Digital Fabrication of Attachment for Implant-Anchored Auricular Prosthesis (Case Report).

Aim: This novel technique, has adopted digital technology to fabricate a customized precision attachment for a patient who has lost his attachment which anchor his implant retained auricular prosthesis. A scanner was used to acquire the ball abutment’ geometry of craniofacial implant in the mastoid area. CAD/CAM technology and special software was used to fabricate a customized small PEEK precision attachment that was no longer available in the market. This attachment was picked-up by an auricular prosthesis. The retention qualities of the auricular prosthesis with this attachment was satisfactory for both the patient and the dentist. This novel approach will add to clinicians a technological tool that allow fabrication of custom-made attachment with high retention qualities that is suitable for restorative situations that require fabrication of customized small attachment and yet provide high retention. Conclusion: This study used CAD-CAM technology for fabrication of a small custom-made PEEK attachment that retain an implant-retained auricular prostheses. The retentive and esthetic outcome was satisfactory to the patient and dentist. It could be indicated in many restorative situations. Keywords: CAD-CAM PEEK attachment, implant-anchored auricular prosthesis

Management of Post COVID 19 Mucormycosis with Osteomyelitis in The Maxilla, New Combined Consequences of The Pandemic. (Case Report).

ABSTRACT: Aim: This case report aims to demonstrate among health providers the importance of timely surgical and prosthetic management procedures of patients who suffered from the newly combined clinical entity of post COVID 19 mucormycosis and osteomyelitis of the palate. Materials and methods: Elaborate advanced diagnosis of the patients including CBCT, MRI, CT, Pathology examination, 3Ds printing reconstruction of the whole skull and digital design of reconstructive mesh that support the prosthesis were carried out. The patients undergone modified infrastructure maxillectomy and immediate prosthetic obturation of the palatal defect that was replaced later by a delayed obturator. Results: Surgical eradication of the necrotic bone and subsequent immediate obturation of the defect minimized morbidly and helped in improving the quality of life of these patients. Conclusion: Early diagnosis of this potentially fatal disease and reach-out a treatment plan immediately, is of prime importance in reducing the morbidly and mortality rate and enhance speech and eating in the two patients reported. It also decreases the psychological impact of this radical surgery

Full mouth implants rehabilitation of a patient with ectodermal dysplasia after 3-Ds ridge augmentation. A clinical report

A 22-year-old female presented with hypodontia and severe atrophy of alveolar ridge associated with ectodermal dysplasia, was treated with 3Ds bone augmentation technique and full mouth implants rehabilitation. Bone blocks harvested from the retro molar area to construct adequate bone volume at posterior maxilla and mandible. The vertical and horizontal bone augmentation allowed proper implant placement according to prosthetically-driven implant placement concept. Ten implants were placed. Six in the maxilla and four implants were inserted in the mandible. A cement-retained full mouth metal ceramic FPDs were fabricated. The outcome of the treatment showed that dental implants placed in bone block grafts should be considered as a good treatment modality for patients with ectodermal dysplasia. It also, provided the patient with a prosthesis that enhanced the patient function and esthetics

Bone changes in ridge split with immediate implant placement: A systematic review.

Introduction: Alveolar width deficiency represents loss of buccal cortical or/and medullary bone. Deficiency of the buccal represents significant difficulty in implant reconstruction. A variety of implant-driven bone augmentation techniques for the deficient alveolar bone have been proposed. Alveolar ridge split is an excellent tool for regaining alveolar ridge width. Material and method: Publications on the subject in English were searched to select articles up to June 2015. A systematic review was conducted searching an electronic database (MEDLINE, Pub- Med and Cochran) for articles in pre-reviewed journals concerning studies on humans. Two independent reviewers screened 815 papers. Result: A consensus on the studies to be selected was reached after discussion; 804 articles were excluded on the basis of the title and abstract. Kappa score for the selection of the paper was 0.89. Full-text articles were obtained for the 11 selected publications. The 11 full texts were independently assessed by the two reviewers and 3 studies were found to qualify for inclusion. Conclusion: Alveolar ridge splitting might be considered a predictable approach that demonstrates a high implant survival rate, adequate horizontal bone gain and minimal postoperative complications. Weak evidence showed the effect of flap design and immediate implantation on marginal bone loss and survival rate

A Simplified Technique for Orientation of a Bone Anchored Auricular Prostheses: a Clinical Report

Background: A simple technique was presented in this clinical report for orientation of a bone anchored auricular prosthesis. Methods: The proposed technique includes drawing the intact ear on a transparent celluloid paper or radiographic film and flipping it to the opposite side and relating it to the fixed anatomical features on the face of patient.Results: The drawing, by this way provides a simple and easy way to duplicate and transfer the exact size and position of the intact ear to the defect side.Conclusions: This technique provides a simple, safe, inexpensive and time saving yet, an accurate and effective surgical template that orients the craniofacial implants to the confines of the definitive auricular prosthesis. It is indicated for restoration of single missing external ear either in aplasia, injuries and total resection

Evaluation of Incorporating Bracing Arm in Precision Attachment Unilateral Removable Partial Denture

ABSTRACT Purpose: This Randomized Control Trial study aimed to compare between two designs of Precision Attachment Unilateral Removable Partial Denture, one conventional design and the other modified with bracing arm and mesial rest. Materials and Methods: twenty male patients having Kennedy Class II mandibular edentulous ridges received the two designs in a split mouth study for a follow-up period of eighteen months. Probing Pocket Depth around abutment was measured. A standardized radiographic technique was used to evaluate bone height changes. Results: The results showed insignificant pocket depth and bone height changes in the two groups. Conclusion: Precision Attachment Unilateral Removable Partial Denture proved to be a viable treatment therapy in treating unilateral edentulous ridges

THE EFFECT OF DIFFERENT FLAP TECHNIQUES ON BONE CHANGES IN SPLIT CREST RIDGES WITH SIMULTANEOUS IMPLANT PLACEMENT.

Statement of problem:-The maxillary ridge split treatment options, which include different flap techniques with simultaneous implant placement, may help eliminate the current undetermined best choice of treatment plan. Purpose: - The aim of this systematic review was to evaluate outcome of simultaneous implants placement in alveolar ridge split carried out by different flap approaches on marginal bone changes and survival rate. Materials and Methods: - English publications on the subject were searched to select articles up to December 2015. Articles in peer- reviewed journals were searched in an electronic database (MEDLINE, Pub- Med and Cochran). Also, a manual search studies on humans was carried out. Two independent reviewers screened 855 papers. Result: - 843 articles were excluded on the basis of the title and abstract. Full-text articles were obtained for the 12 selected publications. The 12 full texts were assessed by the two reviewers and 3studies were found fitting for inclusion. Conclusion: - The limited data indicates that the flap design does not affect bone changes and survival rate in ridge split procedure with simultaneous implant placement

Retrospective digital study of mandibular flexure in patients with long-span fixed restorations supported by natural teeth

Abstract Purpose This retrospective study aims to evaluate the mandibular flexure on a long-span rigid fixed prosthesis supported by natural teeth. Materials and methods Nine patients (five males and four females) were included in this study who had long-span rigid mandibular fixed prostheses for long-term (10–15 years) that have led to radiographic changes around the supporting teeth. The mandibular flexure was measured digitally after adhering reference markers to the prostheses. Intraoral scans were obtained at the minimum and maximum mouth openings before and after splitting the preexisting prostheses. The distances between the markers were measured, and mandibular flexure was calculated. Results This study showed a significant deviation (narrowing) of the mandible before and after splitting the rigid fixed prostheses (P value < 0.05). Conclusion Digital analysis of the data collected from the patients in this retrospective study indicated that deviations occur during mandibular flexure. Clinical relevance Splitting the full arch prosthesis could prevent the negative consequences of mandibular flexure on restorations. Trial registration The study was registered on clinicaltrials.gov with registration number NCT05617274 (15/11/2022