Anxiety is a special variety of fear, experienced in anticipation of threatening stimuli. While some research workers have said that the response of a child improves with the number of visits, many have felt otherwise. The present study is yet another effort to find the patterns of anxiety in children during sequential dental visits. The main aim was to determine the physiological and behavioral variations during sequential dental visits and its impact on age and sex. The study was conducted at the outpatient Department of Pedodontics and preventive dentistry, Meenakshi Ammal Dental College and Hospital, Chennai to evaluate the physiological and behavioural measures of stress and anxiety in children. One hundred and fifteen children, between four and eleven years of age who reported for dental treatment were selected for the study.

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Oral lesions of tuberculosis though uncommon, are seen in both the primary and secondary stages of the disease. In secondary tuberculosis, the oral manifestations may be accompanied by lesions in the lungs, lymph nodes, or in any other part of the body and can be detected by a systemic examination. Primary oral tuberculosis may present as a diagnostic challenge for the clinician. Here we report two patients with primary tuberculosis in the oral cavity who presented to the dental department, were diagnosed and referred for medical management.

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Desmoplastic Ameloblastoma is a rare variant of ameloblastoma. 90 cases of desmoplastic ameloblastoma have been reported so far in literature. We are presenting a rare case of desmoplastic ameloblastoma in the ramus region of mandible with regards to its clinical and radiographical viewpoints. Only one other case of desmoplastic ameloblastoma has been reported in the ramus region of mandible of the 90 cases that we have reviewed. Review of literature has revealed the tumour to most commonly occur in the 3rd to 5th decade of life with a high preponderance of Japanese males. The anterior region of either jaw was most commonly found to be affected. Radiological appearance was most commonly of a mixed radio-lucent/radio-opaque type with a high incidence of poorly defined borders. However our case differed from the reviewed cases as it was found to be a unilocular lesion with well defined borders. Histopathological findings of our case were consistent with the hisotpathological appearance of the reviewed cases and showed extensive stromal desmoplasia and small tumour nests of odontogenic epithelium scattered in stroma.

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AIM : To analyse the prevalence of anatomical variations of mandibular premolars in Chennai population. METHODOLOGY : It was observed, during the routine treatment of mandibular premolars that aberrations were becoming common. This necessitated an encompassing study on 500 patients, evaluating the occurrence of these aberrations. The parameters of this study included sex predilection, unilateral/ bilateral occurrences, and comparison of the incidence of anatomical variations in mandibular first and second premolar canal configuration. The study pattern was designed to observe these premolars using Radiovisiography (RVG) in different angulations to highlight the anatomical aberrations. The results were subjected to statistical analysis, which were performed using SPSS (Statistical Package for Social Science) statistical program version 10.0.5. Descriptive statistics were computed for all the variables. RESULT : The present study revealed high incidence of anatomical aberrations in mandibular premolars among Chennai population. Out of the 500 patients studied, 123 patients [24.6%] showed anatomical variance in the canal configuration. There was high incidence of Vertucci's Type IV canal configuration as compared to Type V, Type II and Type VIII in the descending order of occurrence. CONCLUSION : Within the limitations of this in-vivo study, it was inferred that the incidence of aberrations in the canal configuration of mandibular premolars is common and due considerations are to be given during endodontic intervention.

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Binkley and Johnson first reported this syndrome in 1951. But it was in 1960, Gorlin-Goltz established the association of basal cell epithelioma, jaw cyst and bifid ribs, a combination which is now frequently known as Gorlin-Goltz syndrome as well as Nevoid Basal Cell Carcinoma Syndrome (NBCCS). NBCCS is inherited as an autosomal dominant trait with high penetrance and variable expressivity. NBCCS is characterized by variety of cutaneous, dental, osseous, opthalmic, neurologic and sexual abnormalities. One such case of Gorlin-Goltz syndrome is reported here with good illustrations.

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BACKGROUND & OBJECTIVES : Malodour has been correlated with the concentration of volatile sulphur compounds produced in the oral cavity by metabolic activity of bacteria colonizing the periodontal sites and the dorsum of the tongue. The aim of this study was to detect malodour in mouth air organoleptically and using a portable sulphide monitor and to correlate it with the clinical parameters, halitosis linked toxins and BANA, using tongue and subgingival plaque samples. The halitosis grading is also correlated with the microbial colonies of the subgingival plaque sample. METHODS : 20 patients with chronic periodontitis with 5-7 mm pocket depth, radiographic evidence of bone loss and presence of oral malodour participated in this study. Assessment of mouth air was done organoleptically and by using a portable sulphide monitor. The clinical parameter, plaque index (PI), gingival index (GI), gingival bleeding index (BI), were obtained from all the areas. Samples for BANA and to detect halitosis linked toxins were taken from the dorsal surface of the tongue and periodontal pockets ranging 5-7 mm. Halitosis related microbial colonies were identified using anaerobic culturing from the subgingival plaque. RESULTS : The scores of PI, GI, BI and sample that tested positive for halitosis linked toxins and with the halitosis grading were not significant. The presence of tongue coating and the halitosis grading and toxin levels were significant. BANA has shown to be non contributory due to technical problems. Anaerobic culture has shown to identify Streptococcus, Bacteroides, Fusobacterium, Porphyromonas and Prevotella colonies. INTERPRETATION & CONCLUSION : The results confirmed that there was no correlation between the clinical parameters, halitosis linked toxins and halitosis grading. The microbial colonies have shown to correlate with the presence of oral malodour.

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The aim of the present study was to assess the oral health practices, status and treatment needs of the rural elderly in national capital territory of Delhi. An effort was also made to identify patterns of utilization of dental services and test alternate strategies for service provision. A total of 96 elderly subjects (47 males and 49 females) in 5 rural areas were interviewed and clinically examined using Basic Oral Health Survey criteria of W.H.O. This was followed by a community trial in which the 5 villages were divided into control and test groups. Results of the survey found that both traditional as well as modern oral health practices co-exist in the rural community. Dental services were available to a majority (mostly through private sector), and edentulousness was a condition of primary concern among the elderly as a result of unmet treatment needs for dental caries and periodontal diseases. Age was a variable that was statistically significantly associated with edentulousness (p=0.005). Results of the community trial showed that higher utilization of care can be achieved by providing on-site dental care as compared to referring cases to tertiary care centers. Nevertheless provision of treatment alone is not a suitable policy recommendation since many elderly did not avail care even at on-site community dental health programmes that were operated free of cost. This emphasizes the need of health education over treatment in order to empower the elderly, especially the non-ambulatory patients, to practice prevention and develop favourable attitudes towards accepting prompt treatment at primary health care level.

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The most common clinical features of tempero-mandibular joint internal derangement are correlated with the MRI findings of shape of the disc in an attempt to find the etiology of tempero-mandibular joint internal derangement. In this study, the clinical parameters of pain, muscle tenderness, clicking with in the joint (like early, middle and late) are correlated with the MRI findings of disc shapes. (like biconcave, thick, lengthened, folded, adhesion). The study reveals any trauma that leads to muscle tenderness results in internal derangement of tempero-mandibular joint.

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Maxillary canine is one of the most common teeth that are impacted. This accounts for 1-2% of all patients who attend orthodontic treatment. The key to achieve maximal eruption of these teeth is their surgical exposure and the role of periodontist in such situations is to provide a functional and satisfactory width of attached gingiva on the labial surface. There are different techniques to surgically expose the impacted teeth, namely--gingivectomy technique, apically positioned flap, closed eruption technique, modified apically positioned flap, double pedicle flap and free gingival graft. Selection of the procedure is dependent on the positioning of the tooth in relation to mucogingival junction and attached gingiva. In the present case series we describe three different techniques for uncovering of impacted teeth, which are apically positioned flap, closed eruption technique and a modified double pedicle graft specially planned for the situation. These procedures when selected diligently using sound selection criteria will create adequate width of attached gingiva which minimizes or eliminates the future mucogingival problems.

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