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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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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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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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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This review is the first of series of CBCT. Multiplanar reconstructions for continuing education in three dimensional head and neck anatomy. This review gives the reader the needed anatomical references and clinical relevance for accurate interpretation of CBCT anatomy. The information is useful to all dental clinicians. All images are labeled and complete with legends. Only bone window settings are used for display of the CBCT images. The selected slices are displayed at a resolution of 300 micrometers.

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Fusion is a rare occurrence, and its definitive diagnosis is of prime importance for successful root canal treatment. This case report discusses the endodontic management of a supernumerary tooth fused with a right maxillary second molar. After 1 year of follow-up, there were no clinical symptoms and the maxillary second molar remained vital. Recall radiographs appeared normal.

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Townes-Brocks syndrome (TBS) is an autosomal dominant disorder with multiple malformations and variable expression. Major findings include external ear anomalies, hearing loss, limb deformity, imperforate anus, and renal malformations. Intelligence is usually normal, although mild moderate mental retardation has been reported. It can be difficult to differentiate clinically between hemifacial microsomia (HFM) and Townes-Brocks syndrome (TBS). The distinction is important because TBS is inherited as an autosomal dominant trait, whereas HFM is sporadic. We report a classical case of TBS with overlapping features of hemifacial microsomia in an 11 year old boy who presented with unilateral anotia with hearing defect, renal agenesis and imperforate anus by birth.

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Osteomas are relatively rare benign osteogenic neoplasm's characterized by the proliferation of compact or cancellous bone. Osteomas can develop as peripheral (periosteal) masses attached to the cortical plates or as central lesions arising from endosteal bone surfaces. Although multiple osteomas of the jaws are a hallmark of Gardner's syndrome (familial adenomatous polyposis), non-syndromic cases are typically solitary. The purpose of this paper is to present a large peripheral osteoma originating from the buccal surface of the mandible and causing asymmetry in a 35-year-old woman.

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Fibro-osseous lesions are benign mesenchymal tumors in which mineralized tissue, blood vessels, and giant cells, in varying proportions, replace normal bone. Although this group of lesions includes reactive lesions, harmatomas, and neoplasms, they cannot be distinguished only on the basis of the histopathology which can only confirm their common fibro-osseous nature. Definitive diagnosis requires thorough radiological evaluation. Computed tomographic images of craniofacial fibrous dysplasia on bone windows may be helpful and allow precise pre-operative diagnosis and surgical planning.

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Tooth wear has started to affect a greater number of younger people. Its precautions, symptoms, and treatment modalities therefore have to be well understood. This case study presents a patient with severe tooth wear that had led to displeasing esthetics. Surgical crown lengthening and composite restorations were performed after the provision of a stabilizing splint. This helped to improve the esthetics considerably leaving the patient satisfied. The aim of this case study is to portray an approach to how even a patient with severe tooth wear can have access to an esthetically pleasing dentition.

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Adenomatoid odontogenic tumor (AOT) is a rare tumor generally found in young females. It is more commonly seen in anterior maxilla in association with an unerupted tooth. Dentigerous cyst is a odontogenic cyst commonly seen arising from the impacted mandibular third molars. We present a case of simultaneous occurrence of both these lesions. A female in the second decade of life reported with the complaint of swelling in the anterior region of lower jaw. Clinical and radiographic findings were suggestive of a dentigerous cyst. Cystic lesion was enucleated and the specimen was sent for histopathologic analysis. It showed AOT in association with a dentigerous cyst. This case is worth discussing as it is rare to find the simultaneous occurrence of two pathologies in the same region of jaw. The common site for AOT is anterior maxilla and for dentigerous cyst is posterior mandible. But in our case, it was found in the anterior mandible in association with an impacted canine.

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Keratocystic odontogenic tumor (KCOT) is developmental odontogenic cysts of epithelial origin known for their potentially aggressive behavior and significant rate of recurrences. Single odontogenic cysts are very well documented in the literature. Multiple (KCOT) are principle features of nevoid basal cell carcinoma syndrome (naevoid basal cell carcinoma syndrome; Gorlin-Goltz syndrome). We report an intriguing case of multiple KCOT in a non-syndromic patient simultaneously occurring in maxilla as well as in mandible with brief highlight on molecular data and the treatment modality.

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Osteoradionecrosis (ORN) is frequently encountered in clinical dental practice. The identification and management of such a lesion is often challenging. This clinical report is based on a patient who had radiation therapy to the head and neck region for a salivary gland malignancy. The patient developed ORN of the mandible 12 years later. This demonstrates the need to understand the pathophysiology of this condition better than we currently know.

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Background: The action of ingredients of areca nut, when consumed, depends on their ability to permeate the oral mucosa. The contents of the ingested substances and the barrier functions of the oral mucosa ultimately determine the flow rate of the permeability. The presence of saliva as a medium of dilution has a contributory role. The permeability coefficient of the substances will determine the intensity of the changes brought about in the tissues and resultant development of premalignant and malignant diseases. Aims and Objectives: The present study aims to evaluate and compare the permeability of the oral mucosa to areca nut and paan masala extracts (a concoction of areca nut powder with specified and non-specified additives) by stereo and light microscopy using an animal model. Materials and Methods: Sprague and Dowley (SD) rat buccal mucosa were incubated in aliquots of 20 μl at 37°C in a specially designed humidifying chamber with prepared solutions of areca nut and paan masala according to established procedures. The extent of penetration of the solutions was evaluated at 24, 48 and 72 h; using the light and stereomicroscopy. Results: Areca nut solution showed aggressive permeation and diffused the whole length of the tissues in the first 24 h peaking at 72 h where no further diffusion was noted. Paan masala extracts showed a gradual increase also peaking in 72 h. The results show that the areca nut extracts has better penetration potential than the paan masala solutions. Conclusion: Both paan masala and areca nut extracts are deleterious to the oral mucosa, but the penetration potential of areca nut extract is more than paan masala, which is probably reflective of its capacity to induce fibrotic changes in the tissues.

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Context: Currently there is a growing interest in oral health outcomes in how oral health affects quality of life. When oral health related quality of life measures are used alongside traditional clinical methods of measuring oral health status, a more comprehensive assessment of the impact of oral diseases on the several dimensions of subjective wellbeing becomes possible. In this context, we attempted to study the impact of oral diseases on quality of life, so as to address the patient's needs in an appropriate way and thereby improving one's quality of life. Aims: To evaluate the impact of different oral diseases on quality of life using a modified OHIP-14 questionnaire, so as to address the patient's needs in an appropriate way and thereby improving one's quality of life. Settings and Design: The study was carried out among 302 subjects, attending the outpatient department a dental hospital, India, for check up and treatment of their oral condition. Subjects aged above 20 years, who gave their consent for the study were included. Materials and Methods: The study sample was categorized in to two groups based upon the duration of the affecting disease - group 1 consisted of subjects suffering with chronic diseases and group 2 of subjects suffering with acute diseases. All the subjects were asked to fill up their responses in the given OHIP-14 questionnaires. The completed questionnaires were then collected and statistically analyzed. Statistical Analysis Used: To evaluate the role of age on QOL, age was divided in to 2 groups using median split procedure. For inter and intragroup comparisions, independent sample t test, anova followed by post hoc test and Chi-square tests were employed. Results: Chi square test revealed a moderately impaired quality of life among all the diseases investigated. On comparing the mean domain and total OHIP score between the two groups, the domain of psychological discomfort and disability and the total OHIP score showed statistically significant values in acute diseases. However, no significant differences were obtained on comparing the grades of QOL in between the two groups. Conclusions: Oral health related quality of life is moderately impaired among those suffering with oral diseases. Routine evaluation using patient centred measures like Oral health Impact Profile during clinical activity is feasible, and provides relevant and useful information for the clinical management of patients with oral mucosa pathology.

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Background: Interleukin-17 (IL-17) is a cytokine that modulate the inflammatory process in acute myocardial infarction (AMI) and chronic periodontitis (CP) and has not been assessed in patients with AMI and CP. The aim of this study was to investigate possible association between AMI and CP by estimating and comparing serum concentrations of IL-17 between the group of patients with AMI, periodontal disease and health. Materials and Methods: Total 37 subjects divided into three groups were included in this study, 16 patients with AMI and CP was termed as Group-I, 16 patients with AMI were termed as Group-II and 5 healthy subjects were termed as Group-III. Gingival index, russel's periodontal index, probing pocket depth were assessed in all groups. Serum samples were collected from all participants and tested for lipid profile and were quantified for IL-17 levels using enzyme-linked immunosorbent assay. Results: IL-17 was detected in sera from all three grouped patients; serum concentrations of IL-17 were significantly higher in Group-I when compared to Group-II and III. IL-17 concentrations correlated positively with clinical and lipid parameters in Group-I except for high-density lipoprotein, and with all lipid profile parameters in Group-II and lipid triglycerides correlated positively with IL-17 in Group-III. Conclusions: It can be stated that poor periodontal health which produces higher levels of IL-17, which in turn produces many pro-inflammatory cytokines can place an individual at higher risk for AMI even in the absence of certain traditional risk factors.

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