Abstract: Warthin’s tumor (WT), also known as papillary cystadenoma lymphomatosum, is a benign salivary gland neoplasm predominantly affecting the parotid gland. Despite its benign nature, the tumor presents unique diagnostic and clinical challenges due to its variable presentation and occasional multifocal or bilateral occurrence. The etiology of WT remains incompletely understood, though associations with smoking and lymphoid tissue interactions suggest a complex pathophysiology. Recent advancements in imaging and histopathological techniques have improved diagnostic accuracy, yet differentiating WT from other salivary gland neoplasms remains crucial for appropriate management. Surgical excision remains the primary treatment modality, particularly for symptomatic or enlarging lesions, although conservative management is increasingly considered in select cases. This review aims to provide an updated overview of the epidemiology, pathogenesis, diagnostic strategies, and treatment options for WT, emphasizing the role of modern imaging modalities and the emerging debate over the necessity of surgical intervention in all cases. Understanding the nuances of WT is essential for clinicians to ensure accurate diagnosis, optimize patient outcomes, and avoid overtreatment. Future research should focus on elucidating molecular markers for better risk stratification and exploring non-invasive management approaches.

Abstract: Background: Nowadays, yttria stabilized ZrO2 is the most commonly used esthetic material in fixed dental prosthodontics. The vast majority of full contour monolithic fixed dental restorations were made from multilayered translucent zirconia. The Aim of this Research: Was to study the flexural strength of three different layers of multilayered zirconia discs manufactured with two multilayering technologies (yttria graded and shade graded) and sintered at different temperatures. Method: Ninety bars were divided into 3 groups (n=30) made from three different zirconia discs manufactured with various multilayering techniques, Zircad PRime, Super Translucent Multilayered and Zolid FX, each main group subdivided into three subgroups (n=10) in accordance with the multilayered zirconia materials that were used and three different layers were utilized from each disc: Zircad PRime Cervical ZPRC, Zircad PRime Middle ZPRM, Zircad PRime Incisal ZPRI, STM Cervical STMC, STM Middle STMM, STM Incisal STMI, Zolid FX Cervical ZFXC, Zolid FX Middle ZFXM and Zolid FX Incisal ZFXI. After milling the specimens were separated from zirconia discs, then fully sintered conventionally for 2 hours according manufacturer instructions regarding final temperature and the strength evaluated with three point’s flexural strength bending test utilizing the universal testing equipment. Result: Non significant differences among layers of shade graded zirconia STM and Zolid FX while a difference was observed between layers of yttria graded zirconia Zircad PRime. Highest result was for ZPRC and lowest flexural strength result was for ZFXC. Conclusion: Neither all multilayered zirconia discs nor the variable layers are the same. Incisal layer of varying yttria concentrations multilayered zirconia demonstrates much lower flexural strength than cervical layer at the same disc, while shade graded multilayered disc variable layers have same strength, yttria content greatly influence strength of zirconia materials and sintering temperature has no effect on flexural strength of layers have the same yttria content.

Abstract: Background: The maxillary third molar is among the most commonly impacted teeth and can present in various forms depending on the direction and depth of impaction. However, bilateral inverted impaction of the maxillary third molars is an exceptionally rare condition, with only a single case reported in the current literature. Case Report: This case report unequivocally outlines the uncommon presentation and management of bilateral inverted maxillary third molars in a 50-year-old female. Routine radiographic imaging unmistakably identified the inversion, with crowns oriented upward and roots directed toward the alveolar crest, alarmingly close to the maxillary sinus. Since the teeth were symptomatic, surgical removal was decisively recommended to avert potential complications, such as infection and disruption of prosthetic rehabilitation. The extractions were executed across two sessions, with healing proceeding without any complications. Conclusion: This case underscores the critical necessity for thorough imaging and a bespoke treatment strategy for addressing rare dental anomalies. It accentuates the need for personalized care, considering the patient’s health, surgical risks, and prosthetic objectives. Given the rarity of bilateral inverted maxillary third molar impactions, this report delivers significant insights into their management and surgical strategy

Background: Exodontia, or the removal of teeth, is not only a routine dental procedure but also a significant event that interacts with the cardiovascular system. Stress, anxiety, and pain associated with tooth extraction can lead to fluctuations in blood pressure and heart rate, especially in patients with pre-existing conditions. The role of local anesthesia, the psychological state of the patient, and procedural factors are all critical in understanding these physiological changes. Research indicates a transient elevation in blood pressure and heart rate during exodontia, predominantly due to stress-induced activation of the sympathetic nervous system. This review aims to analyze the existing literature on the interplay between dental procedures and cardiovascular responses, highlighting factors that exacerbate or mitigate these effects. Conclusions: Effective management strategies for anxiety and pain, such as pharmacological interventions and patient preparation, are essential for minimizing risks during such procedures. Understanding these dynamics is vital for ensuring patient safety and improving outcomes in dental practice.

Abstract: Background and Aims: An important enzyme for dental health, alkaline phosphatase (ALP) serves a variety of purposes in preserving the structure and functionality of oral tissues. In order to better understand salivary ALP's potential as a biomarker for dental erosion and its diagnostic and prognostic utility in both young and adult populations, this study set out to clarify its possible role. Materials and Methods: In the study, there were twenty-seven patients with dental erosion and an equal number of age and gender-matched healthy controls. Before a meal and without stimulation, samples were taken from the control and study groups by passively drooling into a sterile glass tube until 5 ml was collected. Results: Salivary ALP levels showed a significant difference between patients with and without dental erosion (63.68 ± 4.36 (IU/L) versus 21.47 ± 1.16 (IU/L)), with a p-value of 0.0001 indicating a very high significance. Alkaline phosphatase enzyme levels and teeth erosion were found to have sturdy positive relation (r= 0.989) high significantly P< 0.001. Conclusion: Salivary alkaline phosphatase is a vital enzyme, which is essential for the mineralization of teeth and it considers biomarker for the severity and progression of dental erosion.

Objective: To evaluate the patterns of pain presentation, management strategies, and medication preferences among dental practitioners, with a specific focus on analgesic prescription practices in various dental conditions. Methods: A cross-sectional study was conducted among dental practitioners using the 24-item questionnaire to gather expert opinions on pain patterns, patient demographics, treatment timelines, and drug prescription practices. Descriptive statistics were used for analysis, with results visualized through pie and bar charts created in Microsoft Excel. Results: This study involved 69 clinicians and most of them (62.32%) identified dental pulpitis as the most common source of pain, with 50.72% reporting that 51-75% of their patients presented with pain complaints. For third molar pain, 37.68% of clinicians noted impacted teeth as the most frequent cause. Regarding treatment, aceclofenac was the most prescribed analgesic following surgical procedures and root canal treatments (92.75%). The preferred combination for managing pain lasting less than 5 days was aceclofenac + paracetamol + serratiopeptidase, favored by 78.26% of clinicians. The survey also found that patients typically experienced pain for 4-7 days before seeking care for dental pulpitis, and many patients were unaware of the complications related to third molar impactions (50.72%). Conclusion: Aceclofenac is the primary analgesic for dental pain management among surveyed clinicians, commonly used across various procedures. While single-agent therapy with aceclofenac is preferred, combination therapy with paracetamol and serratiopeptidase is frequently used for more complex or severe cases. This reflects a tiered approach to pain management, adjusting treatment based on procedure and patient needs.

Cleft lips and palates are congenital anomalies affecting the mouth and face. For fully edentulous patients with a cleft palate, crafting complete dentures is particularly challenging. These dentures, which incorporate an obturator and extend into the palate, must be meticulously designed to address issues related to appearance, speech, swallowing, and chewing. Treatment for cleft lip and palate aims to restore function, speech, and aesthetics through the use of fixed prostheses, removable prostheses, and implants. The approach should follow key principles of oral rehabilitation, including maintaining proper physiology, stability, aesthetics, hygiene, and considering patient expectations. To ensure the durability of prosthetic solutions, it is crucial to respect both the periodontal and dental tissues and the biomechanics of the prosthesis. Palatogram is an effective and straightforward technique for assessing and verifying palatal contours, which helps in addressing speech deficiencies related to affected sounds. Managing completely edentulous adults with cleft palates, particularly those who have not undergone surgical intervention, presents a significant challenge for prosthodontists. This case report explores the use of a conventional complete denture for a cleft palate patient, utilizing the palatogram technique to precisely record the palatal contours, the neutral zone technique to optimize denture stability by aligning forces in harmony with oral musculature, and monoplane teeth to reduce lateral forces and enhance denture stability. Together, these techniques aim to improve speech, mastication, and comfort, providing a functional and aesthetic prosthesis suited to the patient’s unique anatomical needs. This case demonstrates the successful rehabilitation of an edentulous cleft palate patient using a conventional complete denture with specialized techniques to address the unique anatomical and functional challenges presented. The neutral zone technique, monoplane teeth arrangement, and palatogram technique were crucial in achieving a stable, functional, and aesthetically pleasing denture. These methods helped optimize denture retention and stability, improve phonetics, and enhance masticatory efficiency, providing the patient with a significant improvement in quality of life and self-confidence. For patients unable to pursue more invasive and costly implant-supported options, such techniques offer a viable and effective solution for complete denture fabrication, allowing for functional and aesthetic rehabilitation within economical constraints.