Increasing surgical refinement of procedures to meet both biologic and esthetic demands of patients is seen in today's periodontal practice. For these new technologies, instruments, and surgical techniques are necessary. Technical skills of the clinician are challenged by the limit of range of visual acuity. Periodontal microsurgery improves the outcome of basic periodontal surgical procedures by enhancing normal vision through magnification along with favorable lighting system. It gives enhanced outcomes not possible with traditional macrosurgery in terms of passive wound closure and reduced tissue trauma. The purpose of this review is to provide brief knowledge of periodontal microsurgery: the role of magnification, microsurgical instrumentation and applications of microsurgery.

Botulinum toxin was first used therapeutically by a German physician Justinus Kerner (1786-1862). Trade name BOTOX was given by Allergan, Inc, Irvine, Calif for treating strabismus, blepharospasm, and hemifacial spasm. It is neurotoxin derived from an anaerobic bacteria Clostridium botulinum. The toxin inhibits the release of acetylcholine (ACH), a neurotransmitter responsible for the activation of muscle contraction and its administration results in diminution of tone in the injected muscle. It has found a variety of uses in dentistry like treatment of gummy smile, masseteric hypertrophy, bruxism, temporomandibular disorders and so on. It is a minimally invasive and cosmetically effective method of treating several conditions with excessive muscle contraction.

Objective: The aim of the study was to compare the canal transportation and centering ability of Rotary ProTaper Next, Hyflex CM and Wave One primary systems using cone beam computed tomography (CBCT) in curved root canals. Materials and Methods: Total 30 freshly extracted maxillary first molars having root canals with curvature between 10°- 20° were divided into three groups of 10 teeth each. All teeth were scanned by CBCT to determine the root canal shape before instrumentation. In Group 1, the canals were prepared with ProTaper Next files, in Group 2 with Hyflex CM files and in Group 3 with Wave One files. After preparation, post-instrumentation scan was performed. Pre-instrumentation and post-instrumentation images were obtained at 3 mm and 6 mm above the apical foramen and were compared using CBCT software. The amount of canal transportation and centering ability were assessed and statistically compared with one way analysis of variance and Tukey honestly significant test. (p<0.05). Results: All instrumentation systems used resulted in some amount of canal transportation. Data obtained suggested that Wave One files caused significantly lesser transportation and remained better centered in the canal than Hyflex CM and Rotary ProTaper Next files. Conclusion: The canal preparation with Wave One files results in lesser transportation and better centering ability than Hyflex CM and ProTaper Next rotary files in curved root canals.

Background: Along with conventional periodontal surgical therapy, local delivery of antibiotics may provide more effective treatment in smokers by targeting tissue-invasive bacteria. The aim of this randomized, clinical trial was to evaluate the adjunctive effects of subgingivally delivered 0.5% azithromycin (AZM) as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis in smokers versus non smokers. Methods: 38 sites in patients of chronic periodontitis were randomized and categorized into two treatment groups: Group 1 consisted of 19 sites in patients who were smokers and Group 2 consisted of 19 sites in non smokers, who received Scaling and Root Planing (SRP) plus 0.5% azithromycin gel Local drug delivery. Clinical parameters were recorded at baseline, 1 and 2 months. They included probing depth (PD) and clinical attachment level (CAL) and percentage bone fill. Results: Azithromycin resulted in significant improvements in both the groups. Mean decrease in PD in non smokers by the end of 2 months was 3.903mm and in smokers was 3.917mm. Gain in CAL in non smokers by the end of 2 months was 3.879mm and in smokers it was 3.920mm. Mean bone fill at one month for smokers was 15.86% and was 26.58% at 2 months. In non-smokers the mean bone fill was 17.19% at 1 month and 24.03% at 2 months. Conclusions: When compared to the non smokers, the adjunctive use of 0.5% AZM resulted in similar improvement in clinical outcome in the treatment of chronic periodontitis among smokers. Local drug delivery of Azithromycin gel contributed to decrease in probing pocket depth, gain in clinical attachment level and in alveolar bone. The apparent bone regeneration also raises the intriguing possibility that Azithromycin encourages bone formation once tissue inflammation has subsided.

Background: There is a strong genetic influence in determination of tooth dimensions bearing an influence on the facial dimension. Aims and Objective: To determine a correlation between clinical crown height of upper and lower permanent incisor (11 and 41), molar (16 and 46) and lower facial height clinically and cephalometrically in males and females. Materials & Methods: A sample of 180 patients were (90 males and 90 females) included in our study,(60-hypodivergent, 60-normodivrgent and 60-hyperdivergent) with an age range of 17-25 years. Threeanthropometric measurements were considered. The lower facial height from subnasale(Sn) to menton, and cephalometric lower facial height distance from anterior nasal spine(ANS) to menton and the clinical crown height of maxillary and mandibular incisors and molars were measured. Observations: Significant difference was observed in relation to 16 in normodivergent patient and lower facial height clinically and cephalometrically in hyperdivergent growth patient. No significant difference between clinical&cephalometric lower facial height in normodivergent, hypodivergent and hyperdivergent male and female patient. Significant difference was observed between 41 to lower facial height in hypodivergent & 11,41 &46 to lower facial height in hyperdivergent patient. Conclusion: A strong significant correlation was observed with clinical crown height of lower central incisor and lower facial height in hyperdivergent and hypodivergent patient.

Aim: To evaluate the protective potential of calcium sucrose phosphate and novamin containing toothpaste on enamel surface. Settings and Design: In vitro-study. Materials and Methods: This study consisted of 30 samples embedded in orthodontic resin with either buccal or lingual surface exposed. The samples were assigned to either calcium sucrose phosphate containing paste; novamine toothpaste; or control group. The groups were then subjected to cycling in a demineralizing solution and a remineralizing solution. Groups II and III received prior application of calcium sucrose phosphate paste and novamine toothpaste respectively followed by cycling in a demineralizing solution and a remineralizing solution. Following 14 days of cycling, the samples were sectioned and examined using confocal microscopy. The depths of lesions were evaluated. Statistical Analysis: Image Proplus software was used to analyze the images. The values were statistically evaluated using one – way ANOVA and Scheffe's Test. Results and Conclusion: Within the limitations of study it was concluded that enamel surfaces treated with calcium sucrose phosphate paste exhibited the least lesion depths followed by enamel surfaces treated with the novamin tooth paste and control group respectively.

Aim: This study was designed to assessthe prevalence of various oral habits among 3-6 years old school childrenin Chandigarh Method: Fifteen different public schools were randomly selected among 45 public schools in Chandigarh area from where 938 children (3-6 yr) were randomly selected (511 boys and 427 girls) with the objectives of recording the prevalence of oral habits. Statistical analysis was carried out using SPSS 10.0 software and the statistical significance of oral habits as related to age groups and sex were calculated by using ANOVA test. Results: The overall prevalence of oral habits in children was 11.7%. Nail biting was the commonest habit (5.5%) followed by thumb sucking (4.05%), tongue thrusting (1.8%), mouth breathing(0.3%) and lip biting(0%). Also, there were no significant differences between boys and girls with respect to prevalence of oral habits. However, a significant difference was observed between different age groups with respect to the prevalence of oral habits. Conclusions: The data revealed that a significant percentage of the children had deleterious oral habits which can contribute towards the development of malocclusion. This helps in identifying children who are in need to intercept the oral habits at earliest to avoid future occurrence of malocclusion.

Congenital hypothyroidism (CHT) is one of the most common thyroid disorders. It occurs because of dysgenesis of thyroid gland which is responsible for the normal development of neural system. Child patient suffering from congenital hypothyroidism shows various medical and behavioral symptoms which makes routine dental care very challenging to the pediatric dentist. Due to increased awareness and introduction of neonatal screening, the long term hypothyroidism has become rare. The most significant oral conditions related to these patients are delayed eruption and dental caries. The present case report outlines the dental treatment of a 9yr old girl with congenital hypothyroidism.

In the current practice of periodontics, clinicians are faced with the challenge of not only addressing biological and functional problems present in the periodontium, but also providing therapy that results in acceptable aesthetics. The presence of mucogingival problems and gingival recession around anterior, highly visible teeth exemplifies a situation in which a treatment modality that addresses both biological and aesthetic demands is required from the therapist. Periodontal plastic surgery procedures are performed to resolve these mucogingival problems. This paper presents two cases of gingival recession (Miller's class I and class II) successfully treated with complete root coverage by free gingival autografts.

Lymphoepithelioma-like carcinoma (LELC), a rare tumor in oral cavity is characterized by non-keratinizing, undifferentiated squamous cell carcinoma with lymphocytic infiltration bearing microscopic resemblance to lymphoepithelioma (nasopharyngeal carcinoma). A 45 year old female presented clinically with an unusual maxillary swelling and pain in right upper posterior jaw with intermittent serous like discharge from the nose. A diagnosis of rare case of intraoral LELC was made.