Introduction: In the elderly, the insertion of a complete assistant prosthesis in the oral environment leads to a reduction in salivary secretion leading to oral pathologies, such as stomatitis.
Objective of the Study: The objective of this work was to look for variations in salivary pH according to the mode of polymerization, conventional (Protocol1) or by microwave cooking (Protocol2) of the prosthetic bases using the electrometric method at four sites of the oral cavity (inner side of the cheek, on and under the tongue, palate) and at different time intervals.
Materials and Methods: A single-blind randomized clinical trial Protocol 1 versus Protocol 2 was conducted in total bimaxillary edentulous patients divided into two homogeneous groups undergoing for the first a mode of polymerization in a Marie bath (Protocol 1) and the second a polymerization in the microwave (Protocol 2). The salivary pH was measured at the level of the palate, inner side of the cheeks and on, under the tongue before insertion, at d30, j90 after the insertion of the prosthesis.
Results: Our results showed differences in pH averages, from one anatomical site to another. The averages measured on the tongue and at the level of the palate, being a little higher with each measurement time; and this for both methods. Changes in pH were statistically significant for microwave cooking, after d90.
Conclusion: Our results indicate that the pH was not uniform in the oral cavity and that it varies depending on the measuring point. Thus, we were able to highlight a high palatine pH compared to other sites.
Keywords: Salivary pH-Saliva; Complete Assistant Prosthesis; Slowly Complete Polymerization; Methyl Polymethacrylate; Microwave; Bath Mary

Background: All dentists, whether general dentists or specialists have both legal and ethical responsibilities towards their patients and are obligated to refer patients for seeking a specialist’s opinion, depending on the conditions which have been assessed and diagnosed, to carry out their planned treatments. Penang International Dental College (PIDC) has been practicing the current method of communicating to the patient’s physician through referral letters for seeking their opinion regarding fitness of the patients who are medically compromised with systemic disorders, to undergo dental extraction under local anesthesia.
Aim: The aim of this study is to find out the percentage of patients returning to PIDC for extraction after consulting their physician when being referred.
Methodology: The study was conducted by collecting secondary data from case records that were identified through the previously sent referral letter copy book from PIDC polyclinic from the year 2018 to 2019.
Result: 79 patients were referred to their physician in the stipulated time frame. Only 10 (12.66%) patients who were referred got treated at PIDC. Among all the patients who got treated, 7 (17.95%) patients were treated in 2019 and only 3 (7.50%) patients treated in the year 2018.
Conclusion: This study showed low percentage of patients returning back to PIDC for extraction after consulting their physician when being referred. Feedback from the physicians showed that most of the patients being referred were fit for extraction. Common errors found in the referral letter were in the department column, time column, referral number column, results of investigation column, treatment column in the referral letter form.
Keywords: Clinical Audit; Referral Letter; Dental Extraction

The success of immediate loading dental implants depends on the management of the bone tissue and peri implant soft tissues. A significant problem is the loss of peri implant soft and hard tissues. The aim of this study is to present the reabsorption of crestal bone in 25 alveolar post extraction sites with immediate loading implants with PEEK – based abutment. The study confirmed this technique reduces the crestal reabsorption of the bone around the implant and therefore it’s indicated to reduce bone remodelling and the consequential collapse of the soft tissues of the extraction site.
Keywords: Tissue Preservation; Single Tooth Immediate Implant Restauration; Aesthetics Area; P.E.E.K.; Horizontal Bone Reabsorption

Conscious sedation with nitrous oxide is a widespread practice in dentistry and allows you to treat patients that are difficult to treat without its use. This work revisited all the material published between 2019 and August 2021 on the topic of recommendations for the safe use of nitrous oxide sedation in dentistry during the COVID-19 pandemic. The results of the work are recommendations to be used using sedation of the patient with nitrous oxide during the pandemic period.
Keywords: COVID-19; Dentistry; Nitrous Oxide; Inhalation Sedation

Class III malocclusion is a growth-related dentofacial deformity and one of the most challenging treatments for orthodontists. The ideal management of skeletal Class III malocclusion in non-growing patients is an ortho-surgical approach, aimed at modifying the skeletal deformity. However, not every patient is willing to undergo an orthognathic surgery. Hence, for selected cases, an orthodontic camouflage with clear system, such as Invisalign®, may constitute a feasible treatment option.
The purpose of this case report is to present a 26-year-old Caucasian male with a severe skeletal Class III malocclusion and a negative overjet of -2.9 mm, who dismissed the ortho-surgical option in favor of an orthodontic camouflage with Invisalign®. The management of the case was further complicated by the residence of the patient outside the country and by the national lockdown secondary to the COVID-19 pandemic, which caused the interruption of in-office appointments. To overcome the unexpected obstacle, the retention phase was remotely monitoring with Dental Monitoring®, which allowed the clinician to monthly monitor the dental movements of the patient in the absence of chairside visits thought 3D analysis of pictures periodically uploaded by the patient himself. This case suggested that, in selected patients, an orthodontic camouflage with Invisalign® may represent a favorable treatment option, and digital technologies may facilitate a continuity of care, especially in unprecedent times like the current COVID-19 pandemic.
Keywords: Dental Monitoring®; Skeletal Class III Malocclusion; Invisalign®; Clear Aligners; Remote Monitoring System; COVID-19 Pandemic

Fracture of the complete denture (CD) may cripple the day-to-day routine life of the patient. This may eventually be quite disappointing and frustrating for both the patient as well as the clinician. CD fractures may be attributed to a number of reasons namely: natural teeth in the opposing arch i.e. single denture opposing natural dentition or fixed dental prosthesis, extreme palatal vault depth, hard and sharp anatomic formation of the mid-palatal line, high frenal attachments, extremely thin denture base etc. Prosthodontic management of patients with previous history of complete denture fractures is a herculean task and mainly requires an unconventional approach. Conventional heat cure acrylic resins are unable to resist the occlusal loads; subsequently, leading to the complete denture fractures. An easy and an economical solution to reinforce acrylic denture bases involves incorporation of the metal reinforcements to the denture. Metal can be added to the denture bases in various forms namely the wires, bars, mesh and plates. Studies have proven a considerable beneficial effect on the fracture resistance of PMMA by incorporating metal to the PMMA matrix. This case report portrays the prosthetic rehabilitation of an edentulous patient with reinforced complete dentures using prefabricated metal mesh. The reinforcement method using prefabricated metal mesh is an easy, simple, less time consuming and relatively economical approach in unconventional edentulous situations..
Keywords: Acrylic Resin; Complete Denture; Denture Fracture; Flexural Fatigue; Metal Grid Strengthener; Prefabricated Metal Mesh; Reinforced Denture; Sandwiched Technique