Aim: Evaluation of the prevalence and distribution of bone defects associated with chronic periodontitis using cone-beam computed tomography (CBCT). Materials and Methods: CBCT of 100 patients diagnosed with generalized chronic periodontitis was evaluated for the prevalence and distribution of bone defects based on age groups (<30, 31–39, 40–49, and >50 years), jaw segments, and gender. Results: The prevalence and distribution of bone defects associated with different age groups, jaw segments, and gender was evaluated. Out of 2484 teeth which were examined, 2064 teeth were having bone defect; therefore, the prevalence of bone defects was 83.1%. The degree of bone loss was 57.8% in males and 42.2% in females. Severity of bone defects increases with age. The study showed that bone defects were more in maxillary arch than mandibular and more in posterior segments than the anterior segments. Conclusion: CBCT can assess early detection of periodontal disease, thereby applying all primary preventive measures for periodontal disease. It gives a clear understanding of the morphology of alveolar bone loss in chronic periodontitis patients which helps design appropriate regenerative periodontal therapy, thereby preventing tooth mobility and tooth loss. Clinical Relevance to Interdisciplinary Dentistry It is necessary to study the prevalence and distributions of different bone defects by localization as variation in the occurrences of defects is present in the same mouth. It may also provide the clues in determining the pathology behind the particular pattern of occurrences of defects in different segments. according to literatue, as CBCT is accurate as clinical measurement, it can be used for evaluating prevalence and distribution of bone defects

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The absence of teeth most often has a significant impact on the function, esthetics, and thus the psychological condition of the patients. Residual ridge resorption is most common in mandibular anterior region which poses a challenging task to the restoring dentist. Several factors should be taken into consideration before diagnosing and formulating a treatment plan. Andrew's bridge is a fixed, removable partial denture which is mostly indicated in cases where the abutment teeth are capable of supporting a fixed partial denture but the residual ridge defect in the edentulous area where a conventional fixed partial denture may not adequately restore the patient's missing teeth and the supporting structures. The purpose of this article is to describe the management of a Siebert Class III residual ridge defect with a modified Andrew's bridge using a bar attachment and a cast metal removable partial denture. Clinical Relevance to Interdisciplinary Dentistry Siebert Class III condition is most prevalent and most difficult to restore as there is severe ridge defect both vertically and horizontally. Andrew's bridge with an interdisciplinary approach results in the improvement of the aesthetic and functional aspects as well as quality-of-life of the patient.

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Background and Objective: Since their invention in 1970, glass-ionomer cements (GICs) have been widely used in pediatric dentistry. They have undergone many modifications in composition till the recent nano cement which claims to have superior properties compared to their primal versions. One of the important requisites of restorative material is adhesion to the tooth structure, failure of which leads to microleakage. Hence, the main objective of this study was to compare the microleakage of three variables (Ketac Molar, Ketac Silver, Ketac N100) of GIC in primary and permanent posterior teeth. Materials and Methods: Class I occlusal cavities were prepared on 60 extracted, noncarious primary molars and premolars. Each set of dentition (primary and permanent teeth) was divided into three groups of 10 specimens each to restore with the selected restorative material - Group A (Ketac Molar), Group B (Ketac Silver), and Group C (Ketac N100). These teeth were subjected to thermocycling, dye immersion, sectioning, and examination was done under a stereomicroscope to assess the degree of microleakage. The scoring was done according to the scoring criteria put forward by Khera and Chan, which were further tabulated and statistically analyzed. Results: There was no significant difference in microleakage between primary and permanent teeth in all the three groups. In both primary and permanent teeth, Group B showed significantly higher dye penetration scores followed by Groups A and C. Conclusion: The nano-filled resin-modified GIC (Ketac N100) proved to be the better restorative material than the other cements used in the study. Clinical Relevance To Interdisciplinary Dentistry Microleakage is the most common cause of failure for all restorative materials, since it is a major contributing factor to secondary caries and early pulpal involvement. Consequently, an interest arises in finding a restorative material which has better bonding with the dental tissues thereby minimizing the chances of microleakage. Nano-filled RMGIC is found to be a good restorative material in maintaining the longevity of the restoration both in primary and permanent dentition.

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Background: The purpose of the present study was to identify the existence of gingival biotypes in a sample of periodontally healthy volunteers and correlate the prevalence of different gingival biotypes of upper anteriors, in accordance with age, gender. Methodology: 145 subjects (79 males and 66 females) with age groups of 20-35 years, 36-50 years were included in this study.Probe transparency method was adopted to assess the biotype at the midfacial aspect of the maxillary incisors and the canines bilaterally. Results: The association of age and gingival biotype was not significant .Study showed that thick biotype decreased with advancing age.The association of sex and gingival biotype was not significant in relation to 11,12,21and 22 but significant in relation to 13 and 23. Among the female subjects, the prevalence of thick biotype in relation to 11, 12, 21and 22 was less than males, whereas in relation to 13 and 23 the prevalence of thick biotype was high in females. Conclusion: These findings can be utilized for determining the gingival biotype and response of gingiva to dental operative procedures. Clinical Relevance to Interdisciplinary Dentistry Gingival biotype can affect the results of periodontal therapy, root coverage procedures, and implant placement. Thus it becomes necessary for a clinician to know the gingival biotype and carry out the treatment procedures.

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Background: The physiologic dentogingival unit (DGU), also known as the biologic width, is considered to be essential for longevity of the teeth as well as of restorations. Although the clinical relevance of determining the dimensions of DGU is obvious, there is no description in the literature of any simple, standardized, and noninvasive technique for the measurement of DGU in humans. Aim: This study was undertaken to evaluate an innovative radiographic exploration technique (parallel profile radiography [PPRx]) for measuring the dimensions of the DGU on the labial surfaces of maxillary anterior teeth and to provide additional information on the dimensions of the DGU in humans. Methodology: In this study, two radiographs were made in fifty periodontally healthy volunteers, one in frontal projection, while the second radiograph was a PPRx obtained from a lateral position. The dimensions of the DGU were measured radiographically over these images. All data analyses were performed using SPSS 14.0. Results: PPRx was a highly reproducible exploratory technique. Mean dentogingival measurements on the labial surface of right maxillary central incisor were 1.76 ± 0.87 mm for cementoenamel junction (CEJ)-bone crest distance, 1.39 ± 0.50 for gingival sulcus depth, 1.56 ± 0.28 mm for thickness of connective tissue attachment at CEJ, 1.09 ± 0.28 mm for thickness of free gingiva at its base, 1.95 ± 0.43 mm for biologic width, 0.47 ± 0.22 mm for thickness of bone plate at crest level, and 1.76 ± 0.67 mm for gingival overlap on enamel surface. A statistically significant relationship was observed between gingival width and gingival sulcus depth (P = 0.06). These results suggest that the dimensions of DGU are highly variable in humans. Conclusions: We conclude that the dimensions of the DGU in humans can be measured with the PPRx technique, and this technique offers a simple, concise, noninvasive, inexpensive, and reproducible method that can be used in the clinical setup to measure both the length and thickness of the DGU with accuracy. Clinical Relevance to Interdisciplinary Dentistry The dimensions and relationships of the structures of the DGU are essential aspects in many fields of dentistry, and our study strengthen the view that parallel profile radiography can be used as a noninvasive and reliable procedure for measuring the dimensions of the DGU.

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Coronal tooth fractures are most common in anterior teeth, especially in maxillary teeth due to their anatomical position. They create serious esthetic and psychological problems for the patient. Esthetical rehabilitation of fractured anterior teeth is one of the greatest challenges to a dentist. Traditionally, such traumatized teeth are restored with composite resins, but the main disadvantage is variable wear and color mismatch. Reattachment of fractured fragments provides faster natural esthetics, positive psychological response, economical and is the relatively simple procedure. In the recent years, number of techniques and materials are evolved for reattaching the fractured fragments such as flowable composites, dual cure resin cements, fiber posts with self-etch adhesive cement. In this review and case series, different approaches for re-bonding the permanent incisors have been described. All the advantages are mentioned in the literature are summarized to provide a good clinical approach for this innovative procedure. Clinical Relevance to Interdisciplinary Dentistry Reattaching the fractured tooth fragments gives a viable conservative option for the clinician because it restores tooth function and esthetics with the use of a very conservative and cost-effective approach.

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Objective: The aim of this study was to determine the pattern of periodontal diagnosis among the older adult periodontal patients seen in a tertiary health facility in Nigeria, based on their demographic factors and level of risk of periodontal disease. Materials and Methods: The clinical records of all the patients aged ≥65 years, treated at the Periodontology Clinic between 2009 and 2012, were used for this retrospective study. The information retrieved from their clinical notes includes their medical history, history of smoking, and alcohol consumption and other demographic data such as age, sex, and socioeconomic class of the participants. Results: More than one periodontal diagnosis was made in 88.8% of the studied elderly, signifying the involvement of multiple sites. All the various diagnoses recorded in this study were more common among the males, i.e., chronic marginal gingivitis (56.6%), chronic periodontitis (54.7%), tooth wear lesions (59.0%), periodontal abscess (56.3%), and gingival enlargement (60%) (P > 0.05). Majority (59.7%) who had chronic periodontitis belong to the lowest socioeconomic class (P > 0.05). Majority (83.3%) who had a high risk of developing periodontal disease were males (P = 0.005). All the older patients with high risk of developing periodontal disease had multiple diagnoses (P > 0.05). Conclusion: It can be concluded that the pattern of periodontal conditions seen in the studied older adults is similar to what has been previously reported and that demographic factors and level of risk of periodontal diseases may influence the pattern of diagnosis. Clinical Relevance to Interdisciplinary Dentistry

• The older persons present with a variety of periodontal diseases
• Periodontologists and specialists in the area of geriatric dentistry should comanage older person to address all the factors that may militate against optimal plaque control
• Specialists in the area of preventive dentistry should pay special attention to oral health education and promotion among older persons with low economic status and those with lifestyles that are potential risk factors for periodontal diseases.

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Objectives: This study aimed to measure the stability and crestal bone level changes of indigenously developed implants in fresh extraction sockets. Materials and Methods: Forty implants were placed immediately in fresh extraction sockets in 27 patients in the age group of 18–65 years. Clinical assessment of stability was made using resonance frequency analysis (RFA) at the time of placement of implant at 3, 6, and 12 months postoperatively, and radiographic crestal bone changes were evaluated using digital radiograph at 0, 6, and 12 months. The distance between the first visible bone-implant contact and implant shoulder was measured, and crestal bone loss was calculated. Results: The mean RFA values obtained were 48.08 ISQ at the time of placement and reached 66.32 ISQ after a follow-up period of 12 months. The mean radiographic bone loss was 0.67 mm at the end of 12 months. The results emphasized that there was no significant bone loss. Out of forty dental implants, two failed in the early phase. Thus, the survival rate of implants placed in fresh extraction socket was 95% at the end of 12 months. Conclusion: Immediate placed implants can attain adequate level of primary stability. These stability levels improve with time, reaching similar values irrespective of the initial stability. About 50% of mean crestal bone loss occurred during the first 6 months after implant placement suggesting several factors other than occlusal load affecting bone levels around implants. The present study also finds a negative correlation between the crestal bone loss and stability values in terms of ISQ at a statistically significant value. Clinical Relevance to Interdisciplinary Dentistry Dental implants represent one of the most successful treatment modalities in modern dentistry. A multidisciplinary approach comprising surgical, prosthetic, and periodontal treatment was done to achieve a satisfactory result. Achievement and maintenance of implant stability is the most critical factor for successful clinical outcome.

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