Fabrication of Custom Ocular Prosthesis Using a Graph Grid: A Case Report

Patients  requiring  treatment  with  custom  ocular  prosthesis  are  those  who  have  lost  ocular  structures through orbital evisceration or orbital enucleation which was necessary as a surgical intervention for a congenital  defect,  pathology  or  an  accident.  The  disfigurement  associated  with  eye  loss  can  cause significant  physical  and  emotional  disturbance.  As  iris  placement  is  a  technique  sensitive  procedure, visual assessment alone may not be accurate.The  present article  is an illustration of a case report  of  a lady chosen for a custom ocular prosthesis. The method described here uses a transparent grid template from which the iris is traced. An attempt is also made to mimick the shade and colour of the sclera in the wax  pattern  itself;  using  white  paraffin  wax.  This  gives  an  accurate  registration  of  the  position  and  alignment of iris disc assembly, giving a natural look.  Key  words: Custom  ocular  prosthesis,  graph  grid. &nbsp

Split obturator: An innovative approach

A palatal prosthesis can improve function by closing the palatal defect, preventing regurgitation, and improving swallowing and speech. Although techniques have been previously described for fabrication of palatal obturator, but there has not been any technique to devise an obturator for a patient with palatal defect with a quadhelix orthodontic appliance overlying it. One cannot wait in such patients for completion of lengthy orthodontic treatment and then think of devising prosthesis as the patient cannot carry out normal functions like swallowing and speech without the closure of defect. This article focuses on an innovative method of fabricating a palatal obturator which aims at restoring the above-mentioned functions along with improving aesthetics. It also enables us to devise the fabrication of prosthesis in two parts for easy insertion and removal and as well as to be self-cleansable. Such prosthesis would markedly improve patient psychology and confidence

Interoperator variability in shade matching for restoration with two shade guides- a study

A study was undertaken in the department of Prosthodontics to compare to compare the interoperator variability in  shade matching by visual techniques using two shade guides. 2 prosthodontists selected shades of upper right central incisor of 30 patients in a dental chair under ceiling daylight-corrected fluorescent lights. Two shade guides were used- Vitapan Classical and the Vitapan 3D Master shade guides (Vita Zahnfabrik). The 3 closest shade tabs were selected and ranked in order of best, second best, and third best matches. Interoperator agreement was found by comparing the best shade and the common shade for each subject by the 2 clinicians. The result was calculated using the CIE Lab color difference, ΔE*, between the best shade and the common shade selected by the clinicians for each subject. Statistical analysis was done  to find clinician differences of the means of the best shade and the common shade for both shade guides using a t test (α= .05)  Interoperator agreement was 32% for the best shade and over 84% for the common shade ( significant difference at the .05 level). No significant differences were found between the 2 shade guides by means of the mean color differences between the best shade match and the common shade match .Vitapan 3D Master shade guide was better than the Vitapan Classical shade guide in reducing the interoperator color differences from 0.7 to 0.2

A Simplified approach for fabrication of custom tray for Facial prosthesis

Maxillofacial defects are very common and can be due to congenital defect, trauma, infections and neoplasms of facial region. These defects can be restored using different materials and retention methods to give a life like appearance. Rehabilitation of facial defect is a very challenging task. Every good prosthesis needs a skillful hand and it all starts with making a good impression of that defect and to proceed with the same. The aim of present paper was to present a simplified approach for the fabrication of custom tray to take facial impression of the patient with maxillofacial defect

Etiological factors of temporomandibular joint disorders

The temporomandibular joint receives its name from the two bones that enter into its formation, namely the temporal bone and the mandible. This complex synovial system is composed of two temporomandibular joints together with their articulating ligaments and masticatory muscles. This articulation affects other synovial joints that relate specifically to masticatory function. The causes of temporomandibular disorders are complex and multifactorial. There are numerous factors that can contribute to temporomandibular disorders. In some instances a single factor may serve one or all of these roles. Iatrogenic injuries can act as both initiating as well as predisposing factors. The term craniomandibular disorder is used synonymously with the term temporomandibular disorders and is considered a major cause of nondental pain in the orofacial pain region. The successful management of temporomandibular disorders is dependent on identifying and controlling the contributing factors. The temporomandibular disorders are more common in females, the reason is not clearly known. The following article provides detailed information regarding temporomandibular joint disorders

Lost salt technique for severely resorbed alveolar ridges: An innovative approach

The success of a complete denture relies on the principles of retention, stability and support. The prosthodontist skill lies in applying these principles efficiently in critical situations. Severely resorbed maxillary edentulous ridges that are narrow and constricted with increased inter ridge space provide decreased support, retention and stability. The consequent weight of the processed denture only compromises them further. This article describes a case report of an edentulous patient with resorbed ridges where a simplified technique of fabricating a hollow maxillary complete denture using lost salt technique was used for preservation of denture bearing areas. The hollowing of the denture reduces the weight of the denture, thereby enhancing stability and retention, reducing the further resorption of the jaws

Mercury and Other Biomedical Waste Management Practices among Dental Practitioners in India

Objectives. The objective of the study was to assess the awareness and performance towards dental waste including mercury management policy and practices among the dental practitioners in North India. Materials and Methods. An epidemiologic survey was conducted among 200 private dental practitioners. The survey form was composed of 29 self-administered questions frame based on knowledge, attitude, and those regarding the practices of dentists in relation to dental health-care waste management. The resulting data were coded and a statistical analysis was done. Results and Discussion. About 63.7% of the dentists were not aware of the different categories of biomedical waste generated in their clinics. Only 31.9% of the dentists correctly said that outdated and contaminated drugs come under cytotoxic waste. 46.2% said they break the needle and dispose of it and only 21.9% use needle burner to destroy it. 45.0% of the dentists dispose of the developer and fixer solutions by letting them into the sewer, 49.4% of them dilute the solutions and let them into sewer and only 5.6% return them to the supplier. About 40.6% of the dentists dispose of excess silver amalgam by throwing it into common bin. Conclusion. It was concluded that not all dentists were aware of the risks they were exposed to and only half of them observe infection control practices

A multidisciplinary approach for ocular rehabilitation following surgical treatment of retinoblastoma: One year follow‑up

Retinoblastoma is a highly malignant neoplasm. Most of the cases are usually advanced at the time of detection, requiring enucleation to salvage the child’s life. Just treating the patient for cancer is not enough; the cosmetic rehabilitation of these patients is equally important and it should always be an integral part of their treatment, to help them re‑integrate in the aesthetic conscious society. Rehabilitating such patients require a multidisciplinary approach involving the combined and timely efforts of an ophthalmologist, paediatric oncologist and a skilled maxillofacial prosthodontist. This paper presents a case of 3½‑year‑old girl who had enucleation of her right eye due to retinoblastoma along with chemotherapy and radiotherapy at the age of 3 years. The patient was recalled regularly for follow‑up at 3 month intervals for ophthalmic examinations and she was rehabilitated cosmetically with customised ocular prosthesis during the various stages of her developmental growth.Keywords: Custom ocular prosthesis, enucleation, impression technique, ocular defect, retinoblastomaNigerian Medical Journal | Vol. 54 | Issue 4 | July-August | 201

Basic principles of rehabilitation for lost eye: A dentist′s perspectives

Various maxillofacial prostheses are made from materials used in dentistry. The treatment of the patient who loses one or both eyes is a challenging task for the clinician. A multidisciplinary approach is required to fulfill the needs and expectations of an anophthalmic patient. Dentists are now playing a major role in this regard as they are more familiar with the materials used for artificial eyes. Ocular prosthesis is an artifi cial replacement of the eye. The article describes the overall management and treatment of an anophthalmic patient, followed by a procedure for an easy fabrication of a custom-fi tocular prosthesis