The desire to balance between functional stability and cosmetic appeal in partial dentures gave rise to the development of precision attachments, since then, precision attachments have always been surrounded by an aura of mystery. A 35-year-old patient reported a chief complaint of missing upper anterior teeth and wants their replacement. Examination revealed the congenitally missing first and second premolars in the maxillary arch bilaterally, and canines were at first premolar place, which were brought there orthodontically. The patient was planned for 5-unit fixed partial denture from lateral incisor to first molar with semi-precision attachment distal to canine bilaterally, and canines were decided to be converted into the first premolar bilaterally. In this case, it was decided to use the semi-precision attachment and it was procured from Sterngold company, USA. Semi-precision attachments are used to reduce the detrimental stresses and excessive torque on pier abutment, thereby maintaining its health. The decision to use precision attachments in partial denture design should be carefully considered. It is alright to consider such sophistication where the facilities for this precise laboratory work and knowledge of using semi-precision attachment are available.

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In the quest for discovering ideal dental materials, biomaterials or those derived from biological sources play a special role because of their varied usages and inherent biocompatibility. Chitosan has been a rather recent material derived primarily from exoskeletons of life that forms mainly anthropods and fungi, etc. Evolving technology and understanding has made it possible for us to employ more biomaterials that are easy to adapt for uses in humans with less side effects and more therapeutic effects. With increasing applications that chitosan has found in medicine, exploring the dental applications of chitosan needs to be started with more vigor as well. Chitosan owing to its properties of being antimicrobial, biocompatible, biodegradable, osteoconduction, etc., either de novo or on being modified can be a real blessing in disguise for dentistry and find application in therapies from preventive to regenerative dentistry in various of its specialties.

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Cerebral palsy is one of the most severely handicapping conditions affecting irregular gait childhood. This condition manifests itself as a number of neuromuscular dysfunctions and involves muscle weakness, stiffness, paralysis, poor balance irregular gait, and uncoordinated or involuntary movement. These children may have higher risk of caries due to their inability to maintain good oral hygiene, intake of soft and cariogenic food, increased prevalence of enamel hypoplasic defects on the teeth. Periodontal diseases occur with great frequency, as they are unable to brush and floss adequately, they may also be on phenytoin to control seizure activity which is a cause of some degree of gingival hyperplasia. Malocclusion occurs twice, bruxism is commonly seen in athetoid type, and due to the nature of disorder, these children are more susceptible to trauma, especially of the maxillary anteriors. They have excessive drooling and difficulty in swallowing. Spastic children present with spastic tongue thrust, Class II DIV 2 malocclusion with unilateral crossbite. Athetoid patients presents with mouth breathing and anterior open bite. Many patients prefer to be treated in the wheel chair, which may be tipped back into the dentist's lap, head should be stabilized throughout the procedure, use physical restraints for control of failing extremities, mouth props, and finger splints can be used for control of involuntary jaw movements, avoid abrupt movements, lights and noises to minimize startle reflex reactions. Local anesthetic can be used with care, rubber dam can be used to protect the working area from hyper active tongue movements, and gauge shield should be used during extraction to avoid aspiration. Premedication can be used to reduce hypertonicity, involuntary movement, and anxiety; general anesthesia can be used as a last resort. This article discusses about etiology, clinical features along with management of children with cerebral palsy.

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Oral mucosa may be the first site to manifest protean signs and symptoms in immune mediated diseases. Therefore, it is of paramount importance to have a thorough and vast knowledge about various diseases. It is the role of oral and maxillofacial diagnostician to diagnose the lesions according to their salient features. In this review article, we aim to describe the immune-mediated oral lesions, their clinical features, investigations, and management.

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Objectives: Mandibular fractures are treated surgically by either rigid or semi-rigid fixation. The focus of this study was to determine the efficacy of lag screws in treating mandibular parasymphysis fractures. Materials and Methods: We conducted a quasi-experimental study in which ten patients with mandibular sagittal parasymphysis fractures were enrolled. In these patients, two 2.0 mm stainless steel lag screws were installed for open reduction and internal fixation. Throughout the study, patients were examined for occlusion, fracture stability, screw location in relation to vital anatomical structures, reduction precision, maximum mouth opening (MMO), biting efficiency, and several other complications on the 1^st day, 1^st, 2^nd, and 6^th weeks postoperatively. Results: All parasymphysis fractures had a good bony union after surgery. One patient had mild occlusal discrepancies postoperatively, and statistical significance was found between preoperative and postoperative occlusion (P < 0.0004). Only one patient had abnormal mobility between the fracture lines postoperatively, with a highly meaningful statistical observation (P < 0.001). The comparative statistical analysis of MMO at different follow-up periods showed highly significant (P < 0.00001) results. Substantial improvement in biting effectiveness yielded a high statistical significance (P < 0.00001). There was no evidence of postoperative complications such as wound infection, wound dehiscence, intraoral screw exposure, or mental nerve injury in any of these patients. Conclusions: Lag screw fixation is a realistic and reliable method of internally fixing mandibular parasymphysis fractures. This technique allows the skilled surgeon to achieve optimum stability and functional healing by using the least amount of material.

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The mucocele is the accumulation of mucous from salivary glands and its ducts into subepithelial tissue. It is the most common, painless, and harmless oral lesions. Etiology could be trauma, lip habits or unknown. Diagnosis is made mainly on the basis of history and clinical examination. Along with conventional surgical treatment now, we have lasers also for excision of mucocele lesions. We reported a case series of mucocele treated with conventional treatment as well as laser.

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Aim: A study aims to reappraise the merits of nasoalveolar molding before the repair of unilateral cleft lip. Materials and Methods: A prospective study was conducted with 20 cases of the unilateral complete cleft lip for 3 years. We counseled the parents, offered them to choose the surgical procedure with/without preoperative nasoalveolar molding (NAM), and obtained consent from them. The nasolabial closure was done either after aligning the cleft segments with NAM or without preoperative NAM. The patients were followed up for 1 year and assessed. Both groups are then compared with normal healthy individuals of the same age group. Results: Depending on preoperative NAM, the patients were divided into Groups A (without NAM) and B (with NAM). All the facial proportions and angles (except oral commissural width: facial width and nasal tip angle) of Group B are much closer to the values of normal age-controlled individuals. However, a significant difference existed between the Group A values and normal individuals. Group B showed better nasal symmetry and restoration of normal proportions. The quality of scar produced was significantly superior in Group B when compared to Group A. Body weight change was also significantly different in the two groups. Group B seemed to catch the 15^th percentile while Group A stayed at the 3^rd percentile in the postoperative period. Conclusion: Presurgical NAM helps to restore the normal facial proportions and produces a healthier scar. Furthermore, the bodyweight of patients seems to improve as the NAM plate acts as a feeding plate.

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Odontomes are the most common odontogenic tumor of the jaws and generally asymptomatic. Odontomes are basically classified into two types, complex odontomes, and compound odontomes. Various theories or etiological factors are been quoted for the occurrence of odontomes. The sole management depends on the early diagnosis, histopathological examination, and excision of these tissues. This article aims to present a case report on complex odontome in the mandibular premolar region in a 13-year-old male child.

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Dentigerous cyst is a developmental odontogenic cyst of the jaw most commonly associated with impacted third molars. The incidence of the cyst is rare in the maxillary anterior tooth region. Here, we present a case of dentigerous cyst in relation to permanent maxillary central incisor abutting the nasal floor and its management.

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Background: Antibiotics are a subject of intensive abuse due to overprescription and also administration for inappropriate reasons. In India, some studies have reported the use and abuse of antibiotic therapy and their consequential impact on antibiotic resistance. However, there has been no study yet on the use of antibiotics among dentists in North East India. Objective: To determine the rationale and prescription pattern of antibiotics among dentists of Imphal city in North East India. Materials and Methods: A self-administered questionnaire was used. The questionnaire consisted of demographic data and comprised questions related to the use of antibiotics for various dental procedures and in certain clinical situations. Results: The results of this survey indicate that there is wide spectrum of antibiotics prescribed by dentists in Imphal city. Amoxicillin was clearly the choice of antibiotic among dentists. Although the dentists handpicked antibiotics based on its efficacy and side effects, at certain places these drugs were overtly used. Majority of the respondents thought that antibiotic sensitivity tests would help them choose the right antibiotic. Conclusion: The prescription pattern for antibiotics was inconsistent and at times inappropriate. A standard guideline needs to be formulated according to the population for prescribing antibiotics; because when used judiciously antibiotics are lifesaving.

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Mesiodens is the most frequent type of supernumerary tooth, found in the central position of the upper or lower jaw. It presents in between the central incisors either erupted or impacted. Supernumerary teeth are developmental variations characterized by extra teeth besides the normal dentition. This condition is referred to as hyperdontia. The diagnosis of mesiodens is usually an accidental finding through a radiograph, which was intended for investigation of the neighboring teeth. Early diagnosis and prompt treatment are necessary for prevention of deleterious effects on the surrounding dentoalveolar structures. This case report describes the diagnosis and management of an undiagnosed inverted mesiodens along with a palatally impacted maxillary canine in a patient undergoing orthodontic treatment.

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