Dental Research Journal
Volume:11 Issue: 1, Jan 2014

Metabolic syndrome (MS) is a condition, which constitutes a group of risk factors that occur together and increase the risk for Coronary Artery Disease, Stroke and type 2 diabetes mellitus. This disorder is found prevalent in the industrialized societies of the world in epidemic proportions. Periodontitis is an oral disease of microbial origin characterized by loss of attachment apparatus of tooth, resulting in edentulism if untreated. Periodontitis has been attributed to produce a low grade systemic infl ammatory condition. The link of periodontitis to various systemic disorders has led to the evolution of a new branch termed as “periodontal medicine.” Studies reviewed in the present paper have indicated a positive link between the MS and periodontitis and it is suggested that subjects displaying several components of MS should be submitted to periodontal examination. Present studies have displayed coherent relation between the two entities. This review will address the vicious association between MS and periodontitis, depicting the commonality of pathophysiological pathway between the two entities. Systematic reviews, meta-analysis addressing the concerned subject were screened. Whether the systematic periodontal therapy in individuals exhibiting MS has the potential to reduce the incidence of various adverse systemic complications remains a logical proposition. Further, longitudinal and controlled trials with a large population would be imperative to depict the robustness in the association between MS and periodontal disease in human subjects.

Human saliva plays an important role in the health of the oral cavity and of the body as a whole. Salivary diagnostics is a dynamic and emerging fi eld in the diagnosis of oral and systemic diseases. Saliva refl ects the physiologic state of the body, including emotional, endocrinal, nutritional, and metabolic variations. The collection of saliva samples is noninvasive, safe, and inexpensive. Traditional clinical criteria are insuffi cient for determining sites of active disease, for monitoring the response to therapy, or for measuring the degree of susceptibility to future disease progression. Salivaomics includes fi ve diagnostic alphabets proteins, mRNAs, miRNAs, metabolic compounds, and microbes offering substantial advantages because disease states may be accompanied by detectable changes. Salivaomics, the future of saliva-based techniques for early diagnosis of dental diseases, is promising and may offer a robust alternative for clinicians to use in the near future to make clinical decisions.

Limb lengthening by distraction osteogenesis was fi rst described in 1905. The technique did not gain wide acceptance until Gavril Ilizarov identifi ed the physiologic and mechanical factors governing successful regeneration of bone formation. Distraction osteogenesis is a new variation of more traditional orthognathic surgical procedure for the correction of dentofacial deformities. It is most commonly used for the correction of more severe deformities and syndromes of both the maxilla and the mandible and can also be used in children at ages previously untreatable. The basic technique includes surgical fracture of deformed bone, insertion of device, 5-7 days rest, and gradual separation of bony segments by subsequent activation at the rate of 1 mm per day, followed by an 8-12 weeks consolidation phase. This allows surgeons, the lengthening and reshaping of deformed bone. The aim of this paper is to review the principle, technical considerations, applications and limitations of distraction osteogenesis. The application of osteodistraction offers novel solutions for surgicalorthodontic management of developmental anomalies of the craniofacial skeleton as bone may be molded into different shapes along with the soft tissue component gradually thereby resulting in less relapse.

With increase of digital imaging, the need for storage space and transmission speed also increases. Compressed images need less storage space and decrease the transmission time. However, compression could compromise image quality. The aim of this study was to evaluate the infl uence of image compression on the identifi cation of cephalometric points on direct digital lateral cephalogram images, compared with the digital imaging and communications in medicine (DICOM) format. In this analytical-descriptive study, 19 direct digital lateral cephalograms saved in DICOM format were used. They were converted to joint photographic experts group (JPEG) 2000 format with quality factors 85, 75, and 60 adding up to 76 images (DICOM, JPEG 85, 75, and 60). The images were randomized and eight cephalometric points were identifi ed on each image by a professional, using the x-y coordinate system. Analysis of variance (ANOVA) was applied to investigate if there was a statistically signifi cant difference in the location of cephalometric points between each group of images. All tests were applied at a signifi cance level of 5%. The results did not demonstrate any statistically signifi cant difference in the identifi cation of the eight cephalometric points between the DICOM images and the JPEG2000 quality factors 85, 75, and 60. JPEG2000 images of lateral cephalograms with quality factors 85, 75, and 60 did not demonstrate any alterations in the identifi cation of cephalometric points compared with the DICOM format. JPEG2000 is a reliable fi le format for the compression of digital lateral cephalograms.

A few studies have investigated the effect of the activation mode of adhesive systems on bond strength of fi ber posts to root canal dentin. This study investigated the push out bond strengths of a glass fi ber post to different root canal regions with the use of two adhesives with light- and dual-cure polymerization modes. In this in vitro study, 40 maxillary central incisors were decoronated at cement-enamel junction with 15 ± 1 mm root length. After root canal therapy and post space preparations, they were randomly divided into four groups. Post spaces were treated with four different adhesives: Excite, Excite Dual cure Single Component (DSC), self-etch adhesive (AdheSE), and AdheSE dual-cure. Then the fi ber-reinforced composite (FRC) post, Postec Plus, was cemented with dual-cure resin cement, Variolink II. The roots were cut into three 2-mm-thick slices. Push-out tests were performed with a universal testing machine at a crosshead speed of 0.5 mm/min. The mode of failures was determined under a stereomicroscope. Data were analyzed by three way analysis of variance (ANOVA) and Tukey test was conducted to compare post hoc with P < 0.05 as the level of signifi cance. The highest bond strength was obtained for AdheSE dual-cure (15.54 ± 6.90 MPa) and the lowest was obtained for Excite light-cure (10.07 ± 7.45 MPa) and only the bond strength between these two adhesives had signifi cant difference (P = 0.02). Bond strength decreased from the coronal to the apical in all groups and this was signifi cant in Excite (group 1) and AdheSE (group 3) (P < 0.001). In apical regions, bond strength of dual-cure adhesives was signifi cantly higher than light-cure adhesives (P < 0.001). Push-out bond strength of fi ber post to different regions of root canal dentin was affected by both adhesive systems and their polymerization modes.

Linear and angular measurements such as A point, nasion, B point (ANB) angle and Wits appraisal index are not accurate enough to evaluate sagittal relationship of the jaws. The aim of this study was to evaluate and compare the range of μ and β angles in 6-17-year-old children of Isfahan, having normal occlusion. This was an analytical descriptive study. For this study, 235 cephalometric radiographs of patients who didn’t receive orthodontics treatments and based on 13 indexes had normal occlusion, were selected. After tracing of cephalograms, ANB angle, Wits appraisal index, μ angle (resulted from the intersection of AB line and perpendicular line from point A to mandibular plane) and β angle (resulted from the intersection of AB line and perpendicular line from point A on CB line) were measured. Data was analyzed by t-test, ANOVA and Pierson-Spearman correlation coeffi cient (P < 0.05). Mean value of μ and β angles were 17.34 ± 3.47 and 31.7 ± 3.31 and ranged from 8-27 to 21.5-39 respectively. According to t-test, there was a signifi cant difference between two sex groups for μ angle (P = 0.02); however, it was not signifi cant for β angle. According to Spearman correlation coeffi cient, there was no signifi cant difference between age and μ angle; however, β angle was directly and signifi cantly related to age (r = 0.435). There was signifi cant and reverse relationship between μ and β angles with ANB angle and Wits appraisal index. μ and β angles are reliable and can be used to evaluate the anterior-posterior relationship of the jaws.

Dental techniques are frequently used in human identifi cation; some of those include comparative analyses of dental features that, being rare or unique to an individual, can establish a positive identifi cation. The usefulness of each feature depends on its population, frequency, and uniqueness. The aim of this study was to determine the prevalence of talon cusps in a Portuguese population. A prospective study was performed. Three hundred and two patients were studied, and talon cusps presence was assessed. Statistical tests were carried out using Statistical Package for the Social Sciences (SPSS) 17 software (SPSS Inc., Chicago, IL, USA). Statistical analysis relied primarily on descriptive statistics and crosstabs, with Chi-square analysis. Results showed that talon cusps were observed in only 6.3% of patients. The maxillary lateral incisors were the most common teeth showing this feature (82.1% of all teeth). It can be concluded that talon cusps are an uncommon trait in these Portuguese population, and therefore, it is a feature that can be potentially very useful in forensic human identifi cation, when antemortem dental records are available.

The aim of this study was to compare the effects of conventional acid etching and laser etching on the nano-mechanical properties of the dental enamel using nano indentation test. In this experimental in vitro study, buccal surfaces of 10 premolars were divided into three regions. One of the regions was etched with 37% phosphoric acid and another etched with Er:YAG laser, the third region was not etched. The brackets were bonded to both of etched regions. After thermocycling for 500 cycles, the brackets were removed and the teeth were decoronated from the bracket bonding area. Seven nano-indentations were applied at 1 31 μm depth from the enamel surface in each region. Mean values of the hardness and elastic modulus were analyzed with repeated measures analysis of variance and Tukey HSD tests, using the SPSS software (SPSS Inc., version16.0, Chicago, Il, USA). P < 0.05 was considered as significant. The hardness up to 21 μm in depth and elastic modulus up to 6 μm in depth from the enamel surface for laser-etched enamel had significantly higher values than control enamel and the hardness up to 11 μm in depth and elastic modulus up to 6 μm in depth for acid-etched enamel had significantly lower values than the control enamel. The mechanical properties of the enamel were decreased after bracket bonding with conventional acid etching and increased after bonding with Er:YAG laser.

Accurate working length determination is a pre-requisite for a successful endodontic treatment. Even with improved systems of working length measurement, different readings may be recorded in different electrolytes present in the canal. The purpose of this in vivo/ex vivo comparative study was to determine the accuracy in measuring the working length of root canal using Direct Digital Radiographic Method (Radiovisiography or RVG) and ProPex electronic apex locator in the presence of three different irrigating solutions: 0.9% normal saline, 2% chlorhexidine, 3% NaOCl solutions. Forty single-rooted human teeth scheduled for extraction with mature apices were selected for this study. Measurements were performed by using RVG and ProPex in the presence of irrigating solutions. After extraction of the teeth, light microscope was used to confi rm visually the relationship of the tip of the endodontic fi le to the apical foramen, and actual lengths were determined by reducing 0.5 mm from this length. The statistical analysis was performed by one-way ANOVA test and Tukey-HSD post hoc procedure. P < 0.05 was considered as signifi cant. No signifi cant difference was found between overall mean electronic working length and digital radiographic length; however, prediction error (P < 0.05) was signifi cant with respect to different irrigants. Among the irrigating solutions, chlorhexidine gluconate had the smallest distance to the actual lengths, whereas NaOCl had the greatest. Electronic apex locator ProPex yielded best result in the presence of chlorhexidine, whereas the largest error was demonstrated with NaOCl indicating that higher electroconductive irrigating solutions affect the precision of multi-frequency apex locators.

Low- level laser therapy has been used to stimulate the orthodontic tooth movements (OTM) previously. Furthermore, in the orthodontic treatments accompanying tooth extractions, the adjacent teeth move towards the extraction sites and close the space in some cases. Then, the adjacent tooth movements must be prevented in the treatments requiring space. Laser stimulates and at some doses decelerates tooth movement; it also improves healing process and enhances osteogenesis. Hence, it can prevent movement by osteogenesis adjacent to the tooth. The present study investigated the effects of low-level laser therapy on the OTM and root resorption following artifi cial socket preservation. In this experimental animal trial, 16 male albino rabbits were selected with similar characteristics and randomly divided in two groups. Under general anesthesia, an artifi cial socket, 8 mm in height, was created in the mesial aspect of the fi rst premolars of the rabbits and fi lled with demineralized freeze dried bone allograft (DFDBA). The fi rst premolars were connected to the incisors using nickel titanium coil springs. In experimental group, galliumaluminum- arsenide (GaAlAs) laser was irritated mesial to fi rst premolar where artifi cial socket was created continuously (808 nm). The cycle was 10 days irritation, 14 days rest, 10 days irritation, 14 days rest (Biostimulation mode). Control group was not laser irradiated. All animals were sacrifi ced after 48 days and the distance between the distal aspect of the fi rst premolars, and the mesial surface of the second premolars was measured with leaf gauge. The specimens underwent histological assessments. Integrity of root and its resorption was observed under microscope calibration. The size of resorption lacunae was calculated in mm2. Normality of data was proved according to Kolmogorov-Smirnov analysis, and Student’s t-test was done. P value less than 0.05 was considered as signifi cant. The mean OTM were 5.68 ± 1.21 mm in the control group and 6.0 ± 0.99 mm in the laser irradiated teeth with no statistically signifi cant differences(P > 0.75). The mean root resorption was 1.61 ± 0.43 mm2 and 0.18 ± 0.07 mm2 in the control and experimental groups respectively being signifi cantly lower in the laser irradiated teeth (P < 0.0001). The fi ndings of the present study show that GaAlAs irradiation together with the application of DFDBA led to limited amount of the stimulated OTM. The laser beam irradiation in combination with alloplastic materials used for socket preservation could reduce the degree of root resorption signifi cantly.

The aim of the present study is to evaluate the effects of a fl uoride releasing composite resin bonding material on reducing enamel demineralization underneath and around orthodontic brackets and compare that with a conventional adhesive system. Buccal surfaces of 10 intact extracted premolar teeth were divided into two parts with nail varnish and stainless steel brackets were randomly bonded by two resin composite systems: (Transbond XT) and (Transbond XT plus Color Change) (3M, Unitek, Monrovia, CA, USA) on two sides of the teeth and then samples were placed in a demineralization solution. It is claimed that the second system has the ability of fl uoride release. Elastic modulus and hardness of enamel were measured with nanoindentation test in 6 depths in 1-36 μm from the enamel surface and in 7 regions: Control (intact enamel surface), underneath the brackets and also 50 and 100 μm from the brackets edge. These nanomechanical features were evaluated in different regions and depths using analysis of variance and paired t-test (P < 0.05). Considerable difference can be seen in different depths and regions in terms of hardness and elastic modulus. The region under the bracket with fl uoridated adhesive shows similar results with intact enamel, whereas these parameters in fl uoride less side show a signifi cant reduction (P < 0.05). Results show that use of resin composite bonding system with the ability of fl uoride release for bracket bonding, may reduce demineralization of enamel around brackets during orthodontic treatment.

Mechanical torque limiting devices (MTLDs) are necessary tools to control a peak torque and achieving target values of screw component of dental implants. Due to probable effect of autoclaving and number of use on the accuracy of these devices, this study aimed to evaluate the effect of sterilization and number of use on the accuracy of friction-style mechanical torque limiting devices (F-S MTLDs) in achieving their target torque values. Peak torque measurements of 15 new F-S MTLDs from three different manufacturers (Astra Tech, BioHorizons, Dr. Idhe) were measured ten times before and after 100 steam sterilization using a digital torque gauge. To simulate the clinical situation of aging (number of use) target torque application process was repeated 10 times after each sterilization cycle and the peak torque values were registered. Comparison of the mean differences with target torque in each cycle was performed using one sample t test. Considering the type of MTLDs as inter subject comparison, One-way repeated measure ANOVA was used to evaluate the absolute values of differences between devices of each manufacturer in each group (α = 0.05). The results of this study in Dr. Idhe group showed that, mean of difference values signifi cantly differed from the target torque (P = 0.002) until 75 cycles. In Astra Tech group, also mean of difference values with under estimation trend, showed a signifi cant difference with the target torque (P < 0.001). Mean of difference values signifi cantly differed from the target torque with under estimation trend during all the 100 cycles in BioHorizons group (P < 0.05). The torque output of each individual device stayed in 10% difference from target torque values before 100 sterilization cycles, but more than 10% difference from the target torque was seen in varying degrees during these consequent cycles.

Exposure of the gingival sulcus while controlling hemorrhage is prerequisites for maximizing treatment outcomes of cervical carious lesions and for obtaining quality impressions for the fabrication of indirect restorations with cervical fi nish lines. Gingival retraction cords saturated with different chemical agents are widely used for this purpose. The aim of this study was to investigate and compare the infl ammatory potential of 15.5%ferric sulfate on connective tissue when placed at different times. All procedures were performed on three dogs under general anesthesia. Retraction cords saturated with a 15.5% ferric sulfate solution were placed into the gingival sulcus and evaluated after 3 min and 10 min of exposure to the chemical agent. Excisional biopsies of the exposed gingival tissue were then obtained at intervals of 1 h, 24 h, and 7 days. For all specimens, histology evaluation was performed using light microscopy. Data collected from the microscopic images of all tissue specimens were analyzed by using the Wilcoxon Signed Rank and Kruskal-Wallis Tests. P value less than 0.05 was considered as signifi cant. Histopathologic examination of the biopsied gingival tissue revealed that the ferric sulfate solution caused signifi cant tissue changes at the beginning of both the 3-min and 10-min gingival exposure time (P > 0.05). However, the tissue returned to a normal histological appearance by the end of day 7 in all cases (P > 0.05). The results of this study revealed that the biologic effects of 15.5% ferric sulfate solution are clinically acceptable and reliable when gingival exposure times of 3 min and 10 min are used for gingival retraction.

The aim of this in vitro study was to evaluate the effect of shape, diameter and length of implants on their primary stability based on resonance frequency analysis. Replace select tapered and Branemark MK III implants were selected. Each of these two selected groups was divided into nine subgroups based on the implant length (IL) (short, medium and long) and the implant diameter (ID) (narrow platform [NP], regular platform [RP] and wide platform [WP]). Five implants were assigned to each of the nine subgroups. Implants were placed in artifi cial bone blocks with bone quality similar to D3 bone. Immediately after the implant placement, its primary stability was measured using Osstell Mentor equipment. T test and Tukey’s honest signifi cant difference Post hoc were performed for data analysis. Statistical signifi cance was defi ned at P < 0.05. Replace select system showed signifi cantly higher primary stability compared to the Branemark system, when using the short implants for all three diameters (P ≤ 0.004). However, in medium length implants there were no signifi cant differences between the two implant systems (P ≥ 0.31). In long implants, only when the NP and RP implants were used, the Replace Select system showed signifi cantly higher primary stability compared to the Branemark system (P = 0.000). In the replace select system, long implants had a signifi cantly higher primary stability compared to medium and short length implants (P ≤ 0.003). In the NP and RP Branemark implants, short implants showed signifi cantly lower primary stability compared to medium and long implants (P ≤ 0.002). However, in WP Branemark implants, primary stability increased signifi cantly with increasing the IL from short to medium and from medium to long (P = 0.000). There were also signifi cant differences between NP and the two other wider implants in both systems (P = 0.000). The use of tapered implants is recommended, especially, when the use of short implants is necessary. The use of RP implants is also preferred to WP implants, because thicker bone wall will remain in place when applying RP implants. Furthermore, no signifi cant difference was observed between RP and WP implants.

Current methods of closure of the cleft palate result in the formation of scars and impairment of growth. Distraction osteogenesis (DO) might be an effective means to repair or at least reduce the size of wide clefts. This study investigates the biomechanical aspects of this process. DO simulation was applied to reduce the size of a unilateral hard palate cleft on a three-dimensional (3D) model of the maxilla. For the position of osteotomy lines, two different models were assumed, with the osteotomy line on the affected side in model A and on the intact side in model B. In each model, DO screws were placed on two different positions, anteriorly (models A1 and B1) and posteriorly (models A2 and B2). Displacement pattern of the bony island in each of the four models, reaction forces at DO locations, and von Mises stress were estimated. Mesh generation and data processing were carried out in the 3D fi nite element analysis package (ABAQUS V6.7-1; Simulia Corp., Providence, RI, USA). In model B2, the island moved almost evenly, assuring a more complete closure of the cleft. The most uniform stress distribution was found in model B1. The results suggest that the best positions for the DO screw and the osteotomy line for closure of the cleft palate are posteriorly and on the intact side, respectively.

Microleakage is one of the challenging concerns in direct fi lling restorations. Understanding of its related factors is important in clinical practice. The aim of this study was scanning electron microscopy (SEM) evaluation of marginal integrity in three types of tooth-colored restorative materials in class V cavity preparations and the effect of load cycling and polishing time on the microleakage. In this in vitro experimental study, class V cavity preparations were prepared on the buccal and lingual surfaces of 60 bovine incisors. The specimens were divided into three groups each containing 20 teeth: group 1: Filtek Z350, Group 2: Fuji IX/G Coat Plus, Group 3: Fuji II LC/GC varnish. In each group, 2 subgroups (n = 20) were established based on fi nishing time (immediate or delayed by 24 h). All specimens were thermocycled (×2,000, 5-50°C). In each sub groups, half of the teeth were load cycled. Epoxy resin replicas of 24 specimens were evaluated under fi eld emission-SEM and interfacial gaps were measured. All teeth were then immersed in 0.5% basic fuchsin dye for 24 h, sectioned and observed under stereomicroscope. Data were analyzed with Kruskal-Wallis’ test and Mann-Whitney U test and a comparison between incisal and cervical microleakage was made with Wilcoxon test. P < 0.05 was considered as signifi cant. Load cycling and fi lling material had a signifi cant effect on microleakage, but polishing time did not. Cervical microleakage in Z350/load cycle/immediate polish and Fuji IX/load cycle/immediate or delayed polish and Fuji IX/no load cycle/immediate polish were signifi cantly higher than incisal microleakage. It was concluded that the cervical sealing ability of Fuji IX under load cycling was better than Fuji II LC. Under load cycling and immediate polishing Z350 showed better marginal integrity than both Fuji II LC and Fuji IX. The immediate polishing didn’t cause a statistically signifi cant increase in microleakage of evaluated tooth-colored class V restorations.

Tumor markers are substances, which quantitatively changes in serum, during the tumor development, one such tumor marker is serum β2-microglobulin (β2-m). The aim of this study was to establish the role of β2-m as a biochemical parameter for diagnosis and prognosis of oral carcinoma by estimation of serum β2-m levels in potentially malignant lesions, conditions, and oral squamous cell carcinoma. The study was carried out on 48 subjects (16 control, 8 oral submucous fi brosis, 8 oral leukoplakia, and 16 oral squamous cell carcinoma patients of different stages), conducted at department of Oral Medicine, Kothiwal Dental College, Moradabad, India. Under aseptic precautions, 5 ml venous blood was drawn and serum was separated. Estimation of β2-m level in serum was carried out by enzyme linked immunosorbent assay. The data were analyzed by using the statistical package for social sciences (SPSS 17.0) software. Cases and controls were tested for statistical signifi cance with one-way ANOVA with post-hoc Tukey’s HSD. Values of P < 0.05 were considered signifi cant. The mean serum β2-m level in the control group was 1.173 ± 0.059, in potentially malignant lesions/conditions group was 1.688 ± 0.137 and in oral squamous cell carcinoma group was 2.835 ± 0.0313. This progressive increase in serum β2-m level was found to be highly signifi cant (P value < 0.001). Results of Receiver operating characteristic analysis showed β2-m as a 100% sensitive and specifi c biomarker for oral squamous cell carcinoma. The present study establishes β2-m as a specifi c biological tumor marker for diagnostic and prognostic evaluation of oral squamous cell carcinoma.

Debonding of denture teeth from denture bases is the most common failure in removable dentures. The purpose of this study was to evaluate the effect of surface treatments on shear bond strength of denture teeth to heat-polymerized and autopolymerized denture base resins. In this experimental in vitro study, 60 maxillary central incisor acrylic teeth were divided into two groups. Group M was polymerized with heat-polymerized acrylic resin (Meliodent) by compression molding technique and group F was processed by autopolymerized acrylic resin (Futura Gen) by injection molding technique. Within each group, specimens were divided into three subgroups according to the teeth surface treatments (n = 10): (1) ground surface as the control group (M1 and F1), (2) ground surface combined with monomer application (M2 and F2), and (3) airborne particle abrasion by 50 μm Al2O3 (M3 and F3). The shear bond strengths of the specimens were tested by universal testing machine with crosshead speed of 5 mm/min. Data were analyzed by two-way analysis of variance (ANOVA) and Tukey’s honestly signifi cant difference (HSD) tests (P < 0.05). The mean shear bond strengths of the studied groups were 96.40 ± 14.01, 124.70 ± 15.64, and 118 ± 16.38 N for M1, M2, and M3 and 87.90 ± 13.48, 117 ± 13.88, and 109.70 ± 13.78 N for F1, F2, and F3, respectively. The surface treatment of the denture teeth signifi cantly affected their shear bond strengths to the both the denture base resins (P < 0.001). However, there were no signifi cant differences between the groups treated by monomer or airborne particle abrasion (P = 0.29). The highest percentage of failure mode was mixed in Meliodent and adhesive in Futura Gen. Monomer application and airborne particle abrasion of the ridge lap area of the denture teeth improved their shear bond strengths to the denture base resins regardless of the type of polymerization.

Mucoceles are defi ned as chronic, cystic lesions in the paranasal sinuses. When the mucocele content becomes infected, the lesion is defi ned as mucopyocele. Most mucoceles are located in the frontal and anterior ethmoid sinuses and normally they involve the frontal-ethmoid complex, expanding to the superior-medial region of the orbit, leading to ocular disorders; maxillary sinus presentation is rare. In the present article, the authors described a rare case of mucopyocele in the maxillary sinus.

Binder’s syndrome is an uncommon entity characterized by midfacial hypoplasia along with Class III incisal relationship. The individuals with this syndrome are easily recognizable and the syndrome is mostly associated with other malocclusions. The current article presents two cases ofthis rare syndrome and describes its general features.

This report presents a case of severe intrusive luxation of multiple anterior teeth in an 11 yearold girl. The teeth were repositioned successfully by endodontic and orthodontic management.The case was monitored for 7 years. Depending on the severity of the injury, different clinical approaches for treatment of intrusive luxation may be used. Despite the variety of treatment modalities, rehabilitation of intruded teeth is always a challenge and a multidisciplinary approach is important to achieve a successful result. In this case, intruded teeth were endodontically treated with multiple calcium hydroxide dressings and repositioned orthodontically. The follow-up of such cases is very important as the repair process after intrusion is complex. After 7 years, no clinical or radiographic pathology was detected.

The routine treatment for rotated maxillary incisor is a fi xed appliance, but in some instance the use of this method is impossible. In addition, in only limited cases of rotation, removable appliance is applicable. In this study, the use of a semi-removable appliance is presented, which has some benefi ts over the other methods. In this study, the corrections of about 70 -90° rotation of the maxillary central incisors in different phases of mixed dentition were performed in three patients using whip appliance. This method was performed using a simple removable appliance such as Hawley appliance and whip spring that forced the couple to derotate the tooth. In all cases, treatment was successfully completed in relative short duration. Whip appliance can be recommended as an effective method to correct rotation of maxillary incisor in mixed dentition with several advantages like rapid correction.