Indonesian Journal of Prosthodontics

Scanning electron microscopy imaging to assess bone implant contact enhancement after immediate bioactive compound placement

Muthia Mutmainnah Bachtiar — 2023-12-01

Along with the increasing use of implant-supported dentures, the use of biomaterials to accelerate the process of new bone formation is favorable. Chlorella vulgaris is a natural product that contains elements of calcium, minerals, and vitamin D acting in mineralizing bones and teeth. In addition, the content of flavonoids and phenols in Chlorella vulgaris that are applied topically can inhibit TNF-a therefore inducing bone healing. This study aims to assess the effect of bioactive material on bone implant contact (BIC) by using SEM imaging. Nine Landrace pigs were used in this study and surgical procedures were performed in the mandible. Chlorella vulgaris extract gel was placed in the left socket and without gel in the right socket, afterward followed by titanium implant placement. Both treatments were carried out in the same way, then three pigs were observed per one time period, namely the 30^th, 60^th, and 90^th days by using SEM test. The BIC of the sample showed the greatest at day 90th after application of gel and implant placement. It is concluded that the use of bioactive material, gel extract Chlorella vulgaris 15%, can stimulate the osseointegration better, and improve the BIC percentage.

Marginal fit comparison of conventional and CAD/CAM techniques of PMMA temporary crown

Achmad Riwandy — 2023-12-01

Despite the weakness of PMMA as a temporary crown, this material has a high fracture resistance. PMMA can be used for a long time as a temporary and it can replace teeth loss. The marginal fit of the temporary crown must be as precise as that of the definitive crown to prevent irritation of the pulp tissue, inflammation of the periodontal tissues, and also produce an esthetic result. CAD/CAM temporary crown made of PMMA is a new concept in dentistry so it still needs to be investigated regarding the marginal gap in considering the use of conventional PMMA temporary crown. The objective is to review the comparison of the marginal gap of temporary crowns made from PMMA with CAD/CAM technology against conventional method. It is concluded that temporary crowns manufactured by CAD/ CAM method produces a better marginal fit than the conventional method. Polymerization shrinkage is one of the causes of dimensional changes that cause a marginal gap.

Evaluation of treatment on unilateral cleft lip and palate complete dextra to the quality of life: 4-year follow-up: Case report

Alda Arifialda — 2023-12-01

Treatment for the patient with cleft lip and palate (CLP) requires an interdisciplinary team concerned with improving the patient’s quality of life. This case evaluates the influence of comprehensive therapy on unilateral CLP complete dextra within a 4-year follow-up. A 4-days-old female patient visited a government hospital in Bandung after being referred to a pediatric clinic in the same hospital. The patient was born at 3.2 kg weight with no underlying medical conditions or syndromes. Intraoral examination revealed cleft soft and hard palate and separated alveolar segment. Extraoral examination revealed cleft lip unilateral dextra and shortened columella. The patient underwent compre-hensive therapy including presurgical NAM (PNAM), labioplasty, nasoalveolar molding (NAM), veloplasty, speech therapy, and palatoplasty. It is concluded that early treatment of PNAM reduces the severity of the orofacial deformi-ty, induced the reposition of soft & hard tissue and there’s an improvement in intelligibility and production of pharyng-eal sounds and velopharyngeal closure when using intravelar veloplasty in palatal repair along with NAM. In the fourth year of life, the patient has capable on communicates with intelligibility pronounce with relative adequate arch.

Removable partial denture with telescopic overdenture

Riskani Djafri — 2023-12-01

Telescopic dentures have better retention and stability than conventional complete dentures. It improves mastica-tory efficiency, patient comfort, and reduces alveolar bone resorption. This article reports an overdenture telesco-pic denture as a treatment option in progressive bone loss, low stability and retention, loss of periodontal proprio-ception and low masticatory efficiency. A 35-years-old female came to RSGM Unhas, with complaints of difficulty chewing food due to the loss of several posterior teeth of the upper jaw and lower jaw. The patient felt pain when chewing due to cavities. The patient wanted to retain the remaining teeth and wanted minimal denture-covered mu-cosa. After considering all factors, a telescopic overdenture removable denture RA and RB was recommended. Intraoral examination dental caries 13,11,21,22,23,34,35,45; edentulous 12,14,16,24,25,37,36,44,46 anterior deep bite, normal occlusion. It was concluded that the evaluation of occlusion, aesthetics, phonetics and comfort show-ed that the patient was satisfied, could speak, chew well while using his denture.

Relationship between complete dentures and swallowing ability

Mohamad Zaid Novialdi — 2023-12-01

The aging process causes changes in the anatomical structures of the oral cavity and pharynx that are closely re-lated to the ability to chew and swallow. The use of a complete denture may prevent this to happen, but a lower mastication pressure is visible in complete dentures compared to natural teeth. This may have an impact on swal-lowing ability. In general, a complete denture improves the swallowing process and prevents oral cavity and pha-rynx changes. Several factors, such as denture thickness, the interaction of oral musculatures with the denture, and occlusal contacts will affect the effectiveness of the swallowing process. A proper and stable denture will improve the pharyngeal movement involved in swallowing, thus avoiding airway obstructions. It is concluded that the use of a proper complete denture is important as all four phases of the normal swallowing process are affected by the den-ture. Untreated edentulous jaws may cause oropharyngeal expansion which increases the risk of food bolus pene-tration into the hypopharynx and ultimately delay the pharyngeal swallowing process

Implant retained mucous supported overdentures – a case report

Valentine Rosadi Sinaga — 2023-12-01

Background : The increase of life expectancy occurred along the demand of a denture that provides high masticatory efficiency to promotes high quality of life among the elders. Implant supported overdentures has been an attractive procedures because of its simplicity and minimal invasive, in which both the attachment part and mucous provide support, retention and stability. Objective : The purpose of this article is to show how to implement an implant and mucous supported overdenture with CBCT guidance to improve parallelized implant placement. Case report : a 55 years old female came referred to UNPAD Dental Hospital with complete loss of teeth. First phase of treatment was to make complete denture, following by duplicating the denture and used it as guidance in CBCT. Second phase was the implant stage which is two stage surgery. First stage surgery aimed to put two paralleled implant and followed by second stage surgery after three months. Conclusion : Implant overdentures has many advantages to elder patient, which is less invasive, simple reconstruction, provides facial support, retention, stability and easily removed for hygiene.

Presurgical nasoalveolar molding as an effective adjuvant therapy to aid rehabilitation cleft malformations in newborn

Hastinawaty — 2023-12-01

Cleft lip and palate (CLP) is a congenital anomaly that commonly occurs in the mouth and maxilla. Cleft lip and/or cleft palate can alter a child's appearance, affect pronunciation, swallowing and chewing, and lead to varying de-grees of psychological damage in growing children involving the upper lip, hard palate, soft palate and nose. The goal of primary closure of CLP is to ensure normal and symmetrical lips and nose. Presurgical nasoalveolar mold-ing (PNAM) is a non-surgical method reshapes the lips, alveoli, cleft palate, and cleft nose to minimize the severity of cleft lip deformity prior to cleft palate and primary cleft palate surgery. This article is aimed to review management of CLP in newborn using PNAM. It is concluded that PNAM is an effective adjuvant therapy to reduce preoperative hard and soft tissue cleft malformations because helps improve nasal aesthetics, reduce cleft size, and correct the maxil-lary arch with reduction of alveolar size and cleft palate.

Application of UV-resin in the fabrication of iris button to improve occular prosthetic aesthetic

Steven Tiopan — 2023-12-01

Background: One of the success criteria in occular prosthesis is providing a prosthetic that is similar with the natural eye. Several methods for creating artificial iris are the use of iris from stock eyes, photo paper printing, painting with oil paints, and by implanting electronic components (dynamic iris). The oil painting method can produce an aesthetic 3D iris. However, when utilizing heat-cured acrylic resin to integrate the iris into the sclera, the use of a pressing machine when packing can distort the oil paint.

Objectivess: The use of UV-resin material for iris fabrication can reduce the risk of distortion, reduce laboratory procedures, and produce an aesthetic iris.

Case Report: A 28-year-old male came to Universitas Sumatera Utara dental hospital with complaint of the previous occular prosthesis felt loose and unaesthetic. Patient has been wearing the prosthesis for ±10 years. The patient wants a new occular prosthesis to replace the old prosthesis. Iris coloring is done with painting paper and oil paint, iris button is made with UV-resin using a pre-fabricated mold, then the iris is implanted into the sclera. The use of UV-resin for creating an iris requires only a few basic equipment and materials, has a quick-curing period, and facilitates iris position determination.

Conclusion: Fabricating occular prosthetic with iris buttons made from UV-resin reduces the risk of laboratory failure and produces better esthetics.

Narrow-diameter implant in prosthodontics treatment

Delicia Clarance Song — 2023-12-01

Insufficient bone volume and narrow mesiodistal space often compromise Standard Diameter Implant (SDI) treat-ment planning. In order to achieve successful results, these compromises may incorporate prior treatment such as guided bone regeneration (GBR), block bone grafting, or distraction osteogenesis that requires extra time and cost and could result in unpredictable complications. A narrow diameter implant (NDI) is smaller than a standard diame-ter implant with a diameter less than 3.5 mm. This scoping review was performed to assess the use of NDI in pros-thodontic care. It is concluded that NDI reasonably resembles SDI clinical success rate in terms of periodontal health, marginal bone remodeling, restoration, and patient satisfaction. The NDI offers similar survival rate to SDI, with pro-mising long-term esthetic outcomes and can be used as the primary treatment alternative in restoring single tooth or splinted crowns in the anterior and posterior region, especially with narrow mesiodistal space.

Stress distribution on denture-bearing areas with various thickness of soft denture liner using finite element analysis

Andreas — 2023-12-01

Background: Denture-bearing areas in edentulism are unable to tolerate masticatory load because of severe alveolar ridge resorption, which decreases masticatory function in the stomatognathic system. Due to the cushioning effect, the use of soft denture liner (SDL) helps reduce the masticatory load placed upon the denture-bearing areas. The physical properties and thickness of SDL have an impact on the stress distribution and cushioning effect. The masticatory load will harm the alveolar ridge and lead to more severe resorption, when modulus elasticity of SDL lower than the mucosa. The stress distribution of the masticatory load can be analyzed more accurately in-silico study using Finite Element Analysis (FEA) method.

Objectives: In this paper, the stress distribution in denture-supporting areas with various SDL thicknesses is evaluated using FEA. The thickness of SDL contributes to the distribution of stress upon the denture-bearing areas by minimizing the masticatory load.

Conclusion: Through the same modulus elasticity of the mucosa and SDL is able to equally distribute stress on the denture-bearing areas.

Keywords: stress distribution, denture-bearing area, soft denture liner thickness, finite element analysis

The effect of surface treatment of polymethyl methacrylate denture base on the soft-liner bond strength

Fernandy Hartono Prasetyo — 2023-12-01

The increased use of removable denture in elderly population are followed by the increased use of soft liner for denture reline due to bone resorption. However, soft liners are found to be bonded poorly to polymethyl methacrylate (PMMA) denture base. Thus, several methods are developed in order to improve the bonds between denture base and soft liner, i.e., mechanical methods (sandblast, sandpaper, laser), chemical methods (MMA monomer, acids, acetone, and plasma), or combination of both. This article evaluates the effectiveness of various surface treatment methods of PMMA materials in improving the bonds with silicone or acrylic-based soft liner. It is concluded that surface treat-ment on the PMMA in general increase the bond strength with the soft liners compared to the control group; the use of Er:YAG laser and MMA monomer show the highest bond strength between the PMMA and soft liner materials. Several factors such as the duration of treatment and the laser intensity energy may affect the bond strength bet-ween PMMA and soft liner. Acrylic-based soft liner in general shows better bond strength than silicone-based soft liner, nevertheless both materials show improvement in bond strength with PMMA after surface treatments.

Surface modifications of titanium based dental implant to accelerate osseointegration process

Rita Harianti Ladong — 2023-12-01

Dental implants is a prosthesis that is invasively implanted in the patient’s to replace missing teeth. Osseointegra-gration is the process where structural and functional relationships take place between bone and embedded dental implant surfaces. Unfortunately, titanium based dental implants show lack of osseointegration. Therefore, dental im-plant modifications could be one way to overcome this limitation. This article intensively reviews several surface modification methods to accelerate the osseointegration process on titanium dental implants. A literature review presented in this article. It is concluded that implant surface modification with other materials could accelerate the osseointegration process. Otherwise, modification of surface implants such as physical, chemical and biological mo-dification are discussed.

Hardness testing of five brands of acrylic artificial teeth

Daisy Wulansari — 2023-12-01

Acrylic artificial teeth are still widely used in denture fabrication. Several brands marketed in Bandung claimed that their product has met the standard but all the brands do not give the mechanical properties data including hardness. The ADA specification standard no. 15 requires a hardness of minimum 15.00 KHN for acrylic artificial teeth. This study is aimed to find out which acrylic artificial teeth have a standardized hardness value. The study is an analytic descriptive study performed on five brands of acrylic artificial teeth marketed in Bandung. The samples were given 10 indentation spots on the upper and lower surfaces. The results of the study were analysed using Anova test and Dunnet test. The analysis showed that the hardness value of the upper and lower surfaces was as followed, respec-tively: A, 17.95 KHN and 17.46 KHN; B, 17.01 KHN and 17.49 KHN; C, 18.24 KHN and 17.41 KHN; D 17.61 KHN and 17.01 KHN; E 17.01 KHN and 16.59 KHN. The two-ways Anova showed that the hardness value of both sur-faces does not differ significantly. It was concluded that the five brands have met ADA specification standard no. 15 and there were differences in hardness values among the brands.

Telescopic denture load distribution based on the telescopic crown design and material

Devina Angga — 2023-12-01

Retentive force (RF) on the telescopic crown (TC) retainer will be distributed to the abutment teeth. The optimal load distribution measured by RF on the abutment is 5-9 N. If the force is applied excessively, it will damage the tooth's supporting tissue, causing periapical lesions, bone resorption, and mobility. However, if the RF is minimal, the dent-ure will not retentive. This paper will go through how RF will vary based on the chosen design and material. The cy-lindrical, conical, and resilient TC design are affected by the taper angle and the distance between the primary crown (PC) and secondary crown (SC). Resilience design can be modified by Marburg, Hofmann, and Yalisove. To create the precise taper angle and space in telescopic dentures (TD), CAD/CAM can now be used for the manufacture of TD using metal and non-metal materials. It is concluded that cylindrical TC design is rarely used because it is diffi-cult to get tight contact between PC and SC, therefore conus or resilience design is more recommended. The smal-ler the taper angle, the greater the RF, but this depends on the material used. While the space between PC and SC, which is less than 50 μm, can also affect RF

Management of denture stomatitis in removable dentures wearers

Indriani Oktaria — 2023-12-01

Denture stomatitis (DS) is a pathological change in the oral mucosa that commonly occurs in denture users, which is characterized by an inflammatory reaction and erythema in the oral mucosa that is in contact with the denture. Cli-nical manifestations often include red lesions due to excessive occlusal trauma, frequently occurring in the palatal mucosa region. Loose and unstable prosthesis use can also be a predisposing factor for DS. This paper discusses cases of DS in patients with complete dentures (CD) and partial complex dentures. Chronic irritation due to heavy traumatic occlusion results in reduced stability of dentures. The fabrication of CD with proper vertical dimension set-ting and selection of smaller teeth elements can reduce progressive alveolar bone resorption. The use of topical gel medication like Oxyfresh can be an alternative in the clinical management of DS cases. Control of systemic conditi-ons, especially in the presence of comorbidities, is crucial to minimize the risk of DS occurrence and expedite the healing process if it does occur. Maintaining oral hygiene and denture cleanliness are also key factors for the suc-cess of optimal denture care.

The efficacy of oral appliances treatment for obstructive sleep apnea

Geraldine Ria Adrianne — 2023-12-01

Obstructive sleep apnea (OSA) is a sleep disorder caused by upper airway obstruction. There are about one bil-lion people worldwide affected by OSA; in the past decade, the number of people who seek treatment for OSA is increasing. Although continuous positive airway pressure (CPAP) is the gold standard for OSA treatment, the dentist also has a role in treating OSA using oral appliances (OA), especially for those who do not want to be treated using CPAP. However, the efficacy of OA treatment for OSA is varied so further study is needed. This sco-ping review ia aimed to evaluate the efficacy of OA treatment for OSA on adult patients with different severity based on the apnea-hypopnea index (AHI) which is classified as a mild, moderate, and severe group. It is con-cluded that OA effectively reduces the symptoms of OSA. It must be noted that objective examination through the AHI evaluation shows that AHI reduction is affected based on the OSA and BMI classification. Patients with high BMI demonstrated a smaller reduction in AHI, thus showing low effectiveness of OA.

Prosthodontic rehabilitation for maxillofacial defects by mucormycosis post Covid-19 pandemic

Fitrian Riksavianti — 2023-12-01

Since the outbreak of Covid-19, with every mutation, it has posed various challenges to human life and in health sciences. Patients on corticosteroids or with comorbidities like diabetes mellitus are at increased risk of post Covid-19 infections like mucormycosis. Mucormycosis is a rare opportunistic infection, often associated with immunocom-promised states. Fungal invasion of the hard palate, paranasal sinuses, orbits and brain is the commonest form of rhinocerebral mucormycosis. Among the medical professionals involved in managing patients with mucormycosis, maxillofacial prosthodontists are responsible for prosthetic treatment of lost oral and maxillofacial structures, help-ing patients to socialize and have an acceptable quality of life after surgical treatment. This literature review is aimed to describe maxillofacial prosthodontist challenge in rehabilitation of mucormycosis post Covid-19 infection. It is concluded that prosthodontist face many challenges in mucormycosis rehabilitation. Prosthodontist should be ca-pable to early detection and diagnosis, carefull in planning and designing the prosthesis, wise in using of softliner material, and should always maintain long-term follow-up if any sign of lesion recurrence.

Stress distribution evaluation of complete denture with soft denture liners in knife-edge alveolar ridge using finite element analysis

Tiroi Paulina — 2023-12-01

Edentulous induces the function of the stomatognathic system particularly masticatory performance. The conse-quence that occurs in complete edentulous is the resorption of residual ridge and can alter the morphology of al-veolar bone gradually from well-rounded to knife-edge ridge form. Excessive occlusal load absorbed by the knife-edge alveolar ridge when the denture is exposed to masticatory loads enhances ridge resorption and more complex treatments are needed in manufacturing complete dentures (CD). Soft denture liners (SDL) overcome CD problems with knife-edge ridges by utilizing the cushioning effect by distributing the load evenly to the alveolar ridge. The most popular method used today to evaluate the stress distribution at the alveolar ridge is finite element analysis (FEA) because it presents information in both qualitative and quantitative forms. This study is aimed to evaluate the differ-ences in stress distribution received by knife-edge ridges in CD with SDL. Denture base applied with acrylic soft den-ture liner (ASDL) and silicone soft denture liner (SSDL). It is concluded that ASDL provides a better stress distribution than SSDL because of its viscoelasticity, while SSDL is superior in terms of durability.