Esthetics has been an ever-evolving concept and has gained considerable importance in the field of orthodontics in the last few decades. The re-emergence of the soft tissue paradigm has further catapulted the interest of the orthodontist. So much so that achieving a harmonious profile and an esthetically pleasing smile has become the ideal goal of treatment and is no longer secondary to achieving a functional dental occlusion and/or a rigid adherence to skeletal and dental norms. Esthetics in the orthodontic sense can be divided into three categories: macroesthetics, miniesthetics, and microesthetics. Macroesthetics includes the evaluation of the face and involves frontal assessment and profile analysis. The frontal assessment involves assessment of facial proportions, while the profile analysis involves evaluation of anterior–posterior position of jaws, mandibular plane, and incisor prominence and lip posture. Miniesthetics involves study of the smile framework involving the vertical tooth–lip relationship, smile type, transverse dimensions of smile, smile arc, and midline. Microesthetics involves the assessment of tooth proportions, height-width relationships, connectors and embrasures, gingival contours and heights, and tooth shade and color. The harmony between these factors enables an orthodontist to achieve the idealized esthetic result and hence these parameters deserve due consideration. The importance placed on a pleasing profile cannot be undermined and the orthodontist should aim for a harmonious facial profile over rigid adherence to standard average cephalometric norms. This article aims to give an overview of the macro, mini, and microesthetic considerations in relation to orthodontic diagnosis and treatment planning.

The conventional crestal implants are used only when there is adequate jawbone height and width. Results of conventional implants are good in patients with healthy bone at the time of treatment, but prognosis gets deteriorated when surgical augmentation of bone is included with implant placement. These augmentation procedures have surgical risks and are costlier to the patients. Patients with atrophied jawbones are given no treatment, until crestal implants are seen as the last option. In this article, the indications for basal implants and functional differences between basal implants and crestal implants have been discussed. Patients with extreme jawbone atrophy do not benefit from crestal implants. The basal bone is the (cortical) osseous tissue of the mandible and maxilla, and lies below the alveolar process, which has a relatively strong and no resorbing framework. Basal osseointegrated and basal cortical screw (BCS) are two types of implants designed to take anchorage from the cortical bone of the jaw. BCS implants have long shafts and can be placed immediately in the socket after extraction and provided with immediate loading within 72 hours of implant placement. Basal implants are also called bicortical or cortical implants as they utilize the cortical portion of the jawbones for anchorage and implant stability. The basal bone has better quality and quantity of cortical bone for retention of these unique and highly advanced implants. The other names for these implants are lateral implants or disk implants.

Introduction Insufficient seal of apex is a significant reason for an endodontist's disappointment. The materials for root-end filling utilized ought to forestall departure of possible pollutants into periapical areas. The objective of this analysis was to compare the fixing capacity of three materials: white mineral trioxide aggregate (MTA), white Portland cement (PC), and Biodentine. This was analyzed through a test checking for dye leakage. Materials and Methods Thirty human teeth having one root were subjected to instrumentation followed by gutta-percha obturation. An apical pit was readied for the material. The tooth samples were then grouped into three trial bunches: Group I, Biodentine; Group II, white MTA; and Group III, white PC. Root-end pits in the test bunches were loaded-up with the exploratory materials. The tooth samples were kept in India ink for a duration of 72 hours. The degree of color infiltration was estimated with the help of a stereomicroscope at 16× amplification. Color entrance was observed in the whole root in vitro. Results The sequelae of this inspection found that Biodentine shows least leakage compared to MTA and PC. Conclusion Biodentine shows less microleakage compared to MTA and PC.

Aim The purpose of this study was to compare and evaluate the flexural strength and modulus of elasticity of three adhesive luting cements as a function of specimen age, effect of storage media, and effect of curing through porcelain. Materials and Methods Twenty samples fabricated for self-cure resin-modified glass ionomer cement (GIC; RelyX Luting 2, 3M ESPE, United States) were classified as group 1, whereas 40 samples fabricated for two dual-cure resin cements (20 samples each), Universal Resin Cement (Ammdent, Italy) and Maxcem Elite (Kerr Australia Pty. Ltd.), were classified as groups 2 and 3, respectively. The dual-cure cements were photo-activated using light cure unit with an intensity of 550 mW/cm² in nine overlapping sections for 20 seconds per section on both sides. A total of 60 samples (20 samples in each group) were fabricated and tested using universal testing machine to compare flexural strength and modulus of elasticity of resin-modified GIC with two dual-cure adhesive resin cements, to determine the influence of storage of the specimens in artificial saliva at 37°C for 24 hours and to determine the influence of curing through porcelain disk of 2 mm thickness on these properties. Results The overall mean flexural strength and modulus of elasticity of resin-modified GIC was less than the dual-cure resin cements. The values reduced for resin-modified GIC when the samples were tested after 24 hours of storage in saliva, whereas an increase in the strength was seen for dual-cure cements. The curing through porcelain disk reduced the properties of dual-cure cements. Maxcem Elite showed better overall mean flexural strength and modulus of elasticity in all the parameters. Conclusion When comparing all three cements, both dual-cure cements showed better flexural strength and modulus of elasticity compared to resin-modified GIC, which indicates their use in cementation of fixed restorations.

Aim The aim of this study is to asses the influence of sociodemographic factors and behavioral habits on the periodontal disease status of the population in a selected region. Methodology Data were collected using a self-structured questionnaire and clinical examination. Various sociodemographic variables such as gender, age, and socioeconomic status and behavioral habits, such as tobacco usage and oral hygiene practices, were factored into the questionnaire. Factors determining the socioeconomic status were education, work profile, and salary. The data were analyzed using Statistical Package for Social Sciences (SPSS 21, IBM Corp, 2015 Virginia, United States). Results The total prevalence of periodontal disease was 94.6%, out of which 90% had gingivitis and 4.6% had periodontitis. Only 5.4% of the population was healthy. In the present study, sociodemographic factors such as socioeconomic status, age, and gender were found to have a positive correlation with the periodontal disease status. Conclusion Since the treatment of periodontal disease is not simple and is expensive, it needs early intervention for its prevention.

Aim This article evaluates the effect of incorporating different concentrations of silver nanoparticles as an antimicrobial agent on the flexural and impact strength of heat-cured denture base resin. Material and Methods A total of 80 specimens of polymethyl methacrylate resin were fabricated (40 for flexural strength and 40 for impact strength). Specimens were fabricated using stainless steel die of dimension 65 mm × 10 mm × 2.5 mm as per the American Dental Association specification no. 12, and 50 mm × 6 mm × 4 mm as per ISO 1567:1999 for flexural strength and impact strength, respectively, and were divided into four groups (A, B, C, and D) based on the concentrations of silver nanoparticles (0%, 2.5%, 5%, and 10%). The specimens were subjected to three-point bending test and Izod impact tester for testing flexural and impact strength, respectively. Data obtained was compiled and analyzed using one-way analysis of variance and post hoc tests. Results Results showed that for both the properties, maximum strength was observed in group A (control) followed by groups B and C, and minimum was observed in group D. A statistically significant difference in flexural strength was found among all the groups, whereas no statistically significant difference in impact strength was found among any of the groups. Conclusion Within the limitations of this in vitro study, it was concluded that though incorporation of silver nanoparticles exhibited no effect on the impact strength of heat cure denture base resin, it decreased the flexural strength, so it should be used cautiously.

Aim The aim of this study was to evaluate the distribution of stresses in osseointegrated crestal and basal implant in zygomatic region of maxilla and to identify the preferable implant option for better stress distribution. Material and Method The present in vitro study was performed to evaluate stress patterns in bone around basal and crestal dental implant under axial and oblique loading in maxillary zygomatic region with the help of a finite element analysis (FEA). To conduct this study, the following materials were used: computer software ANSYS, basal implants with dimensions 3.7 × 10 mm, and crestal implants with dimensions 3.7 x 10 mm. The amount of load transferred on the bone adjacent to the implant in an axial and transverse load of 100 N at 0 and 45 degrees, respectively, was placed on both types of implants. A three-dimensional (3D) scanner was use to generate 3D simulated model of basal and crestal implants. FEA modelling was generated that replicated the zygomatico maxillary region with special emphasis on bone architecture, bone density, angulation, width, and length of implant prototype. Further, material properties were defined for cortical bone, dense trabecular bone, low density trabecular bone, and titanium on the basis of Young's modulus of elasticity. Results These values were used by FEA software (ANSYS) to generate a 3D mesh model of bone and implant. Finally, Von Mises (equivalent stress) (MPa) values on the implant were computed using FEA software. The values of maximum Von Mises equivalent stress on the implant collars, body, apex, and bony interface were obtained. Conclusion Maximum stresses were seen at the cortical bone with basal implant placed inside the bone. Stresses that are transferred more to the bone through implant promote bone remineralization. Maximum Von Mises stresses were observed on basal implant body. Thus, these greater stresses have the capacity to simulate mineralization in the cortical bone; this makes basal implant a suitable option for placement inside the cortical bone.

Introduction Sagittal skeletal discrepancies are frequently assessed by Wits appraisal and point A–Nasion–point B (ANB) angle. These angular and linear measurements depend upon various factors and sometime produced inaccurate results. Beta angle has been introduced recently and possesses significant advantage over ANB and Wits appraisal, because it is independent of cranial landmarks and dental occlusion. Aim To evaluate and correlate beta angle in various skeletal malocclusions and its correlation with Wits appraisal and ANB angle. Material and Methods The present study was carried out in Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, India. A total of 63 pretreatment lateral cephalograms (23 skeletal class I, 20 skeletal class II, and 20 skeletal class III) of patients aged between 14 to 25 years were included. Various landmarks and planes were identified and marked. Values of Wits appraisal, ANB angle, and beta angle were recorded. Comparisons of group were made with the chi-square test. Spearman correlation coefficient was calculated to see relation between different values. Results Values of correlation coefficient of beta angle with Wits appraisal and ANB angle were –0.645 and –0.815, respectively. Conclusion Overall beta angle showed strong correlation with Wits appraisal and ANB angle, however correlation of beta angle with Wits appraisal and ANB angle among various skeletal malocclusion groups (skeletal class I, II, and III) was not statistically significant.

Traumatic injuries to maxillary anterior teeth while playing are common in children and adolescents. Sequelae of such trauma include broken, lost, aspirated, and swallowed tooth. At times, the broken tooth fragments get embedded in the adjoining soft tissue and frequently get neglected during diagnosis. The present case report discusses the case of a 13-year-old adolescent who had broken tooth fragment emerged in the lower lip and its surgical excision to prevent detrimental reactions and scarring.

Alteration in conventional techniques in anterior maxilla is essential for making a restoration look more natural and harmonious with the rest of the mouth, as this area is more prone to aesthetic failure. The visibility of anterior crowns is obviously more, making it necessary for a restoration to blend with the natural dentition. This makes a person's smile more pleasant and aesthetic. Proper risk assessment must be considered while placing implants in anterior maxillary region as any deficiency in bone and soft tissue could compromise the aesthetics as well as overall success of a dental implant restoration. Timing of implant placement also plays a crucial role in providing aesthetic success in this region. This article presents a case where implant placement is done, enhancing the aesthetics as well as function in the anterior maxillary region.