Background: Prevention from caries is a principle in dentistry and fissure sealant therapy is being used as a preventive method success of sealants is directly depending on their retention. Aim: The Aim of the present study is to evaluate effects of enamel preparation on sealant retention. Settings and Design: Clinical trial Materials and Methods: About 57 children aged 6-8 year old took part in this study. 200 first molar teeth of these children has been randomly separated into two groups: A case group (Mechanically preparation of enamel) and a control group (conventional method, without preparation). After applying fissure sealants children were followed up 6 months later. Statistical Analysis Used: Mann- U- Whitney Test was used. Results: Complete retention after 6 month follow up was 86.7% in case group and 82.8% in control group. No significant difference was seen between the groups after 6 month follow up. ( P = 0.508). Conclusion: Although statistical evaluation didn't show significant difference, but sealant retention was more after preparation technique.

Purpose: To evaluate the correlation between sagittal condylar guidance obtained by protrusive interocclusal records and panoramic radiograph tracing methods in human dentulous subjects. Materials and Methods: The sagittal condylar guidance was determined in 75 dentulous subjects by protrusive interocclusal records using Aluwax through a face bow transfer (HANAU™ Spring Bow, Whip Mix Corporation, USA) to a semi-adjustable articulator (HANAU™ Wide-Vue Articulator, Whip Mix Corporation, USA). In the same subjects, the sagittal outline of the articular eminence and glenoid fossa was traced in panoramic radiographs. The sagittal condylar path inclination was constructed by joining the heights of curvature in the glenoid fossa and the corresponding articular eminence. This was then related to the constructed Frankfurt's horizontal plane to determine the radiographic angle of sagittal condylar guidance. Results: A strong positive correlation existed between right and left condylar guidance by the protrusive interocclusal method (P 0.000) and similarly by the radiographic method (P 0.013). The mean difference between the condylar guidance obtained using both methods were 1.97° for the right side and 3.18° for the left side. This difference between the values by the two methods was found to be highly significant for the right (P 0.003) and left side (P 0.000), respectively. The sagittal condylar guidance obtained from both methods showed a significant positive correlation on right (P 0.000) and left side (P 0.015), respectively. Conclusion: Panoramic radiographic tracings of the sagittal condylar path guidance may be made relative to the Frankfurt's horizontal reference plane and the resulting condylar guidance angles used to set the condylar guide settings of semi-adjustable articulators.

Aims: This study was aimed to determine the effectiveness of Papacαrie^® for caries removal as compared to the conventional method with respect to microbial flora, time, the amount of tissue removal, child's behavior, pain perception, and preference of treatment. Materials and Methods: Sixty primary molars of 30 children of age 4-9 years were selected randomly and divided into two groups of 30 teeth each: Group A treated by conventional method and group B with Papacαrie^® method. Results: Comparatively, no statistical difference was seen in microbial growth, total bacterial count, and lactobacilli count in both the groups ( P = 0.36). The mean cavity entrance size with group A was 0.98133 mm and group B was 0.26083 mm ( P < 0.001). The mean preparation time for group A was 4.7 Mins (minutes) and group B was 17.96 min s ( P < 0.001). Majority of kids of both group A and B scored 3 (Frankl Behavior Rating Scale) before and after the treatment showing no statistical difference in their behavioral score ( P = 1). In group A 50% of children experienced no pain as compared to 86.7% in group B ( P = 0.01). There was no statistical difference in the preference of treatment ( P = 0.12). Conclusion: Thus, the Chemo mechanical caries removal method can be considered as an effective method to control pain and preserve sound tooth structure during caries excavation.

Objectives: The aim of this study was to observe the tooth loss over age in a sample of Brazilian patients and analyze their ability to chew, relating it to how much is the loss of oral function impact over the quality of life (QoL). Materials and Methods: This is a single center, observational study and the data were collected through clinical examination followed of questionnaires to obtain sociodemographic information, the ability to chew (through the index of chewing ability [ICA]) and QoL (through Oral Health Impact Profile, OHIP-14). Results: The sample was composed by 171 random volunteers with mean age of 47 (SD 15.2). Low number of natural teeth was associated with an increase of age (Spearman's rho correlation coefficient-0.7, P < 0.001, 2-tailed) and chew disability (ICA: chew's ability vs. disability) (Mann-Whitney U-Test, P < 0.001). Chew disability showed a negative impact over the QoL (overall OHIP; Mann-Whitney U Test P < 0.001) and in five of seven OHIP domains (Functional Limitation, Physical Pain, Psychological Discomfort, Physical Disability, Psychological Disability). Age over than 40 years, was also associated with chewing disability (Pearson Chi-Square P < 0.001) and poorer QoL (Mann-Whitney U test P = 0.01). Conclusion: This study observed that the chewing disability produces a significant and negative impact over oral-health related QoL and both, poor QoL and chewing disability are related with the decrease of the number of natural teeth.

Visually impaired children are challenged everyday in their everyday skills. Oral hygiene practices among visually impaired children require a special approach with time and patience. The purpose of this study was to evaluate the effect of oral health education and fluoridated dentifrices on the oral health status of visually impaired children. Materials and Methods: Fifty visually impaired children between 8 and 12 years of age formed the study group. Oral health education and motivation was done with the help of Braille. Modified Bass method of brushing was taught to the children and the required dental treatment was done. Subjects were randomly divided into two equal groups fluoridated and non-fluoridated. Oral hygiene index -simplified, DMFT, deft index, and Streptococcus mutans and Lactobacillus count were assessed at baseline, immediately after the treatment and at 3, 6, and 12 month intervals. The oral health awareness was assessed using a questionnaire at the beginning and end of the study. Results: At baseline, the mean OHI-S, DMFT and deft scores were 2.72, 0.47, and 0.51 respectively. At the end of 12 months there was a significant decrease in OHI-S scores in the fluoridated group. No significant difference was seen in DMFT and deft between the fluoridated and non-fluoridated groups at the different time interval. After the oral health education and comprehensive treatment there was a reduction in Streptococcus mutans and Lactobacillus counts in both groups; however, at the end of 3, 6, 12 months there was a significant decrease in fluoridated group as compared to the non-fluoridated. The oral health awareness increased significantly at the end of the study. Conclusion: The oral health education and motivation formulated for the visually impaired children was effective in improving their oral health status. Fluoridated dentifrices decreased the Streptococcus mutans and Lactobacillus counts and improved the oral hygiene status.

Aim: To study the correlation between the caries status and the salivary antioxidant levels among asthmatic children. Settings and Design: One hundred children within the age group of 6 12 years were selected and equally subdivided into children having a history of asthma and their healthy siblings. Materials and Methods: Salivary antioxidant levels were assessed using spectrophotometric method, and the caries status was recorded using DMFT (Decayed, missing and Filled Teeth Index) and dft (decayed, filled teeth index) index. Result: The salivary antioxidant levels were reduced among the asthmatic children which was statistically highly significant, whereas the caries prevalence was reduced, but not statistically significant.

Background: Successful reconstruction of periodontal tissues destroyed due to periodontitis has been an evasive goal for the periodontists. Several GTR materials and bone grafts have been tried with varied success rates. Aims and Objectives: The aim of the present study was to evaluate and compare the efficacy of non-resorbable (GoreTex^® ) and bioabsorbable (Resolut Adapt^® ) membranes in combination with bioactive glass (PerioGlas^® ) in the treatment of periodontal intrabony defects. Materials and Methods: Ten chronic periodontitis patients having bilateral matched intrabony defects were treated with non-resorbable membrane (GoreTex^® ) and bioactive glass or the bioresorbable membrane (Resolut Adapt^® ) and bioactive glass in split mouth design. Clinical parameters like plaque index, gingival index, probing pocket depth, clinical attachment level, and gingival recession were recorded at baseline and 9 months post-operatively. Similarly, radiographic (linear CADIA) and intra-surgical (re-entry) measurements were evaluated at baseline and 9 months post-operatively). Results: Both the membrane groups showed clinically and statistically significant improvement in clinical parameters i.e., reduction in probing depth (4.6 ± 1.4 mm) vs. 3.7 ± 1.3 mm) and gain in clinical attachment level (4.6 + 1.6 vs. 3.2 ± 1.5 mm) for non-resorbable and bioresorbable membrane groups, respectively. Similar trend was observed when radiographical and intra-surgical (re-entry) measurements were evaluated and compared, pre- and post-operatively at 9 months. However, on comparison between the two groups, the difference was statistically not significant. Conclusion: Both the barrier membranes i.e., non-resorbable (Gore-Tex^® ) and bioabsorbable (Resolut Adapt^® ) membranes in combination with bioactive glass (PerioGlas^® ) were equally effective in enhancing the periodontal regeneration.

Introduction: Edentulous condition inadequately compensated for, by dentures, impair oral function and is accompanied by reduced self–confidence. In a continued effort to achieve these goals, implant dentistry was introduced. Immediate temporization is somehow a recent concept, which allows the maintenance of soft tissue contours, along with interdental alveolar contours. Aims and Obectives: Aims of the present study were to study the placement of implant in the post-extracted healed tooth socket of anterior maxilla and to evaluate the feasibility of early function on implants placed. Materials and Methods: In the present study, HI-TECH IMPLANTS TRX-OP one-piece immediate loading implant system with the built on abutment has been used.Immediate temporisation has been done and results have been evaluated in terms of stability, gingival health, esthetics, marginal bone loss, patient's psychological attitude, and satisfaction.
Results: Out of eight implants, 6 successfully healed whereas 2 implants suffered failure
Conclusion: Overall conclusion drawn from the study is, immediate temporization is a successful method providing psychological, financial and emotional benefits to the patient.

Aims: The purpose of this in vitro study was to compare the root canal length determination by Electronic apex locator (EAL) (Raypex 5) and conventional radiography, and then compare them with the actual measurements obtained by direct visualization. Settings and Design: This study was conducted at the Department of Pedodontics and Preventive Dentistry, Government Dental College, Thiruvananthapuram, Kerala, India. Subjects and Methods: One hundred single rooted primary teeth extracted due to extensive caries, trauma, serial extraction or unwillingness of the parent to save the teeth were selected. The teeth were numbered and root canal length was determined using the visual, electronic and the radiographic methods. The actual, electronic and the radiographic measurements were recorded. Statistical Analysis Used: Data were analyzed using Intraclass correlation test and linear regression analysis. Results: The accuracy of EAL and radiographic methods were 92% and 72%, respectively within + 0.5 mm. Both the electronic and conventional radiographic methods showed a high correlation and agreement (ICC intraclass correlation coefficient = 0.99 and 0.98 respectively) with the actual measurements. Conclusions: EALs proved to be more accurate in determining the root canal length than the radiographic method.

Context: Walking bleach technique uses 30% hydrogen peroxide and sodium perborate, and this paste mixture causes loosening of the coronal temporary restorative materials and thus decreasing its clinical effectiveness and causing irritation to the patients oral tissues. In the present study, sealing ability of hygroscopic coronal temporary restorative materials were compared with the other commonly used temporary restorative materials. Aim: To evaluate the effects of walking bleach material on the marginal sealing ability and coronal microleakage of the hydrophilic temporary restorative materials with that of the other commonly used temporary restorative materials in endodontic practice. Materials and Methods: Seventy-five extracted human maxillary central incisor teeth were prepared chemo-mechanically and obturated with gutta-percha in lateral condensation technique. Surface of each tooth was double coated with cyanoacrylate glue. All the teeth were randomly divided in to five groups. Out of 15 teeth in each group, 10 teeth served as experimental specimens, in which bleaching agent was placed in the pulp chamber and 5 teeth served as control, in which no bleaching agent was placed. The access cavities were restored with temporary restorative materials being tested per each group respectively. The specimens were then immersed in 1% India ink dye and subjected to thermo cycling for 7 days. All the teeth were longitudinally sectioned and observed with stereomicroscope and were graded according to the depth of linear dye penetration. Statistical Analysis Used: Mann-Whitney U test and Kruskal-Wallis test. Results: Hydrophilic temporary restorative materials Cavit G and Coltosol F have shown minimal coronal dye leakage with better sealing ability when exposed to walking bleach paste mixture in the dye penetration tests compared to other commonly used temporary restorative materials. Conclusion: Marginal sealing ability of Cavit G and Coltosol F were not influenced by the effects of bleaching agent compared to other temporary restorative materials used in the study.

Aim: The study was designed to explore the changes in oral health-related quality of life (QoL) in the immediate postoperative period following routine (non-surgical) dental extraction. Setting and Design: A prospective study carried out at the Oral and Maxillofacial Surgery clinic of the Lagos University Teaching Hospital, Nigeria. Materials and Methods: Subjects attending who required non-surgical removal of one or two teeth under local anesthesia were included in the study. A baseline QoL questionnaire (oral health impact profile-14 [OHIP-14]) was filled by each patient just before surgery, and only those who were considered to have their QoL "not affected" (total score 14 or less) were included in the study. After the extraction, each subject was given a modified form of "health related QoL" [OHIP-14]-instrument to be completed by the 3 ^rd day-after surgery, and were given the opportunity to review the questionnaire on the 7 ^th day postoperative review. Results: Total OHIP-14 scores ranged between 14 and 48 (mean ± SD, 26.2 ± 8.3). Majority of the subjects (60%) reported, "a little affected." Only few subjects (5.8%) reported, "not at all affected," and about 32% reported, "quite a lot." Summation of OHIP-14 scores revealed that QoL was "affected" in 41 subjects (34.2%) and "not affected" in 79 subjects (65.8%). More than 30% of subjects reported that their ability to chew, ability to open the mouth and enjoyment of food were affected following tooth extraction. Few subjects (14-34%) reported deterioration in their speech and less than 20% of subjects reported that change in their appearance was "affected." Only few subjects (12.5-15.1%) reported sleep and duty impairment. Thirty-percent of subjects reported their inability to keep social activities, and 41% were not able to continue with their favorite sports and hobbies. Multiple regression analysis revealed no significant association between age, sex, indications for extraction, duration of extraction, intra-operative complications, and deterioration in QoL ( P < 0.05). Consumption of analgesics beyond postoperative day 1 (POD1) was more common in subjects with socket healing complications than those without ( P = 0.000). About 33% of subjects reported, "inability to work" (1-3 days). Conclusion: About a third of subjects experienced significant deterioration in QoL. The most affected domains were eating/diet variation and speech variation. Therefore, patients should be informed of possible deterioration in their QoL following non-surgical tooth extraction.

Objective: The purpose of this study was to evaluate the effects of synthetically processed hydroxyapatite particles in remineralization of the early enamel lesions in comparison with 2% sodium fluoride. Materials and Methods: Thirty sound human premolars were divided into nanohydroxyapatite group (n0 = 15) and the sodium fluoride group (n = 15). The specimens were subjected to demineralization before being coated with 10% aqueous slurry of 20 nm nanohydroxyapatite or 2% sodium fluoride. The remineralizing efficacy of the materials was evaluated using surface microhardness (SMH) measurements, scanning microscopic analysis and analysis of the Ca/P ratio of the surface enamel. Data analysis was carried out using paired t-test and independent t-test. Results: The results showed that the nanohydroxyapatite group produced a surface morphology close to the biologic enamel, the increase in mineral content (Ca/P ratio) was more significant in the nanohydroxyapatite group ( P < 0.05) and the SMH recovery was closer to the baseline level in the nanohydroxyapatite group (P < 0.05). Both the groups did not show any significant difference in thickness (P > 0.05). Conclusion: The use of biomimetic nanohydroxyapatite as a remineralizing agent holds promise as a new synthetic enamel biocompatible material to repair early carious lesions.

Background: Autogenous bone graft, although considered as a gold standard, has been relegated to background because of limited quantity and donor site morbidity. Revival of interest in its use has been reflected by its tremendous capacity for regeneration in less than ideal situation. Bone blocks have been used for implant site augmentation, with varied success. Aim: Aim of the study was to evaluate the efficacy of autogenous bone block in the regeneration of bone, for saving teeth with a hopeless prognosis. Settings and Design: A total of six patients and 12 sites with grade II and III mobile teeth were treated with autogenous bone blocks and fiber splinting. Subjects and Methods: Attachment loss, probing depths, and radiographic bone loss were recorded at baseline and at 12 months interval. Statistical Analysis Used: The Student paired t test was used for evaluation of the changes from baseline to 12 months. Results: At 12 months post-operatively, there was a highly significant amount of bone gain as compared to the baseline. The mean amount of bone loss reduced from 9.41 ± 1.16 to 5.41 ± 1.01. The clinical attachment loss reduced from 7.37 ± 1.24 mm to 3.79 ± 0.89 mm and probing depth reduced from 7 ± 1.67 mm to 5.5 ± 0.63 mm. The grafted bone was observed to have been incorporated with the host bone in most of the sites as evidenced by radiographs. Conclusions: For teeth with hopeless prognosis, this method can be considered to be a very viable alternative to extraction and replacement by costly implants.

Objectives: To assess the occlusal relationship, canine relationship, crowding, primate spaces, and anterior spacing in both maxillary and mandibular arches of primary dentition of Indian children of Wardha District and also to study the age-wise differences in occlusal characteristics. Materials and Methods: A total of 1053 (609 males and 444 females) children of 3-5 year age group with complete primary dentition were examined for occlusal relationship, canine relationship, crowding, primate spaces, and anterior spacing in both maxillary and mandibular arches. Results: The data after evaluation showed significant values for all parameters except mandibular anterior spacing, which was 47.6%. Mild crowding was prevalent at 5 year age group and moderate crowding was common at 3 year-age group. Conclusion: Evaluated parameters such as terminal molar relationship and canine relationship were predominantly progressing toward to normal but contacts and crowding status were contributing almost equal to physiologic anterior spacing. Five-year-age group showed higher values with respect to all the parameters.

Background: Tobacco causes the generation of free radicals and reactive oxygen species (ROS) which are responsible for the high rate of lipid peroxidation. Malondialdehyde (MDA) is the most widely used agent to estimate the extent of lipid peroxidation. Timely diagnosis of the condition followed by supplementation with antioxidants like beta-carotene, pro-vitamin A, vitamin A, vitamin C, vitamin E, lipoic acid, zinc, selenium, and spirulina can prevent potentially malignant disorders. Materials and Methods: In this study, serum MDA was measured according to the method of Buege, in 15 normal samples and 15 patients who were histopathologically diagnosed with potentially malignant disordered and they were prescribed with antioxidants for a period of 4 week-time following which potentially malignant patients serum MDA was analyzed again to determine the extent of peroxidation reactions. Results: The mean serum MDA level in Group C1 was 0.7900 ± 0.2336 μM/L were as the mean serum MDA level of Group S1 was 2.478 ± 0.50756 μM/L and the values between them were highly significant. The values between C1 and S2 were found to be statistically significant. The mean serum MDA of S2 was 2.160 ± 0.41252 μM/L and the values were significant when compared to S1. Conclusion: Serum MDA estimation in oral pre-cancer would serve in determining the extent of lipid peroxidation. Diagnosis of patients and administration of antioxidants has proven to be effective in declining the ROS and thus reducing the extent of damage on the cells. MDA may serve as a diagnostic tool in the estimation of oral pre-cancer and in evaluation of post-treated cases.

Aims: The aim of the study was to evaluate the stress distribution patterns in teeth and supporting structures of fixed prosthesis and design modifications in a fixed prosthesis with either normal or reduced bone support of an additional abutment. Study was also undertaken to disprove Ante's law. Materials and Methods: Main models and variations of main models (modification 1, 2, 3, 4, 5, 6, 7, 8) were subjected to 200 N at angulations of 90° and 15° on functional cusps. Results for each loading were obtained as stress distribution color images and numerical values were recorded. A three-dimensional finite element analysis study of variations of normal models was performed using two finite element softwares, namely PRO-Engineer wildfire version 1.0 manufacturer: Parametric technology corporation, Needham, MA 02494 U.S.A. Results: When periodontal compromised abutment teeth was splinted with an additional abutment an increase of stress was observed in periodontally compromised abutments so an additional abutment is not required. Eventhough the pericemental area of compromised abutments with an additional abutment (canine) was more than the combined pericemental area of pontics to be replaced, stress generated was more on abutments. This disproves Ante's law. Hence, it may be a reference, but should not be the ultimate criterion in determining the number of multiple abutments. Conclusions: When periodontal compromised abutment teeth was splinted with an additional abutment an increase of stress was observed in periodontally compromised abutments so an additional abutment is not required. Even though the pericemental area of compromised abutments with an additional abutment (canine) was more than combined pericemental area of pontics to be replaced, stress generated was more on abutments. This disproves Ante's law. Hence, it may be a reference, but should not be the ultimate criterion in determining the number of multiple abutments.

Aim: This prospective randomized clinical study (1) investigated the prevalence of post-obturation pain after single visit root canal treatment and (2) evaluated the influence of factors affecting the pain experience. Materials and Methods: One thousand three hundred and twenty eight (1328) patients were included in this study. Conventional single visit root canal treatment was carried out. The chemicomechanical preparation of root canals was done by a rotary protaper system with a combination of hand instruments. Post-operative pain was recorded by each patient by using visual analogue scale in well-defined categories at three time intervals, 12 h, 24 h, and 48 h. The data were analyzed using Fisher's exact test. Results: The prevalence of post-obturation pain (severe) within 48 h after treatment was 4% ( n = 54) but less as compared to the pain experienced after 12 h (9%) and 24 h (8.6%). The factors that significantly influenced post-obturation pain experience were: Age (Fishers exact test = 46.387, P = 0.0), gender (Fishers exact test = 23.730, P = 0.0), arch (Fishers exact test = 11.710, P = 0.001), and presence of pre-operative pain (Fishers exact test = 67.456, P = 0.0). Conclusion: The presence of post-operative pain was low (4%). The important prognostic determinants of post-obturation pain were: Old age, female, mandibular teeth, and presence of pre-operative pain. The vital condition of the tooth does not affect the intensity and frequency of post-obturation pain.

Cysticercosis is a major health concern in developing countries, as it is a major cause of seizures in these countries. The tissues commonly affected are the neural tissues, muscle, heart, lungs, liver, subcutaeneous layers and peritoneum, but oral manifestations are rare. Present case is of an asymptomatic tongue nodule which was diagnosed as cysticercosis on histologic examination. Thus, emphasizing the importance of routine microscopic examination and diagnosis of apparently innocuous lesions of the oral cavity.

Loss of interdental papilla predisposes to phonetic, functional, and esthetic problem. Surgical techniques are manifold, but are challenging and very unpredictable. The purpose of this case report is to present the use of platelet rich fibrin (PRF) in the reconstruction of papilla in the maxiallry anterior region of a forty year old woman who presented with loss of interdental papillae in 11, 12 and 11, 21 region. PRF was tucked in to the pouch created with a semilunar pedicle flap and the entire gingivopapillary unit was displaced coronally. Optimal fill was noted at 3 and 6 months postoperatively. Use of PRF may thus be the panacea for interdental papilla augmentation.

There has been considerable clinical interest in combining the grafts, particularly bone allografts for support for dental implants, soft-tissue support, periodontal maintenance, and ovate pontic formation. The use of demineralized, freeze-dried bone allograft (DFDBA) offers certain advantages over other graft materials and can avoid the need for a second-site surgery for autogenous donor bone. The advantages of DFDBA include handling properties, osteoinductivity, membrane tenting, and less susceptibility to migration after placement. This article will review available grafting materials and demonstrate a case of ossifying fibroma of the mandible, which was treated by curettage and hollow cavity filled with DFDBA. Six months follow-up period showed successful graft result and this grafted bone form was utilized for implant supported prosthesis.

Unicystic ameloblastoma (UA) refers to those cystic lesions that show clinical, radiographic, or gross features of a mandibular cyst, but on histologic examination show a typical ameloblastous epithelium lining part of the cystic cavity, with or without luminal and/or mural tumor growth. It accounts for 5-15% of all intraosseous ameloblastomas. We report a case of UA in a 35-year-old female with an unusual large multilocular (tennis racket) appearance on the right body of mandible and illustrate the importance and complexity of differential diagnosis with a brief review of recent literature.

Coronal fractures of the anterior teeth are a common form of dental trauma that mainly affects children and adolescents. One of the options for managing coronal tooth fractures when the tooth fragment is available and there is no or minimal violation of the biological width is the reattachment of the fragment. This article presents a novel technique for reattachment of oblique fractured fragment of vital maxillary central and lateral incisor with pulp exposure. Pulp capping was done using mineral trioxide aggregate. Orthodontic extrusion was done to expose the sub gingival fractured site. Polyethylene fiber (ribbond) and panavia F cement were used to reattach the fractured fragment using an internal groove technique to provide high fracture strength to restored tooth. Ribbond fibers can be used to give additional strength to the reattached tooth fragment so that the tooth obtains fracture resistance equal to an intact tooth.

In cases of trauma, dental fragments occasionally penetrate into the soft-tissues and may cause severe complications, if neglected. Clinical and radiographic examinations can provide a diagnosis and help in the surgical removal of any dental fragment embedded in soft-tissue. This case report concerns an 8-year-old boy who was diagnosed with a fragment of a fractured permanent central incisor crown located in the lower lip. The patient was seen initially at a general hospital, where the dental fragment went unnoticed. After 2 days, the patient was seen at the pediatric dentistry clinic, where a fragment embedded in the lower lip, causing a large swelling, was diagnosed. The fragment was removed surgically and bonded to the fractured tooth. A mouth guard was prescribed for sports. The importance of soft-tissue exploration even post-trauma was highlighted in this paper.

Addison's disease is a rare endocrinal disorder, with several oral and systemic manifestations. A variety of pathological processes may cause Addison's disease. Classically, hyperpigmentation is associated with the disease, and intraoral pigmentation is perceived as the initial sign and develops earlier than the dermatological pigmentation. The symptoms of the disease usually progress slowly and an event of illness or accident can make the condition worse and may lead to a life-threatening crisis. In this case, several oral as well as systemic manifestation of the Addison's disease was encountered.

The buccal fat pad is relatively large and prominent in neonates, infants and young children. The main function of this fat pad is considered as a cushioning tissue and sucking pad. A minor tear of buccal mucosa and buccinator muscle can result in herniation of large volume of fat into oral cavity that is termed as "pseudolipoma." The young children tend to be very playful while brushing their teeth. Improper brushing technique resulted in severe trauma to the buccal fat, including soft-tissue between buccinator and retromolar area. This article presents a case-report of a female child who developed traumatic pseudolipoma after faulty tooth brushing for long duration and its management along with its detail review of literature.

To use mineral trioxide aggregate (MTA) in prophylactic management of talon cusp. Talon cusp is an endodontic oddity that possesses a treatment challenge to the clinician, especially when it causes esthetic and functional problems. Management ranges from periodic gradual reduction to radical removal followed by vital pulp/endodontic therapy. MTA has replaced calcium hydroxide as pulp capping material because of its superior properties. A 12-year-old boy reported with a complaint of irregular teeth. Clinical and radiographic examination revealed talon cusp on maxillary left central incisor. Radical removal of talon cusp and MTA pulpotomy was performed. The 4-year follow-up showed the positive pulp vitality test without any radiographic changes, emphasizing the use of MTA pulpotomy in successful management of talon cusp.

Ewing's sarcoma (ES) is a rare malignancy primarily affecting skeletal system and it is commonly diagnosed in children and young adults. It seldom occurs in the head and neck region. ES has poor prognosis because of uncontrolled metastatic potential making early diagnosis and intervention critical for survival of the patient. This paper reports a rare case of ES involving mandible in an 8-year-old girl with clinical, radiological, histopathological and immunohistochemical features.

Presence of supernumerary teeth is well-recognized clinical phenomenon. However, it is uncommon to find multiple supernumeraries in individuals with no other associated disease or syndrome. Presence of multiple supernumerary teeth is thought to have genetic component. We report a rare case where multiple supernumerary teeth were seen without presence of any other syndrome in 3 generations; father, son, and two grandsons. We also present a review of similar cases published in literature till date. The role of genetics in development of supernumerary teeth is highlighted.

Patients presenting with vague head and neck pain can lead to wide-ranging differential diagnosis. Elongation of styloid process (SP) should also be considered as one of the etiological factors for cervical pain radiating to jaws, pharyngodynia, and difficulty in swallowing. Symptomatic elongation of SP or mineralization of stylohyoid ligament is referred as Eagle's syndrome. It is a rare entity presenting with an array of symptoms like recurrent throat pain, dysphagia, otalgia, and neck pain. History and physical examination play a vital role in diagnosing this condition and further radiological investigation confirms the diagnosis. The preferred radiologic modality is 3D-computed tomography, which gives accurate information about length, angulation, type of elongation, and relation to vital structures and hence helps in execution of treatment planning. This paper describes clinical approach, imaging investigations, and management of a case of Eagle's syndrome.

Lipoma is the commonest benign tumor occurring at any anatomical site, where fat is present. In oral cavity and oropharynx, it is a relatively uncommon neoplasm. Tongue, which is totally devoid of fat cell is also a site for lipoma but very rarely. We report one such rare case of the universal tumor, of 20 years of duration and 9 cm in size, presenting at the lateral margin, dorsal and ventral surface of the tongue, for which complete tumor excision was done.

Dental traumatic injuries occur frequently in children. The close relationship between the apices of primary teeth and germ of the permanent successors can lead to developmental disturbances in the permanent dentition. Developmental disorder can occur in any tooth. One of the most common teeth affected is lateral incisor. These developmental anomalies can cause various clinical problems. Clinical and radiographic characteristics of these anomalies may sometime present confusing picture. Therefore, recognition of this condition, early diagnosis, and treatment are important to avoid complications. High prevalence of dental trauma in young children emphasizes the need of educational and preventive programs in schools. Dentist plays important role in early diagnosis of disturbances in the permanent successor teeth by rigorous clinical and radiographic follow-up examination.

The Gorlin-Goltz syndrome, also known as nevoid basal cell carcinoma syndrome (NBCCS), is an infrequent multisystemic disease inherited in a dominant autosomal way, which shows a high level of penetrance and variable expressiveness. It is characterized by odontogenic keratocysts in the jaw, multiple basal cell nevi carcinomas and skeletal abnormalities. This syndrome may be diagnosed early by a dentist by routine radiographic exams in the first decade of life, since the odontogenic keratocysts are usually one of the first manifestations of the syndrome. This case report presents a patient diagnosed as NBCCS by clinical, radiographic and histological findings in a 13-year-old boy. This paper highlights the importance of early diagnosis of NBCCS which can help in preventive multidisciplinary approach to provide a better prognosis for the patient.

Variation in the roots and root canal anatomy seems to be the norm rather than an exception. For a successful endodontic treatment, a clinician should have a thorough knowledge of the internal and external dental anatomy and its variations. Maxillary lateral incisors usually exhibit single canal with a single root. In this case, clinical examination and radiographs clearly demonstrates the presence of two root canals with two separate curved roots. This case report emphasizes the need for attention during endodontic management of maxillary lateral incisors.