The Journal of Indian Prosthodontic Society最新文献

Aim: The purpose of this in vitro study was to comparatively evaluate the marginal and internal fits of cobalt-chromium metal custom post and core fabricated using a conventional technique with two digital techniques.

Settings and design: The study was designed in an in-vitro study setting.

Materials and methods: Five sets of custom post and core restorations were fabricated using the conventional (Group 1) and two semi digital methods (digital scanning of the resin pattern and computer aided additive manufacturing, and digital scanning of the silicone impression and subsequent computer aided designing [CAD] computer aided manufacturing fabrication) (Group 2 and 3). Marginal and internal fits of the posts were evaluated using a micro computed tomography scan at various points.

Statistical analysis used: A one way ANOVA test of the scores was made to evaluate the effect of different methods of custom post and core fabrication on marginal and internal fits. Bonferroni adjusted post hoc tests were conducted for intergroup comparison.

Results: Least marginal gap was reported in Group 3 (82.5 ± 14.36 μm) followed by Group 1 (110 ± 25.19 μm) and Group 2 (112.5 ± 26.75 μm). Least internal gap at cervical, middle and apical as well as overall values were observed in Group 3 (78 ± 9.25 μm, 72 ± 7.79 μm, 160 ± 15.81 μm, 103.3 ± 4.43 μm) followed by Group 1 (113.5 ± 25.35 μm, 132.5 ± 19.92 μm, 502 ± 74.63 μm, 249.3 ± 25.44 μm) and Group 2 (114.5 ± 21.68 μm, 133.5 ± 19.57 μm, 598 ± 87.86 μm, 282 ± 28.91 μm) respectively. The results of one-way ANOVA and Bonferroni adjusted post hoc tests for marginal gap did not show any statistically significant difference between the three groups (P > 0.05) but revealed statistically significant difference (P = 0.02) in internal gap values at the cervical, middle, and apical regions as well as overall internal gap region between the three groups.

Conclusions: Better marginal and internal fits were observed in custom post and core fabricated by digital scanning of the silicone impression and subsequent CAD as compared to those fabricated by the other two groups.

Aim: The conventional technique of implant uncovery using a blade and scalpel is associated with various drawbacks, including profuse bleeding, soft-tissue trauma, delayed healing, and patient noncompliance. Therefore, there is a need to explore the alternative approaches that offer improved accuracy and time efficiency during the cover screw location at the second stage of recovery. This study aims to assess the accuracy and time efficiency of a novel technique that utilizes an apex locator in comparison to conventional locating techniques for implant uncovery.

Settings and design: The study employed a simple randomized controlled trial with a sample size of 161.

Materials and methods: The study employed apex locator (Woodpecker Woodpex III Gold 5th generation) in conjunction with a K-file (Mani k-file #10, 21 mm) for detecting the implant location. The accuracy of the novel technique was determined based on the values measured on the apex locator, with positive values indicating soft-tissue response and negative values indicating the cover screw (metal). The accuracy was cross-verified using radiovisiography (RVG). The clinician-based scoring was also done, considering RVG evaluation, amount of incision given, and ease of the procedure. The time required to locate the cover screw was recorded using a timer for both the novel technique and the conventional method.

Statistical analysis used: All the recorded values were statistically analyzed using the independent t-test (P < 0.005) with the SPSS software (version 23).

Results: The results revealed a significant difference in terms of incision given, ease of treatment, and time taken for the procedure (P < 0.05), while the accuracy of the novel technique was not disturbed (P > 0.05).

Conclusion: Based on the findings of this in vivo study, the use of an apex locator as an alternative to conventional methods for detecting cover screw location at the second stage of recovery is recommended. The novel technique demonstrated faster uncovering of implants without posing any risks to the surrounding tissues or implants.

Aim: This systematic review and meta-analysis aimed to evaluate the accuracy of different methods used for measuring horizontal condylar guidance (HCG) angle in comparison with protrusive interocclusal record (IOR) for dentulous patients.

Settings and design: The design involves systematic review and meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines.

Materials and methods: An electronic search was carried out by two reviewers in the Google Scholar search engine and the EBSCO host, Cochrane Library, and PubMed/MEDLINE databases for quasi-experimental studies, in vivo studies, and cross-sectional studies published from January 2005 to February 2023 determining the HCG angle in dentulous patients.

Statistical analysis used: Meta-analysis was performed to evaluate the quantitative data.

Results: A total of 577 articles were identified, 29 analytical cross-sectional studies that fulfilled the eligibility criteria were included for qualitative synthesis and 26 studies were included for meta-analysis. A statistically significant difference was observed for the right and left HCG angles obtained by the panoramic radiograph method and cone-beam computed tomography (CBCT) method and for the right side HCG angle obtained by cephalogram method showing higher values than the protrusive IOR method. No statistically significant difference was observed for the left side HCG angle obtained by the cephalogram method and both the right and left side HCG angles obtained by the intraoral tracer method.

Conclusions: The panoramic radiograph, cephalogram, and CBCT obtained higher HCG angles in dentulous patients than the protrusive IOR method.

Aim: This study aimed to systematically review the frequency and type of intraoral prosthetic rehabilitation in patients with rhino-orbital-cerebral-mucormycosis (ROCM).

Settings and design: Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Materials and methods: An electronic search was conducted in databases including PubMed, Web of Science, Scopus, and Google Scholar. Case reports that documented prosthetic rehabilitation following surgery in patients with ROCM were included. This review was registered under the International Prospective Register of Systematic Reviews CRD42021262284. Assessment of the quality of the included studies was done using the Joanna Briggs Institute Critical Appraisal Checklist for Case reports, which comprised of an eight-item checklist. The recorded observations were organized and subjected to analysis.

Statistical analysis used: Qualitative analysis was used.

Results: Among the 25 case reports, type IId defect was the most common. Three types of prosthetic treatments were rendered, with the obturator being the most common choice of rehabilitation, followed by implant-retained obturator overdenture and fixed implant-supported prosthesis. Patients undergoing implant-based rehabilitation exhibited a 100% survival rate for implants, with follow-up periods spanning from 6 months to 3 years. No prosthetic complications were reported in any of the included case reports.

Conclusions: The prevailing defect type identified was IId (48%), while the treatment of choice most frequently employed was an obturator (84%). However, with limited evidence available at present, further research is required to draw more definitive conclusions.

Aim: Occlusal splint treatment is commonly used to treat a variety of temporomandibular disorders (TMDs), with efficacy ranging between 70% and 90%. Centric splints are effective in relieving muscular soreness in individuals with TMD. Electromyography (EMG) quantifies muscle activity and can be used as an accessory diagnostic tool to evaluate the efficiency of the splint on the masticatory complex. Electromyography is used for assessing patients with TMD and observing muscle electromyography. TMD patients have altered electromyographic (EMG) masticatory muscle activity because of its change in electrical activity index or because of the compensatory mechanism for the disorder. Therefore, this study serves to evaluate the efficacy of the centric stabilization splint on TMD using EMG.

Settings and design: This cross-sectional study enrolled Ten TMD Patients with TMD, who underwent treatment with centric stabilization splint.

Materials and methods: The study involved ten young adults with TMD aged 18-45 years who were recruited without regard to sex, religion, caste, or socioeconomic background. The participants were randomized to receive a flat-contact upper stabilization splint and pregelled EMG electrodes to assess the immediate impact of centric splints on TMDs. After 3 months of follow-up, muscle activity and muscle symmetrical activity were measured to assess improvement in the symptoms of TMD.

Statistical analysis used: The Shapiro-Wilk test was used to assess the normality of the variables' distribution using SPSS 26.0. Symmetrical activity and treatment response were investigated using the Wilcoxon signed-rank test.

Results: It showed an improvement in the temporalis, masseter, and sternocleidomastoid muscles' resting EMG activity. A statistically significant improvement was seen in the EMG activity of the bilateral temporalis, right masseter, right sternocleidomastoid, and left digastric muscles while clenching. The masseter, sternocleidomastoid, and digastric muscles all displayed significantly enhanced symmetrical activity (P < 0.05).

Conclusions: This research concludes that a centric stabilizing splint assists in relieving TMD symptoms. There was enhanced masticatory muscle activity both at rest and during function. Furthermore, there was an improvement in symmetrical activity of the masticatory muscles, which improved balance and enhanced the effective functioning of the masticatory complex.

Purpose: The purpose of this study was to evaluate the difference in marginal bone level, technical and biological complications between screw-retained and cemented all-ceramic implant-supported crowns fabricated on zirconia abutment at different follow-up periods.

Materials and methods: Independent search was conducted in Cochrane Library, EBSCO, and PubMed/PubMed Central/MEDLINE databases and the Google Scholar search engine for prospective studies and randomized controlled trials published between January 2014 and June 2023 evaluating the marginal bone level, technical and biological complications between screw-retained and cemented all-ceramic implant-supported crowns fabricated on zirconia abutment. Meta-analysis was conducted to assess the quantitative data on the marginal bone level and biological complications.

Results: A total of eight studies were included for qualitative synthesis and six studies for quantitative synthesis. For marginal bone level, no statistically significant difference was observed (P = 0.83 and P = 0.69, respectively) during the follow-up period of 3 years and 5 years. For probing depth, the cemented group showed more amount of probing depth than the screw-retained group at a follow-up period of 3 years (P < 0.05) whereas no statistically significant difference was observed at a follow-up period of 5 years (P = 0.73). For bleeding on probing, the cemented group showed more probing depth than the screw-retained group at a follow-up period of 5 years (P = 0.10).

Conclusion: The evidence suggests that the screw-retained group showed no statistically significant difference in marginal bone level, comparatively fewer biological complications, and relatively higher technical complications than the cemented group at different follow-up periods.

Background: Disc displacement with reduction (DDwR) is among the common disc disorders of temporomandibular joint (TMJ), which can be managed conservatively by splint therapy. Anterior repositioning splint (ARS) is the most commonly prescribed splint by dental practitioners, but not getting a normal disc-condyle relationship always and other side effects lead to need of comparing with other occlusal splints. This review will help in informed decision-making by clinicians in choosing an appropriate splint type for patients.

Aim: The aim is to compare the effectiveness of ARS in the management of DDwR with other occlusal splints for TMJ and muscle pain, TMJ noise, any adverse effects, regaining normal disc-condyle relationship.

Materials and methods: We followed published protocol in the International prospective register of systematic reviews. Databases were searched till May 2023 using different search strategies as per the database. Title and abstract screening, followed by full-text screening and data extraction with risk of bias, was done by two independent reviewers in Covidence. Outcomes were reported as risk ratio (RR) or mean difference (MD) for dichotomous or continuous outcomes, respectively, using RevMan 5.4 (Review Manager 5.4) software. We used a random effect model for statistical analysis. Certainty of evidence was assessed using the Grading of Recommendation, Assessment, Development, and Evaluation Guideline Development Tool (GRADEpro GDT) software.

Results: A total of 1145 reports were found from a database search. After screening, four studies were included for systematic reviews. Other occlusal splints reported were sagittal vertical extrusion device and mandibular ARS, full hard stabilization splint of canine or centric stabilization type. Data of only two studies could be used for meta-analysis having 30 participants received ARS and 40 received other occlusal splints. We did not find evidence of any difference between ARS and other occlusal splints for TMJ clicking in short term (RR 1.25, 95% confidence interval [CI] 0.91-1.72) but a small difference in favor of other occlusal splint in long term (RR 2.40, 95% CI 1.04-5.55). No evidence of any difference was found between both treatments for TMJ pain in short term (MD-5.68, 95% CI-17.31-5.95) and long term (MD 0.00, 95% CI-2.86-2.86) and muscle pain in short term. The certainty of evidence for comparison of two treatments for different outcomes was of low or very low level.

Conclusion: Evidence is uncertain that other occlusal splints reduced TMJ clicking slightly in comparison to ARS. For the remaining outcomes, no evidence of any difference was found between the two splints and it may be biased due to selection bias, inadequate blinding of participants, and outcome assessor.

Aim: The aim of this study was to evaluate the accuracy of models of partially edentulous arches obtained by three-dimensional (3D) printing.

Settings and design: This was an in vitro study.

Materials and methods: Fifteen partially edentulous models were evaluated, using two methods of measuring dimensions: virtual, using the Standard Tessellation Language files of the models and software (control group), and physical, through printing the models and digital caliper (test group). For both methods, measurements were made regarding the dimensions of the teeth (width and length - buccal/lingual or palatal/occlusal) and distances between the teeth.

Statistical analysis used: For the variable of linear measurements (width and length) and distances between teeth of the same hemiarch, the Wilcoxon test was used, while for the variable between opposite hemiarches, the paired t-test was used.

Results: In the evaluation of the linear measurements, a significant difference was observed only when the width of the molar tooth was analyzed (P = 0.014). When the buccal length was measured, all teeth had linear measurements provided by the virtual method that was lower than the physical (P = 0.000), as well as the lingual/palatal length in incisors (P = 0.003) and molars (P = 0.009) and in total (P = 0.001). As for the analyses between teeth, no difference was identified between the measurements provided by the virtual method compared to the physical one.

Conclusions: The 3D printer used to print partially edentulous models provided linear distortions in the teeth but without changes in the distances between teeth of the same hemiarch and between teeth of opposite hemiarches.

Aim: This study investigates the effectiveness of an innovative virtual tooth preparation workflow for the fabrication of dental crowns using cone-beam computed tomography (CBCT) and intraoral scanners (IOSs) with conventional workflow using extraoral/laboratory scanners.

Settings and design: This in vitro experimental study was conducted in the laboratory of a university in Chennai, India. The dental laboratory and research facilities at the institution were utilized for the fabrication of the temporary crowns and the data acquisition process.

Materials and methods: Institutional approval was obtained from the university. It was basically a comparison between the virtual prep technique using CBCT and IOS and the conventional digital technique using extra oral scanners (EOS) for temporary crown fabrication. The sample size was estimated using an effect size of 1.5004, assuming a normal distribution, a significance level of 0.05, and a power of 0.95 in G power software. Based on this calculation, an extracted second lower molar was used to fabricate 10 samples in each group. The samples were divided into three groups: the CBCT (Group 1), the IOS (Group 2), and laboratory scanner (Group 3 as control) groups. The vertical marginal gap of all the surfaces of the crown was evaluated using a scanning electron microscope.

Statistical analysis used: Data were analyzed using one-way ANOVA using the SPSS software version 26.0, IBM, Armonk, NY, USA.

Results: Acceptable marginal discrepancy values were obtained in all three groups. There was no significant difference in the marginal discrepancy recorded (P = 0.113).

Conclusion: Virtual tooth preparation using CBCT and IOSs can be used as an alternative to the conventional workflow for provisional crown and bridge fabrication.