Context: Frontal esthetics should equal the profile in importance when planning orthodontic treatment. Soft tissue profile changes associated with orthodontic treatment have been the subject of many studies, but changes in the vertical dimension of the lips after orthodontic treatment by different appliances has received little attention. Aims: The purpose of this study was to compare the changes of vertical dimension of vermilions after standard and preadjusted orthodontic treatment. Setting and Design: Retrospective study. Materials and Methods: In this retrospective study, 60 patients (30 patients treated with standard edgewise appliances and 30 patients treated with preadjusted appliances) were randomly selected from the practice of two experienced orthodontist. Ratios between vermilion height and inter-commisural width were recorded on pre- and posttreatment photographs using Adobe Photoshop software. Data were analyzed with SPSS version 16 software and ANOVA analysis to compare vertical lip changes between two orthodontic systems. Results: The mean of vermilion height to inter-commisural width ratios after orthodontic treatment in preadjusted group (P = 0.019) and standard group (P ? 0.001) was significantly less than that before treatment. The reduction of this ratio after preadjusted orthodontic treatment was less than that in standard edgewise orthodontic treatment but this difference was not statistically significant (P = 0.127). Conclusion: In this study, the vertical height of lips decreased significantly after orthodontic treatment in both groups and there was no significant difference in standard and preadjusted appliance. Therefore these changes must be discussed with patients before orthodontic treatments.

Objectives: To assess the impact of socioeconomic status (SES) on decayed, missing, filled teeth (DMFT) among state government employees in Shimla city, Himachal Pradesh. Design: Cross-sectional study. Materials and Methods: This study was conducted on 1008 dentate subject 705 (69.9%) males and 303 (30.1%) females out of 10908 government employees. Data regarding dentition status and treatment needs was recorded on a W.H.O. format 1997. Type III examination was conducted under good illumination by the investigator himself. Student's t-test or ANOVA was applied for statistical evaluation of means and the comparisons of proportions. P value ? 0.5 and ? 0.01 was considered statistically significant and highly significant respectively. Results: Total teeth examined were 29575 out of which 14.84% were decayed. Overall mean DMFT was 3.29 (1.86). Females were reported significantly higher ( P < 0.05) DMFT 3.49 (2.31) than males 3.12 (1.42). Subjects who belong to upper SES had lesser mean DMFT than lower SES 2.31 (2.4) vs 4 (3.89), which was statistically highly significant ( P < 0.01). Employees who brush their teeth once a day presented with higher DMFT 4.01 (2.01) than those who brush once daily 2.57 (1.96). The difference was highly significant ( P < 0.01). Conclusions: A preventive and curative oral health policy for the government employees in Shimla city needs to be planned and implemented to maintain their commitment in their official work. Also they must be educated the importance of oral health and methods how to maintain it.

Background: Measurement of normal maximum mouth opening (MMO) in children is an important diagnostic criterion in the evaluation of the stomatognathic system. The aim of this study was to determine the MMO in children from the Indian population, of age six to twelve years, and to examine the possible influence of age, gender, height, and body weight on MMO. Assessment of MMO was accomplished with a modified Vernier Caliper, by measuring the distance between the incisal edges of the upper and lower incisors during maximal mouth opening up to the painless limit. Materials and Methods: The study consisted of 856 children from various schools in the city of Rohtak (Haryana), India, who were randomly divided into three groups based on their age: Group 1: Children of age six to eight years; Group II: Children of age eight to ten years; Group III: Children of age ten to twelve years. For each subject three readings were recorded in millimeters and the mean value was considered. The age, gender, height, and body weight of each child were also recorded at the same time. A P value of < 0.05 was considered to be significant. Results: The results of the present study revealed that MMO in Indian children were 46.04 mm, 48.53 mm and 52.38 mm for boys and 45.95 mm, 47.27 mm and 52.05 mm for girls, in the age groups of six to eight, eight to ten, and ten to twelve years, respectively. Conclusion: Significant associations were observed in between age, height, body weight, and MMO. However, no gender difference was observed.

Context: It is well-known that subjects affected by Ehlers-Danlos Syndrome (EDS), hypermobility type/Joint Hypermobility Syndrome are characterized by severe joint hypermobility with recurrent joint dislocations and chronic pain and biomechanical dysfunction of the temporo-mandibular joint (TMJ). Aims: The study aims to measure TMJ mobility in EDS subjects to quantitatively characterize the TMJ dislocation during specific tasks as well as head adjustments, already documented by literature by observational techniques. Materials and Methods: Female EDS subjects and age matched controls were asked to perform simple opening-closing movements of the mandible. Kinematics data was recorded and analyzed through an optoelectronic motion capture system. Some parameters of the motion were studied: range of motion of the condyles, range of motion of the chin, aperture angle, movement speed, and frequency. Statistical Analysis Used: The statistical t-test was used to compare results from pathological group to the control group. Results: Significant differences, between EDS group and controls, were found for the backward rotation of the head, lateral range of motion of the chin, frequency, and velocity. Results were in accordance with the clinical observations. The results not only confirmed that EDS subjects back-rotate the head while performing the opening-closing task but also quantified the entity of this behavior. Conclusions: The method we proposed is noninvasive and is able to analyze mandible kinematics. It may be used by clinicians to assess the healthy status of TMJ, to quantify mobility, and hypermobility of the mandible and to help diagnosis of TMJ dysfunctions.

Zygomatic air cell defect is extension of pneumatization of temporal bones anteriorly into the articular tubercle. These are variations of normal structures which can be detected on the simplest imaging modality, the panoramic radiograph. A literature search, electronic as well as manual, was done using the keywords zygomatic air cell defect, pneumatized articular eminence and pneumatized articular tubercle. The search yielded considerable literature on the topic, which was analyzed thoroughly for its contents and this paper reviews this normal variant from the time of its recognition to the present day updates. It can be concluded that the zygomatic air cell defect has a low prevalence in general population and can be mistaken for a pathologic process. Further, if not recognized in subjects undergoing surgical procedures may lead to inadvertent complications such as leakage of cerebrospinal fluid.

Recurrent aphthous stomatitis (RAS) is a rather widespread oral ulcerative condition with an unclear etiology. The clinical characteristics of RAS have been defined and therapies include anesthetic gel, oral anti-inflammatory drugs, Vitamin B12 supplements and corticosteroid ointment used on the lips. However, these approaches have not been rigorously evaluated. Persistent and painful RAS was successfully treated with 4% Power Fucoidan Cream ^TM (PFC, Daiichi-Sangyo, Osaka, Japan) in two women. RAS was remarkably improved by PFC. Further clinical trials are needed to confirm the value and safety of topical PFC for treating RAS.

Primary intra-osseous cavernous hemangiomas (PICHs) represent slow-growing benign vascular malformations, most frequently found in parietal and frontal bones and account for ~0.2% of all bone tumors and 10% of benign skull tumors. We report a case of 70-year-old gentleman presented with progressive headache involving left frontal region, aggravated on coughing of five months duration. Radiological features were suggestive of left frontal calvarial lesion and left fronto-parietal chronic subdural hematoma. Histopathology of the calvarial lesion was suggestive of cavernous hemangioma. Meticulous radiological and clinical investigation is essential to rule out all other possible lesions; histopathology confirms the diagnoses, and the preferred treatment is complete tumor removal and management of the associated lesions (i.e., chronic subdural hematoma in present case).

Fusion is a developmental anomaly of dental hard tissues characterized by the union of two adjacent teeth. It may be complete with the formation of an abnormally large tooth or incomplete with the union of crowns or roots only. Exact etiological factors are still enigmatic. It is more common in deciduous than in the permanent dentition with higher frequency in anterior maxillary region. We present a case of fusion in permanent maxillary incisor region in a 35-year-old male who presented with the complaint of pain in same region. Early diagnosis is important to avoid various complications such as compromised aesthetics, space loss, midline shift, and carious exposure.

Discovery of a foreign object embedded in a tooth is an uncommon finding. Many children with a habit of placing various objects in the oral cavity eventually end up with foreign body lodgment into the pulp chamber or root canal leading to pain and infection. This is more likely to occur in a tooth with a wide pulp chamber opened during root canal treatment for drainage of pus. Such a procedure can provoke the patient to fill the open tooth with any foreign body or may place the child at risk of foreign body lodgment in the chamber or canal. As a foreign object can act as a source of pain and cause difficulty in the elimination of infection from the root canal, prompt, but cautious attempts, must be made to retrieve it from the pulp chamber, thereby preventing pushing into the canals, and root canal treatment should be completed as early as possible. The present article describes few such cases and also briefly reviews the different techniques used for removing the foreign body from the pulp chamber and root canal.

Atypical fibroxanthoma (AFX) is a superficial variant of pleomorphic malignant fibrous histiocytoma. AFX an rare tumor of skin seen mainly in the head and neck region of elderly patients. Clinically, it can be difficult to differentiate from other tumors without histopathological examination. It may clinically resemble squamous cell carcinoma, malignant melanoma, or pyogenic granuloma. The histologic differential diagnosis primarily includes peripheral giant cell granuloma, spindle cell squamous carcinoma, and spindle cell melanoma. Clinical findings and immunohistochemical studies are often needed to establish the diagnosis. The prognosis is generally excellent, although there are rare cases of metastatic disease. The case was 77-year-old female patient. She had a 1.5 cm red-brown bulging lesion on her left cheek that sometimes can bleed for 4 years. As clinically piyogenic granuloma was considered. Excisional biopsi was performed. There was not any lymphadenopathy in her head neck region. Microscopically, the case was interpreted as AFX. The histologic appearance of this lesion was reminiscent of the peripheral giant cell granuloma and giant cell variant of malignant fibrous histiocytoma, also termed malignant giant cell tumor of soft parts. Particularly skin lesions, clinicopathologic correlation is important. Appropriately as can be much easier to diagnose.

The nasopalatine duct cyst (NPDC) is regarded as developmental, epithelial, and nonodontogenic cyst occurring in the maxilla. It occurs between the fourth and sixth decades of life with male predilection. Swelling is the common clinical presentation and some may be completely asymptomatic and discovered during routine radiological examinations. Histologically, the epithelium lining of the NPDC may be respiratory, squamous, or a mix of both. Surgical enucleation is the treatment of choice. Here we present a case of NPDC by considering its occurrence in the third decade, recurrent nature, larger clinical and radiological diameter, and intermediate to palatal and nasal epithelial origin.

Giant cell reparative granuloma (GCRG) is an uncommon non-neoplastic reactive tumor which occurs almost exclusively within the mandible and maxilla. GCRG of the temporal bone is a rare condition. It has been found to affect predominantly adolescents and adults (age: 10-25 years). We report a case of a 62-year-old male with GCRG of left temporal bone who presented to us with progressive left temporal swelling for 3 months. It was associated with hearing loss. There was no history of trauma. A non-contrast computed tomography scan brain showed a locally destructive lesion involving squamous temporal bone closely related to the left temporal lobe and infratemporal fossa. Magnetic resonance imaging brain with contrast showed a hypointense lesion on T1 and with peripheral contrast enhancement after gadolinium injection. Patient underwent left temporal craniotomy with atticotomy, mastoidectomy, duraplasty, and opening of middle ear and temporomandibular joint. A bone graft was then taken from right iliac crest and used to repair the resulting defect. Final histopathology report confirmed GCRG. We discuss radiological and histopathological features of lesion in this case report.

The ameloblastic fibrodentinoma is one of the rarest, mixed odontogenic tumor composed of neoplastic odontogenic epithelium and odontogenic mesenchyme with dentin or dentin like tissues. It occurs most frequently in the young age, with most patients being below 30 years. This tumor predominantly affects mandible compared to maxilla and the molar region being the most commonly involved site. The present article shows occurrence of ameloblastic fibrodentinoma in the maxillary anterior region in a 13-year-old male patient, which is a rare reported site of occurrence and describes some unusual features of the tumor. The article also briefly reviews the literature pertaining to this rare tumor entity.