Aim and objective: The aim is to reinforce autopolymerizing polymethyl methacrylate (PMMA) and bis-acrylic composite (BAC) provisional restorative resin with bamboo fibers and evaluate its effect on the flexural strength of the resin in comparison to the unreinforced material. The objective of the study is to find a suitable natural alternative to synthetic fibers like glass to strengthen the materials used for fabricating provisional fixed partial dentures. Materials and methods: A total of 4 groups each containing 15 samples of 25 × 2 × 2 mm dimension namely group I: unreinforced PMMA, group II: PMMA resin reinforced with bamboo fibers, group III: unreinforced BAC and group IV: BAC resin reinforced with bamboo fibers. The bamboo fibers of 22 mm length were initially pretreated with 6% Sodium hydroxide solution for 12 hours and dried thoroughly for 2 weeks. The dried fibers were placed longitudinally in the reinforced samples by a layering method at 5% w/w concentration. For determining the flexural strength, specimens were then tested by 3-point bend test on universal testing machine. The fractured samples were then analyzed using scanning electron microscope at 50×, 100×, 250× magnification. Results: The results obtained were analyzed in STATA software release 14.0 using one-way ANOVA test. According to the results, the mean flexural strength (in MPa) values were group IV (152.42) > group II (127.2) >group III (106.79) > group I (99.28) and was statistically significant p = 0.001. Conclusion: Thus, bamboo fibers have a reinforcing effect on autopolymerizing polymethyl methacrylate and bis-acrylic composite provisional restorative resins and significantly increases their flexural strength.

Aim and objective: This study aimed to evaluate and compare the marginal fit of different provisional restorations before and after thermal cycling. Materials and methods: The study consisted of three main groups of provisional materials, i.e., bisphenol A-glycidyl methacrylate (Bis-GMA) resin (Protemp II), polymethylmethacrylate (PMMA) self-cure tooth-colored resin, and computer-aided design/computer-aided manufacturing (CAD/CAM) PMMA resin. The groups were further subdivided into 2 subgroups with each having 10 specimens. A typhodont mandibular right first molar was prepared for a full veneer restoration and was cast in a base metal alloy. Polyvinyl siloxane putty index of the master die was prepared and poured with die stone. The provisional crowns were fabricated on these dies and cemented. Conditioning of the specimens was done by storing them in artificial saliva for 10 days. Thermal cycling of the experimental group was done by immersing the samples in two temperature-controlled water baths; 5°C (cold bath) and 55°C (hot bath). The samples were tested by stereomicroscope to find the marginal discrepancies. Paired t-test was done to evaluate the change between baseline to follow-up. Intergroup comparison was analyzed using one-way ANOVA followed by post hoc Tukey's test to compare the mean of measurements. Results: The mean marginal discrepancies were Protemp II (21.8750 ± 3.30 μm), CAD/CAM resin (16.6500 ± 8.14 μm), and self-cure tooth-colored resin (24.2250 ± 3.26 μm) for the provisional crowns. A significant difference was seen in the mean marginal discrepancy of crowns fabricated with Protemp II, CAD-CAM resin, and self-cure tooth molding powder (p = 0.013). Conclusion: The types of materials and the thermal cycling process had a significant effect on the marginal gap of interim restorations. The Bis-GMA resin and CAD/CAM PMMA resin exhibited better marginal adaptability than the PMMA self-cure tooth-colored resin groups, both before and after thermal cycling.

Aim and objective: Ferrules can reinforce the endodontically treated teeth by encircling the remaining coronal structure. The adhesive connection of bonded restorations to dental dentine via resin bonds on one hand and the importance of conservative tooth structure removal during crown preparations present the question “is ferrule necessary for bonded restorations?”. This systematic review aimed to study the available literature on the effect of the ferrule on resin-bonded restored teeth. Materials and methods: A search of the literature in PubMed and PMC's databases, without any date restriction, was carried out. The keywords were based on the PICO question “Does ferrule's presence affect the success rate of bonded restorations?”. The full title and abstract of each article were screened by two independent authors using predetermined inclusion and exclusion criteria. Results: Ten articles were included in this review. All teeth were endodontically treated and received lithium disilicate ceramic crowns bonded adhesively. Ferrules designs ranged from no ferrule to 3 mm and/or different ferrule circumferences. Three studies reported a lack of a significant difference in fracture resistance and/or stress levels and/or cyclic fatigue between different ferrule designs. Six studies reported higher fracture resistance, lower stress levels on root dentin and fiberglass post, higher count of fatigue cycles, less fracture count, less tooth strain value for ferrule groups. Conclusion: In the limits of this systematic review, a ferrule is still necessary for resin-bonded restorations, and more ferrule in terms of height or/and circumference presents better results than no ferrule at all or interrupted or less ferrule.

Aim and objective: This study aimed to assess the relative accuracy of two-dimensional panoramic radiographs compared with three-dimensional computed tomography (CBCT) images for identification and measurement of the anterior loop of the mental nerve. Materials and methods: The study was about to determine the comparative diagnostic accuracy of panoramic radiograph and cone-beam computed tomography and the study protocol was set according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagnostic test accuracy guideline. The search was limited to English literature only and included an electronic search through PubMed and Google Scholar databases. The search was further complemented by extensive hand-searching. All studies published up to November 2019 were included (without any starting limit). Two independent investigators extracted the data and assessed the studies based on the inclusion and exclusion criteria. Results: Out of the initial 308 records, only 4 studies were included in this review for qualitative data synthesis. The quality assessment of included studies was done through QUADAS-2. Quantitative data synthesis was done to compare the relative accuracy of two-dimensional radiographs compared with three-dimensional scans from three out of the four selected articles. Statistical analysis was done with the help of Meta-DiSc version 1.4. The pooled sensitivity of panoramic radiography was 0.45 (CI 95%: 0.34–0.56) and pooled specificity was 0.75 (CI 95%: 0.69–0.80). In the symmetric summary receiver operating characteristic (SROC) plot, the area under the curve (AUC) was 0.8832, and Q* was 0.8137. Conclusion: Compared with cone-beam computed tomography (CBCT) images as the gold standard reference test, two-dimensional panoramic radiographs showed lower sensitivity and reasonable specificity. It is clear from the SROC curve that panoramic radiography can be used for the identification of the anterior loops. Still, it is better to avoid it as an alternative to three-dimensional scans to determine the presence and extension of the anterior loop of the mental nerve because of the tendency toward low sensitivity and over or under-estimation of the length.

Aim and objective: This technique describes a novel method for converting an acrylic hybrid into metal-ceramic using a combined digital and analog workflow. Background: Although the acrylic hybrid prosthesis treatment modality has been consistently used for decades, complications such as occlusal wear and tooth debonding have brought to light other alternative restorative materials such as the use of zirconia or a metal framework layered with ceramic. Developing a technique that allows clinicians to convert existing acrylic prostheses easily and conveniently into metal-ceramic ones would overcome many of the complications associated with current acrylic hybrids. Technique: A combined digital and analog workflow are utilized to convert an acrylic hybrid into a metal-ceramic one by making a repositioning impression with the existing prosthesis maintaining the interface fit for the new prosthesis. The metal framework of the new prosthesis was designed and manufactured digitally. After layering the framework with ceramic, the prosthesis is evaluated for ideal fit, occlusion, and esthetics before delivery. Conclusion: The combined analog and digital workflow for converting an acrylic hybrid to a metal-ceramic prosthesis through a pick-up impression reduces overall chairside time and provides a predictably fitting prosthesis.

Aim and objective: This technique aims to improve the outcome of silicone finger prostheses by reducing voids and the risk of tearing. Background: Obtaining an intact porosity-free silicone finger prosthesis is a difficult task owing to the high viscosity of the material, coupled with difficult packing and retrieval in the thin ventral part of the mold (which is overlapped by the stump model). Technique: This technique describes predictable packing of silicone along with easier retrieval of prosthesis and mold. Incorporation of brass dowel pins in the stump model just before investment and packing of mold helps in preventing mold/stump fracture and tearing of silicone finger prosthesis. Conclusion: The described technique helps in creating a silicone finger prosthesis with fewer porosities, which can be easily extricated from the mold, thereby also increasing the longevity of the mold.

Rehabilitation of the atrophic posterior maxilla is complicated owing to poor bone quality, non-optimal quantity, and sinus pneumatization. Such clinical situations demand extensive bone augmentations and sinus lifts which prolong treatment time and increase morbidity. Using preexisting anatomic features for implant placement in patients indicated for extensive augmentation surgeries is an alternative treatment possibility. TTPHIL ALL TILT® technique for partial or complete edentulous atrophic maxilla is an immediate function protocol in this direction. In clinical situations depicting severe anterior pneumatization of the maxillary sinus, placement of implants with palatonasal angulation using TTPHIL ALL TILT® immediate function technique that anchor the lateral wall of nose/medial wall of the maxillary sinus by angulating implants in palatal direction present a minimally invasive treatment option for rehabilitation. The purpose of this clinical report was to present implants with palatonasal angulation as a non-surgical treatment option for the rehabilitation of partially edentulous posterior maxilla using the TTPHIL ALL TILT® technique. Follow-up of 3 years showed stable marginal bone levels without any biological or prosthetic complications. The patient showed a high level of satisfaction with the prosthesis and reduced patient morbidity and costs, thus, it is a viable treatment alternative to sinus lift surgeries for oral rehabilitation of maxillary posterior partially edentulous sites.

High esthetical result outcomes can be achieved with immediate implant-supported crowns in the esthetic zone despite the impossibility to perform an immediate provisionalization. This case report describes the management of a soft tissue complication of two dental implants in the esthetic area. Two immediate dental implants were placed in positions 1.1 and 2.1, while immediate loading was not possible due to low primary stability instead. At the time of loading, the gingival margin of implant 2.1 was apically positioned, volume deficiency was present and partial loss of the interdental papilla between the two central incisors was observed. The soft tissue discrepancy was managed by correctly modifying the critical and subcritical contour of the provisional restoration. The described customization technique of the provisional prosthesis offers satisfactory results in terms of esthetics and soft-tissue stability over time. This case report describes a technique for successfully managing slight soft tissue deficiency around implants, avoiding additional surgical interventions.