The success of the endodontic treatment depends on the microbial suppression in the root canal and periapical region. Endodontic instrumentation alone cannot achieve a sterile condition. With the advent of non-instrumentation endodontic treatment and lesion sterilization and tissue repair, local application of antibiotics has been investigated. Triple antibiotic paste (TAP) containing metronidazole, ciprofloxacin, and minocycline has been reported to be a successful regimen in controlling the root canal pathogen and in managing non-vital young permanent tooth. This paper reviews the existing literature on biocompatibility, efficiency, drawbacks of TAP in endodontic therapy and pulp revascularization.

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Aggressive periodontitis, although not rare, is a fairly unknown condition. Little is known about its optimal management. While majority of patients with common forms of periodontal disease respond predictably well to conventional therapy (oral hygiene instructions (OHI), non-surgical debridement, surgery, and Supportive Periodontal therapy (SPT)), patients diagnosed with aggressive form of periodontal disease often do not respond predictably/favorably to conventional therapy owing to its complex multi-factorial etiology. Protocols for treating aggressive periodontitis are largely empirical. There is compelling evidence that adjunctive antibiotic treatment frequently results in more favorable clinical response than conventional therapy alone. This article mainly focuses on the role of adjunct use of pharmacological agents in improving the prognosis and treatment outcome of aggressive periodontitis patients.

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Immunohistochemistry (IHC) is an important application of monoclonal as well as polyclonal antibodies to determine the tissue distribution of an antigen of interest in health and disease. IHC is widely used for diagnosis of cancers; specific tumor antigens are expressed de novo or up-regulated in certain cancers. This article deals with the various applications of IHC in diagnosis of diseases, with IHC playing an important role in diagnostic and research laboratories.

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Objectives: The aim of our study is to determine the changes in quality of life and patient's perception of esthetic improvement after anterior maxillary osteotomy. Materials and Methods: Our prospective study consisted of 14 patients who had been diagnosed of skeletal orthodontic deformity and underwent anterior maxillary osteotomy, along with orthodontic correction. The quality of life was evaluated using questionnaires based on Oral Health Impact Profile-14 questionnaire (OHIP-14) and a 22-item orthognathic quality of life questionnaire. They were evaluated at baseline pre-surgical, 8 weeks postoperatively, and 24 weeks postoperatively. Results: Our results showed mild improvement in generic health related quality of life immediately following surgery, while condition-specific quality of life and patient's perception of esthetic improvement were noted only at 24 weeks following anterior maxillary osteotomy. Conclusion: We conclude that anterior maxillary osteotomy had a positive impact on the quality of life. The improvement in patient's perception of esthetics is seen only 2 months after surgery, while improvements in oral health and function were seen within 2 months following surgery. The acceptance and satisfaction of patient toward surgery was more positive 2 months after surgery.

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Microarray is one of the most recent advances being used for cancer research; it provides assistance in pharmacological approach to treat various diseases including oral lesions. Microarray helps in analyzing large amount of samples which have either been recorded previously or new samples; it even helps to test the incidence of a particular marker in tumors. Till recently, microarray's usage in dentistry has been very limited, but in future, as the technology becomes affordable, there may be increase in its usage. Here, we discuss the various techniques and applications of microarray or DNA chip.

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Orthodontic treatment is based on the premise that when force is delivered to a tooth and thereby transmitted to the adjacent investing tissues, certain mechanical, chemical, and cellular events take place within these tissues, which allow for structural alterations and contribute to the movement of that tooth. Molecules present in drugs and nutrients consumed regularly by patients can reach the mechanically stressed paradental tissues through the circulation and interact with local target cells. The combined effect of mechanical forces and one or more of these agents may be inhibitory, additive, or synergistic. Current orthodontic research aims to develop methods of increasing the tissue concentration of molecules promoting tooth movement, while simultaneously decreasing the concentration of unwanted elements which can produce harmful side effects. This article discusses in detail the various possible drugs that can bring about alterations in the desired orthodontic tooth movement.

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Impaction of maxillary and mandibular canines is a frequently encountered clinical problem, the treatment of which usually requires an interdisciplinary approach. Surgical exposure of the impacted tooth and the complex orthodontic mechanisms that are applied to align the tooth into the arch may lead to varying amounts of damage to the supporting structures of the tooth, not to mention the long treatment duration and the financial burden to the patient. Hence, it seems worthwhile to focus on the means of early diagnosis and interception of this clinical situation. In the present article, an overview of the incidence and sequelae, as well as the surgical, periodontal, and orthodontic considerations in the management of impacted canines is presented.

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Diabetes mellitus is a systemic disease characterized by increased blood glucose levels and abnormalities of lipid metabolism due to absence or decreased level of insulin. It affects all the body organs and their functions either directly or indirectly. Every dentist should have a basic understanding of the etiopathogenesis, oral and systemic manifestations of this disease. The periodontal diseases are a consequence of extension of the gingival inflammation into the underlying supporting structures of the periodontium, initiated by the presence of plaque and its products on the surfaces of the teeth and the adjoining structures. The progression of periodontal disease is influenced by variety of factors like microorganisms, host response, systemic background, and genetic makeup of the host. Amongst them, diabetes mellitus tops the list. Diabetes and periodontitis influence the clinical outcome of each other and control of both influences the clinical improvement of each.

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The incidences of cracks in teeth seem to have increased during the past decade. Dental practitioners need to be aware of cracked tooth syndrome (CTS) in order to be successful at diagnosing CTS. Early diagnosis has been linked with successful restorative management and predictably good prognosis. The purpose of this article is to highlight factors that contribute to detecting cracked teeth.

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Periodontitis is an inflammatory disease of the supporting tissues of the teeth, caused by a group of specific microorganisms. Aggressive forms of periodontitis can be localized or generalized. The concept that localized problem sites may be treated by local drug delivery appears attractive as the antimicrobial agent is delivered within periodontal pockets and the therapy is targeted on specific pathogenic microorganisms. Periodontitis can result in bone resorption creating bony defects, which may cause tooth loss. Various drugs have been studied using local delivery to improve the periodontal health and to achieve periodontal regeneration. Local delivery of antimicrobial agents using controlled release systems should be considered as adjunctive to mechanical debridement for the treatment of localized forms of periodontal destruction. Pharmacological agents offer great promise in this direction. Simvastatin, used for the treatment of hypercholesterolemia, is a universally accepted and relatively inexpensive drug. Local application of simvastatin has been shown to stimulate bone formation in rodents both in vitro and in vivo and in human periodontal ligament cells in vitro. This article reviews the effects of simvastatin as a local delivery and examines its potential role in periodontal regenerative therapy.

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Periodontitis is a local inflammatory process mediating the destruction of periodontal tissues, triggered by bacterial insult. Recent evidence suggests the presence of chronic inflammatory periodontal disease may significantly affect systemic health conditions such as coronary heart disease, stroke, or adverse pregnancy outcome. C-reactive protein (CRP) is an acute phase protein which reflects a measure of the acute phase response. CRP is used as one of the markers of choice in monitoring the acute phase response because it increases to a relatively high concentration compared to basal concentration. CRP has been shown to predict cardiovascular (CV) mortality in recent studies, and elevated CRP levels have been observed in middle-aged patients with periodontitis. Combination of chronic infections like periodontitis with elevated CRP is associated with higher chronic heart diseases. The recognition of the relationship between periodontal diseases and atherosclerotic events is relatively recent and mostly based on the inflammatory hypothesis of atherosclerosis. Periodontal disease is one of the risk factors for cardiovascular disease and possibly one of its causes. Hence, even associations of modest magnitude have a large impact. The cost to the society directly attributable to atherosclerotic sequelae is very large. Periodontitis is treatable; moreover, it is preventable. Experimental conformation of this shows that another widely prevalent and preventable contributor to the burden of cardiovascular disease would be added to the options available of the clinicians and public health practitioners for the control of the epidemic of cardiovascular disease.

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Wound healing is a dynamic process that involves the integrated action of a number of cell types, the extra cellular matrix, and soluble mediators termed cytokines.In recent years considerable advances have been made in the research, knowledge, and understanding of growth factors. Growth factors are, in essence, proteins that communicate activities to cells. Their function is dependent on the receptor site they attach to. Growth factors were initially named for the type of response generated by them, but newer research has shown that many of these cells may accomplish many different types of response. A growth factor's role in wound repair is a critical component of the successful resolution of a wound. Growth factors help regulate many of the activities involved in healing. The role and function of growth factor is an evolving area of science and offers the potential for treatment alternatives in the future.

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Smile expresses a feeling of joy, success, sensuality, affection, and courtesy, and reveals self-confidence and kindness. The harmony of the smile is determined not only by the shape, the position, and the color of the teeth, but also by the gingival tissues. Although melanin pigmentation of the gingiva is completely benign and does not present a medical problem, complaints of "black gums" are common, particularly in patients having a very high smile line. Thus, perio-esthetic treatment modalities strive to achieve a harmonious inter-relationship of the pink with white, which is imperative of all treatment procedures. For depigmentation of gingival, different treatment modalities have been reported, such as bur abrasion, scraping, partial thickness flap, cryotherapy, electrosurgery, and laser. In the present case series, scraping, electrosurgery, and diode laser have been tried for depigmentation, which are simple, effective, and yield good results, along with good patient satisfaction.

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Aim: Supernumerary teeth are considered as one of the most significant dental anomalies during the primary and early mixed dentition stage. The main objective of the study was to determine the prevalence rate of supernumerary teeth in the patients who reported to the Department of Oral Medicine and Radiology and to study the associated clinical complications. Materials and Methods: A longitudinal observational study was conducted of 2216 patients for a period of 4 months with the documentation of demographic data, the presence of supernumerary teeth, their location, and associated complications such as mechanical trauma, dental caries, and associated pathology. Results: The study recorded 27 supernumerary teeth from the examined 2216 patients. This yields a prevalence of 1.2%, with greater frequency in males which was 1.49% and in females the frequency was 0.85%. The greatest proportion of supernumerary teeth was found in the maxillary anterior region (77.8%). Out of this, 85.7% were classified as mesiodens based on their location. The displacement of adjacent teeth was the most common finding, followed by dental caries. Conclusion: The prevalence of supernumerary teeth in this study was 1.2% which is in agreement with that reported in similar studies and the maxillary mesiodens was the most common location. Displacement of adjacent teeth was the most common finding.

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Orthodontic tooth movement is basically a biological response toward a mechanical force. The movement is induced by prolonged application of controlled mechanical forces, which create pressure and tension zones in the periodontal ligament and alveolar bone, causing remodeling of tooth sockets. Orthodontists often prescribe drugs to manage pain from force application to biologic tissues. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the drugs usually prescribed. NSAIDs block prostaglandin synthesis and result in slower tooth movement. Prostaglandins have been found to play a direct role in bone resorption. Aspirin, acetaminophen, ibuprofen, diclofenac, vadecoxib, and celecoxib are the commonly prescribed drugs. Acetaminophen is the drug of choice for orthodontic pain without affecting orthodontic tooth movement.

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Encephalotrigeminal angiomatosis (Sturge-Weber syndrome) is a rather uncommon congenital condition characterized by the combination of venous angioma of the leptomeninges over the cerebral cortex with ipsilateral angiomatous lesions of the face, and sometimes the skull, jaws, and oral soft tissues. A case of portwine stain with intraoral gingival hemangioma is presented. There were no other systemic manifestations. Patient reported with a complaint of localized tumor-like swelling in gums. Based on the presence of sharply demarcated vascular lesion unilaterally on the face and with ipsilateral intraoral vascular hyperplasia in the lip and gingiva, a variant of encephalotrigeminal angiomatosis was diagnosed. Ultrasound Doppler flowmetry was used to determine the blood flow. Dental management included plaque control instructions, scaling, root planning, and excision of the lesion done under general anesthesia. Close follow-up and meticulous plaque control have kept the oral condition under fairly good control.

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Carnoy's solution is a substance used as a complementary treatment after the conservative excision of odontogenic keratocyst. The application of Carnoy's solution promotes a superficial chemical necrosis and is intended to reduce recurrence rates. However, the inferior alveolar vascular-nervous plexus can occasionally be exposed after the removal of a lesion. The safety of the application of Carnoy's solution over this plexus has been reported, but to date, no clinical report has been made. The authors present a case that was given Carnoy's solution over the inferior alveolar vascular-nervous plexus as a complementary treatment for the keratocystic odontogenic tumor. Effective control of recurrence with low and transient neural morbidity was suggested with this technique.

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Aim: The aim of this study was to determine the prevalence of hepatitis B virus and hepatitis C virus (HCV) infections in patients with oral lichen planus (OLP) and to compare it with that of general population. Materials and Methods: A total of 60 patients were included in the study. Patients were selected from the outpatient department of Rama Dental College Research Centre, Kanpur, Uttar Pradesh. Thirty patients with OLP were included in Group 1. Thirty age- and sex-matched healthy patients with no history of oral or skin lesions were included in Group 2. Detailed case history, biopsy (the most representative site of the lesion is chosen for specimen), detection of hepatitis B surface antigen (HBsAg), and detection of anti-HCV antibody were carried out. Results: The serum of the entire study sample (Group 1 and Group 2) was tested for both hepatitis C antibodies and HBsAgs with the enzyme-linked immunosorbent assay (ELISA) test (using the third generation kit). It was found negative for both HBsAgs and hepatitis C antibodies. Conclusion: In the present study, all the samples including OLP patients and healthy patients were seronegative for both hepatitis B (HBsAg) and hepatitis C (HCV antibody).

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Faciomaxillary and oral surgical procedures are frequently done under local anesthesia. Only few techniques are used widely in these areas in spite of the numerous blocks available. Knowledge about these techniques could encourage use of these techniques for the benefit of patients and operators' comfort. Leaving aside the commonly used intraoral anesthetic technique by faciomaxillary and dental surgeons, focus is given on regional blocks of extraoral route, like maxillary block, mandibular block, superficial cervical plexus block, forehead and scalp block, trigeminal nerve block, sphenopalatine nerve block, and they are discussed with their indications and technical details involved in administering them. Advantages of using the regional blocks over general anesthesia and multiple pricks include reduced dosage and number of needle pricks. Pediatric considerations like prolonged duration of anesthesia and wider area of action for regional blocks warrant that they should be used with caution.

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Progress in understanding the role of bone morphogenetic proteins (BMPs) in craniofacial and tooth development and the demonstration of stem cells in periodontal ligament have set the stage for periodontal regenerative therapy and tissue engineering. Furthermore, recent approval by the Food and Drug Administration of recombinant human BMPs for accelerating bone fusion in slow-healing fractures indicates that this protein family may prove useful in designing regenerative treatments in periodontics. In the near term, these advances are likely to be applied to periodontal surgery; ultimately, they may facilitate approaches to regenerating whole lost periodontal structures.

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Crohn's disease is a granulomatous inflammatory bowel disease and was described in 1932 as a chronic granulomatous disorder of the terminal ileum and is now considered a distinct member of the inflammatory bowel disease family. It may affect any part of the gastrointestinal tract. Oral Crohn's disease has been reported frequently in the last three decades with or without intestinal manifestations. In the latter case, it is considered as one of the orofacial granulomatosis. There has been much doubt whether intestinal manifestations of Crohn's disease will eventually develop in the orofacial granulomatosis. We present a female patient aged 22 years with prominent clinical findings such as persistent swelling of lower and upper lip with fissuring and angular cheilitis, granulomatous gingival enlargement, and cobblestone or corrugated appearance of labial mucosa, which are suggestive of Crohn's disease, but with no evidence of other gastrointestinal involvement. The patient underwent surgical treatment with external gingivectomy procedure. A 6-month follow-up showed minimal recurrence.

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The use of ultrasonic vibrations for the cutting of bone was first introduced two decades ago. Piezoelectric surgery is a minimally invasive technique that lessens the risk of damage to surrounding soft tissues and important structures such as nerves, vessels, and mucosa. It also reduces damage to osteocytes and permits good survival of bony cells during harvesting of bone. Grafting with intraoral bone blocks is a good way to reconstruct severe horizontal and vertical bone resorption in future implants sites. The piezosurgery system creates an effective osteotomy with minimal or no trauma to soft tissue in contrast to conventional surgical burs or saws and minimizes a patient's psychological stress and fear during osteotomy under local anesthesia. The purpose of this article is to describe the harvesting of intraoral bone blocks using the piezoelectric surgery device.

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An ocular defect may affect a patient psychologically. An ocular prosthesis is given to uplift the patient psychologically and improve the confidence. Ocular prosthesis can be custom made or a stock shell. To improve the comfort and matching of the prosthesis with that of the adjacent natural eye an custom made ocular prosthesis is preferred. Different techniques are available to fabricate a custom ocular prosthesis, here we have used paper iris disk technique.

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A mucocele is a benign, mucus-containing cystic lesion of the minor salivary gland. This type of lesion is most commonly referred to as mucocele. The more common is a mucus extravasation cyst; the other is a mucus retention cyst. Other three clinical variants are: Superficial mucocele that is located directly under the mucosa, classic variant located in the upper submucosa, and deep mucocele located in the lower cornium. Mucocele occurs either due to rupture of salivary gland duct or by blockade of salivary gland duct. The common site of occurrence of mucocele is lower lip followed by tongue, floor of mouth (ranula), and the buccal mucosa.

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Aims: To determine if the palatal rugae have a characteristic pattern in untreated class II div 1 malocclusions compared to normal class I occlusions, and to provide a valuable insight whether palatal rugae can be taken up as additional criteria for classifying malocclusions. Materials and Methods: The study was conducted on initial maxillary dental casts of 24 individuals with untreated class II div 1 malocclusion with an overjet of minimum of 5mm, of whom 12 were females and 12 were males, with age ranging from 16 to 24 years and compared with Class I patients casts. Results: There was no statistically significant difference in the mean intermolar widths of the two groups. The first, second and third palatal rugae were shorter in class II div 1 patients than in class I patients which was statistically significant. All the patients with Angle's class I occlusion had good pattern of palatal rugae falling in the score range of 1-3, whereas 22% of the patients with class II div 1 had poor pattern of palatal rugae, with score 4 and 2 patients exhibiting a score of 4 and 5, respectively, but this was not statistically significant. Conclusion: There was a significant constriction of the palatal rugae in class II div 1 individuals as compared to class I individuals, though they were matched for the same intermolar widths. There was a distinct pattern of palatal rugae between the two groups.

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Pyogenic granuloma is tumor-like proliferation to a nonspecific infection. Clinically, pyogenic granuloma presents as sessile or pedunculated exophytic mass with a smooth or lobulated surface which has a tendency to bleed easily. These lesions tend to occur slightly more in females, frequently involving the gingiva of the maxillary region. Histologically, these lesions show an excessive proliferation of vascular type of connective tissue to a nonspecific infection. The most common treatment is surgical excision with eradication of local irritants. This case report describes a pyogenic granuloma on the labial mucosa in a 33-year-old male, discussing the clinical features and histopathologic features that distinguish this lesion from other similar oral mucosa lesions.

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Objectives: To study the prevalence of oral manifestations in HIV-infected patients and to correlate oral manifestations with age, gender, severity, and clinical staging. Materials and Methods: Fifty patients of either sex diagnosed as HIV positive were included in the study. The data obtained were analyzed statistically using Fisher's exact test and Chi-square test. Results: Among the 50 HIV-infected patients, oral manifestations were found in 40 (80.0%) patients. Thirty (60%) patients were seen in the age range between 31 and 65 years, and 29 (58%) patients were females. Majority of the patients [26 (52%)] were in the clinical staging C, of whom 23 (88.5%) were with manifestations with significant statistical value (P < 0.05). Patients with CD4 count less than 200 had manifestations in 22 (88%) patients. Correlation between reduction in CD4 count and presence of manifestations was significant (P < 0.05). Twenty-eight (80%) patients without antiretroviral therapy (ART) reported with manifestations. Correlation between ART and presence of manifestations was not significant (P = 1.00). Interpretation and Conclusion: Oral manifestations are the indicators for the disease progression. Clinical stage C and lower CD4 count may be useful predictors for HIV, with greater prevalence of oral manifestations.

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Background and Objectives: To assess the diagnostic capability of real-time ultrasound imaging, together with the application of color power Doppler in the identification and differential diagnosis of the periapical lesions. Materials and Methods: Fifteen patients with periapical lesions of pulpal origin, diagnosed with clinical and conventional radiographic examination, were examined further using ultrasonography. The results from the biopsies of the lesions were compared and statistically analyzed. Results: The differential diagnosis between periapical granulomas and cystic lesions, which were based on the ultrasonographic findings, were confirmed by the results of the histopathologic examination in 13 (86.7%) of 15 cases, one being granuloma and 14 being cystic lesion. Interpretation and Conclusion: Ultrasound real-time imaging is a technique that may help make a differential diagnosis between cysts and granulomas by revealing the nature of the content of a bony lesion. This technique may have further applications in the study of other lesions of the jaws.

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Periodontal disease susceptible group present advanced periodontal breakdown even though they achieve a high standard of oral hygiene. Various destructive enzymes and inflammatory mediators are involved in destruction. These are elevated in case of periodontal destruction. Host modulation aims at bringing these enzymes and mediators to normal level. Doxycycline, nonsteroidal anti-inflammatory drugs (NSAIDs), bisphosphonates, nitrous oxide (NO) synthase inhibitors, recombinant human interleukin-11 (rhIL-11), omega-3 fatty acid, mouse anti-human interleukin-6 receptor antibody (MRA), mitogen-activated protein kinase (MAPK) inhibitors, nuclear factor-kappa B (NF-kb) inhibitors, osteoprotegerin, and tumor necrosis factor antagonist (TNF-α) are some of the therapeutic agents that have host modulation properties.

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Aim and Objective: To compare conventional and direct digital radiography (DDR) in working length measurement of the root canal and to assess the significance of the different enhancement modes provided by the software to visualize the file length. Materials and Methods: Access cavities were prepared in 30 extracted maxillary central incisors. Size 15 k-file was introduced into the canal till it was flush with the apical foramen. The working length was calculated as 0.5 mm less than the vernier caliper measured length of each file. The files were then sealed with resin at their respective lengths. Intraoral periapical radiographs and direct digital radiographs were taken. Vernier caliper was used to measure the file length in the periapical radiographs, and standard, positive conversion, and colorize modes were used with the CDR system. A multiple regression analysis was conducted to give an accurate analysis between the actual file length and the different groups. Results: There was no statistical significance between the different groups tested. The multiple regression analysis test showed that the positive and colorize modes more accurately corresponded to the actual file length. Conclusion: Both conventional radiography and DDR can be reliably used for working length determination. The positive and colorize modes enhancement features of DDR greatly improve the visual perception, leading to more accurate measurements.

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Knowledge of the causes of and mechanisms behind interappointment pain in endodontics is of utmost importance for the clinician to properly prevent or manage this undesirable condition. The causative factors of interappointment pain encompass mechanical, chemical, and microbial injuries to the pulp or periradicular tissues, which are induced or exacerbated during root canal treatment. This review article underlines the various treatment modalities for relief of pain and swelling in such situations, including premedication, drainage establishment, relief of occlusion, and intracanal and systemic medication.

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Matrix metalloproteinases (MMPs) form a group of more than 20 zinc-dependent enzymes that are crucial in the degradation of the main components in the extracellular matrix, and thereby play important roles in cell migration, wound healing, and tissue remodeling. MMPs have outgrown the field of extracellular matrix biology and have progressed toward being important regulatory molecules in inflammation, and hence are key components in the pathogenesis of periodontitis. This rise in status has led to the development of MMP inhibitors which can act as switches or delicate tuners in acute and chronic inflammation and the regenerative phase after inflammation. The new challenge in MMP research is to better understand the complex role these enzymes play in periodontal disease and to design inhibitors that are successful in the clinic. Perioceutics or the use of the pharmacological agents specifically developed to manage periodontitis is an interesting and emerging aid in the management of periodontal diseases along with mechanical debridement. The purpose of this review is to provide an introduction to MMPs and their inhibitors, the pathologic effects of a disturbance in the functions of enzyme cascades in balance with natural inhibitors, and highlight on the adjunctive use of MMP inhibitors in periodontal therapy and some of the current challenges with an overview of what has been achieved till date.

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Gingival enlargement is a common finding in a routine dental practice. Though it has many etiological factors, enlargement due to drugs which are administered to treat the systemic problems is of major concern which needs attention. Here, we present a case of nifedipine-induced gingival enlargement and discuss the reason for the enlargement.

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Objective: To quantify the adherence of Streptococcus mutans and Candida albicans on brackets made of stainless steel, plastic, ceramic, titanium, and gold, and to evaluate the various sites of adherence of these microorganisms with scanning electron microscopy (SEM). Materials and Methods: Brackets made of stainless steel, plastic, ceramic, titanium, and gold were used. The adherence of S. mutans and C. albicans were studied. The brackets were placed in flat-bottomed vials containing basal medium with 20% sucrose added; the flasks were inoculated with each of the microbial suspensions. The samples were incubated at 37°C for 48 h, after which the brackets were removed. The cells adhering to the glass were counted and the brackets were studied with SEM. Results: When evaluated together, the adherence of S. mutans and C. albicans was increased in the ceramic bracket group. When evaluated separately, metallic brackets had increased number of colony-forming units (CFUs) of S. mutans and the use of titanium brackets increased the CFUs of C. albicans. SEM demonstrated that the adherence of S. mutans and C. albicans together varied according to the bracket materials, with ceramic having the greatest and stainless steel having the least adherence. Conclusions: Oral hygiene may be of greater concern with esthetic brackets since this study shows that microbial adhesion is greater with these brackets.

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Aim: To evaluate the effect of water temperature on the marginal fit of bis-acrylic composite provisional crown during resin polymerization. Materials and Methods: Precisely machined 10 brass master dies were designed to simulate molar teeth. Five brass dies were selected and precisely machined to simulate all ceramic crown preparation. An acrylic jaw replica was made in which brass dies were arranged equidistant from each other. A custom-made metallic tray was fabricated on the acrylic jaw replica to make polyvinyl siloxane impression matrix. Bis-acrylic composite resin provisional crowns were made using polyvinyl siloxane impression matrix. Provisional crowns were polymerized at room temperature (Group I direct technique, on dental stone cast; Group I indirect technique crowns) and at different water temperatures (Group II direct technique crowns). The vertical marginal gap between all the provisional crown margins and the finish line of brass dies was measured using a Research Stereomicroscope System. Results: The results were statistically analyzed using one-way analysis of variance (ANOVA) test and Newman-Keul's test. The results showed that crowns polymerized in 20°C and 30°C water had marginal gap approximately three times smaller than those polymerized in 30°C air, due to the reduced polymerization shrinkage. Conclusion: This study shows that crowns polymerized in 20°C and 30°C water had mean vertical marginal gap approximately three times smaller than those polymerized in 30°C air. It was approximately closer to that of crowns fabricated by indirect technique. Warmer water also supposedly hastens polymerization.

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Pre-prosthetic surgery is that part of oral and maxillofacial surgery which restores oral function and facial form. This is concerned with surgical modification of the alveolar process and its surrounding structures to enable the fabrication of a well-fitting, comfortable, and esthetic dental prosthesis. The ultimate goal of pre-prosthetic surgery is to prepare a mouth to receive a dental prosthesis by redesigning and smoothening bony edges.

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A patient attending for treatment of a restorative nature may present for a variety of reasons. The success is built upon careful history taking coupled with a logical progression to diagnosis of the problem that has been presented. Each stage follows on from the preceding one. A fitting treatment plan should be formulated and should involve a holistic approach to what is required.

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Laser is one of the most captivating technologies in dental practice since Theodore Maiman in 1960 invented the ruby laser. Lasers in dentistry have revolutionized several areas of treatment in the last three and a half decades of the 20 ^th century. Introduced as an alternative to mechanical cutting device, laser has now become an instrument of choice in many dental applications. Evidence suggests its use in initial periodontal therapy, surgery, and more recently, its utility in salvaging implant opens up a wide range of applications. More research with better designs are a necessity before lasers can become a part of dental armamentarium. This paper gives an insight to laser in periodontics.

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The oral cavity harbors a diverse array of bacterial species. There are more than 600 species that colonize in the oral cavity. These include a lot of organisms that are not commonly known to reside in the gastrointestinal (GI) tract and also are more familiar: Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus fermentum, Lactobacillus plantarum, Lactobacillus rhamnosus, and Lactobacillus salivarius. The balance of all these microorganisms can easily be disturbed and a prevalence of pathogenic organisms can lead to various oral health problems including dental caries, periodontitis, and halitosis.

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Exaggerated curve of Spee is frequently observed in dental malocclusions with deep overbites. Such excessive curve of Spee alters the muscle imbalance, ultimately leading to the improper functional occlusion. It has been proposed that an imbalance between the anterior and the posterior components of occlusal force can cause the lower incisors to overerupt, the premolars to infraerupt, and the lower molars to be mesially inclined. This altered condition requires specialized skills for the practitioner. It would be useful if we have a thorough knowledge of how and when this curve of Spee develops, so that it will aid us in our treatment. The understanding of why the curve of Spee develops is limited in literature. The purpose of this article is to increase our knowledge regarding the development and its effect on dentition and its treatment in exaggerated cases.

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Karsch-Neugebauer syndrome is a rare congenital anomaly characterized by split foot, split hand anomalies in association with congenital nystagmus. It is an inherited condition and often occurs in both the hands and the feet. Its pattern of inheritance is autosomal dominant, though occasionally it can skip a generation. It affects about 1 in 90,000 babies, with males and females equally being affected. This rare syndrome may be associated with additional abnormalities such as hypodontia, delayed eruption, variation in morphology and position of teeth, but it is not widely documented. In view of the low incidence of this syndrome and of the limited number of reports on this in the literature, the objective of this article is to highlight the oral findings of this syndrome.

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Impaction of maxillary permanent central incisor is not a frequently reported case in dental practice, but its treatment is challenging because of its importance to facial esthetics. Early detection of such teeth is most important if complications are to be avoided. We report a case of a 14-year-old female with an impacted central incisor tooth in the maxillary anterior region. The impacted supernumerary tooth which was preventing the eruption of permanent incisor was surgically removed. Combined approach with surgical exposure and the application of an orthodontic force brought the impacted left maxillary central incisor down to its proper position in the dental arch.

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Aim: The guidelines for planning an improvement in the facial appearance till recently existed in the form of evaluation of linear and angular parameters and ratios related to the hard tissues in the various cephalometric analyses. The present study aimed at establishing Arnett et al.'s norms of the upper and lower lip for the local population and assessing the extent by which these differ from the original norms proposed by Arnett et al. Materials and Methods: Forty pretreatment lateral cephalograms (20 males and 20 females) with normal occlusion and well-balanced face were chosen for this study. Upper and lower lip lengths, thicknesses, and chin thickness were all measured according to soft tissue cephalometric analysis by Arnett et al. Results: The obtained data were statistically analyzed and compared with other studies. Conclusion: Males had thicker and longer upper and lower lips when compared to females, but they were comparatively thinner than the results of Arnett et al. Females had more interlabial gap than males. The difference in soft tissue parameters in different ethnic groups shows the importance of defining what is optimal for a particular group.

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Aim: The action of irrigant solutions on intra- radicular dentinal surface were evaluated in an in vitro setting using a scanning electron microscope (SEM) and it was observed that sodium hypochlorite and MTAD produced the cleanest surface and that none of the irrigants were able to produce an ideal preparation of the dentinal surface when used individually. The primary objective of endodontic therapy is to achieve a clean, optimal environment in root canals to avoid unsuccessful treatment outcomes. The complexities of the root canal system necessitate the use of irrigating solutions which act on radicular dentin surface, modifying it. The action of irrigants can be beneficial, and yet at the same time, as they modify the surface structure of dentin, they can have an adverse impact on the properties of dentin. The present study was undertaken to assess the effect of various irrigants on the dentinal surface using an SEM. Materials and Methods: Forty-five roots were randomly divided into nine groups (n=5) and prepared by sectioning at the level of cemento-enamel junction (CEJ) and 10 mm from the CEJ and split longitudinally. The dentin surface was prepared and the cemental surfaces were coated with double layer of varnish. The irrigants tested were normal saline, de-ionized water, 17% ethylenediaminetetraacetic acid (EDTA), 5% sodium hypochlorite (NaOCl), 5% NaOCl with ultrasonic agitation, 3% hydrogen peroxide, 2% chlorhexidine (CHX), MTAD, and MTAD with ultrasonic agitation. The prepared samples were placed in the irrigant solution for 3 min, subsequently dehydrated, sputter coated, and observed under SEM. The images were subsequently analyzed for dentinal surface changes. Results: 17% EDTA and MTAD produced the cleanest dentinal surface. Ultrasonic agitation enhanced the effect of irrigants. 5% NaOCl and 3% hydrogen peroxide were efficient at removal of organic debris, but were unable to remove the smear layer. De-ionized water, normal saline, and 2% chlorhexidine were not effective at removing the debris or the smear layer. Conclusion: None of the irrigants individually were able to achieve conditions of an ideal dentinal surface preparation.

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Aim: The aim of the study was to compare the frictional resistance of titanium, self-ligating stainless steel, and conventional stainless steel brackets, using stainless steel and titanium molybdenum alloy (TMA) archwires. Materials and Methods: We compared the frictional resistance in 0.018 slot and 0.022 slot of the three brackets - titanium, self-ligating stainless steel, and conventional stainless steel - using stainless steel archwires and TMA archwires. An in vitro study of simulated canine retraction was undertaken to evaluate the difference in frictional resistance between titanium, self-ligating stainless steel, and stainless steel brackets, using stainless steel and TMA archwires. Results and Conclusion: We compared the frictional resistance of titanium, self-ligating stainless steel, and conventional stainless steel brackets, using stainless steel and TMA archwires, with the help of Instron Universal Testing Machine. One-way analysis of variance (ANOVA), Student's "t" test, and post hoc multiple range test at level of <0.05 showed statistically significant difference in the mean values of all groups. Results demonstrated that the titanium, self-ligating stainless steel, and stainless steel brackets of 0.018-inch and 0.022-inch slot had no significant variations in frictional résistance. The self-ligating bracket with TMA archwires showed relatively less frictional resistance compared with the other groups. The titanium bracket with TMA archwires showed relatively less frictional resistance compared with the stainless steel brackets.

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Ellis-van Creveld (EVC) syndrome is an autosomal recessive disorder that is also known as chondro-ectodermal dysplasia. The common manifestations of this syndrome are short ribs, postaxial polydactyly, growth retardation, and ectodermal and cardiac defects. The present case report is about an 8-year-old boy who had the features of bilateral hexadactyly, knocked knees, cardiac problems, congenital absence of incisors, fused upper and lower labial frenulum, and mulberry molars.

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Pleomorphic adenoma generally occurs in the 4 ^th and 5 ^th decade of life. The adenoma is an uncommon presentation and is exceedingly rare in children and young adolescents. This case report deals with the diagnosis and surgical management of pleomorphic adenoma in the soft palate region in a young adolescent patient.

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Background: In clinical practice aesthetics for any restoration needs to consider the parameters of surface form, translucency and colour.To achieve ideal aesthetics the colour replication process for dental porcelain is the most important step which comprises of a shade selection phase followed by shade duplication. Materials and Methods: The ceramic brands Vita VMK95 (classic) and Ivoclar classic V were used for comparison with Vita classic shade tab guide shades A2 and B2. The samples were made of specific shape, size, and were of the recommended dimensions from investing self-cure acrylic strips to casted NiCr specimens Objective. The objective of this study was to quantify the results in CIE AE units system for the colour differences between the Vita shade guide colours and two commercial porcelains for metal ceramic crowns. Results: The results indicated that the porcelains do not match the shade guides to which they are compared and shade variations exist between different lots of porcelain from the same and different manufacturer. Conclusion: Problems identified that porcelains do not match the shade guides to which they are compared and shade variations exist between different lots of porcelain from the same and different manufacturer

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Aims: The aim of the study was to evaluate the role of three-dimensional computed tomography (3D-CT) in the assessment of temporomandibular joint (TMJ) ankylosis and its importance in treatment planning. The objectives of study were to measure and assess the mediolateral extent of ankylosis mass in 3D-CT and to compare the extent with intraoperative assessment. The study was also aimed to measure the coronoid process elongation in 3D-CT and its significance in treatment planning. Materials and Methods: This prospective study included 3D-CT evaluation of 11 patients with TMJ ankylosis during the period of February 2006-October 2007. Results: The 3D-CT assessment provided the length of the coronoid process and the relation of vital structures including maxillary artery to the ankylosed mass. Measurement of ankylosed mass also aids in preoperative measurement of the graft required to reconstruct the defect following removal of the ankylosed mass. Conclusion: Our study concludes that 3D-CT is a useful tool in the diagnosis and treatment planning of TMJ ankylosis.

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Background: Gingival bleeding is considered as an important clinical sign for diagnosis of periodontal disease pathogenesis. Immune inflammatory reactions caused by local factors are considered as essential reasons for gingival bleeding, as also for the systemic bleeding disorders. In disease-free conditions of gingiva, the bleeding disorders are considered to be the main contender for bleeding. Other than these variables, many systemic drugs including systemic aspirin could also cause gingival bleeding. The main aim of the study was to evaluate the effect of buffered aspirin therapy on gingival bleeding. Materials and Methods: Totally, 36 systemically healthy individuals were included in the 15-day randomized, double-blinded, placebo-controlled clinical trial. The 15 days were divided as: control period for the first 7 days and study period for the following 7 days. On the 1 ^st day, all individuals were given oral prophylaxis after recording gingival parameters such as Plaque Index, probing depth, and Bleeding Index, and then blood samples were collected for hematological investigations. Then, all individuals were administered placebo capsules for 1 week as once daily dose. On the 8 ^th day, all procedures were repeated and the individuals were prescribed with 325 coated aspirin capsules for 1 week. On the 15 ^th day, all parameters were repeated and the results were statistically analyzed. Results: In the study period, the parameters such as Bleeding Index, bleeding time, and prothrombin time were increased significantly, compared to the control period. Conclusion: The variables such as systemic drug therapy should be considered for the examination of gingiva while the diagnosis is considered mainly based on gingival bleeding.

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Background: One method used to disinfect a dental cast is immersion in a disinfecting solution. Repeated immersion of a cast in disinfectant may affect its physical properties. Purpose: The purpose of this study was to evaluate the changes in dimensional accuracy and hardness of the dental casts as a result of repeated disinfection in 0.525% sodium hypochlorite and 2% glutaraldehyde solutions. Materials and Methods: Sixty specimens were made of type III dental stone. Twenty specimens were immersed in slurry, a supernatant solution of calcium sulfate in distilled water (control casts), 20 specimens in 0.525% sodium hypochlorite, and 20 specimens in 2% glutaraldehyde solutions for 30 min and air dried for 24 h. This process was repeated for 7 times for testing. Linear dimensional change and hardness were determined according to American National Standards Institute/American Dental Association (ANSI/ADA) standards. The data were analyzed using two-way analysis of variance. Results: For specimens prepared with type III stones, treatment was by immersion in slurry (group I - control casts), and by immersion in 0.525% sodium hypochlorite (group II - test group 1) and in 2% glutaraldehyde solution (group III - test group 2). The specimens treated with sodium hypochlorite and glutaraldehyde showed more linear dimensional change compared to the specimens treated in slurry. However, the difference between test casts and control casts was significant. But the difference between the two test groups was not significant. Both the test groups showed decrease in hardness of the specimens compared to that specimens in control group. But the difference between two test groups was not significant in hardness.However,the values remained close to ANSI/ADA standards. Conclusion: The results demonstrated that repeated immersion of type III dental stone specimens in slurry with distilled water, 0.525% sodium hypochlorite and 2% glutaraldehyde, along with drying in air, caused a significant increase in linear dimension and a significant decrease in hardness.

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Variations in the newborns' oral cavity have been an enduring interest to the pediatric dentist. The occurrence of natal and neonatal teeth is a rare anomaly, which for centuries has been associated with diverse superstitions among many different ethnic groups. Natal teeth are more frequent than neonatal teeth, the ratio being approximately 3:1. The purpose of this case report is to review the literature related to the natal teeth folklore and misconceptions and discuss their possible etiology and treatment.

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This is a report of 14 patients who suffered from oral cancer and underwent radical excisions of the oral cancer lesion with functional neck dissection at the Department of Oral and Maxillofacial Surgery in Annasawmy Mudaliar General Hospital, Bangalore, between 2010 and 2011. Eleven males and 3 females were involved, with the average age of 68.7 years. All patients had positive cervical lymph nodes proven by clinical and ultrasound examination. Level IB was positive in all cases and Level II of the neck was found additionally involved in five cases. A functional neck dissection in patients with a clinically positive node neck achieved better disease-free survival with minimal postoperative co-morbidity.

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Gastrointestinal disease is associated with alterations in the mouth or influence the course of the dental diseases, and the dental health care workers are expected to recognize, diagnose, and treat oral conditions associated with gastrointestinal diseases and also provide safe and appropriate dental care for afflicted individuals. Drugs used in the management of these diseases result in oral adverse effects and also are known to interact with those prescribed during dental care. Hence, this article has reviewed the drug considerations and guidelines for drug use during dental management of patients with gastrointestinal diseases.

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Pharmacology is the branch of medicine and biology concerned with the study of drug action. The two main aspects of concern are the effects of drugs on biological systems and the effect of biological systems on efficacy and metabolism of drugs. Prosthodontics is that specialty of dentistry which deals with patients of all ages, hence making it more important to know about the local and systemic effects of drugs and their side effects. The aim of this article is to provide necessary information about the drugs to make a more knowledgeable assessment when prescribing any drug to the patients. Pharmacology in prosthodontics is a field which needs further research and studies as it is one of the most neglected fields and is often underestimated by clinicians.

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The primary objective of endodontic therapy is to achieve a three-dimensional obturation of the root canal space after adequate preparation of the canal space to remove the tissue debris, microorganisms, and their byproducts. Anatomical variations have frequently been encountered in endodontic practice and have to be adequately managed by the clinician. Missed roots and canals are a major reason for failure of therapy. Technological advances have given the clinician ample opportunity to identify and treat these aberrations successfully. The present report describes a left mandibular second permanent molar requiring root canal treatment, found to have three separate canals in the mesial root. This case demonstrates a rare anatomical configuration and emphasizes the need for the clinician to be aware of and look out for such variations and use adequate diagnostic methodologies prior to and during therapy to detect such variations. The possibility of additional canals, whenever in doubt, should be explored with the assistance of technologies such as those of magnification and illumination and various diagnostic aids. Operator experience has also shown to be a key factor in negotiation and management of these aberrant canal configurations.

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Alveolar ridge atrophy poses a clinical challenge toward the fabrication of successful prosthesis. Resorption of mandibular denture bearing areas results in unstable non-retentive dentures associated with pain and discomfort. This article describes rehabilitation procedure of a patient with resorbed ridge with maximal areas of coverage to improve support and neutral zone arrangement of teeth to improve stability of denture.

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Only very few studies have been done in the past to evaluate the usefulness and limitations of ultrasonography in oral and maxillofacial surgery. This study, though in an embryonic stage, has been done to bring this technique to limelight and to put forth the importance of its use and limitations in the branch of oral surgery. The purpose of this study was to investigate and study the characteristic pattern of the oral tissues on gray scale ultrasonography and to assess the practical applicability of this new diagnostic technique in diagnosing various tissue pathologies in the field of oral and maxillofacial surgery.

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Background: Simvastatin (SMV) is one of the cholesterol-lowering pharmacological drugs. Recent studies demonstrate that it has a bone stimulatory effect. The present study was designed to investigate the effect of SMV along with collagen membrane on osteoblast-like SaOS-2 cells and also to standardize the dosage of SMV to be incorporated into the collagen membrane to achieve regeneration. Materials and Methods: SMV at doses of 0.5, 1, 1.5, and 2 mg was incorporated into the collagen membrane and cell metabolism was assessed by (3-[4,5-dimethylthiazolyl-2]-2,5-diphenyltetrazolium bromide) (MTT) assay for 24 h. Results: SMV enhanced cell metabolism dose dependently at 24-h time and the maximum effect was obtained at a concentration of 1.5 mg of SMV. Conclusion: These results indicate that collagen with 1.5 mg SMV exhibits positive effect on cell metabolism of human osteoblast-like SaOS-2 cells.

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Aim: To evaluate the efficacy of elective neck dissection versus the "wait and watch" policy in the treatment of early squamous cell carcinoma of tongue. Materials and Methods: This is a retrospective study of 21 patients with surgical treatment between April 2009 and July 2011. The patients were divided into two groups, with Group 1 consisting of patients who underwent wide excision glossectomy with elective neck dissection and Group 2 consisting of patients who underwent glossectomy without the neck being surgically addressed. The selection of patients was done by the random double-blinded method and the review was done by a single reviewer. All patients were examined for an average period of 1 year postoperatively. Results: Twenty-one cases were treated, among which there were 17 T1 and 4 T2 carcinomas. All the patients had primary carcinoma involving only the tongue with no clinical neck palpable neck nodes. Eleven patients underwent wide excision of primary tumor with elective neck dissection (Group 1) and 10 patients underwent only resection of primary tumor without the neck being surgically addressed (Group 2). In Group 1, there were no recurrences, and in Group 2, there were two patients who developed subsequent cervical node metastasis with one patient undergoing further surgery to address the positive neck and the other patient was lost to follow-up. Conclusions: Regional recurrence was the most common cause of failure after surgical treatment of oral tongue carcinoma. Elective neck dissection significantly reduced mortality due to regional recurrence and also increased the overall survival. Our study suggests that elective neck dissection is a treatment strategy of choice for stages I and II carcinoma of the oral tongue. A prospective, randomized study is worthwhile to further evaluate the benefit of elective neck dissection in the treatment of early carcinoma of the tongue with a larger pool of patients and a lengthier follow-up period.

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Context: To understand the effect of masticatory and parafunctional forces on the integrity of the prosthesis and the underlying cement layer. Aims: The purpose of this study was to evaluate the stress pattern in the cement layer and the fixed prosthesis, on subjecting a three-dimensional finite element model to simulated occlusal loading. Materials and Methods: Three-dimensional finite element model was simulated to replace missing mandibular first molar with second premolar and second molar as abutments. The model was subjected to a range of occlusal loads (20, 30, 40 MPa) in two different directions - vertical and 30° to the vertical. The cements (zinc phosphate, polycarboxylate, glass ionomer, and composite) were modeled with two cement thicknesses - 25 and 100 μm. Stresses were determined in certain reference points in fixed prosthesis and the cement layer. Statistical Analysis Used: The stress values are mathematic calculations without variance; hence, statistical analysis is not routinely required. Results: Stress levels were calculated according to Von Mises criteria for each node. Maximum stresses were recorded at the occlusal surface, axio-gingival corners, followed by axial wall. The stresses were greater with lateral load and with 100-μm cement thickness. Results revealed higher stresses for zinc phosphate cement, followed by composites. Conclusions: The thinner cement interfaces favor the success of the prosthesis. The stresses in the prosthesis suggest rounding of axio-gingival corners and a well-established finish line as important factors in maintaining the integrity of the prosthesis.

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Background: The systemic effects attributable to the injection of dental local anesthetic solutions have been the subject of discussion for many years. Aim and Objective: The aim of the present study was to investigate the biochemical and hemodynamic effects of adrenaline in lignocaine local anesthetic solutions when used in clinical doses in patients undergoing third molar surgery under general anesthesia. Materials and Methods: Of the total 30 patients, 15 were given local anesthetic solution containing adrenaline and the other 15 were given the same without adrenaline. Hemodynamic and biochemical parameters were recorded at considerable intervals. The changes from the pre-local anesthetic (baseline) values with each treatment were compared by analysis of variance and Student's t-test. The changes within each treatment were compared by the paired t-test. Results and Conclusion: This study shows that exogenous adrenaline administration in clinical doses produces systemic effects even in conditions where the endogenous release of the catecholamines would be expected to be considerable.

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Bisphosphonates are used widely for variety of bone condition, most notably IV bisphosphonates in the treatment of metastic bone lesion and oral bisphosphonates for osteoporosis. They constitute a group of drugs capable of modulating bone turnover and reducing its remodeling when an excessive resorption occurs. In the last few years, due to their extensive use, many cases of complications associated with their use have been published. This paper provides recent knowledge on general characteristics of these drugs and their mechanism of action, pathogenesis, as well as their relevance to dentist.

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Guidelines to prevent cross contamination with infectious agents have been instituted for dental clinical and laboratory procedures. However, compliance by dental offices and clinics in disinfecting impression material has not been universal. Techniques for disinfecting impression materials are spraying or immersing impression materials. These techniques can reduce the surface detail and dimensional accuracy of impressions; most disinfectants are irritants. This study reviewed whether antimicrobial activity can be achieved by mixing certain drugs with the impression material and their effects on the disinfection are achieved through such additions.

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In the Indian subcontinent, the incidence of squamous cell carcinoma of the oral cavity has been constantly increasing despite the improvement in the awareness about squamous cell carcinoma. The patients generally report to us in the period in which the tumor would have undergone metastasis. This article highlights about the grading, staging, and decision-making regarding the surgical management of squamous cell carcinoma of the oral cavity. The article also stresses upon the early detection of the lesion by the practitioner for a definitive successful surgical treatment of the patient.

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In an orthodontic patient, missing teeth will require restoration or reshaping of an adjacent tooth, after the orthodontic treatment. Furthermore, each type of restoration may require slightly different tooth position. Therefore, it is mandatory for the team to establish a treatment plan. The orthodontist should join hands with the restorative dentist and consult before the treatment plan. However, some adult orthodontic patients may have several missing permanent teeth. If teeth have been absent for several years, the remaining teeth may have been drifted. In such situation, it may be necessary to position the teeth in unusual place. These patients may require a combination of orthodontic and restorative dentistry to rehabilitate their occlusion. In these patients, it may be difficult for the orthodontist to visualize or foresee the final result as she/he may not be aware of restorative requirements or the eventual restoration plans and vice versa for the restorative dentist also.

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Adult patients have many preexisting conditions like tooth loss, severe skeletal dysplasia, periodontal disease, and various temporomandibular dysfunctions. In such adult patients, an interdisciplinary treatment approach is followed by customizing orthodontic treatment for the individual patient. This article shows a case that is managed in an interdisciplinary method of treatment approach.

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Anatomic aberrations are seen in human dentition. The maxillary incisor region of the permanent dentition where these anatomical aberrations are commonly seen is considered an area of embryonic hazard. Aberrations affecting the internal and external morphology can at times be the cause of complex pathological conditions involving the pulpal and periodontal tissues and can pose a challenge to the clinician for the diagnosis and clinical management. Detecting and treating the anomalies at an early phase is essential as it poses a threat for the loss of vitality of the concerned teeth. The aim of this paper is to highlight the fact two different developmental anomalies of maxillary incisors, namely palatoradicular groove and Turner's hypoplasia, led to the loss of vitality of the same.

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Odontomas are malformation of the dental tissue, arising during normal tooth development. They are usually asymptomatic, but often associated with tooth eruption disturbance. This article reports a case of complex odontome in a 23-year-male, which hampered the eruption of mandibular right second molar as well devitalization of first molar.

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Developmental grooves are not rare and often appear on maxillary lateral and central incisors and are an important predisposing factor to localized periodontal disease. Various techniques have been adopted to eliminate the groove and regenerate lost periodontium. This report of two cases describes the technique of using the local drug delivery system with chlorehexidine and the guided tissue regeneration (GTR) to control the disease progression and regeneration.

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Cysticercosis caused by Taenia solium is endemic in many parts of the world. We present a case of one such lesion which presented itself as an asymptomatic buccal swelling. We present the life cycle of T. solium, the endemic nature of this infection, and the relevance of histological examination to arrive at a diagnosis.

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Context: Influence of luting agent, design of tooth preparation for cast posts on tooth resistance to fracture. Aim: To evaluate fracture resistance of teeth restored with cast posts and cores with or without cervical ferrule and cemented with zinc phosphate, glass ionomer, or resin cement. Materials and Methods: Sixty single-rooted maxillary first premolars of similar sizes were selected. Biomechanical preparation and post space preparation for cast post was done for all samples and then they were divided into two groups (n=30). Cervical ferrule preparation was done for Group A, and Group B was prepared without any cervical ferrule. Both groups were further divided into three subgroups (1, 2, and 3; n=10) Cast posts for subgroups 1, 2, and 3 were cemented with zinc phosphate, glass ionomer, and resin cement, respectively. A shearing load was applied to indented buccal cusp of specimens at an angle of 45° in universal testing machine at a cross-head speed of 1 mm/min until fracture. Results: Specimens with ferrule (Group A) had significantly higher shear bond strength values (mean 1503.37 N) than specimens without ferrule (Group B) (mean 1052.09 N). Conclusion: Inclusion of ferrule in tooth preparations for posts increased the fracture resistance regardless of the luting agent.

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Background: Scientific literature has grown tremendously in past five decades in volume as well as content. This communication enlightens young dentist and scientist about availability of scientific literature in digital format and on the web since it has become impossible to maintain literature in printed format due to sheer volume and content. Materials and Methods: The key words were searched in www.google.com. Result: Out of 3500 results relevant web pages was selected by the authors unanimously. Conclusion: This article was primarily written to create awareness among young dentists and orthodontists the availability of varied orthodontic literature and contributors and journals in disseminating knowledge and opportunities.

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Esthetic features are different from one race to another, and this should be considered during the treatment planning. The great variance in soft tissue drape of the human face complicates accurate assessment. The nose-lip-chin relationships are exceedingly important in determining the facial esthetics. One important soft tissue parameter in orthodontic diagnosis is the nasolabial angle. The purpose of this study was to establish norms for nasolabial angle as proposed by Fitzgerald for the Komarapalayam population. Normative data for the three nasolabial parameters were produced from a sample of 40 (20 male and 20 female) adults determined by the authors to have well-balanced faces. Mean and standard deviation values from this pooled sample demonstrated a lower border of the nose to Frankfort horizontal plane angle of 18° ± 7°, upper lip to Frankfort horizontal plane angle of 98° ± 5°, and nasolabial angle of 116° ± 10°. No statistically significant difference was demonstrated between the values for men and women in this study, but men did have a slightly larger nasolabial angle.

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