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This study aims to evaluate the accuracy of immediate implants in mandibular molars between the conventional method and the pre-extractive inter-radicular method. MATERIALS AND METHODS: A total of 20 patients were equally divided into two groups. Implants were placed using the conventional method (Group A) and pre-extractive inte-rradicular method (Group B). Coronal, apical and angular deviation between planned and placed implants were evaluated by superimposing preoperative and postoperative three-dimensional (3D) STL models in Geomagic Freeform software. The data were subjected to an unpaired Student t-test. RESULTS: Results revealed that the coronal, apical and angular deviation were lower in the pre-extractive inter-radicular drilling method than in the conventional method, which was statistically significant. Apical deviation was greater than coronal deviation in both the sagittal and coronal planes. It was also found that the mean deviation was greater in the sagittal plane (mesio-distal axis) than in the coronal plane (bucco-lingual axis). CONCLUSION: Comparison of the two methods revealed significant changes between the planned and actual positions of implant. When stringent steps were followed, the degree of deviation was found to be less in the pre-extractive inter-radicular approach, proving it to be more accurate than the conventional method. However, large-scale research studies are required to extrapolate our findings.

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Introduction: Oral cancer ranks sixth place worldwide among other cancers and is known for its high morbidity and mortality rates. Among oral cancer, oral squamous cell carcinomas (OSCC) remains the most common. Expression of specific biomarkers are known to be related to the prognosis of the OSCC. Methodology: An immunohistochemistry study was performed to evaluate the expression of Cyclin D1 and CENPF for their prognostic significance in twenty OSCC patients. The follow-up period ranged from 10 to 18 months. The expression of these proliferative markers was correlated with demographic, clinical and histopathological grade of the disease. Results: The results revealed 28% mortality rates in relation to OSCC involving retro-molar trigone. Based on the Cyclin D1 and CENPF expression, high mortality rate (Pearson coefficient = 0.800) was seen with grade 3 and 4 expressions of the markers. Decreased survival rates (Pearson coefficient = 0.824) were observed with stage III and IV disease with grade 3 and 4 expressions of the markers. Conclusion: Cyclin D1 and CENPF have shown promising results as proliferative markers which can be linked with prognosis of OSCC in this study. Further studies with larger sample size are needed to extrapolate our findings.

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Lymphangiomas are congenital malformations. Swellings in the cheek may arise from infection, cyst and tumors.Pathological lesions are not always confined to its common site and age of occurrence. Occurrence of lymphangioma in buccal mucosa especially in adults are very rare. Exact knowledge about anatomy and nature of lesion is mandatory for its complete removal as incomplete removal results in recurrence. Herewith,a rare case of recurrent lymphangioma involving left buccal mucosa in an adult is presented with its management. Emphasis is laid on the necessity of combined approach through multidisciplinary team while treating such lesions.

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INTRODUCTION: Facial palsy is a condition where the patients lack voluntary movement on the affected side of the face and are not able to convey their emotions. Besides that, they also succumb themselves to social isolation. Various techniques have been devised to overcome this devastating problem. The aim of this article is to evaluate and compare facial muscle function before and after facial reanimation with temporalis muscle galea pedicled flap by motion mode echomyography in patients with long-standing facial paralysis. PATIENTS AND METHODS: Ten patients with long-standing facial paralysis were included in the study (six patients with LMN palsy and four patients with facial weakness involving specific peripheral branches), and they subsequently underwent facial reanimation surgery with temporalis galea pedicled flap. These patients were followed postoperatively for a period of 1-2 years and were subjectively graded as excellent, good, fair and poor and objectively evaluated by M-mode echomyography, and the results were evaluated and statistically analyzed. RESULTS: Subjectively, out of 6 patients with LMN palsy, results were graded as excellent in 2 cases, good in 3 cases, fair in 1 case, and out of 4 patients with weakness in specific facial nerve branches, the subjective results were excellent in 2 cases, good in 1 case and fair in 1 case. Objectively, the effect of transposed temporalis galea on orbicularis occuli, levator labii superioris and orbicularis oris was found to be statistically significant in patients with LMN palsy. CONCLUSION: Our study proves the versatility of temporalis muscle galea pedicled flap in cases of long-standing facial paralysis by motion mode echomyography.

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INTRODUCTION: Oral-pharyngeal reflexes demonstrate a wide range of complexities due to their intricate synaptic pattern. Most of the reflexes are protective in nature such as preventing aspiration. These reflexes in oral cavity affect the muscles and can be evoked either in isolation or in combination in order to achieve a specific response. Certain sensory inputs induce an entire motor behavior pattern as seen in lingual hypoglossal reflex. MATERIALS AND METHODS: A case report depicting this reflex have been presented. To our knowledge, this is the first case documented in a living human. Along with this, cadaveric studies have been also done in fifteen specimens. RESULTS: Extralingual anastomosis between lingual nerve and hypoglossal nerve were found in six specimens. CONCLUSION: Hereby, we present a clinical paper of this unusual phenomenon which has not been documented in the literature.

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Supernumerary teeth are hyperdontic variants due to abnormalities during tooth development. Here, we report a case on regeneration of bony defect, which ensued following extraction of two supernumerary teeth in the mandibular premolar region, using a combination of bone grafts and platelet-rich fibrin. To the best of our knowledge, it is the first time synergistic use of biomaterials with bone grafts have been used for this type of management.

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CONTEXT: Comprehensive reviews on clinical applications of Platelet rich fibrin (PRF) in surgery are limited despite its extensive utilization resulting in a dearth of knowledge on its effectiveness. Hence this article focuses on shedding light to the various applications of PRF pertaining to surgery through a systematic review. OBJECTIVE: The systematic review is aimed at evaluating the value of PRF in different areas of surgery. DATA SOURCES: A systematic review of articles sourced from MEDLINE-pubmed (2008-2017(July)) was done. Additional articles were searched through GOOGLE SCHOLAR and SCIENCE DIRECT. Search terms such as Platelet rich fibrin; Platelet rich fibrin, surgery; Platelet concentrate; second generation concentrate; Applications of PRF in surgery were used. STUDY SELECTION: Systematic reviews, Randomized control trials, Pilot studies and Case reports were included. Non English articles, in-vitro and animal studies were excluded. DATA EXTRACTION: Independent sourcing of articles by 3 authors using a set of predefined criteria. DATA SYNTHESIS: Out of the 25 articles covering various surgical procedures that met the inclusion criteria, positive outcomes were noted in most. Although categorization into one specific type of study was not done, the overall success rate with PRF usage was 78%.No differences between test and control groups were observed in 2 studies and 3 studies showed no significant improvements with the usage of PRF. LIMITATIONS: The systematic review did not categorize the study designs while evaluating success rates which might be considered as a shortcoming as case reports were also included. CONCLUSIONS: The future propositions are vast and point towards innovative applications of this bio-material possibly in transplant and burn cases if a method of obtaining large amounts can be devised. However since we rely on evidence-based results, further long term studies are needed in distinct areas of applications to decisively prove its effectiveness.

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OBJECTIVE: To evaluate the reliability and validity of Demirjian's, Willems, Nolla's, Haavikko's, and Cameriere's radiographic methods of dental-age estimation in a population of Malaysian children. METHODS: A total of 426 dental panoramic radiographs of 5-15-year-old Malaysian children were included in the study. The mean age error and absolute age error for all the methods were calculated and their usability analyzed. RESULTS: The Nolla, Willems. and Demirjian methods overestimated the dental age with a mean of 0.97, 0.54, and 0.54 years, respectively, while the Cameriere and Haavikko methods underestimated by 0.41 and 1.31 years, respectively. The Cameriere method was highly precise and accurate in the population of Malaysian children, whereas the Haavikko and Demirjian methods were the least precise and accurate. CONCLUSIONS: The Cameriere method of dental-age estimation is highly valid and reliable for Malaysian population, followed by the Willems and Nolla methods.

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BACKGROUND: Application of principles of electrocautery for hemostasis dates back to prehistoric times. Its modern implementation in various fields of general and head and neck surgeries have been well documented. However its usage in minor oral surgical procedures has gained popularity only recently. Complications associated with electro-surgery in the dental field are relatively rare and there is insufficient literature on its management. CASE REPORT: We present a case report on management of an electrosurgery induced osteonecrosis involving maxillary alveolus of left premolars. DISCUSSION: Inadvertent contact of the electrosurgery tip on bone can result in necrosis making it necessary to remove the sequestrum and graft the defect. Platelet rich fibrin in combination with bone grafts have been well documented to provide successful periodontal regeneration. CLINICAL IMPLICATIONS: Our aim of presenting this report is to create awareness among the health care providers regarding electrosurgical injuries. To our knowledge, this is the first time platelet rich fibrin has been used in the management of intraoral electrosurgical injury. Combining bone grafts with platelet rich fibrin is a good alternative as it can be done with relative ease and predictable outcome.

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BACKGROUND: Burns of the oral mucosa may be caused by thermal, mechanical, chemical, electrical or radiation injury. Clinically, these burns can produce localised or diffuse areas of tissue damage depending on the severity and extent of the insult. Most oral thermal burns produce erosions or ulcers on the palate or tongue. MATERIALS AND METHODS: A case of palatal burn in a 66-year-old diabetic patient caused by drinking hot cereal is presented. The role of diabetes in causing oral mucosal dysesthesia that predisposed the occurrence of this burn is also discussed. CONCLUSION: Insensate palatal burn as a rare complication of diabetes mellitus is reported here. With the disease being more widespread now, its potential oral complications will be seen with increasing frequency.

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BACKGROUND: Student-to-student administration of local anesthesia (LA) has been widely used as the teaching modality to train preclinical dental students. However, studies assessing students' outlook towards their first injection were limited. Therefore, this study aims to evaluate students' perception and anxiety levels towards their first LA injection. METHODS: Sixty three pre-clinical dental students swapped their roles as both operator and respondents in relation to their first supraperiosteal injection. After being injected, the students conferred their opinion and experiences to the questionnaire based on the five point Likert's scale and indicated their anxiety levels based on the Interval Scale of Anxiety response (ISAR). Their perception was described using frequencies and percentages and anxiety levels were statistically analysed using one way analysis variance and paired t test. RESULTS: Students learning LA techniques directly on human subjects depicted not only greater confidence in them but also increased anxiety levels. The anxiety levels were found to be high before and during injection in both operator and respondent. CONCLUSION: The students' preferred the use of preclinical models rather than student to student administration for their first LA injection exercise. Based on the results obtained, we recommend the need of preclinical simulation model in LA training program.