Correction of a severe skeletal Class II occlusion with a fixed functional appliance anchored on mini-implants: a patient report

This report describes the treatment of a patient with a severe skeletal Angle Class II occlusion with a 14-mm overjet, crowding, and protrusion of the mandibular anterior teeth. The Class II relationship was caused mainly by a short corpus of the mandible. A fixed functional appliance was directly anchored on mini-implants, which were inserted in the mandible. A significant amount of mandibular advancement was achieved, with no protrusion of the mandibular anterior teeth. Facial esthetics improved considerably. This is the first patient report to demonstrate that mini-implants can be applied to anchor fixed functional appliances. The rationale to use mini-implants with fixed functional appliances and the potential benefits of this procedure are discussed.     

Alternate metal framework designs for the metal ceramic prosthesis to enhance the esthetics

PURPOSE

The objective of the present study was to evaluate the effect of five different metal framework designs on the fracture resistance of the metal-ceramic restorations.

MATERIALS AND METHODS

For the purpose of this study, the central incisor tooth was prepared, and the metal analogue of it and a master die were fabricated. The counter die with the 0.5 mm clearance was used for fabricating the wax patterns for the metal copings. The metal copings with five different metal framework designs were designed from Group 1 to 5. Group 1 with the metal collar, Group 2, 3, 4 and 5 with 0 mm, 0.5 mm, 1 mm and 1.5 mm cervical metal reduction respectively were fabricated. Total of fifty metal ceramic crown samples were fabricated. The fracture resistance was evaluated with the Universal Testing Machine (Instron model No 1011, UK). The basic data was subjected to statistical analysis by ANOVA and Student''s t-test.

RESULTS

Results revealed that the fracture resistance ranged from 651.2 to 993.6 N/m². Group 1 showed the maximum and Group 5 showed the least value.

CONCLUSION

The maximum load required to fracture the test specimens even in the groups without the metal collar was found to be exceeding the occlusal forces. Therefore, the metal frameworks with 0.5 mm and 1 mm short of the finish line are recommended for anterior metal ceramic restoration having adequate fracture resistance.     

Dematiaceous fungi

Dematiaceous fungi are responsible for a wide variety of infectious syndromes. They are often found in soil and generally distributed worldwide. This suggests that most if not all individuals are exposed to them, presumably from inhalation or trauma. In recent years, these fungi have been increasingly recognised as important pathogens. The spectrum of diseases they are associated with has also broadened and includes superficial and deep local infections, allergic disease, pneumonia, brain abscess and disseminated infection. For some infections in immunocompetent individuals, such as allergic fungal sinusitis and brain abscess, they are among the most common aetiological agents. These fungi may have unique pathogenic mechanisms owing to the presence of melanin in their cell walls, which imparts the characteristic dark colour to their spores and hyphae. Diagnosis rests on careful microscopical and pathological examination, as there are no simple laboratory tests to reliably identify these fungi. Therapy depends upon the clinical syndrome. Local infection may be cured with excision alone, while systemic disease is often refractory to therapy. Azoles such as itraconazole and voriconazole have the most consistent in vitro activity, though there is more clinical experience with itraconazole. Further studies are needed to better understand the pathogenesis and optimal treatment of these uncommon infections.