Gaurav Gupta

Cysts of jaw present as swellings of jaws and midface. Of different varieties, dentigerous cyst is most common type of noninflammatory odontogenic cyst. Dentigerous cysts are generally associated with crowns of impacted or unerupted permanent teeth. Here we present a case of dentigerous cyst in 13?year?old female child, which was successfully treated with conservative therapy. Patient also reported after one and half year with protruding teeth and retained deciduous right upper canine & impacted permanent canine. This case report also presents orthodontic management of retained deciduous canine and impacted permanent canine.   Keywords: Dentigerous cyst, Conservative therapy, Protruding teeth, Retained deciduous canine, Impacted permanent canine, Orthodontic management

Computer-Aided Design/Computer-Aided Manufacture (CAD/CAM) and digital imprint systems offer several benefits compared to traditional techniques. Use of CAD/CAM system to scan preparations and generate restorations in-office, removes second appointment for patient. In present case series we describe use of digital dentistry in pediatric patients and will fabricate space maintainer and zirconia crown using digital impression and digital workflow.   Keywords: Digital dentistry, Digital impression, CAD/CAM system, Zirconia crown, Space maintainer

The ceramic veneer in Metal-ceramic crowns and FPDs have potential for fracture. Metal Ceramic Restorations (MCR) are one of most commonly used restorations used in fixed prosthodontics because of their casting accuracy, high strength properties of the metal, durability and the cosmetic appearance of porcelain. Considering the vast differences in modulus between metal and ceramic materials, it is not surprising that mechanical failure of this system can occur. Clinically, such failures often begin as chipping off metal ceramic, leading to failure. In present case, replacement of an extensive prosthesis was done by taking digital impression using CAD/CAM system for fabrication for chairside zirconia bridge using mock -up technique.   Keywords: Dental prosthesis repair, CAD/CAM, Digital Dentistry, Chipping off, Mock­up technique

Dentinogenesis imperfecta (DI) is the result of autosomal dominant genetic defect and affects both the deciduous as well as permanent dentition. It is characterized by: opalescent teeth composed of irregularly formed and under-mineralized dentin with obliteration of pulp chamber and root canal. The teeth with DI show a greyish-blue to brown hue, dislodged enamel, dysplastic dentine with irregular dentinal tubules and interglobular dentine, short roots and pulpal obliteration. All this might lead to rapid and extensive attrition which requires adequate crown reconstruction. The aim of this case report is to show reconstruction of frontal teeth in adult patients with DI thereby providing functional and esthetic dentition.   Keywords: Dentinogenesis imperfecta, Veneer, Crown, Esthetic

Nowadays aligners have become alternative treatment in adult patients who do not want fixed orthodontic appliance due to various reasons such as aesthetic, easier to care and clean as food also don’t get stuck in aligners and patient can smile with confidence with aligners. Present case report demonstrates effectiveness of Clear aligners used to treat an adult female patient with proclination in upper arch having good periodontal condition. Predicted results were achieved with clear aligners as per virtual setup with reduction in proclination and a pleasing facial profile with competent lips within 6 months. Thereby, concluding that invisalign/clear aligners provide esthetic and comfortable option in cases of mild to moderate orthodontic correction even in adults.   Keywords: Clear Aligner, Adult patient, Pleasing facial profile, Proclined, Invisalign

Implant supported restorations have added substantially to clinical treatment options present to patients. Complications related to presence of inflammation includes perimucositis, peri-implant bone loss, and also peri-implantitis. Peri-implantitis is defined as an inflammatory disease that involves mucosa and alveolar bone around dental implant. Determining severity and extent of peri-implantitis, diagnostic process consists of scoring the damage of periodontal tissues, by probing depth and loss of clinical attachment. In present case a 54-year-old male underwent insertion of implant in maxillary anterior region. After two years, there was slight discomfort presenting with signs of inflammation and bleeding on probing. Various treatment options are available which include: nonsurgical therapy like, locally and systemically delivered antibiotics, surgical protocols aimed to regenerate the lost bone and soft tissue around the implant. This case reports on the surgical intervention and curettage of granulation tissue followed by placement of xenograft followed by membrane placement to improve the clinical results.   Keywords: Peri­implantitis, Xenograft, Regenerative procedure

Early caries involvement and gross destruction of permanent first molars result in reduced masticatory efficiency and later may lead to malocclusion, aesthetic and psychological problems for a smaller extent. This case highlights the importance on management of grossly decayed young permanent molar by conservative approach in children followed by placement of customized zirconia crown using CEREC workflow, thus restoring the form, function, and occlusion.   Keywords: Grossly decayed young permanent molar, Customized zirconia crown, CEREC workflow

This article aims to provide a comprehensive literate review on endocrown / customized digital restoration and how they might be a better option for hopeless decayed tooth. Dentist might be hesitant to apply such a successful treatment option for grossly decayed /fractured /traumatic teeth in their clinical practice because it’s not as widely used as other conventional methods. Here we review about innovative treatment approach for endodontically treated teeth, using a digital workflow with IOS and computer-aided design/computer-assisted manufacturing (CAD/CAM) fabrication of restoration. Endocrowns/ customized digital restoration constitutes a reliable approach for restoring severely damaged tooth as they are more precise, aesthetic and time saving.   Keywords: Endodontically treated teeth, CAD/CAM, Crowns, Customized digital restoration

Placement of the dental implants in posterior maxilla requires maxillary sinus floor elevation. However, this is avoided by placing short implant, these implants are increasingly being seen as an alternative to more extensive bone augmentation procedures. Long term follows up revealed survival of the implants. This case report describes extraction of teeth, followed by immediate placement of implantswiss short implant in posterior maxilla using jig trial in the prepared socket with two-year follow-up.   Keywords: Short implant, Immediate placement, Verification jig, Follow­Up

Interdisciplinary care for the management of impacted teeth provides exclusive method in treating patients. Careful diagnosis and planning is necessary to reach desired treatment goals. This case report attempts to highlight the importance of diagnosis and appropriate treatment plan for successful eruption of impacted upper anterior teeth, demonstrating the surgical exposure and orthodontic traction by placing hole in the crown of impacted teeth.   Keywords: Impaction, Orthodontic traction, Surgical exposure

A wide range of accidents might happen during the treatment of the root canal system, where the instrument breakage is one of the most unpleasant occurrences. Several techniques have been developed to facilitate the removal of the broken instruments. The aim of this article is to present the surgical removal of a broken endodontic file from the periapical region of the palatal root of a maxillary first molar depicting importance of radiographs.   Keywords: Separated instrument, Surgical removal, Apicoectomy

Various features of a human face collated in different ratios produce a distinct smile and esthetics. Any deflection from the accepted facial development and symmetry brings about vexatious facial appearance, depression and diffidence of patient. So a compendious smile designing is imperfect without scrutinizing the dentofacial features. Tremendous progress in the surgical discipline has made it possible to treat the major dentofacial deformities successfully, for whom orthodontic camouflage and growth modification would have resulted in unstable and displeasing results. Orthognathic surgery is the art and science of diagnosis, treatment planning and implementation of treatment to correct musculoskeletal, dentoosseous and soft tissue deformities of the jaws and orofacial appratus. With bona fide diagnosis and treatment planning, pleasing smile and functionally stable results can be obtained in skeletal class 3 malocclusion. Orthognathic surgery should be flawlessly integrated with orthodontics and other dental treatments to achieve satisfactory outcome. In orthognathic correction of skeletal discrepancies, various treatment modalities should be considered to come up with adequate outcome and least trauma to patient. Due to the meticulous advancement in recent decades, combined approach of orthognathic surgery and orthodontic treatment has been rewarded for severe dentofacial deformities. We are presenting here a case of skeletal class 3 malocclusion with symmetrical mandibular prognathism treated with combination approach.   Keywords: Combination approach, Mandibular prognathism, Orthognathic surgery, Skeletal Class 3 malocclusion.

Tuberculosis is chronic infectious disease and major cause of morbidity and mortality worldwide. It can affect any part of body, including oral cavity. Oral lesions of tuberculosis, though uncommon, have been observed in both primary and secondary stages of disease. This article presents case of tuberculosis in oral mucosa and mandible in 45 years old female. Involvement of oral cavity in TB is quite rare. Oral lesions seem to occur as chronic ulcers, nodular or granular areas. Most extra-pulmonary lesions represent secondary infections of primary lung infectious focus; therefore, early and accurate diagnosis is required for planning of best treatment and strategies to control disease.   Keywords: Oral tuberculosis, Painless nodular swelling, Mandibular lingual mucosa, Oral ulcer

Edentulism can be a debilitating handicap. Nowadays, most dental surgeons believe that the most basic restoration for the edentulous mandible should be an implant retained overdenture with two implants placed in the anterior mandible. Treatment options for edentulous mandible range from complete denture to implant supported fixed restorations implant retained and tissue supported overdentures, implant retained and implant supported over dentures and hybrid fixed prostheses or bone anchored bridges. With proper selection and treatment planning, using dental implants to support restoration replacing missing teeth can provide long lasting functional and aesthetic restorations. However, in atrophic mandible many problems can arise. In this rare case report, we are highlighting some of the challenges involved in management of atrophic edentulous mandible in a diabetic old patient with implant retained tissue supported overdentures, (IRTOD) which later required inferior alveolar nerve (IAN) trans positioning due to severely atrophic mandible and resulted in accidental mandibular fracture. The key to prevent these types of failures is proper treatment planning. With this article we want to enlighten some useful keys for preventing these kinds of failures. Keywords: Dental implant, Inferior alveolar nerve, Nerve transposition, Mandibular fracture

Dental aesthetics have become highly important nowadays. Treating aesthetic needs with non-invasive and with minimal techniques can preserve tissues. Invisalign aligners are an aesthetic and comfortable option too for orthodontic treatment. The increased demand for orthodontic treatment in adults has increased and widened the upper age limit for orthodontic intervention. The antero-posterior skeletal relationship of the maxilla and mandible is determined by the ANB angle. Veneers can be one of the techniques which show excellent aesthetic results and longevity of the treatment. This report highlights the relevant aspects of Invisalign aligners and veneers in a 54-year-old female with the minimal invasive method where the aesthetics of patient was highly improved.   Keywords: Age, CEREC, Invisalign, Aesthetic, Veneers