This article summarizes relevant scientific data on the alleged high suicide rate among dentists as compared to other health care professions. Potential contributing risk factors for the dental profession are identified. In addition, a brief review is provided for major depressive disorder, a contributor to increased suicide, along with its symptoms, underlying theory, drug treatment and coping skills to combat this disorder.

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Introduction: Calcium hydroxide (CaH) is customarily used for permanent teeth but not for deciduous dentition because it is known to cause internal resorption in the latter. Though this has been attributed to chronic inflammation and odontoclasts, the exact mechanism has not been elucidated. The Hypothesis: The authors propose an explanation that CaH-induced odontoclastogenesis could be multifactorial. Odontoclasts may result from fusion of cells of monocyte/macrophage series either due to inflammatory mediators or through stimulation by stromal odontoblasts /fibroblasts. Pre-existing progenitor cells of primary tooth pulp because of their inherent propensity may transform into odontoclasts. Evaluation of the Hypothesis: The hypothesis discusses the role of various inflammatory cytokines that may be responsible for CaH-induced transformation of pre-odontoclasts to odontoclasts. Alternatively, pre-existing progenitor cells with proclivity to change into odontoclasts may cause internal resorption. The loss of protective layer of predentin over mineralized dentin may also make the primary tooth more susceptible to resorption.

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Objectives: To propose a new classification of median maxillary labial frenum (MMLF) based on the morphology in permanent dentition, conducting a cross-sectional survey. Materials and Methods: Unicentric study was conducted on 2,400 adults (1,414 males, 986 females), aged between 18 and 76 years, with mean age = 38.62, standard deviation (SD) = 12.53. Male mean age = 38.533 years and male SD = 12.498. Female mean age = 38.71 and female SD = 12.5750 for a period of 6 months at Teerthanker Mahaveer University, Moradabad, Northern India. The frenum morphology was determined by using the direct visual method under natural light and categorized. Results: Diverse frenum morphologies were observed. Several variations found in the study have not been documented in the past literature and were named and classified according to their morphology. Discussion: The MMLF presents a diverse array of morphological variations. Several other undocumented types of frena were observed and revised, detailed classification has been proposed based on cross-sectional survey.

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Introduction: Lasers are used in various disciplines in dentistry such as restorative dentistry, endodontics, periodontics, pedodontics, and oral and maxillofacial surgery. Despite many advantages of dental lasers, this method might have some adverse effects. The aim of this review article is to debate about the impacts of lasers on orodental tissues. Methods: An electronic search was accomplished using specialized databases such as Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus to find relevant studies by using keywords such as “laser”, “dentistry”, “adverse effect”, and “side effect”. Results: Several adverse effects of laser were identified such as impacts on dental pulp, effects on tooth surface, subcutaneous and submucosal effects, histopathological changes, and infection transmission due to laser smoke. During dental procedures, necrosis of the pulp, periodontal ligament and odontoblasts, cemental lysis, bone resorption, hypo/hyperpigmentation, burns, itching, and scarring might occur. In addition, laser can weaken the dentin by inducing surface cracks. Restorative procedures by laser might increase microleakage and decrease shear bond strength, as well as microhardness of tooth walls. Meanwhile, laser surgery might cause emphysema after abscess incision and drainage, frenectomy, flap elevation, and gingivoplasty. Conclusion: Practitioners should be very cautious in treatment planning and case selection during laser-based therapeutic procedures.

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Oil pulling has its origin in Ayurvedic medicine, is a natural remedy to improve oral health. Its antibacterial properties help to eradicate the bacteria and other debris from adhering to the oral cavity. It reduces the accumulation of plaque, prevents halitosis, cavities, gingivitis. It is used to heal the bleeding gums and mouth ulcers. Oil pulling with sesame oil improves overall health. Other than oral health, oil pulling also helps in reducing asthma, allergies, chronic fatigue, diabetes, migraine headaches and chronic skin problems. It works by detoxifying or cleansing the body. The aim of this article is to highlight the benefits of oil pulling in management of oral health.

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Introduction: To compare electronic apex locators (EAL) with others root canal determination techniques and evaluate other usage of this devices. Materials and Methods: "Tooth apex," "Dental instrument," "Odontometry," "Electronic medical," and "Electronic apex locator" were searched as primary identifiers via Medline/PubMed, Cochrane library, and Scopus data base up to 30 July 2013. Original articles that fulfilled the inclusion criteria were selected and reviewed. Results: Out of 402 relevant studies, 183 were selected based on the inclusion criteria. In this part, 108 studies are presented. Under the same conditions, no significant differences could be seen between different EALs of one generation. The application of EALs can result in lower patient radiation exposure, exact diagnosing of fractures, less perforation, and better retreatment. Conclusions: EALs were more accurate than other techniques in root canal length determination.

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Lemon grass essential oil has been used for decades to treat respiratory infections, sinusitis, bladder infections, high cholesterol, digestive problem, varicose veins and also for regeneration of connective tissue. It has anti spasmodic, anti-pyretic, anti-fungal, anti-bacterial, anti-inflammatory, anti-septic, insect repellent, sedative, vasodilator and flavoring properties. In china, it has been used traditionally as a remedy for stomach and liver diseases and also to treat rheumatism. Since lemon grass oil possess various pharmacological actions, it is also quite useful in dentistry. Hence, the objective of this article is to highlight various uses of lemon grass oil in the dental field and in the medical field in order to aid the professionals for future research.

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The aim of this study was to elucidate the diagnosis, etiology, and therapeutic options for the treatment of gummy smile. The smile level is an imaginary line after the lower superior lip and used seems to be convex. The presence of 3 mm or grater continuous gingival band exposures to natural smile or speech performs the gummy smile. Original articles studying the diagnosis, etiology, and therapeutic alternatives for the treatment of gummy smile were searched in the Medline, Scopus, Science direct, and EBSCO host databases. Together with some example and diagnosis method was purposed. The authors conclude that the etiology is multifactorial and can be showed excessive vertical maxillary grow up, excessive labial contraction, shorter upper lip, gingival excess, and extrusion of the anterior teeth. The therapeutics alternative are often multidisciplinary, besides can be used orthognathic, plastic and periodontal surgery, and orthodontic.

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Introduction: This paper summarizes different conditions, which have a well-known influence on the resorption of tooth roots. It also highlights factors important for individual susceptibility to root resorption. Furthermore, the paper focuses on idiopathic root resorption where the provoking factor is not known. The Hypothesis: The several different disturbances causing root resorption can be either orthodontically provoked or acquired by trauma, virus or congenital diseases. It is presumed that all these conditions lead to inflammatory processes in the three main tissue layers, comprising the peri-root sheet. Evaluation of the Hypothesis: This paper explains how different etiologies behind root resorption and how different phenotypic traits in root resorption can be understood from immunohistochemical studies of the human periodontal membrane close to the root and thus, gain a new understanding of the phenomenon of root resorption.

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Introduction: Talon cusp is an uncommon odontogenic anomaly which most frequently affects maxillary permanent incisors. Its presence causes the problem in esthetics, prevention of caries, and occlusal accommodation for the patient and problems in the diagnosis and clinical management for the dentist. Case Report: This article reports a case of talon cusp on the palatal surface of the permanent maxillary central incisor. Discussion: Since, the presence of talon cusp usually demands that definitive treatment be instituted; it represents a problem of clinical significance. The dentist should be able to diagnose it as the maxillary incisor is also the principal site for supernumerary tooth.

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Introduction: The aim of this study was to evaluate the degree of pain and discomfort experienced for 1 week after miniscrew insertion using a questionnaire survey. Materials and Methods: Thirty-nine miniscrews were inserted in the mandible and maxilla of 33 patients with a self-drilling JB head type miniscrew under local anesthesia. Patients were asked to rate the degree of pain and discomfort experienced on a visual analog scale (VAS) after 1 hour, 12 hours, 1 day, and 1 week . Data were analyzed using the Statistical Package for the Social Sciences version 22 software. Repeated measures analysis of variance (ANOVA) with considering the jaw, side of insertion, and length of miniscrew as a between subject factor was used. Results: There was no significant association between the length of miniscrew (P = 0.448), the jaw (P = 0.870), and the side of the insertion (P = 0.346) and causing pain. The maximum degree of pain experience was in 1 hour after insertion that was 48.79 mm in VAS scores, which started to decrease significantly after 12 hours, 1 day, and 1 week as the minimum intensity of the pain was 1 week after the miniscrew insertion that was 2.31 mm in VAS scores. Conclusion: On the basis of the patient responses, it can be concluded that miniscrew could be an acceptable option in orthodontic treatments.

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Introduction: Trauma, altered tooth germ position and delayed tooth eruption have been hypothesized as possible causes of tooth root dilacerations and flexion, however these anatomical variations appear more commonly associated with posterior teeth and absence of traumatic history. The Hypothesis: Postulated is that tooth root dilaceration or flexion may be a result of tooth root sheath displacement due to gradients of bone remodeling present within alveolar bone. Evaluation of the Hypothesis: Alveolar bone displays bone remodeling gradients between coronal, apical and basal sections which affect bone plasticity. As a tooth is erupting or experiences delayed eruption, there are other relative dento-skeletal alterations occurring, such as the mesial drift of the dentition and transverse growth of the maxilla. It is plausible that during the physiologic and growth related alteration of the alveolar and basal bones, portions of developing tooth could be found within one or more of the plasticity zones, contributing to alteration of the root sheath and tooth root dilaceration.

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Introduction: The management, treatment and long-term retention of mandibular molar teeth with furcation involvement have always been a challenge in periodontal therapy. Hemisection has been used successfully to retain teeth with furcation involvement. The term hemisection refers to the sectioning of a molar tooth, with the removal of an unrestorable root which may be affected by periodontal, endodontic, structural (cracked roots), or caries. Case Report : This case report describes a simple procedure of hemisection in a mandibular molar with socket preservation with help of an alloplastic bone graft and subsequent restoration of the tooth with fixed prothesis. Discussion: Hemisection represents a form of conservative procedure, which aims at retaining as much of the original tooth structure as possible. It may be a suitable alternative to extraction. Hemisection of the affected tooth allows the preservation of tooth structure, alveolar bone and cost savings (time and money) over other treatment options. The preservation of posterior abutment teeth permits oral rehabilitation with fixed bridges instead of removable prosthesis. Conclusion: The keys to long term success appear to be thorough diagnosis followed by interdisciplinary approach with endodontic, surgical and prosthetic procedures. Preservation of a hopeless tooth is possible by selecting patients with good oral hygiene, and careful surgical and restorative management.

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Introduction: Bleeding from gums is a common feature in periodontitis patient. But abnormal bleeding from the gingiva or other areas of the oral mucosa that is difficult to control is an important clinical sign suggesting a hematological disorder. Case Report: A-40-year old male patient reported to our clinic with the chief complaint of acute gingival bleeding. There was continuous bleeding, fever since 3-4 days with weakness, retro orbital pain, and severe backache. Patient gave a history of bleeding from gums for last 24 hrs. His blood profile revealed; platelet count of 36,000, total wite blood cell (WBC) count of 6000/cumm, differential leukocyte count (DLC) (P45, L53, E2), and hemoglobin 12 g/dL. Patient sera was positive for dengue non-structural protein-1 antigen, anti-dengue immunoglobulin M (IgM), and anti-dengue immunoglobulin G (IgG) antibodies. Discussion: Here is a case report capable of changing our vision that acute gingival bleeding can also occur in dengue fever. Dengue fever can also be considered as one of the differential diagnosis for the acute gingival bleeding.

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Introduction: The aim of the present in vitro study was to evaluate and compare the antibacterial effect of pomegranate and aloe vera extracts on Streptococcus mutans. Materials and Methods: Hydroalcoholic extracts of pulp from both Punica granatum (pomegranate) and Aloe barbadensis miller (aloe vera) were prepared to concentrations of 5, 25, 50 and 100%. Pure sorbitol powder dissolved in distilled water was taken as the negative control. Streptococcus mutans (S mutans) was isolated from saliva by inoculation on to Mitus Salivarius Bacitracin (MSB) agar, which was then streaked onto agar plates containing Brain Heart Infusion. In each petridish, wells were prepared and using a sterile micropipette, 125μl of the specific concentration of the extract (pomegranate/ aloe vera/ sorbitol) was deposited in each well. This was done in triplicate for each concentration of the extracts. The effect of different concentrations of the extracts on S mutans was observed and the data was subjected to statistical analysis. Results: Pomegranate extract showed significantly higher inhibitory effect on S mutans at all concentrations (P≤0.05). On comparison of all three extracts at different concentrations, a significant difference (P≤0.05) was observed only at 50 and 100% concentrations. The inhibitory effect of pomegranate extract was significantly different when compared to aloe vera and sorbitol extracts. (P≤0.01). Discussion: Pomegranate extract has a significant antibacterial effect on S mutans at all concentrations.

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Introduction : Keloids are frequent finding after physical trauma. Keloids of ear lobe are common complication of ear piercing, although its incidence remains unknown. The use of intrakeloid resection and a form pressure device to treat pinna keloids. The recommendation of this therapy is to maintain constant pressure and duration of pressure therapy was about 25 weeks. Clinical innovation : This article will present inexpensive custom made pressure clips of various designs. The dimensions of polymethylmethacrylate (PMMA) plates in ear lobe clip presented by us though they esthetically not so good, but colored PMMA has been used to make it decorative and acceptable by most of the patients. This has been an encouraging experience to use the different designs. Discussion : Ear clip prosthesis has been developed for maintaining pressure on ear lobe keloids before and after surgical removal. The prosthesis includes an ear clip to which heat-polymerized acrylic resin is attached, which covers the keloid area. Pressure therapy is widely used to help in the early maturation of scar tissue and to prevent the recurrence of keloid. The preliminary report by Brent revealed that constant light pressure was an effective means of preventing post excision recurrence of ear lobe keloids using a decorative, spring-pressure earring.

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Aims: The purpose of this study was to introduce a nanosilver particle based endodontic irrigation solution and to evaluate its antimicrobial efficacy in comparison to 5.25% NaOCl. Materials and Methods: In an in vitro experiment the effect of the new irrigant against Enterococcus faecalis (ATCC: 29212) and Staphylococcus aureus (ATCC 25923), two most commonly isolated species of root canal space, was studied in different time intervals of 3, 5 and 15 minutes. Results: No growth of E. faecalis and S. aureus was observed in any of irrigant groups and any of different time intervals. Conclusion: These results indicate that the new irrigant is as effective as NaOCl in preventing the bacterial growth of common root canal bacteria.

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Immediate partial denture is a choice of treatment due to various cases of teeth extraction such as badly carious teeth, periodontal disease, eruption problems, trauma, and other reasons. Many choices are used to replace the lost teeth; one of these choices is a removable plastic denture in which hot cured acrylic resin should be used to fabricate such denture. Aim of Study: To provide an applicable technique to fabricate an immediate partial denture by reducing and declining the prosthetic steps and some materials in proportional to the conventional method. Clinical Procedures: Maxillary and mandibular stone casts are mounted to a simple articulator and the procedures are explained as step by step to fabricate an immediate partial denture without using the conventional methods and material, just using a small quantity of white cold cure acrylic resin to fabricate the artificial teeth, hot cure acrylic resin for the denture base and mold made of a silicon impression material are used to fabricate an immediate partial denture. Conclusion: The finished immediate partial denture showed a good retention and produced the exact shapes and sizes of the extracted teeth with low cost and less time for a dentist and patient.

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Introduction: Tooth wear - attrition, abrasion, or erosion - are modern day problems for dentistry. It usually leads to discomfort and sensitivity especially during eating, drinking, or tooth brushing. If left untreated for a long time, it may lead to loss of vitality of tooth. Various qualitative and quantitative methods have been used in the past to describe tooth wear. However, each method has certain shortfalls. There is no ideal index that is simple and clear in its scoring criteria. The Hypothesis: The classifications described in the literature are very descriptive and hence, it takes a long time to grade for a complete dentition. Some are based on the morphologic appearance and others on severity. A classification system has to facilitate standardized identification of a condition and help in diagnosis and treatment planning. The present manuscript is an attempt to emphasize the need to develop a classification system that is easy to score and describes the condition in details without utilizing much time. Evaluation of the Hypothesis: The hypothesis highlights some drawbacks of the classification systems available today and puts forth a new and easy to use classification system.

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Salvia officinalis is a medicinal herb used as an cosmetic, flavoring agent, It has antibacterial, antifungal, anticaries, antiplaque, antiviral, astringent, and other useful properties, it is also used in dental practice for the management of periodontal disease and to prevent halitosis. The objective of this article is to highlight various uses of S. officinalis in the dental field along with its use in medical problems.

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Introduction: Pleomorphic adenoma (PA) is the most common benign neoplasm of the major salivary glands arising primarily from the parotid gland. Computed tomography (CT) is one of the primary imaging modalities used to assess the tumors of salivary glands. However, magnetic resonance imaging (MRI) may provide additional information over CT. Case Report: We report the case of a 60-year-old male with a slowly enlarging, well-defined, round, painless, non-fixated, rubber-like swelling over the left ramus region below the ear, measuring about 4 × 4.5 cm, covering the lower border of the mandible near the angle. A provisional diagnosis of PA was given and CT and MRI were used to study the lesion. Discussion: Through this case, which was suspected to have undergone malignant transformation because of indistinct margins and focal hypodense areas on CT but was later confirmed to be a benign salivary gland tumor on MRI, we illustrate the role of CT and MRI as diagnostic aids in PA and emphasize on what should be the choice of imaging modality for parotid tumors.

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Introduction: Oil pulling is an ancient, traditional folk remedy that has been practiced for centuries in India and southern Asia as a holistic Ayurvedic technique. The practice of oil pulling involves placing a tablespoon of an edible oil (e.g. sesame, olive, sunflower, coconut) inside the mouth, and swishing or “pulling” the oil through the teeth and oral cavity for anywhere from 1–5 minutes to up to 20 minutes or longer. Materials and Methods: Articles related to oil pulling were collected by using oil pulling as Keyword in Google and Medline. Out of the 21 related articles published till 2016, 6 articles with the proper study designs were used for analysis. Results: The studies were unreliable for many reasons, including the misinterpretation of results due to small sample size and improper study design. Conclusion: Though the promoters claim it as one of the best method to be as adjuvant to mechanical control methods, scientific evidences are lacking.

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Introduction: Salivary mucocele is a common benign lesion of the oral cavity, usually presented as a single bluish lesion caused by trauma to the minor salivary gland ducts. We aimed to describe a new combination therapy (micromarsupialization plus intralesional corticosteroid injection) to treat a large mucocele on the lower lip. Case Report: We administered three intralesional dexamethasone (8 mg/2 ml) shots along with standard silk sutures in one-week intervals on a large labial mucocele (primary size: 3.5 cm Χ 1.5 cm) of a 26-year-old man over a three-week duration. Complete healing was obtained three weeks after treatment. A six-month follow-up revealed no signs of recurrence or complications. Discussion: Combination of intralesional dexamethasone and micromarsupialization leads to complete healing of a large lower lip mucocele, and can be considered as an alternative therapeutic method to conventional surgery.

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Introduction: The management and long-term retention of molars exhibiting furcation invasion have always been a challenge in dentistry. Latest innovations in dental sciences and higher patient's expectations have led to more conservative treatment approaches in saving the teeth with hopeless periodontal prognosis. When periodontal disease affects the furcation area of tooth, the chance of its exfoliation increase considerably. Here, authors have sought to discuss a comprehensive review of literature with case report for the management of decayed mandibular first molars (with furcation invasion) using bicuspidization procedure. Case Report: The furcation defect (in mandibular first molars) was clinically detected in a middle aged male, which was converted into two bicuspids by intentional bisection procedures. The definitive treatment included restoration with double crowns. Bicuspidization procedure with double metal crowns truly yielded a satisfactory result. Discussion: The treatment of furcations affected by periodontal disease is one of the most difficult problems for the general dentist and periodontist. An increase in the exposed root surface, anatomical peculiarities and irregularities of the furcation surface all favor the growth of bacteria. These problems make it harder for the patient to maintain hygiene, and impede adequate treatment. Bisection/bicuspidization of the decayed molars can be a practicable treatment option when there is vertical bone loss involving root/roots with furcation defect. In real terms, it is the separation of mesial and distal roots of mandibular molars along with its crown portion, where both segments are then retained individually.

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