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Gingival enlargement develops as an exaggerated response of periodontal tissues to local factors like dental plaque and dental calculus. Systemic conditions like cerebral palsy, where mental deficiency and loss of manual dexterity is a contributing factor for poor oral hygiene, sometime manifest as gingival enlargement. Nutritional deficiency in combination to systemic disease and conditions, further contributes to an altered response of periodontal tissues to dental plaque and calculus, which may sometimes clinically manifest as gingival enlargement (generalized or localized). Vitamin C deficiency presents with various oral manifestations, specially causing conditioned gingival enlargement. Anemia is also one of the systemic disease/conditions affecting periodontal tissues. Management of these various conditions manifesting as gingival enlargement, warrants diagnosis and treatment of the underlying cause. It becomes more challenging when all these conditions co-exist, demanding a holistic comprehensive approach, not only for addressing the patient’s chief complaint, but also, improving the overall oral and general health as well. This case report is an attempt to discuss the management of an unusual case of massive gingival enlargement mainly due to vitamin C deficiency in an anemic cerebral palsy pediatric patient. Keywords: Anemia, Ascorbic acid deficiency, Cerebral palsy, Gingival overgrowth. Key Messages: Maintenance of proper oral hygiene and nutritional supplementation is essential for overall health of cerebral palsy patient

Unilateral mastication is commonly encountered on daily routine by all dentist. Various causes for unilateral mastication can be enumerated, but it’s seldom the reason for dental visit by the patient. Such negligence’s can be avoided by generating awareness as to how early treatment of a single diseased tooth might save half of the dentition from being severely compromised with the help of this case series. Keywords: Atrophy, Dental calculus, Dental caries, Periodontal diseases, Periodontitis

To report our experience of tracheobronchial foreign body removal in children using flexible bronchoscopy as the primary mode. Hospital records of tracheobronchial foreign body extractions between January, 2006 and January, 2018 were reviewed. Clinical presentations, radiological findings, location and types of tracheobronchial foreign bodies, types of bronchoscopes, complications and outcome of the procedures were analyzed. 283 extractions in children with median (range) age of 18 (5–168) months were reviewed. Extraction by flexible bronchoscope, using wire baskets or grasping forceps, was successful in 260 cases. No major complications were encountered. Mean (SD) time for the procedure was 31 (6.3) minutes. Airway foreign bodies can safely be removed by flexible bronchoscopy with minimal complications. This procedure can be considered the primary mode for removal of airway foreign bodies by a trained and experienced person.

Various studies have shown periodontal disease is one of the risk factors for coronary heart disease (CHD), and periodontal treatment of patients with CHD has also been correlated with reduction in systemic markers of CHD. The aim of this study is to evaluate the effect of non-surgical periodontal treatment (NSPT) on the cardiovascular clinical and biochemical status of patients with CHD.Seventy known patients with CHD were allocated randomly to either a control group (C; no periodontal therapy) (n = 35) or an experimental group (E; NSPT in the form of scaling and root planing [SRP]) (n = 35). Cardiovascular status was assessed using clinical parameters such as pulse, respiratory rate, blood pressure (BP), and biochemical parameters, such as high-sensitivity C-reactive protein (hsCRP), lipid profile, and white blood cell (WBC) count, at baseline and 1, 3, and 6 months. Intergroup and intragroup comparisons were performed using Student t test, and P0.05 was considered statistically significant.The complete data at the end of the study were provided by only 55 patients (group C, n = 25; group E, n = 30). Highly statistically significant reduction was observed in systolic BP (7.1 mm Hg) and very-low-density lipoproteins (VLDLs; 5.16 mg/dL) in group E. Changes were also observed in other cardiovascular biochemical and clinical parameters but were not statistically significant.NSPT (in the form of SRP) positively affects limited cardiovascular (clinical and biochemical) status of patients with CHD. Reduction in triglyceride, VLDL, total WBC, lymphocyte, and neutrophil counts and increase in hsCRP, total cholesterol, high-density lipoprotein, and low-density lipoprotein levels were observed. Highly significant reduction in VLDL cholesterol levels and systolic BP was observed among the various parameters measured.

Narrow dentoalveolar ridges remain a serious challenge for the successful placement of endosseous implants. Several techniques for this procedure may be considered, such as guided bone regeneration, bone block grafting, and ridge splitting for bone expansion. The ridge split procedure provides a quicker method wherein an atrophic ridge can be predictably expanded and grafted with bone allograft or allograft, eliminating the need for second surgical site. Traditionally, osseous surgery has been performed by either manual or motor-driven instruments. Piezosurgery is a relatively new technique for osteotomy and osteoplasty that utilizes ultrasonic vibration which allows clean cutting with precise incisions. This case series describes reports of 2 such cases in which narrow mandibular ridge splitting was carried by mean of piezotome with immediate placement of implants in the osteotomy site. Five months later, the implants were uncovered followed by impression and restored with impant- supported porcelain-fused-to-metal crowns.

The pitch attitude control system for a flexible communications satellite is analyzed using sampled-data techniques. The sampling arises mainly from the use of discrete-time attitude measurement rather than from the digital controller implementation. It is found that Nyquist techniques lead to a relatively simple stability analysis that models the multirate sampling process with considerable fidelity, eliminating guesswork associated with equivalent delays. Controller modifications that improve stability are arrived at by this route. Finally, flexiblemode frequency and damping are varied to evaluate their influence on stability. There seems to exist a critical frequency at which stability margins are very small. Increasing the damping, predictably, improves matters.

A simple model of low-thrust catalytic monopropellant hydrazine thrusters is presented for attitude control simulation purposes. It is derived from test results and represents thrust histories much better than a first-order lag over a wide range of pulse widths, for the thrusters used on the Hermes spacecraft. The structure of the model should be applicable to other cases as well.