Objective: Reconstruction of lost attachment apparatus is a major goal of periodontal therapy. Although various osteoinductive bone replacement grafts (BRGs) have been used with apparent clinical success, unequivocal evidence of osteoinductivity may be obtained only through the demonstration of increased osteoblastic/osteoclastic differentiation following exposure to these materials. Materials and Methods: Bone marrow stem cells (BMSCs) obtained from rat femur were cultured in Dulbecco's Modified Eagles Medium (DMEM) and 10% fetal bovine serum (FBS). They were then exposed to two demineralized bone matrices (DBM's) - Grafton and Osseograft, and divided into three groups, comprising of a negative control (BMSC + DMEM + 10% FBS), Grafton, Osseograft. An osteogenic medium (OM) (10 hm dexamethasone, 10 hm b-glycerophosphate, and 50 μg/ml ascorbic acid) was added to create three subgroups comprising of a positive control (OM), Grafton with OM, Osseograft with OM. Results: After an initial phase (up to day 5), both Grafton and Osseograft induced an increased proliferative activity in the BMSCs, which reached a plateau after day 10. These grafts also induced increased alkaline phosphatase activity when compared to the control groups and to BMSCs with an OM. Conclusion: Both Osseograft and Grafton are capable of inducing osteoblastic proliferation and differentiation.

Background: High serum immunoglobulins and circulating immune complexes (IgG, IgM, IgA and CIC) values in patients with cancer have been used as tumor markers. Hence, the aim of the study was to estimate these immunological markers in pre- and post-treatment phases with a follow-up of 3-24 months and to understand the prognostic significance of the same in patients with oral cancer. Materials and Methods: The malignancy group consisted of 56 patients with different stages (AJCC TNM) of oral cancer and 20 healthy control group. Samples were selected at random and subjected for sequential analysis of serum biochemical markers (IgG, IgA, IgM and CIC-circulating immune complexes levels) in the pre- and post-treatment period. Statistical method employed was the paired t test. Results: We observed significant elevated levels of all the immunological markers ( P < 0.01) when compared with the control group. Sequential analysis of these markers revealed significant reduction in immunological markers in stage I and II patients. On the contrary, stage III and IV patients showed remarkably elevated levels of IgA and CIC one year after initial treatment. Conclusions : All these immunological markers are indicative of tumor burden and Serum levels of CIC and IgA might be employed as prognostic indicators in oral cancer.

Context: During human evolution, the morphology of mandibular molar occlusal surface has changed from pattern "y" to pattern "+". Six types of occlusal patterns were classified as: +4, 4-y,+5, 5-y,+6 and 6-y. Aims: To determine the prevalence of these six types of mandibular second molars in Iranian adolescents. Settings and Design: This descriptive investigation was undertaken in the high schools of Isfahan city, Iran. The students were selected by cluster sampling method, and then they were screened and only those with erupted mandibular second molars bilaterally were selected. Materials and Methods: A total of 794 cases were randomly selected and the number of cusps and groove pattern of mandibular second molar were examined intra-orally and by studying dental casts. Statistical Analysis Used: Descriptive statistics and chi-square test were used for data analysis. Results: The most frequent occlusal configuration was the "+4" form (76.9%). A total of 683 cases (86%) were found to have four-cusp form, 104 cases (13.1%) were five-cusp form and 7 cases (0.9%) were six-cusp form. Conclusion: The most frequent occlusal configuration was the "+4" form; thus, there is a high evolutionary trend in Iranian mandibular second molars.

Objectives : To compare the gingival crevicular fluid (GCF) myeloperoxidase (GM) levels in smokers and non-smokers. Materials and methods : This study comprised 45 subjects: (a) 12 smokers with periodontitis, (b) 10 non-smokers with periodontitis, (c) 11 smokers with healthy periodontium, and (d) 12 non-smokers with healthy periodontium were recruited for the study and their GM levels were analyzed. Results and conclusion : GM levels were significantly higher in smokers with periodontitis compared with others. Hence, more incidence of mutagenesis and cytotoxicity were noted at sites of inflammation mediated by GM in smokers compared with non-smokers.

Context: Tensile properties of elastomeric ligatures become important when efficiency of orthodontic appliances is considered. Aims: The aim of this study was to compare tensile strength, extension to tensile strength, toughness and modulus of elasticity of elastomeric ligatures in both the as-received condition and after 28 days of immersion in the simulated oral environment. Furthermore, the changes that occurred in tensile properties of each brand of ligatures after 28 days were evaluated. Setting and Design : Experimental-laboratory based. Materials and Methods: Elastomeric ligatures were obtained from different companies and their tensile properties were measured using Zwick testing machine in both the as-received condition and after 28 days of immersion in the simulated oral environment. Statistical Analysis Used: The data were analyzed using independent sample t-tests, analysis of variance and Tukey tests. Results: After 28 days, all the ligatures experienced a significant decrease in tensile strength, extension to tensile strength and toughness ( P < 0.05), whereas modulus of elasticity increased in some groups and decreased in others. There were significant differences in tensile properties of different brands of ligatures in both conditions ( P < 0.05), with the exception of modulus of elasticity after 28 days. Conclusions : The decrease in strength properties of elastomeric ligatures shows that they should be replaced at each appointment to reduce the risk of rupture. There are significant differences in tensile properties of different brands of ligatures, which should be considered during selection of these products.

Background and Objectives: In endodontics, various intracanal medications have been advocated to eliminate bacteria after root canal instrumentation. A recent study has revealed that addition of powdered dentin to bioactive glass (BAG) led to increased glass dissolution, and an increased antibacterial efficacy. Therefore, the present study was undertaken to compare the effect of enamel and dentin powder on the antibacterial efficacy of a commercially available BAG. Materials and Methods: Dentin blocks (dbs) were prepared from single rooted human teeth. These dbs were infected with Enterococcus faecalis for two weeks in Tryptic Soy Broth (TSB), while negative controls were kept in sterile TSB. In group I, the infected dbs were filled with BAG, in group II with BAG + Enamel powder and group III with BAG + Dentin powder. Dentin samples were harvested from the dbs and cultured. Statistical Analysis: Kruskal-Wallis ANOVA was used for multiple group comparison followed by Scheffe's post hoc test for pair-wise comparisons. Results: All the combinations of BAG evaluated significantly reduced the bacterial counts compared to the control group. However, at the end of 24 hours, three days, and five days BAG + Dentin powder showed significant reduction ( P < 0.01) in bacterial counts compared to the other experimental groups. Conclusion: Among the various materials evaluated, it appeared that though BAG exhibits antimicrobial efficacy, the addition of powdered enamel and dentin in aqueous suspension definitely enhanced this property. However, the addition of enamel powder BAG did not significantly alter its antimicrobial efficacy compared to BAG + dentin powder.

Aim: To determine the time required for the recontamination of root canals medicated with four different materials. Materials and Methods: A total of 60 intact, caries-free, human single-rooted teeth with straight roots were selected for this study. After chemo-mechanical preparation they must be changed in the specimens into seven groups: 10 teeth medicated with calcium hydroxide (Ca(OH) ₂₎ + Camphorated paramonochlorophanol (CPMC) (G.1); 10 medicated with 2.5% Sodium hypochlorite (NaOCL) (G.2); 10 medicated with 2% Chlorhexidine gluconate (CHX) in gel (G.3); 10 medicated with 2% CHX in gel + Ca(OH) ₂ (G.4); 10 without intracanal medicament and sealed with a coronal temporary filling (G.5). Five teeth were without intracanal medicament and coronally unsealed, used as the positive control group (PC) (G.6) and 5 teeth with intact crowns used as the negative control group (NC) (G.7). Glass vials with rubber stoppers were adjusted for use. The medicaments were prepared and injected into the root canals using sterile plastic syringes. An apparatus was used to evaluate for 30 days leakage. The chamber was filled with 3 ml of human saliva and Brain Heart Infusion (BHI) broth, incubated at 37°C and checked daily for the appearance of turbidity in the BHI broth. Results: Recontamination was detected after an average time of 2.6 days in group 2, 15.9 days in group 3, 30 days in group 1, 27.6 days in group 4, 2.9 days in group 5, 1 day in the positive control, and there was no contamination in the negative control group. Conclusion : The NaOCl group showed the highest worst average of recontamination; on the other hand, high averages were also shown by Ca(OH) ₂ + CPMC and Ca(OH) ₂ + 2% CHX in gel.

Aim : Evaluate in vitro the intratubular penetration and permeability of endodontic sealers in teeth contaminated with Enterococcus faecalis. Materials and Methods : Human canines were filled with AHPlus^® , Endo CPM-sealer^® or EndoRez^® sealers. To evaluate permeability, the coronary portion of each tooth was contaminated with E. faecalis, then the apical portion was immersed in brain heart infusion (BHI) broth, and medium turbidity was observed for thirty days. Scanning electron microscope (SEM) was used to evaluate the intratubular penetration of each sealer at the cervical, middle, and apical thirds of the tooth. Results : Only one tooth from the Endo CPM-sealer^® group presented broth contamination. EndoRez^® showed increased intratubular penetration compared to AHPlus^® and Endo CPM-sealer^® . Conclusions : Endo CPM-sealer^® showed greater permeability to E. faecalis and EndoRez^® showed increased intratubular penetration.

Statement of Problem: Obstructive sleep apnea is the most frequent cause for insomnia in the populace. Snoring is mulled over as the potential factor that can lead the sequel to obstructive sleep apnea. Although the etiology and deterrence measures for snoring are yet to be undoubtedly clarified by our scientific sorority, various means of surgical corrections have been affirmed and put into practice, with a substantial degree of success. Despite this, it is implicit that a noninvasive method of managing obstructive sleep apnea is more relevant for overcoming this condition. Purpose: This manuscript intends to establish how snoring can be controlled prosthodontically by different modalities of scientifically defensible approaches. The most effective among the modalities was affirmed as the investigative analyses of the treatment outcomes with each modality. Novel Methods: Four new methods of managing obstructive sleep apnea - uvula lift appliance, uvula and velopharynx lift appliance, nasopharyngeal aperture guard, and soft palate lift appliance were demonstrated through this article. Clinical Reports: The four new modalities stated and one conventional modality of mandibular advancement appliance for managing obstructive sleep apnea, a total of five types of appliance therapies, were described with case reports for each. Investigation: Five individuals undergoing the appliance therapy were chosen for each modality. The treatment outcome with each modality was examined by analysis of clinical predictors and also by means of standard investigation, with nasal and oral endoscopic analyses. Result: Among the five types of appliance therapies, the nasopharyngeal aperture guard provided the best treatment outcome in terms of clinical predictors and endoscopic analyses. Conclusion: Nasopharyngeal aperture guard, the novel method stated in this article is the better modality for managing obstructive sleep apnea, among the five different appliance therapies.

Aim: The aim of this study was to evaluate the effect of indirect restorative materials (IRMs) and light-curing units (LCUs) on the micro hardness of dual-cured resin cement. Materials and Methods: A total of 36 cylindrical samples (2 mm thick) were prepared with dual-cured resin cement (Relyx ARC) photo-activated with either a QTH (Optilight Plus) for 40s or a LED (Radii) light-curing unit for 65s. Photo-activation was performed through the 2-mm- thick IRMs and the samples were divided into six groups (n=6) according to the combination of veneering materials (without, ceramic and indirect resin) and LCUs (QTH and LED). In the control group, the samples were light-cured with a QTH unit without the interposition of any restorative material. Vickers micro hardness test was performed on the top and bottom surfaces of each sample (load of 50 g for 15 secs). The data were statistically analyzed using a three-way ANOVA followed by Tukey x s post-hoc test ( P < 0.05). Results: There were no statistically significant differences on the top surface between the light curing-units ( P > 0.05); however, the LED provided greater hardness on the bottom surface when a ceramic material was used ( P < 0.05). The mean hardness in photo-activated samples, in which there was no interposition of indirect materials, was significantly greater ( P < 0.01). Conclusions: It may be concluded that the interposition of the restorative material decreased the micro hardness in the deeper cement layer. Such decrease, however, was lower when the ceramic was interposed and the cement light-cured with LED.

Aim: This study compared the effects of hydrogel and solution forms of sodium ascorbate (SA) with two different application times on bracket bond strength subsequent to bleaching. Materials and Methods: A total of 72 sound premolars were randomly divided into six groups (n = 12): An unbleached control group (group one) and five experimental groups of carbamide peroxide. Specimens in group two were bonded immediately after bleaching; specimens in groups three and four were bleached, then treated with SA solution for ten minutes and three hours, respectively, and then bonded. In groups five and six, SA hydrogel was used and the specimens were prepared similar to groups three and four, respectively. Following debonding, bond strengths were recorded in MPa. To evaluate the amount of resin left on the enamel surfaces, adhesive remnant index (ARI) scores were used. Statistical Analysis: The bond strength data were analyzed with ANOVA and pairwise comparisons were made by Tukey test. The ARI data were subjected to Kruskal-Wallis test and two-by-two comparisons were made by the Mann-Whitney U test. Results: There were significant differences in bond strengths between the groups ( P < 0.0005). However, the differences between groups three, four, five and six were not significant. Furthermore, there were no significant differences between group one and groups four and six, whereas the differences between the other groups were significant ( P < 0.05). Regarding ARI, there were significant differences among the groups ( P = 0.004). Conclusion: Bleaching significantly decreased the bracket bond strength. Compromised bonding was reversed with a three-hour application of both forms of SA.

Aim: This study aims to analyze the stress patterns and displacement in the cantilever resin bonded fixed partial denture (RBFPD) and compare it with the conventional cantilever fixed partial denture using 3-D finite element analysis. Also, the effect of cement on the displacement and stress patterns in conventional cantilever fixed partial denture was to be analyzed. Materials and Methods: Three-dimensional models were prepared layer wise to depict the conventional cantilever and the cantilever RBFPD. Once the models were made, the material properties were assigned and divided into three groups. (2-conventional cantilever with resin cement, 1- conventional cantilever with GIC cement and 3-resin bonded cantilever with resin cement). Load was applied in vertical as well as lateral directions and the stress patterns along with displacement were analyzed. Results: The results revealed that the von Mises stresses in all the three groups were found to be almost equal under vertical loading. Under lateral loading, the stress was more in cantilever RBFPD. Displacement in all the three axes was significantly less in the cantilever RBFPD. Conclusion: Stress concentration in the lateral direction in cantilever RBFPD was found to be higher than the cantilever conventional group. Displacement in X, Y and Z axes was less in cantilever RBFPD.

Objective: The aim of this in vitro study was to determine the effects of barium sulfate addition in two dental impression materials previously proved as radiolucent. Materials and Methods: An irreversible hydrocolloid (IH) and polyether (PE) were tested for optical density, linear dimension stability and detail reproduction. Statistical Analysis Used: The optical density data were submitted to Kolmogorov-Smirnov normality test and compared with two-way ANOVA and Tukey (alpha=0.05). Results: The results of optical density (pixel) were: IH control 45.24 ^f (±7.6), PE control 54.93 ^e (±4.45), PE 5Wt% 60.43 ^d (±6.27), IH 1Wt% 61.54 ^cd (±5.3), PE 1Wt% 66.9 ^bc (±5.05), IH 5Wt% 67.17 ^b (±6.01), PE 10Wt% 84.55 ^a (±5.14), IH 10Wt% 85.33 ^a (±5.53). On detail reproduction, polyether control was able to copy the 6 μm line. Adding 1 or 5Wt% of barium sulfate have not change this characteristic. For the irreversible hydrocolloid, the control group was able to copy a line with 14 μm, however, adding 1Wt% barium sulfate, the capability decreased to 22 μm. Adding barium sulfate in the polyether promoted an increase in between the copied lines, for the control, the average distance was 931.6 μm, 936 μm to 1Wt% and 954.5 μm to 5 Wt%. For the IH, the control presented 975 μm in comparison to 987.25 μm for 1 Wt% samples. Conclusion: The addition of barium sulfate was capable of increasing significantly the optical density of tested material, have changed the linear dimension stability, however, have not interfered in detail reproduction only for PE.

Background: Restorative materials must be capable not only of restoring the patient's masticatory function, but also to rescue the self-esteem of those maculated by a disharmonious smile. Among the esthetic materials available on the market, the choice frequently lies between ceramic or indirect laboratory resin restorations. Aim: This study assessed the resistance to compression of two laboratory resins found on the market, namely Artglass^® and Targis^® , considering Omega 900^® ceramic from Vita as control. Materials and Methods: With the aid of stainless steel matrices, with internal dimensions of 8.0 mm diameter at the base, 9.0 mm in the top portion and 4.0 mm height, 15 test specimens were made, being 5 of each material to be tested. The test specimens were kept in distilled water for 72 hours and submitted to an axial load by the action of a point with a rounded tip 2 mm in diameter, adapted to an EMIC 500 universal test machine. The compression speed was 0.5 mm/min, with a load cell capacity of 200 Kgf. Results: The means of the results were calculated in kilogram-force (Kgf). The results found were treated by analysis of variance (ANOVA) and the differences found among the groups were identified by the Tukey test (5%). Conclusion: It was observed that the material Omega 900^® offered significantly greater resistance to compression than the other two materials, which did not present statistically significant difference between them.

Aim: The aim of this study to develop the controlled delivery of combination drug(s) to periodontal pocket. Materials and Methods: In the present investigation mucoadhesive gel formulations were prepared using carboxy methylcellulose (CMC), methylcellulose (MC), hydroxyethylcellulose (HEC), polyvinylpirrolidone (PVP), polycarbophil (PC), and poloxamer. Each formulation was characterized in terms of polarizing light microscopy, gelation, gel melting, hardness, compressibility, adhesiveness, cohesiveness, syringeability, adhesion to a mucin disk, rheological studies, drug release, and antibacterial activities. Addition of CMC and PVP to the gel favored hexagonal phase formation. The gelation temperature was decreased linearly with an increasing concentration of drug(s), whereas, the melting temperature increased with the concentration of drug(s). Increasing the concentrations of each polymeric component significantly increased formulation hardness, compressibility, adhesiveness, mucoadhesion, and syringeability, yet a decreased cohesiveness. Increased time of contact between the formulation and mucin significantly increased the required force of detachment. Drug release from all formulations was non-diffusion controlled and significantly decreased as the concentration of the polymer was increased, due to the concomitant increased viscosity of the formulations and the swelling kinetics of PC, following contact with the dissolution fluid. Result: Antibacterial studies revealed that a gel with 30% HEC had a growth inhibition zone on agar with all three strains. Conclusion: Formulations containing HEC exhibited superior physical characteristics for improved drug delivery to the periodontal pocket and are now the subject of long-term clinical investigations.

Background: Daily toothbrushing and flossing are easy, effective and low-cost practices for removing the microbial dental plaque, which is an important factor in the development of caries and periodontal disease. Aim: The objective of this study is evaluation of oral health behaviors in a group of students from an Iranian university . Materials and Methods: This descriptive analytical cross-sectional study was carried out on 1736 Iranian students (1230 non-medical sciences students and 506 medical sciences students). Subjects were randomly selected. The students were asked to fill out a self-completion questionnaire about daily oral health behavior. Statistical Analysis Used: The chi-square test was used for evaluation of oral health behaviors and relationship between students' oral hygiene behavior and educational levels. Results : There was no difference between the frequencies of tooth brushing in the students of two universities. Medical sciences students used dental floss more than non-medical sciences students, which was a significant difference ( P = 0.000). There was no significant difference in toothbrushing frequency among the students with different levels of education. But the students of doctorate and masters degrees used dental floss significantly more than those of bachelor or associate degrees ( P = 0.000). Conclusions: This study showed that the level of self oral care among Iranian students is at a lower level than in industrialized countries.

Background: It was shown that two parasites of Entamoeba gingivalis (E. gingivalis) and Trichomonas tenax (T. tenax) may be responsible for oral parasitic infection. This study was designed to evaluate the prevalence of these parasites in oral cavity of patients with periodontal disease and in healthy population in Shiraz, Southern Iran. Materials and Methods: A total of 50 patients with periodontal disease (case group) and 50 subjects with healthy gingiva (control group) entered in the present study. A questionnaire recorded general health, smoking habits, and any history of antibiotic consumption during the last six months for each patient. In the case group, saliva was collected by sterile swab and the gingival crevicular fluid by the paper point. The plaque and calculi were collected by sterile curette and scaler. In the control group, saliva and gingival crevicular fluid were collected and sent to laboratory for further studies. Results: In the case group, nine patients were infected, six with E. gingivalis and three with T. tenax. Seven patients had mobility of the teeth, one patient was smoker and five had previous history of antibiotic consumption. In the control group, only one subject was infected with E. gingivalis without any history of smoking and antibiotic consumption. Conclusion: Parasitic infections are relatively common in patients with periodontal disease. It seems that follow-up of instructions are essential in control of parasitic infection in Southern Iran.

Aims : The application of a paint-on die spacer onto the dies prior to the fabrication of cast crowns is an acceptable procedure to improve the fit of the restoration. The primary purpose of this study was to evaluate the variation in thickness of different brands of die spacer based on the effect of storage time and application of additional layers. Materials and Methods: Dies were duplicated from a master model of ivorine teeth, with a full ceramic preparation. Dies obtained were then painted with one, two, and three coats of each brand of die-spacers separately. These dies were embedded in die stone and sectioned bucco-lingually. The same procedure was done after three and six months. The thickness of the paint on die spacer was measured at five points on the die using an optical microscope, and the data were statistically analyzed. Results and Conclusion : There was a definite variation in the thickness of the die spacer with all the three brands and at various points on the die. Two coat thicknesses were found to be in the range of tolerance of 20-40 microns. Thickness at occlusal groove was noted to be the maximum with least at occlusoaxial line angles. Thickness also showed a very significant increase when bottles were stored for a period of three to six months and then applied.

Objective: This ex vivo study compared coronal and apical microleakage of root canals filled with Resilon/Epiphany (RE) or gutta-percha/Grossman sealer (GP), using either lateral condensation (LC) or System B (SB) technique. Materials and Methods: Specimens in eight experimental groups were obturated using the following materials and techniques: Groups 1 and 3 - GP and LC; groups 2 and 4 - GP and SB; groups 5 and 7 - RE and LC; groups 6 and 8 - RE and SB. Apical and coronal leakages were tested using bacterial methods. For coronal analysis, the number of days required for complete contamination of the root canals was recorded according to observation of the brain heart infusion broth turbidity for 15 weeks. For apical analysis, the teeth were cleaved and the leakage was measured at 30 days. Data were collected for each sample and analyzed statistically with the Chi-square and ANOVA tests. Results: Leakage was found in all groups. The difference between filling materials, obturation techniques, and median time of leakage was not statistically significant for coronal ( P=0.847) and apical ( P=0.5789) leakages. Conclusion: There were no differences between the different filling materials (gutta-percha/Grossman sealer and Resilon/Epiphany) and obturation techniques (lateral condensation and system B technique) in coronal or apical leakages.

Objectives: To compare the effectiveness of transcutaneous electrical nerve stimulation (TENS) and microcurrent electrical nerve stimulation (MENS) on masticatory muscles pain bruxism patient. Materials and Methods : A total of 60 subjects with the clinical diagnosis of bruxism were randomly allocated to two study groups. Group A received TENS (50 Hz, pulse width 0.5 mSec, intensity 0-60 mA for 20 minutes for a period of seven days) and Group B received MENS (0.5 Hz, intensity 1,000 μA for 20 minutes for a period of seven days). The outcome measures were assessed in term of Visual Analog Scale (VAS) and digital pressometer of 2 Kgf. Results : The study showed significant change in intensity of pain as per VAS score ( P ≤ 0.0001) and tenderness as per digital pressometer ( P ≤ 0.0001). Conclusion : MENS could be used as an effective pain-relieving adjunct to TENS in the treatment of masticatory muscle pain due to bruxism.

Introduction: One of the effecting factors in prognosis of root canal therapy is accidental procedure as broken files that may be unpreventable. Many manufacturers have designed and marketed various electromotors that can control rotational speed and torque. On the other hand, some studies have recommended applying a manual glide path to diminish contact area between the file and canal walls. The purpose of this study was evaluation of the effect of torque and a manual glide path on defects as separation of Nickel-titanium (NiTi) rotary files. Materials and Methods: This ex vivo randomized controlled trial study was carried out on 160 canals of human's matured molars with mild curvature (15-338). After initial preparation of samples and checking for inclusion criteria, in first group, preparation was carried out with air-driven handpiece, and in group two, Endo IT was used as electromotor. In both groups, Mtwo files with simultaneous technique were used for preparation. Then all data were collected and analyzed with Mann Whitny, Mantel Cox, and t-test. Results: No significant differences between two groups (P < 0.05) were observed. Based on survival analysis, safety probability of files after preparation of nine canals is 64% in group one and 69.9% in group two. There was no significant differences between this safety probability in two groups (P = 0.272). Conclusion: Usage of torque control handpiece is not an important factor, comparing instrumentation technique.

Aim: The need for denture marking is important for forensic and social reasons in case patients need to be identified individually. Majority of the surface marking and inclusion techniques are expensive, time consuming, and do not permit the incorporation of large amounts of information. In this article, the method to include a lenticular identification card stood out from the currently available denture marking methods in various ways. The lenticular card stores the patient's information has two or more images that can be viewed by changing the angle of view. Materials and Methods: The maxillary denture was processed according to the manufacturer's instructions. The lenticular identification card was incorporated in the external posterior buccal surface of the maxillary denture using salt and pepper technique. For testing of durability, denture with the identifier was placed in water for up to 4 months. Conclusion: The proposed method is simple, cheap, and can store a large amount of information, thus allowing quick identification of the denture wearer. The labels showed no sign of fading or deterioration.

Healthcare-associated infections are an important cause of morbidity and mortality among hospitalized patients worldwide. Transmission of health care associated pathogens generally occurs via the contaminated hands of health care workers. Hand hygiene has long been considered one of the most important infection control measures to prevent health care-associated infections. For generations, hand washing with soap and water has been considered a measure of personal hygiene. As early as 1822, a French pharmacist demonstrated that solutions containing chlorides of lime or soda could eradicate the foul odor associated with human corpses and that such solutions could be used as disinfectants and antiseptics. This paper provides a comprehensive review of data regarding hand washing and hand antisepsis in healthcare settings. In addition, it provides specific recommendations to uphold improved hand-hygiene practices and reduce transmission of pathogenic microorganisms to patients and personnel in healthcare settings. This article also makes recommendations and suggests the significance of hand health hygiene in infection control.

Obstructive sleep apnea (OSA) is an increasingly common disorder. It is characterized by frequent episodes of airway obstruction associated with a reduced caliber of the upper airway and is vulnerable to further narrowing and collapse. Acute and repetitive effects of apnea and hypopnea include oxygen desaturation, reduction in intrathoracic pressure, excessive daytime sleepiness, impaired executive function and central nervous system arousals. The apnea-hypopnea index and respiratory distress index help quantify the severity of the condition. The condition is associated with several clinical symptoms of which daytime sleepiness is considered the cardinal symptom. Obesity is one of the major predisposing factors. Three types of apneas have been recognized - obstructive, central and mixed; OSA is the commonest. This review will cover aspects of their radiologic features, diagnosis and management.

Treatment of patients with aggressive periodontitis has always been a challenge to the clinician. Both young and old are known to be affected by this progressive destructive condition of the supporting dental structures. Although dental implants have been offered as a viable treatment alternative for such patients, additional procedures (like bone grafting) and delayed protocols have limited their usage. This case report describes the treatment of a young patient with aggressive periodontitis using a graftless implant solution. Zygoma implants in conjunction with conventional implants were used with immediate loading.

The contour of edentulous ridge should be carefully evaluated before a fixed partial denture is undertaken. The ideal ridge height and width allows placement of a natural looking pontic which facilitates maintenance of plaque-free environment. The localized alveolar ridge defect refers to the volumetric deficit of the limited extent of bone and soft tissue within the alveolar process. Such type of ridge defects can be corrected by surgical ridge augmentation that can be accomplished by the addition of either soft or hard tissues. This article describes a procedure of surgical connective tissue augmentation of a localized deficient alveolar ridge in the maxilla, followed by fixed partial denture, enhancing the esthetics, function and health.

A healthy 32-year-old female patient required an extraction of the right maxillary third molar. Lidocaine containing 1:80,000 epinephrine for right posterior superior alveolar nerve block was administered in the mucobuccal fold above the third molar to be extracted at our hospital. After few minutes of posterior superior alveolar block anesthesia, patient felt double vision. The condition was subsequently diagnosed as transient diplopia due to temporary paralysis of lateral rectus muscle due to involvement of the VI cranial nerve. The patient recovered in 30 minutes and the treatment was performed successfully. This article discusses the possible scientific explanation for this phenomenon.

Numbness of the lower lip, the skin of the chin, or the gingiva of the lower anterior teeth secondary to various dental diseases is a common manifestation that is largely underappreciated. The association of numb chin syndrome (NCS) with serious disease like metastatic malignancy and systemic conditions is frequent enough to warrant a search for these possible etiologies. In this paper we report a case of NCS that occurred secondary to malignant disease; we discuss our findings with special emphasis on metastatic malignancies leading to NCS, when the survival is only for a few months.

Clinical manifestations of tuberous sclerosis (TS) are variable, and oral involvement occurs in less than 10% of the affected patients. We reported herein a nine-year-old boy with dental enamel pits and gingival nodular lesions, histologically diagnosed as angiofibromas that leaded to the diagnosis of a family with TS. In this report, we demonstrated the multiprofessional importance in the diagnosis of TS. Early diagnosis of TS is essential for an appropriate treatment of the affected patients and genetic counseling.

The mylohyoid nerve is the branch of the inferior alveolar nerve (IAN) which arises above the mandibular foramen. An abnormal communication between the mylohyoid nerve and lingual nerve (LN) was noted during the routine dissection of a male cadaver. Communicating branches between IAN and LN have been identified as a possible explanation for the inefficiency of mandibular anesthesia. The communication between mylohyoid and lingual nerve was found in this case after the LN passes in close relation to third molar tooth, which makes it more susceptible to injury during third molar extractions.

Ellis-van Creveld (EvC) syndrome is an autosomal recessive disorder, mainly affecting the ectodermal components such as, enamel, nail, and hair. The gene for EvC syndrome is located on chromosome 4p16. Patients with EvC syndrome characteristically presents with congenitally missing teeth, abnormal frenal attachment, microdontia, and hexadactyly.