The effects of chronic local irritation have been seen commonly in the form of fibroma or mucocele in children. We report a nine year old girl with the chief complaint of multiple swellings in the lower lip which was diagnosed both clinically and histologically as fibroma and mucocele. Surgical excision was done under local anesthesia with no post-operative complications. To our knowledge there was no other occurrence, either at the same site or at different locations, involving these two lesions in the oral mucosa.

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Free-end saddles are liable to be displaced under occlusal pressure. This is as a result of the displaceability of the mucosa. The altered cast technique is employed to try and prevent this by making an impression of the mucosa under controlled pressure. The metal framework was constructed on a cast produced by a mucostatic impression material. Base plates were then constructed in self-cured acrylics on the framework in the saddle areas, and these are close fitting. Border molding was carried out; impression was made with zinc oxide eugenol impression paste. In the laboratory, the free-end saddle areas on the master cast are sectioned off. The denture is then positioned on the model and the new saddle areas are poured. The resulting model represents the free-end saddle areas under conditions, which mimic functional load. Denture construction then continues as normal. The distribution of loading of the free-end saddles is improved and denture is more stable.

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The dilemma confronting many dentists today is that innovations and well-defined specializations have greatly enlarged the treatment realm for tooth preservation as well as tooth replacement. The objectives should be preservation of the remaining tooth structure, restoration of optimum function, esthetics with least invasive procedures, cost effective, and short treatment time. The number of remaining natural teeth is one of the most widely used method for evaluating oral health and the prosthetic treatment of patients with a mutilated dentition. Though the treatment of these patients can be complex, but there are some important principles applicable in most cases. This case report demonstrates a satisfying full mouth rehabilitation using the Hobo and Takayama twin-stage procedure for a patient with esthetically and functionally compromised dentition. The final prosthesis with this twin-stage technique ensured a restoration with a predictable posterior disclusion and anterior guidance in harmony with the condylar path.

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Agenesis of teeth in a patient who also presents with a supernumerary tooth is one of the rare numerical anomalies in human dentition. Agenesis of third molars was shown to be associated with other missing permanent teeth. A review of literature on hypodontia including third molar agenesis, hyperdontia and a concomitant presence of these two conditions which is termed as hypohyperdontia is presented along with a case showing agenesis of three third molars, both mandibular central incisors and a midline supernumerary tooth.

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Pyogenic granulomas and hemangiomas of oral cavity are well-known benign lesions. Although pyogenic granuloma is known to show a striking predilection for the gingiva and capillary hemangioma for lips, check, and tongue, palatal occurrence of these lesions is extremely rare. The clinical diagnosis of such an uncommon occurrence can be quite challenging as they sometimes may mimic more serious lesions such as malignancies. The purpose of this article is to report an unusual case of benign tumor occurring on hard palate which was clinically diagnosed as pyogenic granuloma and histopathologically as capillary hemangioma.

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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.

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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.

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Nasopharyngeal obstruction by adenoid enlargement is one of the main causes of mouth breathing. Cephalometric radiographs and rhinomanometric tests to evaluate nasal obstruction have been available for several decades. Various lines and areas have been interpreted by number of investigators to implicate the enlarged adenoid in a casual relationship with mouth breathing and the subsequent effect on vertical facial growth. The aim of this paper is to review lateral cephalometric tracing methods combined with newer Auto-cad surface area measurement program so that assessment of the nasopharyngeal free airway space can be done based on it, before more rigorous ear-nose-throat follow up is needed for the patient.

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Odontomas are the most common odontogenic tumors. They are usually asymptomatic and are often discovered during routine radiography. Eruption of an odontome into the oral cavity is rare. Odontomas are the most common odontogenic tumors. They are usually asymptomatic and are often discovered during routine radiography. Eruption of an odontome into the oral cavity is rare. We report an unusual case of erupting compound composite odontoma. we report an unusual case of erupting compound composite odontoma.

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Although odontogenic keratocysts (OKCs) are benign, they are often locally destructive and tend to recur after conservative surgical treatment. They must therefore be distinguished from other cysts of the jaw. Keratocysts possess outpouchings and microscopic daughter cysts from which recurrences may arise. Histologic examination is essential for diagnosis since the appearances on roentgenograms and at operation usually do not reveal the true nature of the lesion. Since many non-dental surgeons and pathologists are unaware of OKCs, a case is presented in which surgical treatment was by original conservative method. Decompression causes a reduction in the cyst volume with new bone formation so that the structures impinged upon (e.g., teeth, nerves) are completely free.

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The objectives of this study were (1) to evaluate clinically and radiographically the effects of mineral trioxide aggregate (MTA) as a pulp dressing after coronal pulp amputation (pulpotomy) in primary molars, (2) to compare the effects of MTA and formocresol in pulpotomized primary teeth. Sixty primary mandibular molars of thirty healthy children aged between 5-8 years were treated by conventional pulpotomy technique. The teeth on the right side are assigned to MTA (Group A) and the left side for the Formocresol (Group B). The children were examined clinically and radiographically every 6 months over a period of 36 months. Results of present study revealed that both MTA and Formocresol has the same effect on the first as well as second primary molars, with chi-square value being 1.1483 (P ≥ 0.05). None of the teeth in either group showed any clinical pathology, showing 100% success rate but radiographically formocresol group showed one case of internal resorption that was regarded as failure in the present study. MTA seems to be more promising predictable with positive response in vital pulp therapy in future than formocresol pulpotomy except for the cost factor.

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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.

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Pigmented lesions are commonly found in the oral cavity. Pigmentation has a multifactorial etiology. Most of the oral pigmentations are physiologic but sometimes it can be a precursor of severe diseases. Evaluation of a patient presented with a pigmented lesion should include a full medical and dental history, extraoral and intraoral examinations and even in some cases biopsy and laboratory investigations are required. In this article, we report a case of extensive physiologic pigmentation on the tongue in a 32-year-old female patient, posing a diagnostic challenge.

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Pulp stones are relatively frequent finding on bitewings and periapical radiograph, but their occurrence in the entire dentition is unusual. Such an unusual occurrence of generalized pulp stone was reported in a 13-year-old girl. The dental, medical and family histories as well as the findings from the clinical examination of the patient were not contributory. Biochemical analysis of the removed pulp calcification from one of the teeth during endodontic treatment showed large amount of calcium, phosphorus, and carbonate. However, metabolic evaluation of patient through liver function test, kidney function test , and blood investigation did not show any metabolic disorders. Patient was also evaluated for any systemic, syndromic or genetic involvement, but this was also non-contributing. Therefore, it is suggested that this unusual cases may be of idiopathic origin.

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The aim of the randomized controlled single blind study is to evaluate the treatment of Miller's class II gingival recessions by coronally positioned flap (CPF) with or without acellular dermal matrix allograft (ADMA). Ten patients with 20 sites with maxillary bilateral Miller's class II facial recession defects were selected randomly into two groups of test (ADMA+CPF) and control (CPF alone) group with each group having 10 recession defects to be treated. The clinical parameters included plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), recession height (RH), recession width (RW), height of the keratinized tissue (HKT), and thickness of the keratinized tissue (TKT). These measurements were recorded at baseline and after 6 months post-surgery. Statistical analysis was made by the paired "t" test for intragroup and intergroup comparison was done by the unpaired "t" test. The percentage of root coverage for both the experimental and control groups were 82.2% and 50%, respectively. The changes from baseline to 6 months were significant in both the groups for PD, CAL, and RH; however, for parameters such as RW, HKT, and TKT significance was seen only in the experimental group. On comparison between two groups, only TKT showed statistically significance. It can be concluded that the amount of root coverage obtained with ADMA + CPF was superior compared to CPF alone.

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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.

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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.

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Hypoplasia is the result of disruption in the process of enamel matrix formation, which in turn causes defect in quality and thickness of enamel. Four cases of Turner's hypoplastic teeth with a previous history of trauma/infection in their primary predecessors at the age of 2-3 years have been reported. These hypoplastic teeth had turned non-vital without any carious insult, cavitation or further trauma. This article thereby stresses the importance of early detection of enamel hypoplasia and proper management at the earliest possible stage to enable an efficient prevention from clinically non-evident microbial invasion in the dentinal tubules and concomitant pulp pathosis.

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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.

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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.

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Intraoral fibrous overgrowths of the soft tissues are relatively common and may be benign reactive or neoplastic lesions. A series of 10 lesions is presented which included pyogenic granuloma, fibroma and peripheral ossifying fibroma. Almost all the lesions occurred in the second and third decades and were present in the anterior segment of the jaws, with a distinct female predilection. Majority of these lesions were asymptomatic and the patients reported for treatment only due to the discomfort during function. Histopathologic examinations were done for diagnosis of these lesions. Surgical excision along with removal of causative irritants remains the treatment of choice. The extent of excision should depend on the severity of the lesion, as some of these lesions have a tendency for recurrence. All the patients in this series were closely followed up for a period of 2 years and showed no signs of recurrence.

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Mandibular fractures are relatively less frequent in children when compared to adults, which may be due to the child's protected anatomic features and infrequent exposure of children to alcohol related traffic accidents. Treatment principles of mandibular fractures differ from that of adults due to concerns regarding mandibular growth and development of dentition. A case of a 4.5-year-old boy with fractured body of mandible managed by closed reduction using open occlusal acrylic splint and circum mandibular wiring is presented. This article also provides a review of literature regarding the management of mandibular body fracture in young children.

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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.

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Myiasis is a relatively rare condition arising from the invasion of body tissues or cavities of living animals or humans by maggots or larvae of certain species of flies. It is an uncommon clinical condition, being more frequent in underdeveloped countries and hot climate regions, and is associated with poor hygiene, suppurative oral lesions; alcoholism and senility. Its diagnosis is made basically by the presence of larvae. The present article reports a case of oral myiasis involving 20 larvae in a patient with neurological deficiency.

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