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The current century is an era of microsurgical reconstruction. However, there are situations when free tissue reconstruction is not possible due to extremes of age, their associated co morbidities and dearth of microsurgical expertise and equipment. The significance of local and regional flaps in such reconstructive scenario is paramount. These flaps are well vascularised, easy to master, quick to perform and can be used in both primary as well as salvage reconstruction. The Lateral forehead flap (LFF) is one such useful option. The LFF is an axial myocutaneous flap spanning the entire forehead aesthetic subunit. Herein we describe the operative technique of LFF elevation, advantages and disadvantages of the use of this flap in the reconstruction of facial and intra oral defects reconstruction, both in primary and salvage settings. We describe our experience in the use of this handy flap for various facial reconstructions in our institute. This versatile “forgotten” flap which is easy to master can be handy to all general plastic surgeons who indulge in such reconstructions.

This clinical case report deals with a rehabilitation of a patient with an extensive maxillary and orbital defect using an intra oral prosthesis obturating the maxillary defect and extra oral orbital prosthesis retained with rare-earth magnets for secondary retention; primary retention was derived by snug fit of the prosthesis to underlying and adjacent tissues. The rehabilitation resulted in improved function, esthetics and comfort to the patient thus enabling him to lead a normal life.

Background: The success of various treatments protocols depends on pre-operative diagnostic aids such as radiographic assessment with linear measurements, in such scenario radiographic grid with its unique design aids like a scale for image analysis on intraoral periapical radiograph. Hence, the intra oral grid is a simple and accurate way of measuring objects, and another advantage is to overcome various magnification errors associated with measurements. So, the present study was designed to know its accuracy in assessing the linear measurements. Materials and Method: The study sample comprised a total of 40 subjects, which were categorized into four groups. A total of 240 exposures were taken, where each patient was subjected to six radiographs, of which two are conventional intraoral periapical radiographs without grid, and two are conventional intraoral periapical radiographs with grid by bisecting and paralleling technique and another two radiographs are taken by digital CMOS sensor with intraoral periapical grid in all four groups. The measurements were performed on the radiographs using scale and divider and in case of radiograph with the grid by counting the grid lines from specific points. Results: The results of the study revealed on comparison of conventional and digital radiographs with and without a grid in both bisecting and paralleling technique in all the four groups, there was a statistically significant difference noticed with digital radiography compared to the conventional method in assessing the measurements with the grid with P value

The role of a maxillofacial prosthodontist in the treatment of facial defects cannot be underestimated. A multidisciplinary approach is required during the rehabilitation procedure to bring out effective results. Ancillary maxillofacial prostheses limit the patient's disability and improve function. These prostheses are inevitable in restoring the function, esthetics, general, and psychological health of the patients. This article reviews the various ancillary-maxillofacial prostheses and throws light on their historical development.

Fatal accidents are rather common in mining endeavours. Establishing the identification of the deceased in mining accidents can be extremely challenging and the palatal identity appliance is a custom made intra oral device with an embedded memory chip with complete data stored in it which can be very useful in such situations to establish the identity of the dead.

Aim: The purpose of this clinical study was to compare and clinically, to evaluate the accuracy of six apex locators with intra oral periapical (IOPA) radiograph in multirooted teeth. Materials and Methods: A total of 90 multirooted teeth (maxillary and mandibular molars) with irreversible, infected or necrotic pulp tissue and completely formed roots were included in this study and were divided randomly into six groups (Root ZX II, Raypex 6, I-Root, Romiapex A-15, Sybron Endo Mini and Root ZX mini). The working length was determined using six different apex locators, and the accuracy of the apex locators was compared with IOPA radiographs, to be categorized as accurate, short, and long or beyond. Results: A total of 270 canals were evaluated, of which 233 (86.3%) canals exhibited acceptable working length, 28 (10.4%) canals exhibited short working length, and only 9 (3.3%) canals exhibited working length beyond the apex. There were a statistically significant results in all the groups (P < 0.05) and the comparison between the groups was statistically insignificant. Conclusion: The repeatability with that of apex locators is of great advantage, but the information gained from the radiographs cannot be obtained by any other means. Therefore, it is recommended that radiograph and apex locators are the best combinations in accurately determining the working length and the successful endodontics.

Introduction: Supervised toothbrushing program at schools have indicated limited improvement in oral hygiene among children. Aim: The aim of this study is to evaluate whether the use of an intra-oral camera as a reinforcement tool in a supervised tooth brushing program at school can improve plaque control. Materials and Methods: A double-blind, parallel, two arm interventional study was conducted among 120 school children from 2 schools, aged 12-year in Pune. The study group received an intervention of supervised toothbrushing and reinforcement sessions for 30 days using intra-oral camera. The control group received only supervised toothbrushing. Evaluation for plaque control was performed at the end of 30 days, 3 months, 6 months, and 12 months. Analysis of co-variance was used to find the intergroup difference at different time intervals. Analysis of variance was used to find the intragroup differences of the plaque scores. Post hoc Bonferroni test was used to find the pairwise changes in plaque scores between different time intervals. Results: In the study group, the mean plaque score was reduced to a significant extent from baseline to 30 days and 3 months (P < 0.05) and then the plaque score remained stable until the end of 12 months. While in the control group, the plaque score increased compared to baseline. There was a statistically significant difference between the mean plaque scores of study and control group at each time interval (P < 0.05). Conclusion: Intra-oral camera can be effectively used as a reinforcement tool in supervised toothbrushing program at school for achieving higher plaque reduction.

Aims and Objectives: To assess the prevalence of caries experience using decay-missing-filled teeth (DMFT)/decayed, extracted, and filled teeth (deft) index and severity of clinical consequences of untreated dental caries (PUFA/pufa index) in the age groups of 6, 12, and 15 years in urban and rural school going children of Visakhapatnam District. Materials and Methods: A cross-sectional study of 689 rural and urban school going children of Visakhapatnam District with the age groups of 6, 12, and 15 years were randomly selected. Intra oral examination was carried out to assess dental caries experience using the World Health Organization criteria. For data collection, DMFT/deft and PUFA/pufa index were used and data collected was tabulated and subjected to statistical analysis. Results: The mean prevalence of caries (DMFT + deft > 0) in rural: 37.37% and urban: 26.28%, and the mean prevalence of clinical consequences of untreated dental caries (PUFA + pufa > 0) in rural: 11.9% and urban: 10.7%. The untreated caries, PUFA ratio for 6 years children was found to be 53.33% in rural and 50% in urban, for 12 years children was found to be 41.05% and 16.43%, whereas for 15 years it is 15% and 17.54% in rural and urban children, respectively. Conclusion: The study showed that the prevalence of clinical consequence of the untreated dental caries is high in the rural children of age groups 6 and 12. Hence, the use of PUFA/pufa index as a compliment to the classical caries indices can address the neglected problem of untreated caries and its consequences. Furthermore, PUFA/pufa data may be used for planning, monitoring, and evaluating the treatment plan by the health care providers.

Anticipated difficult intubation if not planned meticulously can be challenging to a anesthesiologist. We describe a successful management of a case of anticipated difficult intubation due to a rare intra oral lipomatous polyp arising from the posterior pharyngeal wall. We use levering McCoy laryngoscope for intuabting trachea because we failed to intubate with conventional MacIntosh laryngoscope in first attempt and for fear of complete airway obstruction dexmedetomidine infusion was used for sedation. In our case we relied on radiological imaging for assessment of difficult airways. So managing each case is highly unique, individualized and no technique is obsolete in managing difficult airways even with a unavailability of modern aids.

Some medical specialties have been using lasers for over 30 years; their use did not become relatively common in oral and maxillofacial surgery but recently. However, over the past 10 years, gradually lasers have become an important part of oral surgical tools. Literature in oral and maxillofacial oncology continues to support the use of lasers in surgery of premalignant and malignant lesions. Various wavelengths that can be used by oral and maxillofacial surgeons are carbon-dioxide (CO 2 ), Nd: YAG, pulsed dye, erbium: YAG, holmium: YAG, and copper vapor. The most useful has proved to be the CO 2 laser. Several authorities have explored the indications, techniques, results, benefits, and risk issues of lasers used in oral and maxillofacial surgery. The advantages of laser application are that it provides relatively bloodless surgical and postsurgical courses with minimal swelling and scarring. In this article, we have discussed about the application of lasers in oral and maxillofacial surgery.

Parotid duct fistula is uncommon but difficult-to-treat complication that often results from a penetrating trauma. While there is general consensus in the literature as to the management of acute parotid injuries, treatment of chronic fistulas remains controversial. Congenital parotid duct fistula is a rare entity. Herein we present a 20-year-old female who presented with a parotid duct fistula since birth. Clinical evaluation revealed no accessory parotid gland or duct. Patient was found to have a combination of more prominent Plica semilunaris of the left eye, a finding not so far reported in the literature. Following complete examination and investigations, intra oral transposition of the fistulous opening and tract was done. We present this case for its rarity and the gratifying outcome of the surgical procedure.

Surgical lasers have been well accepted by all disciplines of healing arts as useful adjunct to care of patients. The attitude toward their use has changed from one of gee-whiz appreciation for modern technology to that of acceptance of lasers as standard surgical instruments. The applications of Laser technology in dentistry and medicine have now entered the age of sophisticated and rational treatment. This presentation is an attempt to distil our experience with the patients in various periodontal soft and hard tissue procedures such as biopsies, frenectomies, white lesions, vesicullobulous lesions, preprosthetic surgery and dentinal hypersensitivity with the use of Carbon dioxide laser. Laser device used for all intra oral procedures in the presentation is LASERSAT TM Carbon dioxide Laser Manufactured by SATELAC R . Dental Laser safety and protection protocol was strictly followed. All patients responded well to Laser treatment with complete healing of lesions with no post operative complications. No recurrence of any lesion was reported at follow up visits. Lasers have become an integral part of periodontal surgeons' armamentarium. They have proved to be useful as adjunct to conventional treatment modalities in various soft and hard tissue intraoral procedures with better patient acceptance.

Chondrolipomas are benign mesenchymal tumors characterized by the proliferation of mature adipocytes associated with variable amounts of mature cartilaginous tissue. Herein, we describe a case of chondrolipoma of the tongue in a 35-year-old Indian male. The lesion presented as a nodular, sessile, pink mass on posterio-dorsal surface of left side of the tongue since approximately 20 years. Histopathologically, the mass revealed a well circumscribed, encapsulated proliferation of mature adipocytes with islands of well formed mature cartilaginous tissue. Chondrolipomas are uncommon in the oral cavity, with only 14 cases being reported in the English literature.

Background and Objectives: The primary goal of periodontal treatment is the maintenance of the natural dentition in health and comfortable function. The shift in therapeutic concepts from resection to regeneration has significantly impacted the practice of periodontology. The objective of the present study is to compare the relative efficacy of intra-oral autogenous graft and decalcified allogenic bone matrix (DABM) in the treatment of periodontal intrabony defects. Materials and Methods: In the present study, 30 patients in the age group of 30-50 years with two almost identical intrabony defects, on either side of the mouth/upper and lower jaw, based upon the radiographic observations were selected from amongst the patients visiting the Department of Periodontology and Oral Medicine, Punjab Government Dental College and Hospital, Amritsar. One of the defect was selected randomly and filled with autogenous cancellous graft and the other with DABM. Post-operative assessment was done by taking radiographs, 12 weeks and 24 weeks post-operatively. Results: Definite bone fill was achieved both with intra-oral free osseous autograft and with DABM at 12 weeks observation, which further increased significantly at 24 weeks observation. The bone fill obtained with intra-oral free osseous autograft was found to be significantly higher than that with DABM both at 12 weeks and 24 weeks post-operative observation. Conclusion: Within the limitations of this study, it establishes the superiority of the intra-oral free osseous autograft over that of DABM graft in correcting the intrabony defects.

One of the commonest problems experienced by a dentist is the broken teeth on the master cast, which occurs during retrieval from the impression, especially when the anterior teeth have gingival recession and open interdental spaces. This article describes a technique of preventing the breakage of cast, by adapting wax on non-critical surfaces intra-orally and thus, reinforcing the critical surfaces. This technique is simple and requires minimal chair side time.