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Background: Literature findings indicate an increase in mandible resection cases. Retention and stability of dentures are the main issues in the prosthetic treatment of these defects. Aim: The aim of the presented clinical case is to explore the possibility of prosthetic treatment of a patient with mandible resection of the frontal area. Materials and methods: The clinical case monitors the prosthetic treatment of a 38-year-old patient with mandible cancer and resection in the frontal zone. The treatment plan was based on taking preliminary alginate impressions and developing gypsum models. It is planned to develop a partial acrylic denture sealed with silicone material. Additional preparation of the gypsum master model in the resection area took place in order to achieve the equal thickness of the special silicone material. The base of the alveolar bone was restored with hard plaster. In addition, the occlusal rim was fabricated with the purpose of establishing the centric relation and occlusal relationship. The denture was fabricated by acrylic resin with a low quantity of residual monomer and adjusted after adding silicone material over the resected part with functional tests to complete the design of the defect area. Results: The accessed treatment results indicate good retention and stability of the denture. The application of silicone material provided a non-traumatic transition of the masticatory pressure without decubital ulcers in the resected zone. Conclusion: The application of appropriate prosthetic treatment methods in patients with mandible resection leads to the successful restoration of feeding and speaking functions.

Background: Over the last few years, there has been an increase in oncologic morbidity in the maxillofacial region. A significant increase in cases of cancer of the maxilla has been established. As a result of the surgical treatment of maxillary tumours, the barrier between the oral and nasal cavity is broken, which leads to serious speech disorders. Aim: The purpose of the literature review is to analyse data from different studies on the changes in speech after maxillectomy and the opportunities for its restoration with different types of dentures. Discussion: The opportunities for treatment of patients with maxillary defects include surgical restoration or obturator, as there are contradictory data on what are the optimal means of restoring speech. The predominant opinion is that the choice of treatment method depends on the size and the location of the defects, with most authors considering obturators the optimal means of treatment. Their role in the normalisation of speech function by restoring the barrier between the oral and nasal cavity is indisputably proven. Immediate prosthetics have been found to provide faster and easier recovery of speech. To preserve the achieved results, a three-stage method of treatment with surgical, temporary and definitive obturator is recommended, which restores not only speech but also normal articulation. Conclusion: Surgical treatment of cancer of the upper jaw causes defects differing in size, which seriously disturbs speech function. Depending on the size and location of the defect, specific prosthetic treatment methods are used, with different types of dentures being produced.

Provisional fixed partial dentures represent a critical phase in dental treatment, necessitating heightened mechanical durability, particularly in comprehensive and extended treatment plans. Strengthening these structures with various reinforcing materials offers a method to enhance their resilience. Utilizing a three-point testing methodology on standardized trial specimens allows for a comparative assessment of various materials and reinforcement techniques for pre-prosthetic applications. This study aims to validate and assess the significance of integrating different reinforcing materials into standardized test bodies. The study focuses on test specimens comprising three types of unreinforced laboratory and clinical polymers for provisional constructions (n = 6)—heat-cured PMMA (Superpont C+B, Spofa Dental, Czech Republic), CAD-CAM prefabricated PMMA (DD temp MED, Dental Direkt, Germany), CAD-CAM printing resin (Temporary CB Resin, FormLabs, USA), self-polymerizing PEMA (DENTALON plus, Kulzer, Germany), light-polymerizing composite (Revotek LC, GC, Japan), and dual-polymerizing composite (TempSpan, Pentron, USA). Additionally, laboratory polymers are evaluated in groups with five types of reinforcing filaments (n = 15)—Glass Fiber (Fiber Splint One-Layer, Polydentia, Switzerland), Polyethylene thread (Ribbond Regular 4.0 mm, Ribbond Inc., USA), triple-stranded chrome-cobalt wire for splinting 015″ (Leone S.p.a., Italy), Aesthetic ligature wire 012″ (Leone S.p.a., Italy), and Glass Fiber coated with light-cured composite 8.5 × 0.2 mm (Interlig, Angelus, Brazil). Analysis of the data using Generalized Linear Models (GLMs) reveals that the experimental bodies, produced via the subtractive digital method using PMMA (DD temp MED, Dental Direkt GmbH, Germany) as the polymer and glass filaments as the reinforcement, exhibit superior mechanical properties, particularly when pre-wetted with Interlig liquid composite (Angelus, Brazil).

Zirconia ceramic is a modern material used for different types of prosthetic constructions, characterized by high mechanical resistance and aesthetics. The main difficulties in treatment are related to ensuring a stable and durable bond between the ceramic and dentin. This study examined the bonding strength of ZirCAD Multi (3rd generation) and ZirCAD Prime (5th generation) ceramics when using different types of cements before and after sandblasting the surface of zirconia with Al2O3. For this purpose, an experimental setup was created by 3D printing, in which sintered ceramic cylinders were cemented to dentin slices of natural teeth with different types of cements. From the formed ceramic-dentin constructions, test specimens were cut with a microtome and tested for tensile strength. The results showed an increase in the strength of the bond after sandblasting from 1.1 MPa to 2.4 MPa for ZirCAD Multi and from 1.6 MPa to 3.3 MPa for ZirCAD Prime. Zirconia ceramic ZirCAD Prime (5th generation) showed higher adhesion resistance, with the strongest bond being with the Speed Cem Plus and Panavia V5 cements. With ZirCAD Multi, the maximum tensile strength was achieved with the Rely X Luting Plus and Speed Cem Plus cements. Optimal strength and bond resistance were registered between the new fifth-generation zirconia ceramic and composite cements with MDP (10-methacryloyloxydecyl dihydrogen phosphate) primers.

Background: Resection of upper jaw violates the border between oral and nasal cavity; thereby leading to the impossibility of feeding, speaking and breathing. The prosthetic treatment methods are the main tool for restoration of the damaged functions. Aim: The aim of this publication is to investigate the options for the application of combined dentures, made from acrylic resin and silicone, in the treatment of patients with maxillary resection and total edentulism. Materials and methods: The prosthetic treatment of a 70-year-old female patient with resection of the frontal area of the upper jaw and total edentulism is studied. The preliminary impressions were taken with alginate and the definitive ones – with custom trays and silicone impression material. An obturator and complete denture of the lower jaw were fabricated from heat cured acrylic resin after fixing the occlusion closure and trial denture. Silicone material for direct relining is used to provide retention and stability to the obturator. Results: Patient's feeding, speaking and breathing functions were successfully restored. The silicone substitution part provided a non-traumatic distribution of the masticatory pressure and tightly insertion in the retentive areas of the defect. The created border between oral and nasal cavity fostered breathing and fluid intake. Conclusion: The performed treatment shows that prosthetic treatment methods continue to be an important method for improving patients' life quality after maxillary resection, despite the progress in modern surgical procedures.

Background: Maxillary resection causes different types of damages in the maxillofacial area, which are treated by surgical and prosthetic restorative methods. Aim: The described clinical case follows up the initial stages of the prosthetic treatment, as well as the possible modification of surgical obturator into temporary obturator in a patient with maxillary resection. Materials and methods: The prosthetic treatment of a 55-years-old female patient with a surgical operation of upper jaw cancer is described. The surgical obturator is developed a week after the resection. The preliminary impressions are taken with irreversible hydrocolloid impression material. The occlusion height and central relation are fixed by occlusion rims. The surgical obturator was fabricated by heat cured acrylic resin with a low amount of residual monomer. Moreover, metal clasps were used for retention and stability. The borders of the obturating part were covered with a thin layer of relining silicone material after the adjustment. The surgical obturator was modified into a temporary one directly in the patient's mouth after two months by applying the same rebasing material and designing a silicone hollow-bulb obturating part. Results: The treatment results revealed a successful restoration of the patient's speaking, feeding, and swallowing abilities. The application of silicone material inhibited the appearance of decubitus ulcers and facilitated the normal healing process. The direct design of hollow-bulb silicone obturating part significantly improved the retention and stability of the obturator. Conclusion: The application of prosthetic treatment methods in the first days after the maxillary resection allows for restoration of speaking and feeding.

Background: Zirconia ceramics are a modern dental material which has a wide range of application in restoration of frontal and distal teeth. This is due to its improved mechanical properties and aesthetics. Aim: This literature review analyses the possibilities for improvement of the bond strength between zirconia ceramics and different types of cement which are used for fixation of prosthetic constructions. Review Results: The evidence from the literature indicates that preliminary treatment of zirconia ceramics increases the bond strength significantly to the cement. In this respect, different methods and materials are used for the treatment of the zirconium dioxide surface. Some of them include only mechanical treatment with diamond burs, a different type of lasers and sandblasting with aluminum oxide. Other methods have chemical action by the use of hydrofluoric acid and fluoride compounds. According to some data, zirconium structure does not allow etching which leads to application of different type of primers for increasing the shear strength. Studies show that silane application significantly improves the shear bond strength to the cement, as well as, zirconium tensile strength. Optimal results are registered with a combination of treatment with mechanical methods and silane application. Conclusion: Preliminary mechanical and chemical treatment of zirconia surface improves the shear bond strength considerably to the cement. The variety of surface treatment methods complicates the establishment of a standard protocol for fixation of zirconium prosthetic constructions.

Introduction: Surgical treatment of tumours in the oral cavity is often associated with damage on the face soft tissues, which makes prosthetic treatment difficult. Aim: The purpose of the clinical case is to investigate the possibility of prosthetic treatment in patients with combined maxillofacial defects. The main goal was to assess the effect of prosthodontics in this case for restoring masticatory and speech function. Materials and methods: The prosthetic treatment of a 68-year-old man with maxilla resection and enucleation is described. The impressions of the two jaws were taken with an irreversible hydrocolloid impression material. The height of the occlusion and the centric relation of the mandible were fixed with wax rims. A buccal flange obturator was made which was held by wire clasps to the retained natural teeth. To ensure optimal sealing, the edges of the obturator part were functionally formed with a wax material which, after moulding, was substituted with acrylic resin. Results: The applied prosthetic treatment allowed good retention and stability of the denture and natural restoration of nutrition, speech and breathing of the patient, as well. Conclusion: The application of special approaches of prosthodontics in patients with combined maxillofacial defects enables normalization of impaired functions.

Aim: The aim of the described method is to present the main stages in the prosthetic treatment with hollow bulb obturator, which provides optimum defect hermetization and restoration of the damaged functions. Materials and methods: The clinical case, described is on a 70-years-old patient with edentulous jaws and maxillary defect in the right half of the upper jaw. The preliminary impressions were taken with irreversible hydrocolloid impression material, and the final impressions were taken with additive silicone material. The occlusion height and the centric relations were registered as the classical technique. After the successful trial denture appointment, the surface of the plaster master model was covered by isolation polish. After this procedure, the master model was covered by even wax layer with 5mm thickness. It was designed to be thinner in the area of the resection line. The designed cavity was filled in with silicone impression material and covered with the folio. The base plate with the arranged teeth was fixed to the model, packed in the cuvette and finished from heat-cured acrylic resin with low quantity of residual monomer. After the polymerization process, the silicone material was removed, and the obturators cap was fixed to the denture’s base plate with cold cured acrylic resin. The obturator and the complete denture of the mandible were adjusted and articulated in patient’s mouth in the final clinical stage. Results: The applied prosthetic method allowed successful defect hermetization and helped for the restoration of the speech, feeding and patient’s self-esteem. Conclusion: Prosthetic rehabilitation of patients with maxillary resection is possible only with the application of specific treatment methods.

Introduction: The prosthetic treatment in patient with alveolar resorption is very difficult, and sometimes it is possible only after surgical preparation of the prosthetic field. In the cases, where surgical lift of the soft tissues in the vestibulum is performed, a forming denture, which has to shape the denture-bearing area, is required to design the healing of the soft tissues. Aim: The aim of the described method is to present the abilities of the forming dentures with silicone base, for conducting surgical preparation of prosthetic treatment in patients with resorption of the alveolar bone. Materials and methods: The prosthetic rehabilitation of 54-years-old female patient with complete edentulism and maxillary resorption, as a result of unsuccessful implant treatment with subperiosteal net, is described. After its surgical removal a complete dentures of the both jaws were made. The upper denture was used as a custom tray for taking impression with additive silicone, during the vestibuloplasty. The impression material was substituted with one-component heat-cured silicone Molloplast B in the dental laboratory and the denture was finished on the classical technology. After cleaning, polishing and disinfection , the denture was adjusted and articulated in patient’s mouth. Results: The described methodology of prosthetic treatment and fabrication of forming denture allowed successful surgical treatment. The silicone base reduced the masticatory pressure and provided atraumatic conditions for the healing process. The vestibuloplasty ensured denture’s retention and stability, which helped patient’s chewing, feeding and speaking. Conclusion: The application of appropriate methodology and technique for fabrication of forming dentures provides successful design of the vestibulum and denture-bearing area. Тhis facilitates the conducting of the following prosthetic treatment.

Introduction: Operative treatment of tumours of the maxilla impairs the barrier between the oral and nasal cavities, making difficult or impossible to eat, speak, and drink liquids. Aim: The purpose of the clinical case described, is to examine the possibility of prosthetic treatment in patients with fully resected hard palate, the treatment effect and recovery of impaired functions. Materials and methods: The article presents the prosthetic treatment of a patient with resection of the entire hard palate as a result of an oncological disease. Due to complete edentulism, the treatment plan included the construction of an obturator and a complete lower denture. Functional impressions with additive silicone were taken with custom trays of the light-cured acrylic resin after pre-edging with wax impression material (ISO Functional GS). The dentures were made of a colourless heat cured the acrylic resin. The volume and localization of the defect necessitated a specific shaping of the replacement part of the obturator. In order to provide the necessary retention and stability, we used our own modification of the open cup-shaped form in which the edges of the replacement part were extended distally in the area of the soft palate. Results: The results of the treatment showed good retention and stability of the obturator and the lower denture. The feeding, speech and swallowing of the patient were successfully restored. Conclusion: Prosthetic treatment with a definitive obturator allows optimal sealing of the maxillary defect even with a fully removed hard palate.

The objective of the authors is to analyse the results of students in their second year of study in Dental Medicine in regards to their fixed partial dentures (FPD) education. Material and Methods: The article is based on an analysis of the work of94 students in second year in the Faculty of dental medicine Sofia (56 females, 38 males), who were rated using a test and practical work marks during the submission of the FPD’s that they fabricated during the 4th semester practices. Results: The analysis indicates that only 2% of the students that were assessed with a mark “average 3” or “good 4” have found up to four correct answers in their tests. The percentage of students who’s practical work was assessed with marks “very good 5” or “excellent 6” and gave five or more correct answers to the test is 83%. With 15% of the student, a major discrepancy between their theoretical knowledge and practical results was noticed. Conclusion: Further researches are needed regarding the introduction in the educational program in Introduction of Prosthetic Dentistry in the Faculty of Dental Medicine of brief test examination in the specific topics.

The aim of this study was to investigate and analyze the possible correlations between findings by manual functional analysis and clinical occlusal analysis in TMD-patients. Material and methods: Material of this study are 111 TMD-patients selected after visual diagnostics, functional brief review under Ahlers Jakstatt, intraoral examination and taking periodontal status. In the period September 2014 - March 2016 all patients were subjected to manual functional analysis and clinical occlusal analysis. 17 people (10 women and 7 men) underwent imaging with cone-beam computed tomography. Results: There were found many statistically significant correlations between tests of the structural analysis that indicate the relationships between findings. Conclusion: The presence of statistically significant correlations between occlusal relationships, freedom in the centric and condition of the muscle complex of masticatory system and TMJ confirm the relationship between the state of occlusal components and TMD.

Aim: The aim of this study is to track the effectiveness of prosthetic treatment with post resection dentures with solid substitute part and their role in the restoration of damaged functions. Materials and methods: The study included 14 patients (9 men and 5 women) with different size and location of defects in the upper jaw treated in the period 2010-2016 with post resection prostheses with a solid substitute part. The impressions were taken with irreversible hydrocolloid impression material. The prostheses were completed by heat-curing acrylic with low quantity residual monomer. The effectiveness of prosthetics was evaluated by the method of Mihaylov for both oral-nasal examination of the pressure with the device "Oronasopneumotest." For objectifying and assess the occlusal-articulation ratios was held computerized occlusal analysis with the system T-SCAN 8. Results: The results showed successful obturation and sealing of defects in all patients. It was found satisfactory recovery of the speaking function and normalization of occlusal-articulation ratios. Conclusion: The prosthetic treatment with post resection prostheses with a solid substitute part allows successful recovery of the lost speech and chewing functions, helping to restore self esteem and social rehabilitation of patients.