Surgical crown lengthening has been proposed as a means of facilitating restorative procedures and preventing injuries in teeth with structurally inadequate clinical crown or exposing tooth structure in the presence of deep, subgingival pathologies which may hamper the access for proper restorative measures. Histological studies utilizing animal models have shown that postoperative crestal resorption allowed reestablishment of the biologic width. However, very little has been done in humans. Aims. The purpose of the study was to evaluate the potential changes in the periodontal tissues, particularly the biologic width, following surgical crown lengthening by two surgical procedures before and after crown placement. Methods and Material. Twenty (20) patients who needed surgical crown lengthening to gain retention necessary for prosthetic treatment and/or to access caries, tooth fracture, or previous prosthetic margins entered the study. The following parameters were obtained from line angles of treated teeth (teeth requiring surgical crown lengthening) and adjacent sites: Plaque and Gingival Indices (PI) & (GI), Position of Gingival Margin from reference Stent (PGMRS), Probing depth (PD), and Biologic Width (BW). Statistical Analysis Used. Student “t” Test. Results. Initial baseline values of biologic width were 2.55 mm (Gingivectomy procedure B1 Group) and 1.95 mm (Ostectomy procedure B2 Group) and after surgical procedure the values were 1.15 mm and 1.25 mm. Conclusions. Within the limitations of the study the biologic width, at treated sites, was re-established to its original vertical dimension by 3 months. Ostectomy with apically positioned flap can be considered as a more effective procedure than Gingivectomy for Surgical Crown Lengthening.

Objective To noninvasively determine the relationship between the thickness of the buccal bone and attached gingiva of the maxillary premolars. Material and Methods 128 maxillary premolars in 32 patients were assessed for measurement of buccal bone thickness and corresponding attached gingival thickness at 3 mm apical to cemento‐enamel junction. Buccal bone thickness was measured on cone‐beam computed tomography scans and attached gingival thickness by ultrasound unit. Pearson's correlation coefficient was calculated to assess the correlation between buccal bone and attached gingival thickness at each tooth type. Results The mean buccal bone thickness at the maxillary premolars was 1.07 mm. The 1st premolars had a buccal bone thickness < 1 mm at 68% of all sites, and the 2nd premolars had a buccal bone thickness of 1.0‐2.0 mm at 32% of all sites. The 1st premolars had a gingival thickness > 1.2 mm at 55% of all sites, and the 2nd premolars had a gingival thickness of 1.1‐1.3 mm at 45% of all sites. The correlation between buccal bone and attached gingival thickness was moderately positive (r = 0.406; P < .001). Conclusions The relationship between buccal bone thickness and gingival thickness is independent of each other in the maxillary right first premolar, whereas a moderate correlation with a dependent relation exists in the maxillary right second premolar, maxillary left first premolar, and maxillary left second premolar. Clinical Significance Soft tissue and hard tissue associated with volumetric changes in maxillary premolar region can be unfavorable for both aesthetic and implant placement. In fact this study highlighted the relationship between the thickness of attached gingiva and corresponding buccal bone in maxillary premolar region so to enable for proper planning of implant therapy following extraction.

The present study was aimed at reviewing the studies that used finite element analysis (FEA) to estimate the biomechanical stress arising in removable partial dentures (RPDs) and how to optimize it. A literature survey was conducted for the English full-text articles, which used only FEA to estimate the stress developed in RPDs from Jan 2000 to May 2021. In RPDs, the retaining and supporting structures are subjected to dynamic loads during insertion and removal of the prosthesis as well as during function. The majority of stresses in free-end saddle (FES) RPDs are concentrated in the shoulder of the clasp, the horizontal curvature of the gingival approaching clasp, and the part of the major connector next to terminal abutments. Clasps fabricated from flexible materials were beneficial to eliminate the stress in the abutment, while rigid materials were preferred for major connectors to eliminate the displacement of the prosthesis. In implant-assisted RPD, the implant receive the majority of the load, thereby reducing the stress on the abutment and reducing the displacement of the prosthesis. The amount of stress in the implant decreases with zero or minimal angulation, using long and wide implants, and when the implants are placed in the first molar area.

A high rate of nerve injury and related consequences are seen during implant placement in the posterior mandibular arch. An approach has been proposed to avoid nerve injury by dodging the inferior alveolar nerve (IAN) while placing an implant. A prospective study with a total of 240 CBCT (cone beam computed tomography) images of patients with three dentate statuses, namely, edentulous (group I), partially edentulous (group II) and dentate (group III) were included in the study. The nerve path tracing was done on CBCT images with On-demand 3D software. The three dimensions, i.e., the linear distance from the outer buccal cortical plate to the inferior alveolar nerve (BCPN), linear distance from the outer lingual cortical plate to the inferior alveolar nerve (LCPN) and linear distance from the midpoint of the alveolar crest to the inferior alveolar nerve (ACN) were assessed. The data were presented and analyzed between variables using one-way ANOVA and independent t-test in SPSS version 21.LCPN of the right 1st premolar region (p < 0.05) was significantly different among the groups with edentulous subjects recorded with the minimum value (6.50 ± 1.20 mm). Females were found to have significantly (p < 0.05) less available bone (6.03 ± 1.46 mm) on the right side of the mandibular jaw compared to males in edentulous group of patients. On comparing age groups for partially edentulous subjects, LCPN of the right 1st premolar region had significantly (p < 0.05) less available bone (6.03 ± 0.38 mm) in subjects with age ≥54 years. The IAN follows a lingual course in the molar region and later flips to the buccal side in the premolar region. The LCPN dimension in the 1st and 2nd premolar region was found to be more than 6 mm irrespective of age, gender and side of the jaw. Thus, it can be considered as a suitable site for placing implants while bypassing the IAN with CBCT assessment remaining as the mainstay in the pre-surgical phase.

An oral assessment is a direct way to assess students' learning outcomes by questioning them. The format of oral examinations () is not uniform. Unlike interviews, which usually have structured question lists, oral assessments usually do not have a question structure. Structured overcomes the weaknesses of traditional The aim of this study was to assess the reliability of structured as a formative assessment of dental students. A sample of 65 third-year and 70 fourth-year dental students at one dental school in India were subjected to structured examinations with questions derived from the subject of periodontics. Each examinee answered five questions (two open and three closed) asked by trained unbiased examiners. The structured examinations were conducted on the seventh and 14th days after the last lecture of a one-month lecture series. Scores were tabulated into three domains of Bloom's taxonomy: knowledge, comprehension, and application. Regarding knowledge, the mean scores were 1.24±0.59 (seventh day) and 1.66±0.64 (14th day), and the difference was statistically significant (p<0.05). Regarding comprehension, the mean scores were 0.92±0.57 (seventh day) and 1.44±0.65 (14th day), and the difference was statistically significant (p<0.05). Regarding application, the mean scores were 0.56±0.50 (seventh day) and 1.0±0.43 (14th day) in Domain II, and the difference was statistically significant (p<0.05). The results suggest that structured was a reliable method for the formative assessment of these dental students.