A Journal of Clinical Dentistry-Heal Talk

6-7

Authors: Dr. D.K. Agarwal, Dr. P.S. Raju Dr. Preeti Bhattacharya, Dr. Ankur Gupta Dr. Abhishek Agarwal

The effect of the Twin Block functional orthodontic appliances is mostly dento-alveolar with small skeletal effect. There are certain clinical indications where functional appliances can be used successfully in class II malocclusion e.g. in a growing patient. The use of these appliances is greatly dependent on the patient's compliance and they simplify the fixed appliance phase. In this case, a 12-year old adolescent was treated with Twin Block appliance followed by fixed appliance to detail the occlusion. The design and treatment effects are demonstrated in this case report.

9-10

Authors: Prof. (Dr.) U.S. Krishna Nayak Dr. Nikhil Malviya Dr. Daryl Crasta

Department of Orthodontics & Dentofacial Orthopaedics, A. B. Shetty Memorial Institute of Dental Sciences, Derlakatte, Mangalore Adjunctive orthodontics is the tooth movement carried out to facilitate other dental procedures necessary to control disease, restore function and /or enhance appearance as the part of adult orthodontics.

10 & 12

Authors: Dr. Puneet Kalra, Dr. A.S. Rana Dr. Gaurav Jain, Dr. Shyam Prasad Dr. Deepak Gupta

Management of patient with space infection is always a challenging job, as in most of the cases there is always an impending risk of airway obstruction. Incision and drainage (I/D) under general anaesthesia via oral or nasal intubation carries a risk of aspiration of pus, so tracheostomy becomes the treatment of choice. In this case report we discussed the management of submandibular and buccal space infection under general anaesthesia via Percutaneous dilatational tracheostomy

11-13

Authors: Prof. (Dr.) U.S. Krishna Nayak Dr. Sushma Shenoy H. Dr. Arjun Nayak, Dr. Trailokya Bharali

Laser is an acronym for “light amplification by stimulated emission of radiation.” A laser is a single wavelength (or color) of light traveling through a collimated tube delivering a concentrated source of energy. Most elements in the periodic system (atoms, gases, organic molecules, diodes, chemicals, or electrons) can be used as media to develop a laser beam.

11-12

Authors: Prof. (Dr.) U.S. Krishna Nayak Dr. K.T. Marattukallam Dr. Rakesh B.C. Dr. Joseph Sebastian

Self- Ligating brackets have made a major impact in orthodontics in last seven or so years, although the idea of self ligating brackets has intrigued and fascinated the orthodontist since the time of Edward Angle , and some of his patented innovations of the edgewise bracket show this preoccupation with simple ligation of the archwire . Self- ligating brackets transcends the limitations imposed on design by providing treatment efficiency and precise tooth movement

13

Authors: Dr. Tamanna Chhabra Dr. Shomik Guha

Prosthetic rehabilitation of acquired maxillary defects can be achieved satisfactorily if all facets of treatment planning and design considerations are taken well into account prior to the rehabilitation process. In many cases effective obturation is achieved but in the relative majority the prosthesis is usually rejected by the patient and the outcome is a failure. Complications associated with maxillary defects limit the treatment protocols to a great extent. The prosthodontist has to identify these problem areas and suitably device feasible options and incorporate them in the design

13-14

Authors: Dr. Muralee Mohan, Dr. Arvind Karika Dr. Smitha Bhat, Dr. Gopinath Thilak P.S. Dr. Ankur Padmaja

Osteochondroma of the mandibular condyle is extremely rare and may cause signs and symptoms like those seen in patients with temperomandibular joint dysfunction. Differentiation between osteochondroma and condylar hyperplasia is not possible on histological grounds alone, but the radiographic and intra-operative findings together are usually sufficient to establish a definite diagnosis.

14-16

Authors: Dr. Prashant Bhasin Dr. Meenu Taneja Dr. Binita Srivastava

Aim The aim of this study was to evaluate the comparative antibacterial efficacy of 10% chlorine dioxide and 3% Sodium hypochlorite as an endodontic irrigant. Material & Methods Thirty intact extracted teeth were taken. Apical 5mm was removed with diamond disc& roots were further sectioned into cylindrical discs of 5mm height lumens were standardized with (no: 25) round bur. Smear layer was removed with EDTA & Sodium hypochloride (NaOCl). Disks were autoclaved and then infected with standardized concentrations of Enterococcus (E) faecalis (ATCC) in brain heart infusion broth for 72hr .The discs were divided into two groups of fifteen each & were exposed to 10% Chlorine dioxide(ClO2) & 3% NaOCl for 5, 15 , 30 min respectively. At intervals of 5, 15, 30 Dentinal shavings were collected from the lumen (Fig. 4) and weighed & transferred to tube containing known quantity of normal saline and were then frozen, pulverized, serially diluted in phosphate buffered saline, and plated cultured in Bile-Esculin Agar (BEA), which is a specific culture medium for E. faecalis12. The plates were then incubated at and later evaluated for the presence of bacteria and the constituents of the colonies. Results & Conclusion After 5 minutes 10% ClO2 was significantly more effective than NaOCl in removing E. fecalis. Efficacy at 15& 30 min were comparable. Keywords: Antimicrobial, Endo-dontics, Enterococcus faecalis, irrigation, Sodium hypochlorite, chlorine dioxide.

15-17

Authors: Dr. Mohit Kamra Dr. Rajnish K. Singhal Dr. Preeti Chowdhary

One of the basic problems in bio-mechanical engineering is forming of implant mechanical characteristics in a way that ensure, both structure durability and an optimal load patterns in surrounding tissues. A significant challenge in implantology is the design of bio-materials that actively promote functional regeneration of the host tissue while avoiding undesirable tissue responses. This requires selective control of interactions at the tissue/implant interface.

16-19

Authors: Dr. Mukhtar Ahmed Javali Dr. Shaik Parvez Dr. Humera Ayesha

Oral halitosis is a frequent or persistent unpleasant odor of breath. It is a common and multi-factorial condition. Halitosis is the result of microbial activity in the mouth. The origin of halitosis is related to both systemic and oral conditions. The advice of dental professionals for treatment of this condition occurs with regularity since 90% of halitosis emanate from the oral cavity. This article provides a comprehensive review of its history, etiopathogenesis, diagnosis, and management.

17-18

Authors: Dr. Rohit Paul, Dr. Rahul Paul Dr. Geeta Paul, Dr. Mayura Paul

It is generally accepted that saliva is of paramount importance for the maintenance of oral health. This is based on the numerous studies reporting subjective and objective functional losses that occur in persons who lack the ability to produce adequate volumes of saliva. These include dry mouth feeling (xerostomia), difficulty with swallowing food and an increased susceptibility for opportunistic infections. The last issue points to an active protective role of saliva in maintaining oral health under normal conditions.

18-23

Authors: Dr. Nitin Kararia Dr. Vandana Kararia Dr. Ajay Chaudhary Dr. H.P. Trivedi

AIMS: aim of this in-vitro study was to evaluate the accuracy of two modern electronic apex locators: Root ZX and Propex, in the detection of simulated horizontal and vertical root fractures. MATERIALS AND METHODS: A total of 60 extracted, straight, single rooted teeth were divided into 6 groups of 10 teeth each. In groups A, B, and C an incomplete horizontal fracture was simulated by preparing a horizontal incision in the coronal, middle or apical portion of the root until the circumferential half of the canal was exposed in the horizontal plane respectively. In groups D, E, and F an incomplete vertical root fracture was simulated by preparing a vertical straight incision to expose the canal in the coronal, middle or apical portion of the root all the way in the longitudinal plane respectively. The simulated fractures were 0.25 – 0.35 mm in thickness in all groups. The teeth were embedded in alginate and irrigated with saline solution during electronic measurement. Detection of the simulated fractures was established with a size 10 K file when the meter value reached “Apex” on each electronic apex locator. Actual length measurements were done with a size 10 K file under a stereomicroscope at x30. Data was analyzed using Statistical Package for Social Sciences. RESULTS: No statistically significant difference was found between Root ZX and Propex for any of the groups under study (P > 0.05). Both apex locators detected the position of horizontal fractures more accurately than that of vertical fractures, with an overall accuracy of 38.33% (horizontal fractures) and 20% (vertical fractures). CONCLUSION: modern electronic apex locators are useful clinical tools for the detection of root fractures, specially the horizontal ones.

18 & 20-24

Authors: Dr. Prerna Kataria Dr. Vishal Sood

The present study was based on clinical evaluation and comparision of the efficacy of bovine derived xenograft with or without chlorhexidine and -Tricalcium phosphate among themselves and with access flap alone in the management of infrabony defects eighteen subjects with twenty-four, two wall infrabony defects were equally divided into four groups. Open flap debridement was done in control group with no graft material placed in infrabony defects. In Experimental group I, intra-osseous defects were filled with HA/Collagen/ Chlorhexidine composite graft material. In Experimental group II, HA/Collagen graft was used. In Experimental group III, ricalcium phosphate was used in infrabony defects.

20-21

Authors: Dr. Shashikala Jain Dr. Sanjay Jain

Can we go anti-ante's law? Anybody would surely say a big 'No'. That is exactly what I was told from the day one-whether it was my first fixed prosthodontic lecture or clinic and throughout my post graduate days it was all Ante's law for me. And as I followed this protocol I lost count of innumerable patients I diagnosed invalid for fixed prosthetics. Before we go into further discussion let's see what is Ante's Law.

20

Authors: Dr. Rakesh Kumar Agarwal Dr. Amit Agarwal Dr. Kokil Agarwal

Stem cell is a generic cell that can make exact copies of itself indefinitely .In addition stem cell has the ability to produce specialized cells for various tissues in the body.Stem cell treatment using special human cells to repair or replace damaged tissues or organs is the cornerstone of future medical sciences.

21-22

Authors: Dr. Sudipto Podder Dr. Sunil Kar Dr. Shilpi Ranjan Mishra

Placement of implant has always been a challenge to the clinician as the final outcome is always dependent upon the case selection,so the clinician always wants a perfect platform to place implant to avoid turbulance.One of the challenging aspect of implant placement is to create sufficient space for implant diameter in ridges with deficient width.This article exibits a clinical case report in which bone width has been increased with the help of osteotomes to accommodate the selected dimiension of implant.Success in implant dentisry requires evaluation of more tan 50 dental criterias,of which bone width and bone density are primary determining factor.s.

22

Authors: Dr. Rakesh Kumar Agarwal Dr. Amit Agarwal Dr. Kokil Agarwal

Ectopic eruption is a developmental disturbance in eruption pattern of teeth. The incidence of ectopically erupting teeth is increasing day by day. This may be due to greater use of panoramic and increasing awareness among public in their dentition and oral health. These can be either primary or secondary. This is a clinical case report on an ectopic supernumerary teeth present in palate.

23-24

Authors: Dr. Mukesh Kumar, Dr. Vikash Vaibhav Dr. Kotni Prem Sagar

Great discoveries change the course of history. Norms and standards that have taken years and even decades to develop are questioned when new and promising innovations appear. What seemed absolute, the doctrine and principles that guided our decisions and gave us security, becomes just another set of well-developed ideas. Accepted practices are reexamined, and many lose the stature that they held for generations. Such a dramatic, all-encompassing change has occurred in prosthodontics . Oral rehabilitation using titanium implants has become a very predictable treatment alternative during last few decades. The complications are constantly decreasing and the success rate is increasing, with the advent of the osseointegrated dental implant.

24-26

Authors: Dr. Mohit Sharma Dr. G.D. Singhal

The loss of an anterior tooth due to periodontal reasons, endodontic reasons or due to trauma has a great psychological effect upon the patient. His primary concern is the restoration of an esthetic appearance. Fiber- reinforced composite resin (FRC) prostheses offer the advantages of good aesthetics, minimal invasive treatment, and an ability to bond to the abutment teeth, thereby compensating for less-than-optimal abutment tooth retention and resistance form. These prostheses are composed of two types of composite materials: fiber composites to build the framework and hybrid or microfill particulate composites to create the external veneer surface. This case report is based on the use of fiber reinforcement in the fabrication of composite-fixed partial dentures of conventional preparation. The possibilities fiber reinforcement technology offers must be emphasized to the dental community. Rather than limiting the discussion to whether FRC prostheses will replace metal- ceramic or full-ceramic prostheses, attention should be focused on the additional treatment options brought by the use of fibers. However, more clinical long term studies are needed.

26-28

Authors: Dr. Musharib Ahmed Dr. Nafis Ahmed Dr. Zeba Jafri

Dental art has long been part of the quest to enhance the esthetics The Search for beauty can be traced to the earliest civilizations of the teeth and mouth. Both the Phoenicians (approx. 800 BC) and Etruscans (approx. 900 BC) carefully carved animal tusks to simulate the shape, from, and hue of natural teeth for use as pontics The introduction of mineral teeth in 1817 was soon followed by the manufacturer of porcelain teeth. Dentures were fabricated with a gingival component made of carved ivory or animal bone that was designed for adaptation to ivory or bone bases.

26-27

Authors: Dr. Varun Kumar, Dr. Puneet Kalra Dr. Nadeem Yunus, Dr. Shivani Kalra

The goal of maintenance of roots of one or more teeth for overdenture are to prevent alveolar bone resorption, provide better load transmission, maintain sensory feedback and achieve better stability of denture with emphasis on psychological aspect of not being completely edentulous. The purpose of this case discussion was to evaluate the usefulness of utilizing abutment teeth in the support of complete dentures.

27-28

Authors: Dr. Puneet, Dr. Palwinder Kaur Dr. Saryu Arora, Dr. Sunint Singh

Improved patient’s acceptance in terms of function, esthetics, and comfort is the primary goal of a dentist to rehabilitate completely edentulous patients. Research aiming specifically at occlusal concept and occlusal schemes that is better for the overall welfare of the patient has been on high priority today. Till date there are various concepts, techniques and philosophies available for the dentist’s to choose according to the requirements of the patient. One of the recent focuses of interest has been the lingualized occlusion concept. The aim of this concept is to provide better esthetics and denture stability than other occlusion schemes available. This paper presents its applications in various anteroposterior and buccolingual arch discrepancies including a wide variety of clinical situations.

28

Authors: Dr. Gary Lauffenburger

In today’s age of advanced dentistry we as clinicians and technicians not only need to be concerned with providing the highest quality of care to our patients but we also need to be aware of the quality of materials we use in our restorations. One of these materials is dental porcelain powder.

29-30

Authors: Dr. Rakesh Kumar Agarwal Dr. Amit Agarwal Dr. Kokil Agarwal

Smile makeover is a process where cosmetic dental procedures are performed on several front teeth in order to produce an overall change in appearance.It involves one or more cosmetic,dental or facial rejuvenation procedure to improve aesthetics of smile.

32

Authors: Dr. Sangeeta Dighe

Antral pseudocysts are dome-shaped shadows (in radiographs) on the floor of the maxillary sinus and are discovered on routine panoramic radiography.1 Awareness of the apt nomenclature and correlation with clinical and radiographic and if necessary, histological features will result in a correct diagnosis.

32-35

Authors: Dr. Shahina Parvez, Dr. H.P. Trivedi Dr. Manju Gupta, Dr. Adil Bharti Dr. Sumera Saleem

The aim of this case report is to assess the healing outcome of MTA as a retrograde filling material over a time span of four years. A 16 years old male patient reported in the dental office with pain & swelling in the mucosa overlying 21 & 22. The patient was treated surgically & MTA was used as a retrograde filling material. Crown lengthening of 22 was also done as it was barely visible in the oral cavity. After initial healing of the surgical wound, post & core procedure was done in 22 then prosthesis was cemented over 21 & 22. The patient was followed up for four years and the healing was observed radiographically. During all follow up radiographs, healing was quite good. The patient had no complaints what so ever.

33-36

Authors: Dr. Krishna Deo Prasad Dr. Basavraj T. Bhagawati

Oral cancer is a disease in which malignant cells form in the lips, oral cavity &oropharynx. traditionally known as squamous cell carcinoma of the lips,oral cavity & oropharynx. Head&neck cancer account for 5% of all tumours & about 50%of head &neck cancer occur in the oral cavity. In the year 2000, about 300,000 out of the 615000 new cases of oral cavity reported world wide were primary oral cavity squamous cell carcinoma.1Recent data from surveillance, epidemiology end result program suggested that 28,900 new cases of oral cancer will be identified&7400 death attributed to oral cancer each year in the U S.2 The sixth leading cause of cancer related morbidity, oral cancer account for 1 death every hour in U S. Despite numerous advances in treatment the 5 year survival has remained approximately 50% for the last 50 years.3 This poor prognosis is likely due to several factors. First, oral cancer is frequently associated with the development of multiple primary tumors. The rate of second primary tumors in these patients, 37% per year, is higher than for any other malignancy.4This characteristic led Slaughter to propose a theory known as ''field cancerization''. To underscore the significance of this complication, the most common cause of treatment failure and death in oral cancer patients is their second primary tumor.5 Second, poor survival among oral cancer patients can also be attributed to the advanced extent of the disease at the time of diagnosis, with over 60% of patients presenting in stages III and IV. Such dismal statistics seem perverse since the disease primarily arises in the surface oral epithelium that is readily accessible to direct visual and tactile examination. The conclusion that at least some lesions are ignored or missed by patients,health care professionals or both, is inescapable. In part, this may be due to an incomplete understanding or awareness that even, small asymptomatic lesions can have significant malignant potential. One approach to this problem wold be to improve the ability of oral health care professionals to detect relevent potentially malignant lesions or cancerous lesions at their earliest or most incipient stage. Such a goal could be achieved by increasing public awareness about the importance of regular oral screening or case finding examinations to identify small, otherwise asymptomatic cancers and precancers (secondary prevention). Another strategy would be the development and use of diagnostic aids that could help the general dentist or dental specialist more readily identify or assess persistent oral lesions of uncertain biologic significance. This paper will examine the role of screening examinations in oral cancer and evaluate the literature regarding currently available diagnostic tests or techniques that are purported to aid in the detection and diagnosis of cancerous and precancerous lesions.

34-35

Authors: Dr. Nutan Tyagi Dr. Rishi Tyagi Dr. Vineeta Gupta

Salivary gland/duct calculi account for the most common disease of the salivary glands. As compared to the frequency with which we see calculi in submandibular gland or its duct, the frequency of sublingual duct calculi is far less. The following case details a case of multiple sialoliths in the sublingual gland duct and brings to light the dilemma that might occur during the clinical diagnosis, owing to the proximity of location of the openings of the ducts of the aforementioned glands.

35-36

Authors: Dr. Pravin Gaikwad Dr. Anuj Garg Dr. Sweta Singh

Background: The aim of present study was to qualitatively determine a relationship exist between glycogen content of gingival epithelium and severity of inflammation. Methods: Sample size consists of 75 cases of healthy and various grades of inflammation of gingiva. The lesions examined in the present study consist of 10 cases of healthy gingiva, 27 cases of mild gingivitis, 17 cases of moderate gingivitis and 21 cases of severe gingivitis. Section was stained with Hematoxyllin & eosin to demonstrate the presence of inflammation and PAS to study the presence and absence of glycogen. Results: In the present study it is found that, as severity of inflammation increases, glycogen content of gingival epithelium also increases proportionately. Maximum content of glycogen is found in the gingival epithelium of severe gingivitis. We also can observe that maximum amount of glycogen is present in spinous layer (75%) followed by granular cell layer (69%), corneum (30%) & basal cell layer (27%). Conclusion: The results showed positive correlation between glycogen and gingivitis. Healthy gingiva contains no glycogen or least amount of glycogen. As the severity of inflammation increases amount glycogen also increases.

36-37

Authors: Dr. Mukhatar Ahmed Javali Dr. Shaik Parvez Dr. Humera Ayesha, Dr. Arjumand Fatima

Dental caries and periodontal diseases are the two main afflictions to mankind. It is generally accepted that oral hygiene maintenance through regular removal of dental plaque and food deposits is an essential factor in the prevention of dental caries and periodontal disease. Methods for oral hygiene vary from country to country and from culture to culture. Despite the widespread use of toothbrushes and toothpastes, natural methods of tooth cleaning using chewing sticks have been practiced for thousands of years in some countries.

37-38

Authors: Dr. Meera Sandhu Dr. Arun Sharma Dr. Shallu Tyagi

Talon cusp is a supernumerary structure projecting from the cemento-enamel junction to a variable distance towards the incisal edge of an anterior tooth. It is composed of enamel, dentine and a variable amount of pulp tissue. Hyperactivity of the enamel organ during morphodifferentiation has been attributed to its formation. Talon cusp normally occurs on lingual aspects of primary and permanent teeth, very rare cases have been reported documented talon cusp on labial surfaces of teeth and both on labial and lingual surfaces of teeth.It may affect the function and aesthetics in the anterior area. Its early detection and treatment is essential to avoid complications.

38-39

Authors: Dr. K.L. Gupta Dr. Jameel A. Saib

Advances in dentistry, as well as the increased desire of patients to maintain their dentition, have lead to treatment of teeth that once would have been removed. In order to carry out this present day mandate, diseased teeth with severe bone loss may well be retained by removal of one or more of their roots. This article describes a simple procedure for hemisection in mandibular molar and its subsequent restoration.

38-44

Authors: Dr. Neelkamal Sharda Dr. Priyanka Kant

RAS is a painful phenomenon, characterized by necrotizing ulcers of the oral mucosa that persist, remit and recur for variable periods of time.1 RAS indeed is one of the most common lesions seen by the dentist.2 RAS is defined as an inflammatory condition of unknown etiology characterized by painful recurrent, single or multiple ulcerations of the oral mucosa.1 RAS is sometimes termed as recurrent oral ulceration, but it is important to note there are various causes of recurrent oral mucosal ulceration other than RAS and hence the term RAS is considered more appropriate.3 RAS was first described in antiquity and since has been the subject of numerous clinical and laboratory investigations.3 However, the disease still remains poorly understood

40-44

Authors: Dr. Syeda Arshiya Ara Dr. Syed Ahmed Raheel Dr. Syed Zakaulla Dr. Mukhatar Ahmed Javali

Non-invasive Imaging in Gene Therapy has emerged as an essential tool for identifying the fate of vectors in tissues, quantifying injected dose in various organs, evaluating toxicity, and analyzing therapeutic gene expression level and treatment outcome. In the field of gene therapy, a considerable effort is being invested in the development of noninvasive imaging of gene expression. Several methods are available for non-invasive imaging of gene delivery and transgene expression, including magnetic resonance imaging (MRI), single photon emission tomography (SPECT)/positron emission tomography (PET), and fluorescence and bioluminescence imaging. Modern imaging techniques provide an opportunity to monitor direct vascular gene therapy. This article presents the various strategies currently being developed, the methodologies in use and highlights recent key approaches using the latest imaging modalities in gene therapy, its clinical applications in the field of research with its future trends.

42-43

Authors: Dr. Dinker Goel Dr. Puneet Anand Dr. Shomik Guha

One of the most challenging tasks of modern restorative dentistry is resolving the dilemma of spaces between anterior teeth. Treatment planning to correct a diastema may include orthodontics, restorative dentistry, or a combination of several therapies. Although direct bonding, porcelain laminate are generally preferred but there are certain situations for which porcelain fused to metal crowns will be the technique of choice. A 24 year old patient female reported to the Department of Prosthodontics. A review of her dental examination revealed that the patient had a history of trauma in relation to her maxillary right central incisor Ellis class III fracture. Further examination revealed that the patient had a midline diastema. Since the trauma occurred many years back there was misalignment of the central incisor.

42-43

Authors: Dr. Debkant Jena

Maxillary premolars have highly variable root canal morphology, but it is rare, to find three root canals. This article describes the diagnosis and clinical management of a maxillary first premolar with three canals and three separate roots emphasizing on radiographic interpretation and access refinements

44

Authors: Dr. Pratibha Kavle Dr. G.P. Rathod Dr. Pravin Gaikwad Dr. Tabita Benjamin Dr. Mohit Sharma Dr. Anuj Garg

Oral epithelial dysplasia is the histologic marker of premalignancy and as such predictive of an increased rate of development of squamous cell carcinoma. Squamous cell carcinoma constituted about 90% of oral malignancy. Despite advances in the detection and management of cancer survival rate has remain poor 3. Oral cancer may develop as a two stage process first stage as premalignant lesion and second as development of cancer with in this lesion. Epithelial dysplasia is the most important indicator of malignant potential. However subjective variation has restricted the role of epithelial dysplasia as a predictor for malignant transformation

44-46 & 48-49

Authors: Dr. Sidharth Malik, Dr. Harsh Malik Dr. Deepak Chopra

Objectives: This review critically evaluates the different therapies that are available to manage drug-induced overgrowth (DIGO). Material and Methods: This review is based on literature identified using the online databases MEDLINE and PUB MED. It is not a systematic review, but a conventional review of the relevant literature. Results: Patients benefit from a non-surgical approach if this can be delivered before commencement of medication although in many instances this may not be practicable. Systemic antibiotic usage has been evaluated in the management of ciclosporininduced gingival overgrowth. Efficacy appears to be equivocal and long-term use is undesirable. Surgical excision remains the main treatment option especially for patients with severe overgrowth. Few studies have compared different techniques with respect to recurrence rate or post-operative sequelae. Conclusion: DIGO is a common clinical problem that often requires intervention. Non-surgical techniques can limit the occurrence of this unwanted affect, reduce the extent of plaque-induced gingival inflammation and reduce the rate of recurrence. Wherever possible this management strategy should be adopted first. Surgical treatment is often the most reliable option and scalpel gingivectomy remains the treatment of choice.

45-46

Authors: Dr. Vineeta Gupta, Dr. Anil Khanna Dr. Shalu Khanna, Dr. Ruchieka Vij Dr. Hitesh Vij, Dr. Aish Gupta

The term ‘odontoma’, by definition alone, refers to any tumor of odontogenic origin. Here enamel and dentin are usually laid down in an abnormal pattern because the organization of the odontogenic cells fail to reach a normal state in morphodifferentiation. As this lesion is composed of more than one type of tissues it is referred to as a composite odontoma. Here if the tissues are ordered in structure, bearing atleast a superficial anatomic similarity to a normal tooth they are referred to as compound composite odontomas. Whereas those calcified masses which show no morphologic resemblance to even rudimentary teeth are called as complex composite odontomas.

45-46 & 48

Authors: Dr. Deepak Girdhar

All children should be able to expect painless, high quality dental care. The following guideline is intended to assist dentists in the management of healthy anxious children; discussion of the sedation of medically compromised children or those with a learning disability is not included.

47

Authors: Dr. Piyush Tandon Dr. Monika Tandon

A pronounced gag reflex can be a severe limitation to a patient’s ability to accept dental care and for a clinician’s ability to provide it. It can compromise all aspects of dentistry from diagnostic procedures to active treatment and can be distressing for all concerned. Acupressure can be used as a method to control gag reflex.

48-50

Authors: Dr. H.P. Trivedi Dr. Manju Gupta Dr. Manoj Agarwal

ABSTRACT The major challenge in performing endodontic treatment in teeth with necrotic pulps & wide open apices is to obtain an optimal apical seal of the root canal system. Initial aim of the therapy is to induce a hard tissue barrier at the tooth apex. This process is known as apexification. The aim of the procedure is to limit bacterial infection and create an environment conducive to the production of mineralized tissue in the apical region.

49

Authors: Dr. Nishant Raj Chourasia Dr. Sachin Dev Dr. Anupam Bagdi Dr. Archana Bagdi

Osteo-odonto-keratoprosthesis (OOKP) (also known as "tooth in eye" surgery[1]) is a medical procedure to restore vision in the most severe cases of corneal and ocular surface patients. It includes removal of a tooth from the patient or a donor.[2] After this, a lamina of tissue cut from the tooth is drilled and the hole is fitted with optics. The lamina is grown in the patients' cheek for a period of months and then is implanted upon the eye.

50

Authors: Dr. Pooja Palwankar Dr. Vivek Mehta

Tooth transposition is a severe disturbance of tooth order and eruptive position involving certain teeth that may occur at any of specific sites in the mouth14. Tooth transposition affected the maxillary dentition more frequently than the mandibular dentition (76%). Unilateral transposition accounted for 88% of cases13. Transposition is a rare developmental disturbance of tooth order characterized by positioned interchange of the two teeth on the same side of the dental arch.1 It is identified as complete transposition when the crown and the roots of the involved teeth exchange places in the dental arch and incomplete transposition when the crowns are transposed but the roots remain in their normal positions.2,3 The canine shows the highest incidence of transposition with the first premolar.5 Transpositions affect both sexes, but female patient have been reported to outnumber male patients.6 This condition may occur both bilaterally or unilaterally, but a greater incidence of unilateral cases has been reported, left side dominance has been reported.6,4,8 The aetiology of transposition is still obscure, however transposition of tooth buds anlarge stage, migration of a tooth during eruption, hereditary retained deciduous teeth and trauma have been proposed as possible etiological factors.8,4,3 Transposition in the maxilla is always as a result of displacement and ectopic eruption of the maxillary canine where as transposition in the mandible is typically a result of migration of the mandible lateral incisor .Conversely the mandibular canine erupts in a relatively normal anatomic positions 3 Maxillary canines develop high in the maxilla and are among the last teeth to develop and travel a long path before they erupt into the dental arch

51

Authors: Dr. Arun Gupta Dr. Manju Gupta Dr. Khushbu Jain

Afemale aged 84 years completely edentulous with the history of wearing present set of U/L complete dentures of 10 years reported to clinic having C/O inability to chew from many months & slight pain in TMJ since 6 months.

52 & 54

Authors: Dr. Rohit Paul, Dr. Mayura Paul Dr. Rahul Paul, Dr. Geeta Paul

The term ‘odontogenic keratocyst’ was introduced by Philipsen in 1956. It has a bimodal age of occurrence, first peak in second decade and the second peak in fifth decade.1 Odontogenic keratocyst (OKC) is a developmental odontogenic cyst, characterized by unique and distinct histopathologic characteristics and an aggressive biologic behavior.2-6 The aggressive clinical behavior and frequent recurrence following curettage has been the focus of several studies, which indicated that the OKC epithelial lining may have some intrinsic growth potential

54-55

Authors: Dr. Pravin Gaikwad Dr. Meesam Abbas Zaidi

This report describes a case report of Geographic tongue (GT) in Bareilly, UP. The patient was having soreness or burning sensation and sometimes itching. The clinical examination revealed features characteristic of GT.

56 & 58

Authors: Dr. Roediger M. Dr. Gersdorff N. Dr. Huels A. Dr. Rinke S.

In this prospective clinical study, the performance of three- and four-unit fixed partial dentures (FPDs) with frameworks fabricated of yttria partially stabilized Zirconia was determined after a mean observation period of 50 months. The study focused on the survival of the restoration (in situ criterion) and the success of the ceramic veneers (no defect).