Context: The possibility of bleaching vital teeth with peroxide-based products considerably revolutionized esthetic dentistry. Aim: The aim of this clinical study was to evaluate tooth color change and dental sensitivity after exposure to preloaded film containing a 10% hydrogen peroxide whitening system (Opalescence Trθswhite Supreme). Materials and Methods: A total of 13 volunteers, aged 18 to 25 years, participated in this study. The patients used the whitening system once a day for 60 minutes during the 8-day study. For maxillary incisors and canines, the color change was visually evaluated with the Vita color scale before, immediately, and six months after the treatment. Tooth sensitivity was evaluated during the daily gel applications. All whitening applications were done in office and under the supervision of a dental professional. Statistical Analysis Used: The results were analyzed using the Friedman Test (nonparametric repeated measures ANOVA) at a level of 5%, and Dunn's Multiple Comparison Test at the level of 5%. Results: It was verified that the original mean color values observed at the baseline analysis differed significantly from those observed immediately after bleaching, as well as from those seen in the analysis at six months ( P = 0.001). There was no significant difference between the mean color values observed in the immediate time and in the analysis at six months ( P = 0.474). No tooth sensitivity was observed in any patients. Conclusion: It was concluded that the bleaching technique using the 10% hydrogen peroxide system was effective in a short period of time without tooth sensitivity during applications.

Context: Bruxism is the habit of clenching or grinding one's teeth in non-functional activities and affects both children and adults alike. Respiratory problems, such as asthma and upper airway infections, are reported to be the etiological factors of bruxism. Aims: The aim of the present study was to determine whether there is an association between respiratory problems and dental caries in children who exhibit the habit of bruxism. Setting and Design: An observational cross-sectional study was carried out. Materials and Methods: Patient histories were taken and clinical exams were performed on 90 children for selection and allocation to one of two groups. For the determination of bruxism, a questionnaire was administered to parents/guardians and an oral clinical exam was performed based on the criteria of the American Academy of Sleep Medicine. Thirty-three male and female children between 4 and 7 years of age participated in the study - 14 children with bruxism and 19 children without bruxism. Statistical Analysis: The data were statistically analyzed using the chi-square test, with level of significance set at 5% (P < 0.05). Results: Mean age of the participants was 5.73 years. The male gender accounted for 45.5% (n = 15) of the sample and the female gender accounted for 54.5% (n = 18). A statistically significant association was found between respiratory problems and dental caries among the children with bruxism. Seventy-seven percent of the children with bruxism had caries and 62.5% the children with respiratory problems exhibited the habit of bruxism. Conclusions: There seems to be an association between bruxism, respiratory problems, and dental caries in children.

Context: Dental pulp stem cells (DPSCs) are the most diagnosed type of stem cells isolated from dental tissues. Previous studies demonstrate that tissues in earlier stages of development could be better stem cell resources for tissue engineering. Aims: In this study, aiming at finding younger stem cell resources, we chose the pulp of human unerupted third molar teeth when the crown was completely formed and the roots had not begun their development, Nolla's 6 ^th developmental stage (N6 ^th ). Materials and Methods: Surgical removal of the third molar was performed by aseptic technique with minimal trauma. The tissues were digested enzymatically and the resulted single cells were cultured. Immunophenotypic characterization of the cells was done via immunocytochemistry, immunofluorescence, and flow cytometry assays. Adipogenic and osteogenic differentiation potential of these cells was examined and confirmed by histochemical staining and reverse transcription-polymerase chain reaction analysis. Statistical Analysis Used: This study is descriptive. Results: N6 ^th -unerupted dental pulp cultured cells expressed DPSC markers: Vimentin, CD73, CD90, CD105, CD166, CD44, CD146, and STRO-1, but did not express hematopoietic cell markers: CD14, CD34, CD45, HLA-DR and were also negative for dentin sialoprotein negative showing an undifferentiated preodontogenic state. Adipocytes differentiated from N6 ^th -DPSCs were positively stained with Oil-Red-O and expressed both early and late adipocyte specific genes. Formation of Alizarin-red positive condensed calcium-phosphate nodules accompanied by strong expression of two osteogenic mRNAs, exhibited osteogenic differentiation. Conclusion: Based on the results of this study, we suggest that N6 ^th -DMSCs are a viable choice for cryo-banking and future usage in regenerative therapies; however, more investigations are necessary before clinical application can commence.

Background: Calcium phosphate cements (CPC) are a group of biomaterials possessing wide scope of use in various branches of medical science. These materials have been proposed to be highly biocompatible and osteoconductive. This study is based on a newly developed CPC formulation (Chitra-CPC) and is aimed at the evaluation of its biocompatibility through an Endodontic Usage Test in a porcine study model. Objective: To evaluate the periapical tissue reaction to Chitra-CPC when used as a root canal sealer/filler material in comparison with a resin sealer, AH Plus (Dentsply). Materials and Methods: The procedure was done on porcine animal model following the ISO 7405 criteria. The material was implanted intentionally into the periapical area of 36 teeth through a root canal procedure carried out in six animals which were divided equally among 1-month and 3-month time periods. Results were based on the histological evaluation of the autopsied specimens after the prescribed time periods. Results: Mild to moderate periapical tissue reaction was found in Chitra-CPC samples belonging to the 1-month time period, whereas majority of the 3-month CPC samples showed an absence of inflammation. Samples of AH Plus in 1-month period showed severe to moderate inflammation, whereas 3-month AH Plus samples had a mild to moderate inflammation. Conclusions: Chitra-CPC is a biocompatible material.

Objective: The practice of playing musical instruments can affect structures of the head, neck, mouth, and the masticatory system. The aim of this study was to obtain information regarding the prevalence of orofacial pain in musicians according to the type of instrument they play, by applying a specific questionnaire. Materials and Methods: One hundred and seventeen musicians of Sao Paulo state's orchestras participated in this study. They answered an anamnesis questionnaire with 20 questions regarding their personal data, type of instrument played, hours of daily practice, and presence or absence of orofacial pain according to the Chronic Pain Grade Classification (CPGC). Musicians were divided into two groups in accordance with the risk of affecting TMJ: RG (risk group, including violin, viola, vocalist, trombone, tuba, clarinet and saxophone); CG (control group, other instruments). They received an informative brochure about the subject. Data obtained from the questionnaire were submitted to descriptive statistics, Pearson's correlation analysis and Z-test for difference between two proportions. Results: The participants were from 15 to 62 years old. Pain degree showed positive correlation for reported symptoms (P = 0.002) and hour/day practice (P = 0.030). Regarding the prevalence of pain degree, data were, for RG: Grade 0 (54.5%), Grade 1 (30.3%), and Grade ≥2 (15.1%). For CG, Grade 0 (84.4%), Grade 1 (8.9%), and Grade ≥2 (6.6%). Z-test showed positive difference between groups (P = 0.0001). Conclusion: It was concluded that the musicians of risk group presented higher prevalence of orofacial pain than control (non-risk) group.

Objective: The aim of the present study was to evaluate the possible deformations in the surface of dental implants submitted to pullout and insertion test in polyurethane synthetic bone, using scanning electron microscopy. Material and Methods: Four different types of implants were used: Master Screw, Master Porous, Master Conect AR and Master Conect Conical (n = 8). These implants were into the femoral head synthetic bone (Synbone) and removed through the pullout test, performed with a universal testing machine (EMIC MEM 2000). All the screws, before and after the mechanical tests, were micro structurally analyzed in a Scanning Electron Microscope (SEM - Zeiss EVO50), utilizing a magnification of 35 times. The results were subjected to ANOVA and Tukey tests (α =0.05). Results: Only the Master Conect Conical and Master Porous implants presented statistically significant difference to pullout and maximum deformation (P = 0.014 and P = 0.009, respectively). The SEM images did not show morphological changes of the implants when compared before and after the mechanical tests. Conclusion: We concluded that Master Porous presented higher pullout resistance, suggesting a greater primary stability.

Objectives: The objective of this study was to determine whether digital panoramic radiography is a reliable method to detect calcified carotid artery atheromatous plaques (CCAAP) as compared with ultrasonography. Study Design: Digital panoramic radiographs were obtained from 50 patients who also underwent carotid ultrasound examination. The images were interpreted by trained maxillofacial radiologist for the presence or absence of calcified atheromatous plaques. The extent of carotid calcification on carotid ultrasonography was determined by a trained Sonologist, which was considered as the gold standard assessment. Results: Digital panoramic radiographs had a sensitivity of 76% and specificity of 98.66% in determining CCAAP. There was a high level of agreement between diagnoses, with a kappa value of 0.8. Conclusion: To conclude, digital panoramic radiographs had good sensitivity and high specificity in detecting CCAAP. If properly trained, dentists can detect such plaques and can refer patients to physician for timely medical treatment.

Context: The physiological changes in the humoral immune system of patients with orofacial epithelial cancers (OECs) are considered key factors in the pathogenesis, prognosis, and management of these individuals. Aim: This study assessed the serum and salivary immunoglobulin M (IgM) levels in patients with OECs. Settings and Designs: This is a cross-sectional study of the serum and salivary IgM profile among patients with OEC and healthy controls. Materials and Methods: There were 78 subjects comprising 30 patients with untreated OEC, 18 patients with OEC receiving treatment and 30 healthy, age and gender matched individuals. The serum and salivary samples from the participants were analyzed for IgM using the enzyme linked immunosorbent assay technique. Results: The mean value of serum IgM in OEC patients receiving treatment was significantly lower compared to untreated OEC patients and healthy controls (P = 0.01). However, the mean serum IgM among untreated OEC patients was not significantly different compared with healthy controls. In contrast, the salivary IgM level did not show any significant difference among the three groups (P = 0.06). Furthermore, there was no correlation between the serum and salivary levels of IgM among the subjects. Conclusion: The findings from this study suggest that serum IgM levels in OEC patients receiving treatment might be good biomarker while salivary IgM may not be reliable as a marker in these individuals.

Context: Non-syndromic cleft lip/palate (NSCL/P) is a congenital anomaly with significant medical, psychological and social ramifications. There is sufficient evidence to hypothesize that locus for this condition can be identified by candidate genes. Aims: The aim of this study is to amplify the chosen region (799 G >T) of MSX ₁ gene, investigate the degree of association and perform a mutation research from Raichur cleft lip and palate patient sample. Settings and Design: Case history and clinical examination of the patient were recorded to rule. Written consent was obtained from patients and controls for in vivo study. Study was designed in four steps as follows:

1. Collection of a blood sample
2. Genomic deoxyribonucleic acid (DNA) extraction
3. Polymerase chain reaction (PCR)
4. Restriction fragment length polymorphism (RFLP).

Materials and Methods: Blood samples were collected from 50 subjects having NSCL/P and 50 controls. Genomic DNA was extracted, PCR and RFLP was performed for digestion products that were evaluated. Statistical Analysis: Chi-square test with P value at 95% confidence intervals. Results: The results showed a positive correlation between MSX ₁ 799 G >T gene variant and NSCL/P patients in Raichur patients. Conclusions: From a genetically diverse etiology MSX ₁ 799 G >T gene variant may be a good screening marker for NSCL/P in Raichur patients.

Background and Aim: Throughout a woman's life, hormonal influences affect therapeutic decision making in periodontics. A woman undergoing infertility treatment is given drugs to stimulate the ovaries, which lead to sustained higher levels of female sex hormones. The differing levels of these hormones, either in infertile women or in women undergoing therapy for infertility or in women who have conceived and delivered naturally could suggest a differing periodontal status amongst these three groups. Hence, this cross-sectional study was undertaken to assess and compare the periodontal status in the above three groups. Materials and Methods: 180 women including 60 women undergoing treatment for infertility (Group I), 60 women in whom infertility treatment had not yet been initiated (Group II) and 60 women who had conceived and delivered naturally (Group III-control group), of age range 25-35 years, were included. Clinical parameters including oral hygiene index simplified (OHI-S), gingival index, sulcus bleeding index (SBI) and clinical attachment loss (CAL) were assessed by a single examiner. Results: Despite similar OHI-S scores (P > 0.05) in all groups, women of Group I had significantly higher gingival inflammation and SBI (P < 0.05) as compared to women of Group II and Group III. Furthermore, the women in Group I and Group II had statistically higher CAL (P < 0.05) as compared with the control group. Conclusion: Within the limits of this study, it can be concluded that altered hormonal levels in infertile women undergoing assisted reproductive therapy and infertile women not undergoing this treatment can lead to increased attachment loss, suggesting that these women may require constant periodontal monitoring.

Context: Accurate assessment of periapical status is critical in diagnosis, treatment planning, and evaluation of healing. Novel imaging modalities like sonography offer promising results with reduced radiation risks. Aims: To evaluate the potential of ultrasound imaging technique together with the application of color Doppler to differentiate between periapical lesions of endodontic origin. Materials and Methods: Twenty patients with periapical lesions of endodontic origin who were already scheduled for undergoing endodontic surgery were examined further using sonography. Color Doppler was performed to assess blood flow. Information on the size of the lesion, its content, and vascular supply was gained and recorded by means of ultrasound images. The sonographic images were analyzed and discussed with an expert sonologist, and a tentative diagnosis between a periapical cyst and periapical granuloma was made. Endodontic surgery and histopathological examination was done for each case and the results were compared. Results: The sonograms revealed the lesions within the bone in three dimensions and their contents, that is, fluids or tissues or blood vessels. Measurements of the periapical lesions in three dimensions were also obtained. Of the twenty cases studied, ultrasound could detect periapical granulomas in all 9 cases and radicular cysts in all 11 cases. Conclusion: Ultrasound imaging had the potential to be used for the evaluation of periapical lesions of endodontic origin. However, further studies are required to establish a definite correlation.

Background: Post-retained crowns are indicated for endodontically treated teeth (ETT) with severely damaged coronal tissue. Metallic custom and prefabricated posts have been used over the years, however, due to unacceptable color, extreme rigidity and corrosion, fiber posts, which are flexible, aesthetically pleasing and have modulus of elasticity comparable with dentin were introduced. Aim: To compare clinical performance of metallic and glass fiber posts in restoration of ETT. Materials and Methods: 40 ETT requiring post retained restorations were included. These teeth were randomly allocated into 2 groups. Twenty teeth were restored using a glass fiber-reinforced post (FRP) and 20 others received stainless steel parapost (PP), each in combination with composite core buildups. Patients were observed at 1 and 6 months after post placement and cementation of porcelain fused to metal (PFM) crown. Marginal gap consideration, post retention, post fracture, root fracture, crown fracture, crown decementation and loss of restoration were part of the data recorded. All teeth were assessed clinically and radiographically. Fisher's exact test was used for categorical values while log-rank test was used for descriptive statistical analysis. Results: One tooth in the PP group failed, secondary to decementation of the PFM crown giving a 2.5% overall failure while none in the FRP group failed. The survival rate of FRP was thus 100% while it was 97.5% in the PP group. This however was not statistically significant (log-rank test, P = 0.32). Conclusion: Glass FRPs performed better than the metallic post based on short-term clinical performance.

Background : Due to the complex anatomy of the root canal system, biomechanical preparation is not able to completely eliminate all microorganisms present in the endodontic infections, making it necessary the use of an intracanal medication. Aim: The aim of this study was to assess the antimicrobial activity of an intracanal medication containing the ethyl-acetate fraction of Pothomorphe umbellata against Enterococcus faecalis. Materials and Methods: Fifty seven human maxillary canine teeth were used, of which 54 were infected with E. faecalis every 72 h, for 28 days, and cultured for 24 h. Contaminated teeth were randomly separated into three groups (n = 18) and treated as follows: Group I - calcium hydroxide-based medication; Group II - P. umbellata-based medication; Group III - contaminated teeth without medication. Three teeth were used as negative control. After 7, 14 and 28 days of treatment, six teeth from each group were assessed for the level of microbial growth after each period of treatment. Results: The intracanal medication containing P. umbellata was effective against E. faecalis after 7, 14, and 28 days of treatment without statistically significant difference in comparison to calcium hydroxide treatment (Kruskal-Wallis test, P > 0.05). Conclusion: Ethyl-acetate fraction of P. umbellate was efficient against E. faecalis, making this phytotherapy a viable option for endodontic treatment.

Context: Different factors can affect the marginal adaptation of MTA. Aims: The present study was designed to investigate the effect of two ultrasonic irrigation methods on the marginal adaptation of MTA plug in open apex teeth by scanning electron microscope. Settings and Design: Thirty single mature teeth were included in this in vitro experimental prospective study. Materials and Methods: A total of 5 mm thickness of MTA plug was inserted at the end of the canals and after 24 h an ultrasonic file was used to irrigate the canals and remove the MTA remnants. Teeth were randomly divided into three groups: In the first and second groups, the canals were irrigated for 1 min by 2.5% sodium hypochlorite as #25 ultrasonic file was in direct contact and 1 mm away from MTA plug, respectively. The third group was not irrigated and left as control. A total of 1 mm transverse sections were prepared through the coronal and the apical parts of MTA plug and specimens were prepared for SEM analysis. The extent of gap was measured linearly under SEM device. Statistical Analysis Used: Statistical analysis of the results was performed using the kruskal-Wallis test by SPSS software ver.18(a = 0.05). Results: There was no significant difference between groups regarding the marginal gap size in apical (P: 0.17) and coronal sections (P: 0.33). However, the mean marginal gap size was higher in apical section compared to coronal section. Conclusions: It can be concluded that ultrasonic irrigation dose not adversely affect the marginal adaptation of MTA plugs.

Objective: The purpose of this study is to evaluate the ultimate compressive strength of 50% and 25% Portland cement mixed with Polymer-reinforced zinc oxide eugenol and zinc oxide eugenol cement after 1 hour, 24 hours, and 7 days. Materials and Methods: One hundred and eighty samples were selected. The samples were made cylindrical of size 6 × 8 mm and were divided into six groups as follows with each group consisting of 10 samples. Group 1: Polymer-reinforced zinc oxide eugenol with 50% Portland cement (PMZNPC 50%) Group 2: Polymer-reinforced zinc oxide eugenol with 25% Portland cement (PMZNPC 25%) Group 3: Polymer-reinforced zinc oxide eugenol with 0% Portland cement (PMZNPC 0%) Group 4: Zinc oxide eugenol with 50% Portland cement (ZNPC 50%) Group 5: Zinc oxide eugenol with 25% Portland cement (ZNPC 25%) Group 6: Zinc oxide eugenol with 0% Portland cement (ZNPC 0%) These samples were further subdivided based on time interval and were tested at 1 hour, 24 hours and at 7 ^th day. After each period of time all the specimens were tested by vertical CVR loaded frame with capacity of 5 tones/0473-10kan National Physical laboratory, New Delhi and the results were statistically analyzed using ANOVA and Scheffe test. Results: Polymer-reinforced cement with 50% Portland cement, Zinc oxide with 50% Portland cement, Polymer-reinforced cement with 25% Portland cement and Zinc oxide with 25% Portland cement exhibited higher compressive strength when compared to Zinc oxide with 0% Portland cement and Polymer-reinforced cement with 0% Portland cement, at different periods of time. The difference between these two groups were statistically significant (P < 0.05) and it is suggested that mixture of 50% and 25% Portland cement in Zinc oxide eugenol and Polymer-modified zinc oxide cement can be used as core build up material and permanent filling material. Conclusion: It is concluded that 50% and 25% Portland cement in zinc oxide eugenol and polymer-modified zinc oxide eugenol results in higher compressive strength and hence can be used as permanent filling material and core built-up material.

LASER (Light Amplification by Stimulated Emission of Radiation) is a powerful source of light, which has innumerable applications in all the fields of science including medicine and dentistry. It is one such technology that has become a desirable and an inseparable alternative to many traditional surgical procedures being held in the field of dentistry, and orthodontics is no exception. The current article describes the uses of a diode laser as an indispensable tool in an orthodontic office.

Radiotherapy is regarded as one of the most important therapeutic modality for the treatment of malignant lesions. This field is undergoing rapid advancements in the recent times. With the use of radiosensitizers and radioprotective agents, the course of radiotherapy has improved the sensitization of tumor cells and protection of normal cells, respectively. The aim of this paper was to critically review and analyze the available compounds used as radiosensitizers, radioprotectors, and radiation mitigators. For reviewing, the author used the electronic search for the keywords 'Radiosensitizers', 'Radioprotectors', 'Radiation mitigators' on PubMed for inclusion of previously published articles and further search of reference papers on individual radiosensitizing and radioprotecting agents was done. Radiosensitizers are agents that sensitize the tumor cells to radiation. These compounds apparently promote fixation of the free radicals produced by radiation damage at the molecular level. The mechanism of action is similar to the oxygen effect, in which biochemical reactions in the damaged molecules prevent repair of the cellular radiation damage. Free radicals such as OH ⁺ are captured by the electron affinity of the radiosensitizers, rendering the molecules incapable of repair. Radioprotectors are compounds that are designed to reduce the damage in normal tissues caused by radiation. These compounds are often antioxidants and must be present before or at the time of radiation for effectiveness. Other agents, termed mitigators, may be used to minimize toxicity even after radiation has been delivered. This article tries to discuss the various aspects of radiosensitizers, radioprotectors, and radiation mitigators including the newer agents.

The diagnosis of any pathology is fundamentally based on the microscopic structure of cells and tissues and this remains as the standard by which all other diagnostic tests are measured. In this era, the pathologists are relying on the examination of tissue section stained by histochemical means and it is supported by the advanced immunological, biochemical and molecular techniques. This review will provide the information about one of the way that can be followed to unravel the molecular mechanism in spotting the disease process. Technologies used to study the cellular process are same for the normal and the abnormal cell. Experimental strategy briefed here is also applicable for both. The cellular process can be studied either from protein to gene or from gene to protein. Earlier days biochemical analysis (isolation of protein, protein sequencing) was separate and genetic analysis (genomic mapping) was separate. But now with advent of recombinant DNA technology it is possible to have a link between the biochemical and genetic analysis. Intermediary step of development of oligonucleotide synthesis, complementary DNA probe and cloning has revolutionized the research process. Identified gene can be compared with the normal gene by comparative genomics or expressed proteins by expression proteomics.

Radicular fractures in permanent teeth are uncommon injuries among dental traumas, being only 0.5-7% of the cases. Management of horizontal root fractures presents a formidable challenge for clinicians because of the difficulty of achieving a stable reunion of fracture fragments. This case report presents the management of horizontally fractured canine by approximation of fracture fragments, fiber splinting, and use of MTA - both as an obturating material and intra-radicular splint. Short-term follow-up of the case showed promising results both clinically and radiographically.

We report two cases in which cone beam computed tomography (CBCT) was essential for the establishment of the diagnosis of periapical lesions. CBCT allows a three-dimensional assessment of a specific region with no superimposition of structures. Therefore, its use is recommended when radiographic images are not sufficient for the diagnosis.

Segmental odontomaxillary dysplasia (SOD) is an uncommon, nonhereditary, rare developmental disorder primarily involving the posterior part of the maxilla and related dental components. It is a rare condition of uncertain etiology that results in painless unilateral expansion of the posterior dentoalveolar complex, gingival hyperplasia, lack of one or both premolars in the affected area, delayed eruption of adjacent teeth and malformations of the primary molars. Radiographically, the affected bone is thickened and irregular in outline, with a coarse trabecular pattern that is vertically oriented resulting in a relatively radioopaque granular appearance. The treatment is focused on extraction of the involved teeth, while in some milder cases the teeth may be retained for a long period. The treatment plan should be based on the degree of involvement as well as the functional and esthetic needs in each case. Considering the rarity of the condition, we report three cases of SOD with variable presentations in a 45-year-old, 24-year-old and 23-year-old individual.

The fracture of an endodontic instrument is an obstacle in completion of a routine successful pulp space therapy. Ni-Ti instruments corrode when in contact with sodium hypochlorite which leads to their deterioration and ultimately fracture during use. Removal of separated instrument from root canal is often a very difficult procedure. This procedure is more complicated when the instrument separated is closer to the mandibular canal. A case is presented in which a separated hand instrument was retrieved from the mesio buccal of a second molar approximating the mandibular canal root by replantation.

Penetrating injuries to head and neck region with varying objects have been reported in the literature. ^{[1],[2],[3],[4],[5],[6],[7],[8],[9],[10]} Majority of these injuries occur in interpersonal violence or bomb blasts or road traffic accidents. Despite the improvement in imaging technologies and surgical methods, penetrating injuries to head and neck with impacted foreign bodies are very challenging due to the proximity to vital structures and/or difficulties in accessing them for the removal. ^[1] Following injury the normal anatomy could be altered because of edema or tissue destruction, which makes the diagnosis or retrieval more difficult. ^[3] Parapharyngeal or prevertebral space is an unusual place for lodgment of foreign bodies and in these cases the usual point of entry is the oral cavity, cheek or neck. Here, we report a case of a ball point pen extending to the prevertebral region at the level of C1-C2 vertebrae from point of entry at the suprazygomatic region in the temporal fossa.

Benign fibrous histiocytoma (BFH) is a mesenchymal tumor which commonly affects the skin of extremities. Histologically, BFH of soft tissues and bone shows similar features, but BFH of the bone is rare with less than 100 cases reported worldwide and usually it involves tibia, femur, and pelvic bone. As far as the oral cavity is concerned, majority of the BFHs are found in the soft tissues of the buccal mucosa, gingiva, lower and upper lips, soft palate, and floor of the mouth. Occurrence of this tumor in the jaw bones is extremely rare as only one case of the maxilla and six cases of the mandible have been reported so far . Hence, the purpose of this article is to report the second case of BFH of the maxilla in a 23-year-old female patient and to review the literature of this entity affecting the jaws.

Paroxysmal hemicrania (PH) is a trigeminal autonomic cephalalgia, a rare primary headache characterized by unilateral periorbital and/or temporal attacks of severe intensity and short duration. In this situation, the determination of a correct diagnosis is crucial for the establishment of a proper management strategy. In the case of head and facial pain, this step is usually a big challenge since many conditions share the same features, as some primary headaches and temporomandibular disorders (TMD). The relationship between PH and TMD has not been determined. This paper describes a case of a female patient diagnosed with TMD and presenting concomitant headache attacks fulfilling the International Headache Society's criteria for PH. It is also emphasized the importance of dentist in this scenario, for many times responsible for the initial diagnosis of facial/head pain. Moreover, it is presented an integrated and simultaneously approach of both conditions, PH and TMD.

Pleomorphic adenoma (PA) is the most common tumor of the salivary glands. About 90% of these tumors occur in the parotid gland and 10% in the minor salivary glands. The most common sites of PA of the minor salivary glands are the palate, followed by lips and cheeks. Throat, floor of the mouth, tongue, tonsil, pharynx, retromolar area and nasal cavity are rarely involved. Here, we report a case of PA of the cheek in a 42-year-old female. The mass was excised and the patient was followed for 3 years post operatively with no recurrence.

This case report illustrates the management of four impacted canines in an adult patient associated with prolonged retention of the four deciduous teeth. The treatment plan was formulated to extract the lower deciduous teeth, application of the forced eruption with the permanent canines, and extract the upper permanent canines and maintenance of the maxillary deciduous canines. No reshaping of the maxillary deciduous teeth was performed because the patient was satisfied with the results.

Maxillofacial prostheses are usually fabricated on the basis of conventional impressions and techniques. The extent to which the prosthesis reproduces normal facial morphology depends on the clinical judgment and skill of the individual fabricating the prosthesis. Recently, as a result of advances in technology, various computer-aided design and manufacturing techniques have been successfully introduced for the automated fabrication of maxillofacial prostheses. These systems are able to provide more consistently accurate reproduction of facial morphology.