Background: The purpose of this in vivo study was to compare the marginal and internal gap widths of monolithic zirconia crowns fabricated by CAD/CAM technique and metal-ceramic crowns fabricated by conventional technique. Materials and methods: 10 participants needing a single restoration were selected. Zirconia crowns using CAD/ CAM technology (Group A) (n=10) and metal-ceramic crowns (Group B) (n=10) using lost wax casting technique were fabricated for each selected tooth. The marginal and internal gaps of crowns were recorded using a replica technique with light body silicone material stabilized with a regular set putty. Each replica was sectioned buccolingually and mesiodistally and then evaluated at five predetermined sites. The points measured were PM for marginal gap, PA for axial gap, PAO for axio-occlusal transition gap and PO and PCO for occlusal gaps using a stereomicroscope at 30× magnification. The Paired Sample (t) test was used to detect significant differences between the two groups in terms of marginal and internal fit (α= 0.05). Results: The mean for the marginal gap was 77.42μm (±39.5μm) for Group A compared with 95.86μm (±55.12μm) for Group B. Mean values for internal gap was 87.24 (±21.7 µm) for Group A and 132.91 µm (± 50.63 µm) for Group B. Significant differences were observed between both the groups for marginal (p=.010) and internal (p=.000) fit. Conclusions: The CAD/CAM fabricated zirconia crowns demonstrated a better accuracy of fit when compared to metal-ceramic crowns fabricated by conventional technology.

BACKGROUND For fabricating dental prostheses that meet patients' demands and have good longevity and function, appropriate treatment planning and decision-making are required. Therefore, not only technical skills and clinical judgment of the dentist are needed, but also patients' attitude toward treatment plays a critical role in posttreatment satisfaction. The aim of this study was to investigate empirically the factors affecting the patients' decision-making and to contribute to improvement of public oral health. METHODS A cross-sectional survey was conducted to determine patients' attitudes towards dental prosthetic treatment. Part A of the questionnaire consisted of demographic information of participants enrolled for the study. Part B of the questionnaire comprised of close ended multiple-choice questions stating the reasons cited by them if they decline the proposed treatment plan. Data was subjected to frequency analysis, cross-tabulation analysis and logistic regression analysis to determine how each independent variable is affecting patient's decision making. RESULTS Among 60 participants, 16 (27 %) accepted and 44 (73 %) rejected the proposed treatment plan. About 43.2% of the participants cited high expenditure as the reason for not accepting the given treatment option. Cross tabulation analysis showed better acceptance in elderly group (p= 0.049). Logistic regression analysis was also applied to evaluate the influence of age on the decision-making process which showed that aging increased the logarithm multiplication. CONCLUSIONS In the sample of population studied, most of the patients declined the proposed treatment plan and accepted the alternate one. High expenditure was the most common reason for this rejection. Among all the independent variables, aging increased the logarithm multiplication and had a positive relation with the decisionmaking process.

Velopharyngeal insufficiency resulting from a defect in the soft palate, acquired or congenital, causes incomplete closure of the palatopharyngeal sphincter. An individual with such a defect suffers from multiple problems in eating, speaking, breathing, as well as psychological trauma, in society. This case report describes the rehabilitation of a patient with a congenital velopharyngeal defect using a definitive speech bulb obturator and an intensive speech therapy program. The patient underwent speech therapy for a period of three months. A speech and voice assessment was conducted before and after speech therapy. A speech intelligibility test was conducted, and nasalance was measured using a nasometer. Significant improvement in speech, mastication, and velopharyngeal function was achieved after bulb reduction and speech therapy.

The maxillary anterior region is considered to be the esthetic zone of human dentition. Missing teeth in this area leads to severely compromised esthetics and function. Endosseous implants are a viable treatment option in this scenario, but the placement of endosteal implants requires adequate bone volume for successful osseointegration. When the morphology of the bone does not allow proper implant placement, there are various bone augmentation procedures which aid in reconstruction of the residual alveolar ridge for ideal implant placement. The mandibular parasymphysis can act as an excellent source of autogenous bone for the augmentation of alveolar ridge deficiencies. This article describes successful augmentation of the maxillary alveolar ridge using block bone autografts harvested from the mandibular symphysis along with platelet-rich fibrin. At 6 months after surgery, implant was inserted, and after a healing period of 5 months, permanent restoration was placed.

Background: The purpose of this in vivo study was to compare the marginal and internal gap widths of monolithic zirconia crowns fabricated by CAD/CAM technique and metal-ceramic crowns fabricated by conventional technique. Materials and methods: 10 participants needing a single restoration were selected. Zirconia crowns using CAD/ CAM technology (Group A) (n=10) and metal-ceramic crowns (Group B) (n=10) using lost wax casting technique were fabricated for each selected tooth. The marginal and internal gaps of crowns were recorded using a replica technique with light body silicone material stabilized with a regular set putty. Each replica was sectioned buccolingually and mesiodistally and then evaluated at five predetermined sites. The points measured were PM for marginal gap, PA for axial gap, PAO for axio-occlusal transition gap and PO and PCO for occlusal gaps using a stereomicroscope at 30× magnification. The Paired Sample (t) test was used to detect significant differences between the two groups in terms of marginal and internal fit (α= 0.05). Results: The mean for the marginal gap was 77.42μm (±39.5μm) for Group A compared with 95.86μm (±55.12μm) for Group B. Mean values for internal gap was 87.24 (±21.7 µm) for Group A and 132.91 µm (± 50.63 µm) for Group B. Significant differences were observed between both the groups for marginal (p=.010) and internal (p=.000) fit. Conclusions: The CAD/CAM fabricated zirconia crowns demonstrated a better accuracy of fit when compared to metal-ceramic crowns fabricated by conventional technology.