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Background: Dental scanners play a critical role in computer-aided design/computer-aided manufacturing technology. This study aimed to compare the accuracy (precision and trueness) of eight dental scanners for dental bridge scanning. Materials and Methods: In this in-vitro experimental study, a typodont model with a missing maxillary right first molar was prepared for a 3-unit fixed partial denture. Each scanner (Sirona inEos inLab, Sirona X5, Dentium, Imes icore 350I I3D, Amann Girrbach map 100, 3Shape D100, 3Shape E3) performed seven scans of the typodont, and the data were analyzed using 3D-Tool software. The abutment length, abutment width, arch length, and interdental distance were measured. To assess the accuracy of each scanner, trueness was evaluated by superimposing the scanned data on true values obtained by the 3shape Triosscanner as the reference. Precision was evaluated by superimposing a pair of data sets obtained from the same scanner. Precision and trueness of the scanners were compared using the one-way ANOVA followed by the post-hoc Tukey's HSD test and one-sample t-test (P

Objective Pediatric femoral fracture including supracondylar and subtrochanteric fracture constitutes 1.6% of all paediatric fracture. Elastic nails remain the standard treatment of choice in a midshaft transverse femoral fracture in children weighing less than 45 kg. But in subtrochanteric and spiral femoral fracture, the failure rate of elastic nails are quite high. Hence, in accordance with AAOS guidelines, we treated complex femoral fracture in children with submuscular mini-invasive bridge plate because of its advantage of minimal incision, early union with proper alignment and lower failure. Material and methods We retrospectively reviewed 30 complex femur fracture in children treated with Submuscular bridge plate by mini-invasive approach. Patients were analysed according to their age, type of fracture, time of union in weeks, complication and results were evaluated with modified Flynn's criteria. Result Out of 30 patients 28 were boys and 2 were females, with an average age of 11.5 years in which Spiral fracture (n = 12), subtrochanteric fracture (n = 9), Complex Shaft fracture (n = 10). All fracture united well on an average of 11 weeks. And 29 patients has excellent results and in 1 patient there is Acceptable result. The single complication was 3 mm limb lengthening but it didn't change gait of the patient. Conclusion Mini invasive bridge plating is an easy and soft tissue preserving procedure for managing complex femoral fracture in children. It has shown promising results in achieving union without any major complication. We strongly recommend the SBP in a complex femoral fracture in children.

Periodontitis has a multifactorial etiology as a result of interactions between periodontal pathogens and the host response. Due to the complex etiology and esthetic complications, the management of such patients is a challenging task. Vast arrays of treatment modalities are employed in the treatment of generalized periodontitis with varying success rates. Placental-derived tissues as allografts have recently been introduced for guided tissue regeneration in dentistry with favorable results. In this case report, successful periodontal treatment of a 25-year-old male patient with generalized periodontitis; Stage IV, Grade C, is presented with a 3-year follow-up. An interdisciplinary approach using regenerative periodontal surgery and a modified Andrew's bridge was used to successfully rehabilitate the patient. In a compliant patient with a well-structured interdisciplinary approach, questionable and hopeless teeth too can be retained over an extended period of time with no detrimental effect on the adjacent teeth.

Endocrown restorations are single unit prostheses fabricated from metal. These restorations are indicated for endodontically treated teeth, molars especially, that have significant loss of coronal structure. Endocrowns gain their retention from the coronal portion integrated into the apical projection that fills the pulp chamber space, and possibly the root canal entrances. In this case report a new style Fixed Partial Denture is introduced. Here mandibular second molar had compromised tooth structure and hence Endocrown was planned with the tooth. For replacement of missing first molar a three unit fixed partial prosthesis was planned. This unique three unit prosthesis had Endocrown on mandibular second molar and a full veneer crown on mandibular second premolar as an abutment fabricated in metal. This innovative design of Fixed Partial Denture is better suited in cases where there is compromised tooth structure and the tooth is strategically important and has to be retained.

Alveolar bone loss subsequent to long-term edentulism and trauma may be severe and treatment plan is always an esthetic and functional challenge. Implant supported hybrid prosthesis is widely regarded as an effective treatment option for patients with excessive and irregular bone loss. However, implant placement is occasionally impossible without surgical procedures in such cases. This case report presents rehabilitation of 19-year-old maxillary anterior edentulous male patient with maxillary anterior bone defect and excessive cross-bite anterior closure with multidisciplinary approach. The patient was rehabilitated with implant supported hybrid prosthesis with Malo Bridge design following autogeneous iliac bone augmentation, teeth leveling with orthodontic treatment, and surgical placement of three implants. Esthetics, pleasing phonetics and function were achieved as desired with this treatment option and no complications were observed.

It is possible to rehabilitate fully edentulous patients with implantsupported fixed or removable prostheses; however, implantsupported fixed prostheses are the gold standard for patients who not prefer to use removable dentures. This case report, prosthetic rehabilitation of a completely edentulous young patient with an implantsupported fixed hybrid prosthesis using the "Malo Bridge" technique is described. A 18 years old male patient was referred to the clinic with complaints of tooth loss, aesthetics, function, and phonetic. A total of 5 implants were placed in both the jaws. Considering that screw holes may cause aesthetic problems due to the Class III occlusion, these problems have been solved with the implant-supported hybrid prosthesis called Malo bridge. With the Malo Bridge design, the patient's aesthetic, functional and phonetic loss was eliminated, patient comfort and quality of life were improved, and patient expectations were met. It is a viable treatment option to rehabilitate completely edentulous jaws with a cross relationship and increase interarch distance using Malo Bridge to support a fixed prosthesis.

The periodontal health of abutment teeth and the durability of fixed partial denture depends on the marginal adaptation of the prosthesis. Any discrepancy in the marginal area leads to dissolution of luting agent and plaque accumulation. This study was done with the aim of evaluating the accuracy of marginal fit of four unit crown and bridge made up of Ni-Cr and Cr-Co alloys under induction and centrifugal casting. They were compared to cast fixed partial denture (FPD) and soldered FPD. For the purpose of this study a metal model was fabricated. A total of 40 samples (4-unit crown and bridge) were prepared in which 20 Cr-Co samples and 20 Ni-Cr samples were fabricated. Within these 20 samples of each group 10 samples were prepared by induction casting technique and other 10 samples with centrifugal casting technique. The cast FPD samples obtained were seated on the model and the samples were then measured with travelling microscope having precision of 0.001 cm. Sectioning of samples was done between the two pontics and measurements were made, then the soldering was made with torch soldering unit. The marginal discrepancy of soldered samples was measured and all findings were statistically analysed. The results revealed minimal marginal discrepancy with Cr-Co samples when compared to Ni-Cr samples done under induction casting technique. When compared to cast FPD samples, the soldered group showed reduced marginal discrepancy.

Introduction: Fixed partial denture (FPD) is the term used for denoting partial dentures that are cemented to the natural teeth or root, thereby furnishing and providing primary prosthetic support. Prosthetic failure in patients rehabilitated with dental treatment can affect the periodontal health of the abutment teeth. Aim and Objectives: The present study was conducted to evaluate the FPD's complications among patients attending a dental college in Ahmedabad, Gujarat, India. Materials and Methods: The study was carried out among patients who visited the Department of Prosthodontics and Crown and Bridge, AMC Dental College and Hospital, Ahmedabad, Gujarat, India, as outpatients from March 2018 to August 2018. A total of 300 patients were randomly selected and interviewed. Results: Regarding the nature of problems faced with the FPD and crown wearers, 64% of them reported with looseness and repeated dislodgement, whereas 36% of them had no such complaints. The second most common problem encountered with the patients was inability to maintain proper oral hygiene. Nearly 54% of the patients found it difficult to maintain oral hygiene. Conclusions: Knowledge regarding the clinical FPD complications enhances dentists' ability to complete a thorough diagnosis, develop the most appropriate treatment plan for patients, communicate realistic expectations to patients, and plan time intervals needed for posttreatment care in the dental institutions.

Apexification is a procedure for closure of the open apex in an immature necrotic tooth. Apexification with calcium hydroxide is considered as the gold standard. However, this technique is associated with certain difficulties such as very long treatment period, possibility of tooth fracture, and incomplete calcification of the bridge. Single-visit mineral trioxide aggregate (MTA) apexification has become popular over the calcium hydroxide technique. In this article, three case reports of 3 months to 1-year follow-up are presented, which were treated by the single visit apexification procedure which includes recent artificial barrier methods with MTA as the apical plug and the rest of the canal was obturated with thermoplastisized gutta-percha.

A fixed implant-supported full mouth prosthesis has been a routine treatment plan for completely edentulous patients. A systematic planning is must for successful implant placement and restoration. This article describes a technique to form a bridge between implant planning and execution of the plan using radiographic markers and cone beam computed tomography.

Statement of Problem: In clinical situations, short implant abutments create lack of retention with overlying cemented prosthesis. Aims: The aim of this study is to evaluate the impact of different surface treatments on the retention of implant-supported cement-retained bridge with short implant abutments. Materials and Methods: Six straight Adin implant abutments of similar sizes (3 mm diameter × 3 mm height) were selected. All were divided into three groups (n = 2): with circumferential grooves and sandblasting (G + SB), with a circumferential groove and bur modification (G + B) and third one taken as control. The framework simulating three-unit bridge was casted in each group. A total of 30 such frameworks (10 for each group) were fabricated. Each casting was cemented with a zinc phosphate cement (Dentsply). The cemented frameworks were then being stored in 100% humidity at 37°C for 24 h. Retention tests were conducted with a universal testing machine (5 mm/min), and retentive forces were recorded. Data were subjected to one-way analysis of variance, Tukey's honestly significant difference test, (α = 0.05). Results: For the first group, retentive value increased by 619.30 N, the second group increased the retention by approximately 749.80 N (P < 0.001). The null hypothesis was rejected, the abutments with G + B showed significantly higher retention, than the G + SB and control group (F = 15.95, df = 29, P < 0.001). Conclusion: The addition of G + B to implant abutments significantly increased the retention of cement-retained frameworks. For long-term prognosis of the prosthesis; G + B modification can be a better option as compared to G + SB.

Introduction: Bruxism is defined as a nonfunctional activity or a parafunctional habit characterized by the unconscious repetitive motion of clenching and/or grinding of the teeth. Soft occlusal splints have been considered as the first-line strategy for treating nocturnal bruxism. Cortisol is a major steroid hormone secreted by fascicular zone of the adrenal cortex, belonging to the glucocorticosteroidal group of hormones. Clinical studies have shown that when humans are placed under stress, the hypothalamic–pituitary–adrenocortical axis is activated, leading to an increase in cortical secretion. However, the effect of splint is questionable by some researchers, and best way to perceive the effect of soft splints in patients with bruxism is by evaluating the stress levels. Materials and Methods: A total of 20 individuals suffering from bruxism were selected from the Outpatient Department of Prosthodontics and Crown and Bridge, JSS Dental College and Hospital, Mysore. Saliva samples were collected before and after using the occlusal soft splints and subjected to enzyme-linked immunosorbent assay for determining the salivary cortisol levels. Results: The collected data were subjected to appropriate descriptive statistics, paired sample t-test, and one sample t-test. The paired sample t-test shows that intragroup comparison of the mean cortisol level in the study group shows near significant values, which means there is a decrease in the salivary cortisol levels in patients after using soft occlusal splint, but statistically nonsignificant. Conclusion: In the present study, it has been found that 70% of individuals after using the soft occlusal splint showed decreased cortisol levels.

Introduction: For a successful fixed partial prosthodontics, obtaining an accurate impression for making an accurate cast is of prime importance. Aim: The study emphasizes on using modified impression techniques for fixed prosthodontics without using retraction cord. Various mechanical and chemical methods have been used for achieving gingival retraction. Most of them are expensive, time consuming and uncomfortable for the patient. Cordless impression procedures using conventional impression materials are alternative to these methods. Methodology: In the present study, two cordless fixed prosthodontic impression procedures, matrix impression system and prefabricated crown shell technique; have been described and compared in terms of dimensional accuracy.An articulated acrylic resin typodont prepared with reference points was used as a master model. Addition silicon impression materials in various consistencies were used for making impressions. The coordinate measurement machine (Llyod,Germany) was used for three dimensional measurement of master model and stone casts with an accuracy of 0.0001mm. Observations: When comparing the accuracy of casts as per statistical analysis Group B (prefabricated crown shell technique) casts were less accurate in relation to inter abutment distance whereas all other distances produced statistically insignificant mean deviation from the master model. Conclusion: It can be concluded that prefabricated crown shell technique is not recommended for a long span bridge framework but is well indicated while making cordless impressions for fabrication of single crown.

A 42-year-old male patient complaint with missing right eye was referred to the Department of Prosthodontics and Crown and Bridge. This patient was seeking artificial eye replacement. On careful clinical examination, a defect with a shrunken orbit and intact tissue bed was found in the patient. As the patient was economically very poor, modified stock ocular prosthesis was advised. To rehabilitate this ocular defect, “single” appointment technique with clinically available material was adopted, which is discussed in the present communication.

Various treatment modalities have been proposed and practiced over the years for comforting the functions of individuals with enhanced life expectancy leading to an aging population. These therapeutic modalities are directed toward providing masticatory apparatus to patients with atrophic edentulous ridges. After evolving over several years, clinicians have now been enabled to use dental implants and provide a functionally viable and esthetically pleasing masticatory apparatus to their patients. However, majority of the dentists lack the detailed knowledge, skills, and experience which are necessary and essential for a successful implant therapy. Various training programs have been conducted across the country with the motive to bridge the gap between the clinician and the therapy. However, the existing training programs and courses lack the detailed theoretical inputs and deliberations, which form the very basis for an implicative understanding of the therapeutic modality and thus do not offer desired outcomes many a times. The success of implant therapy depends not only merely in achieving osseointegration of the implant but also providing the esthetic and functional standards, which are in tune with the patient's expectation. Oral implantology cases can be briefly divided based on their complexity as either straightforward or complex placement and/or restoration of implant. To benefit the society at large, it is high time that training programs be proposed with differential skill upgradation with different avenues. The article proposes a few training avenues for the dental professionals which if taken up in the right perspective will restructure the education in oral implantology in our country. Such training avenues need to be brought under regulatory bodies such as the State Health Universities and Dental Council of India so as to achieve a desired standardization and uniformity.

Purpose: The purpose of this study was to evaluate and compare the flexural strength and microhardness of provisional restorative materials fabricated utilizing rapid prototyping (RP), Computer Assisted Designing and Computer Assisted Milling (CAD-CAM) and conventional method. Materials and Methods: Twenty specimens of dimensions 25 mm × 2 mm × 2 mm (ADA-ANSI specification #27) were fabricated each using: (1) Three dimensional (3D) printed light-cured micro-hybrid filled composite by RP resin group, (2) a milled polymethyl methacrylate (CH) using CAD-CAM (CC resin group), and (3) a conventionally fabricated heat activated polymerized CH resin group. Flexural strength and microhardness were measured and values obtained were evaluated. Results: The measured mean flexural strength values (MegaPascals) were 79.54 (RP resin group), 104.20 (CC resin group), and 95.58 (CH resin group). The measured mean microhardness values (Knoop hardness number) were 32.77 (RP resin group), 25.33 (CC resin group), and 27.36 (CH resin group). The analysis of variance (ANOVA) test shows that there is statistically significant difference in the flexural strength values of the three groups (P < 0.05). According to the pairwise comparison of Tukey's honest significant difference (HSD) test, flexural strength values of CC resin group and CH resin group were higher and statistically significant than those of the RP resin group (P < 0.05). However, there was no significant difference between flexural strength values of CC resin and CH resin group (P = 0.64). The difference in microhardness values of the three groups was statistically significant according to ANOVA as well as the intergroup comparison done using the Tukey's HSD (post oc) test (P < 0.05). Conclusions: CC-based CH had the highest flexural strength whereas RP-based 3D printed and light cured micro-hybrid filled composite had the highest microhardness.

A single complete denture (SCD) opposing fixed porcelain bridge is not an uncommon occurrence in clinical practice. Selecting denture posterior teeth to oppose fixed porcelain bridges, poses several problems. Porcelain teeth will not wear, but their cost and availability may preclude their use whereas resin teeth will wear and clinically, they are less efficient. A 53-year-old male patient presented with completely edentulous maxillary arch and partially edentulous mandibular arch with fixed porcelain bridges on remaining natural teeth, with the history of having worn two maxillary CDs, which he got replaced after using just for 1 year as denture teeth got attrited. This article describes a cost-effective technique of using amalgam modified resin teeth by developing functionally generated amalgam paths to overcome this problem. The patient was followed up for 6 months, and it was found that the loss of vertical dimension was clinically insignificant. Amalgam modified resin teeth, using functionally generated path technique seem to be a simple and precise method to improve the efficiency of resin teeth and subsequently, better wear resistance against porcelain restoration.

The absence of teeth most often has a significant impact on the function, esthetics, and thus the psychological condition of the patients. Residual ridge resorption is most common in mandibular anterior region which poses a challenging task to the restoring dentist. Several factors should be taken into consideration before diagnosing and formulating a treatment plan. Andrew's bridge is a fixed, removable partial denture which is mostly indicated in cases where the abutment teeth are capable of supporting a fixed partial denture but the residual ridge defect in the edentulous area where a conventional fixed partial denture may not adequately restore the patient's missing teeth and the supporting structures. The purpose of this article is to describe the management of a Siebert Class III residual ridge defect with a modified Andrew's bridge using a bar attachment and a cast metal removable partial denture. Clinical Relevance to Interdisciplinary Dentistry Siebert Class III condition is most prevalent and most difficult to restore as there is severe ridge defect both vertically and horizontally. Andrew's bridge with an interdisciplinary approach results in the improvement of the aesthetic and functional aspects as well as quality-of-life of the patient.

Objective: This survey was undertaken to assess dentist's opinion regarding the occurrence and pattern of food impaction in relation to fixed partial denture (FPD) prostheses, its commonly observed consequences, factors contributing to it, and its management. Methods: A descriptive survey was conducted on a sample size of 150 dental practitioners. The pro forma consisted of informed consent, demographic information, and questionnaire. The results were tallied and quantitative analysis was performed to obtain the descriptive statistics for the data using SPSS version 20. Results and Interpretation: All the study respondents had come across patients who complained of food impaction in relation to FPD. The most common consequences of food impaction were proximal caries of the adjacent teeth and interdental bone loss. Majority of the dentists considered faulty FPD design with improper contact relation, improper crown contour, poor margin adaptation, and faulty pontic design as the most likely reason for food impaction. Repeating the FPD with emphasis on prescribing and reinforcing the use of proper interdental aids was considered as the ideal treatment option. It was also observed that about half of the dentists always communicated inadequate information of the FPD prostheses that needed replacement to the dental laboratory technician for the successive bridge. Most of the times, prosthodontists were consulted to rectify the problem of food impaction resulting from faulty FPD prostheses. However, it is obvious that it is easier and more prudent to prevent rather than treat food impaction. This study gives an overview of some of the common errors in designing the FPD prostheses which often lead to food impaction and measures to be taken to overcome them. Conclusion: It may be concluded as all the dentists participating in the survey agreed that food impaction is one of the common complaint among FPD Patients. Proximal caries and interdental bone loss were the prevalent outcomes of food impaction. Faulty FPD design was allegedly attributed as the reason for food impaction. Prosthodontists were routinely consulted to resolve the dilemma of food impaction. However, it is rational to prevent food impaction rather than to tackle the sequel later.

Introduction: As implant dentistry becomes popular with each passing, need to understand its awareness in the general population exists. The aim of this study was to assess the public awareness of dental implants as a treatment option and its demographic distribution in the Indian Metropolitan City of Mumbai. Materials and Methods: A questionnaire-based survey consisting of 12 questions on implant treatment awareness was conducted on randomly selected 1000 individuals attending eight dental clinics in the city of Mumbai, India. Distribution for each question was assessed using frequencies and percentages for various sociodemographic groups. Results: 32.30% of the participants were aware of dental implants as an option to replace missing teeth, without significant variance in gender and age groups ranging from 18 to 70 years. Awareness of dental implant treatment increased with the increase in socioeconomic status. Dentists were the main source of information on implants, followed by the internet. 46.8% of the participants wanted additional information on dental implants. Among those aware of implants, 62.85% of the participants regarded high cost of the treatment as the biggest disadvantage, 31.89% of the participants blamed their dental professional for the failure of implants, 48.92% of the participants thought implants would last a lifetime, and 85.45% of the participants were ready to restore their missing teeth with implant-based treatment options. Conclusion: This study reveals that there is a lack of awareness of dental implants and implant-based treatment in the population, especially in those with a low socioeconomic status. However, a significant portion of the population wanted to have more information on dental implants. Special efforts to improve doctor-patient communications will be needed to bridge the information gap.

Hypodontia is the congenital absence of CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY Correction of dental problems is a complex procedures and usually it requires a interdisiplinary approch for the best outcome. Interdisiplinary dentistry covers the broad area and involves management of patient records, diagnose the various problem, and establising the chain of communication.

Computer-aided design/computer-aided manufacturing (CAD/CAM) restorations have developed at rapid pace since their introduction offering accuracy and more options. The paradigm shift from traditional techniques to CAD/CAM technology has brought about a revolutionary change in the way the restorations are fabricated. Impression techniques, burnout oven, and casting machines have been replaced by model scanning and CAD/CAM milling machines. Keyboards, monitors, and cursors have replaced Bunsen burners, wax, and carving instrument to fabricate crown and bridge prosthesis. CAD/CAM technology offers automated production, patient comfort, esthetically pleasing and strong restorations and cost-effectiveness to laboratories. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY Computer-aided design/computer.aided manufacturing technology is now a viable, predictable, and efficient alternative to traditional methods for fabrication of dental restorations It has innumerable clinical applications including fabrication of indirect restorations, occlusal splints, implant prosthodontics, maxillofacial prosthodontics, and orthodontics.

A female patient aged 28 years reported to the Department of Prosthodontics and crown and bridge with a complaint of missing teeth in maxillary anterior region. An interdisciplinary approach was planned for rehabilitating the patient. The oral presentation showed severe attrition of the anterior teeth and loss of vertical dimension of occlusion. A full mouth rehabilitation was thus carried out using multidisciplinary approach along with Hobos twin table technique to restore the dentition to esthetic and functional needs and the patient was rehabilitated satisfactorily.

This case report describes the management of maxillary arch spacing due to congenital absence of lateral incisors along with anterior proclination in a patient with esthetic concerns. The treatment encompassed fixed orthodontic procedure for proclination correction including canine substitution by the conversion of right maxillary canine to lateral incisor with restorative approach and the right first bicuspid was used as cuspid. On the left side, maxillary cuspid was converted to lateral incisor with prosthetic crown and bridge that involved interdisciplinary treatment modality.

Prosthetic dentistry involves the replacement of missing and contiguous tissues with artificial substitutes to restore and maintain the oral functions, appearance, and health of the patient. The treatment of edentulous areas with ridge defects poses a challenging task for the dentist. Management of such cases involves a wide range of treatment options comprising mainly of surgical interventions and non surgical techniques such as use of removable, fixed or fixed- removable partial dentures. But each treatment plan undertaken should be customized according to patient needs. A variety of factors such as quality and quantity of existing contiguous hard and soft tissues, systemic condition and economic status of the patient play an important role in treatment planning, clinical outcome and prognosis. This case report presents the restoration of a Seibert′s Class III ridge defect by an economical modification of Andrews Bridge in a 32 Year old patient.

Anterior ridge defects can occur due to congenital defects such as cleft lip and palate, surgical removal of any pathological condition, or removal of teeth and supporting bone fractured due to traumatic injury. These types of defects require not only the replacement of the missing teeth, but also an acceptable aesthetic outcome. This article presents a case report that describes the process of fabrication of Andrews's bridge to treat an anterior alveolar defect using canines as abutments for its fixed component followed by a removable component.

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

To create a general awareness among the clinicians regarding the appropriate choice of crown removal systems and techniques in various clinical situations. Fixed prosthodontic treatment is often faced with complications involving failure of restoration or of the abutment due to improper treatment planning. In such situations, further management can be accomplished either by removal and replacement or repair of the restoration. Removal of the crown and bridges for refabrication is extremely tedious and can lead to unpredictable consequences if proper technique is not used. An external device is always required for the removal of the failed restorations. Decrowning devices are a boon to dentistry to deal with such situations. Numerous decrowning devices are available commercially. This review describes and demonstrates the various available devices based on the mode of action. Literature search was carried out using PubMed and Google Scholar from 1970's to till date. Any decrowning device will be successful only if used appropriately. Hence, this literature attempts to suggest the possible application of each system based on clinical situations. A few modified techniques have also been discussed in this article for ease of the clinician. Clinical Relevance to Interdisciplinary Dentistry The field of fixed prosthodontics warrants the use of coronal disassembly systems in situations such as loosened retainer of a bridge, fractured facing, unesthetic patient appeal, loosened abutment of an implant, etc. Removal of a crown or bridge is important for conservative retreatment in conditions such as secondary caries underneath a cemented crown or recurring periapical infection of a root canal treated tooth restored with a crown. Special care should be exercised while removing fixed restorations from a periodontally compromised abutment. Safe removal of crowns is also important in the field of implant dentistry.

Treatment of severe generalized dental fluorosis with surface defects to rehabilitate esthetics, phonetics, and mastication require removal of unsupported and pitted enamel and/or dentine, reestablishment of centric relation with or without reestablishing vertical dimension of occlusion and fabrication of full mouth crown and bridge work. In this case full occlusal reconstruction was done using simultaneous arch technique and Hobo twin-stage procedure following reorganizing approach as generalized fluorosis led to severe structural defects, oblique facets because of anterior traumatic occlusion and multiple dental caries, which were otherwise not possible to be treated by direct restorations alone. Centric relation was also recorded at reestablished vertical dimension.

This case report describes the management of crown- and root-fractured maxillary and mandibular anterior permanent teeth in a 22-year-old patient because of a bicycle accident. Six teeth (11, 21, 22, 23, 31, and 32) of patient were affected by trauma. A nonsurgical endodontic treatment was performed to coronal root fragments of teeth 11, 21, and 22. The coronal parts of the canals were filled with mineral trioxide aggregate (MTA). These teeth were restored with a fiber-reinforced hybrid composite resin bridge. Other root-fractured teeth 23 and 32 were healed spontaneously. The tooth 31 with complicated crown-fractured was prepared and filled with gutta-percha and sealer. After, a glass-fiber post was applied, the restoration of this tooth was performed a hybrid composite resin using an incremental technique. The teeth were in function with satisfactory clinical and radiographic results after 24-month. Healing was achieved without any need for further endodontic surgical intervention. This case shows that traumatized teeth can be managed with endodontic and prosthetic treatments, which can result in satisfactory periradicular healing.

Background: During treatment planning for dental implant placement, there is a need for assessment of alveolar bone. Bone evaluation limited to the use of panoramic and or periapical radiographs may be insufficient, as it provides only two-dimensional information about the implant sites. Computed tomography (CT) provides three-dimensional information. The measurement of alveolar ridge dimensions can be accomplished using ridge-mapping technique. This technique involves penetrating the buccal and lingual mucosa down to the alveolar bone (following the administration of local anesthetic) with calipers and measures the bucco-lingual width of the underlying bone. Purpose: The aim of the study is to compare the techniques, i.e. ridge mapping, direct surgical exposure, and CT scan, which are used to measure the alveolar ridge bone width, and determine their accuracy in the clinical application. Materials and Methods: The study was conducted on 20 patients who reported to the Out-patient Department (OPD) of Prosthodontics and Crown and Bridge, PGIDS, Rohtak (Haryana) for replacement of edentulous span with dental implant. Width of alveolar ridge was studied by three techniques, i.e. CT scan procedure, ridge mapping, and direct surgical exposure at two points (3 mm from the crest of ridge and 6 mm from the crest of ridge), and then taking measurements of surgical exposure as the control group, the measurements obtained from the other two techniques were compared and then accuracy of these methods was assessed. The mean, standard deviation, standard error of mean, and degree of freedom were calculated and subjected to statistical analysis using Student's unpaired t test. Results: Results suggested that there is no significant difference in the measurements obtained by direct surgical exposure technique, ridge-mapping technique, and CT technique. Conclusion: Use of ridge-mapping technique along with panoramic and intraoral radiograph is adequate in cases where the pattern of resorption appears more regular and where mucosa is of more even thickness. It is suggested to use CT scan technique in situations where the alveolar ridges are resorbed, there is presence of maxillary anterior ridge concavities, vestibular depth is inadequate, and ridge mapping is not feasible.

Gingival recession in anterior teeth is a common concern due to esthetic reasons or root sensitivity. Gingival recession, especially in multiple anterior teeth, is of huge concern due to esthetic reasons. Various mucogingival surgeries are available for root coverage. This case report presents a new bridge flap technique, which allows the dentist not only to cover the previously denuded root surfaces but also to increase the zone of attached gingiva at a single step. In this case, a coronally advanced flap along with vestibular deepening technique was used as root coverage procedure for the treatment of multiple recession-type defect. Here, vestibular deepening technique is used to increase the width of the attached gingiva. The predictability of this procedure results in an esthetically healthy periodontium, along with gain in keratinized tissue and good patient's acceptance.

Sports injuries are injuries that occur in athletic activities. In many cases, these injuries are due to overuse or acute trauma of a part of the body when participating in a certain activity. Sports Dentistry is the treatment and prevention of oral/facial athletic injuries and related oral diseases and manifestations. In sports, the challenge is to maximize the benefits of participation and to limit injuries. Prevention and adequate preparation are the key elements in minimizing injuries that occur in sport. Treatment of oral/facial injuries, simple or complex, is to include not only treatment of injuries at the dental office, but also treatment at the site of injury, where the dentist may not have the convenience of all the diagnostic tools available at their office. Preseason screenings and examinations are essential in preventing injuries. Examinations are to include health histories, at risk dentitions, diagnosis of caries, maxilla/mandibular relationships, orthodontics, loose teeth, dental habits, crown and bridge work, missing teeth, artificial teeth, and the possible need for extractions for orthodontic concerns or wisdom teeth. These extractions should be done months prior to playing competitive sports as to not interfere with their competition or weaken their jaws during competition. Determination of the need for a specific type and design of mouthguard is made at this time.

Implant rehabilitation involving patients with facial deformities and temporomandibular joint (TMJ) ankylosis requires competence and expertise. It is important to understand that such patients present with minimal or restricted mouth opening, severe joint and facial pain, mandibular deviation, and facial deformities. The case reported here involved two-stage implant rehabilitation for a 54-year-old female patient who had undergone custom-made TMJ condyle and fossa reconstructive prosthesis due to severe facial deformity and ankylosis of the right TMJ following previous unsuccessful surgeries. Following the reflection of a mucoperiostel flap three implants corresponding to the missing maxillary canine, first and second premolars were placed. To achieve better distribution of occlusal load and optimal esthetics, the prosthesis was restored with 3-unit porcelain fused to metal crown and bridge. Clinical Relevance to Interdisciplinary Dentistry This case report signifies the multidisciplinary approach to complex implant dentistry through surgical and prosthodontic functional rehabilitation. It also highlights the importance of restoring the dentition in situations of facial and mandibular reconstruction, whereby we achieve optimal and adequate function and esthetics. This unique case report also will conclude the need for future rehabilitation of patients with TMJ condylar reconstruction, and the special care needed to improve occlusal balance.

The loss of a permanent first molar in adolescent patient creates a need for early space maintenance and restoration of function. To ascertain function and esthetics, immediate treatments include interim restorative approaches. This paper describes a conservative, functional and cost-effective bridge as an interim restoration after the loss of permanent first molar in an early adolescent dentition.

Anatomical aberrations and abnormalities are frequently associated with functional, psychosocial, and emotional problems. One such aberration is crestal attachment of frenum or muscle on the alveolar processes of the jaws. Crestal attachment of buccinator muscle is a rare phenomenon, which may pose various problems in routine oral exercises/functions or restoring the edentulous area. A case of abnormal buccinator muscle attachment is presented here, which was relocated apically by surgical means using an acrylic stent. The healing was uneventful and significant apical repositioning was observed. A fixed bridge was fabricated and the long-term results of the restorative therapy were assured because the patient could maintain the oral hygiene well after the muscle repositioning operation.

Background : Porcelain from prosthesis such as crown or bridge can be fractured if exposed to trauma; and, can be repaired at chairside using composite resin. Aim : To investigate the fracture resistance of few techniques of surface preparation in repairing fractured porcelain using composite resin. Materials and Methods : Eighty samples of porcelain blocks were divided into 4 groups for different surface preparations, such as, Cimara repairing kit; porcelain etch kit containing hydrofluoric acid; Panavia F resin cement; and, sandblasting using aluminium oxide, before composite resin (Filtek Z250, 3M ESPE) was bonded to the prepared porcelain blocks. Twenty others samples in the control group comprised of pure porcelain blocks. The fracture resistance of each sample was tested using Instron machine (UK). Results : With the exception of the group repaired using hydrofluoric acid (3.04±1.04 Mpa), all the other groups showed significant difference in the fracture resistance values when compared to the control group (3.05 ± 1.42 MPa) at P Conclusions : Etching of the porcelain blocks with hydrofluoric acid holds promise in the repair of fractured porcelain with composite resin at chairside.

When acrylic resin is inadvertently embedded in oral tissue, it can result in a pronounced chronic inflammatory response. This report describes a case in which temporary crown and bridge resin was forced into a surgical extraction site after the two adjacent teeth were prepared for a bridge immediately following extraction of a maxillary premolar. The patient experienced swelling at the extraction site over a ten month period despite treatment with antibiotics and anti-inflammatory drugs. After detection and removal of the foreign body, the symptoms resolved. The episode contributed to periodontal bone loss around an adjacent tooth. While morbidity of this nature is rare, this case reinforces the need to investigate persistent signs of inflammation and account for dental materials that are lost during the course of treatment.

Prosthodontic treatment of an endodontically treated tooth poses a challenge to the practitioner. Endodontic therapy has provided a solution to retain mutilated teeth. Coronoradicular reconstruction in the form of cast post and core is used as a method to provide retention and resistance form to the restoration. Endodontically treated teeth are dessicated, inelastic and brittle& have lower resistance to caries. Their inability to form secondary dentin makes them weak and susceptible to fracture. To prevent fracture and support crown and bridge, reinforcement in the form of intraradicular devices is being used. A cast post is one such method. Vertical and horizontal root fractures can occur as a result of excessive removal of tooth structure during root canal treatment, dowel placement or inceasing the width of the dowel. A cast post and core should fit passively in the canal. Even a minimally oversized post can lead to transfer of stresses to the canal walls and increase the risk of root fracture. Therefore it is necessary to ensure that there is passive fit of the post and core. Shrinkage of the mould cavity is desired during the casting process to allow a passive fit. The effect of lined and unlined rings in the dimensional behaviour of the investment during setting and subsequent heating has been investigated and it is shown that casting made of unlined rings are undersized.

Biomechanics comprises all kinds of interactions between tissues and organs of the body and the forces acting on them. Biomechanics comprises the response of the biologic tissues to the applied loads. AIMS AND OBJECTIVES: Attempt has been made to understand the basics of biomechanics with a view on finite-element stress distribution analysis in three situations namely: 1. To compare the stress distribution in a single implant with the narrow ceramic occlusal table and wide ceramic occlusal table. 2. To compare the stress distribution in two implants supporting a three-unit bridge, one model with implants placed parallel to each other and the other with one implant placed in angular position to the other. 3. To compare the difference in the stress distribution in six implants and four implants supporting mandibular over-denture. MATERIALS AND METHODS: The three-dimensional (3-D) finite-element mesh model was modeled with the standard dimension of the implant with 11-mm long and 4-mm wide using the software package 'NISA'. RESULTS AND DISCUSSION: The design, number and placement of implants play an important role. SUMMARY AND CONCLUSION: The basic principles of biomechanics must be respected.