Journal of Nepalese Prosthodontic Society 2021-04-14T19:48:32+00:00 Prof.Dr. Suraj R B Mathema Open Journal Systems <p>The Journal of Nepalese Prosthodontic Society (JNPS) is the biannual official publication of Nepalese Prosthodontic Society and is devoted to the field of prosthetic dentistry.</p> Temporomandibular Disorders and Perceived Emotional Stress Among Medical and Dental Students Studying in a Private Medical Institution in Kathmandu, Nepal 2021-04-14T19:48:16+00:00 K Bimb M Budhthoki A Khapung SK Singh <p><strong>Introduction:&nbsp;</strong>Temporomandibular disorder (TMD) is a collection of complex signs and symptoms that typically involves the temporomandibular joint (TMJ) and masticatory muscles. Multifactorial etiologies of TMD include occlusal disharmony, oral habits, dysfunction of masticatory muscles and adjacent structures, emotional stress, and extrinsic and intrinsic changes on TMJ structure. Stress has been inflicted as one of the major etiological factors for developing TMD.</p> <p><strong>Materials and Methods:&nbsp;</strong>An observational cross-sectional study was conducted among the medical and dental undergraduate students and interns studying in Nepal Medical College and Teaching Hospital, Kathmandu, Nepal from January 2018 to February 2018. Fonseca Amnestic Index (FAI) was used to evaluate and characterize the TMD signs and symptoms. The stress factor was assessed by the Cohen Perceived Stress Scale (CPSS-10) which is a self-report measure of stress level which consists of 10 questionnaires in which the subjects respond on how much they suffer from the listed symptoms. Data were analyzed using the Statistical Package of Social Sciences (SPSS) Version 16.0. Association of different variables was tested, with Chi-square test, with a value less than 0.05 as statistically significant.</p> <p><strong>Results:</strong> A total of 487 students had participated. Among them 32.4%were male and67.6%were female. Among the participants, 44.6%were from dental school (BDS), and 55.4%were from medical school (MBBS). The age group of the participants was 17 to 27 years. The prevalence of TMD was 50.3% in the study participants. Among the participants with TMD, 81.2% had mild TMD, 17.2% had moderate TMD and 1.6% had severe TMD. Out of the total participants, 16.4% had low stress, 76.6% had moderate stress and 7% had high stress. This study showed a statistically significant association between stress factor and temporomandibular disease (p &lt;0.001).</p> <p><strong>Conclusion:</strong> Higher rate of TMD and level of stress has become common in medical and dental college students. Identifying the TMD at an early age can control or at least minimize its long-term effects. Moreover, identifying the stress factor highlights the importance of providing support programs and implementing preventive measures to help students.</p> 2020-07-01T00:00:00+00:00 Copyright (c) 2020 K Bimb, M Budhthoki, A Khapung, S K Singh The use of posts in endodontically treated teeth among Nepalese Prosthodontists. 2021-04-14T19:48:21+00:00 B Khanal B Adhikari <p><strong>Introduction:</strong> One of the most studied and researched subjects in dentistry is the restoration of endodontically treated teeth. The success of an endodontically treated tooth depends not only good endodontic therapy but is equally if not more dependent on the nature, type, and execution of post-endodontic restorations. The purpose of this study was to know the opinions, techniques, and materials used by Nepalese Prosthodontists for restoring endodontically treated teeth with a post.</p> <p><strong>Materials and Methods:</strong> A nationwide survey was performed among Nepalese Prosthodontists through electronic communication media by distributing a questionnaire to find out the various treatment strategies, post types, and materials being used by them. Descriptive statistics were used to analyze the responses given by the Prosthodontists by using SPSS statistical software package (version 21.0).</p> <p><strong>Results:</strong> A total of 69 returned questionnaires out of the 114 sent were included in the study. The majority of the respondents were in the age group of 31-40 yrs (70.6%, N=48). 51% of the respondents were male and 49% were female. Out of the responses analyzed, 91% (N=63) think that the primary purpose of a post is to retain a core. The quantity of remaining tooth structure affects the decision to place a post (98.5%, N=68). The ideal post length for 81.2% (N=56) respondents was 2/3rd the root length. 55% (N=38) of respondents think that 4-5mm of apical Gutta Percha should be left during post space preparation. The preferred type of post was custom cast metal post for 69.5 % (N=48) and prefabricated fiber-reinforced post for 66.6% (N=46).55% (N=38) of respondents preferred the passive type of post. Out of the respondents, 72% (N=50) were using Glass Ionomer Cement for cementing cast posts and 91% (N=63) of them were using resin cement for fiber-reinforced posts. The most popular core build-up material was dual-cured composite resin (63.8%, N=44).</p> <p><strong>Conclusion:</strong> Although the results obtained cannot give a definitive guide for restoration of endodontically treated teeth with a post, it pictures how the Nepalese Prosthodontists are practicing posts for restoring endodontically treated teeth. The varied responses obtained here can be taken into consideration to conclude that the preference of techniques and materials depends upon the individual clinician and the clinical scenario.</p> 2020-07-01T00:00:00+00:00 Copyright (c) 2020 B Khanal, B Adhikari Factors Related to Patient Expectation and Satisfaction among New and Existing Denture wearers with Complete Denture therapy 2021-04-14T19:48:23+00:00 A Pandey <p><strong>Introduction:</strong> Edentulism is considered a debilitating condition with aging in which several dental and non-dental factors play a vital role in the success of prosthodontic treatment. Patient satisfaction is an important non-dental component. The dentist should aim for functional rehabilitation by satisfying the patient medically, functionally, and psychologically. Patient satisfaction depends on two factors: patient factor and dentist factor. From the patient’s view, satisfaction is guided by improved quality with factors like eating, easy communication, comfort, social life, economic status, and vocational opportunities. From dentist’s view, treatment options, treatment cost etc. affects the patient’s satisfaction.</p> <p><strong>Materials and Methods:</strong> Experimental study conducted in Department of Prosthodontics, College of Medical Sciences, Bharatpur in patients receiving complete denture by convenience sampling in six months duration in sixty-five samples. Questionnaires regarding patient’s expectations and satisfaction in terms of retention, mastication, phonetics, esthetics, and comfort were used in both 1st-time denture wearer and existing denture wearer was recorded. Grading was rated with Visual Analog Scale (VAS) from 0 to 10 using the optimum cutoff values. Data were recorded in SPSS 21 and analyzed.</p> <p><strong>Results:</strong> Independent t-test was carried out for expectation showing a statistically significant difference between retention, mastication, aesthetics, phonetics, comfort, and denture status with p value 0.036, 0.00, 0.001, 0.003, and 0.013 respectively. Statistically, a significant difference was found for satisfaction between aesthetics and denture status with a p-value of 0.01.</p> <p><strong>Conclusions:</strong> Expectation and satisfaction were found to be more in first-time denture wearers than existing denture wearers. Experiences obtained beforehand with complete dentures could influence patient expectations and satisfaction.</p> 2020-07-01T00:00:00+00:00 Copyright (c) 2020 A Pandey Perception of confidence among dental interns when performing removable prosthodontic treatment 2021-04-14T19:48:26+00:00 B Maskey K Shrestha B Pathak <p><strong>Introduction:</strong> Removable prosthodontics constitutes the majority of the prosthodontic curriculum at an undergraduate level and it is expected that the students will be able to perform these procedures independently. However, in recent years, it has been observed that the majority of the removable prosthodontic treatment have been referred to consultants or at times even delegated to the technicians. One of the major reasons behind this trend may be the result of an individual graduate's internal perception of their ability or lack of confidence in their ability to perform these procedures.</p> <p><strong>Materials and Methods:</strong> A cross-sectional study was conducted among dental interns in People’s Dental College and Hospital, affiliated to Tribhuvan University, Kathmandu, Nepal after the ethical approval from PDCH-IRC. A self-designed validated questionnaire related to the experience of individual interns and level of confidence pertaining to clinical procedures related to removable prosthesis fabrication was distributed by the authors to the interns. The data were analyzed using SPSS software (version 21); descriptive statistics and Fisher’s exact test was applied.</p> <p><strong>Results:</strong> Overall most of the interns (77.8%; n=28) were confident in removable prosthodontics and they were equally confident while performing both complete and partial denture prostheses. Male interns were significantly more confident (p&lt;0.5) in performing complete denture prostheses while the clinical experience did not have a significant effect on the confidence level. The interns were confident in performing most of the procedures related to complete and partial denture prostheses (median=3).</p> <p><strong>Conclusions:</strong> The interns at People’s Dental College and Hospital were confident in removable prosthodontics. The few procedures where our interns lacked have been identified and efforts will be made to overcome these shortcomings.</p> 2020-07-01T00:00:00+00:00 Copyright (c) 2020 B Maskey, K Shrestha, B Pathak Odontogenic Factors Associated with Food Impaction in Patients Attending Periodontics OPD of Universal College of Medical Sciences 2021-04-14T19:48:29+00:00 K Adhikari K Dutta H Bali <p><strong>Introduction:</strong> Food impaction is a common problem experienced by almost everyone during their lifetime. It is believed that the interproximal wedging of food normally occurs due to loss of integrity of the proximal contact and its location along with the contour of the marginal ridges and lack of papilla fill. The objective of the study was to assess the role of odontogenic factors for food impaction and identify the odontogenic factors most prevalent in patients attending Periodontics OPD of Universal College of Medical Sciences.</p> <p><strong>Materials and Methods:</strong> A total of hundred subjects with natural dentition from the second molar to the second molar in both the maxillary and mandibular arches were enrolled in this cross-sectional study. Clinical parameters like pocket depth, bleeding index, and plaque index were recorded. The integrity of contact was recorded using dental floss. A study cast was fabricated for each subject. The presence of plunger cusps along with marginal ridge relationship, the position of the tooth in the arch, and contiguity of contact points were analyzed on it.</p> <p><strong>Results:</strong> A significant association between plaque index score and food impaction was found (p=0.03). Of all the factors, loose contact showed a slightly significant positive correlation with a plaque index score (r= 0.19, p=0.05).</p> <p><strong>Conclusions:</strong> Amongst all the odontogenic factors, loose contact is positively correlated with plaque index and food impaction is significantly associated with plaque score. The odds of food impaction were significant with the brushing technique employed and frequency of tooth brushing in the subjects.</p> 2020-07-01T00:00:00+00:00 Copyright (c) 2020 K Adhikari, K Dutta, H Bali Biologic width-A Review 2021-04-14T19:48:18+00:00 A Bhochhibhoya R Shrestha <p>Replacement of missing, damaged, or unaesthetic tooth by dental prostheses helps the patient to rehabilitate the structure and function of the lost tissues. During delivery of the prostheses, the overall health of the oral tissues, including the periodontium, must be considered. The gingival tissues must be healthy and it is of paramount importance to respect the biologic width of the tissues. The biologic width varies among different individuals and at different sites of the same individual. Instead of following a mean value, each patient should be examined to determine the biologic width. In case violation of biologic width is anticipated, appropriate measures should be adopted to maintain the dimensions of the biologic width.</p> 2020-07-01T00:00:00+00:00 Copyright (c) 2020 A Bhochhibhoya, R Shrestha An Alternative Impression Technique for Fabrication of Feeding Appliance for an Infant with Cleft Palate: A Clinical Report 2021-04-14T19:48:19+00:00 S Dhital S R.B. Mathema B Maskey <p>Cleft lip and palate is the most common congenital defect of the orofacial region, which results in difficulty in feeding, deglutition, and speech. Before the surgical intervention, a feeding appliance is used to restore the palatal cleft and aid in feeding an infant. The impression procedure during the fabrication of a feeding appliance is a crucial step and selection of impression tray and impression material is a challenging task. This article attempts to briefly describe an alternative technique for making impressions in infants with cleft palate.</p> 2020-07-01T00:00:00+00:00 Copyright (c) 2020 S Dhital, S R.B. Mathema, B Maskey A Simplified Approach for Ocular Rehabilitation - A Case Report 2021-04-14T19:48:22+00:00 P Manandhar S R.B. Mathema <p>Loss of an eye or any body part has an intimidating and crippling effect on the psychosocial well-being of the patient. Although the artificial prosthesis cannot restore the function, it can highly improve the patient’s esthetics and help them regain their psychological confidence. Literature has advocated various rehabilitation modalities including empirical use of stock shells, modifying stock eyes, custom-made ocular prostheses, ocular implants, etc. A custom-made ocular prosthesis, among all the techniques, shows improved adaptation to tissue bed, distributes uniform pressure, provides a more esthetic and precise result, and is relatively cost-effective. This case report explores a relatively comprehensive method of custom ocular prosthesis fabrication for an ocular defect with a satisfactory outcome.&nbsp;</p> 2020-07-01T00:00:00+00:00 Copyright (c) 2020 P Manandhar, S R.B. Mathema The Altered Cast Technique: A Case Report 2021-04-14T19:48:25+00:00 S K Singh R K Singh P Suwal P K Parajuli I K Limbu B B Basnet <p>The altered cast impression technique is commonly used for the mandibular distal extension partially edentulous arches. The technique is relatively simple and improves the residual ridge to dentition relationship of the prosthesis. Due to the displaceability of the mucosa, free end saddles get displaced under occlusal load. A 45-year-female patient reported to the Department Of Prosthodontics and Crown-Bridge, College of Dental Surgery, B.P. Koirala Institute of Health Sciences, Nepal with a chief complaint of missing bilateral lower posterior teeth. Clinical examination revealed missing teeth w.r.t 36, 37, 45, 46, and 47. The treatment&nbsp;plan was made to rehabilitate the patient with removable partial denture using functional impression along with the altered cast technique. The altered&nbsp;cast technique is the best alternative technique in the case of distal extension cases because better tissue adaptability, proper extension of a denture base, equal stress distribution, better support, and stability can be achieved. Finally, increased patient comfort and function are obtained.</p> 2020-07-01T00:00:00+00:00 Copyright (c) 2020 S K Singh, R K Singh, P Suwal, P K Parajuli, I K Limbu, B B Basnet Gingival Reshaping Using Provisional Restoration in a Maxillary Anterior Implant - A Case Report 2021-04-14T19:48:28+00:00 S Karki D Thapa N Pandey <p>Oral implants are regarded as one of the most successful and reliable treatment options for replacing missing tooth/teeth. Various studies have reported that it can be used to meet the functional as well as esthetic demands of missing teeth. The most common indication of oral implants is the replacement of single or multiple teeth to support the denture. While replacing teeth in the esthetic zone, then consideration should be towards creating the right emergence profile. So, replacing a tooth with the implant-supported prosthesis in the anterior region is more challenging as compared to the posterior. With clinical examination, radiographic investigation, and treatment planning good results can be achieved. This case report highlights the placement of a single-tooth dental implant in the anterior region where the emergence profile was created with gingival moulding similar to that of adjacent gingiva using provisionalization.</p> 2020-07-01T00:00:00+00:00 Copyright (c) 2020 S Karki, D Thapa, N Pandey Prosthetic Management of Post-surgical defect in the Mandible following Marsupialization: A Case Report 2021-04-14T19:48:31+00:00 A Gurung S R.B. Mathema B Maskey K Shrestha B Pandey A Adhikari N Dhyako S Subedi <p>Marsupialization is a conservative surgical approach for the surgical management of large odontogenic lesions. Such procedure often results in a post-surgical defect in the form of an intraoral opening. The patency of such defect, if not maintained can result in food accumulation which may lead to infection and thus delayed healing of the defect. Obturator is one of the modalities to facilitate closure of the resultant defect. This report presents a case where an acrylic plug obturator retained with clasp, was provided to the patient for the interim period following marsupialization on the mandibular left posterior region.</p> 2020-07-01T00:00:00+00:00 Copyright (c) 2020 A Gurung, S R.B. Mathema, B Maskey, K Shrestha, B Pandey, A Adhikari, N Dhyako, S Subedi Editorial 2021-04-14T19:48:15+00:00 Suraj R.B. Mathema <p>Not available</p> 2020-07-01T00:00:00+00:00 Copyright (c) 2020 Suraj R.B. Mathema