Rehabilitation of maxillofacial defect patients is a challenging task. The most common prosthetic treatment problem with such patients is, getting adequate retention, stability, and support. In cases of large maxillofacial defect, movement of the prosthesis is inevitable. The primary objectives in rehabilitating the maxillofacial defect patients are to restore the function of mastication, deglutition, speech, and to achieve normal orofacial appearance. This clinical report describes maxillofacial prosthetic rehabilitation of large midfacial defect including orbit along with its contents, zygoma and soft tissues including half of the nose, cheeks, upper lip of left side, accompanying postsurgical microstomia and orofacial communication, which resulted from severe fungal infection mucormycosis. The defect in this case was restored with magnet retained two piece maxillofacial prosthesis having hollow acrylic resin framework and an overlying silicone facial prosthesis. The retention of prosthesis was further enhanced with the use of spectacles. This type of combination prosthesis enhanced the cosmesis and functional acceptability of prosthesis.
The present study was planned to assess the efficacy, utility and complications of transmylohoid intubation in facial polytrauma patients, by setting and design: prospective study.
Aims:The aim of the study was to evaluate the stress distribution patterns in teeth and supporting structures of fixed prosthesis and design modifications in a fixed prosthesis with either normal or reduced bone support of an additional abutment. Study was also undertaken to disprove Ante's law.Materials and Methods:Main models and variations of main models (modification 1, 2, 3, 4, 5, 6, 7, 8) were subjected to 200 N at angulations of 90° and 15° on functional cusps. Results for each loading were obtained as stress distribution color images and numerical values were recorded. A three-dimensional finite element analysis study of variations of normal models was performed using two finite element softwares, namely PRO-Engineer wildfire version 1.0 manufacturer: Parametric technology corporation, Needham, MA 02494 U.S.A.Results:When periodontal compromised abutment teeth was splinted with an additional abutment an increase of stress was observed in periodontally compromised abutments so an additional abutment is not required. Eventhough the pericemental area of compromised abutments with an additional abutment (canine) was more than the combined pericemental area of pontics to be replaced, stress generated was more on abutments. This disproves Ante's law. Hence, it may be a reference, but should not be the ultimate criterion in determining the number of multiple abutments.Conclusions:When periodontal compromised abutment teeth was splinted with an additional abutment an increase of stress was observed in periodontally compromised abutments so an additional abutment is not required. Even though the pericemental area of compromised abutments with an additional abutment (canine) was more than combined pericemental area of pontics to be replaced, stress generated was more on abutments. This disproves Ante's law. Hence, it may be a reference, but should not be the ultimate criterion in determining the number of multiple abutments.
Aim:We compared the clinical efficacy of three gingival displacement systems to accurately record intra-crevicular margins of tooth preparation.Materials and Methods:One mechanical (magic foam cord) and two chemico-mechanical (expasyl paste and retraction cord impregnated with 15% aluminum chloride) gingival displacement systems were used. This study was conducted on the maxillary central incisors of 20 patients (20-60 years old) requiring full coverage restoration. All the three gingival displacement systems were tested in three sessions at an interval of 14 days in same order. The casts were sectioned and viewed under an optical microscope, followed by quantitative measurements of the width of the pre and postretracted sulci.Results:All the three displacement systems produced highly significant horizontal gingival displacement. Retraction cord soaked in 15% aluminum chloride produced maximum displacement (0.74 mm), followed by expasyl paste (0.48 mm) whereas magic foam cord produced the least displacement (0.41 mm).Conclusions:Gingival displacement shown by each displacement system was found to be more than the accepted value necessary for elastomeric impression accuracy (0.2 mm) to record intra-crevicular margins of tooth preparation.
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