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To evaluate and compare the positional and angular accuracy of virtual implant positions planned on cone-beam computed tomography and final implant positions achieved using a universal open guide system.A dual scan of a partially edentulous jaw model along with prosthesis was done, and virtual implant planning was performed. Three implant positions in relation to 35, 36, and 37 were simulated (Group A). In total, 24 implants were placed in eight replaceable bone blocks (Group B) in the same region on the model using an open stereolithographic template. The linear positions and angulation of the placed implants were determined using Vision Measuring Machine. Deviations between virtually planned and surgically placed implants were analyzed in terms of linear and angular measurements. Data were analyzed with the independent-sample t-test with differences P ≤ 0.05 being considered statistically significant.The linear distance (mean ± standard deviation [SD]) in mesiodistal direction between implants in relation to 35 and 36, 36 and 37, 35 and 37 in Group A was 8.79 ± 0 mm, 8.71 ± 0 mm, and 17.50 ± 0 mm, respectively, and in Group B was 7.70 ± 0.58 mm, 8.11 ± 0.30 mm, and 15.80 ± 0.48 mm. All these above values were found to be statistically significant (P ≤ 0.05). The linear distance (mean ± SD) in the vertical direction (mesial) for implants placed in the region of 35, 36, 37 for Group A was 1.51 ± 0 mm, 1.51 ± 0 mm, and 2.47 ± 0 mm, respectively, and for Group B was 1.37 ± 0.32 mm, 1.65 ± 0.48 mm, and 1.79 ± 0.36 mm, respectively. The linear distance (mean ± SD) in the vertical direction (distal) for implants placed in the region of 35, 36, 37 for Group A was 3.37 ± 0 mm, 1.51 ± 0 mm, and 1.51 ± 0 mm, respectively, and for Group B was 1.86 ± 0.48 mm (P ≤ 0.05), 1.56 ± 0.23 mm, and 1.29 ± 0.39 mm (P ≤ 0.05), respectively. The angular deviation (perpendicularity) values for virtually planned implants (Group A) were 90.00° ± 0° and for implants placed in the region of 35, 36, and 37 (Group B) were 84.52° ± 5.4°, 83.57° ± 1.52°, and 80.41° ± 2.37°, respectively, which are highly significant (P ≤ 0.05).The stereolithographic universal open guide used in the study may be considered accurate for placement of implants in mesiodistal position and also in terms of perpendicularity but not in the vertical position. Stereolithographic open guide may be recommended for more accurate implant position, especially for the placement of multiple implants.

The most frequent type of treatment for patients diagnosed with a malignant neoplasia of the oral cavity is surgical resection of the tumor. Ablative surgery may be followed by a reconstructive phase, in which the surgeon may choose between local flaps, nonvascularized bone grafts or free vascularized flaps to close the surgical site, depending on the general conditions of the patient. Esthetic and functional results are challenging to achieve for the prosthodontist, as variable amount of hard and soft tissues are removed. This report describes the fabrication of a two-piece hollow obturator for a 19-year-old patient who underwent wide surgical excision of the osteosarcoma of the maxilla and was rehabilitated to function. In this case, the surgical site was covered with submental flap, and the second piece of the obturator provided fullness to the lost malar prominence.

Purpose: To evaluate and compare the positional and angular accuracy of virtual implant positions planned on cone-beam computed tomography and final implant positions achieved using a universal open guide system. Materials and Methods: A dual scan of a partially edentulous jaw model along with prosthesis was done, and virtual implant planning was performed. Three implant positions in relation to 35, 36, and 37 were simulated (Group A). In total, 24 implants were placed in eight replaceable bone blocks (Group B) in the same region on the model using an open stereolithographic template. The linear positions and angulation of the placed implants were determined using Vision Measuring Machine. Deviations between virtually planned and surgically placed implants were analyzed in terms of linear and angular measurements. Data were analyzed with the independent-sample t-test with differences P ≤ 0.05 being considered statistically significant. Results: The linear distance (mean ± standard deviation [SD]) in mesiodistal direction between implants in relation to 35 and 36, 36 and 37, 35 and 37 in Group A was 8.79 ± 0 mm, 8.71 ± 0 mm, and 17.50 ± 0 mm, respectively, and in Group B was 7.70 ± 0.58 mm, 8.11 ± 0.30 mm, and 15.80 ± 0.48 mm. All these above values were found to be statistically significant (P ≤ 0.05). The linear distance (mean ± SD) in the vertical direction (mesial) for implants placed in the region of 35, 36, 37 for Group A was 1.51 ± 0 mm, 1.51 ± 0 mm, and 2.47 ± 0 mm, respectively, and for Group B was 1.37 ± 0.32 mm, 1.65 ± 0.48 mm, and 1.79 ± 0.36 mm, respectively. The linear distance (mean ± SD) in the vertical direction (distal) for implants placed in the region of 35, 36, 37 for Group A was 3.37 ± 0 mm, 1.51 ± 0 mm, and 1.51 ± 0 mm, respectively, and for Group B was 1.86 ± 0.48 mm (P ≤ 0.05), 1.56 ± 0.23 mm, and 1.29 ± 0.39 mm (P ≤ 0.05), respectively. The angular deviation (perpendicularity) values for virtually planned implants (Group A) were 90.00° ± 0° and for implants placed in the region of 35, 36, and 37 (Group B) were 84.52° ± 5.4°, 83.57° ± 1.52°, and 80.41° ± 2.37°, respectively, which are highly significant (P ≤ 0.05). Conclusions: The stereolithographic universal open guide used in the study may be considered accurate for placement of implants in mesiodistal position and also in terms of perpendicularity but not in the vertical position. Stereolithographic open guide may be recommended for more accurate implant position, especially for the placement of multiple implants.

The study was undertaken to evaluate the reliability of different facial measurements for determination of vertical dimension of occlusion in edentulous subjects using accepted facial dimensions recorded from dentulous subjects. The hypothesis was that facial measurements can be used to obtain the vertical dimension of occlusion for edentulous patients where no pre-extraction records exist. A total of 180 subjects were selected in the age groups of 50–60 years, consisting of 75 dentate male and 75 dentate female subjects for whom different facial measurements were recorded including vertical dimension of occlusion and rest, and 15 edentulous male and 15 edentulous female subjects for whom all the facial measurements were recorded including the vertical dimension of rest and occlusion following construction of upper and lower complete dentures. The left outer canthus of eye to angle of mouth distance and the right Ear–Eye distance were found to be as valuable adjuncts in the determination of occlusal vertical dimension. The Glabella–Subnasion distance, the Pupil–Stomion distance, the Pupil–Rima Oris distance and the distance between the two Angles of the Mouth did not have a significant role in the determination of the occlusal vertical dimension. The vertical dimension can be determined with reasonable accuracy by utilizing other facial measurements for patients for whom no pre-extraction records exist.

Prosthetic rehabilitation of acquired maxillary defects can be achieved satisfactorily if all facets of treatment planning and design considerations are taken into account before the rehabilitation process. Complications associated with maxillary defects limit treatment protocols to a great extent. The prosthodontist has to identify these problem areas and suitably devise feasible options and incorporate them in the design. In this report, an acquired maxillary defect with unfavorable undercuts in the defect was successfully treated by making a two-piece sectional obturator. The two pieces were connected by the use of double-die pin system. The methodology greatly reduced chairside time and number of visits, and effective obturation was satisfactorily achieved.

Women smokers are likely to increase as a percentage of the total. If the percentage of women who smoke in developing countries rise to the levels of men smokers, there will be more than 500 million women smokers in the next generation. Because women who smoke die from the same tobacco-caused diseases as men, such an increase will have dramatic effects on women's health and on the health and incomes of their families. In addition, women smokers are also at risk for developing cancer of the reproductive organs and osteoporosis. A gender perspective contributes to a better understanding of the epidemiological trends, social marketing strategies, economic policies, and international actions relating to women and the tobacco epidemic.

Full mouth rehabilitation continues to be the biggest challenge to any clinician in Restorative dentistry. It requires efficient diagnosis and elaborate treatment planning to develop ordered occlusal contacts and harmonious articulation in order to optimize stomathognathic function, health and esthetics which then translates to patient's comfort and satisfaction. Thorough knowledge of the various concepts of articulation is therefore integral to any full mouth rehabilitation that is taken up to address the patient's problem related to restoration of multiple teeth that are either decayed, worn, broken, discolored, missing or suffer developmental deficits. This case report describes the Full mouth rehabilitation of a 22 year old girl who reported with multiple decayed and discolored fluorosed teeth with proclined anteriors. The case was treated with individual Porcelain fused to metal crowns and a bridge with Group function occlusal scheme using Simultaneous full arch technique which is although exacting, exhaustive and demanding provides for a structured stable and predictable articulation. Several techniques of Full mouth rehabilitations are available and a clinician should ascribe to one after a comprehensive diagnosis of the patient's clinical condition and prospective consideration of his/her oral health, function, comfort and esthetic requirements.

Endodontically treated teeth with loss of tooth structure from cemento-enamel junction require post and core restoration for their long-term survival. Thus, an in vitro study was conducted, in which 30 extracted human maxillary central incisors, cut from cemento-enamel junction, were divided into 3 groups of 10 teeth each and restored with fiber-reinforced composite post–core, Ti-alloy post with fiber-reinforced composite core, and Ni–Cr cast post–core following endodontic treatment. Ni–Cr cast post–core group showed highest maximum force tolerated and fracture strength followed by fiber-reinforced composite post–core group and Ti-alloy post with fiber-reinforced composite group. Maximum incident of root fracture was found in Ni–Cr post–core group, followed by Ti-alloy with fiber-reinforced composite core group, thus rendering the teeth non-treatable.

A variety of functional tooth contact patterns exist in population of young adult patients.The purpose of the present study is to find the relationship between different lateral tooth contact patterns and dental morphology and their effect on masticatory efficiency. Forty young dentulous subjects were selected and their impression with irreversible hydrocolloid was made. Polyvinyl silicone bite registration paste was used to record lateral tooth contact patterns in functional range of mandibular movement. Overjet and overbite including mesiodistal relation of tooth recoded with cast secured in the intercuspal position and masticatory efficiency was determined by calorimetric method by using raw carrot. Among all subjects 15% having canine protection, 55% group function, and 30% balance occlusion. There is positive correlation between age and masticatory efficiency [r=+0.656, p

Structured Abstract Authors – Batra P, Kharbanda OP, Duggal R, Singh N, Parkash H Objectives – The aim of the study was to investigate alkaline phosphatase activity in the gingival crevicular fluid (GCF) during orthodontic tooth movement in humans. Setting and Sample Population – Postgraduate orthodontic clinic. Ten female patients requiring all first premolar extractions were selected and treated with standard edgewise mechanotherapy. Experimental Variable – Canine retraction was done using 100 g sentalloy springs. Maxillary canine on one side acted as experimental site while the contralateral canine acted as control. Outcome Measure – Gingival crevicular fluid was collected from mesial and distal of canines before initiation of canine retraction (baseline), immediately after initiation of retraction, and on 1st, 7th, 14th and 21st day and the alkaline phosphatase activity was estimated. Results – The results show significant (p

This prospective study was conducted on 24 North Indian subjects (10 Control and 14 Twin-block) to evaluate the skeletal and dentoalveolar effects of Twin-block appliance in the treatment of Class II division 1 malocclusion. The result of the present study showed that Twin-block is an effective appliance in accelerating mandibular growth. It also helped dramatically in molar correction and overjet reduction in Class II division 1 malocclusion subjects.

Klippel-Feil syndrome (KFS) is a rare congenital abnormality characterized by shortening of the neck because of fusion of 2 or more cervical vertebrae frequently associated with other congenital abnormalities of the spine with or without neurologic disturbances. In its extreme form, there is a gross restriction of movement of the neck. A slight abnormality may go unrecognized until chance detection (usually in an x-ray of the cervical spine). Maurice Klippel, a French internist, and Andre Feil first recorded the complete picture of the syndrome in a case report of a 46-year-old tailor having an unusually short neck with gross restriction of movement. He had only 4 cervical vertebrae, which were fused in a single mass with posterior spina bifida. The syndrome consists of easily recognizable signs (short neck and posterior hairline lower than normal) and definite limitation of head and neck movements. It may also be associated with anomalies of the genitourinary, musculoskeletal, neurologic, and cardiac systems. However, a patient of this syndrome may otherwise be normal. Three patterns of vertebral abnormalities have been described with KFS: type I: fusion of several cervical and upper thoracic vertebrae. Type II: fusion of 1 or 2 interspaces sometimes accompanied by hemi-vertebrae, occipito-atlantal fusion, and other vertebral abnormalities. Type II has the lowest risk of the scoliosis. Type III: fusion of cervical vertebrae associated with fusion of lower thoracic and lumbar vertebrae. A fourth type (type IV) has been suggested and is associated with sacral agenesis. Abnormal bony masses have been reported in the mandibular ramus region along with congenital duplication of mandibular rami. These masses extend from the zygomatic arch region toward the ascending ramus of the mandible and the maxillary tuberosity area (producing partial to complete trismus). The inferior end either lies free in the buccal soft tissues or may be attached to the rudimentary coronoid process by a fibrous joint.

Non-syndromal bilateral dentigerous cysts are rare. It is conceivable that they are either under-recognized or under-reported. In this article we report the unusual occurrence of non-syndromic bilateral dentigerous cysts associated with mandibular third molars with polymorphism in chromosome 1qh+. It is suggested that in non syndromal cases of bilateral dentigerous cysts karyotyping should be done to confirm the association with chromosomal 1 anomaly.

During the recent years orth odontic ca re fo r medica lly compromised pati ents have received considerabl e attention. Th e influence s of various systemic diseases on orthodontic treatment have been disc ussed and vari ous recommendati ons to overcome the potential probl ems have bee n hi ghlighted in thi s article.

This cross-sectional study was conducted on 40 subjects to investigate the effects of timings and number of palate surgeries on maxillary growth in complete unilateral cleft lip and palate patients.The number of surgeries performed for palate repair was not an important growth inhibiting factor of maxilla, rather the age at which the initial palate surgery was performed for palate repair was an important factor in influencing maxillary growth.

Cleft lip with or without cleft palate (CL/CP) is one of the most common structural birth defects, with treatment including multiple surgeries, speech therapy, and dental and orthodontic treatments over the first 18 years of life. Providing care for these patients and families includes educating patients and parents about the genetics of CL/CP, as well as meeting the immediate medical needs.Attempts at identifying susceptibility loci via family and case-control studies have proved inconsistent. It is likely that initial predictions of the complex interactions involved in facial development were underestimated. The candidate gene list for CL/P is getting longer and the need for an impartial, systematic screening technique, to implicate or refute the inclusion of particular loci, is apparent. So we are faced with the question "Can this complex trait be too complex?"The aim of this review is to make the dentist aware of the differences between syndromic and non-syndromic cleft as well as understanding the etiological variation in cleft lip with and without cleft palate. This will aid the dentist in diagnosis and give proper genetic counseling to parents and patients of cleft lip and palate.

Item does not contain fulltext Competency-based education, introduced approximately 10 years ago, has become the preferred method and generally the accepted norm for delivering and assessing the outcomes of undergraduate (European) or predoctoral (North America) dental education in many parts of the world. As a philosophical approach, the competency statements drive national agencies in external programme review and at the institutional level in the definition of curriculum development, student assessment and programme evaluation. It would be presumptuous of this group to prescribe competences for various parts of the world; the application of this approach on a global basis may define what is the absolute minimum knowledge base and behavioural standard expected of a 'dentist' in the health care setting, while respecting local limitations and values. The review of documents and distillation of recommendations is presented as a reference and consideration for dental undergraduate programmes and their administration.

The most frequent type of treatment for patients diagnosed with a malignant neoplasia of the oral cavity is surgical resection of the tumor. Ablative surgery may be followed by a reconstructive phase, in which the surgeon may choose between local flaps, nonvascularized bone grafts or free vascularized flaps to close the surgical site, depending on the general conditions of the patient. Esthetic and functional results are challenging to achieve for the prosthodontist, as variable amount of hard and soft tissues are removed. This report describes the fabrication of a two-piece hollow obturator for a 19-year-old patient who underwent wide surgical excision of the osteosarcoma of the maxilla and was rehabilitated to function. In this case, the surgical site was covered with submental flap, and the second piece of the obturator provided fullness to the lost malar prominence.

This prospective cephalometric study was undertaken to assess the mode and magnitude of Class II correction with nonextraction Begg mechanotherapy in growing children. The sample comprised subjects with similar malocclusion and age range (9-12 years) who were specifically selected for nonextraction Begg mechanotherapy. Cephalograms were analyzed to assess the skeletal, dental, and soft tissue changes that occurred after correction of the molar relationship, the overjet, and the overbite during the 9-month treatment period. The results revealed a significant improvement in the anteroposterior jaw relationship, suggested by the significant reduction in the ANB angle (1.62°) and in Wits AO-BO (1.42 mm). The mandibular length increase of 0.56 mm suggests that the Class II elastics used in nonextraction Begg mechanotherapy had a minimal stimulatory effect on mandibular growth. There was a significant increase in the anterior and posterior facial heights and the ramal height. Almost all of the dental changes were significant. The most striking feature were a significant retraction and extrusion of the maxillary incisors and proclination and intrusion of the lower incisors accompanied by extrusion of the mandibular molars. The maxillary incisors extruded by 1.64 mm under the influence of the undesirable downward component of the Class II elastic forces. The major contribution to overjet and molar correction was predominantly dentoalveolar. (Am J Orthod Dentofacial Orthop 2000;118:641-8)

Objective. The purpose of this study was to determine the cause of temporomandibular ankylosis and the long-term results of gap arthroplasty with coronoidectomy followed by immediate postoperative jaw exercises as a treatment of the condition. Study Design. This retrospective study evaluated the cause of temporomandibular joint ankylosis and the 36-month postoperative results of gap arthroplasty in 50 patients (62 joints). The patients were divided into 2 groups; group I (aged 0-12 years) consisted of 29 cases (24 unilateral and 5 bilateral; 34 joints); group II (aged 13-30 years) consisted of 21 cases (14 unilateral and 7 bilateral; 28 joints). A postoperative jaw opening exercise regimen was followed. Descriptive statistics, the Wilcoxon signed rank test, and rank sum 2-sample (Mann-Whitney) tests were applied. Result. Trauma to the temporomandibular joint was documented as a major etiologic factor in 86% of cases. The 36-month postoperative mean maximal incisal opening was 30.62 mm (± 6.25 mm) for group I and 30.14 mm (± 3.9 mm) for group II. The P value in each group was highly significant for the Wilcoxon signed rank test; the Mann-Whitney test showed no difference between the groups, indicating that both groups had done well. The recurrence rate was 2%. Conclusion. Trauma is the major cause of temporomandibular joint ankylosis in India. The long-term functional results of gap arthroplasty are satisfactory and comparable to those obtained through use of other treatments. Postoperative exercises play a crucial role in lasting success.(Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;87:166-9)

The present study was conducted on 10 subjects to evaluate dental and skeletal changes after intraoral molar distalization. The maxillary molars were distalized with a sectional jig assembly. Sentalloy open coil springs were used to exert 150 gm of force for a period of 12 weeks. A modified Nance appliance was the main source of anchorage. The pre- and postdistalization records included dental study casts, clinical photographs, and cephalograms. A total of 665 readings recorded from lateral cephalograms and dental casts were subjected to statistical analysis. The mean distal movement of the first molar was 2.78 mm, which was highly significant (p < 0.001). It moved distally at the rate of 0.86 mm/month. There was clinically some distal tipping (3.50°) and distopalatal rotation (2.40°). These changes were statistically significant (p < 0.001). The second molars accompanied the first molars and moved distally by nearly the same amount. There was 1.00 mm increase in the overjet and 2.60° mesial tip of second premolar. The changes in the facial skeleton and dentition bases were minimal and statistically not significant. However, there was clockwise rotation of the mandible of 1.30° that was statistically significant. This was the result of molar extrusion (1.60 mm). (Am J Orthod Dentofacial Orthop 1998;114:319-27.)

Fractures of metal-ceramic restoration pose an esthetic and functional dilemma both for patient and the dentist. Intraoral repair systems eliminate the remake and removal of restoration. Many intraoral repair materials and surface treatments are available to repair intraorally fractured metal-ceramic restoration. Bond strength data of various materials and specific technique used for repair are necessary for predicting the success of a given repair system. This study evaluated the shear bond strength of three different intraoral repair systems for metal-ceramic restorations applied on exposed metal and porcelain surface. One hundred and twenty metal discs (20 mm in diameter × 0.7 mm thick) were fabricated with nickel–chromium alloy (Mealloy, Dentsply, USA). Feldspathic porcelain (Duceram, Degudent, Germany) were applied over one test surface of the discs in the thickness of 1.8 mm followed by conventional firing. The defect, which simulates clinical failures were created in 1/4th area of the metal-ceramic discs. The metal-ceramic discs samples were divided into ceramic substrate (Group I, n = 60) and metal substrate (Group II, n = 60), according to the defect location. Then, samples of ceramic substrate (Group I) and metal substrate (Group II) were subdivided into A, B according to the surface treatments (A; roughening with diamond bur and B; abraded with 50 μ Al2O3) and repaired with one of the intraoral repair systems tested (a. Ceramic repair system, Ivoclar Vivadent; b. Clearfil repair system, Kurary, c; Porcelain repair system, 3 M ESPE). All the repaired samples were stored in distilled water at 37 °C for 24 h. After thermocycling at 6–60° C, all the samples were stored at 37 °C for additional 7 days. Shear bond strength of all the samples were calculated by using Universal testing machine. The mean shear bond strength values for the group I (A/B) were as follows: Ceramic repair system (9.47 ± 1.41/14.03 ± 2.54 MPa), Clearfil repair system (14.03 ± 2.32/14.64 ± 2.28 MPa), and Porcelain repair system (14.41 ± 3.96/14.86 ± 3.10 MPa). The mean shear bond strength values for the group II (A/B) were as follows: Ceramic repair system (9.42 ± 1.44/18.61 ± 2.60 MPa), Clearfil repair system (14.44 ± 3.23/14.98 ± 2.73 MPa), and Porcelain repair system (11.86 ± 2.24/13.24 ± 2.72 MPa). Air abrasion with 50 μm aluminum oxide particles is the preferred surface treatment. Porcelain repair system showed the highest shear bond with air abrasion for ceramic substrate and for metal substrate Ceramic repair system showed the highest bond strength with air abrasion as a surface treatment. This study suggest that the three repair systems tested are adequate for intraoral chairside repair of metal-ceramic restoration when air abrasion is used for surface treatment of the substrate (Ceramic repair system, Ivoclar Vivadent, Germany; Clearfil repair system, Kurary, Japan; Porcelain repair system, 3M ESPE, Germany).

The purpose of this study was to evaluate the reliability of different anatomic reference planes in determination of Occlusal plane in dentulous and edentulous subjects with Angle’s class I and class II Maxillomandibular relationship. Eighty subjects were included in the study which was divided into four Groups based on dentition and skeletal relationship. The Group I (n = 20) and Group II (n = 20) includes young and completely dentulous subjects in Angle’s class I and class II relationship, respectively. The Group III (n = 20) and Group IV (n = 20) subjects were completely edentulous in Angle’s class I and class II relationship, respectively. For all subjects, right lateral cephalograms were taken and cephalometric analysis was done and data obtained from cephalometric tracings were then statistically analyzed. The results showed no significant difference of angle between Occlusal plane and Frankfort Horizontal plane, Camper’s plane and Palatal plane when Group I and Group III, and Group II and Group IV subjects were compared. The Frankfort Horizontal plane, Camper’s plane and the Palatal plane may be used as a reliable guide to establish Occlusal plane in edentulous subjects in both Angle’s class I and class II Maxillomandibular relationships.

Tumor resection of a cancer lesion produces maxillary defects that can be easily restored with an obturator to close the defect area. Postsurgical maxillary defects predispose a patient to hypernasal speech, fluid leakage into the nasal cavity, and impaired masticatory function. Therefore, the primary aims of prosthetic rehabilitation in total and partial maxillectomy patients include: separation of oral and nasal cavities to allow adequate deglutition and articulation, possible support of orbital contents and support of soft tissue to restore mid-facial contours. A method of fabricating a simple hollow obturator for maxillectomy patients is described. The use of a relatively long-lasting light cure resin materials in making obturators allows stable, comfortable, and effective obturation. The hollow prosthesis is lightweight and sufficiently flexible to allow relatively simple placement in retentive undercut regions.

Prosthetic rehabilitation of acquired maxillary defects can be achieved satisfactorily if all facets of treatment planning and design considerations are taken into account before the rehabilitation process. Complications associated with maxillary defects limit treatment protocols to a great extent. The prosthodontist has to identify these problem areas and suitably devise feasible options and incorporate them in the design. In this report, an acquired maxillary defect with unfavorable undercuts in the defect was successfully treated by making a two-piece sectional obturator. The two pieces were connected by the use of double-die pin system. The methodology greatly reduced chairside time and number of visits, and effective obturation was satisfactorily achieved.

To evaluate and compare the centric relation and horizontal condylar guidance using interocclusal wax and extra oral Gothic arch methods and subjective evaluation of dentures thus fabricated. Centric relation and horizontal condylar guidance was recorded by using interocclusal wax and gothic arch tracing in 28 completely edentulous patients. These records were transferred to the articulator and difference in both values was recorded. After that patients were divided in two groups according to the centric relation and horizontal condylar guidance recording method used to achieve balanced occlusion. Response of the dentures was subjectively evaluated using “Woelfel subjective evaluation criteria”. Centric relation recorded by both the methods did coincide in 7.14 % of patients. Centric relation recorded by interocclusal wax was posterior to Gothic centric relation in 21.43 % of patients, and anterior to Gothic centric relation in 71.42 % patients. Gothic arch tracings gave higher mean guidance values on both the sides as compared to protrusive wax record in all the subjects, although the difference was statistically insignificant (P > 0.05). Subjective evaluation showed statistical insignificance for all the parameters in both groups. Gothic arch method records the centric relation at a more posterior position than the Static method, but it does not make any difference in clinical performance of the complete denture. Horizontal condylar guidance angle was approximately similar by both the methods.