iosr-JDMS   Volume-13 ~ Issue-1 ~ January-2014

Abstract: The study aims to evaluate the incidence of types of impaction of mandibular third molars. Since mandibular third molars are the most common teeth to get impacted, it is important to know the incidence and prevalence in a particular community. The study is done using radiographic records of patients visiting the department of oral and maxillofacial surgery, with a diagnosis of an impacted third molar that has the need to undergo extraction. The sample size was of 100 patients, all above 16 years of age. The orthopantomogram and intra oral periapical radiographs of the patients were interpreted to analyze the pattern of impacted mandibular third molars. The type of impaction was determined using Winter's Classification of Impacted Teeth (1926). Based on these values the incidence of type of impaction was determined.
Keywords: Impaction, Incidence, Mandibular third molars.

[1] Ramamurthy A, Pradha J, Jeeva S, Jeddy N, Sunitha J, Kumar S. Prevalence of Mandibular Third Molar Impaction and Agenesis: A
Radiographic South Indian Study. J Indian Aca Oral Med Radiol, 24(3), 2012, 173-176.
[2] Neelima Anil Malik, Textbook of Oral and Maxillofacial Surgery (Daryaganj, New Delhi :Jaypee 2008) 122-123.
[3] S M Balaji, Textbook of Oral and Maxillofacial Surgery (Ajantha offset, New Delhi :Elsevier 2007) 233.

Paper Type	:	Research Paper
Title	:	Case Report Down's syndrome (Trisomy 21)
Country	:	India
Authors	:	N. Harshithaa || G. Maragathavalli
	:	10.9790/0853-13170304

Abstract: Downs syndrome is defined as a genetic disorder caused by the presence of all or a part of a third copy of chromosome 21. Downs syndrome is the most common chromosomal abnormality in humans. This article reports a case of downs syndrome in a 18yr old female patient who came to SAVEETHA DENTAL COLLEGE describing the classical signs.
Key Words: Chromosome 21 trisomy, mental retardation, stunted growth.

[1] American Academy of Pediatrics committee on genetics(February 2001)."American Acadamy of Pediatrics:Health supervision for
children with Down syndrome".Pediatrics 107(2):442-49.
[2] Burton L. Shapiro, Robert J. Gorlin , Robert S. Redman and Heinz h. Bruhl.The Palate and Down's Syndrome.The New England
Journal of Medicine 1967: 276: 1460-1463.
[3] Grover, P.S and L.Lorton. The incidence of unerupted permanent teeth and related clinical cases.Oral surgery Oral Med Oral Pathol
1985.59:420-425.
[4] Oliver,R.G , J.E. Mannion, and J.M. Robinson. Morphology of maxillary lateral incisor in cases of unilateral impaction of the
maxillary canine. Br J Orthod 1989. 16:9-16.
[5] Kramer,R.M. and A.D.Williams.The incidenceof impacted teeth. Oral surgery Oral Med Oral Pathol 1970.29:237-241.

Paper Type	:	Research Paper
Title	:	Ileo-uterine fistula after dilatation and curettage: Case report
Country	:	India
Authors	:	Dr. Satyajeet Kr. Singh || Dr. Kunal Kr. Singh || Dr. Chitrangada Singh || Prof. Dr Subrata Nag
	:	10.9790/0853-13170506

Abstract: Ileo-uterine fistula is a very rare occurrence. In this case we presented a case of ileo-uterine fistula , which developed after dilatation and curettage for termination of pregnancy.The case was managed surgically.

[1]. Martin DH, Hixson CH, Wilson EC Jr. Enterouterine fistula; review; report of an unusual case. Obstet Gynecol. 1956 Apr;7(4):466-9.
[2]. McFarlane MEC, Plummer JM, Remy T, Christie L, Laws D, Richard H, Cherrie T, Edwards R. Coward C. Jejunouterine fistula: a case report. Gynecol Surg (2008) 5:173–175.
[3]. Duttaroy D. Jejuno-uterine fistula. European Journal of Obstetrics & Gynecology and Reproductive Biology 129 (2006) 92–99.
[4]. Singh RB, Pavithran NM, Parameswaran RM, Sangwan K. Chronic jejuno-uterine fistula: an unusual cause for recurrent second trimester abortions. Aust N Z J Obstet Gynaecol 2005 45(6);533-534.

[5]. Vohra PA, Kumar Y, Raniga S, Vaidya V, Verma S, Mehta CA Case Of Jejunouterine Fistula Ind J Radiol Imag 2005 15:4:427-
428.

Paper Type	:	Research Paper
Title	:	Comparative study of Omeprazole, Rabeprazole and Ilaprazole for their efficacy in patient suffering from reflux esophagitis with symptoms
Country	:	India
Authors	:	Dr. Deepak Kumar || Dr. G. P. Singh
	:	10.9790/0853-13170712

Abstract: AIM- To evaluate whether there is any difference in efficacy between three proton pump inhibitors, Omeprazole, Rabeprazole and Ilaprazole in patients of reflux esophagitis with symptoms METHODS- The study was a prospective , randomized open label comparison, total one hundred and four patients with erosive reflux esophagitis in which 32 patients(group-A) received 20mg Omeprazole, 35 patients (group-B)received 20mg Rabeprazole, 37 patients (group-C) received 10mg Ilaprazole once a day in the morning. Daily change in heart burn and acid reflux symptoms in the first 7 days of administration were assessed using a four-point scale (0: none; 1: mild; 2: moderate; 3: severe). Rate of endoscopic healing of reflux esophagitis at week 8 were also assessed between three groups. RESULTS- All the groups were well matched in terms of age, sex, H pylori status, and the proportion of cases with heart burn and acid reflux symptoms before the administration of drugs. The mean heart burn scores in patients treated with Ilaprazole more rapidly decreased than those receiving Omeprazole or Rabeprazole. Complete resolution of heart burn was also more rapid in patient treated with Ilaprazole for 5 days compared with patients taking other proton pump inhibitors. Again acid reflux scores more rapidly decreased with Ilaprazole but no significant difference were seen between groups. Rate of endoscopic healing of reflux esophagitis was also more in Ilaprazole group. CONCLUSION- Ilaprazole is more effective than Omeprazole and Rabeprazole for rapid relief of heartburn, acid reflux and ulcer healing rate in patient with reflux esophagitis.
Key Words: Omeprazole, Rabeprazole, Ilaprazole, Reflux esophagitis, Symptom relief.

[1]. Aihara T, Nakamura E, Amagase K et al.Pharmacological control of gastric acid secretion for the treatment of acid-related peptic disease: past, present, future. Pharmcol Ther 2003;98:109-27.
[2]. Gardner JD,Sloan S, Miner PB et al. Meal- stimulated gastric acid secretion and integrated gastric acidity in gastroesophagealreflux disease. Aliment Pharmacol Ther 2003;17:945-53
[3]. Williams JL. Gastroesophageal reflux disease: Clinical manifestations. Gastroenterol Nurs 2003;26:195-200.
[4]. Lehmann F, Hildebrand P, Benglinger C, New molecular targets for treatment of peptic ulcer disease. Drugs 2003;63:1785-97.
[5]. Eisen GM, Sandler RS, Murray S et al . The relationship between gasto-esophageal reflux disease and its complications with Barrett's esophagus. Am J Gastroenterol 1997;92:27-31.

Paper Type	:	Research Paper
Title	:	Effectiveness of Negative Pressure Dressing In Chronic Non Healing Wound
Country	:	India
Authors	:	Dr. K. P. Abid Ali || Dr. Mohammed Sajid || Dr. Rajanish Radhakrishnan || Dr. Prasad Paul || Dr. Ganesh Marutinath
	:	10.9790/0853-13171321

Abstract: Management of chronic non healing wound is always a challenging problem to the treating surgeon. So many newer modalities are now available and all are under trial .Here we are comparing the effectiveness of vacuum assisted wound closure in management of chronic non healing wound. We found out its more effective in granulation tissue formation and to reduce the bacterial overload and also it considerably reduced the incidence of amputation rate also.
Key Words: granulation tissue , non healing chronic ulcer , negative pressure dressing , tissue cover ,Vacuum assisted closure.

[1]. Obdeijn MC, de Lange MY, Lichtendahl DH, de Boer WJ. Vacuum-assisted closure in the treatment of poststernotomymediastinitis. Ann ThoracSurg 1999; 68(6): 2358-60. [2]. Fleischmann W, Strecker W, Bombelli M, Kinzl L. [Vacuum sealing as treatment of soft tissue damage in open fractures]. Unfallchirurg 1993; 96(9): 488-92.
[3]. Blackburn JH, Boemi L, Hall WW, Jeffords K, Hauck RM, Banducci DR, Graham WP. Negative-pressure dressings as a bolster for skin grafts. Ann PlastSurg 1998; 40(5): 453-7.
[4]. Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation.AnnPlastSurg 1997; 38(6): 553-62.
[5]. Philbeck TE, Whittington KT, Millsap MH, Briones RB, Wight DG, Schroeder WJ. The clinical and cost effectiveness of externally applied negative pressure wound therapy in the treatment of wounds in home healthcare Medicare patients. Ostomy Wound Manage 1999; 45(11): 41-50.

Paper Type	:	Research Paper
Title	:	Assessment of Smoking Pattern among Patients Visiting a Private Dental Hospital in Chennai, India
Country	:	India
Authors	:	Sonti Sri Harsha || Dr. R. Pradeep Kumar
	:	10.9790/0853-13172225

Abstract: The aim of the study is to evaluate the assessment of smoking pattern among 200 patients who are current smokers and have smoked tobacco in any form at any point of time during last month, with no history of trauma or mental disabilities, with the habit of smoking, who are randomly selected using a structured self-administered questionnaire. From this study it was evident that more than 50% of the population started smoking between 21-25 years of age. And more than 50% of the smokers started smoking because of peer pressure, 33.5% due to stress and 13.5% responded that insomnia, social situation and nervousness/anxiety are factors which influenced them. The study also showed that although 72.5% of smokers showed interest to quit smoking, only 51% of them attempted to quit and 98.5% of them are not confident. To conclude, the present study reported the pattern of smoking in Chennai and a low success rate to quit smoking.. Hence improving the awareness about ill effects of smoking should be able to control tobacco epidemic.
Keywords: Cigarette, Habit, Smoking pattern, Tobacco.

[1] Makwana, N., Shah, V., & Yadav, S. (2007). A study on prevalence of smoking and tobacco chewing among adolescents in rural areas of Jamnagar district, Gujarat state. Journal of Medical Sciences Research, 1(1), 47-50.
[2] World Health Organization. (2011). WHO report on global tobacco epidemic 2011: Warning about the dangers of tobacco (Report No. ISBN 978 92 4 156426 7). Geneva, Switzerland: WHO.
[3] World Health Organization. (2012). WHO global report: Mortality attributable to tobacco (Report No. ISBN 978 92 4 156443 4). Geneva, Switzerland: WHO.
[4] Guindon GE and Boisclair D. Past, Current and Future Trends in TobaccoUse. HNP Discussion paper, Economics of Tobacco Control Paper No.6.February 2003.
[5] Rani M, Bonu S, Jha P, Nguyen SN, Jamjoum L. Tobacco use in India: prevalence and predictors of smoking and chewing in a national cross-sectional household survey. Tobacco Control 2003; 12: e4.

Paper Type	:	Research Paper
Title	:	Serum Acid Phosphatase Activity in Diabetes Mellitus
Country	:	India
Authors	:	Sonam Tashi Dolma || Davina Hijam || David Gangte || Ng. Arunkumar || Abhishek Dubey || Asitava Roy || Heirangkhongjam Lakhipyari || T.h Ibetombi Devi
	:	10.9790/0853-13172630

Abstract: Lysosomal enzymes acid phosphatase show increase in diabetes mellitus and this is closely related to diabetic metabolic alterations. This was a cross- sectional study conducted on 50 diabetic subjects (25 patients with complications and 25 patients without complications) in RIMS hospital during the period from September 2010 to August 2012. Twenty five age and sex matched healthy individual were taken as controls. Glycosylated haemoglobin (HbA1c) was estimated by Fast Ion Exchange Resin Method. Acid Phosphatase was estimated by colorimetric kit method. The difference in the level of Fasting Blood Sugar(FBS), Postprandial Blood Sugar(PPBS) and HbA1c between control, diabetic groups without and diabetes with complication groups was significant statistically (P<0.001) indicating a poor control of glucose in the study group.

Key Words: Acid phosphatase, Diabetes.

[1]. Amos AF, McCarty DJ and Zimmet P. The rising global burden of diabetes and its complications: Estimates and projections to the year 2010. Diabetic Medicine 14,1997, S7-S85.
[2]. The expert committee on the diagnosis and classification of diabetes mellitus: Follow up report on the diagnosis of diabetes mellitus. Diabetes Care, 26, 2003:3160-7.
[3]. Bull H, Murray PG, Thomas D, Fraser AM and Nelson PN. Acid phosphatases. J Clin Pathol: Mol Pathol 55, 2002; 65-72.
[4]. Girach A, Manner D and Porta M. Diabetic microvascular complications: can patients at risk be identified? A review. Int J Clin Pract, 60, 2006, 1471-83.
[5]. Barham D and Trinder P. GOD-PAP enzymatic colorimetric method of glucose estimation without deproteinization. Analyst, 97, 1972,312-22.

Paper Type	:	Research Paper
Title	:	Periodontal Soft Tissue Expanders - A Review
Country	:	India
Authors	:	G. Harini || DR. G. Kaarthikeyan
	:	10.9790/0853-13173135

Abstract: Insufficient regeneration of missing bone and soft-tissue may present aesthetic or functional problems in patients indicative for dental implant surgery by using several techniques like bone augumentation ,bone substitutes and guided tissue regeneration.Soft tissue expansion is a technique used by plastic and restorative surgeons to cause the body to grow additional skin ,bone or the other tissues.Extensive bone augumentation procedures are frequently carried out prior to implant surgery.Preaugmentation of soft tissue expansion with expanders leads to higher functional microvessel density in the tissue above the augmentation material and thus to more rapid osseointegration and inceases the probability of success in peri-implant bone augmentation.[1]Also Extensive soft tissue mobilization is required to achieve a tension -free wound closure at the grafted site and thus avoid wound dehiscence and loss of bone graft.[2]
Keywords: Complications of expansion,Osmotic hydrogel expanders,Tissue expansion,Tissue expanders.

[1]. Constantin Von See,Nils-Claudius Gellrich,Ulrike Jachmann,MatthiasW.Laschke,Kai-Hendrik Bormann,Martin Rucker,Bone augmentation after soft tissue expansion using hydrogel expanders:effects on microcirculation and osseointergration,Journal of Periodontol ,Volume 21,Issue 8,pages 842-847,august 2010.
[2]. Dogan Kaner,Han Zhoa,Hendrik Terheyden,Wolfgang Arnold,Anton Friedmenn,Effect of soft tissue expansion on microcirulation and healing after vertical augmentation in dogs.grant 687-2010.
[3]. Stellingsma C,Vissink A,Meijer HJ,Kuier C,Raghoebar GM.Implantology and the severly resorbed edentulous mandible.Journal of Oral implantology,2004 jul 1;15(4):240-8.
[4]. Manfro R,Batassini F,Bortoluzzi MC.Severly resorbed mandible treated by soft tissue expansion(tent pole) grafts:case report.2008 Dec;17(4):408-13.
[5]. Andrew Kelly,DDS,Dennis Flanagaan,DDS.Ridge Expansion and Immediate Placement With Piezosurgery and Screw Expanders in Atrophic Maxillary Sites,Journal of Oral Implantology,Feburary 2013,vol.39,No.1,pp. 85-90.

Paper Type	:	Research Paper
Title	:	Comparative Study of Diagnostic Accuracy of Modified Alvarado Score and Ultrasonography in Acute Appendicitis
Country	:	India
Authors	:	Dr SATYAJEET KUMAR SINGH || Dr KUNAL || Dr CHITRANGADA.
	:	10.9790/0853-13173640

Abstract: Comparative study of Diagnostic accuracy of Modified Alvarado Score and Ultrasonography in Acute Appendicitis.Research design and methods: A total of 55 patients of age group between 7-65yrs,both male and females,with clinical features suggestive of acute appendicitis were selected non-randomly for the study.Data was collected as Alvarado score,ultrasonograpic findings and histopathological reports.Statistical analysis was performed and results of both Alvarado score and Ultrasonography were compared.Results: Of 55 patients taken,maximum percentage of patients were in age group 10-20yrs with males dominated the series.The sensitivity and specificity of Modified alvarado score was 82.05% and 81.25% with PPV 91.42% and NPV 65% and diagnostic accuracy of 81.82% respectively.Ultrasonography study revealed 84.61% sensitivity and specificity of 56%,PPV and NPV were 80.48% and 57.14% and diagnostic accuracy was 70.91% respectively.Conclusions: From present study,it is concluded that Modified Alvarado score is better diagnostic tool than ultrasonography alone in diagnosis of acute appendicitis.

[1]. Charles D Douglas et al, Randomised controlled trial of ultasonography in diagnosis of acute appendicitis, incorporating the Alvarado score BMJ, 2000, October 14; 321(7266): 919.
[2]. Shrivastava UK et al, Evaluation of the Alvarado score in the diagnosis of acute appendicitis. Trop Gastroenterol 2004 Oct-Dec; 25(4) : 184-6.
[3]. Siddique K Evaluation of Modified Alvarado Score and Ultrasonography in Acute Appendicitis.
[4]. Nasiri et al.Diagnostic values of ultrasound and the Modified Alvarado Scoring System in acute appendicitis;International Journal of Emergency Medicine 2012, 5:26 doi:10.1186/1865-1380-5-26.
[5]. Caren Dsouza, John Martis & VinayVaidyanathan Diagnostic efficacy of modified alvarado score over graded compression ultrasonography; Nujhs Vol. 3, No.3, September 2013, ISSN 2249-7110.

Paper Type	:	Research Paper
Title	:	Study of cephalic index in Southern Odisha Population
Country	:	India
Authors	:	Dr. Sunita Patro || Dr. Ramkristna Sahu || Dr. Sadananda Rath
	:	10.9790/0853-13174144

Abstract: Morphology of all living beings undergo changes in varying degrees during their life and the features are variable in the individuals of the same species. No two persons are similar in their measurable character. Previewing the various works on the cephalic index and observing the socio-cultural uniqueness of southern odisha this study was done to find out the distribution of the cephalic index in the population of southern odisha. This study was carried out on 1030 outdoor patients of different parts of southern Odisha. Maximum head length and maximum head breadth were recorded using the spreading callipers. Cephalic indices were calculated using the formula (Maximum head breadth/ Maximum head length) x 100. Basing these indices the head shapes were classified as dolicocephalic, mesocephalic, brachycephalic and hyperbrachycephalic. From this study it was observed that mean cephalic index in females is higher than that of males. In males, maximum were mesocephalics followed by dolicephalics but in females, maximum were mesocephalics followed by brachycephalics. The data of the present study may be useful for forensic medicine experts, plastic surgeons, anatomists, anthropologists, oral surgeons, for clinical and in research studies.

[1]. Eickstedt E.V. The races and types of the western Himalayas. Map in India. 1926; 6: 237.
[2]. Imami-Mibodi MA and Mastri-Frahani R. Study of normal range of anatomical dimensions of one-day old newborn by cephalometry. J Med Council Islamic Republic of Iran.1996; 14: 1-8.
[3]. Afak SY and Turgut HB. Weight,length.head and face measurements in Turkish newborns of central Anatolia. Gaji Medical Journal.1998;9: 116-120.
[4]. Del Sol M. Cephalic index in a group of mapuche individuals in the IX Region of Chile. Int. Jr. Morphology, 2005; 23(3):241-246.
[5]. Golalipur et al. The shapes of head and face in normal female newborns in south-east of Caspian sea (Iran-Gorgan). Eur. Jr. Anat. 2005;9(2):95-98.

Paper Type	:	Research Paper
Title	:	A Study of Bile and Stone in Patient with CalculousCholecystitis
Country	:	India
Authors	:	Dr. Abid Ali K. P. || Dr. Prasad Paul || Dr. Monish || Dr. Sarvotaman Nedungadi
	:	10.9790/0853-13174551

Abstract: Cholelithiasis is a major problem worldwide now and its incidence increased rapidly in recent years and also the various newer surgical modalities are now available for the treatment of gall stones.The main factor for the increased incidence is found to be change in lifestyle and appearance of newer imaging techniques.In our studies we mainly focusing on the type of stone in our population and some of the risk factors for stone development. We are also studying here the type of organism and the antibiotic sensitivity pattern also in patient with symptomatic cholelithiasis.
Keywords: Cholelithiasis,choledocholithiasis,bactibilia,diabetesmellitus,klebsiella,obstructive jaundice.

[1]. Bodmer M, Brauchli YB, Krahenbuhl S, Jick SS, Meier CR: Statin use and riskof gallstone disease followed by cholecystectomy. JAMA 2009,302(18):2001-2007.
[2]. Guss DA, Oyama LC: Disorders of the Liver and Biliary Tract. In Rosen'sEmergency Medicine: Concepts and Clinical Practice.. 7 edition. Edited by:John Marx RH, Ron Walls. Philadelphia: Mosby; 2010:.
[3]. Meshikhes AW: Asymptomatic gallstones in the laparoscopic era. J R CollSurgEdinb 2002, 47(6):742-748.
[4]. Ayantunde AA, Agrawal A: Gallstone ileus: diagnosis and management.World J Surg 2007, 31(6):1292-1297.

[5]. Gasparrini M, Liverani A, Catracchia V, Conte S, Leonardo G, Marino G,Milillo A, Mari FS, Pezzatini M, Favi F: Gallstone ileus: a case report andreview of the literature. ChirItal 2008, 60(5):755-759.

Paper Type	:	Research Paper
Title	:	A double blinded randomized controlled trial to compare Ormeloxifene and Norethisterone in the treatment of Dysfunctional Uterine Bleeding
Country	:	India
Authors	:	Dr. Chitrangada MS || Dr. Satyajeet Kumar Singh || Dr. Prof. Subrata Nag
	:	10.9790/0853-13175256

Abstract: Aims: To compare the safety and efficacy of ormeloxifene and norethisterone in treatment of dysfunctional uterine bleeding as measured by decrease in menstrual blood loss using pictorial blood assessment chart. To assess the percentage change in haemoglobin and endometrial thickness before and after treatment. To assess the subjective improvement in life style as evaluated by a five point Likert scale. Methods: A double blinded randomized control trial was conducted on patients attending gynaecology OPD with complaints of menorrhagia with following inclusion criteria women between 18 and 51 years of age, absence of coagulopathies and any pelvic pathology, not taking any drug affecting menstruation, no hormonal therapy in previous three months and normal renal function.
Findings and Interpretation: The menstrual blood loss was observed to decrease by 19.31% at end of two months, 30.74% at the end of four months and 43.25% at end of six months in case of norethisterone and 20.72% at the end of two months, 43.37% at end of four months and 59.50% at the end of six months in case of Ormeloxifene. There was an increase in haemoglobin percentage in both the groups and it was significantly better in case of Ormeloxifene. PBAC score and endometrial thickness improvement was better in case of ormeloxifene compared to norethisterone. The side effects were similar in both the cases except for follicular cyst which was seen in Ormeloxifene group.

[1]. Indian Journal of Clinical Practice (2001): (12), 2, 31-34: Evecare syrup in dysfunctional uterine bleeding.
[2]. Kriplani A, Kulshrestha V, AgarwalN. "The efficacy and safety of ormeloxifene in the management of menorrhagia: a pilot study". J. Obstet. Gynaecol 2009; 35 (4): 746–52.
[3]. Biswas SC, Saha SK, et al.ormeloxifene a selective estrogen receptor modulator, for the treatment of DUB .J ObstetGynaecol Ind:2004:54(1):56-59.
[4]. Higham et al, (1990), Assessment of menstrual blood loss using a pictorial chart, British Journal of Obstetrics & Gynaecology, 97, pp734-739.
[5]. Bhattacharyya, Tapan Kumar; Banerji, Anusyuaetal :Efficacy of a Selective Estrogen Receptor Modulator: 'Ormeloxifene' in Management of Dysfunctional Uterine Bleeding : Journal of South Asian Federation of Obstetrics & Gynecology;Sep-Dec2010, Vol. 2 Issue 3, p207.

Paper Type	:	Research Paper
Title	:	Management of immature non-vital tooth with single visit MTA apexification: A case report
Country	:	India
Authors	:	Dr. Rajshekhar Chatterjee || Dr. Venugopal P. || Dr. Jyothi K. N. || Dr. Jayashankar C. M.
	:	10.9790/0853-13175759

Abstract: Management of fracture dimmature teeth presents a special challenge to dentists. Apexification, Apexogenosis or Regeneration are the only options for conserving such tooth. Traditional apexification with calcium hydroxide is associated with certain difficulties, like longer treatment time, risk of tooth fracture and incomplete calcification of apical bridge. Treatment outcome of regenerations are not much convincing. Moreover, as all these treatments take longer time to show their outcome. Thus use of a biocompatible material which can form a physical apical barrier with tissue healing properties became a material of choice for treating these types of cases. Although various such materials are available, MTA has got all its favourable properties to serve as an immediate apical barrier. This case report demonstrates application of MTA apical plug followed by custom made post and core for the re-construction of maxillary central incisor. The patient was evaluated for a period of one year and peri-apical radiographs demonstrate complete healing of the peri-apical lesion. This new technique is advantageous in teeth with open apex and thin radicular dentin, where treatment can be completed in fewer visits.

[1] Jhon I Ingle, Leif K Bakland, J Craig Baumgartner. Ingle's Endodontics. Sixth edition. India: CBS; 2013.
[2] Kenneth M. Hargreaves, Stephen Cohen. Cohen's pathway of the pulp. Tenth edition. India: Elsevier; 2011.
[3] Beenaphilipmathew ,mithra n. Hegde. Management of non vital immature teeth – cases reports and review. Endodontology. 2010:18-22
[4] Shikhadogra ,Mukundaks , ArunaA,Shwetha m rao. Apexification. Journal of dental sciences and research. 2012; 3(1): 41-44
[5] Donald R, James O, CtnilYesilsoy. Apexification: review of the literature. Quintsence International 1990;7: 589-98.

Paper Type	:	Research Paper
Title	:	Treatment of Gout—A new Approach
Country	:	India
Authors	:	Dr. Anil Batta
	:	10.9790/0853-13176064

Abstract: Since a long time back allopurinol has been constantly use to subsidize uric acid level in blood by competitive and suicidal inhibition of xanthine oxidase. Barring a few side few tolerable effects there was never felt any emergency for invention of an alternative. But a dire research was going on to bring into light an alternative which is better than allopurinol in some aspects. Now a non-purine xanthine oxidase Febuxostat is a new non-purine xanthine oxidase inhibitor that is more potent than allopurinol 300 mg daily. Febuxostat was more effective than allopurinol in the subset with impaired renal function. Long-term extension studies at different levels confirmed the efficacy and tolerability of Febuxostat. In patients who achieved the Serum uric acid level of 6 mg/dl (360 μmol/l), the incidence of gout flares fell steadily and tophi resolved in many patients. The incidence of adverse events such as dizziness, diarrhoea, headache and nausea with Febuxostat was similar to allopurinol.
Key words: Gout, Urate lowering capacity, Febuxostat, Clinical studies, Serum uric acid, Adverse effects.

[1]. W, Doherty M, Bardin T, et al . EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 2006;65:1312-24. [2]. Jordan KM, Cameron JS, Snaith M, et al . British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of gout. Rheumatology 2007;46:1372-4. [3]. Becker MA, Schumacher HR Jr, Wortmann RL, et al . Febuxostat compared with allopurinol in patients with hyperuricemia and gout. N Engl J Med 2005;353:2450-61. [4]. Becker MA, Schumacher HR Jr, Wortmann RL, et al . Febuxostat compared with allopurinol in patients with hyperuricemia and gout. N Engl J Med 2005;353:2450-61.
[5]. Perez-Ruiz F, Alonso-Ruiz A, Calabozo M, Herrero-Beites A, Garcia-Erauskin G, Ruiz-Lucea E . Efficacy of allopurinol and benzbromarone for the control of hyperuricaemia. A pathogenic approach to the treatment of primary chronic gout. Ann Rheum Dis 1998;57:545-9.

Paper Type	:	Research Paper
Title	:	Three years clinical outcome of hybrid fixed-fixed bridges
Country	:	Saudi Arabia
Authors	:	Mohammed M. AL- Moaleem || Mahmoud M. Ammar || Mohsen A. Alhamzi || Mansoor Shariff || Abdulla A. Dhabali
	:	10.9790/0853-13176570

Abstract: Subject: Hybrid fixed-fixed partial dentures present a conservative approach to the conventional type when a single tooth is replaced in the posterior region with certain indications. Aim: To evaluate various criteria's like, post-operative sensitivity, gingival response, de-bonding of the retainer, secondary caries, retainer fracture resistance and patient satisfaction. Materials and methods: A total of 16 bridges were included in this clinical study. The patient selection, preparation techniques as well as bridges constructions were followed the current principles that recommended by the manufactures instructions and recent textbooks. Patients were clinically evaluated after 3 months from the final cementation. At 9, 18, and 36 months as follow-up period the patients were called by phone. Results: A good rate success was observed during the different evaluation periods. Gingival inflammation of one case was reported during 18 month evaluation, while two cases with de-bonding and post-operative sensitivity were recorded during the 36 month. 100% of patients were satisfied with these types of restorations. Conclusions: Hybrid fixed-fixed retained bridges appear to be an effective restoration in a single posterior missing tooth. Practitioners should consider its use as an alternative to bilateral full crown retained restorations.
Key Words: Hybrid fixed prosthesis, Conventional bridges, Survival rate, Posterior teeth.

[1]. Piovesan EM, Demarco FF, Piva E: Fiber-reinforced fixed partial denture: a preliminary retrospective clinical study. J Appl Oral Sci 2006; 14: 100-4.
[2]. Jokstad A, Gokce M, Hjortsjo C: A systemic review of the scientific documentation of fixed partial dentures made from fiber-reinforced polymer to replace missing teeth. Int J Prosthodont 2005; 18: 489-96.
[3]. Rappelli G, Coccia E: Fiber-reinforced composite fixed partial denture to restore missing posterior teeth: a case report. J Contemp Dent Prac 2005; 6: 168-177.
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