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OBJECTIVE Titanium bridges are used to separate the thyroid ala during type 2 thyroplasty for adductor spasmodic dysphonia. Revision surgeries have adventitiously indicated that bridge wing failure occurs in the area of the medial hole in some cases. This study investigated the rate and cause of device malfunctions and developed an improved device. METHODS We conducted a questionnaire survey to determine the number of surgeries performed in Japan up to the end of 2014, and to obtain information about revision cases. In addition, damage analyses were performed on the fracture surfaces of recovered titanium bridges through use of scanning electron microscopy (SEM). RESULTS Between 2002 and 2014, titanium bridges were used in 385 patients. Revision surgery was performed in 19 cases. Revision surgeries revealed that in 11 cases breakage occurred in the wings of the device in the region of the medial hole. However, such fractures were not associated with any signs of recurrence or any adverse events. SEM analyses of fracture surfaces confirmed that fatigue fractures were caused by repeated bending stress in the area of the medial hole. Based on these results, the shape of the hole was changed from round to oval and the wing thickness was increased to prevent breakage. CONCLUSIONS The wings of titanium bridges may break without any associated signs, symptoms or tissue damage. Based on the malfunctions detected and analyses of the devices recovered following malfunction, changes to the specification were made for commercial development of the titanium bridge.

In long-span fixed partial denture restoration, especially when pier abutment is present, a non-rigid connector as a stress breaker is indicated. The Non-rigid connector is classified into a dovetail, loop connector, split pontic, cross-pin, and wing. Split pontic is an attachment placed entirely inside the pontic, particularly indicated in the tilted abutment case, to prevent the box preparation of distal pier abutment. This case report presents A pier abutment case treated with long span porcelain fused to the metal fixed movable bridge using dovetail shaped attachment, assembling the split pontic as a non-rigid connector. Split pontic acts as the stress breaker to prevent the pier abutment acts as a fulcrum. Split pontic also transfers the shear stress to the alveolar bone, minimalizes the mesiodistal torquing of the abutment teeth, and enables individual tooth movement. The advantages of this design are preparation with minimal reduction and better esthetic outcome as the porcelain build up can be done. Thus, there is no metal exposure of the restoration. Longevity and success of fixed partial denture restoration depend on the size, shape, type, and connector position. In pier abutment cases, a non-rigid connector must be considered one of the treatment choices to restore the missing teeth and preserve the abutments.KEYWORDS: pier abutment, split pontic, non-rigid connector

Background/purpose The three-unit bridge that combines a natural tooth and an implant provides extended treatment possibilities for partially edentulous patients. We conducted a systematic review and meta-analysis of clinical trials to evaluate three-unit porcelain-fused-to-metal (PFM) tooth-implant-supported prosthesis (TISP) compared with implant-supported-prosthesis (ISP) reconstruction outcomes and complications. Materials and methods The PubMed, Embase, and Cochrane library databases were searched for articles published before February 2021. The meta-analysis used a random-effects model to calculate overall effect size. The study was registered with PROSPERO (number: CRD 42021232606). Results Seven articles published between 2004 and 2015, with sample sizes ranging from 10 to 250 patients were included. No significant difference in the prosthesis failure rate, implant failure rate, prosthesis technical complication rate, implant technical complication rate, and marginal bone level change was observed between the TISP group and the ISP group. In TISP group, natural tooth failure rate was reported to range from 0% to 4.3%, biological complication related to the natural tooth was reported to range from 0% to 26.9%, and no trial reported natural tooth intrusion. Conclusion The three-unit short-span TISP is a potentially reliable treatment option for patients with missing posterior teeth.

Background The aim of this retrospective study was to document the long-term clinical efficacy of a surgical-prosthetic technique (the flat one-bridge technique) involving the immediate restoration of both postextraction and nonpostextraction implants supporting full-arch restorations. Methods Implants were placed by adapting the axis to the available bone. Flat definitive abutments were connected during surgery and never disconnected to compensate for eventual implant disparallelism. Bone grafting was performed when needed. The patients received a screw-retained provisional restoration within 48 h of surgery and a final screw-retained prosthesis within 1 year. Results Sixty-six patients received 494 implants distributed in 75 prostheses. The median follow-up was 86 months (range 82–168 months). Only three implants had failed at the last follow-up. Implant survival was 99.6%. Conclusion The flat one-bridge prosthetic protocol is a viable procedure with excellent long-term outcomes. No difference in clinical success could be observed between postextractive and nonpostextractive implants.

BACKGROUND In Australia, because of inequity in dental service accessibility and affordability, patients can see general medical practitioners (GPs) for acute dental conditions. METHODS This cross-sectional study consisted of surveys distributed to the board registered GPs practising in Australia. The main outcome measures included statistical analysis of GPs managing different dental emergency scenarios and their confidence and expectations in managing dental emergencies. RESULTS A total of 425 GPs participated in the study. The sample primarily consisted of GPs practising in metropolitan clinics (n = 315). Most participants reported that they would refer to the dentist for mobilized tooth (n = 402). There was a negative correlation between GPs with 5-29 years of experience and traumatized tooth management (P

Introduction: Anterior bridge plating with minimally invasive technique for type A shaft humeral fractures is reported as an acceptable less traumatic and reproducible procedure by several authors. We have evaluated the clinical, radiological, and functional outcome of such fractures in twenty patients, all of which were managed with dynamic compression plate over an average follow- up period of 12 months. Though open reduction and plating technique of humerus shaft fracture is prevailing, this technique also gives favorable outcome.Materials and Methods: Twenty patients with type a humerus shaft fractures were managed by anterior bridge plating using MIPO technique between March 2017 to November 2019 were included in this series. All cases were treated with closed reduction and 10-12 whole 4.5mm dynamic compression plate fixation over anterior aspect in bridging mode using the MIPO technique. The dominant side, gender ratio, surgery time, and fracture union time, and complications were noted. The UCLA shoulder and Mayo elbow performance scores were used for assessing the shoulder and elbow function.Results: Of the Twenty patients in the study, ten were males and ten were females. The mean age was 34.3 years (range 18 to 85 years) twelve out of twenty patients (60%) had the dominant side fractured. Mean surgical time in minutes was 88.98 (range: 50 to 150 minutes). The mean fracture union (radiological) time was 14.3 weeks (range: 10–16 weeks) and clinical union time was 10.4 week. However Shoulder function was excellent in 20 cases (100%) on the UCLA score.Conclusion: This study confirmed a high overall rate of union and excellent functional outcomes. Mini incision anterior bridge technique for type A fracture shaft humerus gives good functional results and should be considered as an effective, cosmetically advanced surgical option in the treatment of type A humeral shaft fractures. It is a safe and less time consuming method for type a humeral shaft fractures when the surgeon is experienced in the technique.

Expansion of bridge girders in summer moves integral bridge abutments toward backfill, causing high lateral earth pressures behind the abutment. Some backfill material slumps downward and toward the abutment when the abutment moves away from the backfill due to bridge girder contraction in winter. Placement of geogrids within the backfill can increase stability of the backfill while placement of compressible inclusions (e.g., Expanded Polystyrene (EPS) foam) can reduce lateral earth pressures behind the abutment caused by bridge girder expansion. In this study, six physical model tests were conducted with 30 abutment top movement cycles due to simulated seasonal temperature changes to study the performance of integral bridge abutments with different mitigation measures. The test results showed that geogrid reinforcements caused higher maximum lateral earth pressures at the same abutment movement, but geogrids with wrap-around facing significantly reduced the backfill surface settlements. The combination of the EPS foam and geogrids could minimize lateral earth pressure increase and backfill settlement. The EPS foam reduced the abutment toe outward movement when the abutment top was pushed against the backfill; however, the mitigation effects by the EPS foam was limited due to its small thickness and relatively high elastic modulus in this study.

A series of experiments were carried out for developing a paint coating removal method for high-strength bolted joints in steel bridges. The paint-coated bolted joint specimens were heated to the target temperature of 200 °C by using a sheet-type ceramic heater. The maximum temperature of specimens could be controlled within 10% of the target value. The paint coating was easily removed by using general tools after heating. The behaviour of bolts with thermal expansion and shrinkage was monitored by strain gauges attached to the bolts during heating. It was estimated that the axial forces of the bolts were reduced by 2.6% of the initially installed axial forces, on average.

Aim: Traumatic dental injuries at the anterior region of the maxilla occur frequently in children and adults. In this case report, we aimed to describe the temporary aesthetic restoration of the upper lateral incisor with a fiber-reinforced bridge by using the original tooth crown, which had avulsed after dental trauma. Methodology: Case 1: A 14-year-old girl with an avulsion in tooth #11 due to trauma visited our clinic. During the examination, it was seen that the wound had healed, and there was no luxation in teeth #21 and #12. Since the patient could not undergo prosthetic procedures, for reasons including implants, and did not want a removable prosthesis, a single crown supported by acrylic tooth fibers was constructed. Case 2: A 17-year-old male patient was referred to our clinic because of an avulsed left lateral incisor tooth, which was traumatized 15 days before visiting the clinic. His medical history revealed that his parents had found the tooth two hours after the trauma. However, the emergency clinic that he had previously visited did reimplant that tooth and repaired it with fiber-reinforced composite. Case 3: In the examination of a 12-year-old male patient who applied to our clinic due to trauma, it was observed that tooth #11 had an avulsion and tooth #12 had a crown fracture. Root canal treatment was performed. A crown was made for the patient by supporting the fiber inside the canals of tooth #11 and tooth #21. It was revised aesthetically with the support of the crown of the other tooth. Conclusion: Avulsion after anterior trauma affects patients’ appearance aesthetically; thus, patients want to be treated as soon as possible. Function, phonation, and aesthetics must be quickly provided for a loose anterior tooth. Fiber-reinforced adhesive bridge techniques may be considered as a temporary treatment for providing an aesthetically appealing appearance until the completion of permanent prosthetic treatment. How to cite this article: Şahin M, Toptancı İR. Temporary adhesive bridge restoration of the upper anterior teeth lost due to trauma: Three case reports. Int Dent Res 2021;11(Suppl.1):285-91. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.42 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Vital pulp therapy (VPT) is deliberated as an ultraconservative/minimally invasive approach for the conservation of vital pulpal tissues, preservation of dental structure, and maintenance of tooth function in the oral cavity. In VPT, following the exposure of the dental pulp, the environment is prepared for the possible healing and probable refunctionalisation of pulpal connective tissue. However, to succeed in VPT, specific biomaterials are used to cover and/or dress the exposed pulp, lower the inflammation, heal the dental pulp, provoke the remaining odontoblastic cells, and induce the formation of a hard tissue, i.e., the dentinal bridge. It can be assumed that if the employed biomaterial is transferred to the target site using a specially designed micro-/nanosized local drug delivery system (LDDS), the biomaterial would be placed in closer proximity to the connective tissue, may be released in a controlled and sustained pattern, could properly conserve the remaining dental pulp and might appropriately enhance hard-tissue formation. Furthermore, the loaded LDDS could help VPT modalities to be more ultraconservative and may minimise the manipulation of the tooth structure as well as pulpal tissue, which could, in turn, result in better VPT outcomes.

Made available in DSpace on 2022-04-29T08:32:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Dental implants are widely used as a long-term treatment solution for missing teeth. A titanium implant is inserted into the jawbone, acting as a replacement for the lost tooth root and can then support a denture, crown or bridge. This allows discreet and high-quality aesthetic and functional improvement, boosting patient confidence. The use of implants also restores normal functions such as speech and mastication. Once an implant is placed, the surrounding bone will fuse to the titanium in a process known as osseointegration. The success of osseointegration is dependent on stress distribution within the surrounding bone and thus implant geometry plays an important role in it. Optimisation analyses are used to identify the geometry which results in the most favourable stress distribution, but the traditional methodology is inefficient, requiring analysis of numerous models and parameter combinations to identify the optimal solution. A proposed improvement to the traditional methodology includes the use of Design of Experiments (DOE) together with Response Surface Methodology (RSM). This would allow for a well-reasoned combination of parameters to be proposed. This study aims to use DOE, RSM and finite element models to develop a simplified optimisation analysis method for dental implant design. Drawing on data and results from previous studies, two-dimensional finite element models of a single Branemark implant, a multi-unit abutment, two prosthetic screws, a prosthetic crown and a region of mandibular bone were built. A small number of combinations of implant diameter and length were set based on the DOE method to analyse the influence of geometry on stress distribution at the bone-implant interface. The results agreed with previous studies and indicated that implant length is the critical parameter in reducing stress on cortical bone. The proposed method represents a more efficient analysis of multiple geometrical combinations with reduced time and computational cost, using fewer than a third of the models required by the traditional methods. Further work should include the application of this methodology to optimisation analyses using three-dimensional finite element models. Centre for Simulation in Bioengineering Biomechanics and Biomaterials (CS3B) Department of Mechanical Engineering Engineering College of Bauru (FEB) São Paulo State University (UNESP) Department of Mathematics Faculty of Science (FC) São Paulo State University, São Paulo State Centre for Simulation in Bioengineering Biomechanics and Biomaterials (CS3B) Department of Mechanical Engineering Engineering College of Bauru (FEB) São Paulo State University (UNESP) Department of Mathematics Faculty of Science (FC) São Paulo State University, São Paulo State

Background: Rehabilitation of Kennedy Class I edentulous involves a variety of treatment alternatives such as overdenture, metal frame removable partial denture, RPD with precision attachment and implants. The combination of RPD and fixed dent-ture using precision attachment or semi-precision is one of the best forms of RPD. Case: A 59-year-old male came to the RSGM FKG UI clinic. He wants to have new denture to eat more comfortable and improve his appearance. Management: Anamnesis, extra-oral and intra oral examinations, and panoramic x-ray were performed. After that, bridge was removed, periapical x-ray and definitive treatment was determined using metal frame RPD in upper jaw and RPD with precision attachment in lower jaw. Conclusion: Patient feels satisfied and comfortable with his dentures both in upper and lower jaw with precision attachments.

Nasal reconstruction for total rhinectomy is challenging, especially if locoregional flaps are unavailable. Herein, we report the case of a nasal reconstruction combining a forearm free flap as “vascular bridge” and a Delto-Acromial Artery Perforator (DAAP) flap in its free form. The forearm free flap was used to restore missing elements of the nasal lining while the distal part of the radial pedicle has served as a donor vessel for the DAAP free flap which restores the nasal covering. A chondrocostal graft was used as a nasal framework. The nasal aspect at 24 months postop support the patient's satisfaction. The main advantages of the DAAP Flap are the pliability, relative hairless nature, skin thinness and its geographical proximity with the nose avoiding major dyschromia. Moreover, the anatomy consistency makes it easier to harvest, the underlying muscles are respected, and it allows for tension free primary closure without shoulder movement limitation.

Aim To present the healing, development, and long-term clinical results after a combined gingival-bone graft as an alternative treatment for the management of critical extraction sites in the esthetic zone. Background To enhance the knowledge of in vivo soft and hard tissue remodeling, in this case report, we observed the healing, development, and long-term clinical results after a case of a combined gingival-bone graft as an alternative treatment for the management of critical extraction sites. Case description Autogenous grafts of gingival and bone tissue were placed in a 56-year-old female patient, where a hopeless upper left central incisor with an evident loss of both the buccal and the palatal bony plates and with endodontic problems was due for extraction. In order to obtain enough autogenous tissue for filling the defect, a cylindrical free gingival and bone graft was retrieved from the retromolar area with a trephine drill, to obtain hard and soft tissues for grafting the postextraction defect. After 6 months, following soft tissue maturation and once esthetic and natural gingival contours were achieved, the surgical site was prosthetically restored with a porcelain fused to a metal bridge and scheduled for regular follow-up. Conclusion No complications were observed either from the donor site or from the recipient site. The post-treatment result was esthetically pleasing, based upon successful architectural stability of both hard and soft tissues. Although more studies are needed to confirm the beneficial use of this approach, the procedure can be considered a viable option in the management of soft and hard tissue remodeling in esthetically compromised cases. Clinical significance The gingival-bone graft may be considered as an alternative treatment for the management of critical extraction sites in the esthetic area. How to cite this article: Signore A, Stepanov M, Angelis ND, et al. Free Gingival-Bone Graft in the Anterior Maxilla: A Clinical Case Report. J Contemp Dent Pract 2021;22(5):568-571.

Statement of the problem: Digital scanning has been widely used nowadays, however its accuracy in relation to the bridge span length needs further investigations. Objective: The aim of this study was to determine the effect of span length on the trueness of an intra-oral scanner. Materials and methods: On a typodont (Nissin Dental Model, Japan) preparations for two bridge span lengths were made. One resembling missing upper second premolar representing short straight span length (SS) while the second resembling missing upper first and second premolars representing long curved span (LS). Then typodont was scanned by a laboratory scanner (InEos X5 scanner) (Sirona Dental System, Bensheim, Germany) to act as a reference model scan to compare measurements for trueness. Then for each group five scans were taken for the typodont by Medit intraoral scanner (iScan version 1.2.0.1; Medit, Seoul, Korea) to be compared with the reference scan. Then data set from the scans were transferred to STL format and then exported to exocad (exocad version 2.3 Matera exocad GmbH,Darmstadt, Germany) software to get the measurements to determine the trueness. Results: Results of this study showed that in the comparison between short and long span bridges, the long span bridge scans showed statistically significant higher root mean square (RMS) mean value (0.23±0.10 mm), lower trueness than short span bridge scans (0.06±0.04 mm). Conclusions: Long span fixed bridge had an adverse effect on the scanning accuracy. Trueness of intraoral scanner may be affected by the complexity and length of the scanning area.

Introduction Open tibial shaft fractures present a challenge to the orthopedic surgeon, because they are common, have a high rate of complications and still have a controversial treatment. As a result of the high incidence of these fractures, the need of a definitive treatment and the unavailability of the intramedullary nail or a well-trained team, we developed this study to compare the effectiveness of the bridge-plating (BP) with the unreamed intramedullary nail (UIMN) in the treatment of open tibial shaft fractures. Materials and methods Eighty patients were included in a prospective, consecutive and random way and then randomized in two groups of treatment: unreamed intramedullary nail and bridge-plating. The primary outcomes were the reoperation rate and the Johner-Wruhs functional criteria. Secondary outcomes were complication rates, partial and total weight bearing time and bone consolidation time. We verified the existence of normality in the quantitative variables for the outcomes using the Kolmogorov-Smirnov test. The Chi-Square test was utilized to compare the methods according to the relative frequencies and the comparison between the methods regarding the average of the quantitative variables was done through the T-Student test. Results Both the reoperation rates and the functional criteria of Johner-Wruhs showed no difference between the two groups. The exposure time and the total surgical time were longer in the UIMN group, however the consolidation time, partial weight bearing time and total weight bearing time did not show significant difference. A significant difference was found between the groups in the implant failure rate, in favor of UIMN, the angular malalignment was another secundary outcome that showed a non significant difference in favor of UIMN. Conclusions We concluded that both methods were effective for the treatment of open tibia shaft fractures, however, the implant failure rate was higher in the bridge plate group.

A new type of prefabricated abutment with a weak connection is proposed. The longitudinal load (like banking force, earth pressure) distribution of this new type of prefabricated abutment was analyzed based on the hinge-joined slab method. A simplified method for calculating the stiffness parameters of the panels was introduced. The influence lines of the longitudinal load on the prefabricated abutment of an actual bridge were calculated by using the proposed theoretical method and finite element method. The comparison between theoretical calculation and simulation results shows that the theoretical calculation method proposed in this paper is correct. In order to investigate the influence of the different thicknesses of the cap beam and dimensions of prefabricated panels on the calculation error of the theoretical calculation method. The influence lines of the prefabricated abutments with different parameters were calculated theoretically and simulated. All calculation errors of the central values of influence lines were less than 20% when the thickness of the cap beam changes from 0.8 to 2.4 m, the errors were all less than 10% when the thickness of the cap beam was 1.2–1.575 m. This calculation further verified that the theoretical calculation method proposed in this paper is suitable for longitudinal load distribution of a weakly connected Prefabricated bridge abutment. It provides a reference for the design and theoretical calculation of prefabricated abutment.

Gastrostomy tube placement is an appropriate option for long-term nutritional support for patients who cannot tolerate oral intake. Common indications for a gastrostomy tube include head and neck tumors and neurological disorders. Several methods for gastrostomy tube insertion exist (eg, surgical, endoscopic, and radiologic) that require sedation or general anesthesia, which can pose risks of cardiopulmonary compromise and postsurgical pulmonary complications. Unlike other methods, our practice uses a percutaneous balloon-assisted gastrostomy tube insertion method for which we can perform without sedation. We report a case of a percutaneous radiologic gastrostomy procedure for a patient with end stage lung disease as a bridge to lung transplantation, who is not a candidate for sedation and is high-risk for general anesthesia. Through enteral feeds administered through the successfully placed gastrostomy tube, the patient showed steady improvement in weight gain over the course of several months before approval for listing by the lung transplant selection committee. Our case highlights how gastrostomy tube placement can be safely performed in patients who are not sedation candidates using the minimally invasive balloon-assisted gastrostomy tube insertion method and local anesthetic.

The increasingdemand by patients for estheticandmetal-freerestorations has driventhe development of cera-mic restorations with good esthetic and mechanical stability. The use of porcelain laminates veneers to solve aestheticandorfunctionalproblemshas been shown to beavalid management option especially in the anterior aestheticzone.Thecurrent porcelain veneers are esthetically superior,conservativeand durabletreatmentmo-dality.The present case report describes the treatment of discoloured tetracycline teeth in the anterior dentition withthinporcelainlaminateveneersandYttrium-oxidepartiallystabilizedzirconia(YTZP)bridgeformissingupper right lateral incisor tooth and treated for problem.The restorations were evaluated clinically over for retention, colour match,surface texture, marginal integrity and gingival response. The patient was very satisfied with the result and had no complaints during 1.5 years of follow-up.

This study aimed to investigate the effect of various framework designs on the failure of posterior fiber reinforced composite (FRC) bridges and assess the post crack performances of the repaired prostheses. Thirty samples were prepared into three different groups of framework designs: cuspal support (CS), anatomic features (AF) and circular reinforcement (CR). All specimens were subjected to static loading test and acoustic emission analysis. Significant differences were found in the load and time of initial failures among the three groups (p

The aim of this work was to analyze the causes of complications of orthopedic treatment of dentition defects with metal-ceramic crowns and non-removable metal-ceramic bridges. Materials and methods. A total of 140 patients aged 34 to 49 years were examined during the work, who underwent the production of both single metal-ceramic crowns and non-removable metal-ceramic bridges. All patients were divided into 2 groups (70 patients each): the first one included patients with vital abutment teeth, the second one – with depulped. The abutment teeth had a different functional state – they were filled, had wedge-shaped defects or increased abrasion. Results. Orthopedic treatment showed that the manufacture of solid metal-ceramic crowns on dental teeth, which were filled more than 1 year ago, led to complications in 18 of 35 (51.4 %) patients in this group, which is insignificantly (P ˃ 0.05) by 17.2 % less than with similar prosthetics on depulped teeth. Regarding the manufacture of bridges, the trend of more complications in prosthetics on devital teeth persists, because in group I we had 20 (57.7 %) patients with complications, and in group II – 29 (82.9 %) cases, which is significantly different at the level of P < 0.05. In prosthetics of vital teeth, defects of hard tissues of which are replaced by filling material immediately before prosthetics, single crowns of complications occurred in 3 patients, i.e. in 8.6 %, which is insignificantly (P ˃ 0.05) less by 5.6 % than in group II where complications were found in 5 (14.2 %) people. Analysis of orthopedic treatment of patients with included defects of dentitions with metal-ceramic bridge prostheses revealed that when using filled teeth (filled for 1 year before prosthetics) in the case, when they were depulped, as abutment, complications were observed in 9 people, i.e. in 25.7 % of this group. This indicator insignificantly (P ˃ 0.05) exceeds the identical one from the first group (14.3 %) by 11.4 %, therefore, there is a tendency to reduce tooth resistance to negative external and internal factors, which has not acquired statistical significance. Conclusions. The study found that the frequency of complications that occur after prosthetics with fixed dentures depends on the condition of the tooth pulp, because the viable pulp provides metabolism, renewal of tooth cells and response to any damage. The need to replace fillings that were made more than 1 year ago to reduce the risk of secondary caries has been proven. Defects of hard tissues in the form of a wedge-shaped defect and the increased attrition do not increase frequency of complications in prosthetics by fixed dentures.

This article describes a novel approach for horizontal guided bone regeneration (GBR) using a dehydrated amnion/chorion membrane (dHACM) in conjunction with a composite mixture of cortical autogenous particulate bone scrapings and mineralized bovine bone particulate in the anterior maxilla, allowing for placement of dental implants in a previously deficient alveolar ridge. The grafted region was reentered 8 months after GBR surgery, and a substantial increase in horizontal bone width was observed. Endosseous dental implants were placed with excellent primary stability in a prosthetically driven manner (which could not have been done prior to GBR) and successfully restored with a screw-retained bridge prosthesis. To the authors' knowledge, this is the first reported documentation of successful horizontal GBR using dHACM with subsequent implant placement and restoration, and the first to demonstrate the excellent clinical potential of this biomaterial.

Rehabilitation of a compromised anterior dentition when particularly there is a loss of a variable amount of residual ridge and adjacent soft tissue is difficult and unpredictable. In such cases to achieve a predictable treatment outcome, a fixed-removable partial denture system can be used wherein a removable prosthesis is retained by a bar and sleeve attachment to fixed retainers on the either side of the edentulous space. This system can also be used when the alignment of the opposing arches and/or esthetic arch position of the replacement teeth create difficulties for placement of a conventional fixed partial denture. This case report shows the fabrication of a fixed-removable partial denture using the Andrews Bridge philosophy to meet the requirements for esthetics, comfort, phonetics, hygiene, and favorable stress distribution to the abutments and soft tissue.

Background. Minimally invasive plate osteosynthesis (MIPO) is one of the generally accepted surgical techniques for the treatment of humeral shaft fractures. However, despite the high bone union rate, a variety of complications are still prevailing. Moreover, the current literature lacks data comparing the anterolateral MIPO approach using dynamic compression plates accommodating different numbers of screws. The aim of this study was to analyze the biomechanical performance of comminuted humeral shaft fractures fixed with dynamic compression plates using either two or three screws per fragment. Methods. Six pairs of fresh-frozen human cadaveric humeri from donors aged66.8±5.2years were randomized to two paired study groups for simulation of bridge-plated comminuted shaft fracture type AO/OTA 12-C1/2/3 without interfragmentary bony support, using a dynamic compression plate positioned on the anterolateral surface and fixed with two (group 1) or three (group 2) screws per fragment. All specimens underwent nondestructive quasistatic biomechanical testing under lateral bending, anterior bending, axial bending, and torsion in internal rotation, followed by progressively increasing cyclic torsional loading in internal rotation until failure. Results. Initial stiffness of the plated specimens in lateral bending, anterior bending, axial bending, and torsion was not significantly different between the groups (P≥0.22). However, cycles to 10°, 15°, and 20° torsional deformation and cycles to construct failure were significantly higher in group 2 compared with group 1 (P≤0.03). Conclusions. From a biomechanical perspective, no significant superiority is identified in terms of primary stability when using two or three screws per fragment for bridge compression plating of comminuted humeral shaft fractures. However, three-screw configurations provide better secondary stability and maintain it with a higher resistance towards loss of reduction under dynamic loading. Therefore, the use of a third screw may be justified when such better secondary stability is required.

Arthroscopic reduction–internal fixation (ARIF) is an increasingly popular option for surgical management of displaced tibial eminence fractures. Although a variety of ARIF techniques have been described, anatomic reduction and stable fixation remain challenging. As a result, complications such as malunion, nonunion, anterior instability, arthrofibrosis, and hardware issues persist. In an effort to reduce complications and improve outcomes, modern suture-based ARIF techniques have been developed. However, the optimal technique and construct remain elusive. This article presents a technique for ARIF of tibial eminence fractures using a transosseous suture bridge construct with extracortical fixation. This technique uses a commercially available suture-passage device and meniscal root repair system for accurate tunnel placement, efficient suture management, and reliable fixation., Technique Video Video 1 Arthroscopic technique of reduction and internal fixation of a tibial eminence fracture in the right knee with transosseous suture bridge fixation.

Objectives To evaluate a dental nurse-led triage system at a private dental practice in England after the cessation of face-to-face care during the COVID-19 pandemic; to assess types of presenting problems and their management upon practice reopening at alert level 4; and to explain the benefits of dental nurse-led triage and its relevance to other practices. Methods This retrospective service evaluation used anonymised data gathered for the purpose of assessing and triaging patients when they could not be seen face-to-face. Effectiveness of the triage system was assessed using predetermined criteria. Results Seventy patients were triaged during a 12-week period; 68.5% of patients were managed by the triaging dental nurse without escalation to a dentist and 77% of patients called only once. The most common presenting complaint was pain, followed by loose crown/bridge and fractured crown/tooth/bridge. Sixty-one percent of all patients accepted a face-to-face appointment upon reopening of the dental practice. Conclusions This study demonstrates the effectiveness of a dental nurse-led triage model where dental nurses have the skills and experience required to manage patients at first contact. This model would be applicable to other practices in the case of future emergency closures, as well as a routine out-of-hours service., Key points Demonstrates the effectiveness of a dental nurse-led triage model during the cessation of face-to-face care in the COVID-19 pandemic.Outlines the presenting problems of patients and their uptake of treatment upon practice reopening.Suggests that this model is applicable to a routine out-of-hours service as well as at times of practice closures, and that other practices may wish to adopt it.

The aim of this paper has been to define the behaviour of an OT Bridge fixed prosthesis system (Rhein83®). Through the use of finite element analysis, the typical load conditions of the chewing dynamics were studied, in order to highlight possible errors of inadequate use of the implant itself. These techniques highlight how knowledge of the stresses produced on the implant prosthesis becomes necessary and indispensable. The innovation in this retention system lies in the use of Seeger rings in acetal resin. The Seeger ring constitutes a revolution in the concept of anchoring the prosthesis; having a retentive function, it prevents the screws from unscrewing by taking most of the retentive load.

During earthquakes, the bridge abutments can undergo large displacements that are required to develop high passive earth pressures behind the abutment walls. In the present study, a finite element (FE) model of a Geogrid Reinforced Soil (GRS) wall has been developed to study the passive earth pressure induced under cyclic lateral loading. An advanced constitutive model has been used as VUMAT to characterize the soil elements. Uniform lateral displacement is applied to the abutment wall. Pushing and pulling of the wall is repeatedly done with small increments of lateral displacement towards the soil in each cycle. The loading is continued until the passive resistance of the soil doesn't increase much or stands almost at the same value. The improvement in the pushover capacity because of the provision of reinforcement is about four times that of the unreinforced abutment. Well compacted backfills show a peak capacity, which then decreases to a residual capacity with further push, indicating the dilation of the dense backfill. Whereas the relatively less compacted backfills attain a maximum capacity after being compacted more due to the initial intruding movement of the wall.

Introduction: Direct pulp capping treatment (DPC) maintains pulp vitality by promoting healing or repair in dentistry, which can be attributed to the advent of bioceramic materials. Aim: This examination looked to evaluate the clinical and histological effectuality of Biodentine with Dycal for DPC. Materials and Methodology: In this study, 30 intact human orthodontic teeth undergoing therapeutic extraction were chosen to perform DPC. They were arbitrarily divided into two groups (n = 15) and DPC with Biodentine and Dycal was performed. Composite resin was used as permanent restoration. After a period of 1 and 6 weeks, clinical as well as electric pulp tests were carried out. Asymptomatic patients were re-called after 6 weeks; follow-up radiograph was taken. Electric pulp testing and thermal testing was done to check the pulpal status of the teeth. This was followed by atraumatic extraction, and the teeth were sent for histological examination. SPSS Version 21.0. Armonk, NY: IBM Corp.was used for data analysis. Results: There was no pain and sensitivity in using Biodentine. Whereas, sensitivity and pain was noted when Dycal was used. The dentinal bridge was better with Biodentine when compared with Dycal. Conclusion: In accordance with the obtained results, it was concluded that on clinical and histological evaluation, Biodentine performed better as DPC agent. Subsequently, Biodentine is more dependable for the long-haul protection of dental pulp than Dycal.

Objective The aim: The research was to evaluate the effectiveness of acute traumatic pulpitis treatment with the use of bioceramics according to the results of a clinical study. Patients and methods Materials and methods: Acute traumatic pulpitis of 25 teeth in 25 patients aged 18-25 years were treated by biological direct pulp capping. In 13 patients of the main group, bioceramics was placed on the exposed pulp, and in 12 patients of the control group, calcium hydroxide paste was applied on the exposed pulp. Treatment effectiveness was evaluated according to the following criteria: the absence of clinical signs of pulpal inflammation, on X-ray - signs of dentinal bridge formation, the absence of periapical changes. Results Results: The use of bioceramic material in patients of the main group provided a positive dynamic of treatment in 12 teeth. The need for re-treatment was diagnosed only in 1 clinical case (7.7%), in the control group - in 4 cases (33.3%). Conclusion Conclusions: Pulpitis treatment with the use of bioceramics provides preserving the functional properties of pulp, creation of a calcified barrier - dentin bridge and prevents the periodontal complications compared to the pulp capping with a material based on calcium hydroxide. The effectiveness of treatment in the main group was 92.3%, in the control - 66.7%.

The restoration of composite bone defect is always a challenge. When it is an anterior partially edentulous area then the prime importance is the esthetic outcome of the prosthesis. A combination of fixed and removable prosthesis such as Andrews bridge can be utilized to give an excellent esthetic result. Andrew’s bridge restores the orofacial structures by replacing the lost natural teeth and the supporting tissues. This case series describes the successful treatment of severe anterior bone defects due to trauma which was restored with the help of Andrew’s bridge.

The absence of upper anterior teeth is a serious problem and often needs a challenging treatment. The treatment alternatives include resin-bonded bridge work, osseointegrated implants, removable dentures, and autotransplantation of developing premolars. The aim of the study was to evaluate implant prosthesis as a treatment option for missing maxillary anterior teeth among young adults. A study comparing different treatment modalities advised for replacement of missing anterior teeth with implants placed in those patients was conducted. Date of age, gender, type of replacement advised and chosen by the patients were obtained from the records at the dental hospital. About 64.07% of patients were advised for fixed partial dentures and 35.93% of patients were advised for implants in replacement of missing anterior teeth among young adults. The 21-30 years age group was found to be the most common age group with replacement of implant in the missing anterior tooth among young adults with higher incidence among males (84.81%). Anterior implant supported prosthesis in patients with missing maxillary teeth improves patients' psychological outlook in terms of dental aesthetics and instills a positive attitude and behaviors among patients.

Purpose In this review, we evaluate the survival rate of resin-bonded fixed partial dentures (RBFPDs) made of metal alloys. Methods An electronic search of English peer-reviewed dental literature on PubMed was conducted to identify all publications reporting on RBFPDs made of metal alloys until March 2019. The searched keywords were: bridge OR fixed partial denture OR fixed prosthesis OR fixed prostheses AND resin bonded AND metal OR alloy AND survival OR longevity (RBFPD was not included). Furthermore, the "Related Articles" feature of PubMed was used to identify further references of interest during the primary search. A definitive list of articles was screened to extract qualitative data after the application of the inclusion and exclusion criteria, and the results were analyzed. Results Overall, 977 publications were found through an electronic and manual search, out of which 130 articles were selected after screening based on title and abstract. A total of 52 publications passed the second review phase after assessment for eligibility, from which 24 studies were excluded after full-text screening. Finally, a total of 28 studies were selected. Conclusions The survival rate of RBFPDs differed greatly depending on the type of metal alloy, adhesion system, and observation period assessed, e.g. the 10-year survival rate ranged from 18 % to 88 %. The wide range of survival rates of the RBFPDs reported indicates that though RBFPD is a reliable prosthesis, it is prone to failure if some processes are not completed.

Resin materials are commonly used in various dental treatments in patients with metal allergies. Recently, some reports have revealed the association between resin materials and allergic reactions. However, no study has assessed the association between dental adhesive resin cements and allergic reactions. We present the case of a 56-year-old woman with a history of allergic reaction to pollen, iodine, and platinum and some metals. She received periodontal and prosthodontic treatments for 4 years. In the middle of May 2019, a zirconia bridge was cemented to the right molar region of the upper jaw using a dental adhesive resin cement. Two days later, she complained of pain in the tongue, swelling and blistering of the lips, and respiratory stenosis. At the end of May, her temporary bridge was adjusted, and she immediately experienced symptoms similar to those she had after the zirconia bridge cementation. The patient was suspected to have an allergic reaction to the resin. Thus, she underwent an allergy patch test for different dental materials, including some adhesive resin cements. The patch test results revealed a positive allergic reaction to tooth primer on days 2, 3, and 7 and to light-cured adhesive resin paste on day 7. Additionally, the test revealed a false-positive reaction to a self-cured acrylic resin on day 7. However, there were no positive reactions to other adhesive resin cements and glass ionomer cements. Some types of adhesive resin cement may induce an allergic reaction in patients sensitive to different materials. In such a case, we should choose a glass-ionomer cement instead of adhesive resin cement.

Introduction: Effectiveness of the learning process can be measured by evaluation of interns’ confidence level in each of the competencies which will be helpful in their future dental practice. This study was conducted to assess self-confidence level of dental interns of a dental college in performing various dental procedures. Methods: A descriptive cross-sectional study was conducted among 65 dental interns selected by census method. Self-administered questionnaire was provided to the study participants for assessment of their confidence level in different dental procedures. Data were analyzed in the Statistical Package of Social Sciences version 20. Mean and standard deviation for quantitative data and frequency/percentage for qualitative data were calculated. Results: Majority of dental interns had good confidence in history taking (53, 83.1%), radiography (53, 81.5%), diagnosis (39, 60%), treatment planning (34, 52.3%), scaling (42, 64.6%), preventive resin restorations (39, 60%), anterior composite restorations (35, 53.8%), posterior composite restorations (55, 84.6%), anterior endodontics (29, 44.6%), premolar endodontics (23, 35.4%), treating pediatric patients (43, 66.2%), indirect pulp capping (41, 63.1%), acrylic partial denture design and construction (33, 50.8%) and simple extractions (33, 50.8%). They had poor/least confidence in metal partial dentures design and construction (58, 89.2), bridge preparation (44, 67.7%), molar endodontics (31, 47.7%), bleaching (57, 87.7%), veneering (61, 93.8%) and surgical extractions (38, 58.5%). Conclusions: The findings of the study concluded that the dental interns were confident in simple dental procedures and had least confidence in complex dental treatments. They need more exposure to the complex procedures during internship to enhance their confidence level.

Background. Reconstruction of subtotal and total defects of maxillofacial region after ablative tumor surgery is a challenging task of reconstructive surgery. The “golden rule” is maintaining of radicalism of ablative surgery as well as appropriate surgical reconstruction and prosthodontic rehabilitation, that allows patient return to normal life. Wherein reconstructive procedure is focusing on restoring of mandibular continuity by the means of different flaps and grafts, while prosthodontic rehabilitation is performing after some period of time (usually around year) by the means of removable and non-removable prosthodontic devices. Non-removable device requiring dental implants insertion into grafted material followed by period of osteointegration, that is requiring some time as well. However, within this period of time one could observe significant soft tissue deformity.The objective is to improve the outcomes of surgical reconstruction of extensive defects of the mandible and to carry out rapid prosthodontic rehabilitation supported by dental implants by application of 3D preoperative planning and navigation devices.Clinical case. Forty-nine years-old female patient with recurrent ameloblastoma, that affects vertical and horizontal ramus of the mandible. Within virtual preoperative planning one performed: resection of the mandible associated with exarticulation of condylar head, virtual plate bending according to contours of the mandible (that were determined by application of “mirror” function of virtual planning software), arthroplasty of temporomandibular joint, determination of donor site on fibula bone, osteotomy of fibula free flap, positioning of dental implants, transferring of composite flap and it’s fixation by reconstructive plate. According to acquiring data one performed fabrication of patient specific navigation guides for both fibula flap segmentation and dental implants positioning. Surgical procedure included single-step tumor ablation and exarticulation of condylar head, reconstruction of defect by the means of osseo-myo-cutaneous fibula free flap, that was pre-implanted by dental implants, total joint reconstruction by titanium condylar head and polypropylene fossa, fixation of the flap and condylar head in recipient site by the means of prebended reconstructive plate, as well as insertion of non-removable bridge prosthodontic device. Postoperative result was asses clinically and radiologically. No significant postoperative complications occurred. Restoration of facial contours, mouth opening, I class occlusion, as well as adequate meal and speech were detected. Postoperative radiological investigation revealed adequate positioning of dental implants within neo-mandible, as well as positioning of artificial joint.Conclusion. In cases of extensive tumors of the jaws single-step ablative surgical procedure, reconstruction of missing anatomical structures of the jaws and simultaneous prosthodontic rehabilitation allows to prevent possible deformities of the soft tissues and due to rapid restoration of vital functions has great impact to quality of patient’s life. Adequacy of performing procedures could be reached by implementation of virtual preoperative planning and fabrication of patient-specific surgical guides.

In this report, we present the case of a 68-year-old male patient with a complaint of mastication and speech limitations one year after the prescription of a fixed bridge and the construction of "connected" crowns by a "street dentist." A thorough oral examination revealed a multilobulated swelling in the right buccal mucosa that extended to the buccal sulcus. The lesion, which was first noticed as a small, asymptomatic swelling by the patient one year prior, seemed to have undergone enlargement since the prostheses were prescribed. The lesion was completely removed via surgical excision under general anesthesia. Histopathological examination of the excisional mass revealed mature adipocytes and features consistent with conventional or classic lipoma. This case highlights the importance of receiving dental treatment from a qualified professional, whose responsibilities include performing a thorough examination of the oral cavity during treatment planning and delivery, review appointments, and regular dental visits. Such investigation is important to allow for early disease detection and control, especially for patients with complex treatment needs as well as those who may present with asymptomatic and slow-growing lesions such as lipomas.

The objective of this study was to evaluate the feasibility and safety of a minimally invasive percutaneous plate osteosynthesis (MIPPO) procedure for proximal humeral shaft fractures using lateral minimal proximal and distal approaches and lateral bridge plating with primary radial nerve control, and to assess its clinical and radiographic outcomes. A retrospective review was done for the medical records of adult patients admitted for fracture of the proximal humeral shaft without associated injury to the ipsilateral upper limb and who consented to undergo a novel MIPPO technique herein reported. Patients were reviewed at regular follow-up periods and assessed at a final follow-up for evaluation of Constant, normalized Constant, and QuickDASH scores. There were 21 adult patients with mean age of 56 years. Three patients were lost from early follow-up; one of them had post-operative radial nerve paralysis. Eighteen patients were reviewed for the purpose of this study at a mean of 20 months of final follow-up; among them, one patient developed post-operative radial nerve paralysis with complete recovery after three months. Bone healing was achieved without any malalignment in 17 patients at a mean of 15 weeks, and one patient developed nonunion. At final assessment (mean, 20 months), the mean values of Constant, normalized Constant, and QuickDASH scores were 84 (range, 59 to 100), 95 (range, 73 to 100), and 5 (range, 0 to 18.2) respectively. Compared to pre-reported methods of MIPPO, this technique of lateral proximal and distal mini-approaches with lateral bridge plating after primary control of the radial nerve seems safe and feasible for proximal humeral shaft fractures. It gives good clinical and radiographic results with excellent restoration of upper limb function, very low incidence of post-operative radial nerve injury, and high rate of bone union in good alignment.

This case report is of a 31-year-old female who presented with splinted and faulty metalloceramic prosthesis on maxillary anterior teeth, which was responsible for localised periodontal disease and poor aesthetics. At multiple sites the ceramic had chipped off and the prosthesis colour did not match with the adjacent healthy teeth. A multidisciplinary approach of endodontics, periodontics and prosthodontics was employed for this case. The treatment plan consisted of removing the faulty prosthesis, endodontic retreatment of inadequately root-treated teeth and endodontics in the other coronally prepared abutment teeth. Crown lengthening surgery was performed for the correction of periodontal pockets and high smile line and maintenance of an adequate biological width. After periodontal healing, all-ceramic individual crowns were placed on the maxillary anterior teeth along with a three-unit all-ceramic bridge for the replacement of the left upper maxillary first premolar. The final results were aesthetically pleasing with good marginal fit. The patient was extremely satisfied with the outcome as all her concerns were addressed. It is, therefore, advisable to consider placing individual crowns rather than multiunit splinted prosthesis whenever possible.

The objective of this study was to evaluate the ex vivo effect of cyclic loading on the stability of screws placed in locking plates used to bridge segmental bone defects. The primary interface stability was assessed using peak reverse torque. Eighteen, 8‐hole stainless‐steel 4.5 mm locking plates and 4.0‐mm self‐tapping locking‐head screws were used to stabilize 40‐mm segmental defects in goat tibiae. Treatment groups included control constructs without cyclic loading (n = 6) and constructs tested to 5000 (n = 6) and 10,000 cycles (n = 6) of 600 N compressive axial loading. The insertion of all screws was standardized to 400 N‐cm insertion torque. Peak reverse torque was measured immediately after screw placement (control), or after the completion of the respective loading cycles. The difference between treatment groups was compared using univariate analysis of variance. The analysis revealed a significant difference in peak reverse torque of the screws among the treatment groups (p = .000). The mean reverse torque values equaled 343.5 ± 18.3 N‐cm for non‐cycled controls, 303.3 ± 25.9 and 296.0 ± 42.9 N‐cm after 5000 and 10,000 cycles, respectively. Among all treatment groups, screws placed in the distal bone segment tended to have lesser peak reverse torque reduction than those placed in the proximal segment and the difference was proportional to the number of cycles (p = .562; p = .255; p = .013 in control, and after 5000 and 10,000 cycles, respectively). Cyclic loading may have a negative effect on the primary stability of screws placed in locking plate constructs used to bridge segmental bone defects and could contribute to the risk of screw loosening.

Objective The purpose of this investigation is to highlight the technical components of a new kind of screw-retained dental implant prosthesis. The hypothesis is whether the OT Bridge (Rhein 83 S.R.L.; Bologna, Italy) system could be applied without secondary screw in the “all-on-four” retention system, thanks to the presence of an internal seeger. Materials and Methods By using engineering device such as finite element method (FEM) and von Mises investigation, it has been studied how the fixed prosthodontics for full-arch retention can be influenced by the presence of the screw for stabilizing it. Results In a dental implant, one model with four different configurations of the full-arch prosthesis retainer and the seeger has been investigated and then examined in contrast with or without the passant screw for locking the system. The experiments of this virtual study highlighted different features and mechanical behaviors of prosthodontic attachments. Conclusion The first two configurations, respectively those in which there are four and three connection screws, are safe and predictable. Therefore, the presence of the seeger significantly improves the stability and the retention of the whole prosthesis.

The aim of this work is to describe a case of severe disparallelism between two implants supporting a cement-retained bridge, placed in the maxilla, employing two custom-angled abutments. Fractured abutment screw and fractured abutment involved two implant restorations in the maxilla. Once prosthetic components have been removed, a new prosthetic rehabilitation has been planned. The divergence between the implants was measured, obtaining an angle of divergence of 39°. Then, two custom-angled titanium abutments and two metal-ceramic splinted crowns were realized.

An important issue in river engineering is to control scour around bridge piers and abutments using either a collar or a slot. This study examines the use of a slot or a collar, either alone or in conjunction with one other, to reduce scour at bridge abutments. In research on abutments equipped with slots only, collars only, and a combination of both were tested 15, 9, and 18 times, respectively. According to the results, in abutments equipped with slots only, the closer the slot is to the channel wall, the better the performance. At the same time, according to the results of research on collars, mere protection of the upstream face of the abutment is not sufficient to prevent down flows due to the presence of horseshoe and wake vortices, but the downstream faces of collars play a substantial role in reducing scour. With an increase in collar length, the scour depth decreases and the scour hole shifts downstream farther away from the abutment. Finally, it was found that the slot–collar combination model takes a more proactive role in reducing scour compared to collars only or slots only. The most robust combinatorial model used managed to fully control scour around abutments. For combinatorial models, scour showed a 42–100% decrease under different flow conditions in an erodible bed.

Prosthodontic rehabilitation of mandibular anterior missing teeth with large ridge defect due to poor abutment support and inadequate quality and quantity of bone. Often, a customised treatment plan has to be drawn to meet patient’s requirement of estheics, form, function and longevity of the prosthesis. This article describes procedure for fabrication of fixed-removable type of prosthesis in such cases. Keywords: Andrew’s bridge, Ridge defect, Mandibular anterior, Horix bar attachment.

Dental luting cements are important materials in securing FPD to abutment teeth. During the cementation process of FPDs finger force is applied to fully seat the restoration in place. Normally the dentist maintains force on the restoration until the luting cement sets, however, little is known as to the consistency of force application over time. The aim of this study was to compare the force applied by dentists during cementation of all-Zirconia FPD manufactured by CAD CAM and to investigate the effect that this has on the seating and fit of the cemented FPD. Two plastic teeth mounted in Frasaco jaws (teeth 24 and 26 were prepared for a three unit all ceramic (zirconia) bridge to replace tooth 25. Each tooth was prepared in the laboratory with a high-speed hand piece and coolant to a pre-set standard. Ten practitioners were recruited for this study and allocated one SLA model and one all zirconia bridge each. RelyX™ Unicem 2 Clicker™ self-adhesive Universal Resin Cement was used as the luting cement. Each examiner performed the seating procedure six times over a two week period, the participants applied the force for two minutes in each time. To measure the cementation force (Newton), a universal testing machine (Instron) was used. Finally, the internal and marginal fit (µm) was determined using SEM. The results showed high initial force which reduced and plateaued after 30 seconds. Maximum force applied was 88.0 N and the minimum was 8.0 N with a mean value of 27.23 N. SPSS was used to perform statistical analysis. Two-way ANOVA with post hoc test were performed on the force results and showed significant difference between most examiners. One-way ANOVA was performed on the internal and marginal fit results and this showed no significant difference between all examiners. Dentists apply different forces when seating FPDs but this does not affect the internal and marginal fit of FPD.

The clinical results of a case demonstrating dental implant insertion in a patient receiving chemotherapy is the focus of this report. A 74-year-old male patient came on his own accord because five units of porcelain long bridge in his right mandibular region were loosened. The one abutment tooth had a severe problem due to the periodontal problem (tooth 47), and teeth 43 and 44 were treated with root canal treatment, intrapulp post and porcelain crowns. After insertion of the fixture bone level implant, the patient is diagnosed with lymphoma and chemotherapy is performed for treatment. Clinically, the implants had no mobility, with no apparent exudate or bleeding upon probing 1 year after. At the time second procedures were performed, the dental implants had provided support for the abutments. One of the abutments was changed with anatomic abutment due to realignment of prosthesis position. Finally, three crowns porcelain fused to metal were used as final restorations and harmonized occlusion was achieved. The following is a discussion of the purposes and technique used for the insertion of these dental implants.

Introduction Teaching dental caries removal is limited by the material and methods available in the preclinical teaching space. Plastic teeth do not simulate the tactile feel of a lesion and natural teeth do not allow for standardised training and assessment. A novel method for simulating caries has been reported. Here, to investigate the construct validity of a caries simulation, whether haptic simulation could contribute to the understanding of caries removal, the performance of first-year dental students on the haptic simulation exercise is compared with that of experienced dentists. Method A virtual block comprising healthy dentine, pulp, enamel and a carious lesion with significant spread along the amelodentinal junction (ADJ) was developed for the Simodont dental trainer. The case was presented to 112 first-year students and 17 clinicians following a 15 min training period on a block which contained green caries and displayed live progress throughout the exercise. All participants were given the same verbal instructions: to remove all unsupported enamel and caries along the ADJ while retaining as much healthy tissue as possible. Results Clinicians performed better than the dental novices in precision and overall performance. Clinicians removed more material on average, except for healthy dentine, of which similar amounts were removed by both groups. Discussion We presented a novel haptic caries exercise and investigated the construct validity of the task. The simulation may bridge the gap between preclinical and clinical dental education in caries removal. Conclusion Clinically experienced dentists outperformed novices on a haptic caries simulation exercise. The exercise may be a useful tool for assessing conceptual understanding of caries removal.

Objective: To compare the patients’ satisfaction between patients treated with single tooth implant (STI) or resin bonded bridge (RBB) for single missing tooth replacement. Methods: A cross-sectional study was conducted in Faculty of Dentistry, Universiti Teknologi MARA (UiTM). Patients treated using STI (n=26) and RBB (n=26) were prospectively recruited. A validated patient satisfaction questionnaire was given to the participants to assess the aesthetics, masticatory function, phonetics, ease of cleaning and cost satisfaction using 7- point Likert scale. Demographic data (gender and age) and treatment data (site of treatment) were also collected. Differences in various aspects of satisfaction were compared. Results: STI and RBB groups has similar demographic and treatment characteristics. Both groups revealed high satisfaction with most of the aspects in the questionnaire. There was no statistically significant difference in overall satisfaction between the two treatment groups (p = 0.189). However, STI group had a significant higher score in existing appearance (p = 0.010), mastication (p = 0.018) and phonetics (p = 0.029) compared with RBB. Level of satisfaction did not differ by gender, age and site of the prostheses (p > 0.05). Almost all of the participants would choose to undergo the same treatment again in UiTM (STI = 96.2%, RBB = 92.3%). Conclusion: Both STI and RBB participants were highly satisfied with the aesthetics, phonetics, cost and found that the treatment fees were justified and reasonable in UiTM. Therefore, both treatment options are good to be indicated for single missing tooth replacement.