Background : This disorder, also known by terms such as obstructive sleep apnea (OSA), upper airway sleep disorder and snoring. Snoring has also been identified as a possible risk factor for hyper tension, ischemic heart disease and stroke. The role of dentistry in sleep disorders is becoming more significant, especially in co- managing patients with simple snoring and mild to moderate OSA. The practicing dental professional has the opportunity to assist patients at a variety of levels, starting with the recognition of a sleep -related disorder, referring patients to a physician for evaluation and assisting in the management of sleep disorders. The first and simplest option would be behaviour modification, followed by insertion of oral devices suited to the patient, especially in those with mild to moderate OSA. Continuous positive airway pressure (CPAP) and surgic al options are chosen for patients with moderate to severe OSA.

Background : There is sufficient evidence supporting a causal relationship between periodontal disease and smoking. Smoking has major effects on the host response, and there are a number of studies that show it has potentially devastating effects on neutrophils. Neutrophils, being the first line defense of the host immune system, play a key role in several aspects of initiation and resolution of inflammation. The functional overview of the neutrophil consists of emigration to the local site of infection, consequent chemotaxis and phagocytosis, followed by release of its vast antimicrobial arsenal and various cellular mediators. At the conclusion of infection, these cells being active indicators of inflammation go into a state of programmed cell death (apoptosis) and signal the way for resolution of inflammation. This review describes in a step by step format the functional dysregulation that occurs with the neutrophil, its possible role in increasing the host's susceptibility to periodontitis, and also decreasing the host's response to periodontal therapy.

Background : Oral health professionals are constantly exposed to a number of specific occupational hazards which cause the appearance of various ailments, specific to the profession and intensified over a period of time resulting in diseases and disease complexes, some of which are regarded as occupational illnesses. Relying on relevant literature, the present paper discusses occupational hazards leading to the musculoskeletal system diseases. Awareness regarding these occupational hazards and implementation of preventive strategies can provide a safe working environment for all the dental personnel. There is also a need for continuing dental education programs in dentistry so that dentists can update themselves with the latest and newer techniques.

Background : Forensic dentistry represents the overlap between the dental and legal professions. Throughout this century, odontological examinations have been a critical determinant in the search for identity of individual remains. Dental maturity has played an important role in estimating the chronological age of individuals. Age estimation is a sub-discipline of the forensic sciences and should be an important part of every identification process, especially when information relating to the deceased is unavailable. Forensic dentist helps in identification of deceased victims by age, sex and race determination from teeth and skull. Since the scope of forensic odontology is very broad and challenging, dental surgeons trained in forensic odontology can make unique contributions in the administration of justice, which is the key note of democracy.

Aim : Peyronie's disease is a disorder of the connective tissue involving the soft tissue surface of the penis. There are various modalities to treat this disease ranging from intralesional injections to surgical removal. Extra Corporeal Shock Wave Therapy is a recent non-surgical modality to treat this disease. So, the aim of the present study was to check the efficacy of Shock Wave Therapy on Peyronie's Disease. Materials and Method: Thirty male patients were selected from the outpatient department. 300 shock waves were applied in 3 sets for 20 minutes. They were delivered at 009mJ/mm2 and frequency of 120/min. Data analysis was carried out by SPSS version17. Results: Forty percent patients had penile curvature. Penile plaque was found in all patients where 50% had it on dorsum of shaft, 33% on lateral and 17% on ventral surface. Calcified type of plaque was most commonly found (70%) in these patients. Shock wave therapy reduced the pain as well as the plaque size. There was significant reduction in the curvature of penis after treatment. Conclusion: The result of this study concluded that extra corporeal shock wave therapy can be a new non- invasive modality to treat connective tissue diseases like Peyroni's Disease.

Background : The use of herbal drugs for the prevention and treatment of various health ailments has been in practice from the time immemorial. Acacia arabica is considered as an astringent, demulcent, aphrodisiac, antihelminthic, antimicrobial, antidiarrhoeal with good nutritional value in Indian traditional medicine system. This study was done to evaluate the efficacy of a commercially available gel containing Acacia Arabica in reducing the gingival inflammation in chronic generalized gingivitis patients. Materials and Method: The study included 15 subjects diagnosed with chronic generalized gingivitis. They were asked to apply the Acacia Arabica gel for 1 week before undergoing mechanical therapy. The clinical parameters such as the Gingival Index (GI) and the Plaque Index were taken at baseline and one week after application of the gel. Results: The clinical parameters were compared using the Paired sample t- test and the commercially available gel containing Acacia Arabica was found to be effective in reducing inflammation in patients with chronic generalized gingivitis. The gingival index score reduced from 1.94 ± 0.234 at baseline to 1.22 ± 0.196 after one week whereas the plaque score reduced from 3.82 ± 0.524 at baseline to 2.86 ± 0.520 after one week. Conclusion: Herbal gel containing Acacia Arabica has proven to be useful in reducing the inflammation as well as an anti-plaque agent.

Aim: Successful root canal therapy requires an in depth knowledge of root anatomy and canal morphology. Generally the maxillary first molars have three roots and four canals. Unidentified second mesiobuccal canal may result in failure of the root canal treatment in maxillary first molar. The aim of the study was to compare the efficiency of dentist with unaided eye(UAE), assisted with surgical loupes (SL) or Dental Operating Microscope (DOM) in locating second canal in the mesio buccal root of the maxillary first molar in patients undergoing root canal treatment. Materials & Method : Access cavity preparation was done for maxillary first molars in 50 patients. A thorough visual examination to locate the second mesio buccal canal was carried out. If canal was not identified, further evaluation was done with SL. If canal was not found under SL, then DOM was used. In each method appropriate irrigation, lubrication, exploration and negotiation of the canal was performed with required armamentarium. Photographic documentation and multiple angled radiographs were taken. Results: Out of 50 patients, second mesiobuccal canal was located in 11 patients with UAE, 20 with surgical loupes, 37 under Dental Operating Microscope. DOM showed statistically significant difference in comparison with SL and UAE. SL showed no statistically difference in comparison with UAE. Conclusion : The use of DOM proved to be a better aid in location of the second mesio buccal canal than SL and UAE.

Aim : The aim of this study was to determine the prevalence of oral hygiene practices and halitosis among undergraduate students from Darshan Dental College, Udaipur, Rajasthan, India. Materials and Method: A questionnaire was developed to assess the self-perception of oral health, treatment received for bad breath. The questionnaire was explained to the class leaders before the start of the study. The Chi-square test was used for comparisons among males and females, preclinical and clinical students. The significance level (p value) was set at 0.05. Results: 36% percent of male and 61% of female students reported the self-perception of oral breath. 50 % of male Clinical students and 20% of male preclinical students and 64% of female clinical students and 52% of female preclinical students reported the self-perception of oral breath. Almost 6% of male and 5% of female students experienced bad breath interference at their work during the last month. Conclusion: It is highly recommended that both male and female students put more emphasis on oral hygiene including tongue cleaning and self-perception of healthy conditions and behaviors as they have to be healthy role models for their patients. Further research is needed to objectively assess the oral bad breath by standard procedures available for clinical research.

Aim: To determine the number of colony forming units of Streptococcus mutans and Lactobacillus acidophilus present in human dental plaque before and after chewing fresh Ocimum basilicum leaves. Material and Method: 15 female school children, aged 14-15 years, were selected from a high school using convenience sampling technique. Baseline plaque sample was collected using plaque harvesting technique from the buccal surfaces of posterior teeth. Subjects were asked to chew 10 fresh Krishna Tulsi leaves for 1 minu te everyday for 15 days. After this, a second plaque sample was collected using the same technique. The microorganisms were cultured from both the plaque samples in their respective culture media. The colony forming units were counted and compared between the pre intervention and post intervention samples. Student's paired't' test was carried out. Results: There was a statistically significant decrease in the Streptococcus mutans count after chewing Tulsi leaves. There was a numerical decrease in the Lactobacillus acidophilus count after chewing Tulsi leaves, but the difference was not statistically significant. Conclusions : Chewing fresh Krishna Tulsi leaves reduced Streptcoccus mutans and Lactobacillus acidophilus colony count in human dental plaque.

Aim : This study is carried out on Gujarati population to collect the relevant data & evaluate the arch dimensions. Materials and Method: Full mouth dental casts were obtained from 60 subjects (30 males and 30 females) aged 18-25 years belonging to Gujarati population inhabiting in Gujarat. Eighteen buccal cusp tips and mid-incisal edge points were marked on each maxillary and mandibular cast. All the digital images were transferred to AutoCAD and the co-ordinates of buccal cusp tips of all teeth were determined. Arch widths and depths were computer generated as straight-line distance between the dental landmarks. Results: Comparison of arch dimensions between males and females showed that, the transverse measurements i.e. inter-canine width and inter-second molar width were significantly larger in male subjects as compared to those of females in both the arches. Also in the maxillary and mandibular arch the canine depth and second molar depth was significantly larger in males as compared to that of females. In the maxillary and mandibular arch, the inter-canine width and inter-second molar width were highly significant, and second molar depth was significant, while canine depth was significant in maxilla but not in mandible. Conclusion: The arch dimensions showed that the males had significantly larger inter-canine width, inter-molar width, canine depth and molar depth in maxillary and mandibular arches as compared to those of females.

Aim : Over-prescription and misuse of allopathic medicines has contributed to the popularization of traditional, indigenous or ayurvedic medicines in which herbs are used as the major components. Different herbs of the Indian subcontinent, are being used individually or in combinations to promote oral hygiene and to treat oral diseases for their beneficial effects on oral health. The galls of Quercus infectoria and bark of Mimusops elengi Linn. are known for their medicinal properties. This study was carried out to investigate the clinical efficacy of these two herbal aqueous extract against the gingival inflammation and to maintain the oral hygiene . Materials and Method: Twenty subjects who met the inclusion criteria were chosen for the study. They were randomly divided into 3 groups where they were prescribed mouthwash containing galls of Quercus infectoria, bark of Mimusops elengi Linn. And Listerine mouthwash respectively. Clinical parameters like Plaque Index and Gingival Index were taken before and after completion of the study. Results: Plaque Index and Gingival Index reduced significantly from baseline to 8th day in M1, M2 and M3 groups on intragroup comparison, but on intergroup comparison revealed significant result in M1 and M3 group as compared to M2 group. Conclusion: The results of the present study showed that Mimusops elengi Linn. Mouthwash was as effective as Listerine mouthwash whereas Quercus infectoria mouthwash was least effective of all the three mouthwashes.

Background : This case report highlights the issue of hyper sexuality as a presenting feature in people with dementia and outlines the possible etiology and challenges associated with inappropriate sexual behavior in dementia. A case of a 75-year-old female with vascular dementia who developed hyper sexuality as a presenting complaint is reported here. The management of this patient included a combination of pharmacological and psychosocial intervention leading to the resolution of her inappropriate sexual behavior and improvement in her relationship with her family members. Inappropriate sexual behaviors need to be recognized and managed without compromising the fulfillment of the human's basic need of sexuality.

Background : Temporomandibular joint is one of the most complex of all synovial joints. There are certain abnormal conditions like traumatic irreparable condylar injuries, idiopathic condylar resorption, TMJ ankylosis that require surgical removal of the affected condyle affecting its form and function, so reconstruction of TMJ is required to restore the same. The principle used in transport distraction osteogenesis is a classic Illiazarov technique used in reconstruction of large osseous defects. The aim of this clinical study was to evaluate the use of transport distraction osteogenesis in the reconstruction of ramus-condyle unit of the temporomandibular joint by using an indigenously designed internal distraction device.

Background : Early childhood caries is a very chronic form of dental caries affecting young children. It impairs quality of life by causing acute and chronic infection. Eating and sleep disruptions impair the daily routine of children also affecting school performances. In the present case reports first full mouth rehabilitation was performed chairside whereas in second case report full mouth rehabilitation was performed under GA. In both the cases the Michigan Oral Health-related QOL Version PG questionnaire containing 10 questions were given to the parents to fill before the start of treatment and 6 months after completion of the treatment. The scale used to measure QOL in both the above cases revealed satisfaction of the parents and improvement in oral health as well as overall health which was observed by increase in weight in both the cases.

Background : Supernumerary teeth are the teeth present in addition to the normal set of teeth. They may be single, multiple, unilateral or bilateral, erupted or unerupted present in one or both jaws and may or may not be associated with other disease or syndrome. Multidisciplinary approach is necessary to meet the treatment challenges of supernumerary teeth. Supernumerary teeth can be managed either by removal/ endodontic/ orthodontic therapy or by maintaining them in the arch and frequent observation. Removal of supernumerary teeth is recommended where there is compromised esthetic and functional status. This article reviews case series of supernumerary teeth with no associated disease or syndromes.

Background : Prosthetic rehabilitation of the hemimandibulectomy patient has always been a difficult task for the prosthodontist. Mandibular discontinuity following resection is a debilitating condition for patients. Mandibular deviation results in impaired masticatory function and facial disfigurement. Early prosthetic intervention by guide flange prosthesis helps the patient to achieve normal maxillo-mandibular relationship and early restoration of normal function. This case report presents the fabrication of guide flange prosthesis prior to hemimandibulectomy procedure, preventing mandibular deviation.

Background : Perforation peritonitis is a common surgical emergency. Geriatric patient presenting with perforation peritonitis is a challenge for an anaesthetist. Risk and outcome in such patients depend upon age, the patient's physiological status, co-existing disease and whether the surgery is elective or emergency and type of procedure. Preoperative optimization, hemodynamic stability can reduce intraoperative and postoperative morbidity and mortality. Considering decreased physiological reserve of all body organs and systems intensive care in critical care setting is essential.

Background : Hypodontia a condition where tooth / teeth are missing congenitally, has a great impact if the condition is involved for the anterior tooth since they affect the appearance of an individual. Facial perception is subjective to the alignment of the teeth in an arch - maxilla and or mandible. Alignment of teeth not only refers to proper positioning within an arch but it involves its relationship to opposite arch and its relation with the neuromuscular envelope. Adult orthodontic practices in recent times have reached its peak due to an increasing awareness among the adult patients regarding the possibilities of orthodontic solution for their oral rehabilitation. Oral rehabilitation among the adults is one of the challenging task for a general practitioner since it does not only concern replacement of what is lost but also concerns the integrity of what needs to be maintained. Stability and retention goes hand in hand if the rehabilitation done is integrated through interdisciplinary approach. This article highlights the interdisciplinary approach executed for oral rehabilitation of an adult patient where esthetics was of prime concern along with function.