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Rhino-cerebral mucormycosis, a fateful fungal infection which was commonly known to affect the immunocompromised patients, is now thriving in conjunction with Corona virus disease 2019 (COVID-19). Early diagnosis and aggressive medical and surgical intervention are the key factors to extricate the patients. However, this leads to abundant hard and soft tissue loss, leaving behind a huge orofacial defect, along with certain morbidities and psychological trauma, necessitating surgical and prosthodontic rehabilitation. The present paper reviews on role of prosthodontist in various stages of treatment for mucormycosis patients. It also summarizes several treatment modalities including recent trends to rehabilitate the defect and restore the patients’ quality of life.

Three dimensional (3D) printing is the most widely used technology in reconstructive surgery to fabricate complex maxillofacial prosthesis. 3D Bioprinting, a combination of 3D printing and tissue engineering is a rapidly expanding technology in the field of regenerative medicine for autograft production. It is an additive manufacturing process in which there is computer-aided deposition of living cells with extracellular matrix (ECM) components with a biomaterial in particular combinations, for the fabrication of 3D biologically active tissue. In this review, we introduced the techniques, principles, limitations and future prospects of 3D bioprinting, a method that can open up new avenues in reconstructive surgery, by solving the problem of organ shortage and decreasing the donor site morbidity.

Introduction: Denture-induced candidiasis is a common disease in elderly denture wearers with Candida albicans as the principal causative agent. The problem is aggravated for elderly patients with limited motor skills who fail to follow a strict antifungal drug regime. To overcome this and to avoid the formation of biofilm on denture base resins, several attempts to incorporate antifungal agents/antiseptics into denture base resins, denture reliners and tissue conditioners have been reported. No study has been done to incorporate any herbal extract into polymeric systems and shows its elution and to compare it with commercially available antifungal drug. Aim: To evaluate the leaching of fluconazole and herbal neem extract incorporated into auto polymerising acrylic resin, heat polymerising acrylic resin and permanent silicone soft liner over a period of 21 days. And comparatively evaluate the effect of the leached antifungal agents on the growth of Candida albicans in-vitro. Materials and Methods: A total of 60 samples; 20 each of auto polymerising acrylic resin, heat polymerising acrylic resin and permanent silicone soft liner, (10 samples in each group incorporated with 10% w/w herbal neem extract and the other 10 with 10% w/w fluconazole), were fabricated using a stainless steel die of specific dimensions (50±1 mm in diameter and 1.0±0.05 mm thickness), as per the American Dental Association (ADA) specification no. 12. They were subsequently checked for leaching of the antifungal agents over a time period of three weeks at the intervals of 2,14 and 21 days using the High Performance Liquid Chromatography (HPLC) apparatus. The eluates were also checked for their anti-candidal activity by measuring the zones of inhibition of each agent in all the three test groups. Results: Fluconazole exhibited significantly better elution profile and antifungal activity against Candida albicans as compared to herbal neem extract. Amongst the materials tested, permanent silicone soft liner exhibited significantly higher elution and better antifungal activity in terms of colony inhibition of Candida albicans followed by auto polymerising acrylic resin and heat polymerising acrylic resin. Conclusion: 1) Fluconazole was established to be more potent than herbal neem extract against Candida albicans; 2) Permanent silicone soft liner was established to be the most effective polymeric system for sustained release of antifungal agents up to 21 days.

Background: A common problem faced by prosthodontists is achieving adequate retention and stability in the mandibular dentures. Recording the lateral throat form (LTF) correctly can aid in the retention and stability. Till date, Neil's classification has been considered as the gold standard in measuring the depth of the LTF. This is a subjective classification and varies among different operators. In this study, a customized tool was used to measure the depth of the LTF, and a classification was proposed according to the measured depths. Objectives: The objective of this study is to measure the exact depth of LTF using customized gauge and to propose a classification based on the measured depth. Materials and Methods: A customized gauge was made to measure the depth of the LTF. Two different observers classified the LTFs according to Neil's classification and according to the proposed classification in a total group of 50 patients. The customized gauge was inserted into the alveolo-lingual sulcus to measure the depth. The Pearson's correlation statistics was carried out to observe the inter-observer relationships of sulcus depth using this customized gauge. ANOVA test was used to compare the mean depth of the sulcus as measured by observers 1 and 2. Results: There was more inter-observer variability when Neil's classification was used as compared to the one with the proposed classification using the gauge. The inter-observer agreement for the proposed new classification was assessed by Cohen's kappa value, with P < 0.001. The mean depth of the sulcus as calculated by observers 1 and 2 was compared with ANOVA test and found to be significant with P < 0.001. Conclusion: The proposed new classification for LTF gave consistent results and was easier to use with less variability when compared to the Neil's classification.

A key factor for the success or failure of a dental implant is the manner in which stresses are transferred to the surrounding bone. This depends on the type of loading, bone–implant interface, the shape and characteristics of the implant surface and the quality and quantity of the surrounding bone. This study was done to evaluate the pattern of stress distribution with two different implant designs in four different densities of bone using 3D finite element analysis. Graphic pre-processing software Ansys version 10 was used for creating the geometric configuration of a section of the mandible with a missing first molar. Eight 3D models of this section restored with implant-supported all ceramic crowns were created. Four of these models were created to simulate a single threaded implant placed in four different densities of bone (D1, D2, D3 and D4). The other four models were created to simulate a single cylindrical implant placed in four different densities of bone (D1, D2, D3, and D4). The Poisson’s ratio (μ) and Young’s modulus (E) of elasticity of the material were incorporated into the model. An average vertical load of 400 N was applied on the occlusal surface of the first molar between the buccal cusp, central fossa and the marginal ridge. Maximum Von Mises stresses in all the eight models were observed at the crestal region or neck of the implant. The stresses observed were more for the threaded implants in all the four densities of bone when compared to that of the cylindrical implants. The study concluded that the cylindrical implant design was more favorable in softer bone than the threaded implant design.

Background and objectives The relationship between oral health and the nutritional status in the elderly is complex and controversial. It has been suggested that poor oral health and a decreased ability to chew have a profound influence on food selection, diet and thereby the nutritional status of the individual. This study aimed to evaluate the effect of edentulousness and prosthetic treatment on the nutritional status of the individual. Methods A total of 94 patients were selected for the study, which was conducted over a period of 16 months. The nutritional status was assessed using the Mini Nutritional Assessment Form (MNA) before the complete denture treatment and after an interval of 6 months and 9 months following the treatment. The individual scores obtained for each question and the total scores at the baseline study were compared with those obtained after 6 and 9 months. Proportions were compared using chi-squared test of significance. Results The results showed statistically significant differences in the total MNA scores between the baseline study and after 6 and 9 months. The edentulous patients without complete dentures had significantly lower MNA scores. Conclusion Prosthetic rehabilitation of the edentulous patients with complete dentures, along with the dietary counselling, improved the nutritional status of these patients.

The primary goal of the dental surgeon is to restore function as well as esthetics, and these objectives influence both the surgical andrestorative phases of treatment.This report presents a conservative management of congenitally missing bilateral maxillary lateral incisors that was treated with amultidisciplinary approach between an orthodontist and a prosthodontist to redistribute spaces and establish buccolingual alveolarwidth by orthodontic movement of permanent canines distally in the maxillary arch followed by placement of implants to achieve adesirable esthetic result.

Loss of the continuity of the mandible destroys the balance and the symmetry of mandibular function, leading to altered mandibular movements and deviation of the residual fragment towards the surgical side. To regain normal mandibular function for surgical resection of the ameloblastoma, initial rehabilitation was done using avascular fibular bone graft. Prosthetic rehabilitation was done by Placement of four implants in the anterior region followed by fabrication of suprastructure using UCLA abutments and ceramic crowns.

Aims: Assessment of prosthetic treatment needs is essential to determine oral health care needs in a systematic manner and to gather the information required to bring about change beneficial to the oral health of the population. Systematic assessment of treatment needs and patient satisfaction ensures that the available resources are optimally utilized to improve the oral health of the population. The objective of this survey was to assess the prosthetic status of patients visiting the Department of Prosthodontics of DAPMRV Dental College, Bengaluru, which was followed by the assessment of patient satisfaction 3 months after treatment. Furthermore, the influence of patient's gender, their mental attitude, and the type of prosthesis given on patient satisfaction was evaluated. Methods: A short interview was carried out with the selected patients to collect preliminary data. The socioeconomic status was recorded, following which an intra-oral examination was carried out to assess the prosthetic status and the type of prosthesis required by the patient. Patients were then given a questionnaire before the commencement of treatment to assess their mental attitude. The treatment decided on was completed for each patient. Patients' satisfaction with the treatment was assessed after 3 months using a questionnaire. Subsequent to the collection of data from the questionnaires, statistical analysis using the Chi-square test at a significance level of P < 0.05 was done to evaluate relationship between age, personality, mental attitude, and prosthetic treatment needs. Patient satisfaction was also assessed. Results: Statistically significant results were obtained on correlating the age and the treatment required, patients' mental attitude and the various treatment options. The relationship between the patients' gender, socioeconomic status, and mental attitude with their satisfaction was found to be noteworthy. Conclusion: The highest prosthetic treatment need was for complete dentures in both genders. Higher satisfaction levels were noted in individuals belonging to higher socioeconomic status and in males. No particular treatment modality had significantly higher or lower satisfaction scores.

Face is an important part of one's personality and body image. Facial disfigurement can have extremely negative psychological impact on any individual, which may include feeling of being ugly, deformed, disfigured, and complete loss of self-confidence. A facial prosthesis is fabricated to restore any such anatomical compromise, which can be congenital, due to trauma or oral/facial malignancies. Patients who need such prosthesis usually present a wide array of rehabilitation challenges mainly associated with restoring normal appearance. The following case report illustrates the prosthetic rehabilitation of a 9-year-old boy who was diagnosed with basal cell carcinoma of the nose and underwent partial rhinectomy. Surgical reconstruction was also done for the same, which was unsuccessful due to failure of graft. This led to loss of right lateral ala of the nose and depression of the upper half of the bridge of the nose. This case was then prosthetically managed with a spectacle retained nasal prosthesis made up of acrylic.

The most commonly seen intraoral defect is the one affecting the maxilla, through an opening into the nasopharynx. These defects can either be congenital or acquired. These are usually large openings in the palate and/or the surrounding structures. Obturators are used to close or seal these defects to restore proper mastication, speech, deglutition, and esthetics. This article presents case reports describing two different techniques for fabricating hollow bulb oburator.

The loss of a part of the face, particularly the eye, requires early replacement and hence that the patient may return to a normal life. The maxillofacial defect causes esthetic, functional, and psychological difficulties for the patient. Although most ocular prostheses can be made from a prefabricated artificial eye, customized ocular prostheses offer better esthetics. This article describes the fabrication of a custom ocular prosthesis where a prefabricated iris was modified to fit into a custom-made scleral portion of prostheses. The time for fabrication of prosthesis was less and good esthetics was achieved.