Quantitate evaluation of photogrammetry with CT scanning for orbital defect

Facial deformities can be caused by cancer, tumours, trauma, infections, congenital or acquired defects and may lead to alteration in basic functions such as communication, breathing, and mastication and aesthetic thereby affecting quality of life. Traditional processes for manufacturing maxillofacial prostheses involve complicated, time-consuming and tedious processes for the patient and the operator. Impression of the defect area, which is the one of the crucial step in fabrication of prosthesis, is the longest and most difficult process as it requires a long contact with the patient. The digital revolution is now changing the landscape of prosthetic production and making the impression making procedure simpler. Digital technology reduces patient chair side time by providing more accurate display data in less time (3-5 min) than traditional methods. Digital impressions eliminate the need for bulky impression materials and provide a more comfortable patient experience.

Revolutionizing Neurosurgery: The Cutting-Edge Era of Digitally Fabricated Cranial Stents

Cranial defects are broadly classified as either congenital or acquired. The prevalence of cranial injuries has notably increased, propelled by a heightened emphasis on aesthetics and the demand for skull reconstruction in contemporary society. Consequently, rehabilitation for these defects has also surged. Surgical correction or repair, known as cranioplasty, not only aims at aesthetic rehabilitation but also addresses psychological issues, improving social acceptance and overall performance. Amid evolving trends, the availability of advanced biomedical tools, technologies, and materials empowers surgeons and prosthodontists, leading to improved outcomes in aesthetics and functionality. One noteworthy technique highlighted in this case report involves using bone cement in conjunction with polymethyl methacrylate, adding novelty to the approach. The interdisciplinary management team, consisting of prosthodontists and neurosurgeons, played a pivotal role in improving neurological status and cosmetic outcomes for the patients.

Association of Salivary Cortisol With Anxiety in Type 2 Diabetes Mellitus Patients Before and After Complete Denture Rehabilitation: An In-Vivo Analysis

Background Complete edentulism negatively impacts emotional, physical, social, and psychological well-being, leading to a decline in quality of life and heightened stress and anxiety. Stressful situations associated with edentulism can elevate cortisol levels, potentially increasing the risk of diabetes. Rehabilitation with complete dentures needs careful evaluation for its impact on general health, considering stress points and systemic effects. This study aimed to assess salivary cortisol levels in type 2 diabetes mellitus patients before and after complete denture rehabilitation, highlighting the intricate relationship between diabetes, cortisol, and the stress response. Methods This is a cross-sectional study centered on individuals with diabetes who were completely edentulous and undergoing evaluation by the outpatient prosthodontic department. Glycated hemoglobin, anxiety levels, and the fabrication of complete dentures were all accomplished with the participants' consent. Patients underwent evaluations before and one month after receiving complete denture rehabilitation. Results An absolute correlation between salivary cortisol levels and anxiety may be established because anxiety levels dramatically decreased during complete denture rehabilitation. Conclusion By learning how the patient's general health is related to their new set of complete dentures and how to correlate that information with dental rehabilitation, professionals can help patients better adapt to their new set of dentures.

Pulpotomy for the Management of Irreversible Pulpitis in Mature Teeth

Strict protocols for evaluating the pulp's preoperative state should be developed, along with a new classification scheme for the different pulp states, as case selection plays a major role in the effectiveness of adult pulpotomy. In this case report, a male patient, age 15, who had a carious lower left first molar underwent pulpotomy. The pulp's initial state was ascertained by pulse oximetry, electric pulp testing (EPT), and cold testing. The final diagnosis was symptomatic irreversible pulpitis. A 12-month follow-up period following the placement of mineral trioxide aggregate (MTA) (MTA Angelus Angelus, Londrina, Brazil; Clinician's Choice, New Milford, CT) and tooth-colored composite restoration revealed no visible anomalies in the postoperative radiographs, and the tooth remained functional and free of symptoms.

Quad Zygoma: A Graftless Solution in Post-mucormycosis Maxillectomy

Mucormycosis, a fungal infection that commonly affects individuals with diabetes and compromised immune systems, often requires surgical excision and debridement. However, this can result in significant defects, posing a challenge for clinicians in terms of reconstruction and rehabilitation. Prostheses, local and regional pedicled flaps with or without bone grafts, and titanium mesh application are available options for maxillary reconstruction. Soft-tissue flaps are not sufficient to provide osseointegrated implants with both bone repair and structural support, which emphasises the quad zygoma's beneficial role in treating maxillary abnormalities. Patients benefit from quad zygoma, which uses zygomatic implants and eliminates the need for subsequent procedures, which shortens the course of treatment and lowers costs. Because zygomatic implants are securely fixed into the zygoma, temporary prostheses can be loaded right away. Then, four to six months later, a fixed prosthesis may be introduced. Clinical results with zygomatic implants often surpass those of bone grafting, representing a potential novel gold-standard approach for the compromised maxilla. This case report details the rehabilitation of post-mucormycosis patients with maxillary defects using quad zygomatic implants. The absence of complications during follow-up, conducted at 15, 30, 45, and 90 days, and subsequently monthly for two years, highlights the success of this approach. Evaluation parameters included soft tissue recovery, infection, wound separation, stability of prosthesis, eating effectiveness, and aesthetic outcomes. The positive outcomes observed at follow-up appointment emphasize the viability and effectiveness of quad zygomatic implants in addressing maxillary defects post-mucormycosis.

Appliances Therapy in Obstructive Sleep Apnoea: A Systematic Review and Meta-Analysis

Obstructive sleep apnea (OSA) is a recurrent partial or complete obstruction of the upper airway during sleep caused by narrowing or collapse of the pharyngeal wall. It leads to microstimulation and oxyhemoglobin desaturation, resulting in sleepiness and loud snoring. OSA negatively affects the cardiovascular system and may contribute to neurocognitive impairment. The aim of this systematic review is to evaluate the effectiveness and efficacy of appliance therapy in obstructive sleep apnea. The effectiveness was assessed by using the Apnea Hypopnea Index (AHI). An electronic search of the Cochrane Library, PubMed, and Google Scholar was conducted between 1998 and 2021. Articles were independently assessed by three reviewers. The quality of a randomised control trial (RCT) is assessed using the Cochrane risk of bias method. The tool GRADE was used to achieve the desired level of confidence for each outcome reported. Several studies used continuous positive airway pressure (CPAP), mandibular advancement devices (MAD), and tongue retention devices (TRD). The meta-analysis included a total of six papers that met the inclusion criteria. Results showed that CPAP significantly improved AHI compared with an oral appliance (random effects: difference in means = 8.40, 95% CI = 7.21 to 9.60). It was also found that oral appliance (OA) therapy significantly improved AHI compared with baseline before appliance therapy (random effects: mean difference = 13.40, 95% CI = 10.87 to 15.93; p.00001). For mild to moderate OSA, CPAP is considered the gold standard. Our meta-analysis of six RCTs found favorable evidence for OSA patients receiving oral devices; however, they were less effective than CPAP. A subgroup analysis found that MAD may be a beneficial treatment for mild to moderate OSA patients who do not respond to CPAP. The findings suggest that oral appliances may be an effective treatment for OSA, especially in patients with mild to moderate OSA.

The Good Old Masserann Technique for the Retrieval of a Separated Instrument: An Endodontic Challenge

Instrument separation is one of the most upsetting endodontic errors, and it can occur at any time during root canal surgery. A broken file causes a metallic restriction in the root canal and makes it difficult to clean and shape the instrument effectively, thereby making the prognosis questionable. Hence, such a fragment should be properly retrieved when it becomes difficult to bypass it. A variety of techniques and tools are utilized for instrument recovery; however, most of them are expensive, difficult to master, and technique-sensitive. One such tool for orthograde removal of intracanal metallic obstacles is the Masserann kit. We discuss a case involving file removal from the maxillary premolar by using the Masserann technique.

Evaluation of accuracy of photogrammetry with 3D scanning and conventional impression method for craniomaxillofacial defects using a software analysis

BACKGROUND

Facial mutilation and deformities can be caused by cancer, tumours, injuries, infections, and inherited or acquired deformities and has the potential to degrade one's quality of life by interfering with fundamental tasks like communication, breathing, feeding, and aesthetics. Depending on the type of defect, producing maxillofacial prostheses for the rehabilitation of patients with various defects can be challenging and complex. The prosthesis is used to replace missing or damaged parts of the cranium and face, like the nose, auricle, orbit, and surrounding tissues, as well as missing areas of soft and hard tissue, with the primary goal of increasing the patient's quality of life by rehabilitating oral functions such as speech, swallowing, and mastication. Traditional maxillofacial prosthesis impression and fabrication processes include a number of complicated steps that are costly, time-consuming, and uncomfortable for the patient. These rely on the knowledge of the maxillofacial team, dental clinicians, and maxillofacial technician. The foundation of the impression is the keystone for creating a prosthesis. However, this is the most time-consuming and difficult chair-side operation in maxillofacial prosthesis manufacturing since it requires prolonged interaction with the patient. The field of prosthesis fabrication is being transformed by the digital revolution. Digital technology allows for more accurate impression data to be gathered in less time (3 to 5 min) than traditional methods, lowering patient anxiety. Digital impressions eliminate the need for messy impression materials and provide patients with a more pleasant experience. This method bypasses the procedure of traditional gypsum model fabrication. This eliminates the disparity caused by a dimensional distortion of the impression material and gypsum setting expansion. Traditional dental impression processes leave enough room for errors, such as voids or flaws, air bubbles, or deformities, while current technology for prosthesis planning has emerged as an alternative means to improve patient acceptability and pleasure, not only because the end result is a precisely fitted restoration but also because the chair-side adjustments required are reduced. The most frequent approaches for creating 3D virtual models are the following. To begin, 3D scanning is employed, in which the subjects are scanned in three dimensions, and the point cloud data is used to create a virtual digital model.

METHODS

It will be a hospital-based randomised control trial, carried out at the Department of Prosthodontics, Sharad Pawar Dental College, Sawangi (Meghe), Wardha, a part of Datta Meghe Institute of Medical Sciences (Deemed University). A total of 45 patients will be selected from the outpatient department (OPD) of the Department of Prosthodontics. All the patients will be provided written consent before their participation in the study.

METHODOLOGY

1. Patient screening will be done, and the patient will be allocated to three techniques that are the conventional manual method, photogrammetry method, and 3D scanning in a randomised manner 2. The impression of the defect will be recorded by conventional manual method, photogrammetry method, and 3D scanning 3. The defect will be modelled in three ways: first is as per the manual dimension taken on the patient, second is the organisation of photographic image taken with lab standards and third is plotting of point cloud data to generate the virtual 3D model 4. For photogrammetric prosthesis design, finite photos/images will be taken at multiple angles to model the 3D virtual design. With the use of minimum photographs, the 3D modelling can be performed by using freeware, and a mould is obtained 5. The CAD software was used to design the prosthesis, and the final negative mould can be printed using additive manufacturing 6. The mould fabricated by all three methods will be analysed by a software using reverse engineering technology Study design: Randomised control trial Duration: 2 years Sample size: 45 patients DISCUSSION: Rodrigo Salazar-Gamarra1, Rosemary Seelaus, and Jorge Vicente Lopes da Silva et al., in the year 2016, discussed, as part of a method for manufacturing face prostheses utilising a mobile device, free software, and a photo capture protocol, that 2D captures of the anatomy of a patient with a facial defect were converted into a 3D model using monoscopic photogrammetry and a mobile device. The visual and technical integrity of the resulting digital models was assessed. The technological approach and models that resulted were thoroughly explained and evaluated for technical and clinical value. Marta Revilla-León, Wael Att, and Dr Med Dent et al. (2020) used a coordinate measuring equipment which was used to assess the accuracy of complete arch implant impression processes utilising conventional, photogrammetry, and intraoral scanning. Corina Marilena Cristache and Ioana Tudor Liliana Moraru et al. in the year 2021 provided an update on defect data acquisition, editing, and design using open-source and commercially available software in digital workflow in maxillofacial prosthodontics. This research looked at randomised clinical trials, case reports, case series, technical comments, letters to the editor, and reviews involving humans that were written in English and included detailed information on data acquisition, data processing software, and maxillofacial prosthetic part design.

TRIAL REGISTRATION

CTRI/2022/08/044524. Registered on September 16, 2022.

Quantifying the Selection of Maxillary Anterior Teeth Using Extraoral Anatomical Landmarks

Background: Regardless of skin color, age, sex, or other factors, all beautiful faces follow the divine proportion. Proportions of face components appear to play a role in facial attractiveness.

Aim: The study determines the correlation between the mesiodistal width of anterior maxillary teeth, inter-canthal distance, inter-alar distance, and inter-commissural distance as a criterion for selecting anterior maxillary teeth.

Material and Methods: A cross-sectional study was carried out at the institutional level with a sample size of 200 participants with 100 male and 100 female participants. Inter-canthal distance, inter-alar distance, and inter-commissural distance were measured using the digital caliper and a customized silver scale to measure the mesiodistal width of anterior maxillary teeth. The data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 24.0 (IBM Corporation, Chicago, USA). Pearson's correlation test calculated the correlation coefficient, and the level of significance was kept at p<0.05.

Result: The width of the maxillary anterior and the inter-canthal gap showed a strong positive correlation, the inter-alar difference and the mesiodistal width of anterior teeth showed a moderately positive correlation, and the estimated inter-commissural width and the mesiodistal width of anterior teeth showed a strong positive correlation (p<0.05).

Conclusion: These parameters are correlated to the dimensions of the tooth size and can act as a guide while selecting the teeth for future rehabilitation treatment when the natural teeth are lost.