Background: One out of every two children sustains a dental injury most often between 8 and 10 years of age. Majority of these teeth subsequently become non-vital and most often with immature apex. Management of these teeth is an enormous challenge for lack of apical stop. Calcium hydroxide in various formulations has maximum literature support in favor of "successful apexification or induced apical closure." Aim: The aim of the following study is to determine the efficacy of calcium hydroxide in a different formulation to induce apexification. Materials and Methods: The present study was undertaken on 51 children of 8-10 years of age (both sexes) at Dr. R Ahmed Dental College and Hospital from April 2006 to March 2007. All children had one or two maxillary permanent central incisor (s), non-vital and apices open. In all the cases, apexification was attempted with either calcium hydroxide mixed with sterile distilled water, or calcium hydroxide plus iodoform in methyl cellulose base, or calcium hydroxide plus iodoform in polysilicone oil base. The success of apexification was determined on the basis of clinical and radiographic criteria. Results: In the pre-operative asymptomatic cases (72.55%), failure occurred in only 5.45% cases and pre-operative symptomatic cases failure rate was as high as 35.71%. Success rate was 94.6% in cases with narrow open apices, whereas 64.28% in wide open apices. In cases with pre-existing apical radiolucencies, successful apexification occurred in 63.63% and success rate was 92.5% in the cases without pre-existing apical radiolucencies. Average time consumed for apexification was minimum with calcium hydroxide plus iodoform in polysilicone oil base. Conclusion: The overall success rate observed to be 86.27%, which is in close proximity to the findings of most of the previous studies across the globe.

Background: Research on oral health contributes to improved health outcomes; it is an indispensable tool in health policy. But how to fill the gaps in research oral health and to strengthen its capacity is the question. The main objective of the present study is to identify the current status of oral health research and potential strategies, thereby strengthening the research infrastructure and capacity. Delphi consultation, in the perspective of assisting decision-makers to identify strategies to promote better research on oral health in Africa, was initiated. Design and Methods: The panels of 30 experts were asked to complete the questionnaire with 42 items into four groups by web survey. Each indicator statement was considered to be in consensus if the expert's opinion rating was of "A or B" for more than 75% in a scale of seven categories. Quantitative analysis was made from the answers of Delphi round. Results: There was a strong consensus about three items concerning the role of oral health research, the development of research policy for oral health going through an effective governance of research institutes, migration of researchers and fund raising. Conclusion: This study shows strong many dispersal opinions by experts, but highlights the need for to improve the effectiveness of oral health research capacity strengthening activities. Africa's researchers, policy makers and partners will have to give special attention to ensuring that knowledge generated from oral health research is acted on to improve health for all.

Aims: The aim of this study was to evaluate the sealing ability of new experimental nano-ZOE-based sealer. Settings and Design: Three types of nano-ZOE-based sealer (calcined at different temperatures of 500, 600 and 700°C) with two other commercially available sealers (AH26 and micro-sized zinc oxide eugenol sealer) were used. Materials and Methods: Zinc oxide nano-particles were synthesized by a modified sol-gel method. The structure and morphology of the prepared powders were characterized using x-ray diffraction (XRD) and transmission electron microscopy (TEM) techniques. The instrumented canals of 60 single-rooted teeth were divided into five groups (n = 10), with the remaining ten used as controls. The canals were filled with gutta-percha using one of the materials mentioned above as sealer. After 3, 45 and 90 days, the samples were connected to a fluid filtration system. Statistical Analysis Used: The data were analyzed using Student's t-test. Results: The XRD patterns and TEM images revealed that all the synthesized powders had hexagonal wurtzite structures with an average particle size of about 30-60 nm at different calcination temperatures. Microleakage in AH26 groups was significantly more than that in three groups of ZnO nano-particles at all the three evaluation intervals. Apical microleakage of ZnO micro-powders was significantly more than that of all the materials, but the sealing ability of ZnO nano-powder sealers did not differ significantly. Conclusion: The results of this study showed that the synthesized ZnO nano-powder sealers are suitable for use as a nano-sealer in root canal therapy to prevent leakage; however, further studies should be carried out to verify their safety.

Background: The lactoferrin (LF) is an iron binding protein present specifically and in abundance in the secondary granules of polymorphonuclear leukocytes (PMN's). It has been suggested that LF in crevicular fluid is a useful marker of PMN activity. Hence, this study aimed to estimate the levels of LF in gingival crevicular fluid (GCF) before and after surgical therapy in chronic periodontitis patients to assess the validity of LF in monitoring of treatment results. Materials and Methods: A total of 30 patients with chronic periodontitis having probing depth of ≥5 mm who were scheduled for periodontal surgery were included in the study. The clinical parameters were recorded and GCF samples were obtained 2 weeks after scaling and root planing and 2 weeks after conventional flap technique. The samples collected were then assayed for LF using Enzyme-linked immunosorbent assay (ELISA). Results: The results showed that LF levels decreased significantly from 266.53 ± 75.86 to 195.47 ± 74.53 after scaling and root planing. There was further significant reduction in LF levels to 90.42 ± 32.89 following 2 weeks of periodontal surgery, indicating decrease in inflammation. Conclusion: There is a significant reduction in GCF LF levels following periodontal surgery. Hence, LF levels in GCF could serve as a useful marker for monitoring of periodontal treatment results.

Objective: Temperature fluctuations and material mixing times are likely to affect the consistency and integrity of the material mixture, and hence the restoration made out of it. The purpose of the present study was to determine the influence of the ambient temperature and the mixing time of glass ionomer cement (GIC) restorative material on the survival rate of proximal atraumatic restorative treatment (ART) restorations placed in primary molars. Materials and Methods: A total of 804 restorations were placed in the primary molars of 6-8-year-olds using the ART approach. The restorations were then followed for a period of 2 years and evaluated at given intervals. The data collected were analyzed using SPSS computer statistical program, and the results tested and compared using the Chi-square, Kaplan Meier survival analysis and Cox Proportional hazard statistical tests. Results: The cumulative survival rate of the restorations dropped from the initial 94.4% to 30.8% at the end of 2 years. The higher survival rate of the restorations was associated with the experienced operators and assistants when using the rubber dam isolation method. However, there was no statistically significant difference in the survival rate of the restorations when related to the room temperature and the mixing time of the GIC materials used in spite of the variations in the temperature recoded and the methods used in mixing the materials. Conclusion: The ambient temperature and mixing time of GIC did not have a significant effect on the survival of the proximal ART restorations.

Aim: The aim of this study was to compare smear layer removal at apical 1 mm level after final irrigation activation with an EndoVac system and Max-I probe. Materials and Methods: Fifty freshly extracted maxillary central incisors were randomly divided into two groups after completing cleaning and shaping with ProTaper rotary files. In one group, final irrigation was performed with an EndoVac system while in the other group final irrigation was performed with a 30 gauge Max-I probe. 3% sodium hypochlorite and 17% ethylenediaminetetracetic acid were used as final irrigants in all teeth. After instrumentation and irrigation, the teeth were sectioned longitudinally into buccal and palatal halves and viewed under a scanning electron microscope for evaluation of the smear layer. Statistical analysis was performed using the Kruskal Wallis and Mann-Whitney U tests. Results: The EndoVac group showed significantly better smear layer removal compared with the Max-I probe at the apical 1 mm level. Conclusion: An apical negative pressure system (EndoVac) results in better debridement at apical 1 mm when compared with side-vented closed ended needle irrigation (Max-I probe).

Aim: To assess the impact of dental fear on different domains of oral health-related quality of life (OHRQoL) among school going and non-school going children in the Indian scenario. Materials and Methods: The study sample consisted of 279 school children and 257 non-school going children thus making a total sample of 536 children. The sampling frame comprised of 12-15-year-old children attending two upper primary public schools and non-school going children working at shops or not working in Udaipur city, India. Information on dental fear and OHRQoL was obtained by personal interviews by a single trained and calibrated examiner through a structured questionnaire. Intercooled STATA version 9.2 was employed to perform statistical analysis. The level of significance was set at 5%. Results: Mean dental fear scores among school going (35.41 [11.79]) and non-school going (47.59 [3.80]) children revealed that dental fear was significantly (P ≤ 0.05) higher among non-school going than among school going children. In school going children, the likelihood of having poor oral symptoms, functional limitation and poorer social and emotional well being were significantly (P ≤ 0.05) lesser as compared with non-school going children. Conclusions: Fear has a significant impact on different domains of OHRQoL, except emotional well being, among non-school going children.

Objective: The objective of the following study is to evaluate freshly prepared tranexamic acid mouth wash (FTAMW) as an alternative to factor replacement therapy (FRT) in controlling gingival bleeding in hemophiliacs during dental scaling. Materials and Methods: Experimental treatment regime (ETR) involved saline transfusion followed by FTAMW and the control treatment regime (CTR) involved FRT followed by placebo mouthwash. A total of 22 hemophiliacs randomly received dental scaling under either CTR or ETR at two different visits, following a split mouth design. They were instructed to use the rendered mouthwash 4 times a day for 5 days and record the mouthwash usage and bleeding episodes in a logbook. The difference in the bleeding episodes was analyzed using Chi-square test with the level of significance predetermined at 0.05. Results: Totally 19 patients completed the study. Seven patients reported no bleeding either in ETR or CTR; five patients noticed bleeding in CTR, but not in ETR. Three patients noticed bleeding in ETR, but not in CTR. Patients reported ease in usage and cost-effectiveness of ETR. Conclusion: FTAMW was found to be an effective alternative to FRT in controlling gingival hemorrhage in hemophiliacs during dental scaling.

Context: The knowledge of the reasons for the placement of direct restorations makes possible to trace an epidemiological profile of a specific population and to direct the teaching of dentistry to techniques that are commonly used today and will be continued performed in the future. Purpose: The aim of this study was to verify the reasons for placement and replacement of direct restorations in patients treated in the Dental Clinic of the Uberaba University - Brazil. Materials and Methods: This study evaluated 306 restorative procedures carried out on 60 patients. During the treatment planning, a form that contained information about the patient's gender, tooth number, the classification of restorations, the reasons for placement and replacement of amalgam and tooth-colored restorations, the material that had to be removed and the new material used to fill the cavities was filled for each patient. Statistical analysis was carried out using Chi-square test (α = 0.05). Results: The data showed that most of the patients were female (66.7%). Of all the restorations placed, 60.45% were 1 ^st -time placements, while 39.55% were replacements. For 1 ^st -time restorations, the main reason for placement was primary caries (76.76%), followed by non-carious cervical lesions (15.14%). The amalgam restorations were replaced more frequently (67.77%). The primary reason for replacements was the presence of secondary caries (for both previous amalgam (42.68%) and composite (66.67%) restorations (P < 0.05). The resin composite was the most indicated material for the new restorations (98.04%) (P < 0.05). Conclusions: The main reason for placement of direct restorations was primary caries, while secondary caries was the main reason for replacements. In almost all cases, the material used to fill the cavities was the resin composite.

Background: Epilepsy is described as a chronic neurological disorder characterized by recurrent seizures of cerebral origin, presenting with episodes of sensory, motor or autonomic phenomenon with or, without loss of consciousness. A recent meta-analysis of published and unpublished studies puts an overall prevalence rate of epilepsy in India at 5.59 per 1,000 populations.There have been studies that report clinical benefits of the use of folic acid as an adjuvant to the anti-epileptic therapy in the prevention of anti-epileptic drug induced gingival enlargement. However, studies conducted in the past have also reported precipitation of epileptic attacks in patients on folic acid adjuvant therapy due to fall in sera levels of phenytoin due to drug interactions. The study was planned to investigate the association of phenytoin induced gingival enlargement and sera levels of folic acid in epileptic patients on phenytoin therapy so as to justify the use of folic acid as a routine adjuvant to the usual anti-epileptic therapy to prevent this inevitable adverse effect without destabilizing the ongoing regimen leading to the precipitation of seizures in an otherwise stable patient (breakthrough seizures). Materials and Methods: A total of 100 patients between the ages 18 and 50 years were clinically diagnosed with epilepsy prior to the start of phenytoin therapy were included based on selection criteria and written informed consents were obtained. Assessment of serum folic acid levels and gingival enlargement was performed prior to the start of and after 1 year of phenytoin therapy. Statistical Analysis Used: The statistical analysis was carried out using t-test and the baseline serum folate levels and the serum folate levels obtained after 1 year of phenytoin therapy were correlated with the respective grades of gingival enlargement using Pearson's coefficient formula. Results: The results of the study confirmed a significant association between low serum folate levels with increasing severity as well as an early onset of phenytoin induced gingival enlargement. Conclusions: The results of the study suggest a higher incidence of gingival enlargement with an early onset and increased severity in phenytoin treated epileptic patients with a positive correlation with falling serum folic acid levels as the duration of the therapy increases.

Background: Attempts to enhance bond strength of the sealant have been among the most important sides of dental research. Aim: The purpose of the present study was to evaluate the effect of using different rinsing angles on the micro-tensile bond strength of the sealant to the etched enamel. Settings and Design: Experimental study. Materials and Methods: Sixty first-premolars were randomly assigned to six groups based on the rinsing angle applied (15°, 30°, 45°, 60°, 75°, and 90°). Following etching and rinsing, a 4-mm height build up of sealant material was created. Bonded specimens were sectioned into sticks (1 Χ 1 mm), which were subjected to micro-tensile bond strength, testing at a cross-head speed of 0.5 mm/min. Statistical Analysis Used: The data were analyzed by Kolmogorov-Smirnov and post-hoc Tukey test. Results: The tensile bond strength in specimens rinsed at 90° were statistically higher compared to those rinsed at 15° and 30° (P < 0.05), and increasing the angle from 15° to 90° was correlated with a reduction in the number of specimens with adhesive failures. Conclusions: Rinsing the conditioned enamel surface at 90° may improve the bond strength and retention of the sealant.

Aims: The purpose of this study was to compare microbial penetration method and electrochemical technique for evaluation of the apical seal. Materials and Methods: A total of 28 teeth were prepared using the step-back technique to ISO size 40 master apical files. The specimens were randomly divided into an experimental group, two positive and two negative controls. Root canals in the experimental and negative control group were filled with gutta-percha (GP) and sealer, using lateral condensation technique. In the positive control group, canals were filled with GP without any sealer. The external surface of each tooth was coated with two layers of the nail varnish, except for the access opening and the apical foramen. In the negative control group, the teeth were completely covered with nail varnish. The apical seal was recorded with two methods, each successively used on the same teeth: An electrochemical method and a bacterial penetration method. Statistical Analysis Used: The correlation of the electro chemical readings with the results obtained from bacterial micro leakage test was evaluated by Pearson's correlation coefficient. Results: Correlation coefficient of the measurements obtained from the two evaluation methods, was 0.23 (r = 0.23), so the correlation was not statistically significant (P = 0.275). Conclusions: This study shows that several studies by different methods are necessary before evaluation of the marginal leakage.

Context: Demineralization of tooth by erosion is caused by frequent contact between the tooth surface and acids present in soft drinks. Aim: The present study objective was to evaluate the remineralization potential of casein-phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste, 1.23% acidulated phosphate fluoride (APF) gel and iron supplement on dental erosion by soft drinks in human primary and permanent enamel using atomic force microscopy (AFM). Materials and Methods: Specimens were made from extracted 15 primary and 15 permanent teeth which were randomly divided into three treatment groups: CPP-ACP paste, APF gel and iron supplement. AFM was used for baseline readings followed by demineralization and remineralization cycle. Results and Statistics: Almost all group of samples showed remineralization that is a reduction in surface roughness which was higher with CPP-ACP paste. Statistical analysis was performed using by one-way ANOVA and Mann-Whitney U-test with P < 0.05. Conclusions: It can be concluded that the application of CPP-ACP paste is effective on preventing dental erosion from soft drinks.

Objectives: The aim of this study was to assess the prevalence of oral mucosal lesions (OMLs) and dental caries and to evaluate oral health practices among institutionalized orphan-children in Sana'a city, Yemen. Subjects and Methods: A sample of 202 institutionalized male-orphan-children in the main orphanage in Sana'a city, were matched to 202 non-orphan schoolchildren. Clinical examination included assessment of OMLs based on standard international diagnostic criteria and evaluation of dental status using the Decayed/decayed, Missed/missed and Filled/filled (DMFT/dmft) index according to World Health Organization recommendations. Demographic data and oral hygiene practices were obtained by interviewing each subject using special questionnaire form. Results: Majority of children were in the 12-15 year age group. Nine types of lesions were reported among orphans; the most common lesions were fissured tongue (24.3%), herpes labialis (7.9%) and traumatic ulcers (2.5%). The occurrence of herpes labialis was found to be significantly higher in orphans than in controls (P < 0.01). The prevalence of dental caries was insignificantly lower among the orphans (84.7%) compared with the non-orphans (89.61%; P = 0.136). The mean dmft score was significantly lower in orphans than in controls (2.28 vs. 3.82; P = 0.001). Conclusions: The institutionalized children in this orphanage had a high prevalence of OMLs but low prevalence of dental caries, though they revealed poor oral hygiene practices. Effective oral health promotion strategies need to be implemented to improve the oral health and oral health practices of children living in orphanages.

Aim and Objective: The aim of the following study is to comparatively evaluate the microleakage of triclosan incorporated GIC with conventional restorative GIC. Materials and Methods: Triclosan in powder form was added to conventional GIC to formulate a concentration of 2.5%. Class five cavities were prepared in non-carious extracted molars and were respectively restored with conventional restorative GIC and triclosan incorporated GIC. Samples were kept in 10% methylene blue dye. Ground sections were obtained and were observed under a binocular microscope for dye penetration. Result: No significant difference was found in the microleakage of two groups. Conclusion: Triclosan incorporated GIC can be considered as an alternative to GIC with enhanced antibacterial property.

Juvenile Idiopathic Arthritis (JIA) is the most chronic musculoskeletal disease of pediatric population. The chronic course of disease has a great impact on oral health. Temporomandibular joint is involved in JIA causing limited mouth opening with progressive open bite, retrognathia, microgenia and bird like appearance. Joints of upper and lower extremities are also involved. Effect on upper limb function leads to difficulty with fine motor movements required for brushing and flossing. This increases incidence of caries and periodontal disease in children. The cause of JIA is still poorly understood and none of the available drugs for JIA can cure the disease. However, prognosis has improved as a result of progress in disease classification and management. The dental practitioner should be familiar with the symptoms and oral manifestations of JIA to help manage as multidisciplinary management is essential.

We present a rare case of radiopaque lesion with radiolucent rim in the right body of mandible, with history of extraction of involved tooth, which made diagnosis confusing unless pre-extraction intraoral periapical radiography radiograph was recovered, finally diagnosed as benign cementoblastoma. It was surgically managed, with no recurrence of the lesion more than 2 years of follow-up. Benign cementoblastoma is a rare, benign tumor of odontogenic ectomesenchymal origin, usually associated with roots of first mandibular molar.

Hemangiomas are developmental vascular abnormalities and more than 50% of these lesions occur in the head and neck region, with the lips, tongue, buccal mucosa, and palate most commonly involved. They are considered as hamartomas rather than true neoplasms. Here we report a case of hemangioma of the body of the tongue, discussing the diagnostic aspects and treatment modalities of such lesion and emphasizing the role of the color Doppler ultrasonography, especially in the diagnosis and treatment. Factors such as patient's age, size and site of lesion and the proximity of lesion to vital structure are paramount in the determination of the therapeutic approach and surgical excision. Even though radiotherapy, cryotherapy, laser therapy, medical treatment, injection of sclerosing substances and the selective embolization of the lingual artery seem to have some efficacy, the author conclude that surgery is the therapy of choice in the isolated vascular lesions of the body of the tongue.

Salivary gland tumors comprise of less than 3% of all tumors of the head and neck region. Pleomorphic adenoma represents 45 to 74% of all these salivary gland tumors and 65% of them occur in the parotid gland. Owing to the close proximity of this tumor to the facial nerve, there have been various techniques for surgical management of this tumor in the literature. Extracapsular dissection of pleomorphic adenoma is a conservative treatment modality which spares the handling of facial nerve. We are reporting a case of extracapsular dissection of pleomorphic adenoma in the lower pole of the superfi cial lobe of the parotid gland in a 22 year-old Indian male with a 1-year follow-up.

This case report presents an unusual swelling of the palate in a 61-year-old-male patient. Histopathologically, it revealed features of two separate adjacent lesions, a spindle cells lesion showing diffuse immune-positivity for S-100 protein and focal positivity to glial fibrillary acid protein and an osseous lesion with numerous trabaculae of bone, adipocytes and myxoid tissue confirming the diagnosis of collision tumor of benign peripheral nerve sheath tumor and osteoma. Extensive search of English literature shows no reported cases of peripheral nerve sheath tumor with osteoma. The probable histogenesis of this collision tumor is discussed in detail. The purpose of this case report is to document this rare case in the literature so as to increase the awareness of this entity.

Traumatic injuries occur commonly in children and adolescents and the prevalence of such injuries has increased over the last decade. Such injuries may result in pulpal exposure, which can endanger tooth vitality. Therefore, the treatment for such injuries should be carefully planned so as to preserve the pulp vitality. Teeth with immature roots pose a great challenge for the clinician and procedures like pulpotomy may prove effective as a treatment strategy. Such procedure may ensure continued root development and apexogenesis. Lasers have varied applications in the dental practice such as oral surgical procedures, cavity preparation, disinfection etc. This article is a case report on the use of diode laser for pulpotomy in a young permanent tooth with traumatically exposed pulp in an 8-year-old male.

Ridge splitting with bone expansion is a technique of manipulation of bone to form receptor site for implant without removing any bone from the implant site. Maxillary bone has inherent quality of flexibility which can bemolded to desire location by using series of instrument namely chisels and osteotome. This further improves quality of bone all around implant, at the crest and apex both. This article describes a report of a clinical case with management of bucco-palatal ridge defect with modified ridge splitting and expansion osteotomy technique using chisel and osteotomes in an esthetic zone.

Neurofibromas are benign tumors of peripheral nerve tissue, frequently associated with neurofibromatosis type 1. Their isolated occurrence in the maxillary antrum is rare, with only 6 cases described in the English literature to the best of our knowledge. Primary neurogenic tumors in the maxillary sinus are unusual entities. The majority of the reported cases that have dealt with neurilemmomas and isolated neurofibromas are extremely rare. Here, a case of neurofibroma of the maxillary sinus. We present the case of a 60-year-old female patient with the chief complain of growth in the upper right back region of the jaw, which was preceded by exfoliation of teeth in the same region 1 month back.

Lymphatic malformations of the head and neck, also known as lymphangiomas or cystic hygromas, are a diverse group of lesions. Lymphangiomas represent benign hamartomatous tumors of lymphatic vessels with a marked predilection for the head, neck and oral cavity. These lesions, like most of the swellings occurring in the neck, frequently pose a dilemma in diagnosis and treatment. This is a case report of a lymphatic malformation which presented as a painless mass in the lower border of mandible.

Marginal mandibular resection to treat neoplasms leads to loss of alveolar bone and teeth at the affected side. Consequently patient suffers with poor masticatory performance and esthetic disfigurement, which we need to restore with the help of prosthodontic rehabilitation. The success of rehabilitation of these patients depends on strategic treatment planning and choice of most suitable treatment modality. In this article, case of a patient has been presented who underwent marginal mandibular resection and reported with many limiting factors like obliterated buccal and lingual sulci, attachment of lingual frenum and lower lip at the level of alveolar ridge and Macroglossia. Impression making and fabrication of a retentive prosthesis were the main challenges. Therefore, a modified impression technique was used to fabricate mandibular cast partial denture with extracoronal semi precision attachments to enhance the retention of the prosthesis.

Keratinizing dentigerous cyst is a rare entity. This article reports a case of keratinizing dentigerous cyst associated with an impacted mandibular canine. Clinical and radiological features, cone-beam computed tomography findings and histological features of the case are reported along with a discussion on keratinizing odontogenic cysts and the need for follow-up.

Knowledge of root canal morphology and variations is an essential factor to successful endodontic treatment. Presence of extra roots, canals, lateral canals, deltas etc., is commonly encountered. Maxillary second molar with two palatal roots or root canals is a rare dental anatomy. The purpose of this case report is to describe the successful endodontic management of a maxillary second molar with four root canals using a single reciprocating file system. The morphology is a typical characterized by two palatal roots with widely separated two orifices and canals. The tooth presented an individual mesiobuccal, distobuccal and two separate palatal roots.

Retention, stability and support are the basic principles on which the success of a complete denture relies. The severely resorbed maxillary and mandibular edentulous arches that are narrow and constricted with increased interarch space provide decreased support, retention and stability. To decrease the leverage, reduction in the weight of the prosthesis was recommended and also found beneficial. This article describes a simple procedure to reduce the weight of maxillary complete denture by use of an autopolymerizing acrylic resin shell which is incorporated during the packing stage.This method has the advantage of being easy and requires very little additional time.Hollow maxillary complete denture considerably reduces the weight of the prosthesis, which in turn prevents transmission of detrimental forces by reducing leverage action. This results in increased retention and stability and up to some extent it also preserves the existing residual alveolar ridge. The technique uses a clear matrix of trial denture to facilitate shaping of dough spacer to ensure an even thickness of acrylic to resist deformation and prevent seepage of saliva into the cavity making this technique more predictable. An autopolymerizing acrylic resin shell which creates hollow space and also has strength. Technique is simple to execute, easy economical and matching the shade of autopolymerizing acrylic resin with heat cures acrylic resin enhances esthetics. Light weight hollow dentures provide healthy and comfortable living for the geriatric edentulous patient.

It is the responsibility of the dentist to fabricate a denture that is fully functional and perfectly esthetic. One prime oral function that has always been overlooked in this regard is speech. It has been thought that speech will follow mere replacement of teeth and that it is the patient's duty to fine tune this function with practice. Phonetics, esthetics, function and comfort form the foundation of a successful prosthodontic treatment. Accurate approximation of palatal contours of a maxillary complete denture to a patient's tongue can improve speech intelligibility, if other factors such as tooth position, occlusal plane and occlusal vertical dimension are satisfactory. Customizing palatal contours of a maxillary complete denture can be accomplished by using tissue-conditioning material, which provides sufficient working time for a patient to pronounce a series of sibilant sounds while recording dynamic impression of the tongue. This article describes a technique of obtaining palatogram and customizing palatal contours of a maxillary complete denture with autopolymerizing acrylic resin to improve the intelligibility of speech.

In our esthetic conscious society people are now demanding all types of treatments possible to have a pleasing and attractive personality. A dazzling and beautiful smile can work wonders for anyone's personality. Our smile mirrors our persona, our unique being. However, a beautiful smile comprises of a perfect balance of the white and pink. This imbalance of excessive gingival display (EGD) can be managed by a variety of treatment modalities, depending on accurate diagnosis. This case report demonstrates the successful management of EGD with a lip-repositioning procedure in a patient with incompetent short upper lip. This was accomplished by removing a partial thickness strip of mucosa from the maxillary buccal vestibule and suturing the lip mucosa to the mucogingival line. This resulted in a narrower vestibule and restricted muscle pull, thereby resulting in competent lips and reduced gingival display during smiling.