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  1. Dudley J, Pellew J, Jamayet NB
    Clin Case Rep, 2023 Jun;11(6):e7287.
    PMID: 37273667 DOI: 10.1002/ccr3.7287
    The conservative prosthodontic construction of an ocular prosthesis utilizing our novel threaded iris fabrication technique required high time and prosthodontic resource inputs and produced a lifelike aesthetic result.

    ABSTRACT: Patients with ocular defects frequently present with significant local anatomical deficiencies and complex histories and require extensive time and resource inputs to treat. This case report describes the conservative management of an ocular defect completed in a postgraduate prosthodontics clinical residency program utilizing a novel threaded iris fabrication technique.

  2. Jamayet NB, Kirangi JK, Husein A, Alam MK
    Eur J Dent, 2017 4 25;11(1):130-134.
    PMID: 28435380 DOI: 10.4103/1305-7456.202636
    Enucleation and evisceration are the most common surgical procedures that are performed to manage tumor, trauma, and infection. Given the consequences of surgical intervention, the conditions of the remaining eye socket may affect future prosthetic rehabilitation. A custom-made ocular prosthesis can be used to help restore the esthetics and functional defects and to improve the quality of life of patients with such conditions. An assessment must be performed on the prosthetic outcome before rehabilitation. The etiology of defect, type of surgery, condition of the remaining socket, and patient's age should all be considered. This report discusses three different etiological eye defects that have undergone enucleation and evisceration and describes the factors that have a significant role in the esthetic and functional outcome of the prosthesis. This report should serve as a helpful aid for maxillofacial prosthodontists to understand the primary objective of rehabilitating each eye defect and to meet patient expectations.
  3. Farook TH, Abdullah JY, Jamayet NB, Alam MK
    J Prosthet Dent, 2021 Feb 15.
    PMID: 33602541 DOI: 10.1016/j.prosdent.2020.07.039
    STATEMENT OF PROBLEM: Computer-aided design (CAD) of maxillofacial prostheses is a hardware-intensive process. The greater the mesh detail is, the more processing power is required from the computer. A reduction in mesh quality has been shown to reduce workload on computers, yet no reference value of reduction is present for intraoral prostheses that can be applied during the design.

    PURPOSE: The purpose of this simulation study was to establish a reference percentage value that can be used to effectively reduce the size and polygons of the 3D mesh without drastically affecting the dimensions of the prosthesis itself.

    MATERIAL AND METHODS: Fifteen different maxillary palatal defects were simulated on a dental cast and scanned to create 3D casts. Digital bulbs were fabricated from the casts. Conventional bulbs for the defects were fabricated, scanned, and compared with the digital bulb to serve as a control. The polygon parameters of digital bulbs were then reduced by different percentages (75%, 50%, 25%, 10%, 5%, and 1% of the original mesh) which created a total of 105 meshes across 7 mesh groups. The reduced mesh files were compared individually with the original design in an open-source point cloud comparison software program. The parameters of comparison used in this study were Hausdorff distance (HD), Dice similarity coefficient (DSC), and volume.

    RESULTS: The reduction in file size was directly proportional to the amount of mesh reduction. There were minute yet insignificant differences in volume (P>.05) across all mesh groups, with significant differences (P

  4. Xin KY, Eusufzai SZ, Jamayet NB, Alam MK
    Work, 2020;67(1):165-171.
    PMID: 32955481 DOI: 10.3233/WOR-203262
    BACKGROUND: Accidental occupational injuries increase the risk of communicable diseases like hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among dental personnel. Such occupational injuries affect healthcare quality by enhancing dissatisfaction and lack of motivation to work among dental personnel.

    OBJECTIVE: The present study aims to assess knowledge and awareness regarding needle stick and sharp injury among dental personnel and compared the knowledge and awareness level about needle stick injuries between dental professionals and dental supporting staff working at the School of Dental Sciences, Universiti Sains Malaysia.

    METHODS: This cross-sectional study was conducted from March 2016 to March 2017. The total sample included 112 registered dental personnel including dental professionals (lecturers, dental officers, and postgraduate students) and dental supportive staff (including staff nurses and dental surgery assistant) who were selected from the School of Dental Sciences, Universiti Sains Malaysia at Kelantan District of Malaysia. Data were collected by a structured questionnaire.

    RESULTS: In our study 60.7% respondents answered correctly for all the statements regarding knowledge and 51.8% of the respondents answered correctly for the statements regarding awareness on needle stick and sharp injury. No significant difference of knowledge level has been observed between the dental professionals and dental supportive staff (p 

  5. Farook TH, Barman A, Abdullah JY, Jamayet NB
    J Prosthodont, 2021 Jun;30(5):420-429.
    PMID: 33200429 DOI: 10.1111/jopr.13286
    PURPOSE: Mesh optimization reduces the texture quality of 3D models in order to reduce storage file size and computational load on a personal computer. This study aims to explore mesh optimization using open source (free) software in the context of prosthodontic application.

    MATERIALS AND METHODS: An auricular prosthesis, a complete denture, and anterior and posterior crowns were constructed using conventional methods and laser scanned to create computerized 3D meshes. The meshes were optimized independently by four computer-aided design software (Meshmixer, Meshlab, Blender, and SculptGL) to 100%, 90%, 75%, 50%, and 25% levels of original file size. Upon optimization, the following parameters were virtually evaluated and compared; mesh vertices, file size, mesh surface area (SA), mesh volume (V), interpoint discrepancies (geometric similarity based on virtual point overlapping), and spatial similarity (volumetric similarity based on shape overlapping). The influence of software and optimization on surface area and volume of each prosthesis was evaluated independently using multiple linear regression.

    RESULTS: There were clear observable differences in vertices, file size, surface area, and volume. The choice of software significantly influenced the overall virtual parameters of auricular prosthesis [SA: F(4,15) = 12.93, R2 = 0.67, p < 0.001. V: F(4,15) = 9.33, R2 = 0.64, p < 0.001] and complete denture [SA: F(4,15) = 10.81, R2 = 0.67, p < 0.001. V: F(4,15) = 3.50, R2 = 0.34, p = 0.030] across optimization levels. Interpoint discrepancies were however limited to <0.1mm and volumetric similarity was >97%.

    CONCLUSION: Open-source mesh optimization of smaller dental prostheses in this study produced minimal loss of geometric and volumetric details. SculptGL models were most influenced by the amount of optimization performed.

  6. Farook TH, Jamayet NB, Abdullah JY, Alam MK
    Pain Res Manag, 2021;2021:6659133.
    PMID: 33986900 DOI: 10.1155/2021/6659133
    Purpose: The study explored the clinical influence, effectiveness, limitations, and human comparison outcomes of machine learning in diagnosing (1) dental diseases, (2) periodontal diseases, (3) trauma and neuralgias, (4) cysts and tumors, (5) glandular disorders, and (6) bone and temporomandibular joint as possible causes of dental and orofacial pain.

    Method: Scopus, PubMed, and Web of Science (all databases) were searched by 2 reviewers until 29th October 2020. Articles were screened and narratively synthesized according to PRISMA-DTA guidelines based on predefined eligibility criteria. Articles that made direct reference test comparisons to human clinicians were evaluated using the MI-CLAIM checklist. The risk of bias was assessed by JBI-DTA critical appraisal, and certainty of the evidence was evaluated using the GRADE approach. Information regarding the quantification method of dental pain and disease, the conditional characteristics of both training and test data cohort in the machine learning, diagnostic outcomes, and diagnostic test comparisons with clinicians, where applicable, were extracted.

    Results: 34 eligible articles were found for data synthesis, of which 8 articles made direct reference comparisons to human clinicians. 7 papers scored over 13 (out of the evaluated 15 points) in the MI-CLAIM approach with all papers scoring 5+ (out of 7) in JBI-DTA appraisals. GRADE approach revealed serious risks of bias and inconsistencies with most studies containing more positive cases than their true prevalence in order to facilitate machine learning. Patient-perceived symptoms and clinical history were generally found to be less reliable than radiographs or histology for training accurate machine learning models. A low agreement level between clinicians training the models was suggested to have a negative impact on the prediction accuracy. Reference comparisons found nonspecialized clinicians with less than 3 years of experience to be disadvantaged against trained models.

    Conclusion: Machine learning in dental and orofacial healthcare has shown respectable results in diagnosing diseases with symptomatic pain and with improved future iterations and can be used as a diagnostic aid in the clinics. The current review did not internally analyze the machine learning models and their respective algorithms, nor consider the confounding variables and factors responsible for shaping the orofacial disorders responsible for eliciting pain.

  7. Farook TH, Radford J, Alam MK, Jamayet NB
    Br Dent J, 2020 Oct 20.
    PMID: 33082524 DOI: 10.1038/s41415-020-2026-4
    Objective Following a survey of the literature, a systematic review was carried out with the aim of answering the following questions: 1) What is 'acceptable plagiarism'?; 2) Who carries out plagiarism?; 3) What factors could encourage plagiarism?; 4) How can plagiarism be managed?Data source and selection Following PRISMA guidelines, data were gathered by searching Scopus, PubMed and Web of Science. After removal of duplicates, 345 titles were identified. Then, having satisfied a priori eligibility criteria, 29 papers were interrogated. The quality of relevant papers (n = 23) was assessed using the Joanna Briggs Critical Appraisal Tool.Data extraction There was no clear threshold as to what is 'acceptable plagiarism'. Despite this lack of clarity, it is argued consistently that males, and those who wrote in a language that is not their mother tongue, were more likely to plagiarise.Conclusion Plagiarism is all but inescapable due to various reasons: 1) there is no agreed threshold as to what is 'acceptable plagiarism'; 2) the internet; 3) institutional; and 4) societal expectations. Plagiarism could be mitigated in the student domain by grammar support and, for example, non-written submissions such as presenting work by video. Academic fraud is fundamentally undermined by valuing original and creative scholarship and sound ethical principles.
  8. Jamayet NB, Rahman AM, Nizami MMUI, Johari Y, Husein A
    Indian J Dent Res, 2018 12 28;29(6):840-843.
    PMID: 30589017 DOI: 10.4103/ijdr.IJDR_20_17
    Exenteration surgery greatly affects a person in terms of function, esthetics, and psychological trauma. In such cases, restoration by silicone orbital prosthesis is a well-accepted treatment option. However, this is a difficult task, necessitating personalized design of method for each patient. This case report describes the technique for fabrication of a silicone orbital prosthesis for a male patient with left orbital defect due to exenteration of a Grade 3 squamous cell carcinoma of the left eye and surrounding tissues. The patient was delivered with a satisfactory silicone orbital prosthesis having good retention and finish. Multidisciplinary management and team approach are crucial in providing precise and effective rehabilitation for improving the patient's quality of life and help them return to their normal social life.
  9. Beh YH, Farook TH, Jamayet NB, Dudley J, Rashid F, Barman A, et al.
    Cleft Palate Craniofac J, 2021 03;58(3):386-390.
    PMID: 32808548 DOI: 10.1177/1055665620950074
    OBJECTIVE: The virtual cone beam computed tomography-derived 3-dimensional model was compared with the scanned conventional model used in the fabrication of a palatal obturator for a patient with a large palatal defect.

    DESIGN: A digitally derived 3-dimensional maxillary model incorporating the palatal defect was generated from the patient's existing cone beam computerized tomography data and compared with the scanned cast from the conventional impression for linear dimensions, area, and volume. The digitally derived cast was 3-dimensionally printed and the obturator fabricated using traditional techniques. Similarly, an obturator was fabricated from the conventional cast and the fit of both final obturator bulbs were compared in vivo.

    RESULTS: The digitally derived model produced more accurate volumes and surface areas within the defect. The defect margins and peripheries were overestimated which was reflected clinically.

    CONCLUSION: The digitally derived model provided advantages in the fabrication of the palatal obturator; however, further clinical research is required to refine consistency.

  10. Barman A, Rashid F, Farook TH, Jamayet NB, Dudley J, Yhaya MFB, et al.
    Polymers (Basel), 2020 Jul 12;12(7).
    PMID: 32664615 DOI: 10.3390/polym12071536
    Although numerous studies have demonstrated the benefits of incorporating filler particles into maxillofacial silicone elastomer (MFPSE), a review of the types, concentrations and effectiveness of the particles themselves was lacking. The purpose of this systematic review and meta-analysis was to review the effect of different types of filler particles on the mechanical properties of MFPSE. The properties in question were (1) tensile strength, (2) tear strength, (3) hardness, and (4) elongation at break. The findings of this study can assist operators, technicians and clinicians in making relevant decisions regarding which type of fillers to incorporate based on their needs. The systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 26 original articles from 1970 to 2019 were selected from the databases, based on predefined eligibility criteria by two reviewers. The meta-analyses of nine papers were carried out by extracting data from the systematic review based on scoring criteria and processed using Cochrane Review Manager 5.3. Overall, there were significant differences favoring filler particles when incorporated into MFPSE. Nano fillers (69.23% of all studies) demonstrated superior comparative outcomes for tensile strength (P < 0.0001), tear strength (P < 0.00001), hardness (P < 0.00001) and elongation at break (P < 0.00001) when compared to micro fillers (30.76% of all studies). Micro fillers demonstrated inconsistent outcomes in mechanical properties, and meta-analysis of elongation at break argued against (P < 0.01) their use. Current findings suggest that 1.5% ZrSiO4, 3% SiO2, 1.5% Y2O3, 2-6% TiO2, 2-2.5% ZnO, 2-2.5% CeO2, 0.5% TiSiO4 and 1% Ag-Zn Zeolite can be used to reinforce MFPSE, and help the materials better withstand mechanical degradation.
  11. Rahman AM, Jamayet NB, Nizami MMUI, Johari Y, Husein A, Alam MK
    J Prosthet Dent, 2021 Jan 17.
    PMID: 33472753 DOI: 10.1016/j.prosdent.2020.07.026
    STATEMENT OF PROBLEM: The climate of tropical Southeast Asia includes high humidity and ultraviolet radiation that reduce the lifespan of silicone prostheses by inducing changes in their mechanical properties and color stability. Studies on the surface roughness (SR) and mechanical properties of different silicone elastomers (SEs) subjected to the natural tropical weather of Southeast Asia are lacking.

    PURPOSE: The purpose of this in vitro study was to evaluate the SR, tensile strength (TS), and percentage elongation (% E) of different SEs subjected to outdoor weathering in the Malaysian climate.

    MATERIAL AND METHODS: Type-II dumbbell-shaped specimens (N-120) (nonweathered=15, weathered=15) were made from 3 room-temperature vulcanized (A-2000, A-2006, and A-103) and 1 heat-temperature vulcanized (M-511) silicone (Factor II). For 6 months, weathered specimens were subjected to outdoor weathering inside a custom exposure rack. Simultaneously, the nonweathered specimens were kept in a dehumidifier. Subsequently, the SR was measured with a profilometer; TS and % E were measured by using a universal testing machine. Two-way ANOVA was used to compare the means of the tested properties of the nonweathered and weathered specimens, and pairwise comparison was carried out between the silicones (α=.05).

    RESULTS: After outdoor weathering, the SR, TS, and % E were adversely affected by weathering in the Malaysian environment. Among the silicone materials, A-2000 showed the least TS changes (2.51 MPa), while A-2006 demonstrated significant changes in percentage elongation after outdoor weathering (266.5%). M-511 exhibited the highest mean value (2.50 μm) for SR changes. In addition, A-103 SE showed statistically significant differences in most pairwise comparisons for all 3 dependent variables.

    CONCLUSIONS: Based on the evaluation of mechanical properties, A-103 can be suggested as a suitable silicone for maxillofacial prostheses fabricated for tropical climates. However, A-2000 can be a suitable alternative, although significant changes to surface roughness were detected after outdoor weathering.

  12. Ahmed N, Halim MSB, Ghani ZA, Khan ZA, Abbasi MS, Jamayet NB, et al.
    Biomed Res Int, 2021;2021:6674400.
    PMID: 33969123 DOI: 10.1155/2021/6674400
    The objective of this paper was to evaluate the existence of golden percentage in natural maxillary anterior teeth with the aid of 3D digital dental models and 2D photographs. And to propose regional values of golden percentage for restoration of maxillary anterior teeth. For this purpose, one hundred and ninety dentate subjects with sound maxillary anterior teeth were selected. Standardized frontal images were captured with DSLR, and the apparent width of maxillary anterior teeth was measured utilizing a software on a personal laptop computer. Once the dimensions were recorded, the calculations were made according to the golden percentage theory (GPT). The data were analyzed by independent and paired T-test. The level of significance was set at p < 0.05. The golden percentage values were not found in this study. The values obtained were 16%, 15%, 20%, 20%, 15%, and 16% moving from the right canine to the left canine teeth. There was no significant gender difference in the golden percentage values. Thus, golden percentage should not be used solely for the correction of anterior teeth or for determining dental attractiveness. Emphasis should be given to a range of dental proportion on regional basis.
  13. Alam MK, Alfawzan AA, Haque S, Mok PL, Marya A, Venugopal A, et al.
    Front Pediatr, 2021;9:651951.
    PMID: 34026687 DOI: 10.3389/fped.2021.651951
    To investigate whether the craniofacial sagittal jaw relationship in patients with non-syndromic cleft differed from non-cleft (NC) individuals by artificial intelligence (A.I.)-driven lateral cephalometric (Late. Ceph.) analysis. The study group comprised 123 subjects with different types of clefts including 29 = BCLP (bilateral cleft lip and palate), 41 = UCLP (unilateral cleft lip and palate), 9 = UCLA (unilateral cleft lip and alveolus), 13 = UCL (unilateral cleft lip) and NC = 31. The mean age was 14.77 years. SNA, SNB, ANB angle and Wits appraisal was measured in lateral cephalogram using a new innovative A.I driven Webceph software. Two-way ANOVA and multiple-comparison statistics tests were applied to see the differences between gender and among different types of clefts vs. NC individuals. A significant decrease (p < 0.005) in SNA, ANB, Wits appraisal was observed in different types of clefts vs. NC individuals. SNB (p > 0.005) showed insignificant variables in relation to type of clefts. No significant difference was also found in terms of gender in relation to any type of clefts and NC group. The present study advocates a decrease in sagittal development (SNA, ANB and Wits appraisal) in different types of cleft compared to NC individuals.
  14. Farook TH, Jamayet NB, Abdullah JY, Asif JA, Rajion ZA, Alam MK
    Comput Biol Med, 2020 03;118:103646.
    PMID: 32174323 DOI: 10.1016/j.compbiomed.2020.103646
    OBJECTIVE: To design and compare the outcome of commercial (CS) and open source (OS) software-based 3D prosthetic templates for rehabilitation of maxillofacial defects using a low powered personal computer setup.

    METHOD: Medical image data for five types of defects were selected, segmented, converted and decimated to 3D polygon models on a personal computer. The models were transferred to a computer aided design (CAD) software which aided in designing the prosthesis according to the virtual models. Two templates were designed for each defect, one by an OS (free) system and one by CS. The parameters for analyses were the virtual volume, Dice similarity coefficient (DSC) and Hausdorff's distance (HD) and were executed by the OS point cloud comparison tool.

    RESULT: There was no significant difference (p > 0.05) between CS and OS when comparing the volume of the template outputs. While HD was within 0.05-4.33 mm, evaluation of the percentage similarity and spatial overlap following the DSC showed an average similarity of 67.7% between the two groups. The highest similarity was with orbito-facial prostheses (88.5%) and the lowest with facial plate prosthetics (28.7%).

    CONCLUSION: Although CS and OS pipelines are capable of producing templates which are aesthetically and volumetrically similar, there are slight comparative discrepancies in the landmark position and spatial overlap. This is dependent on the software, associated commands and experienced decision-making. CAD-based templates can be planned on current personal computers following appropriate decimation.

  15. Ahmed N, Halim MS, Khalid S, Ghani ZA, Jamayet NB
    J Prosthet Dent, 2021 Jul 31.
    PMID: 34340826 DOI: 10.1016/j.prosdent.2021.06.015
    STATEMENT OF PROBLEM: The color and form of teeth are 2 of the 3 main determinants of success in an esthetic restoration; the third is dental proportion. A recent systematic review of the literature devoted to the evaluation of dental proportion is lacking.

    PURPOSE: The purpose of this systematic review was to investigate the quality and outcome of studies into maxillary anterior tooth proportion and to determine whether dental proportion ratios based on different geographic regions are appropriate.

    MATERIAL AND METHODS: An electronic search was conducted using PubMed, MEDLINE, Google Scholar, Embase, Scopus, Cochrane Library, Web of Science, and Science Direct databases. English-language articles reporting with the specific combination of medical subject heading (MeSH) key words were analyzed by 2 investigators. The titles, full text, and abstracts were scanned by investigators independently to identify articles that fulfilled the inclusion criteria. The general characteristics, outcomes, and quality of each study were reviewed and analyzed systematically.

    RESULTS: The search plan resulted in a total of 73 articles until September 2020; of which, 16 articles fulfilling the inclusion criteria were selected. The geographic distribution of the selected article revealed 12 articles from Asia, 2 from Continental Europe, and 2 from the United Kingdom. Golden percentage values of 25%, 15%, and 10% for central, lateral incisor, and canine teeth were not found. The mean predicted dental percentage was either larger or smaller than the successive widths of maxillary natural anterior teeth.

    CONCLUSIONS: The golden percentage could not be used to formulate a smile design. Rather, the dental ratios should be set on a racial and ethnic basis for a population.

  16. Al-Oulabi A, Al Rawas M, Farook TH, Rashid F, Barman A, Jamayet NB, et al.
    Work, 2021 Jun 25.
    PMID: 34180457 DOI: 10.3233/WOR-213519
    BACKGROUND: Two patients received ocular injuries from rusted metallic projectiles at their industrial workplaces. Said injuries resulted in the loss of their eyes by evisceration surgeries to prevent fatal infections.

    CASE DESCRIPTION: The first case, a man in his twenties, received a stock conformer immediately after surgery and started prosthetic therapy within 2 months. The second case, a man in his forties, started prosthetic therapy after 10 years. Definitive custom ocular prostheses were fabricated and relined according to conventional protocol.

    RESULTS: On issue of the prosthesis, there was adequate retention, aesthetics and stability to extra-ocular movements and treatment was considered successful for both cases. However, follow-ups showed noticeable prosthetic eye movements for case 1 which, to some extent mimicked the physiologic movement of its fellow natural eye. Case 1 adjusted to his prosthesis better while case 2 was still adjusting with little to no physiologic movement.

    CONCLUSION: Prosthetic rehabilitation should be started as early as possible to obtain optimum rehabilitative results.

  17. Mousa MA, Abdullah JY, Jamayet NB, El-Anwar MI, Ganji KK, Alam MK, et al.
    Biomed Res Int, 2021;2021:5699962.
    PMID: 34485518 DOI: 10.1155/2021/5699962
    The present study was aimed at reviewing the studies that used finite element analysis (FEA) to estimate the biomechanical stress arising in removable partial dentures (RPDs) and how to optimize it. A literature survey was conducted for the English full-text articles, which used only FEA to estimate the stress developed in RPDs from Jan 2000 to May 2021. In RPDs, the retaining and supporting structures are subjected to dynamic loads during insertion and removal of the prosthesis as well as during function. The majority of stresses in free-end saddle (FES) RPDs are concentrated in the shoulder of the clasp, the horizontal curvature of the gingival approaching clasp, and the part of the major connector next to terminal abutments. Clasps fabricated from flexible materials were beneficial to eliminate the stress in the abutment, while rigid materials were preferred for major connectors to eliminate the displacement of the prosthesis. In implant-assisted RPD, the implant receive the majority of the load, thereby reducing the stress on the abutment and reducing the displacement of the prosthesis. The amount of stress in the implant decreases with zero or minimal angulation, using long and wide implants, and when the implants are placed in the first molar area.
  18. Mousa MA, Abdullah JY, Jamayet NB, Alam MK, Husein A
    Biomed Res Int, 2021;2021:6419774.
    PMID: 34447852 DOI: 10.1155/2021/6419774
    Aim: This systematic review is aimed at investigating the biomechanical stress that develops in the maxillofacial prostheses (MFP) and supporting structures and methods to optimize it. Design and Methods. A literature survey was conducted for full-text English articles which used FEA to examine the stress developed in conventional and implant-assisted MFPs from January 2010 to December 2020.

    Results: 87 articles were screened to get an update on the desired information. 74 were excluded based on a complete screening, and finally, 13 articles were recruited for complete reviewing. Discussion. The MFP is subjected to stress, which is reflected in the form of compressive and tensile strengths. The stress is mainly concentrated the resection line and around the apices of roots of teeth next to the defect. Diversity of designs and techniques were introduced to optimize the stress distribution, such as modification of the clasp design, using materials with different mechanical properties for dentures base and retainer, use of dental (DI) and/or zygomatic implants (ZI), and free flap reconstruction before prosthetic rehabilitation.

    Conclusion: Using ZI in the defective side of the dentulous maxillary defect and defective and nondefective side of the edentulous maxillary defect was found more advantageous, in terms of compression and tensile stress and retention, when compared with DI and free flap reconstruction.

  19. Rahman AM, Jamayet NB, Nizami MMUI, Johari Y, Husein A, Alam MK
    J Prosthodont, 2019 Jan;28(1):36-48.
    PMID: 30043482 DOI: 10.1111/jopr.12950
    PURPOSE: This systematic review aims to identify and interpret results of studies that evaluated the changes in the physical properties of maxillofacial prosthetic materials (1) without aging, (2) after natural or artificial accelerated aging, and (3) after outdoor weathering.

    METHODS: Relevant articles written in English only, before January 15, 2017, were identified using an electronic search in the PubMed, Scopus, and Google Scholar databases. Furthermore, a manual search of the related major journals was also conducted to identify more pertinent articles. The relevancy of the articles was verified by screening the title, abstract, and full text if they met the inclusion criteria. A total of 37 articles satisfied the criteria, from which data were extracted for qualitative synthesis.

    RESULTS: Among the 37 included articles, 14 were without aging, 15 were natural or artificial accelerated aging, 7 were outdoor weathering, and 1 contained both artificial aging and outdoor weathering. Only 4 studies out of the 14 without aging had significant observations; whereas 9 articles with natural or artificial aging published significant results, and 3 out of 7 outdoor weathering articles showed significant changes in the evaluated silicone elastomers.

    CONCLUSIONS: Despite the varying research, it seems that the single "ideal" maxillofacial prosthetic material that can provide sufficient resistance against different aging conditions is yet to be identified. Therefore, it is imperative for standardization organizations, the scientific community, and academia to develop modified prosthetic silicones possessing improved physical properties and color stability, limiting the clinical problems regarding degradation of maxillofacial prostheses.

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