This case report presents clenching as one of the etiological factors in the causation of multiple acute periodontal abscesses. Acute inflammatory periodontal diseases often present diagnostic problems for the clinician. These are not numerous, but cannot be glossed over. Acute periodontal abscess is one such condition which requires timely intervention and management. The development of the acute exacerbation occurs from an alteration in the tissues immediately adjacent to the affected teeth. Occlusion of the orifice of the periodontal pocket, diabetes, and clenching or bruxism are factors that can cause such an alteration. Here, we report a rare case of multiple acute periodontal abscesses due to clenching in an adult male. A 19-year-old male patient reported to the Department of Periodontics, College of Dental Sciences, Davangere, Karnataka, India, with pain and swelling of left cheek and left lower back teeth region of 2 days duration associated with difficulty in mouth opening. Detailed history revealed forceful clenching of teeth during his sleep. He appeared toxic and febrile. There was a diffuse, tender extraoral swelling in the left cheek. The patient had trismus and intraoral examination revealed multiple periodontal abscesses from 34 to 37. The drainage of the abscesses was obtained through the pocket orifice. The root surface was thoroughly planed to remove the deposits and to enhance further drainage. Subgingival irrigation with 0.1% povidone iodine was done and systemic antibiotics were prescribed. The patient was explained regarding the cause of the disease and motivated to stop clenching again. Subgingival irrigation with povidone iodine was continued for the next 3 days and the area curetted after 1 week to prevent recurrence. The healing was uneventful. Clenching of teeth can be one of the etiological factors for the causation of multiple acute periodontal abscesses which can be managed with proper and timely intervention of periodontal therapy.

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The usual pulpal diagnostic instruments have been shown to be unreliable in diagnosing the pulpal status of the teeth following a traumatic injury, especially for teeth with immature root formation and open apex. Compounding the problem with these testing methods is that they all are very subjective, dependant on cooperation and understanding of the situation by the patient, which can lead to a further difficulty in cases involving young children. It is important to note that the usual pulp vitality tests provide information only about the presence or absence of nerve receptors in the pulp and not about the pulpal blood supply. Recent efforts for assessing pulpal circulation have involved the use of laser Doppler flowmetry and pulse oximetry. Though both methods are in their infancy and are not yet ready for general clinical applications, but hopefully before long, these technologies will become part of dentists' diagnostic armamentaria. The PubMed database search revealed that the reference list for Pulse Oximetry featured 2196 articles; in dentistry-121 articles and for Laser Doppler Flowmetry-932 articles and in dentistry-18 articles. A forward search was undertaken on selected articles, author names, and contemporary endodontic texts. A review is presented on the key developments in the arena of these pulp-tests to familiarize the modern dentists with the new advances in endodontic diagnosis.

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The misuse of various chemicals in dentistry may cause damage to gingiva and alveolar bone. In this case report, we describe necrosis of the gingiva and alveolar bone caused by pulp devitalizer. A paraformaldehyde preparation was applied to an inflamed and symptomatic pulp of the maxillary left first molar (tooth #26), in a 20-year-old male. Spillage of the product was responsible for marked necrosis of the gingiva and the alveolar cortical bone, which resulted in great loss of the supporting bone. Surgical intervention was required wherein the necrosed bone was removed and the bone defect was filled with bone graft. The flap was coronally repositioned and sutured securely. After the treatment, the patient's complaints had resolved. Extreme care must be exercised while delivering of such products during treatment.

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The success of a complete denture relies on the principles of retention, stability and support. The prosthodontist's skill lies in applying these principles efficiently in critical situations. Severely resorbed maxillary edentulous ridges that are narrow and constricted with increased inter ridge space provide decreased support, retention and stability. The consequent weight of the processed denture only compromises them further. This article describes a case report of an edentulous patient with resorbed ridges where a simplified technique of fabricating a light weight maxillary complete denture was used for preservation of denture bearing areas.

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The interdisciplinary treatment is becoming an ever-increasing part of modern-day orthodontic practice. Subgingivally fractured incisors pose a true therapeutic dilemma to the dental team. Attempts to expose the fracture line by alveolar re-contouring and periodontal procedures may compromise the functional root length and esthetics. Placing the margin of the restoration in the biologic width frequently leads to chronic gingivitis, the loss of clinical attachment, pockets and gingival recessions. Controlled orthodontic extrusion is considered as the easiest orthodontic tooth movement to expose the fracture line, which can produce excellent results with a good prognosis and a low risk of relapse. This case report describes in detail the chosen treatment for subgingivally fractured permanent incisors and is followed by a discussion of the considerations involved in the choice of treatment.

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Porcelain is known to be the most aesthetic material for dental restorations. Dental porcelains have had to be reinforced with metal substructures in the past due to their unpredictable strength. However, clinicians have often faced an aesthetic challenge when restoring anterior teeth with porcelain-fused to metal restorations. A demand for a more aesthetic alternative has led to the evolution of metal-free restorations. This article discusses the various metal-free ceramic systems available, their applications, including their margin configurations and cementation protocols and specific indications and advantages of each system. Clinical evidence and experimental studies have been reviewed to provide an evidence-based application of these materials in different situations.

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The use of dental implants to support either fixed crowns and bridges or removable dentures has made it possible for many patients to experience an artificial dentition that is as esthetic and functional as their natural teeth were. Dental implant treatment has evolved over the years. Progress in implantology has been focused at increasing patient's comfort by reducing the treatment time and achieving esthetic and functional rehabilitation as early as possible. Although this has been achieved to a large extent by the use of immediate loading concepts, the same cannot be applied to all clinical situations. There are still many clinical situations wherein the patient would have to go through a waiting period after a surgical procedure (it could be the surgery to place a dental implant or bone grafting surgery, or even extraction of some teeth). During such a waiting period, the patient needs to function on a fixed temporary restoration till the final restoration can be placed. This has been made possible today by the advent of transitional implants which have been designed for and are placed along with the conventional implants for the replacement of the patient's missing dentition and enabling the patient to experience the benefits of implantology immediately. This paper presents an overview of transitional implants and its clinical application.

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This case report describes the treatment of two pulpless immature maxillary central incisors. Conventional apexification techniques were not used. A regenerative technique based on literature to achieve revascularization was followed. This treatment approach involves disinfection of the canal space with topical antibiotics followed by blood clot induction from the periapical tissues. At the one year follow-up, significant root growth was achieved.

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Dental literature supports the concept that vertical dimension of occlusion is normally not lost in severely worn dentition, and the bite should generally not be opened to facilitate dental reconstruction. Many of us think that an excessive worn dentition results in loss of vertical dimension of occlusion, and that this loss should be regained during reconstruction. However, restoration of a periodontally sound but severely worn dentition, at existing vertical dimension, frequently presents unique challenges in patient management, diagnosis, treatment planning, and restorative methodology. This report reviews and demonstrates a planned approach to this complex treatment situation that can lead to a favourable and predictable prognosis i.e. restoration of a functional occlusion and esthetics along with endodontic treatment, at existing vertical dimension of occlusion.

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The challenging concept of "reconstructive esthetic implant dentistry," and its prime goal of achieving a functional and esthetically pleasing rehabilitation of the mouth, has finally reached where the nature could be mimicked. Commonly confronted issues of insufficient bone volume and thread exposure warrant bone augmentative procedures. Bone reconstruction should restore bone volume in both horizontal and vertical directions. Besides autogenous grafts being the golden standard of augmentation, various bone substitutes have been used with promising results. The main rationale in guided bone regeneration (GBR) techniques is the creation of space for matrix producing cells if significant volumes of bone are to be achieved. This case report highlights the technique of using allograft and alloderm on the principles of GBR technique with satisfactory clinical results.

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Aims : To evaluate the effect of two fibers (polyethylene or glass) and a flowable resin liner on microleakage in Class II adhesive restorations. Materials and Methods : Class II cavities were prepared on mesial and distal surfaces of 40 extracted sound human molars. The cavity margins were below the CEJ on one side and above the CEJ on the other. The teeth were randomly divided into four groups according to the restoration technique: group 1: restored with a resin composite in bulk after SE Bond application; group 2: flowable resin liner was used before composite restoration; group 3: polyethylene fibre and in group 4: glass fiber was placed into the bed of flowable resin before composite restoration. Samples were finished, stored in distilled water and then thermocycled. Apices were sealed and tooth surfaces were coated with nail polish within 1 mm of the margins and placed in basic fuschin dye for 24 h at 37ºC. Teeth were rinsed and sectioned longitudinally through the restorations. Microleakage was evaluated and scored. Statistical Analysis Used : Kruskal-Wallis, Mann-Whitney U-test. Results : Flowable resin, everStick NET, and Ribbond THM used in combination with flowable resin significantly reduced leakage at occlusal enamel margins (P<0.05). Conclusions : Use of flowable composite alone or in combination with polyethylene or glass fibers reduces occlusal leakage in Class II adhesive cavities with enamel margins.

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Implant dentistry is the fastest evolving field in dentistry. The ability to treat a wide range of tissueswith a laser has been a fact of life for a long time. What is new, are the potential applications (new indications) and the refinement of techniques. A case series has been presented with laser being used for tissue management in various implant systems.

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