Prosthetic management of congenital anophthalmia-microphthalmia patient

Congenital anophthalmia and microphthalmia are rare developmental defects of the globe that cause deficient orbitofacial growth and impaired visual capability. Anophthalmia whether congenital or acquired is not just a question of cosmesis. It has many ramifications such as monocular status, loss of facial esthetics and psychological challenges for a growing child. The management of such a patient requires the coordinated involvement of a multidisciplinary team of health care professionals, including pediatrician, pediatric ophthalmologist, geneticist, genetic counselor, oculoplasty surgeon, and prosthetist. This article focuses on the rehabilitation of an adult female patient with congenital anophthalmia who was successfully treated with progressive expansion therapy with custom conformer followed by custom ocular prosthesis

A study to correlate various facial landmarks with intercanine distance

Context: Ideal interaction of dental and facial beauty proportions highly influences a harmonious facial appearance. Racial anatomical variations have been significantly noted and using these norms during prosthodontic rehabilitation will be greatly helpful in successful treatment outcome. Aim: The present study aims to correlate various facial landmarks (interpupillary distance [IPD], intercanthal width, bizygomatic width [BZW], and interalar width) with intercanine distance (ICaD) in Indian young adults to determine the mesiodistal width of the maxillary anterior teeth in edentulous patients. Setting and Design: This is an observational cross-sectional study. Materials and Methods: This study was conducted in 500 individuals ranging in age from 18 to 28 years. IPD, intercanthal width, BZW, and interalar width were measured with a digital caliper (accuracy - 0.01 mm). A “T-” shaped flat metal plate called “canine tip marker” was made to mark the tips of the maxillary canines, which were further measured with the digital caliper. The data were summarized in table form and were statistically analyzed. Statistical Analysis Used: Student's t-test and ANOVA test were used. Results: A significant correlation (P < 0.001) was found between these landmarks with ICaD, in which interalar width shows highest degree of correlation (r = 0.639). ANOVA test showed that maximum number of individuals had < 5% variability range between actual values and calculated values of ICaD for all extraoral facial landmarks except intercanthal width. Conclusion: Combination of various facial and oral factors should be considered while selecting artificial teeth. Regression equations obtained can be well used during teeth selection to achieve a significant result

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

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

A study to evaluate the effect of oral stereognosis in acceptance of fixed prosthesis

Aims: The aim of the study was to evaluate and compare the oral stereognostic ability and satisfaction for fixed prosthesis in human being. Materials and Methods: The present study was carried out on 40 subjects, the purpose being to investigate the relation of oral perception to diagnostic and therapeutic procedures. Two types of cast metal crowns-one had morphology closely resembling original tooth and other one confirmed to ideal contours were constructed on endodontically treated posterior tooth. One cast metal crown was randomly selected from two cast metal crown and fitted on prepared tooth. Oral stereognostic score of subject was determined by correct response to questionnaire based on the recognition ability of subjects. Patient satisfaction level was checked by psychometric parameter Likert scale. Same procedure was repeated with other type of cast metal crown. Results: Data obtained were compared by paired and unpaired two sample t-test. Oral stereognostic score and satisfaction score were found to be higher for cast metal crown with morphology resembling to original tooth due to recognition and discriminatory ability of subjects and recall-memory. Oral stereognostic level was found to be higher in younger than older subjects. The level of satisfaction was found to be higher in older subjects than younger subjects. Conclusion: It was concluded that acceptance of fixed prosthesis is not only based on dentist′s routine procedure of treatment and patient′s judgment about oral health, function, and esthetics, but also depends upon patient′s oral perception and discriminatory skill for external morphology of fixed prosthesis

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