Vascular malformations (VM) are errors of vascular morphogenesis present at lower incidence accounts approximately 7% of all benign tumors, about 1/3 ^rd of all VMs occur in the head and neck region, more than 50%. Arteriovenous malformations are present in the head and neck region. Clinicians who diagnose and treat oral conditions should be aware of these lesions and their impact on routine procedures. Proper recognition and therapeutic intervention can help avoid serious complications and potentially tragic outcomes.

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Grossing is a gross examination of surgical specimens in which pathologists inspect the excised specimen with the bare eye to obtain diagnostic information. It refers to the examination and dissection of surgical specimens, along with preparation of sections from those tissues requiring processing, and is the initial step in surgical pathology dissection. Careful handling of the tissue with proper fixation and tissue processing will enable a confident histopathological diagnosis.

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Recent advances in color matching have been driven by the market demand for high-quality esthetic restorations. Improved shade guides, availability of shade-taking devices and research in the area of human color vision have improved the potential of clinicians to achieve excellent color-matched restorations. A thorough understanding of appearance attributes of natural teeth is required along with these new tools to maximize shade-matching results.

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After tooth loss, alveolar ridge resorption is a common phenomenon, which alters the size and shape of the host bone available for the dental implant placement. In the era of prosthetic driven implant dentistry, the final prosthesis type and design dictates the number, size and the ideal implant position. In clinical practice, though patients often demand osseointegrated implants to replace their missing teeth; the deficiency of bone volume is the primary reason for avoiding such treatment options. The solution to such situations lies in the re-establishment of the ridge height consistent with prosthetic design and with suitable load-bearing lamellar bone for implant placement and long-term stability. Despite recent advances in bone grafts and bone-substitute technology, the use of autogenous bone grafts continues to represent the "gold standard" in implant site reconstructive surgery. The mandibular symphysis (chin bone in interforaminal region) is a favorable donor site as it has an excellent risk-benefit ratio. Several reconstruction procedures by using chin graft have been proposed to increase alveolar bone volume both vertically and laterally to prepare the ridge for a correct placement of oral implants. This article reviews the various aspects of chin grafts, wherein the regional surgical anatomy, various incision designs, surgical protocols for harvesting and the possible clinical and esthetic complications of chin grafts have been discussed.

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Inflammation is the initial response of the host to a diverse array of biological stressors including bacterial infection, burns, trauma, and invasive surgery. Most inflammatory reactions begin as a suppurative or purulent exudation process when the first line of cellular defense, the neutrophils, accumulate in the area which may lead to the formation of microabscesses. This article on microabscess is an effort in providing information available about microabscess from various sources. The matter has been extracted from internet sources with the help of Google search, dictionaries, and articles from the online journals, and textbooks. In this paper, we have discussed the mechanism behind the formation, regression of microabscess and the different types of microabscesses that have appeared in the literature related to different disease processes.

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Variations and abnormalities of skull appearance and shape are generally related to a primary maldevelopment of the brain. The copper-beaten skull appearance is typically associated with craniosynostosis, where premature fusion of the cranial bone sutures results in the growing brain exerting pressure on the malleable cranium, producing a pattern known as the beaten silver appearance or copper-beaten skull appearance. In this article, we have reported a case of 5-year-old child with classical features of beaten silver skull.

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Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), milk derivative helps in remineralization of the carious lesion by replenishing lost minerals like calcium, phosphate ions into the tooth structure. Several in vitro and in vivo studies have proven that CPP-ACP to be useful in the treatment of white spot lesions, early childhood caries, dental erosion, root caries, and dentin hypersensitivity. CPP-ACP is delivered in the form of oral hygiene products such as chewing gum, tooth cream, and even incorporated in dental restorative materials also.

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Idiopathic thrombocytopenic purpura is an acquired platelet disorder reported to have spontaneous hemorrhagic gingiva as one of the earliest manifestations, sometimes as a presenting symptom. It is very important for general dentists to be aware of such conditions as prolonged bleeding may occur as a life-threatening complication during and posttreatment of such patients. They must have a basic insight of the oral findings of thrombocytopenia and should arrange and prepare the necessary assistance in advance. A diligent cooperation among patient, hematologist and dentist are crucial in the management of bleeding disorder patients. This paper provides an overview of thrombocytopenia and current recommendations for its periodontal management. We concluded that thrombocytopenia is not an absolute contraindication for dental procedures; however, the course of treatment should be commanded by the clinical manifestations and the platelet count.

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Oral piercing is a practice that was done even in the before Christ era, but the designs and purposes are changing with time. These days, it is mainly used as a style statement and for religious reasons. Although it aids in marking the identity of a person, but at the same time if not done with precision, then it can lead to various disastrous effects as well. This review highlights the various facets of oral piercing, including its history, designs, procedure, complications, precautions to be taken for a patient bearing oral piercing jewelry and the current status.

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There are recent advances in periodontal surgical techniques, from resection to regeneration, the focus of surgical access has shifted to regeneration of lost tissues. To achieve goals of periodontal surgical therapy, minimal invasive surgery can be considered as a potential future for the treatment of periodontal disease with the concept of being minimal in our treatment approaches. This article reviews the various techniques, its applications, and future prospects of minimal invasive periodontal surgery.

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The mastication, phonation and esthetics: The trident factors are very important and should be given due consideration when any dental procedure is initiated to achieve the successful outcome of treatment. The prosthetic management of edentulous patient has long been a major challenge for dentistry. For well over a century, complete maxillary and mandibular denture have been the traditional standard of care. However, most of the patients report significantly more problems adapting to their mandibular denture due to a lack of comfort (e.g., they suffer from an increase in pain and soreness), retention, stability and inability to chew and eat. Recent scientific studies carried out over the past decade have determined that the benefits of a mandibular two implant over denture/coping retained are sufficient to propose the two implant over denture - rather than conventional denture - as the first treatment option. This in the prosthodontics literature has led to shift in therapeutic philosophy regarding restoration of the edentulous patient. This article presents four and two tooth supported conventional over denture - two case reports.

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Introduction: Oral health is significantly related to oral hygiene behaviors and their knowledge. Poor oral hygiene can have a profound effect on the quality of life. Oral hygiene practices are those measures taken to ensure that the mouth is clean. Oral hygiene practices are essential for the prevention of dental and other associated systemic diseases. The aim of this study is to determine the level of knowledge, attitude, and oral hygiene practices among secondary school students in Debre Tabor town, Amhara region, North Central Ethiopia 2018. Materials and Methods: An institution-based cross-sectional study was conducted among 422 systematically selected students using stratified random sampling technique from January 20 to 30, 2018. Data were collected using a pretested questionnaire on 422 selected students in three secondary schools found in Debre Tabor town. Variables collected included the frequency of brushing teeth and the use of toothpaste, knowledge of plaque, and students' perception of the importance of oral hygiene practices. The data were entered into Epi-Info version 3.5 and cleaned and analyzed using SPSS version 20. Results: A total of 422 patients participated in the study; among whom 216 (51.2%) were female students. The study revealed that 253 (60%) of the respondents had good knowledge with regard to oral hygiene, more than half 281 (66.6%) of the students had positive attitude toward oral hygiene, but their oral hygiene practices were still low that 260 (61.6%) of the students had poor oral hygiene practice. Conclusions: The study showed that more than half of the respondents had good knowledge and positive attitude toward oral hygiene to maintain proper oral health, but their practices toward oral hygiene were remain poor. The majority of students were aware that teachers and parents had not an important role to play in their oral hygiene. Establishment of oral health education programs in the school curriculum that will help a life-long oral hygiene practice in the school environment and at large in the community with the support of teachers and parents are crucial.

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The problem of stability and retention of conventional mandibular complete dentures is far from a solution that is universally satisfactory. However, the use of overdenture therapy preserves the sensation of proprioception, preserves the edentulous ridge, maintains the border seal and provides the patient with good speaking ability and chewing efficiency. The retention and stability of such prosthesis is enhanced greatly in bar-supported overdentures. This case report depicts the step by step procedure for the fabrication of a canine splint bar for a bar and clip-retained mandibular overdenture that opposes a conventional complete maxillary denture. The bar was fabricated from readily available castable bar system and female clips were attached by an indirect technique. The mode of retention was primarily through frictional resistance. It is a relatively simple and easy technique, overcoming the limitations of the direct technique for clip attachment.

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Implant restorations, a boon to dentistry, often suffer from ridge and soft tissue deficiencies because of the postextraction tissue remodeling. This hindrance could be overcome through soft and hard tissue augmentation as future implant site development. A good pink carpet is one of the prerequisite for esthetics around implant restoration, which could be achieved adequately through hard and soft tissue grafting procedures. In this regard, many techniques have been advocated, wherein the pedicle grafts gained popularity owing to the ability to maintain intact vascularity. Palatal tissue is desirable graft of choice for its thick biotype. Thus a combination of palatal tissue with pedicle grafts are said to be novel in this application. In this article, we discussed the applications of different palatal pedicle grafts along with elaborating their varied applications in three patients.

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There are a number of pathological conditions that may affect the lips. Cheilitis glandularis (CG) is a rare disorder characterized by hyperplasia of the labial mucous glands and mixed salivary glands as well as by ectasia of salivary glands ducts. It is a rare condition and most commonly involves the lower lip of adult males with little predilection for females. The exact etiology of this condition is unknown, but various agents have been linked. In this paper, we report a rare case of CG of the superficial suppurative type in a 20-year-old Indian female affecting upper and lower lip which was diagnosed based on clinical and histopathological findings and was treated with steroids. The present case is different because of its occurrence in a young aged female with the involvement of both lips. Early diagnosis and prompt treatment and frequent monitoring and follow-up are necessary to prevent further complications.

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Human teeth may show variations and changes in morphological structures. Such changes may be found on the crown either in the form of anomalous cusps or in an increased number of roots, which in some instances is associated with an anomalous cusp. Accessory or supernumerary cusps are common variations of tooth morphology that are occasionally encountered clinically. The most commonly reported accessory cusps are cusp of Carabelli of the molars, talons cusps of the incisors and Leong's tubercle of premolar. Herewith, we present a case of maxillary third molar associated with six supernumerary cusps along with a dens evaginatus that is a rarely reported dental variation in the literature. The article also discusses the need for continuous dental surveillance of this rare anomaly with a review of the literature.

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"It is more important to preserve what already exists than to replace what is missing," as stated by M.M. Devan has never been challenged or disapproved. In situations with few remaining natural teeth, prosthodontists are posed with a dilemma for the treatment options. In such cases, overdenture therapy has been proven to be advantageous. Bearing in mind the philosophy of preventive prosthodontics, overdenture therapy has a long-term advantage by preserving the proprioception and thereby residual alveolar ridge. This clinical report describes the prosthodontic rehabilitation a patient with few remaining mandibular natural teeth by telescopic mandibular overdenture for added advantages like better retention, stability, support and psychological benefits of the patient.

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Cervicofacial infections of dental origin are the most difficult and complex issues in our day to day practice. Perceiving the severity of the condition at the earliest is of utmost importance since they are known to spread rapidly to the surrounding soft tissues and can even spread to vital structures such as paranasal sinuses, orbits, intracranial sites, and even to mediastinum. Orbital cellulitis is a postseptal cellulitis involving intraorbital muscles with diminishing visual acuity. Aggressive treatment more frequently with surgical intervention along with higher antibiotics in a well-equipped hospital is required since it is associated with rapid deterioration. A 40-year-old male who is a known diabetic and smoker underwent dental extraction and presented with fever, left facial swelling with the blurring of vision. Clinically he was in sepsis having crepitus over left facial swelling, edema of left eyelids with proptosis with facial nerve palsy. On investigating further, he was found to have left cervicofacial abscess associated with left orbital cellulitis due to odontogenic infection with very high blood sugar level. Cervicofacial abscess of odontogenic cause is a life-threatening complication. In this case report, we have highlighted the unusual findings of orbital cellulitis and facial nerve palsy associated with cervicofacial abscess since a handful of cases have been reported about the same in the literature. Early recognition with prompt surgical and antibiotic treatment is implemented for good prognosis and outcome.

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Periodontal disease is a chronic inflammatory disease affecting the supporting structures of teeth and may lead to bleeding gums, tooth mobility, and eventually tooth loss. With the limited effectiveness of current forms of mechanical therapy in the management of periodontal diseases, there has been a shift in focus on to alternative therapies. One such area where maximum research has been going on is phytotherapy. Several studies now focus on the efficacies of herbal extracts on various important periodontal pathogens such as Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, Treponema denticola and Tannerella forsythia. Furthermore, recent studies have explored the benefits of using plant-based products on various periodontal clinical parameters such as gingival inflammation, gingival bleeding, etc. The aim of this review to focus on potential, of pros and cons of the several plants/extracts that have been used in vitro or in vivo for management of periodontal diseases and also to highlight the direction of future research to improve their efficacy.

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Dentin dysplasia (DD) type I is an inherited autosomal dominant genetic defect affecting the dentin formation. Here, the teeth are characterized by normal appearing crowns, with absence or severe restriction of root formation, obliterated pulp chambers and periapical radiolucencies without an obvious cause. Clinically, the teeth can be poorly aligned, drifting and mobile and can prematurely exfoliate due to abnormal root formation. This condition is rarely encountered where little is known about the specific treatment of this disorder and management of patients with DD. This report documents one such rarity of DD type I in a 16-year-old female and the clinical and radiographical findings of this condition.

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Peri-implant mucositis and peri-implantitis are diseases that affect the tissues surrounding a functional implant. Poor oral hygiene, smoking and previous history of periodontitis are known risk factors for the disease. The probing depth, the presence of bleeding on probing, suppuration and radiographs should be assessed regularly for the diagnosis else it can lead to implant loss and impaired function. In addition, the extent of the disease and pattern of bone loss are poorly described. There is limited information regarding the management of peri-implantitis. Various treatment modalities have been tried and tested, but there is yet to be a predictable outcome for peri-implantitis.

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The presence of palatal and lingual tori complicates the rehabilitation of partially edentulous maxillary and mandibular arches with a removable partial denture, as a major connector in denture crosses the midline and joins the components on one side of the arch with another side. The present case report describes the modified design of major connectors used in maxillary and mandibular removable partial dentures for the management of Kennedy's Class 3 maxillary partially edentulous arch and Kennedy's Class 2 mandibular partially edentulous arches with multiple exostoses.

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As patients become increasingly aware of the esthetic potential through cosmetic dentistry, there is an increasing demand for smile makeovers with perioplastic surgeries. When gum tissue recedes due to periodontal disease, it pulls away from the teeth. Periodontal plastic surgery procedures can restore some coverage and dramatically improve a person's smile. Soft-tissue grafts and other root coverage procedures cover exposed roots and restore healthy gum tissue. This will reduce further bone loss and recession, make the tooth less sensitive, protect the root from root cavities and look more natural when you smile. In this paper, the scope of periodontal plastic surgery with the use of soft-tissue autografts has been outlined to aid the dental team in the proper diagnosis and treatment of the esthetic dental case.

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Background: Painless dentistry, minimal intervention and thus giving relief, comfort, and solace and thereby instilling a positive attitude toward dental treatments, are some of the factors justifying the specialty of pediatric dentistry. Aim: The purpose of this study was to evaluate clinically the effectiveness, total working time and pain reaction following treatment with a new chemomechanical caries removal gel (Carie-Care™) compared to conventional drilling method in primary teeth. Settings and Design: This study is a split-mouth clinical trial wherein two methods of caries removal were performed within the same patient. Methods: Two methods of caries removal were compared in the same patient. Sixty carious primary teeth were evaluated from thirty children and divided into two groups as test and control group. In the test group, the caries was removed using the new chemomechanical caries removal gel, and in control group, caries was removed using the dental bur. Statistical Analysis used: Unpaired t-test. Results: The mean time taken for complete caries excavation with Carie-Care™ was 3.24 ± 0.74 s. This was significantly longer compared with the conventional drilling wherein the mean time was 2.08 ± 0.24 s (P < 0.001). Patient treated with Carie-Care™ gel experienced significantly comfort (Score 1) (P < 0.001), and it was as effective as drill in caries removal. Conclusion: Carie-Care™, a new chemomechanical caries removal agent could be an effective caries removal method for the treatment of patients seeking an alternative to conventional methods.

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Aim: To assess the clinical performance of zirconia (ZrO₂) infused glass ionomer cement (GIC) compared to conventional GIC. Study Design: Experimental, in vivo, intergroup split-mouth study. Methods: Cavities were prepared on bilateral teeth and restored with Conventional GIC on one side and ZrO₂infused glass ionomer on the other. The two sides were compared with regards to their clinical performance and color stability. Results: Statistically significant differences were found with respect to surface texture and color match between ZrO₂infused GIC and conventional GIC. Statistics: Results were analyzed using Friedman test and Wilcoxon test. Conclusions: ZrO₂infused GIC showed better color stability but conventional GIC was much better as far as color match, surface texture, and marginal adaptation were concerned.

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