Bisphosphonates are potent inhibitors of osteoclast activity that reduce bone turnover and re-establish the balance between bone resorption and formation. They are effective in multiple clinical settings including postmenopausal osteoporosis, low bone mass in men, and drug-induced bone loss. Bisphosphonate-associated osteonecrosis of jaws (BRONJ) may result in serious oral complications, such as osteomyelitis and chronic exposure of necrotic bone. Dentists must be familiar with this disorder and pay special attention to all patients on bisphosphonate therapy due to their defective osteoclast function and reduced osseous tissue vascularity, leading to impaired wound healing and progressive necrosis of jaw bones. The purpose of this article is to review the history and pathogenesis of BRONJ, provide guidance to dentists on possible measures to prevent and manage patients with BRONJ.

Gene therapy "the use of genes as medicine" involves the transfer of a therapeutic or working copy of a gene into specific cells of an individual in order to repair a faulty gene copy. The technique may be used to replace a faulty gene, or to introduce a new gene whose function is to cure or to favorably modify the clinical course of a condition. The objective of gene therapy is to introduce new genetic material into target cells while causing no damage to the surrounding healthy cells and tissues, hence the treatment related morbidity is decreased. The delivery system includes a vector that delivers a therapeutic gene into the patient's target cell. Functional proteins are created from the therapeutic gene causing the cell to return to a normal stage. The vectors used in gene therapy can be viral and non-viral. Gene therapy, an emerging field of biomedicine, is still at infancy and much research remains to be done before this approach to the treatment of condition will realize its full potential.

Dental radiology has long played an exciting and critical diagnostic role in dentistry. This has been never truer than now with the rapidly expanding array of imaging modalities. Radiography offers the sole method of (non-surgical) analysis of bone required for implant therapy. The choice of when to image, along with which imaging modality to use, depends on a combination of factors including determination of the bone quality and quantity to establish the most favorable position of implant placement, detection of the presence or absence of pathoses and accessibility at a reasonable cost to the patient. In addition, exposing patients to radiation dose as low as reasonably achievable should always be considered when selecting radiographic examinations. This article, reviews the current concepts on implant planning using different radiographic techniques and their applicability to facilitate the clinician's work in successful implant placement.

Background: Odontogenic cysts and tumors are lesions that tend to arise from the tooth apparatus or its remnants. Odontogenic cysts and tumors constitute an important aspect of oral maxillofacial pathology as they can be diagnosed in general dental practice. Aim: The purpose of this study was to evaluate the prevalence of odontogenic cysts and tumors diagnosed in the UAE and to compare the results with findings in the literature. Materials and Methods: Data of odontogenic cysts diagnosed between 1990 and 2010 were collected from the files of the Oral Pathology Laboratory and Oral Surgery Department of Tawam Hospital, UAE. Results: Most of the prevalent odontogenic cysts are radicular cysts (69.1%) - followed by dentigerous cysts (7.9%). Among the odontogenic tumors, the most prevalent is odontoma (12.2%) followed by ameloblastoma (2.9%). The middle and posterior mandible was the most common anatomic site for the formation of cysts and tumors. In fact, 93.4% of patients over 40 years presented with odontogenic cysts, whereas 6.3% presented with odontogenic tumor. Odontoma as odontogenic tumor was seen mostly in the first and second decades of life. Conclusion: The prevalence of odontogenic cysts was similar to that reported in the literature, with inflammatory cysts occurring most frequently.

Aim: The aim of this study is to compare shear bond strength (SBS) and adhesive remnant index (ARI) of self-ligating orthodontic brackets bonded to different porcelain crowns. Materials and Methods: Three groups of different types of porcelain crowns, each containing 12 crowns were fabricated by the same technician and allocated to one of the study groups as follows: Group I - IPS porcelain crowns (Ivoclar Vivadent AG, Schaan, Liechtenstein), Group II - Porcelain fused to zirconia crowns (Zirkonzahn GmbH, Gais, Italy, Noritake Co., Tokyo, Japan) and Group III - Conventional porcelain fused to metal crowns (Ceramco3, Densply, PA, USA). The orthodontic brackets were bonded to these crowns using hydrofluoric acid (HFA) + silane etching protocol. After bonding, the SBS of the brackets were tested with a universal testing machine under standard test conditions. Results: Statistical evaluation using analysis of variance showed a significant difference between the groups (P < 0.001). The IPS group showed the highest SBS (11.58 ± 2.23 MPa) (P < 0.001). No significant difference was found between ceramo-zirconia and ceramo-metal groups (P > 0.05). Chi-square comparison revealed no significant difference in ARI scores between groups (P > 0.05). Conclusions: When HFA + silane etching protocol were used, IPS crowns showed the greatest SBS of orthodontic brackets. The ARI score was non-significant. Therefore, if there is a need to place crowns over teeth then these crowns can be used for restoration of teeth before orthodontic treatment.

Context: Fluorosis is an endemic disease resulting due to excess ingestion of fluoride. Ground water has been a significant water source for domestic, irrigating, and industrial purposes in India. India is placed in a geographical fluoride belt. Kolar, a drought prone area with semiarid climate, is one among 16 fluorosis endemic districts of Karnataka. Aims: To study the prevalence of dental fluorosis among school children and to estimate the fluoride levels in drinking water sources. Settings and Design: A cross-sectional study was conducted among school-going children. Materials and Methods: School-going children from two randomly selected schools of two randomly selected Panchayat areas of Kyasamballi and Gollahalli were studied in August 2011. All the children in these schools were evaluated for dental fluorosis based on Dean's index. Fluoride levels of drinking water sources in these communities were estimated by ion-electrode method. Statistical analysis: The data were analyzed with Epi-info 7 statistical software and expressed in proportions. Chi-square test was employed to test the significance. Results: A total of 380 children in the age group of 6-15 years were studied. The prevalence of dental fluorosis was 31.05%, predominant in females. The community fluorosis index was 0.718 indicating slight public health importances. The fluoride levels in drinking water sources exceeded 1.5 mg/L. Conclusion: Dental fluorosis is a public health problem in Kolar. High fluoride content in the sources of drinking water is the main reason for dental fluorosis, suggesting an urgent need for defluoridation of water sources with sustainable long-term measures in Kolar.

Background: Dental profession is susceptible to various postural and nonpostural occupational risks. Aim : To determine knowledge, practice, and condition of work place regarding ergonomic posture among dental students from Bhopal city, Central India. Also to observe any correlation among knowledge, practice, and condition of work place scores. Materials and Methods : A self-administered questionnaire study was conducted among 231 dental students. The questionnaire consisted of three parts: Knowledge, practice, and condition of work place. Analysis of variance was used to compare mean of knowledge, practice of clinical posture, and condition of work place. Pearson's correlation coefficient has been applied to compute correlation among knowledge, practice, and condition of work place scores. A P value < 0.05 was considered significant for all statistical analyses. Results : We found that 70% of dental students perform torsion of the body and cervical flexion to improve vision and prefer direct vision when working. Only 59% reported that they are working with ergonomically designed dental unit and instruments. Most of them reported that the work stool is not comfortable. Mean knowledge, practice, and condition of work place scores were 3.93 (1.26), 5.01 (1.58), and 2.60 (1.14), respectively. Significant differences between the groups were noted for means of practice scores (P ≤ 0.01). Significant linear correlation was seen between knowledge-practice scores (r = 0.20) (P ≤ 0.01), practice-condition of work place scores (r = 0.14) (P ≤ 0.05), and knowledge-condition of work place scores (r = 0.14) (P ≤ 0.05). Conclusion : The knowledge of ergonomic postural requirements and their clinical application among the dental students surveyed were not satisfactory. A multifactorial approach that includes preventive education, postural and positioning strategies, proper selection, and use of ergonomic equipment should be employed.

Objective: To determine the factors that lead to the choice of dentistry as an occupation among the first-year dental students in a private dental college in Mangalore, Karnataka, India. Materials and Methods: A cross-sectional survey of 100 first year Bachelor of Dental Surgery (BDS) students was carried out using a self-administered questionnaire. The questionnaire consisted of total eight close-ended questions, which included demographic (age and gender) and career choice-related items. Data was collected, analyzed, and was represented as numbers and percentage. Results: The response rate was 100%. Majority of the students (80%) chose dentistry as a professional career as compared to the 20% who got in by chance. About 72% of them chose dentistry because of their interest, 13% because they were unable to procure a seat in medicine and 10% due to family influence. Majority of them (85%) had undergone career guidance courses in school and were told about various career options. On completion of their undergraduate course in dentistry, 73% preferred to pursue post-graduation and 23% desired to establish private practice. Conclusions: The first years of A. B. Shetty Memorial Institute of Dental Sciences, Mangalore have chosen dentistry as a professional career mostly due to their personal interest and influence of family and friends.

Aim: The numerous changes occurring during pregnancy affect every body system, resulting in localized physical alterations in almost all parts of the body, including the oral cavity. The aim of the present study was to find the incidence of oral conditions seen particularly in the pregnant women than in the nonpregnant women. Materials and Methods: The oral health condition of 120 pregnant women referred to the outpatient department of Jodhpur Dental College General Hospital from a gynecology clinic were examined and compared with 120 nonpregnant women. The pregnant women were divided in a 3 groups of 40 each, according to the stage of pregnancy. The common oral conditions seen during pregnancy were assessed. Results: Pregnant women had a higher incidence of gingivitis and pyogenic granuloma. Gingivitis and erosion of teeth due to vomiting was seen commonly in the 3 ^rd trimester. The results indicated that pregnancy had an effect on the oral condition, which was mainly due to the hormonal changes seen during this period rather than other factors. Conclusion: Women planning a pregnancy or those already pregnant should be informed about the role of oral health during pregnancy and the possible outcomes of these conditions for the welfare of their foetus. They should be referred to the dental clinician for necessary counselling for preventive oral self-care and treatment, if required.

Context: Oral submucous fibrosis (OSF) is a potentially malignant oral disorder leading to increased fibrosis in the sub-epithelial layer. The collagen in the condition has been a subject of intense scrutiny in an attempt to understand the pathogenesis of the disease. Aim: The present study aims to quantify and qualify the collagen fibers in different histological grades of OSF using picrosirius red stain under the polarizing microscope. The quantification of the fibrosis was carried out using image analysis software and the fibers were graded according to staining hue and intensity into their respective subtypes. Comparison was done with normal mucosa, scar/keloid tissue samples. Materials and Methods: The present study included OSF (n = 50) of differing histological grades, keloid/scar (n = 4) and normal mucosa (n = 6) as control cases. Histological assessment was performed on hematoxylin and eosin stained sections. Picrosirius red stained slides were observed under a polarizing microscope for assessment of collagen subtypes. Quantification of collagen was done under polarizing microscope and image parameters were analyzed using ProReg^® Capture Pro 2.8.8 (Lawrence and Mayo India Pvt Ltd, 2011) image analysis software. Results: The epithelial thickness in OSF, scar and keloid is less than that of normal mucosa and progressive decrease in the epithelial thickness is seen in the successive stages of OSF. The fibrosis increases with increasing grades of OSF, was higher in scar and keloid and was highly statistically significant. Type I collagen was more predominant in all stages of OSF, in normal oral mucosa and scar/keloid tissue samples as compared with type III. Though quantitative analysis of the collagen types I and III is possible, with picrosirius red qualitative analysis is an arduous task. The specificity of detection of collagen subtypes was acceptable with the picrosirius red stain, but the sensitivity left a lot to be desired.

Gingival recession caused due to periodontal disease disturbs patients because of sensitivity and esthetics. Gingival prosthesis may be fixed or removable and can be made from silicones, acrylics, composite resins or ceramics according to what is best suited for the case. The gingival veneer is esthetically appealing and easy to maintain. This case report describes the use of gingival veneer as a treatment modality for recession.

Hemangiopericytoma is an aggressive vascular tumor with a high propensity for recurrence and metastasis. The tumor is extremely rare in the head and neck region. We present a case of hemangiopericytoma on the right side of the hard palate in a 28-year-old male patient, which recurred after 5 years. This report demonstrates the malignant nature of this neoplasm. Computed tomography scans revealed a mass on the right side of the hard palate, which extended into the nasal cavity. Microscopic features of malignant hemangiopericytomas have been described as ovoid or spindle shaped tumor cells surrounded by reticular fibers that proliferate around recognizable capillaries. The examination of resected recurrent tumor was consistent with hemimaxillectomy.

Sialoblastomas are very rare epithelial tumors of salivary gland that usually occur in parotid or submandibular gland. Most of the sialoblastomas present in the neonatal period or early childhood. The biological behavior of these tumors is variable because of the potential for local and systemic recurrences. Only ten cases have been reported in submandibular gland so far. We report a case of newborn female child who presented with a left submandibular swelling.

Acrofacial dysostosis (AFD) is a generic name for a variety of different but possibly related genetic disorders that result in craniofacial and limb malformations and are, therefore, categorized under oroacral disorders. Several different variants have been identified and Nager preaxial AFD represents the association of mandibulofacial dysostosis with limb anomalies, particularly hypoplasia of the radial aspect of the hand. This report features a case of a 21-year-old male presenting with malar hypoplasia, downward sloping palpebral fissures, high-arched palate, radioulnar synostosis, hypoplasia of the right thumb and lower limb anomalies.

Metastatic adenocarcinoma is a glandular tissue malignancy, which spreads to other regions of the body. Adenocarcinoma may develop anywhere in the body and commonly metastasizes to the jaw bone. We present a case of 83-year-old male, with a complaint of swelling on the lower left side of mandible. The clinical description of our case is supported by clinical, radiographic and pathological features.