Aim: To evaluate the color stability and flexural strength of poly (methyl methacrylate) (PMMA) and bis-acrylic composite based provisional crown and bridge auto-polymerizing resins exposed to tea, coffee, cola, and food dye. Materials and Methods: Two provisional crown and bridge resins, one DPI self-cure tooth molding powder (PMMA) (Group A), and one Protemp 4 Temporization Material (bis-acrylic composite) (Group B) were used. Disk-shaped specimens for color stability testing (n = 30 for each material) and bar-shaped specimens for flexural strength testing (n = 30 for each material) were fabricated using a metal mold. The specimens were immersed in artificial saliva, artificial saliva + tea, artificial saliva + coffee, artificial saliva + cola, and artificial saliva + food dye solutions and stored in an incubator at 37°C. Color measurements were taken before immersion, and then after 3 and 7 days of immersion. Flexural strength was evaluated after 7 days of immersion. Results: Group A showed significantly higher color stability as compared to Group B, and artificial saliva + coffee solution had the most staining capacity for the resins. Test solutions had no effect on the flexural strength of Group A, but Group B specimens immersed in artificial saliva + cola showed significantly lower flexural strength values as compared to the control group. Conclusion: The findings of the study showed that for materials used in the study, PMMA was more color stable than bis-acrylic composite based resin. Also, material based on PMMA was more resistant to damage from dietary beverages as compared to bis-acrylic composite based provisional crown and bridge resin.

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Background: Cytokines play an important role in the pathology associated with chronic inflammatory diseases. Because of pro-inflammatory and neutrophil chemotactic properties, the cytokines like interleukins (IL) may play a significant role in the pathogenesis of periodontitis. The biological effects of IL-8 are relevant in this regard. Aim: This study was done to compare the level of this molecule in gingival crevicular fluid (GCF) from patients with adult periodontitis (experimental group) and from individuals with clinically healthy gingival (control group). Materials and Methods: GCF was collected from patients with adult periodontitis and clinically healthy gingival for 30 s using a Periopaper strip and the volume of the sample determined. Following elution of the fluid, assays for IL-8 were carried out by enzyme-linked immunosorbent assay (ELISA). The concentration of IL-8 was calculated in the original volume of GCF on each strip. Results: The level of IL-8 in the experimental group was significantly higher than in the control group ( P < 0.01). The clinical parameters were positively correlated to IL-8, suggesting that the GCF IL-8 exhibited dynamic changes upon severity of periodontal disease ( P < 0.05). Conclusion: These data suggest that level of IL-8 is associated with periodontal status. The level of IL-8 in GCF is valuable in detecting the inflammation of periodontal tissue.

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Background: Complete debridement and obturation of the root canal system is a key factor in successful endodontic treatment and the operator should therefore have thorough knowledge of the root canal morphology of the teeth. Numerous studies have been carried out to investigate the canal configuration of different tooth types in various populations. Aims: The aim of the present study was to investigate the internal anatomy of mandibular incisors and canines in an Iranian population. Materials and Methods: A total of 463 mandibular anterior teeth, including 186 centrals, 128 laterals, and 149 canines, were examined. A standard clearing technique was used to make the teeth transparent. India ink was injected into the canals of the teeth and the samples were examined with a magnifying glass. The root canal configurations were categorized according to the Vertucci classification. Results: All the incisors in this study had one root, and 12.08% of the canines had two roots. We found a slightly higher prevalence of the second canal in incisors than in canines (36.62% vs. 20.48%). However, the probability of canines having two separate apical foramina was higher than that for incisors (12.08% vs. 0.64%). Conclusions: In view of the high prevalence of two-canaled mandibular anterior teeth found in this study, it would be prudent to assume that any mandibular anterior tooth being treated is two-canaled until a thorough search proves otherwise.

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Recurrent aphthous stomatitis (RAS) is one of the most common and painful ulcerative lesions of the oral cavity, but until now no cure has been recognized for it. Two patients diagnosed with minor RAS were treated in a single sitting with low level laser therapy using 940-nm diode laser. The lesions healed completely within 3-4 days and a follow-up for 1 showed no recurrence in these patients. According to the results of this study, low level laser therapy can decrease the healing time, pain intensity, size, and recurrence of the lesion in patients with minor RAS, and hence can be considered the most appropriate treatment modality for minor RAS, with greatest clinical effectiveness.

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Objective: To assess the incidence of cystic changes in the impacted lower third molar (ILTM) in which the pericoronal (follicular) space is less than 2.5 mm as measured from the radiograph. The relationship between the cystic changes and patient's age, sex, and angular position and contact of ILTM with adjacent tooth was also evaluated. Materials and Methods: Follicular space less than 2.5 mm as measured from the panoramic radiograph was included in the study. A total of 73 tissue samples collected during the extraction ILTM were examined histopathologically. Then the data were analyzed for associations with age, sex, angular position, and contact of the ILTM with an adjacent tooth. Results: There were 37 male and 36 female patients, age ranging from 17 to 35 years (mean 23.95 years). Out of 73 specimens, 17 (23.3%) showed cystic changes; among them 16 (22.1%) showed dentigerous cysts and 1 (1.2%) showed odontogenic keratocysts. Most of the cystic changes occurred in the 26-30 year age range. The cystic changes showed male predominance but could not gain statistical significance. The relationship between cystic changes and angular position was statistically significant (P < 0.05). Higher probability was found in distoangular positioned ILTM. The relationship between cystic changes and communication of ILTM with the second molar was not statistically significant. Conclusion: Incidence of cystic changes in ILTM justifies extraction of the impacted tooth associated with symptoms. The decision to extract or not to extract impacted third molar should be individualized, rather than generalized.

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Objective: The aim of this study was to review cases of odontogenic tumors diagnosed in two pathology centers in Tehran, Iran, during a 10-year period. Study Design: Patients' records were seen at two teaching pathology Centre's of Shahid Beheshti University between the months of March 2000 to 2010 with histologic diagnosis of any type of odontogenic tumors. The records were analyzed for frequency, age, sex, site, as well as clinical, radiographic and histopathologic findings. Results: Of 30706 biopsies, 4767 (15.5%) cases were diagnosed as oral and maxillofacial lesions. Among these, 720 cases were tumoral with 188 (26.1%) cases of odontogenic tumors. Tumors with odontogenic epithelium origin formed 70.2% of total numbers of odontogenic tumors. Mixed odontogenic tumors and tumors of odontogenic ectomesenchyme comprised 12.2% and 17.5% of the cases respectively. Ameloblastoma, with a frequency of 62.2% was the most common tumor in this review which was followed by odontoma and odontogenic myxoma. Conclusion: Although there are few studies on odontogenic tumors in literature, the comparison of our results with existing data shows significant differences in the distribution of tumors and age of patients, which may be due to ethnic features and geographic distribution of patients. Future studies on other ethnic groups are essential for further clarification of the findings in this research.

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Background: Dental caries is one of the most common chronic diseases of early childhood. Dental problems in early childhood have been shown to be predictive of future dental problems, growth and development by interfering with comfort, nutrition, concentration, and school participation. Aim: To find out the prevalence of Early childhood caries (ECC) among the children attending the Anganwadis of Wardha district, to determine the feeding habits and their relationship to early childhood caries. Materials and Methods: Community-based cross-sectional study among the selected Anganwadis children of 2-5 years of Wardha district. Result: A total 330 subjects, 105 children were found to be having ECC, 47 (30.92%) males and 58 (32.58%) females. Total 215 children belonged to 43-60 months age group. Out of these, 72 (33.48%) children were having ECC. A significant association was found between the history of bottle-feeding and ECC (P = 0.0218). Prevalence of ECC was more among those who were bottle-fed than those who were not bottle-fed. Conclusion: Future health promotion and education programs in Anganwadis should include oral health issues and the risk factors for ECC, and its consequences should be addressed. Public-funded oral health program should be started and targeted at children from lower socioeconomic status. Effective strategies should be developed to promote use of brush and paste for cleaning teeth and discouraging inappropriate bottle-feeding, discouraging on demand consumption of chocolates and sugars.

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Context: Oxidative stress is defined as an imbalance between the production of reactive oxygen species and antioxidant defense systems which are widely recognized as an important feature of many diseases including dental caries, suggesting that total antioxidant status may be of importance in determining the progression of caries. Aim: The aim of this study was to estimate the total antioxidant capacity (TAC) in saliva and serum of caries-free and caries-active adults and to correlate the TAC level with DMFT index (D = decayed, M = missing, F = filled, T = teeth). Settings and Design: The present study included 100 healthy adults who were divided into four groups: Control, group I, group II, and group III, with a DMFT index 0, <3, <10, and >10, respectively. Materials and Methods: Saliva and serum samples were collected from all the four groups. The TAC of saliva and serum was estimated by phosphomolybdenum method. Statistical Analysis Used: One-way analysis of variance (ANOVA) was used to compare the TAC of saliva and serum. Only differences with "P" < 0.05 were considered statistically significant. Results: The mean TAC level of both saliva and serum increased significantly (P < 0.001) with the DMFT index. Conclusion: Total antioxidant capacity of saliva has a linear relation with caries, i.e., as the severity of caries increases, the TAC level also increases.

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Context: Predicting ovulation is the basis on which the fertile period is determined. Nowadays there are many methods available to detect the ovulatory period. Unfortunately, these methods are not always effective for accurate detection of ovulation. Hence, an attempt was made to detect ovulation through single dimension sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) analysis of protein with the help of saliva ferning. Aims: The aim of this study was to determine the association of protein level with endogenous reproductive hormone level across the menstrual cycle. Settings and Design: Salivary protein and its confirmation were evaluated during menstrual cycle followed by SDS-PAGE and Mass spectrometry. Statistical Method Used: The protein content present in saliva throughout menstrual cycle is trail by SPSS statistical software version. Materials and Methods: Salivary proteins were investigated serially during pre-ovulatory, ovulatory and post-ovulatory periods of normal menstrual cycle in eighteen healthy volunteers. The samples were collected in three consecutive menstrual cycles. Salivary protein was estimated and analyzed by single dimension SDS-PAGE. Results: The results revealed significant variations in protein concentrations during the menstrual cycle. Protein levels were maximum during ovulation and minimum during postovulatory phase. Further, single dimension SDS-PAGE analysis showed seven different fractions of proteins is from 14-90 kilo Dalton (kDa) in the three phases of the menstrual cycle. Conclusions: Among the proteins, 48 kDa protein was more predominantly exhibited during ovulatory phase than pre and post-ovulatory phase. The present study indicates that the protein level and the specific protein band (48 kDa) through MALDI-TOF MS analysis might serve as an indicator for ovulation.

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Background: The anatomic shape of maxillary premolars show a tendency towards separation of their cusps during mastication after endodontic treatment. Preservation of the marginal ridge of endodontically treated and restored premolars can act as a strengthening factor and improve the fracture resistance. Objectives: To evaluate the effect of varying thickness of marginal ridge on the fracture resistance of endodontically treated maxillary premolars restored with composite and Ribbond reinforced composites. Materials and Methods: One hundred and twenty, freshly extracted, non carious human mature maxillary premolars were selected for this experimental in vitro study. The teeth were randomly assigned in to twelve groups ( n = 10). Group 1 received no preparation. All the premolars in other groups were root canal treated. In subgroups of 3 and 4, DO cavities were prepared while MOD cavities were prepared for all subgroups of group 2, the dimensions of the proximal boxes were kept uniform. In group 3 and 4 the dimensions of the mesial marginal ridge were measured using a digital Vernier caliper as 2 mm, 1.5 mm, 1 mm and 0.5 mm in the respective subgroups. All samples in groups 2.2 and all the subgroups of 3 were restored with a dentin bonding agent and resin composite. The teeth in group 2.3 and all subgroups of 4 were restored with composite reinforced with Ribbond fibers. The premolars were submitted to axial compression up to failure at 45 degree angle to a palatal cusp in universal testing machine. The mean load necessary to fracture was recorded in Newtons and the data was analysed. Results: There was a highly significant difference between mean values of force required to fracture teeth in group 1 and all subgroups of group 2, 3 and 4 (i.e., P < 0.01) Conclusion: On the basis of static loading, preserving the mesial marginal ridge with thicknesses of mm, 1.5 mm, 1 mm and 0.5 mm, composite restored and Ribbond reinforced composite restored maxillary premolars can help preserve the fracture resistance of teeth.

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Background: Mucocele is a common benign neoplasm of oral soft tissues and the most common after fibroma. It generally occurs in the lower lip and its treatment includes excision of cyst and the responsible salivary gland, in order to prevent recurrences. Aims: To evaluate the capability of three different lasers in performing the excision of labial mucocele with two different techniques. Materials and Methods: In the presented cases, excision was performed using two different techniques (circumferential incision technique and mucosal preservation technique) and three different laser wavelengths (Er,Cr:YSGG 2780 nm, diode 808 nm, and KTP 532 nm). Results: All the tested lasers, regardless of wavelength, showed many advantages (bloodless surgical field, no postoperative pain, relative speed, and easy execution). The most useful surgical technique depends on clinical features of the lesion. Conclusion: Tested lasers, with both techniques, are helpful in the management of labial mucocele.

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Background : Oral lesions of tuberculosis (TB) are rare and usually associated with the secondary form of the disease. Aim : The aim of the present study was to determine the prevalence of oral lesions in a cohort of TB-infected individuals. Materials and Methods : The study was carried out in two reference centers for the treatment of TB in Recife, Brazil. All patients treated for TB in the period from July 2008 to March 2009 were included in the study. The data was subjected to descriptive statistical analysis. Results : One hundred and twenty-one patients were included in the study. A marked male prevalence was observed, with a male:female ratio of 6.12:1. HIV coinfection was a common event (33%). Head and neck lesions of TB were rare. Cervical node enlargement was observed in seven individuals (5.8%) and oral ulceration in one patient (0.8%). Discussion : The low prevalence of oral lesions of TB is in accordance with other studies. Nodal involvement is the most common form of head and neck disease. Conclusion : While TB may be a common accompanying feature of HIV disease, orofacial complications of TB are rare in individuals resident in northern Brazil.

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A 43-year-old male presented with an asymptomatic swelling of the lower labial mucosa. Examination revealed that the tip of maxillary canine was causing trauma on the affected side. A diagnosis of extravasation type of mucocele was established clinically. Vaporization of the mucocele was done with a 940-nm diode laser in contact mode. The lesion healed uneventfully and there has been no recurrence for 3 months.

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Background: The degree of conversion of dental adhesive is an important parameter since poor mechanical properties are related to low percentage of monomer-to-polymer conversion within resin-based materials. Objectives: To evaluate the influence of polymerization time and light guide distance on the degree of conversion (DC) of three contemporary dental adhesives. Materials and Methods: The spectral data of ExciTE DSC, Single Bond ^® , and Adper ^® Prompt L-Pop were analyzed using FTIR spectroscopy after 20 s, 40 s, and 60 s of photoactivation times. Light tip distances were kept at 1, 3, and 6 mm during the exposures. Statistics: Data were analyzed using ANOVA and Tukey's test (α = 0.05). Results: Within groups, greater DC values were found using a tip distance of 1 mm or a 60-s curing time for Single Bond ^® (59%) and Adper ^® Prompt L-Pop (65%). No statistically significant difference (P > 0.05) was found using either 1 mm or 3 mm tip distances after 20 s, 40 s, and 60 s of light curing time for Single Bond ^® . ExciTE ^® DSC showed the greatest DC values with light tip distances of 1 mm (90%) and 3 mm (89%), using 60 s of light curing. Conclusion : The self-etch adhesive Adper ^® Prompt L-Pop could be applied in shallow cavity preparations and must be light cured for at least 40 s. The light-cured total-etch adhesive ExciTE ^® DSC could be applied in every restorative scenario if the curing time is extended up to 60 s or if the tip distance is extended up to 3 mm.

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Aims: To assess through scanning electron microscopy (SEM) and cross-sectional microhardness (CSMH) test whether the methodology exposed in this experiment can be used to produce artificial active white spot lesions (AAWSLs) on smooth unabraded human dental enamel. Materials and Methods: Ten human permanent molars were used in this experiment. One section of each tooth was double coated with nail varnish except for a limited central area sized 2.5 mm × 1 mm (2.5 mm ² ). Each specimen was individually exposed to 10.4 ml of a demineralizing solution at pH 5.0, during 42 days (37°C) without agitation. Samples were sectioned in the center of the AAWSL and one half was analyzed in SEM and the other half was subjected to CSMH. Descriptive statistics was performed to determine mean depth of the lesion. Results: The mean depth of AAWSL was 100 μm (s.d. =12.1) and a white dull rough surface could be detected by the unaided eye. SEM images demonstrated that although some surface areas of the lesion appeared to be relatively intact, erosion was present. A prismatic pattern of dissolution was observed in all samples with an enlargement of the prism sheaths and some samples had also sites of destruction of prism cores. Conclusion: This methodology can be used to induce AAWSLs in human dental enamel but surface erosion has to be taken into account when performing CSMH test.

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Aim and Objectives: Obtaining a correct working length is necessary for successful root canal treatment. The aim of this study was to compare conventional and digital radiography in measuring root canal working length. Materials and Methods: In this in vitro study 20 mesio buccal canal from maxillary first molars with moderate and severe curvature and 20 canal form anterior teeth with mild curvature were chosen and their working length were measured with number 15 k file (Maillefer, DENTSPLY, Germany). Then for each canal five radiographies were taken, three conventional radiographies using three methods of processing: Manual, automatic, and monobath solution; in addition to two other digital radiographies using CCD and PSP receptors. Two independent observers measured working length in each technique. Finally, the mean of working length in each group was compared with real working length using a paired T-test. Also a one-way ANOVA test was used for comparing the two groups. The level of statistical significance was P < 0.05. Results: The results have shown that there was a high interobserver agreement on the measurements of the working length in conventional and digital radiography (P≤0.001). Also there was no significant difference between conventional and digital radiography in measuring working length (P > 0.05). Conclusion: Therefore it was concluded that the accuracy of digital radiography is comparable with conventional radiography in measuring working length, so considering the advantages of the digital radiography, it can be used for working length determination.

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Background: Flexural strength (FS) is one of the most important properties of restorative dental materials which could be improved in fiber-reinforced composites (FRCs) by several methods including the incorporation of stronger reinforcing fibers. Aim: This study evaluates the influence of the glass fiber diameter on the FS and elastic modulus of FRCs at the same weight percentage. Materials and Methods: A mixture of 2,2-bis-[4-(methacryloxypropoxy)-phenyl]-propaneand triethyleneglycol dimethacrylate (60/40 by weight) was prepared as the matrix phase in which 0.5 wt. % camphorquinone and 0.5 wt. % N-N'-dimethylaminoethyl methacrylate were dissolved as photoinitiator system. Glass fibers with three different diameters (14, 19, and 26 μm) were impregnated with the matrix resin using a soft brush. The FRCs were inserted into a 2 × 2 × 25 mm ³ mold and cured using a light curing unit with an intensity of ca. 600 mW/cm ² . The FS of the FRCs was measured in a three-point bending method. The elastic modulus was determined from the slope of the initial linear part of stress-strain curve. The fracture surface of the composites was observed using scanning electron microscopy to study the fiber-matrix interface. Statistical Analysis: The results were analyzed and compared using one-way ANOVA and Tukey's post-hoc test. Results: Although the FS increased as the diameter of fibers increased up to 19 μm (P < 0.05), no significant difference was observed between the composites containing fibers with diameters of 19 and 26 μm. Conclusion: The diameter of the fibers influences the mechanical properties of the FRCs.

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Fusion has been described as a developmental anomaly characterized by the union of two adjacent teeth. Few cases of this rare anomaly in primary dentition have been reported in Indian population. A rare case of bilateral fusion between primary mandibular lateral incisors and canines is presented in this report.

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Background: Though, increased emphasis is being given on spreading dental care facilities and awareness in Indian villages, the target population is unfortunately less literate and is not financially equipped compared to their urban counterparts. The rural aged additionally may have to face problems like desertion by the educated youth to follow better opportunities in cities, disease, and lack of mobility. Aims: The present study strived to evaluate dental myths, oral hygiene methods, and tobacco habits awareness in a rural ageing population in the perspective of a changing India. Setting and Design: The study area consisted of a group of ten villages, situated in district Lucknow, Uttar Pradesh, India. Materials and Methods: The subjects were questioned about dental myths, tobacco habits, and oral hygiene methods and then divided into groups on the basis of age, sex, and educational status. The number of sound teeth in each subject was also counted. Statistical Analysis: Mean-values, standard deviation, Chi-square test and P values were used to make inter-group comparisons. Results and Conclusion: Forty percent of the subjects considered oral hygiene unnecessary, 60.8% of the population was relying on simple mouth rinsing for maintaining oral hygiene, 48% had either the habit of smoking and chewing tobacco or both and 81% of the subjects had one dental myth or the other. We concluded that the rural aged is a deprived lot and a targeted program to infuse scientific dental practices in them is necessary.

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Background: Knowledge of the variations in pulp chamber topography is very useful to the dentist while performing endodontic access cavity in primary teeth. Aim: To determine the horizontal crown dimensions and the pulp chamber topography of shedding maxillary primary molars in a sample of Tunisian children. Materials and Methods: Forty two maxillary primary molars (24 first and 18 second molars) were used. Teeth were ultrasonically cleaned before taking morphometric measurements of the buccolingual and mesiodistal sizes. Statistical student test was used comparing the mean sizes. Results: All the crown measurements were higher in the second molar. While the buccolingual dimension of the pulp chamber was higher in the second molar, the mesiodistal sizes were equivalent among the teeth. The thickest walls were in the buccal side of the first molar and in the mesial side of the second one. The ratio of several measurements indicate that the pulp cavity is more vestibularly and distally located in the second molar. Conclusion: Mesiodistal dimension of the pulp cavity is not proportional to that of the dental crown. Endodontic access cavity have to be shifted to the distal and vestibular sides from the first to the second upper molar.

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Background: Drug-induced gingival overgrowth (DIGO) is one of the unwanted side effects of amlodipine therapy, but the pathogenesis still remains unclear. Apoptosis, which plays a ubiquitous role in tissue homeostasis, including gingiva, may be involved in the development of gingival enlargement. Aims and Objectives: (i) To study the distribution of Bcl-2 in healthy and overgrown gingival tissues. (ii) To compare and correlate the Bcl-2 expression in gingival samples from subjects on amlodipine therapy to the findings in healthy controls. Materials and Methods: A total of 25 subjects were recruited for the study - 15 hypertensive patients and 10 systemically healthy subjects. Both the groups were analyzed for Bcl-2 expression using immunohistochemistry. Results: Few of the control specimens showed weak positivity to Bcl-2 antibody, with the distribution limited to the basal cell layers alone, whereas 10 hyperplastic specimens expressed Bcl-2 and, unlike the control group, the distribution pattern was seen in both basal and suprabasal layers. Conclusion: The results indicate that the pathogenesis of amlodipine-induced gingival overgrowth might involve inhibition of apoptosis, especially with morphogenesis of hyperplastic gingival epithelia.

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Aims: Resistance form of full metal-ceramic crown is an important feature that determines longevity of these restorations. This study evaluated the resistance form of full metal-ceramic prepared with four different design features. Materials and Methods: An acrylic tooth was prepared with 20° total occlusal convergence (TOC) angle, 2.5 mm of occlusocervical dimension and a shoulder finishing line. This design lacked resistance form. The crown preparation was subsequently modified by preparing Mesial Occlusal Distal isthmus, placing occlusal inclined plane, and reducing TOC. Four metal dies from these designs were constructed by lathe machine and then 10 metal copings were fabricated for each preparation. Metal coping were cemented on metal dies with temp-bond cement. Force was applied at 45° from lingual to buccal direction with universal testing machine. Statistical analysis used: The data were evaluated by Kruskal-Wallis and non-parametric Mann-Whitney test. Results: All features increased resistance form when compare to control group. However, reduce TOC group showed greatest value of resistance. Conclusion: Within the limitation of this study, reducing the tapering of occlusocervival dimension is the most effective way in increasing resistance form, although, other features were also effective.

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The majority of patients with head and neck cancer present with locally advanced disease. Locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN) poses one of the most complex management challenges. This stage of disease is still potentially curable, but requires combined-modality therapy. One of the novel approaches is the use of targeted agents, particularly the epidermal growth factor receptor (EGFR) inhibitors, in treatment strategies in LA-SCCHN. A Medline search covering topics related to targeted therapies in head and neck cancer over the last two decades was made and the facts were compiled. Cetuximab was the first novel agent to obtain regulatory approval in the United States for the treatment of patients with Head and Neck Squamous Cell Cancer HNSCC. Cetuximab has been evaluated in combination with radiotherapy, chemo-radiotherapy, and induction chemotherapies, and was found to increase the overall survival rates in all the arms without raising the toxicity level of the combined modality of treatment significantly. The tyrosine kinase inhibitors Gefinitib and Erlotinib also produced an average response rate of 11% and 4% in different studies and also prolonged the disease control rates when used with chemotherapy. This paper will review the role of targeted agents, particularly the EGFR inhibitors, in the present treatment strategies in advanced, recurrent/metastatic head and neck cancer.

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Objective: Odontogenic tumors are lesions derived from epithelial, ectomesenchymal, and/or mesenchymal elements that still are, or have been, part of the tooth-forming apparatus. Approximately 80% of odontogenic tumors occur in the mandible, with a marked predilection for the posterior region, and are often associated with an unerupted tooth. The aim of this study was to determine whether cytokeratin (CK) 18 immunostaining decorated the follicular tissue removed at the time of prophylactic extraction of impacted mandibular third molars, which might suggest oncofetal transformation. Materials and Methods : Fifty-four impactions met the study inclusion criteria, of which 24 cases showed the presence of reduced enamel epithelium and/or connective tissue with odontogenic epithelium, which were subjected to CK 18 immunostaining. Results: All 24 cases with adequate epithelium were CK 18 immunonegative. Conclusion: There was no oncofetal transformation in the odontogenic epithelia of the dental follicles studied. Thus, although we reaffirm that evaluation of follicular tissue is imperative since disease conditions may be found in minute follicular spaces, development of odontogenic cysts and tumors is unlikely.

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Objectives: The goal of every prosthetic management is to simulate nature and be in harmony with nature within the physiological limits. The occlusal forces on a fixed dental prosthesis are transmitted to the surrounding structures through pontics, connectors and retainers and more stresses are seen at the connector region. To analyze the stress patterns in cast and soldered connectors between the two pontics and between the retainer and pontic of a four unit fixed dental prosthesis on axial and non axial loading and also to observe and ascertain the need to modify the design of the rigid connectors. Materials and Methods: Subsequently four models each of cast and soldered connectors with cylindrical and triangular design, of dimension 3 × 4 mm and thickness 0.5 mm was designed for the study. The first premolar and second molar were considered as the abutments and 2 ^nd premolar and 1 ^st molar as the pontics. The analysis was done using ANSYS version 8.0 software and by placing axial and non-axial load of 40 Newtons each. Results: Von Misses stresses were observed at the connector region between the two pontics, especially in the cervical region. Conclusion: The cylindrical cast connectors showed less stress in comparison to triangular design and the difference in the stress distribution of cast and soldered connectors were marginal. Clinical Significance: The occlusal forces on a fixed dental prosthesis are transmitted to the surrounding structures through pontics, connectors and retainers with maximum stresses concentrated at the connectors. Hence this three-dimensional finite element analysis study investigated stress distribution in a four unit posterior fixed dental prosthesis, having cylindrical and triangular connector designs.

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Introduction: Lichen planus is a chronic inflammatory mucocutaneous disease that clinically and histologically resembles lichenoid lesions, although the latter has a different etiology. Though criteria have been suggested for differentiating oral lichen planus from lichenoid lesions, confusion still prevails. Aims: To study the cellular and nuclear volumetric features in the epithelium of normal mucosa, lichen planus, and lichenoid lesions to determine variations if any. Materials and Methods: A retrospective study was done on 25 histologically diagnosed cases each of oral lichen planus, oral lichenoid lesions, and normal oral mucosa. Cellular and nuclear morphometric measurements were assessed on hematoxylin and eosin sections using image analysis software. Statistical Analysis: Analysis of variance test (ANOVA) and Tukey's post-hoc test. Results: The basal cells of oral lichen planus showed a significant increase in the mean nuclear and cellular areas, and in nuclear volume; there was a significant decrease in the nuclear-cytoplasmic ratio as compared to normal mucosa. The suprabasal cells showed a significant increase in nuclear and cellular areas, nuclear diameter, and nuclear and cellular volumes as compared to normal mucosa. The basal cells of oral lichenoid lesions showed significant difference in the mean cellular area and the mean nuclear-cytoplasmic ratio as compared to normal mucosa, whereas the suprabasal cells differed significantly from normal mucosa in the mean nuclear area and the nuclear and cellular volumes. Conclusions: Morphometry can differentiate lesions of oral lichen planus and oral lichenoid lesions from normal oral mucosa. Thus, morphometry may serve to discriminate between normal and premalignant lichen planus and lichenoid lesions. These lesions might have a high risk for malignant transformation and may behave in a similar manner with respect to malignant transformation.

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Performing intraoral radiography in certain patients is difficult as these patients are unable to tolerate intraoral film placement. To assist such patients a new technique has been innovated using extraoral film placement. Use of this technique has been documented in Caucasian and Taiwanese populations. In this paper we report use of this technique for Indian population. We have done about 40 cases using this technique and have found the average angulation for maxillary (-25+/-5 degrees) and mandibular (-15+/-5 degrees) teeth for Indian population. We recommend use of this technique in the personal dental clinics where panoramic radiographic machines are not readily available. Here we report the technique and cases where diagnostic imaging was performed in patients using the extraoral periapical technique.

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Treatment of fused teeth needs special care and attention to the bizarre anatomy. This paper describes root canal treatment of a fused carious tooth presenting with apical periodontitis. It is a rare case of fusion of the mandibular second molar with a paramolar. There is no literature regarding placement of crown over endodontically treated fused teeth. In this case, the fused teeth were endodontically treated and restored by a porcelain fused to metal crown.

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This article presents a case with a fenestration defect which was treated by placing a resorbable barrier alone. In the case presented, the osseous defect was a natural space maker with the wall of the defect providing sufficient support to prevent collapse of the membrane into the space. So the use of membrane alone is the preferred treatment. Resorbable collagen membrane was placed in order to avoid a second surgical procedure to remove the nonresorbable membrane. The membrane was positioned by placing a resorbable sling suture such that it covered the defective site adequately. Postsurgical healing of the defect was evaluated 1 month after the surgery and it was satisfactory. Thus guided bone regeneration of the fenestration defect is a reliable treatment procedure.

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