iosr-JDMS   Volume-6 ~ Issue-1

Abstract: Among the various laser types with corresponding wavelengths, diode laser systems quickly began establishing themselves as compact, competitively priced and versatile additions to the dentist's repertoire. Research has shown that near infrared (NIR) wavelengths have high absorption in haemoglobin. This fact gives NIR laser the ability to precisely and efficiently cut, coagulate, ablate or vaporize the target tissue. The added advantage of performing desired procedures is the sealing of small blood and lymphatic vessels, resulting in hemostasis and reduced post-operative edema, disinfection of target tissue due to local heating and production of eschar layer and decreased amount of scarring due to decreased post-operative tissue shrinkage. Research has shown that Diode laser is one of the most versatile with regard to the number of possible treatment options and can be effectively used in the field of soft tissue surgery, periodontics, endodontics, tooth whitening etc. The versatility of the instrument, combined with the latest achievements in diode laser technology, compact design and affordability, should appeal to dental professionals seeking to optimize the procedures they currently perform.

Keywords: Diode Laser, Emisssion Modes, Optic Fiber, Target Tissue.

[1]. Raj Wadhwan : Lasers in dentistry – An introduction to new technology; International Dentistry SA vol. 9, No. 2

[2]. Coluzzi DJ. Fundamentals of dental lasers:science and instruments. Dent Clin North Am 2004; 48(4):751-770.

[3]. Samo Pirnat: Versatility of an 810 nm Diode Laser in Dentistry: An Overview: Journal of Laser and Health Academy Vol. 2007 No. 4 1 -8.

[4]. V. K. Kononenko History and Developments of Semiconductor Lasers :Stepanov Institute of Physics NASB, Independence Ave., 68, 220072 Minsk, Belarus

[5]. Sebeena Mathew, Deepa Natesan Thangaraj: Lasers In Endodontics: JIADS VOL -1Issue 1 Jan- March,2010 ,31

[6]. Academy of laser dentistry.2008; 1-18

[7]. Stubinger S, Saldamli B, Jurgens P, Ghazal G, Zeilhofer HF.Soft tissue surgery with the diode laser- theoretical and clinical aspects. Schweiz Monatsschr Zahnmed. 2006; 116(8): 812-820

[8]. Parker S. Lasers and soft tissue: 'fixed' soft tissue surgery. Br Dent J. 2007 Mar 10; 202(5): 247- 253.

[9]. Bladowski M, Konarska-Choroszucha H, Choroszucha T. Comparison of Treatment Results of Recurrent Aphthous Stomatitis (RAS) with Low- and High-power Laser Irradiation vs a Pharmaceutical Method (5-year Study). J Oral Laser Applications 2004, 3: 191 – 209

[10]. Lanning S K, Waldrop T C, Gunsolley J C, Maynard J G. Surgical crown lengthening: evaluation of the Biological width. J Periodontol 2003; 74: 468-474.

Abstract: Fine-needle aspiration of the thyroid gland is safe, inexpensive, minimally invasive, and highly accurate in the diagnosis of nodular thyroid disease. Limitations of FNAC are related to the skill of the aspirator, the experience of the cytologist, and the difficulty in distinguishing some benign cellular adenomas from their malignant counterpart[1] .Papillary thyroid cancer or papillary thyroid carcinoma is the most common type of thyroid cancer, representing 75% to 85% of all thyroid cancer cases.[1] [2] It occurs more frequently in women and commonly between 30-40 years. It is also the predominant type thyroid cancer in children, especially in patients who had previous radiation to the head and neck.[3] This study was conducted in Al Hussein teaching hospital through 5 years from 2008 to 2013 on 300 patients complained from thyroid nodules ,FNAC performed to these patients who suspected to have thyroid malignancy from history and clinical examination, 52 patients(17.3%) was diagnosed as a papillary carcinoma,40patients were females(76.2%) and 12 were males (23.8%), ages ranged between 28 –46 years, follow up of these patients with histopathplogical examination to confirm the diagnosis. After histopathological examination we get 41 cases(78.8%) were confirmed as apapillary carcinomas (32 cases were females and 9 males cases. ) , 6 patients (11.5%) diagnosed nodular hyperplasia , 2 cases (3.8%) of follicular adenoma and 3 cases(5.7%) of thyroiditis. 15 patients (36.5%) of these 41 cases were from areas proved to be exposed to radiation through 1991 & 2003 wars , 11 patients (26.8%) had positive family history of thyroid malignancies, 9 patients (21.9%) from radiation exposed area & had family history of thyroid tumors and 5 cases (12.2 %) had negative history & one case with long standing MNG . Key Words: Papillary thyroid carcinoma , FNAC

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Abstract: Introduction: The exact contributions of postprandial and fasting glucose increments to overall hyperglycemia remain controversial. An observational prospective study is designed to know the relationship of the defined range of various values of glycosylated hemoglobin with fasting and postprandial glycemic status in pre-diabetics and diabetic subjects. Methods & Material: The 402 patients enrolled for this study are divided into 5 groups (Quintiles) depending upon their HbA1C levels. Results: The mean value of Fasting Plasma Glucose (FPG) and Postprandial Plasma Glucose (PPG) increases with the increasing quintile of HbA1C. The Correlation Coefficient (r- value) for the mean FPG increases with increasing HbA1C Quintiles while that of the mean PPG decreases with higher HbA1C Quintiles. Mean BMI is significantly and positively correlated with HbA1C Quintiles in Groups C, D and E. The occurrence of Diabetic Neuropathy is seen more with rising trends of HbA1C Quintiles. Conclusion: With the severity of diabetes mellitus in relation to increased HbA1C values, attention should be paid more for better control of Fasting Plasma Glucose. When the values of HbA1C are near normal or in pre-diabetic range, glycemic control should be achieved by controlling postprandial plasma glucose since here fasting plasma glucose is negatively correlated. When the values of HbA1C remain at the moderate limit due attention is needed for controlling both the fasting and the postprandial plasma glucose, judiciously.

Key Words: Glyosylated Hemoglobin Quintiles, Fasting Plasma Glucose (FPG), Postprandial Plasma Glucose (PPG).

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[4]. Fong DS, Aiello LP, Ferris FL, Klein R. Diabetic Retinopathy. Diabetes Care 2004; 27(10): 2540-53.
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[9]. Monnier L, Lapinski H, Colette C. Contributions of fasting and postprandial plasma glucose increments to the overall diurnal hyperglycemia of type 2 diabetic patients. Diabetes Care 2003; 26:881–85.

Abstract: Objective: To compare the performance of children with mental retardation with and without Down's syndrome on Standardised Walking Obstacle Course. Method: A prospective comparative study consisted of 30 participants between the age group of 6-14 years. These participants were divided into 2 groups Mentally retarded with Down's syndrome and Mentally retarded without Down's syndrome. Standardised Walking Obstacle Course Test (SWOC) is used to measure stability and speed during gait in terms of time, number of steps, number of stumbles and number of steps off the path for each participant Paired , Unpaired t test and ANOVA were used for data analysis. Results: The time taken and the number of steps off the path was significantly more (p<0.01) in children with Down's syndrome as compared to children without Down's syndrome. The number of steps and the number of stumbles was also more (p<0.01) in children with Down's syndrome as compared to children without Down's syndrome. Conclusion: Overall the quality of functional ambulation is decreased in children with Down's syndrome as compared to those with Mental retardation in time, number of steps, stumbles and steps off the path.

Keywords: Down's syndrome, Mental retardation, Standardised Walking Obstacle Course

[1]. Tecklin Jan S Pediatric Physical Therapy, Fourth edition Lippincott Williams & Wilkins, Philadelphia chap. 10, pg 378;2008
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Abstract: Gingival recession is defined as "Displacement of soft tissue margin apical to the cemento-enamel junction". Gingival recessions require treatment for many reasons – impaired aesthetic appearance, root sensitivity, cervical caries or abrasion. Presence of gingival recession and gingival inflammation in areas with a lack or narrow band of attached gingiva is identified as a mucogingival problem. Periodontal plastic surgery procedures are performed to resolve these mucogingival problems. According to Miller, root coverage procedure is quite predictable and produces patient satisfaction. Present paper presents two cases of class I gingival recession (Miller's Classification) successfully treated with complete root coverage by free gingival autograft. Free gingival graft proved more effective and seems to be a promising treatment modality with the benefit of more stable results for class I gingival recession.

Key words: Gingival recession, root sensitivity, root coverage, mucogingival surgery, free gingival autograft (FGG ).

[1]. Chr. Popova, Tsv. Boyarova,Two-step Surgical Procedure for Root Coverage (Free Gingival Graft and Coronally positioned Flap) , Journal of IMAB - Annual Proceeding 2007.
[2]. Tugnait A., Clerehugh V,Gingival recession – its significance and management, Journal of Dentistry Vol.29, 2001, 381-394
[3]. Alparslan Dilsiz1, Tugba Aydin, Gingival Recession Associated with Orthodontic Treatment and Root Coverage, Journal of Clinical Experimental Denistry 2(1):2010; 30.
[4]. Wennström J, Mucogingival therapy, Annals of Peridontology, 1(1, 1996, 671.
[5]. Miller PD Jr, Regenerative and reconstructive periodontal plastic surgery, Dental Clinics of North America, 32, 1988, 287-306
[6]. Sullivan H, Atkins J, Free autogenous gingival grafts-Utilization of grafts in the treatment of gingival recession, Periodontics 6(4), 1968; 152.
[7]. Miller Jr P. Root coverage with the free gingival graft-Factors associated with incomplete coverage, Journal of Periodontology 58(10),1987, 674.

Abstract: The placental examination provides significant information related to intrauterine and perinatal death, Intrauterine Growth Retardation, malformations, infection and effects of maternal diseases on fetal growth. The Magnitude of clinical problem related to the development the function of placenta is so vast, that it is worth to undertake the histological aspect of human placenta A thorough examination of placenta is neglected and often underestimated by the physician gynecologist, pediatrician and pathologist in spite of its invaluable role in the fetal development. A sound knowledge of normal structure and development is highly essential to appreciate the pathological changes. Here I am presenting histological findings of 50 placenta at different gestational ages. present study was conducted in the Department of anatomy Sri venkateswara medical college, Tirupati in collaboration with the department of Obstetrics and Gynecology of maternity hospital Tirupati. small placental bits of fresh tissue of various gestational ages were collected from the Government maternity Hospital Operation Theatres and labour Rooms subjected for processing for histological studies. It is observed that In 33 cases of 6-12 weeks of gestation the histological observations of loose stroma, double layered trophoblast and small centrally placed foetal capillaries were observed. In 12 cases of gestation period between 13-24 week the histological findings are increased number of villi, scanty trophoblastic layer, large and peripherally placed foetal capillaries and less conspicuous Hofbauer cells. In 5 cases between 25 and full term the villi are numerous, with small syncytial knots, ill defined stroma, foetal capillaries are placed more peripherally and less number of Hofbauer cells

Keywords :Trophoblastic layer, Hofbauer cells , syncytial knots,fetal capillaries

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[8]. Fox H editor, 1978, Pathology of the placenta London 1978,Saunders.

Abstract: The gingival recession was evaluated in 400 subjects aged more than 20 years, looking for dental treatment at Rural Dental College and Hospital, Loni, Maharashtra, India. Clinical examination was conducted by a single examiner and analysis of four surfaces (mesial, buccal, distal and lingual) was done. The gingival recession was measured in millimeters from the cementoenamel junction to the gingival margin with the help of UNC-15 periodontal probe. The recessions were scored by the criteria suggested by P. D. Miller. The study showed the prevalence, extension and severity of the gingival recession increased as age advances. Class I and Class II gingival recessions were the most prevalent in subjects less than 40 years old whereas from 40-49 years of age class III gingival recession was more common, in subjects older than 50 years, class IV gingival recession was more prevalent and it was mainly of generalized in distribution. The mandibular teeth displayed more surfaces with gingival recession than the maxillary teeth and the mandibular incisors were the most affected. Such high prevalence of gingival recession in adult subjects demonstrates that dental professionals should provide attention to the clinical significance, etiologic factors and management of gingival recession.

Key words: Gingival recession, UNC-15 periodontal probe, cementoenamel junction (CEJ), gingival margin.

[1]. Caranza FA, Takey HH, Muco-gingival surgery In: Caranza FA, Newman MG (9 th ed). Clinical Periodontology, chapter. 59, pages. 651-671, (Philadelphia, Saunders Company, 1996).
[2]. Caudill RF, Oringer RJ, Langer L, Esthetic Periodontics (Periodontal Plastic Surgery) In: Wilson TG, Kornman KS, Fundamentals of Periodontics, chapter 26, pages 497-518, (Chicago, Quintessence Publishing Co. Inc, 1996).
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[5]. Albandar JM, Kingman A, Gingival recession, gingival bleeding and dental calculus in adults 30 years of age and older in the United States, Journal of Periodontology, 70(1), 1999, 30-43.
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[7]. Susin C, Haas AN, Oppermann RV, Gingival recession: epidemiology and risk indicators in a representative urban Brazilian population. Journal of Periodontology, 75, 2004, 1377-1386.
[8]. Beck JD, Koch GG, Characteristics of older adults experiencing periodontal attachment loss as gingival recession or probing depth.
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Abstract: Carotid stenosis is a major sequela of head and neck irradiation that has not received the attention it deserves. Its impact on the quality of life of patients can be substantial. This review discusses the incidence of radiation induced carotid stenosis and its role in prediction of stroke .Atherosclerotic changes of the common carotid artery(CCA) may appear like irregularities of the intima-media thickness (IMT) in B-mode ultrasound. Early detection can help to decrease or slow down the rate of prognosis of atherosclerosis and this can improve the quality, and increase the length of patient's life. The incidence of significant increase in carotid IMT following head and neck irradiation is seen. Patients with carotid stenosis are at increased risk for stroke. In this study,subjects with any other major risk factor for atherosclerosis were included . Subjects with previous history of cerebrovascular accidents were excluded.

Key words: Ultrasound, Carotid stenosis, Neck irradiation, Atherosclerosis, Intima-media, cerebrovascular accidents

[1] S.C. Elerding, R. N. Fernandez , J. C. Grotta , R.D. Lindberg, L.C. Causay, M. J. McMurtrey, Carotid artery disease following external cervical irradiation, Ann Surg,. 194 (5 ),1981,609-15.
[2] Framingham Heart Study: www.framinghamheartstudy.org.

[3] K. Abayomi Olubunmi, Neck irradiation, carotid injury and its consequences, Oral Oncol., 40, 2004, 872–8.

[4] L. E. Chambless, A. R. Folsom, L. X. Clegg, et al., Carotid wall thickness is predictive of incident clinical stroke: The Atherosclerosis risk in communities (ARIC) study, Am. J. Epidemiol., 151, 2000, 478-87.

[5] M. L. Bots, A. W. Hoes, A. Hofman , J C M Witteman, D. E. Grobbee, Cross-sectionally assessed carotid intima–media thickness relates to long-term risk of stroke, coronary heart disease and death as estimated by available risk functions, Journal of Internal Medicine, 245, 1999, 269–276.

[6] L. J. King, S. N. Hasnain, J. A. W. Webb, J. E. Kingston, E. A. Shafford, T. A. Lister, J. Shamash, R. H. Reznek, Asymptomatic carotid arterial disease in young patients following neck radiation therapy for hodgkin lymphoma, Radiology, 213, 1999, 167–172.

[7] N. M. C. So, W. W. M.Lam, P. Chook, et al., Carotid intima–media thickness in patients with head and neck irradiation for the treatment of nasopharyngeal carcinoma, Clin. Radiol., 57, 2002, 600–3

[8] M. Shariat, A. Alias, B. M. Biswal, Radiation effects on the intima media thickness of patients with head and neck malignancy the common carotid artery in post-radiotherapy, Postgrad. Med. J., 84, 2008, 609-612.

[9] Garima Khatri, Mohan Singh, Sunita Bika , B L. Mehta. Neck irradiation , carotid stenosis and carotid intima-media thickness as stroke predictor. IOSR-JDMS, 4(4),2013, 10-13.

Abstract: Submandibular suppurative sialadenitis occurring as an isolated lesion in the neonatal period is extremely rare. This report presents a rare case of isolated suppurative submandibular sialadenitis in a full-term newborn without any risk factors. Possible etiology, diagnosis and management of this uncommon disease are discussed.

Keywords: newborn, submandibular, sialadenitis

[1]. Greenberg MS. Salivary gland disease. In: Burkets Oral Medicine–Diagnosis and Treat-ment, 9th edn. Eds. Lynch MA, Brightman VJ, Greenberg MS. Philadelphia, J.B. Lippinott Co, 1994; pp 415-431.
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[4]. Brook I. Suppurative sialadenitis associated with anaerobic bacteria in newborns. Pediatr InfectDisJ2006;25:280.
[5]. Weibel L, Goetschel P, Meier R, Radivojevic V, Berger C. Neonatal suppurative submandibularsialadenitis.PediatrInfectDisJ2005;24:379-381.
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[7]. McAdams RM, Mair EA E , Rajnik M. Neonatal suppurative submandibular sialadenitis: case report and literature review. Int J Pediatr Otorhinolaryngol 2005; 69: 993-997.
[8]. Garavello W, Romagnoli M, Somigliana E, Zorloni C, Sordo L, Gaini RM. The intriguing association between prematurity and neonatal isolated submandibular suppurative sialadenitis. Int J Pediatr Otorhinolaryngol 2002; 62: 41-44.
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Abstract: Pleomorphic adenoma in adolescence is relatively rare. In buccal pad fat area these tumors are even rarer. A case of Pleomorphic adenoma of buccal pad area of 5 yrs duration, painless & slow growing is reported. The mass was removed by wide local excision & a follow up period of 1 yr with no recurrence has been noted. Pleomorphic adenoma should be considered in differential diagnosis of mass of the cheek in youngsters.

Keywords: Juvenile, Pleomorphic, Adenoma, Salivary, tumors

[1]. Rogerson KC: Salivary gland pathology in children.Oral Maxillofac Surg Clin N Am 7: 591–598, 1995
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[3]. Bablani D, Bansal S, Shetty SJ, Desai R, Kulkarni SR, Prasad P, Karjodkar FR: Pleomorphic adenoma of the cheek: a case report and review. J Oral Maxillofac Surg 2009, 67:1539-42.
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Abstract: The finding of E. vermicularis in appendectomy pathological specimens is infrequent. We report a case of acute appendicitis due Enterobius vermicularis in a middle aged adult. Acute appendicitis due to parasitic infection is rare. Clinical features of intestinal Enterobius infection can resemble acute appendicitis, though the patient might not have appendicitis .If E. vermicularis is found to be the cause of appendicitis on histopathological examination of the excised appendix though rare as in our case , the patient should be given anti helminthic post operatively.

Key words: Appendicitis, Enterobius vermicularis, helminth , intestinal, parasitic infection

[1] Aydin O. Incidental parasitic infestations in surgically removed appendices: a retrospective analysis. Diagnostic Pathology 2007;2:16.( PubMed)
[2] Eleni Efraimidou, Anthia Gatopoulou, Charilaos Stamos,Nikolaos Lirantzopoulos and George Kouklakis; Enterobius Vermicularis infection of the appendix as a cause of acute appendicitis in a Greek adolescent: a case report, Cases Journal 2008, 1:376 doi:10.1186/1757-1626-1-376 (Cases Journal). Chapters in Books:
[3] John Maa, Kimberly S.Kirkwood; The Appendix; Sabiston Textbook of Surgery18 th Edition,2009,2, 49 (1334).
[4] P Ronan, O Conell; The vermiform appendix; Bailey and Love's Short textbook of Surgery, 25 th edition2008, 67(1206). Journal Papers:

[5] Stavros Panidis, Daniel Paramythiotis, Dimitris Panagiotou, Georgios Batsis,Spyridon Salonikidis, Vassiliki Kaloutsi and Antonios Michalopoulos; Acute appendicitis secondary to Enterobius vermicularis infection in a middle-aged man: a case report,Journal of medical case reports. 2011, 5:559.( Journal of medical case report).

Abstract: Alkaloids, natural organic compounds present majorly in plants have been used in all culture as portion, medicine and poison. Vegetables are no exception; they contain varying degree of alkaloids. However, different processing methods are usually applied before consumption which may affect their alkaloids contents. Evaluation and effect of processing (blanching and juicing) were investigated on eight selected vegetables consumed in south western Nigeria. Standard Laboratory procedures were employed. Results showed highest level of alkaloids: in the fresh vegetable; Manihot esculenta 42.09±5.55mg/100d dry weight, in the blanched; Teleferia occidentalis 146.22±96.96 mg/100d dry weight while in the juiced vegetable Manihot esculenta leaf 296.69±61.02mg/100g dry weight. The lowest values were observed in the fresh; Amaranthus spp. (local name "Ebiden") 6.40±.47 mg/100d dry weight, in the blanched; Ipomoea batatas leaf 14.15±2.22 mg/100d dry weight and in the juiced extract; Amarantus cruentus 93.16±2.22 mg/100d dry weight. The study revealed that the alkaloids content of fresh vegetables varied while blanching and juicing increased its content.

Keywords: Vegetable, alkaloids, blanched, fresh and juice

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Abstract: Inflammatory Myofibroblastic Tumor (IMFT) belongs to a rare class of pseudosarcomatous benign inflammatory lesion. It usually affects young adults and children. Lung is the most common site. Mesentery, omentum, liver, spleen, colon are rare sites. We reported a case of 4 year old female child who presented with abdominal distension. On examination multiple masses were seen in small intestine, omentum, omental lymph nodes and few lesions even outside the abdominal cavity in lung. Resected part of small intestine on histological examination showed dense proliferation of spindle cells and inflammatory cells. Case was diagnosed as inflammatory myofibroblastic tumor. The follow-up of the case was uneventful.

Key words: Small bowel, pseudosarcomatous, inflammation

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Abstract: Developmental malformations of tooth can occur due to various environmental and genetic factors playing role while tooth development. It is not unusual to find two or more such malformations in a dentition and in a single tooth. Simultaneous occurrence of dens invaginatus and dens evaginatus (talon cusp) is rare and complex. Hence, proper diagnosis and treatment plan is important so as to achieve favourable prognosis. This paper will discuss about such a rare combination in light of review on its various aspects.

Keywords: Developmental malformation,; Dens Invaginatus, Dens Evaginatus, Talon cusp

[1] Neville BW, Damm DD, Allen CM, Bouquot JE: Oral and Maxillofacial Pathology. 3rd ed. Philadelphia: WB Saunders, 2008.

[2] Attur K.M, Shylaja, Mohtta A, Abraham S, Kerudi V. Dens invaginatus , clinically as talon cusp: an uncommon presentation. Indian J Stomatol 2011;2(3):200-03.

[3] Hulsmann M. Dens invaginatus: aetiology, classification, prevalence, diagnosis, and treatment considerations. International Endodontic Journal 1997;30:79–90.

[4] Munir B, Tirmazi S.M, Majeed H.A, Khan A.M, Iqbalbangash N. Dens invaginatus: aetiology, classification, prevalence, diagnosis and treatment considerations. Pakistan Oral & Dental Journal 2011;31(1):191:198.

[5] Dixit PB. Dens invaginatus : diagnosis and its treatment options. J. Nepal Dent. Assoc. 2010;11(1):82-84

[6] Alani A and Bishop K. Dens invaginatus. Part 1: classification, prevalence and aetiology. International Endodontic Journal 2008;41:1123–1136.

[7] Jaramillo A, Fernandez R, Villa P. Endodontic treatment of dens invaginatus: A 5-year follow-up. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:E15-21.

[8] Ferraz J.A.B, de Carvalho Junior J.R, Saquy P.C, Pecora J.D, D. Sousa-Neto M. Dental anomaly: dens evaginatus (talon cusp). Braz Dent J 2001;12(2):132-134.

[9] Hegde U, Mull J P, Danish G, Nabeel S. An uncommon dental anomaly: Talon cusp. World Journal of Dentistry 2010;1(1):47-50. [10 ] Bolan M, Nunes A.C.G.P, de Carvalho Rocha M.J, de Luca Canto G. Talon cusp: report of a case. Quintessence Int 2006;37:509-514.

Abstract: Aesthetic anterior tooth restoration is one of the greatest challenges for dentists in clinical practice. Patients expect contemporary dentistry to provide restorations that reproduce natural beauty while ensuring stability and functionality. The Fixed dental prosthesis fabrication requires equal consideration to be given to the retainer, pontic and connector design. The excessive flexing of the long-span fixed dental prosthesis, which varies with the cube of the length of span, can lead to material failure of prosthesis or to an unfavorable response. The size, shape, and position of the connector leads to the success of prostheses, as it prevent the distortion and fracture of the prosthesis. The conventional use of a non rigid connector aids in compensating for the difference in the resistance and retention form between the abutments. This paper describes a modified technique of restoring anterior aesthetics with non rigid connector.

Keywords – Fixed Dental Prosthesis, Non Rigid Connectors, Pier Abutment.

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