Nevin Manimala

J Indian Prosthodont Soc. 2021 Jan-Mar;21(1):99-105. doi: 10.4103/jips.jips_463_19.

ABSTRACT

AIM: The purpose of the study was to evaluate the frictional resistance and the vertical force required to achieve the frictional resistance for different length and designs of extracoronal attachments used in fixed partial denture (FPD).

SETTING AND DESIGN: Finite element analysis.

MATERIALS AND METHODS: Four different designs and five different lengths (3 mm, 3.5 mm, 4 mm, 4.5 mm, and 5 mm) of extracoronal attachments for FPD were selected from different manufacturers. Three-dimensional models of all the samples were simulated using Catia V5 software. The properties were incorporated to the software to simulate the clinical conditions. The frictional resistance and the vertical force required to achieve frictional resistance were analyzed using ANSYS workbench 15.0 finite element software.

STATISTICAL ANALYSIS USED: ANOVA and Tukey’s post hoc test.

RESULTS: The mean microhardness of the Variolink N resin cements were significantly higher than Panavia SA ones (P < 0.001). Variolink N cements exhibited lower sorption/solubility than Panavia SA resin cements (P < 0.05). The ceramic shade had a significant influence on the microhardness of both cements (P < 0.001) but had no significant effect on the sorption/solubility of resin cements (P > 0.05).

CONCLUSION: Interposition of monolithic zirconia decreases the microhardness of resin cement especially Panavia SA. The microhardness decreased in Variolink N with the increase in the chroma saturation of ceramics. However, in Panavia SA, it was altered by the shades. For both cements, there were no statistical differences between the sorption/solubility. There was a reverse correlation between microhardness and water sorption/solubility of both cements.

PMID:33835074 | DOI:10.4103/jips.jips_463_19

J Indian Prosthodont Soc. 2021 Jan-Mar;21(1):88-98. doi: 10.4103/jips.jips_373_20.

ABSTRACT

AIM: The aim of the study was to evaluate the effect of dentist’s communication skills and patient’s psychological factors in predicting denture satisfaction and quality of life.

SETTINGS AND DESIGN: Cohort study.

MATERIALS AND METHODS: Patient-related variables were obtained using questionnaires in both pre- and post-intervention phases. In addition to this, in preintervention phase, lacunae in doctor-patient communication were obtained. Based on this, the postgraduates were trained in relevant communication skills required during complete denture treatment. In postintervention phase, the postgraduates were again followed up for continuation or decay of skills.

STATISTICAL ANALYSIS: Mixed-mode approach – quantitative and qualitative analysis.

RESULTS: Both groups were similar in psychological parameters, personality domains, denture quality and quality of life at baseline. However, there was significant difference in denture satisfaction (P < 0.001) in both the groups. In the experimental group, denture satisfaction was more (80.4%) and quality of life had improved from baseline to 3 months (P = 0.000). Denture satisfaction was associated with self-efficacy (P = 0.002) and the communication skills of the dentist (P = 0.000). Quality of life was associated with the conscientiousness domain of personality (P = 0.049) and the communication skills of the dentist (P < 0.05).

CONCLUSION: Satisfaction and quality of life with dentures were associated with self-efficacy, conscientiousness domain and the communication skills of the dentist. Denture satisfaction can be predicted by dentist communication skills. Therefore, training in communication skills for complete denture patient management and assessment of the psychological profile of the patient could contribute to the effective patient-centered practice to avoid patient dissatisfaction.

PMID:33835073 | DOI:10.4103/jips.jips_373_20

J Indian Prosthodont Soc. 2021 Jan-Mar;21(1):81-87. doi: 10.4103/jips.jips_255_20.

ABSTRACT

AIM: The purpose was to evaluate the morphological variations of the condyle in patients presenting with myalgia associated with and without clicking of temporomandibular joint (TMJ) and its possible effect on the contour and height.

SETTING AND DESIGN: Cross sectional study.

MATERIAL AND METHODS: A total of 60 patients comprising of 20 patients with myalgia, 20 patients with myalgia associated with clicking of TMJ, and a control group of 20 patients without any signs and symptoms of temporomandibular disorder were selected for purpose of the study. Using a digital panoramic radiograph, the contour of the condyle was evaluated for shape, condylar height (CH), and condylar asymmetry.

STATISTICAL ANALYSES USED: Chi-square test, One- way ANOVA.

RESULTS: Rounded contour of the condyle was the most prevalent shape of the condyle amongst the three groups. There was a significant decrease in mean right and left CH in subjects with myalgia (0.71 cm and 0.73 cm) and subjects with myalgia associated with clicking (0.65 cm and 0.62 cm) compared to control group subjects. There was also an increase in the mean asymmetry index in subjects with myalgia presenting with clicking (2.362 ± 1.4) and without clicking (1.388 ± 2.1) (P < 0.05).

CONCLUSION: Within the limitations of the current study, round contour of the condyle is the most common variant. Subjects with myalgia showed a significant reduction in condyle height. Condyle contour, height, and asymmetry may not predispose the joint for clicking.

PMID:33835072 | DOI:10.4103/jips.jips_255_20

J Indian Prosthodont Soc. 2021 Jan-Mar;21(1):74-80. doi: 10.4103/jips.jips_297_20.

ABSTRACT

AIMS: The study compared changes in implant stability and bone loss of implants with different designs using early loading at 6 weeks.

SETTING AND DESIGN: In vivo-comparative study.

MATERIALS AND METHODS: Forty subjects were selected and divided randomly by sealed envelope method in Group X and Group A for early loading for missing single posterior tooth in mandible. Implants in Group X had flared crest module and buttress thread design, whereas implants in Group A had parallel crest module and V-shaped thread design. All subjects were evaluated by Ostell for implant stability at the interval of baseline, 6 weeks, 3 months, and 6 months. ImageJ software was used for measurement of crestal bone loss in intraoral periapical radiographs at the interval of 6 weeks, 3 months, and 6 months.

STATISTICAL ANALYSIS USED: Unpaired t test, repeated ANOVA, Tukey post hoc test.

RESULTS: The mean bone loss values of Group X at predetermined interval were 1.51 ± 0.20 mm, 2.11 ± 0.21 mm and 2.13 ± 0.21 mm. The mean bone loss values of Group A were 1.79 ± 0.16 mm, 2.92 ± 0.23 mm and 2.95 ± 0.23 mm. The mean bone loss was statistical significant (P < 0.05) at 6 weeks, 3 months and 6 months. It was highly significant in Group A at 6 months (P < 0.001).

CONCLUSIONS: It was concluded that Group X implants design showed better implant stability and less bone loss when compared to Group A implants design.

PMID:33835071 | DOI:10.4103/jips.jips_297_20

J Indian Prosthodont Soc. 2021 Jan-Mar;21(1):66-73. doi: 10.4103/jips.jips_303_20.

ABSTRACT

AIM: To evaluate anxiety in patients undergoing complete denture treatment.

SETTINGS AND DESIGN: The most overlooked factor during complete denture treatment is the patient’s anxiety regarding the treatment. The awareness amongst dentists regarding such anxiety and its effects on the complete denture treatment is important to form a proper communication channel through which measures to ease this anxiety can be formulated and implemented.

MATERIALS AND METHODS: A valid pre-structured questionnaire of 10 questions was presented to the patients desirous of receiving complete dentures after obtaining an informed consent. The questionnaire for the survey was filled and collected from 500 patients receiving complete denture treatment.

STATISTICAL ANALYSIS USED: Descriptive statistics.

RESULTS: Reasons inducing anxiety included: materials used – 359 (71.8%), sight of instruments – 71 (14.2%), dental chair – 66 (13.2%), airotor – 4 (0.8%), denture breakage – 225 (45.0%), ill-fitting prostheses – 153 (30.6%), repeated removal and insertion of dentures 104 (20.8%), swallowing the denture 19 (3.8%). Factors aggravating anxiety included: gagging while impression making – 298 (59.6%), mouth fullness – 122 (24.4%), swallowing the impression material – 61 (12.2%), breathlessness – 20 (4%). 422 (84.4%) patients indicated comfort with the procedure being explained beforehand, 429 (85.8%) patients indicating more so in a language understood by them.

CONCLUSION: There is a greater need that the patient’s expectations be understood and their doubts, concerns and fears be lessened by proper communication. Proper understanding of patient’s mental attitude will help us improve the approach of dentists towards complete denture treatment in a more patient friendly way.

PMID:33835070 | DOI:10.4103/jips.jips_303_20

J Indian Prosthodont Soc. 2021 Jan-Mar;21(1):57-65. doi: 10.4103/jips.jips_19_20.

ABSTRACT

AIM: To evaluate the microleakage of metallic copings luted with three different commercially available luting cements.

SETTING AND DESIGN: Comparative evaluation in vitro study.

MATERIALS AND METHODS: Thirty replicas of abutment analog were milled and divided into 3 groups. Nickel chromium copings were fabricated; marginal gap was evaluated with optical microscope and luted with Zinc Oxide Non Eugenol cement, Zinc Polycarboxylate cement and Zinc Phosphate cement. After Thermocycling, cemented specimens were placed into 0.5% aqueous solution of basic fuchsin solution for 24 hours for dye penetration. Copings were longitudinally sectioned and microleakage scores were evaluated.

STATISTICAL ANALYSIS USED: Kruskal-Wallis analysis of variance (ANOVA) followed by Chi-Square test. Pairwise comparison of groups with Mann Whitney U test.

RESULT: Mean microleakage score was least for Zinc Phosphate cement (1.075 ± 0.85) followed by Zinc Polycarboxylate cement (1.80± 0.23) and most for Zinc Oxide Non Eugenol (2.1± 0.37). The results of the study were statistically significant, P < 0.05.

CONCLUSIONS: Within the limitations of the study, it was found that all cements exhibited certain amount of microleakage. Zinc Phosphate cement exhibited a mean microleakage score that was significantly lower than Zinc Oxide Non Eugenol cement and Zinc Polycarboxylate cement. When microleakage scores of Zinc Oxide Non Eugenol cement and Zinc Polycarboxylate cement were compared, the difference was found to be insignificant indicating that microleakage in these cements is similar.

PMID:33835069 | DOI:10.4103/jips.jips_19_20

J Indian Prosthodont Soc. 2021 Jan-Mar;21(1):50-56. doi: 10.4103/jips.jips_284_20.

ABSTRACT

AIM: The objective is to evaluate the effect of shades of monolithic zirconia on the microhardness and sorption/solubility of the underlying two dual-cured resin types of cement.

MATERIALS AND METHODS: Eighty samples of two dual-cured resin cement discs were polymerized under 60 monolithic zirconia discs in three shades and directly activated resin discs of cement were used as the control group (n = 10). After 24 h storage at 37°C in an incubator, Vickers microhardness and the sorption and solubility were measured.

STATISTICAL ANALYSIS USED: Two-way ANOVA , one-way ANOVA, Independent t-test, Tukey’s honestly significant difference, and Tamhane’s T2 tests.

RESULTS: The mean microhardness of the Variolink N resin cements were significantly higher than Panavia SA ones (P < 0.001). Furthermore, Variolink N cements exhibited lower sorption/solubility than Panavia SA resin cements (both P < 0.05). The ceramic shade had a significant influence on the microhardness of both cements (P < 0.001) but had no significant effect on the sorption/solubility of resin cements (P > 0.05).

CONCLUSION: Interposition of monolithic zirconia decreases the microhardness of resin cement especially Panavia SA. In Variolink N, by increasing the chroma saturation of ceramics, the microhardness decreased, however in Panavia SA, it was altered by the shades, but not in a specific pattern. For both cements, there were no statistical differences between the sorption/solubility of samples photo-cured under different shades. There was a reverse correlation between microhardness and water sorption/solubility of both cements.

PMID:33835068 | DOI:10.4103/jips.jips_284_20

J Indian Prosthodont Soc. 2021 Jan-Mar;21(1):45-49. doi: 10.4103/jips.jips_252_20.

ABSTRACT

AIM: To compare the rise in temperature using trephines over conventional ones during bone site preparation.

SETTING AND DESIGN: An-vitro, evaluative study.

MATERIALS AND METHODS: Twenty implant sites were prepared using pilot drill up to depth of 10 mm on bovine femoral bone. In first part, no irrigation was used. Five sites were prepared using conventional drill of 2.8 mm, and other five were prepared with help of trephine drills. On completion of each drill, infrared thermometer was used to measure temperature on both the drill tip and the shaft. The same procedure was repeated with bone immersed in saline.

STATISTICAL ANALYSIS USED: Student t test was used to evaluate the significance of difference.

RESULT: Study showed that the temperature rise at drill tip was significantly higher for trephine drill (52.98 ± 1.67 °C) than conventional drills (48.20 ± 0.67 °C), however the temperature difference in trephine and conventional drills was statistically insignificant.

CONCLUSION: The temperature increase was more distributed in conventional drills than trephine. Copious irrigation is thus mandatory for trephine drills. Intermittent drilling is preferred with conventional drills.

PMID:33835067 | DOI:10.4103/jips.jips_252_20

J Indian Prosthodont Soc. 2021 Jan-Mar;21(1):28-44. doi: 10.4103/jips.jips_400_20.

ABSTRACT

AIM: The purpose of systematic review and meta-analysis was to compare the efficacy of short implant versus conventional long implant with sinus graft in patients rehabilitated for posterior atrophic maxilla.

SETTING AND DESIGN: Systematic review and meta analysis.

MATERIALS AND METHODS: Electronic searches were conducted in Pub Med, Embase, and Medline with supplemented by manual search up to December 2019. The randomized controlled trial (RCTs) comparing short implant (<8.5 mm) and long implant (>8.5 mm) with sinus graft were included. (Prospero CRD42020186972).

STATISTICAL ANALYSIS USED: Random-effect model, fixed-effect model, A funnel plot and the Egger’s test.

RESULTS: Twenty-two Randomized controlled trials (RCTs) were assessed with 667 patients and 1595 implants (short implant:767, Long implant:835). No significant difference of implant survival rate was recorded for short and long implant (at patient level: RR: 1.01, 95% CI = 0.52-2.0, P = 0.87, I² = 0%, at implant level RR = 1.09, 95% CI = 0.6-2.0, P = 0.7, I² = 0%). Similarly marginal bone resorption was reported no difference for short and long implant (MD = 0.16. 95% CI: -0.23 = -0.08, P = 0.00, I2 = 74.83%). Biological complications were marginally higher for long implant (RR = 0.48, 95% CI = 0.23-0.8, P = 0.13, I² = 29.11%). and prosthetic complications were marginally higher for short implants (RR=1.56, 95% CI=0.85-3.15, P = 0.43, I² = 0%).

CONCLUSION: There was no significance difference in implant survival rate and marginal bone resorption recorded for both the short implant and long implant with sinus graft, in the patients rehabilitated with posterior atrophic maxilla. Hence, short implant is a suitable alternative to long implant with sinus graft, for the rehabilitation posterior atrophic maxilla.

PMID:33835066 | DOI:10.4103/jips.jips_400_20

Sci Rep. 2021 Apr 8;11(1):7769. doi: 10.1038/s41598-021-87064-7.

ABSTRACT

Automated machine learning approaches to skin lesion diagnosis from images are approaching dermatologist-level performance. However, current machine learning approaches that suggest management decisions rely on predicting the underlying skin condition to infer a management decision without considering the variability of management decisions that may exist within a single condition. We present the first work to explore image-based prediction of clinical management decisions directly without explicitly predicting the diagnosis. In particular, we use clinical and dermoscopic images of skin lesions along with patient metadata from the Interactive Atlas of Dermoscopy dataset (1011 cases; 20 disease labels; 3 management decisions) and demonstrate that predicting management labels directly is more accurate than predicting the diagnosis and then inferring the management decision ([Formula: see text] and [Formula: see text] improvement in overall accuracy and AUROC respectively), statistically significant at [Formula: see text]. Directly predicting management decisions also considerably reduces the over-excision rate as compared to management decisions inferred from diagnosis predictions (24.56% fewer cases wrongly predicted to be excised). Furthermore, we show that training a model to also simultaneously predict the seven-point criteria and the diagnosis of skin lesions yields an even higher accuracy (improvements of [Formula: see text] and [Formula: see text] in overall accuracy and AUROC respectively) of management predictions. Finally, we demonstrate our model’s generalizability by evaluating on the publicly available MClass-D dataset and show that our model agrees with the clinical management recommendations of 157 dermatologists as much as they agree amongst each other.

PMID:33833293 | DOI:10.1038/s41598-021-87064-7