Facial trauma, with or without life- and sight-threatening complications, may arise following isolated injury, or it may be associated with significant injuries elsewhere. Trauma management has evolved significantly in the past few decades thereby reducing mortality in the golden hour. However, challenges remain, and one such area is maxillofacial injuries in a polytrauma patient. A systematic review of the literature was undertaken to formulate an evidence-based approach to the treatment of life-threatening maxillofacial trauma. This review article aims to provide a concise, contemporary guide for the knowledge about complications and treatment of maxillofacial trauma in the emergency setting.

To remove the inter-proximal plague, flossing has received the most attention among all the dentists. However, difficulty in dental flossing has made this technique to be avoided during tooth brushing. The proper transfer of Information and motivation to use dental floss and brush can change the attitude of the patient from an unhealthy approach to a healthy approach. The main aim of this study is to assess the knowledge and awareness of the adult population in Saudi Arabia about dental flossing. The pre-designed, pre-tested, and self-administered questionnaire survey was conducted among the adult patients visiting the various clinics in Saudi Arabia. The data that was collected from the questionnaire were analysed using the computer software Statistical package for social sciences that is SPSS 16. Among these 1011 patients, most of them were in the age group ranging from 19 to 25 years. About 971 (55%) participants used toothbrush and toothpaste to clean their teeth, while 234 (23%) patients used mouthwash, and 177 (17%) used miswak. Only 140 (14%) participants used the dental floss, 566 (56%) didn't use dental floss, and 305 (30%) rarely use dental floss.

The head face, temporomandibular joint, and the maxillary and the mandibular muscles consist of the trigeminal system and hence the pain is more prevalent in these structures. The orofacial pain affects the patient’s quality of life dramatically. In order to manage the orofacial pain disorders, the clinician need to be familiar with different types of etiologies and characteristics of facial region. In order to attain safe and best therapeutic results, the trigeminal system plays a significant role. It is a cross-sectional descriptive study aimed at evaluation of prevalence and characteristics of dental orofacial pain. The Diagnostic Criteria of Temporomandibular Disorders (DC/TMD) questionnaire was disseminated online, limiting participants to those who resided in Saudi Arabia. A total of 226 participants completed the survey. Axis I related disorders were diagnosed in 195 patients, whereas Axis II related disorders were diagnosed in 36 of patients. This study showed high prevalence rate and an immense range in pain intensity with commensurate and often significant impact on the quality of life. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD), has been widely used globally to estimate prevalences of TMD. Additional research is necessary to establish comprehensive classification schemes for all patients with orofacial pain.

Introduction: Mandibular third molar is commonly encountered impacted teeth. The present study aimed to assess relation of mandibular canal wit IANC. Materials & Methods: The present study was conducted on 82 patients with impacted mandibular third molar of both genders requiring surgical extraction. Patients underwent OPG and CBCT. Images thus obtained were analyzed by oral and maxillofacial radiologist followed by classification of Michele. Results: Out of 82 patients, males were 48 and females were 34. Darkening of roots (DR) was seen in 14 males and 10 females, diversion of canal (DC) in 10 males and 6 females, narrowing of canal (NC) in 8 males and 5 females, presence of cortication in 10 males and 7 females and interruption of white line (IWL) in 6 males and 6 females. The difference was significant (P< 0.05). Maximum number of subtype 3A relation was seen followed by subtype 1B, subtype 3A, subtype 3B, subtype 1A, subtype 4B etc. Conclusion: Authors found that impacted mandibular third molar surgery may lead to damage to inferior alveolar canal. Therefore a radiographic imaging with OPG and CBCT may be useful in preventing damage to the nerve.

Most of the physiological processes in the mammals exhibit the circadian rhythms which are guided by endogenous biological clock. This biological clock consists of a central unit which is located in hypothalamic suprachiasmatic nucleus (SCN) and the secondary clocks are located in the peripheral tissues. Circadian rhythms endure 24-hour oscillations of substantial number of the master genes that control the synchronization of varied metabolic and physiological actions within our bodies. This is a very complex regulative network which contributes to an important association between brain and several peripheral tissues as well as organs. The circadian fluctuations of the gene expression are regulated at the molecular level by a family of transcription factors known as “clock genes”. The imbalance or dysregulation in the expression of these clock genes can result in the varied human pathological conditions, inclusive of cancer and autoimmune diseases. The evidences are escalating regarding the effect of circadian clock in the tooth development, homeostasis of the oral epithelium, salivary gland and saliva production. The present article summarizes the available knowledge regarding the roles of the clock genes in the genesis as well as perpetuation of the oral tissues, and also mention about the potential association between the “oral clocks” and the diseases like head and neck cancer as well as Sjögren’s syndrome.

Internet addiction has gradually become a serious issue in public health worldwide. Especially college students are vulnerable to developing dependence on the Internet, more than most other segments of the society. Hence the present was intended to assess the internet addiction and dietary habits and also to find association between internet addiction and dietary habits among college students. A cross-sectional questionnaire survey was conducted amongst 5 colleges of Coorg district. Data was collected on a semi constructed, close ended, structured questionnaire consisting socio-demographic information, questions on Internet addiction (10) and dietary habits (6). Collected Data was coded and fed in SPSS for analysis. A total of 300 students (19.86 ± 0.94 years) were included. When the scores were tabulated, 46.1% mildly addicted, 47.2% moderately addicted and 6.6% severely addicted to internet. 20.3% occasionally found it difficult to stay away from net for several days. 26.7% of participants always lost sleep due to late night log-ins. Among severe internet addicts, 17.6% eat more when they are anxious, worried or tense (p= 0.001). 64.7% often snack more in the evening (p= 0.006) and 58.8% of severe internet addicts took longer time to eat dinner (p = 0.006). In the current study, internet usage had an adverse impact on the college students in terms of difficulty in staying away from net for several days, losing sleep and to certain extent on dietary habits too. Hence it is necessary to increase the public awareness regarding internet addiction and its impact on dietary habits.

Rehabilitation of a patient with moderate attrition after restoring his vertical dimension is a complex procedure. Therefore, the vertical dimension should be assessed in such a case. This clinical report describes the full-mouth rehabilitation of an elderly patient who was clinically monitored for 30 months to evaluate his adaptation to a removable occlusal splint to restore his vertical dimension. Provisional restorations were then cemented to evaluate the aesthetic and functional outcome to the new occlusion for a time period. Metal ceramic prostheses were cemented. The patient’s tolerance to changes in the existing occlusion was confirmed before proceeding to the next steps. During follow-up visits, the patient’s family reported a marked improvement in his facial appearance, dental aesthetics, speech articulation, and social life.

Background: The most frequent complication which follows the removal of impacted mandibular third molars is ‘dry socket’ or Alveolar Osteitis (AO). The present study aimed to evaluate the incidence, risk factors (age, sex, infection) contributing to the development of dry socket and clinical feature following surgical removal of impacted mandibular third. Material & Methods: The present study was conducted in 86 adult patients requiring surgical extraction of impacted mandibular third molar. The surgery was performed in a standardized technique. Patients were recalled regularly and symptoms and signs of dry socket was noted if developed. Patients were reviewed at 3rd and 7th day of surgery. Results: Out of 86 patients, 46 were males and 40 were females. Out of 46 males, 5 and out of 40 females, 4 developed dry socket. Age group 18-30 had 2 dry socket, 30-50 had 2 and >50 years had 5 cases of dry socket. The difference among both genders was significant in age >50 years (P< 0.05). The incidence of DS was in 7 patients suffering from systemic diseases and 2 medically fit patients developed dry socket. Postoperative symptoms such as pain, empty socket, bare bone and halitosis on 3rd and 7th day. There was significant reduction in symptoms on 7th day. Conclusion: Dry socket is multifactorial in nature. Authors found that higher number of dry socket was in age group >50 years, in males and in patients with systemic diseases. Need of the Study: Assessment of risk factors may be useful in preventing complications arising from mandibular third molar extraction.

Fibrous dysplasia is a developmental anomaly which involves the replacement of normal medullary space by abnormal fibrous osseous tissue in the affected bone. It has been reported to cause increased rate of bone resorption and bone refilling has been observed in <50% of the defect. Patients with fibrous dysplasia can have periodontitis which is an immuno-inflammatory disease of the supporting tissues of the teeth with classic signs of periodontal pockets, recession or both. The goal of periodontal therapy is to thoroughly debride the periodontal pockets so as to prevent further damage to the surrounding bone and regenerate the lost periodontal structures. However, the treatment of periodontitis subjects with fibrous dysplasia is unpredictable and hence possesses a greater challenge for the clinician. This is a first report of its kind in the literature. This case report presents a 32year old patient with monostotic fibrous dysplasia having periodontitis and was treated by non surgical periodontal therapy which include scaling, root planning and curettage with soft tissue LASER as a non-invasive treatment modality. Laser assisted periodontal therapy resulted in resolution of the periodontal pocket as well as significant radiographic bone fill at the end of 6month recall visit.

Dental decay is one of the most prevalent diseases of mankind. In many countries, its severity increased in correlation with importation of sugar, reaching its zenith in about 1950s and 1960s. Dental caries, unlike periodontal disease, is now recognized as an infectious, transmissible, multifactorial disease of bacterial origin. The philosophy of caries management by risk assessment, or CAMBRA®, represents a paradigm shift. Current evidence-based emphasis is on the need to recognize a carious lesion in its earliest stage before demineralization has produced a cavitated lesion that requires restoration by a dentist. Prevention strategy is to determine the dental caries risk factors for patients of all ages and to introduce remineralization strategies into the patient's dental care plan. Therapy should focus on patient-specific approaches that include disease monitoring and preventive therapies supplemented when necessary by restorative care. Changes in the management of dental caries will require health organizations and dental schools to educate students, practitioners, and patients in evidence and risk-based care. This paper discusses current understanding of the caries balance, the process of demineralization and remineralization of tooth structure, caries risk assessment, the different levels of caries risk and a brief review of strategies to control dental caries. Adequate treatment protocols specifically related to the remineralization of non-cavitated lesions using dentifrices and related studies are discussed.

Objectives: The study was done to evaluate efficacy of chemiluminescent method (vizilite) as a screening test in detecting the malignant changes in potentially malignant lesions of oral cavity. Study also compares sensitivity and specificity of toludiene blue with chemiluminescent method. Materials & methods: 30 patients clinically diagnosed as potentially malignant lesions of oral cavity were recruited. After obtaining consent form, all patients were subjected chemiluminescent method and toludiene blue. All patients were then compared with histopathological results and statistically analyzed. Results: After histopathological results, Sensitivity and specificity of vizilite was found to be 66.6% and 71.4% respectively and that of toluidine blue was 77% and 87%. Conclusion: Although vizilite accentuated the visibility of the lesion but overall detection rate in patients was not significantly improved. Qualities like easy to perform, less time consuming and instant results concur with the properties of an ideal screening test but diagnostic propensity is questionable.

Stem cells are biological cells that are undifferentiated and can be differentiate into specialized cells. They are of embryonic or adult stem cell. Another classification is dental pulp and bone marrow- derived. Bone marrow type stem cells are commonly used for regenerative procedures in prosthodontics. They have excellent regenerative ability without neoplasm formation. They help to build the bone structures of the craniofacial region, particularly the maxilla and mandible. Stem cell therapy can revolutionize next era in regenerative prosthodontics.