The relationship between periodontal health and the restoration of teeth is intimate and inseparable. Human teeth are designed in such a way that the individual tooth contributes significantly to their own support as well as collectively the teeth in the arch. Decay on the proximal surfaces occurs mainly due to the faulty interrelationship between the contact area, marginal ridge, the embrasures and the gingiva. An adequate understanding of the relationship between periodontal tissues and restorative dentistry is paramount to ensure an adequate form, function, aesthetics and comfort of the dentition. For long-term survival of restoration, both functionally and esthetically, certain biological considerations are very critical to preserve the health of the periodontium and thus must be given due importance in clinical practice. While most clinicians are aware of this important relationship, uncertainly remains regarding specific concept such as biologic width and its maintainces.

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Periodontitis is a chronic infectious inflammatory disease characterized by the destruction of tooth. The contribution of bacteria to the disease progression is poorly understood probably due to the multifactorial background of this disease. Aggregatibacter actinomycetemcomitans is part of the normal flora in many healthy individuals, but is also a major etiologic agent in some aggressive forms of periodontitis. The genetic diversity among different isolates of Aggregatibacter actinomycetemcomitans is great and its ability to express and release virulence factors varies. Aggregatibacter actinomycetemcomitans, a pathogen not only in periodontal but also in some nonoral infections, possesses several virulence determinants which contribute to its ability to colonize the oral cavity, persist in the periodontal pocket, resist and evade host defenses, cause destruction of soft and hard tooth-supporting tissues, and interfere with host tissue repair after infection. Authors conducted a comprehensive search through PubMed/Medline databases to compile the available literature till June 2014, for the purpose of detailed insight into the bacteria. The search was designed to identify appropriate articles related to virulence factors of Aggregatibacter actinomycetemcomitans, and the articles were independently screened for eligibility.

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Periodontitis is a common inflammatory condition of the oral cavity. Successful management of periodontal disease and its sequelae basically focuses towards the reduction and/or elimination of pathogenic bacteria that are thought to cause periodontitis which has been accomplished by the use of mechanical treatment approaches including scaling, root planning, and finally surgical intervention. However, emerging evidence strongly suggests that it is the inflammatory response of the host that drives the tissue destruction, and the unpredictability of host responses can account for much of the variability in the clinical manifestation of periodontitis. Recently advances in study of bone metabolism are opening up new avenues of understanding regarding the bone loss subsequent to periodontitis. This knowledge, together with the development of novel drugs (e.g., alendronate, etidronate) which can inhibit bone loss/destruction, provides us with opportunities to target not only soft tissue inflammation but also the destructive bone loss occurring during periodontitis. The use of such agents as an adjunct to conventional periodontal therapy, not only reduces the current periodontal disease severity and improves treatment prognosis, but also reduce future susceptibility towards periodontal disease.

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Increase in the size of gingiva referred to as "gingival enlargement," usually overfills the interproximal spaces, ballooning out over the teeth and sometimes even protruding into the oral cavity. It may occur as localized enlargement in relation to a single tooth, a group of teeth, or may be generalized involving the entire dentition. It is multifactorial in origin having the influence of bacterial plaque, systemic factors or conditions, genetic predisposition (hereditary or familial), and various medications. Sometimes, it may appear as diffuse enlargement of gingiva without any specific etiologic factor. It is then considered as idiopathic enlargement. In this case report, an idiopathic gingival enlargement was successfully treated using gingivectomy by ledge and wedge procedure. The surgical technique performed yielded functionally as well as esthetically satisfying results. Gingivectomy provides a viable option to manage diffuse enlargement cases. This procedure provides the functional as well as esthetic demands and at the same time, it maintains the integrity of periodontium.

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The lips form the frame of a smile and define the esthetic zone. Excessive gingival display during smile is often referred to as "gummy smile". A successful management of excessive gingival display with lip repositioning procedure has shown excellent results. The procedure involves removing a strip of partial thickness mucosa from maxillary vestibule, then suturing it back to the lip mucosa at the level of mucogingival junction. This technique results in restricted muscle pull and a narrow vestibule, thereby reducing the gingival display. In this case gummy smile was treated by modification of Rubinstein and Kostianovsky's surgical lip repositioning technique which resulted in a harmonious smile.

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The Army Dental (AD) Corps is an essential entity under the Indian Army, rendering comprehensive dental care to the combatants and dependents of the Army, Navy, and Air Force. It has a pan-Indian presence, with deployments in all terrains, deep seas, and air spaces in addition to overseas establishments. It delivers high-end clinical services through different levels: Primary dental units, secondary and tertiary dental centers. In addition, it runs some of the finest training schools for dental and paradental professionals. It maintains high standards in clinical practice in all disciplines of dentistry. All these has been made possible largely because of the consistent research pursuits; the corps accomplishes to addresses the clinical requirements and emerging challenges. Research in the AD Corps is done in three modes: (i) Armed Forces Medical Research Committee Projects (AFMRC) done every year by the Indian Army, (ii) Interdisciplinary research among medical and dental specialities, and (iii) Defence Research and Development Organization (DRDO). Through these, it has embarked on advanced, cutting-edge research for new technologies, protocols, and products in the dental sciences. This paper takes stock of current trends in the AD Corps in these domains and highlights its thrust areas toward quality dental treatment.

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Reactive lesions found on the gingiva are common and tend to be nonneoplastic growths. They are usually not painful and are often overlooked by the patient until they become symptomatic or are identified by their dentists. Peripheral ossifying fibroma (POF) is a lesion of the gingival tissues that predominantly affects women and is usually located in the maxilla anterior to the molars. The definitive diagnosis though is established by histological examination, which reveals the presence of cellular connective tissue with focal calcifications. Surgery is the treatment of choice, though the recurrence rate can reach 20%. This article presents a case of POF in a 21-year-old male in the mandibular posterior region, diagnosed and treated at our hospital.

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A mucous cyst (mucocele, mucous retention cyst, ranula, and epulis) is usually a painless, thin sac on the inner surface of the lips. It contains clear fluid. It is painless but can be bothersome. The cyst is thought to be caused due to sucking of the lip membranes between the teeth. A mucous cyst is common and harmless. However, if left untreated, it can organize and form a permanent bump on the inner surface of the lip. A mucous cyst is called ranula when it occurs on the floor of the mouth and epulis when it occurs on the gums. The sac may also be formed around the jewellery (piercings) that has been inserted into the lips or the tongue. This article highlights the use of lasers in the treatment of the excision of mucocele.

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Crown lengthening is a surgical procedure aimed at the removal of periodontal tissue to increase the clinical crown height. The clinician needs to have an understanding of the biological width, indications, technique as well as limitations regarding crown lengthening. Taking into account the biological factors, crown lengthening can be carried out in a controlled and predictable manner as part of an overall treatment plan. Today's dentist has to face an increase in the number of patients who exhibit wearing of teeth that might result in shortened teeth, which makes the creation of crowns for these teeth problematic. In addition, it is evident that patients are becoming more aware of the importance of a pleasing smile. This case report discusses surgical crown lengthening of attrited teeth for adequate prosthetic restoration.

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Background: Esthetic enhancement of smile requires prior quantification of gingival component of smile. Hence, a study has been designed on randomly selected volunteers' and posed frontal smiling photographs were taken and analyzed through computer-aided ImageJ software. Aim: To determine the role of gingival component in designing a smile. Settings and Design: Present observational study includes one frontal photograph from each of 212 subjects who were attending the Department of Periodontics (examined during the study period) and then divided into three age groups (18-30, 31-40, and 41-50 years). Materials and Methods: Standardized frontal photographs with posed smile from 212 volunteers irrespective of age and sex were taken and the images were analyzed in computer by using ImageJ software. Statistical analysis used: Mean and standard deviation of intercommissural width (ICW), interlabial gap (ILG), and smile index (SI) during posed smiling were calculated for different sex. Comparison between male and female group were done by Mann-Whitney U test, and P-values were calculated for ICW, ILG, and SI. Spearman's rank correlation coefficients (rho) were calculated for SI and different components of central zone of smile. Results: Male group as compared to female group exhibited greater ICW and ILG, and there was existence of fair to good correlation between lip dynamics and different factors of smile. Conclusion: Present study indicates that different factors of central zone of smile havefair to good correlation with lip dynamics assessed by SI.

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Animals contribute to the development of medical and dental sciences by being sacrificed in the hands of scientists. The experimental design demands a specific type of animal to be used for experimentation. Each animal needs proper handling, care, and diet. Alongside specific advantages and disadvantages pertaining to each type of animal need to be understood well depending on the type of study/experiment. It is important for the researcher to know the disease susceptibility of each animal. The purpose of this paper is to highlight the salient factors that need to be considered for animal experimentations.

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This short communication aims to highlight the role that physiological coherence may play in dental caries. Although many theories are proposed, there is no universally accepted theory for the etiology of dental caries. Existing theories tend to give power to insults from outside the organism, whereas the theory of physiological coherence gives power to the organism operating in harmony which offers protection from within. Does physiological coherence play a role in dental decay? Is dental decay a sign of a breakdown in physiological coherence? Is there more than one mechanism of decay? Physiological coherence occurs when the heart and brain are well-coordinated, united by our positive emotional health; resulting in increased synchronization, harmony, and efficiency in the interactions within and among the physiological, cognitive, and emotional systems of the body, including the craniofacial region, which produces saliva. High heart coherence causes an increased order and complexity in crystallization patterns in human saliva which releases the intelligence embedded in the proteins. When there is physiological incoherence such as in mouth breathing, the salivary proteins become dysfunctional; and thereby, allowing caries unopposed access to the tooth surfaces. It is proposed that should this be the case then caries management should be directed to include methods to regain coherence so as to harmonize the body systems to regain correct signaling and function.

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Background: Hyperlipidemia is one of the major risk factors for cardiovascular disease (CVD). In the recent years, some evidence has been presented that periodontitis is associated with an increased risk of CVD. To further elucidate this association, we have studied the levels of serum lipid profile in a periodontally healthy group and a diseased group. Aim: To study the correlation between serum lipid profile and periodontitis. Materials and Methods: The levels of serum lipid profile in 60 subjects, 30 with chronic generalized periodontitis based on clinical attachment loss (CAL) constituting the test group and 30 without periodontitis constituting the control group, were measured and compared with each other. Both these groups were free from other systemic illnesses. Statistical Analysis: The mean CAL was positively correlated with serum low-density lipoprotein (LDL) cholesterol (P < 0.01). Results: The mean serum LDL cholesterol (126.62) and total cholesterol (173.32) in periodontitis patients were found to be significantly higher as compared to that of the controls. The mean CAL (5.32 mm) was positively correlated with serum LDL cholesterol. The frequency of persons with pathologic values of LDL cholesterol and total cholesterol was significantly higher in periodontitis patients compared with that of the controls. Conclusions: These results showed that high serum LDL cholesterol and total cholesterol may be associated with periodontitis in otherwise healthy people. However, it is unclear whether periodontitis causes an increase in the levels of serum LDL.

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Background: Recent literature suggests psychosomatic and occupational stresses have a bearing on the etiology of periodontitis. The aviation field is a high-risk environment and rich in potential stresses which can be potent environmental factors. The purpose of this pilot study was to clinically evaluate the incidence of periodontitis amongst military aviators and its management on the health-related quality of life recovery. Materials and Methods : A total of 252 individuals were examined, equally divided into ground duty and flying groups. In addition to standard parameters, the clinical attachment loss (CAL) was estimated according to a three-point scale. Stress factor was evaluated as per short form of Minnesota Job Satisfaction Questionnaire (MSQ). Numbers of visits after diagnosis, limitation from flying tasks due to the acute phase of disease and during treatment were recorded. The subjects who presented with active phases of disease were taken up for surgical mode of treatment. Results: Out of 252 individuals examined in this study, active periodontitis was found in 7.9% of the total population. Group 1 and 2 subjects presented an incidence rate of 5.6 and 10.3%, respectively. Among the aviators, 12.2% of the helicopter crews, 10.3% of fighter pilots, and 8.9% of the transport crews showed active form of periodontal diseases during routine annual medical examination. Ten cases presented limitation from flying due to acute phase of disease. Conclusions : Periodontitis causes early teeth loss and compromises the quality of life. It is mandatory for quick recovery and return to professional activities in the aviators. The annual medical checkup must include a thorough check up by a dental officer/periodontist and assessment with an appropriate radiograph once in every 3years advised. The screening examination used is suggested for use as part of each aviator's annual dental examination.

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Trigeminal neuralgia (TN) is a rare neurological disease that causes sudden, severe, brief, stabbing recurrent episodes of facial pain in one or more branches of the trigeminal nerve. Over the last few decades, there is evidence that TN may be a result of compression of the trigeminal nerve root at or near the dorsal root entry zone by a blood vessel. TN is treated on an outpatient basis, unless neurosurgical intervention is required. Treatment can be subdivided into pharmacologic therapy, percutaneous procedures, surgery, and radiosurgery. Medical therapy is often sufficient and effective, allowing surgical consideration only if pharmacological treatment fails. Medical therapy alone is an adequate treatment for 75% of patients.

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