This report demonstrates the clinical use of a modified, truly anatomic, root analogue zirconia implant for immediate replacement of a right mandibular first premolar. A 22-year-old female patient with chronic apical periodontitis of the right mandibular first premolar was referred and the tooth was carefully extracted. A truly anatomical, root identical, roughened zirconia implant modified by macro-retentions was manufactured and placed into the extraction socket by tapping 3 days later. After 4 months a composite crown was cemented in place. No complications occurred during the healing period. A good functional and aesthetic result was achieved with minimal bone resorption and soft tissue recession at 18 months follow-up. This report describes the successful clinical use of an immediate, single stage, truly anatomical root-analogue zirconia implant for replacement of a single rooted tooth. Significant modifications such as macro-retentions yielded primary stability and excellent osseointegration. This novel approach is minimally invasive, respects the underlying anatomy and aids socket prevention. In addition the procedure saves time and cost, has good patient acceptance as there is no need for osteotomy, sinus lift or bone augmentation.

We measured the amount of bite force generated by patients treated for parasymphyseal fractures of the mandible by open reduction and internal fixation at various predetermined time intervals. Sixty volunteers ranging from 18 to 60 years old were selected as the control group. All measurements were made on a bite force measurement device with the head in an upright position and in an unsupported natural position. Bite forces were measured at the incisor and right and left molar regions. These bite forces were compared with six patients with isolated mandibular unilateral parasymphyseal fractures. All patients were operated using open reduction and internal fixation using two miniplates at the fracture site. In the volunteer group, bite forces ranged from 22 to 50 kg in the molar region and 3 to 27 kg in the incisor region. Mean adult healthy values (male and female) in the molar region were 36 kg and in the incisor region, 15 kg. In mandibular parasymphyseal fractures, incisor bite forces were reduced significantly when compared with the control group in the first 2 postoperative weeks and regained significantly thereafter till 4 to 6 weeks. Bite forces in the molar region took $6 to 12 weeks to regain maximum bite forces when compared with the volunteer group. Restoration of functional bite forces was evident by 6 to 8 weeks. However, the restoration of maximum bite forces may require up to 12 weeks in parasymphyseal fractures.

Background:The microbiology of acute dental infections has been in the midst of many researches. Various bacteriological studies show variations in their conclusion. The purpose of our study was to evaluate the microbial flora in orofacial space infections of odontogenic origin, which is essential for appropriate antibiotic selection.Materials and Methods:Thirty-five patients with odontogenic infection causing fascial space involvement were included. Aspirated specimen was transported in nutrient broth and thyoglycollate media within an hour for further culture and sensitivity testing.Result and Conclusion:This study indicates that orofacial odontogenic infections are usually polymicrobial, consisting of a complex mixture of both anaerobes and aerobes.

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We conclude that Midazolam and Dexmedetomidine are equivalent and can be used in minor oral surgery with minimal complications. These drugs can be used intranasally using nasal atomization device in routine outpatient basis in otherwise normal healthy but anxious patients. All procedures must however be performed in the presence of an anaesthesiologist and with ready availability of emergency drugs and equipment.