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  1. Seong, Lim Ghee, Buzayan, Muaiyed Mahmoud Ali, Elkezza, Aeman
    JUMMEC, 2021;24(1):23-29.
    MyJurnal
    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.
  2. Buzayan, Muaiyed Mahmoud, Omar Tawfiq, Choudhary, Suchismita, Sivakumara, Indumathi, Norsiah Yunus, Elkezza, Aeman
    Archives of Orofacial Sciences, 2017;12(2):110-113.
    MyJurnal
    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.
  3. Khalid T, Yunus N, Ibrahim N, Elkezza A, Masood M
    Clin Oral Implants Res, 2017 May;28(5):535-542.
    PMID: 26989853 DOI: 10.1111/clr.12831
    OBJECTIVE: To determine oral health-related quality of life (OHRQoL) and denture satisfaction (DS) in patients provided with mandibular implant-supported overdentures (ISOD) retained by two different attachment types, and the association of mandibular bone volume with the change in patient-reported outcome, before and after implant treatment.

    MATERIAL AND METHODS: Thirty-four patients (mean age 60.70  ±  8.7 years) received telescopic crown or locator attachments for ISOD and completed OHIP-14 (Malaysian version) and DS questionnaires, at baseline (T0 ) with new conventional complete dentures (CCD) and 3 months (T1 ) and 3 years (T2 ) after ISOD conversion. Mandibular bone volume was calculated from cone beam computed tomography (CBCT) datasets using Mimics software. Mean changes (MC) in OHIP-14 and DS at intervals were analyzed using the Wilcoxon signed-rank test and effect size (ES). The association of bone volume, implant attachment type, and other patient variables with the change in OHIP-14 and DS were determined using multivariate linear regression analysis.

    RESULTS: The MC in OHIP-14 and DS scores from T0 to T1 and T2 showed significant improvement with moderate and large ES, respectively. Regression analyses for the change in OHIP-14 score from T0 to T2 showed significant association with implant attachment type (P = 0.043), bone volume (P = 0.004), and baseline OHIP-14 (P = 0.001), while for DS, the association was only significant with baseline DS score (P = 0.001).

    CONCLUSION: Improvement in patients' OHRQoL and satisfaction with ISOD was associated with their baseline ratings. Mandibular bone volume had a stronger association for improvement in OHRQoL compared to type of attachment.

  4. 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.

  5. Mofreh Altarawneh H, Nasser Alhajj M, Mohd Salleh N, Elkezza AHH, Adida Mahmood W
    Acta Stomatol Croat, 2023 Dec;57(4):329-338.
    PMID: 38283308 DOI: 10.15644/asc57/4/4
    OBJECTIVES: This study aimed to assess the color stability, surface roughness, and flexural properties of the injection-molded thermoplastic polyamide Vertex ThermoSens denture base resin following a 3-minute immersion in Polident 3-minute denture cleanser.

    METHODS: Sixty specimens (Vertex ThermoSens) were processed and divided into two main groups (n = 30) based on the type of test. Group 1 was further subdivided into two subgroups (n = 15): the control group immersed in distilled water (G1DW) and the test group immersed in Polident cleanser solution (G1PD). Group 2 was divided into three subgroups: a non-immersed group (G2None), a group immersed in distilled water (G2DW), and a group immersed in Polident cleanser solution (G2PD). Color change (∆E) and surface roughness measurements were conducted for group 1, and flexural modulus (E) test was performed for group 2. The CIE Lab* formula was utilized to calculate ∆E. An optical 3D surface analyzer and a three-point bending test were employed for surface roughness and E assessments, respectively. Data were subjected to statistical analysis using a paired-sample t-test for differences within each group before and after immersion. Furthermore, independent-sample t-tests and one-way ANOVA were conducted to analyze differences between groups. A significance level of P < 0.05 was considered.

    RESULTS: The results revealed a slight, statistically insignificant (P > 0.05) ∆E in all color components (L*, a*, b*) after immersion in distilled water. However, after immersion in the denture cleanser, only the L* component exhibited a statistically significant ∆E (P = 0.002), which was slight in magnitude. Additionally, a significant difference was found in the ∆E between G1DW and G1PD, with G1PD showing a higher change (P = 0.007). A significant increase in surface roughness after immersion was observed in G1PD (P = 0.017), with a notable difference between G1DW and G1PD. However, the E remained unaffected (P = 0.537).

    CONCLUSION: Denture cleansers have the potential to modify the properties of thermoplastic polyamide resin. Further research is needed to explore the clinical implications of these observed changes on denture performance.

  6. Asaduzzaman K, Mannan F, Khandaker MU, Farook MS, Elkezza A, Amin YB, et al.
    PLoS One, 2015;10(10):e0140667.
    PMID: 26473957 DOI: 10.1371/journal.pone.0140667
    The concentrations of primordial radionuclides (226Ra, 232Th and 40K) in commonly used building materials (brick, cement and sand), the raw materials of cement and the by-products of coal-fired power plants (fly ash) collected from various manufacturers and suppliers in Bangladesh were determined via gamma-ray spectrometry using an HPGe detector. The results showed that the mean concentrations of 226Ra, 232Th and 40K in all studied samples slightly exceeded the typical world average values of 50 Bq kg(-1), 50 Bq kg(-1) and 500 Bq kg(-1), respectively. The activity concentrations (especially 226Ra) of fly-ash-containing cement in this study were found to be higher than those of fly-ash-free cement. To evaluate the potential radiological risk to individuals associated with these building materials, various radiological hazard indicators were calculated. The radium equivalent activity values for all samples were found to be lower than the recommended limit for building materials of 370 Bq kg(-1), with the exception of the fly ash. For most samples, the values of the alpha index and the radiological hazard (external and internal) indices were found to be within the safe limit of 1. The mean indoor absorbed dose rate was observed to be higher than the population-weighted world average of 84 nGy h(-1), and the corresponding annual effective dose for most samples fell below the recommended upper dose limit of 1 mSv y(-1). For all investigated materials, the values of the gamma index were found to be greater than 0.5 but less than 1, indicating that the gamma dose contribution from the studied building materials exceeds the exemption dose criterion of 0.3 mSv y(-1) but complies with the upper dose principle of 1 mSv y(-1).
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