Indonesian Journal of Prosthodontics

Assessment of stress distribution and displacement of complete dentures on flabby ridge with multiple occlusion schemes using finite element analysis

2024-08-01T13:07:41+00:00

ABSTRACT

Background: Loss of teeth and supporting tissues, which are functional components of the stomatognathic system, significantly affects masticatory function. Flabby ridges are one of the soft tissue anomalies in the edentulous. The main choice of treatment for edentulous patients with flabby ridges issues is a complete denture (CD). Flabby ridges cause problems with the retention and stabilization of the CD which causes displacement of the denture base during function. Lingualized and linear occlusion schemes were used to overcome the stabilization of CD by reducing stress distribution in the flabby ridge area when obtaining masticatory load. Assessment of stress distribution and displacement of CD can be analyzed using Finite Element Analysis (FEA).

Objectives: This paper describes the use of FEA to assess the stress distribution and displacement of CD on flabby ridges by simulating axial and oblique forces in lingualized and linear occlusion schemes. Conclusion: The use of FEA for assessing stress distribution and displacement of CD in flabby ridges with multiple occlusion schemes has advantages in terms of accuracy and flexibility.

Keywords: finite element analysis, occlusion schemes, flabby ridges, stress distribution, displacement of complete denture

Re-Establishment of an Occlusal Vertical Dimension: A Literature Review

2024-08-01T13:07:41+00:00

Background : Determination of the correct Occlusion vertical dimension (OVD) is one of the factors that dentists need to pay attention to in important dental procedures. One of the most important strategies of restorative care is the assessment andre-establishment of the occlusal vertical dimension. Tooth attrition causes changes in facial morphology dimensions and OVD

decreases.

Discussion: The occlusion vertical dimension (OVD) was the height of the lower third of the face as measured from the point of subnation to gnathion at the maximum intercuspation position. One of the factors that affect a person's occlusion vertical dimension is the presence of tooth abrasion, attrition and tooth loss. One way to improve a patient's occlusion vertical dimension is by rehabilitative action with restorative treatment by making crowns for teeth

experiencing anterior attrition.

Conclusion: Tooth attrition causes changes in facial morphology dimensions and occlusion vertical dimension decreases. Determination of the correct occlusal vertical dimension is one of the success factors in rehabilitation treatment, because if it is not restored properly, the guard teeth will decrease, damage to the teeth, muscles, TMJ, swallowing and can occur

speech disorders.

The role of laser power and frequency on metal surfaces of adhesive bridge in increasing the bond strength of resin cement

2024-08-01T13:07:41+00:00

Background Adhesive Bridge is a fixed denture that is attached to the tooth structure, especially the enamel, which has been etched to achieve micromechanical retention. Among other things, adhesive bridge attachment depends on, one important factor is the adhesive bond between the etched enamel and the retained metal. To increase the retention of adhesive bridges, variations of micromechanical surface treatment on metal can be carried out in the form of chemical or electrical etching, air particle abrasion (sandblasting), primary metal, tin plating, silica coating, and lasers.

Objective Lasers with different energies, strengths, frequencies, wavelengths, durations and distances can create a thin layer of porous oxide which increases the bonding strength of resin cement for adhesive bridges. The role of laser power and frequency as well as the selection of the right type of resin on the metal surface of the adhesive bridge can increase the bonding strength of the resin cement on the adhesive bridge.

Conclusion The selection of the type of surface treatment such as laser and the right type of resin cement can affect the bond strength of the resin cement on the adhesive bridge.

Benefits of eggshell reinforcement in water sorption and color stability of heat-cured polymethyl-methacrylate provisional fixed partial dentures

2024-08-01T13:07:41+00:00

Background: Oral rehabilitation procedures such as crown lengthening, implants for anterior teeth, and endodontic procedures with limited tooth structure require provisional restoration for a long time. The material used in fabricating provisional fixed partial dentures is polymethyl-methacrylate (PMMA). PMMA is divided into heat cured and self-cured based on the polymerization. Heat-cured PMMA has better mechanical properties than self-cured PMMA. Despite its advantages, however, there are also some disadvantages, such as high water sorption, low color stability, and wear of use. Research on the use of eggshells as reinforcement in denture bases has been conducted. However, the use of eggshells in provisional fixed partial dentures has not been done yet. Eggshell, as an environment by-product waste material, is composed of 95% calcium carbonate (CaCO₃), magnesium, potassium, and other inorganic components, can be used as alternative natural reinforced materials for PMMA provisional restoration.Objectives: To describe use of provisional restoration for a long time, PMMA as provisional restoration material, as well as the merit of eggshell as natural reinforcement material in water sorption and color stability of heat-cured PMMA provisional fixed partial dentures.Conclusion: Eggshell, which is composed of calcium carbonate, can be converted into hydroxyapatite as a reinforcement in long term provisional restoration, could improve the physical properties of heat-cured PMMA, such as water sorption and color stability.

Role of laser power and focus diameter in increasing retention of metal porcelain fixed dentures with short clinical crowns

2024-08-01T13:07:41+00:00

ABSTRACT
Background: In teeth with short clinical crowns that will be used as a support for metal porcelain fixed dentures, the problem that often occurs is that the dentures easily fall off after being installed. Surface treatment is one of the efforts to increase retention. Advances in laser technology provide advantages in increasing microstructural and wear resistance on the metal surface of the crown that will be used as abutment teeth.
Objectives: In addressing the retention problem of short clinical crowns, modification of tooth preparation, casting, and proper cementation procedures need to be considered. Improving the mechanical properties by surface treatment of the dental crown to be cemented by modifying the strength and focus of the laser diameter can play a role in surface roughness and shear bond strength.
Conclusion: The use of lasers to increase microstructural and wear resistance in teeth with short clinical crowns can minimize the failure of making metal porcelain fixed dentures.

Keywords: fixed denture, short clinical crown, surface roughness, shear bond strength, laser

The role of intraoral abrasion pressure with alumunium oxide on the bond strength of resin cement in adhesive bridge restorations

2024-08-01T13:07:41+00:00

Background: Adhesive bridge is a fixed denture with minimal abutment preparation attached with resin cement. Exposure of the dentin during preparation in the posterior region causes frequent detachment of the adhesive bridge. This is due to the presence of fluid and changes in the smear layer on the dentinal tubules, to increase bond strength, the intraoral abrasion method was developed. Intraoral abrasion is a mechanical technique using air and water sprays to produce tooth surface roughness while increasing bond strength without damaging the tooth structure.

Objective: One of the intraoral abrasion materials used is aluminum oxide (Al₂O₃). One of the operating parameters of intraoral abrasion that can affect bond strength between resin cement and the tooth surface is pressure. Optimal intraoral abrasion pressure with Al₂O₃ and the right type of resin cement aims to create tooth surface roughness while increasing the bond strength of resin cement in adhesive bridge restorations.

Conclusions: The success of adhesive bridges, especially in the posterior area, cannot be separated from the role of optimum intraoral abrasion pressure on the tooth surface. The correct use of intraoral abrasion pressure can increase the bond strength of resin cement on the tooth surface while reducing tooth structure damage.

Keywords: adhesive bridge, adhesive resin cement, intraoral abrasion, alumunium oxide, water airborne abrasion.

The role of tooth preparation modification on retention and resistance in short abutment

2024-08-01T13:07:42+00:00

Background: The parameters for the long-term success of fixed dentures are retention and resistance. Fixed denture treatment for short abutments requires modification of tooth preparation to increase retention and resistance. The proximal area of the preparation can be modified to increase retention by adding grooves, boxes, and frustums. To increase resistance, proximal modifications in the form of adding grooves and boxes, and cervical angle of convergence modification can be used.

Objectives: To analyze retention and resistance based on convergence angle and tooth preparation modification on short abutment. In abutment with ideal convergence angle, addition of grooves and boxes will causes the cement-restoration interface to increase. The frustrum-shaped preparation will convert the retention value from the shear strength of the cement material into the compressive strength of the cement material. In abutment with compromised convergence angle, proksimal modification in the form of grooves and boxes, as well as reducing the convergence angles in the cervical region will result in paralleling of axial walls and increase the resistance.

Conclusion: In cases of a short abutment with an ideal convergence angle, the highest retention is obtained by modifying the proximal area with a frustum shape. Meanwhile, if the convergence angles are compromised, reducing the convergence angle in the cervical region would be the most effective method to improve the resistance.

Potential Color Change in Ceramic-based Restorations

2024-08-05T04:57:14+00:00

Ceramic materials are among the materials used in restorative dentistry. They are widely used for restoration in esthetically demanding areas. Consequently, this material requires excellent color stability on top of adequate strength and good biocompatibility to achieve prosthodontic treatment success, especially in the aesthetic aspect. Lithium disilicate and zirconia are two popular ceramic materials used in dentistry mainly due to their translucency and strength. This scoping review aims to evaluate the potential for ceramic materials, mainly lithium disilicate and zirconia, to change colors after thermocycling with or without the staining process. Thermocycling is a laboratory method used to simulate daily oral use in relatively short periods. Twelve (12) articles extracted from 172 articles in 3 database resources based on the inclusion and exclusion criteria (journal articles in English from 2017-2021 that evaluate the color change in ceramic materials after thermocycling with or without staining process) are reviewed for the color change of several ceramic restoration materials. All materials generally show color change; lithium disilicate and zirconia-reinforced lithium silicate show the slightest color change compared to zirconia, feldspathic, or hybrid ceramic materials. Glazed materials offer better color stability compared to polished materials. Several staining solutions significantly contribute to the color change: coffee, tea, and wine. The thickness of materials and adhesive cement may also contribute to the color change of ceramic materials. In conclusion, all materials show color change after the thermocycling process; however, only hybrid ceramics show a level of color change that is above the tolerated limit.

Keywords: ceramics, color change, lithium disilicate, thermocycling, zirconia

Accuracy of Various Scanning Strategies in Partial Edentulous with Digital Impression

2024-08-01T13:07:42+00:00

Digital impression of partial edentulous in removable partial denture requires special attention, based on Kennedy's classification, amount of tooth loss and position will affect the accuracy of digital impression. Factors affecting accuracy of intra oral scanner are handling and learning, powdering, lighting, scanning distance, and scanning strategy. The scanning strategy is a certain movement when scanning to improve the accuracy of the virtual model. The accuracy of the scanning strategy in digital impression can be assessed based on trueness and precision. This literature review aims to explain the various scanning strategies on partial edentulous on digital impression accuracy. Most IOS manufacturers recommend specific scanning strategies. In removable partial dentures, it was found that modified scanning strategies were more accurate than the manufacturer's recommended scanning strategies in some clinical situations. For cases in Kennedy Class IV and Class III maxillae the scanning strategy from occlusal to palatal and then to buccal proved to be more accurate. In Kennedy's Class I maxilla, the T-R (Teeth-Ridge) strategy was more accurate than the M (Manufactured) and R-T (Ridge-Teeth) strategies with reduced seesaw effect and high stabilization of the partial removable denture framework. This requires special strategies that depend on the IOS system. The scanning strategy affects the accuracy of digital impression, where the manufacturer's recommended scanning strategy is not necessarily better than the modified scanning strategy. In addition, the location and case of tooth loss also affect the scanning strategy.

Key word: strategy scanning, digital impression, trueness, precision, intra oral scanner

The benefits of adding eggshells to the porosity and flexural strength of temporary fixed denture in long-term-use

2024-08-01T13:07:42+00:00

ABSTRACT
Background: Temporary fixed partial dentures (FPD) are worn for a limited time before definitive FPD, but in some cases like crown lengthening procedures, supra structure implant, temporomandibular
disorders, and endodontic treatment, require long-term temporization. Polymethyl Methacrylate (PMMA)
which is commonly used for temporary fixed dentures has weaknesses, namely porosity, low value of
flexural strength and impact, low abrasion resistance, ease of fracture, shrinkage after polymerization, and
leaves monomer residue, so modification is needed with the addition of reinforcing materials. Reinforcement like fiber filler is difficult to absorb resin monomers causing space between the surfaces of fiber and polymer matrix thereby reducing the mechanical strength of the resin. Eggshell is a natural source of calcium, has the potential as a biocompatible material with an economical price, and is easy to
obtain as an alternative material for PMMA reinforcement. Objectives: This paper discusses the long-term use of temporary FPD, PMMA as a temporarily fixed material, and the benefit of eggshell waste to porosity and flexural strength of PMMA materials. Conclusion: The addition of eggshell to PMMA for temporary fixed restoration could decrease porosity and increase the flexural strength of PMMA material because it contains calcium carbonate so that it could be used for the manufacture of provisional fixed restoration which requires long-term use
Keywords: temporary fixed denture, polymethyl methacrylate, eggshell, porosity, flexural strength

Influence of immersion in heat-cured resin acrylic in chitosan solution to hardness, transversal strength and modulus of elasticity

2024-08-01T13:07:42+00:00

Background: Heat-cured acrylic resin is a commonly used material for removable denture bases but has a low mechanical strength. Heat-cured acrylic resin used as a denture base must be kept clean by immersing the denture in a cleaning agent. Denture cleaning materials on the market generally come from chemicals. Immersion of heat-cured acrylic resin as denture base in chitosan solution can inhibit the growth of Candida albicans better than oxygenizing denture cleaning solution. Biologically, chitosan is safe because it has biocompatible and biodegradable properties. Objectives: To determine the effect of immersion of heat-cured acrylic resin in chitosan solution on hardness, transverse strength, and modulus of elasticity. Materials and method: 25 acrylic resin plates measuring 65 x 10 x 2.5 mm divided into five groups. Each group was immersed in a solution of 1%, 2%, 3% chitosan, distilled water, and 1% ascorbic acid, then tested for transverse strength using the Universal Testing Machine. The values of transverse strength and modulus of elasticity were calculated using the formula. Hardness test pre and post-test used 15 acrylic resin plates measuring 12mm x 12mm x 3mm were divided into five groups with each group immersed in 1%, 2%, 3% chitosan solution, distilled water, and 1% ascorbic acid. Results: Statistical analysis used one-way ANOVA for each test. The only significant difference was the modulus of elasticity between the immersion groups. The value of transverse strength, modulus of elasticity, and hardness was higher in the group with a 3% chitosan solution, with no difference statistically in transverse strength and hardness between groups. Conclusion: there was a significant difference in the effect of elastic modulus from the immersion of heat-cured acrylic resin in solution distilled water and 1% ascorbic acid as a control and 1%, 2%, and 3% chitosan solutions with ascorbic acid as a solvent

Knowledge, Attitude, and Implementation toward Denture Adhesive among Indonesian Dental Students and Dentists

2024-08-01T13:07:42+00:00

ABSTRACT

Introduction: Increased exposure of denture adhesive commercially may have impact on how denture wearers use this material without dentist’s prescription. Dentists need to know the proper use of denture adhesive so that they can educate public the indication and contraindication to avoid side effects. The aim of this study was to assess knowledge, attitudes, and implementation toward of denture adhesive among dental students and dentists.

Methodology: The questionnaire was made through expert discussion and psychometric test to determine the validity and reliability of the questionnaire was tested on 146 subjects consist of 73 dental students and 73 dentists in Jakarta. Test retest reliability was tested on 30 subjects. Univariate analyze were carried out on knowledge, attitudes, and implementation of each group of respondents.

Result: The 29 items of questionnaires were consist of three domains of knowledge (23 items), attitude(3 items) and implementation (3 items). Convergent validity was confirmed by correlation coefficients ranged from 0.327 to 0.355 for knowledge, attitude, and implementation domain. Internal consistency showed Cronbach alpha values from 0,669 to 0,859. The interclass correlations were ranged form 0.821-0.923. Significant differences between dental students and dentists were found for implementation domain toward denture adhesive. In this study, 87.7% dental students and 80.8% dentists were already know about denture adhesive. But 78.1% dental students and 39.7% dentists have never applied this material.

Conclusions: Questionnaire knowledge, attitude, and implementation toward denture adhesive in Indonesian has a good validity and reliability value, especially in knowledge and implementation domain. The majority of respondents in the dental student and dentist groups already know about indications and contraindications toward denture adhesive.

Eyeglass Frame - Supported Nasal Prosthesis Rehabilitation: A Case Report

2024-08-01T13:07:42+00:00

Patients with facial defects resulting from neoplasm, congenital malformation or trauma can be restored aesthetically and emotionally with facial prosthesis using different materials and retention methods to restore missing tissues and help patients to overcome social, psychological difficulties, and function. A nasal prosthesis can re-establish esthetic form and anatomic contours for midfacial defects. For successful results, a lot of factors such as harmony, texture, color matching and blending of tissue interface with the prosthesis are important. This clinical report describes the details of a prosthodontic rehabilitation of a 52-years old female patient, who came to RSGM UGM Prof. Soedomo who received partial rhinectomy and complaints of esthetic appearance. The treatment plan was making nasal prosthesis using high temperature vulcanized (HTV) silicone rubber using an eyeglass frame and adhesive silicone. Mechanical devices such as eyeglass frames can provide more retention and support for the nasal prosthesis. One week after insertion, the patient felt comfortable and had no complaints. Nasal prosthesis can cover the nasal defect and help to improve the patient’s quality of life.

Prosthetic Rehabilitation with Artificial Palpebra of an Ocular Defect with Contracted Socket

2024-08-01T13:07:43+00:00

Eyes are one of the most important organs of the body which are set inside the protective orbital bone. Loss of an eye can be caused by congenital defects, trauma, or tumors. The removal of the eyeball (enucleation) may cause a massive impact on the self-image, confidence, and personality of an individual. Acceptable cosmetic results usually can be obtained with an ocular prosthesis which is an artificial maxillofacial prosthesis to replace the lost eye. This paper describes the prosthetic rehabilitation of a 71-year-old male patient with a left ocular defect accompanied by a contracted socket caused by the poorly fitting old prosthesis which results in subpar cosmesis. The soft tissue around the eye is normal, but the palpebral conjunctiva forms an abnormal adhesion to the eye socket. An impression was made using a custom tray and alginate in the defect area, followed by filling the impression with gypsum type 3 to get a working model, from which a wax model was made and adjusted to the patient. Sclera and ocular acrylic prostheses were made on the basis of an adjusted wax model. The prosthesis was then polished and colored according to the contralateral eye, followed by the manufacturing of an artificial palpebra made of silicone for a more aesthetic result. The custom-made eye prosthesis with silicone palpebra is an artistic solution for the treatment of ocular defects with contracted sockets. This technique was able to improve the patient’s psychological and emotional status.

Prosthodontic presurgical treatment of midline facial cleft in West syndrome infant

2024-08-05T05:17:45+00:00

Background: Midline facial cleft is extremely rare congenital malformation. It may be associated with other syndromes, including West syndrome (WS), a severe form of epilepsy in infancy. Objective: This report presents modified Presurgical Nasoalveolar Molding (PNAM) treatment of midline facial cleft in WS patient. Case Report: An infant girl born with midline facial cleft, characterized by flat nose due to complete absence of nasal cartilage, columella, and premaxilla. She was also diagnosed with WS, hydrocephalus, and cerebral palsy. PNAM treatment was performed, consisting of feeding plate and extraoral nasal hook. The feeding plate prevented tongue protrusion which could interfere the airway during multiple spasms and trained her to place the tongue in its normal position. The extraoral strapping was retracted across the upper lip and feeding plate was grinded selectively to approximate the lip and alveolar segment concurrently. An elastic band was paired on nasal hook and attached to the forehead to elevate nasal dome and maintain the airway during retraction. After 1 year follow-up, alveolar gap was reduced by 4,5mm, lip segment moved closer to the midline, and bodyweight increased sufficiently. Conclusion: Modified PNAM can help infant with WS breath, increase nutritional intake and mold the alveolar tissue properly.

Keywords: midline facial cleft, West syndrome, modified PNAM

A Immediate Surgical Obturator and Interim Obturator for Recurrent Nasal Cavity Cancer Patient with Aramany’s Class II: A Case Report

2024-08-05T05:17:56+00:00

The maxillary defect can interfere a patient’s speech, masticatory, aesthetic and psychologic. To overcome this problem, an obturator prosthesis is needed. This case report focuses on prosthetic rehabilitation for Aramany’s class II patient. In January 2022, a woman, 46 years old, was diagnosed with recurrent cavum nasi cancer. She got a subtotal maxillectomy at RSUP Dr. Sardjito. After maxillectomy, the patient was assigned a surgical obturator with vacuum formed retainer material to close the palate gap. One month after the operation, the patient came to Oral Clinic RSUP Dr. Sardjito for evaluation. On the intraoral examination, there was a maxillary defect in Aramany’s class II. Resin acrylic obturator with hollow bulb was made as an obturator interim. The obturator insertion showed that the palate gap was tightly closed by the acrylic plate. In this case, the obturator interim successfully helps the patient bring back the function of speech, masticatory, and aesthetics

Management of lower eyelid laxity with pressure using conformer and custom ocular prosthesis

2024-08-05T05:17:34+00:00

Background: One of the successes in making an ocular prosthesis is sufficient eye socket condition, so post-enucleated patient treatment with lower eyelid laxity is a challenge for prosthodontists due to its difficulty in obtaining the retention of an ocular prosthesis. Long-term use of an ill-fitting ocular prosthesis will cause lower eyelid laxity and irritation due to the movement of the prosthesis that is insubordinate with the eye muscles when it is functioning.

Objectives: This paper represents the management of lower eyelid laxity in a post-enucleated patient with pressure using conformer and custom ocular prosthesis.

Case Report: A twenty-year-old female patient came to Dental Hospital Universitas Sumatera Utara with a red, swollen, and frequent discharge from the eye socket. The custom ocular prosthesis used by the patient often falls out of the socket and she requests a new custom ocular prosthesis. The patient was referred to an ophthalmologist for irritated socket. Then, a definitive impression is made. Two sclera waxes were fabricated in a definitive cast to obtain a conformer and custom ocular prosthesis. Conformer was worn for three weeks to ensure an adequate lower eyelid. Then, a new custom ocular prosthesis was inserted into the socket. Pressing the conformer towards the lower eyelid will stimulate and train the eyelid muscles to move and prevent atrophy, so it can restore the support of the lower eyelid.

Conclusion: Lower eyelid laxity can be corrected with a pressure-assisted conformer, resulting in a functionally and aesthetically pleasing custom ocular prosthesis.

Keywords: conformer, ocular prosthesis, lower eyelid laxity

Challenges in dental education

2024-08-13T06:35:27+00:00

Dental education faces numerous challenges that significantly affect the training and preparedness of future dental professionals. This article highlights the primary obstacles and proposes potential solutions to address them. The rapid advancement of technology necessitates continuous updates to curricula, incorporating innovations such as digital imaging, CAD/CAM systems, and laser dentistry. Ensuring faculty and student proficiency in these technologies requires substantial investment in training and resources.In summary, addressing these challenges requires curriculum reform, investment in technology, enhanced clinical training opportunities, financial support mechanisms, mental health initiatives, and adaptable Dental education faces numerous challenges that significantly affect the training and preparedness of future dental professionals. This article highlights the primary obstacles and proposes potential solutions to address them.