Background: The aim of this paper is to illustrate the expansion of mandibular arch using Transforce appliance. Case Report: Use of Transforce appliance for arch expansion for severely constricted mandibular arch. The patient is successfully treated with arch expansion. Conclusion: Transforce appliance is a good choice for mandibular arch expansion. Since mandible lacks sutures to open up, light force is required for arch development and Transforce appliance is capable of producing light forces.

Clinical Audit (CA) is considered as one of the great tools of quality improvement in health care practice worldwide. Despite the fact that clinical audit concept has been implemented in several countries of the world, in Saudi Arabian context it is still not a well-performed practice. As such, many health professionals of Saudi Arabia including dental practitioners are still not aware of this concept though improving the quality of preventive and therapeutic health care services is one of the targets that has been set out by the National Transformation Program (NTP) based on 2030 vision of the Kingdom of Saudi Arabia (KSA). Hence, to improve the awareness, as well as, the knowledge of the positive implications and benefits of CA in practice, it is essential for dental professionals and other health practitioners to perceive the methodology of CA. In order to develop the quality of care and enhance evidence-based practice, activation of CA is of great importance. Hence, a clear view on the different stages in the implementation process of CA has been attempted to explain in this paper. Also, several study reports on the clinical audit in various dental specialities has been put forward in this review that may play an inspirational role for dental practitioners in grasping this procedure in providing a perfect dental health care.

Background: The perioral region plays an important role in facial recognition, gender classification, esthetics, facial expression, speech and eating. Aim: To establish normative perioral data for South-East, Nigerian children Methods: A sample of 120 healthy subjects within the age range of 1 to 5 years were enrolled in this study. Two dimensional photographs of the face were captured non-invasively using a Nikon D 90 camera, ten perioral landmarks were identified and four indices deduced Results: It was observed that vertical mouth height index, upper lip thickness and lip index in the males showed higher values when compared to the females which indicates sexual dimorphism (P≤0.05). Most children in our cohort were classified as having a thick lip index, mouth of intermediate height in relation to the height of the face, thick upper and lower lip thickness index, narrow mouth in relation to the width of the eyes. The mean values of Vermillion height of Lower lip and Lower Lip Thickness Index was also observed to be consistently higher when compared to upper lip in both sexes. Conclusion: The study presents a primary data base for perioral anthropometric indices of children in South-East Nigerian which can aid ethnic specific postoperative evaluation of congenital or post-traumatic orofacial reconstructive surgeries.

Background: According to Egyptian pictograms and medical records, non-surgical periodontal treatment (NSPT) has been practised for a very long time. Several clinical studies have depicted relevant clinical results when subgingival irrigation was carried out as an adjuvant therapy to SRP. This study aims to compare essential oils as subgingival irrigant agents with chlorhexidine gluconate (CHX) and sterile saline over a period of 21 days. Setting and Design: This is a comparative study of three groups (chlorhexidine group, essential oil group, sterile saline group). Each group had ten patients having chronic periodontitis who were randomly assigned and treated with subgingival irrigants. For, the essential oil group, the irrigant was indigenously prepared at chairside. Material and Methods: Following the initial examination and selection of patients, clinical parameters were noted and collection of plaque samples was done. These samples were then sent for microbiological assay at baseline. SRP was done along with subgingival irrigation at baseline, 7th and 14th day. Clinical parameters were monitored again and plaque samples were sent for microbiological test on the 21st day. Results: There was no significant difference noted between the groups in any of the clinical parameters. However, regarding microbiological parameter, better results were demonstrated in CHX group and essential oil group compared to sterile saline group that was statistically significant. CHX and essential oil group demonstrated no statistical difference. Conclusion: The result of this study suggests that essential oils can be used as a subgingival irrigant in the treatment of chronic periodontitis.

Introduction: Severe unitary atrophies in the horizontal direction make the direct insertion of dental implants difficult. Block grafting or guided bone regeneration in small sites is also complex, sometimes requiring a highly predictable option. The insertion of small-platform, low-diameter implants can be a safe and effective alternative for these sites, even on a single-unit basis. In the following article we present a series of cases rehabilitated with these implants. Material and Methods: Patients with horizontal atrophy of a tooth requiring the insertion of a single implant in the premolar and canine area were recruited, and 3 mm platform implants with a diameter of 3.3 mm were placed between May 2018 and December 2019 in a dental clinic in Vitoria, Spain. Marginal crestal bone loss was calculated by measuring from the implant shoulder to the first site where bone-to-implant contact was evident. The reference for comparing the radiographic records and thus estimating the bone loss produced in each of the patients was the radiograph taken at the time of prosthesis insertion. Qualitative variables were described by frequency analysis. Quantitative variables were described by means of mean and standard deviation. Implant survival was calculated using the Kaplan- Meier method. Result: Eight patients were recruited and eight 3.0 implants were placed in the canine and premolar region in a unitary form with a diameter of 3.3 mm. All implants were rehabilitated in a unitary form, in two phases, using a screw-retained prosthesis with unitary transepithelial. The mean follow-up time was 39.8 months (+/- 18). Survival of the implants studied was 100% and of the prostheses as well. The mean mesial crestal bone loss of the implants studied was 0.77 mm (+/- 0.01) and distal bone loss was 0.35 mm (+/- 0.7). Conclusions: Implants with a reduced diameter and platform can be used as a unit provided that a correct surgical and prosthetic treatment plan is followed, analysing the case as a whole and individualising the approach for each patient.