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Fulltext The development of flexible denture materials and concept: A narrative review

Seong, Lim Ghee, Buzayan, Muaiyed Mahmoud Ali, Elkezza, Aeman

JUMMEC, 2021;24(1):23-29.
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Introduction: Flexible denture is an alternative treatment modality for removable partial denture (RPD) that aid the retention by ensuring seal around the entire border of the denture. It is also referred as hypoallergenic denture especially for those who are allergic towards conventional acrylic denture which is the poly-methylmethacrylate monomer (PMMA) and metal (cobalt chromium). The flexible material exhibits lower flexural modulus than conventional type of baseplate material denture that makes it nearly unbreakable. Nowadays, there are a handful of different flexible materials in the dental market for the general dental practitioners to choose but somehow the studies on the properties of these different types of flexible materials are sparse.

Objectives: The present study is to study the development of the flexible materials, the different type of flexible materials and their physical properties.

Methods: From the limited article journals available, the authors have summarized the history, development and constituents of different type of flexible materials used in fabricating denture. Besides that, the authors also discussed about the indications, contraindications, advantages and disadvantages of the materials in denture constructions based on all the published researches available on this topic using published materials available in the dental library, University of Malaya and the databases (Science Direct, PubMed).

Conclusion: Each flexible material has its pros and cons. Therefore, careful selection of material and understanding of the flexible dentures’ indications and contraindications are utmost importance to make sure the best treatment outcome. Hence, patients’ best interest and quality of life can be upheld.
Fulltext A technique utilising cobalt-chromium framework as a key in master cast preparation for removable prosthesis in microstomia patients: A case report

Buzayan, Muaiyed Mahmoud, Omar Tawfiq, Choudhary, Suchismita, Sivakumara, Indumathi, Norsiah Yunus, Elkezza, Aeman

Archives of Orofacial Sciences, 2017;12(2):110-113.
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Prosthodontic rehabilitation and management of microstomia patient presents challenges at all stages
during prosthesis fabrication; from making primary impressions to the prostheses insertion. These patients have
reduced mouth opening, and hence it can be extremely challenging to make impressions and to fabricate
dentures using the conventional methods. The present case report describes prosthodontic management of a
partially dentate patient with microstomia that developed secondary to surgical resection and radiation therapy of
head and neck cancer. A simplified novel approach has been advocated using the patient’s existing metal
removable partial denture as a key in master cast preparation.
Fulltext Passive Fit in Screw Retained Multi-unit Implant Prosthesis Understanding and Achieving: A Review of the Literature

Buzayan MM, Yunus NB

J Indian Prosthodont Soc, 2014 Mar;14(1):16-23.
PMID: 24604993 DOI: 10.1007/s13191-013-0343-x

One of the considerable challenges for screw-retained multi-unit implant prosthesis is achieving a passive fit of the prosthesis' superstructure to the implants. This passive fit is supposed to be one of the most vital requirements for the maintenance of the osseointegration. On the other hand, the misfit of the implant supported superstructure may lead to unfavourable complications, which can be mechanical or biological in nature. The manifestations of these complications may range from fracture of various components in the implant system, pain, marginal bone loss, and even loss of osseointegration. Thus, minimizing the misfit and optimizing the passive fit should be a prerequisite for implant survival and success. The purpose of this article is to present and summarize some aspects of the passive fit achieving and improving methods. The literature review was performed through Science Direct, Pubmed, and Google database. They were searched in English using the following combinations of keywords: passive fit, implant misfit and framework misfit. Articles were selected on the basis of whether they had sufficient information related to framework misfit's related factors, passive fit and its achievement techniques, marginal bone changes relation with the misfit, implant impression techniques and splinting concept. The related references were selected in order to emphasize the importance of the passive fit achievement and the misfit minimizing. Despite the fact that the literature presents considerable information regarding the framework's misfit, there was not consistency in literature on a specified number or even a range to be the acceptable level of misfit. On the other hand, a review of the literature revealed that the complete passive fit still remains a tricky goal to be achieved by the prosthodontist.
Does HIV infection affect the survival of dental implants? A systematic review and meta-analysis

Sivakumar I, Arunachalam S, Choudhary S, Buzayan MM

J Prosthet Dent, 2021 Jun;125(6):862-869.
PMID: 32694022 DOI: 10.1016/j.prosdent.2020.04.001

STATEMENT OF PROBLEM: Immunosuppression and coinfections associated with human immunodeficiency virus (HIV) infection pose a relative contraindication for dental implant therapy. However, although implants have been placed in patients with HIV with reasonable success, how HIV infection affects their survival is unclear.
PURPOSE: The purpose of this systematic review of the literature and meta-analysis was to analyze the data on the survival of dental implants in patients with HIV.
MATERIAL AND METHODS: A search for relevant articles published up to November 2019 was performed in PubMed/Medline and Cochrane databases, Clinicaltrials.gov, and Google Scholar. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were adopted for the conduct of the systematic review. The most pertinent data were extracted and pooled for qualitative and quantitative analyses with 95% confidence intervals. Heterogeneity was analyzed by using I-squared statistics.
RESULTS: A total of 8 studies involving 411 individuals with HIV and 1109 implants were included in the meta-analysis. The mean follow-up period was 2.8 years. A pooled estimate of 95% of implant survival rate with 95% confidence interval(92% to 96%) was noted. Heterogeneity across the 8 studies was found to be 41% with moderate true variability.
CONCLUSIONS: This systematic review demonstrated that HIV infection does not pose a serious threat to implant survival on short-term evaluation, but the evidence is of low quality.
Draw to learn: Removable partial denture designing through team-based learning

Sivakumar I, Arunachalam S, Buzayan MM

J Dent Educ, 2023 Jun;87 Suppl 1:892-894.
PMID: 36469857 DOI: 10.1002/jdd.13153
A new approach for better anterior esthetic using platelet-rich fibrin as sole graft material combined with ovate design dental bridge

Buzayan MM, Mahdey HM, Ning CJ

J Indian Prosthodont Soc, 2020 04 07;20(2):219-223.
PMID: 32655228 DOI: 10.4103/jips.jips_264_19

Alveolar ridge deficiency is considered a major esthetic limitation, especially in the maxillary anterior region. Several approaches have been developed to enhance and increase the soft-tissue volume. Among those approaches are connective tissue grafts, platelet-rich fibrin (PRF) membrane and implying the guided bone regeneration concept. The PRF grafting technique was employed in this clinical case to improve and enhance the anterior esthetic without the need for the bone graft and augmentation. This article describes the use of PRF as a sole grafting material for both socket and soft-tissue augmentation for a 23-year-old male, who had an accident 8 years ago while he was playing a basketball, which caused his upper front teeth to be intruded and discolored. The upper left central tooth suffered a major external root resorption; hence, it was extracted. PRF was prepared and packed in and extruded out of the socket. This was combined with ovate design provisional bridge. Ten days, 1 month, 3 months, and 6 months postoperative review showed a significantly well-progressed healing. According to the encouraging result obtained in this clinical case in regard to tissue healing and esthetic, the PRF can be a potential sole graft material for small anterior deficient areas. This may reduce the need of bone augmentation and graft in such selected cases.
Culture of reflection through case scenarios reversing the Bloom Learning Framework

Sivakumar I, Arunachalam S, Buzayan MM, Chidambaram R

J Dent Educ, 2022 Dec;86 Suppl 3:1742-1744.
PMID: 35412660 DOI: 10.1002/jdd.12945
A comparative evaluation of photogrammetry software programs and conventional impression techniques for the fabrication of nasal maxillofacial prostheses

Buzayan MM, Elkezza AH, Ahmad SF, Mohd Salleh N, Sivakumar I

J Prosthet Dent, 2023 Sep 23.
PMID: 37748996 DOI: 10.1016/j.prosdent.2023.08.027

STATEMENT OF PROBLEM: The fabrication of facial prostheses is complicated and time-consuming because of the need for accurate impressions of the facial defects and surrounding tissues. Inaccuracies can arise from soft-tissue compression, involuntary patient movements, and insufficient support for the impression material. Various 3-dimensional (3D) imaging and scanning techniques, including photogrammetry, have been introduced, but their accuracy remains insufficiently evaluated.
PURPOSE: The purpose of this in vitro study was to evaluate and compare the accuracy of 3D digital casts generated by 4 photogrammetry software programs (Agisoft Metashape, 3DF Zephyr, Meshroom, and Polycam) and casts from 2 conventional impression materials (alginate and polyvinyl siloxane [PVS]) for the fabrication of nasal maxillofacial prostheses.
MATERIAL AND METHODS: A stone cast of a patient's nose was used as the basis for generating a reference digital 3D cast and another 54 test 3D casts. The reference cast was created by scanning the stone cast using a FARO Optor Lab 3D scanner. The 54 test 3D casts were generated and divided into 6 test groups as follows: Agisoft group: 9 3D casts generated using Agisoft Metashape, a commercial personal computer (PC) software program; 3DF Zephyr group: 9 3D casts generated using 3DF Zephyr, a commercial PC software program; Meshroom group: 9 3D casts generated using Meshroom, a free PC software program; Polycam group: 9 3D casts generated using the Polycam, a commercial Android cloud application; PVS group: 9 3D casts generated indirectly by 3D scanning a gypsum cast made from a polyvinyl siloxane (PVS) impression of the stone nose cast; and Alginate group: 9 3D casts generated indirectly by scanning a master cast made using alginate impressions of the stone nose cast. Deviation measurements of the produced specimens were analyzed using the Geomagic Control X software program, and statistical comparisons were performed employing the Kruskal-Wallis test (α=.05).
RESULTS: The results showed that the 3DF Zephyr group had the smallest deviation measurements (median: 0.057 mm ±0.012) among the 4 photogrammetry software programs, while the alginate impression group had the largest deviations (median: 0.151 mm ±0.094) of the 2 conventional impression materials. Significant differences were observed among the 4 photogrammetry software programs and the 2 conventional impression materials (H=39.41, df=5, P.05).
CONCLUSIONS: Photogrammetry software programs, specifically Agisoft Metashape and 3DF Zephyr, demonstrated better accuracy than conventional impression materials in creating nasal digital casts. Photogrammetry has the potential to improve workflow and reduce patient discomfort during the fabrication of maxillofacial prostheses. Further research is needed to validate these findings in clinical settings.