International Journal of Research and Reports in Dentistry

Wisdom Tooth Surgery: A Two-Cycle Clinical Audit of Post-Operative Complications and Antibiotic Stewardship

2026-01-05T08:02:12+00:00

Introduction: Wisdom tooth removal is one of the most frequently performed oral surgery procedures across primary and secondary care. Although it is generally safe, it can lead to complications such as pain, dry socket, and infection, often prompting antibiotic prescriptions. National guidelines advise against routine prophylactic antibiotics for simple extractions, yet prescribing practices differ. This study evaluated post-operative complication rates, antibiotic use, and adherence to established guidelines across two audit cycles with an educational intervention.

Aim: This study assessed post-operative complications and antibiotic prescribing practices following third molar surgery in an oral and maxillofacial surgery (OMFS) unit. It also evaluated the impact of an educational intervention on clinical outcomes and antimicrobial stewardship (AMS) compliance.

Methods: A retrospective two-cycle audit was conducted involving 707 third molar removals. Cycle 1 (September 2024–January 2025, n=447) was followed by an educational intervention at a departmental Quality, Safety and Patient Experience meeting. Cycle 2 (April–July 2025, n=260) assessed post-intervention outcomes. Data on post-operative complications, antibiotic prescribing patterns, and documentation quality were compared against national benchmarks.

Results: Overall complication rates decreased from 15.6% to 9.2% between cycles, remaining below national thresholds and with no severe adverse events. The infection rate was exceptionally low (Cycle 1: 0.9%; Cycle 2: 0%). The antibiotic prescription achieved modest reduction in prescribing and marked improvement in documentation, with 100% compliance for recording intra-operative intravenous (IV) antibiotics in Cycle 2.

Conclusion: Third molar surgery in this OMFS setting is safe, showing excellent outcomes. However, the relatively high antibiotic prescription rate highlights a continued AMS need. The minimal infection rates in more complex cases in our service strongly support the argument against routine prophylactic use in more simple extractions managed in primary care. Regular audit and targeted education, as demonstrated here, serve as powerful and readily transferable tools for general dental practitioners (GDPs) to improve patient safety and support national AMS goals.

Beyond Legal Formalities: Dentists’ Perspectives on Informed Consent in Clinical Practice

2026-01-02T13:37:28+00:00

Background: Informed consent is a foundational ethical and legal obligation in dental practice. While its theoretical importance is well acknowledged, its consistent implementation remains variable across clinical settings.

Objective: This study explores the perceptions, practices, and challenges surrounding informed consent among dental practitioners in Hyderabad, Telangana, with the aim of identifying gaps and proposing improvements to enhance ethical standards and patient-centered care.

Methods: A qualitative, cross-sectional approach was employed to assess how dentists interpret and apply informed consent in routine clinical contexts. Data were gathered on attitudes, procedural habits, and barriers to implementation.

Results: The majority of respondents (56%) viewed informed consent primarily as a tool for medico-legal protection, reflecting a defensive practice culture. While 44% recognized its role in building trust and enhancing communication, practical adherence was inconsistent. Consent was often limited to surgical or invasive procedures, with routine care frequently proceeding without formal documentation. Verbal consent (30%) and implied consent through outpatient cards were also common. Barriers included lack of standardized protocols (40%), language and cultural challenges (26%), time constraints (10%), and legal insecurity (10%). These findings aligned with previous literature emphasizing the disconnect between ethical ideals and clinical realities.

Conclusion: Despite awareness of its ethical significance, the application of informed consent in dentistry is often reduced to a legal safeguard. There is a pressing need for standardized guidelines, practitioner training, and institutional support to ensure consent processes are both ethically sound and practically feasible. Future research should consider the influence of clinical setups and patient demographics on consent practices.

Distribution of Selected Occlusal Traits among a Sample of Sudanese Orthodontic Patients: A Descriptive Cross-sectional Study

2026-01-03T12:21:46+00:00

Background: The objectives of this study were to assess the prevalence of malocclusion among a sample of Sudanese patients seeking orthodontic treatment, to estimate the distribution of various malocclusion traits in the same cohort, and to evaluate the link between various malocclusion categories and specific malocclusion traits.

Methods: A descriptive cross-sectional study of 300 Sudanese patients’ casts was conducted. The casts were collected from patients attending the Orthodontic Training Centre in Khartoum, Sudan. The data were obtained from 300 sets of pretreatment orthodontic study models, which were articulated through bite registration using silicone material to assess the prevalence of malocclusion.

Results: Three hundred participants met the inclusion criteria (Mean age 21.42; SD 7.91). Of these, 95 (32%) were males and 205 (68%) were females. In order of prevalence, Class II division 1 malocclusion was the most prevalent type (126; 42%). Class I malocclusion was the second most prevalent type (118; 39%), followed by Class III malocclusion (47; 16%). Class II division 2 was present among 9 (3%) participants. No significant differences related to age (p = 0.231) and gender (p = 0.496) were found.

Conclusion: Class II division 1 malocclusion displayed the most significant prevalence in the sample, while Class III malocclusion showed the lowest prevalence. An open bite was primarily associated with Class III malocclusion. The prevalence of malocclusion in this study was comparable to that reported in regional populations.

Innovating Quality Evaluation in Swedish Dental Care: Development and Testing of a New Assessment Method

2026-01-13T09:32:27+00:00

Objectives: Swedish dentistry is covered by a strict set of regulations via laws, constitutions and regulations. There is a need for further improvements in the area. We decided to start a framework for quality development based on the treatment patients have received. The objectives of this pilot study were to a) develop a questionnaire for evaluation of the documentation and dental care in Swedish dentistry, b) use this questionnaire to evaluate the documentation and dental care by dentists in our organization (Dentalum AB), and c) develop, validate and evaluate a short questionnaire version.

Methods: An external expert in odontology and dental care developed a 98-item questionnaire about documentation/record keeping and patient care according to science and proven experience (named T98). 136 patient records from 22 of our clinics and 65 dentists were analyzed. The expert also proposed a short version questionnaire with 18 essential questions around patient safety (T18). Degree of fulfilled and unfulfilled efforts/measures was calculated for individual issues, subject areas and overall areas.

Results: The average patient reached ca 70 and ca 30 % degrees of fulfilled and non-fulfilled efforts/measures, respectively. Low levels of fulfilment were found for some efforts/measures (6-31 %) and dentists (7 % with <50 %). This shows moderate overall and low individual compliance rates, underserved areas and development potential and needs. In 7 % of the cases, 90-100 % fulfilment was reached, which shows that top quality is reachable. Findings demonstrate that T18 can be used for more rapid and convenient evaluations without losing important information.

Conclusion: In this single-organization pilot study with assessments performed by one expert reviewer, we reached the primary objectives. T18 was found to be useful for faster and more convenient evaluations without losing essential information. We have created a basis for discussion about dental education, competence and competence assurance. Ultimately this is considered to strengthen skills and benefit patients.

Musculoskeletal Disorders among Dentists in Morroco: A Descriptive Cross-sectional Analysis

2026-02-21T07:48:02+00:00

Aims: Musculoskeletal disorders (MSDs) are the leading occupational health problem among dental practitioners, causing pain and loss of function that may compromise performance and quality of life.

Objectives: This study evaluated the prevalence of MSDs among Moroccan dentists and identified major demographic, occupational, and behavioral risk factors, aiming to inform prevention.

Methods: In a cross-sectional survey between January and April 2025, 132 dentists from public and private practices in the Rabat-Salé-Kénitra region completed the Nordic Musculoskeletal Questionnaire. Associations between MSD prevalence and age, sex, working hours, and physical activity were analyzed using chi-square, Fisher’s exact test, and univariate logistic regression (p < 0.05).

Results: MSDs affected 98.5% of dentists. The most common sites were lower back (72.7%), neck (71.2%), shoulders/arms (67.4%), wrists/hands (49.2%), and upper back (41.7%). Older age, being female, longer hours, and lack of exercise increased risk. These associations likely reflect cumulative biomechanical overload from prolonged static postures, repetitive fine motor movements, and reduced muscular conditioning, which together accelerate fatigue and tissue micro‑damage in dentists.

Conclusions: There is a very high burden of MSDs among Moroccan dentists. Promoting ergonomic adaptations, regular physical activity, and appropriate workload management is essential to reduce MSD risk and to protect practitioners’ health and careers.

Knowledge, Attitude, and Clinical Adoption of Rubber Dam Usage among Dental Undergraduate Students and Interns: A Cross-sectional Study

2026-03-28T12:05:31+00:00

Aim: The aim of this study is to determine the Knowledge, Attitude and Prevalence regarding Rubber Dam usage among Dental Undergraduate final year students and interns.

Methodology: An e-questionnaire as Google forms was sent to final year students and interns. Eighteen questions were asked regarding the knowledge, attitude and awareness about the rubber dam and its usage, which also includes the demographic details of the respondents.

Results: A total of 213 dental students, including final-year students and interns, took part in the study. Most of them showed good understanding of rubber dam usage and agreed that it is the gold standard in endodontic procedures.The study design is cross-sectional and the sampling technique used is random sampling and statistical method is Chi-square test. Even though almost all participants had received pre-clinical training, only a few reported using rubber dams regularly in clinical practice. Patient discomfort and lack of awareness were the main reasons for not using them consistently. Overall, the results highlight a clear gap between what students know and what they actually practice in clinics.

Conclusion: In conclusion, dental students exhibit good knowledge and a positive attitude toward rubber dam use in endodontics. However, despite adequate training, its regular clinical application remains limited. Strengthening clinical reinforcement and addressing perceived barriers may help improve consistent usage in practice.

Prevalence of Developmental Disturbances Affecting Maxilla and Mandible in Coimbatore Population: A Cross-section Epidemiological Study

2026-04-09T11:54:49+00:00

Aim: To assess the prevalence and distribution of developmental disturbances affecting the maxilla and mandible, including micrognathia, macrognathia, dental arch abnormalities, and cleft palate, and to evaluate their association with age and gender.

Study Design: Cross-sectional study.

Place and Duration of Study: The study was conducted at RVS Dental College and Hospital, Coimbatore, among patients attending the dental clinic and outreach camps over a defined period.

Methodology: A cross-sectional study was conducted among 400 individuals aged 12–40 years, selected via non-probability convenience sampling from patients attending the dental clinic at RVS Dental College and Hospital and outreach camps in Coimbatore. Developmental disturbances, including micrognathia, macrognathia, malocclusion (Class II Division 1, II Division 2, III), and cleft palate, were assessed clinically using a mouth mirror and probe. Examiners were trained and calibrated (Cohen’s kappa >0.80). Sample size was calculated using standard population proportion formula. Data were analyzed using SPSS version 28 (IBM Corp., Armonk, NY, USA), with frequencies, percentages, and Chi-square tests to evaluate associations with age and gender (p < 0.05).

Clinical Implications: Early identification of developmental disturbances facilitates timely intervention, enabling multidisciplinary management by dentists, orthodontists, and maxillofacial specialists. Routine screening, particularly during adolescence, can prevent functional and aesthetic complications, improve oral health outcomes, and guide appropriate referral for orthodontic or surgical care.

Results: Out of 400 individuals, Class II Division 1 malocclusion was most prevalent (15%), followed by Class III (10%) and Class II Division 2 (8%). Micrognathia and macrognathia were observed in 5% and 4% of individuals, respectively, while cleft palate was the least common anomaly (1.5%). A higher prevalence of developmental disturbances was observed among males and younger individuals; however, the association between gender and anomalies was not statistically significant (p = 0.16). Similarly, the association between age and occurrence of anomalies was also not statistically significant (p = 0.24).

Conclusion: Developmental disturbances of the maxilla and mandible are relatively common and can significantly affect function, aesthetics, and overall oral health. Early diagnosis and timely intervention are essential to optimize functional outcomes and facilitate effective multidisciplinary management. Routine clinical screening, particularly during adolescence, along with school-based dental programs, enables early detection, preventive strategies, and appropriate referral for orthodontic or surgical care. Clinically, these findings highlight the need for dentists, orthodontists, and maxillofacial specialists to collaborate in identifying anomalies, planning individualized treatment, and minimizing long-term complications. Implementing such strategies can improve patient outcomes, prevent progression of malocclusion or skeletal discrepancies, and enhance overall quality of life.

Comparative in vitro Analysis of Microbial Load Reduction on Dental Burs and Endodontic Files Following Different Decontamination Methods

2026-04-10T11:19:27+00:00

Background: Dental instruments when reused poses significant risks of cross-infection. Autoclaving is the gold standard for sterilization, but repeated cycles can degrade the cutting efficiency of burs and files

Aims: This study aims to evaluate the sterilization efficacy of a chemically enhanced glutaraldehyde solution using a 4-hour immersion protocol, compared to standard moist heat sterilization and 70% alcohol.

Study Design: In vitro Comparative study

Place and Duration of Study: Department of Pediatric and Preventive Dentistry, in collaboration with the Department of Microbiology, at Mar Baselios Dental College, between July 2025 and December 2025.

Methodology: A total of 120 clinically contaminated instruments (diamond burs, hand K-files, and rotary NiTi files) were divided into four groups (n=30): Group A (70% Isopropyl Alcohol), Group B (4-hr Glutaraldehyde solution), Group C (Autoclave) and Group D (Control). Post-treatment, samples were incubated in Brain Heart Infusion Broth and plated on Brain Heart Infusion (BHI) agar to quantify Colony Forming Units (CFU/mL)

Results: Both the Autoclave and 4-hour glutaraldehyde solution groups achieved complete elimination of viable microorganisms. Statistical analysis via ANOVA and Tukey's post-hoc test revealed no significant difference in efficacy between the two methods (P >.05). Conversely, 70% alcohol demonstrated significantly inferior performance, leaving residual contamination on all instrument types (P < .001).

Conclusion: The 4-hour glutaraldehyde protocol is an ideal decontamination method, demonstrating microbial reduction levels comparable to the efficacy achieved by autoclaving. This offers a time-efficient and non-corrosive alternative for maintaining the longevity of heat-sensitive dental instruments.

Knowledge, Awareness and Practice about Chronic Oro-facial Pain among Interns Postgraduates and Dentists of Gujarat, India: A Cross-sectional Questionnaire Study

2026-04-15T09:00:05+00:00

Background: Chronic orofacial pain (COFP) presents diagnostic and therapeutic challenges due to its multifactorial etiology. In India, dental professionals’ competency in managing COFP is variable. This study aimed to assess the knowledge, awareness, and clinical practices regarding COFP among dental interns, postgraduates, and practicing dentists in Gujarat.

Methods: A cross-sectional, online questionnaire-based study was conducted among 144 dental professionals (interns, postgraduates, and general practitioners) across Gujarat. A 15-item validated questionnaire covered domains of definition, etiology, diagnosis, and management of COFP. Data were analyzed using descriptive statistics and the Chi-square test (SPSS v21.0). Statistical significance was set at p<0.05.

Results: A total of 144 responses were analyzed. While 90.3% correctly defined orofacial pain, a significant gap persisted: 45.8% believed all orofacial pain is dental in origin. Regarding etiology, 70.1% identified oral pathology as a cause, but only 54.9% recognized stress as an exacerbating factor. In clinical practice, 49.3% reported weekly encounters with unexplained orofacial pain, yet only 39.6% routinely performed temporomandibular joint (TMJ) examinations, and 39.6% were unfamiliar with standard management guidelines. Furthermore, 50.7% had never attended any COFP-related training. Support for a multidisciplinary approach (66.0%) and formal recognition of orofacial pain as a distinct specialty under the National Dental Commission (56.0%) was evident.

Conclusion: Although basic awareness of orofacial pain is high among Gujarat’s dental professionals, critical knowledge gaps remain—particularly regarding non-dental etiologies, diagnostic protocols, and structured management. The majority lack formal training and familiarity with clinical guidelines. Mandating continuing dental education (CDE) programs and integrating COFP as a distinct specialty are essential steps to improve clinical competence and patient outcomes.

Digital Shade Selection in Dentistry: A Comprehensive Review

2026-01-06T12:05:46+00:00

Achieving a harmonious shade match between restorative materials and natural dentition is one of the most demanding tasks in aesthetic dentistry. The perceived color of a tooth is a result of complex optical interactions involving enamel translucency, dentin chroma, and light scattering. Visual shade matching using traditional shade guides has long been the standard practice, yet it remains subjective and prone to error due to environmental lighting, observer variability, and fatigue.

The Introduction of digital shade selection systems, including spectrophotometers, colorimeters, and intraoral scanners, has significantly improved the objectivity and reproducibility of color determination. These devices measure color numerically using standardized models such as Munsell, CIELAB, CIE color space, and RGB, providing a universal communication platform between clinician and laboratory.

Future directions are rapidly evolving toward the integration of Artificial Intelligence (AI) and machine learning to further enhance objectivity, analyze complex visual features (like translucency), and improve the precision of the final shade prescription.

This review consolidates current evidence on aesthetic restorative materials, ideal light sources for clinical color assessment, and instrumental shade-matching technologies. It further explores color coding systems, differentiates conventional from digital shade selection, and discusses potential errors and management strategies. Emphasis is placed on the need for calibrated lighting, understanding of color metrics, and integration of digital workflows for achieving predictable and patient-centered aesthetic outcomes.

Periodontitis and Circadian Rhythm Disruption: Unveiling the Neuro-Immuno-Metabolic Axis

2026-01-14T07:08:35+00:00

Background: Periodontitis is a chronic inflammatory disease driven by dysregulated host immune responses. Emerging evidence suggests that circadian rhythm disruption acts as a significant biological stressor that impairs tissue repair and immune function. This review aims to propose a novel "neuro-immuno-metabolic axis" to explain the bidirectional relationship between periodontal inflammation and systemic chronobiological health.

Methods: A comprehensive literature search was conducted across PubMed, Scopus, and Google Scholar to identify peer-reviewed research, systematic reviews, and meta-analyses published up to the time of review. The search strategy focused on the intersection of periodontitis, clock genes such as Brain and Muscle ARNT-Like Protein-1 (BMAL1), Period (PER), and inflammatory markers including Interleukin-6, Tumor Necrosis Factor-Alpha, and the Receptor Activator of Nuclear Factor Kappa-B Ligand / Osteoprotegerin axis.

Results: Periodontal inflammation acts as a systemic stressor, where cytokines like Interleukin-6 and Tumor Necrosis Factor-alpha dampen circadian amplitude and repress core clock genes like Brain and Muscle ARNT-Like Protein-1. Conversely, circadian rhythm disruption exacerbates periodontitis by skewing macrophages toward a pro-inflammatory M1 phenotype and dysregulating the Receptor Activator of Nuclear Factor Kappa-B Ligand / Osteoprotegerin ratio, leading to accelerated alveolar bone loss.

Conclusion: Periodontitis and circadian rhythm disruption are linked through a self-perpetuating biological cycle. Recognizing this bidirectional axis allows for the development of chronotherapeutic strategies, such as timed melatonin supplementation or synchronized periodontal therapy, to improve clinical outcomes.

Periodontal Phenotype and Gingival Biotype: Clinical Implications for Risk Assessment and Personalized Therapy

2026-01-19T09:33:07+00:00

Gingival biotype—historically described as “thin” or “thick”—has evolved into the broader concept of periodontal phenotype, integrating gingival thickness, keratinized tissue dimensions, and the underlying bone morphotype. This shift reflects growing evidence that soft tissue thickness and architecture are not merely anatomic descriptors but clinically meaningful modifiers of periodontal stability, aesthetic outcomes, and complication risk across preventive, surgical, restorative, orthodontic, and implant therapies. Thin phenotypes have greater susceptibility to recession resulting from inflammation or mechanical insult, greater vulnerability to post-surgical marginal tissue changes, and an increased likelihood of aesthetic compromise when restorative or implant components shine through delicate tissue. Conversely, thicker phenotypes often demonstrate greater resistance to recession, more predictable wound stability, and improved capacity to mask restorative materials. Importantly, phenotype is not fixed; contemporary mucogingival and peri-implant soft tissue augmentation strategies can enhance gingival thickness and keratinized tissue conditions, potentially reducing risk and improving long-term stability. This narrative review synthesizes current knowledge regarding definitions, assessment methods, biologic mechanisms, and evidence-based clinical implications of gingival biotype/periodontal phenotype, emphasizing practical decision-making and interdisciplinary treatment planning. The review highlights where phenotype-based personalization is supported by clinical studies and systematic reviews, where evidence remains indirect, and how emerging digital diagnostic workflows may standardize phenotype assessment in daily practice. Current evidence supports phenotype-informed treatment planning in mucogingival surgery and peri-implant care, especially where tissue thickness is linked to early remodeling and the stability of soft tissue outcomes.

Advances in 3D Printing for Periodontal Regeneration: A Comprehensive Review

2026-03-12T06:21:34+00:00

Three-dimensional (3D) printing and bioprinting are emerging as advanced tools for periodontal regeneration, enabling patient-specific scaffolds and precise tissue engineering. The periodontium comprising alveolar bone, periodontal ligament, cementum, and gingiva has a complex architecture that makes complete regeneration challenging. Bioprinting strategies allow controlled placement of cells, biomaterials, and growth factors, closely mimicking the native periodontal environment. Advances in 3D bioprinting enable precise spatial control of cells, biomaterials, and bioactive molecules, allowing the fabrication of scaffolds that closely mimic the native periodontal microenvironment. This review highlights bioprinting techniques, bioink formulations, and its applications for alveolar bone, periodontal ligament, and gingival regeneration. By enabling functional and spatially organized tissue regeneration, 3D bioprinting represents a promising shift from conventional reparative therapies toward true biological and clinically relevant periodontal regeneration.

A Review of Functional Considerations in Removable Partial Denture Design

2026-04-04T13:13:53+00:00

Esthetics has become a critical determinant of success in removable partial denture (RPD) therapy, strongly influencing patient acceptance, comfort, and oral health–related quality of life. While RPDs have traditionally focused on restoring function and biomechanics, contemporary prosthodontic practice increasingly emphasizes natural appearance, particularly in esthetically sensitive regions. This review summarizes current concepts and evidence related to esthetic considerations in RPD design, encompassing patient-related and oral determinants, framework design principles, clasp selection and modification, precision and semi-precision attachments, and denture base and artificial tooth selection. Special attention is given to anterior edentulous situations, high smile line patients, and geriatric cases where implants may be contraindicated. Recent advances in biomaterials, CAD–CAM fabrication, and digital smile analysis are also discussed for their role in improving esthetic predictability and clinical outcomes. Overall, the literature supports a balanced, individualised, and patient-centered approach that integrates esthetics with functional efficiency, ensuring long-term satisfaction and clinical success of RPDs in modern prosthodontic practice.

Juvenile Maxillary Ossifying Fibroma: A Rare Case in a 12-Year-Old Girl

2026-01-13T07:48:37+00:00

Ossifying fibroma (OF) is a benign fibro-osseous neoplasm characterized by the replacement of normal bone with a fibro-cellular stroma containing variable mineralized material such as bone and cementum. It most commonly affects the mandibular premolar–molar region, with maxillary involvement being relatively uncommon. This report describes a rare case of ossifying fibroma in a 12-year-old girl presenting with a painless swelling on the right side of the face for four months. Radiographic evaluation showed a well-defined radiolucent lesion with a sclerotic border and displacement of adjacent tooth roots. Surgical enucleation and curettage were performed under local anesthesia. Histopathological examination demonstrated a fibrocellular stroma with irregular trabeculae of lamellar bone and cementum-like calcifications, confirming the diagnosis of ossifying fibroma. Surgical enucleation and curettage were performed under local anaesthesia. Postoperative healing was uneventful, and no recurrence was observed during six months of follow-up. Overall, this case emphasizes the value of integrating clinical, radiographic, and histopathological assessment for definitive diagnosis and successful management of ossifying fibroma.

Orthodontic Space Closure and Molar Protraction in the Presence of Advanced Periodontal Disease: A Multidisciplinary Treatment Approach

2026-01-13T12:06:01+00:00

Loss of posterior teeth secondary to periodontitis can profoundly influence occlusal relationships and subsequent treatment planning. When periodontal inflammation is adequately controlled, orthodontic tooth movement may be incorporated within an interdisciplinary therapeutic framework. This report demonstrates a clinical case of a young female adult, presenting severe periodontitis, along with multiple missing teeth and atrophic mandibular first molar extraction sites. We chose a multidisciplinary approach; starting with periodontal therapy in order to obtain a healthy periodontium, followed by orthodontic treatment to correct malocclusion and restore the dentition, ensuring in the way uprighting and protraction of the second molars and thereby closure of the large posterior edentulous spaces. As a result, clinical gingival inflammation, attachment loss and vertical bone resorption were improved and stabilized. Follow-up at 1-year post-treatment confirmed the stability of the orthodontic and periodontal results.

Orthodontic Camouflage of an Asymmetric Angle Class III Malocclusion in an Adult Patient: A Case Report with 10-Year Follow-Up

2026-01-14T09:09:40+00:00

Background: The management of Angle Class III malocclusion in adults is challenging, particularly when skeletal discrepancies are moderate and patients refuse surgical treatment. Orthodontic camouflage using extraction protocols may represent a valid alternative in carefully selected cases.

Case Presentation: This case report describes the orthodontic treatment of a 35-year-old woman presenting with an asymmetric Angle Class III malocclusion associated with maxillary protrusion, severe mandibular crowding, and a significant dental midline deviation. Cephalometric analysis revealed a Class I skeletal pattern with dentoalveolar compensation. An asymmetric premolar extraction protocol was selected, followed by fixed appliance therapy. Treatment was completed after 24 months, achieving correction of crowding, midline alignment, satisfactory facial esthetics, and stable occlusion.

Results: Post-treatment records demonstrated improved facial harmony, normalized overjet and overbite, Class I occlusal relationships, and correction of dental compensations. Clinical and radiographic evaluations at a 10-year follow-up confirmed long-term stability of the results.

Conclusion: Orthodontic camouflage with asymmetric premolar extraction can be an effective and stable treatment option for selected adult patients with Angle Class III malocclusion who are not candidates for, or refuse, surgical intervention.

Reconstruction and Closure of Oroantral Communication with Buccal Fat Pad and Management of Chronic Sinusitis: A Case Report

2026-01-22T12:31:16+00:00

Aim: To describe the clinical presentation, surgical management, and outcome of implant-related oroantral communication complicated by chronic maxillary sinusitis following sinus augmentation, using a staged approach involving implant retrieval, antral lavage, and combined buccal advancement flap and buccal fat pad closure.

Methodology: A 65-year-old male patient presented with pain and pressure in the right infraorbital region, halitosis, poor oral hygiene, chronic rhinosinusitis, and mobility of implant-supported prosthesis in the right posterior maxilla. Cone beam computed tomography revealed bone loss around implant associated with chronic sinus pathology and oroantral communication. Surgical management included retrieval of the displaced implants, thorough antral lavage, placement of autologous PRF within the defect, and closure using a buccal advancement flap reinforced with harvested buccal fat pad to achieve tension-free primary closure in two steps due to active sinus infection. Postoperative evaluation was performed at regular intervals, including 7 days and 3 months.

Results: Healing was uneventful with successful closure of the oroantral communication. The patient demonstrated complete resolution of sinonasal symptoms, absence of nasal regurgitation, and stable soft tissue healing. At 3-month follow-up, no recurrence of oroantral communication or sinus infection was observed.

Conclusion: Combined use of implant retrieval, antral lavage, PRF, and dual soft tissue closure using buccal advancement flap and buccal fat pad provides a predictable and effective approach for the management of implant-related oroantral communication with chronic sinusitis.

Refining the Frenum: A Multi-Technique Case Series on Management of Aberrant Labial Frena

2026-01-29T09:00:33+00:00

Introduction: An aberrant labial frenum, when attached close to the gingival margin or papilla, can lead to midline diastema, gingival recession, and impaired oral hygiene. Several surgical techniques have been proposed to manage such attachments, aiming to improve function and esthetics with minimal morbidity.

Presentation of Case: Four patients with maxillary aberrant frena were treated using different techniques—conventional scalpel, Z-plasty, V-Y plasty, and diode laser frenectomy. All presented with papillary attachments affecting esthetics and posing relapse risks in orthodontic cases. Procedures were done under local anesthesia with uneventful healing.

Discussion: The laser technique demonstrated superior intraoperative hemostasis and greater patient comfort. In contrast, Z-plasty and V-Y plasty were more effective in enhancing vestibular depth and achieved optimal tissue repositioning with minimal scar formation. Although the conventional scalpel technique was clinically effective, it was associated with comparatively increased bleeding and a longer healing period. Overall, technique selection should be individualized according to the type of frenal attachment, the need for tissue repositioning, and esthetic demands. Flap-based procedures such as Z-plasty and V-Y plasty are particularly advantageous in papillary and papilla-penetrating frena, as they redistribute tension and help preserve papillary integrity. Diode laser frenectomy, on the other hand, represents a minimally invasive alternative, offering rapid healing, excellent hemostasis, and superior patient comfort.

Conclusion: Overall, all methods were successful, with diode laser and flap-based approaches yielding the most favorable esthetic and functional outcomes through individualized, predictable treatment.

Rare Mandibular Occurrence of Psammomatoid Juvenile Ossifying Fibroma: A Case Report

2026-02-10T12:57:42+00:00

Psammomatoid juvenile ossifying fibroma (PsJOF) is an uncommon benign fibro-osseous lesion known for its locally aggressive behaviour and characteristic involvement of the paranasal sinuses and orbital region. Occurrence within the mandible is rare and represents a departure from its usual sinonasal distribution. A 16-year-old male patient with an uncommon case of mandibular PsJOF is described in this study. The patient's clinical presentation included a steadily growing mandibular enlargement, cerebral expansion, and facial asymmetry. Cone beam computed CT showed a well-defined expansile lesion with internal septations, cortical thinning with localized perforation, mixed radiolucent–radiopaque density, and inferior alveolar canal displacement. Histopathological evaluation showed a highly cellular fibrous connective tissue stroma containing numerous psammoma body–like ossicles, establishing the diagnosis of PsJOF. Surgical management consisted of complete lesion excision with thorough curettage while preserving adjacent vital structures, followed by meticulous postoperative surveillance. This case highlights the diagnostic challenge posed by atypical mandibular involvement and emphasizes the need for comprehensive clinico-radiographic and histopathologic correlation, along with long-term follow-up, owing to the lesion’s aggressive nature and risk of recurrence.

Management of Endo-periodontal Lesion of Mandibular Anterior Teeth: A Case Report

2026-02-11T11:11:38+00:00

Endo-periodontal lesions remain a challenging clinical entity due to the complex anatomical and pathological relationship between the pulp and the periodontium. Case reports highlighting sequential endodontic and periodontal management can help clinicians understand appropriate treatment planning and prognosis. This manuscript attempts to reinforce the concept of addressing the endodontic component prior to periodontal intervention. With appropriate revisions, the case could contribute useful clinical insight for general practitioners and postgraduate students. The intimate physiological connection between the periodontium and the dental pulp significantly increases the complexity of managing combined endo-periodontal lesions. Achieving a successful outcome requires the total eradication of pathogens from both the periodontal and endodontic systems. These lesions are frequently encountered in clinical settings; if left unaddressed, an endodontic infection will inevitably compromise the periodontium, and vice versa. This report presents a tooth with combined endodontic-periodontal involvement treated with a staged approach: first root canal therapy, then flap surgery. Post-operative evaluation at nine months revealed significant clinical attachment gain.

Familial Cleidocranial Dysplasia: A Case of Two Siblings

2026-02-17T11:26:01+00:00

Cleidocranial dysplasia (CCD) is a rare hereditary skeletal disorder affecting bones formed by intramembranous ossification. It is most commonly inherited in an autosomal dominant pattern and is associated with mutations in the RUNX2 (CBFA1) gene, which plays a critical role in osteoblast differentiation and skeletal development. Clinically, CCD is characterized by hypoplastic or absent clavicles, delayed closure of cranial sutures, and multiple dental abnormalities. Dental manifestations are often the most prominent features and include delayed exfoliation of primary teeth, delayed or failed eruption of permanent teeth, multiple impacted and supernumerary teeth, malocclusion, and maxillary hypoplasia.

This case series reports two siblings diagnosed with cleidocranial dysplasia, highlighting familial occurrence and variability in clinical expression. Both patients presented with complaints of missing permanent teeth and retained deciduous teeth since childhood. Extraoral examination revealed characteristic craniofacial features, including depressed zygomatic arches and a concave facial profile suggestive of mandibular prognathism. Intraoral and radiographic evaluations revealed multiple impacted and supernumerary teeth, supporting the diagnosis of CCD.

These cases emphasize the importance of thorough clinical and radiographic assessment in patients presenting with delayed tooth eruption and multiple missing teeth. Early recognition by dental professionals is crucial for timely multidisciplinary management and genetic counselling. Documentation of familial cases contributes to better understanding of the phenotypic spectrum of cleidocranial dysplasia and aids in improving diagnostic awareness.

Comprehensive Multidisciplinary Management of Amelogenesis Imperfecta in an Adolescent Patient: A Case Report

2026-03-28T09:27:09+00:00

Amelogenesis Imperfecta (AI) is a hereditary disorder of enamel formation characterized by defective mineralization, altered tooth morphology, discoloration, and an increased risk of caries. Managing AI in pediatric patients is challenging due to short clinical crowns, weakened enamel, and high aesthetic demands. This case report describes the comprehensive management of a 13-year-old female patient with Amelogenesis Imperfecta, presenting with generalized yellow discoloration, molar hypomineralization, short anatomic crowns, and deep carious lesions involving multiple permanent molars. The mandibular right first permanent molar, which had carious pulp exposure, was treated endodontically. To enhance clinical crown height and facilitate definitive restorations, diode laser–assisted crown lengthening was performed on all permanent molars. Stainless steel crowns were subsequently placed on all eight permanent molars to restore function and protect the compromised tooth structure. For aesthetic rehabilitation, conventional surgical gingivectomy was carried out in the maxillary anterior region, extending from the right premolar to the left premolar, followed by direct composite veneering. This multidisciplinary approach resulted in satisfactory functional rehabilitation and improved aesthetics. Early diagnosis and individualized, minimally invasive treatment planning are essential for improving oral health outcomes and quality of life in children with Amelogenesis Imperfecta.

Surgical Management of a Mandibular Odontogenic Keratocyst Using Enucleation and 5-Fluorouracil: A Case Report

2026-04-07T05:56:50+00:00

Background: Odontogenic Keratocyst (OKC) is a developmental cyst known for its locally aggressive behavior and high recurrence rates. Traditional surgical management ranges from conservative enucleation to radical resection. The use of chemical adjuvants is critical to reducing recurrence while maintaining jaw function.

Case Report: A 34-year-old female presented with pus discharge in the lower right posterior mandible. Clinical and radiographic examination revealed a large radiolucency in the right mandible (region 41-48). Fine Needle Aspiration Cytology (FNAC) and subsequent biopsy confirmed the diagnosis of an Odontogenic Keratocyst. The patient was managed with cystic enucleation and chemical curettage using 5-Fluorouracil (5-FU) ointment. Post-operative follow-up at 3 months showed satisfactory clinical healing with no neurosensory deficits. Radiographic evaluation confirmed progressive bone regeneration at the surgical site, with no evidence of recurrence.

Non-surgical Periodontal Management of Nifedipine- Induced Gingival Overgrowth: A Case Report

2026-04-07T13:04:49+00:00

Introduction: Gingival overgrowth is a common adverse effect associated with long-term use of antihypertensive, anticonvulsant, and immunosuppressant drugs, influenced by drug-related factors and periodontal status.

Case Presentation: A 40-year-old patient presented with nifedipine-induced gingival enlargement affecting function, aesthetics, and oral hygiene. Nonsurgical periodontal therapy, including scaling, root planing, and oral hygiene reinforcement, was performed without altering medication.

Discussion: Progressive reduction in gingival overgrowth was observed, with complete resolution achieved through meticulous plaque control and regular supportive periodontal therapy, avoiding surgical intervention.

Conclusion: Nonsurgical management can effectively treat drug-induced gingival overgrowth, with long-term stability achievable through consistent maintenance and patient compliance.

Influence of Multirooted Teeth on Periodontitis and Treatment Outcomes: A Case Series

2026-04-08T06:23:39+00:00

Aim: To evaluate the influence of root morphology, particularly root trunk length and crown–root ratio, on periodontal disease progression, diagnosis, and treatment outcomes.

Case Description: This case series presents three patients with furcation involvement affecting both premolar and molars. Each case highlights anatomical variations such as long and short root trunks and crown–root ratio differences, demonstrating their impact on periodontal management.

Outcome: All three cases showed uneventful healing, with reduction in probing depths and improved gingival architecture following regenerative therapy. Intraoperative findings confirmed that teeth with long root trunks exhibited delayed furcation involvement but posed challenges for complete debridement, while those with short root trunks demonstrated early furcation exposure, increased mobility, and compromised biomechanical support. Premolar furcation involvement further complicated diagnosis and limited therapeutic access.

Conclusion: Root morphology substantially influences disease severity and treatment complexity. Careful morphological assessment is essential for accurate diagnosis, effective treatment planning, and long‑term periodontal stability. This case series emphasizes the clinical importance of anatomical variations in guiding periodontal therapy.

Pitfalls in Differential Diagnosis of Pediatric Periapical Lesions: A Case of Maxillary Odontogenic Myxoma

2026-04-20T12:09:34+00:00

Radiolucent lesions in pediatric patients are frequently presumed to be inflammatory in origin. However, certain odontogenic tumors may present with similar clinical and radiographic features, leading to diagnostic challenges and potential mismanagement. A 12-year-old male presented with a gradually enlarging, painless swelling of the left maxilla initially suspected to be periapical pathology. Radiographic evaluation using orthopantomogram and Cone Beam Computed Tomography revealed a large radiolucent lesion with cortical expansion and displacement of developing teeth. Fine needle aspiration was non-contributory. Incisional biopsy established the diagnosis of odontogenic myxoma. Surgical excision was performed under general anaesthesia with satisfactory postoperative healing. This case underscores the importance of comprehensive radiographic assessment and histopathological confirmation in pediatric jaw lesions and highlights the need for clinicians to consider non-inflammatory pathologies when evaluating periapical radiolucencies.