Periodontal diseases are among the most frequent diseases affecting children and adolescents. These include gingivitis, localized or generalized aggressive periodontitis (a.k.a., early onset periodontitis) and periodontal diseases associated with systemic disorders. The effects of periodontal diseases observed in adults have earlier inception in life period. Gingival diseases in a child may progress to jeopardize the periodontium in adulthood. Therefore, periodontal diseases must be prevented and diagnosed early in the life. This paper reviews the most common periodontal diseases affecting children: chronic gingivitis (or dental plaque-induced gingival diseases) and aggressive periodontitis. In addition, systemic diseases that affect the periodontium in young children and necrotizing periodontal diseases are addressed. The prevalence, diagnostic characteristics, microbiology, host- related factors, and therapeutic management of each of these disease entities are discussed.

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Treatment of periodontal disease in recent years has moved toward an antibiotic/antimicrobial model of disease management. Time has come to shift the paradigm of treatment from specific bacteria elimination to altering bacterial ecology by probiotics. With increase in the incidence of resistance to antibiotics, probiotics may be a promising area of research in periodontal therapy. Probiotics utilize naturally occurring bacteria to confer a healthy benefit when administered in adequate amounts. This paper reviews the evidences for the use of probiotics or prebiotics for the prevention of periodontal diseases. The role of probiotics in periodontics is still in infancy and a complete understanding of the broad ecological changes induced by probiotics is essential to assess their long term consequences for oral health and disease.

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Objectives: This review has been done with the objective of evaluating different imaging modalities available to the dental practitioners in treatment planning for implant placement. Material and Methods: A systematic online search was conducted with relevant keywords. The inclusion criteria was all articles that discussed 2-dimensional and 3-dimensional imaging modalities that have been introduced for pre, peri & post operative implant surgery. Textbooks relevant to the topic were also hand searched. The data obtained has been included in the discussion and summarized as per the available literature. Conclusion: The evolution of implant imaging modalities from simple 2-dimensional to complex 3-dimensional techniques have improved the sensitivity & specificity with which a favorable implant site may be located preoperatively, its location (in all the three planes) more objectively assessed peri operatively and the prognosis of the implants followed more accurately. Yet the more complex modalities are more technique sensitive & their high radiation dosage require more rigorous justification for routine usage.

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Osteomyelitis is inflammation of bone and bone marrow that develops in jaws usually after chronic infection. It is rarely seen in healthy individuals. Patients with chronic infections in jaws where inflammatory response is impaired are prone to develop this condition. Therefore there is high risk of developing osteomyelitis in these immuno-compromised patients. Patients with chronic disease are prone to bacterial infection and succumb to death due to septicemia and pneumonia. In maxillofacial region so far there is only one case reported in literature about osteomyelitis as post extraction complication in alcoholic. A case of osteomyelitis of mandible in chronic alcoholic is discussed with clinical features, investigations and treatment along with role of alcohol in immuno-suppression. In the present case alcohol induced immuno- suppression was predisposing factor in development of osteomyelitis. This case report highlights how alcohol has profound modulatory effect on immune system.

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Objectives: The dawn of minimally invasive dentistry has led to the development of materials which rely on the use of effective adhesion to remaining tooth tissue. Despite making important advances, dentin bonding has to overcome hurdles with respect to structural heterogencity of dentin and long term stability of the bond. The primary mode of failure for adhesive restorations has been described as the loss of marginal adaptation and loss of retention. Methods: This in vitro study was undertaken to assess marginal adaptation and microleakage of Class V lesions using two cavity designs, a fifth generation dentin adhesive and a glass ionomer bonding agent-liner in extracted human molars, restored with composite resin restorations. Extracted permanent molars were divided into four groups (n=10). Class V cavities on buccal surfaces with retentive or non retentive features were prepared. A comparative dye leakage study was done between Syntac single component and Fujibond LC bonding agent, when cavities were restored with Heliomolar composite resin. 2% methylene blue dye was used to assess microleakage under stereomicroscope. The scores obtained were subjected to the Kruskal Wallis one-way analysis and Mann Whiteney U test. Results: Results of this study showed that the glass ionomer bonding agent-liner groups in both retentive and non-retentive cavities exhibited statistically significant (P<0.05) less microleakage as compared to the non-retentive dentin bonding agent group on the dentinal/cemental cavosurface margins. Conclusion: Within the limits of the study, it was concluded that the glass ionomer bonding agent-liner may be effective in reducing gingival microleakage in Class V situations with gingival margins in cementum and dentin.

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Objectives: Total obliteration of the canal space and perfect sealing of the apical foramen with an inert, dimensionally stable and biologically compatible material are the goals for successful endodontic treatment. A microscopic layer of debris is formed during bio-mechanical preparation of the canal called Smear layer. This interferes with adhesion and penetration of canal sealers and its removal is necessary. Dentin bonding agents have been studied extensively for their adhesive properties in restorative dentistry and recently as root canal sealers. Microleakage studies of their sealing abilities are few. Materials and Methods: This study evaluated sealing efficacy of a dentin bonding agent when used as root canal sealer along with AH26, an epoxy resin sealer and the effect of the smear layer on the sealing ability. 60 extracted maxillary anterior teeth were taken, sectioned at the Cemento enamel junction, cleaned and shaped with 2% K files. They were divided into 4 groups, GroupsAandBwithoutEDTApre-treatment and GroupsCandDwithEDTApre-treatment. GroupsAandCwere obturated withAH26 and Groups B and D were obturated with dentin bonding agent Polibond andAH26 with gutta percha and lateral condensation method. Apical dye penetration was measured using 2% Methylene Blue and evaluated with stereo microscope. Results were tabulated and statistical analysis done. Results: The chemically cured bonding agent Polibond used with AH26 showed significantly less apical leakage when smear layer was removed before obturation. Conclusion: Use of dentin bonding agents and resin sealers in root canal obturations achieves effective apical sealing when used with gutta percha. This improves the success of endodontic therapy.

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Skeletal Class III malocclusion in an adult patient presents a challenge to the operator as it involves a variety of features. The case report presented here shows a combination of surgically assisted rapid palatal expansion and mandibular set back with bilateral sagittal split osteotomy. The technique used for maxillary expansion was minimally invasive as the patient's age gave a leeway for using a different surgical approach.

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Objectives: To evaluate and compare the shear bond strength of four self etching primer adhesives to dentin. Materials & Methods: A total of 75 extracted human maxillary and mandibular molars were selected for the study. The teeth were divided into 5 groups of 15 teeth each, Group A- AdheSE (Ivoclar Vivadent), Group B-Adper prompt (3M ESPE), Group C- i bond (Heraeus-Kulzer), Group D-XenoIII (Dentsply, De Trey) Group E-Single bond (3M ESPE) was used and served as control. All the adhesives were applied according to the manufacturer's instructions. Composite post was built on these bonded surfaces using Z-100 hybrid composite. The teeth were subjected to thermocycling for 500 cycles between 5°C to 55°C. The teeth were then mounted on universal testing machine and fractured under a shearing load, applied at a speed of 0.2mm/min. The readings were noted, tabulated and shear bond strength calculated in Mega Pascal (Mpa) units. Results: There was significant difference in the mean shear bond strength of the four self etching primers, adhesives tested. Shear strength values were in the range of 16.57 to 21.73 Mpa. Xeno III gave the highest mean of shear bond strength whereas Adhe SE showed the lowest value of shear strength. Conclusion: Based on the results of the study, it can be concluded that contemporary self etching primer adhesives bond successfully to dentin. Moreover the bonding ability of Self Etching Systems seems to be comparable to the conventional Total Etch Systems.

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Distraction Osteogenesis claims to reduce the duration of treatment as well aid in conservation of anchorage. With the introduction of Dento- alveolar distraction retraction of canine can now be done in about 2-3 weeks with minimal loss of anchorage and little/no root resorption. However, surgical procedure required for dento-alveolar distraction can cause significant swelling and post operative discomfort. Our small modification in the surgical procedure drastically reduces the discomfort and improves patient compliance.

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Currently implants in dentistry have become a successful treatment option for replacement of missing teeth or tooth. However, sufficient width and height of maxillary or mandibular alveolar ridge is a must for implant placement. Deficient ridge may occur due to trauma, other local pathologies or periodontal diseases. Retention and success of implants in insufficient ridge height becomes questionable. A correct diagnosis of the deficient ridge especially in the maxillary posterior region, whether due to pneumatization of the maxillary sinus or due to periodontal disease, needs to be made prior to deciding the treatment protocol. Surgical reconstruction of such alveolar ridge using autologous bone grafts allows implant fixation in an esthetic and functional manner. For repair of most localized alveolar defects, block bone grafts from the symphysis offer advantages over iliac crest grafts, like close proximity of donor and recipient sites, convenient surgical access, decreased donor site morbidity, decreased cost and hidden scar. We hereby present a case of deficient alveolar height in the maxillary posterior region which was reconstructed with intraoral symphysis graft from the mandible before implant placement.

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Traumatic isolated frontonasal injuries are seldom reported in literature as they are generally seen along with panfacial, high velocity accidents. A peculiar case, in which the patient reported with an isolated frontonasal injury due to a freak accident involving a hoe is presented here. After surgical intervention, titanium plates were used to fix the frontal bone. The sinus lining was preserved and the nasal bone was reduced and immobilized. The patient was discharged and kept on a weekly follow up.

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