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Dental implants are now widely used in a wide range of clinical settings because of the growing research in the field of dental implantology. Dental implant placement is becoming more and more prevalent, which might lead to complications. One common issue is placing a dental implant improperly. The restorative dentist, laboratory technician, and the patient have an enormous challenge when it comes to prosthetically unfavorable implant rehabilitation. Aim: The purpose of this narrative review is to discuss classic prosthodontic challenges faced by clinicians for anterior implant restorations when the alterations/improvement of the surgical site is not an option and requests for rehabilitation of the existing situation. Methods: Researchers conducted a search of 13 studies using databases from the Cochrane Library, EBSCO, EMBASE, PubMed, and Web of Science. It gathered articles published from January 2000 to December 2023 with comprising terms such as “Angulated Abutment, Angulated Screw access, UCLA abutment, Cross-pin screw-retained implant prosthesis, Gingival ceramic collar.” Results: A total of 13 articles were collected and used to formulate this review. It describes different scenarios for correction of esthetic complications of malpositioned anterior implant region with a focus on prosthesis design and material selection. Other aspects such as advantages, disadvantages, and complications of different prosthetic options are also considered. Discussion: Even in cases where the implants are misaligned or malpositioned, labially located screw access of anterior implant restoration can be nonsurgically managed at the abutment level; material basis and prosthesis type (fixed or removable) may contribute to both esthetic and functional restorations. Conclusion: A thorough esthetic analysis of both hard and soft tissues, as well as precise treatment planning, may be required to achieve an optimal outcome during treatment. However, in certain cases, surgical corrections rather than prosthetic modifications would be required to improve results, which may pose a limitation.

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.

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.

Purpose: Surface roughness promotes adhesion and colonization of denture plaque. Therefore, it is important to know the effects of polishing and finishing on the surface roughness of various acrylic resin materials. Objectives: To evaluate and compare the effects of different conventional lathe polishing techniques on heat cured acrylic resins in producing surface roughness. Materials and Methods: Three different commercially available heat-cured acrylic resin materials namely DPI, Meliodent and Trevalon Hi were selected. 30 Specimens of each acrylic material (30 x 3 = 90, 10 x 60 x 2mm) were prepared and divided into 5 groups, each group consisted of 6 Nos. of specimens per material(6x3=18) and were grouped as Group A(unfinished), Group B (finished), Group C (Polishing Paste), Group D (Polishing Cake) and Group E (Pumice and Gold rouge). The resulted surface roughness (µm) was measured using Perthometer and observed under Scanning Electron Microscope. The values obtained were subjected statistical analyses. Results: Among the materials tested, better results were obtained with Trevalon Hi followed by Meliodent and DPI. Among the polishing methods used, superior results were obtained with universal polishing paste followed by polishing cake; Pumice and Gold rouge. Although Pumice and Gold rouge values produced greater roughness value, they were well within the threshold value of 0.2 mm.

Implant dentistry is the latest developing field in terms of clinical techniques, research, material science and oral rehabilitation. Extensive work is being done to improve the designing of implants in order to achieve better esthetics and function. The main drawback with respect to implant restoration is achieving good osseointegration along with satisfactory stress distribution, which in turn will improve the prognosis of implant prosthesis by reducing the crestal bone loss. Many concepts have been developed with reference to surface coating of implants, surgical techniques for implant placement, immediate and delayed loading, platform switching concept, etc. This article has made an attempt to review the concept of platform switching was in fact revealed accidentally due to the nonavailability of the abutment appropriate to the size of the implant placed. A few aspect of platform switching, an upcoming idea to reduce crestal bone loss have been covered. The various methods used for locating and preparing the data were done through textbooks, Google search and related articles.

Objectives: The primary objective of the following study is to evaluate and secondary objective is to compare the hardness of two different tissue conditioners before and after the addition of three types of antifungal agents. Materials and Methods: Two types of tissue conditioners: viscogel and coe-soft were manipulated with three types of antifungal agents (fluconazole, clotrimazole, neem) and placed in the metal mold as per the manufacturer′s instructions. A total of 240 samples were fabricated and divided into two groups of 120 samples each and were grouped as, T1 - Viscogel., T2 - Coe-soft. These were subjected to hardness test on 1 st , 7 th 14 th days with the Shore-A-Durometer equipment. Results: Tissue conditioners showed an increase in hardness values with the use of antifungal agents in all the groups. Conclusion: The study can be concluded that hardness of Viscogel was statistically significant when mixed with fluconazole and compared with coe-soft as on 1 st day, 7 th day and 14 th day.

Due to the rise over the years in patient emphasis on better esthetic outcomes, veneering the metal base of a restoration with composite resin or porcelain is widely used in dentistry. For the preservation of the opposing natural dentition and the potential for repair, the use of composite veneering materials has been suggested because of their resilience, low abrasive properties, and superior repair potential. Composites are not as popular as porcelain, but they are still widely used to cover metal because of low cost and because the laboratorial procedures are faster and simpler.

Aim: The aim was to compare the efficacy of various herbal disinfectants on irreversible hydrocolloid impressions and to investigate the effectiveness of three herbal disinfectants and a chemical disinfectant against particular pathogens., Settings and Design: In vitro -a comparative study., Materials and Methods: The following methodology was followed to achieve the objectives. Four maxillary impressions were made for each selected patient with irreversible hydrocolloid impression material. The predisinfection swabs were taken from impression sites of teeth 17, 13, 27, and 23 (FDI system of tooth numbering). The impressions were immersed in all four different disinfectants such as 2% glutaraldehyde, Aloe vera solution, 50% neem oil, and apple vinegar solution, then the postdisinfection swabs were taken from the same sites 17,13,27,23 and then cultured onto sheep blood agar and examined for growth, and colony forming units (CFUs) of Streptococcus viridans, Streptococcus mutans, Streptococcus sanguis, and Actinomyces viscosus. The comparative analysis was done for the predisinfection and postdisinfection values in each study group., Statistical Analysis Used: Descriptive analysis, Kruskal Wallis test, Mann Whitney post hoc test, Wilcoxon signed rank test., Results: The results revealed that the mean CFUs of S. viridans, S. mutans, S. sanguis, and A. viscosus during postdisinfection samples were statistically significant when compared to predisinfection samples. Multiple comparison of the mean CFUs of all 4 microorganisms in the control group and in 50% Neem oil group was significantly lesser compared to A. vera and Apple Vinegar group., Conclusion: CFUs of S. viridans, S. mutans, S. sanguis, and A. viscosus significantly decreased in the 50% neem oil group as well as the control group. As a result, 50% Neem oil was a viable option for disinfecting alginate impressions.

Treatment of pediatric patients with partial anodontia is a challenge requiring interdisciplinary approach. Growth period, reduced vertical dimension, microdontia, and unacceptable esthetics present difficulties at various stages of prosthetic rehabilitation. Congenital absence of teeth impairs the nutritional status of the growing child and causes a psychological setback. This article describes the prosthetic management of a patient suffering from partial anodontia done over a period of 10 years. Considering the age and psychological and financial requirements of the patient, removable and fixed prostheses were fabricated at different phases of the treatment. The ultimate aim was restoration of function, improvement of esthetics, and overall psychological upliftment of the patient which was achieved by maxillary metal ceramic bridge and mandibular implant retained hybrid prosthesis., Competing Interests: None

Statement of Problem: Published data regarding association between edentulous mandibular residual ridge resorption and nutritional status of geriatric patients is limited., Purpose: The purpose of this clinical study was to evaluate the degree of mandibular residual ridge resorption in completely edentulous participants and to investigate the role of dietary nutrients in the resorption process., Material and Methods: Three hundred (55% men and 45% women; aged between 35 and 85 years) completely edentulous participants with specific inclusion and exclusion criteria were enrolled for the study. A standardized panoramic radiograph was made, measurements were made digitally, and the amount of resorption was calculated using the Wical and Swoope method. The blood plasma levels of vitamin D3 were analyzed by using the direct competitive chemiluminescence immunoassay (CLIA) method, whereas the total calcium and phosphorus were determined by using spectrophotometer method. Statistical data of serum nutrient levels (calcium, phosphorus, and vitamin D3), age, sex, and residual ridge resorption were subjected to the Mann-Whitney U test, the Spearman correlation test, and a stepwise multiple linear regression analysis (α=.05)., Results: Calcium (P=.003) and phosphorus (P<.001) levels were significantly increased in the female participants as compared with the male participants. Vitamin D3 levels were similar in all the participants. Moreover, metabolic levels of calcium (rho=-0.09), phosphorus (rho=-0.10), and vitamin D3 (rho=-0.02) were found to be reduced with increasing age. However, male participants had increased mandibular residual ridge resorption (P<.001) with positive correlation (rho=0.06) when compared with female participants. Mandibular ridge resorption was increased with a decrease in levels of serum nutrients., Conclusions: Increased levels of mandibular residual ridge resorption were observed in participants with decreased levels of systemic biochemical parameters, including calcium, phosphorus, and vitamin D3. Moreover, male participants showed increased residual ridge resorption when compared with female participants, who showed a significantly higher level of serum nutrient levels. Serum nutrient levels decreased, whereas mandibular residual ridge resorption increased with age., (Copyright © 2020 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

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.

Background and Objectives: A limitation of vinyl polysiloxane (VPS) impression materials is hydrophobicity, and manufacturers have added surfactants and labeled these new products as "hydrophilic." The purpose of this investigation was to evaluate and compare the dimensional accuracy and surface detail reproduction of two hydrophilic VPS impression materials under dry, moist, and wet conditions., Materials and Methods: Ten impressions were made under dry, moist, and wet conditions respectively, with monophase, and regular body VPS impression material using a stainless steel metal die similar to that described in American Dental Association (ADA) specification 19, with lines scribed on it. Dimensional accuracy was measured by comparing the average length of the middle horizontal line in each impression to the same line on the metal die, by using a measuring microscope. The surface detail was evaluated. A one-way analysis of variance and Student t-test were used to compare mean dimensional changes (α = 0.05)., Results: Conditions (dry, moist, and wet) did not cause significant adverse effects on the dimensional accuracy of either material. The mean dimensional changes were 0.00084% (+0.00041%) for monophase and 0.00119% (+0.00033%) for regular body. Monophase material was satisfactory in detail reproduction 100% of the time in dry conditions, 90% in moist, and only 20% in wet conditions. The regular body showed 100% satisfactory impressions in dry, 80% in moist, and 10% in wet conditions. With the additional smooth surface evaluation, only under dry conditions impressions with clinically acceptable surface quality were produced., Conclusions: Dimensional changes for both materials were well within ADA standards of minimal shrinkage value of 0.5%.

Chondrosarcoma is a malignant tumor in which the tumor cells produce cartilage but not bone. The recommended management is wide local or radical excision, followed by surgical and prosthetic reconstruction. This article explains postsurgical prosthetic rehabilitation of a chondrosarcoma patient by means of intraoral acrylic, and extraoral silicone prosthesis for restoration of normal orofacial function and appearance.

Background and Objectives: This in-vitro study was conducted to evaluate the strength and properties of Type III and Type IV gypsum mixed with disinfectant solutions., Materials and Methods: Type III and Type IV gypsum were used for the study. Three different mixing solutions namely waterqueous solutions of 0.525% sodium hypochlorite and 2% glutaraldehyde were used. Gypsum materials were subjected to further modification by adding a mixture of 1.0% gum arabic and 0.132% calcium hydroxide before mixing with the disinfectant solutions, at two different liquid/powder (L/P) ratios for each. Both, the unmodified and the modified gypsum were tested for compressive and tensile strength after one hour and one week from the start of the mix. The crystalline configuration of the fracture fragments of the unmodified and modified set gypsum were studied under the scanning electron microscope., Results: The disinfectant solutions reduced the strength of both Type III and Type IV gypsum. Water showed higher-strength, which was followed by 0.525% sodium hypochlorite and 2% glutaraldehyde. The modified Type III and Type IV gypsum with reduced L/P ratio also showed strength values less than that of the control groups., Interpretation and Conclusion: Chemical disinfectants reduced the strength of gypsum when used as water substitutes. Gum Arabic and calcium hydroxide additives permitted lower L/P ratio, however, there was still excess water retained in the set gypsum that lowered the strength values of Type III and Type IV gypsum. Hence, further reduction of L/P ratio may increase the properties of the modified Type III and Type IV gypsum.