density between the controlled diabetic and nondiabetic subjects. Within the limitation of this study, it can be concluded that bone density does not seem to be affected in controlled type II diabetics.

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This study compared levels of the 2 crevicular enzymes-myeloperoxidase (MPO) and alkaline phosphatase (ALP)-in peri-implant sulcus fluid (PISF) around platform-switched implants (implant group) vs the 2 enzymes' levels in gingival crevicular fluid around contralateral natural teeth (control group). Twenty subjects were selected from a population who were set to receive fixed implant prostheses. Samples for PISF were collected at 3 different intervals: 1 week after the placement of a healing abutment, 1 week after the implant prosthesis was loaded, and 3 months post-treatment. Control group samples were taken at the same time points. The results from the implant group showed a statistically significant reduction in MPO levels from the first to the third collection, and a statistically significant increase in ALP levels over the 3-month post-treatment period, as compared to the control group.

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INTRODUCTION: The prevalence of group function and canine guided occlusion is common in natural dentition, but cross arch balance is not often seen. Hence, a study was carried out with following objectives: Analysis of incidence of cross arch balance in different age groups and working side occlusal wear facets in following subjects. MATERIALS AND METHODS: A total of 200 patients with natural dentition were included in the study. Subjects with cross arch balance were analyzed for working side occlusal wear facets. Data were analyzed statistically by Chi-square test. RESULTS: The incidence of cross arch balance in the study group was 0.7%. On examination, subjects with group function on the working side and cross arch balance on the non-working side had more occlusal wear facets. CONCLUSION: From the study, it was observed that there was no significant variation in the number and extent of wear facets between the cross arch and without cross arch subjects due the smaller sample size hence it was difficult to conclude the relationship non-working side contact as interference and its influence in wearing of dentition in this study.

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CONTEXT: To ascertain the use of nasion as a guide in locating the position of orbitale as an anterior reference point in the face-bow transfer records in individuals having different facial types. AIMS: This study evaluated the distance from the nasion to the orbitale using cephalometric measurements to ascertain the use of nasion as a guide in locating the position of orbitale as an anterior reference point in individuals having different facial types among a population of South Coastal Karnataka. SUBJECTS AND METHODS: Anthropometric measurements were made on 61 subjects and they were classified into mesoprosopic, euryprosopic and leptoprosopic facial type groups based upon the prosopic index. Lateral cephalometric radiographs were taken and nasion to orbitale distance was measured. The collected data was tabulated and statistically analyzed. STATISTICAL ANALYSIS USED: The statistical test carried out was the analysis of variance test and correlations were checked for using Pearson's correlation test. RESULTS: The study found the mean distance from nasion to orbitale was 24.25 mm with a standard deviation 4.26 mm. A good correlation was found between prosopic index and nasion to orbitale distance. No statistically significant variation in nasion to orbitale distance in individuals of different facial types was found. CONCLUSIONS: Although, variation exists it was not statistically significant. However, since a large range of measurements were found, prior evaluation using cephalometric radiographs may be necessary in certain individuals.

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To evaluate dimensional accuracy and tensile strength of a type IV gypsum product, at different time intervals, dried in air or a microwave oven. Eighty specimens prepared from a cylindrical mould were used for measuring tensile strength (group A). Twenty specimens from a master die mould were used for determining dimensional accuracy (group B). In group A, 40 specimens were dried in open air at room temperature (A1). The other 40 were removed after 30 min and air dried for 20 min. These were subjected to microwave oven drying for 5 min (A2). Ten specimens each were tested under diametral compression at each of the following time periods: 1, 2, 4 and 24 h after drying. In group B, ten specimens were dried in open air at room temperature (B1). Ten specimens were removed from the mould after 30 min and air dried for 20 min. These were then dried in a microwave oven for 5 min (B2). The data was statistically analyzed using students unpaired "t" test. At all time intervals, diametral tensile strength (DTS) values for specimens dried in microwave oven were significantly higher than for those dried in open air. There were no significant differences between the dimensional accuracy of the two groups. In this study, microwave oven drying had a positive effect on the DTS of a type IV gypsum and the microwave oven dried specimens were as accurate as the air dried specimens over the same time period.