A Journal of Clinical Dentistry-Heal Talk

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Authors: Dr. Medha Deora Senior Lecturer Dept. of Oral Pathology & Microbiology Desh Bhagat Dental College, Muktsar, Punjab

Oral cancer (OC) is an epithelial neoplasia generally beginning as a focal clonal overgrowth of altered stem cells near the basement membrane, expanding upward and laterally, replacing the normal epithelium. This is an overview on cultural, dietary, gender related hormonal factors and dental factors in relation to oral precancer and cancer.

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Authors: Dr Mudit Uppal Associate Professor, Dept. of Conservative Dentistry & Endodontics Qassim Private College, Burayda, Kingdom of Saudi Arabia Dr. Gurleen Arora Associate Professor Dept. of Prosthodontics Qassim Private College, Burayda, Kingdom of Saudi Arabia

ABSTRACT Objectives: In our current economy, it is obligatory that the dentists and technicians be cost conscious about the materials they use. Therefore, it would be economically advisable to reuse them. No matter ‘cost’ is always an important factor in selection of alloys, but the physical, chemical and biological properties for a specific clinical situation should always be the first priority. Before a definitive recommendation can be made for repeatedly using non precious metals, carefully researched information should be available. The purpose of this study was to evaluate the effect of reusing a Ni Cr alloy on its ultimate tensile strength, yield strength and modulus of elasticity. Method: Three groups of 12 samples each were prepared. 100% new alloy was used to cast the samples of group A. Group B consisted of samples which were cast using 100% once used alloy, and Group C consisted of samples cast using 100% twice used alloy. The materials were judiciously chosen and the method employed was standardized to produce satisfactory test specimens. All tensile testing was done on a modified tensile test bar of ADA specification no. 14, which was further modified to facilitate sample alignment during investing and reduce the problems associated with castings. Results: The tensile bars were then tested for its properties of Ultimate tensile strength, yield strength (at 0.2% offset) and modulus of elasticity. The results were then subjected to standard statistical analysis. The comparisons of means of ultimate tensile strength, yield strength, modulus of elasticity values of different groups were made using ‘student t test’. It shows a significant reduction in these values if the alloy is reused. Conclusion: The practicality of recasting base metal alloys as an economy measure came under close scrutiny during the investigation.

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Authors: Prof.(Dr.) Muralee Mohan Professor, Department of Oral & Maxillofacial Surgery, A.B.S.M.I.D.S. Dr. Deepthi Shetty Assistant Professor, Department of Oral & Maxillofacial Surgery, A.B.S.M.I.D.S Dr. Suman Banerjee Post Graduate Student. Department of Oral & Maxillofacial Surgery, A.B.S.M.I.D.S Dr. Dharnappa Poojary Associate Professor, Department of Oral & Maxillofacial Surgery, Manipal College of Dental Sciences, Mangalore. Manipal University

Ameloblastoma, previously known as adamatinoma, a distinctive benign, locally invasive odontogenic tumor grows slowly and progressively. Among the six histopathological variants, the granular cell type is the rarest form but the most aggressive in terms of recurrence. A patient presented with a recurrent anterior mandibular swelling. The swelling was finally excised and was reported to be granular cell variant

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Authors: Dr McQueen Mendonca Lecturer, Dept of Orthodontics A.B.Shetty Dental College, Mangalore Dr.Audrey Madonna D'Cruz Reader, Dept. of Community Dentistry, A.B.Shetty Dental College Dr. Murali P.S. Lecturer Dept of Orthodontics, A.B.Shetty Dental College Dr.CrystalRunaSoans Lecturer, A.B.Shetty Dental College. Prof.(Dr) U.S. Krishna Nayak Principal and HODDept of Orthodontics A.B.ShettyDental College,Mangalore

The purpose of this study was to assess the awareness and attitudes of medical students with regard to the subject of Orthodontics. Considering the fact that today's medical students will be tomorrow's medical practitioners, they would probably encounter patients with various malocclusions or dentofacial defects, who would not have an esthetically pleasing profile. Hence it was considered pertinent to assess their level of awareness.This cross sectional study was conducted among the first yearMBBS students at the K.S.Hegde Medical Academy, Mangalore. 132 students participated in the survey. A validated questionnaire was distributed among the students. Descriptive statistics, i.e., number and percentage was used to describe the variables. There was a difference between male and female students' awareness and their attitudes towards orthodontics.While there is scope for conducting similar studies in future, it was concluded in this study that medical students had average awareness of orthodontics as a sub-specialty of dentistry.A basic introduction to dental sub-specialties would help them identify dentofacial problems and make appropriate referrals. Orthodontists for their part could improve their communication skills and allay patient fears about treatment discomfort.

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Authors: Dr.Naresh Kumar Junior Resident Dr.Renu Gupta Professor & Head Dr.R. P. Luthra Professor & Principal Dr.Reena Sirohi Junior Resident Dr.Savisha Mehta Junior Resident Department of Prosthodontics, H.P.Government Dental College & Hospital, Shimla, Himachal Pradesh, India

Prosthetic rehabilitation of a partial or total maxillectomy patient with an obturator prosthesis is a predictable intervention to recreate an anatomic barrier between the oral and nasal cavities, and to restore mastication, deglutition, speech and esthetics. The use of a hollow bulb design reduces the weight of the prosthesis and gives better comfort to the patient as the retention, stability and support of the prosthesis is improved. This case report describes fabrication of single piece hollow bulb definitive obturator prosthesis for a patient with left side total maxillectomy

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Authors: Dr. Aparna S Barabde BDS, MDS Prof. & PG Teacher Dept. of Prosthetic Dentistry V.Y.W.S. Dental College & Hospital, Amravati, India Dr. Barabde Dental Clinic, Badnera Road Rajkamal Sq Amravati, India 444 602 Dr. Mradul Gupta PG Student Dept. of Prosthetic Dentistry V.Y.W.S. Dental College & Hospital Amravati Dr. R.U.Thombare MDS,Professor,Dean Dept of Prosthetic Dentistry V.Y.W.S. Dental College & Hospital Amravati Dr. Shailesh M Barabde MBBS, MD P.D.M.Medical College Amravati,india Dr. B.R.Thombare BDS,MDS Senior Lecture Dept. of Prosthetic Dentistry V.Y.W.S. Dental College & Hospital Amravati, India.

Obstructive sleep apnea is a sleep disorder of airflow at the nose and mouth during sleep. It is apotentially hazardous condition and appropriate treatment should be strongly advised to all OSA patients. Dentist are becoming increasingly aware of the importance of detection and management of obstructive sleep apnea. Mandibular repositioning appliance plays an important role in management of OSA. This articles reviews etiology, clinical features, diagnosis and various treatment options with special reference to oral appliances how snoring can be controlled prosthodontically by different modalities of scientifically defensible

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Authors: Dr. Snehal Chavan PG Student Dept. of Conservative dentistry & Endodontics Dr. D.Y. Patil University School of Dentistry Nerul, Navi-Mumbai Dr. Leena Padhye Professor & Guide Dr. D.Y. Patil University School of Dentistry Nerul, Navi-Mumbai Dr. Lalitagauri Mandke Professor & H.O.D Dr. D.Y. Patil University School of Dentistry Nerul, Navi-

Chitosan, a versatile hydrophilic polysaccharide derived from chitin, has a broad antimicrobial spectrum to which gram-negative, gram-positive bacteria and fungi are highly susceptible.The chitosan minimum inhibitory concentrations (MIC) are summarized according to recent data found in the literature. In the current review the possible applications ofchitosan in dentistry are briefly discussed

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Authors: Dr. Anu Dhawan PG Student Dr. Sumit Gupta Reader Dept. of Endodontics Sudha Rustagi Dental College & Hospital Faridabad (Haryana)

The main objective of non-surgical root canal treatment is the thorough chemomechanical debridement of the entire pulp space cavity and its complete obturation with an inert filling material [1]. Since the work of Hess and Zurcher[2], it has become apparent that the pulp cavity comprises a complex network of anatomical structures and knowledge of this complex internal dental morphology is an extremely important step in planning and administering endodontic therapy because nontreatment of even one canal can lead to endodontic treatment failure.[3]

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Authors: Dr. Crystal Runa Soans Lecturer Dept. of Orthodontics & Dentofacial Orthopaedics, A.B.Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore Dr. Muhammed Shibin Private Orthodontic Practitioner Kerala,India. Dr. Mc Queen Mendonca Assistant Professor, Dept. of Orthodontics & Dentofacial Orthopaedics, A.B.Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore Prof. Dr. Binnoy Kurian Private Orthodontic Practitioner Kerala, India. Prof.Dr.U.S.Krishna Nayak Head Of Department, Dept. of Orthodontics & Dentofacial Orthopaedics, A.B.Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore

Chronic renal disease is defined as a progressive and reversible decline in the renal function associated with a reduced glomerular filtration rate (GFR).In addition to their associated morbidity, such disorders are important due to the number of affected individuals and the many patients subjected to treatment because of them. An inadequately controlled CRD patient constitutes a risk case in Orthodontic practice due to greater bleeding tendency, hypertension, anaemia, drug intolerance, increased susceptibility to infections. Orthodontic practitioners therefore must take a series of aspects into account before treating such patients, in order to avoid complications. This paper is a review of the general aspects of renal diseases, oral manifestations,dose adjustments of drugs,orthodontic considerations and their management.

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Authors: Dr. Maya Dalaya Professor Dept. of Prosthodontics Bharati Vidyapeeth Deemed University Dental College and Hospital (Navi Mumbai) Dr. Geet Vijay PG Student Dept. of Prosthodontics Bharati Vidyapeeth Deemed University Dental College and Hospital (Navi Mumbai) Dr. Sumeet Agarwal PG Student Dept. of Prosthodontics Bharati Vidyapeeth Deemed University Dental College and Hospital (Navi Mumbai) Dr. Mahesh Ghadage PG Student Dept. of Prosthodontics Bharati Vidyapeeth Deemed University Dental College and Hospital (Navi Mumbai)

Bisphosphonate has been the drug of choice for the patients who have bone related pathologies like osteoporosis, Paget's disease, metastasis of bone cancers etc. Though these classes of drugs have been successful in treating and curing such pathologies but still it has got its side effects. Studies have shown that patients taking bisphosphonates are prone to develop osteonecrosis of jaws. This side effect of bisphosphonate make it must for a prosthodontist to take a different protocol for treating a patient receiving bisphosphonate drugs. This article aims at reviewing the literature on how to manage patients taking bisphosphonates for both removable and fixed prosthesis.

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Authors: Dr. Samvit Mishra PG Student Dept. of Orthodontics Babu Banarasi Das College of Dental Sciences Lucknow Dr. Tripti Tikku Prof. & H.O.D Dept of Orthodontics Babu Banarasi Das College of Dental Sciences Lucknow Dr. Rohit Khanna Professor Dept of Orthodontics Babu Banarasi Das College of Dental Sciences Lucknow Dr. Kiran Sachan Dept. of Orthodontics Babu Banarasi Das College of Dental Sciences Lucknow Dr. Akhil Agarwal Reader Dept. of Orthodontics Babu Banarasi Das College of Dental Sciences Lucknow Dr. Kamna Srivastava Sr. Lecturer Dept. of Orthodontics Babu Banarasi Das College of Dental Sciences Lucknow

Introduction – LED lights have been successfully used to enhance the polymerization of photosensitive restorative materials and to shorten the curing time without compromising bond strength. Bond strength should be sufficient to withstand the masticatory forces and be low enough to allow for bracket debonding without causing damage to the enamel surface. Aim and objectives – To compare the effect of different light cure systems on shear bond strength (SBS) of bonded orthodontic brackets at different exposure times. Materials and method – 100 extracted human premolar teeth were randomly divided into 2 groups according to 2 different light sources, i.e. Group I (Halogen), Group II (Coltolux LED) which were further subdivided into two subgroups on the basis of various exposure times (10sec, 15sec). After bonding procedure, the teeth were subjected to SBS testing by Instron machine. ANOVA and Tukey analysis done for adequate comparisons between different groups and subgroups. . Results – The mean SBS obtained for Group II > Group I for the 2 exposure times. Maximum SBS was noted for both the groups at 15sec. Mean SBS obtained with Coltolux and Halogen at 15sec was found to be within the clinically acceptable range. Statistically significant difference (p<0.001) was obtained at 15sec only. Conclusions – Though bond strength increases with the increase in curing time but clinically acceptable SBS can be obtained at 15 sec with Coltolux which confers worthwhile time savings with lower risk of contamination. Hence, using higher light intensity of acceptable wavelength for curing produces same SBS with much shorter exposure time.

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Authors: Dr. Era Arora Senior Lecturer Dr. Prashant Bhasin Reader Dr. Karan Khurana P.G. Student

The C-shaped canal system is an anatomical variation mostly seen in mandibular second molars, although it can also occur in maxillary and mandibular premolars and molars. It wasfirst documented by Cooke and Cox in 1979.The main anatomical feature of C-shaped canals is the presence of a fin or web connecting the individual root canals—the orifice may appear as a single ribbon shaped opening with a 180° arc linking the two main canals. They are typically found in teeth with fusion of roots either on its buccal or lingual aspect. The floor of the pulp chamber is usually situated deeply. The prevalence of C-shaped canalsappears to be genetically determined. The prevalence in second mandibular molars has been reported to be as high as 31.5% for the Chinese population, which is much higher than that reported for other populations. When found on one side, it is found in the contralateral teeth in over 70% of individuals.Roots containing a c-shaped canal often have a conical or square configuration.Manning speculated failure of the Hertwig’s epithelial root sheath to fuse on the lingual or buccal root surface as the main cause of a C-shaped root, which always contains a c-shaped canal.The C-shaped root may also be formed by coalescence because of deposition of cementum with time.The c-shaped canal system can assume many variations in its configuration. Melton and co-workers in 1991, proposed a classification of C-shaped canals based on their cross-sectional shape

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Authors: Dr. Radhika Malik P.G. Student Dr. Sumita Giri Nishad Professor & H.O.D. Dr. Mohit sharma Reader Dr. Deepti Bindal Reader Dr Deepak Tomar Sr. Lecturer Dr. Anurag Sarin Sr. Lecturer

Taurodontism can be described as a change in tooth shape caused by the failure of the Hertwig's epithelial sheath diaphragm to invaginate at the proper horizontal level. The characteristic features are an enlarged pulp chamber, apical displacement of the pulpal floor, and no constriction at the level of the cementoenamel junction. The most commonly affected teeth are the permanent molars. Here, we report a case in which endodontic treatment of the mandibular left second molar with taurodontism was performed using the thermoplasticised obturation technique.

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Authors: Dr. Ravina Dhanda P.G. Student Dr. Sumita Giri Nishad Professor & H.O.D. Dr. Mohit sharma Reader Dr. Deepti Bindal Reader Dr Deepak Tomar Sr. Lecturer Dr. Anurag Sarin Sr. Lecturer

Aim To present a case of mandibular first molar with an additional distolingual root (radix entomolaris), a mesial root with three canals (an extra middle mesial canal) and its endodontic management. Summary The awareness and identification of anatomical variations is vital to achieve endodontic success. Radix entomolaris(RE) was detected by identifying the presence of a double or extra root outline in the preoperative radiograph and a middle mesial(MM) canal by modifying the access opening and closely inspecting the pulp chamber and was endodontically treated following cleaning, shaping, and obturation of the canals.

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Authors: Dr. Chandulal D. Dhalkari, Associate Professor and Guide, Government Dental College and Hospital, Aurangabad. Dr. Pallav Ganatra, Postgraduate Student, Government Dental College and Hospital, Aurangabad. Dr. Pawan Sawalakhe, Postgraduate Student, Government Dental College and Hospital, Aurangabad. Department Of Periodontology Government Dental College and Hospital, Aurangabad , Maharashtra.-431001

The Speciality of Periodontics has a long history in civilization, dating back to prehistoric, early middle eastern and Egyptian cultures where there is skeletal and written evidence of periodontal diseases. Ancient Indian and Chinese histories describe scurvy and other conditions and advocate cleansing of teeth for health. On through the Greek and Roman civilizations, through the renaissance and into modern times, disease of the periodontium as well as remedies and preventions were described

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Authors: Dr. Derek Mahony BDS, MScOrth, DOrth RCS, MDOrth RCPS, MOrth RCS, FRCD, MOrth RCS/CDS, FICD, IBO Dr. Edmund A. Lipskis DDS, MS, DABCP, FAACP, FAAFO, FIAO

I would like to thank Dr Ken Lipworth for giving me the idea to write this article. After attending my recent OSA symposium, Ken told me that he, and many other course participants, were confused about the role of TENS, in establishing the “correct bite” for a snoring appliance

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Authors: Dr Akanksha Maheshwari Assistant Professor Department of prosthodontics Modern dental college and Research centre Indore (M.P.) Dr Bharat Maheshwari Assistant Professor College of Dentistry Indore ( M.P.)

Human bite injuries are usually rare. The cases that are frequently reported in the literature relate to cat and dog bites, or other mammalian bits but cases of human bites are not reported frequently. For over half a century, oral and maxillofacial surgeons have been treating such injuries of head and neck.1 Most of these bites occur during interpersonal fights, whereas some are associated with sexual activities.3

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Authors: Prof. (Dr.) Muralee Mohan Professor Dr. Deepthi Shetty Assistant Professor Dr. Tripthi Assistant Professor Dr. Mansi Vakil P.G. Student

Ranula by definition is a mucous filled cavity in the floor of the mouth in relation mostly to the sublingual gland. This paper highlights a case report of ranula in the floor of the mouth that reported to the outpatient department of Oral & Maxillofacial Surgery of our college and has been successfully treated by marsupialization.

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Authors: Dr Chandulal D. Dhalkari Associate Professor & Guide Dept.of Periodontology Government Dental College& Hospital, Aurangabad, Maharashtra Dr Pawan B. Sawalakhe P. G. Student Dept.of Periodontology Government Dental College& Hospital, Aurangabad, Maharashtra

The interrelationship between periodontal and endodontic disease has always aroused confusion and queries. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. The differential diagnosis of endodontic and periodontal diseases can sometimes be difficult, but it is of vital importance to make a correct diagnosis for providing the appropriate treatment. This review article aims to discuss various classifications of endo-perio lesions. Method and material: In this review article, articles were selected from Google chrome search engine between 1964 to 2014. Amongst 1500 articles, 10 articles were selected for a full-text reading based. Discussion: The endo-perio lesion is association of periodontal and pulpal disease in the same dental element. So there is importance of taking the complete clinical history and making the right diagnosis to ensure correct prognosis and treatment. Taking into consideration all these factors and the divergences regarding the origin and direction that these infections developed, the classificationoftheselesions should be justified.

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Authors: Dr Himanshu Aeran Director-Principal Professor& HOD Dr Neeraj Sharma Reader Dr Jyotsina Seth Sr. Lecturer Dr Gagan Sharma P.G. Student

Maxillofacial Prosthodontics is an art and science which provides life-like appearance to the missing structures of an individual. Planning the prosthesis, making an impression, sculpting the model and choosing the material all contribute to a successful prosthesis. Thumb, finger and partial finger amputation are commonly due to traumatic injuries; digit loss may also be attributed to congenital malformations. Thumb is one of the vital parts of the hand . Thumb prosthesis is difficult to fabricate as they demand both aesthetic and function. Its partial or complete loss leads to psychological disturbances to an individual. This clinical report describes a technological process of designing and manufacturing a silicone rubber prosthesis for a patient who lost his thumb caused due to trauma. Restoring the natural appearance with the prosthesis eliminated the trauma generated by the dysfunction and represented an efficient psychological therapy.

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Authors: Dr Charushilla S. Sardar Professor Dept.of Prosthetic Dentistry Dr D. Y. Patil Dental College& Hospital, Navi Mumbai. Dept.of Prosthetic Dentistry Dr D. Y. Patil Dental College& Hospital, Navi Mumbai. Dept.of Prosthetic Dentistry Dr D. Y. Patil Dental College& Hospital, Navi Mumbai. Dept.of Prosthetic Dentistry Dr D. Y. Patil Dental College& Hospital, Navi Mumbai Dr Omkar Shetty Dean, Professor & HOD Dr Swapnil Chaudhari P.G. Student Ms. Siddhi S. Sardar P.G. Student

Imagine a well crafted crown in a single day………… A very exciting development has taken place in the field of Dentistry since last two decades. Due to advanced computer technology and innovative materials, Dental procedure has led to much higher standards. Highly sophisticated chairside and laboratory CAD/CAM system have been introduced. Using CAD/CAM technology in the dental office and laboratory was a dream 20 years ago. But today it’s a reality. We now have the ability to create inlays, onlays, veneers, crowns, fixed partial dentures, implant abutments, and a full mouth construction using CAD/CAM.

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Authors: Dr Niladri Maiti Senior Lecturer, Department of Conservative Dentistry & Endodontics, Guru Nanak Institute of Dental Science and Research, Kolkata India Dr Utpal K. Das Professor & HOD Department of Conservative Dentistry & Endodontics, Guru Nanak Institute of Dental Science and Research, Kolkata India

'Bulk-filling' is highly desired in routine restorative practice, but concerns about shrinkage stress have caused certain reluctance in its application.A real breakthrough came a few years ago, when SDR was introduced. It is a single component, fluoride containing, visible light cured, radiopaque, low-viscosity resin composite restorative material specially designedfor the bulk-filling technique. This was the first material that allows reliableadaptation to the cavity wall of bulk increments up to 4 mm in thickness .Itis the first posterior composite for dentin replacement combining the handling properties of a flowable composite with minimal shrinkage stress. The'Smart Dentin Replacement' layer is applied as a base inClass I and II cavities following the use of a conventionaldentin/enamel adhesive. It is chemically compatible withall methacrylate-based universal/posterior compositesused to replace the occlusal enamel layer and completethe adhesive filling. SDR offers interesting advantages ineveryday practice, because it allows dentists to providetheir patients with high-quality aesthetic posteriorrestorations in a cost-effective way.This case reportemphasis the innovative technique that outlines the management of a carious toothwith the new-generation flowable composite resinmaterial as a dentin substitute.

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Authors: Dr. Ettishree P.G Student Dr. Vineeta Gupta Professor & Head Dr. Nutan Tyagi Senior Lecturer Dr. Akansha Misra Senior Lecturer Dept. of oral Pathology & Microbiology Institute of Dental Studies & Technologies, Kadrabad, Modinagar, (U.P.)-201201, India

In human body, tooth is the hardest known structure which is impervious to adverse conditions like incineration, immersion, trauma, mutilation, decomposition etc and hence, can be used in forensic investigations.Blood, hair, teeth, and various body fluids can be used as samples for DNA analysis.As compared to other samples which may get destroyed or degraded over time, teeth are more resistant and can be used as a valuable source of DNA. The DNA print is specific to an individual.By analyzing the DNA recovered from the teeth,the identification of human remains may be possible.DNA profiling can help in providing the exact identification of the human remains in mass disasters, in the identification of culprits in crime scene investigations and also in solving paternity issues. It can also provide information regarding the physical characteristics, ethnicity and gender determination of the individual to be identified. Dental tissue can be considered for DNA analysis as they are a rich source of quality DNA and hence can be utilized in forensic investigations. Recent advances in DNA profiling have high reliability and are accepted as legal proof in courts.

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Authors: Dr. Allen J. Moses DDS, DABDSM, DABCFP Dr. Derek Mahony BDS, MSc Orth, D Orth RCS, MDOrth RCPS, MOrth RCS, FRCD, MOrth RCS/CDS, FICD, IBO

there are approximately 100 intraoral appliances that have FDA clearance for the treatment of obstructive sleep apnea and snoring in the US. Simply put, an intraoral appliance for the treatment of snoring and OSA is merely a piece of plastic with screws for adjustment. Clinical success is ultimately determined by the skill of the dentist, but there are at least six design principles to be considered when selecting the appropriate appliance:

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Authors: Dr. G Student Dr. S. V. Bhide HOD Dr. Sonali Babar P.G Student Dr. Rajshree Jadhav Reader Dept. of Prosthodontics & Crown & Bridge Bharati Vidyapeeth Deemed University Dental College & Hospital, Pune. Avantika Jadhav

The practice of prosthetic dentistry can be affected by the 'Combination Syndrome' and its associated difficulties. They may present considerable clinical and technical difficulties to the dental practitioner even if this condition was first recognized over 30 years ago. This clinical scenario classically relates to changes found in the mouth after prolong use of a maxillary complete denture that has opposed natural mandibular anterior teeth mainly. The purpose of this article is to describe treatment of a patient who has shown clinical features of this condition, and review some of the relevant literature on this condition. For a variety of sound dental, medical and financial reasons, conventional prosthodontics still has much to offer in the oral rehabilitation of patients presenting with Combination Syndrome.

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Authors: Dr. Abhishek Khare Reader Dr. Amit Thahriani Private Practicinor Dr. Avinash Singh Chauhan Private Practicinor Dr. Anupama Khare P.G Student Dept. of Oral Pathology & Microbiology Career Post Graduate Institute of Dental Science, Lucknow

Cells possess a cytoskeleton that provides the structural framework. It facilitates intracellular transport, supports cell junctions, transmits signals about cell contact and permits motility. The cytoskeleton is a complex network of filaments that influence the dynamic morphology of eukaryotic cells in their tissue environment. It maintains the structural integrity of cells, anchoring intra-cytoplasmic organelles to the cellular membranes. The three structural elements of the cytoskeleton are microfilaments, microtubules and intermediate filaments, all are dynamic structures assembled from protein sub-unit and disassembled as cellular activities and external influences on cell changes.

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Authors: Dr. Pawan Sawalakhe P.G Student Dept. Of Periodontology Government Dental College & Hospital Aurangabad Maharashtra - 431001

Improper or no bone healing is a significant clinical problem within orthopedics, oral and maxillofacial surgery, plastic surgery, as well as periodontology. A main obstacle for successful bone healing and the formation of new bone is that, in contract to osteogenesis, connective tissue formation occurs rapidly, thus, ingrowth of soft tissue may disturb or totally prevent osteogenesis from taking place in a defect or wound area