Background: The Mandibular first molar is the tooth that requires root canal treatment most often. It usually has two roots with two canals mesially and one or two canals distally. A mandibular first molar with more than four canals represents a rare anatomical variation, especially when the three canals are found in distal root. With increasing reports of aberrant canal morphology, the clinician needs to be aware of this varied anatomy. This case report discusses endodontic management of 2 rooted mandibular molar with 3 distal canals (disto-buccal, middle- distal, disto-lingual) and 2 mesial canals.

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Aim: Inferior dental anaesthesia via the direct intraoral approach, mandibular conduction anaesthesia via extraoral landmarks (Gow-Gates) and mandibular conduction anaesthesia via the tuberosity approach (Akinosi) were evaluated using pain during injection, aspiration test, pinprick, depth and frequency of anaesthesia, onset and duration of anaesthesia. Materials and Methods: 120 patients of both sexes, aged from 16 years to 50 years undergoing mandibular molar tooth extraction were included. They were randomly designated into 3 groups with regards to the applied technique of mandibular anaesthesia. Each patient was given injection of 2 ml of 2% lignocaine with adrenaline (1:80,000) using 2ml disposable syringes and a 25 gauge, 1.5 inch needle. Results: Classical inferior nerve block showed greater incidence of pain among the applied techniques. Positive aspiration was most frequently observed with classical inferior nerve block. The onset of anaesthesia was found to be slower with Gow-Gates technique while duration of anaesthesia was longer. Mandibular conduction anaesthesia via the tuberosity approach did not show any particular advantage over the other two techniques in this study. Conclusions: After using Gow-Gates method, it was found that the Gow-Gates technique is a highly successful alternative to the conventional inferior nerve block with regards to increased success rate, constancy of landmarks, decreased positive aspiration rate, decreased incidence of complications such as trismus, the advantage of one injection to anaesthetize a greater area supplied by the mandibular nerve, longer duration of anaesthesia and less amount of pain experienced during injection.

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Objective: Emblica officinalis fruit is used in Indian traditional medicine since ages as an antimicrobial agent. Review of literature yielded a paucity of studies related to the effect of Emblica officinalis fruit extract against Streptococcus mutans, Enterococcus faecalis and Candida albicans, so the present study was designed. Our aim was to determine the antimicrobial efficacy of ethanol, acetone and distilled water extracts of Emblica officinalis against Streptococcus mutans, Enterococcus faecalis and Candida albicans. Materials and Method: Extract of Emblica officinalis in ethanol, acetone and distilled water were obtained by cold maceration. The crude residue was obtained by evaporation at room temperature. The antimicrobial efficacy of Emblica officinalis in all extracts were assessed against oral microorganisms by finding out zone of inhibition and minimal inhibitory concentration. Results: Emblica officinalis in ethanol, acetone and distilled water were found to be effective against Streptococcus mutans, Enterococcus faecalis and Candida albicans by highest zone of inhibition being 38 mm for acetonic extract of emblica officinalis against Enterococcus faecalis. Minimum inhibitory concentration of ethanolic and acetonic emblica officinalis extracts for Candida albicans was established at 0 .09% and distilled water extract at 1.56%. Minimum inhibitory concentration for ethanolic extract of emblica officinalis for Enterococcus faecalis was 3.12%, acetonic extract of Emblica officinalis was established at 0.39% and distilled water extract of emblica officinalis was established at 12.5%. Conclusion: Emblica officinalis could be considered as an effective antimicrobial agent. The antimicrobial activities can be enhanced if the phytoactive components are purified and adequate dosage determined for proper administration.

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Aim: To compare shear bond strength and surface structure between acid etching and air-abrasion techniques Materials and Methods : Sixty three extracted human premolar teeth were taken, divided into three groups and mounted with color codings. Group l was acid etched with 37% phosphoric acid. Group ll and lll -air abrasion was done with 50μ & 90μ Al2O3 particles respectively. After enamel preparation, from each group one tooth was selected for surface roughness study by scanning electron microscope (SEM). The other sixty teeth were selected to evaluate shear bond strength by Instron universal testing machine. Results : Group I showed significantly higher shear bond strength (10.1± 3.6 Mpa) than Group II and Group III. In SEM study Group l etching pattern showed peripheral dissolution of the prisms. The enamel removal of Group ll was more regular, uniform and less as compared to Group lll. Adhesive remnant index showed that no adhesive material was left on the tooth surface of Group ll & lll as compared to Group l after debonding. Conclusion: From the present study it was concluded that air abrasion can be used as an adjunct to acid etching but by itself it is not a potent enamel preparation agent.

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Aim : The acrylic resin material is an indispensable material in removable prosthodontics. There has been continuous search to reduce processing time and enhance physical properties such as strength deformation. Fracture of acrylic resin is an unresolved problem in removable prosthodontics. Numerous attempts have been made to determine its causes. The present study was done to compare the fracture resistance of acrylic resin denture base reinforced with steel strengtheners. Materials and Methods : To measure the fracture resistance of heat cure acrylic resin, a total of ,, specimens were prepared and divided into , categories: Group,: No strengtheners, Group ,: Thin gauge strengtheners and Group ,: Thick gauge (,., mm X , mm). All the samples prepared were of specific dimensions i.e. ,, mm in length, ,, mm in width and , mm in thickness as a means for standardization. The flexural strength of the samples was recorded using a universal testing machine and the data obtained was statistically analysed. The statistical analysis was done by calculating the average and standard deviation for each parameter used in the study. To find out the significant difference between different concentrations and different time intervals unpaired 't' test was performed. Here 'p' and't' value is used to evaluate the fracture resistance. Results: Acrylic samples with steel strengtheners fared better when compared to those without steel strengtheners. Thick gauge strengtheners were found to be more resistant to fracture. The difference was statistically significant. Conclusion: The incorporation of thick steel strengtheners few millimetres apart and perpendicular to anticipated line of fracture will produce significant resistance to flexure and reduce the likelihood of fracture of the acrylic resin denture base.

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Background: Planning and executing the restorative rehabilitation of a decimated dentition is probably one of the most intellectually and technically demanding tasks being faced by a dentist. Full mouth rehabilitation involves restoring the dentate or a partially dentate mouth to provide an orderly pattern of occlusal contact and articulation that will optimize oral function, occlusal stability and esthetics. This case report demonstrates a full mouth rehabilitation of a patient for esthetically and functionally compromised dentition by a recently introduced 'metal-free' restoration. The final prosthesis ensured a restoration resulting in predictable posterior disclusion and anterior guidance in harmony with the condylar path.

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Background: Patients seeking correction of dental or dentofacial deformities also present with concomitant soft tissue deformities like decreased lip length, increased or decreased lip thickness, inadequate vermillion show etc. Correction of skeletal or dental deformities alone may not achieve appreciable results unles s a focus is made on the correction of soft tissue deformities during the treatment planning. Soft tissue deformities that exist with the skeletal or dental deformities may be self-corrected by Orthognathic surgery/Orthodontics or combination of both. But in many situations adjuvant procedures to the perioral structures may need to be performed to get the optimal overall results. This can be accomplished by dermal fillers, Botulinum Toxin A injections or by surgical soft tissues procedures.

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Background: Periodontal therapy has developed beyond the scope of the treatment of periodontal pathoses. Periodontal plastic surgery consists of the reconstructive procedures designed to enhance the both function and esthetics. Deficient ridges pose a severe problem to the restorative dentist in restoring the natural form, function and esthetics of the prosthesis replacing the natural dentition. Depending upon the severity, location of these defects and the prosthetic option chosen, hard and soft tissue ridge augmentation or non-surgical approach or a combination may help to address them. The present clinical report describes a soft tissue ridge augmentation of a localized ridge defect in maxillary aesthetic region using onlay interpositional graft followed by fixed partial denture.

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Background: A 13 year old boy presented with gradual poor grade in his school performance. Parents of the boy were worried because of his deteriorating academic performance and physical appearance. Patient was subjected to thorough clinical examination and Radiological examination and was found to be having features and findings consistent with Crouzon Syndrome. The patient was properly counselled and was lost to follow up after 6 months due to his social and economical constraints.

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Background: Idiopathic gingival fibromatosis is a rare hereditary condition that has no definite cause. The pathogenesis of gingival fibromatosis is still unknown but an increase in proliferation of the gingival fibroblasts as well as increased collagen synthesis may be involved. In modern times, a mutation in the son of sevenless -1 (SOS-1) gene has been suggested as a possible cause of isolated (non-syndromic) gingival fibromatosis, but no definite linkage has been established. A twenty four year old patient presented with gingival enlargement since one year. Based on clinical and radiographic examination, laboratory tests, and thorough oral hygiene instructions, an external bevel gingivectomy was performed to remove excess gingival tissue. There was recurrence within two months following the surgery. The exact cause of the gingival enlargement was not identified, although amelioration of the fibrotic, enlarged gingiva was observed which recurred within two month after performing conventional gingivectomy. Recurrence of gingival fibromatosis in such patients can also be attributed to genetic predisposition.

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Background: Multiple impacted teeth by itself is a rare condition and often found in association with syndromes. A rare case of multiple impacted mandibular anterior teeth in which no syndrome or systemic conditions are associated is being reported.

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