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SUMMARYThis cross-sectional study was aimed at possible relationships between tobacco habits and selected behavior characteristics in an adult sample from India. Contemporaneous clinical examination comprised an intra-oral examination with specific emphasise to dental caries status in the form of DMFT (Decayed, Missing, and Filled Teeth) index. The study comprised 805 subjects in the age group from 30 to 69 years (72% of males and 28% of females). The participants were divided into regular smokers, occasional smokers, ex-smokers, tobacco chewers and non-tobacco users. The highest prevalence of oral mucosal lesions were found in tobacco chewers (22.7 %) followed by regular smokers (12.9 %), occasional smokers (8.6%), ex-smokers (5.1%) and non tobacco users (2.8%) (p < 0.001). The mean number of decayed teeth was highest in tobacco chewers (6.96) followed by regular smokers (6.44) and ex-smokers (5.5) (p < 0.001). The mean number of missing teeth was highest in the group of regular smokers (1.9) and lowest in non-tobacco users (1.53), but the results were not statistically significant (p = 0.529). The mean number of filled teeth were highest in the group of tobacco chewers (3.67) followed by regular smokers (3.29) (p < 0.001). DMFT value of tobacco chewers, regular smokers and ex-smokers is higher when compared to non-tobacco users (p < 0.001). The study documents that chewing tobacco and smoking can present significant risk factors for dental caries. However, the conclusions are burdened by some limitations. Further studies for investigation of the effect of tobacco using on dental caries are needed.

Summary: Alloplastic bone graft materials are widely been used in combination with barrier membranes to achieve guided tissue regeneration in the treatment of periodontal intrabony defects. This study was designed to evaluate the clinical outcome of a composite material, beta tricalcium phosphate in combination with calcium sulphate in the treatment of periodontal intrabony defects. The combination of these materials is believed to aid in guided tissue regeneration owing to their properties. Thirty nine intrabony defects in 21 patients were treated with Fortoss ® Vital (Biocomposites, Staffordshire, UK). Clinical parameters were evaluated including changes in probing depth, clinical attachment level/loss and gingival recession at baseline and one year postoperatively. The mean differences in measurements between the baseline and one year postoperatively are a reduction of 1.98±1.16 mm (p=0.000) in case of probing depth and a gain of 1.68±1.12 mm (p=0.000) in clinical attachment level and an increase of 0.31±0.67 mm (p=0.009) in gingival recession measurements. The study results show that the treatment with a combination of beta tricalcium phosphate and calcium sulphate led to a significantly favorable clinical improvement in periodontal intrabony defects one year postoperatively.

Over the past 35 years, multiple types of all-ceramic materials have been introduced as an ideal alternative for metal-fused to ceramic. This review covers state-of-the-art development of all-ceramic systems in terms of history, material composition, fabrication technologies, and structural and strength properties. These materials are proved to be ideal in terms of mechanical properties and biocompatibility, making metal-free ceramic restorations a realistic clinical alternative for conventional metal-fused-to ceramic.

Advantages of all-ceramics over metal ceramic systems• Aesthetic advantages of all-ceramic systems are proved by replacing the light blocking metal substructure by more opaque high strength ceramic. • Wide range of patients' tooth shades ('value' in Munsell scale) can be satisfied.• Because of colour, finish line can be at gingival margin or 0.5 mm subgingival without compromising aesthetics.• All-ceramic systems have reduced thermal conductivity, resulting in less thermal sensitivity and pulpal irritation.• Because of lesser accumulation of bacteria on ceramic surfaces, it can be used over implants in the sub gingival area (20). • More biocompatible.• Emergent profile of all-ceramic crowns is less likely to be over-contoured. In vitro and in vivo dataAll-ceramic crowns/bridges The metal ceramic system is the longest studied FPD system; it would be better to compare the all-ceramic system with the data of metal ceramic system. Walton's retrospective study of 515 metal-ceramic FPDs showed the cumulative survival rate of FPDs was 96 % for 5 years, 87 % for 10 years, and 85 % for 15 years. Reported modes of failure for metal ceramic FPDs were tooth fracture (38 %), periodontal breakdown (27 %), loss of retention (13 %), and Caries (11 %) (24). In literature review there are 5 ceramic systems which were studied in detail. They are: a. Glass infiltrated alumina (In-ceram alumina, Vita). b. Leucite-reinforced glass (Empress, Ivoclare), c. Glass infiltrated magnesium aluminate spinell (In ceram spinell, Vita), d. Poly crystalline alumina (Procera, Noble Biocare) e. Zirconium-oxide Ceramics A reported failure rate appears to be lower for anterior crowns than molar crowns. The least amount of failure was reported for posterior restorations manufactured by high strength all-ceramic systems (All Ceram alumina; Procera, In-Ceram Alumina; Vita). Documented data is in agreement with reported data of metal ceramic systems. Long term follow up of newer Zirconium system results are widely expected. Selection criteriaAn ideal ceramic material for the fabrication of artificial replacement should allow for control of substrate colour Summary: Current all-ceramic materials offer a accepted level of fracture resistance, fit and aesthetics. High fracture resistance recommends it to be a material to support fixed partial denture (FPD) in a stress bearing area with clinical success. This part of the present literature review covers the success rate, selection criteria of all ceramic systems, cementation technique, finishing and polishing. In vitro and in vivo studies of new high strength ceramics were well documented. Data suggest that single crowns in the anterior and posterior region are more predictable than bridges. Well-studied longterm success rate for FPDs are very limited.

Summary: Two maxillary first molars and two central incisor typhodont teeth were prepared with 0.8 mm chamfer, 2.0 mm occlusal reduction, and 6 degree taper. The prepared teeth were duplicated 9 times to obtain 36 die stone models and divided into three groups (n = 12). Luting agents tested were zinc phosphate, glass ionomer and resin cement. Procera ® AllCeram 0.6 mm coping was fixed with a calibrated finger force of 50 N. The absolute marginal discrepancy was measured using the scanning electron microscope on four axial walls with 4 measurements on each wall to obtain a total of 16 readings for one tooth. Mann Whitney U test was applied to find significant differences between luting cements and Kruskal Wallis tests among groups. Results The absolute marginal discrepancies of cements were in reducing order zinc phosphate (AZ) 53 μm; resin (AR) 44.5 μm, glass ionomer (AG) 29 μm. There was a significant difference among luting cements AG V/s AZ (p = 0.001) and AR V/s AG (p = 0.003), except AR V/s AZ (p = 0.213). All axial surfaces except mesial showed a significant difference. Conclusion The study concluded that different luting media have a definite effect over the final fit of AllCeram coping. Absolute marginal discrepancy was within the accepted level of 100 μm. Distal axial surface demonstrated a wider gap among all the luting agents.

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AbstractThe aim of the present study was to establish the relationship between tobacco use and periodontal health in an adult sample in India. A cross-sectional population-based study was conducted in a province of southern India. A total of 805 subjects between the ages of 30 and 69 years were interviewed, and clinical examinations were made by three cooperating dentists. The examiners recorded oral mucosal findings, gingivitis, and the Community Periodontal Index of Treatment Needs index using a WHO-621 Trinity probe. Among the 805 participants, 72% were males and 28% were females. Among regular smokers, 98% were males and 2% were females. In the studied population, 64.6% visited the dentist only when they had some dental problems. Oral mucosal findings were present more in of the regular smokers and chewing tobacco users than in the non-consumers. The maximum findings from six sextants indicate that non-consumers exhibited higher rates of healthy periodontium and bleeding on probing but lower rates of pockets than tobacco consumers. The present analysis shows that tobacco use exerts a strong and chronic effect on periodontium and oral mucosa and reduces bleeding on probing.