Dental implants in the past were mainly restricted to completely edentulous patients and to a certain extent in the distal extension situations. In the present scenario with a dramatic increase in the survival rates of the dental implants and their widespread acceptance by the patients, they are often being used in partially edentulous conditions and as well as single tooth replacements. However, longevity of the restoration, both functionally as well as esthetically depends on various factors prevailing in the clinical situation. One such factor of immense importance is the selection of connection between the implant abutment and the final prosthesis. This connection can be screw-retained or cement-retained depending on the clinical situation of the particular case. Although, screw-retained restorations have been successfully used since many years, there has been a shift in paradigm toward cement-retained restorations. This article reviews the various complications associated with screw-retained restorations and subsequently analyzes the various factors associated with the selection of the attachment mechanism in implant dentistry. Clinical Relevance To Interdisciplinary Dentistry

• The article involves various disciplines of dentistry, particularly Prosthodontics, Periodontics, Oral Surgery and Dental Materials. As specified, in this literature, selection of connection system between implant and the prosthesis plays a significant role in reducing the prevalence of various periodontal (Peri-implantitis, bone loss), prosthetic (screw loosening or fractured prosthesis) and surgical complications associated with implant supported prosthesis. Thus, a thorough knowledge of this aspect, significantly increases the success rate of implant supported prosthesis in partially and completely edentulous patients.

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Overfilled gutta-percha (GP) can lead to failure of root canal treatment. Management of overfilled GP may require periradicular surgery with root end procedures. However, these procedures have drawbacks, particularly in a young patient. This article describes a case of periradicular cyst due to overfilled GP managed by periradicular surgery. Root capping at the apex was carried out with mineral trioxide aggregate (MTA) instead of root end procedures. MTA root capping promoted apical build up, sealing and periapical healing. Clinical Relevance To Interdisciplinary Dentistry

1. The article describes a technique called "root capping" that can be carried out during periradicular surgery instead of root end procedures in a young patient.
2. This technique is of clinical importance due to challenges encountered during endodontic treatment in permanent teeth of young patients such as thin dentinal walls.
3. The need for periradicular surgery in the management of periapical lesions due to overfilled gutta-percha is emphasized.

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Origin of light amplification for stimulated emission of radiation (LASER) had its roots way back in 1960 when Maiman invented the first hand held ruby laser. LASER is the common acronym used for LASER. Current scientific review has touched various aspects like the historical landmarks, luminaries behind several landmarks in the invention of lasers in a chronological order, hard tissue lasers along with dental operating microscope and magnification have made practice of restorative and microsurgery facile and due to its versatility have found numerous applications extending to almost all spheres of restorative dentistry and minor oral surgery. Owing to its profound advantages such as reduced anxiety to drill phobic patients, excellent predictability, and uneventful postoperative healing have urged modern dental surgeons to embrace laser technology aggressively. This review addresses hard tissue laser physics, protocols and parameters and clinical applications and tips. Clinical Relevance To Interdisciplinary Dentistry

• Erbium lasers have increased affinity for basic chromphores like water and hydroxyapatite crystals. This affinity makes these lasers suitable for various restorative clinical procedures involving both hard and soft tissues. They are a valuable adjunct in:
• Tooth preparation for restorative procedure, etching of enamel, relative analgesia, disinfection of root canal lumen and they can also effectively disinfect enamel up to 300-400 μm
• Periodontal surgical procedures such as gingivectomy, gingivoplasty, frenotomy, osseous recountouring and removal of subgingival calculus
• Crown lengthening, tooth preparation, implant osteotomy, recovery of implants, effective disinfection of perimplantitis, creating positive bony architecture etc.

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Appropriate application of principles of smile designing for any restorative work can drastically improve the esthetics of the patients. This case report describes the treatment for the hypoplastic teeth with generalized wear out facets using digital smile designing (DSD) technique rather the conventional approach. Much Literature is available on conventional smile designing, but discussion on DSD is sparse. The treatment plan included DSD and measurements using digital ruler, diagnostic wax-up and fabrication of crowns. DSD is a promising treatment option for good esthetic outcomes. Clinical Relevance To Interdisciplinary Dentistry

• Aesthetic value and Functional efficiency to be provided in any restorative dentistry case, can be diagnosed and assed in advance by using digital gadgets.
• How far can we integrate such protocol like DSD-Digital Smile Designing in our routine practice-a case demonstration?

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Owing to anatomic considerations, implants could be inadvertently placed in less than ideal positions. These misaligned Implants in partially edentulous arches can be difficult to restore with conventional abutments and may necessitate implant removal in severe angulations. We present a case restored with a UCLA abutment due to buccal angulation of implant fixture in the posterior mandible and emphasize the need for adequate running room in such cases. Clinical Relevance To Interdisciplinary Dentistry

• UCLA abutments offer a way of the prosthetic correction of inadvertent surgical placement of dental implants.
• Provision of adequate running room by the surgeon at the time of placement makes prosthetic rehabilitation easier.
• Adequate running room also decreases the periodontal procedures that might be required.

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Cone-beam computed tomography (CBCT) has been specifically designed to produce undistorted three-dimensional information of the maxillofacial skeleton, including the teeth and their surrounding tissues with a significantly lower effective radiation dose compared with conventional computed tomography. The revolutionary introduction of CBCT in all fields of dentistry is unprecedented as it has created a true paradigm shift from a conventional two-dimensional approach to a three-dimensional understanding. In doing so it has expanded the role of imaging from its traditional one in diagnosis to image guidance of operative and surgical procedures. Clinical Relevance To Interdisciplinary Dentistry

• Detecting anatomical variants such as accessory neurovascular canals, bony undercuts, and local alterations in trabecular patterns, all of which influence implant treatment planning
• Identification of root canal system anomalies and determination of root curvature for successful endodontic practice
• Cone beam computed tomography, offers an opportunity to see inside the bone and pinpoint and measure densities in small localized areas such as a vertical periodontal defect or alveolar bone graft
• Three-dimensional and cross-sectional evaluation of the implant patient and it allows virtual implant placement that can guide the implantologist in terms of density and thickness of the alveolar bone.

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Aim: The purpose of this study is to evaluate the horizontal depth of prenetration of various irrigants into dentinal tubules using sodium hypochlorite, chlorhexidine and diode laser when used alone and in combination. Materials and Methods: 60 single rooted extracted human teeth were collected. Access cavity was prepared and the canals enlarged to file size 30 of 0.04 taper rotary instrument. After decoronation, vertical grooves extending from coronal to apical thirds were done on proximal surfaces of each tooth roots. Following which EDTA was used to remove the smear laryer from the root canal dentin and a turbid suspension of Enterococcus faecalis was inoculated in the root canals and incubated at 370C for 24 hours. The teeth were divided into 4 groups of 15 teeth each: Group Group I positive control, Group II diode laser irradiation, Group III 2.5% sodium hypochlorite and 0.2% chlorhexidine gluconate, Group IV 2.5% sodium hypochlorite and 0.2% chlorhexidine gluconate and diode laser irradiation. Irrigation of each group followed by the splitting the tooth into two halves were done within a lumina air flow chamber using chisel and a mallet. Prepared teeth samples from each group were then subjected to environmental scanning electron microscopy to the horizontal depth of penetration of various irrigation into dentinal tubules. Results: The horizontal depth of penetration of various irrigants were calculated in each group and statistical analysis done using Kruskal Wallis test for group comparison. The group where irrigation was done with 2.5% NaOCl, 0.2% chlorhexidine gluconate and irradiation with high power diode laser performed against Enterococcus faecalis showed the best results when compared with other groups. Conclusion: The horizontal depth of penetration was more when 2.5% NaOCl, 0.2% chlorhexidine gluconate in combination with 810nm diode laser was used.Hence this combination can be used for effective disinfection of the root canal system during chemomechanical preparation. Clinical Relevance To Interdisciplinary Dentistry

• Combination of NaOCl ,Chlorhexidine gluconate and Laser can be used for effective disinfection of the root canal system during chemomechanical preparation before we give a final restoration
• Prognosis of the root canal therapy will be better with prevention of reinfection with this combination of irrigant
• Prolonged action of this combination of irrigants with laser which penetrate deep into radicular dentinal tubules will maintain the sterility of root canal system.

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Teeth with immature root development, necrotic pulps, and apical periodontitis present multiple challenges for successful endodontic treatment. Regenerative endodontics is a contemporary approach to managing these problems. Successful regeneration depends on a race between the new tissue and bacteria populating the pulp space and on the ability of the patient to heal the dental pulp tissues. Importance of prevention of bacterial entry into the root canal and maintaining proper coronal seal should not be overemphasized. Evidence suggests that mineral trioxide aggregate (MTA) apexification may be more beneficial for severely injured teeth than a regenerative endodontic procedure. Fiber posts, in combination with composite resin or with accessory fiber posts, can be recommended alternative to cast post and core in flared roots, due to the lower risk of catastrophic failures and better stress distribution. It is the tactic of choice for reinforcing structurally weakened roots as the function, and the prognosis of the restored root is improved, compared with the use of one single, inadequately fitting post. This report is about a case with failed regeneration procedure and managed with MTA apexification and multiple fiber posts to enhance its fracture resistance of maxillary central incisor. Clinical Relevance To Interdisciplinary Dentistry

• Mineral trioxide aggregate apexification may be more beneficial for severely injured teeth than a regenerative endodontic procedure
• Large diameter posts contribute more favorably to the fracture resistance of the root postcore-crown system than small diameter posts
• Fiber posts, in combination with composite resin or with accessory fiber posts, can be recommended alternative to cast post and core in flared roots, because of the lower risk of catastrophic failures and better stress distribution.

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Objective: There are only a few case reports in the literature evaluating the effects of the diode laser on gingival melanin pigmentation. This study was performed to evaluate the efficacy of melanin depigmentation using a scalpel and diode lasers based on effective removal of gingival pigmentation, recurrence, and patient acceptability. Study Design: Gingival melanin pigmentation at the anterior maxillary or mandibular gingiva at 20 sites from 7 patients was included. Pigmented areas were measured on pre-and post-operative 1 and 6 months using Dummett Oral Pigmentation Index. This was a split mouth study where gingival depigmentation was carried out using a scalpel and diode laser. For one quadrant scalpel techniques were used and for other quadrant laser ablation was done. Results: Ablation of the hyperpigmented gingiva was accomplished with minimal carbonization and almost no bleeding. Postoperative healing was uneventful with no significant postoperative pain. Statistical analysis of the data revealed a significant difference between pre- and post-operative measurements of pigmented area. No significant changes in pigmentation were seen between 1 and 6 months follow-up with both the procedures. Conclusion: Application of diode laser appears to be an effective and safe method for the elimination of gingival melanin pigmentation. Clinical Relevance To Interdisciplinary Dentistry

• Esthetics plays an important role in treatment planning

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Esthetic dentistry is a combination of measurable dimensions and artistic sensitivity. Complete rehabilitation of smile of a patient with multiple esthetic challenges involves a multidisciplinary approach and presents a considerable clinical challenge. The interactions between new restorative materials and techniques allow the reproduction of dental structures, restoring form and function in such a way that restorative procedures become imperceptible. Porcelain laminate veneer has become one of the most predictable, most esthetic, and least invasive modalities of treatment. This case report describes a methodical procedure of successful esthetic rehabilitation of anterior hypoplastic teeth using a multidisciplinary approach recreating an esthetically and functionally acceptable dentition. Clinical Relevance To Interdisciplinary Dentistry

• Hypoplastic teeth present a serious challenge in esthetic dentistry due to reduced amount of enamel.
• Interdisciplinary approach results in the improvement of the esthetic and functional aspects as well as quality-of-life were observed.

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