Recurrent aphthous stomatitis (RAS) is a painful condition, often leading to impairment of the basic functions such as mastication, speech, and brushing. Several treatment modalities have been advocated in the past, but none hasve been proven efficacious. A novel treatment modality in the form of low-level laser therapy (LLLT) has evolved in recent years. LLLT also known as "cold laser" works on the principle of biostimulation. This biomodulatory effect plays a pivotal role in accelerating the healing process and provides analgesia. Hence, it constitutes an alternative to processes that present pain and inflammatory reaction. The present series of cases throw light regarding the use of diode laser for LLLT as an effective and quick tool in the painless management of recurrent aphthous ulcers.

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Aims and Objectives: To provide information regarding the changes of mandibular basal bone height using panoramic radiography, in relation to age, sex, and the state of dentulousness, which could be utilized in clinical practice, especially in implantology and pre-prosthetic surgery. Materials and Methods: A total of 200 subjects, who were categorized according to age, sex, and state of dentulousness, were subjected to vertical measurements of mandibular basal bone in panoramic radiographs. Two measurements were made, D ₁ and D ₂ . The distance measured between the lower border of mental foramen to the lower border of the mandible was termed as D ₁ . The distance between the lowest point of mandibular canal to the lower border of the mandible was termed as D ₂ . These measurements were compared between males/females and dentulous/edentulous, which were further subjected to statistical analysis with Student's t-test. Results: Males had higher D ₁ and D ₂ values compared to females and edentulous groups had higher D ₁ and D ₂ values compared to dentulous subjects. Conclusions: Men have higher values of mandibular basal bone height compared to females and also that there exists some potential for mandibular basal bone to increase in height as the age progresses.

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Aim: The objective of this study was to compare the efficacy of supportive periodontal therapy (i.e., scaling and root planning [SRP]) alone versus Aquolab ^® ozone therapy used in association with SRP in the treatment of chronic periodontitis in adult patients. Materials and Methods: A total of 20 patients with a diagnosis of chronic periodontitis (40 localized chronic periodontitis sites) were enrolled. None of these patients have previously received any surgical or nonsurgical periodontal therapy and demonstrated radiographic evidence of moderate bone loss. Two nonadjacent sites in separate quadrants were selected in each patient to verify treatment efficacy (split-mouth design). Microbial analysis was analyzed at baseline and the 7 ^th day after treatment. SPSS program and paired simple statistic t-test were used to detect statistically significant differences. Results: There was a statistically significant reduction of Tannerella forsythia loading in sites treated with ozone therapy respect to those treated with SPR alone. A similar trend was obtained also for additional 5 species and for total bacterial loading (CBT). These results were obtained with a single local application of ozone therapy just after SPR and with a molecular control 7 ^th day after treatment. Conclusion : Aquolab ^® ozone therapy in is effective in reducing the CBT in pockets of patients affected by periodontitis. It is an efficacy medical device to be used as adjuvant therapy to be added to SRP in the management of moderate to severe chronic periodontitis.

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Background: Papillon-Lefèvre syndrome (PLS) is a rare autosomal recessive genodermatosis characterized by a diffused palmoplantar hyperkeratosis and severe early-onset periodontitis. Although the exact pathogenesis of this syndrome is still unknown, however, it has been linked to mutations in the cathepsin C gene. Case report: This paper is a clinical presentation of a 12-year-old male with severe periodontitis and characteristic palmoplantar hyperkeratosis diagnosed as PLS. Conclusion: An early diagnosis of the syndrome can help preserve the teeth by the early institution of treatment, using a multidisciplinary approach. Thereby, sparing the patients increase the risk of social, psychological, and economical stigma. Owing to the vast degree of periodontal breakdown involved at such an early age. Incidentally, the dentist is might often be the first to encounter such patients.

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Effective patient communication and comprehension are fundamental toward empowering the patient to make optimal health decisions. Barriers in patient health literacy extend beyond cultural and language differences and can significantly impede this process. This case report illustrates a major communication gap that resulted in contradictory perceptions between a treating oncologist and a patient. The patient's dentist was able to resolve this miscommunication and facilitate the patient's acceptance of the recommended intravenous chemotherapy for management of malignant desmoid tumors occurring secondary to Gardner's syndrome (GS). This report also documents classic craniofacial manifestations of GS including multiple unerupted supernumerary teeth, compound odontomas associated with a dentigerous cyst, as well as multiple osteomas in both arches and in the ethmoid and irregularly shaped radioopacities in both arches. In summary, effective patient-centered communication is a prerequisite for the optimal delivery of healthcare. Both interdisciplinary care and one-on-one patient-provider relationship center on coherent bidirectional communication.

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Parapharyngeal schwannomas are rare benign neoplasms located in a difficult anatomical region. Most of them are asymptomatic and some presents late. Neurological deficit is a late finding, and it occurs only when the lesion is very large and compresses contiguous structures. Computed tomography (CT) guided fine needle aspiration cytology along with preoperative CT and magnetic resonance imaging can detect and diagnose it correctly and helps in proper planning and management. Total surgical excision is the treatment of choice. The approach is different as per the site, but trans-cervical approach is preferred. Recurrence is rare after complete excision. We are presenting a very rare parapharyngeal schwannoma arising from the hypoglossal nerve that was excised by trans-cervical approach without any complications and less morbidity as compared to other described approaches.

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Background: Recent advances in understanding complex tumor interactions have led to the discovery of an association between inflammation and cancer. An abundance of pro - inflammatory cytokines in a tumor micro-environment can lead to angiogenesis, thus favoring neoplastic growth. Serum C reactive protein is a sensitive marker of inflammation and may have significant prognostic value as early biomarker for cancer diagnostics. Aims and Objectives: This was a pilot study done to assess the serum C reactive protein levels in potentially malignant disorders (PMDS) and to evaluate their role as prognostic marker. Materials and Methods: The study sample consisted of 20 cases of oral potentially malignant disorders (10 each of Leukoplakia, Oral Sub mucous fibrosis) confirmed by histopathological examination and 10 controls. All the samples were subjected to C - reactive protein analysis by immunoturbidometery. Results were subjected to Statistical analysis. Statistical analysis: Data was entered in data base management of the software SPSS version 20.0. Comparison of three groups with respect to C reactive protein levels was done by one way ANOVA. Pair wise comparison of three groups was done by Turkeys multiple post hoc procedure. Results: Mean C reactive protein levels in leukoplakia was 0.33±0.17, in oral submucous fibrosis was 0.58±0.83 where as in controls it was 0.26±0.05. In potentially malignant disorders, C reactive protein was slightly elevated when compared with the controls. Conclusion: Our findings demonstrate that serum C reactive protein concentration is associated with subsequent development of oral cancer and could serve as a potential prognostic biomarker.

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Neurofibromas (NFs) are rare neurogenic tumors of the oral cavity. They can present as solitary, or multiple when associated with neurofibromatosis-1 (NF-1)/von Recklinghausen's disease. Solitary intraoral NFs unassociated with NF-1 are sporadic and mimic any other soft tissue tumors of the oral cavity. Hence, final diagnosis can only be rendered after histopathological examination although they exhibit numerous microscopic variants. They show numerous mast cells and immunopositive for S-100 protein. Here, we are presenting one such case of NF in a 55-year-old male patient.

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Taurodontism is an anomaly or variation of the anatomy of the tooth basic shape, characterized by an enlarged pulp chamber, apical displacement of the pulpal floor, and no constriction at the level of the cement-enamel junction. Due to these characteristics, endodontic treatment and restoration of these teeth is extremely challenging. In this paper, a review of the phenomenon and prevalence of taurodontism is carried out, and interesting clinical case is described in terms of endodontic notification and final crown restoration. In order to achieve longevity, by preventing microleakage, the final restoration is considered provocative, concerning the selection and combination of restorative materials to be used in such cases. Special care should always be given in occlusion and cuspal protection.

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Mandibular hypoplasia (MH) is a condition, which characterizes deviation in the mandibular growth patterns causing functional and esthetic alterations. MHs encountered in the craniofacial region may be of three types: Congenital, developmental and acquired. Majority of the MHs are associated with syndromes with very little emphasis on the "nonsyndromic" category. Furthermore, the hypoplasias generally have a bilateral manifestation on the mandible. We focus on the nonsyndromic category and report a case of isolated unilateral MH in a 17-year-old boy with obvious facial disfigurement but with no association to any syndrome. The objective of this presentation is to highlight the rarity, possible manifestations and diagnostic approach of the nonsyndromic group.

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The objective of this study was to report a case of tooth fracture during the sport practice and the treatment performed for the patient. A 17-year-old male patient was subjected to an endontic treatment followed by the reattachment of the fractured teeth. Teeth were endodontically treated by conventional method. After, the acid etching with 37% phosphoric acid gel was performed and a bonding agent was applied on the dental surface. The fragments were reattachment and bonded with minimum amount of composite resin since the teeth/fragment interface was small. The occlusal contacts were adjusted in the finish line of restorations with a diamond bur and the polishing was performed with aluminum oxide discs. Positive esthetical and periodontal outcomes with no complications in the endodontic treatment were observed on radiographic examinations after twelve months of follow up. The endodontic treatment associated with the reattachment of the fractured teeth by a bonding procedure was a conservative treatment for the patient. The use of mouthguards is important to prevent such dramatic events.

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Background: Oral submucous fibrosis (OSF) is a chronic debilitating disease predominantly affecting the oral cavity and oropharynx. Characteristic histological traits of OSF include epithelial atrophy, inflammation, and a generalized submucosal fibrosis. Several studies and epidemiological surveys provide substantial evidence that areca nut is the main etiological factor for OSF. Hesitance of patients to undergo biopsy procedure together with clinicians becoming increasingly reluctant to take biopsies in cases of OSF has prompted researchers to develop animal models to study the disease process. Materials and Methods: The present study evaluates the efficacy, sustainability, and reproducibility of using Sprague-Dawley (SD) rats as a possible model in the induction and progression of OSF. Buccal mucosa of SD rats was injected with areca nut and pan masala solutions on alternate days over a period of 48 weeks. The control group was treated with saline. The influence of areca nut and pan masala on the oral epithelium and connective tissue was evaluated by light microscopy. Results: Oral submucous fibrosis-like lesions were seen in both the areca nut and pan masala treated groups. The histological changes observed included: Atrophic epithelium, partial or complete loss of rete ridges, juxta-epithelial hyalinization, inflammation and accumulation of dense bundles of collagen fibers subepithelially. Conclusions: Histopathological changes in SD rats following treatment with areca nut and pan masala solutions bears a close semblance to that seen in humans with OSF. The SD rats seem to be a cheap and efficient, sustainable and reproducible model for the induction and development of OSF.

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Aims: The aim of this study was to investigate the theoretical and practical skill levels of the general dental practitioners (GDPs) toward oral biopsy and to compare these results with other developed countries. Materials and Methods: A total of 500 Jordanian GDP from the 12 major governances of the Hashemite Kingdom of Jordan were conveniently sampled and included in this cross-sectional study. Participants were asked to complete a self-reported questionnaire that was specially designed to achieve the aims and objectives of this study. Results: Results demonstrated that a significant difference exists between the perceived theoretical knowledge related to oral biopsy and the clinical practical application of this knowledge among the participant dentists. Although 93.8% of the participants claim to have the ability to diagnose oral mucosal lesions, 91.4% recognize the diagnostic importance of oral biopsy and 67% know the indications of performing an oral biopsy, only 30.7% consider the oral biopsy as a diagnostic method to be used to reach a diagnosis of an oral mucosal lesion. Conclusions: A significant difference present between the theoretical information related to oral biopsy and the practical application of this information among the GDP.

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