Three-dimensional cleaning, shaping, and obturation of root canal system can be considered as foundations for a predictable endodontic success. One guiding strategy that has emerged as a critical part of endodontic success is the creation and maintenance of a glide path. Without it, cleaning and shaping become unpredictable because there is no guide for endodontic mechanics. Thus, a smooth glide path is the secret to safe and successful rotary shaping. However, this subject of glide path has no formal training in the endodontic curricula in most of the dental schools worldwide. The purpose of this review article is to serve as a reference guide for endodontic glide path preparation. Knowing what to do is only half of the job, implementing different skills in day-to-day clinical practice will accomplish the job fully, ensuring successful endodontic treatment outcomes.

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Mandibular complete dentures frequently lack retention and stability and offer less denture-supporting area than maxillary dentures. In case of severely resorbed ridges retention is highly compromised. Extending the anterior lingual flange of the lower denture sublingually makes it possible to achieve satisfactory retention in severely resorbed ridges. This clinical report describes a simpler method to achieve retention during impression making and thus help to maintain the retention and stability of lower dentures during the function.

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Conventional complete denture apart from all its merits has the prominent disadvantage of leaving the patient for a brief period of edentulous state till definitive prosthesis can be fabricated. Therefore, the concept of immediate denture is to preserve the jaw relation, keep the patient habituated to the complete denture and in the process preserve the esthetic concern of the patient. In the process, the psychological well-being of the patient is preserved as the patient is not without teeth for any prolonged period. The challenge in this technique is to record the edentulous and dentulous portion of the arch in conjecture with each other so that the final impression is closest to the intraoral situation, enabling us to provide the best results in short-and long-term of complete denture fabrication.

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Dentistry has witnessed some major discoveries during the past two decades, to the extent that many routine procedures in modern dental practice vary considerably from the way in which they were practiced for over half a century. The purpose of this article is to provide an insight to the latest techniques of crown preparation. A sound tooth preparation is the foundation stone for the longevity of a restoration. This can only be achieved if the dentist has an adequate knowledge and understanding of the various factors, which enable one to achieve this goal.

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Healthy mouth needs a stable occlusal relationship to help in efficient mastication, maintaining vertical dimension of the face, stabilizing the arches, and protecting the soft tissues. Restorative dentistry loses its significance in the absence of good occlusion. Poorly occluding restored tooth surfaces not only provide a deleterious effect to the tooth and its associated periodontium but also to the dentition of the opposing arch. The damaging effects of premature contacts, cuspal interferences, faulty proximal contacts, etc., have an adverse influence on the overall health of stomatognathic system. In this article, the significance of establishing occlusal anatomy while restoring teeth to maintain healthy and harmonious occlusion has been described.

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The introduction of lasers in the field of prosthodontics has replaced many conventional surgical and technical procedures and is beginning to replace the dental handpiece. Since its first experiment for dental application in the 1960's the use of the laser has increased rapidly in a couple of decades. Today lasers have become an integral part of effective treatment planning. This article reviews the literature on lasers with the aim of providing a complete understanding of fundamentals of lasers and their applications in various fields of prosthodontics.

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The case report here tries to describe the variation of root canal anatomy in a second mandibular molar, which is rare in occurrence in literature. This case report presents a relatively rare case of mandibular second molar with single root and a single root canal in a 45-year-old female patient who had come to dental clinic with a complain of pain in the left lower tooth region. Ambiguity in the canal morphology of the second molar is quite common. Knowledge of variations in internal anatomy of teeth is important for success in endodontic treatment. Root canal morphology is limitless in its variability and clinicians must be aware that anatomic variations constitute a formidable challenge to endodontic success. Hence, clinicians have to take utmost care when these cases with single canal and single root come to clinic.

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Recent developments in medical and dental field have shown that magnification and microsurgery can greatly improve clinical practice. The main aim of surgical intervention is not only the survival of the patient or one of his organs but also the effort to preserve a maximum amount of function and to improve patient comfort. These demands are mostly met owing to a minimally invasive surgical approach. The improved visual acuity provided by magnification opens a whole new world for those who make effort and take time to become proficient in microsurgical principles and procedures. The promising periodontal microsurgery will provide new possibilities to improve the therapeutic results for variety of periodontal surgeries. The purpose of this paper is to provide a brief review of periodontal microsurgery, role of magnification systems, and advantages of microsurgery over conventional surgery.

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Introduction: Plants have been used for health disorders and to prevent diseases including epidemics since times immemorial. The knowledge of their healing properties has been transmitted over the centuries within and among human communities. Aims and Objectives: To evaluate and compare the antimicrobial potential of herbal extracts, namely neem (Azadirachta indica), tulsi (Ocimum sanctum), bitter gourd (Momordia charantia), and arka (Calotropis procera) as endodontic irrigants against Enterococcus faecalis and Candida albicans in vitro. Materials and Methods: Agar well diffusion test was performed. The inoculums of E. faecalis and C. albicans were streaked on the blood agar plate, and wells were made using cork borers. The prepared herbal extracts of the test samples were loaded onto agar plate. The plates were incubated at 37°C for 24 h. The inhibition zones indicating the antimicrobial potential were measured using a millimeter scale and results were analyzed statistically. Results: Bitter gourd showed the maximum zones of inhibition followed by neem, tulsi, and calotropis for both E. faecalis and C. albicans. Conclusion: The tested irrigants showed significant antimicrobial efficacy against E. faecalis and C. albicans. Thus, the use of herbal alternatives as root canal irrigants might prove advantageous considering the undesirable characteristics of presently used irrigants.

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Aims: The aim of this study is to evaluate the hardness and degree of conversion (DC) of different bulk-fill materials when cured with the Quartz Tungsten Halogen (QTH) and Light emitting diode (LED) devices using same energy density. Settings and Design: This was in vitro study. Materials and Methods: Three different bulk-fill materials, i.e., Filtek™ [3M ESPE], Tetric^® N-Ceram [Ivoclar Vivadent], and SDR (Smart Dentin Replacement) by Dentsply Caulk, were used for making 180 samples (60 samples each) in Teflon mold. Out of these 60 samples, samples of three heights were prepared, i.e., 2 mm, 4 mm, and 6 mm (20 each). All the sample molds were filled in single increment and were exposed to the QTH and LED using the same energy density. Then, these samples were tested for microhardness using the Vickers hardness (VH) testing machine (Mitutoyo, Japan) and DC using Fourier Transform Infrared Spectroscope (Cary 630 FTIR Agilent Technologies, Germany). Statistical Analysis Used: The statistical analysis was performed on the collected data. The Kolmogorov–Smirnov and Shapiro–Wilk tests showed that the data are normally distributed. Since all the variables were continuous and statistically independent, independent t-test was applied to compare mean values of VH and DC of inter groups. Results: The statistical analysis of readings revealed that there was no significant difference in the mean values of microhardness and % DC for both groups cured by QTH and LED. Conclusions: It can be concluded that irrespective of the type of the light cure unit if the energy density applied is same then almost similar performance can be expected from the devices.

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Objective: The objective is to analyze most popularized xylocaine and to compare the adequacy of analgesia achieved and the effects of xylocaine hydrochloride 2% without adrenaline and xylocaine hydrochloride 2% with adrenaline (1:200,000), used as local anesthetics in dentistry for extraction of tooth. Materials and Methods: Two hundred and fifty patients of varying age and sex, requiring at least extraction of two teeth, were picked from the outpatient department of oral and maxillofacial surgery. In each patient, two teeth were extracted under local anesthesia, one under xylocaine plain and other under xylocaine with adrenaline. Time of onset, depth, and duration of analgesia were recorded. Conclusion: Lidocaine with epinephrine (1:200,000) local anesthesia efficacy in dental extractions is more effective than lidocaine without adrenaline in extraction of tooth, and the onset, duration, and depth of analgesia of xylocaine hydrochloride with adrenaline were good as compared to plain xylocaine (xylocaine without adrenaline). Thus, lignocaine as a local anesthetic may be an effective drug in dental extractions with the higher safety margin.

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Osteoblastoma, a rare osteoblastic tumor, constitutes approximately 1% of all primary bone tumors. It is characterized by osteoid and bone formation with the presence of numerous osteoblasts. A 24-year-old female presented with a chief complaint of a painless swelling beneath the mandible, which was growing during the past 3 years. Radiological picture disclosed a well-circumscribed lesion with patchy radiopaque internal structure. After complete excision, the histopathological diagnosis was a benign osteoblastoma of the mandible. Differential diagnosis and immunohistochemical features are potentially useful for refining diagnosis of osteoblastoma.

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A new revolution in three-dimensional radiologic advances in dentistry was introduced in the year 1998, as cone beam computed tomography (CBCT). Over the years, it has become an increasingly popular technique in orthodontic diagnosis, treatment planning, and research. This rise in its popularity has been facilitated by the relative advantages of three-dimensional (3D) over 2D radiography. CBCT imaging involves only a minimal increase in radiation dose relative to combined diagnostic modern digital panoramic and cephalometric imaging. A combination of volumetric reconstruction and multiplanar views can provide the orthodontic clinician with skeletal hard tissue, soft tissue, dentition, and airway information. Despite many suggested indications of CBCT, scientific evidence that its utilization improves diagnosis and treatment plans or outcomes has only recently begun to emerge. This article provides a comprehensive review of the application of CBCT in orthodontics. The current indications for CBCT in standard orthodontic diagnosis include impacted teeth, cleft lip, and palate and skeletal discrepancies requiring surgical intervention, root resorption, supernumerary teeth, temporomandibular joint (TMJ) pathology, facial asymmetry, temporary anchorage devices, root morphology and angulation; alveolar boundary conditions; maxillary transverse dimensions and maxillary expansion, and vertical malocclusion. Advanced CBCT software applications can be used to quantify airway space in the cases of obstructive sleep apnea, perform superimpositions to semiquantitatively visualize changes over the hard and soft tissues, including the TMJ and airway.

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The success of the prosthetic rehabilitation in a long-span fixed partial denture (FPD) requires adequate restoration of its function, periodontal health, and esthetics. This case report describes various treatment options to overcome stresses produced in a long-span FPD with tilted molar.

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Eagle's syndrome, also known as an elongated styloid process, is a condition that may be the source of craniofacial and cervical pain. It is infrequently reported but is probably more common than generally considered. The symptoms related to Eagle's syndrome can be confused with those attributed to a wide variety of facial neuralgias and/or oral, dental, and temporomandibular joint diseases. Surgical treatment is considered as the best option to remove the styloid process to its normal limit through extraoral or intraoral techniques. We are reporting a case and reviewed the recent literature of trans-oral extratonsillar approach without tonsillectomy and advantage such as simple, time-saving, and without any extra oral scar.

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The interdental papilla is extremely important for an esthetic smile. Black triangles, also known as gingival embrasures, are defined as the embrasures cervical to the interproximal contact that is not filled by the gingival tissue architecture of periodontal protection. These spaces are the foremost negatively ranked gingival factor by layman. Management of black triangles require high-quality diagnosis, and a multidisciplinary approach must be considered mandatory to attain a successful clinical outcome. Much of which is applicable is instinctive from severely complicated periodontal regeneration and implant therapy. This review will discuss the definition, etiology, classification, and various deliberations required in handling the case of a black triangle. The methods used here for selecting the topic were repeated exposure to the cases of a black triangle by the author's clinical practice. The material was selected by extracting out the content by studying the journals in all the fields of dentistry and formalizing all the obtained data together into one complete article.

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Papillon–Lefevre syndrome is a rare autosomal recessive disorder, in which the clinical manifestations are periodontitis which results in premature loss of both deciduous and permanent teeth and palmoplantar keratinization. The palmoplantar keratoderma typically has its onset between the ages of 1 and 4 years and severe periodontitis starts at the age of 3 or 4 years. The deciduous teeth frequently fall out by about age five and most of the permanent teeth may also be lost by approximately age 17. In the present case, a young, edentulous male of this syndrome having most the characteristic features was treated by modified complete denture prosthesis considering his young age and low socioeconomic status.

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In dentistry, ceramics are often referred to as nonmetallic, inorganic structures primarily containing compounds of oxygen with one or more metallic or semimetallic elements. They are composed of sodium, potassium, calcium, magnesium, aluminum, silicon, phosphorus, zirconium, and titanium. Structurally, dental ceramics contain a crystal phase and a glass phase based on the silica structure, characterized by silica tetrahedra, containing central Si4+ ion with four O− ions. Biocompatibility, esthetics, durability, and easier customization properties have led to the increased usage of ceramics. The specialty of ceramic teeth is its ability to mimic the natural tooth in color and translucency along with its strength. Ceramics have excellent intraoral stability and wear resistance adding to their durability. Basically, the inorganic composition of teeth and bones are ceramics which is hydroxyapatite. Over the past few years, the technological evolution of ceramics for dental applications has been incredible, as new materials and processing techniques are being introduced. The improvement in strength, as well as toughness, has made it possible to expand the range of indications to long-span fixed partial prostheses, implant abutments, and implants. While porcelain-based materials are still a major component in dental science, there have been moves to replace metal ceramics systems with all-ceramic systems. Numerous all-ceramics are being developed which is highly esthetic, biocompatible to tissue, and long-lasting in nature. Advances in computer-aided design/computer-aided manufacturing technologies have led to immense popularity of high-strength ceramic materials. These materials are highly esthetic, biocompatible to tissue, and long-lasting in nature. In this review, we will discuss all-ceramic materials which are used in dentistry.

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Objective: The aim of the present study was to compare autologous platelet-rich fibrin (PRF) combined with a porous hydroxyapatite bone graft to porous hydroxyapatite bone graft alone in the treatment of periodontal intrabony defects clinically and radiographically using Dentascan. Materials and Methods: In a split-mouth study design, 10 patients suffering from generalized chronic periodontitis, having two almost identical intrabony defects with probing pocket depth of at least 5 mm were selected for the study and randomly divided into two groups. In Group I periodontal flap surgery followed by placement of porous hydroxyapatite bone graft was done and in Group II, periodontal flap surgery followed by placement of a homogenous mixture of PRF and porous hydroxyapatite bone graft was done. All the clinical parameters were recorded at baseline, 3 and 6 months postoperatively and radiographic parameters were recorded at baseline and 6 months postoperatively. Results: There was statistically significant reduction in probing pocket depth and gain in clinical attachment level in both groups. On comparison Group II showed statistically significant more probing pocket depth reduction than Group I at all-time intervals. There was statistically significant mean defect fill and mean defect resolution observed in both groups at all-time intervals. However, the intergroup comparison was statistically nonsignificant. Conclusion : Within limits of the study it may be concluded that a combination of PRF with porous hydroxyapatite bone graft demonstrated better results as compared to porous hydroxyapatite bone graft alone in the treatment of periodontal intrabony defects. Spiral multislice computed tomography equipped Dentascan provides three-dimensional images of excellent quality for evaluating the morphology of the periodontal bone defects. Its use in ascertaining the various defect parameters in the periodontal treatment of intrabony defects is promising.

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Background: Avulsion is defined as complete displacement of a tooth from its socket after trauma. The most accepted treatment for an avulsed permanent tooth is immediate replantation. Children spend a considerable amount of waking hours in school where teachers are the primary caregivers. Hence, this study was carried out to evaluate knowledge and attitudes of school teachers regarding the emergency management of an avulsed tooth in the district of Patiala, Punjab. Materials and Methods: A two-stage sampling process was used which involved the sampling of schools within the educational district followed by sampling of teachers in the selected schools. A self-structured pretested questionnaire was personally administered to 500 school teachers of district Patiala. Statistical analysis was done using frequency and percentages and descriptive statistics like Student's t-test. Results : Almost half of respondents were aware of mouth guards. 82.8% felt that treatment should be carried out immediately after injury. Approximately, one-fourth of respondents (25.6%) believed that knocked out tooth cannot be saved so no attempt should be made at cleaning it. There was a statistically significant association of knowledge regarding replantation of tooth with education level and training in first aid. Conclusion: The present study revealed that overall knowledge regarding the emergency management of avulsed tooth was low in teachers. There is a need of first aid training to all the teachers along with emergency management of dental trauma.

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Regenerative endodontics is now an established treatment modality for necrotic immature permanent teeth. This case report describes the treatment of a necrotic immature permanent maxillary central incisor with crown fracture using a regenerative approach instead of the conventional apexification procedure. The necrotic root canal was gently debrided, irrigated and then medicated with triple antibiotic paste. At 1-month recall appointment, the tooth was asymptomatic. Bleeding was induced by filing the canal beyond the apex and collagen was placed along with induced blood clot. After 12 months follow-up, healing of periapical lesion, progressive thickening of the root canal walls, and apical closure was radiographically evident. This suggests that regenerative endodontic treatment is an appropriate treatment modality for the management of necrotic immature permanent teeth. Collagen scaffold combined with bleeding induction results in apical closure in immature teeth.

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Oral health influences the general quality of life and poor oral health is linked to chronic conditions and systemic diseases. Inter-relationship of oral diseases and the oral microbiota is well established. A number of species of bacteria that are inhabitant of the oral cavity are also implicated in oral diseases. Various plant species like Garlic, lemon, walnut and their extracts are now a days used in place of allopathic drug regimen because of near to minimum side effects. The advent and progression of dental caries involves acid producing gram-positive and gram negative bacteria and these bacterial strains have also been seen as the cause of periodontal diseases. Keeping in view the adverse effects of the various medications used in dentistry such as vomiting, diarrhoea and tooth staining and financial considerations in developing countries, there is a need for a safe and effective alternative and treatment options. Natural medicinal extracts isolated from plants come as good alternatives as they inhibit the growth of oral pathogens thereby reducing the development of biofilm on the tooth thus reducing the symptoms of oral diseases thereby enhancing the immunity.

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The successful treatment of a badly broken down tooth with pulpal disease depends not only on a good endodontic therapy but also on a good prosthodontic reconstruction of the tooth following the root canal treatment. Often, we come across an endodontically treated tooth with little or no clinical crown. In such cases, a postspace is prepared into the canal for the cementation of post and an artificial crown structure called the core is prepared over it to support the fixed partial denture. Post and cores though commonly used now have their own limitations. Failures associated with these systems include the loss of retention of posts and fracture of roots or even root perforations. Moreover, placement of a post in situations with limited interarch space is a challenge for any dentist. The failure rate associated with the conventional techniques would be higher in these conditions. This case report discusses an alternative technique of restoration of a badly broken down endodontically treated tooth with a specially designed post and core attachment to provide the necessary resistance and retention form for the overlying prosthesis in patients with limited interarch space.

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Osseointegration, i.e., structural and functional union of the surface of dental implant with surrounding bone is paramount for the success of device. In recent years, osteogenesis at the bone-implant interface has been induced by structural modifications of the implant surface, particularly at the nanoscale level. This has been achieved through modulation of osteoblast adhesion. There is strong belief that nanoscale features in materials processing is truly a new frontier. This paper reviews recent advances in fabrication of novel coatings and nanopatterning of dental implants and their subsequent cellular interactions, leading to an improvement in osseointegration and hence the long-term clinical success of the "third dentition" i.e., dental implants.

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Overdentures is a preferred treatment option in patients who have to go for extraction of the remaining teeth for fabrication of complete dentures. The teeth which are preserved, play a vital role by improvement of crown root ratio, provide proprioception, decrease the rate of resorption, and improve support to the denture. Rehabilitation using overdentures is a widely accepted preventive approach due to its ease of fabrication and the successful prognosis. An over denture is a preventive prosthodontic concept with a multidisciplinary approach involving periodontic, endodontic, and prosthodontic intervention. An overdenture improves retention, stability, maintains proprioception, prevents residual ridge resorption, and improves patient satisfaction. This is a case report of a patient with few remaining teeth, successfully treated with Preci-Sagix (Ceka attachments Preci-line, Belgium) overdenture attachments.

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