Pulse therapy is defined as discontinuous/intermittent intravenous infusion of very high doses of corticosteroids along with certain immunosuppressive agents over a short period. It has gained its popularity since last three decades due to the advantage of minimizing the adverse effects of conventional corticosteroid therapy, and their action is supposed to be mediated through nongenomic actions within the cell. The aim of pulse therapy is to achieve a faster response and stronger efficacy and to decrease the need for long-term use of systemic corticosteroids. This paper intends to review the various available pulse therapy regimens with dosages, indications, contraindications, and adverse effects.

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There are more than 65,000 possible combinations of standing teeth and edentulous spaces which are encountered in the human dental arch. The system of classifying the partially edentulous arch would be an enormous aid in providing a precise word picture of a particular dental arch that is to be discussed. However, there are numerous classification systems which create confusion. Hence, a broad search of published literature was performed electronically using the keyword classification, partially edentulous, and denture from January 1928 to December 2018. This article enlisted the various classification systems and its critical analysis.

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Advances in dentistry, as well as the increased desire of patients to maintain their dentition, have led to treatment of teeth that once would have been thought to be removed; as furcally involved teeth present unique challenges to the success of periodontal therapy. The treatment, management, and long-term retention of molar teeth exhibiting furcation invasions, always have been a challenge to the discerning general dentist or dental specialist. Anatomically and morphologically complicating factors dictate modifications in treatment approaches used for managing these areas. This review evaluates the different aspects of furcation in terms of etiology, classification, diagnosis, and various treatment possibilities. This review evaluates the different aspects of furcation in terms of aetiology, classification, diagnosis and various treatment possibilities.

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Objectives: Esthetics and smile-enhancing treatments have become an integral part of the dentistry; people always consult with periodontist for obtaining acceptable gingival esthetics. In smile designing esthetics, the color of gingiva has a major role. Although there is no any gold standard technique for managing melanin hyperpigmentation, esthetic concerns have lead increasing awareness about different depigmentation procedures. The aim of this study is to identify gingival melanin pigmentation patterns and to investigate its relationship based on clinical analysis with skin color, gender and gingival phenotype for various treatment modalities. Methods: In total, 200 subjects without any systemic disease (100 males and 100 females with mean age 26.5 years) screened by a single person and categorized them by skin color as fair, wheatish, brown, and dark to identify the different distribution patterns of gingival melanin pigmentation anatomically. Along with this severity of melanin pigmentation and gingival phenotypes were assessed. By using a Chi-square test correlations of variables were checked. Results: A positive statistical correlation was noticed between severity of gingival pigmentation and skin color. Dark-skinned subjects had heavy gingival pigmentation. The majority of population had pigmentation in attached gingiva and interdental papillae. Conclusion: Within the limits of the present study, the majority of population showed a positive correlation with their skin color and the severity of melanin pigmentation.

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Anterior dental esthetics becomes crucial in patients with periodontal disease with open embrasures, increased crown height, black triangles. This article describes a technique for fabrication of gingival veneer for patients with black triangles and gingival recession. This is a conservative method of obtaining esthetics with the advantage of predictable esthetics.

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Introduction: In teaching institutes, most of the patients got treated by the students and the interns. They are the budding dentist of dental health-care profession. As these students and the interns work in direct contact with biomedical waste (BMW), they should have proper knowledge about its management to avoid the associated risk. Aims and Objectives: The aim of this study was to evaluate BMW education/awareness, awareness of BMW generation, hazard, and legislation and its management practices among the final BDS students and interns of VSPM Dental College and Research Centre, Nagpur, Maharashtra, India. Methodology: A cross-sectional questionnaire-based study was designed. The study was approved by the Institutional Ethical Committee. The questionnaire was consisted of 19 close-ended questions and one open-ended question. It was distributed anonymously among BDS final year students and interns. The solved questionnaire was collected back after 10 min and the data were analyzed. Results and Conclusion: The present study showed that awareness regarding the BMW was good and awareness about its generation; hazards, legislation, and awareness about BMW practices were moderate to poor.

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Postinflammatory hyperpigmentation (PIH) is an acquired hypermelanosis occurring after cutaneous inflammation or injury that can affect all skin types but more in dark-skinned patients. Etiologies for facial PIH include infections, allergic reactions, papulosquamous diseases such as psoriasis or lichen planus, medication-induced hypersensitivity reactions, and cutaneous injury from irritants, burns, or cosmetic procedures. PIH results from the melanocyte's response to the cutaneous insult causing increased production and/or redistribution of melanin. Literature search could show that this is the first case report on isolated acute perioral PIH following perioral contact dermatitis.

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Trauma has been reported to contribute to the development of aphthous ulcer, but uncomplicated forceps extraction as a form of trauma has not been reported. This article reports a case of aphthous ulcer in an otherwise healthy 30-year-old female 2 days after forceps extraction of the upper right 3^rd molar. The ulcer was painful and disturbed patient mastication. There was associated dysphagia and hypersalivation. Warm saline mouthwash, topical application of Bonjela cream (choline salicylate and cetalkonium chloride), and tablets of prednisolone (5 mg) were prescribed for the patient for 1 week while the patient continued the other postoperative medications. One-week review of the patient showed significant improvement in the clinical presentation. In conclusion, aphthous ulcer may be considered a potential complication of forceps extraction after excluding other contributing factors. The authors hereby recommend (1) ensuring adequate precaution geared toward minimizing trauma to the oral mucosa during forceps extraction and (2) inclusion of aphthous ulcer as a complication of forceps extraction to reduce chances of possible litigation.

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Periodontitis is a multifactorial infectious disease of the supporting structures of the teeth, characterized by destruction of the bone and connective tissue. Specific periodontopathic bacteria and their virulence factors are the primary etiologic agents. However, the interaction of host defense mechanisms and these etiological agents play an important role in the onset and progression of the disease. Research began to focus very closely on bacterial-host interaction, leading to host bacterial interrelationship era. The shift in concentration on host response has led to the development of host modulatory therapies which could improve therapeutic outcomes, slow the progression of disease, allow for more predictable management of patients, and possibly even work as preventive agents against the development of periodontitis. This paper reviews the host modulatory therapy, which is the effective means when used as an adjunct to mechanical periodontal therapy in treating periodontal diseases.

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Unresolved inflammation is associated with several widely occurring diseases such as arthritis, periodontal diseases, cancer, and atherosclerosis. Endogenous mechanisms are that which curtail excessive inflammation. A newly emerging chemical mediators derived from polyunsaturated fatty acids were identified that controls the acute inflammatory response by activating local resolution. They are specialized pro-resolving lipid mediators that includes lipoxins (LXs), resolvins (Rv), protectins, and maresins, because they are enzymatically biosynthesized during resolution of self-limited inflammation. They have anti-inflammatory and pro-resolution actions of Rv of the D1 with up regulation of arachidonic acid-derived endogenous resolution pathways (LXA4). A novel therapeutic host modulating are for resolution of inflammation.

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The first karyotype investigation in a patient with Turner syndrome (TS) was performed in England, in 1959; prior to that, it was thought that humans possessed 48 chromosomes. Most individuals with down-syndrome possess 47 chromosomes, with an extra copy of chromosome 21. Most individuals with TS possess 45 chromosomes, with a missing X chromosome. Here, we present 45 XO karyotype analysis in a 12-year-old girl with TS; although it is common in females, it is still rare to encounter in dental institutions. Oral physicians and pediatric dentists need to be aware of the major clinical features for definitive diagnosis of TS for early recognition and timely investigation which will improve their quality of life and to guide for the oral care.

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Background: Music surrounds our lives. Music therapists assess emotional well-being, physical health, social functioning, and communication activities through musical responses. During all types of dental treatments, patients are very much apprehensive about the procedures. In prosthodontics, tooth preparation, patient's anxiety levels can be reduced, if his/her mind is diverted to listen to music, thus getting maximum cooperation. Aim: To reduce the anxiety levels in patients receiving fixed partial dentures (FPDs), by listening to passive music using earphones. This was a randomized control experimental study. Materials and Methods: A total of 100 patients requiring FPDs between the ages of 18 and 45 years were randomly selected. Patients dental anxiety scale (DAS) and their blood pressure (BP) as well as heart rate (HR) were recorded before starting the procedure. They were divided into two groups: Group I as control (without music) and Group II (with music, where patients listened to the passive music using earphones throughout the treatment). In both the groups, patient's BP and HR were also recorded at the end of impression making. The data were tabulated. Statistical analysis was performed using Chi-square test and Fisher's exact tests. Results: From DAS scale analysis, among patients with medium and high levels of anxiety, music had a significant influence on their fear and comfort. Findings of Group I and Group II in hemodynamic variables were also much comparable including dentist's rating and patient's behavior, treatability, and cooperation during the procedure. Conclusion: The influence of music showed reduced anxiety levels among patients receiving FPDs. It also helped lower the level of tension, better treatability, and better adjustment to the prosthodontic treatment.

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A multidisciplinary approach including an orthodontist and a periodontist is done in patients with periodontal disease. Both specialists should be involved in the treatment planning of such patients, and care should be taken in evaluation of progress of the treatment undertaken. Importance of multidisciplinary approach has increased as majority of patients seeking orthodontic treatment are adults. Orthodontic patients are highly susceptible to increased accumulation of plaque which makes integration of a periodontist very essential. Careful attention needs to be given to orthodontic patients as undesirable periodontal changes are seen. The purpose of this article is to highlight the importance of both specialties and in which conditions they are used as an adjunct and the mutual benefits shared by them.

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Background: Injuries to oral soft tissues are common. These can be caused by chemical, thermal, physical agents, self-mutilation, denture associated, etc., In this study, 110 patients were included from western Punjab population coming for routine checkup. Different causes for different types of injuries were noticed and tabulated to find the percentage of each cause, causing injuries to oral soft tissue. Objective: To determine the quantitative analysis of different causes which are a causative factor of oral injuries. Methods: The sample for the study consisted of 110 patients undergoing routine dental checkup in the dental center. Quantitative analysis of each causing factor was done by taking proper history from the patients and careful oral examination. Results: Females are more prone to soft tissue injuries as compared to males, and chemical burn is most common cause of soft tissue injury found in 44 patients followed by denture associated ulcers in 36 patients out of 110 patients.

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The aim of the present case report is to introduce a modified and innovative design for effective habit breaking with minimal patient discomfort. Abnormal oral habits are one of the major etiological factors in malocclusion. The harmful, unbalanced pressure bears upon the immature, highly malleable alveolar ridges and brings about potential changes in the position of teeth and occlusion. These habits can also cause behavioral problems and are socially unacceptable. Various methods and appliances are used to break the abnormal oral habits, as a part of treatment of malocclusion. The traditional habit-breaking appliances used so far can cause irritation to the tongue, subsequently leading to ulceration and in addition can also cause mastication and speech problems. The appliance is a regular Hawley's appliance with the addition of the light-emitting diode bulb and the switch. When the child's tongue or the finger touches the appliance, the light bulb gets illuminated, thus reminding the child to quit the habit. The said appliance utilizes easily available electrical gadgets that will function by disturbing the subconsciously built vicious cycle. The reminders send by its activation will break the pleasure perception obtained during the habit. Habit breaking through this appliance is effective as it is superior to other appliances in the mode of action as well as the design itself is attractive to the children.

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Immunity is divided into two parts – the innate and adaptive responses. The innate immune system relies upon limited receptors to detect invading pathogens but compensates by targeting conserved microbial components that are shared by the large groups of pathogens. Various cells involved in innate immune responses include neutrophils, macrophages, dendritic cells, mast cell, neutrophils, natural killer cells, and eosinophils. The innate immune responses are the first line of defense against invading pathogens. They are also required to initiate specific adaptive immune responses. The second kind of protection is adaptive immunity which develops throughout our lives. It uses two basic strategies – Humoral immunity which works to eliminate antigens that are extracellular and cellular immunity which deals with antigen residing within a host cell. T- and B-lymphocytes are the main self-defense weapons of the adaptive immune system. Adaptive immunity relies upon a clonal system with each T-cell and B-cell expressing its own unique receptor.

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Background: Gingivitis is common in children which if neglected may progress to periodontitis in the adults. Therefore, early diagnosis of gingivitis and appropriate therapeutic measures in children are of utmost importance to prevent or minimize progression of periodontitis in the adult population. Aims: The aim of this study was to determine the prevalence of gingivitis and periodontitis among preschool children in Kolkata. Materials and Methods: A cross-sectional survey of 200 children aged 2–5 years were performed from March 2015 to February 2016. The gingival index (GI) and pocket depth of fully erupted teeth were measured. Results: The comparison (t-test) of mean pocket depth was least (0.89 mm) between 3- and 4-year-old children and was highest (3.09 mm) between 2- and 4-year-old children. The mean GI among boys and girls differ significantly (P < 0.001). The boys had a higher GI and pocket depth than girls the mean GI in school going children was 0.67 ± 0.22 and in nonschool going children, it was 1.189 ± 0.12, and mean pocket depth was 2.05 ± 0.32 and 2.77 ± 0.55, respectively. The mean GI and pocket depth in children of upper and lower socioeconomic condition differ significantly. Conclusion: Preschool children in and around Kolkata suffer from varying degree of gingival diseases, and comprehensive preventive programs are needed to improve their oral health.

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Recurrent aphthous stomatitis is the most common chronic disease of the oral cavity, affecting 5–25% of the population. The underlying etiology remains unclear, and no curative treatment is available. Local treatment will suffice for the majority of aphthous ulcers and only in the case of continuous outbreaks and symptoms systemic drug should be prescribed as pain is intense, and topical treatment is unable to afford symptoms relief. Systemic therapy is indicated in such situations with the triune action of providing symptom relief, promoting wound healing, and preventing recurrence. A PubMed search with the keywords of aphthous ulcers and systemic management was done, and all clinical trials and review articles in English literature from 1985 to 2014 were retrieved and compiled.

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Background: Prevalence and treatment of the caries disease are interconnected concepts. Association between dental caries and ABO blood group is not studied in relation to a specific geographic location. Here a study conducted on a group of patients belonging to Western Punjab region. Objective: To determine the severity of dental caries in each type of blood group (ABO). Methods: The sample for the study consisted of 150 patients undergoing routine dental checkup in the dental center. Correlation between dental caries and blood groups were done using decayed, missing, and filled teeth index. Results: There is increased the prevalence of dental caries in nonsecretor as compared to secretors in Western Punjab population. Conclusion: Non secretors are more prone to dental caries as compared to secretors.

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Management of impacted canine teeth requires early diagnosis and interception of the clinical situation. Various treatment modalities are available in literature, and the clinical situation may demand interdisciplinary approach. The treatment options should be time- and cost-effective with promising result both functionally and esthetically. This review article is an overview of etiology, diagnosis, and treatment modalities for the management of impacted canine.

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Endodontic and dentistry surgical procedure has surpassed the success rates for ancient dental medicine and dentistry surgical procedures. Achieving primary closure with the grafts contains a positive result on guided tissue regeneration (GTR) outcome. New techniques of dentistry microsurgery, such as minimally invasive papilla conserving flaps with passive internal pad stitching, have managed to obtain 90% primary flap closure over grafted sites. Root surface treatment and acquisition has conjointly shown to be helpful for GTR. The present case report describes a case of the localized primary periodontal lesion with secondary endodontic involvement in a mandibular first molar. The case was managed by root canal therapy followed by a periodontal regenerative procedure using GTR technique. Two years follow-up without replacement of the tooth with crown showed healing of the lesion with a minor defect in the restoration which was replaced by tooth-colored restoration.

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Dentin hypersensitivity is a common occurrence and is often a chief concern among patients. The successful management of dentin hypersensitivity is often very challenging for the dental professional as the cause of the pain and the description of the discomfort varies. There are traditional methods that have been clinically evaluated and found to be effective, but a more effective, faster acting, and long-lasting treatment is required. Hence, Pro-Argin technology is considered to be a promising treatment for dentin hypersensitivity and stain removal.

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Cystic hygromas are rare, congenital, benign lesions occurring early in life, mainly in the head, neck, and oral cavity. It is an aberrant proliferation of lymphatic vessels resulting from abnormal development of the lymphatic system. Lymphangiomas are classified as microcystic, macrocystic, and cystic hygromas according to the size of the lymphatic cavities incorporated. They are soft, vary in size and shape, and tend to grow extensively if not surgically excised. They are multilocular cysts filled with clear or yellow lymph fluid. Histopathologically, lymphangiomas are of three types: Lymphangioma simplex, cavernous lymphangioma, and cystic hygroma depending on the size of vascular spaces and thickness of the adventitia. The present report describes a case of cystic hygroma of the left posterior region of jaw in an 11-year-old male child and its clinical, ultrasonographic, and cytological correlation.

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Intraosseous involvement of jaw bones are commonly seen with squamous cell carcinoma (SCC) of the oral cavity. Ameloblastic carcinoma (AC) is a rare malignant odontogenic neoplasm that tends to occur in mandible with or without intraosseous involvement. We present one such rare case of, 60-year-old female with gray white growth in the left lower buccal cavity with enlarged lymph nodes. The computed tomography scan showed a mass from the left submandibular salivary gland and fine-needle aspiration was suggestive of malignant salivary gland tumor. The patient was posted for frozen section and mandibulectomy. Frozen section showed squamous cells with keratin pearl formation suggestive of metastatic SCC. The routine histopathology proved it as AC with keratin pearl formation. With this case, we would like to highlight the pitfalls, difficulties, and importance in the diagnosis of AC.

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