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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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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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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Introduction: Malignant neoplasm is a major cause of death in developed countries, and its incidence continues to grow, placing a heavy burden on the community. Diabetes mellitus is a serious and leading health problem. Recent studies demonstrated that glucose intolerance was associated with a higher risk of oral cancer death, beginning in the prediabetic range of glucose intolerance. However, few population-based studies, especially in Asian populations, have addressed these issues or have estimated glucose intolerance status. Aim: We undertook this study with the aim of finding out an association between impaired glucose tolerance (IGT) and oral cancer along with finding out prevalence of other risk factors for oral cancer. Materials and Methods: Forty-five cases and 45 controls were selected for the study. Oral glucose tolerance was performed on subjects who satisfied inclusion criteria and were willing to sign informed consent form. Results: Fifty-three percent of the cases had abnormal glucose tolerance when compared to 31% of the controls. Conclusion: To conclude, hyperglycemia (which includes impaired fasting glucose, IGT and diabetes) increases the risk of oral cancer two-fold, however IGT alone as defined by American Diabetes Association does not appear to play a role.

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Objective: Lipomas are the most common soft tissue tumors in the human body, but only 15-20% of cases occur in the oral and maxillofacial region. Hence in this study, we describe the clinical and histopathologic features of eight cases of lipomas in the oro-facial region. Materials and Methods: The cases reported during the period 2009-2014 to the Department of Oral and Maxillofacial Pathology were retrieved for the study as none of the cases of lipomas reported before. Clinical data were collected from patient's records, and cases were reviewed and classified microscopically. Results: Of the eight cases, six were female patients, and two were males; their mean age was 47 years (ranges: 22-76 years). In the present case series, lipomas showed multiple site involvement in the oral and maxillofacial region with the mean size of tumor being 3 cm (ranges 1.5-4.5 cm). Microscopically, three cases were classic lipomas, four were fibrolipomas and one was intramuscular or infiltrating lipoma. All cases had been treated by simple surgical excision, were followed, and no recurrence was reported. Conclusion: Lipomas of oral and maxillofacial region are relatively uncommon tumors. They have no gender as well as the site predilection for occurrence. The most common histological variant was found to be fibrolipoma. Surgical excision is the treatment of choice with a good prognosis.

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Aim: The objective of this study was to evaluate a new laser fluorescence device, DIAGNOdent for occlusal caries detection and to compare the diagnostic accuracy of DIAGNOdent with conventional bitewing radiography. And to determine the sensitivity and specificity of DIAGNOdent. Methods: 60 teeth were selected having pit and fissure carious lesions by 2 examiners. After visual and tactile examination of each lesion, DIAGNOdent readings were recorded and bitewing radiographs were taken. Caries removal was done and volume of the cavity was calculated by packing the cavity with composite of specific density. Results: Correlation between DIAGNOdent and visual tactile is 0.398 (P < 0.05); correlation between DIAGNOdent and radiographic method is 0.578 (P < 0.001). Sensitivity is 0.68 % and specificity is 0.37 %. Conclusion: DIAGNOdent is more accurate than visual- tactile and radiographic methods of caries detection. It is a more sensitive system of occlusal caries detection.

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Aim: The aim was to evaluate the antimicrobial effect of olive extracts on Streptococcus mutans in in-vitro conditions. Materials and Methods: An in-vitro experimental study was conducted in a laboratory setting. Ethanolic extract of olive was prepared separately by cold maceration technique. The extract was then diluted with an inert solvent, dimethylformamide, to obtain five different concentrations (2%, 4%, 6%, 8%, and 10%) of each. 0.2% chlorhexidine was used as a positive control and dimethylformamide was used as a negative control. The different extracts, along with controls, were then subjected to microbiological investigation to determine, which gave a wider zone of inhibition against S. mutans. The zone of inhibition was measured in millimeters. Results: Olive extract presented the largest zone of inhibition of 33 mm at the concentration of 8%. Conclusion: Ethanolic extract of olive demonstrated antimicrobial activity against S. mutans.

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Background: Oral lesions, especially oral candidiasis, oral hairy leukoplakia, necrotizing periodontal conditions and variety of other viral and bacterial infections are essentially presented in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients due to low CD4+ count. Aims: This study was designed to determine various oral clinical and cytological mucosal changes seen in HIV/AIDS patients not taking antiretroviral therapy (ART) in Pakistan and their relation to CD4+ lymphocyte count as no study has been reported yet in our country. Materials and Methods: Patients were clinically examined and staged according to World Health Organization (WHO) staging system. Oral smears, from n = 25 patients not taking ART, were prepared and examined microscopically using hematoxylin and eosin, periodic acid-Schiff and Papanicolaou stains. The CD4+ lymphocyte count was determined using flow cytometry. Result: Oral lesions were present in 36% of the patients with chronic periodontitis in 20%, oral candidiasis in 12%, oral pigmentation in 8% and oral ulcers in 4% patients. On cytological examination, fungi were detected in 56% smears. Inflammation was seen in 60% smears, micronuclei in 72%, nuclear atypia in 44% and dysplastic changes in 16% (grade 1 in 12% and grade 2 in 4%) smears. The mean CD4+ lymphocyte count was 338.12 ΁ 127 cells/mm ³ . The CD4+ lymphocyte count was grouped as < 350 cells/mm ³ (Group 1) and > 350 cells/mm ³ (Group 2). Group 1 comprised of n = 15 while Group 2 had n = 10 patients. Most of the oral lesions were seen in CD4+ Group 1 having low CD4+ count. When the cytopathological variables were compared with WHO clinical stages, a statistically significant association (P < 0.05) was observed in the case of pseudomembranous candidiasis clinically and dysplasia and presence of fungi cytologicaly. Conclusion: This study highlights the importance of oral lesions as a marker of HIV/AIDS progression and immunosuppression as oral lesions were frequent with low CD4+ count especially < 350 cells/mm ³ .

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Gorlin-Goltz syndrome is an autosomal dominant disorder showing multiple organ involvement. The syndrome consists principally of nevoid basal cell carcinomas, keratocystic odontogenic tumors (KCOT), skeletal anomalies and intracranial calcifications. A case report of a 25-year-old female patient emphasizing its clinical and radiographic manifestations is presented in this article. Radiographs and computed tomography showed recurrent, multilocular and expansile lesions, which were examined histologically, confirming the diagnosis of KCOT. Skin lesions in the form of palmar pits and solitary pigmented nevi were seen. The sella turcica was bridged and the right fifth rib was bifid. The bilamellar falx cerebri calcification was confirmed on computed tomography of brain. The patient was treated and explained about the prognosis.

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