Saliva is the most valuable oral fluid is critical to the preservation and management of oral health. Saliva containing various organic and inorganic substances provides primary natural protection for teeth and soft tissues in the oral cavity assists in mastication, deglutition and digestion of food. The secretion of saliva can be affected due to various local and systemic causes. However if a patient is taking medication and has altered salivary secretion the differential diagnosis should include the possibility of an adverse drug reaction. The drugs may lead to alteration in the flow rate of saliva, which can be either increased or reduced, however certain drugs have been reported to cause change in the color of the saliva. Several drugs may lead to sialadenitis associated with altered salivary secretion. These symptoms may simulate systemic diseases, Hence oral physicians need to be vigilant in recognizing these adverse drug reactions in the patients and it is incumbent upon the practitioner to try to stay abreast of this ever evolving field especially as it relates to dental therapeutics.

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Introduction: Habitual unilateral chewing develops subconsciously and serves as an example for lateral preference. This study aims to assess the possible impact of chewing side preference to facial asymmetry, temporomandibular joint (TMJ) and oral hygiene and existence of any link between the preferred chewing side (PCS) and handedness. Materials and Methods: A 2-month cross-sectional (observational) study was performed on 76 healthy dentate subjects [24 males (31.6%) and 52 females (68.4%)] with a mean age of 20.8 ± 1.5 years who participated in this study according to the selection criteria. Results: A total of 75 subjects out of 76 (98.6%) were observed to have a PCS. Out of them, 38 chewed on their right and 37 on the left side. Of the 74 right-handed subjects, 48.6% chewed on the right, 50% on the left and 1.4% chewed equally on both the sides. Conclusion: Chewing side preference has a detrimental effect on the TMJ of the corresponding side and is also related to lateral facial asymmetry, which suggests that examination and recording of chewing side preference merit consideration in routine dental examination and treatment planning.

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Oral surgical procedures mainly tooth extraction can be related with an extended hemorrhage owed to the nature of the process resulting in an "open wound." The attempt of this paper is to present a case of massive postoperative clot formation after tooth extraction and highlight on the oral complications of surgical procedures. A 32-year-old male patient reported to the Dental Clinic for evaluation and extraction of grossly decayed 46. Clinical evaluation of 46 revealed root stumps. Extraction of the root stumps was performed, and it was uneventful. Hemostasis was achieved and postsurgical instructions were specified to the patient. The patient reported to the clinic, the very subsequent morning with a criticism of bleeding at the extraction site. On clinical examination, bleeding was noted from the socket in relation to 46. To control bleeding, oral hemostatic drugs Revici - E (Ethamsylate 500 mg) was prescribed and bleeding was stopped in 2 h. However, a massive clot was formed at the extraction site. Further, this clot resolved on its own in 1-week time. Despite the fact that dental extraction is considered to be a minor surgical procedure, some cases may present with life-threatening complications including hemorrhage. Vigilant and significant history taking, physical and dental examinations prior to dental procedures are a must to avoid intraoperative and postoperative complications.

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The opening and closing mandibular axis is not a purely theoretical postulation, but an absolutely demonstrable biomechanical entity. It is very crucial to accurately record and transfer to articulators for the purpose of maxillofacial rehabilitation. Following the Face bow record and transfer of the mandibular axis to an anatomic articulator, we can then mount the casts so that they open and close on the articulator in the same fashion as the patient's jaws. For this reason one of the fixed factors presented by the patient is taken into the consideration, which if properly considered, can be of inestimable value in all phases of dental treatment. This paper has sought to review the current concepts and practical implications regarding anterior point of reference in prosthodontics.

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Lectins comprise a stracturally vary diverse class of proteins charecterized by their ability to selectively bind carbohydrate moieties of the glycoproteins of the cell surface. Lectins may be derived from plants, microbial or animal sources and may be soluble or membrane bound. Lectins is a tetramer made up of four nearly identical subunits. In human, lectins have been reported to cause food poisoning, hemolytic anemia, jaundice, digestive distress, protein and carbohydrate malabsorption and type I allergies. The present review focuses on the classification, structures, biological significance and application of lectins.

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The cell damage will cause the release of free radicals. These free radicals will play an important role in any bioactive process of the cells. Antioxidants are one of the important components which plays a critical role to maintain the cell functioning and integrity of the cells. Antioxidants play an important role against the reactive oxygen species and maintain the normal activity of the cell. Antioxidants are preventing the free radical configuration tissue damage by preventing the formation of radicals or promoting their breakdown of free radical species. The review article explains the role of antioxidants in normal healthy conditions as well as diseases.

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Panoramic radiography is a unique and a very useful extraoral film technique that allows the dentist to view the entire dentition and related structures, from condyle to condyle, on one film. Capturing a wide range of structures on a single film grounds the odds of errors in the digital panoramic radiographs. Improper positioning of the patient complicates it more, reducing the diagnostic usefulness of these radiographs. Wide knowledge about the common positioning errors and the ways to rectify it benefits the dentists in interpretation and diagnosis. Aim: This study is aimed at analyzing the 10 common positional errors (anteriorly positioned, posteriorly positioned, head tilted upwards, head tilted downwards, head twisted to one side, head tipped, overlapping of spine in lower anterior region, tongue not placed close to palate, patient movement, and ghost images) in 200 digital panoramic radiographs selected randomly. Materials and Methods: Two hundred digital panoramic radiographic images of the patients above 6 years of age were selected randomly from the stored data in the system, projected on the white screen, and studied. The radiographs were analyzed by two oral medicine and radiology specialists, by recording separately, and then the results were analyzed. Results: The most common error was failure to place the tongue close to the palate, which leads to the presence of radiolucent airspace obscuring the roots of the maxillary teeth.

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The use of fluorescence probes the field of cell and molecular biology. Immunofluorescence is a molecular method for detection of antigen or antibody in a tissue section/serum sample. Although histopathology remains gold standard for most of auto immune, immune mediated and vesiculo - bullous diseases. Immunofluorescence is an ancillary investigation, which are used to support clinical diagnosis more evidently. This method provides additional diagnostic, prognostic information and remains more specific diagnostic aid for vesiculo - bullous diseases of skin. This review article discusses about immunofluorescence techniques and its application in dermatopathology with oral manifestations.

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Introduction: Antimicrobial resistance is a well-known entity and the most common factor leading to this is the irrational use of antibiotics. Several studies from the West have substantiated the irrational use of antibiotics in dentistry. Aims: The aim was to assess the knowledge, attitude, and practice (KAP) of antimicrobial drug use among dental fraternity in a tertiary care teaching dental college and hospital. Materials and methods: A cross-sectional survey of various dental fraternities using a structured validated questionnaire. The study was initiated following approval from Institutional Ethics Committee and interns, junior residents and faculty members of various departments in dentistry were enrolled after obtaining written informed consent. A structured validated questionnaire was developed to assess the above-mentioned objectives. Statistical analysis: Descriptive statistics was used for representing each category of response and kappa statistics were used to assess the reliability in the initial cohort. Chi-square test for independence was used to evaluate the difference in proportion between different professional cadres. Results: A total of 120 participants were recruited out of which 81.6% (98/120) of the participants accepted their frequent antibiotic usage. The most common dental indication of antibiotics among dentists was post dental extraction, attributing to 30.8% (37/120), followed by dental abscess 21.6% (26/120) and 60% (72/120) prescribed antibiotics after most minor surgical procedures. Surprisingly, 37.5% (45/120) of the participants opined that they use antibiotics against viral infection. Regarding the spectrum of antibiotic usage, 74.1% (89/120) preferred broad spectrum instead of narrow spectrum 25.8% (31/120). The commonly prescribed antibiotics were amoxicillin 71.7% (86/120), metronidazole 33.3% (40/120), amoxicillin with clavulanic acid 26.6% (32/120). A total of (43/120) 35.8% opted generic name for mentioning the antibiotics while the rest (77/120) 64.2% preferred to prescribe using their brand name. Furthermore, (76/120) 63.3% did not know about the recent antibiotic policy/guidelines from the Government of India. There was no significant difference observed in any of the responses between various academic levels. Conclusion: We found poor KAP regarding antimicrobial use in dentistry thereby conferring increasing potential for the development of more serious antimicrobial resistance. Immediate constitution of hospital antibiotic committee and scrutinizing the prescription of antibiotics is mandatory in dental hospitals as well.

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A C-shaped canal with varying configuration is commonly observed in single-rooted mandibular second molars. Cooke and Cox (1979) first documented the C-shaped canal in endodontic literature. The presence of high incidence of transverse anastomoses, lateral canals, and apical deltas makes it difficult to clean and seal the root canal system in these teeth. The main reason for failure in endodontic treatment of mandibular second molars is the inability to detect the presence of C-shaped canals prior to an endodontic therapy. This case report presents successful management of two rare cases of C-shaped canal configurations.

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Tumor markers are substances, usually proteins that are produced by the body in response to cancer growth or by the cancer tissue itself. Measurement or identification of these markers is useful in patient diagnosis and clinical management. An ideal tumor marker should be highly sensitive, specific, accurate, reliable and easily assayable. But none of the tumor markers have all these characteristics. Apart from their limitations, tumor markers are precious tools for screening a healthy and a high risk population for the presence of cancer, making a diagnosis of a specific type of cancer, along with determining the prognosis and monitoring the course of the disease in the patient, at the time of remission or during the course of treatment. This overview discusses and emphasizes currently available tumor markers, their role in cancer and their recent development in cancer diagnosis and prognosis.

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Cell death is one of the essential processes. Balance between cell division and cell death is of utmost importance for the development and maintenance of multi-cellular organism. Disorders of either process have pathologic consequences and can lead to disturbed embryogenesis, neurodegerative diseases, or the development of cancers. This article reviews the apoptotic as well as anti-apoptotic molecules along with molecular pathways, which may alter in many diseases.

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Branchial cleft cysts are the most common congenital neck masses. The other name for Branchial cleft cyst is Benign cervical lymphoepithelial cyst, which occurs on the lateral aspect of the neck. These cysts originate from remnants of the branchial arches or branchial pouches. The lesions presents as an asymptomatic circumscribed movable mass on the anterior border of the sternocledomastoid muscle. Many cases have been reported at the angle of the mandible, in the submandibular area and even in the pre-auricular and parotid areas. Dentist should be aware of this entity, because it can be easily confused with an odontogenic infection or parotid pathology, especially, if it develops high up in the neck. A solitary, 1 month old swelling on the right submandibular region, in a 13-year-old girl, caused diagnostic dilemma with clinical presentation. Diagnosis was done after all the investigations and treated accordingly.

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Aims: Liquid dish washing solution (DWS) was used as a substitute for xylene to dewax tissue sections during hematoxylin and eosin (H and E) staining. The aim was to test and compare the hypothesis that xylene-ethanol free (XEF) sections deparaffinized with diluted DWS are better than or at par with the conventional H and E sections. Materials and Methods: Fifty paraffin-embedded tissue blocks was included. One section was stained with conventional HandE (group A) and the other with XEF HandE (group B) staining method. Slides were scored for parameters: nuclear, cytoplasmic, clarity, uniformity, and crispness of staining. Z test was used for statistical analysis. For accuracy of diagnosis, sensitivity, specificity, positive predictive value, and negative predictive value were tested. Results: Adequate nuclear staining was noted in 94% in group A and 96% in group B, ­adequate cytoplasmic staining in 92% in group A and 86% in group B, clarity in 94% of group A and 96% of group B sections, uniform staining in 92% of group A and 80% of group B sections, crisp stain in 96% of group A and 88% of group B sections, and 94% of group A sections stained adequately for diagnosis as compared with 90% in group B sections. Conclusion: Liquid DWS can be used as an alternative and effective substitute to xylene and ethanol in routine HandE staining procedure.

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Restoration of endodontically treated teeth is important for the success of endodontic treatment. In full coverage restorations, maximum amount of tooth structure is compromised, so as to conserve the amount of tooth structure partial coverage restorations, can be preferred. This case report is on fabrication of a conservative tooth colored restoration for an endodontically treated posterior tooth. A 22-year-old male patient presented with pain in the mandibular left first molar. After endodontic treatment, composite material was used as postendodontic restoration. The tooth was then prepared to receive a ceramic onlay and bonded with self-adhesive universal resin cement. Ceramic onlay restoration was periodically examined up to 2 years.

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Objectives: Present study was undertaken to estimate and compare erythrocyte superoxide dismutase (E-SOD) and glutathione peroxidase (GPx) levels in oral submucous fibrosis, oral leukoplakia, oral cancer patients, and healthy subjects. Materials and Methods: E-SOD and GPx levels were estimated in OSF, oral leukoplakia, and oral cancer patients with 25 subjects in each group. The results obtained were compared with the corresponding age-/sex- matched control groups. Results: Statistically significant ( P < 0.001) decrease in E-SOD and GPx levels were observed in OSF, oral leukoplakia, and oral cancer groups as compared to the control group. Oral leukoplakia group showed lower levels in comparison with OSF ( P > 0.05). Oral cancer group had the lowest levels amongst the study groups. Conclusion: Imbalance in antioxidant enzyme status may be considered as one of the factors responsible for the pathogenesis of cancer and may serve as a potential biomarker and therapeutic target to reduce the malignant transformation in oral premalignant lesions/conditions.

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Oral cancer prevalence in Asia-pacific region is at an alarming stage due to the adverse habits and different socio-economic and cultural status of the population. The better understanding of the disease process at the molecular level has altered the approach of the oral cancer towards early diagnosis of the lesion rather than late stages to reduce the morbidity and mortality. A good number of screening techniques has been time tested for the sensitivity and specificity in diagnosing oral cancer in the initial premalignant stages. Surgical biopsy is a gold standard for diagnosis but this needs professional services, which are impractical at times. Alternative screening methods which are noninvasive, easily performed and highly accurate are the norms for any test to accept as an alternative for histopathology. This article focuses on some screening techniques, which are done either as confirmative or adjuvant for histopathology.

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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.

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Nanotechnology offers advances particularly in each and every field of human activity such as electronics, industry, telecommunications, environmental science, etc., The field of nanotechnology has got remarkable potential that can bring considerable improvements to the human health, enhanced use of natural resources, and reduced environmental pollution. Since 1990s, nanotechnology has been exploited for potential medical and dental applications. Nanotechnology holds promise for advanced diagnostics, targeted drug delivery, and biosensors. Dentistry is undergoing yet another change to benefit mankind, this time by transforming itself to the nanodentistry. A variety of nanostructures such as nanorobots, nanospheres, nanofibers, nanorods, etc., have been studied for various applications in dentistry and medicine. Preventive dentistry has also utilized nanodentistry to develop the nanomaterials for inclusion in a variety of oral health-care products. However, due to insufficient evidence on potential hazards on human health and environment, nanotechnology has become a controversial issue. It is documented that nanomaterials can enter the human body through several routes and can pose a threat to human health by interacting with the DNA. The present article focuses on the current status and the future implications of nanotechnology in dentistry.

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Aloe vera is a cactus like plant that actually is part of the lily family. There are more than 300 varieties of the Aloe plant, but the Aloe barbadensis variety exhibits the best medicinal properties. It has strong antiseptic, antibacterial, fungicidal and virucidal properties. It promotes cell growth and is neurologically calming and acts as a detoxifying agent. Others provide nutritional support and some increase the regenerative potential of tissues while others act with anti-inflammatory responses. This article reviews the uses of the plant in different fields of medicine and dentistry.

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Sialolithiasis is the most common salivary gland disease accounting for more than 50% of the cases. Majority of salivary calculi occur in the submandibular gland and its duct. It has male predilection and is often seen in adults. Majority of the calculi are less than 10 mm in size. Calculi > 15 mm in size are considered giant. Giant sialoliths within the parenchyma of the salivary glands are frequently reported in the literature, but they are uncommon in the salivary ducts. The purpose of this article is to report a case of giant sialolith in the Wharton's duct of a 65-year-old male, which had caused sialo-oral fistula. Literature in English language on "giant sialolith in Wharton's duct" is reviewed since 1990. Also etiology, pathogenesis, clinical features, diagnosis and management aspects are discussed.

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Marginal tissue recession exposes the anatomic root on the teeth, which gives rise to ­common patient complaints. It is associated with sensitivity, tissue irritation, cervical abrasions, and esthetic concerns. Various types of soft tissue grafts may be performed when recession is deep and marginal tissue health cannot be maintained. Double papilla flap is an alternative technique to cover isolated recessions and correct gingival defects in areas of insufficient attached gingiva, not suitable for a lateral sliding flap. This technique offers the advantages of dual blood supply and denudation of interdental bone only, which is less susceptible to permanent damage after surgical exposure. It also offers the advantage of quicker healing in the donor site and reduces the risk of facial bone height loss. This case report presents the advantages of double papilla flap in enhancing esthetic and functional outcome of the patient.

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Aim: To determine whether Triphala (Terminalia bellerica, Terminalia chebula, Emblica officinalis) extract has an antimicrobial activity against Lactobacilli and Candida albicans. Materials and Methods: Ethanolic extract of Triphala was prepared by using the cold extraction method. The extract was diluted with an inert solvent, dimethylformamide, to obtain 15 different concentrations of the extract. 0.2% chlorhexidine was used as a positive control and dimethylformamide was used as a negative control. The extract, along with the controls, was subjected to microbiological investigation to determine which concentration among the 15 different concentrations of the extract gave a wider inhibition zone against Lactobacilli and C. albicans. The zones of inhibition were measured in millimeters using a Vernier caliper. Results and Conclusions: Triphala extract demonstrated antimicrobial property against Lactobacilli and C. albicans with maximum zone of inhibition of 22 mm at 6% and 20 mm at 9%.

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The aneurysmal bone cyst is an uncommon lesion which has been found in most bones of the skeleton, although the majority occur in the long bones and in the spine. It was first described as a distinct clinical entity by Jaffe and Lichenstein in 1942 to describe the ­characteristic "blow-out" of the bone seen in the radiographs of the lesion. In the past, the lesion has been classified as an atypical giant cell tumor or benign bone cyst. We report a case of an aneurysmal bone cyst in an 18-year-old patient who reported with the chief complaint of swelling on the right side of the face since 4 months. It was non-tender, non-fluctuant, and hard in consistency. Radiographic examination revealed a large, expansile, multilocular lesion suggestive of benign odontogenic tumor. Complete enucleation was carried out and the final histopathologic diagnosis of aneurysmal bone cyst was given.

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