The infection of the root canal system is considered to be a polymicrobial infection, consisting of both aerobic and anaerobic bacteria. Because of the complexity of the root canal infection, it is unlikely that any single antibiotic could result in effective sterilization of the canal. A combination of antibiotic drugs (metronidazole, ciprofloxacin, and minocycline) is used to eliminate target bacteria, which are possible sources of endodontic lesions. Three case reports describe the nonsurgical endodontic treatment of teeth with large periradicular lesions. A triple antibiotic paste was used for 3 months. After 3 months, teeth were asymptomatic and were obturated. The follow-up radiograph of all the three cases showed progressive healing of periradicular lesions. The results of these cases show that when most commonly used medicaments fail in eliminating the symptoms then a triple antibiotic paste can be used clinically in the treatment of teeth with large periradicular lesions.

The esthetic restorations of primary anterior teeth have always occupied an important part of the pediatric dentist's armamentarium. Various materials have been tried for this purpose and ample materials have been researched in an attempt to fulfill the prerequisites for an ideal esthetic restorative material. Composite resins have been traditionally noted to have decreased bonding ability to primary teeth and the use of secondary retentive features has been advocated to increase bonding. Fifty pairs of anterior class III carious teeth were selected having mirror image lesions on their contralateral proximal surfaces. These teeth were prepared with either a slot or a modified dovetail type of cavity preparation. The patients were then kept on recall to check the clinical characteristics of the restorations at 3, 6, and 12 months. The criteria for evaluation included marginal adaptation, anatomic form, surface discoloration and secondary caries. It was concluded from the results that the both slot and dovetail types of cavity preparations were equally effacious when clinically reviewed for a period of 12 months. Hence the use of slot type of cavity preparation with reduced loss of the tooth structure is indicated for class III cavities in primary anterior teeth.

Oral hairy leukoplakia (OHL) is a white, hyperplastic, vertically corrugated lesion that occurs on the lateral border of the tongue, usually unilateral. Caused by the Epstein-Barr Virus (EBV), the lesion is said to be an early indicator of an immune deficiency status, thereby unmasking subclinical systemic conditions. OHL mimics many other white lesions of the oral cavity; therefore, it becomes imperative to identify the lesion. This study used exfoliative cytology, a noninvasive procedure, which helped in identifying the cellular changes brought about by the virus in the oral epithelium. The study revealed a subclinical phase of OHL, where the cellular changes were seen even before the appearance of the clinical lesion.

A cross-sectional study was conducted on dental students at Bahadurgarh, Haryana, for the assessment of periodontal health and possible associated factors. A total of 329 students were examined clinically by periodontists. Students with bleeding on probing and attachment loss ≥ 2 mm were assessed further for extent of bone loss radiographically. The awareness of disease and knowledge of management was also assessed. Sixty-three (19.1%) students showed clinical signs of disease and 21 (6.3%) had cemento-enamel junction (CEJ) to the bone crest distance of ≥2 mm. Proximal carious lesions were observed in nine cases of attachment loss. Mottled enamel with a roughened surface had association with attachment loss. The clinical students showed reasonable knowledge of disease and management. The need to strengthen the diagnostics for early detection of periodontal disease in young adults is suggested.

Background: Early childhood caries (ECC) is a common disease process that afflicts a large proportion of the child population worldwide. Extensive research in past indicates that it is the result of bacterial infection, also influenced by host and dietary factors. Current caries research seeks to identify risk factors as well as natural oral defenses that may protect against or prevent caries development. Saliva, in spite of being the strongest defense system, still has a wide array of properties and proteins whose role is yet not clearly known. Aim: To compare the resting human whole salivary characteristics in children with ECC and those who are caries free. Settings and Design: The study was conducted over a period of 9 months in 4- to 6-year-old 100 children comprising two groups - 50 with ECC and 50 caries free. Materials and Methods: The whole salivary flow rate, pH, mean protein concentration, and the electrophoretic profile of salivary proteins by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) were compared among both groups. Statistical Analysis: The SPSS (version 11.0) software package was used to conduct the chi-square, Fisher's exact and Pearson's chi-square tests to compare the data. Results: On gel electrophoresis, there was a significant difference among both groups with caries-free subjects having a higher number of proline-rich protein bands, substantiating the protective role of this protein. A significantly higher number of glycoprotein bands were observed in the whole saliva of subjects with ECC. A significant inverse correlation between the mean protein concentration and the whole salivary flow rate was observed in both groups.

Background: The health model which forms the basis is knowledge, attitude, temporary, and permanent behaviors. Currently, more emphasis has been directed towards the combined influence of lifestyle, education, levels and socioeconomic factors, instead of regular risk factors in dealing with chronic illnesses. The present study is conducted to correlate the periodontal health of people with reference to lifestyle, education level, and socioeconomic status. Materials and Methods: A cross-sectional study was conducted in the Department of Periodontics, Narayana Dental College and Hospital, Nellore. A total of 1350 subjects were examined and 948 patients were randomly selected from out patient department. Information about their lifestyle, education level, and socioeconomic status were recorded using a questionnaire and correlated with the periodontal status. Results: The statistical analysis showed significant decrease in periodontitis when income and education levels increased. Also the prevalence of periodontitis associated with a healthy lifestyle is significantly lower when compared to an unhealthy lifestyle. Conclusions: There is a strong association of lifestyle, education level, and socioeconomic status with periodontal health.

Objective: To evaluate sensitivity of orthopentograph (OPG) in assessing the number and morphology of roots of the mandibular third molar. Materials and Methods : The study population consisted of 100 ILTMs (impacted lower third molars) ranging from 18 to 42 years with equal sex distribution. All the teeth were subsequently extracted , collected and compared with OPG features for position, numb,er, morphology, and relation to mandibular canal. Conclusion: In conclusion, a large sample study is suggested with techniques like Clark's and right angle technique which determines the three-dimensional orientation of the impacted teeth.

The infection of the root canal system is considered to be a polymicrobial infection, consisting of both aerobic and anaerobic bacteria. Because of the complexity of the root canal infection, it is unlikely that any single antibiotic could result in effective sterilization of the canal. A combination of antibiotic drugs (metronidazole, ciprofloxacin, and minocycline) is used to eliminate target bacteria, which are possible sources of endodontic lesions. Three case reports describe the nonsurgical endodontic treatment of teeth with large periradicular lesions. A triple antibiotic paste was used for 3 months. After 3 months, teeth were asymptomatic and were obturated. The follow-up radiograph of all the three cases showed progressive healing of periradicular lesions. The results of these cases show that when most commonly used medicaments fail in eliminating the symptoms then a triple antibiotic paste can be used clinically in the treatment of teeth with large periradicular lesions.

The loose and unstable lower complete denture is one of the most common problems faced by denture patients. One of the methods used to solve this problem is the neutral zone technique. The neutral zone is the area where the displacing forces of the lips, cheeks, and tongue are in balance. It is in this zone that the natural dentitions lie and this is where the artificial teeth should be positioned. This area of minimal conflict may be located by using the neutral zone technique. The artificial teeth can then be set up in the correct positions.

Bifid mandibular condyle with ankylosis is an extremely rare condition and may arise as a developmental or traumatic defect. It may be associated with ankylosis. We here report a case of unilateral bifid mandibular condyle with ankylosis in a 3-year-old child. This is the youngest patient reported with the condition making it one of its first kind in the literature. The detailed description of the case, its radiological findings, and the literature on bifid condyles are reviewed.

Most supernumerary impacted teeth are located in the anterior maxillary region. They are classified according to their form and location. Their presence may give rise to a variety of clinical problems. The detection of supernumerary teeth is best achieved by thorough clinical and radiographic examination. Their management should form part of a comprehensive treatment plan. This article presents an overview of the diagnostic problems associated with multiple supernumerary impacted teeth and includes a discussion of the classification, diagnosis, and management of this difficult clinical entity.

A 17-year-old male patient presented for the evaluation of his nonhealing interdental deep pocket in relation to the mandibular second premolar and mandibular first molar. He denied any history of pain. Excessive food lodgment, salty taste, and smell related to the specific region were his chief complaints. The periapical radiograph exhibited well-defined interradicular unilocular radiolucency with sclerotic margins between the vital mandibular second premolar and mandibular first molar. The lesion was completely enucleated with deep curettage and root planning. Histopathologic reports showed a heavy inflammatory infiltrate. Successive radiographs showed excellent bone healing. Teeth were endodontically treated for severe sensitivity to cold. Step-by-step radiographic follow-up showed osseous repair with no evidence of disease till 25 months.

Traumatic injuries to the young permanent teeth lead to devitalization of the pulp with concomitant arrest in further development of the immature root of the involved tooth. Hermetic seal of the root canal system during obturation is not possible in such cases, due to the lack of an apical constriction. The traditional management technique in such cases has been apexification involving induction of a calcific barrier at the apex using calcium hydroxide, which in turn facilitates obturation of the root canal. However this becomes complicated when there is persistent infection leading to periapical changes. This case report describes the use of mineral trioxide aggregate (MTA) for management of a periapically compromised immature tooth.

The gingiva is often the site of localized growths that are considered to be reactive rather than neoplastic in nature. Many of these lesions are difficult to be identified clinically and can be identified as specific entity only on the basis of typical and consistent histomorphology. Peripheral ossifying fibroma is one such reactive lesion. It has been described with various synonyms and is believed to arise from the periodontal ligament comprising about 9% of all gingival growths. The size of the lesion is usually small, located mainly in the anterior maxilla with a higher predilection for females, and it is more common in the second decade of life. A clinical report of a 12-year-old girl with a large peripheral ossifying fibroma in the posterior maxilla showing significant growth and interference with occlusion is presented.