Mirza Rustum Baig

Objectives: This study aimed to investigate the sociodemographic factors influencing oral hygiene habits and oral health-related quality of life (OHRQoL) among complete denture wearers at Kuwait University Dental Clinic (KUDC). Methods: A cross-sectional observational study was conducted using a self-administered questionnaire and an Oral Health Impact Profile-19 (OHIP-19) instrument to assess oral hygiene habits and OHRQoL in 61 complete denture patients, treated by dental undergraduate students at KUDC, between January 2019 and December 2023. Additionally, a clinical assessment of denture hygiene was performed using the Budtz-Jörgensen denture plaque index for all patients (n = 61). Sociodemographic, general health status, oral hygiene habits, and OHRQoL-related data were collected. Results: A total of 37.7% of included participants were aged 51–60 years, with 75.4% being male. Most participants (81.96%) had a high school education or less. Caries was reported as the primary cause of tooth loss (83.6%), and 77.04% recorded irregular dental visits. Only 46.05% of participants demonstrated optimal and/or good denture hygiene. Toothpaste was the most common cleaning method (79.21%), and 70.62% removed their dentures at night. A significant association was found between education level and denture wearing (p = 0.035), as well as between gender and the frequency of dental visits (p = 0.024). However, no significant relationship was observed between gender and denture hygiene (p = 0.52). The OHIP-19 results revealed that poor denture hygiene impacted OHRQoL across multiple domains, including functional limitation, physical pain, psychological discomfort, and social disability. Conclusions: Unsatisfactory denture hygiene was prevalent among participants, possibly due to limited awareness or inadequate instructions provided by dental health practitioners. Education level and gender influenced certain aspects of denture care, highlighting the need for targeted oral health education programs and improved patient guidance from dental practitioners. Additionally, poor denture hygiene was associated with reduced OHRQoL, emphasizing the importance of addressing both oral hygiene practices and their psychosocial impacts to improve overall well-being.

Objective: Selecting suitable materials and luting agents for single crowns is critical yet challenging, as dentists must consider different factors. This study aimed to assess dentists’ preferences for materials and luting agents under different clinical conditions and evaluate the nonclinical factors influencing their preferences. Methods: A paper-based survey supplemented with photographs illustrating anterior and posterior single-crown preparation designs was used, incorporating three clinical scenarios for each as examples. Participants provided demographic data and were asked to select their preferred material and luting agent for each scenario. Comparisons between the crown material/luting agent choices and dentist/practice characteristics were performed. Significant differences were determined using the chi-square test. Results: Overall, 262 (87.3%) dentists participated in this survey. The top-selected material for anterior preparation designs was lithium disilicate; monolithic zirconia was the most selected for posterior preparation designs. Dual-cure resin was the most selected luting agent for all anterior and posterior clinical scenarios, except for posterior subgingival preparation design. There was a significant association between the dentist’s age and the selection of material and luting agent (p < 0.05) in all clinical scenarios, except for the luting agent selection in the posterior subgingival preparation designs (p < 0.05). Other nonclinical factors yielded mixed results; some preparation designs showed significant differences, while others did not, depending on the clinical scenario. Conclusions: Reliance on new materials and luting agents that require minimally invasive treatment with dental ceramics and resin cement is increasing. However, the choice of materials and luting agents is influenced by clinical presentation and nonclinical factors, making it crucial for dentists to be aware of these factors when selecting materials for single-crown restorations. Clinical Implications: An overall trend was observed for the use of strong monolithic ceramics with adhesive resin cements. These findings could assist dentists in reviewing and re-evaluating material choices in their clinical practices, both at a national and regional level. Additionally, the findings could be useful for dental policy makers, wholesale suppliers, and retail distributors in making future decisions.

Background: Sterilization is required for any biomedical device intended to be used in contact with the human body. Several studies have reported alterations in the bulk and surface properties of such devices after repeated sterilization cycles. These surface modifications may influence other clinical parameters. Therefore, the aim of this study was to investigate the surface and chemical properties of implant scan bodies (SBs) after consecutive autoclave sterilization procedures. Methods: The objective was to analyze the scan bodies using Fourier transform infrared spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS) for chemical analysis and an optical profilometer to analyze the surface roughness. Results: FTIR spectra depicted the appearance of peak at 1741 and 1100 cm⁻¹ due to the diphenyl ether band disappearance. The XPS spectra showed alterations in the elemental composition after autoclaving and roughness were significantly reduced in PEEK BL and TL SBs. Conclusions: These results indicated that some surface modifications were induced by repeated sterilization cycles.

Fracture resistance is an important parameter used to predict the performance of indirect dental restorations. The purpose of this in vitro study was to assess the fracture load of posterior milled nanoceramic crowns, in comparison with the lithium disilicate crowns, after fatigue loading, for two different restoration occlusal thicknesses. Forty test metal dies were fabricated by duplicating a master metal model consisting of an anatomic abutment preparation of the maxillary first premolar for a single crown. The dies were divided into two groups of 20 each for the fabrication of nanoceramic (Lava Ultimate) and lithium disilicate (IPS e.max CAD) single crowns. Each material group was further divided into two sub-groups of 10 dies each, based on crown occlusal thickness, of 0.5-mm and 0.75-mm (n = 10). Dental Type V stone dies poured from polyvinyl siloxane impressions of the test metal dies were laboratory scanned in order to design and mill 40 ceramic crowns. The crowns were cemented on to the test metal dies with a self-adhesive resin luting cement. All crowns were thermocycled (2500 cycles) and mechanically loaded (250,000 cycles) in a chewing simulator followed by static loading until failure, and the values noted. The data were statistically analyzed by 2-way ANOVA and Tukey HSD post-hoc multiple comparison tests (α = 0.05). The mean fracture loads ranged from 1022 to 1322 N for nanoceramic crowns and from 1145 to 1441 N for the lithium disilicate crowns. Two-way ANOVA revealed insignificant differences between the nanoceramic and lithium disilicate crowns (p > 0.05) in terms of fracture load. Significant differences were noted in the fracture resistance of crowns based on occlusal thickness (303 N; p = 0.013) regardless of the material used. Multiple comparisons by Tukey HSD post-hoc test showed insignificant differences between the four material-occlusal thickness groups (p > 0.05). The nanoceramic crowns were found to be comparable with lithium disilicate crowns in terms of fracture load. The mean fracture loads of all of the tested crowns were within the normal physiological masticatory load limits. Based on the fracture-resistance results, nanoceramic crowns seem to be suitable for clinical use for the tested occlusal thicknesses.

Objectives: The objective of this retrospective clinical study was to investigate the survival rates and complications of implant (I)-retained or tooth-implant (TI)-retained prostheses and abutments (teeth, implants) over a mean observation period of 11.26 years. The study also aimed to analyze the differences and complication rates between implant-retained double crown removable dental prostheses (I-DC-RDPs) versus tooth-implant-retained double crown removable dental prostheses (TI-DC-RDPs). Material and Methods: We reviewed the clinical data of 110 nonsmokers (mean age = 53.9 years) who received DC-RDPs in maxillary or mandibular arches. 153 teeth and 508 implants were used to restore partially edentulous (PE; TI-DC-RDPs; n = 53) and completely edentulous (CE; TI-DC-RDPs; n = 57) arches. Two designs of the distal extension were used: cantilevers (CANs) and saddles (SADs). Restorations were examined for abutment survival, mechanical, or biological complications. Results: The 10-year survival rates were 99.3% (95% CI: 95.4–99.9%) for teeth and 99.3% (95% CI: 97.5–99.7%) for implants. The cumulative rates of TI- and I-RDPs free of technical complications were 77% and 86%, respectively. The risk of complications was not significantly different between the CAN and SAD subgroups of I-RDPs (p > 0.05). However, for TI-RDPs, technical complication risk was significantly higher in SAD type compared with CAN restorations (p = 0.02). Conclusions: I- and TI-DC-RDPs seem to be recommendable for restoration of CE or PE arches. The technical and biological complication rates were lower for I-DC-RDPs in the CE arches than for TI-DC-RDPs in the PE arches. Regarding the RDP design, CAN prostheses produced significantly fewer technical complications than did SAD prostheses.

Edentulism is considered a poor health condition and may compromise the quality of life. Prosthodontic replacement of missing teeth results in significant improvement of oral functions. Treating a patient with Down syndrome can pose clinical challenges in handling the emotional aspect as well as in rendering treatment. Careful oral analysis and diagnosis of the existing conditions in such patients will enable and pave the way for clinically acceptable treatment results. This clinical report describes the challenges encountered in the prosthodontic management of an edentulous young patient with Down syndrome.

Mirza Rustum Baig BDS, MDS, FDSRCSEd, FDSRCPS, MRD/Yacoub Al-Tarakemah DDS, MS/Noor Hayaty Abu Kasim BDS, MSc, PhD/Ridwaan Omar BSc, BDS, MSc, FRACDS, FDSRCSEd: Purpose: To evaluate the marginal fit of zirconia (Zi) CAD/CAM crowns in terms of gap and overhang compared to lithium disilicate (LDS) computer-aided design crowns, as well as the effect of finish line design on marginal accuracy. Materials and Methods: Stone dies were acquired from two master metal dies (n = 20 each) with two different finish lines and were scanned to produce digital models. Ceramic crowns (ZS-Ronde Zi, KaVo and IPS e.max CAD LDS, Ivoclar Vivadent) were designed and milled on the resulting 40 dies: 10 Zi-shoulder, 10 Zi-chamfer, 10 LDSshoulder, and 10 LDS-chamfer. Marginal gap and overhang were evaluated at six designated margin locations. The data were obtained, and the influence of material and finish line on the marginal fit of crowns was assessed using two-way analysis of variance and Bonferroni multiple comparisons test (α = .05). Results: Mean marginal gap and overhang on Zi crowns were 30 ? 14 μm and 79 ? 27 μm for the shoulder, respectively, and were 68 ? 34 μm and 104 ? 34 μm for the chamfer. The corresponding values for LDS crowns were 57 ? 22 μm and 74 ? 29 μm for the shoulder, and 62 ? 12 μm and 59 ? 27 μm for the chamfer. ANOVA revealed that the differences in marginal gap between the two materials were not significant (P > .05), but that the finish line effect and interaction were significant (P < .05). With regard to marginal overhang, significant differences were found between Zi and LDS crowns (P < .05), although the finish line geometries did not show any significant differences (P > .05). LDS crowns showed no differences between shoulder and chamfer margins for gap or overhang (P > .05), whereas significant differences were found in marginal gap between the Zi shoulder and chamfer margins (P < .005). Conclusion: In terms of marginal accuracy, shoulder margins produced smaller marginal gaps compared to chamfers for Zi CAD/CAM crowns.