Flap design in facial reconstruction is particularly delicate given the face is the most visible structure of the body and has some of the most complex three-dimensional topography. The goals of facial reconstruction center on closing defects in an inconspicuous manner. Fortunately, the robust vascular supply of the face allows for many reconstructive options using flaps that are localized to the face.

Mandibular premolars are known for having variations in root canal anatomy, Endodontic and periodontal success of such anatomical variations requires the clinician to be aware of their clinical and radiographic anatomy. This study was done to evaluate the mandibular second premolars in a Kashmiri population using routine digital radiography.

Dental implants are in dynamism of the new world. Different systems are available in the market according to the patient’s economical standards. Even implants systems able to manage the treatment time simultaneously with cost. As it’s a surgical procedure and can be performed for replacement of single tooth or the whole edentulous arch there are protocols which needs to be followed. Various categories and criteria’s-based evaluation decides the implant placement strategies. It’s a specialty practice but now a day’s even general dentists are successfully placing implants. Keeping all this in mind this review is put forward about loading protocols in the implant dentistry which will be helpful for Implantologist throughout the world.

Aim: The purpose of the present investigation was to evaluate and compare the efficacy of resorbable collagen-based tetracycline fibers and chlorhexidine chip placement in the treatment of chronic periodontitis. Methods: A split-mouth design was used to conduct this study. Fifty one patients with periodontal pockets ranging from ≥5 mm to ≤7 mm were selected for the study. The treatment sites were randomly divided into the control and experimental groups. All of the selected sites were treated with scaling and root planning, and then collagen-based resorbable tetracycline fibers and chlohexidine chip were placed adjunctively in equal number of experimental sites at the same visit. Baseline and followup measurements in both treatment groups included plaque index, probing pocket depth, and relative attachment level. Results: Although significant clinical benefits were obtained in all the treatment groups, the adjunctive antimicrobial use of chlorhexidine chip demonstrated better results compared to the locally tetracycline fibers over the 3-month observational period. Conclusions: The delivery of both antimicrobial agent’s tetracycline in a collagen Matrix and chlorhexidine chip was found to improve the benefits of scaling and root planing by a larger magnitude in patients with moderate-to-deep pockets.

Binder's syndrome is a rare congenital condition characterized by a retruded mid-face with an extremely flat nose due to an underdevelopment of the mid-facial skeleton. It primarily affects the anterior part of the maxilla and nasal complex. Hence the condition is also known as Maxillonasal dysplasia. This paper aims to put forth the etiopathogenesis, clinical presentation & the, management of Binder’s syndrome.

Epulis is the most commonly detected benign tumor of the oral cavity. Usually presents as a solitary lesion involving the marginal and attached gingiva. It is the 1st reported case of a 56 year old female patient with four isolated epulides on all four sides of oral cavity and this rare finding is coined as „Quadra Epulis‟.

In this present scenario of oral surgical intervention proper instrumentation and technique holds a superior position which comes with experience of the operator, despite that, some accidents may happen when defective instruments are unknowingly used. This article reports a case of a retained fractured dental elevator tip during surgical extraction of impacted mandibular third molar. The vast majority of cases reported in the literature occur during endodontic treatment, and this is an accepted common risk within the endodontic specially. However, there is very little literature regarding instrument fracture and management of cases following simple or complex exodontia. Although this is a rare incident, it reinforces the importance of checking instruments pre- and post-surgery by both the dental surgeon and assistants.

Maxillary reconstruction is still an evolving art when compared to the reconstruction of the mandible. The defects of maxilla apart from affecting the functions of the speech, swallowing and mastication also cause cosmetic disfigurement. Rehabilitation of the form and function in patients with maxillary defects is either by using obturator prosthesis or by a surgical reconstruction. Literature is abundant with a variety of reconstructive methods. The classification systems are also varied, with no universal acceptance of any one of them. The oncologic safety of these procedures is still debated, and conclusive evidence in this regard has not emerged yet. Management of the orbit is also not yet addressed properly. Tissue engineering, that has been hyped to be one of the possible solutions for this vexing reconstructive problem, has not come out with reliable and reproducible results so far. So, this article reviews the various recent advances in maxillofacial prostheses.

Background: The posts selection and cementation helps to bond with restorative material. Hence, post retention is responsible for long span survival of endodontically restored teeth. The technique and selection of cement selected for cementation will determine the bearing effect of the post retention. Aim: The purpose of the study, evaluate and compare using 3 different techniques about the carbon fibre post push out bond strength at the coronal, middle and apical levels of extracted mandible tooth of single root. Methodology: The premolars extracted were selected about 50 and based on the technique using lentulo-spiral instrument, to the surface post, with the support of elongation tip the material was injected and divided into 3 groups the post space drilled using rely-x light polymerized. In the acrylic resin the root specimens embedded and sectioned and finally measured using Universal testing machine. The overall effort is to subject for the bond strength push out. The failure bond strength specimens were studied and evaluated using operating microscopes. Result: The Elongation tip method as well as lentulo-spiral method p (value 0.052 and 0.0089). Conclusion: Using three techniques Post hoc analysis was done to find out stress bearing capacity at coronal middle and apical levels. The comparison between lentulo-spirals and direct method, the study results such as nil difference in stress bearing capacity.

Maxillectomy is one of the most common procedures performed by oral and maxillofacial surgeon. Various classification systems exist in literature to describe the surgical defect, left behind after maxillectomy. Success in Maxillofacial defects depends on the principles of facial harmony, retention, durability, tissue compatibility & tolerance. The Velopharynx is tridimensional muscular valve located between the oral and nasal cavities, consisting of lateral and posterior pharyngeal walls and the soft palate & controls the passage of air. Cleft palate is the most common cause of velopharyngeal insufficiency. Velopharyngeal insufficiency may take place when the velopharyngeal valve is unable to perform its own closing, due to lack of tissue or lack of proper movement. Treatment options include surgical correction, prosthetic rehabilitation & speech therapy; though optimal results often require a multidisciplinary approach for the restoration of anatomical and physiological defects. This article is a case report of the treatment procedure done for a young patient with cleft palate and velopharyngeal insufficiency.

A new field of biomedical science, known as tissue engineering, applies the principles of biology and engineering to the development of functional substitutes for tissues and organs. The influence of Keratinised Mucosa dimension around implants on the soft and hard tissue health. The purpose of this case report is to understand the importance of healthy tissue around the implants for long term success and how biomimetic materials like PRF Membrane can be incorporated in treatment plan as an important modality in selected cases.

Vascular Endothelial Growth Factor (VEGF) is closely related to tumour progression and prognosis. This study aims to evaluate the pattern and clinical implication of VEGF expression in benign and malignant neoplasms and to determine the effect of surgery on serum level of VEGF. Cases were drawn from among histologically confirmed orofacial tumours, while controls were from consecutive, ambulatory dental patients at the University of Benin Teaching Hospital. Blood samples taken from cases and controls, preoperatively and at one -month post-surgery, were allowed to clot and the serum aliquots stored at -600C till analyses. Serum VEGF was analysed using Sandwich ELISA and mean levels as well as median were measured. Spearman correlation was estimated, t-test measured significance (at p ≤ 0.05). Eighty-one subjects were studied (55 cases and 26 controls). Preoperatively, there were significantly different serum levels of VEGF in benign (48.11 ± 25.19 pg/ml) vs. malignant cases (1065.00 ± 412.14 pg/ml), and when compared with controls (45.42 ± 29.83 pg/ml), p <0.001. After definitive surgical intervention, there was a significant reduction in the level of serum VEGF in both benign (45.50 ± 24.71 pg/ml) and malignant cases (51.22 ± 16.84 pg/ml), p <0.001. One-way ANOVA revealed no significant differences between cases and controls post-surgery. There was elevated levels of serum VEGF in benign and malignant orofacial neoplasia. Surgery caused a significant reduction of circulating VEGF to normal levels irrespective of age, gender, previous medical history, perceived duration of the lesion and lymph node involvement.

Purpose: Uncontrolled clinical trial aims to evaluate clinical and radiographic healing after repairing mechanical furcal perforations that occurring during pulpotomy in primary molars by using MTA (Mineral Trioxide Aggregate). Materials and Methods: 34 primary molars in 32 healthy children aged 5-10 years old were treated after occurring of mechanical furcal perforations during pulpotomy by using MTA. Mediate and immediate treatment had been performed after clinical and/or radiographic diagnosis of the perforation, and then teeth had been followed clinically at 1st week 3rd, 6th, 9th, and 12th month and radiographically at 6th and 12th month after perforation repair. Statistical analyses were done at p-value = 0.05 and confidence interval CI 95%. Results: All teeth were successful at the first week. Overall success rate recorded 79.3%, and CI of success was 65% to 93%, 5 teeth had been extracted because of totally failure. There was no significant statistically difference between totally success rates according to gender, tooth position, tooth type, previous sub-base of ZOE, pre-used of Formocresol (p-value > 0.05). Conclusions: Iatrogenic furcal perforated primary molars can be treated by using MTA successfully. Mediate treatment and pre used of FC may have unfavorable prognosis of repairing perforations.

Background: Individuals should spend at least 2 minutes brushing their teeth with an effective technique at least twice a day, However, most estimates of actual brushing time vary between just over 30 seconds to 60 seconds. Aim: To study the relationship between time of manual tooth-brushing and plaque removal. Methods: Turesky index was used in this study group to assess the plaques. Brushing times were assigned over a 3 week period and brushing times assigned were 30, 45, 60, 120 and 180 seconds. Dental plaque before and after brushing were evaluated and recorded. Results: Changes in Turesky index score for 30 seconds brushing from pre brushing to post brushing were 3.276 ± 0.064 to 2.628 ± 0.175. For 45 seconds brushing time, pre brushing and post brushing scores were 3.262 ± 0.036 and 2.648 ± 0.151. Turesky index score for 60 seconds changed from 3.287 ± 0.065 to 2.562 ± 0.114. for 3 minutes brushing, pre brushing and post brushing scores were 3.064 ± 0.071 and 2.657 ± 0.143. Conclusion: Oral health education towards educating the patients about the duration of brushing time required for plaque removal.

Background: Candida infection today is highly prevalent, especially the increase in carriers of removable dentures and poor oral hygiene society. Aim: To evaluate the role of fluconazole and clotrimazole in treating oral candidiasis patients. Methods: Two hundred subjects suffering from oral candidiasis formed the study population. Microbiological culture confirmed the diagnosis of oral candidiasis. Study subjects were divided into Group A - subjects who were under treatment with fluconazole therapy, Group B - subjects who were on clotrimazole therapy. Follow up of the study subjects was done after 2 weeks of continuation of the treatment. Results: Among group A subjects, before starting the treatment, 164 (82%) of the them had moderate severity of clinical symptoms, whereas in group B, 148 (74%) of the subjects had moderate severity of symptoms. After the treatment, most 190 (95%) of the them were devoid of any symptom in group A, whereas such proportion was 172 (86%) in group B. In group A subjects, before and after the treatment, the colony count was 1376.4 and 10.8, respectively, whereas in the group II patients, the mean colony count was 854.1 and 23.3, respectively. Conclusion: Both fluconazole and clotrimazole were approximately equally effective while treating subjects having oral candidiasis.

Background: Various root canal filling materials for primary teeth have been used from time to time; the most commonly used and readily available materials are zinc oxide eugenol and Vitapex. Aim: We conducted this study with the aim of comparing the effect of Zinc oxide eugenol and Vitapex for carrying out endodontic therapy of necrotic primary teeth. Methods: Study was performed on 165 teeth. Clinical and radiographic assessment of the patients was done pre-operatively. In the zinc oxide eugenol group, paste was prepared and paper points covered with the material were used to coat the root canal walls. In the Vitapex group, the premixed paste was packaged in a syringe with a number of disposable tips. Results: On pre-operative clinical and radiographic assessment of 165 teeth, pain was found among 116 (70.3%), bone radiolucency 90 (54.5%), abnormal mobility 75 (45.5%) subjects. Swelling outside the oral cavity was seen in least 31 (18.8%) number of subjects. Among subjects in which Zinc oxide eugenol was used, 31 (18.8%) subjects showed short fillings while in cases where Vitapex was used, 9.7 percent showed short fillings. Conclusion: Premixed calcium hydroxide and iodoform paste (Vitapex) offered as a healthy choice as a filling material following pulpectomy in primary non-vital teeth as compared to zinc oxide eugenol.