Aim: This study aims to evaluate the effect of two bioflavonoids (epigallocatechin-3-gallate [EGCG] and catechin) and a protein inhibitor (chlorhexidine [CHX]) on the immediate and delayed microtensile bond strength of self-etch and total-etch adhesive systems to sound dentin. Materials and Methods: The occlusal surfaces of 96 mandibular human third molar teeth specimens were ground after removal of the excess tissues, to expose the middle dentin. The dentin specimens were randomly allocated into four groups, each consisting of 24 teeth (n = 24) according to the application of the enzyme inhibitor. The adhesive system used in this study was Adper easy bond, a self-etch adhesive system, and Adper Single Bond 2, a total-etch adhesive system. Microtensile bond strength testing was conducted using thermocycler 2000, Heto-Holten A/S. Results: All the three enzyme inhibitors increase the bond strength values of the resin–dentin interphase when used during dentin bonding. The EGCG enzyme inhibitor has shown the highest immediate bond strength to dentin when used with both the adhesive systems.

Introduction: Soft-tissue analysis has become an important component of orthodontic diagnosis and treatment planning. Photographic evaluation of an orthodontic patient is a very close representation of the appearance of the person. The previously established norms for soft-tissue analysis will vary for different ethnic groups. Thus, there is a need to develop soft-tissue facial profile norms pertaining to Indian ethnic groups. Aim and Objectives: The aim of this study is to establish the angular photogrammetric standards of soft-tissue facial profile for Indian males and females and also to compare sexual dimorphism present between them. Materials and Methods: The lateral profile photographs of 300 random participants (150 males and 150 females) between ages 18 and 25 years were taken and analyzed using FACAD tracing software. Inclusion criteria were angles Class I molar occlusion with acceptable crowding and proclination, normal growth and development with well-aligned dental arches, and full complements of permanent teeth irrespective of third molar status. This study was conducted in Indian population, and samples were taken from various cities across India. Descriptive statistical analysis was carried out, and sexual dimorphism was evaluated by Student's t-test between males and females. Results: The results of the present study showed statistically significant (P < 0.05) gender difference in 5 parameters out of 12 parameters in Indian population. Conclusion: In the present study, soft-tissue facial measurements were established by means of photogrammetric analysis to facilitate orthodontists to carry out more quantitative evaluation and make disciplined decisions. The mean values obtained can be used for comparison with records of participants with the same characteristics by following this photogrammetric technique.

Background: The use of rubber dam (RD) has been recommended in dental procedures including root canal treatment. The aim of the study was to identify factors that were associated with patients' satisfaction and acceptance of RD. Setting and Design: This was a cross-sectional study, conducted from January 2015 to December 2016 at Kuwait University School of Dentistry. Materials and Methods: A pretested questionnaire was used by a face-to-face interview of patients after taking informed consent. The study was approved by the Institutional Ethics Review Board. The providers/operators who applied RD were grouped into three categories: undergraduate final year (7^th year) dental students; general dentists and postgraduate students; and specialists. Results: Mean age of the patients (n = 175) was 31.6 ± 13.0 years. About 55% had past experience, and 52% expressed a better experience during the current procedure compared with the previous one. A positive experience during the current procedure correlated significantly with the future intention of RD use (r = 0.244, P = 0.001). Time needed for RD application was short (4 min), irrespective of the operators. The duration of RD use during the procedure was significantly shorter among dental specialists compared with the other groups. Time for RD application was the only significant predictor for patient satisfaction, after controlling for other independent variables. Conclusion: Based on the positive influence of current RD use on the future intention, dentists should spend time needed to explain the importance, safety and effectiveness of RD use with their patients.

Background: Oral hygiene maintenance is crucial for prevention of various oral diseases. Oral hygiene practices across the country vary largely and people in peri-urban and rural areas use traditional methods of oral hygiene like powders, bark, oil and salt etc. Their effect on oral soft and hard tissues need to be studied to understand their beneficial and/ or harmful effects on maintenance of oral hygiene and prevention or causation of oral diseases. Objectives: This study aimed to assess the plaque-cleaning efficacy, gingival bleeding, recession and tooth wear with different traditional oral hygiene methods as compared to use of toothpaste-toothbrush, the most accepted method of oral hygiene practice. Study Design: Hospital based cross sectional analytical study. Results: Total 1062 traditional oral hygiene method users were compared with same number of toothpaste-brush users. The maximum number in the former group used tooth powder (76%) as compared to other indigenous methods, such as use of bark of trees etc and out of tooth powder users; almost 75% reported using red toothpowder. The plaque scores and gingival bleeding & recession were found to be more in traditional oral hygiene method users. The toothwear was also more severe among the toothpowder users. Conclusions: Traditional methods were found to be inferior in plaque control as was documented by increased bleeding and gingival recession. Its effect on hard tissues of teeth was very damaging with higher tooth wear scores on all surfaces.

Background: Anthropometric measurements of the face can be used as a guide in selecting proper sized anterior teeth. Aim: The aim of this study is to evaluate the relationship between the interpupillary distance (IPD) and the combined mesiodistal width of maxillary central incisors (MDW of MCIs) to establish their morphometric criterion and their significance in two ethnic groups of Northeast India. Methodology: A total of 120 participants consisting of 60 indigenous students each from Assam and Meghalaya in the age group of 18–25 years were selected after taking their written consent. Standardized facial frontal photographs of all the participants were taken using a digital camera in such a manner that maxillary anterior teeth were visible. The photographs were uploaded onto the computer and saved in a file. Anthropometric measurements of IPD and combined MDW of MCIs in centimeters were made using both Adobe Photoshop^® 7.0 software program and manually using a digital vernier caliper on the developed photographs to a same size of 15 cm × 10 cm. Data obtained were tabulated and analyzed using Student ”t”-test and Pearson correlation test. Results: The present study reveals a positive correlation with a high degree of statistical significance between IPD and combined mesiodistal width of maxillary central incisors among all the samples irrespective of gender and ethnicity where P < 0.01. Conclusion: IPD can be used as a guide in determining the suitable mesiodistal dimension of the maxillary central incisors.

Background: Oral health of schoolchildren is a strong predictor of their overall well-being. This study was planned to assess and compare the objective and subjective parameters of oral health of South Indian school children. Methodology: Three hundred and sixty school children participated in this cross-sectional study. Their oral hygiene status, dental caries status, and treatment needs were assessed. Two questionnaires were filled by these children, to assess their oral health-related quality of life (OHRQoL) and their knowledge on oral health. Their academic scores were collected from the schools. Statistical analysis was done using Kruskal–Wallis ANOVA test and Spearman correlation test appropriately. Results: Children with no caries had better OHRQoL (P = 0.02). There was a negative correlation between dental caries status and OHRQoL score (P = 0.003) and dental caries treatment needs and OHRQoL score (P = 0.01). There was a positive correlation between knowledge on oral health and OHRQoL score (P = 0.02). Conclusion: Children with no caries had a better OHRQoL when compared to children with caries. Children with caries had more treatment needs, poor oral hygiene, low quality of life, and performed lesser in academics. However, they had adequate knowledge on oral health. Hence, both objective and subjective parameters of oral health should be given importance while treating children.

Purpose: The purpose of this study is to assess the outcomes of frontalis sling using fascia lata and silicone aurosling for congenital unilateral ptosis patients with poor levator function. Material and Methods: Retrospective study of archival cases from 22 patients from author's center. All the patients with unilateral ptosis with poor levator function were included excluding those having poor Bell's phenomenon and associated pathology like jaw winking, 3^rd nerve misdirection, squint, impaired corneal sensitivity, and neoplastic lesions. Patients were diagnosed based on the history and clinical examination including measurements. Corrections were performed by single surgeon. Marginal reflex distance-1 (MRD1) values observed preoperatively, immediate postoperatively, and late postoperatively in both groups. Results: Of the 22 cases, 12 were treated with fascia while the remaining 10 were treated with silicone aurosling material. The mean age of the fascia group was 11.42 ± 3.55 years while it was 14 ± 4.2 years for the silicone group. There were 10 males and 12 females in the study group. The mean follow-up in the study group was 20.14 ± 2.05 months, and the difference between the groups was not statistically significant. The difference between the two groups at the preoperative and immediate postoperative did not vary with statistical significance (P = 0.926 and P = 0.242, respectively). The late postoperative MRD1 did vary significantly between the two groups. The mean late postoperative MRD1 for fascia group was 3.67 ± 0.32 with a range of 3.1–4.15 while for the silicone group was 3.2 ± 0.46 with a range of 2.5–4. The difference was statistically significant (P = 0.023). Discussion and Conclusion: The stability of the change in silicone aurosling group was relatively less as compared to the fascia lata. The recent material aspect study of such silicone aurosling material indicates that they are susceptible to damage and that cause the loss of stability. More studies with larger sample size and longer follow-up are needed.

Context: Polo-like kinase 1 (PLK1) is a critical molecule in the proliferation of several human cancers. Overexpression of PLK1 has been correlated with cancer cell proliferation and lower overall survival rates. Although PLK1 has been studied in various tumors, information regarding its expression in oral cancer and precancer is limited. Aims: This study is aimed at evaluating the expression of PLK1 in a potentially malignant and malignant disorder of the oral cavity, namely, oral submucous fibrosis (OSMF) and oral squamous cell carcinoma (OSCC), respectively, using the immunohistochemistry technique. It also intended to evaluate the association of the various histological grades of OSCC with the intensity of PLK1 expression. Subjects and Methods: Thirty OSMF, thirty OSCC tissues, and thirty control tissues were obtained, and the expression of PLK1 was detected by immunohistochemistry using rabbit antihuman PLK1 polyclonal antibodies (Abcam Ab47867). The association between staining intensity and histological grade of OSCC was evaluated. Statistical Analysis Used: Using SPSS 20 version, a test for proportions, nonparametric Chi-square/correlation analysis was used to compare differences in proportions of categorical variables of interest between groups. Results: PLK1 was positively expressed in 27 (90%) OSCC tissues. OSMF showed no detectable staining in 27 (90%) tissues and positive staining in 3 (10%) tissues. PLK1 showed no staining (0%) in normal tissues. Statistically significant associations were not found between staining intensity and histological grade of OSCC. Conclusions: PLK1 could be a promising progression marker for OSCC. Therapeutically, targeting PLK1 may be a new approach to fight oral cancer.

Aims: To evaluate the use of various gingival displacement techniques prior to impression making in fixed partial dentures by the Prosthodontists in Vadodara. Settings and Design: Questionnaire based survey among prosthodontists in Vadodara city. Methods and Material: All the prosthodontists practitioners and those prosthodontists in academic institutes in Vadodara City, Gujarat, were surveyed through a questionnaire regarding their usage of gingival displacement technique and their reasons and methods of using gingival displacement technique for fixed partial denture. The results were analysed through discriminant statistical analysis. Results: Among all the Prosthodontists in Vadodara city, 62% prefer the use of gingival displacement technique for successful clinical practice while 38 % of them do not follow the procedure believing it does not make major difference in clinical practice. Conclusions: Those Prosthodontists who preferred the use of gingival displacement technique were able to detect many advantages of using it in their daily fixed partial denture practice and the percentage of prosthodontists not following gingival displacement technique blamed it as a time consuming affair and was not feasible on economic grounds for the class of patient they treated.

Aims: Haller Cells refer to the ethmoidal pneumatization and are the extensions of anterior ethmoid sinus into the floor of the orbit and superior aspect of the maxillary sinus, basically an anatomic variation. They may be associated with orofacial pain, sinusitis, nasal obstruction, impaired nasal breathing, headache, chronic cough, and mucocele. The aim of the present study was to identify, determine the prevalence and characteristics of Haller's cells on Digital orthopantomographs in patient's reporting to a dental institution in Chennai. Settings and Design: This was a retrospective, cross-sectional study. Subjects and Methods: The study group comprised 600 radiographs inclusive of both genders (379 females and 221 males) with an age range of 20–80 years. Retrospectively panoramic radiograph for each of the patients was viewed and interpreted for the presence of Haller's cells. The data collected was subjected to statistical analysis: frequencies/percentages, descriptive statistics to obtain the results. Statistical Analysis Used: Frequencies/percentages, descriptive statistics using SPSS for Windows Version 20 (SPSS Inc., Chicago, IL, USA), to obtain the results. Results: Haller's cells were noted in patients, accounting for a prevalence of 23.61%. The majority of the cells were circular, ovoid, and irregular in shape. Conclusions: This study has attempted to explore the characteristics of Haller's cells on panoramic radiographs. A description of Haller's cells on these radiographs may prove vital in enumerating the differential diagnosis for patients afflicted with intractable orofacial pain and reduce the risk of untoward intraoperative complications during endonasal procedures.

Background: Many studies have been carried out on the prevalence of dental diseases in children although not much information is available regarding its outcome among Indian children. Aim: The aim of the present study was to analyze the type of primary tooth extracted and the reasons for the extraction among children attending a tertiary care hospital in the Southern part of India. Materials and Methods: The dental records of pediatric patients who had visited the dental clinic of a tertiary care hospital located in Tamil Nadu, South India from December 2013 to November 2016 were reviewed. Patients who underwent extraction of at least one primary tooth under local or general anesthesia were included in the study. Results: A total of 943 primary teeth were extracted from 447 patients over 3 years. The most commonly extracted tooth type was the first primary molar followed by the primary central incisor. Grouping by age, the most frequently extracted tooth type between 2 and 5 years was the primary central incisor, the first primary molar among the 6–9-year-old and the second primary molar among 10–15-year-old. The majority of primary teeth extractions were performed in the age group of 6–9 years. No significant gender differences were noted. The most common reason for extraction of primary teeth in children was dental caries. Conclusions: This study demonstrates a high prevalence of untimely primary teeth extractions in young children and dental caries continues to be the leading cause. It clearly reflects on the lack of infant oral health care, the inadequacy of awareness and underutilization of oral health services among children in India.

Objective: The aim is to analyze the pattern of maxillofacial injuries and treatment outcomes in the past 15 years (2002–2016). Materials and Methods: One thousand eight hundred and fifty patients from two tertiary referral center hospitals were studied retrospectively in which the age, sex, etiology, site of fracture, and treatment modality was recorded. Results: One thousand two hundred and twenty-eight males and 622 females were operated between 2002 and 2016. Mean age was 29 ± 17.2 years. Maximum incidence was seen in the age group of 16–30 years in males, whereas in females, the predominance of trauma was seen in both 16–30 and 31–45 age groups. Road traffic accidents were responsible for the majority of fractures (42.2%), followed by assaults (26.4), sports injuries (17.6%), and fall (10.7%). Maximum fractures were of the mandible (53.5%) followed by midface (25.6%) and panfacial trauma (20.8%). Nearly 53.6% of patients underwent open reduction, and internal fixation (ORIF), 34.2% managed by the closed method and 12.1% were kept under observation. Conclusion: This study verified a young male predominance, a shift toward more assault related fractures, especially in females. Mandibular fractures were the most common of all. Moreover, the changing trend toward ORIF in the past 15 years.

Background: Verrucous carcinoma (VC) should be considered a distinct clinicopathologic entity different from the more common oral squamous cell carcinoma (OSCC) because of its unique biological behavior. Best way to understand the behavior of these carcinomas is to study them by means of molecular methods, especially in tumor progression tests and Bcl-X is an important antiapoptotic member of the Bcl-2 family and is one of the newest and most useful markers to determine the aggressiveness of many carcinomas. The relationship between this Bcl-X protein and carcinomatous behavior toward it is not studied extensively, which we attempted to evaluate using immunohistochemical analysis in selected carcinomas of the head and neck region. Method: We studied Bcl-X protein expression in sections of thirty OSCC and ten VC samples and correlated this with tumor differentiation. Results: There was a significant difference in cytoplasmic staining of Bcl-X expression with statistical analysis (P < 0.005) for VC and OSCC when compared as a group. No significance was seen among the different histological grades of OSCC and when compared with VC individually. Conclusion: The significant result between OSCC and VC suggests that their biologic course is comparable and can be helpful in differentiating them with each other for establishment of a better treatment protocol.

Introduction: Resin composite restorative materials can mimic the natural color and shade of the tooth. However, exogenous colorants from food and drinks can stain them due to adsorption. The influence of Indian food colorants and spices on resin composite restorations has not been evaluated extensively. Aim: This study aims to evaluate the staining capacity of microhybrid and nanohybrid resin-based composites, to saffron extract, tandoori powder, and turmeric powder. Subjects and Methods: Forty samples of microhybrid (Kulzer Charisma) and nanohybrid (3M Filtek Z350) resin composites were prepared using an acrylic template of dimension 5 mm × 3 mm. They were randomly divided into four groups and immersed into solutions of saffron extract, tandoori powder, and turmeric powder. Distilled water was used as the control group. Color values (L*, a*, b*) were measured by colorimeter using the CIE L*a*b* system before and after 72 h of immersion. Color differences ΔE*ab were statistically analyzed. Statistical Analysis Used: Two-way ANOVA and post-hoc Tukey (honest significant difference) test were done using IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY: IBM Corp. Results and Discussion: All the immersion media changed the color of the resin composites to varying degrees. However, turmeric solution showed the maximum mean color variation ΔE*ab of 14.8 ± 2.57 in microhybrid resin composites and 16.8 ± 3.50 in nanohybrid resin composites. Conclusion: Microhybrid and nanohybrid resin composites tend to stain to Indian food colorants, especially to turmeric powder.

Introduction: The circumferential 2 mm ferrule during the fabrication of the crown is strongly advocated for the long-term clinical success. During the routine clinical practice, the dentist encounters the endodontically treated tooth (ETT) with inadequacy of the ferrule in some segment due to caries, abrasion, and erosions. The aim of this in vitro study was to investigate the consequence of inadequate segmental ferrule location on fracture strength of the root canal-treated anterior and posterior teeth. Materials and Methods: Fifty each maxillary canine and mandibular premolar intact human teeth were root canal treated and sectioned at 2 mm above the cementum-enamel junction. The teeth samples were divided into 5 groups of 10 each. The G-I and G-V samples had the 360° ferrule and complete absence of the ferrule, respectively. The G-II had the inadequate ferrule on the palatal surface, while G-III and G-IV had inadequate ferrule at buccal and proximal area. Teeth samples were subsequently restored with glass-reinforced fiber post, composite core, and full veneer metal crown. The samples were tested with universal testing machine under static load to record the fracture resistance. The acquired data were subjected to ANOVA and Tukey's post hoc statistical analysis. Results: The G-I with circumferential ferrule showed the higher fracture resistance. The teeth samples with lack of the ferrule had the least fracture resistance. Among the segmental absence of ferrule, teeth samples with lack of the proximal ferrule were least affected. Deficiency of a ferrule on the lingual wall significantly affected the fracture strength in both anterior and posterior ETT. Conclusions: The ETT with sectional inadequacy of the ferrule is significantly more effective in resisting the fracture in comparison to the complete absence of the ferrule.

Aim: The aim of this study was to evaluate the kinetic frictional properties of colored titanium molybdenum alloy (TMA) archwires (purple-coated TMA and honey dew-coated TMA) and the regular TMA archwires. Materials and Methods: The experiment comprised of three groups, Group I – Regular TMA archwires, Group II – Purple-coated TMA archwires, Group III – Honey dew-coated TMA wires involving 21 samples each that were evaluated for their frictional properties using Instron Universal Testing Machine. Results: The results were subjected to statistical analysis using analysis of variance wherein Group I Regular TMA wires revealed mean kinetic frictional value of 8.236 N and a standard deviation of 0.4038 N, while Group II (purple-coated TMA wires) showed a mean value of 5.297 N, standard deviation of 0.3128 N and Group III (honey dew-coated TMA wires) showed a mean value of 4.206 N and a standard deviation of 0.5353 N. Conclusion: The kinetic frictional values are higher for regular TMA wire exhibiting superior characteristic of color-coated TMA. Wires exhibiting superior characteristics are color-coated TMA wires, especially honey dew-coated TMA wires over the regular and purple-coated TMA wires. These superior properties of newly introduced wires can be considered for its application in both details friction and frictionless mechanics in retraction phase of fixed orthodontic treatment.

Purpose: This review was intended to discuss the various possible modifications suggested in the literature for prosthetic steps and surgical corrective procedures in nonresponding or complicated cases during rehabilitation of patients with restricted mouth opening. Material and Methods: Medline, PubMed, and Google were searched electronically for articles using keywords: microstomia and treatment options for restricted mouth opening. The various articles on prosthodontic rehabilitation in microstomia were segregated. From these, various modifications in the prosthetic steps were reviewed. Results: Oral hygiene maintenance is difficult for patient either due to limited access or due to associated lack of manual dexterity, so dental decay and periodontal problems are more extensive in such patients; hence, tooth loss is a common finding. All prosthetic procedures require wide mouth opening to carry out various steps, starting from tray placement during impression making to the final prosthesis insertion, especially removable prosthesis. Various prosthetic modifications given by authors are included in this review for each step in prosthodontic management. A total of eight stock tray designs, 12 custom tray designs, and 17 removable prosthesis designs are discussed along with fixed (either tooth-supported or implant-supported) and maxillofacial prosthesis. However, some patients require surgical intervention also for the correction of microstomia either for function or for esthetic purpose before prosthetic rehabilitation and are also enumerated here. Conclusion: Among all prosthetic restorative options, removable prosthesis is most difficult for dentist to fabricate as conventional methods are either very difficult or impossible to apply. To get a more accurate final prosthesis, we need to modify these steps according to the existing case. Several modifications available are discussed here which can help while managing these patients.

Objectives: The purpose of this study was to conduct a systematic review and if appropriate a meta-analysis of the efficacy of daily rinsing with green tea-based mouthwashes in terms of plaque index (PI) and/or gingival index (GI) as compared to other mouthwashes in plaque-induced gingivitis patients. Materials and Methods: MEDLINE, Cochrane Central Register of Controlled Trials, IndMed, Google Scholar, and major journals were searched for studies up to December 2016. A comprehensive search strategy was designed, and the eligible articles were independently screened for eligibility by two reviewers. Randomized controlled trials in which individuals were intervened with oral mouthwashes of interest were included. Where appropriate, a meta-analysis was performed and standardized mean differences (SMDs) for GI and PI were calculated. Results: A total of 9 articles out of the 311 titles met the eligibility criteria. A meta-analysis was performed for five studies that compared green tea-based mouthwashes with chlorhexidine (CHX). The SMD for PI was −0.14 (95% CI: −1.70, 1.43; P = 0.86 and I² = 94%), while that for GI was 0.43 ((95% CI: -0.63, 1.49; P = 0.43, I² = 89%). Both these estimates suffered from significant heterogeneity. For both PI and GI, two studies were in favor of green tea while three studies were in favor of CHX. Conclusions: Green tea-based mouthwashes can be considered an alternative to CHX mouthwashes in sustaining oral hygiene, especially because of the added advantages provided by such herbal preparations.

Background: Gingival recession is one of the most usual esthetic concerns associated with the periodontal tissues. Classification of such condition is important to diagnose, determine the prognosis, and frame the treatment plan. Various classifications have been put forward since decades to classify gingival recession. Miller's classification is the widely used classification among all classifications, but certain drawbacks have been noted in this classification. Therefore, an effort is made to review most commonly used classification systems for gingival recession, and their drawbacks further come up with a proposal of new classification system for gingival recession.

Ghost cell odontogenic carcinoma (GCOC) is a malignant odontogenic epithelial tumor which is an exceedingly rare, highly aggressive, rapidly growing, and infiltrative tumor forming the malignant counterpart of long-standing benign cystic lesions coming in the spectrum of calcifying odontogenic cysts. To date, only a few cases have been reported in the medical literature. A case of unusual presentation of GCOC is presented and the clinical, histopathological, and immunohistochemical features are discussed along with a literature review. Our case report further emphasizes the bizarre biological behavior of this tumor and the need for strict long-term surveillance of the patients as metastasis to distant sites has been reported.

Developmental malformations of the teeth might result in alterations of their size, shape, and structure. An accessory cusp is a developmental alteration to the shape of the teeth and is more commonly found in anterior teeth, and its occurrence in permanent molars is quite rare. Accessory cusps occurring in permanent mandibular molars are termed as protostylids. Although they do not pose any significant problem with respect to the function and occlusion, it is of tremendous importance in forensic odontology. This case report presents a rare finding of protostylid on the permanent mandibular molar, and its clinical implications are illustrated.

Osteomyelitis is an infection that is challenging to manage due to the poor vascularization of bone that favors the proliferation of microorganisms. We report a case of osteomyelitis occurring in endodontically treated teeth in the maxillary palatal region. Clinically and radiographically, it was initially diagnosed as osteomyelitis and was treated accordingly with antibiotics for 1 year with no reported healing. Later, biopsy was done and the findings were consistent with that of chronic osteomyelitis in association with infection by Actinomyces organisms. Thus, the case highlights the rare occurrence of actinomycotic osteomyelitis in maxilla and the importance of biopsy and histopathology which will help in correct diagnosis and rapid resolution through appropriate antibiotic therapy.

Recent trends in maxillofacial surgery are to reduce the trauma to the adjacent soft tissue. The distoangular impaction presents a challenge to the maxillofacial surgeon and also results in more surgical morbidity. Here, we present a minimally invasive extraction technique for the distoangular mandibular third molar impaction.

Context: Periodontal diseases are among the most prevalent oral diseases in the world. Apart from repercussions in the oral cavity, there is evidence that periodontitis contributes to systemic damage in chronic diseases such as cardiovascular disease, diabetes, and preterm low birth weight. Aims: The aims of this study were to estimate the prevalence of chronic periodontitis in a sample urban population (<18 years) in Tamil Nadu and to estimate the inflammatory burden posed by chronic periodontitis by calculating the periodontal inflammatory surface area. Settings and Design: This was a population-based study and cross-sectional design. Subjects and Methods: A total of 1000 individuals (<18 years) were selected and screened for their periodontal status, oral hygiene status (OHI), and the periodontal inflamed surface area (PISA) in an outreach center located in Chennai, India. Statistical Analysis Used: The proportion of individuals with different periodontal states (health, gingivitis, and periodontitis) was determined. A multivariate logistic regression analysis was performed to assess the influence of the individual risk factors such as habits (tobacco use), systemic conditions (diabetes), and oral hygiene maintenance on periodontitis prevalence in the sample population. Results: A high prevalence of periodontal disease was observed in the study population (42.3%). Among the urban participants, age, cigarette smoking, pan chewing, decayed, missing, and filled teeth scores, OHI scores, and PISA scores were found to be significantly associated with periodontitis (P < 0.05). Conclusions: Periodontitis prevalence appears to be high even in areas with adequate access to oral health care and an inflammatory burden risk exists in a definitive manner.