Background and Objectives: Myofascial Pain Dysfunction Syndrome (MPDS) has been recognized as the most common, nontooth-related chronic orofacial pain condition that confronts dentists. A variety of therapies has been described in literature for its management. The present study is a prospective study carried out to evaluate the efficacy of occlusal splint therapy and compare it with pharmacotherapy (using analgesics and muscle relaxants) in the management of Myofascial Pain Dysfunction Syndrome. Materials and Methods: Forty patients in the age range of 17-55 years were included in the study and randomly assigned to one of two equally sized groups, A and B. Group A patients received a combination of muscle relaxants and analgesics while Group B patients received soft occlusal splint therapy. All the patients were evaluated for GPI, VAS, maximum comfortable mouth opening, TMJ clicking and tenderness during rest and movement as well as for the number of tender muscles at the time of diagnosis, after the 1 ^st week of initiation of therapy and every month for three months of follow-up. Results: There was a progressive decrease in GPI scores, number of tender muscles, TMJ clicking and tenderness with various jaw movements and significant improvement in mouth opening in patients on occlusal splint therapy during the follow-up period as compared to the pharmacotherapy group. Conclusion: Occlusal splint therapy has better long-term results in reducing the symptoms of MPDS. It has better patient compliance, fewer side effects, and is more cost-effective than pharmacotherapy; hence, it can be chosen for the treatment of patients with MPDS.

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Background: To organize community-oriented oral health promotion programs systematic analysis of the oral health situation would be needed, including information on oral health knowledge, attitudes, and practices (KAP). Aim: The aim of this study was to assess knowledge, attitude, and practice (KAP) toward oral health among 11 to 12-year-old school children in a government-aided missionary school of Bangalore city. Materials and Methods: The study group comprised of 212 children (Male: 108; Female; 104) who were in the age group of 11-12 years studying in a government-aided missionary school of Bangalore city. Data on oral health KAP were collected by means of a self-administered questionnaire. Statistical significance was determined by Chi-square test. Results: This survey found that only 38.5% of the children brush their teeth two or more times a day. Pain and discomfort from teeth (35.1%) were common while dental visits were infrequent. Fear of the dentist was the main cause of irregular visit in 46.1% of study participants. High proportion of study participants reported having hidden sugar at least once a day: soft drinks (32.1%), milk with sugar (65.9%), and tea with sugar (56.1%). It was found that 5.4% and 3.9% of study participants smoke and chew tobacco, respectively. Conclusion: Results of this study suggest that oral health KAP of study participants are poor and needs to be improved. Systematic community-oriented oral health promotion programs are needed to improve oral health KAP of school children.

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Objective: To obtain information on caries prevalence and treatment needs of children aged 5-10 years to plan appropriate dental care services in rural areas. Materials and Methods: Children studying in all the primary schools (six schools) in the field practice area of the Rural Health Centre of the Faculty of Medicine, Annamalai University, Chidambaram, were surveyed. Each child was clinically examined in the schools by calibrated examiners. Dental caries was assessed using diagnostic criteria recommended by WHO (1997). The chi-square test and two-way analysis of variance were used for statistical analysis. Results: Five hundred and eight 5-10 year-old school children (247 boys and 261 girls) were surveyed. Caries prevalence was 71.7 and 26.5% in primary and permanent dentition, respectively. The mean dmft and decayed missing filled tooth (DMFT) scores were 3.00 and 0.42 respectively. The mean dmft decreased with age ( P < 0.01) whereas the mean DMFT increased with age ( P < 0.001). Although the mean dmft scores were not statistically significant different for the two sexes, the mean DMFT score was found to be higher among girls than among boys ( P < 0.02). The entire dmft/DMFT value represented the 'decay' component only. There was a strong need for single surface restorations (60.6%). In the WHO index age (5-6 years), the caries prevalence was 70.2% (29.8% caries-free) with a mean dmft value of 3.54 ± 3.71. Conclusion: Dental caries is a significant public health problem in this population. An extensive system to provide primary oral health care has to be developed in the rural areas of India.

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Purpose: To assess the common oral findings and anomalies of Down syndrome (DS) children in Chennai city, India. Materials and Methods: Among the 130 DS children examined, 102 children aged 15 years and below were included in the study. There were 57 male children and 45 female children in the total study sample. A specially prepared case record was used to record the following findings in each child: a brief family and personal history; anomalies of soft tissues, teeth, occlusion, and temporomandibular joint. Age wise and sex wise comparisons of the findings were done. Results: About 97 children (95%) had the habit of regular tooth brushing. Everted lower lip (66%), retained primary teeth (31%), and midface deficiency (76%) were the most commonly seen soft tissue, dental, and occlusion anomalies, respectively. Conclusions: Midface deficiency was the most common orofacial anomaly seen in these children, followed by everted lower lip and retained primary teeth. Almost all the children had a regular tooth brushing habit. All the children examined were offered free dental treatment in our dental college.

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Background: Vital pulpotomy is a single-stage procedure defined as the surgical amputation of the coronal portion of exposed vital pulp, usually as a means of preserving the vitality and function of the remaining radicular portion. Objectives : The aim of this study was to compare the clinical and radiographic success rates for electrosurgical vs formocresol pulpotomy in human primary molar teeth. Settings and Design: This was a prospective, randomized clinical trial. Materials and Methods: In this randomized clinical trial, pulpotomies were performed on 70 primary molars in children aged 5-10 years. The teeth were treated using either a conventional formocresol (35 teeth) or electrosurgical technique (35 teeth). Following the pulpotomy procedure, the teeth were evaluated for clinical and radiographic success for three, six and nine months. The teeth were evaluated for the presence of pain, abscess, fistula, mobility, internal and external resorption, and radiolucency. Statistical Analysis : The data were assessed with Fishers' Exact test. Results: After nine months of follow-up, the clinical and radiographic success rates were 96 and 84% respectively in the electrosurgical group and 100 and 96.8% respectively in the formocresol group. There was no statistically significant difference between the success rates in the two groups ( P > 0.05). Conclusions: Our results showed the failure rates for electrosurgical pulpotomy to be equal to those for formocresol pulpotomy. Although electrosurgical pulpotomy is a nonpharmacological technique giving favorable results, it is still a preservative technique. Further studies using larger samples and longer evaluation periods are recommended.

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Segmental resection of the mandible commonly results in deviation of the mandible to the defective side. The amount of deviation depends on the amount of hard and soft tissue involvement, the method of surgical site closure, the degree of impaired tongue function, the number of remaining teeth and the extent of loss of sensory and motor innervations. Prosthodontic treatment along with physical therapy may be useful in reducing mandibular deviation and improving masticatory efficiency. This clinical report describes the use of two rows of nonanatomic teeth on the unresected side. This provided a broader occlusal table and improved masticatory efficiency in our edentulous madibulectomy patient.

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Purpose: To assess the prevalence of caries and the treatment needs of Down syndrome children in the Indian city of Chennai. Materials and Methods: Among the130 Down syndrome children examined, only the children aged £15 years were included in the study ( n = 102). There were 57 male and 45 female children in the total study sample. A specially prepared case record was used to record the findings for each child. The dentition status and the treatment needs required were recorded. Comparisons of the findings were done based on age and gender distribution. Results: Twenty-nine per cent of the total sample of Down syndrome children was found to be caries-free. Extraction (in 38 children) and one-surface filling (in 26 children) were the most needed specific treatments for primary and permanent teeth, respectively. Oral prophylaxis (99%) was the most required treatment in the overall treatment category. Conclusions: Contrary to the findings of earlier studies, the percentage of caries-free Down syndrome children was found to be lower in our study. However, their basic needs like oral prophylaxis, restorations and extractions remain the same and can be easily fulfilled by an efficient, community-based dental team.

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Aim: The purpose of this study was to assess the success and predictability of root coverage and esthetics obtained with free gingival grafts (FGGs) in the treatment of early class III gingival recessions for a period of 12 months. Materials and Methods: Ten patients contributed to 12 sites, each with early class III recession with interdental bone loss £4 mm from cemento enamel junction(CEJ). Clinical parameters recorded at baseline and at 1, 6, and 12 months were probing depth (PD), recession depth (RD), recession width (RW), and clinical attachment level (CAL). Results: Reduction of recession resulted in a significant gain in CAL and PD at the end of 12 months. A statistically significant mean root coverage of 41.25 ± 21.07% was obtained at the end of 12 months. A statistically significant improvement in Visual Analog Scale score was seen after a 12-month follow-up period. Conclusion: In a south Indian population, early class III gingival recessions treated with FGG procedures resulted in 40-50% root coverage with fairly acceptable esthetics.

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The aim of this article is to provide an insight into different techniques of cleaning and shaping of curved root canals with hand instruments. Although a plethora of root canal instruments like ProFile, ProTaper, LightSpeed^® etc dominate the current scenario, the inexpensive conventional root canal hand files such as K-files and flexible files can be used to get optimum results when handled meticulously. Special emphasis has been put on the modifications in biomechanical canal preparation in a variety of curved canal cases. This article compiles a series of clinical cases of root canals with curvatures in the middle and apical third and with S-shaped curvatures that were successfully completed by employing only conventional root canal hand instruments.

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Pilomatricoma, also known as "Calcifying Epithelioma of Malherbe" is an uncommon, benign, cutaneous tumor originating from the hair matrix. Most often, its precise preoperative diagnosis is not possible. Rarity of this lesion and its histological resemblance to the calcifying odontogenic cyst (the Gorlin's cyst) make it relevant, both to the maxillofacial surgeons and the pathologists. Here, we describe a case of pilomatricoma of the periorbital region in a young Indian female patient. We believe that its inclusion is essential in the differential diagnosis of hard masses of the maxillofacial and paraoral regions.

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Aim: To comparatively evaluate the amount of apically extruded debris when ProTaper hand, ProTaper rotary and ProFile systems were used for the instrumentation of root canals. Materials and Methods: Thirty minimally curved, mature, human mandibular premolars with single canals were randomly divided into three groups of ten teeth each. Each group was instrumented using one of the three instrumentation systems: ProTaper hand, ProTaper rotary and ProFile. Five milliliters of sterile water were used as an irrigant. Debris extruded was collected in preweighed polyethylene vials and the extruded irrigant was evaporated. The weight of the dry extruded debris was established by comparing the pre- and postinstrumentation weight of polyethylene vials for each group. Statistical Analysis: The Kruskal-Wallis nonparametric test and Mann-Whitney U test were applied to determine if significant differences existed among the groups ( P < 0.05). Results: All instruments tested produced a measurable amount of debris. No statistically significant difference was observed between ProTaper hand and ProFile system ( P > 0.05). Although ProTaper rotary extruded a relatively higher amount of debris, no statistically significant difference was observed between this type and the ProTaper hand instruments ( P > 0.05). The ProTaper rotary extruded significantly more amount of debris compared to the ProFile system ( P < 0.05). Conclusion: Within the limitations of this study, it can be concluded that all instruments tested produced apical extrusion of debris. The ProTaper rotary extruded a significantly higher amount of debris than the ProFile.

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Objective: The objective of the present study was to evaluate early and late effects of radiation and a-tocopherol on the secretion rate of saliva and on selected saliva salivary parameters in oral cavity cancer patients. Patients & Methods: Eighty-nine histologically confirmed oral cavity cancer patients (OCC) were enrolled in the study. Resting whole saliva was collected before, during and at the end of the radiation therapy (RT) and simultaneous supplementation with α - tocopherol to the radiation treated patients (RT + AT). Results: Salivary flow rate, pH, amylase activity, total protein, sodium and potassium were analyzed. Increased pH, potassium and decreased flow rate, amylase activity, protein content and sodium were observed in 6 weeks of radiation treated patients when compared to OCC patients. A significant improvement of those parameters was observed on α - tocopherol supplementation in RT + AT patients. Conclusion: Supplementation with α - tocopherol improves the salivary flow rate thereby, maintains salivary parameters.

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Background: The follicular tissue around impacted third molars has a potential to develop pathosis. However, it is generally assumed that the absence of abnormal radiolucency indicates the presence of a normal follicle. Aims: The aim of this study was to investigate abnormalities associated with radiographically normal follicular tissue of third molar impactions. Materials and Methods: One hundred eighty-five impacted third molars from 170 patients with no signs of abnormal radiolucency (follicular space <3 mm) were used for this study. Follicular tissues of the relevant teeth were collected. Specimens were fixed in 10% formalin and stained routinely with hematoxilin and eosin to be independently examined by two pathologists. A diagnosis was registered only when the results from both pathologists were in concordance. Clinical details for each patient were registered in WHO standard forms to undergo chi-square statistical analysis. Results: Fifty-three per cent of the specimens had developed pathosis. The incidence of pathosis was higher in the age group of 20-30 years, in men compared to women and in the mandible compared to the maxilla. Conclusion: The findings of this study suggest that radiographic appearance may not be reliable in the diagnosis of pathosis in follicular tissue as a surprisingly high rate of pathosis was found in the absence of any radiographically detectable sign.

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Aim: The value and success of a well-fitting and anatomically correct prosthesis are compromised if the color does not match the adjoining tissues. The use of powder colors to help develop a simplified silicone shade guide to aid in the fabrication of silicone facial prostheses for Indian patients has been described here. Materials and Methods: Ten powder pigments were used to fabricate the silicone samples for three different subjects having light, medium and dark complexions who were separated into three groups depending on the value of their shades. Four-step wedge silicone samples with thickness variations of 1, 2, 4 and 6mm were fabricated. Visual assessment of the samples was done by four evaluators to check the agreement of color match. Data was statistically analyzed using kappa coefficients. Results: The kappa values were found to be 0.09-0.44 for a light skin tone, -0.11 to 0.77 for medium skin and 0.44 to 0.85 for dark skin tones. This study showed that the samples of dark skin tone matched the skin tone well and showed a statistically good agreement. To further test the validity of these shade guides, facial silicone veneers were fabricated for three patients having light, medium and dark complexion. The color matching showed satisfactory results. Conclusion: The silicone veneers matched the skin color of all three patients. Hence, this shade guide will help clinicians to obtain a good intrinsic shade and minimize extrinsic coloration.

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Background: The esthetic of smile is influenced by such features as the amount of incisor show and gingival display. Aims: The purposes of this study were to compare smile esthetics among normal occlusion and non extraction patients, assess upper lip height in two groups and discuss how this feature relate to smile esthetics. Settings and Design: We therefore conducted a case control study to determine the mentioned aims. Materials and Methods: Thirty females with non extraction orthodontically treated occlusions and thirty three with normal occlusions were selected. Standardized black and white photographs of their posed smiles were evaluated by a panel of 5 men and 5 women of varied vocations by use of visual analogue scale. Then upper lip height of the two groups were measured from photographs. Statistical Analysis: Smile esthetics and differences among the two groups were subjected to ANOVA and Mann-whitney test was used to compare upper lip height in them. Results: This study showed that upper lip height did not differ among the 2 groups ( P = 0.98). Also there were no significant differences in the distribution of fair,good and very good smiles among the two groups. Conclusions: This study demonstrates that the non extraction orthodontic treatment does not influence smile esthetics.

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There is an increasing demand to improve dentofacial esthetics in the adult population. This demand usually requires a close collaboration within the various disciplines of dentistry and the patient at every stage of the therapy. The materials and techniques used by these interdisciplinary clinicians must be conservative and minimally invasive. Fiber-reinforced composite technology offers such solutions for chairside applications. This case report presents two cases where fiber-reinforced ribbon and composite complex was used in a multidisciplinary approach to improve esthetics.

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Background: The purpose of the present cross-sectional study was to assess the extent of agreement between clinical and self-assessed periodontal health status among patients visiting the outpatient department of M.S. Ramaiah Dental College, Bangalore, India. Materials and Methods: The study population included 216 patients aged between 20 and 44 years who attended the outpatient department of the M.S. Ramaiah Dental College, Bangalore. The study population was subjected to a self-administered questionnaire (questions regarding bleeding gums, deposits on teeth, receding gums, swelling of gums, loose teeth), which was followed by periodontal examination. The clinical examination included an assessment of the periodontal condition, using the criteria of Loe and Silness Gingival Index, the Community Periodontal Index, and Mobility, respectively. Conclusion: The present study showed that the perceived periodontal health status was low and the discrepancy between the subjectively and objectively assessed needs was very distinct. The awareness of the periodontal problems has been reported to increase with increasing severity of the disease due to the destructive changes that set in.

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Objective: Cleidocranial dysostosis (CCD) is a skeletal disorder associated with dental anomalies such as failure or delayed eruption of permanent teeth and multiple impacted supernumerary or permanent teeth. Absence of cellular cementum at the root apex is presumed to be one of the factors for failure or delayed eruption. The aim of this study was to analyze the root cementum of supernumerary(S) and permanent teeth (P) of a CCD patient and to compare the findings with those of normal individuals with special emphasis on delayed eruption. Materials and Methods: Ground sections of 12 extracted teeth (9S + 3P) of a CCD patient and 12 teeth of normal individuals (5S + 7P) were taken for the study. The sections were longitudinal and 50 µm thick. Root characteristics were recorded with the aid of a light microscope. Results: The absence of apical cellular cementum, increased root resorption and increased percentage of the gap type of cemento-enamel (C-E) junctions were significant findings noted both in the supernumerary and permanent teeth of the CCD patient. Conclusion: The presumption of cellular cementum is essential for tooth eruption is not supported by the findings of the present study. Delayed exception could be attributed to various other factors like mechanical obstruction, reduced serum alkaline phosphatase levels etc. Also, the significance of the increased percentage of the gap type of C-E junctions and its role in tooth eruption has to be further evaluated.

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Temporomandibular joint dysfunction (TMJD) is a common problem seen in many of the dental clinics. Management of this depends on an accurate diagnosis of the cause for the TMJD. Physical therapy and rehabilitation play a vital role in the management of these dysfunctions. Physical therapy is useful in treating post-traumatic stiffness of the TMJ while strapping of the TMJ for a dysfunction along with conventional physical therapy is of benefit in terms of reduction in click, decrease in pain, and an improvement in function.

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Papillon-Lefθvre Syndrome (PLS) is a rare autosomal recessive trait, which is transmitted with an estimated frequency of one to four per million individuals. It is characterized by palmar plantar keratosis and severe early-onset periodontitis affecting both deciduous and permanent dentition. In this report, we present clinical, microbiological and leukocyte function test findings of a thirty-five year-old patient with symptoms typical of Papillon-Lefθvre Syndrome except for premature loss of deciduous and permanent dentition. The patient exhibited palmar plantar keratosis and an isolated, moderately deep periodontal pocket in the third quadrant. No anaerobic bacteria were isolated from the plaque culture. The neutrophil function test revealed defective chemotaxis and phagocytosis while intracellular killing and respiratory burst were normal.

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