This case report describes extraction of a fractured left maxillary lateral incisor tooth, followed by immediate placement of a dental implant in the prepared socket and temporization by a bonded restoration. The tooth was atraumatically extracted, the socket was prepared to the required depth and a Biohorizon Implant was inserted followed a week later by temporization by a bonded restoration. An impression was made 4 months after implant insertion, and a definitive restoration was placed. The atraumatic operating technique and the immediate insertion of the Implant resulted in the preservation of the hard and soft tissues at the extraction site. The patient exhibited no clinical or radiologic complications through 5 years of clinical monitoring. The dental implant and provisional restoration provided the patient with immediate esthetics, function, comfort, and most importantly preservation of tissues.

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Replacement of multiple missing teeth mainly in the Kennedy's class I and class II condition is a challenge for the clinician and the patient in terms of retention, masticatory efficiency, esthetics, comfort and importantly economics. Here, a case using implants in the distal denture bearing area with ball attachments and fabricating a cast partial denture over it utilizing the best of all benefits has been presented.

AimTo compare the periodontal status in relation to the lower anteriors of patients between labial and lingual orthodontic therapy. Materials and methodsThe study includes a total of 20 patients in the age group of 20-30 years. All the included patients were selected with limited lower anterior crowding within 0-8 mm. The subjects were randomly divided into two groups: labial (n=10) and lingual (n=10) fixed orthodontic therapy. The periodontal status was evaluated using three indices, plaque index, calculus index, and gingival index, at two different treatment intervals -the first month and the third month -of orthodontic treatment. ResultsThe values of all the three indices at both time intervals were tabulated. There was no statistical significance when compared to the values in the first month. In the third month, all three indices were statistically significant for both labial and lingual therapy (p<0.001). The lingual appliance had more plaque and calculus accumulation. ConclusionTherefore, the study proves that the lingual surface of patients undergoing lingual orthodontic treatment exhibits more plaque and calculus deposition, thereby the weakening of the periodontal status.

e18634 Background: Coronavirus disease 2019 (COVID 19) pandemic saw its first case in the United States in 2020. Although lung imaging for COVID-19 patients theoretically increased chances of detecting cancerous lung nodules, strict quarantine measures disrupting routine cancer screening was a concern. Real-world data on lung cancer diagnosis during the pandemic at community level is less known. Methods: We conducted a retrospective chart review on patients newly diagnosed of lung cancer from 2018- 2022 in our community hospital. Demographic details, year of diagnosis, type and stage of cancer, inpatient or outpatient diagnosis and mode of diagnosis (surveillance, incidental or symptomatic) was noted. Descriptive analysis of the above parameters was conducted across three eras- 2018 and 2019 as pre-COVID era (PreCo), 2020 and 2021 as COVID era (Cov) and 2022 as post-COVID era (PosCo) irrespective of COVID-19 diagnosis. Results: Out of 287 patients included, 40% (116) were diagnosed during PreCo, 27.5% (79) during Cov and 32% (92) during PosCo. In the PreCo, 16% (19) were incidentally detected, 21% (24) were ISym, 48% (56) on surveillance, and 15% (17) were OSym. In Cov, 13.9% (11) were incidentally detected, 53.3% (42) were ISym 13.9% (11) on surveillance, and 18.9% (15) were OSym. In PosCo, 11.3% (11) were incidentally detected, 19% (18) were ISym, 44% (41) on surveillance, and 24% (22) were OSym. Stage IV cancers among new lung cancer diagnoses were noted to be highest in PosCo (43.4%) followed by PreCo (31.9%) and Cov (26.6%). Conclusions: Cov saw a decrease in the annual rate of new lung cancer diagnosis compared to PreCo likely secondary to reduced routine screening. A staggering increase in new and stage IV cancers were noted in PosCo which could stem from missed screening as well as rapid progression of undiagnosed cancers during the pandemic. In Cov, there was a dramatic increase in symptomatic inpatient lung cancer cases (53.3%) as symptoms of COVID-19 and lung cancer overlap. Comparable rates of cancer diagnosis via surveillance in PosCo (44%) and PreCo (48%) hints at possible restoration of access to outpatient cancer care. [Table: see text]