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The control of anchorage is essential in orthodontic treatment of adult patients. Complex tooth movements in lingual appliances and aligners require anchorage planning. Mini-screws enable the orthodontists to have good control over tooth movement in all three dimensions, while preserving the patient’s aesthetics. This article describes various clinical cases performed through aligners and lingual appliances by using mini-implants.

Superior mesenteric artery (SMA) syndrome also known as Wilkie’s Syndrome is a rare condition characterized by symptoms of small bowel obstruction. It is caused when the angle between the SMA and aorta, also known as the aorto-mesenteric angle, reduces to

Lymphocytic lobulitis , is a fibroinflammatory benign condition of the breast which is associated with type 1 diabetes mellitus. This benign condition is uncommon and may be mistaken for inflammatory carcinoma of the breast. We report the case of a 61 year old female patient who presented with a lump in the right breast with a history of Type 2 diabetes mellitus. The lump was associated with discharge and recent onset pain. On examination a vague lump which was non mobile, involving the right breast was palpable. A single firm mobile right axillary lymph node was palpable. Peau d’orange or orange peel appearance which occurs due to blockage of sub dermal lymphatics by tumour infiltrates, was noted over the skin. Clinically the features were suggestive of inflammatory carcinoma. Mammogram suggested an inflammatory carcinoma. Ultrasound of the breast was suggestive of right duct ectasia and diffusely thickened breast with a Breast Imaging Radiology and Data System (BIRADS) score of 3. An incision biopsy was performed with histopathology confirming the lesion as lymphocytic lobulitis with fibrocystic breast disease. The patient was symptomatically managed with analgesics and reassured. She was observed on regular follow up and is currently healthy. Lymphocytic lobulitis is a rare benign lesion which mimics carcinoma. Clinically it presents with ill defined single or multiple breast lumps in young or middle aged women with thickening and hardening of skin. Magnetic Resonance Imaging better differentiates this otherwise indolent lesion from malignancies. A histopathological examination is usually confirmatory and required to alleviate concerns of patients regarding presence of a malignancy which has a much fearsome physical and psychological implication

Globally, the pandemic of the coronavirus disease, which started in Wuhan, China, has become a major issue for public health. The COVID-19 epidemic notably causes health professionals to experience significantly more emotional stress than the general populace. The present study proposes to investigate the fear aspect in dentists in the initiation of clinical practice during these times. An online cross-sectional study was conducted among dental practitioners based on a pre-validated questionnaire. The data were expressed as frequency and percentage analyzed using the chi-square test using SPSS version 25. The data was obtained from 271 participants, where clinical practice after the first wave was mostly by freelancers (p-value = 0.01); most of whom were married (p-value = 0.065); 19.1% attached to institutes did not have changes in earnings; 28.1% of private practitioners had less than 10% reduction in cases. A total of 62% of private practitioners are concerned about the vaccine’s preventative effects (p-value = 0.026), and 57% of private practitioners worry about being sued for the delay in treatment (p-value = 0.036). Only 33.1% of employees in institutions worry that becoming sick could endanger their family. As dentists continue to work their way through this pandemic, these pressures only occasionally have an impact on them. According to the researchers, this is the first study that has captured the anxiety and apprehensions that dental practitioners experienced during the height of the COVID-19 outbreak in India in April 2021. The study’s findings demonstrate that the study population was generally upbeat and confident that they could quickly overcome their fear.

Objective: Acute appendicitis is one of the common abdominal emergencies encountered in surgical practice. However there are a host of other medical and surgical conditions that closely mimic it, clinically. The objective of this paper is to present a study and analysis of our burden of incidental encounters with such mimicking surgical conditions that were erroneously diagnosed as acute appendicitis, prior to surgery. Methods: Data was retrieved from the hospital’s electronic medical records about all patients operated for acute appendicitis, by a single surgeon, over a 14 year period. Results: A total of 450 patients were operated for acute appendicitis from 2008 to 2022. Out of these, we identified 20 patients who had a normal appendix with some other mimicking surgical condition (Incidence 4.44%). Conclusion: Acute appendicitis has many differential diagnoses, both common and rare. At times, some of these are confirmed ‘on table’; as seen in this case series. A sound, reliable and fool proof palpatory assessment of the abdomen is crucial in diagnosing it’s surgical conditions. It is interesting to note that although the initial diagnosis of acute appendicitis made for all the subjects of this case series was erroneous, all still turned out to have alternate conditions which merited surgery.

Periodontal risk assessment is essential to ensure the successful outcome of periodontal therapy. Various assessment tools have been devised over the years of which the periodontal risk assessment(PRA) tool by Lang & Tonetti is one of the more authentic tools, and it assesses the risk of severity of periodontal disease by taking into account various components which are a combination of risk factors, indicators, and markers. The present study used this tool to evaluate the change in periodontal risk following phase 1 periodontal therapy. Following the approval from the institutional ethical committee, 299 male and female patients aged 18 to 60 years undergoing comprehensive clinical care (CCC) at ISNC dental clinics from October 2020 until April 2021 were selected, and PRA was assessed at baseline (before phase 1 therapy) and following a re-evaluation of phase 1 therapy (4-6 weeks after phase 1 therapy). All the parameters of the Lang and Tonetti’s PRA model were recorded, and the periodontal risk was calculated accordingly. The data collected was entered into a Microsoft excel sheet. Statistical analysis was carried out using SPSSV 22 software. The results showed significant differences in essential risk parameters – sites with bleeding on probing(BOP), alveolar bone loss, and polygon surface area for risk. (P0.05) These factors are usually permanent and often impossible to eliminate, even if under control. Concerning smoking, even if the patients quit or reduce the number of cigarettes smoked, the alteration in risk levels is minimal or negligible. Thus, Phase 1 periodontal therapy significantly influences the risk levels in adult patients.

Introduction: The outbreak of novel coronavirus disease (COVID-19) has influenced every aspect of life. Healthcare professionals, especially dentists, are exposed to a higher risk of getting infected due to close contact with infected patients primarily through aerosol generated procedures. This study aimed to assess the awareness and risks of getting infected among dentists in the western region of Saudi Arabia, while working during the current novel coronavirus disease (COVID-19) pandemic. In addition, dentists’ knowledge about various practice modifications to combat COVID-19 cross infection and spread were evaluated. Materials and Methods: A total of 329 participants including 123 males and 196 females responded to an online questionnaire consisting of 30 questions, which was circulated among all kinds of dental healthcare professionals through social media and e-mails after obtaining approval from the institutional ethical committee. Results: Chi square tests revealed significant differences when comparing the responses of the participants based on qualification with regard to key responses related to awareness and practice perceptions such as HEPA filters, pulse oximeter, wearing an N-95 mask, using a face shield, a High volume suction and rubber dam.(p

Cone beam computed tomography (CBCT) has gained wide popularity among dentists. This can be attributed to its ability to provide bone morphology, bone dimension details and vital structure locations by producing cross-sectional images along the arches. However, one of the reasons routine usage is hampered is its high cost. It would be a great benefit to the practice of dental implants if there was a more economical alternative. Anatomic landmarks in both the maxilla and the mandible are important to be considered during implant placement, and if overlooked, may lead to failures and complications and this is where Cone beam computed tomography (CBCT) has a slight edge over its other diagnostic counterparts. However, newer digital radiographs have been found to be economical and fairly accurate in line with the highly sophisticated CT scans. Therefore, this study aimed to compare and assess the diagnostic accuracy of CBCT and digital radiography (vistascan) in the placement of implants, which may provide an aid in terms of providing an accurate implant size during the surgical procedure for successful dental implant placement. Data was collected from CBCT and vistascan image measurements made pre-operatively prior to implant placement. The measurements were then compared using certain anatomical landmarks as reference in the maxillary and mandibular arches and additionally, with the actual size of implant placed post-operatively. Statistical analysis using SPSS V22 and paired ‘t’ tests and ANOVA revealed no significant differences in the measurements between both the images. (P>0.05). Additionally, both the image measurements were very close to the actual size of the implant placed. Since both imaging techniques were similar in terms of accuracy for implant placement, use of digital radiography (vistascan) may be encouraged as a cost effective option as against CBCT which is expensive for routine assessment.

COVID 19 was originated from Wuhan city of Hubei Province in China in December 2019. It is a viral disease spread due to severe acute respiratory Syndrome Coronavirus virus. The virus has been spread extensively worldwide leading to a worldwide emergency. The strain of the virus is new and not been studied earlier. However the transmission of the virus is quick and immoderate. Efforts to contain the spread of the disease have led to major disruptions forcing regional and in many cases national emergencies and lockdown, leaving only essential services to continue. Human transmission is predominantly through the respiratory track via droplets, respiratory secretions and or direct contact where the virus enters the mucous membrane of the mouth, nose and eyes. Although contact with symptomatic patients is the typical route of transmission, asymptomatic individuals or those within the viral incubation period may also be able to transmit COVID 2019. In many such efforts performing elective tasks including orthodontic treatment are required to be suspended on orders of the central, state and civic and public health regulatory bodies. Due to unpresented nature of this pandemic and the unknown length of time that mandatory suspension of elective treatment may be in effect in different regions, consolidated information and guidelines for the clinical orthodontic management of patients during the COVID-19 pandemic are lacking. Keywords: COVID19, SARSCoV2, Pandemic, Emergency protocol, Orthodontics, Dentistry, Patient management.

Lymphocytic lobulitis , is a fibroinflammatory benign condition of the breast which is associated with type 1 diabetes mellitus. This benign condition is uncommon and may be mistaken for inflammatory carcinoma of the breast. We report the case of a 61 year old female patient who presented with a lump in the right breast with a history of Type 2 diabetes mellitus. The lump was associated with discharge and recent onset pain. On examination a vague lump which was non mobile, involving the right breast was palpable. A single firm mobile right axillary lymph node was palpable. Peau d’orange or orange peel appearance which occurs due to blockage of sub dermal lymphatics by tumour infiltrates, was noted over the skin. Clinically the features were suggestive of inflammatory carcinoma. Mammogram suggested an inflammatory carcinoma. Ultrasound of the breast was suggestive of right duct ectasia and diffusely thickened breast with a Breast Imaging Radiology and Data System (BIRADS) score of 3. An incision biopsy was performed with histopathology confirming the lesion as lymphocytic lobulitis with fibrocystic breast disease. The patient was symptomatically managed with analgesics and reassured. She was observed on regular follow up and is currently healthy. Lymphocytic lobulitis is a rare benign lesion which mimics carcinoma. Clinically it presents with ill defined single or multiple breast lumps in young or middle aged women with thickening and hardening of skin. Magnetic Resonance Imaging better differentiates this otherwise indolent lesion from malignancies. A histopathological examination is usually confirmatory and required to alleviate concerns of patients regarding presence of a malignancy which has a much fearsome physical and psychological implication.

Platelets and leukocytes activated in response to periodontal microorganisms during bacteremia can go on to excite other cells, enhancing the likelihood of atherosclerosis and coronary artery disease. Reports also indicate that decrease in the number of erythrocytes may occur secondary to periodontal disease. Smoking is a known risk factor for periodontal disease by virtue of its adverse effects on the blood cells. It was therefore decided to investigate the relationship between the red blood cel l(RBC), white blood cell (WBC) and platelet counts and periodontal parameters among smokers and non- smokers; to subsequently assess any implication of the systemic effects. Blood counts(RBC, WBC, platelets) for the present study were obtained from peripheral venous blood of 126 patients , both male and female aged between 18-45 years, in each group as follows: GROUP 1 :Periodontally healthy (n = 42) (non-smokers) GROUP 2: Chronic periodontitis (n = 42)( non- smokers) GROUP 3: Chronic periodontitis (n = 42) ( smokers) The clinical parameters to assess periodontitis included plaque index(PI), bleeding index(BI) and Clinical Attachment Loss( CAL) and history of smoking was elicited based on amount, frequency and duration of smoking. ANOVA tests followed by post HOC –Tukey HSD test revealed that there were significant differences between the 3 groups with respect to PI, BI and RBC counts(p

Background: Both periodontal disease and hypertension individually, have been found to be linked to certain blood groups. However, the association of the blood groups to abnormal blood pressure and co-existing periodontal disease has not yet been explored. The objective of this study was to explore a possible association, if any among the three conditions. Materials and Methods: In this pilot project, a total of 300 patients were screened initially, of which, 270 patients (205 males and 65 females) with mean age range of 34.5 years from various ABO blood groups, with gingivitis / periodontitis were selected and their blood pressure was measured in a standardized manner with a digital automated BP monitor. Patients with any systemic disease or condition or consuming any kind of medications and smokers were excluded from the study. The data thus obtained was statistically analyzed to assess prevalence and associations. Results: Overall, blood group O(29.26%) reported the highest number of patients with abnormal blood pressure in the presence of periodontal disease followed by B(18.89%) and A(17.03%). No association was found with abnormal blood pressure and blood groups in the individual gingivitis and periodontitis groups. However, a significant association with abnormal blood pressure in males over females in blood group A and B in the gingivitis group and in blood group A in the periodontitis group was observed.(P

Objective: Sound periodontal foundation of abutment teeth is essential for successful restorative therapy and also for long-term success of prosthodontic restorations. Porcelain fused to metal (PFM) has been a popular choice of novel esthetic material in fixed prosthodontics over the last few decades. The present study aimed to assess the long term effect and tissue responses of fixed partial prosthesis using PFM material on vital and non- vital abutments on the periodontal parameters both clinically and radiographically. Methodology: Following ethical committee approval, the study group comprised of 86 abutment teeth in 41 systemically healthy patients (24 males and 17 females) aged between 18 – 45 years who had received 3 unit fixed prosthesis made of PFM, having equigingival margins using vital and non-vital abutments. The following parameters were assessed at baseline, phase 1, 3 and 4 (1 year follow up) – CAL, Probing depth, Distance between CEJ/ cervical crown margin and alveolar crest of the abutment teeth (radiograph). Results: Statistical analysis carried out by SPSSV22 software revealed no significant changes in probing depth and CAL (p>0.05) and significant changes in radiographic bone levels (p0.05) with non vital abutments. However, significant differences were observed between vital and non vital abutments with regard to probing depth at the end of 2years, CAL and radiographic bone levels at 6months, 1 year and 2 years (p

Objective To assess the feasibility and impact of integrating electronic patient-reported outcome measures (PROMs) into the routine outpatient care of patients with SLE. Methods We conducted a prospective cohort study, utilizing a mixed-methods sequential explanatory design, of SLE outpatients receiving rheumatology care at two academic medical centres. Participants completed electronic PROMs at enrolment and then prior to their next two routine rheumatology visits. PROM score reports were shared with patients and rheumatologists before visits. Patients and rheumatologists completed post-visit surveys evaluating the utility of PROMs in the clinical encounters. Focus groups of patients and interviews with treating rheumatologists were conducted to further explore their experience utilizing PROMs. Results A total of 105 SLE patients and 17 rheumatologists participated in the study. Patients completed PROMs in 159 of 184 encounters (86%), with 93% of surveys completed remotely. Patients reported that PROMs were ‘quite a bit’ or ‘very’ useful (55% of encounters) and beneficial to communication (55% of encounters). In contrast, physicians found PROMs useful (20%) and beneficial to communication (17%) less frequently. There was no significant change in visit length, health-related quality of life or disease activity after implementation of PROMs; however, patient satisfaction improved slightly. Qualitative analyses revealed that patients felt PROMs provided utility primarily by facilitating communication, particularly when physicians discussed the surveys. Conclusion The remote capture and integration of electronic PROMs into clinical care was feasible in a diverse cohort of SLE outpatients. PROMs were useful to patients and enhanced their clinical experience primarily by facilitating communication.

High levels of cholesterol in the body can be alarming and point toward a possible cardiac or diabetic problem. Current evidence reveals that the harmful low-density lipoproteins (LDL) cholesterol tend to increase in poorly controlled diabetes, whereas the useful high-density lipoprotein (HDL) cholesterol, known for its protective anti-inflammatory and antioxidant activities, is decreased. With a positive evidence of periodontal disease being implicated in diabetes, it was decided to investigate whether there was any association between serum HDL, LDL, glycated hemoglobin (HbA1c) and periodontal status with Type II diabetes mellitus patients.A total of 500 nonsmoking patients (males and females) aged between 35 and 55 years with Type 2 diabetes mellitus and no other systemic disease were selected from the diabetic center, Diacon hospital, Bengaluru, Karnataka, India. Periodontal examination consisted of the clinical parameters, namely, attachment loss, gingival index (GI) and plaque index based on which the patients were divided into periodontally healthy and diseased groups. Blood samples were collected from each patient to evaluate the serum levels of HDL, LDL and HbA1c.No significant differences were observed between the HDL, LDL and HbA1c levels in both the periodontal groups (Varied associations were found between dyslipidemia, glycemic control and periodontal inflammation. Further longitudinal as well as interventional studies may be beneficial to ascertain the causal relationship between cholesterol levels, periodontal status and diabetes mellitus.

Aim The novel coronavirus disease‐2019 (COVID‐19) is a major health problem and has affected innumerable people around the world. The current online‐based study was conducted to assess the knowledge, attitude and practice (KAP) of dental students and professionals during the early days of lockdown in India from 2 April to 1 May 2020. Methodology An online‐based cross‐sectional study was undertaken through WhatsApp messenger and e‐mail groups among dental students and professionals. The KAP on COVID‐19 was ascertained using an investigator designed and validated questionnaire. The results were stratified based on student vs professionals. The data were expressed as frequency and percentage analysed using the chi‐square/Fishers exact test using IBM version 17. A probability value of

BACKGROUND:The replacement of missing teeth with fixed partial dentures is largely dependent upon the health and stability of the surrounding periodontal structures. FPDs are often prepared on vital teeth as abutments. Esthetic materials have become popular in fixed prosthodontics today. AIM:The present study aimed to assess the long term effect and tissue responses of various types of fixed partial prosthesis placed on vital abutment teeth on the periodontal parameters both clinically and radiographically. MATERIALS AND METHOD: Following ethical committee approval, the study group comprised of 87 abutment teeth in 41 systemically healthy patients (24 males and 17 females) aged between 18 – 45 years who had received 3 unit fixed prosthesis(IPS empress, PFM or zirconia), having equigingival margins using vital teeth as abutments. The following parameters were assessed at the time of bridge placement and 1 year follow up – CAL, Probing depth, Distance between CEJ/ cervical crown margin and alveolar crest of the abutment teeth(radiograph). RESULTS:Statistical analysis carried out by SPSSV22 software revealed significant changes in clinical parameters with IPS empress and radiographic parameters with PFM and Zirconia from time of bridge placement till the 1 year follow up.(P CONCLUSION:There seemed to be favorable responses of the periodontal tissues to the various esthetic materials used on vital abutments of FPDs.

Background:The outcomes of techniques employed for depigmentation are varied and no one method can be deemed as ideal. The present case series is an evaluation of 4 popular depigmentation procedures `carried out today. Material and methods: 5 patients with non-syndrome associated gingival hyperpigmentation in all 4 quadrants based on Dummetts scoring criteria were included. Healing and pain were assessed following depigmentation carried out by scalpel, bur, electro surgery and laser in the 4 quadrants respectively and followed up for a period of 2 years. Results: Healing following Scalpel method and laser were better than bur and electro surgery. Post-operative pain was less with the use of scalpel and laser when compared to the other 2 techniques at the end of 1month. Pain was still evident at the site of electro surgery at the end of 2 months. However at the end of 3, 6 months and 1 and 2 years there was no difference in all 4 techniques. Conclusion: Better treatment outcomes were observed with the scalpel and laser techniques than bur and electrosurgery.

Background and Objectives Herbal dentifrices are fast gaining popularity in most parts of Asia and Europe. Although effects of dentifrices on pathogenic plaque microorganisms has been documented, little or no evidence exists with regard to their effects on the useful microflora, which help to keep the pathogenic strains at bay. The present study was attempted to evaluate and compare these effects of herbal and conventional dentifrice. Methods 60 student participants in the age group of 18 to 28 years with good oral hygiene (OHI score = 0) were randomly divided into two groups, test and control. The test group used herbal dentifrice and the control group, a regular dentifrice. Plaque and saliva samples were collected at baseline, immediately after brushing, 12 hours after brushing, at 1 week and at 1 month, and cultured. The Streptococcus mitis and Lactobacillus counts along with total microbial counts were estimated at the various time intervals. Results Day 1 showed no significant difference between test and control groups with regard to Streptococcus mitis and Lactobacillus counts as well as total CFU (P>0.05), but at one week control group showed significant increase in streptococcus count in plaque and saliva(P>0.01). Whereas, the test group showed significant increase in L. bacillus and total CFU count in saliva, 12 hrs after brushing, when evaluated at one month (p>0.01). Conclusion Herbal dentifrices may be slightly more effective in preservation of beneficial oral microflora when compared to regular dentifrices, although both are equally effective in inhibiting the pathogenic microorganisms.

Background Host modulation is fast gaining popularity as one of the most safe and effective therapeutic modalities in a number of systemic ailments and also periodontal disease. Of these, herbal agents and probiotics have emerged as popular therapeutic agents. The present study was attempted to comparatively evaluate for the first time the effects of both these agents on chronic periodontitis. Materials and methods In this double blinded randomized controlled clinical trial, 96 systemically healthy patients with chronic periodontitis between the ages of 25-55 years were randomly divided into 3 groups. Following scaling and root planing, group 1 was administered the herbal immunomodulator tablets twice daily for 2 weeks, group 2, probiotic tablets twice daily for 2 weeks and group 3 was not administered any agent. Changes in gingival index, gingival bleeding index, pocket depth and interleukin - 6 (IL-6) levels in saliva and GCF were assessed at day 0, at 1 month, at 3 months and 6 months following which statistical analysis was done. Results Statistically significant reduction (p

Background: The search for an agent that would predictably and permanently occlude the tubules, and blend with them led to the discovery of HYDROXYAPATITE (HAP). The present double blinded randomsed controlled clinical trial aimed to compare the desensitizing effects of two forms of HAP with 2 other popular agents, potassium nitrate and potassium nitrate with sodium monofluorophosphate. Methods: Clinical study: 716 hypersensitive teeth in 50 patients with hypersensitive symptoms, confirmed by visual analogue scale (VAS) and verbal rating scale (VRS), were randomly divided into 4 groups (A,B,C and D) treated with HAP dry sol gel and liquid precipitate form, potassium nitrate and sodium monofluorophosphate respectively. The responses were evaluated at 0, 1 day, 1, 2, 4 and 8 weeks respectively for all groups and later statistically analysed. Results: HAP treated teeth showed statistically significant reduction in hypersensitive symptoms (p

Introduction: The maxillary central incisor in particular holds the key in creating a highly esthetic frontal profile and therefore appropriate selection of the tooth is of utmost importance in the restoration of the anterior segment of teeth in completely or partially edentulous patients. Although a number of studies have suggested various reference guides towards estimation of the width of central incisor, there have been no suitable guides to ascertain the length of the incisor in the absence of pre-extraction records. Purpose of the study: The present study attempted to arrive at a correct proportion for determining as far as possible the correct length of the maxillary central incisor with the help of facial measurements in the absence of pre-extraction records in a small proportion of the subcontinent Indian population. Materials and methods: The distance from the bridge of the nose to the base was compared to the length (actual and calculated by regression) of the maxillary central incisor in 400 patients of both sexes between the age groups of 20-35 years. Results: The length of the maxillary central incisor by calculated measurement ratios of facial measurements and regression equation showed variations between 0.2 to 0.4 mm in males and females respectively which was statistically significant (p

Background: Schizophrenia is a psychosis characterized by delusions and hallucinations occurring in clear consciousness. Studies have shown that the cytokines may modulate dopaminergic metabolism and schizophrenic symptomatology in schizophrenia. Cytokine involvement in periodontal disease is also well documented. To date, however, there has been relatively little research assessing periodontal status of patients with schizophrenia. The present study was therefore mainly intended to understand the exact link, if any, between periodontal disease and schizophrenia. Materials and Methods: A total of 250 schizophrenic patients (140 males and 110 females), between 25 and 55 years of age, were selected from the out patient department of National Institute of Mental Health and Neural Sciences, Bangalore and their periodontal status was assessed as part of this cross-sectional epidemiological survey. Results: ANOVA showed that there was increased evidence of poor periodontal condition, as evidenced by gingival index and plaque index in patients who had been schizophrenic for a longer duration of time (P < 0.001). So also, higher probing pocket depths were found in schizophrenics suffering from a longer period of time than others (P < 0.001). Conclusions: Although oral neglect might be a cause of poor periodontal health in schizophrenics, the possible link between periodontal diseases giving rise to schizophrenia cannot be overlooked due to the presence of cytokine activity which is present both in schizophrenia and periodontal disease.

Achieving and maintaining implant stability are prerequisites for a dental implant to be successful. Implant stability can be defined as the absence of clinical mobility, which is also the suggested definition of osseointegration. Primary implant stability at placement is a mechanical phenomenon that is related to the local bone quality and quantity, the type of implant and placement technique used. Secondary implant stability is the increase instability attributable to bone formation and remodeling at the implant/tissue interface and in the surrounding bone. There are many ways in which the implant stability can be evaluated such as clinical measurement of cutting resistance during implant placement, reverse torque test, the periotest. This article aims to throw light on the various methods to determine implant stability.

Background and objectives: Tissue engineering is fast gaining popularity in the field of periodontics, as periodontal disease is a complex condition, involving destruction of vital tooth supporting structures.