New implant designs have appeared in the literature which claim that certain modifications may be helpful for maintaining crestal bone levels and consequently preserving normal soft tissue contours. Maintenance of soft tissue has been shown to depend on preservation of bone surrounding the implant. In order to achieve this goal, each step of the treatment must be managed carefully. This requires knowledge of pre-surgical treatment planning, site development, implant positioning, soft tissue management, provisionalization and prosthetic management. Placement of a smaller diameter abutment on a large diameter implant platform (platform switching) has been proposed as an effective way to control circumferential bone loss around dental implants. The purpose of this paper is to evaluate the literature from an evidence based point of view regarding implant design modifications for preserving soft and hard tissue around implants.

Obstructive sleep apnea (OSA) is recognized as an important health issue in the last two to three decades. It is characterized by frequent episodes of upper airway collapse during sleep, causing recurrent arousals, intermittent hypoxaemia, sleep fragmentation and poor sleep quality. Obstructive sleep apnea (OSA) is a prevalent disorder with significant co-morbidities. There are evidences that OSA is being considered as an independent risk factor for hypertension, glucose intolerance / diabetes mellitus, cardiovascular diseases and stroke, leading to increased cardiometabolic morbidity and mortality. Early recognition and treatment of obstructive sleep apnea may prevent adverse health consequences. In this sense, treating the patient with obstructive sleep apnea requires a long-term partnership between patient and healthcare providers. With a strong partnership, obstructive sleep apnea may be effectively treated in the growing numbers of patients. In this article some of the epidemiological aspects, consequences, medical and dental treatment options of obstructive sleep apnea are reviewed.

Background: The inequity of oral health services persist due to inadequate dentist to patient ratio in the peripheral areas. The possibility of management of more number of patients lies within an efficient work force, in order to render oral health services in a well-organised manner. Objectives: The research was taken up with the primary objective of determining the most time efficient manpower in a peripheral dental unit. Secondary objective was to determine the time spent in each treatment procedure in proportion to total time involved in direct patient care. Third objective, was to recommend an appropriate range of sample for further similar studies using observatory methodology in peripheral centres. Methodology: Work measurement was done for the postgraduate and the undergraduate students for the treatments performed by them in the unit. Participatory observations were made on randomly selected days, and timings were recorded using standardised stop watch. Descriptive analysis was performed for the data obtained using Statistical Package for Social Science (IBM Corp. Released 2010. IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY: IBM Corp.). Results: Mean timing was found to be highest for all treatment procedures amongst graduates when compared to the postgraduates and maximum proportion of time was spent for extractions amongst all the treatments performed. Conclusion: Availability of speciality services will help the hospitals render more proficient services to the rural masses.

An altered facial appearance is more difficult to face, than problems related to ill-fitting denture or eating. The selection of maxillary anterior teeth for complete denture has long posed problem in clinical practice and a controversy about the best method to employ still exists. An attempt is made in the present study to clinically correlate the face form with maxillary central incisor tooth form in males and females of Davangere population. In 1914, Leon William's projected the “the form method” where he classified facial forms as square, tapering, and ovoid. Maxillary central incisors were selected according to the facial forms. Of total 100 subjects four different tooth forms and face forms were evaluated. They are: square, ovoid, square-tapered, tapered. No significant correlation existed between face form in male and females. Females exhibited greater correlation between face forms and inverted tooth form but that correlation is not sufficient to serve as a guide for selection of anterior teeth.

Aim: The present in vitro study aims to evaluate canal preparation comparing centering ability of ProTaper, Mtwo, Wave One, Hand Ni-Ti K-files using Computed Tomography(CT). Materials and Methods: Sixty extracted permanent teeth were selected and decoronated at 11 mm from the apical end. Samples were randomly divided into 4 groups as ProTaper, Mtwo, Wave One, Hand Ni-Ti K-files. Teeth were scanned by CT Scanner. Sectioning was started at 1 mm from the apex up to coronal orifice. Nine levels at 1 mm each were chosen for evaluation in the Computed Tomography. The canals were prepared and a post instrumentation scan was again taken. The pre and postoperative CT images were superimposed at all nine levels. The canal centering ability was calculated. Statistical data was evaluated using One Way Analysis Of Variance test. Results: Amongst the rotary and reciprocal groups the best canal centering ability at the apical third was seen with Wave one. All the three groups behaved similarly in the middle and coronal thirds of the root canal. Conclusion: Keeping in mind the importance of apical third preparation and consistent behaviour in all directions, Wave One may be considered by far the best in the apical third.

Aim: The aim of this study was to evaluate and compare the tensile bond strength of nickel-chromium alloy to dental enamel by using four different resin cements. Materials and Methods: 40 extracted central incisor teeth embedded in acrylic blocks were flattened not to expose dentin. Wax rectangular blocks of 5 mm length, 5 mm width and 1 mm height with a loop were invested and casted using Nickel-Chromium alloy by conventional induction casting method and sandblasted. Then casted rectangular blocks and 40 tooth embedded acrylic samples were divided into four groups (10 each) and cemented to tooth enamel following manufacturer's instructions as; GroupAcemented using RelyX U200, Group B cemented using Smartcem 2, Group C cemented using Multilink Speed and Group D cemented using Multilink N and then stored in artificial saliva for 24 hours. The direct pull tensile test was carried out on Universal Testing Machine at cross head speed of 0.5mm/min. Results: One way ANOVA showed a highly statistically significant (p<.01) difference between all the four resin cements. Post Hoc Tests- Multiple comparisons showed highly statistically significant (p< 0.01) difference between RelyX U200: Multilink N, Smartcem 2: Multilink Speed, Smartcem 2: Multilink N, Multilink Speed: Multilink N. Difference between RelyX U200: Smartcem 2 and RelyX U200: Multilink Speed was statistically significant(p< 0.05). Conclusion: Self etch resin cement (Multilink N) showed maximum mean tensile bond strength as compared to self-adhesive resin cements (Smartcem 2, RelyX U200 and Multilink Speed). Clinically the greatest advantage of self-adhesive cements is the easy and fast application technique. But this time saving technique is not as effective as self-etch resin luting agents. The presumed benefit of saving time with self-adhesive luting agents may only be realized at the expense of compromising bond strength.

Objective: The aim of the study was to determine the clinical outcome when polyglactin 910 membrane was used to treat 30 patients with isolated buccal millers class II gingival recessions. Materials and Method: Thirty subjects were selected with a chief complaint of hypersensitivity or denuded roots; all were willing to participate in the clinical study. Inclusion criteria were the presence of 4 mm or more of buccal millers class II gingival recession, a lack of contraindications for periodontal surgery. Results: The mean reduction in clinical recession from baseline to 6 months postoperatively was 2.47 ± 0.86 mm, i.e, 54%, which was statistically significant. There was a definite reduction in Pocket Depth, from a mean at baseline of 1.53 ± 0.63mm to a mean of 1.07 ± 0.26mm at 6 months. Conclusion: The use of GTR is a suitable alternative to the use of patient's own palatal masticatory mucosa. Polyglactin 910 as a GTR resorbable membrane gives the clinician another tool that provides acceptable root coverage.

Aim and objective: The aim of the present study was to evaluate clinical and radiographic outcome of MTA as a pulpotomy agent in permanent teeth as an alternative to conventional root canal treatment. Materials and Methods: Ten permanent teeth with symptoms of irreversible pulpitis with vital pulp were selected for the study. MTAPulpotomy procedure was done in all the cases using standard protocol. Teeth were evaluated for various clinical and radiographic parameters at 3, 6, 9 and 12 months of follow up. Results: None of the patients reported any kind of clinical discomfort or radiographic abnormality during the follow up period of 3, 6, 9 and 12 months. All the teeth responded positive on electric pulp test at all successive follow ups. Conclusions: MTA Pulpotomy may be used as an alternative treatment modality to root canal treatment in permanent teeth with irreversible pulpitis, if future research continues to show promising results.

Introduction: The great variance in soft-tissue drape of the human face complicates accurate assessment of the soft-tissue profile and it is a known fact that facial features of different ethnic groups differ significantly. This study was undertaken to establish soft tissue norms for Himachali ethnic population. Method: The sample comprised lateral cephalograms taken in natural head position of 100 normal subjects (50 males, 50 females). The cephalograms were analyzed by Arnett soft tissue cephalometric analysis for orthodontic diagnosis and treatment planning. The Student t test was used to compare the means of the 2 groups. Results: Statistically significant differences were found between Himachali males and females in certain key parameters. Males have thicker soft-tissue structures than females. Whereas females have greater interlabial gap when compared with Himachali males. When compared with other ethnic groups, Himachali subjects have thicker soft tissue structures. Conclusions: Statistically significant differences were found between Himachali males and females in certain key parameters. Differences were also noted between other ethnic groups and Himachali faces.

TMDs have a multifactorial etiology varying from bruxism, psychological illness and traumatic injuries from mastication, extreme mouth opening, or faulty dental restorations. The present case study highlights the importance of right diagnosis of the patients problem as this forms the foundation to formulate a comprehensive treatment plan which further ensures the right solution to the stated patient problem along with long term maintenance of healthy stomatognathic system. An hard occlusal splint has been indirectly fabricated on the semiadjustable articulator. Occlusal splint used in treatment of TMDs is designed to provide even and balanced Occlusal contacts without forcefully altering the mandibular rest position or permanently altering the dentition. One case of fabrication of mandibular occlusal splint and its therapeutic role is discussed in this case report. The splint successfully relieved the patient TMD signs and symptoms, when used over four months.

Aims and Objectives: Deep bite is one of the common malocclusion which has a varied of etiologies; this case report includes correction of deep bite with help of anterior bite plane. Materials and Methods: One post pubertal patient of age 15 years with proclined maxillary incisors with class II skeletal and class II molar treated with fixed orthodontic appliance with anterior bite plane. Results: It resulted in favorable skeletal and dentoalveolar changes. Midlines were coinciding, molars were in class I relationship and smile was improved. Conclusion: Using anterior bite plane corrected class II deep bite in patient, corrected lip trap and proclined maxillary incisors.

Peripheral odontogenic fIbroma (POF) is a rare odontogenic tumor. It resembles clinically with other peripheral exophytic lesions like pyogenic granuloma, peripheral ossifying fibroma, and peripheral giant cell granuloma. Hence, needs to be differentiated from such other lesions. Histopathological examination being the only diagnostic approach for peripheral odontogenic fibroma, which can provide a basis for treatment and prognosis evaluation. This case report presents a rare clinical case of a 14-year-old female patient with a palatal overgrowth along the maxillary incisors, which was diagnosed as peripheral odontogenic fibroma.

Focal cemento-osseous dysplasia is a benign fibroosseous lesion that can be seen in dentulous and edentulous patients mainly in middle aged women. Although it is asymptomatic condition associated with vital teeth and needs no treatment but symptomatic patients require surgical debridement and sequestrectomy. We present a case report of symptomatic focal cemento-osseous dysplasia which requires surgical intervention.

When all the remaining natural teeth are removed, there exists a space within the oral cavity that can be called the potential denture space. Within this denture space there is an area that has been termed the neutral zone. Neutral zone is defined as that area or position within the oral cavity where the forces between the tongue and cheeks or lips are equal. Thus making it the zone of minimal conflict, where the function of musculature will not unseat the denture and help in stabilizing the denture. In the present case the neutral zone was recorded using admix technique and impression compound as the material of choice.