Impaction of the maxillary canine is a frequently encountered problem in orthodontic practice. Maxillary canines are the most commonly impacted teeth next to the third molars. Alignment of an impacted canine requires a combined surgical and orthodontic approach. Maxillary canines present a high esthetic and functional demand, hence, a precise diagnosis and treatment planning with soft tissue considerations is essential for a favorable and stable outcome. An overview of the etiology, incidence, and diagnosis of the factors affecting the management of impacted maxillary canines, the soft tissue consideration, and various surgical and orthodontic techniques have been discussed.

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Management of the patient with congenital or acquired defect of palate, resulting in communication between oral cavity and nose and/or maxillary sinus, presents challenge to the clinician. The prosthodontic management involves use of obturator prosthesis. This article discusses various aspects of the obturator prosthesis.

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Background: Dental fluorosis is a major public health problem in 15 states of India. Himachal Pradesh has considerable amount of problem though not an endemic zone for dental fluorosis. Aims: To determine the prevalence and severity of dental fluorosis using Dean's index among school going children of rural and urban areas. Settings and Design: A cross sectional study was conducted among the students in the age group of 5, 9 and 12 years from rural and urban areas of six district of Himachal Pradesh in the year 2009 to 2010. Materials and Methods: A total of 1,800 school children of both sexes from randomly selected schools were examined as per the WHO survey proforma to identify the presence of dental fluorosis and grade it using Dean's index. Statistical Analysis Used: SPSS 15.0 was used. Data expressed as proportions and test applied was Chi-square test. Results: Out of these total 1,800 children, 973 were boys and 827 were girls. Of them, 612, 564 and 624 children belonged to the age groups of 5, 9 and 12 years, respectively. The overall prevalence of dental fluorosis was 4.1%. The prevalence ranged from highest 7% in district Shimla to lowest 1.7% in district Sirmour (P < 0.002). Dental fluorosis was equally distributed in rural and urban areas of six districts but was more common among girls than boys. The trend of increase in prevalence was observed with increase in age (P < 0.00002). Conclusions: A well-designed epidemiological study should be undertaken to evaluate the risk factors associated with the condition in the study region.

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Pulpal diseases progress to periapical lesions. The incidence of cysts and granulomas within periapical lesions are 55% and 70.07%, respectively. It is accepted that all inflammatory periapical lesions should be initially treated with conservative nonsurgical procedures. Studies have reported a success rate of up to 85% after endodontic treatment of teeth with periapical lesions. The various options for the removal of obturating material are K-files or H-files, gutta percha solvent, combination of paper points and gutta percha solvent, rotary instruments, retreatment files, heat transfer devices, heat carrier tips, ultrasonic tips and soft tissue laser. In the present case, we removed the gutta percha using K-files and H-files. The various methods of removing detached gutta percha are K-files and H-files, heat carrier tips or periapical surgery. Various methods can be used in the nonsurgical management of periapical lesions: The conservative root canal treatment, decompression technique, active nonsurgical decompression technique, aspiration-irrigation technique, calcium hydroxide methods, lesion sterilization and repair therapy and the apexum procedure. In the present case, we removed the gutta percha using K-files and H-files and we followed the aspiration-irrigation technique as a line of management. This case report describes an aspiration-irrigation technique achieved through the root canal space, which might hasten osseous regeneration, thereby eliminating the need for periapical surgery.

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Aim: To evaluate the association of serum alkaline phosphatase (ALP) and calcium level in type 2 diabetes mellitus with periodontitis. Materials and Methods: In this study, a total of 240 subjects, aged 34-42 years were selected and was divided into four groups as 60 healthy individuals (group A), 60 type 2 diabetes mellitus without periodontitis (group B), 60 type 2 diabetes mellitus with periodontitis (group C), and 60 non-diabetes mellitus with periodontitis (group D). Blood samples were collected after an overnight fast for the estimation of serum glucose, ALP, and calcium using glucose oxidase-peroxidase (GOD-POD), p-Nitrophenyl Phosphate (p-NPP), and o-Cresolphthalein Complexone (OCPC) methods, respectively. Results: The concentration of serum ALP and calcium showed a significant increase ( P < 0.0001) in type 2 diabetes mellitus patients with periodontitis (group C) when compared to control. Conclusion: Increased serum ALP and calcium level could be often associated with the alveolar bone loss and tooth loss in type 2 diabetes mellitus with periodontitis among the South Indian population.

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As the body of medical education continues to expand, physicians must develop the necessary skills to keep up with the vast amount of information available. The journal club provides a forum to allow residents to remain updated with the literature while also teaching them the methods to evaluate it critically. The articles are evaluated as to their quality and also whether and how the findings can be applied to practice. Recently, journal clubs have been designed to teach critical appraisal skills to physicians-in-training. This powerful educational tool has played an active role in medical education for over a century. Although this tool has been incorporated in the postgraduate curriculum, there still remains a lack of understanding of the concept and importance of journals. This paper provides a comprehensive review about what a journal article discussion is and how to evaluate a journal club.

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Hemifacial microsomia, a developmental anomaly involving the first and second branchial arches, is one of the most common craniofacial anomalies. This disorder affects orofacial structures with varying clinical features. It is also associated with underdevelopment of the temporomandibular joint, mandibular ramus, masticatory muscles, ears, and occasionally defects in facial nerve and muscles. Physical deformities affecting face, ears, eyes, and oral cavity can pose esthetic and functional problems. The rehabilitation of these patients should be multidisciplinary including prosthodontic management as these patients present with complex clinical features. Treatment approach depends on patient's age, extent of physical and psychological deformity. The fabrication of auricular prosthesis is considered to be one of the most difficult replacements in maxillofacial rehabilitation. The severe undercuts and pronounced convolutions of the ear's surface present a challenge in simulating a natural proportioned prosthesis. This paper presents an outline in basic fabrication of prosthetic ear by conventional technique where the wax pattern is fabricated from the impression of an individual with a similarly proportioned ear.

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Context: The dental profession is the most stressful of all the health professions, and this is true for all stages of the dental career, i.e., for established dentists, young dentists and dental students. Aim: To identify the various sources and coping mechanisms of stress as perceived by Indian undergraduate dental students. Settings and Design: Descriptive cross-sectional questionnaire study. Materials and Methods: A modified version of the self-administered dental environment stress (DES) questionnaire was used. The responses were based on a four-point Likert scale (1 = little, 2 = moderate, 3 = considerable and 4 = great). Statistical Analysis Used: Descriptive analysis was carried out for the study variables. Results: Examinations, short lunch breaks, relationships, not knowing the local language, competition for sports and cultural activities, counseling rounds, difficulty of getting patients, portion and quota completion were the highest stressors. Having friends, planning and problem solving were the methods adopted by most of the students to cope with stress. Conclusions: The undergraduate dental students in India had high levels of perceived stress. Academic and nonacademic perceived sources of stress should be considered in curriculum planning and in the working environment for dental education.

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Background: Incorporating fluoride in the orthodontic bonding resin to prevent demineralization around orthodontic brackets reduces the bond strength, which is critical in the clinical performance of the resin. Aim and Objective: The aim of the study is to evaluate the shear bond strength of a polyacid-modified composite resin and compare it with a conventional composite resin and a resin-modified glass ionomer cement and to evaluate the site of bond failure and the amount of adhesive remaining on the tooth surface after debonding. Materials and Methods: Brackets were bonded using the three orthodontic bonding agents to 120 human premolars embedded in self-cure acrylic blocks, and shear bond strength was evaluated using the Instron universal testing machine. The debonded bracket surfaces were examined with a stereomicroscope to evaluate the site of bond failure and the presence of residual adhesive. Results: Composite resin bonding material showed the maximum initial and final bond strength followed by the polyacid-modified composite resin and resin-modified glass ionomer cement. The mode of bond failure for the polyacid-modified composite was adhesive failure at bracket adhesive interface or cohesive failure. Conclusion: The polyacid-modified composite resin produced shear bond strength in vitro within the range that is considered in the literature to be adequate for routine clinical use. Further clinical research is recommended to validate this finding.

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Odontogenic fibromyxoma is a rare odontogenic tumor of mesenchymal origin. It is composed of large amounts of intercellular substance rich in acid mucopolysaccharides, making it locally very aggressive and with high recurrence rates following conservative excision. Its histological and radiological features make it difficult to differentiate from other odontogenic tumors and, occasionally, may be misinterpreted as a malignant lesion. Although the origin of a myxoma is still obscure, its origin from the dental follicle seems to be the most reasonable explanation. We report a case of odontogenic fibromyxoma of maxilla in a 32-year-old female patient.

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Ethics is a system of moral principles that not only applies values and judgments to medical practice, but also to any research that deals with human participants. Before pursuing any research, it is mandatory for a researcher to have some basic information about the ethics and ethical guidelines. Hence, the purpose of this review article is to give a brief insight into the ethics and ethical guidelines to Biomedical Research.

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