This clinical report describes how to achieve a successful rebonding of a debonded porcelain veneer successfully using several procedures such as grinding enamel to eliminate the remaining adhesive from the first bonding and ultrasonic treatment of the veneer’s surface. Care is given the bonding protocol in order to optimize the durability of the interface.

Reconstruction within the head and neck is challenging. Defects can be anatomically complex and may already be compromised by scarring, inflammation, and infection. Tissue grafts and vascularised flaps (either pedicled or free) bring healthy tissue to a compromised wound for optimal healing and are the current gold standard for the repair of such defects, but disadvantages are their limited availability, the difficulty of shaping the flap to fit the defect and, most importantly, donor site morbidity. The importance of function and aesthetics has driven advances in the accuracy of surgical techniques. We discuss current advances in reconstruction within oral and maxillofacial surgery. Developments in navigation, three-dimensional imaging, stereolithographic models, and the use of custom-made implants can aid and improve the accuracy of existing reconstructive methods. Robotic surgery, which does not modify existing techniques of reconstruction, allows access, resection of tumours, and reconstruction with conventional free flap techniques in the oropharynx without the need for mandibulotomy. Tissue engineering and distraction osteogenesis avoid the need for autologous tissue transfer and can therefore be seen as more conservative methods of reconstruction. Recently, facial allotransplantation has allowed whole anatomical facial units to be replaced with the possibility of sensory recovery and reanimation being completed in a single procedure. However, patients who have facial allotransplants are subject to life-long immunosuppression so this method of reconstruction should be limited to selected cases [1].

Supernumerary teeth are uncommon but have been well documented clinically. They are extra teeth or tooth-like structure, either erupted or unerupted in addition to the 32 permanent teeth. Mesiodens is one of these located in the midline between the two central incisors. Nasal teeth result from ectopic eruption of supernumerary teeth, can be identified by performing Cone Beam Computed Tomography (CBCT). Supernumerary teeth may lead to delayed eruption or non-eruption, displacement of permanent teeth, resorption or malformation of adjacent roots, and cystic formation (rarely). Multiple supernumerary impacted teeth are usually associated with syndromes, metabolic or hormonal disorders. This paper describes surgical management of a rare case of 2 palatally placed, one horizontal and impacted supernumerary, one in the anterior maxilla and other in the floor of the nasal cavity, which were detected during a radiographic examination for labial placement of permanent right central incisor due to a rotated mesiodens in the case of a healthy 14-year-old boy reported at the Dental centre.

Background: Fluoride is a double-edged sword. The assessment of dental caries and dental fluorosis in endemic fluoride areas will facilitate in assessing the relation between fluoride concentrations in water with dental caries, dental fluorosis simultaneously. Aim of the study: The aim of the study was to assess the prevalence of dental caries and dental fluorosis in association with fluoride drinking water in district of Nalgonda and to create awareness among school children regarding fluorine and its effects. Materials and methods: A cross-sectional study was conducted among 12 and 15 years old school children in Nalgonda district for a period of 6 months. Ten schools were selected in Nalgonda district using lottery method of simple random sampling. The oral examination of available 12 and 15 years old school children fulfilling the inclusion and exclusion criteria was carried out to assess dental caries and fluorosis. A pre designed questionnaire was used to collect the desired information of school children. The clinical examination was conducted by a single trained and calibrated examiner using the mouth mirror and community periodontal index probe under natural daylight. Decayed, missing and filled teeth (DMFT index) and Modified Dean’s Fluorosis Index was calculated. Water samples were collected in a 500ml bottle from drinking source which was used by children, and all the bottles were labelled and sent to the laboratory for estimation of fluoride concentration. The obtained data was subjected to statistical analysis using SPSS 20 software. Results: The overall prevalence of dental caries among the school children was 41% (226/556). The prevalence of dental caries was significantly higher among females 47 % (135/285) compared with males 33.6% (91/271). The overall prevalence of dental fluorosis among school children was 62% (343/556). There were no gender differences in the prevalence of dental fluorosis. Conclusion: The prevalence of dental caries was more in low and medium fluoride areas followed by high and very high fluoride area. There is a positive correlation between water fluoride content and prevalence of dental fluorosis. The prevalence of dental fluorosis was more in very high and high fluoride areas compared to low fluoride areas.

Background: Many studies investigated the value of sinus lift with or without different bone substitute materials. However, sinus floor elevation with no graft material except a blood clot under the Schniderian membrane is becoming more popular. This study aims to evaluate both bone quantity and quality around dental implants inserted immediately after indirect graft-less sinus lift. Materials and Methods: Thirteen dental implants were used for the treatment of 8 patients with reduced posterior alveolar height using crystal approached sinus lift with the placement of Gel-Foam as an augmentation material before inserting the dental implant, from May to December 2017, then after 4 months from the surgery, a radiological evaluation was done by using Cone Beam Computed Tomography for assessment of the newly formed bone height and density. Results: preoperative and postoperative radiographic comparison using CBCT scan demonstrated the new bone formation within the compartment created by the sinus membrane elevation procedure with an average gain (2.75, ± 1.5) mm. The mean density of the newly formed bone was (298.1, ±130.1) Hounsfield unit. There is a postoperative increase in the native alveolar bone density around the dental implant from (398.9, ± 146.7) Hounsfield unit to (595.5, ±159.4) Hounsfield unit. Conclusion: There is A potential for a new bone formation of up to 7 mm bone in the maxillary sinus with Gel-foam supplement without the need for bone grafts. The newly formed bone quantity and the quality show promising results of the graft-less sinus lift with simultaneous dental implant insertion.

It is important for a clinician to have knowledge of the possible complications that are to arise due to implant therapy. This review article focuses on complications of implant due to systemic health conditions of the patient, followed by complications due to improper treatment planning and complications due to prosthetic components. It also throws light on the criteria for implant prognosis.

Implant prosthetic treatment planning has seen a shift from surgically driven implantology to prosthetically driven to decrease the ratio of implant failures due to prosthetic reasons. This approach of prosthetically driven implantology balances implant aesthetics and implant function by considering factors of prosthesis planning before surgical implantation. Thorough evaluation of the patient and treatment planning of the prosthesis decreases the chances of implant failures. This review article describes the factors to be considered during implant prosthesis treatment planning. Each of these factors plays an important role in determining the long-term success of the prosthesis.