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   Table of Contents - Current issue
January-February 2019
Volume 9 | Issue 1
Page Nos. 1-98

Online since Thursday, February 14, 2019

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Dental implant bioactive surface modifiers: An update p. 1
Osamah Mohammed Al Mugeiren, Mohammad Abdul Baseer
Objectives: Main purpose of this review was to present an update on various coating materials utilized in improving the surface chemistry of the dental implants. Methods: Literature search was carried out in various on-line databases such as PubMed, Medline, Google scholar, EBSCO, Wiley Science Library, and Saudi Digital Library using appropriate keywords (dental implant surface coatings, dental implant surface modifiers, and dental surface coatings). Results: Total of 569 studies were retrieved. All the relevant studies among them were reviewed and compiled. Conclusion: Current implant surface's biomimetic coatings offer many benefits compared to the traditional plasma sprayed coatings. Further incorporation of biomimetic coatings with various material has lead improvement in mechanical and biological properties of implants.
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Effectiveness of using a vibrating device in accelerating orthodontic tooth movement: A systematic review and meta-analysis p. 5
Mohamed Atfy Abd Elmotaleb, Manal M Elnamrawy, Foud Sharaby, Amr R Elbeialy, Amr ElDakroury
Objective: The aim of current systematic review was to evaluate the efficiency of the vibrating devices in accelerating orthodontic tooth movement. Methods: A systemic unrestricted search was done in three electronic databases up to July 2018. A manual search was also performed. Eligibility criteria included Randomized clinical trials (RCTs), quasi randomized clinical trials and prospective controlled trials (CCTs) comparing the rate of the tooth movement with and without vibrating devices. The study characteristics and data extraction of the vibrating device group and control group were performed by two reviewers independently. Results: Seven articles were eligible to be included in the qualitative analysis. Three of them were included in meta analysis. One hundred and five patients received vibrating device to accelerate orthodontic treatment while forty-nine patients received shame device and seventy-eight patients were control group. Conclusion: There was no significant difference between vibrating devices group and control group. There is no evidence that vibrating appliances are effective in acceleration of orthodontic tooth movement.
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Periodontal regeneration with enamel matrix derivative in the management of generalized aggressive periodontitis: A case report with 11-year follow-up and literature review p. 13
Dimitra Trikka, Spyridon Vassilopoulos
Objectives: Aggressive periodontitis (AgP) represents an uncommon but rapidly advanced inflammatory process, which involves the destruction of periodontal tissues. This study aimed to report a case of generalized AgP (GAgP), where the treatment approach consists of the utilization of the full-mouth disinfection protocol (FMDP) in conjunction with flap curettage and regenerative appliance of enamel matrix derivatives (EMDs). The associated literature was also reviewed. Materials and Methods: A 19-year-old female patient was diagnosed with GAgP. The treatment was initiated with FMDP and administration of antibiotics. Afterward, open flap debridement was performed, and EMD was selected as the regenerative material for the reconstruction of the periodontal defects. Over an 11-year period and during all the phases of the treatment, the outcomes were regularly evaluated with clinical measurements and radiographic controls. Results: The 11-year results demonstrated no recurrence of disease, and the patient's periodontal health exhibited evident improvement. Overall, the pocket depths presented satisfactory reduction while the clinical attachment loss (CAL) was improved. Both our limited experience and available literature data revealed that the use of EMD in AgP treatment contributes to bone fill of the intrabony defects as well as regeneration of the destructed periodontal apparatus. Conclusions: Although the outcomes of this treatment approach have not been widely evaluated, it seems that the use of EMD may be an effective means of periodontal regeneration in patients with GAgP. Additional prospective studies with adequate number of GAgP patients are essential to thoroughly assess the effectiveness of this approach.
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Effect of audio-visual treatment information on hemodynamic parameters during the transalveolar extraction of mandibular third molars: A randomized clinical trial Highly accessed article p. 21
Rishi Raghav Saincher, Kalyana Chakravarthy Pentapati, Srikanth Gadicherla
Objectives: Anxiety regarding dental procedures is a universal challenge for every patient and the treating dental surgeon. Measurement of heart rate, blood pressure, and oxygen saturation is now commonly accepted by the scientific community as an accurate and objective measurement of the patient's anxiety compared to other subjective assessments. The aim of this study was to assess the influence of educational videos demonstrating transalveolar extraction of mandibular third molars on hemodynamic parameters. Materials and Methods: The study was designed as a prospective clinical trial. The modified dental anxiety scale was used to assess the preoperative anxiety of the patient. Participating patients were divided randomly into two groups (verbal and video group). Each patient's hemodynamic parameters such as heart rate, blood pressure, and oxygen saturation were measured in the waiting area, sitting on the dental chair, incision, bone drilling, tooth elevation, suturing, and in the postoperative area. All the analysis was done using the SPSS version 18 software. Results: Overall, there were no significant differences between the two groups with respect to hemodynamic parameters. The mean heart rate and blood pressure of patients between both groups were comparatively consistent and did not very much from the onset of procedure to the end. On the other hand, oxygen saturation levels were statistically significantly higher in the video group at the onset of incision and drilling. Conclusions: Videos can be interpreted in different ways by patients. Overall, hemodynamic parameters are overall not influenced with videos.
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Impact of habitual snoring on subjective dental esthetics in university population p. 27
Khaled Al-Dekhel, Saeed M Banabilh
Objective: The aims of this study were to assess the prevalence of snoring in the University population and to test the null hypothesis that there is no impact of habitual snoring on the self-perceived of dental esthetics. Materials and Methods: Berlin Questionnaire and esthetic component of the index of orthodontic treatment need was given to 700 students and employees aged 17–59 years (22 ± 4.5). Both snorers and nonsnorers were assessed for orthodontic treatment need. Chi-square and Student t-test were used to compare the difference between both groups using SPSS Statistics for Windows, Version 23.0. (IBM Corp, Armonk, NY). Results: The prevalence of snoring was 19.2% (male 11.8% and female 7.4%). Nodded off or fall asleep during driving a car or while waiting at least twice a month were reported in 46%. The prevalence of tiredness and fatigue after sleep from 3 to 4 times a week was 36.9% and during the working time was 33.6%. Based on the Berlin Questionnaire stratification for risk of obstructive sleep apnea (OSA), 8.2% were considered as a high-risk patient for OSA, (males: 3.8% and females: 4.4%). About 38.3% of the participants with habitual snoring have gone through orthodontic treatment, while only 28.5% of nonsnoring participant have done that. About 12.3% of snoring participant consider themselves in need of orthodontic treatment compared to 6.6% of a nonsnoring participant (P < 0.04). Conclusion: The null hypothesis is rejected; snoring has an impact on the self-perceived of dental esthetics. Snoring participant seeks orthodontic treatment more than the nonsnoring participant in our University population.
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Evaluation of nanomechanical properties, surface roughness, and color stability of esthetic nickel-titanium orthodontic archwires p. 33
Jamal A Alsanea, Hassan Al Shehri
Objectives: The objective of the study is to evaluate the surface roughness, nanomechancial properties the color stability of three brands of coated (rhodium, epoxy, and Teflon) nickel-titanium (NiTi) esthetic archwires. Materials and Methods: Three brands of coated (rhodium, epoxy, and Teflon) esthetic NiTi archwires and three brands of uncoated (NiTi) archwires from the same manufactures were evaluated for the surface roughness, nanomechanical properties, and color stability. The specimens with 20 mm length (n = 5) were cut from the straight buccal segments of the coated and uncoated archwires. The specimens with 20 mm length (n = 10) were subjected to color measurement after immersion in a coffee staining solution. The color measurement was evaluated after 7, 14, 21, and 28 days after immersion in staining solution using color eye 7000 spectrophotometer. The experimental data were analyzed using descriptive statistics, analyses of variance, and Tukey's post hoc test. Results: Epoxy (1.517 ± 0.071) and rhodium (0.297 ± 0.015) coated archwires showed the highest and lower value of surface roughness. All the intergroup comparisons showed a significant difference (P < 0.05) in surface roughness except between rhodium and control group (P = 0.998). There were significant differences between control and the experimental groups for both nanohardness and elastic modulus was observed. All the three NiTi-coated esthetic archwires demonstrated trace” (extremely slight change) color changes as measured by the National Bureau of Standards units after 4 weeks of immersion. Conclusion: Surface roughness of rhodium-coated archwires was almost similar to that of uncoated wires. Whereas Teflon and epoxy coated archwires showed a significant difference in surface roughness compared to uncoated archwires. Uncoated archwires showed higher nanohardness values compared to the coated archwires. Teflon-coated archwires demonstrated significantly slight color change after 4 weeks of immersion in staining solution.
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Comparison of the water sorption and solubility of four reline acrylic resins after immersion in food-simulating agents p. 40
Mitra Zirak, Mahroo Vojdani, Sorour Mohammadi, Amir-Alireza Khaledi
Objectives: Water sorption and water solubility adversely affect the mechanical properties and biocompatibility of the denture material. This study aimed to evaluate the water sorption and solubility of three direct hard reline acrylic resins and a heat-curing one after immersion in food-simulating agents. Materials and Methods: This study was performed on four groups of samples (n = 10 per group). The samples were made of three direct hard reline acrylic resins (TDV Cold Liner Rebase, Tokuyama Rebase II Fast, GC Reline Hard) and a heat-curing one (Meliodent). Each group was divided into four subgroups (n = 10) to undergo 7-day immersion in distilled water, 75% ethanol/water, 0.02 N citric acid, and heptane. Water sorption and solubility were calculated according to Oysaed and Ruyter formula. The statistical analyses were done by using SPSS software (version 22). Kruskal–Wallis H Test and Dunn's test were used to detect any significant difference among the groups (P < 0.05). Results: The median range of water solubility and water sorption values were −0.87–4.92 and 3.75–27.25 μg/mm3, respectively. The median solubility and sorption values of different resins differed significantly in the same solution (P < 0.05). Besides, immersion in different solutions caused significant differences in the median solubility and sorption values of each reline material (P < 0.05), except for Meliodent whose solubility was not significantly affected by different solutions (P = 0.16). Conclusions: Water sorption and solubility values of the tested hard reline resins were within the range of International Standards Organization 1567:1999. Given the low sorption and solubility values, these hard reline materials can be safely used in clinical situations.
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Assessment of inhibition of mineral loss from human tooth enamel by carbon dioxide laser and 1.23% acidulated phosphate fluoride p. 47
Vilas Takate, Adesh Kakade, Pooja Bheda, Kishor Dighe, NIharika Singh Rathore, Niharika Singh Chauhan
Aims and Objectives: The efficacy of carbon dioxide (CO2) laser irradiation combined with fluoride in inhibiting enamel demineralization has been demonstrated by several laboratory investigations. However, there are very few reports about the in situ or in vivo caries preventive effect of CO2laser combined with topical fluoride on dental enamel. Hence, an in situ study was designed and carried out to assess inhibition of mineral loss from human tooth enamel by CO2laser and 1.23% acidulated phosphate fluoride (APF). Material and Methods: Impressions of upper and lower arch of the volunteers were made in alginate impression material. Study models were poured, duplicated, and duly labeled. On the working model, appliances were fabricated in acrylic resin to fit the upper dental arch of the volunteers. Four enamel slabs (one from each group) were fitted on the palatal surface of the appliance as close as possible to posterior teeth. Surfaces of slabs were kept below the outer surface of acrylic. The analysis was done using SPSS version 15 (SPSS Inc., Chicago, IL, USA) Windows software program. Results: Statistically significant increase in inhibition of mineral loss of enamel slabs when treated individually or in a combination of low power CO2laser and 1.23% APF solution. The application of 1.23% APF solution after low power CO2laser treatment showed maximum inhibition of mineral loss. Conclusion: The combined use of this specific laser treatment plus fluoride was more successful than either laser treatment or fluoride alone in the inhibition of mineral loss in the mouth. The results of this study also suggest that the combination of low power laser treatment with fluoride therapy may be effective as a caries inhibition treatment.
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A clinical and radiographic evaluation of resonance frequency analysis of sand blasted acid etched (sae) and chemical modified sae dental implants p. 55
TP Beena Kumary, Anuj Singh Parihar, Joe Mathew, Ipe Sabu K, Sindhuja Kota Venkata, Prashant Babaji
Aims and Objective: Chemically modified and sandblasted acid-etched (SAE) mechanism leads to wettability of surfaces of dental implants which helps in osseointegration. The present study was conducted to determine the implant stability quotient (ISQ) of SAE and SAE chemically modified dental implants. Materials and Methods: The present study was conducted on 210 patients with 120 males and 90 females. Dental implants (Adin) with SAE (Group A) and SAE chemically modified (Group B) were inserted in patients. RFA was done immediately after implant insertion and after 1 week, 2 weeks, 6 weeks, 10 weeks, and 14 weeks. Results were statistically evaluated using SPSS Statistics for Windows, Version 21.0, IBM Corp., Armonk, NY, USA. Results: Maximum patients were in the age group of 25–35 years (males – 65, females – 48), followed by 35–45 years (males – 40, females – 32) and 45–55 years (males – 15, females – 10). Maximum dental implants were given in the right side (88) in males than females (56). On the left side, maximum implants were given in females (62) than males (56). Maximum RFA value of 86.2 and minimum value of 44.6 were observed in SAE dental implants (A). The maximum mean RFA value in chemically modified implants SAE (B) was 89.4 and minimum was 32.5. Conclusion: It was observed that surface treatment of dental implants shows higher implant–bone osseointegration. There is fastest osseointegration in implants with hydrophilic surfaces than those with SAE surfaces. ISQ was higher than 75 in both groups, which indicate higher implant stability.
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Arch expansion efficiency of coaxial tubular superelastic nickel-titanium in comparison to single-stranded superelastic nickel-titanium while relieving mandibular anterior crowding: A randomized controlled study p. 60
Joe Joseph, Vivek Suku Ninan, Merin Elsa Abraham, Jacob John, Karun Koshy Cherian, Reema Mary Thomas
Aim: The aim of the study is to compare the efficiency of six-stranded coaxial tubular superelastic nickel–titanium (NiTi) archwire and a single-stranded wire in relieving anterior mandibular crowding. Materials and Methods: This double-blind randomized study included 40 patients, categorized into two groups: Sentalloy round group and Speed tubular supercable group (20 each). After taking alginate impressions, the allocated archwire was engaged. With a digital caliper, intercanine, interpremolar, and intermolar width were recorded on the study models, immediately and at 4, 8, and 12 weeks stages. The Statistical Package for the Social Sciences (SPSS) version 20 was used for analysis. Results: The measured parameters were increased in both the groups, with the difference being insignificant statistically. Conclusion: Superelastic coaxial NiTi wires show better efficiency in relieving anterior crowding than single-stranded NiTi wire.
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Knowledge, attitude and practice of dental professionals towards substance use p. 65
Smita R Priyadarshini, Pradyumna Kumar Sahoo, Debkant Jena, Rajat Panigrahi, Swati Patnaik, Abhilash Mohapatra
Introduction: The dentist must be aware of this drug use in their individual patients to: (1) avoid possible contraindications during dental treatment, (2) be aware of the many oral and craniofacial manifestations of such drug use, (3) be able to provide necessary dental treatment to combat the dental/oral ravages of drug use, and (4) be able to refer such patients, if so desired by the patient. Aims and Objectives: The aim of the study is (1) To determine the knowledge of abusive drugs among dentists and (2) To determine the attitude and role of dentists in identifying patients with abusive drugs. Subjects and Methods: A modified 27-item questionnaire was formulated and distributed among the study. The participants were to return the filled questionnaire to the investigators within a week. A total of 203 validated entries were collected. Data were entered into Microsoft Excel 2007 and analyzed in SPSS V20. Associations between categorical variables were determined using Chi-square or Fisher's exact test. P < 0.05 was considered statistically significant. Results: Irrespective of the educational qualification drugs are perceived harmful with definite oral manifestations, and dentists should be concerned with identifying individuals with drugs. It is believed that trying drugs once could lead to possible addiction and that dental practitioners should have their skills developed to handle cases and referred to deaddiction centers with modification of treatment plans. Conclusions: Educating dental graduates and postgraduates about the oral implications of drugs intake and making it a part of the dental curriculum may help us dealing with the global issues of drugs. Even making dental students a part in counseling and part of the behavioral therapies advocated in treating drug addicts.
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Three-dimensional assessment of the oral health-related quality of life undergoing fixed orthodontic therapy p. 72
Jana Alqefari, Reema Albelaihi, Ramy Elmoazen, Rabia Bilal
Aims and Objectives: Discomfort associated with the use of fixed orthodontic appliances may have a negative influence on the patient's oral health-related quality of life (OHRQoL). In general, OHRQoL assessments have the potential to provide information on the need to improve the overall quality of care. This study aims to assess the impact of fixed orthodontic appliances on OHRQoL of Saudi population and to explore the impact of the patient's gender and age on perceived treatment. Subjects and Methods: This cross-sectional study used a generic measure of OHRQoL the Arabic version of the Oral Health Impact Profile (OHIP-14), which is a responsive measure to changes in oral health conditions. Data were collected using self-completed e-questionnaire which was distributed through social media and were analyzed using Statistical Package for Social Sciences (SPSS) version 21.0. Results: A total of 149 subjects, 110 (73.8%) were females and 39 (26.2%) were males. Adolescents between 13 and 20 years were 63 (42.3%) and adults between 21 and 30 years were 86 (75.7%). A response rate of 100% was obtained. The prevalence of oral health impacts according to OHP-14 was 22.5%. OHIP-14 consists of 14 items covering seven domains. A three-dimensional structure was used to test the existence of separate dimensions: functional limitation, pain discomfort, and psychosocial impact. A significant difference was found between males and females in the first dimension (P = 0.038) and the third dimension (P = 0.022). In addition, a significant difference was also found between the two age groups included in the study within the third dimension (P = 0.025). Conclusion: Fixed orthodontic appliances had an evident impact on OHRQoL. However, males had significantly altered functional limitations while females had a higher psychological impact. Furthermore, adults had a significantly higher psychological impact than adolescents.
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The impact of background music in reducing stress during preclinical dental laboratories p. 77
Sudhir Rama Varma, Shibu Thomas, Ahmed Al Radaideh, Suleiman Ergieg, Esraa Fayez, Lubna Malik
Objective: The reported high level of stress among dental students and its consequences, considering the known benefits of background music (BM). This study was designed to evaluate students' level of stress and impact of BM on their efficiency of work, performance, and learning ability during preclinical laboratory. Materials and Methods: In this cross-sectional questionnaire study, 61 preclinical students from the College of Dentistry, Ajman university-Fujairah campus who met the defined inclusion criteria participated. After a semester of the normal laboratory without BM, various genres of BM were introduced in the laboratory. Psychological stress assessment was done using the perceived stress scale. Students were asked to fill up a written feedback questionnaire at the end of 6 weeks of BM. Descriptive statistics and Chi-square test were used to study the statistical relationships among groups. Results: About 100% male and female students were found to be highly stressed due to exams and tests, 98% were stressed due to lack of time in the laboratory. About 82.5% females and 76% of males sample population expressed passion for music and also reported BM to be helpful to reduce stress in the preclinical laboratory and also to increase their concentration level. Conclusion: A strong positive relation has been shown in the reduction of stress with the BM in the preclinical laboratory.
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Knowledge, attitude, and behavior of restorative, orthodontic, and pediatric departments' members toward bisphenol A dental exposures p. 83
Sara M Bagher, Heba J Sabbagh, Mariam Aldajani, Nouf Al-Ghamdi, Ghufran Zaatari
Aim and Objectives: The aim of this study is to evaluate the knowledge, attitude, and behavior of Restorative, Orthodontic, and Pediatric Dentistry Departments' members at King Abdulaziz University (KAU), Jeddah, Saudi Arabia, toward bisphenol A (BPA) dental exposure. Materials and Methods: A survey was pretested for face and content validity. It included ten knowledge-, four attitude-, and five behavior-based items. The collected data were analyzed using Windows SPSS software version 22 (IBM Corp., Armonk, NY, USA). Significant levels were set at 0.05. Results: A total of 109 members participated in this study. Most of them (80 [73.4]) had never attended a lecture or read an article on BPA dental exposure previously. The restorative department members showed the highest (mean ± standard deviation score) in knowledge-based questions (3.32 ± 3.323), and those who reported that they had heard of BPA previously, read an article, or attended a lecture on BPA received significantly higher mean knowledge scores (P < 0.0001). The pediatric dentistry departments' members showed significantly higher agreements to attitude questions. Only ten participants (9.2%) followed the recommended guidelines to reduce patients' exposure to BPA during the application of BPA-containing dental materials. Conclusions: Reading an article or attending a lecture on BPA significantly improves the knowledge scores. Therefore, there is a need to increase the awareness on BPA dental exposure among different departments' members in KAU to ensure that BPA exposure to patients is minimized and to ensure the spread of this knowledge to the dental students.
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Predictors and level of job satisfaction among the dental workforce in national guard health affairs Highly accessed article p. 89
Abed Al-Hadi Hamasha, Abdulmajed Alturki, Nasser Alghofaili, Ahmed Alhomaied, Faisal Alsanee, Faris Aljaghwani, Mohammed Alhamdan, Ashraf El-Metwally
Objective: To assess the level of job satisfaction among the dental workforce in the National Guard Health Affairs (NGHA) in Saudi Arabia and to explore any predictors that have impact on the level of satisfaction. Materials and Methods: A cross-sectional study targeted dentists, dental assistants, dental hygienists, and dental lab technicians who are workers for the NGHA. A cluster random sampling procedure was conducted from seven dental centers. Data were collected through a self-reported questionnaire that was previously published. Satisfaction questions were related to (a) professional and personal life, (b) income and job security, (c) quality of service, and (d) prestige and self-perception domains. Data analysis included frequency distributions, and a comparison of mean using t-test was conducted using SPSS software. Results: The response rate was 55.5%. The mean satisfaction score was 65.7 out of 112 (2.9 out of 5). Of the four domains pertaining to job satisfactions, the highest mean score was obtained for quality of service (4.2 out of 5), followed by prestige and self-perception (2.8 out of 5), professional and personal life (2.8 out of 5), and income and job security (2.6 out of 5). Non-Saudis were found to be significantly more satisfied in professional and personal life; however, Saudi dentists were more satisfied for income and job security and quality of services. Conclusions: In general, the dental workforce practicing in NGHA experience a low level of job satisfaction. Professional and personal life, income and job security, and quality of services are all important factors affecting the level of job satisfaction.
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Esthetic clasp cast partial denture p. 94
Neeraja Turagam, Durga Prasad Mudrakola, Ravi Shankarbabu Yelamanchi, Mandava Deepthi, Manikandan Natarajan
Denture esthetics as defined by Glossary of prosthodontics terms the effect produced by a dental prosthesis that affects the beauty and attractiveness of the person.[1] Removable partial dentures (RPDs) are the widely accepted and treatment of choice for most cases as it is both effective and affordable. Partially edentulous treatment planning includes both esthetics and masticatory function. A prosthesis that is highly esthetic will improve patient's motivation and acceptance. It is a very wrong notion to expect that patients will tolerate unesthetic partial dentures because good masticatory capability has been achieved. Esthetics plays a vital role in the success of partial dentures, and the length and mobility of the patient's lips play a significant role in achieving it.[2] Patients with short lips or highly mobile lips pose problems as esthetics are compromised because most clasp arms, denture borders, and other components will show when the patient smiles or speaks.[3] RPDs can easily look artificial; hence, special emphasis should aim toward restoring function, phonetics, esthetics with a long-term benefits which requires meticulous attention during fabrication. This case reports is an esthetic clasp designed for a cast partial denture for a young girl for esthetic and function.
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