Context:To understand the effect of masticatory and parafunctional forces on the integrity of the prosthesis and the underlying cement layer.Aims:The purpose of this study was to evaluate the stress pattern in the cement layer and the fixed prosthesis, on subjecting a three-dimensional finite element model to simulated occlusal loading.Materials and Methods:Three-dimensional finite element model was simulated to replace missing mandibular first molar with second premolar and second molar as abutments. The model was subjected to a range of occlusal loads (20, 30, 40 MPa) in two different directions – vertical and 30° to the vertical. The cements (zinc phosphate, polycarboxylate, glass ionomer, and composite) were modeled with two cement thicknesses – 25 and 100 μm. Stresses were determined in certain reference points in fixed prosthesis and the cement layer.Statistical Analysis Used:The stress values are mathematic calculations without variance; hence, statistical analysis is not routinely required.Results:Stress levels were calculated according to Von Mises criteria for each node. Maximum stresses were recorded at the occlusal surface, axio-gingival corners, followed by axial wall. The stresses were greater with lateral load and with 100-μm cement thickness. Results revealed higher stresses for zinc phosphate cement, followed by composites.Conclusions:The thinner cement interfaces favor the success of the prosthesis. The stresses in the prosthesis suggest rounding of axio-gingival corners and a well-established finish line as important factors in maintaining the integrity of the prosthesis.

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Background: Chengannur, a town in the south Indian state of Kerala, was 1 of the worst affected towns during the floods of 2018. Post-flood, Kerala state was under the threat of many infectious diseases including leptospirosis, but did not report any leptospirosis infections. Objectives: This study was conducted with the following objectives: (1) Assess the knowledge, attitude and practices regarding the prevention of leptospirosis among the flood affected population and Accredited Social Health Activists (ASHAs) of Chengannur; and (2) Analyze the factors responsible for and contributing to leptospirosis control in the area post flood. Methodology: A cross-sectional questionnaire based observational study was conducted among 2 groups: the flood affected population, and ASHA. The questionnaire was divided into 3 parts. Part A contained the socio-demographic information. Part B contained questions on assessment of knowledge, attitude, and practices regarding the prevention, and control of leptospirosis. Part C was only for the ASHA involved. Results: The final sample size was 331 (244 from the general population and 87 ASHAs). With respect to knowledge, attitude, and practice, the responses were dichotomized into correct and wrong responses. The mean knowledge score was 9.01 ± 1.08 (maximum score of 10), mean attitude score was of 3.61 ± 0.55 (maximum score of 4) and the mean practice score was 4.12 ± 1.05 (maximum score of 5). Conclusion: Knowledge and attitude scores did not significantly differ between the general population and ASHA, but the practice score showed a higher score among the ASHA, all of which could have probably contributed to the prevention of a leptospirosis outbreak in the region.

Beautiful confident smile has a positive impact on the psychosocial well-being of patients. Spacing present in the anterior region makes a patient feel dissatisfied with their smile. Over the years, a number of innovative techniques have been described in the treatment of diastema. However, a less invasive and short-time treatment procedure with satisfactory result is preferred by the patient. This case report describes the technique of anterior diastema closure by applying Recurring Esthetic Dental (RED) proportion for smile designing using direct composite resin. The RED proportion has been stated to be an essential tool for achieving esthetics and harmony in smile.