Cytokines and selective inflammatory mediators play crucial roles in the maintenance of tissue homeostasis. Growth factors such as fibroblast growth factor, platelet-derived growth factor, insulin-like growth factor, and transforming growth factor-β are thought to play important roles in modulating the proliferation and migration of structural cells in the periodontium. These biomolecules have a range of overlapping functions to help engage and control immune and inflammatory responses.

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The restoration of endodontically treated pulpless teeth is a challenging dental procedure. Post and core is indicated in cases of extensive coronal tooth destruction where additional retention is required. The post is used to retain a core that can be used to retain definitive prosthesis. The choice between using a cast post and a prefabricated post depends on multiple factors such as canal configuration and remaining tooth structure. It has been said that if a canal requires extensive preparation, a well-adapted cast post and core will be more retentive than a prefabricated post that does not match the canal configuration. The cast post and core is fitted to the prepared root canal space and designed to resist torsional forces. However, one drawback of cast post is its tedious and time-consuming wax pattern technique. In this case report, we have used a time saving modified indirect technique for fabricating cast post and core, without the use of any reinforcement, no wax, no pattern resin but only rubber base impression material along with a novel technique of cementation, which utilizes a modified syringe with needle to facilitate even distribution of luting cement within the canal.

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Advancements in dental technology enable patients to receive modern solutions of conventional dental problems. Prosthodontists can incorporate digital technology into their practices to improve their workflow efficiency and ease of collaboration with laboratories. In this article, digital technologies that are available for prosthetic dentistry such as digital radiography, electronic prescriptions, computerized case presentations, virtual articulator and facebow, computer-aided design/computer-aided manufacturing restorations, digital impressions, and shade selection are described along with emphasis on advantages and limitations of digital technology.

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Orthodontic treatment aims at providing an acceptable functional and esthetic occlusion. Tooth movements are strongly related to interactions of teeth with their supportive periodontal tissues. In recent years, due to the increased number of adult patients seeking orthodontic treatment, orthodontists frequently face patients with periodontal problems. Esthetic considerations, such as uneven gingival margins or functional problems resulting from inflammatory periodontal diseases, should be considered in the orthodontic treatment planning. The purpose of this article is to provide a dental practitioner with basic understanding of the interrelationship between periodontics and orthodontics and also to highlight the orthodontics and periodontics interface in clinical practice for optimized treatment outcomes.

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Treatment and management of teeth with furcation involvement is one of the most challenging problems confronting general dentist. In advanced furcation involvement, the tunnel preparation procedure is preferable to extraction when other treatments are precluded for financial or other reasons. Certain technical problems, such as gaining access for oral hygiene procedures on posterior molars, are obvious; this heroic technique could not be considered as a regular treatment modality for any tooth or any patient. This treatment was done for a 38-year-old female patient in good general health. After raising a full thickness flap on the mandibular left side of the mouth, the furcation of tooth #36 was widened by a #2 round bur and bone file. Osteoplasty continued by bur, file, and chisel until enough space was created for interdental brush use to control dental plaque. Flap was placed apically and sutured. Prosthodontic treatment was done 4 months after the periodontal therapy. After 1-year, the treated tooth is still functioning in the mouth of the patient. We are satisfied with the result of treatment.

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In the recent years, numbers of suspected bite mark cases examined by forensic odontologist are increasing. Human bite mark analysis is most demanding and complicated part of forensic dentistry, involving identification of assailant by comparing record of their dentition with record of bite mark left on a victim. Like fingerprints and DNA, bite marks are unique to individual such as distance and angles between teeth, missing, and teeth fillings. This type of impression evidence can be left in the skin of a victim and also in food, chewing gums, pens, pencil, etc., In some crimes, bite mark evidence is the only evidence on which conviction has been achieved, particularly alleged rape and child abuse cases. The current protocol for collection, management, preservation analysis, and interpretation of evidences should be employed if information is to be obtained for the court. The aim of this article is to give brief overview of bite mark analysis, its clinical applications, and limitations.

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Lichen planus pigmentosus is a condition characterized by persistent and asymptomatic slaty-gray pigmentation, predominantly in the face. Two patients, aged 11-year-old female and 35-year-old male, reported to the Department of Oral Medicine and Radiology with burning sensation on taking spicy foods. On examination, only extensive symmetric brownish-black pigmentation of the buccal mucosa was observed bilaterally. The workup and management of these cases are presented along with the relevant review of literature.

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Background: Supragingival plaque control is elementary to the prevention and management of periodontal diseases. Conversely, significant proportions of all individuals fail to practice a high standard of plaque removal. The adjunctive use of chemicals would therefore appear a way of overcoming deficiencies in mechanical tooth cleaning habits. This prospective, randomized positively controlled clinical trial was aimed to evaluate the short-term clinical effects of a licorice oral rinse in the reduction of plaque and gingival inflammation in individuals with gingivitis. Materials and Methods: A total of 104 individuals, 12–15 years of age diagnosed with chronic generalized gingivitis, were selected and randomly divided into two groups: Group 1: chlorhexidine mouthwash and Group 2: licorice mouthwash. Clinical evaluation was undertaken using the gingival index, the plaque index, and bleeding on probing at baseline, 1^st, 2^nd, and 4^th week. Results: Both chlorhexidine and licorice mouthwash showed a significant reduction in plaque and gingival index scores from baseline to 1^st, 2^nd, and at 4^th week. However, the improvement in plaque and gingival index scores were better in chlorhexidine group than herbal mouthwash. Both mouthwashes were found to be equally effective in reducing bleeding on probing. Conclusion: Unlike chlorhexidine mouthwash, licorice mouthwash was not associated with any discoloration of teeth or unpleasant taste and was effective in reducing plaque accumulation and gingival inflammation. However, chlorhexidine still remains a gold standard in reducing plaque, gingivitis, and bleeding on probing.

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There is a presence of interarticular space between the bony components of the temporomandibular joint (TMJ), i.e., between articular eminence and glenoid fossa of the temporal bone at the base of the skull and the condylar process of the mandible. The intervening articular disc, together with its attachments, divide the joint into two separate compartments, i.e., upper (superior) and lower (inferior) compartments located above and below the disc, respectively, which are referred as joint spaces. The clinical significance of joint space is of great value; the presence of normal joint space is needed for free movement of condyle along with articular disc. The widening or obliteration of joint space may indicate the involvement of TMJ or its pathology. The joint space configuration is greatly influenced by the glenoid fossa, condyle, and condylar positions within the fossa in TMJ on the right and left sides. The present review work is undertaken primarily including 37 studies from PubMed and Medline databases to reveal the information relating to the joint space, its measurement in normal subjects and TMJ disorder (TMD) patients, its correlation to other factors, and its role in TMDs. The review work would be of help to gain insight to predict the TMDs with respect to joint space morphometrics.

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A new orthodontic spring design that can be employed in the narrow labial vestibule to provide traction force for movement of impacted teeth in the anterior arch is described. The spring is fabricated at chairside in TMA wire of 0.016 × 0.022″ or 0.017 × 0.025″ size. The method for deployment of this spring design is illustrated with a case report of management of horizontally impacted maxillary central incisor in an 18-year-old patient. The spring design was able to deliver variable force vectors that are customarily required to move impacted teeth from a horizontal to vertical orientation.

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Background: Ultra conservative caries removal now has become an integral part of Minimal Invasive Dentistry. The main objective of deep caries removal is to conserve the tooth structure as well to maintain the integrity of pulpal health. Aim: To evaluate clinically the efficiency of caries removal using Carie-Care compared to the SmartPrep burs for complete caries excavation. Materials and Methods: Split mouth study was done in 64 children where caries excavation was done using Carie-Care on one side and Smart burs on the other side. The parameters assessed were complete caries excavation, pain reaction, need for local anesthesia and mean time required. Results: The differences between complete caries excavation, pain reaction and need for local anesthesia using both the techniques were statistically insignificant. Whereas the time taken for caries removal using Carie-Care was significantly less than Smart burs (P = 0.001). Conclusion: Both the techniques can be used effectively for caries excavation in primary teeth.

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Salivary duct cyst is the rare nonneoplastic lesion of the salivary gland. Although most authors describe salivary duct cyst and mucocele as one entity, we are describing them separately because of different histopathological features. Unlike a mucocele, which is surrounded by granulation tissue, the salivary duct cyst is lined by epithelium. This article reports a case of salivary duct cyst in a 13-year-old male child in the parotid gland duct.

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Adenoid cystic carcinoma (ACC) is a rare malignant tumor arising from salivary glands. ACC of the head and neck has some features such as slow growth, high recurrence percentages, distant metastasis, and a tendency for perineural invasion. It comprises almost 2%–4% of head and neck area tumors. In minor salivary glands, it is generally observed in the palate. We report such a rare case that affected the base of the tongue in a 65-year-old-female patient and also carried out a brief literature review on the subject.

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Over-the-counter, (OTC) dental products are oral care products sold directly to a consumer without a prescription from a healthcare professional. In the recent years, there is an increase in a number of the OTC products which make false claims and without sound scientific evidence. In many developed countries, OTC products are regulated by federal regulatory agencies such as the Food and Drug Administration and also by the countries professional dental organizations such as the American Dental Association (ADA). ADA provides a seal of approval to those products, however, in many developing countries; the OTC dental products are not regulated due to lax rules. Vendors use this opportunity and are marketing OTC products without sound scientific evidence. While in the some developed countries of Northern America professional bodies provide with their seal of approval for many OTC products. This will help individuals to make their choice. This review paper presents an overview of OTC dental products with questionable scientific evidence and their effects on the oral health. The main purpose of the review is to highlight the need for regulation in the sale of these OTC dental products.

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Some patients with Class II subdivision malocclusions have Class I characteristics on one side and Class II characteristics on the other. The resulting asymmetric occlusal relationship complicates orthodontic treatment. Traditionally, four premolars are extracted in such cases to achieve a bilateral Class I molar relation which needs patient compliance with the use of Class II elastics. The present case report shows one such Class II subdivision malocclusion case which was treated by asymmetric extractions. This approach is independent of the patient compliance and saved one premolar, with no compromise in dental occlusion or esthetics.

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Background: The most common dental disease facing the human race is dental caries. For caries, management of early lesions, prevention of initiation, and interruption of progression are desirable. Remineralization is an effective way of preventive management of caries. Aim: To evaluate remineralization efficacy of two different remineralizing agents. Materials and Methods: Forty enamel samples were taken, and they were divided into four groups (n = 10). Demineralization was carried out with Groups A, B, and C. Remineralization was carried out with Groups A and B for 7 continuous days using casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) and calcium sucrose phosphate (CaSP). Group D was kept as positive control with intact enamel without any surface treatment, whereas Group C was kept as negative control with surface demineralization of enamel. Microhardness testing was done using Vickers microhardness tester after 7-day remineralization cycle. Statistical Analysis: One-way analysis of variance and post hoc Tukey tests were performed. Results: Microhardness of CaSP and CPP-ACPF was comparable. Conclusion: Both remineralizing agents showed surface remineralization.

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Aim: The aim of the study is to investigate the influence of temperature rise on a single rooted tooth during biomechanical tooth preparation, obturation and root canal preparation for radicular post. Materials and Methods: Forty-five extracted human mandibular premolars with a single canal, extracted for orthodontic reasons, were stored in saline. Access cavity was prepared with endo access bur and pulp extirpations were done. The teeth were randomly divided into five groups of 9 teeth each. In group 1 and group 2 cleaning and shaping of the root canal was done using protaper file system and Hyflex system respectively. In group 3 and 4 obturation was done using Step-One obturation system and Calamus Dual respectively. In group 5 post space preparation was done using peeso reamers. Each sample tooth was embedded in alginate contained in Eppendorf tube. Tooth was placed in water bath with the two thermocouples attached at the apical and middle third which was in turn attached to thermometer. The rise in temperature was noted at the desired level and statistical analysis was done. Results and Conclusion: The mean temperature rise at the middle third for group 1, 2, 3, 4, 5 was 0.4°C, 0.15°C, 1.80°C,10.33°C, 9.46°C respectively. The mean temperature rise at the apical third for group 1, 2, 3, 4, 5 was 0.08°C, 0.08°C, 1.20°C, 6.91°C, 6.4°C respectively. ANOVA showed significant difference in mean temperatures of different methods. post hoc test comparison using Duncan's test revealed maximum rise in temperature during obturation using Calamus dual (Group 4).

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Objectives: The objective of this study was to assess knowledge, attitude, and practices (KAPs) related to orthodontic treatment among college students in rural and urban areas of Mysore, India. Materials and Methods: This was a cross-sectional questionnaire study conducted among college students in rural and urban areas of Mysore, India, over 2 months from August to September 2015. The sample size was estimated using nMaster software. One government and one private college each in rural and urban areas of Mysore were selected based on administrative convenience. All eligible participants from these colleges were recruited. A sixteen-item questionnaire was developed and validated. This predesigned and validated, self-administered, structured questionnaire was used for data collection. The statistical analysis was done using SPSS. Results: Four hundred and forty-one college students participated in the present study. 89.3% of the participants were aware about malalignment of teeth. The awareness was significantly higher among females and those in urban areas. 39.2% of the study participants expressed willingness to undergo orthodontic treatment even if treatment duration extends up to 1–2 years with no significant difference in relation to gender and area of residence. 14.1% of the study participants have undergone treatment for malalignment of teeth with no significant difference between males and females. However, a significantly higher percentage of participants from urban areas have undergone treatment. Conclusion: The KAP related to orthodontic treatment was significantly higher among females and those in urban areas. This highlights the need to augment orthodontic awareness programs in rural areas.

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Mandibular incisors are smallest teeth in the dentition. It is assumed that mandibular incisor is the most easy tooth to treat but sometimes these teeth are difficult to treat because of presence of extra canal which is present more lingually and often misdiagnosed and leads to treatment failure. Success of root canal treatment depends on careful diagnosis of additional canal and thorough debridement of root canal space and obtaining a fluid-tight seal. Thus, this article emphasis on careful management of mandibular incisors with the second canal (type II anatomy) in a single patient.

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Peripheral reactive lesions of gingiva are common lesions of the oral cavity that dentists come across in daily life. Among these are focal fibrous hyperplasia, pyogenic granuloma, peripheral giant cell granuloma, and peripheral ossifying fibroma. Localized irritation fibroma is a gingival growth, usually arising from interdental papilla due to the presence of some chronic irritation due to dental calculus or other iatrogenic factors. This article reports a case of a 39-year-old male with a recurrent irritation fibroma in the maxillary anterior gingiva treated by excision. The presence of growth in the esthetic maxillary anterior segment and the possibility of unesthetic defect due to excision of the growth have been discussed. The importance of treating the chronic infectious irritational factor and regular follow-up to prevent long-term recurrence of the growth has been discussed.

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Background: The variations in the morphology of the soft palate in normal patients help to establish the variations in morphology in various diseases. The classification system and statistical findings help to research velopharyngeal closure in cleft palate individuals and etiological study of obstructive sleep apnea syndrome and other conditions. The aim of our study was to investigate the variations in the velar morphology and to analyze the variations of length and density of the soft palate. Materials and Methods: In this study, a sample of 100 normal digital lateral cephalograms was analyzed for the variations in morphology of the soft palate and evaluated for analysis of length and density of the soft palate. Results: The morphology of the soft palate showed seven different morphological types. There was a significant difference in length of the soft palate between preadult and adult age groups. Males showed significantly longer and denser soft palate than the females. Conclusion: There was a significant difference in length of the soft palate between preadult and adult age groups. Males showed signifi cantly longer and denser soft palate than the females

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The Indian Government has recently introduced various fiscal and nonfiscal measures for tobacco control, including pictorial health warnings on tobacco packaging. Health warnings on tobacco products are arguably the most cost-effective tool for educating on the health risks of tobacco use. However, interventions are effective upon being transferred from one setting to another with appropriate adjustment to the local context. Authors argue that there is a need to strengthen and target the health messages in a better way to ensure that the warnings reach all smokers, including those buying loose cigarettes/bidis. Any measures that make anti-tobacco messages more meaningful in the Indian context will lead to significant contributions towards the fight against tobacco.

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Within the field of dentistry, loss of primary teeth due to caries, pulp conditions, and crown fractures has been recognized as one of the most severe etiological factors of dental problems in the pediatric dentistry field. One of the greatest headways in dentistry in the last years encompasses the adhesion to enamel of primary teeth; this has led to the development of many techniques to restore the tooth. In spite of all the preventive measures adopted, caries still remains a most common chronic childhood disease.

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Obstructive sleep apnea (OSA) is a potentially disabling condition characterized by disruptive snoring, repeated episodes of complete or partial pharyngeal obstruction during sleep resulting in nocturnal hypoxemia, frequent arousals, and excessive daytime sleepiness. Among adults, sleep apnea is more common than asthma. Recognized as a separate clinical entity nearly 35 years ago, OSA still remains substantial but frequently ignored public health threat. Although recognized for centuries, its importance for individuals and society has only recently been appreciated. Because individuals with narrow airways and/or craniofacial anomalies may have increased risk for OSA/hypopnea syndrome, dentistry can play a pivotal role in the identification and possible treatment of patients with this syndrome. This article makes an attempt to review some of the basic aspects of this sleep-related disorder, its diagnosis, pathophysiology, various treatment options, and consequences in adults as well as children.

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Background: Biopsy is an important tool which aids in the diagnosis of lesions ranging from simple non-neoplastic growths to malignancies. The choice of technique depends on factors such as anatomic site and morphology of the lesion. Oral biopsies can be performed using different techniques, in which scalpel biopsy is the conventional method. Punch biopsies are also quite popular because they are safe and can be rapidly performed. However, the above techniques cannot provide hemostasis which is required on highly vascular tissues. As a result, lasers have been gaining popularity. Nevertheless, laser-tissue interactions may produce some artifactual changes, especially at the margins, such as thermal damage and coagulation which may impair the histopathological diagnosis. Aim: The aim of this study was to compare artifacts produced in scalpel, punch, and laser biopsies and to determine the most effective tool of the three in terms of oral biopsies. Materials and Methods: Thirty hematoxylin and eosin stained sections, ten each of conventional scalpel, punch, and laser biopsies, were retrieved from the archives and analyzed for artifacts under a light microscope. Results: There was no statistically significant difference between the three techniques in terms of orientation, crush, and hemorrhage. Both horizontal and vertical splits were seen in scalpel biopsies (70%) while none were present in the other two techniques. Loss of epithelium was maximum with laser biopsies, and thermal damage was also exclusively seen in this technique. Conclusion: Punch biopsy revealed the least number of artifacts. Laser, compared to scalpel and punch, produces artifacts which may render the margins of the lesions uninterpretable.

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