Variations and abnormalities of skull appearance and shape are generally related to a primary maldevelopment of the brain. The copper-beaten skull appearance is typically associated with craniosynostosis, where premature fusion of the cranial bone sutures results in the growing brain exerting pressure on the malleable cranium, producing a pattern known as the beaten silver appearance or copper-beaten skull appearance. In this article, we have reported a case of 5-year-old child with classical features of beaten silver skull.

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Hypothyroidism refers to deficiency of thyroid hormones. It is potentially fatal if left untreated. It is more commonly seen in females and can be classified on the basis of age, severity, and etiology. Clinical manifestations of hypothyroidism range from subtle changes to life-threatening condition. The most common features are fatigue, lethargy, cold intolerance, weight gain, puffy face, constipation, change in voice, decreased mental activity, and dry skin. Oral manifestations include over-retained deciduous teeth, macroglossia, anterior open bite, enamel hypoplasia, enamel defects, poor periodontal health, and increased incidence of caries. Oral physicians play an important role in early diagnosis of this condition by identifying various signs and symptoms and thus prevent complications associated with dental treatment of such patients. Here, we are presenting a case of hypothyroidism in a 15-year-old female patient diagnosed by oral physician, highlighting the role of dentists in management of such cases.

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1,25(OH)₂D₃ is a lipid-soluble vitamin which plays an important role in calcium metabolism. It also plays an important role in maintaining oral health through bone and mineral metabolism and innate immunity. Osteoporosis is loss of bone when there is an imbalance between bone formation and resorption. In osteoporosis, loss of bone density may render the host highly susceptible to periodontal destruction. Thus, there might be a possible association between Vitamin D, osteoporosis, and periodontitis characterized by loss of bone. Thus, understanding the underlying mechanisms of these associations will help improve prevention, diagnosis, and treatment of these diseases. A systematic search of the literature was conducted in the Cochrane Library, PubMed, Web of Science (ISI), Scopus, Copernicus, and Lilacs for full articles published until 2015 for this review.

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Context: Periodontal diseases considered as the infectious condition of the periodontium. The prevalence of these diseases can be reduced by mechanical plaque removal along with systemic and locally delivered antimicrobial agents. Moxifloxacin in situ gel was evaluated as an adjunct to scaling and root planing as local drug delivery (LDD) for its efficacy in the treatment of chronic periodontitis. Aims: The aim of the study was to evaluate the efficacy of moxifloxacin as LDD in the treatment of chronic periodontitis. Settings and Design: Study design was randomized control trial. Subjects and Methods: Sixty-seven sites from chronic periodontitis patients of age 25–65 years with a pocket depth of >5 mm, showing radiographic evidence of bone loss were included in the study. The scaling and root planing (SRP) was performed for all the patients and randomly divided into three groups: Group A: SRP + moxifloxacin in situ gel, Group B: SRP + chlorhexidine in situ gel, and Group C: Control group received SRP as monotherapy. The clinical and microbiological parameters were recorded at baseline, 6^th week, and 3 months. Statistical Analysis Used: Data were subjected to statistical analysis with repeated analysis of varience and paired t-test using SPSS (V.22) IBM Corporation, Washington, DC, United States) software. Results: All the three groups showed improvement in both clinical and microbial parameters, but at the end of the 3^rd month, Group A showed highly significant results in comparison with Group B and Group C. Conclusions: Moxifloxacin showed more gain in clinical attachment level, and reduction in probing depth and in situ gel can be used as a safe vehicle to deliver the drug locally.

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Background: Two techniques with the most successful documentation of periodontal regeneration are osseous grafting and guided tissue regeneration (GTR). The aim of the present study was to clinically and radiographically evaluate the efficacy of synthetic bonegraft in comparison with bone graft and GTR membrane in the treatment of intrabony defects in molars. Materials and Methods: A total of 10 patients aged between 30 and 55 years diagnosed with moderate to advanced periodontitis with twenty bilateral angular defects were recruited for the study and were divided into two groups randomly (control group: Biograft-HT^® and test group: Biograft-HT^® and Cologide^™). Clinical and radiographic parameters such as gingival index, plaque index, gingival bleeding index, pocket probing depth, relative attachment level (RAL), radiographic area of the defect, and the bone fill (BF) were recorded at baseline, 3 months, and 6 months. Results and Conclusion: There was a significant reduction in probing depth and RAL from baseline to 3 and 6 months in both groups with statistically significant radiographic BF. Both the treatment modalities showed potential in enhancing periodontal regeneration.

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Introduction: The gingival morphology plays an important role in determining the final esthetic outcome. Different gingival biotypes respond differently to inflammation, restorative, trauma, and parafunctional habits. Some gingival features are influenced by tooth shape, position, and size, as well as gender and age. The thick biotype is more resistant to gingival recession and thin gingival biotype is more prone to recession, bleeding, and inflammation. Methods: A total of 220 patients of the age group of 20–50 years with well-aligned dentition and healthy gingival tissues, who agreed to be a subject of the study were included. Gingival biotype (GT) was assessed by a single examiner. Crown width/crown length ratio (CW/CL) of both central incisors and canines was determined according to Olsson and Lindhe. Gingival biotype was evaluated and categorized into thick or thin. Papillary Height (PH) was calculated as the distance from the top of the papilla to a line connecting the midfacial soft tissue margin of the two adjacent teeth, and the mean value was calculated. Results: In this study, 103 males and 117 females had participated. CW/CL ratio of the maxillary central incisors and canines, respectively, was 0.80 and 0.82 in males and 0.82 and 0.79 in females. Males had a short, wide form while females had long, narrow form. Thicker gingival biotype was more common in males. 71.84% of subjects with short, wide tooth form of maxillary central incisors had a thick and 28.16% had thin gingival biotype, whereas 48.72% of long, narrow tooth form of central incisors had thick and 51.28% had thin gingival biotype. Thick gingival biotype (62.20%) was more prevalent in young age group. The mean PH was 4.51 mm in males and 4.04 mm in females. Discussion: The determination of thickness of the gingival tissue plays an important role in treatment planning process for orthodontics, root coverage, extractions, and implant placement, especially in the maxillary anterior area. GT is assessed by an invasive and a noninvasive method. Many studies have emphasized the findings that the thicker biotype prevents mucosal recession, hides the restorative margins, and camouflages the titanium implant shadows. It also prevents biological seal around implants, thus reducing the crestal bone resorption. Conclusion: Our study confirmed that the thicker gingival biotype is more prevalent in males and is associated with short, wider form of teeth while thinner scalloped biotype is more common in females and is associated with long, narrow tooth form. Thick flat biotype is seen in younger individuals while thin scalloped gingival biotype in older age. Decrease in PH is observed with thin biotype.

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Diabetes is a group of metabolic diseases resulting from defects in insulin secretion, insulin action, or both and is characterized by hyperglycemia. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels. The prevalence of diabetes mellitus (DM) is growing rapidly worldwide and is reaching epidemic proportions. This article briefly deals with the medical aspects of DM, its oral manifestations and orthodontic treatment considerations.

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Peripheral ossifying fibroma (POF) is a focal, reactive, non-neoplastic tumor-like growth of the soft tissue occurring frequently in the maxillary anterior region, mainly affects females, predominating in the second decade of life. POF typically presented as a solitary, slow growing nodular mass that is either pedunculated or sessile. POF is commonly associated with poor oral hygiene, trauma, microorganisms etc and majority of cases showing no marked underlying bone involvement radiographically. The definitive diagnosis is based on histology, with identification of cellular connective tissue and focal presence of osseous component or other calcifications. Surgery is the treatment of choice, though it has a recurrence rate of 8-20%. We report an unusual case of a large POF in the posterior mandible region of a male child patient with histopathological correlations and also highlights the differential diagnosis and management.

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