Gingival recession is defined as “the displacement of marginal tissue apical to the cementoenamel junction (CEJ)”. Various classifications have been proposed to classify gingival recession. Miller's classification of gingival recession is most widely followed. With a wide array of cases in daily clinical practice, it is often difficult to classify numerous gingival recession cases according to defined criteria of the present classification systems. This article outlines the limitations of present classification systems and also the new classifications that have been proposed to classify gingival recession.

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Steroids are one of the widely used drugs in dentistry. These are immunosuppressive agents. The reason for its use is its anti-inflammatory as well as immunosuppressive properties. Corticosteroids have revolutionized the management of several disabling conditions, but its use in term of dosage is inappropriate. The current review highlights its uses, contraindications, side-effects as well as a guideline for its use in dentistry.

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The healing of hard and soft tissue in mediated by a wide range of intracellular and extracellular events that are regulated by signaling proteins. Platelets can play a crucial role in periodontal regeneration as they are the reservoirs of growth factors and cytokines which are the key factors for regeneration of bone and maturation of soft tissue. Platelet-rich plasma (PRP) is first generation platelet concentrate. However, the short duration of cytokine release and its poor mechanical properties have resulted in search of new material. Platelet-rich fibrin (PRF) is a natural fibrin-based biomaterial prepared from an anticoagulant-free blood harvest without any artificial biochemical modification (no bovine thrombin is required) that allows obtaining fibrin membranes enriched with platelets and growth factors. The slow polymerization during centrifugation, fibrin-based structure, ease of preparation, minimal expense makes PRF somewhat superior in some aspect to PRP.

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Any occlusal force which goes beyond the adaptive capacity of our periodontium causes injury to periodontal structures, and the resultant trauma is called as trauma from occlusion (TFO), several schools of thoughts are there that whether TFO is an etiological factor or cofactor for the occurrence of periodontal diseases. Present review paper is an effort to clear the actual concept of TFO along with its historical background, etiological factors, relevant terminologies, signs and symptoms, and advanced diagnostic methods.

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The paradigm shift in our understanding of the dynamic, multifactorial nature of dental caries and the resultant change in caries preventive and treatment strategies necessitates that caries risk assessment (CRA) should be an integral part of any caries management protocol. This review discusses the rationale for CRA and the role various risk indicators play in the fluctuating demineralization-remineralization cycle of dental caries. It also provides an overview of different CRA methods and a risk-based clinical protocol for dental caries management in infants and children.

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Background: Dental caries is one of the most common oral problems affecting children globally involving the people of all region and society. It can be seen in all age groups of children involving both deciduous and permanent teeth. Dental caries is a lifetime disease, and the highest priority risk group is between 6 and 12 years of age. Aims: The aim of the study was to evaluate the prevalence of dental caries in both primary and permanent dentition among the school-going children in Mahbubnagar district. Materials and Methods: A cross-sectional study was carried out in 2000 children in different areas of Mahbubnagar district in age group 6–12 years. The dental caries status was assessed by decayed, missing, and filled teeth (DMFT)/dmft index using the World Health Organization criteria 1997. Statistical Analysis: Collected data from each patient is subjected to statistical analysis to know the prevalence of dental caries. Results: Dental caries in both primary dentition and permanent dentition was 64.2% and 26.6%, respectively. The prevalence of dental caries in primary dentition was more in 7–8-year-old children and less in 11–12-year-old children (P > 0.05). Overall, mean dmft score of both males and females is 1.49 ± 1.56, the overall mean DMFT score of both males and females is 0.57 ± 1.23. Conclusion: The present study showed that the frequency of caries was found to be a higher in the Northern region of Mahbubnagar district. The dental caries was more in 7–8 years and less in 11–12 years children, whereas less in local villages of Mahbubnagar.

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Plaque control is the daily removal of dental plaque, oral biofilm and also prevention of their accumulation on the teeth and other parts of oral cavity. Dental plaque is the major etiology of maximum gingival and periodontal diseases. It is also related with various dental problems. Mechanical plaque control is a very effective method to get rid of plaque accumulation in oral cavity. In 3000 BC there was the first toothbrush invented by human beings. With time several modifications came in toothbrushes to make mechanical plaque control more effective in day to day oral hygiene practice. This article emphasizes on the advanced and emerging tools in mechanical plaque control methods in attaining an optimal level of oral hygiene standards and maintenance of oral health.

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Cigarette smoking represents a major preventable cause of human disease. Smokers have significantly elevated risks of all-cause mortality and developing a variety of pathological conditions. A direct causal relationship between smoking exposure and the prevalence and the severity of periodontal disease has been firmly established. Although the direct cause for periodontitis is oral bacterial infection, smoking is arguably the strongest behavioral risk factor for the incidence and progression of periodontitis. Smoking has a deleterious effect on all the aspects of periodontium. Smokers have been shown to respond less well to nonsurgical as well as surgical therapy than nonsmokers. Based on this evidence, dental health professionals should advise patients about tobacco's negative health effects as well as the benefits of quitting tobacco use, and tobacco cessation counseling should be a part of the armamentarium of the dental office.

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The history of operative dentistry dates back to the era when Babylonians, Assyrians, and Egyptians (4500–4000 BC) were familiar with gold, and Etruscans and Phoenicians (2700 BC) were practising gold crowns. Since then, there have been numerous advances, developments, and researches which have proceeded continuously. These inventions have transformed the practice of operative dentistry into one which is more efficient and more comfortable for the patients as well as for the operating team. This article highlights the significant advancements in the field of operative dentistry which have occurred over a period of time and have helped us to serve our patients better.

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Can infection with the dental caries pathogen, Streptococcus mutans, be intercepted or modified immunologically? Resolving this question requires answer to many questions: What are the pathways by which this cariogenic streptococcus enters and accumulates in the dental biofilm? Can bacterial components associated with virulence induce immune responses? What is the level of maturity of immune pathways in the oral cavity of the young child at the time of infection? Many such questions have been answered. For example, preclinical application of modern methods of mucosal vaccine design and delivery has routinely resulted in protection from dental caries caused by S. mutans infection, using antigens involved in the sucrose-independent or sucrose-dependent mechanisms of infection by these cariogenic streptococci. Passive administration of antibody to functional epitopes of S. mutans virulence antigens has also provided a degree of protection in preclinical studies and small-scale human investigations. The caries-protective capacity of active immunization with dental caries vaccines now awaits proof of principle in pediatric clinical trials.

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Posterior atrophic maxilla with pneumatized sinus often challenges dental implant surgery. Sinus lift in order to augment the residual alveolar ridge height resulted in various sinus lift surgical techniques. Sinus augmentation in atrophic maxilla transforms the atrophic posterior maxilla to a favorable place for implant placement. Additional surgery of sinus lift during implant placement becomes a difficult decision for both dentist and patient. This literature search focuses on many valuable articles that support evidence on the treatment options and predictable increase in bone height after sinus lift procedure. This literature review explains on the classification of posterior atropic maxilla and its treatment options, sinus lift techniques, recommendations, complications, and a precise discussion that supports this procedure.

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Maxillary Antrolith is a rarely found calcified mass that occurs in the maxillary sinus formed by exogenous or endogenous origin. Stones arising in the antral cavities are uncommon, and their development is similar to that of a sialolith. We report a case of 55 yr. old male who came with h/o heaviness on right cheek region, nasal discharge and headache since 1 month. On evaluating the PNS radiograph shows the radiopacity in the right maxillary sinus. Caldwell-luc operation was done and the calcified masses (antroliths) along with antral polyps were removed. We report this case because of its rarity. The etiology, clinical and radiographic aspects and differential diagnosis of antrolith are also discussed.

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Crossbite can be treated using both removable and fixed appliances. This paper describes the report of two cases by a method of treating anterior single tooth in crossbite which is locked out of arch form with a simple fixed partial appliance. Orthodontic treatment was initiated by creating space for the locked out incisor using open coil spring and further corrected using MBT brackets and nitinol archwire for alignment. Treatment goals were achieved, and esthetics and occlusion were maintained postoperatively. Treatment objectives were obtained within a short duration using this technique, and there was an improvement in patients' smile.

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Vascular lesions are among the most common congenital and neonatal abnormalities. These anomalies can occur throughout the whole body, with 60%, however, being located in the head and neck region probably due to its intricate vascular anatomy of region. There is a significant confusion in the literature because of the use of confusing descriptive terminology for the same vascular entity and eponyms. Correct naming of lesion, appropriate classification, and clinical appearance of vascular lesions have a direct impact on understanding of etiologies of these complex lesions, diagnosis, and in treating patients. Thus, the aim of this article is to provide comprehensive knowledge about classifications and to have an insight of various important vascular lesions affecting head and neck region based on its pathogenesis, clinical presentation, and management.

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The topic of tumor markers is an immeasurable one, and there is an opulence of data collected till now. It has been deduced that tumor markers can suffice as an acceptable screening test for initiating definitive diagnostic procedures with a goal of making an “early diagnosis.” Through modern techniques of sensitive immunoassays such as radioimmunoassay and enzyme-linked immunosorbent assay, quantitative as well as qualitative evaluation of these markers is possible. Most tumor markers are substances produced by some types of nonneoplastic cells, although perhaps in much lower quantities than they are produced by tumor cells. The review article on tumor markers in oral squamous cell carcinoma (OSCC) as an adjunct to diagnosis is grounded totally on our analysis, consultation, experience, exploration, reviews, and original articles on the subject. Guidelines have been developed by various national skillful and international Oracle groups for the use of tumor markers for cancers, but none of these are currently formalized to maneuver in OSCC. It has been concluded that tumor markers cannot be maneuvered as fundamental modalities for the diagnosis of oral cancer. Tumor markers' main profitability in clinical medicine has been a laboratory test to support the diagnosis; further detailed studies are required to determine their practical usefulness in clinical workflow. It cannot be used as a sole diagnostic tool but can be used as an adjunct to routine histopathology using hematoxylin and eosin stain. Instead by combining various tumor markers, we can achieve a great specificity and sensitivity in the follow-up of one type of malignancy, for example, OSCC.

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Background: An adequate width of the attached gingiva helps in maintaining esthetics and proper plaque control. A thin gingiva may lead to recession after trauma or surgical and inflammatory injuries, thus sufficient thickness of the attached gingiva is desirable. Studies have shown considerable intra- and inter-examiner variation in both width and thickness of attached gingiva, which might be due to the presence of different gingival biotypes present in the adult population. By ascertaining gingival thickness, we can diagnose periodontal diseases and plan a proper treatment which is important for a good prognosis. Aims: The aim of the study is to evaluate the variations in the thickness of gingiva with respect to age, gender, and location in the dental arch. Materials and Methods: A total of 90 (45 males and 45 females) periodontally healthy subjects were divided into three different age groups. These individuals were examined for their gingival thickness in the maxillary and mandibular arches. Results: It was observed that the thickness of gingiva significantly decreased with age in both the arches and was significantly higher in females than males. The maxillary arch had thicker gingiva as compared to mandibular arch. Conclusion: In the present study, we concluded that the thickness of the gingiva varies with age, gender, and arch location.

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In the recent times, chair-side/bed-side monitoring tests have gained importance over the routine laboratory tests as they are easier and faster to perform without requiring skilled personnel. Biosensors refer to such type of point-of-care devices that are developed to help in the early diagnosis, periodic monitoring, and treatment of disease. These devices utilize biological reactions for detecting and measuring a particular substance (analyte) of interest. Till date, blood has been the gold standard diagnostic fluid for various diseases. However, oral fluids such as saliva and gingival crevicular fluid offer advantages such as noninvasive collection of sample, smaller sample aliquots, easy storage and transportation, repeated sampling for monitoring over time, and greater sensitivity, making them an alternative clinical tool over serum and tissues for many biomedical diagnostic assays. This review highlights the use of oral fluid-based biosensors for diagnosis of caries, periodontitis, oral cancer, and various systemic diseases.

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An increased emphasis on the perio–restorative interface in restorative dentistry is important to enable the utilization of the concept of biologic width in a practical manner. Regarding management of gingival tissues, the goal is to ensure that the peridontium is in a healthy state. As the oral cavity is a difficult-to-treat area because of the hindrance of lips, cheeks, and tongue, it becomes difficult to visualize and manipulate instruments in the area to be treated related to the gingival tissue which bleeds if improperly managed.The aim of this review is to describe the four categories of biological width and provide the clinician with an overview of gingival retraction techniques available for clinical situations that are frequently encountered.

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Amputation of finger causes devastating physical, psychosocial, and economic damage to an individual. The concealment of an amputated part with the help of prosthesis can shield an amputee from social stigma. Prosthesis for such patient must be comfortable to wear lightweight, durable, cosmetically pleasing easy to put on and remove. The restoration of finger amputations depends on the amount of tissue involved, the involvement of bone, the angles and levels of amputation, and the involvement of other fingers. The microsurgical reimplantation helps to save many severely injured and traumatically amputed finger. The prosthetic rehabilitation of an amputated finger is considered when microvascular reconstruction is not possible, unavailable, unsuccessful, or unaffordable. Most accepted material is silicones because of their better esthetics, ease of manipulation, and availability. This paper presents prosthetic rehabilitation of index finger of the right hand with custom made silicon prosthesis.

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The purpose of this review is to evaluate the previous studies that describe the effects of functional appliances and their efficiency in treating class II malocclusion. This review is limited to three appliances: activator, bionator, and twin-block appliances.

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Background: The present study is conducted to evaluate and compare the clinical performance of conventional band and loop space maintainer and fiber reinforced composite resin (FRCR) space maintainers. Materials and Methods: A total of 45 extraction sites in the age group of 6–9 years having premature loss of primary molars or indicated for extraction were selected for the study. The patients were randomly divided into three groups as Group I, in which conventional band and loop space maintainer was given, Group II and Group III (FRCR), in which FRCR (everStick CandB) and impregnated glass fibers (Interlig) space maintainers were given, respectively. Patients were recalled at 3, 6, and 12-month interval for evaluation of all the three types of space maintainer. Results: Overall success rate of Group I was 86.7%, for Group II was 80%, and for Group III was 73.3% at the end of the study. Patient acceptability was significantly higher in Group II and Group III (FRCR) as compared to Group I (Conventional band and loop). In Group I, cement loss and fracture of loop, whereas in Group II and Group III, debonding at enamel composite was the most common failure followed by debonding at fiber composite and fiber fracture. FRCR space maintainers were found to be cost-effective as compared to Group I. More linear changes and angular changes were recorded in Group I as compared to Group II and Group III but difference was not significant (P > 0.05). Conclusion: Only single (buccal) surface application of FRCR space maintainers showed almost equal clinical efficacy compared to conventional band and loop space maintainer with significantly better patient acceptability, less cost, and time taken.

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Background and Objective: Aerosol produced during the procedure of scaling and root planing is a potent source of infection. Preprocedural mouthrinsing has been found effective in reducing the bacterial load of the aerosol produced during the procedure. Thus, the aim of the present study was to evaluate and compare the efficacy of three different mouthwashes containing Chlorhexidine, Essential Oils & Herbal Extracts by using them as preprocedural rinsing agent in reducing the bacterial load of the aerosol produced by ultrasonic scaler. Material and Methodology: 40 subjects age and gender matched were randomly divided into four groups on the basis of agents used for preprocedural mouthrinsing - Group I: Distilled Water (Control), Group II: Chlorhexidine (CHX), Group III: Herbal Extracts (HR) & Group IV: Essential Oils (EO). The aerosols were collected on three previously prepared and sterilised blood agar plates at three different positions in the operatory. The colony forming units were counted after incubating the plates for 48 hours. Result: At all locations, the mean CFU was highest in Group I followed by Group III, Group IV and Group II. Conclusion: In the study 0.2 % chlorhexidine was found to be most effective preprocedural mouthwash in reducing the bacterial load in the aerosol produced during ultrasonic scaling followed by essential oil and herbal mouthwash respectively.

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Dental assessments and evaluations for children during their 1^st year of life have been recommended by the American Academy of Pediatric Dentistry and the American Association of Pediatrics. Early dental intervention evaluates a child's risk status based on parental interviews and oral examinations. These early screenings present an opportunity to educate parents about the medical, dental, and cost benefits of preventive rather than restorative care and may be more effective in reducing early childhood caries than traditional infectious disease models. A comprehensive infant oral care program includes: (1) risk assessments at regularly scheduled dental visits, (2) preventive treatments such as fluoride varnishes or sealants, (3) parental education on the correct methods to clean the baby's mouth, and (4) establishment of dental home and use of anticipatory guidance. The present article highlights the important guidelines of infant oral health care.

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Buccal exostoses are broad-based, non-malignant surface growth occurring on the outer or facial surface of the maxilla and/or mandible, found usually in the premolar and molar region. Etiology is still not established, but it has been suggested that the bony overgrowth can be because of abnormally increased masticatory forces to the teeth. Compensatory response to periodontal disease has been proposed to explain some cases of exostoses; they tend to appear in early adolescence and may very slowly increase in size with time. They are painless, self-limiting and may increase patient concern about poor esthetics, inability to perform oral hygiene procedures, and compromised periodontal health by causing food lodgment. The following article presents a very rare case of bilateral buccal-sided maxillary and mandibular exostoses in the anterior region which was an accidental finding in a chronic generalized periodontitis patient.

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Cosmetic surgery is not a new thing. The boom of cosmetic surgery is at its pace in India; people have been getting habituated to esthetics for so many years. Esthetic adjustment of various body parts such as rhinoplasty and lip modifications are more common nowadays. A dimple is a small depression on the surface of the body which can be easily noticeable; people appreciate the presence of dimple on the face and believe that it is a sign of good fortune and prosperity. With the advancements in the cosmetic surgery, there has been a upsurge in having artificial dimple on face. With this increased demand in having facial dimples in people, surgeons now are in an idea of creating an artificial dimple with dimple surgery or “dimpleplasty.” The procedure of dimpleplasty is as simple as making a cut in the skin, suturing the underside of the skin to a deeper layer to create a small depression. The suture creates a permanent scar which maintains the dimple. It is a thumb rule that any surgery has minor risks which are avoidable; the current review enumerates the various procedures for dimpleplasty and their outcomes. This article emphasizes on routine as well as recent procedures used for dimpleplasty and its relative complications.

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