STATEMENT OF PROBLEM Knowledge of the effect of a shortened dental arch on masseter muscle thickn... more STATEMENT OF PROBLEM Knowledge of the effect of a shortened dental arch on masseter muscle thickness and occlusal force is sparse but could help clinicians understand how a shortened dental arch might affect the stomatognathic system. PURPOSE The purpose of this pilot clinical study was to evaluate and compare the masseter muscle thickness and occlusal force of participants rehabilitated by using a shortened dental arch with matched completely dentate individuals. MATERIAL AND METHODS Twelve partially edentulous participants with a minimum of 1 posterior occluding pair on each side of the arch were enrolled in the study. The mandibular arch of these participants was rehabilitated by using a single posterior mandibular implant crown (group S). The maxillary arch of all participants in group S was intact. Masseter muscle thickness (cm) and occlusal force (N) were recorded before (T1) and 6 months after implant rehabilitation (T2) for each participant. Twelve participants were selected as controls (group C). They were matched for age, sex, height, and weight with group S and evaluated for masseter muscle thickness and occlusal force. Masseter muscle thickness was evaluated by using ultrasonography during the rest position and maximum volumetric clenching. Occlusal force was measured with an occlusal force measuring appliance. All recordings were done for the left and right sides of the arch. Descriptive analysis was followed by comparison between groups and within group S by using the paired t test (α=.05). RESULTS Higher masseter muscle thickness and higher occlusal force were observed in group C than in group S before and after rehabilitation. An increase in masseter muscle thickness in the rest position and in maximum volumetric clenching was observed within group S after rehabilitation. Before rehabilitation, a difference in the masseter muscle thickness between group S and group C was statistically significant for the left side at the rest position (P=.017) and during maximum volumetric clenching (P=.016). After rehabilitation, the difference between group S and group C was not statistically significant for masseter muscle thickness at the rest position (P=.890 for right side and P=.555 for left side) and during maximum volumetric clenching (P=.109 for right side and P=.755 for left side). The difference in occlusal force between group S and group C was statistically significant for the right side and left side (P<.001) before rehabilitation and statistically not significant after rehabilitation (P=.161 for the right side and P=.134 for the left side). CONCLUSIONS Rehabilitation following the concept of a shortened dental arch increased masseter muscle thickness and occlusal force in partially edentulous individuals, making the masseter muscle thickness and occlusal force comparable with those of a completely dentate arch.
Journal of Pierre Fauchard Academy (India Section), 2012
Prosthetic rehabilitation of facial defects has always been a challenge for M ax illofacia l Pros... more Prosthetic rehabilitation of facial defects has always been a challenge for M ax illofacia l Prosthodontists. These defects not onl y ha ve functional and cosmetic problems but also have crippling effec t on patient' s psychology. An early re h ab ilitation is th e key to successful alleviation of these de bili ta tin g effe cts. T his case report presents the esthetic rehabilitation of a patient of par ti al rhinectom y with a n acrylic nas al prosthe sis tinted with a commercial fa cial ma ke-u p. .
Long-term clinical failures of cemented prosthesis depend, to a large extent, on the integrity of... more Long-term clinical failures of cemented prosthesis depend, to a large extent, on the integrity of the luting agent. The causative factors that lead to microfracture and, hence, failure of the luting agents are the stresses acting inside the oral cavity. Therefore, the present study was designed to develop an understanding of the relationship between stresses in the tooth and the failure potential of the luting agent. Two-dimensional finite element stress analysis was performed on the mandibular second premolar. The behavior of zinc-phosphate and glass-ionomer were studied under different crowns (metal-ceramic and metal crown) and loading conditions (mechanical force of 450 N acting vertically over the occlusal surface, thermal loads of 60° and 0°C). It was observed from the study that failure threshold of the luting agent was influenced both by the elastic modulus of the luting agent and by the type of the crown.
Exenteration of the orbital contents as well as removal of a part of maxilla with an ablative sur... more Exenteration of the orbital contents as well as removal of a part of maxilla with an ablative surgery for the removal of a malignant tumor can severely affect a person in terms of function, esthetics and psychological trauma. A well-retained, user-friendly, removable maxillofacial prosthesis is the key to successful prosthetic rehabilitation in such cases. Various retentive techniques include using spectacle frame, conformers, adhesives, osseointegrated implants, magnets or buttons. This paper describes a novel technique for retention of silicone orbital prosthesis using acrylic resin base attached to maxillary obturator with the help of pin and socket of an electric plug wherein the latter is attached to the eye prosthesis with the help of a mechanical undercut. This helps in better retention of both the prostheses.
PURPOSE. The study was conducted to compare the radiographic and clinical methods of measuring th... more PURPOSE. The study was conducted to compare the radiographic and clinical methods of measuring the horizontal condylar guidance (HCG) values. MATERIALS AND METHODS. The condylar guidance was measured using the radiographic (CT scan) and three clinical methods i.e. the wax protrusive records, Lucia jig record and intraoral central bearing device in 12 patients aged between 20-40 years irrespective of sex. The records were taken and transferred on the semi-adjustable articulator to record the HCG values. The CT scan was taken for 3D reconstruction of the mid facial region. Frankfort horizontal plane (FHP) and a line extending from the superior anterior most point on the glenoid fossa to the most convex point on the apex of articular eminence (AE) was marked on the CT scan. An angle between these two lines was measured on both right and left sides to obtain condylar inclination angle. Three interocclusal protrusive wax and jig records were taken and transferred to the semi adjustable articulator. Three readings were recorded on each side. Similarly the records were taken and transferred to the same articulator using the intra oral central bearing device to record the readings. RESULTS. The statistical analysis showed insignificant differences in the HCG values between the right and left sides [(P=.589 (CT), P=.928 (wax), P=.625 (jig), P=.886 (tracer)]. The clinical methods provided low Pearsons correlation values [(R = 0.423 (wax), R = 0.354 (jig), R = 0.265 (tracer)] for the right as well as the left sides when compared with the CT values. Among the clinical methods, jig and wax method showed strong level of association which is statistically significant while the intra-oral tracer showed weak association with the other two methods. CONCLUSION. The right and left HCG values were almost similar. The CT scan showed higher HCG values than the clinical methods and among the clinical methods, values obtained from all the methods were comparable. [
To evaluate and compare the centric relation and horizontal condylar guidance using interocclusal... more To evaluate and compare the centric relation and horizontal condylar guidance using interocclusal wax and extra oral Gothic arch methods and subjective evaluation of dentures thus fabricated. Centric relation and horizontal condylar guidance was recorded by using interocclusal wax and gothic arch tracing in 28 completely edentulous patients. These records were transferred to the articulator and difference in both values was recorded. After that patients were divided in two groups according to the centric relation and horizontal condylar guidance recording method used to achieve balanced occlusion. Response of the dentures was subjectively evaluated using ''Woelfel subjective evaluation criteria''. Centric relation recorded by both the methods did coincide in 7.14 % of patients. Centric relation recorded by interocclusal wax was posterior to Gothic centric relation in 21.43 % of patients, and anterior to Gothic centric relation in 71.42 % patients. Gothic arch tracings gave higher mean guidance values on both the sides as compared to protrusive wax record in all the subjects, although the difference was statistically insignificant (P [ 0.05). Subjective evaluation showed statistical insignificance for all the parameters in both groups. Gothic arch method records the centric relation at a more posterior position than the Static method, but it does not make any difference in clinical performance of the complete denture. Horizontal condylar guidance angle was approximately similar by both the methods.
Decimated dentitions may require raising the vertical dimension in some conditions while performi... more Decimated dentitions may require raising the vertical dimension in some conditions while performing a full mouth rehabilitation treatment. Increase in a vertical dimension should be diagnosed by reversible methods prior to performing any irreversible methods for a minimum time period. Reversible methods like splints and overlay dentures are often used for this purpose. These methods however cannot be used in some conditions like in cases of brittle teeth. An alternative technique based on adhesive technology has been described which is reversible and yet minimally traumatic to teeth. The technique has two basic aims. The first is to accurately implement the occlusal scheme as planned in the diagnostic wax-up in the reversible method of altering the vertical dimension. The second aim is to increase the vertical dimension with minimal damage to the teeth.
The art of maxillofacial prosthetics restores esthetics and function in patients with gross devel... more The art of maxillofacial prosthetics restores esthetics and function in patients with gross developmental or acquired defects of face and helps them to restore hope and ambition to lead a useful life. This valuable service provided by maxillofacial prosthodontist lifts the morale of the patient and thus aids in physical well being and quality of life. Diagnosis and treatment planning should include attention to each detail prior to rehabilitation process. This paper describes a clinical case of mid face defect due to basal cell carcinoma, rehabilitated with facial prosthesis and intraoral obturator.
Orbital exenteration is executed by the ophthalmic surgeon to treat various neoplasms or non-mali... more Orbital exenteration is executed by the ophthalmic surgeon to treat various neoplasms or non-malignant diseases. But it leads to several functional, esthetic and psychological problems for the patients. Orbital prosthesis is a good alternative for cosmetic and psychological rehabilitation, if reconstructive surgery is not possible or not desired by the patient. In the following article, diff erent materials and retentive aids for fabrication of an orbital prosthesis given in the literature along with few novel methods have been discussed for four patients who underwent orbital exenteration. Factors that an ophthalmic surgeon should consider during surgery, which may later on help the prosthodontist to obtain good cosmetic results, are also discussed briefly. Remarkable results can be obtained if both work as a team for one common goal i.e. improvement of quality of life of the patient after orbital exenteration.
Purpose: To evaluate the effect of bulb height of hollow bulb obturator prosthesis on articulatio... more Purpose: To evaluate the effect of bulb height of hollow bulb obturator prosthesis on articulation and nasalance. Method: A total of 10 patients, who were to undergo maxillectomy falling under Aramany class-I and II, with normal speech and hearing pattern were selected for the study. They were provided 2 maxillary obturators, one extending full height of the defect and other with bulb height approximately up to inferior nasal concha. The patients were asked to wear each obturator for 6 weeks and the speech analysis was done to measure changes in articulation and nasalance at 6 different stages of treatment i.e. preoperative, postoperative (after complete healing), 24 h and 6 weeks after providing full bulb height obturator and reduced bulb height obturator. Articulation was measured objectively for distortion, addition, substitution and omission by speech pathologist and nasalance was measured by Dr. SPEECH software. Result: Comparison between full and reduced bulb height for nasalance and articulation, showed that there was no statistical significant difference (P > 0.05) between the two for both the parametres. Conclusion: Articulation and nasality improves after providing obturator. Articulation and nasalance both are independent of bulb height.
Objective: The purpose of the pilot study was to determine the effect of restoring lost occlusal ... more Objective: The purpose of the pilot study was to determine the effect of restoring lost occlusal vertical dimension (OVD) due to attrition on maximum bite force in humans. Methodology: A total of 124 subjects in age range of 25-40 years, with moderate to severe attrition, having full complement of teeth were screened according to inclusion and exclusion criteria. After consent, occlusal vertical dimension was assessed by employing mechanical and physiological methods in the experimental group and a maxillary canine guided hard splint was fabricated for each subjects fulfilling inclusion criteria and with positive consent (78). Bite force in experimental group was measured before, immediately after delivery of splint and subsequently at an interval of four, eight, and twelve weeks. Due loss during follow up, only 50 subjects could be available for bite force recording till 12 weeks. Bite force of age, gender, height and weight matched controls with no signs of attrition was also measured for comparison. Results: Bite force of the experimental group was found to be significantly less than the matched controls (P = 0.000) initially. After delivery of splint, bite force values increased progressively till twelve weeks. However comparison of bite force values of experimental group with control group showed no significant difference at end of eight (P = 0.008) and twelve weeks (P = 0.162). Conclusion: It was concluded that maximum bite force increases with restoration of lost vertical using splint therapy. A time period of 8-12 weeks is required to restore the maximum bite force value approximately similar to matched controls.
Journal of Oral Biology and Craniofacial Research, 2012
Osteopetrosis is a rare autosomal hereditary disorder characterized by abnormal functioning of os... more Osteopetrosis is a rare autosomal hereditary disorder characterized by abnormal functioning of osteoclasts, which leads to delayed wound healing. Hence chances of infection are increased even after minor surgical procedures. This paper aims to describe clinical features, and prosthodontic management of two patients who presented with clinical features of intermediate form of osteopetrosis and missing teeth. A 27-year-old patient having intermediate osteopetrosis presented with difficulty in chewing food and swallowing, due to edentulous maxillary and mandibular arches with large antral cavities, which developed secondary to tooth extraction. Another case discussed is a 25-year-old female patient who reported with chief complaints of difficulty in chewing due to resected left side of lower jaw. In these case reports, importance of avoiding extractions, preservation of remaining teeth and conservative management with minimum number of patients&amp;amp;amp;amp;amp;amp;amp;amp;#39; visits has been emphasized. Efforts should be made to avoid dental extraction in such cases as chances of bone infection and fracture are more. If patient is partially or completely edentulous only removable type of prosthesis is advisable as bones are hypocalcified and maintenance of oral hygiene is easy with removable prosthesis.
To determine and compare the flexural and fracture strength of three-unit fiber-reinforced compos... more To determine and compare the flexural and fracture strength of three-unit fiber-reinforced composite (FRC) fixed partial dentures (FPDs) using three abutment design preparations. The flexural and fracture strength of three-unit FRC FPDs were evaluated using three design preparations of the abutments (conventional full crown [group A], box-shaped [group B], and tub-shaped [group C]). Thirty three-unit FRC FPDs were fabricated (10 specimens per group) for the replacement of missing mandibular first molars and were adhesively luted to extracted human teeth. The flexural and fracture strength were determined using a universal testing machine with a steel loading pin of 20 mm diameter with a 3-mm-diameter hardened circular tip. Each specimen was evaluated under SEM to determine mode of failure. Mean fracture strength for group A was 820.00 ± 56.51 N, group B was 536.94 ± 65.62 N, and group C was 501.24 ± 66.71 N. The highest mean flexural strength was found in group A (68.33 ± 4.71 MPa), followed by group B (44.74 ± 5.46 MPa) and lowest in group C (41.77 ± 5.56 MPa). The SEM evaluation showed partial or complete debonding of veneering composite from fiber framework, leaving intact fiber frameworks in all the specimens. Full-coverage design had significantly higher flexural and fracture strengths than box and tub-shaped designs. Since both values were noted to be in the order of masticatory stresses, the full coverage design is a good alternative for the replacement of missing molar teeth; however, the framework veneering composite interface was the weakest phase of FRC FPDs, thus indicating that further improvement in veneering composite or fiber framework is needed to improve the compatibility of veneering composite with that of fiber framework for long-term clinical implications.
Clinical Relevance Indirect composite restorations have better marginal adaptation than direct co... more Clinical Relevance Indirect composite restorations have better marginal adaptation than direct composite restorations, and cyclic loading has a more deteriorating effect on the marginal adaptation and microtensile bond strength of direct composite restorations than indirect composite restorations.
The aim of the present study was to compare the marginal fidelity and surface roughness of porcel... more The aim of the present study was to compare the marginal fidelity and surface roughness of porcelain veneers fabricated by the refractory die and pressing techniques under in vivo conditions. A total of 72 veneers were prepared for anterior teeth in 12 participants. Veneers on anterior teeth in the first and second quadrants were fabricated using refractory die (group I) and pressing techniques (group II), respectively. Surface roughness was evaluated using a profilometer in three areas (cervical, mesio-incisal, disto-incisal) for each veneer. Marginal adaptation of all the veneers (N = 36/group) was evaluated at each margin (cervical, incisal, mesial, and distal) at 7 days and at 3 months after cementation under a scanning electron microscope (SEM) at 200× magnification. The mean surface roughness of veneers in cervical, mesio-incisal, and disto-incisal areas was 0.41 ± 0.25, 0.33 ± 0.14, and 0.32 ± 0.14 μm, respectively, for group I; and 0.31 ± 0.11, 0.36 ± 0.18, and 0.29 ± 0.11 μm, respectively, for group II. Intra- and intergroup comparisons showed no statistically significant values for all areas (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). In 144 margins evaluated for each group, a visible gap was present in 15 (10.4%) and 18 (12.5%) recordings at 7 days for groups I and II, respectively. They increased to 19 (13.1%) and 20 (13.8%) after 3 months. These gaps were further broken down into percent distribution of total recordings at the cervical, incisal, mesial, and distal margins. Intragroup comparison was made using the Cochrane test. The chi-square test and Fisher&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s exact test were used for intergroup comparison of margins, revealing no statistical difference (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05) CONCLUSION: Within the limitations of the study, the surface roughness and marginal fidelity of porcelain veneers fabricated by refractory die technique and pressing technique were comparable.
Journal of Indian Society of Pedodontics and Preventive Dentistry, 2005
Papillon-Lefevre syndrome is a rare recessive genetic disorder. The clinical manifestations inclu... more Papillon-Lefevre syndrome is a rare recessive genetic disorder. The clinical manifestations include palmar-plantar hyperkeratosis with precocious rapidly progressive periodontal disease that results in premature exfoliation of primary and permanent dentitions. Patients are often edentulous at an early age. Here is the report of prosthodontic rehabilitation of a case of Papillon-Lefevre syndrome in a 6-year-old child.
Journal of Indian Society of Pedodontics and Preventive Dentistry, 2005
These cases had been discussed having massive coronal fracture, rotation and intrusion of teeth. ... more These cases had been discussed having massive coronal fracture, rotation and intrusion of teeth. In case one, both the central incisors, i.e. 11 and 21 were fractured only one-third of tooth material was remaining. In case two, 21 was fractured and intruded. In case three, 12 and 21 were avulsed and 11 was rotated and intruded. These cases were successfully treated by multidisciplinary approach. Fractured crown with periapical pathology were endodontically treated and then rotated and intruded teeth were repositioned by removable or fixed orthodontic appliance. Subsequent to endodontic and orthodontic treatment prosthodontic rehabilitation was done.
To evaluate the effect of hollow bulb obturator prosthesis on articulation and nasalance in maxil... more To evaluate the effect of hollow bulb obturator prosthesis on articulation and nasalance in maxillectomy patients. A total of 10 patients, who were to undergo maxillectomy, falling under Aramany classes I and II, with normal speech and hearing pattern were selected for the study. They were provided with definitive maxillary obturators after complete healing of the defect. The patients were asked to wear the obturator for six weeks and speech analysis was done to measure changes in articulation and nasalance at four different stages of treatment, namely, preoperative, postoperative (after complete healing, that is, 3-4 months after surgery), after 24 hours, and after six weeks of providing the obturators. Articulation was measured objectively for distortion, addition, substitution, and omission by a speech pathologist, and nasalance was measured by Dr. Speech software. The statistical comparison of preoperative and six weeks post rehabilitation levels showed insignificance in articulation and nasalance. Comparison of post surgery complete healing with six weeks after rehabilitation showed significant differences in both nasalance and articulation. Providing an obturator improves the speech closer to presurgical levels of articulation and there is improvement in nasality also.
Differences in the balance of shape, size, and position of body organs are immediately perceived ... more Differences in the balance of shape, size, and position of body organs are immediately perceived as &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;looking…
To investigate the effect of restoration of lost vertical by centric stabilizing splint on electr... more To investigate the effect of restoration of lost vertical by centric stabilizing splint on electromyographic (EMG) activity of masseter and anterior temporalis muscles bilaterally in patients with generalized attrition of teeth. EMG activity of anterior temporalis and masseter muscle was recorded bilaterally for 10 patients whose vertical was restored with centric stabilizing splint. The recording was done at postural rest position and in maximum voluntary clenching for each subject before the start of treatment, immediately after placement of splint and at subsequent recall visits, with splint and without the splint. The EMG activity at postural rest position (PRP) and maximum voluntary clench (MVC) decreased till 1 month for both the muscles. In the third month, an increase in muscle activity toward normalization was noted at PRP, both with and without splint. At MVC in the third month, the muscle activity without splint decreased significantly as compared to pretreatment values for anterior temporalis and masseter, while with the splint an increase was seen beyond the pretreatment values. A definite response of anterior temporalis and masseter muscle was observed over a period of 3 months. This is suggestive that the reversible increase in vertical prior to irreversible intervention must be carried out for a minimum of 3 months to achieve neuromuscular deprogramming. This allows the muscle to get adapted to the new postural position and attain stability in occlusion following splint therapy.
STATEMENT OF PROBLEM Knowledge of the effect of a shortened dental arch on masseter muscle thickn... more STATEMENT OF PROBLEM Knowledge of the effect of a shortened dental arch on masseter muscle thickness and occlusal force is sparse but could help clinicians understand how a shortened dental arch might affect the stomatognathic system. PURPOSE The purpose of this pilot clinical study was to evaluate and compare the masseter muscle thickness and occlusal force of participants rehabilitated by using a shortened dental arch with matched completely dentate individuals. MATERIAL AND METHODS Twelve partially edentulous participants with a minimum of 1 posterior occluding pair on each side of the arch were enrolled in the study. The mandibular arch of these participants was rehabilitated by using a single posterior mandibular implant crown (group S). The maxillary arch of all participants in group S was intact. Masseter muscle thickness (cm) and occlusal force (N) were recorded before (T1) and 6 months after implant rehabilitation (T2) for each participant. Twelve participants were selected as controls (group C). They were matched for age, sex, height, and weight with group S and evaluated for masseter muscle thickness and occlusal force. Masseter muscle thickness was evaluated by using ultrasonography during the rest position and maximum volumetric clenching. Occlusal force was measured with an occlusal force measuring appliance. All recordings were done for the left and right sides of the arch. Descriptive analysis was followed by comparison between groups and within group S by using the paired t test (α=.05). RESULTS Higher masseter muscle thickness and higher occlusal force were observed in group C than in group S before and after rehabilitation. An increase in masseter muscle thickness in the rest position and in maximum volumetric clenching was observed within group S after rehabilitation. Before rehabilitation, a difference in the masseter muscle thickness between group S and group C was statistically significant for the left side at the rest position (P=.017) and during maximum volumetric clenching (P=.016). After rehabilitation, the difference between group S and group C was not statistically significant for masseter muscle thickness at the rest position (P=.890 for right side and P=.555 for left side) and during maximum volumetric clenching (P=.109 for right side and P=.755 for left side). The difference in occlusal force between group S and group C was statistically significant for the right side and left side (P<.001) before rehabilitation and statistically not significant after rehabilitation (P=.161 for the right side and P=.134 for the left side). CONCLUSIONS Rehabilitation following the concept of a shortened dental arch increased masseter muscle thickness and occlusal force in partially edentulous individuals, making the masseter muscle thickness and occlusal force comparable with those of a completely dentate arch.
Journal of Pierre Fauchard Academy (India Section), 2012
Prosthetic rehabilitation of facial defects has always been a challenge for M ax illofacia l Pros... more Prosthetic rehabilitation of facial defects has always been a challenge for M ax illofacia l Prosthodontists. These defects not onl y ha ve functional and cosmetic problems but also have crippling effec t on patient' s psychology. An early re h ab ilitation is th e key to successful alleviation of these de bili ta tin g effe cts. T his case report presents the esthetic rehabilitation of a patient of par ti al rhinectom y with a n acrylic nas al prosthe sis tinted with a commercial fa cial ma ke-u p. .
Long-term clinical failures of cemented prosthesis depend, to a large extent, on the integrity of... more Long-term clinical failures of cemented prosthesis depend, to a large extent, on the integrity of the luting agent. The causative factors that lead to microfracture and, hence, failure of the luting agents are the stresses acting inside the oral cavity. Therefore, the present study was designed to develop an understanding of the relationship between stresses in the tooth and the failure potential of the luting agent. Two-dimensional finite element stress analysis was performed on the mandibular second premolar. The behavior of zinc-phosphate and glass-ionomer were studied under different crowns (metal-ceramic and metal crown) and loading conditions (mechanical force of 450 N acting vertically over the occlusal surface, thermal loads of 60° and 0°C). It was observed from the study that failure threshold of the luting agent was influenced both by the elastic modulus of the luting agent and by the type of the crown.
Exenteration of the orbital contents as well as removal of a part of maxilla with an ablative sur... more Exenteration of the orbital contents as well as removal of a part of maxilla with an ablative surgery for the removal of a malignant tumor can severely affect a person in terms of function, esthetics and psychological trauma. A well-retained, user-friendly, removable maxillofacial prosthesis is the key to successful prosthetic rehabilitation in such cases. Various retentive techniques include using spectacle frame, conformers, adhesives, osseointegrated implants, magnets or buttons. This paper describes a novel technique for retention of silicone orbital prosthesis using acrylic resin base attached to maxillary obturator with the help of pin and socket of an electric plug wherein the latter is attached to the eye prosthesis with the help of a mechanical undercut. This helps in better retention of both the prostheses.
PURPOSE. The study was conducted to compare the radiographic and clinical methods of measuring th... more PURPOSE. The study was conducted to compare the radiographic and clinical methods of measuring the horizontal condylar guidance (HCG) values. MATERIALS AND METHODS. The condylar guidance was measured using the radiographic (CT scan) and three clinical methods i.e. the wax protrusive records, Lucia jig record and intraoral central bearing device in 12 patients aged between 20-40 years irrespective of sex. The records were taken and transferred on the semi-adjustable articulator to record the HCG values. The CT scan was taken for 3D reconstruction of the mid facial region. Frankfort horizontal plane (FHP) and a line extending from the superior anterior most point on the glenoid fossa to the most convex point on the apex of articular eminence (AE) was marked on the CT scan. An angle between these two lines was measured on both right and left sides to obtain condylar inclination angle. Three interocclusal protrusive wax and jig records were taken and transferred to the semi adjustable articulator. Three readings were recorded on each side. Similarly the records were taken and transferred to the same articulator using the intra oral central bearing device to record the readings. RESULTS. The statistical analysis showed insignificant differences in the HCG values between the right and left sides [(P=.589 (CT), P=.928 (wax), P=.625 (jig), P=.886 (tracer)]. The clinical methods provided low Pearsons correlation values [(R = 0.423 (wax), R = 0.354 (jig), R = 0.265 (tracer)] for the right as well as the left sides when compared with the CT values. Among the clinical methods, jig and wax method showed strong level of association which is statistically significant while the intra-oral tracer showed weak association with the other two methods. CONCLUSION. The right and left HCG values were almost similar. The CT scan showed higher HCG values than the clinical methods and among the clinical methods, values obtained from all the methods were comparable. [
To evaluate and compare the centric relation and horizontal condylar guidance using interocclusal... more To evaluate and compare the centric relation and horizontal condylar guidance using interocclusal wax and extra oral Gothic arch methods and subjective evaluation of dentures thus fabricated. Centric relation and horizontal condylar guidance was recorded by using interocclusal wax and gothic arch tracing in 28 completely edentulous patients. These records were transferred to the articulator and difference in both values was recorded. After that patients were divided in two groups according to the centric relation and horizontal condylar guidance recording method used to achieve balanced occlusion. Response of the dentures was subjectively evaluated using ''Woelfel subjective evaluation criteria''. Centric relation recorded by both the methods did coincide in 7.14 % of patients. Centric relation recorded by interocclusal wax was posterior to Gothic centric relation in 21.43 % of patients, and anterior to Gothic centric relation in 71.42 % patients. Gothic arch tracings gave higher mean guidance values on both the sides as compared to protrusive wax record in all the subjects, although the difference was statistically insignificant (P [ 0.05). Subjective evaluation showed statistical insignificance for all the parameters in both groups. Gothic arch method records the centric relation at a more posterior position than the Static method, but it does not make any difference in clinical performance of the complete denture. Horizontal condylar guidance angle was approximately similar by both the methods.
Decimated dentitions may require raising the vertical dimension in some conditions while performi... more Decimated dentitions may require raising the vertical dimension in some conditions while performing a full mouth rehabilitation treatment. Increase in a vertical dimension should be diagnosed by reversible methods prior to performing any irreversible methods for a minimum time period. Reversible methods like splints and overlay dentures are often used for this purpose. These methods however cannot be used in some conditions like in cases of brittle teeth. An alternative technique based on adhesive technology has been described which is reversible and yet minimally traumatic to teeth. The technique has two basic aims. The first is to accurately implement the occlusal scheme as planned in the diagnostic wax-up in the reversible method of altering the vertical dimension. The second aim is to increase the vertical dimension with minimal damage to the teeth.
The art of maxillofacial prosthetics restores esthetics and function in patients with gross devel... more The art of maxillofacial prosthetics restores esthetics and function in patients with gross developmental or acquired defects of face and helps them to restore hope and ambition to lead a useful life. This valuable service provided by maxillofacial prosthodontist lifts the morale of the patient and thus aids in physical well being and quality of life. Diagnosis and treatment planning should include attention to each detail prior to rehabilitation process. This paper describes a clinical case of mid face defect due to basal cell carcinoma, rehabilitated with facial prosthesis and intraoral obturator.
Orbital exenteration is executed by the ophthalmic surgeon to treat various neoplasms or non-mali... more Orbital exenteration is executed by the ophthalmic surgeon to treat various neoplasms or non-malignant diseases. But it leads to several functional, esthetic and psychological problems for the patients. Orbital prosthesis is a good alternative for cosmetic and psychological rehabilitation, if reconstructive surgery is not possible or not desired by the patient. In the following article, diff erent materials and retentive aids for fabrication of an orbital prosthesis given in the literature along with few novel methods have been discussed for four patients who underwent orbital exenteration. Factors that an ophthalmic surgeon should consider during surgery, which may later on help the prosthodontist to obtain good cosmetic results, are also discussed briefly. Remarkable results can be obtained if both work as a team for one common goal i.e. improvement of quality of life of the patient after orbital exenteration.
Purpose: To evaluate the effect of bulb height of hollow bulb obturator prosthesis on articulatio... more Purpose: To evaluate the effect of bulb height of hollow bulb obturator prosthesis on articulation and nasalance. Method: A total of 10 patients, who were to undergo maxillectomy falling under Aramany class-I and II, with normal speech and hearing pattern were selected for the study. They were provided 2 maxillary obturators, one extending full height of the defect and other with bulb height approximately up to inferior nasal concha. The patients were asked to wear each obturator for 6 weeks and the speech analysis was done to measure changes in articulation and nasalance at 6 different stages of treatment i.e. preoperative, postoperative (after complete healing), 24 h and 6 weeks after providing full bulb height obturator and reduced bulb height obturator. Articulation was measured objectively for distortion, addition, substitution and omission by speech pathologist and nasalance was measured by Dr. SPEECH software. Result: Comparison between full and reduced bulb height for nasalance and articulation, showed that there was no statistical significant difference (P > 0.05) between the two for both the parametres. Conclusion: Articulation and nasality improves after providing obturator. Articulation and nasalance both are independent of bulb height.
Objective: The purpose of the pilot study was to determine the effect of restoring lost occlusal ... more Objective: The purpose of the pilot study was to determine the effect of restoring lost occlusal vertical dimension (OVD) due to attrition on maximum bite force in humans. Methodology: A total of 124 subjects in age range of 25-40 years, with moderate to severe attrition, having full complement of teeth were screened according to inclusion and exclusion criteria. After consent, occlusal vertical dimension was assessed by employing mechanical and physiological methods in the experimental group and a maxillary canine guided hard splint was fabricated for each subjects fulfilling inclusion criteria and with positive consent (78). Bite force in experimental group was measured before, immediately after delivery of splint and subsequently at an interval of four, eight, and twelve weeks. Due loss during follow up, only 50 subjects could be available for bite force recording till 12 weeks. Bite force of age, gender, height and weight matched controls with no signs of attrition was also measured for comparison. Results: Bite force of the experimental group was found to be significantly less than the matched controls (P = 0.000) initially. After delivery of splint, bite force values increased progressively till twelve weeks. However comparison of bite force values of experimental group with control group showed no significant difference at end of eight (P = 0.008) and twelve weeks (P = 0.162). Conclusion: It was concluded that maximum bite force increases with restoration of lost vertical using splint therapy. A time period of 8-12 weeks is required to restore the maximum bite force value approximately similar to matched controls.
Journal of Oral Biology and Craniofacial Research, 2012
Osteopetrosis is a rare autosomal hereditary disorder characterized by abnormal functioning of os... more Osteopetrosis is a rare autosomal hereditary disorder characterized by abnormal functioning of osteoclasts, which leads to delayed wound healing. Hence chances of infection are increased even after minor surgical procedures. This paper aims to describe clinical features, and prosthodontic management of two patients who presented with clinical features of intermediate form of osteopetrosis and missing teeth. A 27-year-old patient having intermediate osteopetrosis presented with difficulty in chewing food and swallowing, due to edentulous maxillary and mandibular arches with large antral cavities, which developed secondary to tooth extraction. Another case discussed is a 25-year-old female patient who reported with chief complaints of difficulty in chewing due to resected left side of lower jaw. In these case reports, importance of avoiding extractions, preservation of remaining teeth and conservative management with minimum number of patients&amp;amp;amp;amp;amp;amp;amp;amp;#39; visits has been emphasized. Efforts should be made to avoid dental extraction in such cases as chances of bone infection and fracture are more. If patient is partially or completely edentulous only removable type of prosthesis is advisable as bones are hypocalcified and maintenance of oral hygiene is easy with removable prosthesis.
To determine and compare the flexural and fracture strength of three-unit fiber-reinforced compos... more To determine and compare the flexural and fracture strength of three-unit fiber-reinforced composite (FRC) fixed partial dentures (FPDs) using three abutment design preparations. The flexural and fracture strength of three-unit FRC FPDs were evaluated using three design preparations of the abutments (conventional full crown [group A], box-shaped [group B], and tub-shaped [group C]). Thirty three-unit FRC FPDs were fabricated (10 specimens per group) for the replacement of missing mandibular first molars and were adhesively luted to extracted human teeth. The flexural and fracture strength were determined using a universal testing machine with a steel loading pin of 20 mm diameter with a 3-mm-diameter hardened circular tip. Each specimen was evaluated under SEM to determine mode of failure. Mean fracture strength for group A was 820.00 ± 56.51 N, group B was 536.94 ± 65.62 N, and group C was 501.24 ± 66.71 N. The highest mean flexural strength was found in group A (68.33 ± 4.71 MPa), followed by group B (44.74 ± 5.46 MPa) and lowest in group C (41.77 ± 5.56 MPa). The SEM evaluation showed partial or complete debonding of veneering composite from fiber framework, leaving intact fiber frameworks in all the specimens. Full-coverage design had significantly higher flexural and fracture strengths than box and tub-shaped designs. Since both values were noted to be in the order of masticatory stresses, the full coverage design is a good alternative for the replacement of missing molar teeth; however, the framework veneering composite interface was the weakest phase of FRC FPDs, thus indicating that further improvement in veneering composite or fiber framework is needed to improve the compatibility of veneering composite with that of fiber framework for long-term clinical implications.
Clinical Relevance Indirect composite restorations have better marginal adaptation than direct co... more Clinical Relevance Indirect composite restorations have better marginal adaptation than direct composite restorations, and cyclic loading has a more deteriorating effect on the marginal adaptation and microtensile bond strength of direct composite restorations than indirect composite restorations.
The aim of the present study was to compare the marginal fidelity and surface roughness of porcel... more The aim of the present study was to compare the marginal fidelity and surface roughness of porcelain veneers fabricated by the refractory die and pressing techniques under in vivo conditions. A total of 72 veneers were prepared for anterior teeth in 12 participants. Veneers on anterior teeth in the first and second quadrants were fabricated using refractory die (group I) and pressing techniques (group II), respectively. Surface roughness was evaluated using a profilometer in three areas (cervical, mesio-incisal, disto-incisal) for each veneer. Marginal adaptation of all the veneers (N = 36/group) was evaluated at each margin (cervical, incisal, mesial, and distal) at 7 days and at 3 months after cementation under a scanning electron microscope (SEM) at 200× magnification. The mean surface roughness of veneers in cervical, mesio-incisal, and disto-incisal areas was 0.41 ± 0.25, 0.33 ± 0.14, and 0.32 ± 0.14 μm, respectively, for group I; and 0.31 ± 0.11, 0.36 ± 0.18, and 0.29 ± 0.11 μm, respectively, for group II. Intra- and intergroup comparisons showed no statistically significant values for all areas (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). In 144 margins evaluated for each group, a visible gap was present in 15 (10.4%) and 18 (12.5%) recordings at 7 days for groups I and II, respectively. They increased to 19 (13.1%) and 20 (13.8%) after 3 months. These gaps were further broken down into percent distribution of total recordings at the cervical, incisal, mesial, and distal margins. Intragroup comparison was made using the Cochrane test. The chi-square test and Fisher&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s exact test were used for intergroup comparison of margins, revealing no statistical difference (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05) CONCLUSION: Within the limitations of the study, the surface roughness and marginal fidelity of porcelain veneers fabricated by refractory die technique and pressing technique were comparable.
Journal of Indian Society of Pedodontics and Preventive Dentistry, 2005
Papillon-Lefevre syndrome is a rare recessive genetic disorder. The clinical manifestations inclu... more Papillon-Lefevre syndrome is a rare recessive genetic disorder. The clinical manifestations include palmar-plantar hyperkeratosis with precocious rapidly progressive periodontal disease that results in premature exfoliation of primary and permanent dentitions. Patients are often edentulous at an early age. Here is the report of prosthodontic rehabilitation of a case of Papillon-Lefevre syndrome in a 6-year-old child.
Journal of Indian Society of Pedodontics and Preventive Dentistry, 2005
These cases had been discussed having massive coronal fracture, rotation and intrusion of teeth. ... more These cases had been discussed having massive coronal fracture, rotation and intrusion of teeth. In case one, both the central incisors, i.e. 11 and 21 were fractured only one-third of tooth material was remaining. In case two, 21 was fractured and intruded. In case three, 12 and 21 were avulsed and 11 was rotated and intruded. These cases were successfully treated by multidisciplinary approach. Fractured crown with periapical pathology were endodontically treated and then rotated and intruded teeth were repositioned by removable or fixed orthodontic appliance. Subsequent to endodontic and orthodontic treatment prosthodontic rehabilitation was done.
To evaluate the effect of hollow bulb obturator prosthesis on articulation and nasalance in maxil... more To evaluate the effect of hollow bulb obturator prosthesis on articulation and nasalance in maxillectomy patients. A total of 10 patients, who were to undergo maxillectomy, falling under Aramany classes I and II, with normal speech and hearing pattern were selected for the study. They were provided with definitive maxillary obturators after complete healing of the defect. The patients were asked to wear the obturator for six weeks and speech analysis was done to measure changes in articulation and nasalance at four different stages of treatment, namely, preoperative, postoperative (after complete healing, that is, 3-4 months after surgery), after 24 hours, and after six weeks of providing the obturators. Articulation was measured objectively for distortion, addition, substitution, and omission by a speech pathologist, and nasalance was measured by Dr. Speech software. The statistical comparison of preoperative and six weeks post rehabilitation levels showed insignificance in articulation and nasalance. Comparison of post surgery complete healing with six weeks after rehabilitation showed significant differences in both nasalance and articulation. Providing an obturator improves the speech closer to presurgical levels of articulation and there is improvement in nasality also.
Differences in the balance of shape, size, and position of body organs are immediately perceived ... more Differences in the balance of shape, size, and position of body organs are immediately perceived as &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;looking…
To investigate the effect of restoration of lost vertical by centric stabilizing splint on electr... more To investigate the effect of restoration of lost vertical by centric stabilizing splint on electromyographic (EMG) activity of masseter and anterior temporalis muscles bilaterally in patients with generalized attrition of teeth. EMG activity of anterior temporalis and masseter muscle was recorded bilaterally for 10 patients whose vertical was restored with centric stabilizing splint. The recording was done at postural rest position and in maximum voluntary clenching for each subject before the start of treatment, immediately after placement of splint and at subsequent recall visits, with splint and without the splint. The EMG activity at postural rest position (PRP) and maximum voluntary clench (MVC) decreased till 1 month for both the muscles. In the third month, an increase in muscle activity toward normalization was noted at PRP, both with and without splint. At MVC in the third month, the muscle activity without splint decreased significantly as compared to pretreatment values for anterior temporalis and masseter, while with the splint an increase was seen beyond the pretreatment values. A definite response of anterior temporalis and masseter muscle was observed over a period of 3 months. This is suggestive that the reversible increase in vertical prior to irreversible intervention must be carried out for a minimum of 3 months to achieve neuromuscular deprogramming. This allows the muscle to get adapted to the new postural position and attain stability in occlusion following splint therapy.
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