Radicular cyst is the most common odontogenic cystic lesion of inflammatory origin. It is also known as periapical cyst, apical periodontal cyst, root end cyst, or dental cyst. It arises from epithelial residues in the periodontal ligament as a result of inflammation. This condition is usually asymptomatic but can result in a slow-growth tumefaction in the affected region. Radiographically, the archetypal description of the lesion is a round or oval, well circumscribed radiolucent image involving the apex of the infected tooth. In the management of these lesions the endodontic treatment only is not sufficient and it should be associated with surgical management. This paper presents a case of endodontics cum surgical management of large radicular cyst in the maxillary anterior region with complete resorption of maxillary nasal floor.

Introduction: There are various methods for dental rehabilitation but osseointegrated oral implants are now a days one of the most successful method to restore oral esthetics and function. But still immediate implants are often deferred or avoided at a site where infection is present because of the fear of failure. Recent experimental studies and updated literature have shown that with meticulous socket debridement and prophylactic use of antibiotics, successful outcome can be achieved for implants placed in infected socket. Aim and Objectives: The aim of this present study was to evaluate the feasibility of immediately placed dental implant into infected and debrided dentoalveolar socket and Clinico radiographic evaluation to assess the osseointegration of immediately placed dental implants. Materials and Method: A total of Twelve implants were placed in 10 patients reporting to Department of Oral and Maxillofacial Surgery at Guru Nanak Dev Dental College and Research Institute Sunam. All implants were immediately placed following extraction of tooth having periapical pathology where the extraction socket was thoroughly debrided and curetted to remove any granulation tissue and necrotic bone from the socket and treated with clindamycin prior to implant placement. Patients were examined on 1st day, 7th day, 1 month and 3 months post-operatively. Results: The various parameters evaluated included pain, inflammation, infection/suppuration, detectable implant mobility and periimplant radiolucency. Where pain, inflammation and infection was evaluated at 1st day, 7th day, 1 month and 3 months postoperatively and implant mobility and periimplant radiolucency was checked at 3rd month after implant surgery. None of the implants failed during the healing or follow-up period in our study. No peri-implant complications were seen either. Conclusion: It can be concluded that successful immediate implant placement in infected dentoalveolar socket depends upon the meticulous debridement of alveolar socket and controlled regeneration of alveolar defect.

Reconstruction of defects of the oral cavity can be challenging. The armamentarium of the reconstructive surgeon includes local and regional flaps as well as free tissue transfer. The anatomy, location, and size of the defect guide the surgeon in treatment planning to determine the type of flap best suited for a specific reconstruction. Despite the enhanced techniques of repair of cleft palate, fistula occurrence is still a possibility either due to an inaccuracy in the surgical technique or due to the meagre tissue quality of the patient. Though usually the fistula closure is established by use of local flaps but at times the site and the size of the fistula make use of local flaps for its repair a remote possibility. Tongue flap can be the most versatile flap because of its central position in the floor of mouth good vascularity makes it a choice of flap for closure of anterior palatal fistulae than any other tissues. We are presenting a case report regarding closure of anterior palatal fistula with dorsal tongue flap.

Rehabilitation of post-surgical defects maxillofacial region requires a multidisciplinary approach. Maxillofacial prosthodontist plays an eminent role in restoring the normal health and function of the patient. This review highlights the role they plan in diagnosing, treatment planning along with conventional and advanced prosthetic management of such acquired defects.

First thing which strikes in the mind after coming across with post traumatic necrosis of maxilla that is it possible? Looking back into literature we found only handful of incidences with traumatic maxillary necrosis. Osteonecrosis of the mandible and the maxilla is known; however, aseptic necrosis of the maxilla after traumatic fracture is hardly reported. Management of these cases can be quite cumbersome and require utmost care. We present a peculiar case report of post traumatic necrosis of maxilla and partial maxillectomy. This case aims to help clinicians realize the need to closely follow up and treat such patients with trauma as it can lead to osteonecrosis of the bone and cause difficulty in daily activities.

Soft tissue repair following injury can be very challenging for a reconstructive surgeon. The goals of management of facial trauma are the preservation of form and function. The management of facial soft-tissue trauma is particularly critical where injuries can cause not only esthetic deformities but also can affect neural function, normal mastication, visual fields, and salivary outflow. Special consideration must be given to injuries of functional structures such as the facial nerve, ductal systems or organs, and ensuring appropriated management of these structures. This article discusses on few case report and a review of literature pertaining to facial soft tissue injuries.

Repair of a bilateral cleft lip deformity is challenging yet rewarding. Many surgeons find it hard to achieve results comparable to those of unilateral repairs. Poorly planned surgeries can leave noticeable residual deformities. There is a combination of genetic and environmental factors that may affect development of cleft lip in weeks 4 to 10 of gestation. Bilateral cleft lip and palate is recognized by the presence of a central echodense mass in the region of the upper lip. This mass is known as the premaxillary protrusion and it represents abnormal alveolar and gingival tissue due to uninhibited growth of the premaxilla caused by lack of continuity of the bony, gingival and lip structures. This case report is going to throw light on the unique surgical technique for severly prominent premaxilla in bilateral cleft lip and palate using reductive ostectomy on the vomero-premaxillary suture.

An esthetic smile is a common cosmetic concern in the dental field. Excessive gingival display (EGD), also called gummy smile (GS), is one of the main complaints related to an unsatisfying dental smile; it is said to be present when the gingival display exceeds 4 mm. The dental smile is achieved by a harmonious relationship between the size, shape, arrangement, and color of the anterior teeth; lip framework; and gingival contour. Altered passive eruption (AEP) is characterized by short square-shaped teeth occuring when the gingiva covers the crown of the teeth excessively. Altered passive eruption is one of the causes of GS along with maxillary lip length, bony maxillary excess, hyperactive upper lip, anterior dentoalveolar extrusion, and vertical maxillary excess. There are various options for periodontal management of EGD, such as surgical or laser gingivectomy, esthetic crown lengthening, forced eruption, lip repositioning surgery, use of Botox, or a combination of these. The aim of this paper is to review main etiologies and for proper diagnosis before the clinician can settle on the management. Dental professionals should also outline the principles of an acceptable esthetic smile, which should be the target of each GS correction procedure.

In order to achieve success in the fabrication of fixed prostheses, an appropriate marginal fit is mandatory. Despite the technological advancements in terms of the improvement of casting techniques, die fabrication, waxing pattern and coping fabrication, a discrepancy remains between the restoration’s margin and the cervical edge of the prepared tooth. The purpose of the study was to evaluate the casting accuracy by axial coverage of the die spacer 1.00 mm short from the finish line. Efforts were made to select and utilize standard method. Increased casting accuracy with die spacer application short by 1.00 mm from finish line could be due to the reason that unpainted area will ensure an area of close adaptation at the margin. Irrespective of the method of the die spacer application, all the castings showed deficiency in the marginal fit. application of die spacer 1.00 mm short from finish line on the die is beneficial to reduce the discrepancy in marginal fit and also to reduce the exposure of the cement at the margins.

The aim of this review is to highlight the awareness and utilization of mouthguards and reasons for not wearing it. A literature search was performed using the PubMed, Web of Science, Scopus and Google scholar data base for all the articles between 2000 and 2018 and was not restricted to specific languages. The search terms used were mouth guard, mouth piece, mouth protector, awareness and use. The results revealed that the awareness of mouthguards is high but the usage is low. In most of the studies the given reason for not using mouthguards is not necessary to wear it followed by discomfort.

Aim: to investigate the antifungal effect of spirulina plantensis against candida albicans. Materials and methods: In the present study, we used 60 adult rats weighing between 150 and 200gm. The rats were divided into three equal groups: Group I: Animals served as controls, Group II: Animals were subjected to Candida albicans inoculation on the dorsal surface of the tongue and received systemic antibiotic treatment, Group III: Animals were subjected to Candida albicans inoculation on the dorsal surface of the tongue under systemic antibiotic treatment and then received 15 mg/kg body weight Spirulina platensis extract orally by gastric gavage daily. After 3 weeks, by cervical dislocation, animals of the three different groups were sacrificed. Tongue specimen were dissected from each rat and prepared for histological staining done with Haematoxylin & Eosin and transmission electron microscopic examination. Results: histological examination revealed atrophy of the lingual epithelium and the surface layers was infiltrated with candida yeasts in-group II while in Group III the papillae begin to regain their normal appearance with decreased infiltration of candida to the superficial layers. Ultrastucturely, showed normal appearance of different layers of the lingual epithelium in-group I. Group II: Candida albicans yeasts invaded the keratin layer. The different layers of the lingual epithelium appeared with severely widened intercellular spaces and destructed desmosomal junctions. Group III: keratin layer appeared with disappearance of candida spherical plastopores. The different layers of the lingual epithelium showed less widened intercellular spaces and less destructed desmosomal junctions. Conclusion: Spirulina plantensis can be useful against candida albicans instead of the traditional antifungal drug.

The forensic odontology is the study making use of the human dentition throughout each stage of dental evaluation. The key element for identification includes their radiographic morphology and filling materials. The knowledge of detecting this is a valuable tool mark in the presumptive identification of the dentition of a burned victim. Dental identification of a deceased individual is a core task in forensic odontology. The accurate recording of clinical dental procedures has become more important over time due to the increasing trend of medicolegal issues worldwide. Previous reports have discussed the practical usefulness of endodontic evidence for human identification. Advances in endodontic imaging, root and root canal anatomy, and biomaterials have been consistently emerging in endodontic research and practice. This paper throws light on the clinician’s role & perspectives in forensic odontology & endodontics.

Generally, many large tissue defects occur with surgery treatments of tumors in the maxillofacial region. Maxillofacial prosthesis application can be used as an alternative treatment for cases where plastic surgery reconstructions cannot be applied. While the retention of maxillofacial prostheses used to be provided generally via adhesive bands, adhesives in liquid or spray form, and tissue undercuts, the current treatment of an intra-oral edentulous condition is frequently conducted via osseo-integrated implants. The most significant problem facing the reinforcement of the facial implants is inadequate bone thickness. While the most suitable reinforcement points for implant are the temporal region and supraorbital edge, the bone thickness varies between 2.5 and 6mm for those regions. This article reviews the application of implants in different maxillofacial prostheses.

Traditionally, the orthodontist dealt with correcting malocclusions in growing patients however an increased awareness among adult patients for dentofacial aesthetics has resulted in a huge demand for orthodontics in the adult population. However, successful orthodontic treatment can be difficult when treating adult patients since dentoalveolar development ceases after adolescence. Short treatment time is a constantly recurring request by many adult patients, hence clinicians have searched for alternative methods to accelerate tooth movement. Therefore the aim of the present study was evaluation of modified alveolar corticotomy-facilitated orthodontic treatment in adult patients with bimaxillary protrusion. Three patients with the age range of 24-30 years having class I malocclusion with Bimaxillary protrusion were included.

Background: There is no standard protocol for treating oral lichen planus. We need to develop potent alternative immunosuppressive agent to benefit the patients. Aim: To investigate the efficacy of 0.1% tacrolimus with Colgate Oraguard-B paste for the treatment of patients with oral lichen planus. Methods: One hundred patients with clinical evidence of the lesion of oral lichen planus followed by histopathological confirmation seeking care at outpatient department were included in the study. Patients were provided with 0.1% tacrolimus ointment with Colgate Oraguard-B paste as the study medication. Reassessment was done from 3 months to 4 months, with follow-up of 2 years and 6 months. Results: Mean values of pre and post VAS (Visual Analogue Scale) for erosive and atrophic forms of oral lichen planus were 9.35±1.02, 2.96±0.24 and 7.82±0.56, 1.71±0.22 respectively. Similarly mean pre and post VAS scores for reticular and mixed forms of oral lichen planus were 4.16±0.44, 1.32±0.34 and 7.36±0.59, 3.33±0.48 respectively. Statistically significant results were obtained between pre and post treatment values on the Visual Analogue Scale among all forms of oral lichen planus. Conclusion: Topical tacrolimus ointment 0.1% with Oraguard-B paste showed us encouraging results for symptomatic Oral lichen planus. Clinical improvement was achieved in about a month’s treatment course.

Background: Removal of endodontic infection is quite different from most other sites in the human body. Aim: To investigate the antibacterial property of biodentine and mineral trioxide aggregate cement against Streptococcus and Enterococcus. Methods: Antibacterial activity of Biodentine and mineral trioxide aggregate was evaluated by the agar diffusion method against E. faecalis and S. mutans among sixty patients. The experimental materials included 50 mg Biodentine and 50 mg mineral trioxide aggregate. The diameter of microbial inhibition zones around each well was measured to the closest size in mm with a digital caliper. Results: Biodentine produced 3.02±0.27 mm inhibition zone against Streptococcus mutans and Enterococcus faecalis within 24 hours. This difference between the S. mutans and E. faecalis was not statistically significant. Sililarly Mineral trioxide aggregate produced 2.01±0.22 mm inhibition zone against Streptococcus mutans and Enterococcus faecalis within 24 hours. Conclusion: Biodentine showed us encouraging results against Streptococcus and Enterococcus compared to mineral trioxide aggregate by creating higher inhibition zones.

Purpose: To investigate the effect of using mucoperiosteal-bone flap split technique when width of alveolar bone ridge is insufficient. Methods: The width of alveolar bone ridge is 3-5mm. Patients underwent mucoperiosteal-bone flap splitting. A horizontal incision was made at the top of the alveolar ridge, and two vertical incisions at the mesio-distal alveolar bone, and the whole layer of the periosteum was cut through. The cortical bone was cut using an ultrasonic scalpel. As a result, the mucoperiosteal-bone flap was split. Results: The narrow alveolar bone was succeeded to be split. And gingiva was not recessionary, split bone was not necrotic after operation. Conclusion: Mucoperiosteal-bone flap split technique can solve the problem of insufficient bone width.

Antioxidant agents stimulate new bone formation during the process of repair of bone defects. This study aimed to examine the effects of systemic administration of resveratrol, an antioxidant agent, on new bone formation in a rat model of experimentally induced bone defects. The study consisted of four groups. Each group was divided into 2 subgroups on the basis of the date on which the animals were sacrificed. We formed a 5-mm bone defect in the right mandible of the animals in each group. Control group (C) received no further treatment, first experimental group (G) received a bovine bone graft, second experimental group (R) received systemic administration of resveratrol (10 mg/kg), third experimental group (GR) received systemic administration of resveratrol (10 mg/kg) with a bovine bone graft. The results of histopathological examination on the 14th and 28th day showed significant differences in the degree of ossification, fibrosis, angiogenesis, and the density of inflammatory cells between the groups (p < 0.05). Results of biochemical analysis showed significant differences in the serum levels of bone morphogenetic protein-2 (BMP-2) and tumor necrosis factor α (TNF-α) between the groups (p < 0.05). Thus, our results showed that systemic resveratrol administration with graft placement may have positive effects on bone healing in critical-sized bone defects.

The aim of this study was to evaluate the practitioner’s fears with respect to patients with special care needs. 150 dental practitioners (aged 22 to 38 years) at a tertiary care dental teaching hospital were included in the study. A specifically designed 10-item schedule was used to access the fear. The results showed that 10 (6.7%) respondents had no fear or hesitation in offering treatment, 74 (49.3%) had hesitation, 62 (41.3%) had specific fears only and 4 (2.7%) had generalized fear. It can be concluded the fear to attend a dental patient with special care needs was quite prevalent and was affected by the dentist’s practice area, clinical experience and teaching/academic experience.

Objectives: The study aimed to evaluate the prevalence and patterns of impacted and transmigrated canine and associated pathologies in a dental population. Methods: The panoramic radiographs of 5531 patients [1820 (32.9%) male and 3711 (67.1%) female] who attended to several dental clinics between August 2018 and January 2019 were retrospectively evaluated. The number, position, impaction and transmigration of canine were noted. An impacted canine was diagnosed to be transmigrated when at least part of its length had crossed the midline. The presence of other coexisting anomalies was also noted. Results: A total of 388 patients (7.0%) presented with at least one impacted tooth. The most common impacted canines were in the maxilla among 368 (94.8%) patients, while 51 (13.1%) patients showed impacted canines in the mandible. About 32 (8.2%) patients showed both co-existed maxillary and mandibular canine impaction, while 126 (32.5%) impacted canines were bilateral either in the maxilla or in the mandible. Transmigrated canine was observed among 26 (6.7%) of impacted canine patients. Impaction of other teeth was found among 173 (44.6%) patients. Certain anomalies were co-existed along with canine impaction in 98 (25.3%) patients. Pericoronal radiolucency was the most common am-ong 84 (21.6%) patients followed by dentigrous cyst among 23 (5.9%) patients. Other anomalies were supernumerary teeth among 5 (1.3%) patients, and odontoms in only 1 (0.3%) patient. Conclusions: The prevalence of impacted teeth was high, and there was a predilection for impacted teeth in the maxilla. Pericoronal radiolucency was commonly seen in relation to the impacted canines followed by dentigrous cyst.

Background: Dentists are often faced with a large fluctuation in patient’s inflow to the clinic due to seasonality. This unpredictability of seasonal variation has high impact on revenue. High seasons bring in significantly more revenue than low seasons; dentists may find that certain months have few new patients and more empty chairs. There has been no study documented to find seasonal variation in patient’s inflow to dental clinic. Purpose of this study was to crack the code of relationship between seasonal variation and patients visit to clinic. Materials and method: cross-sectional study was performed for a period of one year in five major cities. Selection of dental clinic was done by probability sampling and one clinic was from all five cities were selected. Result: Study shows monsoon in India is not fruitful for dental practitioners as it attracts fewer numbers of patients to the clinic following summer season. Conclusion: Dental practices can encounter difficulties keeping the doors open if they do not learn to manage changes in seasonality. Study revealed that there was an obvious decline in no patients flow in months of July to September.

During the past few decades’ endodontic treatment has benefited from the development of new techniques and equipment, which have improved outcome and predictability. Important attributes such as the operating microscope and ultrasonics (US) have found indispensable applications in a number of dental procedures. Ultrasonics in endodontics has enhanced the quality of treatment and represents an important adjunct in the treatment of difficult cases. Since its introduction, Ultrasonics has become increasingly more useful in applications such as gaining access to canal openings, cleaning and shaping, obturation of root canals, removal of intra canal materials and obstructions, and endodontic surgery. Currently, although ultrasonics (US) is used in dentistry for therapeutic and diagnostic applications as well as for cleaning of instruments before sterilization, its main use is for scaling and root planing of teeth and in root canal therapy, both for orthograde and retrograde therapy. This review article brushes up the role of ultrasonics in endodontotlogy.