Kiran Awchat

Abstract

Rehabilitation of mutilated dentition is esthetic and functional challenge. The present condition of dentition, patient’s level of motivation for maintaining oral hygiene, social status etc are the key factors to successful rehabilitation. Maxillary teeth supported overdenture against mandibular complete denture is a potential risk for enhancing residual ridge resorption of mandibular arch. In such situation mandibular implant prosthesis is a better treatment option. In this case report a comprehensive management of patient with mutilated dentition has been carried out in phased manner.Here three roots with healthy periodontium were preserved in maxillary arch. Fixed implant prosthesis was made in mandibular arch. Presently patient has been followed up for 6 years and found to be highly satisfied and having a good oral hygiene. Maxillary overdenture against mandibular fixed implant prosthesis should be considered as effective rehabilitative modality in rehabilitating such cases.   Keywords: Mutilated Dentition, Maxillary Overdenture, Mandibular Implant fixed prosthesis

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Abstract

Introduction: The available shade guide system in dentistry includes Manual and Digital. Although there is lot of research going on better system to choose dental shade but still there are many factors including source of light illuminating the tooth, the characteristics of tooth and the observer viewing the tooth which needs to study further. In this study, a comparative analysis is made between the Manual and Digital shade guide systems. Objective: The objective of the study is to record the manual (subjective method) and a digital shade (Objective method) of 500 subjects by two observers (Prosthodontist 1 {P1} and Prosthodontist 2 {P2}). Materials and Methods : 500 patients having a complete set of anterior teeth with sound maxillary central incisors were selected for the study. Manual shade selection (Vita 3D Master) of 50% of subjects is made by P1. Then P2 does shade selection of the same subjects by digital method (Vita Easy Shade Advance) and records the deviation of values including ?E, ?L, ?C, and ?h by digital shade guide from the manual shade as recorded by P1 using verification mode of Digital shade guide. Recording of shades and deviation values is done for the remaining 50 % of patients by role reversal between P1 and P2. Results: The kappa correlation values for Hue value and chroma when P1 records manually and P2 documents shade by digital shade guide include 0.26, 0.42, and 0.13 indicating fair, moderate, and slight to no agreement respectively. The kappa correlation values for Hue value and chroma when P2 records manually and P1 records shade by digital shade guide include -0.08, 0.51 and 0.12 indicating no agreement, moderate and slight to no agreement respectively. Conclusion: It is advisable to use technology to overcome the errors of subjectivity. Due to edge loss with a spectrophotometer, especially in the incisal and cervical region, a combination of digital and manual systems always comes in handy when deciding on a particular shade or shade map.   Keywords: Shade matching, Shade guides, Spectrophotometer

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