Dental Research Journal
Volume:10 Issue: 1, Jan 2013

Rapidly evolving implantation and alveolar ridge reconstruction techniques created a new area in modern dentistry where tooth loss is no longer a problem. Endless variations of implant’s length, diameter, surface, and design along with autogenous, alogenous, aloplastic, or xenogenous bone substitutes made it possible to recreate physiological occlusion, esthetic and masticatory function. However, none of nowadays technologies in implant dentistry have the potential to adapt to a growth and development changes of a child’s jaw. Therefore, patient’s young age is a restriction for implantation and a particular challenge for a dentist willing to restore missing tooth. Thus, tooth auto-transplantation can be a good choice for treatment. The objective of this review is to underline the biologic principles required for successful auto-transplantation of teeth. Limits, indications, technique, and prognosis will be analyzed.

Providing an esthetic restoration in the anterior region of the mouth has been the basis of peri-implant esthetics. To achieve optimal esthetics, in implant supported restorations, various patient and tooth related factors have to be taken into consideration. Peri-implant plastic surgery has been adopted to improve the soft tissue and hard tissue profi les, during and after implant placement. The various factors and the procedures related to enhancement of peri-implant esthetics have been discussed in this review article.

Cross- sectional tomograms have been used for optimal pre-operative planning of dental implant placement. The aim of the present study was to assess the accuracy of Cone Beam Computed Tomography (CBCT) measurements of specifi c distances around the mandibular canal by comparing them to those obtained from Multi-Slice Computed Tomography (MSCT) images. Ten hemi-mandible specimens were examined using CBCT and MSCT. Before imaging, wires were placed at 7 locations between the anterior margin of the third molar and the anterior margin of the second premolar as reference points. Following distances were measured by two observers on each cross-sectional CBCT and MSCT image: Mandibular Width (W), Length (L), Upper Distance (UD), Lower Distance (LD), Buccal Distance (BD), and Lingual Distance (LID). The obtained data were evaluated using SPSS software, applying paired t-test and intra-class correlation coeffi cient (ICC). There was a signifi cant difference between the values obtained by MSCT and CBCT measurement for all areas such as H, W, UD, LD, BD, and LID, (P < 0.001), with a difference less than 1 mm. The ICC for all distances by both techniques, measured by a single observer with a one week interval and between 2 observers was 99% and 98%, respectively. Comparing the obtained data of both techniques indicates that the difference between two techniques is 2.17% relative to MSCT. The results of this study showed that there is signifi cant difference between measurements obtained by CBCT and MSCT. However, the difference is not clinically signifi cant.

Poor literacy can impede one’s ability not only to seek out needed health information but also to process, understand and use it to make appropriate health care decisions. The objective of the study was to assess the health literacy among adult patients seeking oral health care at in a private dental hospital in Bangalore, Karnataka, India. A cross sectional questionnaire survey was carried out on 500 subjects. The questionnaire designed by Chew and colleagues (2004) was modifi ed and used as the survey instrument. To be eligible to participate in the study, the participants had to be aged above 18 years and able to read or write English/Kannada (local language). Analysis of variance (ANOVA) and Student’s t-test (two tailed, independent) was used to fi nd the signifi cance of study parameters at 95% confi dence interval. About 60.4% of the subjects had low health literacy level, 29.4% average and only 10.2% had high health literacy levels. Age and educational qualifi cation had a suggestive signifi cant difference with the mean health literacy scores while gender did not have any signifi cant difference. Subjects who had completed post-graduation (57.8%) too had low health literacy levels. A large number of patients have low levels of health literacy that may interfere with their ability to process and understand basic health information.

Routine use of gloves, masks and spectacles are important in infection control. Aim of this study was to assess the knowledge and attitudes of infection control measures among the patients attending clinics of Riyadh Colleges of Dentistry and Pharmacy (RCsDP) in Saudi Arabia. It was a cross-sectional descriptive study of a convenient sample of dental patients attending dental clinics of RCsDP. A structured, close ended, self-administered questionnaire was distributed to 350 patients and a response rate of 86% was obtained. Questionnaire consisted of series of queries related to knowledge and attitudes of patients towards infection control measures. Data analysis included frequency distribution tables, Mann-Whitney and Kruskal-Wallis tests. Level of signifi cance was set at P < 0.05. Final study sample included 301 patients (147 males and 154 females). Almost 99%, 93.7% and 82.7% of the patients agreed that dentist should wear gloves, face mask and spectacles while providing treatment. However, 60.1%, 30% of the patients said that HIV and hepatitis-B infections can spread in dental clinics. Half of the patients felt that they were likely to contract AIDS and 77.7% refused to attend clinics if they knew that AIDS and Hepatitis-B patients treated there. Only 25.2% said that autoclave is the best method of sterilization. A signifi cantly higher knowledge of infection control was observed among the previous dental visitors compared to the fi rst time visitors to the dental clinics (P < 0.05). Patients revealed adequate knowledge towards the use of gloves, face mask and spectacles by dentist. However, their knowledge regarding the spread of Hepatitis-B, HIV infection and use of autoclave was poor. Previous visitor of dental clinics showed higher knowledge of infection control as compared to the fi rst time visitors. Many patients expressed their negative attitudes towards dental care due to AIDS and Hepatitis-B concerns.

Pericoronal tissue is the soft tissue located between the bony crypt and the impacted tooth, which is histologically composed of fi brous connective tissue and is usually lined by the reduced enamel epithelium. Increased epithelial cell proliferation in the pericoronal tissue is associated with pathological changes such as development of an odontogenic cyst or an epithelial odontogenic tumor. This study is an attempt to evaluate and compare the proliferative index in the epithelium surrounding the impacted third molar teeth, dentigerous cysts, and gingiva. A case control study on pericoronal tissues and dentigerous cysts was carried out using immunomarkers. Forty pericoronal tissues were obtained from asymptomatic impacted third molars, with pericoronal radiolucency less than 2.5 mm. Samples of 20 dentigerous cysts and normal gingiva were also included. Routine hematoxylin and eosin and immunostaining for Ki-67, a cell proliferation marker and Bcl-2, an anti apoptotic protein were performed on sections of pericoronal tissues, dentigerous cysts, and gingival tissues. The percentage of Ki-67-positive cells and Bcl-2 positive areas was found using the DigiPro™ version 4.0 Image analysis software. cl-2 immunopositivity and Ki-67-Li were analyzed using the Chi-square test and paired t-test. P- values of less than. 05 were considered to indicate statistical signifi cance. The immunohistochemical analysis revealed overexpression of Bcl-2 in the pericoronal tissues with squamous metaplasia, which was comparable to the dentigerous cyst. Ki-67 Li of the pericoronal tissue with squamous metaplasia was equal to the proliferative index of the dentigerous cyst. The expression of Ki-67 Li and infl ammatory cells were highly signifi cant (P < 0.0001). The results of this study indicate that the pericoronal tissues of asymptomatic impacted third molars may be actively proliferating and normal pericoronal radiolucency cannot serve as an indicator for the differentiation potential.

The aim of this clinical trial study was to clinically evaluate the use of enamel matrix protein derivative combined with the coronally positioned fl ap to treat gingival recession compared to the subepithelial connective tissue graft by a new method to obtain denuded root surface area. Thirteen patients, each with two or more similar bilateral Miller class I or II gingival recession (40 recessions) were randomly assigned to the test (enamel matrix protein derivative + coronally positioned fl ap) or control group (subepithelial connective tissue graft). Recession depth, width, probing depth, keratinized gingival, and plaque index were recorded at baseline and at one, three, and six months after treatment. A stent was used to measure the denuded root surface area at each examination session. Results were analyzed using Kolmogorov-Smirnov, Wilcoxon, Friedman, paired-sample t test. The average percentages of root coverage for control and test groups were 63.3% and 55%, respectively. Both groups showed signifi cant keratinized gingival increase (P < 0.05). Recession depth decreased signifi cantly in both groups. Root surface area was improved signifi cantly from baseline with no signifi cant difference between the two study groups (P > 0.05). The results of Friedman test were signifi cant for clinical indices (P < 0.05), except for probing depth in control group (P = 0.166). Enamel matrix protein derivative showed the same results as subepithelial connective tissue graft with relatively easy procedure to perform and low patient morbidity.

One ideal property of a root-end fi lling material is its apical sealing ability. The aim of this in vitro study was to assess bacterial and dye microleakage of white and gray mineral trioxide aggregate (WMTA and GMTA), Portland cement and calcium-enriched mixture (CEM) cement used as root-end fi lling material, and to assess the agreement between these two test methods. Fifty-four single-rooted teeth were used. The roots were randomly divided into four study and two control groups. After decoronation, root canals were instrumented and fi lled with gutta-percha and AH26 sealer. Root-ends were resected 3 mm above the root-end and 3 mm deep cavities were prepared. Root-end cavities were fi lled with each material. Enterococcus faecalis and methylene blue dye were used for determination of bacterial and dye leakage respectively. Data were analyzed using Fisher’s Exact Test, one-way ANOVA, Kaplan-Meier analysis, and Cohen’s Kappa. There was 100% bacterial leakage in Portland cement and CEM cement, 58.3% in GMTA, and 91.7% in WMTA. GMTA showed signifi cantly less bacterial leakage than Portland cement and CEM cement (P < 0.05). In those samples with leakage occurrence, times of observation of leakage were not signifi cantly different; however, by survival analysis, the results of the GMTA group were signifi cantly different from those of the CEM cement and Portland groups. The difference in complete dye leakage was not signifi cant. There was poor agreement between dye and bacterial leakage methods. CEM cement provides leakage results comparable to other commonly used root-end fi lling materials such as WMTA.

Gingival overgrowth is a serious side-effect that accompanies the use of Cyclosporin A (CsA). Up to 97% of the transplant recipient children, who were submitted to CsA therapy, have been reported to suffer from this side-effect. Several confl icting theories have been proposed to explain the fi broblast’s function in CsA-induced gingival overgrowth. The aim of this study is to assess the proliferation of gingival fi broblasts and levels of released cytokines after being exposed to CsA, in both adults and pediatric groups, and to make a comparison between the results of the two groups. The adult fi broblast samples were derived from four healthy adults, aged 35 to 42 years and pediatric samples were obtained from four healthy children, age between four and eleven years. Tissue samples were plated in Dulbecco’s Modifi ed Eagle Medium (DMEM) containing 10% fetal bovine serum (FBS), streptomycin, and penicillin. The samples were cultured in 25 cm2 plates containing 5% CO2, and incubated at 37°C. The cells used for all the experiments were at the fourth passage. The concentration of PGE2, IL-1â, IL-6, IL-8, TNF-á, and TGF-â1 was determined by the enzyme-linked immunosorbent assay (ELISA) and the proliferation rate was assessed by the MTT assay. Alpha error levels were set as 0.05. CsA stimulated signifi cantly higher levels of IL-6, IL-8, and TGF-â1 in adult gingival fi broblasts than it did in the control group; whereas, the expression of IL-1â and PGE2 in the fi broblasts exposed to CsA was signifi cantly weaker (P < 0.05). The fi broblasts in the two groups did not reveal any noticeable difference in the production of TNF-á. Furthermore, cell proliferation in the CsA group was not signifi cantly higher than that in the control group. No signifi cant difference in cytokines TNF-á and IL-1â were noted between the two groups. The results indicated that CsA stimulated cell proliferation in the pediatric fi broblast cell line Comparison between the results in the adult and pediatric groups demonstrated that the levels of IL-1â, IL-6, IL-8, and PGE2 were signifi cantly higher in the pediatric group than in the adult group; however, statistics showed no signifi cant difference in the levels of TNF-á and TGF-â1 and CsA-induced proliferation between these two groups. The mechanism of a CsA-induced fi broblast overgrowth may converge on the steps involving fi broblast proliferation and cytokine network including IL-6, IL-8, IL-1â, TGF-â1, and PGE2, in both adults and pediatrics. As the prevalence and intensity of drug-induced gingival overgrowth is more serious in the pediatric group than in adults, we suggest that more studies be conducted on the pediatric group.

Reinforcement of root canals obturated with Resilon was reported by several investigators, but no studies reported the reinforcement of overtly fl ared root canals obturated with Resilon material. The aim of this study was to investigate the fracture resistance of overtly fl ared root canals fi lled with Resilon as compared to similar root canals fi lled with gutta-percha (GP). Sixty single-rooted premolars were divided randomly into six groups. Group 1 served as control group. The control group was sub-divided into two groups, a negative group and a positive group. The negative group consisted of root canals that were only cleaned from residual pulpal tissues, however, the positive group had prepared and overtly fl ared root canals without obturation. Groups 2 and 4 were shaped using 0.04 taper rotary fi les, while groups 3 and 5 were shaped using 0.06 taper rotary fi les. Before obturation, the last four groups were further fl ared coronally with a reverse cone diamond bur. Groups 2 and 3 were obturated with GP and a resin-based sealer, while groups 4 and 5 were obturated with Resilon and Epiphany self-etching primer and Epiphany sealer. Roots were then fi xed into a universal testing machine and vertically loaded until fracture. SPSS software (Release 9.0 for Windows, SPSS, Chicago, USA) was used to perform the statistical analysis. Fracture resistance measurements showed that there were differences in resistance to fracture among the experimental groups (ANOVA, P < 0.0001). Mean values of the loading force applied to the negative control group were the highest at 1.81 KN, whereas the mean values for the Resilon groups (Groups 4 and 5) at 1.13 KN and 1.54 KN were found to be higher than the GP groups (Groups 2 and 3) at 0.45 KN and 0.88 KN, respectively. Tukey’s post hoc test showed that there was no statistical difference between the mean values of the negative control group and Group 5 (P = 0.69). Obturation of overtly fl ared roots with Resilon material increased the resistance of these teeth to vertical root fracture.

Addition of disinfectant to irreversible hydrocolloid impression materials can eliminate the disinfection step to avoid dimensional changes associated with it. The aim of the present study was to evaluate the effect of various disinfectant mixing liquids on the properties of commercially available irreversible hydrocolloid impression materials. Four commercially available irreversible hydrocolloid impression materials (Zelgan, Vignette, Tropicalgin, and Algitex) were mixed with disinfectant liquid containing chlorhexidine (0.1 and 0.2%) and sodium hypochlorite (0.1 and 0.5%). After mixing with disinfectant liquids, materials were evaluated for pH changes during gelation, gelation time, fl ow, gel strength, permanent deformation and detail reproduction. Signifi cant changes in gelation time were observed in irreversible hydrocolloid impression materials upon mixing with disinfectant liquids. In general, chlorhexidine increased the gelation time, whereas sodium hypochlorite reduced it. However, no signifi cant changes in the fl ow were observed both with chlorhexidine and sodium hypochlorite. Gel strength was found to decrease when mixed with chlorhexidine, whereas an increase in gel strength was observed upon mixing with sodium hypochlorite. Permanent deformation of the most irreversible hydrocolloid impression materials was below the specifi cation limit even after mixing with disinfectant liquids. Sodium hypochlorite signifi cantly reduced the surface details reproduction, whereas no change in details reproduction was observed with chlorhexidine. Chlorhexidine solution can be used to mix irreversible hydrocolloid impression materials in regular dental practice as it did not signifi cantly alter the properties. This may ensure effective disinfection of impressions.

Although esthetic rhinoplasty has many advantages, it might lead to some complications as well. The literature includes scarce and severely controversial studies on these complications, and there is no research on complications of cosmetic closed rhinoplasty. In addition, some complications are not assessed after any rhinoplasty types. Besides, there is no investigation on the outcome of rhinoplasty carried out by graduate students. The purpose of this study was to determine these. In this preliminary prospective cohort study, 96 healthy patients underwent closed esthetic rhinoplasty by senior residents of otolaryngology and maxillofacial surgery at Taleghani Hospital (Tehran, 2004-2006). Afterward, at 11 follow-up sessions (the 1st, 2nd, 3rd, 4th, 6th, 8th, 10th, 12th, 16th, 20th, and 24th postoperative weeks), fi ve functional complications (hyposmia/anosmia, nasal obstruction, unpleasant voice changes, recurrent colds, and synechiae) were questioned/ examined. The presence of a symptom during at least four subsequent sessions (without elimination until the sixth postoperative month) and the appearance of synechiae in any session were regarded as positive. The data were assessed using Spearman’s correlation coeffi cient (á =0.05). The incidence rates of synechiae, nasal obstruction, unpleasant voice changes, hyposmia/ anosmia, and recurrent colds were 56.25%, 37.5%, 0%, 1.04%, and 29.17%, respectively. No statistically signifi cant relationship was found between the complications with age, gender, or the surgeon’s specialty (P > 0.05), but the correlation with home care compliance was signifi cant (ñ = −0.29, P = 0.01). High complication rates were observed in both residency programs. Failure to follow home care instructions might prevent/delay recovery. Further in-depth studies are needed to assess this.

Bonding of molar tubes is becoming more popular in orthodontics. Occasionally, these bonding are done on posterior porcelain crowns or bridges. The purpose of this study was to evaluate the shear bond strength of buccal tubes on feldspathic porcelain crowns with two different methods. Forty porcelain right molar crowns were fabricated for this study. The crowns were randomly divided into two groups. In group 1, the crowns were etched with 9.6% hydrofl uoric acid, silane coupling agent applied, coated with bonding primer and bonded with Transbond XT (3M Unitek, Monrovia, Calif). In group 2, the crowns were etched with phosphoric acid 37%, silane coupling agent applied, coated with bonding primer and bonded with Transbond XT. All the crowns were stored for 24 hours at 37°C and thermo-cycled before the shear bond test. The analysis of variance (ANOVA) was used to determine whether signifi cant difference were present between the groups. The results of the analysis of variance (F = 0.23) indicated the shear bond strength of group 1 (3.57 ± 0.87 MPa) was not signifi cantly different (P > 0.05) from group 2 (3.46 ± 0.65 Mpa). Fisher’s exact test for the adhesive remnant index (ARI) revealed signifi cant difference between both groups (P < 0.05). Eighty percent of group 1 buccal tubes failed at buccal tube/resin interface and eighty percent of group 2 mostly failed at porcelain/resin interface. Etching with phosphoric acid with the use of silane coupling agent would be safer and should make it easier for clinicians to clean the adhesive on the porcelain surface after debonding.

Candidal colonization in complete denture wearers is a commonly encountered condition that worsens in the presence of untreated Diabetes Mellitus. The aim of this study was to evaluate the correlation between oral candidiasis in denture‑bearing mucosa and elevated blood glucose levels in complete denture wearers and to evaluate the effect of oral hypoglycemic drug therapy in controlling oral candidal colonization in denture‑bearing mucosa of complete denture wearers with Type II Diabetes Mellitus. This prospective observational study involved the participation of 15 complete denture wearers with Type II Diabetes Mellitus. The sample collection was made prior and after oral hypoglycaemic drug intervention, by swabbing the rugal surfaces of palatal mucosa, cultured and the density of the candidal colony formed was analyzed and interpreted as colony forming units (CFU) per mL. The candidal samples CFU and corresponding pre‑ and post‑prandial blood glucose levels were estimated, analyzed and compared using Karl Pearson correlation analysis and paired t‑test (α = 0.05). The Karl Pearson correlation analysis showed that there was a positive correlation between the blood glucose levels (PPS and FBS) and the candidal colonization (CFU) (P < 0.05). The mean values of all the variables were analyzed using the paired t‑test. There was significant reduction in the mean values of blood glucose levels (P < 0.001) and the mean values of the CFU (P < 0.001) following oral hypoglycemic drug therapy. Positive correlation was observed between oral candidiasis in complete denture‑bearing mucosa and elevated blood glucose levels and oral hypoglycemic drug therapy has a positive effect in controlling oral candidal colonization in complete denture wearers with Type II Diabetes Mellitus.

The sialolipoma is a rare neoplasm of salivary glands, described as a distinct entity by Nagao et al. in 2001. Thirty-six cases of sialolipoma in minor and major salivary glands have reported thus far in addition to reporting two new cases of osteolipoma arising in the major salivary gland in this study. Thirty-six cases of sialolipoma that published in English language reports were analyzed including gender, age, location, size, duration of symptoms, treatment mode, follow-up, and histologic fi nding. Congenital sialolipomas were considered in this study. Also, two new cases of this lesion are reported in this study. The fi rst case occurred in a 45-year-old female and presented as a localized swelling in right tragus. The second case occurred in an 18-year-old female as a swelling in the left parotid region. On histopathological examination, these lesions were diagnosed as sialolipoma.

The anterior maxilla presents a challenging milieu interior for ideal placement of implants because of the compromised bone quality. With the advent of intraoral bone harvesting and augmentation techniques, immediate implant placement into fresh extraction sockets have become more predictable. Immediate implant placement has numerous advantages compared to the delayed procedure including superior esthetic and functional outcomes, maintenance of soft and hard tissue integrity and increased patient compliance. This case report exhibits immediate implant placement in the maxillary esthetic zone by combining a minimal invasive autogenous block bone graft harvest technique for ensuring successful osseointegration of the implant at the extraction site.

Ameloblastomas are regarded as a homogeneous group of neoplasms with locally invasive character. They generally do not show induction of dental hard tissue formation except in few cases. Biological behavior and histogenesis of these tumors is still unexplored as there is lack of relevant studies and long follow-up of these patients. So, we aimed to report this rare case of dentinoameloblastoma with unique presence of ghost cells in middle-aged female involving maxilla with emphasis on its biological behavior. We conclude that although histogenesis of this tumor is not clear but biological potential is similar to conventional ameloblastoma requiring wider excision.

Progressive hemifacial atrophy, also known as Parry-Romberg Syndrome, is an uncommon degenerative and poorly understood condition. It is characterized by a slow and progressive but self-limited atrophy affecting one side of the face. The incidence and the cause of this alteration are unknown. A cerebral disturbance of fat metabolism has been proposed as a primary cause. Possible factors that are involved in the pathogenesis include trauma, viral infections, heredity, endocrine disturbances and auto-immunity. The most common complications that appear in association to this disorder are: trigeminal neuralgia, facial paresthesia, severe headache and epilepsy. Characteristically, the atrophy progresses slowly for several years and, it becomes stable. The objective of this work is, through the presentation of a clinical case, to accomplish a literature review concerning general characteristics, etiology, physiopathology and treatment of progressive hemifacial atrophy.

Ameloblastic fi brosarcoma (AFS) is a rare malignant mixed odontogenic tumor which is usually considered as the malignant counterpart of ameloblastic fi broma. Only mesenchymal component represents sarcomatous alterations and ameloblast-like epithelial nest remains bland in AFS. Here, we report a case of AFS in a 26-year-old man in the maxilla, which was regarded as an uncommon location for this tumor. After 2 years follow up, no evidence of recurrence was noted. We also emphasize on comprehensive clinical, radiographic, and histopathologic evaluation of such patients rather than immunohistochemical staining to make an accurate diagnosis.

Snus (nass) is a form of snuff used in a similar manner to American dipping tobacco, but it does not typically result in a need for spitting. Possible hazards associated with this material include malignant and premalignant lesions in the oral cavity and gastrointestinal tract. The use of smokeless tobacco has increased in the Middle East in recent decades, particularly among teenagers and young adults. Therefore, practitioners must be able to recognize malignant and premalignant lesions. Although, an estimated 10‑25% of the world’s population uses smokeless tobacco, this practice is virtually unknown in Iran. The aim of this study is to report a series of cases of squamous cell carcinoma and verrucous carcinoma occurring in the users of snus, who referred to the Department of Oral Medicine in Kerman Dental School.

Central cementifying fibroma is a bony tumor, which is believed to be derived from the cells of the periodontal ligament. Central cemento‑ossifying fibroma behaves like, a benign bone neoplasm. This bone tumor consists of highly cellular, fibrous tissue that contains varying amounts of calcified tissue resembling bone, cementum, or both. Central cemento‑ossifying fibromas of the mandible are common; however, they are rare in the maxilla region. This tumor is most frequent between 35 and 40 years of ages. In this report we have described a 37‑year‑old male with cemento‑ossifying fibroma of the maxilla region with the mass that had been appeared 2-3 months prior to his first referral. Radiologic imaging such as intra‑oral, panoramic, and Cone Beam CT had been performed. Histological analysis was done and finally diagnosis of central cementifying fibroma was made. The postoperative follow up at 12 months revealed no recurrence.

The rehabilitation of heavily abraded occlusion in patients with parafunctional habits is a restorative challenge to the dentist. Use of all-ceramic systems in such cases is widely considered, but uncertainty over their resistance hinders their broad use. The authors would like to illustrate a possible approach by mixing two all-ceramic systems based on zirconium dioxide and lithium disilicate. A 48-year-old female patient attended with reduced vertical dimension in a full dentition. She suffered from craniomandibular (CMD) pain and desired an esthetic rehabilitation. Prosthodontic treatment was started in a pain-free condition, after correction of the vertical dimension with an occlusal splint, over four months. Determination of the treatment was based on the clinical fi ndings: IPS e.max® ZirCAD frameworks veneered with IPS e.max® Ceram were used for discolored retainers or subgingival fi nishing lines. All the rest received IPS e.max® Press crowns. A zirconiia-based, single-tooth-retained distal cantilever reconstruction was used to replace a missing second molar. No technical or biological complication was observed 24 months after treatment. The patient was highly satisfi ed and pain-free.

Madam,A successful endodontic treatment very much depends on the endodontist’s ability to recognize unusual root canal anatomy. Most teeth have shown accessory canals, multiple foramina, fins and deltas.

Madam,Oral health is an integral part of general health.[1] Two most common oral diseases, dental caries and periodontal diseases are strongly age related; exist in all population; varying only in severity and prevalence; and are irreversible. According to WHO Oral Health Report 2003, oral diseases are fourth most expensive disease to treat in most industrialized countries.[1] Present study was conducted in Raj Nagar part 1 of South West Delhi, between Nov. 2005 and Dec. 2006 to assess the status and pattern of oro‑dental health problems and treatment needs among residents of this area.