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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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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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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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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Retention, stability and support are the basic principles on which the success of a complete denture relies on. The skill lies in applying these principles efficiently in critical situations. Residual ridge resorption occurs at a three times faster rate in mandibular arch than in the maxillary arch. The severely resorbed maxillary and mandibular edentulous arches that are narrow and constricted with increased interarch space provide decreased support, retention and stability. The consequent weight of the processed complete denture only compromises them further. The severely resorbed jaw can have various treatment options. Extreme resorption of the maxillary denture-bearing area may lead to problems with prosthetic rehabilitation. The advantage of a hollow maxillary or mandibular denture is the reduction of excessive weight of acrylic resin, which normally replaces lost alveolar ridge in the interridge space of the denture wearer. This clinical report describes two case reports of edentulous patients with resorbed ridges where a simplified technique of fabricating a light weight hollow maxillary complete denture was used for the preservation of denture bearing areas.

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The epithelial-mesenchymal transition (EMT) is described as a rapid and reversible process of change of cell phenotype seen during embryonic development, organ fibrosis, and tumor progression. EMT was first described by Gary Greenberg and Elizabeth Hay in 1982. During EMT the epithelial cells alter their cell polarity, reorganize their cytoskeleton thus become isolated and motile. Depending upon the biological context in which they occur, EMT is divided into three types namely EMT type I, II, III. The article describes the process of EMT implicated in the oral cavity as in palate and root development (type I EMT), gingival fibromatosis and oral sub-mucous fibrosis (type II EMT), and oral squamous cell carcinoma (type III EMT). The reverse process of EMT is called as mesenchymal-epithelial transition seen in association with kidney formation.

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Tooth resorption can occur from the internal surface of a tooth or from the external surface of a tooth. Internal resorption is commonly termed to be "idiopathic" because of unknown cause. The aim is to report a case of idiopathic internal resorption showing unusual features. A 25-year-old female patient complains of mobility of tooth in right lower back tooth region since 2 months. Clinically, there was slight mobility in 48. Radiographically a resorptive area was seen in crown region of 48. The crown part was removed with gentle pressure using probe. A hollow crown with resorbed dentin and intact thin enamel was seen in gross specimen. A final diagnosis of idiopathic internal resorption was given. Early detection is essential for successful management of idiopathic internal resorption. This prevents further weakening of remaining tooth structure leading to crown or root perforations.

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The nasolabial cyst is an uncommon non-odontogenic cyst arising in the maxillofacial tissues. This lesion presents in an extraosseous location in the region of the nasolabial fold and can cause swelling in the furrow, alar nose elevation, and upper lip projection. Despite the uncommon occurrence of nasolabial cysts, it is important to recognize the characteristics of this lesion. The paper documents the presentation of nasolabial cyst in a 33 year old woman and discusses considerations related to the diagnosis.

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The placement of endosseous dental implants is often hampered by unfavourable anatomy of the alveolar bone. Most frequently patients lose their teeth due to alveolar bone loss, tooth extraction; trauma and long term use of removable appliances tend to lose the bone making it difficult for the placement of implant in an optimal prosthetic position. The loss of width of the residual alveolar ridge necessitated measures which could refurbish the lost dimensions. Here we report the successful management of such a condition wherein placement of implant was made possible by placement of autogenous bone block graft obtained from the mandibular symphysis region and predictable osseointegration thus achieved.

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Medical ethics is primarily a field of applied ethics, the study of moral values and judgments as applicable to medicine. Dental practitioners constitute a group of health professionals who deal with human health care on a regular basis. Various ethical principles govern their conduct and their approach toward the patients. Ethical code of conduct prescribes a minimum standard of care which is applicable to all dental professionals. Substandard dental care is unacceptable and mounts to negligence on the part of the professional. Knowledge on what constitutes standard of care is a pre-requisite for dental professionals in providing quality health care. This paper presents a brief overview on standard of care as applicable to dentist and its practical implications with a note on the legal issues pertaining to medical negligence as applicable in India.

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Objective: The aim of this study was to evaluate genotoxic and cytotoxic effects of low level ionizing radiation used in digital panoramic radiography on gingival epithelial cells. Materials and Methods: We included 50 healthy individuals advised for digital panoramic radiography for diagnostic purpose were included in this study. Demographic data and personal history of all subjects were recorded in a proforma before the examination. Gingival epithelial cells were obtained by gentle scraping with a modified cytobrush immediately before X-ray exposure and 10 ± 2 days later. Cytological preparations were stained according to the Feulgen/fast green method and analyzed under a light microscope. Micronuclei and degenerative nuclear alterations (pyknosis, karyolysis, karyorrhexis and condensed chromatin) were scored. Results: The frequency of formation of micronuclei was not significant with regard to age, gender and after exposure to digital panoramic radiography ( P = 0.276). However this study showed significant increase in the frequencies of nuclear alterations like karyorrhexis, pyknosis, condensed chromatin, karyolysis and indicative of cell death ( P < 0.001). Conclusion: Panoramic radiographic examination does not induce genotoxic effect like micronuclei, but it does induce cytotoxic effects leading to cell death.

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Background: Through the years the dental profession has held a variety of theories about the causes of abfractions, including chemical wasting of the teeth, the effects of tooth brushing, and lateral forces. Acidic and abrasive mechanisms have been well documented as an etiologic factor but the stress theory remains controversial. Materials and Methods: In this study using a three-dimensional finite element model (FEM) of a maxillary central incisor with its supporting structures the normal compressive stress occurring in the tooth is plotted for a normal occlusal load of 24 kgs at an angle of 50° to the long axis of the tooth. Results: The results showed an increased stress concentration at the cervical region, which may be susceptible to cracking that, could eventually contribute to the development of cervical lesion (abfraction). Conclusion: The results of the study demonstrate higher stress values in the cervical region of the tooth for normal occlusal load. The cumulative effect of these stresses would result in abfraction as the age advances along with other wasting diseases of teeth.

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Background: The aim of this study was to estimate the levels of tumor necrosis factor-α (TNF-α) in serum of healthy, term gestation women and periodontitis affected pre-term gestation women and to find out the association between TNF-α levels, gestational age and different periodontal variables in serum. Materials and Methods: Clinical parameters, including pocket depth, Russel's periodontal indexes were recorded from 36 subjects divided into two groups based on presence of pocket beyond 5 mm and gestational age above or below 36 weeks. Blood samples from all 36 subjects were obtained from the fetal side of the umbilical cord of the term and pre-term gestation infants at delivery. Serum was separated from the collected blood samples and TNF-α from the resultant serum was quantified using enzyme linked immunosorbent assay essay. Results: The mean amounts of TNF-α was significantly higher in Group-II when compared to Group-I, which was statistically significant ( P < 0.001). Positive correlation was found between TNF-α concentration and Gestational age ( P < 0.001), Russel's periodontal index ( P < 0.001), Pocket depth ( P < 0.001) which were statistically significant. A positive correlation was found between pocket depth, Russel's periodontal index and gestational age ( R = −0.69, P < 0.001), ( R = −0.71, P < 0.001) i.e., when pocket depth (beyond 4 mm or above) and Russel's periodontal index increase, estimated gestational age shows a steady decline. Conclusion: TNF-α concentrations correlated positively with the extent of periodontal destruction, Russel's periodontal index score and gestational age, With increase in amount of periodontal destruction, there is a substantial increase in clinical parameters and TNF-α level in serum, which is inversely related to premature gestation.

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