The first and most basic objective of restorative dentistry is preservation of the tooth structure. However, for the long-term survival of restoration the periodontium must also remain healthy or vice versa. The connective tissue of the attachment apparatus consists of three-dimensionally oriented fibers connecting firmly the tooth structures to the surrounding gingiva. Both the epithelial as well as connective tissue attachment contribute to a 'protection mechanism' in a most challenging area where the natural tooth penetrates the ectodermal integrity of the body. The attainment of this objective would be far less complex if it could be considered independent of restoration of function, comfort and esthetics, but such is not the case. The latter objectives usually require sophisticated restorative dentistry as often such esthetic restorations require placement of intra-crevicular margins without compromising on the periodontal health.

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Removable partial dentures (RPDs) are an effective and affordable treatment option for partial edentulism. Restoration of esthetics is an important function of RPD and it determines the success of the treatment. The goal of achieving optimal esthetics - while maintaining retentive integrity, stability, and protecting the health of the tooth - is the most difficult task. The traditional use of the metal clasp like cobalt chromium (Co-Cr), gold, stainless steel, and titanium hampers esthetics, since its obvious display conflicts with patient's prosthetic confidentiality. Acetal resin (polyoxymethylene or POM), a thermoplastic resin, may be used as an alternative denture clasp material. This material was promoted primarily on the basis of superior esthetics, which allowed the clasps to better match the color of abutment tooth. PubMed and Google Scholar were used to search original research articles, case reports, and other reviews about acetal resin. The keywords used were acetal resin, esthetic, clasp, removable partial denture, thermoplastic, metal free framework. This article is the result of a literature study on acetal resin clasp material for conventional RPD.

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Antiplatelet therapy is commonly recommended for the prevention of the thromboembolic events, including the myocardial infarction and stroke. It has reduced the mortality and morbidity of cardiovascular diseases remarkably. A considerable number of patients presenting before a dentist give a history of antiplatelet therapy. A clinical dilemma exists whether to discontinue the antiplatelet therapy or to continue during the routine and invasive dental procedures. Continuing antiplatelet therapy during surgery minimizes the risk of thromboembolic complications but theoretically increases the risk of hemorrhage. Discontinuing antiplatelet therapy may expose patients to life-threatening thromboembolic events, while presumably reducing the risk of hemorrhagic complications. Diverse opinions exist regarding the management of such patients. Some advice continuation of the antiplatelet therapy rather than inviting possible thromboembolic event, while others encourages its discontinuation.

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The success of fixed partial dentures and crowns depends to a great extent on the prevention of infringement of the biological width. This case report discusses a crown-lengthening procedure that permits successful placement of prosthesis with good prognosis, by preservation of the biologic width. This article also reviews the various aspects of crown lengthening, highlighting the importance of comprehensive treatment planning with an interdisciplinary approach.

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Correction of class II deep bite can be achieved by orthodontic treatment alone or by combination of orthodontics and orthognathic surgery. Orthognathic surgery is indicated when dental discrepancy cannot be corrected by the use of orthodontic mechanotherapy alone or when facial aesthetics are compromised. The purpose of this paper is to describe a technique of subapical osteotomy performed along with periodontal therapy, to correct the anterior traumatic deep bite, thus salvaging the mutilated teeth and achieving facial aesthetics.

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Radicular grooves are developmental anomalies of maxillary incisors, which contribute to localized periodontitis resulting in loss of anterior teeth. Radicular grooves, when present, act as a site for plaque accumulation and causes periodontal destruction. The clinician has to be check for variations in the anomalies of the tooth and treat them. This case report of describes the diagnosis and management of bilateral radical groove maxillary central incisors.

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Purpose: To evaluate fluid absorbancy of retraction cords of different thickness after various medicament immersions. Materials and Methods: Ultrapak retraction cords of three different thicknesses (No. 000, 00, 0) with identical lengths (25 mm) were used. They were immersed in two different medicaments (25% aluminum chloride and saturated alum) for 20 min. Two different immersion fluids (artificial saliva and human plasma) were compared for fluid absorbancy. The capability of the cords to absorb fluids was measured by a gravimetric method. The data were analyzed by F test analysis and P<.05 was regarded as significant. Results: Regardless of the medicament used and immersion fluid, a relationship existed between cord thickness and the amount of fluid absorbed. There was a significant difference in the fluid absorbancy of all the three groups (P<0.01). A significant difference was also observed in the fluid absorbancy of saliva and plasma (P<0.05). Conclusion: The results of this study indicated that fluid absorbancy increased in linear proportion to the increase in thickness of the retraction cord. Ultrapak (#0) when treated with alum showed most favorable results. All the cords absorbed artificial saliva more than plasma irrespective of cord thickness and medicament used.

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The loss of anterior teeth is often a serious esthetic concern. Conventional fixed partial denture and implant-supported restorations may be the treatment of choice although non-impregnated fibers and fiber reinforced composite resins offer a conservative alternative for improved esthetics. This article describes a clinical situation in which non-impregnated fiber glass ribbon and fiber reinforced composite are successfully used to provisionally restore anterior edentulous area in an esthetic, functional and timely manner.

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Aim: To assess the occurrence of apical transportation of mesio-vestibular canals of mandibular molars using two rotary techniques and one hybrid technique during shaping and cleaning. Materials and Methods: Forty-five human mandibular molars with a degree of mesial canal/root curvature of 20° to 55° were selected, which were included in acrylic resin blocks and randomly separated into three groups. Group 1-Fifteen teeth were debrided using the ProTaper rotary technique; Group 2-Fifteen teeth were debrided using the Manual Hybrid and ProTaper rotary technique; Group 3-Fifteen teeth were debrided using the PathFile-ProTaper technique. Apical deviation was assessed by the radiographic platform method that enables obtaining superimposed images of the first and last instrument used in root canal preparation in the same radiograph. Apical transportation was measured in millimeters with the aid of the Adobe Photoshop CS4 software. Results: The mean deviation for Group 1 was 0.03 mm, for Group 2, 0.1 mm and for Group 3, 0.08 mm. Statistical analysis (Kruskal-Wallis test) of the results demonstrated that there was no statistically significant difference among the samples (P>0.05) with regard to the apical deviation. Conclusion: The techniques provided minimum apical deviation.

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Recent advances in all ceramic restorative materials have made it possible to restore a patient with high esthetics and comfort. This article brings about the case report in which a young male patient lost his maxillary anterior teeth in a road side accident; and, because of combined efforts of endodontics, periodontics and prosthodontics' departments, the patient's dentition was restored achieving high levels of esthetics and comfort.

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Many developmental or pathological anomalies can occur within the periodontium which may affect the attachment levels on the tooth structure. These anomalies may lead to or predispose the tooth to periodontitis or may affect the outcome of treatment provided to them. A case is reported of a 28-year-old male with attachment loss, recession and furcation involvement in a nonvital tooth, associated with a root stump concrescence, mimicking a cemental growth.

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Background and Objective: Keeping marginal gingiva healthy is possible with some cellular processes. Activator Protein-1 (AP-1) members Fos and Jun proteins regulate cellular processes including growth, proliferation, differentiation and apoptosis. The aim of this study was to compare of immunoreactivity (IR) of some same or different family member AP-1 proteins in cells forming marginal gingival mucosa. Materials and Methods: IR of Fos family members c-Fos (c-Fos-IR) and Fra-2 (Fra-2-IR) and Jun family member c-Jun (c-Jun-IR) were analysed in epithelial cells (ECs) and lamina propria cells (LPCs) of healthy human marginal gingiva by immunohistochemical method. Results: Both in ECs and LPCs, c-Fos-IR positivity was found higher than the others and Fra-2-IR positivity was found lower. The most postivity was observed in c-Fos-IR in ECs and the least IR was observed in Fra-2-IR in LPCs. Furthermore, the IR positivity percentage of all proteins was found higher in ECs than in LPCs. In the comparision of each of c-Fos-IR, c-Jun-IR and Fra-2-IR in ECs and LPCs, no statistically significant difference in c-Jun-IR was observed; however, there were statistically significant differences in c-Fos-IR and Fra-2-IR. Conclusions: According to these findings, it can be proposed that c-Fos protein in healthy gingiva is more related with physiological processes than other proteins. In this study, establishing a statistically significant difference between c-Fos-IR and Fra-2-IR in both ECs and LPCs has shown that as well as these proteins are within the same family, each one may be related with different cellular processes.

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