Multiple myeloma is a relatively rare malignant hematological disease, which is characterized by multicentric proliferation of plasma cells in the bone marrow and radiographically by osteolytic bone lesions and detectable presence of monoclonal immunoglobulins in serum and/or urine. Diagnosis of multiple myeloma can sometimes be challenging because of its plethora of clinical signs and symptoms. The product of the malignant plasma cells causes the different types of unusual clinical manifestations. We present the case of a 55-year-old female who presented with a periapical swelling in anterior maxilla in relation with 11 as the first sign of the disease.

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Background: Periodontitis is a common bacterial infection precipitated by exaggerated host responses to the oral microorganisms, As the first cells to encounter the oral pathogens the gingival epithelial cells (GEC) respond via toll-like receptors (TLR) that recognize conserved microbial patterns. Here we investigated the expression of TLR-2 and TLR-4 in GEC of naοve mice in response to infection with the periodontal pathogen Aggregatibacter actinomycetemcomitans (Aa). Methods: 7-9 weeks old mice were induced experimental periodontitis by inoculating the palatal gingival with 1x109 colony forming units of Aa. Mice were sacrificed 50 days later and intact maxilla harvested. The degree of alveolar bone loss was determined by micro-CT. Single suspensions of the epithelial cells isolated from palatal gingival tissues were assessed for the expressions of TLR-2 and TLR-4 proteins by flow cytometry and for TLR-2 and TLR-4 mRNA by reverse transcriptase PCR. Differences between the control and the disease groups were determined by students't- test. Results: Both TLR-2 and TLR-4 proteins were significantly elevated in the GEC of mice infected with A. actinomycetemcomitans when compared to the control group. The ratio of TLR-4 to TLR-2 mRNA was upregulated in chornic periodontitis as compared with the control group. Conclusion: Our data suggest that TLR-2 and TLR-4 are regulated differentially in A. actinomycetemcomitans-induced periodontitis.

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One of the most important and challenging aspects of implant dentistry is the correct planning and placement of the dental implant so as to achieve a prosthetically, aesthetically, and biologically stable outcome. It is also important to prevent encroachment on vital structures. To aid in the correct placement of dental implants, a variety of surgical guides have been proposed. If a fully limiting surgical guide is used, the encoded information should be reliable, as deviations are not possible during surgery. This article describes an acrylic resin implant placement guide, which is based on bone mapping of the edentulous ridge at the implant site.

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Endodontic management of immature non-vital permanent teeth in young pediatric patients is a great challenge to dentists. When the pulp of an incompletely formed tooth loses its vitality, then the entire root system has also lost its ability to continue to develop. The walls of the root canals are frequently divergent and open apices make debridement and obturation difficult. Thus, closure of the root apex is very essential for the success of endodontic treatment. Many different materials are used for the apexification procedure, for apical barrier formation and healing. However, in this present case the apical closure was achieved only by means of infection control.

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Aims and Objectives: Decision regarding the option to treat tooth mobility should be based on the etiology and detected severity of tooth mobility. The most widely used method of mobility assessment is to tap the tooth between two extreme positions. The study was designed to evaluate the association of Periotest values (PTV) with the amount of bone, clinical attachment loss, and various clinical indices. The aim of the present study was to evaluate the association between bone loss and Periotest values. Also we evaluated the effects of attachment loss and tooth position on the Periotest values. Materials and Methods: A total number of 60 patients between the age group of 18 and 55 years were divided into subjects with healthy periodontium (Group A), and those with Chronic Generalized Periodontitis (Group B), having a generalized pocket probing depth of 3 - 8 mm, respectively. With the help of the Periotest, Florida probe, and radiographs the assessment was carried out. The data was statistically analyzed using the Student's unpaired t-test. Results: It was found that the values were highly significant in the incisor, premolar, and molar areas. However, the value was found to be insignificant in the canine region. The anterior teeth showed higher PTV compared to the posterior teeth; and the mandibular teeth showed higher PTV compared to the maxillary teeth. There was no association between the clinical indices and Periotest values. Conclusion: The study showed that tooth mobility was dependent on bone support as well as the clinical attachment level.

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Aim: To study the effect of the scaling and root planing of some blood glucose levels in Type II Diabetes patients. Study Population and Methods: The clinical study was conducted in 15 Type II diabetic patients of Dr. D Y Patil Dental College and Hospital, Pimpri, Pune. All the participants underwent a baseline examination for periodontal status using the community periodontal index of treatment needs and also estimation of fasting and post-prandial blood sugar levels. The participants received the intervention of scaling and root planing, as also routine oral hygiene instructions, and were recalled after one month for a final periodontal examination and blood sugar level investigation. The significance of difference between the means of the baseline and the final examination was tested using the paired 't' test. Results and Conclusion: There was no significant change in the fasting and post-prandial blood glucose levels in patients treated with scaling and root planing.

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Tooth trauma has been and continues to be a common occurrence that every dental professional must be prepared to assess and treat when necessary. Tooth trauma and its management loom as a major challenge to the dental practitioner. Transverse root fractures occur most commonly in the maxillary teeth. This case report describes a new technique for the management of transverse root fractures in zone 2 with dowel inlay. This enables the utilization of the fractured fragment crown for stabilizing a transverse root fracture in zone 2, in a simple, economical, and minimally invasive manner. It can save considerable time over other alternative treatment options available for the treatment of trauma zone 2 fractures. Both clinical and radiographic follow-up have shown a stable condition, without any probing defects, ongoing root resorption or periapical pathosis.

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Objectives: To measure the bone density in Hounsfield unit (HU) values at the sites of implant placement by Dentascans, and correlate it with respect to sex, individual jaws, side of the jaw, and zone in the jaw. Study Design: Twenty-five patients in the age group of 10 and 80 years, requiring implant placement, were selected for this study, using Siemens Somatom Sensation 64. The density was evaluated subjectively by the Dentascan software. Density of the bone at the implant sites was correlated with the sex of the patients, individual jaw, and zone in the jaw. Moreover, an independent 't' test was applied and the 'P' value was determined at 95% confidence limits. Also the mean (minimum and maximum) density of the bone was evaluated according to the side of the jaw and an ANOVA test was applied followed by a Turkey test. Results: Based on the HU values, 75.40% values were in the D3 group, 16.39% in the D4 group, 4.95% in the D5 group, and 3.27% in the D2 group. In the D5 group, the lowest mean HU value was 124.5. Statistical analysis did not show any significant relationships. Conclusion: Bone density at the implant sites dictate the successful osseointegration of the implants. Dentascans provide a subjective evaluation of bone density at the implant sites.

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