Background: In India, a number of fixed dose drug combinations of non-steroidal anti-inflammatory drugs (NSAID's) are available, often as over-the-counter products. These combinations are being prescribed too. Evidence for efficacy of NSIAD fixed dose combination is lacking. Objectives: The current study was undertaken to assess the analgesic and anti-inflammatory efficacy of these combinations over their individual components. Materials and Methods: The study used three NSAIDs viz; paracetamol, ibuprofen and diclofenac sodium, alone or in combination with paracetamol. Animals were divided into six groups with six animals in each group. Analgesic activity was tested by writhing test and paw edema model was used to assess the anti-inflammatory activity. The test drugs were administered orally 30 min prior to injecting 0.6% solution of glacial acetic acid intraperitoneally for writhing test. For paw edema test, after 30 min of drugs administration, animals were injected with 0.1 ml of 1% carrageenan in subplanter region for inducing inflammation. Paw volume was again measured at baseline and after 3 h of subplanter injection of 1% carrageenan. Results: The analgesic and the anti-inflammatory activity of paracetamol and ibuprofen combination were significantly greater than the individual agents when used alone. However, no significant difference in the analgesic or anti-inflammatory activity was found between diclofenac sodium and its combination with paracetamol. It was observed that diclofenac sodium was the most efficacious of the analgesics tested. Combining paracetamol with diclofenac did not show superior analgesic activity compared to diclofenac alone (P = 0.18). Conclusion: Combining paracetamol with ibuprofen enhances analgesic/anti-inflammatory activity over their individual component but potentiation of analgesic activity of diclofenac was not seen when paracetamol was added to it.

Context: This study was carried out on the assumption that oral mucosal cells might show DNA damage in oral squamous cell carcinoma (OSCC). Aims: To evaluate the extent of DNA damage in oral smears of patients with OSCC and determine correlation if any of the extent of DNA damage to TNM staging of oral cancer. Settings and design: A randomized controlled study at a regional cancer centre was designed for this project. Smears were taken from lesion proper of 30 patients with OSCC and from the buccal mucosa of 30 normal healthy volunteers. Materials and methods: Collected cells were centrifuged and single-cell gel electrophoresis (SCGE) assay was performed. DNA damage was visualized under a fluorescent microscope. Statistical analysis used : Mean DNA damage levels of both the groups were measured and statistically analyzed with students' test. The extent of DNA damage was correlated with the TNM stages by employing the one way ANOVA 'F' technique. Results: High statistical significance (P < 0.0001) was found in DNA damage levels between control and study groups. A stepwise increase in DNA damage levels with high statistical significance (P < 0.005) was also found between all the TNM stages. Conclusions: Statistically significant increased DNA damage levels in OSCC patients and their correlation to clinical staging suggest that comet assay may be used effectively to assess the prognosis of OSCC.

Objective: The purpose of this study was to develop a reliable instrument [Oral Health related Early Childhood Quality of Life (OH- ECQOL) scale] for measuring oral health related quality of life (OHrQoL) in preschool children in North Indian population. Methodology: Four pediatric dentists evaluated a pool of 65 items from various QoL questionnaires to assess their relevance to Indian population. These items were discussed with eight independent pediatric dentists and two community dentists who were not a part of this study to assess relevance of these items to preschool age children based on their comprehensiveness and clarity. Based on their responses and feedback a modified pool of items was developed and administered to a convenience sample of 20 parents who rated these items according to their relevance. The test retest reliability was evaluated on another sample of 20 parents of 2-5 year old children. The final questionnaire comprised of 16 items (12 child and 4 family). This was administered to 300 parents of 24-71 months old children divided on the basis of early childhood caries to assess its reliability and validity. Results: OH-ECQOL scores were significantly associated with parental ratings of their child's general and oral health, and the presence of dental disease in the child. Cronbach's alpha was 0.862, and the ICC for test-retest reliability was 0.94. Conclusions: The OH-ECQOL proved reliable and valid tool for assessing the impact of oral disorders on the quality of life of preschool children in Northern India.

Context: Chronic periodontitis is an inflammatory condition of supporting tissues initiated by organisms in dental plaque. The reactive oxygen species and free radicals mediate connective tissue destruction in periodontitis. In order to counteract the free radical mediated tissue damage, numerous antioxidant mechanisms exist within the host. One such system is heme oxygenase enzymes. Heme oxygenase is the key enzyme involved in catabolism of heme. It cleaves the heme molecule to yield equimolar amounts of biliverdin, carbon monoxide, and iron. These end products act as important scavengers of reactive oxygen metabolites. Increased heme oxygenase expression has been identified in inflammatory condition, such as pancreatitis, diabetes, nephritis, and atherosclerosis. Since chronic periodontitis is one such inflammatory condition, we assessed the expression of heme oxygenase-1, in smokers and periodontitis group using immunohistochemistry technique. Aims: The aim of this study is to compare the expression of heme oxygenase-1 in patients with healthy periodontium, periodontitis and smokers. Materials and Methods: Gingival tissue samples were taken from 30 patients, who were divided into three groups healthy controls (n = 10), chronic periodontitis (n = 10), and smokers with chronic periodontitis (n = 10). All the samples were subjected to immunohistochemical staining using the antiheme oxygenase-1 antibody and were tested for efficiency by staining a positive control (prostate cancer tissue sections) and a negative control. The results were tabulated and analyzed. Results: Our results showed increased expression of heme oxygenase-1 in the gingival tissue samples taken from smokers compared with periodontitis and healthy tissue. Conclusion: The results of our study is an increasing evidence of involvement of antioxidant enzymes like heme oxygenase-1 in periodontal inflammation and their implication for treatment of chronic periodontitis.

Aim : The aim of the present study was to determine the occurrence of furcation involvement in the molars of patients with chronic periodontitis and correlate clinical and radiographic findings. Materials and Methods: Seventy subjects aged 35-69 years enrolled for treatment at a periodontics specialization program in Pernambuco, Brazil (EAP-SCDP-ABO/PE) participated in the study, comprising a total of 350 molars examined. The clinical diagnosis of furcation involvement was performed with a horizontal Nabers probe, whereas the radiographic examination was performed with periapical and bite-wing radiographs. The images were analyzed with an X-ray viewer at 3× magnification. The Chi-square test was used, with the level of significance set at 5%. Results: A total of 64.5% individuals presented with furcation involvement, 43.1% of whom had degree II furcation. A significant association (P = 0.0060) was found between tooth type and frequency of furcation involvement. The first lower and upper molars were affected in 64.5 and 58.5% of cases, respectively. Adequate agreement (0.65) was observed between the clinical and radiographic findings. Conclusion: Taking into consideration the method employed and the results obtained, it may be concluded that the clinical and radiographic examinations performed are effective tools for diagnosing furcation involvement in teeth affected with periodontal disease.

Aim: This study evaluated the efficiency and effectiveness of three glass fiber post removal techniques. Materials and Methods: Forty-five extracted maxillary teeth were endodontically treated and cross-sectioned in thirds. Presence of cementing agent and dental structure wear were assessed by analyzing images taken before luting of glass fiber post and after removal procedure. Teeth were divided into 3 groups: Group 1 - diamond bur + Largo reamer; Group 2 - ultrasonic insert; Group 3 - carbide bur + ultrasonic insert. Time spent on removal procedures, dental structure wear and amount of remaining cement agent were recorded and results submitted to ANOVA, Kruskal Wallis and Tukey-Kramer tests. Results: Group 1 - 16'46", 33.33% and 6.99%; Group 2 - 12'31", 40% and 7.86%; and Group 3 - 10'24", 80% and 8.14%. Group 3 presented the most effective removal of glass fiber posts. Conclusion: There was no significant difference in efficiency among the evaluated techniques.

Background: Heat shock proteins-47 (HSP47) is a collagen specific molecular chaperone, involved in the processing and/or secretion of procollagen. It seems to be regularly upregulated in various fibrotic or collagen disorders. Hence, this protein can be a potential target for the treatment of various fibrotic diseases including oral submucous fibrosis (OSF), which is a collagen metabolic disorder of oral cavity and whose etiopathogeneic mechanism and therapeutic protocols are still not well documented. Aim: The aim of this study is to identify the novel therapeutic agents using in-silico methods for the management of OSF. Objectives: The objectives of this study are to identify the binding sites of HSP47 on the collagen molecule and to identify the lead compound with anti-HSP47 activity from the library of natural compounds, using in-silico methodology. Materials and Methods: The web-based and tool based in-silico analysis of the HSP47 and collagen molecules are used in this study. The crystal structure of collagen and HSP47 were retrieved from Protein Data Bank website. The binding site identification and the docking studies are done using Molegro Virtual Docker offline tool. Results: Out of the 104 Natural compounds, six ligands are found to possess best binding affinity to the binding amino acid residues. Silymarin binds with the 4AU2A receptor and the energy value are found to be −178.193 with four Hbonds. The other best five natural compounds are hesperidin, ginkgolides, withanolides, resveratrol, and gingerol. Our findings provide the basis for the in-vitro validation of the above specified compounds, which can possibly act as "lead" molecules in designing the drugs for OSF. Conclusion: HSP47 can be a potential candidate to target, in order to control the production of abundance collagen in OSF. Hence, the binding sites of HSP47 with collagen are identified and some natural compounds with a potential to bind with these binding receptors are also recognized. These natural compounds might act as anti-HSP47 lead molecules in designing novel therapeutic agents for OSF, which are so far unavailable.

Purpose: The aim of this study was to test the null hypothesis that there is no change in the lower anterior teeth's crown size when measured just after the treatment with Frankel-2's orthopedic appliance and in a long-term posttreatment follow-up. Materials and Methods: The sample was composed of 34 plaster models belonging to 9 male and 8 female individuals, treated at the College of Health, Methodist University of São Paulo, São Bernardo do Campo, São Paulo, Brazil, with mean age of 12 years and 6 months (standard deviation [SD] =7 months) at T1 (end of the treatment with Frankel-2's function regulator), and 19 years and 8 months (SD = 7 months) at T2 (7.11 years after the end of the treatment). Results: The distance from the incisal edge to the most concave portion of the gingival margin of the lower incisors and canines was measured using a digital caliper. Data analysis was carried out by means of Student's t-test and paired-t test. Among the lower anterior teeth, the teeth 31, 33, 42 and 43 showed a statistically significant increase in their crown length, whereas the teeth 32 and 41 showed no changes. Conclusion: It can be concluded that there is a tendency to increase the clinical crown of lower anterior teeth throughout the years after the mandibular advancement treatment by using functional devices, rejecting the null hypotheisis.

Aim: The aim of this study was to assess the enamel matrix derivative (EMD) as biomaterial used in autogenous tooth transplantation. Material and Methods: The study consisted of 3 beagle dogs, 5 months old, in which six incisors and six premolars were transplanted to mechanically prepared recipient alveolar sockets. One group of teeth was transplanted to a recipient bed, with EMD in the root surface. The second groups of teeth were transplanted using saline solution in the root surface. Every week, clinical examinations were done. Nine weeks later, the animals were killed and the specimens decalcified and prepared for histological and imunohistochemical analysis. Periodontal healing was evaluated by undertaking histomorphometric investigation and analyzed using the Mann- Whitney test (P = 0.05). Results: In both groups, all the transplanted teeth survived. Between the experimental groups, there was statistically significant difference in the complete healing (P = 0.004). There was statistically significant difference between the treatment group in the occurrence of inflammatory root resorption (P = 0.015) and the occurrence of replacement root resorption (P = 0.041). Conclusions: Emdogain gel used on the surface of transplanted teeth improves the occurrence of complete healing and reduces root resorption.

Introduction: Bone grafts are frequently used in the treatment of bone defects. Bone harvesting can cause postoperative complications and sometimes does not provide a sufficient quantity of bone. Therefore, synthetic biomaterials have been investigated as an alternative to autogenous bone grafts. Aim and Objectives: The aim of this study was to evaluate and compare bovine derived hydroxyapatite (BHA) and synthetic hydroxyapatite (SHA) graft material as bone graft substitute in maxillary cystic bony defects. Patients were analyzed by computerized densitometric study and digital radiography. Materials and Methods: In this study, 12 patients in each group were included randomly after clinical and radiological evaluation. The integration of hydroxyapatite was assessed with mean bone density, surgical site margin, and radiological bone formation characteristics, of the successful graft cases using computer densitometry and radio-visiograph. Statistical analysis was carried out using Mann-Whitney U-test, Wilcoxon matched pairs test and paired t-test. Results: By the end of 24 ^th week, the grafted defects radiologically and statistically showed similar volumes of bone formation. However, the significant changes observed in the formation of bone and merging of material and surgical site margin at 1 ^st week to 1 ^st month. The results were significant and correlating with all the parameters showing the necessity of the grafting for early bone formation. However, the bone formation pattern is different in both BHA and SHA group at 3 ^rd month interval with significant P value. Conclusion: Both BHA and SHA graft materials are biocompatible for filling bone defects, showing less resorption and enhanced bone formation with similar efficacy. Our study showed maximum bone healing within 12 weeks of grafting of defects. The BHA is economical; however, price difference between the two is very nominal.

Context: Problematic eating behavior in children presents a wide spectrum from anorexia, selective eating, and fussy eating to neophobia. Pouching of food and slow eating represents eating behavioral problems that may be relevant to pediatric dentist as far as early childhood caries (ECC) is concerned. Aim: The aim of this study was to determine the prevalence of problematic eating and its association with ECC among 46-71-month-old children in Bengaluru city, India. Settings and Design: A cross-sectional study was carried out in 250 children aged 46-71 months old in various schools of Bengaluru city. Subjects and Methods: All the selected children were clinically examined for dental caries using decayed, missing, filled surfaces index. Children's eating behavior was assessed using Children's Eating Behavior Questionnaire (CEBQ) which was filled by the parents. Statistical Analysis Used: Both descriptive statistics as well as Chi-square test was used with SPSS 16.00. Results: The prevalence of dental caries was found to be 34%. It was observed that 81.6% of the children did not have a tendency to keep food in their mouth all the time and ECC was found to be significantly less. Furthermore, approximately 90% of the children did not have a tendency to eat too much and in those, 68% of them were caries free which was statistically significant. Prevalence of ECC was highest (52.6%) in children who ate more when they had nothing else to do. Conclusion: Problematic eating behavior is prevalent in the preschooler group and needs to be considered by the pediatric dentist.

Aim: The aim was to determine the effect of four different intracanal medicaments on the apical seal of the root canal system in vitro. Methodology: Fifty freshly extracted intact human permanent maxillary central incisors were collected, stored and disinfected. The root canals were prepared to a master apical size of number 50 using step back technique. Depending upon the intracanal medicament used, the teeth were divided randomly into five groups of 10 teeth each including one control group and four experimental groups. Group A: No intracanal medicament. Group B: Calcium hydroxide powder mixed with distilled water. Group C: Calcium hydroxide gutta percha points (calcium hydroxide points). Group D: 1% chlorhexidine gel (hexigel). Group E: Chlorhexidine gutta percha points (Roeko Activ Points). The medication was left in canals for 14 days. Following removal of the intracanal medicament, all the groups were obturated with lateral compaction technique. The apical leakage was then evaluated using dye extraction method with the help of a spectrophotometer. Results: Results were statistically analyzed using Kruskal-Wallis and Mann-Whitney U-test, which showed statistically significant difference among the five groups tested. Conclusion: It can be concluded from this study that the control group showed least amount of leakage, whereas the 1% chlorhexidine gel group showed maximum amount of leakage. Apical leakage was observed with all the experimental groups with little variations in between them. Under the parameters of this study, it can be concluded that use of intracanal medicaments during endodontic treatment has a definite impact on the apical seal of the root canal system.

Background: Periodontal disease is an immune-inflammatory disease characterized by connective tissue breakdown, loss of attachment, and alveolar bone resorption. Under normal physiological conditions, a dynamic equilibrium is maintained between the reactive oxygen species (ROS) and antioxidant defense capacity. Oxidative stress occurs when this equilibrium shifts in favor of ROS. Oxidative stress is thought to play a causative role in the pathogenesis of periodontal diseases. Aim: The present study was designed to estimate and compare the superoxide dismutase (SOD) and glutathione (GSH) levels in the serum of periodontitis, gingivitis, and healthy individuals before and after nonsurgical periodontal therapy. Materials and Methods: The present study was conducted in the Department of Periodontics, A. B. Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore. The study was designed as a single blinded interventional study comprising 75 subjects, inclusive of both sexes and divided into three groups of 25 patients each. Patients were categorized into chronic periodontitis, gingivitis, and healthy. The severity of inflammation was assessed using gingival index and pocket probing depth. Biochemical analysis was done to estimate the SOD and GSH levels before and after nonsurgical periodontal therapy. Results obtained were then statistically analyzed using ANOVA test and paired t-test. Results: The results showed a higher level of serum SOD and GSH in the healthy group compared to the other groups. The difference was found to be statistically significant (P < 0.0001). The post-treatment levels of SOD were statistically higher than the pre-treatment levels in periodontitis and gingivitis group.

Aims: Comparative evaluation of cleaning efficacy of smear layer removal by different irrigating solutions such as 2.5% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA) with 2.5% NaOCl, 10% citric acid with 2.5% NaOCl and 1% tetracycline Hydrochloride (HCl) with 2.5% NaOCl for smear layer removal in the apical third of root canal. Settings and Design: In vitro material science study. Materials and Methods: Seventy-five single rooted permanent maxillary central incisor teeth were subjected to standardized root canal instrumentation (crown down technique). The teeth were randomly divided into five groups with 15 teeth in each groups: (1) Normal saline (n = 15) (2) 2.5% NaOCl (n = 15) (3) 17% EDTA + 2.5% NaOCl (n = 15) (4) 10% citric acid + 2.5% NaOCl (n = 15) (5) 1.0% tetracycline HCL + 2.5% NaOCl (n = 15). After final irrigation, the teeth were prepared for scanning electron microscope analysis to evaluate the cleaning of apical third of radicular dentine to determine the presence or absence of smear layer. Statistical Analysis Used: The results were analyzed by nonparametric statistical analysis techniques. Kruskal-Wallis test, Mann-Whitney test and Chi-square tests were carried out. Results: There was no significant statistical difference in the efficacy of smear layer removal when 2.5% NaOCl was compared with 17% EDTA with 2.5% NaOCl, 10% citric acid with 2.5% NaOCl and 1% tetracycline HCl with 2.5% NaOCl in apical third of root canals. Conclusions: The present study suggests that irrigating agents, citric acid and tetracycline HCl can be used as an alternative to EDTA for the removal of smear layer in endodontics.

Aims and Objectives: To evaluate the pre-treatment and post-treatment dental arch changes in both upper and lower arches in orthodontic patients treated with extraction of first premolar teeth. Subjects and Methods: Measurements were made on casts of 50 post treated cases in the age group of 12-30 years for individual tooth measurements, width of the arches (inter-incisal, inter-canine, inter-premolar and inter-molar) arch length (both right and left sides, anterior segment, posterior segment and total arch length for both for the maxillary and mandibular dental casts. Statistical Analysis Used: Kolmogorov-Smirnov test for Normality, Regression Analysis was done as variables were tested and proved to follow normality. Statistical software  Statistical Package for the Social Sciences version 18 (SPSS Inc.; Chicago, Illinois, USA) was used for data analysis. Descriptive statistics and paired t-tests were used to compare the changes in the Class I and Class II div 1 groups. Results: There was a significant increase in the inter-incisor and inter-canine width post-treatment in the Class I and Class II div 1 subjects in the upper arch but no significant change in inter-incisor width in the lower arch in class I subjects. A significant decline in the inter-molar arch width in both the groups were seen. The inter-premolar arch width declined significantly in Class I cases while it increased significantly in Class II div 1 subjects. There was a significant increase in anterior arch length and a significant decrease in posterior arch length in all subjects. Conclusions: The findings of this original clinical research should significantly help the orthodontists in orthodontic treatment planning in patients requiring extractions of premolars.

Context: Moist environment in the mouth varies and causes variable amounts of corrosion of dental materials. This is of concern particularly when metallic implants, metallic fillings, orthodontic appliances are placed in the hostile electrolytic environment in the human mouth. Components of diet rich in salt and spices are important factors influencing the corrosion of metallic appliances placed in the oral cavity. Aims: To study in vitro corrosion of orthodontic metallic brackets immersed in solutions of salt and spices in artificial saliva. Materials and Methods: Orthodontic brackets were used for corrosion studies in artificial saliva, salt, and spices using electrochemical technique and surface analysis. Electrochemical studies using different parameters were done in solutions of artificial saliva containing salt and spices. Photomicrographs from the optical microscope were also obtained. Results: Results of corrosion studies have clearly demonstrated that certain spices such as turmeric and coriander are effective in reducing corrosion, whereas salt and red chili have been found to enhance it. Surface analysis of small pits present on the surface of the as-received bracket will initiate corrosion which leads to more pitting.

Introduction: A proper cast is essential for a successful rehabilitation with implant prostheses, in order to produce better structures and induce less strain on the implants. Aims: The aim of this study was to evaluate the precision of four different mold filling techniques and verify an accurate methodology to evaluate these techniques. Materials and Methods: A total of 40 casts were obtained from a metallic matrix simulating three unit implant-retained prostheses. The molds were filled using four different techniques in four groups (n = 10): Group 1 - Single-portion filling technique; Group 2 - Two-step filling technique; Group 3 - Latex cylinder technique; Group 4 - Joining the implant analogs previously to the mold filling. A titanium framework was obtained and used as a reference to evaluate the marginal misfit and tension forces in each cast. Vertical misfit was measured with an optical microscope with an increase of 120 times following the single-screw test protocol. Strain was quantified using strain gauges. Data were analyzed using one-way ANOVA (Tukey's test) (α =0.05). The correlation between strain and vertical misfit was evaluated by Pearson test. Results: The misfit values did not present statistical difference (P = 0.979), while the strain results showed statistical difference between Groups 3 and 4 (P = 0.027). Conclusions: The splinting technique was considered to be as efficient as the conventional technique. The strain gauge methodology was accurate for strain measurements and cast distortion evaluation. There was no correlation between strain and marginal misfit.

Introduction: Abundant resources and techniques have been used for complete coverage crown fabrication. Conventional investing and casting procedures for phosphate-bonded investments require a 2- to 4-h procedure before completion. Accelerated casting techniques have been used, but may not result in castings with matching marginal accuracy. Aims and Objectives: The study measured the marginal gap and determined the clinical acceptability of single cast copings invested in a phosphate-bonded investment with the use of conventional and accelerated methods. Materials and Methods: One hundred and twenty cast coping samples were fabricated using conventional and accelerated methods, with three finish lines: Chamfer, shoulder and shoulder with bevel. Sixty copings were prepared with each technique. Each coping was examined with a stereomicroscope at four predetermined sites and measurements of marginal gaps were documented for each. Statistical Analysis: A master chart was prepared for all the data and was analyzed using Statistical Package for the Social Sciences version. Evidence of marginal gap was then evaluated by t-test. Analysis of variance and Post-hoc analysis were used to compare two groups as well as to make comparisons between three subgroups . Results: Measurements recorded showed no statistically significant difference between conventional and accelerated groups. Conclusion: Among the three marginal designs studied, shoulder with bevel showed the best marginal fit with conventional as well as accelerated casting techniques. Accelerated casting technique could be a vital alternative to the time-consuming conventional casting technique. The marginal fit between the two casting techniques showed no statistical difference.

Introduction: Dental anomalies (DAs) are the result of disorders that are able to modify the shape, number, size, and structure of teeth. This study aimed to evaluate the prevalence of DAs using panoramic radiographs in a population of the City of Belém, northern Brazil. Materials and Methods: In this study, 487 panoramic radiographs were evaluated searching for DAs. Dental records were reviewed for diagnostic confirmation. DAs related to the shape, number, size, and structure of teeth were investigated. Results: Our results showed a DA prevalence of 56.9%. The most prevalent DA was taurodontism, which was present in 27.19% of cases. Root dilaceration was the second most prevalent DA in adults, whereas hypodontia was the second most prevalent DA in children. A total of 13 DAs were found. Conclusions: Dental anomalies were present in over half of the sample, and most of them were related to the shape of the teeth. Although there was a high prevalence of shape-related DAs, these alterations are generally of lower severity, and most do not require specific treatment. However, in 19.25% of cases, DAs were found involving the number, size and structure of the teeth. These DAs should be diagnosed and treated early, avoiding thus more serious complications.

Aim: The aim of this study was to understand the tobacco consumption patterns and their relationship with life course socioeconomic mobility among fish industry workers as this could provide important information in dealing with the tobacco problem in this very vulnerable population. Materials and Methods: Socioeconomic life course data and information about tobacco habits was collected from 102 fish industry workers. A subject was considered to be upwardly mobile if the family head's educational attainment and the number of earning members increased and the number of children and dependents decreased since childhood in his or her household. Oral examination was also done for malignant/premalignant lesions. Results: Of the 102 subjects, 64 regularly consumed tobacco either in smoking or smokeless forms and the common reasons for the habit were the co-workers' influence and to keep awake at work. Fourteen subjects had premalignant lesions in the oral cavity and all them were in the buccal mucosa. The prevalence of the tobacco habit was much lesser (25%) among the upwardly mobile group when compared to the minimal or no improvement group (75%). A majority of those free from the habit (73.7%) were belonging to the group, which showed improved educational attainment. Among those with good social mobility, the percentage of workers with high frequency of tobacco consumption and those with a longer duration of the tobacco habit was low when compared to the minimal social mobility group. Conclusion: A holistic approach consisting of efforts to improve the overall socioeconomic conditions can be more effective than piecemeal solutions in dealing with the tobacco menace.

Background: Leptin is a polypeptide hormone associated with the occurrence of legion of diseases including obesity, cardiovascular diseases, and diabetes. Periodontitis, that is, inflammation of the periodontium has also been linked to a number of systemic manifestations. Aim: The aim of the present study was to analyze the role of leptin as a biomarker linking periodontitis with obesity, cardiovascular diseases, and diabetes. Setting and Design: The inclusion criteria included, clinical trials available in English language; studies involving human participants; studies relating leptin and periodontal diseases to either obesity, cardiovascular diseases or diabetes. Exclusion criteria enlisted manuscripts in language other than English; if they were case reports, narrative reviews, personal communication, conference presentations, editorial and expert opinion; experiments not involving humans. Methods: We performed a literature search encompassing the time period from January 2000 to May 2013. A systematic search of the Cochrane Library and the Medline through PubMed was performed using the selected keywords/phrases "leptin and periodontitis," "leptin and periodontal diseases," "leptin, periodontitis and obesity," "leptin, periodontitis and cardiovascular diseases," and "leptin, periodontitis, and diabetes." Result: A total of 23 studies was obtained using the selected keywords/phrases. On screening, the chosen studies seven fulfilled the inclusion criteria. Four demonstrated association of leptin with periodontitis and obesity. One study associated cardiovascular diseases and periodontitis through leptin whereas two were found linking leptin, periodontitis, and diabetes mellitus. Conclusion: We could find some positive consociation between the serum concentration of leptin, periodontitis, and systemic diseases including obesity and cardiovascular diseases. The results were conflicting when its relation with diabetes mellitus type 2 was examined, as one study favored the association whereas the other one claimed that there was no effect on the levels of leptin.

The lack of the left first molar maxillary and the left second molar maxillary, caused respectively by impaction and agenesis is a very rare case, which determines an important occlusal imbalance and asymmetrical mandible movement. A gnatologic and functional orthodontic approach were planned to improve the retrognathic mandible and the muscular activity using kinesiograph and electromyography.

Dentofacial deformities involve deviations from the normal facial proportions and dental relationships and can range from mild to being severe enough to be severely handicapping.The term handicapping malocclusions though not a term commonly used, involves a fortunately small section (2-4%) of patients who can suffer from esthetic,psychological and functional problems. Craniofacial Orthodontics is the area of orthodontics that treats patients with congenital and acquired deformities of the integument and it's underlying musculoskeletal system within the craniofacial area and associated structures.This case report of a young woman with severe mandibular deficiency and facial asymmetry due to condylar ankylosis highlights the importance of team work in rehabilitation of such severe craniofacial deformities.

Lipomas are benign soft tissue mesenchymal neoplasms. Fibrolipoma is a histological variant of lipoma that mostly affects the buccal mucosa and causes functional and cosmetic disabilities. The diagnosis and differentiation of fibrolipoma with clinically similar lesions such as fibroma and pleomorphic adenoma is very essential for a correct treatment plan and complete follow-up. This article presents a case of a 35-year-old female with a fibrolipoma on the lingual marginal gingiva of the mandibular left third molar.

Zygomatic bone forms major buttress of the facial skeleton and plays an important role in facial contour. Fractures of zygomatic complex are second most common only next to nasal bone fractures. Motor vehicle accidents and interpersonal violence are common causes. Bilateral fractures of zygomatic complex and zygomatic arch are very rare. We present a case report of isolated fractures involving bilateral zygomatic complex and zygomatic arch with oral submucous fibrosis, which is unique and first of its kind to be reported.

Restoration of a traumatically injured tooth presents a clinical challenge for a predictable aesthetic outcome. This case report describes a multidisciplinary approach of a subgingivally fractured permanent maxillary central incisor. A removable orthodontic appliance was used for orthodontic extrusion of root, and surgical gingival recontouring was done with electrocautery to reestablish the biological width. Form and function were restored establishing biological width and esthetics was repaired with porcelain fused to metal crown.