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Acute coronary syndrome (ACS) refers to a group of clinical symptoms compatible with acute myocardial ischemia and includes unstable angina, non-ST segment elevation myocardial infarction and ST-segment elevation myocardial infarction.To study the incidence of lipid profile abnormalities in young patients (age 40 years or below) with ACS with clinical and cardiovascular risk profile.The study was conducted on 223 young patients of acute coronary syndrome with age 40 years or below. 89 young patients with acute coronary syndrome having lipid abnormalities were further followed up after 1 month.Majority of patients (55.15%) in the study population belonged to 35-40 years age group. Mean age of study population was 35.65 + 4.62 years with 90.13% males and 9.86% females. Main presenting symptom was precordial chest pain in 93.72% patients. Smoking was the commonest risk factor in young adults (81.7%). Other risk factors like diabetes, hypertension, family history were less common in young adults. Drug addiction was also higher in younger population (16%). Majority of young adults with acute coronary syndrome had more than 1 (47.53%) risk factor. Majority of patients were in Killip class I (86.9%) and only few patients (13.1%) had Killip class II or above. ST elevation myocardial infarction was far more common than NTEMI/USA and was found in 164 (73.5%) patients. Most common type of infarction was anterior wall myocardial infarction (62.80%). Majority of young patients had negative TMT, so it suggests that ACS in younger population has lesser complications during presentation, hospital stay and on follow-up.ACS in young continues to increase in Indian subcontinent. Younger patient with an ACS have different clinical characteristics and a different prognosis than older patients. The extent of CAD and degree of myocardial necrosis has influence on presentation and subsequent MACE in ACS and in this study, it appears dyslipidemia do not play any significant role in influencing extent of CAD and has little effect on outcome whether during acute stage or on immediate follow-up after ACS.

Dens evaginatus (DE) is a developmental disturbance that clinically appears as an accessory occlusal tuberculated cusp composed of enamel and dentin, enclosing a thin pulp tissue. It mainly involves the mandibular premolars. These cusp-like protrusions are susceptible to wear and fractures with subsequent pulp exposure leading to pulpal necrosis. In most cases, DE is discovered due to periapical inflammation in the absence of obvious clinical presentation of caries, trauma, or other pathologies, thus making it a diagnostic challenge. A case of nonvital tooth with an obscured DE in an 18-year-old male is reported here with a review of literature.

Aim: The purpose of this study was to evaluate the accuracy of implant casts generated with splinted and nonsplinted impression techniques with multiple parallel and nonparallel implants. Materials and Methods: In this experimental study, two edentulous maxillary stainless steel models with seven implant analogs in the central incisor, canine, premolar, and first molar region simulating clinical condition were used (control groups). In one master model, implant analogs were placed parallel to each other, whereas in another model, analogs were placed with a tilt-to-longitudinal axis. Forty stone casts were made from each model using splined and nonsplinted technique using polyether with open-tray technique. Then, the difference in the distance between the master cast and experimental cast in three dimensions was measured by coordinate-measuring machine. One-way ANOVA, post hoc Bonferroni test, and unpaired t-test were used for data analysis. Results: Statistical comparisons were made using ANOVA test, post hoc test, and unpaired t-test. Splinted technique with parallel implants generated interimplant distance values closest to the master model, followed by nonsplinted technique with parallel implants, splinted technique with angulated implants, and nonsplinted technique with angulated implants. Conclusions: Splinted impression technique exhibited higher accuracy than the other technique studies in both parallel and angulated implants.

This clinical report describes the fabrication of a two-piece obturator used to close the mandibular buccal defect. Two-piece obturator prosthesis was fabricated with clear heat cure acrylic resin to be used during the healing period following the marsupialization of odontogenic keratocyst which had lead to the loss of portions of the mandibular buccal region. The prosthesis fabricated in two parts was joined by the rare earth magnets. Retention was increased by lining the prosthesis with tissue conditioner material engaging the undercut.

Background: Fewer studies were conducted on resistance form. This study evaluated the effect of different auxiliary features on inadequate resistance form. Aim: The aim of the study is to evaluate the resistance at 22° taper with reduced occluso-cervical height with different auxiliary features. Methodology: An ivorine tooth was prepared with computer-aided design-computer-aided manufacturing with total occlusal convergence (TOC) of 22°, shoulder finish line 0.9 mm wide, reduced occluso-cervical height, i.e., 2.5 mm, and reduced diameter. The crown preparation was subsequently modified to include interproximal grooves, interproximal boxes, and reduced TOC in the axial wall from 22° to 8° in the cervical 1.5 mm of the axial wall. A total of four groups with ten standardized metal dies were prepared for each design with the computer-aided milling machine. Standardized complete metal crowns using silicon mold were fabricated and cemented on metal dies with glass ionomer cement. The resistance of each specimen was evaluated when force was applied at a 45° angulation to the long axis of the die in a lingual to buccal direction by a universal testing machine. The values were then analyzed using one-way analysis of variance test and post hoc Bonferroni test. Results: The comparison of the mean resistance test values was done among all the groups, and there was a significant (P ≤ 0.001) difference found among the groups. Conclusion: The most effective method of enhancing resistance form preparation is to decrease the TOC of the cervical portion of the prepared axial walls. Two interproximal boxes significantly increased the resistance form. However, two interproximal grooves did not significantly increase the resistance form.

Herpes zoster (HZ) infection of the maxillary and mandibular divisions of the trigeminal nerve manifests orally as unilateral vesicular eruption localized to the skin and mucus membrane of the dermatome innervated by the trigeminal nerve. Herpes zoster infection has been observed in immunocompromised states like uncontrolled diabetes, cancer chemotherapy, lymphoproliferative diseases, and recently in HIV-positive patients. There are only a few case reports of osteonecrosis due to HZ in an HIV-positive patient in an Indian population, this being the first in a North Indian population. We propose that osteonecrosis should be considered as a strong indicator of HIV infection, especially in a developing country like India. The present case highlights the complexities which can arise in an HIV-inflicted individual suffering from HZ infection. Early diagnosis of such infections can lead to effective treatment and prevention of complications.

Purpose: This study was aimed to determine the effect of various tray spacer thickness and subsequent repeated pours on the accuracy and dimensional stability of the impression made from monophasic polyvinyl siloxane material. Materials and Methods: Custom trays with different spacer thickness (2, 4 and 6 mm) were used for making an impression of a master model simulating 3 unit fixed partial denture with monophasic polyvinyl siloxane material. These impressions were poured with die stone and repoured. Distance between the reference points were measured and subjected to statistical analysis. Result: Casts obtained from 1 st , 2 nd and 3 rd pour of the impression in 2, 4 and 6 mm spacer thickness tray have similar dimensional accuracy amongst each other and with the master model except in molar diameter and inter-abutment distances of cast obtained from 6 mm spacer thickness tray. Conclusion: The vertical distance of stone dies were decreased, whereas horizontal distance increased as the thickness of impression material is increased. There were statistically non-significant changes occurring among the repeated pours in 2, 4 and 6 mm spacer thickness. Clinical Implication: 2 and 4 mm spacer thickness are acceptable for making an impression for three unit fixed partial denture with monophasic polyvinyl siloxane material and it was not affected by two subsequent (1 st and 2 nd ) repeated pours.

Predictable retrievability of cement retained prosthesis has been a major clinical concern. This article presents review of techniques used for implant prosthesis removal without any potential damage to abutments and implants.