Aim: The concept of the Recurring esthetic dental (RED) proportion is useful in diagnosing and developing symmetry, dominance and proportion for esthetically pleasing smiles. This study was undertaken to evaluate validity of RED proportion in mandibular anterior teeth. Materials and Method: One hundred and three subjects in age group of 50 yrs. and more were selected for the study. Photographs of subjects were taken using Nikon D200 camera with 135mm lens and analyzed using Adobe Photoshop CS4 extended software. The widths of mandibular central incisor, lateral incisor and canine were measured with this software and their successive proportions were calculated. Results: After calculating proportions in mandibular anterior teeth, P value was found to be statistically insignificant (P > 0.05). Conclusion: Within the limitations of the study, RED proportion was not seen in mandibular natural dentition.

Aim: The purpose of the study was to examine the changes in dimension of pharyngeal airway spaces (PAS) and hyoid bone position after surgery in class II and class III skeletal malocclusion. Methods: This study included 50 patients of class II and class III skeletal and dental malocclusion who had undergone orthognathic surgery. The pre and post treatment lateral cephalograms were taken to calculate upper and lower air way spaces and position of hyoid bone was also measured before and after the surgery. Results: Changes in upper and lower airway spaces and alteration in the location of hyoid bone was seen in Class II cases only. Conclusion: Maintaining of lower air way spaces in surgical class III cases of mandibular set back and position of hyoid bone is very important.

Aim: To evaluate the crazing of preformed stainless steel crowns by two different temperatures of autoclave sterilization. Materials and Method: 15 stainless steel crowns (3M ESP) were divided into 3 groups namely Group 1(G1) which was taken as control, Group 2(G2) which underwent Steam autoclaving at 121΀c, 15psi pressure for 20 minutes and Group 3(G3) which underwent Steam autoclaving at 132΀c, 30psi pressure for 8 min. The changes on the vestibular surface were then scored for presence or absence of crazing by using stereomicroscopy. The data was then analysed. Results: In control group the surface was relatively smooth when observed under stereomicroscope. However, in Group 2 cracks involving one-third to one-half of the surface were seen under stereomicroscope. Similar results were obtained in Group 3. Conclusion: Technique of steam autoclaving of sterilization has harmful effect on the surface of stainless steel crowns.

Aim: In office bleaching has gained popularity in recent times as one of the most efficient and cost effective technique for treatment of discoloured teeth. Aim of this study was to evaluate the bleaching efficiency of two different In office bleaching materials and the efficacy of light on the shade change. Materials and Methods: 24 patients were randomly assigned to 4 treatment groups. Treatment involved application of 40% H2O2 (Opalescence Boost, Ultradent, US), 35% H2O2 (Whiteness HP Maxx, FGM Dental Products, Brasil) with and without using LED Bleaching light. Evaluation of shade change was done subjectively (Vita Classical shade guide) as well as using spectrophotometer (Vita Easy shade). Results: Statistical analysis of data revealed that there was no significant difference among the two bleaching materials with or without the use of light, but a significant difference was observed when bleaching with light was compared to bleaching without light. Conclusion: The use of light enhances the bleaching efficiency of in office beaching gels irrespective of the concentration.

Aim: Arthrocentesis of the temporomandibular joint traditionally involves irrigation of the upper joint space and manipulation of the joint, using 2 needles inserted through two separate puncture sites. The blind insertion of the second needle is often challenging. The surgeon may lose the right place during the procedure. So it may need manipulation and sometimes even multiple punctures. This often leads to extra -articular leak of the lavage solution which decreases the intra-articular pressure required for lysis. To overcome this unwanted clinical situation, a simple technique of introducing both the needles through a single puncture to accomplish the procedure of arthrocentesis more effectively has been followed in this study. Materials and Method: This study was conducted on 20 patients diagnosed with inflammatory conditions of the temporomandibular joint. Patient underwent arthrocentesis using a modified dual needle device with Ringer's lactate as a lavage solution. Pre-op and post-op data were recorded over three months and analyzed statistically. Results: Mouth opening and visual analogue score for pain which were analyzed by student paired t test revealed that mouth opening increased and pain decreased significantly (p<0.05). Joint sounds reduced only in two patients. Conclusions: Arthrocentesis is a simple conservative surgical procedure with minimal inVASion performed to flush the inflamed TMJ. Single puncture arthrocentesis technique with a dual needle device further simplifies the procedure which is evident with significant results. Future studies with larger sample size and longer duration of follow up will test the true efficacy of this technique.

Aim: To evaluate the efficacy of commercially available nano-hydroxyapaptite paste as a desensitizing agent. Materials & Methods: The study included 30 subjects complaining of dentinal hypersensitivity. After prophylactic scaling & root planing, patients were instructed to brush with the given commercially available nano-hydroxyapatite paste twice a day. A numeric rating scale was used to measure the parameter of pain related to the stimuli at the baseline and after the application of gel at the intervals of 24 hours, 1 month, 3 months and 6 months. Results: There was remarkable decrease in the dentinal hypersensitivity at the end of 6 months. Intragroup comparisons at various time intervals were significant (p<0.0001). The mean pain score at the end of 6 months was 3.00 +/- 0.468 from 7.93 +/- 0.248 at the baseline. Conclusion: Hence, commercially available nano-hydroxyapatite paste is effective in reducing dentinal hypersensitivity.

Aim: To check the knowledge and technique of Wright's modification of Frankl's behavior rating scale among postgraduate students of pediatric dentistry in Ahmedabad city. Materials and Method: 21 postgraduate students studying in pediatric dentistry of different colleges from Ahmedabad city were selected. A questionnaire containing various questions regarding Wright's modification of Frankl's behavior rating scale was asked to fill. Result: The results suggested that they use this scale routinely and rate it properly but there are differences in timing of the rating. Conclusion: All Post Graduate students in pediatric dentistry from Ahmedabad city colleges use Wright's modification of Frankl behavior rating scale routinely and correctly.

Background: Twinned or geminated teeth may cause spacing, caries, aesthetic and periodontal problems which are usually seen in the anterior region. Various treatment methods can be used for correction of double teeth according to the demands of the condition. This article reports bilateral fused maxillary incisor teeth. The fused right side incisor was separated by hemisection and remaining mesial incisal margin was built using composite. Further, comprehensive orthodontic treatment was done to align the anterior maxillary teeth.

Background: Airway management in patient with Facio-Maxillary injury is challenging due to disruption of components of upper airway, and anesthesiologist has to share the airway with the surgeons. Submental Endotracheal Intubation is safe, simple and useful technique, where oral and nasal Endotracheal Intubation cannot be performed. It avoids tracheostomy and its consequent morbidity. Here is described a case of Submental endotracheal Intubation in a 52 years old patient with panfacial trauma (FMI). He was schedule for surgical reconstruction involving Maxilo-Mandibular Fixation. Intermittent intra-operative, dental occlusion was needed to check alignment of fractured segment. Patient had nasal bone fracture and crush injury to tongue and its challenging task for an anesthesiologist to manage such airway without further damage to upper airway. Several techniques have been proposed. In this case Submental endotracheal Intubation technique for surgery with the help of surgeon was used and intra operative and post-operative period was uneventful.

Background: The term Riga-Fede disease has been used historically to describe traumatic ulceration that occurs on the ventral surface of tongue in neonates and infants. It is most often associated with natal and neonatal teeth in newborns. A case of Riga-Fede disease is presented here.

Background: Occurrence of giant cells has been reported in malignancies of pancreas, breast and thyroid but rarely in benign tumors. However, giant cells were observed in some benign odontogenic neoplasms like solid multicystic ameloblastoma. Studies were carried out in the past to establish the origin and nature of these giant cells and the results were quite variable. Here, a very rare case of unicystic ameloblastoma (UA) is presented which revealed focal multinucleated giant cells in close proximity to the calcifications seen in the connective tissue. An attempt was made to identify the nature and origin of these giant cells by immunohistochemical staining, the cells were negative for cytokeratin and positive for CD68. This suggests that the giant cells were non-epithelial in origin and probably were of foreign body type and stromal in origin.

Background: Pyogenic granuloma is primarily a reactive tumour like overgrowth seen in the oral cavity caused due to irritation, physical trauma or hormonal factors. Pyogenic granuloma is not an infectious but a reactive lesion, and causes functional and esthetic challenges. This case report describes the occurrence of multiple pyogenic granulomas; a rare entity; in the oral cavity of a 35 year old female patient. Diagnosis and treatment of pyogenic granuloma is important to prevent its recurrence. Based on clinical findings and histopathological reports a proper diagnosis was achieved and the multiple lesions were treated using a minimally invasive technique of excision using a diode laser.

Background: A maxillary first molar with more than four canals is an interesting example of anatomic variations, especially when two of these canals are detected, with separate apical foramen in the distal root. The inability to locate the unexpected canals of various anatomical configuration and subsequently treat them , may lead to therapeutic failures. Endodontic retreatment is usually the modality of choice in such cases. This report describes a case of a maxillary first molar with five canals (two mesial canals in mesial root, two distal canals in two distal roots and a palatal canal in palatal root). Additionally it shows a rare anatomic configuration and emphasizes the importance of identifying additional canals.

Background: Prosthetic reconstruction of partial maxillectomy defects is a challenging procedure that requires multidisciplinary expertise to achieve an acceptable function, speech and esthetics. This procedure improves the quality of life for the patient as a normal individual. Obturation of the defect depends on its volume and position of remaining hard and soft tissues which determine the retention, stability and support for the prosthesis. The prosthesis should be simple to handle, easy to maintain, biocompatible, light in weight and convenient for future adjustments. This case report describes a clinical case of partial maxillectomy which was successfully rehabilitated with a definitive closed hollow bulb obturator and cast metal denture base.