Increased life expectancy is causing an explosion of the aging population that will continue now and in the foreseeable future. Improved quality of life at old age will demand tooth retention and consequently the need for restorative care. Retaining teeth disease free and maintaining them amidst multitude of risk factors associated with old age, is a multi- faceted challenge. This review article discusses the etiology of various dental diseases seen in older dentate population and their management keeping in mind the special needs of these matured people, so as to render a professional service that is sensitive and caring.

Background and objectives This study was undertaken to evaluate the effect of different placement techniques (bulk, oblique incremental, centripetal and split horizontal) on marginal microleakage in class II composite restoration. Method Standardized class II preparations were made in 40 caries-free extracted molars and randomly assigned to four groups (n = 10): (1) Bulk technique (2) oblique incremental insertion technique,(3) centripetal incremental insertion technique and (4) split horizontal incremental insertion. The teeth were restored with a total-etch adhesive and nanocomposite resin. The specimens were immersed in a solution of 2% methylene blue for 24 hours, and subsequently evaluated for leakage. The microleakage scores (0 to 4) obtained from the occlusal and cervical walls were analyzed with Kruskal-Wallis and Mann-Whitney tests (p < 0.05). Results Microleakage scores indicated that incremental technique was better than bulk for composite placement and among incremental techniques split incremental technique showed best results. Conclusion Incremental placement technique showed lower microleakage compared to bulk, and lower microleakage was seen at occlusal margin compared to gingival margin. Split horizontal incremental technique showed the least microleakage scores among incremental techniques

AIM:The aim of this study was to evaluate effect of placement techniques, flow able composite, and fiber inserts in marginal adaptation of class II composite restorations. MATERIALS AND METHODS: 120 class II box cavities were prepared on both mesial and distal surfaces of extracted human molars. The prepared teeth were randomly assigned to 6 groups: 1) bulk insertion. (Single increment), 2) Oblique incremental placement technique, 3) Centripetal incremental placement technique. 4) Split horizontal incremental placement technique. 5) flow able composite as gingival increment 6) ribbond fiber insert in gingival increment. The preparations were restored with a total etch adhesive (Adper Single Bond, 3M ESPE) and nano composite (Z350, 3M ESPE). Specimens were isolated with nail varnish except for a 2-mm-wide rim around the restoration and thermocycled (1,000 thermal cycles, 5°C/55°C; 30-second dwell time). The specimens were immersed in a solution of 2% methylene blue dye for 24 hours. The teeth were sectioned longitudinally, observed under stereomicroscope and evaluated for microleakage using an ordinal scale of 0 to 4. The microleakage scores obtained from gingival walls were analyzed with Kruskal-Wallis and Mann Whitney nonparametric tests. RESULTS: Among all placement techniques split incremental technique showed least microleakage scores. The group that used flowable composite liner did not show significant reduction in microleakage and group with fiber inserts showed significant decrease in microleakage scores. CONCLUSION: None of the techniques eliminated marginal microleakage in class II composite restorations. However, the split incremental technique and group with fiber inserts showed significantly lower microleakage at gingival margin when compared to other groups.

Detecting pathologies at their earliest stages can signifi cantly aff ect patient discomfort, prognosis, therapeutic intervention, survival rates, and recurrence. The use of tissue biomarkers in basic and clinical research and even in clinical practice not only became very common but also their presence as primary endpoints in clinical trials are now very well accepted. The use of tissue biomarkers, and mainly laboratory-measured biomarkers, in clinical set up is somewhat newer, and the suitable approaches to this practice are still in the process of development and refi nement. This review highlights contemporary innovations and explores recent discoveries about markers in lesions of oral cavity.