It is important for orthodontists to make every effort to develop a harmonious balance that will produce the most attractive smile possible for each patient treated. A smile usually translates a common man emotional intelligence and expresses his feeling in a unique fashion Thus, he seeks the orthodontist to improve the esthetics and especially the smile. The success of smile design is determined by the patient's profile and the orthodontist's esthetic goals and skill so as to re-establish patients' expectations. This article enlights the overview few characteristics for a balanced smile.

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All-ceramic restorations have revolutionized the concept of esthetics in the practice of dentistry. The increasing use of polycrystalline alumina and zirconia as framework materials and the increasing popularity and variety of CAD-CAM systems seem to be mutually accelerating trends. In fact, CAD-CAM technology opens-up new vistas for increased esthetics. With ever emerging developments, it becomes more versatile and convenient. However, this comes at the expense of making the application more complicated. The present review gives an overview on the different materials available in ceramics used in dental CAD/CAM technology.

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The basic objective of this review is to understand the role of Merkel cells (MCs). MCs are neuroendocrine cells present in the epidermis of basal layers of vertebrates. The origin of MCs is controversial. They act as mechanoreceptors. MC carcinoma is known to be aggravating primary cutaneous neoplasm. Diagnosis of this is based on their staining. Radiation therapy and chemotherapy are given for such patients.

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Background: Depression is a strong mood involving sadness, discouragement, despair, or hopelessness that lasts for weeks, months, or even longer and tends to have negative and self-critical thoughts. The purpose of the present study was to explain the correlation between depression and self-esteem among dental students of Udaipur. Materials and Methods: Three hundred and fourteen students participated in the study. Self-esteem was estimated using Rosenberg method using 4-point Likert scale format ranging from strongly agree to strongly disagree. Beck depression inventory is a 21-question multiple-choice self-report inventory and was used for measuring the severity of depression with a 4-point scale ranging on severity. Descriptive statistics were used to calculate means. T-test and Pearson's correlation were used for statistical analysis. Results: The mean scores of depression and self-esteem were found to be 9.11 ± 10.11and 20.11 ± 5.17, respectively, and a negative correlation was found between depression and self-esteem (r = −0.38). The mean score of self-esteem of male participants was higher, i.e., 22.24 ± 5.16 and the mean depression score was lesser, i.e., 10.12 ± 7.82 and the findings were statistically significant. Conclusion: The present research suggests that low self-esteem and depression have strong negative correlation. Improving self-esteem reduces risk of depression regardless of whether the individual is enduring stressful or nonstressful life experiences.

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Aim: This study aims to evaluate the knowledge, attitude, and practice toward disclosing solution among dental students using a questionnaire survey. Materials and Methods: The survey was conducted among 200 undergraduate dental students. Data were collected using a questionnaire consisting of questions regarding students opinions, viewpoints, and recommendations about disclosing agents. Results: About 80% of the students were aware of the indications for disclosing agents; however, when asked about the types of disclosing agents available, only 27% of the students were aware. Regarding the methods of using disclosing agents, only 21% of students had knowledge about it. Majority of students were not aware of the commercially available brands (90%), recent advances (97), and side effects (98%) of disclosing agents. In this study, it was found that 33% of students were aware of importance of using disclosing agents at home and in dental practice, and 10% of students prescribed it while the majority of students (90%) failed to do so. Conclusion: Despite having theoretical knowledge, most of students do not give importance to use of disclosing agents in proper oral hygiene maintenance in patients. As dental professionals, students must take responsibility of their patient's health even after treatment. Students should update themselves about new materials available in the market to create the oral hygiene practice efficient among the patients.

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Background: There is still inadequate information available regarding the role of GTR techniques in such lesions with the presently available data suggesting that there is a possibility of healing of apico-marginal defects without use of GTR technique by using modern microsurgical procedures. Fewer randomized-clinical trials have evaluated the response of GTR membranes in the treatment of apico-marginal defects. Aim: The present prospective, controlled clinical trial was, therefore, planned to evaluate the role of collagen membrane as GTR material in the healing of apico-marginal defects. Subjects and Methods: Thirty patients meeting inclusion criteria were selected and allocated randomly to either the GTR membrane group or, the control group. Clinical and radiographic examination was done after one week for baseline measurements and then, during follow-ups at regular intervals of 3, 6, 9, and 12 months after the procedure. The criteria for success included the absence of clinical signs and symptoms and signs of radiographic healing. Statistical Analysis Used: The statistical analysis of the ordinal data was carried-out by using non-parametric methods. Mann-Whitney and Wilcoxon signed rank test were used for the unpaired and paired data respectively. Chi-square test was used to evaluate dichotomous data. Results: Significant reductions were observed in the periodontal pocket depth (PD), clinical attachment level (CAL), gingival margin position (GMP) and the size of the peri-apical lesion at 12-month follow-up (P < 0.05) in each treatment group except gingival margin position (GMP) in the GTR membrane group with the corresponding P value being 0.059. The results for the reduction in the size of the peri-apical lesion were, also, found to be statistically significant with the corresponding P value being <0.05. Furthermore, 83.33% of the patients showed complete healing in case of GTR membrane group while the same was found to be 90.9% in case of the control group although the difference in the percentage reduction in the size of the peri-apical lesion at different time intervals after surgery was found to be statistically insignificant between the two groups. Conclusion: The results of the present study indicated that there might not be any additional clinical advantage obtained from GTR membrane barriers in the surgical management of isolated apico-marginal defects of primary endodontic origin with absent or, minimal proximal bone loss.

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Tooth agenesis is not a rare phenomenon. Most often, the tooth that shows agenesis is the maxillary lateral incisor or the third molars. Agenesis of maxillary central incisor is an extremely rare phenomenon. A case of congenital absence of maxillary central incisor in a 42-year-old, otherwise healthy individual is being presented. When one encounters a case, it is important that it is differentiated from the other serious form of the disease which is solitary median maxillary central incisor syndrome.

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Context: Cephalometric analysis to assess facial skeletal patterns does not come without limitations. Complementary radiographic analysis has been suggested by many authors to better analyze facial patterns and discrepancies. Aims: This study aims to find correlations between the vertical and sagittal relationships of cephalograms and orthopantomograms (OPG), use the OPG to assess facial symmetry, and test the efficacy of a novel OPG analysis technique in the skeletal facial analysis. Settings and Design: Cephalograms, OPG, and facial pictures were taken from 23 volunteers from the orthodontic clinic at RAKCODS (13 males and 10 females). Subjects and Methods: Symmetry was assessed in the OPG. The traditional cephalometric analysis was performed and correlated to an experimental OPG technique. Facial convexity (pictures) and cephalometric measurements were used to identify participants with normal facial skeletal patterns. Preliminary standards for the OPG analysis technique were determined from this normal subgroup. Statistical Analysis Used: Pearson's correlation was used to assess the relation between angles. means and standard deviations were calculated to establish norms. Results: Significant correlations were observed between the cephalometric analyses and the OPG technique. Perfect symmetry was uncommon. Sagittal, vertical, and transverse preliminary norms were established. Conclusions: Perfect symmetry is uncommon, which makes lateral cephalometric analysis insufficient to analyze facial skeletal patterns. Complementary frontal assessment may improve the accuracy of orthodontic diagnosis. The OPG technique introduced in this study correlates with traditional cephalometric analysis and can be a potential adjunct to cephalometric analysis. Further studies using a larger sample should be used to establish more reliable measurement standards.

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With the invention of light-cured resin materials used in bonding and restorations, the use of light cure units has become an integral part of dentistry. There is a vast change in the curing devices over the last 30 years. At present, the following types of light-curing devices are available – Quartz-tungsten-halogen, light-emitting diode, plasma arc curing, and Argon laser. This review is primarily focused on discussing the types and limitation of each type of light cure units and also maintenance of light cure units to optimize their use.

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Aim: The aim of this research is to compare the lip elevation to the normal lip height. Background: Lip elevation is one of the eight parameters of a balanced smile the others being lip line, smile arc, upper lip curvature, lateral negative space, smile symmetry, and frontal occlusal plane. Materials and Methods: Sixty (30 males and 30 females) individuals were included in the study and were divided into 2 age groups. The age groups were between 15–20 and 21–25 years. These age groups were selected because studies show that 90% of patients reporting for orthodontic treatment are in this age group range. Two measurements were taken including (i) relaxed upper lip length and (ii) smiling external upper lip length. Results: The mean total lip elevation while smiling in males is 4.1 mm and for females was 4.9 mm. Maximum lip elevation was seen in the age group of 20–25 years in both males and females. The results are significant for both males and females across all measured age groups. To evaluate the lip elevation as for a balanced smile. Conclusion: As public awareness of esthetic dental treatment increases patient seeks to enhance and resolve several common concerns to achieve a good smile. Orthodontic case in which occlusion meets every criterion of American Board of Orthodontics for a successful treatment may not produce an esthetic smile. Thus, the goal of a clinician is to create not only an admired look but also the ability to harmonize with hard and soft tissues.

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Orthodontist and his personnel are at risk of being exposed to a wide range of patients with blood-borne diseases such as HIV/AIDS, hepatitis B, hepatitis C, and airborne diseases such as tuberculosis and influenza. Infection can be directly transmitted by blood, oral fluids, contaminated instruments and surfaces, or through the respiratory system. Control of infection that spreads through various instruments and armamentarium, which are used in the field of orthodontics and dentistry in general, is an important measure to prevent cross infections which can be achieved by following universal precautions, including the imperative steps of disinfection and sterilization. The objective of sterilization is to remove microorganisms or destroy them from areas or from materials since they cause contamination, infection, and decay. Specific issues in orthodontic office that need to be addressed include increased hand washing, use of barrier techniques, puncture-proof containers for disposal of sharps, and heat sterilization of handpieces and orthodontic instruments. This is of utmost importance to keep patient-to-patient and dentist-to-patient infection transmission at a minimum. In the following article, authors have attempted to provide certain practical guidelines to be followed in practice for optimal infection control.

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Introduction: It is seen that the failure of mandibular third molars to erupt is most affected by a lack of space in the alveolar arch between the distal of the second molar and the ascending ramus. Therefore, an appreciation of mandibular and facial growth may assist in predicting mandibular third molar eruption. Aim: The reason for this study is to appreciate the growth of mandible and facial growth which may assist in predicting mandibular third molar eruption as the lack of space in the alveolar arch between the distal of the second molar and the ascending ramus has been associated with failure of mandibular third molars to erupt. Materials and Methods: A list of patients who had visited the outpatient department at the Saveetha Dental Hospital of Chennai in April and May 2016 were sourced. The facial type determined by the facial index is calculated using an equation where; (i) Brachyfacial: Smaller than 80.0%–84.9%, (ii) Mesofacial: 85.0%–89.9%, (iii) Dolichofacial: 90.0%–95% or greater. Results: The incidence of horizontal impactionwas higher in dolichofacial patients when compared to people with mesofacial profile. The incidence of mesioangular impaction was seen to be higher in mesofacial patients. Conclusion: In this study the classification of impaction describes only the impaction status at the time of taking the radiograph, and not the potential final status of the third molar. Further research may be done to assess whether the changes in impaction status are more likely to be seen in dolichofacial or brachyfacial subjects.

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Objective: To evaluate the awareness on oral manifestation of diabetes in general population in Chennai. Background: Diabetes mellitus (DM), according to the World Health Organization is a silent epidemic which affects large number of people around the world and is directly related to the oral health status of the patients. DM is a metabolic disorder of multiple etiologies due to disturbances of carbohydrate, fat, and protein metabolism. It is characterized by chronic hyperglycemia, and it is associated with oral disorders, cardiovascular, and renal complications. These complications result in diminished quality of life and reduced life expectancy. Although dental caries was comparatively low in diabetics, periodontal status was compromised. Awareness on diabetes and increase risk of oral disorders in diabetic patient is comparatively less than awareness on systemic diseases in general population. Hence, this study was conducted to evaluate awareness and educate them by reinforcing the importance of oral health care in diabetes. Methodology: A total of 159 self-completion questionnaires were distributed to assess the main objectives of the study. Results: The awareness of public toward increased risk for oral diseases in diabetes is low compared to their awareness of systemic diseases. On average, only 41.8% people is aware of an oral complication of DM, which is very low and 58.2% of population is unaware of a complication of DM. Conclusion: People were found to have little knowledge on oral manifestation of DM. To promote proper oral health and to reduce the risk of oral diseases, health professionals in both the dental and medical fields need to take the responsibility to develop programs to educate the public about the oral manifestations of diabetes and its complications on oral health.

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Context: The occurrence of dental anomalies varies between different populations. Knowledge of regional occurrence and prevalence of dental anomalies is important for proper diagnosis and patient management. Aims: This study was intended to determine the prevalence of developmental dental defects in patients from a teaching hospital in the United Arab Emirates. Settings and Design: A retrospective study was performed using 2925 radiographs from the database of the radiology department at RAK College of Dental Sciences. Subjects and Methods: Panoramic radiographs of 400 patients between 17 and 60 years of age were presented anomalies in teeth number, shape, size, and position. The patient general information, type of anomaly, and affected tooth was determined. Statistical Analysis: Data were summarized and analyzed using nonparametric tests. P < 0.05 was considered significant. Results: The prevalence of developmental dental defects was 14.7% (n = 400) out of which 170 cases were further analyzed. The anomalies were evenly distributed among both genders and were most prevalent and diverse in the Syrian subpopulation. The most common anomalies were tooth hypodontia (19%) and root dilaceration (16%). The least common anomalies were hyperdontia (3%), taurodontism (3%), and retained primary teeth (1%). The most affected teeth were the maxillary and mandibular third molars. Conclusions: The high prevalence of dental defects suggests the need for proper diagnosis, intervention, and treatment. Further research into etiological factors for dental defects could create awareness and guide preventive strategies to assist in minimizing the associated dental problems.

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Objective: The purpose of the study was to demonstrate the presence of heat-shock protein (HSP) 27 in developing tooth germs and ameloblastoma and compare their expressions. Materials and Methods: The study was conducted in the Department of Oral Pathology and Microbiology, Mahatma Gandhi Postgraduate Institute, Puducherry. Orofacial complexes of five abortus fetuses between 9^th and 18^th weeks were processed for fetal sections and ten formalin-fixed paraffin-embedded tissues for ameloblastoma were taken up from the archives of the department. All tissues were stained for routine hematoxylin and eosin, and immunohistochemistry was done using anti-HSP27 antibody. Results: Dental lamina was found positive for HSP27 in all the five cases; succedaneous bud stage was found positive in two of five cases. Stellate reticulum and outer enamel epithelium were found positive in one each of five cases and inner enamel epithelium was negative in all five cases. In ameloblastoma, ten cases were studied in which positivity was seen in the columnar or cuboidal cells of the tumor islands in various histological variants of ameloblastoma. Conclusion: The immunostaining pattern of HSP27 revealed that the differentiation level of ameloblastoma corresponds to the differentiation level of odontogenic cells in tooth germ and that HSP27 might play a role in this. Further, HSP27 can be taken up as a marker of differentiation of ameloblasts along with markers such as cytokeratin 19.

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Purpose: The aim of the study was to evaluate the dental students' attitude and preference toward denture cleansing methods using a questionnaire survey. Materials and Methods: This survey was conducted on 200 undergraduate dental students of Saveetha Dental College and Hospitals. Data were collected using a questionnaire consisting of questions regarding students' opinions, viewpoints, and recommendations about denture cleansing routines. Results: A total of 200 students studying in final year and interns were reviewed in this study. About 78% of students felt denture hygiene is important to maintain esthetics and longevity of the denture. In the present study, 63% of the patients recommended mechanical method, 35% combination, and 2% chemical method. Regarding the frequency of denture cleansing, 40% of students recommended denture cleansing more than thrice a day, 37% recommended twice a day, and 23% once a day. This study reveals only 10% of students were aware of commercially available brands of cleansers in the market, 3% were aware of side effects, and only 2% were aware of recent advanced methods of denture cleansing. Conclusion: Despite having theoretical knowledge, most of students do not give importance to proper denture hygiene maintenance in patients. As dental professional students must take responsibility for their patients' health even after treatment, students should update themselves about new materials available in the market to create the denture hygiene practice efficient among the patients.

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Aim: The aim was to examine root canal morphology of permanent mandibular incisors in an Indian subpopulation using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images of 150 patients with 100 healthy permanent mandibular incisors were evaluated. According to Vertucci's classification, teeth were examined to determine the number of roots, number of canals, and canal configurations. The effects of gender and age on the incidence of root canal morphology were investigated. Results: Of permanent mandibular incisors, 71.64% had a single root with single canal. Mandibular lateral incisors (10.45%) had a higher incidence of the second canal compared with mandibular central incisors (8.34%). A slightly higher percentage of incidence of a second canal was found in males (10%) than in females (5%). Vertucci type I (68.5%) was most common followed by type IV (0.62%) which was the least common. Conclusion: The prevalence of the second canal in mandibular incisors was high but within the range of previous studies performed on different populations. CBCT imaging is an excellent method for detection of different canal configurations of mandibular incisors.

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Surgical intervention for the management of ocular disorders may lead to eye defects. The primary objective in rehabilitating such defects with an ocular prosthesis is to reestablish the physical and mental well-being of the patient. A series of detailed steps for custom-made ocular prosthesis fabrication using the advantages of digital photography are presented in this article. The iris reproduction by capturing it in a digital camera and editing the image in graphic software is presented. The presented technique replicates the natural iris without the need for iris painting and special artistic skills in a short time and simplified manner.

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Aim: The aim of this study is to determine the factors that influence the desire for orthodontic treatment among outpatients of Saveetha Dental College. Materials and Methods: A questionnaire was prepared and handed out to 100 random outpatients of Saveetha Dental College. The questionnaire contained four questions, of which the last one pertained to the reason for not undergoing orthodontic treatment. Results: Of 100 people, 23% were not aware of the treatment options available, 16% were not interested, 14% felt they did not have time to spare, 14% said they would start treatment soon, 11% felt they could not afford the treatment, 9% were satisfied with their appearance and did not feel the need to undergo any treatments, 5% had fear of dentists, 4% had a fear of pain, 3% felt they were too old to start any treatment now, and 1% felt it would cause discomfort while eating. Conclusion: From the above study, it can be concluded that lack of awareness is the main factor that keeps people away from undergoing orthodontic treatment. Self-perception of orthodontic treatment motivated only a small percentage of the study population.

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Context: The practice of self-medication has been recognized since ages. There has been enough literature available regarding it being there for medical illnesses; however, there is a relative dearth of information about it being there for orodental causes. The present study was planned to determine the abuse of self-medication for orodental causes and the reasons for resorting to it. Materials and Methods: The present study was conducted in rural areas of Central India with 230 consenting participants selected by random sampling and interviewed with the aid of an 18-point, closed-ended question-based, semi-structured questionnaire. Results: Nearly 63.59% of the participants admitted they had resorted to self-medication without any consultation. Odontalgia was the most common reason, for which people resorted to self-medication (57.69%). Seventy percent of the participants did not have the knowledge about the dose, duration, adverse drug reactions, and interactions of drugs with other drugs they had been using. Paracetamol was the most commonly abused drug for self-medication. Conclusion: Analgesics were the most common drugs abused for self-medication. Adequate health education of the populace was found mandatory to make people aware of the use and misuse of drugs and regarding the potential adverse effects and drug interactions they might have led to, especially, when used repeatedly or on a chronic basis. Furthermore, dental health-care services were supposed to be made more readily available and affordable so that self-medication among populace in rural areas could be checked effectively.

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Regional odontodysplasia, also commonly known as ghost teeth, is a rare dental anomaly affecting the teeth. It is a nonhereditary disorder and affects the maxillary teeth of females. This condition is localized to one or more teeth of one quadrant; it hardly crosses the midline to affect the teeth of the next quadrant. Controversy regarding the management of this condition is still prevalent, and some believe in extraction while others in retaining them. A case of ghost teeth in an 11-year-old boy, crossing the midline with radiographic evidence of advancing development, is being presented, which supports the “wait and watch” policy in the management of this condition.

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Gingival melanin pigmentation is a common finding, especially in non-Caucasians population. This often results in unaesthetic appearance concerning many patients especially those with gummy smile or excessive gingival display. Gingival depigmentation procedure can be performed in such patients with for esthetic reasons. The currently available treatment options for the correction of gingival depigmentation include conventional periodontal plastic procedure with scalpel, cryosurgery, laser treatments, and radiosurgery. Out of this diode laser remains a simple, effective, and minimally invasive treatment option. The present case series makes an effort to assess the gingival depigmentation procedure using diode laser 980 nm.

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Aim: The aim of this study is to determine the prevalence of two roots of mandibular permanent canines on intraoral periapical radiographs (IOPARs). Methods: Two hundred and two IOPARs of patients in the age range 18–70 years were retrospectively analyzed for the presence of two roots in permanent mandibular canines. Statistical Analysis and Results: The data obtained were analyzed using Microsoft Excel (Version 2007) for Windows. Three patients out of 202 exhibited two roots, indicating the prevalence to be 1.48%. The mean age of the patients depicting two roots was 37 years. All the patients were females. In all the three patients, the additional root was noted on the left side canines. Conclusion: This study demonstrates the prevalence of two-rooted mandibular permanent canine.

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