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Women smokers are likely to increase as a percentage of the total. If the percentage of women who smoke in developing countries rise to the levels of men smokers, there will be more than 500 million women smokers in the next generation. Because women who smoke die from the same tobacco-caused diseases as men, such an increase will have dramatic effects on women's health and on the health and incomes of their families. In addition, women smokers are also at risk for developing cancer of the reproductive organs and osteoporosis. A gender perspective contributes to a better understanding of the epidemiological trends, social marketing strategies, economic policies, and international actions relating to women and the tobacco epidemic.

Structured Abstract Authors – Batra P, Kharbanda OP, Duggal R, Singh N, Parkash H Objectives – The aim of the study was to investigate alkaline phosphatase activity in the gingival crevicular fluid (GCF) during orthodontic tooth movement in humans. Setting and Sample Population – Postgraduate orthodontic clinic. Ten female patients requiring all first premolar extractions were selected and treated with standard edgewise mechanotherapy. Experimental Variable – Canine retraction was done using 100 g sentalloy springs. Maxillary canine on one side acted as experimental site while the contralateral canine acted as control. Outcome Measure – Gingival crevicular fluid was collected from mesial and distal of canines before initiation of canine retraction (baseline), immediately after initiation of retraction, and on 1st, 7th, 14th and 21st day and the alkaline phosphatase activity was estimated. Results – The results show significant (p

This prospective study was conducted on 24 North Indian subjects (10 Control and 14 Twin-block) to evaluate the skeletal and dentoalveolar effects of Twin-block appliance in the treatment of Class II division 1 malocclusion. The result of the present study showed that Twin-block is an effective appliance in accelerating mandibular growth. It also helped dramatically in molar correction and overjet reduction in Class II division 1 malocclusion subjects.

Klippel-Feil syndrome (KFS) is a rare congenital abnormality characterized by shortening of the neck because of fusion of 2 or more cervical vertebrae frequently associated with other congenital abnormalities of the spine with or without neurologic disturbances. In its extreme form, there is a gross restriction of movement of the neck. A slight abnormality may go unrecognized until chance detection (usually in an x-ray of the cervical spine). Maurice Klippel, a French internist, and Andre Feil first recorded the complete picture of the syndrome in a case report of a 46-year-old tailor having an unusually short neck with gross restriction of movement. He had only 4 cervical vertebrae, which were fused in a single mass with posterior spina bifida. The syndrome consists of easily recognizable signs (short neck and posterior hairline lower than normal) and definite limitation of head and neck movements. It may also be associated with anomalies of the genitourinary, musculoskeletal, neurologic, and cardiac systems. However, a patient of this syndrome may otherwise be normal. Three patterns of vertebral abnormalities have been described with KFS: type I: fusion of several cervical and upper thoracic vertebrae. Type II: fusion of 1 or 2 interspaces sometimes accompanied by hemi-vertebrae, occipito-atlantal fusion, and other vertebral abnormalities. Type II has the lowest risk of the scoliosis. Type III: fusion of cervical vertebrae associated with fusion of lower thoracic and lumbar vertebrae. A fourth type (type IV) has been suggested and is associated with sacral agenesis. Abnormal bony masses have been reported in the mandibular ramus region along with congenital duplication of mandibular rami. These masses extend from the zygomatic arch region toward the ascending ramus of the mandible and the maxillary tuberosity area (producing partial to complete trismus). The inferior end either lies free in the buccal soft tissues or may be attached to the rudimentary coronoid process by a fibrous joint.

Non-syndromal bilateral dentigerous cysts are rare. It is conceivable that they are either under-recognized or under-reported. In this article we report the unusual occurrence of non-syndromic bilateral dentigerous cysts associated with mandibular third molars with polymorphism in chromosome 1qh+. It is suggested that in non syndromal cases of bilateral dentigerous cysts karyotyping should be done to confirm the association with chromosomal 1 anomaly.

This cross-sectional study was conducted on 40 subjects to investigate the effects of timings and number of palate surgeries on maxillary growth in complete unilateral cleft lip and palate patients.The number of surgeries performed for palate repair was not an important growth inhibiting factor of maxilla, rather the age at which the initial palate surgery was performed for palate repair was an important factor in influencing maxillary growth.

Cleft lip with or without cleft palate (CL/CP) is one of the most common structural birth defects, with treatment including multiple surgeries, speech therapy, and dental and orthodontic treatments over the first 18 years of life. Providing care for these patients and families includes educating patients and parents about the genetics of CL/CP, as well as meeting the immediate medical needs.Attempts at identifying susceptibility loci via family and case-control studies have proved inconsistent. It is likely that initial predictions of the complex interactions involved in facial development were underestimated. The candidate gene list for CL/P is getting longer and the need for an impartial, systematic screening technique, to implicate or refute the inclusion of particular loci, is apparent. So we are faced with the question "Can this complex trait be too complex?"The aim of this review is to make the dentist aware of the differences between syndromic and non-syndromic cleft as well as understanding the etiological variation in cleft lip with and without cleft palate. This will aid the dentist in diagnosis and give proper genetic counseling to parents and patients of cleft lip and palate.

Item does not contain fulltext Competency-based education, introduced approximately 10 years ago, has become the preferred method and generally the accepted norm for delivering and assessing the outcomes of undergraduate (European) or predoctoral (North America) dental education in many parts of the world. As a philosophical approach, the competency statements drive national agencies in external programme review and at the institutional level in the definition of curriculum development, student assessment and programme evaluation. It would be presumptuous of this group to prescribe competences for various parts of the world; the application of this approach on a global basis may define what is the absolute minimum knowledge base and behavioural standard expected of a 'dentist' in the health care setting, while respecting local limitations and values. The review of documents and distillation of recommendations is presented as a reference and consideration for dental undergraduate programmes and their administration.

The most frequent type of treatment for patients diagnosed with a malignant neoplasia of the oral cavity is surgical resection of the tumor. Ablative surgery may be followed by a reconstructive phase, in which the surgeon may choose between local flaps, nonvascularized bone grafts or free vascularized flaps to close the surgical site, depending on the general conditions of the patient. Esthetic and functional results are challenging to achieve for the prosthodontist, as variable amount of hard and soft tissues are removed. This report describes the fabrication of a two-piece hollow obturator for a 19-year-old patient who underwent wide surgical excision of the osteosarcoma of the maxilla and was rehabilitated to function. In this case, the surgical site was covered with submental flap, and the second piece of the obturator provided fullness to the lost malar prominence.

This prospective cephalometric study was undertaken to assess the mode and magnitude of Class II correction with nonextraction Begg mechanotherapy in growing children. The sample comprised subjects with similar malocclusion and age range (9-12 years) who were specifically selected for nonextraction Begg mechanotherapy. Cephalograms were analyzed to assess the skeletal, dental, and soft tissue changes that occurred after correction of the molar relationship, the overjet, and the overbite during the 9-month treatment period. The results revealed a significant improvement in the anteroposterior jaw relationship, suggested by the significant reduction in the ANB angle (1.62°) and in Wits AO-BO (1.42 mm). The mandibular length increase of 0.56 mm suggests that the Class II elastics used in nonextraction Begg mechanotherapy had a minimal stimulatory effect on mandibular growth. There was a significant increase in the anterior and posterior facial heights and the ramal height. Almost all of the dental changes were significant. The most striking feature were a significant retraction and extrusion of the maxillary incisors and proclination and intrusion of the lower incisors accompanied by extrusion of the mandibular molars. The maxillary incisors extruded by 1.64 mm under the influence of the undesirable downward component of the Class II elastic forces. The major contribution to overjet and molar correction was predominantly dentoalveolar. (Am J Orthod Dentofacial Orthop 2000;118:641-8)

The present study was conducted on 10 subjects to evaluate dental and skeletal changes after intraoral molar distalization. The maxillary molars were distalized with a sectional jig assembly. Sentalloy open coil springs were used to exert 150 gm of force for a period of 12 weeks. A modified Nance appliance was the main source of anchorage. The pre- and postdistalization records included dental study casts, clinical photographs, and cephalograms. A total of 665 readings recorded from lateral cephalograms and dental casts were subjected to statistical analysis. The mean distal movement of the first molar was 2.78 mm, which was highly significant (p < 0.001). It moved distally at the rate of 0.86 mm/month. There was clinically some distal tipping (3.50°) and distopalatal rotation (2.40°). These changes were statistically significant (p < 0.001). The second molars accompanied the first molars and moved distally by nearly the same amount. There was 1.00 mm increase in the overjet and 2.60° mesial tip of second premolar. The changes in the facial skeleton and dentition bases were minimal and statistically not significant. However, there was clockwise rotation of the mandible of 1.30° that was statistically significant. This was the result of molar extrusion (1.60 mm). (Am J Orthod Dentofacial Orthop 1998;114:319-27.)

Prosthetic rehabilitation of acquired maxillary defects can be achieved satisfactorily if all facets of treatment planning and design considerations are taken into account before the rehabilitation process. Complications associated with maxillary defects limit treatment protocols to a great extent. The prosthodontist has to identify these problem areas and suitably devise feasible options and incorporate them in the design. In this report, an acquired maxillary defect with unfavorable undercuts in the defect was successfully treated by making a two-piece sectional obturator. The two pieces were connected by the use of double-die pin system. The methodology greatly reduced chairside time and number of visits, and effective obturation was satisfactorily achieved.

Supernumerary teeth are common in the general population and occur more frequently in-patients with family history of such teeth. Multiple supernumerary teeth are associated with cleidocranial dyplasia and Gardner syndrome. However it is rare to find multiple supernumeraries in individuals with no other associated disease or syndrome. We describe the occurrence of multiple supernumerary teeth in a family occurring as a non-syndromal trait. The autosomal dominant transmission of non-syndromal multiple supernumerary teeth is new.

Adenomatoid odontogenic tumour is a benign (hamartomatous), noninvasive lesion with slow but progressive growth. The 3 variants--follicular, extrafollicular and peripheral--present with identical histological findings. This report describes a patient with a large adenomatoid odontogenic tumour in the mandible, with the involved mandibular canine being pushed to the contralateral side. The paper also provides a refresher for general dental practitioners about various diagnostic aspects of this tumour and highlights the controversies regarding its origin and management in light of recent findings.

Etiology of class-III malocclusion is generally believed to be genetic. A wide range of environmental factors have been suggested as contributing factors for the development of class-III malocclusion. Twin study is one of the most effective methods available for investigating genetically determined variables of malocclusion. Discordancy for class-III malocclusion is a frequent finding in dizygotic twins. However, class-III malocclusion discordancy in monozygotic twins is a rare finding. The purpose of this study of monozygotic twins is to assess the genetic and environmental components of variation within the cranio-dento-facial complex.

Impactions with severely dilacerateci root is seldom reported, especially the maxillary incisor. It is probably because of the high clinical difficulty of bringing the dilacerated tooth into position: most patients probably would choose extraction with replacement by prosthesis instead. However, the philosophy seems to have changed recently. We report two cases one in which an impacted central incisor was brought in the arch by orthodontic traction. In the second case the impacted premolar was brought into the arch and was shaped as a mandibular canine for achieving a good functional occlusion.J Clin Pediatr Dent 29(2): 105-112, 2005

In an orthodontic practice, it is common to deal with impacted teeth, which are one of the most difficult situations dealt with by dentists. This case report describes the surgical and orthodontic management of the impacted teeth in a large dentigerous cyst. In the initial stage of treatment, the cyst was marsupialized over 7 months. After decompression of the cyst, spontaneous eruptions of the impacted tooth were noticed. Then, they were orthodontically brought into the proper occlusion.

Two cases are presented where the odontomas had caused the impaction of the anterior teeth and required a combined surgical and orthodontic treatment to bring these teeth into the arch. In the first case a large a complex odontome had caused the impaction of the right central incisor, lateral incisor and canine. In the second case a compound odontome blocked the eruption pathway of the right central incisor. It is emphasised that radiographic examination of all pediatric patients that present clinical evidence of delayed permanent tooth eruption or temporary tooth displacement with or without a history of previous dental trauma should be performed. Early diagnosis of odontomas allows adoption of a less complex and less expensive treatment and ensures a better prognosis.

Introduction: The purpose of this study was to evaluate the skeletal and dentoalveolar effects of the Twin-block and bionator appliances in the treatment of Class II Division 1 malocclusions. Methods: Fifty-five girls from North India with Class II Division 1 malocclusion and the same physical growth maturation status were selected for the study. The subjects were divided among a Twin-block group (n = 25), a bionator group (n = 20), and a control group (n = 10). Pretreatment and posttreatment lateral cephalometric radiographs of the treatment group subjects, and prefollow-up and postfollow-up radiographs of the control group subjects, were traced manually and subjected to the pitchfork analysis. Results: Statistical software was used for 1-way analysis of variance and multiple comparisons (post-hoc test, Bonferroni). A P value of .05 was considered statistically significant. Neither the Twin-block nor the bionator appliance significantly restricted forward growth of the maxilla ( P = .476). Mandibular growth in the Twin-block subjects was significantly greater than in controls ( P = .005). Mandibular growth was comparable in the control and the bionator subjects. Molar correction, overjet reduction, and proclination of the mandibular incisors were significantly greater ( P = .000) in the treated subjects compared with the controls. Conclusions: Both the Twin-block and bionator appliances were effective in correcting molar relationships and reducing overjets in Class II Division 1 malocclusion subjects. However, the Twin-block was more efficient than the bionator in the treatment of Class II Division 1 malocclusion.

Secondary bone grafting in cleft lip and palate patients is performed preferably before the eruption of permanent canine in order to provide adequate periodontal support for eruption and preservation of the teeth adjacent to the cleft. Presented here with is a case of unilateral cleft lip and palate, which was followed up from birth to 15 years of age. The role of an orthodontist in the team approach for management of such anomalies is described. Also discussed in detail is the entire range of treatment procedures the child underwent, especially the role of secondary bone grafting.

Aarskog syndrome is a rare syndrome with a typical triad of facial, digital and genital characteristics. Orthodontic treatment of a patient with Aarskog syndrome has not been documented in literature till date. This case report shows that an individual with Aarskog syndrome can be an excellent orthodontic patient and should not be excluded from the general patient population. A stable occlusion can be achieved with acceptable profile and soft tissue contours in these patients as well.

Apert's syndrome is a developmental malformation characterized by craniosynostosis, a cone shaped calvarium, midface hypoplasia, pharyngeal attenuation, ocular manifestations and syndactyly of the hands and feet. The prodromal characteristic for the typical craniofacial appearance is early craniosynostosis of the coronal suture, cranial base and an agenesis of the sagittal suture. These craniofacial characteristics predispose the patient to maxillary transverse and sagittal hypoplasia with concomitant dental crowding, a pseudo cleft palate and a skeletal and dental anterior open bite. A case of Apert syndrome is presented with special emphasis on craniofacial characteristics and multidisciplinary approach to treatment. The differences between Apert and Crouzon's syndrome are highlighted.

Fibromatosis forms the most important group of lesions among the fibrous tumors of childhood. There have been a number of classification schemes proposed by authors over the years.1-4 The Kiel Pediatric Tumor Registry (KPTR) has endorsed the classification proposed by Enzinger and Weiss5 and a recent classification is proposed by Coffin et al.6 Infantile desmoid fibromatosis or tumor forms a subtype of the fibromatosis group. A confusing terminology persists, as synonyms such as aggressive fibromatosis, infantile fibromatosis, aggressive infantile fibromatosis, extraabdominal desmoid, and nonmetastasizing fibrosarcoma have been used.7-10 The frequency of desmoid fibromatosis in the KPTR classification of fibromatoses is 60%, followed by infantile myofibromatosis.5 In a study by Coffin and Dehner,9 who analyzed 108 pediatric cases, infantile myofibromatosis was the most frequent tumor (22%), followed by desmoid fibromatosis (19%). There is a male predominance of about 2:1, 1.8:1, and 1.5:1 in the literature.5,9,10 The median age in the series reported by Schmidt5 was 5 years; 7% were congenital and 30% occurred in infants younger than 1 year. The series (103 cases) reported by Coffin and Dehner9 had an age range of newborn to 20 years. Ayala et al10 reported a study in 25 patients under 15 years of age. The localization of infantile desmoid fibromatosis to the head and neck region in the literature ranges from 24% to 30%.5 We report the case of rapidly growing, very large, infantile desmoid fibromatosis in the submandibular region of a 3-year-old child, which posed a diagnostic problem. A conservative surgical approach was used to treat the case successfully.

Jacob disease is a rare condition that affects the coronoid process; it was first described in 1899. Jacob disease involves the development of an osteochondroma of the coronoid process and leads to the formation of a pseudo joint between the zygoma and the coronoid process.1-9 A review of the literature reveals only 34 (including the present case) histologically proved cases of osteochondroma of the coronoid process (Table 1). The disease appears to involve males (73.5%) more often than females at a mean age of 35 years and an age range of 10 to 73 years. There is slight predilection for involvement of the left coronoid process. Initial signs and symptoms are a feeling of tightness in the joint region and a gradual reduction in mouth opening. Later stages show a total trismus and appreciable swelling at the malar prominence. Pain is not a feature of this disease. Radiographs taken in the initial stages do not show any significant abnormality, but the later stages show the enlarged coronoid process. The bilateral involvement has also been reported.18 The bilateral cases are self-limiting, but the unilateral cases enlarge progressively to form mushroom-shaped enlargement of the coronoid processes.3, 33 Coronoidectomy and excision of the tumor via an extraoral approach (50%), an intraoral approach (34.3%), and a combined intraoral and extraoral approach (15.7%) has been the most preferred treatment in the published reports. Because of its insidious clinical onset, Jacob disease is often overlooked and misdiagnosed as a temporomandibular joint disorder. Although it is a rare disorder, Jacob disease merits reporting to familiarize clinicians with a condition that may affect the evaluation of patients with restricted mouth opening.

Aim of the Study: There is dearth of literature regarding the effects of oxidation heat treatment (OHT) as surface pretreatments on bond strength of base metal alloys and porcelain. Materials and Methods: Forty-five bar specimens of each two commercially available base metal alloys Mealloy and Wirorn-99 (were fabricated. Dimensions of each specimen were 15.0 × 2.0 × 0.5 mm (according to the ISO 6872-1984). According to the surface pretreatments the samples of the two groups were categorized into three subgroups: With OHT only, with sandblasting only (with Al 2 O 3 of 110 μm) and with OHT and sandblasting. Application of commercially available Duceram porcelain in thickness of 2.00 mm was applied over the surface of metal with the pretreatments. Samples were then placed under SEM for EDX examination to evaluate ionic changes that occurred at the metal-ceramic interface. Flexural bond strength of each sample was calculated under Universal Testing Machine. Results: The one-way ANOVA indicated no significant influence of either metal type (P=0.811) or any surface pretreatment (P=0.757) on the metal-ceramic bond strength. Conclusion: OHT resulted in the increase in amount of oxides at the metal-ceramic interface. However, neither metal type nor surface pretreatments affected bond strength.

Introduction: Abundant resources and techniques have been used for complete coverage crown fabrication. Conventional investing and casting procedures for phosphate-bonded investments require a 2- to 4-h procedure before completion. Accelerated casting techniques have been used, but may not result in castings with matching marginal accuracy. Aims and Objectives: The study measured the marginal gap and determined the clinical acceptability of single cast copings invested in a phosphate-bonded investment with the use of conventional and accelerated methods. Materials and Methods: One hundred and twenty cast coping samples were fabricated using conventional and accelerated methods, with three finish lines: Chamfer, shoulder and shoulder with bevel. Sixty copings were prepared with each technique. Each coping was examined with a stereomicroscope at four predetermined sites and measurements of marginal gaps were documented for each. Statistical Analysis: A master chart was prepared for all the data and was analyzed using Statistical Package for the Social Sciences version. Evidence of marginal gap was then evaluated by t-test. Analysis of variance and Post-hoc analysis were used to compare two groups as well as to make comparisons between three subgroups . Results: Measurements recorded showed no statistically significant difference between conventional and accelerated groups. Conclusion: Among the three marginal designs studied, shoulder with bevel showed the best marginal fit with conventional as well as accelerated casting techniques. Accelerated casting technique could be a vital alternative to the time-consuming conventional casting technique. The marginal fit between the two casting techniques showed no statistical difference.

An electromyographic study was performed on 10 young growing girls in the age group of 9 to 12 years with Class II Division 1 malocclusion and retruded mandible, who were under treatment with Twin-block appliances. Bilateral EMG activity of elevator muscles of the mandible (ie, anterior temporalis and masseter) was monitored longitudinally with bipolar surface electrodes to determine changes in postural, swallowing, and maximal voluntary clenching activity during an observation period of 6 months. The changes were noted at the start of treatment (0 month), within 1 month of Twin-block insertion, at the end of 3 months, and at the end of 6 months. The results revealed a significant increase in postural and maximal clenching EMG activity in masseter (P

We report on 2 brothers with Hutchinson-Gil-ford progeria. These patients have 2 unusual findings, i.e., marked resorption of the mandible along with loss of teeth in the elder sib and prolonged survival. Both sibs are still alive and active at the age of 32 and 24 years.

The adenomatoid odontogenic tumour of the jaws is rare. It is important to differentiate it from other odontogenic tumours because of its benign behaviour and this can be reliably done by the histological features.

In a period of ten years 64 patients with odontogenic cystic lesions were found in 80,408 patients attending the Dental Out-Patient Department, All India Institute of Medical Sciences Hospital, New Delhi. Two-thirds of the lesions were found in male patients and no neoplastic lesion was recorded in the maxilla. There were more periodontal cysts in the maxillary than in the mandibular incisor region. The majority of lesions were found in age groups 10-40 years.

Two cases of melanotic neuroectodermal tumour in infancy are reported. The most common site is in the anterior region of the maxilla. Local excision of the tumour is the treatment of choice and in the present cases there has been no recurrence after 12 and 18 months respectively. Histopathological examination is essential and established the diagnosis.

A case of a primary malignant fibrous histiocytoma of the maxilla in a 14-year-old girl is presented. A search of the literature has revealed only one previous case. Primary malignant fibrous histiocytoma is a rare tumour of the jaws which is locally aggressive with little tendency to metastasize, although there have been reports of distant spread. There is no effective treatment but surgery might increase the survival time. The tumour does not respond to radiotherapy or chemotherapy. Recurrence is common, being about 73 per cent. In the present case in spite of early diagnosis and prompt treatment the patient survived for only 10 months.

A case of Ewing's sarcoma in a young girl with the primary in the mandible is presented. Though trauma has not been established as a definite aetiology, it could have been the initiating factor in this case. The patient was treated by surgical excision followed by radiotherapy. The follow-up is as yet too short to comment upon the postoperative survival.

The case of a 33-year-old woman with Burkitt's lymphoma is presented. This is the third case that has been reported from India. The primary involvement was in the mandible. Endoxan was administered without response. Radiotherapy was resorted to as the second choice of treatment, but metastases developed rapidly in other organs. The patient survived for only 3 months after a diagnostic biopsy.

A rare case of metastatic renal carcinoma of the mandible is reported. Since there was no history indicative of kidney trouble, the primary was located only after histological examination of the growth excised from the mandible. When malignant tumours affect the jaws, skeletal survey and systemic examination may be important.