Management of Medically Compromised Prosthodontic Patients

The medical evaluation of patients considering prosthodontic treatment is a vital step in the treatment planning. The prosthodontist should be able to assess the inherent risks associated with the treatment of patients with systemic conditions. Many factors are associated with evaluating the patient's health status and risk including the patient's current and past medical and dental history, current and past use of medications, type of treatment, length of treatment, invasiveness of treatment, and degree of urgency of treatment. In this article, some of the systemic diseases like arthritis, cardiovascular diseases, endocrine disorders, hematologic and oncologic disease, neurologic disorders, bone disorders, pulmonary diseases, liver diseases, and chronic kidney disease that commonly affect aged individuals are reviewed. The prosthodontic considerations that should be taken care of while managing patients with these systemic conditions will also be discussed.

Happiness among dentists: a multi-scale, multi-national study from 21 countries

OBJECTIVES

The extent to which dentists are happy with their profession and their life has not been well studied. The present study aimed to explore the level of happiness, satisfaction with life and psychological well-being among a sample of dental professionals from 21 countries.

MATERIALS AND METHODS

The sample comprised 2,200 dentists from 21 countries. Three scales - Subjective Happiness Scale (SHS), Satisfaction With Life Scale (SWLS), and Affect Balance Scale (ABS) - were used to measure the subjective responses. Data related to demographic and social characteristics were recorded. Mann-Whitney and Kruskal-Wallis tests were used as appropriate. Scales were correlated, and multiple linear regression analyses were employed to identify the independent determinants of SHS, SWLS and ABS. Data were analysed using the SPSS software program; a value of P <0.05 was considered significant.

RESULTS

The overall mean scores of SHS, SWLS and ABS were 18.53 ± 5.06, 23.06 ± 6.25 and 1.26 ± 2.40, respectively, with significant differences found across countries: dentists working in Croatia, Peru and Serbia recorded the highest scores, unlike dentists practicing in Yemen, Syria, and Iraq, who recorded the lowest scores. There were significant, moderately positive correlations between the various scales: SHS and SWLS: r = 0.535, P < 0.001; SHS and ABS: r = 0.58, P < 0.001; and SWLS and ABS: r = 0.533, P < 0.001. Country of practice, age, qualification and monthly income were the significant independent predictors of SHS, SWLS and ABS.

CONCLUSION

Country of residence and social characteristics were associated with dentists' responses regarding their feelings and subjective well-being.

Oral Hygiene and Tobacco Use Practices in Rural Villages of Jhapa District, Nepal

BACKGROUND

Smoking and use of smokeless tobacco affect oral as well as general health. People are reluctant to achieve good oral health in lieu of the avoidance of deleterious habits. The objective of this study was to analyze two contrasting health behaviors; the oral hygiene practices against tobacco use in a sample from eastern Terai.

METHODS

This is questionnaire-based cross-sectional survey carried out in Jhapa district located in eastern Nepal. In this report, practice of toothbrushing, use of fluoridated toothpaste, frequency of using tobacco related products (paan, gutkha, chilim, cigarette, bidi, hukkah) was assessed. Association of health behavior to sociodemographic variables were tested with regression analysis at 95% confidence limits.

RESULTS

A total of 1178 respondents (response rate = 96.8%) completed the interview, among them 80.8% were males. Mean age was 52.21 years (SD = 15.943). Overall 72.6% used fluoridated toothpaste and toothbrush for cleaning teeth, 58.8% consumed tobacco related products. Interdental aids utilization was very less (1.2% using dental floss). Age was significantly related to both toothbrushing and tobacco-consuming. Educational status was related significantly to toothbrushing (p less than 0.05). Other sociodemographic variables (marital status, ethnicity, educational status) were not related to consumption of deleterious products (p>0.05).

CONCLUSIONS

Our results showed that consumption of tobacco related products is moderately high in Terai village and oral health practice was found to be influenced by educational status. More such studies to identify status of oral health and impact of tobacco are recommended.

Perceived Benefits, Knowledge about Cancer and Attitude towards Promotion of Gutkha Amongst Gutkha users from Nepal

Introduction: Gutkha, a mixture of areca nut pieces, tobacco and slaked lime, is a potential carcinogen. It causes oral submucous fibrosis. Many people do not possess this knowledge and thus consume gutkha daily. The consumption is highly prevalent in Nepal because of easy availability of this material. Although ban of advertisement is implemented in Nepal in electronic media, the impact has not been significant. Objective: To find the prevalence of different beneficial effects cited, to determine awareness about cancer and attitude towards ban of advertisement, production and sale in current gutkha users from rural Terai dwellers of Nepal. Methodology: We interviewed 1217 households in a community survey in which 151 were current gutkha consumers, their responses about perceived benefits, cancer knowledge and views on ban of its sale and promotion was analyzed. The relationship with demographic variables were tested with Chi-square test with level of significance set at 0.05. Results: Among the current users, the reason of consuming gutkha was mostly 'feeling of well-being' (38.4%), about 40% thought it can cause cancer. The knowledge was not associated with gender, age group and literacy but statistically related with marital status (p<0.05). Majority were in favor of ban on advertisement (74.2%) and on production, sale and consumption (70.2%). Conclusion: The level of knowledge of cancer causation is very low and education level had not been significantly associated to knowledge. More gutkha users were in favor of its ban which is a positive finding.

An In-Vitro Study on the Influence of Ceramic Thickness in the Color of Titanium Ceramic Restoration

Background: Various factors such as metal alloy, thickness of the opaque porcelain, different methods of condensation of ceramic, thickness of the dentine ceramic, different ceramic firing condition affect the color of final ceramic restoration. It is not considered significant while taking single variable into account but several subtle changes in these factors lead to discernible color change. Purpose: The aim of this study was to evaluate the influence of ceramic thickness over color of ceramic layered on the titanium casting. Methods: Ultra low fusing ceramics of different thickness (0.5mm, 1mm, 1.5mm and 2mm) was veneered over a metal substrate of pure titanium and spectrophotometric analysis of 20 such discs was done to determine parameters (CIELAB system). One-way ANOVA and multiple comparison results of ANOVA were performed for statistical analysis. Results: The different thickness of ceramic significantly influences the ΔE value. There was significant change in the L* value (P<0.05) with different thickness of titanium metal ceramic tabs. There was also significant difference in C*ab values with different thickness of ceramic. Conclusions: The thickness of the ceramic has significant effect in the L* value of the titanium ceramic restoration. The thicker restoration appeared darker than the thinner one. There was also significant effect in the color saturation or chroma with different thickness of ceramic. Chroma decreased with increased thickness. Color difference between groups were significant. Overall thickness had effect on the final color of the titanium ceramic restoration.  

Perceived sources of stress amongst dental students: A multicountry study

AIMS

The aim of this study was to explore the perceived sources of stress reported by dental students from fourteen different countries.

METHODS

A total of 3568 dental students were recruited from 14 different dental schools. The dental environmental stress (DES) questionnaire was used including 7 domains. Responses to the DES were scored in 4-point Likert scale. Comparison between students was performed according to the study variables. The top 5 stress-provoking questions were identified amongst dental schools. Data were analysed using SPSS software program. Mann-Whitney and Kruskal-Wallis tests were used as appropriate. Logistic regression analysis was also conducted to determine the effect of the studied variables on the stress domains. The level of statistical significance was set at <.05.

RESULTS

Internal consistency of the scale was excellent (0.927). Female students formed the majority of the total student population. The percentage of married students was 4.8%. Numbers of students in pre-clinical and clinical stages were close together. The most stress-provoking domain was "workload" with a score of 2.05 ± 0.56. Female students scored higher stress than male students did in most of the domains. Significant differences were found between participating countries in all stress-provoking domains. Dental students from Egypt scored the highest level of stress whilst dental students from Jordan scored the lowest level of stress.

CONCLUSION

The self-reported stress in the dental environment is still high and the stressors seem to be comparable amongst the participating countries. Effective management programmes are needed to minimise dental environment stress.

Dental-Implant Retained Mandibular Overdenture: A Case Report

The prosthetic management of the patient with resorbed ridge has long been a major challenge for dentistry. Conventional complete denture for long was the standard of care for all such patients. However, most patients find it difficult to adapt to mandibular denture due to lack of retention and stability. Recent scientific studies carried out over the past decade have determined that the benefits of a mandibular two-implant overdenture are sufficient to propose the two-implant overdenture-rather than the conventional denture - as the first treatment option. BJHS 2018;3(2)6:488-491.

Relationship Between Prosthodontic Treatment and Nutritional Status: A Review

Pertinent literature search about changes or effects of prosthodontic treatment on nutritional status was performed. The articles were electronically and hand searched in all available journals including research works, reviews, randomized controlled trials and systematic reviews. The information were obtained to answer the question whether denture therapy has a role in altering nutritional intake or not. Most articles agreed that the risk of malnutrition is elevated by being edentulous. However, there were contrasting results about improvement of nutrition by providing prosthodontic treatment. Thus, many authors have emphasized the role of nutritional counseling along with denture therapy for the benefits of geriatric patients who undergo the inevitable process of being edentulous.BJHS 2018;3(1)5 : 385 - 389

Immediate Placement of Dental Implant on Freshly Extracted Socket: A Case Report From B. P. Koirala Institute of Health Sciences, Dharan

 Immediate placement of implants into the freshly extracted tooth sockets is viable and preferable option in many cases who have to wait for healing phase in traditional implant therapy. This has been a great boon for the implant dentistry. In this case a young lady who had unusual trauma to her upper front tooth had immediate implant placed on the same day of extraction and metal-ceramic crown restored her esthetics after about 4 months. With extensive treatment planning and execution of surgical and prosthetic phases of implant therapy, immediate placement of dental implant gives wonderful results. Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, page: 230-233

An anthropometric study to evaluate the correlation between the occlusal vertical dimension and length of the thumb

BACKGROUND

Establishment of proper occlusal vertical dimension (OVD) is one of the important tasks for successful prosthodontic therapy. An ideal method for determining OVD in terms of cost, time, and instrument requirements has been sought in prosthodontics by various investigators. However, no such single method has been formulated. In the current anthropometric study, the relationship of the length of the thumb to the OVD was tested in two ethnic groups of Nepal, Aryans, and Mongoloids. The result of this study can be useful in determining proper OVD in edentulous patients.

AIMS AND OBJECTIVES

The primary aim of the present study was to evaluate the correlation between the length of the thumb and OVD in Aryan and Mongoloid ethnic groups. The secondary aim was to compare the correlation between OVD and other anatomic measurements (eye-ear distance and pupil-to-rima oris distance) in these ethnicities.

MATERIALS AND METHODS

The OVD, thumb length, eye-ear distance and distance between pupil of eye and rima oris were measured in a total of 500 adult dentulous volunteers. The correlation between OVD and thumb length as well as other anatomic measurements was checked with Pearson's product moment correlation coefficient. Linear regression analysis was performed to determine the relationship of OVD to the length of the thumb.

RESULTS

The thumb length was significantly (P≤0.05) correlated with strong and positive values (Pearson's coefficient =0.874 in the whole population, 0.826 in Aryans, and 0.944 in Mongoloids). Regression analysis showed that thumb length was significantly related to OVD in both ethnic groups.

CONCLUSION

Within the limitations of the present study, the result implies that thumb length can be used as an adjunct for establishing OVD in the edentulous patients.

Selecting suitable sites for animal waste application using a raster GIS

Rapid growth of intensive animal industries in southeast Queensland, Australia, has led to large volumes of animal waste production, which possess serious environmental problems in the Murray Darling Basin (MDB). This study presents a method of selecting sites for the safe application of animal waste as fertiliser to agricultural land. A site suitability map for the Westbrook subcatchment within the MDB was created using a geographic information system (GIS)-based weighted linear combination (WLC) model. The factors affecting the suitability of a site for animal waste application were selected, and digital data sets derived from up to 1:50,000 scale maps were acquired. After initial preprocessing, digital data sets were clipped to the size of the delineated subcatchment boundary producing input factors. These input factors were weighted using the analytical hierarchy process (AHP) that employed an objectives-oriented comparison (OOC) technique to formulate the pairwise comparison matrix. The OOC technique, which is capable of deriving factor weight independently, formulated the weight derivation process by making it more logical and systematic. The factor attributes were classified into multiple classes and weighted using the AHP. The effects of the number of input factors and factor weighting on the areal extent and the degree of site suitability were examined. Due to the presence of large nonagricultural and residential areas in the subcatchment, only 16% of the area was found suitable for animal waste application. The areal extent resulting from this site suitability assessment was found to be dependent on the areal constraints imposed on each input factor, while the degree of suitability was principally a function of the weight distribution between the factors.