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A lot of biomedical waste (BMW) is generated in dental practices, which can be hazardous to the environment as well as to those who come in contact with the materials, if not dealt with appropriately. Most of the rules world-wide are not specific for dental BMW management and hinder easy understanding by dental practitioners. Because of lack of clear-cut guidelines either from Dental Council of India or Government of India or Indian Dental Association (IDA) on disposal of dental wastes, this article is designed to explore and review on these issues and formulate a simplified scheme. The guidelines by the Maharashtra Pollution Control Board from the directives of The Ministry of Environment and Forests, Government of India through BMW (Management and Handling) Rules, 1998, (BMW-MH-98), similar guidelines being followed elsewhere in the world, the local BMW disposal company's rules and the IDA's Clinic Standardization Program guidelines. We developed and implemented a simplified waste segregation protocol for practicing dentists and dental hospitals. A methodological dental waste segregation protocol was required considering its disposal and ill-effects on health and the environment. The simplified scheme provided a good model to be followed in developing countries like India. The scheme improved understanding among dentists because of its self-explanatory nature.

Background: There are no authoritative meta-analyses and no clear quantitative assessments available estimating effects of open flap debridement (OFD) combined with platelet-rich fibrin (PRF) or platelet-rich plasma (PRP) over and above that of OFD. This study evaluated the actual quantitative mean gain for various clinical (clinical attachment level [CAL], probing pocket depth [PPD] and gingival marginal level [GML]) and radiographic (intrabony defect depth [IBD]) parameters of Platelet Concentrates- PCs (PRP/PRF) as sole grafting material along with OFD and OFD alone in the treatment of intrabony defects. Materials and Methods: A detailed electronic search was carried out in PUBMED/MEDLINE, COCHRANE, EBSCOHOST, and Google Scholar databases by unifying related search terms with additional hand searches in select specialty journals up to May 2017. The eligibility criteria included human randomized clinical trials, either of a parallel group or a split-mouth design with follow-up period of at least 6 months. Periodontal intrabony defects with radiographic IBD ≥3 mm with corresponding CAL ≥5 mm were included. For the meta-analysis, the inverse variance method was used in fixed- or random-effect models. Results: Actual quantitative mean gains were calculated for OFD with PRF/PRP (CAL = 1.1 mm, IBD = 1.68 mm, PPD = 0.97 mm and GML = 0.48 mm) over and above that of OFD alone. Conclusion: Because of very high heterogeneity, the results may not be dependable. Apart from gains in radiographic bone fill, all other periodontal clinical parameters showed negligible gains. Using PRF technologies in periodontal intrabony defects may not be of great clinical significance over and above that of OFD alone, the effect sizes are also not large enough.

Background:Accidental ingestion of medium-to-large instruments is relatively uncommon during dental treatment but can be potentially dangerous. A case of BiTine ring ingestion is presented with a note on inefficient ring separation forceps.Case description:A 28-year-old male patient accidentally ingested the BiTine ring (2 cm diameter, 0.5 cm outward projections) while it was being applied to a distoproximal cavity in tooth # 19. The ring placement forceps were excessively flexible; bending of the beaks towards the ring combined with a poor no-slippage mechanism led to sudden disengagement of the ring and accelerated movement towards the pharynx. We followed the patient with bulk forming agents and radiographs. Fortunately the ring passed out without any complications.Clinical implications:Checking equipment and methods is as important as taking precautions against any preventable medical emergency. It is the responsibility of the clinician to check, verify and then use any instrument/equipment.