Title: Using Chu’s Aesthetic Gauge for Planning the Size and Proportions of Front Teeth Prosthetic Restorations

Abstract:Introduction: Chu’s Aesthetic Gauges are used to restore the proper natural size and proportion of teeth based upon width once the incisal edge position is established. \nAim: To demonstrate how the gauge can be helpful for planning prosthetic restorations in the front area.\nMaterials and methods: A 24-year-old patient is subject to prosthetic restoration. She presented with an old unaesthetic crown, two congenitally missing lateral incisors, persistent deciduous canine and altered passive eruption of the front teeth. Er:YAG laser soft tissue crown lengthening was performed. After the surgery Chu’s Aesthetic Gauge was used to help the dentist and the dental technician predict the proportions of the future prosthetic restorations.\nResults: Using the measurements from the gauge, a prognostic wax-up was made in the laboratory. After the patient approved of the mock-up, the deciduous canine was extracted. Lithium disilicate crowns and a bridge were the final restorations, that restored the natural look of the smile.\nDiscussion: Measurements are performed directly on the teeth, which helps both the clinician and the dental technician to visualize the future outlines of the restorations more precisely.\nConclusion: Chu’s Aesthetic Gauge helps visual precision, and results in a successful and predictable treatment.




Title: IMPACT OF HYPERTENSION AND SMOKING UPON THE INFERTILITY AMONG URBAN WOMEN OF SINDH, PAKISTAN

Abstract:Infertility is defined as the major handicap that prevents the people to achieve the major goal of life which is having the children. The prevalence of infertility is increasing day by day in females all round the globe. In addition the rate of hyper tension and smoking addiction is also increasing with the same pace. The major endeavor of research was to analyze the prevalence of infertility prevailing high due to ever increasing hypertension and trend of smoking in the adjoining areas of Hyderabad, Sindh, Pakistan. The data was collected by specially designed questionnaire and biochemical tests profile of the female patients from various hospitals and testing labs of the Hyderabad and its surrounding areas after getting the consent from patients and was analyzed precisely. Statistical analysis of the data was done by software SPSS 20.0. The data analysis showed that out of the 90 infertile women 12 were suffering from hypertension or elevated blood pressure. The poor quality of the ova is highly associated with chronic type of hypertension. Furthermore, the data analysis showed that out of the 90 infertile women 10 were smokers. Cigarettes contain nicotine and high intake nicotine results in the fertilization delay caused due to early menopause and the production of hormone production in women resulting in the reduction of the fertility length.




Title: SURGICAL INSTRUMENTER ETHICS: A RESPONSIBILITY TO THE PATIENT AND THE TREATMENT TEAM

Abstract:Surgical Instrumentation in Colombia, is a profession regulated by Law 784 of 2002, whose main objective is the training of professionals in the use and knowledge of surgery teams, so that they integrate the surgical teams and be able to promote the improvement of the condition of patients\' lives. In Colombia, few studies have been carried out since the deontology of the professions, within which, surgical instrumentation is no exception, therefore, the purpose of this research is to describe the ethical and deontological aspects related to the profession of surgical instrumentation in Colombia. The review of the updated literature, allowed to conclude that surgical instrumentation, is a profession oriented to a specific function (administer and manage the surgical instruments) its ethical commitment has several senses: patient, treating team, operating room, profession, and society, what makes necessary the implementation of a code of ethics that establishes particular ethical guidelines for the profession, since, within the Law 1164 of 2007, generic principles are established that do not have a specific relationship with the responsibilities, duties, obligations and commitments of the professional In surgical instrumentation, for this, it is necessary to start from the particular tasks and responsibilities that are held before, during and after the surgical process.




Title: Comparison of two generations of systems for digital occlusion analysis

Abstract:Introduction: The modern concept of occlusion includes the relationship between teeth, masticatory muscles, and temporomandibular joints in function and dysfunction. Occlusion can be defined very simply: it means the contacts between teeth. Qualitative and quantitative methods are used to register and evaluate occlusal contacts. The T-Scan handpiece model was updated in 2015 as T-Scan Novus (software version 9.1) and the latest updated one being the T-Scan v10 software version introduced in 2018\nThe purpose of this study is to demonstrate the capabilities and results of two generations of systems - T-Scan III and T-Scan Novus.\nMaterial and methods: For the realization of the set goal the occlusion of a patient with the initials S.K. is examined with two systems. The patient is 43 years old with intact teeth, Angle\'s class I jaw relation. The study with T-Scan III was conducted in 2015, and with T-Scan Novus in 2019\nResults: The software of both systems uses a graphical interface, which transforms the data obtained during the recording of the occlusion as the model of the upper dentition of the patient in T-Scan III and the upper and lower dentition in T-Scan Novus. Registered occlusal contacts are illustrated as 2D and 3D images of different colours. The Graph force/time shows the power versus time from the first contact to the end of the movie. The timing Table displays the patient\'s total occlusal bite timing, and the force applied. T-Scan Novus software allows you to import digital fingerprint files of the upper and lower dentition in .stl format.\nConclusion: The software programme of the system version 9.1 provides better visualisation of dental arches making it much more informative than other versions. The T-Scan system allows fast and accurate registration and analysis of occlusion.




Title: Prevalence of Glucose Intolerance and its Associated Factors in District Jamshoro, Sindh, Pakistan

Abstract:Objectives: This research was aimed to analyze the IGT (impaired glucose tolerance) and occurrence of non-insulin dependent diabetes mellitus (NIDDM). It was a population based survey to relate these disorders with obesity as well as the age and hypertension amongst different areas of District Jamshoro, Sindh, Pakistan. Methodology: The study sample was 220participantsaged above 25 years consisting of 130 females and 90 males selected using randomized sampling technique. WHO criteria was followed and standard test was employed to diagnose IGT and diabetes. The questionnaire was designed to obtain the basic information from the study population regarding demographics, weight, age, height and waist hip ratio, blood pressure. The relationship between different variables was measured using Chi Square test. Results: The prevalence of IGT and NIDDM was calculated to be 34% in population. The prevalence of diabetes among females was observed to be 18.46% and 32.22% in males. Obesity, diabetes family history and elderly age were the factors associated with high diabetic rates. The higher WHR (Waist Hip Ratio) in both the genders was found to be highly related to diabetes as compared to the higher values of BMI. Conclusion: The prevalence of diabetes mellitus along with glucose tolerance (IGT and NIDDM) in Jamshoro was much high.




Title: Autoimmune bullous diseases associated with inflammatory bowel disease: A literature review

Abstract:Autoimmune bullous diseases (ABDs) are a series of blistering disorders of the skin and mucous membranes induced by pathogenic autoantibodies. Inflammatory bowel disease (IBD) mainly comprises of ulcerative colitis (UC) and Crohn’s disease (CD). This article reviews the cases of ABD associated with IBD. There have been more than 40 reported cases of concomitant linear IgA bullous disease (LABD) and UC. There have been 50 concomitant cases of ABD and IBD, apart from comorbidity of LABD and UC, in which 44% (22/50) were concomitant cases of bullous pemphigus (BP) and UC. Therefore, LABD and BP may be frequent ABDs in patients with IBD, and comorbidity of pemphigus and IBD may be relatively uncommon. ABD associated with IBD was estimated to be more predominant in patients with UC than in those with CD. IBD preceded ABD in almost all concomitant cases, excluding cases with nearly simultaneous diagnoses. The occurrence of ABD seems not to have an association with IBD activity.




Title: IPS e.max Press Crowns as a Treatment Solution for Patients with Amelogenesis Imperfecta

Abstract:Introduction: Rehabilitation of patients with amelogenesis imperfecta is a challenge because esthetics and function have to be restored, while keeping the treatment as conservative as possible.\nAim: To demonstrate a treatment solution option for patients with amelogenesis imperfecta. \nMaterials and methods: A 21-year-old Caucasian female presented with a mild case of amelogenesis imperfecta. She expressed concern about the esthetics of her central incisors and wanted to change only them. Tooth 11 had an extensive composite restoration done years ago, which lead to the withdrawal of the pulp. Teeth 11 and 21 were prepared for IPS e.max Press (Ivoclar Vivadent, Lichtenstein) crowns. After removal of the old composite filling, tooth 11 was short, but due to the pulp withdrawal, its vitality was preserved. \nResults: The lithium disilicate crowns of 11 and 21 were cemented with white and opaque composite cement to mimic the color of the adjacent teeth.\nDiscussion: Amelogenesis imperfecta (AI) is a hereditary condition that affects the formation of the enamel matrix or the enamel mineralization process of the primary and permanent dentition. The esthetic treatment of dark front teeth is challenging, as the final restorations should resemble the optical properties of natural teeth.\nConclusion: Treatment of patients with amelogenesis imperfecta requires careful planning depending on the severity of the case.




Title: Metal-Ceramic Post-and-Cores for Complex Esthetic IPS e.max Press Indirect Restorations

Abstract:Introduction: Esthetic front teeth indirect restorations may be challenging for the clinician, as well as for the dental technician.\nAim: To describe an indication for the use of metal-ceramic post-and-cores in complex esthetic restoration cases. \nMaterials and methods: A 24-year-old Caucasian female presented with severely destructed endodontically treated 21 and 22. 12 had a big composite restoration, 14, 16, 24, and 26 were extracted. Teeth 25 and 27 were endodontically treated and severely destructed, as well. Post-and-core were made for teeth 21, 22, 25 and 27. The core part of the post-and-cores of 21 and 22 was covered with opaque porcelain to hide the metal color. The final restorations were two metal-ceramic bridges – X-15-X-17 and X-25-X-27 and six lithium disilicate IPS e.max Press (Ivoclar Vivadent, Lichtenstein) crowns of 13, 12, 11, 21, 22 and 23. The opaque ceramics on the post-and-cores aided the esthetic effect and hid its metal color.\nResults: The opaque porcelain on the metal-ceramic post-and-cores hid the metal color, thus highly esthetic result was achieved.\nDiscussion: The esthetic treatment of dark and endodontically treated front teeth remains a challenge because dental materials should mimic the optical properties of natural teeth. Placing a layer of opaque ceramics on the core part is an excellent way of avoiding the esthetic drawbacks of a metal dowel-core, while preserving at the same time its strength. \nConclusion: Esthetic rehabilitation discolored front teeth requires a complex approach in order to provide a satisfactory outcome.




Title: Esthetic Management of Pseudo Hypodontia and Diastemata with IPS e.max Press Veneers

Abstract:Introduction: Hypodontia and diastemata are common aesthetic complaints of patients and often – a challenge for the clinician.\nAim: To demonstrate a prosthetic management of a pseudo hypodontia and diastemata case. \nMaterials and methods: A 27-year-old Caucasian female presented with wide diastemata between her front teeth. Tooth 24 was extracted in childhood, which lead to the distalization of 23 and the impaction of 25. 23 was in contact with 26, and the space between 23 and 22 was about one premolar in width. IPS e.max press veneers were made on 12, 11 and 21. An IPS e.max Press bridge was made between 22 and 23 due to the wide diastema between them. The pontic resembled a canine, and tooth 23 was made to look like a premolar for a more harmonious smile. \nResults: After the cementation of the final restorations, the smile line was parallel to the lower lip line and the smile looked balanced and symmetrical.\nDiscussion: Porcelain veneers, crowns and bridges have become an alternative to composite bonding and metal-ceramic crowns and an excellent solution for hypodontia and diastemata cases. \nConclusion: Press ceramics restorations may be used for correction of such cases without compromising the esthetics, function and stability of the outcome.




Title: Er:YAG Laser Soft Tissue Crown Lengthening Using the Crane-Kaplan Pocket Marker in a Case of Altered Passive Eruption

Abstract:Introduction: Crown lengthening procedures are esthetic and reflect the growing popularity of the ‘smile makeover’ procedures, as well as the understanding of the dentists of preserving the biologic width. \nAim: To demonstrate how the Crane-Kaplan pocket marker and the Er:YAG laser can be used for soft tissue crown lengthening with a predictable result and fast healing.\nMaterials and methods: A patient with altered passive eruption of the front teeth and premolars was subjected to Er:YAG laser soft tissue crown lengthening. The surgery was guided using the Crane-Kaplan pocket marker that pierced the gingiva and designated the bleeding points indicative of the gingival margin level. \nResults: The patient reported no discomfort immediately after the surgery or the week following it. Two weeks post-surgery the soft tissues were calm and pale.\nDiscussion: The Crane-Kaplan pocket marker helps applying in practice the biologic width concept and creating a 3 mm distance from the alveolar ridge to the margin of the future restoration. The Er:YAG laser ensures excellent hemostasis and moisture control, as well as precision and predictability. \nConclusion: The Crane-Kaplan pocket marker facilitates the management of aesthetic and functional demands. Er:YAG lasers ensure a faster and gentler procedure compared to the classic scalpel soft tissue crown lengthening.