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The August Voice of Dentiana

January 2016 Vol. 1 Issue 1

E-JOURNAL only Pages: 142

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IDA

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An Official Publication of Indian Dental Association, Ludhiana Branch

L.E.D. E-Journal

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L.E.D. E-Journal January 2016 Vol. 1 Issue 1

Welcome
Basic Info &
Contact Us
Mission &
Vision
Aim & Scope
About Us
Information
The Stalwarts

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Dr. Ajay Kakar

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Dr. Sonali
Luthra Gandhi
& Dr. Komal
Majumdar
14. BRB Technique Style Dr. K. Varsha
Italiano A Case
Rao

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11 13
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15 16
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19 21
22 31
32 33
36
37 38

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Thank You
Congratulations
Best Wishes
Sneak Peek
Suggestions
Dr. Bhavdeep
Singh Ahuja
Dr. Sujit
Pardeshi
Dr. Gautam
Madan

IDA

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Insight into the Journal

Advisory & Editorial
Board
Acknowledgments
Welcome Messages
Foreword/s
Preface
Feedback
From the Editors
Desk
Practice Management
Need of the Hour
28 Hours a Day Be
the Master of Your
Time Part I
Diagnosing
Periodontal Disease
Easy or Tough
Sometimes Implant is
not the Answer A
Case Report

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FromTo
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Introduction

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9.

Details

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Contents Index

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45 51

61 73

75 82

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20.

Feedback
Appendices
Author Guidelines
DCI - Revised Code of
Ethics

Vol. 1 Issue 1

Prize Winning
E-Journal
For Publishing
Dental Council
of India

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121 122

124 125

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128 132
133 142

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18.

Access to Success
Part I
Digital Smile Designs

Making Smiles,
Transforming Lives
Resorbed Ridges A
Dr. Rohit
True Challenge to
Gupta
Treat
Maynes Space
Dr. Harsimran
Maintainer A Useful
Singh Sethi
Tool
Managing Better An Dr. Bhavdeep
Art and a Science
Singh Ahuja
Part I

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Dr. Mayur
Davda
Dr. Roheet
Khatavkar
Dr. Aslam
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15.

Report
Photodontics Part I

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Happy New Year 2016

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Merry Christmas

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L.E.D. EJournal
Lets Enjoy Dentistry, Ludhiana
The August Voice of Dentiana

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L.E.D. EJournal is the Official Monthly Publication of IDA

(Indian Dental Association) Ludhiana Branch, launched
w.e.f. 1st January, 2016. L.E.D. stands for Lets Enjoy
Dentistry. The name has no direct reference to any
individual, corporate, society etc. and is just a means to
inform and enlighten about the visual dentistry amongst
dental professionals & in particular, the IDA Members
through this medium. The contents in the L.E.D. E
Journal is for information purposes only. It is the users
discretion to follow the path & procedures enlisted within,
blindly or under proper guidance or using their own wit &
judgment and IDA Ludhiana holds no responsibility for the
same.
L.E.D. EJournal is the August Voice of Dentiana,
where the word Dentiana is a short combined word for
Dental (Dentists of) + Ludhiana. The Name L.E.D. E
Journal, Dentiana and the Logo are copyrighted
properties of IDA (Indian Dental Association) Ludhiana
Branch. The contents remain the property of the
copyright owner & all rights are reserved. Any misuse of
the name & logo for any purpose and without valid
permissions from the Editor, Publisher or IDA Ludhiana
Branch shall make the user at risk of violation under
copyright laws.
Published & Printed by: Dr. Bhavdeep Singh Ahuja on

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behalf of IDA Ludhiana Branch

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Owned by: IDA Ludhiana Branch

IDA Ludhiana Email: idaludhianajournal@gmail.com

IDA Ludhiana Websites & Mirror Links: www.idaludhiana.org,

www.idaludhiana.com, www.ludhianaida.com

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Editor-in-Chief: Dr. Bhavdeep Singh Ahuja

Vol. 1 Issue 1

IDA

Editorial Office:
Dr. Bhavdeep Singh Ahuja,
c/o Dr. Ahujas Dentech Smiles Dental Clinic & Implant
Centre, # 363-B, B.R.S. Nagar, Main Road,
Ludhiana 141 012
Punjab
INDIA
Tel: +91 161 5099 039
Mobile: + 91 98761 93039
Website: www.drbhavdeep.com (E-Journal available here also)
Email: drbhavdeep@gmail.com

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Templates Design: Nishtha Computers, Satya Printing,

Creative Publishing, Raju Cyber Print & Gagan Printing.
Templates Final Binding & Design: Creative Publishing
House & Raju Cyber Print.
Cover Page Design: Big Ideas Inc.
Cover Page Conceptualized, Designed & Compiled by:
Dr. Bhavdeep Singh Ahuja
Creative Framework & Lay out: Dr. Bhavdeep Singh
Ahuja, Dr. Navjot Singh Khurana & Dr. Manjot Singh

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Copyright2016 by IDA Ludhiana All rights reserved. No part

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of this publication may be reposted, reproduced, reprinted,

transmitted or otherwise used in any form or by any means,
electronic or mechanical, without the express written permission
from the Editor/Publisher. The opinions expressed in the articles
and advertisements are those of the authors/companies/ dealers
and dont necessarily reflect those of the Editor or Publisher or the
Members of the Editorial or Advisory Board of L.E.D. EJournal. IDA
Ludhiana makes every effort to report clinical information and
manufacturers product news accurately but cannot assume
responsibility for the validity of product claims or for typographical
errors. The publisher also does not assume responsibility for product
names, claims or statements made by advertisers. The views &
opinions expressed by authors/companies/dealers published in
L.E.D. EJournal are their own and do not necessarily reflect the
policy or position of the Editor or Publisher or the Members of the
Editorial or Advisory Board of L.E.D. EJournal. This E-Journal is
sent free of charge to IDA Ludhiana Branch Members via their email
and for others; it is available for free download from
www.idaludhiana.org, www.idaludhiana.com & from the Editors
personal website www.drbhavdeep.com (as a tribute to IDA Ludhiana
Branch).

Acknowledgments The Gyaan snippets & Images have been

copied from www.ida.org.in in the L.E.D. EJournal by IDA
Ludhiana, being a small tributary of the big river, the IDA Head
Office with the sole aim of creating awareness of IDA Head office
activities through an entertaining mode.

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P.S. It is essential to read this EJournal under a screen resolution

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of 1600 x 1200 dpi or more, and preferably on a 17" or bigger

monitor (as it contains several tables and high resolution graphics).
If the resolution is less than this, you may see broken or
overlapping tables/graphics, graphics overlying text or other
anomalies. It is strongly advised to switch over to this resolution to
read this EJournal. These pages are viewed best in Internet
Explorer 8 and above, Google Chrome etc. The IDA Ludhiana
websites have been constructed and maintained by IDA Ludhiana
Branch. You may want to give me the feedback to make this E
Journal better. Please be kind enough to write your comments/
feedback/suggestions & send it to the Editor-in-Chief, Dr. Bhavdeep
Singh Ahujas email at drbhavdeep@gmail.com. These feedbacks
would help us grow further & become better.

L.E.D. E-Journal

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About L.E.D.: L.E.D. E-Journal, is a multi-specialty & peer

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reviewed E-Journal coming out every month online free & print
on request and is a compilation of articles, case reports, research
reviews etc. published to provide a platform for the presentation
and criticism of interesting, innovative and thought provoking ideas
in dentistry. L.E.D. E-Journal is open to publish new, challenging
and radical ideas, along with re-publishing of any old but
contemporary ideas as long as they are logical, rational, coherent
and reasonably expressed. The re-publishing of the old cases would
however, be done with the prior permission & consent of the Author
& the Publisher and with proper acknowledgment to in the footnote
of the contribution itself. The main idea behind publishing not only
new but old & interesting cases is that India is a diverse country
with varied cultural & geographical distributions. Just to quote an
example here, that many a times, an interesting case report or a
dynamic study presented in Kerala (South) in a print journal might
not have its far spread reach in Punjab (North). We would like to
keep the number of scientific articles in the L.E.D. E-Journal to
around 10-12 per issue and would like it to be a medium for
discussing varied issues like ethics in dentistry, informed consent,
medico-legal issues in dentistry etc. as well. It is also indented to
present this as a form suitable to the general practitioner. The
journals
full
text
will
be
available
online
free
at
http://www.idaludhiana.org, http://www.idaludhiana.com & on
the Editor-in-Chief, Dr. Bhavdeep Singh Ahujas personal website
http://www.drbhavdeep.com. The E-Journal allows free access
(Open Access) to its contents. The print version of L.E.D. EJournal, however, would be available on request for the authors at
a nominal payment. Submitted papers must be in technical
English, suitable for scientific publication. All articles submitted
will be passed on to the members of the Editorial Board and will be
peer reviewed by them. Receipt of the manuscript will be
acknowledged by e-mail. Every effort will be made to complete the
review process within 2-4 weeks and communicated to the
corresponding author. The Editorial Board will strive for the quality
and will also try for indexing the journal in various indexing bodies
and if successful, the information will be updated on the IDA
Ludhiana website from time to time. We welcome all of you and we
hope you will consider L.E.D. E-Journal for your next submission.
Papers should be submitted to the Editor-in-Chief, Dr. Bhavdeep
Singh Ahujas email at drbhavdeep@gmail.com.

Mission & Vision: The mission of L.E.D. E-Journal is to serve

Vol. 1 Issue 1

IDA

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as a platform for stimulating, guiding, motivating & support young

upcoming dentists to rub shoulder to shoulder with senior
professional colleagues & thereby find a footing for themselves in
hard working, yet a lot competitive dental world. We wish to
promote research & developmental activities in the world of
dentistry, manifold. We also intend to increase the scientific
contribution & promote development of dentistry in Punjab
especially Ludhiana through increased exchange of knowledge &
ideas. L.E.D. E-Journal will strive to be a high quality medium
which aims to increase the understanding of new upcoming dental
technologies & revolutions every month, thus with the overall goal
of improving dentistry standards in Punjab especially Ludhiana.

L.E.D. E-Journal

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Aim, Scope & Research: L.E.D. E-Journal will cover technical

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and clinical articles, case reports, research reviews etc. related to

health, ethical and social issues in field of Dentistry. L.E.D. EJournal will comprehensively try to cover the frontier of trends in
dentistry and rapidly growing technologies. The aim of L.E.D. EJournal will be to contribute to advancing knowledge and
understanding of both theory and practice in dentistry, by
promoting high quality applied and theoretical research. The
primary audience of this publication comprises of the mass
general practitioners of Ludhiana, undergraduate students of the
three local dental colleges, the academicians and all other
dentists interested in up-gradation of dental knowledge through
research updates. The discipline of clinical dental research has
been undergoing changes in scope, methods, instrumentation
and technology which is driven by increased awareness of quality
health care in India as a whole and Punjab & Ludhiana in
specific. The changes in pattern of dental diseases have further
increased the scope of clinical research with shift in focus of
research
to
explore
unknown
etiological
factor
and
etiopathogenesis. The journal welcomes and encourages articles
from both practitioners and academicians. Articles with clinical
interest and implications will be given a preference. The journal
does not charge for submission, processing or publication of
manuscripts and even for color reproduction of photographs.

ISSN Number: Very soon we will be applying for an ISSN

ISSN 0317-8471
ISSN 1050-124X

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number for both online & print versions.

An International Standard Serial Number (ISSN) is an 8-digit
code used to identify newspapers, journals, magazines and
periodicals of all kinds and on all media print and electronic.
The ISSN role is to identify a publication & it is a digital code
without any intrinsic meaning and is associated with the title of
the publication. The ISSN takes the form of the acronym ISSN
followed by two groups of four digits, separated by a hyphen; for
e.g.;

IDA

L.E

ISSN for Online publications: The online publications are

usually not ISSN assigned ahead of publication unlike the print
versions. ISSN is assigned to online publications only after the
release of the first issue, provided that this issue contains a
significant number of articles. If it is considered that the first
issue has not enough articles for being regarded as an actual and
complete one, the ISSN assignment will be deferred. Regarding
open access scholarly publications, 5 articles are considered as a
minimum for making a complete issue. Journal should have a
valid URL (Online) address and cover a precise subject or address
a specific target audience.
[As per ISSN International Centre, Paris Guidelines]

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Indian Dental Association, Ludhiana Branch

There can be no achievement without action.
No action is possible without a plan.

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No plan can be made without a vision.

And no vision can arise without a dream.

About Us: Indian Dental Association, Ludhiana Branch was

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found in 1972 under the able leadership of Late, Dr. S. L. Thapar.

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After the formation of IDA Ludhiana, Late, Dr. S. L. Thapar

received honorary membership of Indian Dental Association.

Since its inception, IDA Ludhiana branch has hosted 13 State

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Dental Conferences and 2 National All India Dental Conferences;

the 49th Indian Dental Conference in 1995 and the 59th Indian

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Dental Congress in 2006. It has given three Vice Presidents and

two Presidents at national Level, Late Dr. D. K. Sabharwal in
1995 and Dr. Bhagwant Singh in 2005.

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Indian Dental Association Ludhiana Branch, like its Alma

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Mator, Indian Dental Association, Head Office & its immediate

parent, the IDA Punjab State Branch is an authoritative,
independent and recognized voice of dental professionals in
Ludhiana. We are committed to public oral health, ethics, science

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and advancement of dental professionals through its initiatives in

advocacy, education, research and development of standards. As
an authority on oral health, the association endeavors to meet the
public needs and expectations. We at IDA acknowledge that oral

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health is an integral part of general health and well-being.

Therefore, our aim is to lead the nation to optimal oral health. We

IDA

pledge our knowledge, experience and expertise for dental

excellence and the advancement of dental professionals. Your
collective support makes it possible for us to make a difference.
Become a part of our expanding family in case you have not
yet registered as a IDA Member.

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Mission: Our mission is to improve the oral health of the public

by innovation in education, training, research, advocacy and
related programmes. This translates into a commitment for dental
excellence. Therefore, IDA Ludhiana Branch is dedicated to
supporting dental professionals in their practice by enhancing,

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updating skills and knowledge.

IDA Ludhiana Branch like IDA Head Office & IDA Punjab State

Branch endeavors to accomplish its mission of optimal oral

health for all by:

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1. Supporting new scientific innovations to meet the changing

needs of society and promoting the well-being of the nation.

2. Preventing oral diseases by promoting oral health through

awareness and dissemination of information.
continuing

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3. Conducting

education

(CDE)

and

professional development programs to ensure an adequate

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number of talented, skilled and dental care professionals.

4. Coordinating and assisting scientific and research-related

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activities among all sectors of the dental community.

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5. Promoting the timely transfer of knowledge gained from

research to improve public health by educating oral health
professionals and policy- makers.

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Vision: IDA Ludhiana branch's vision like IDA, Head Office is to

improve oral health and quality of life and achieving optimal
national oral health for all by 2020. We also aim to represent the
dental profession and support members in the provision of

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comprehensive and quality oral health care.

IDA

Code of Ethics: The Code of Ethics is a set of principles of

professional conduct, a benchmark to which the dentist must
aspire when fulfilling their duties to their patients, public,
profession and colleges. It promotes ethical conduct, professional
responsibility and facilitates dialogue on common problems in
dental practice.

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Goal & Core Values: Our goal is to enhance the nations overall
health and well- being. IDA Ludhiana Branch like IDA Head Office
& IDA Punjab State Branch urges that oral health promotion,
disease prevention, and oral health care have a presence in all
health policy agendas set at local, state and national levels. We

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aim to inform the public and dental professionals on ways to

reduce the burden of oral disease through education, behavioral
change, risk reduction, early diagnosis and disease prevention
management. To set a criteria and strong foundations for

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evaluating the scientific evidence, promoting awareness and

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effective interventions by the following:

Science: Our programs and activities to support research,

research training, and information dissemination are scientific-

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based.

Trust: Our resources and programs are managed, conducted and

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evaluated to uphold the trust placed in us by the public.

Society: Our programs and actions improve the oral health of

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every citizen and eliminate health disparities.

a. Building strong and lasting relationships

b. Working in team spirit

responsibly

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strength.

2. Performance

with

integrity

and

demonstrating

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c. Acting

a. Delivering on our promise to the members and to the

public.

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b. Always ensuring excellence.

c. Working together and striving to delight the public with

care.

3. Passion
a.

Passion,

IDA

best preventive and interceptive solutions for oral health

dedication,

excellence

and

care

reflects

in

everything we do.
b.

We take our core values seriously. Our actions display our

values.

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Insight into L.E.D. EJournal

Dear Fellow IDA Members,
Here is a sneak peek into the L.E.D. EJournal:
1. The EJournal is in a safe, secure & encrypted PDF format & all

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the EJournal download website links (from IDA Ludhiana and

the Editor-in-Chief) are compatible with all the digital devices

viz. Desktop, Laptop, Tablets, All Cell Phones (with internet) &

i-Phones as well. The encrypted format is to ensure against

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plagiarism.

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2. The EJournal content has been watermarked and guarded

against printing so as the authors can feel safe whilst

publishing with us. However, Authors can request the Editorin-Chief for a printable copy for their record, inspection or any

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other purposes.

3. The print version of the EJournal would be available on

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request and payment (even for authors).

4. The size lay out of the EJournal is around 11" by 20" (A

normal A4 paper is 8" by 11") with body text size 20 and font

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Bookman Old Style.

5. The EJournal will be available on the IDA Ludhiana Websites

& Mirror Links and also on the Editor-in-Chiefs personal
website (www.drbhavdeep.com) and across all the member
emails (if provided and on request). So, if you still haven't

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updated your email id with Hon. Secretary/Hon. Treasurer,

please do so at the earliest.

6. It will be a monthly outing and would release around the first

week of every month.

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7. Each issue will have around 11 articles - 8 by the crme de la

crme (best of the best) of the dentistry (National Authors from

IDA

India) which includes some of the top notch speakers and 3

from the members of IDA Ludhiana Branch.

8. There will be some special issues in the calendar year (approx.

2-3), in which the volume of scientific content would be huge.

9. A few of the best known names are writing a series of articles as

well for the E-Journal.

10. The E-Journal will be available alone as

coupled/combined with the ENewsletter, Page 3
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Editorial Board
Editor-in-Chief: Dr. Bhavdeep Singh Ahuja
Associate Editors:

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1. Dr. Navjot Singh Khurana (Conservative Dentistry &

Endodontics)
2. Dr. Harsimran Singh Sethi (Pedodontics & Preventive
Dentistry)
Editorial Board:

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Advisory Board:

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A. Kumarswamy (Periodontics & Implants)

Adwait Aphale (Dental Photography)
Ajay Chhabra (Conservative Dentistry & Endodontics)
Ajay Kakar (Periodontics & Implants)
Gautam Madan (Oral Surgery & Implants)
Kanwal Bir Singh Kuckreja (Prosthodontics & Implants)
Komal Khatri Majumdar (Implant Dentistry)
Lanka Mahesh (Implant Dentistry)
Navdeep Saini (Conservative Dentistry & Endodontics)
Neeru Singh (Pedodontics & Preventive Dentistry)
Rajan Jairath (Orthodontics)
Sameer Kaura (Oral Surgery & Implants)
Sanghmittra Dasgupta (Oral Surgery & Implants)
Sumeet Rajpal (Pedodontics & Preventive Dentistry)
Surinder Pal Singh Sodhi (Oral Surgery & Implants)
Vijay Deshmukh (Oral & Maxillofacial Surgery)
Vivek Saggar (Pedodontics & Preventive Dentistry)

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Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.
Dr.

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1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.

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IDA

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1. Principal, Christian Dental College, Dr. Abi M. Thomas

2. Principal, Baba Jaswant Singh Dental College, Dr.
D.S.Kalsi
3. Principal, Sardar Kartar Singh Sarabha Dental College, Dr.
Rajesh Bhanot
4. President, IDA Ludhiana Branch, Dr. Tarun Kumar
5. Hon. Secretary, IDA Ludhiana Branch, Dr. Rajan Bir Singh
Thind
6. Hon. Treasurer, IDA Ludhiana Branch, Dr. Abhijit Kathpal
7. Immediate Past President, IDA Ludhiana Branch, Dr.
Jaidev Singh Dhillon
8. President-Elect, IDA Ludhiana Branch, Dr. Vandana
Chhabra
9. Dental Council Member from Punjab, Dr. Vikas Jindal
10. President, IDA Punjab State Branch, Dr. Pankaj Shiv
11. Hon. Secretary, IDA Punjab State Branch, Dr. Sachin Dev
Mehta
12. Dr. Puneet Girdhar - Past President, IDA Punjab State, &
Past Vice President IDA Head Office

L.E.D. E-Journal

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Editorial & Advisory Board, L.E.D. E-Journal The Selected 32 Gems & Pearls

Associate Editor 2, L.E.D.

Dr. Harsimran Singh Sethi
Pedodontics & Preventive
Dentistry

Dr. A. Kumarswamy
Periodontics & Implants
Editorial Board

Dr. Adwait Aphale

Dental Photography

Dr. Ajay Kakar

Periodontics & Implants

Dr. Gautam Madan

Oral Surgery & Implants

Editorial Board

Dr. Ajay Chhabra

Conservative Dentistry &
Endodontics
Editorial Board

Dr. Kanwal Bir Singh Kuckreja

Dr. Komal Majumdar

Prosthodontics & Implants

Implant Dentistry

Dr. Lanka Mahesh

Implant Dentistry

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Editorial Board

Dr. Navdeep Saini

Conservative Dentistry &
Endodontics
Editorial Board

Editorial Board

Dr. Neeru Singh

Pedodontics & Preventive
Dentistry
Editorial Board

Dr. Rajan Jairath

Orthodontics

Dr. Sameer Kaura

Oral Surgery & Implants

Dr. Sanghmitra Dasgupta

Oral Surgery & Implants

Editorial Board

Editorial Board

Editorial Board

Dr. Sumeet Rajpal

Pedodontics & Preventive
Dentistry
Editorial Board

Dr. Surinder Pal Singh Sodhi

Oral Surgery & Implants

Dr. Devinder Singh Kalsi

Principal, BJSDCH
Advisory Board

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Dr. Rajesh Bhanot
Principal, SKSSDC
Advisory Board

IDA

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Dr. Abi Mathai Thomas

Principal, CDC
Advisory Board

Dr. Vijay Deshmukh

Oral & Maxillofacial
Surgery
Editorial Board

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Editorial Board

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Editorial Board

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Editorial Board

Editorial Board

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Associate Editor 1, L.E.D.

Dr. Navjot Singh Khurana
Conservative Dentistry &
Endodontics

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Editor-in-Chief, L.E.D.
Dr. Bhavdeep Singh Ahuja
drbhavdeep@gmail.com
98761 93039

Dr. Vivek Saggar

Pedodontics & Preventive
Dentistry
Editorial Board

Dr. Tarun Kumar

President, IDA Ludhiana
Advisory Board

Dr. Rajan Bir Singh Thind

Honorary Secretary,
IDA Ludhiana Branch
Advisory Board

Dr. Abhijit Kathpal

Honorary Treasurer,
IDA Ludhiana Branch
Advisory Board

Dr. Jaidev Singh Dhillon

Immediate. Past President,
IDA Ludhiana Branch
Advisory Board

Dr. Vandana Chhabra

President-Elect.
IDA Ludhiana Branch
Advisory Board

Dr. Vikas Jindal

Member, Dental Council of
India (Punjab)
Advisory Board

Dr. Pankaj Shiv

President,
IDA Punjab State
Advisory Board

Dr Sachin Dev Mehta

Honorary Secretary,
IDA Punjab State
Advisory Board

Dr. Puneet Girdhar

Ex-Vice President,
IDA HO
Advisory Board

Vol. 1 Issue 1

L.E.D. E-Journal

Page 16

Acknowledgements for the L.E.D. Journal

I want to really thank the presently, BIG 3 of IDA Ludhiana from
the core of my heart - President, Dr. Tarun Kumar, Hon. Sec., Dr.
Rajan Bir Singh Thind & Hon. Treasurer, Dr. Abhijit Kathpal for
Journal with absolutely no interference whatsoever.

nch

giving me an absolute freehand in doing whatever I could for the

I would be failing in my duty, if I dont thank my dear friends,

seniors & peers in profession viz. Dr.s A. Kumarswamy, Abhijeet

nal

Bhasin, Adwait Aphale, Ajay Bajaj, Ajay Chhabra, Ajay Kakar, Ajay

Bra

Vikram Singh, Ajit Shetty, Akash Jain, Akshay Sharma, Amol

Thorat, Anant Pal Singh, Anil Kohli (Forensic), Aslam Inamdar,
Atamjeet Singh, Bikramjeet Singh, Devisri Yogarajan, Dinesh Rai,

Deepil Mehta, Gagan Bajaj, Gautam Madan, Gurneet Sandhu

our

(USA), Gursimrat Kaur Brar, Hardik Parekh, Haren Pandya,

Harpreet Singh, Harshil Shah, Harsimran Singh Sethi, Hetal Buch,

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Jaibin George, Jatin Kalra, Jasbrinder Singh Teja, Jigar Gala, K.

Varsha Rao, Kamal Malhotra, Kanwal Bir Singh Kuckreja, Komal
Majumdar, Lakshdeep Chopra, Lanka Mahesh, Mayur Davda,

hia

E-J

Mayur Khairnar, Moez Khakiani, Mona Kakar, Navdeep Saini,

Navjot Singh Khurana, Neeru Singh, Nigam Buch, Nikhil Churi,
Prabhpreet Singh Kaila (USA), Pratiek Gupta, Raghav Verma, Rahul
Vaid, Rajan Jairath, Rajeev Chitguppi, Rajeev Ranjan, Rajeev
Verma, Rajesh Ahal, Ramandeep Singh Brar, Ratandeep Singh

Lud

.D.

Ahuja, Ravi Sher Singh Toor, Ritu Ahal, Roheet Khatavkar, Rohit
Gupta, Rolly Jairath, S.P.S. Sodhi, S.V. Bhardwaj, Sahil Chawla,
Sameer Kaura, Sandeep Singh (Allahabdad), Sandeep Singh
(Ludhiana), Sanghmitra Dasgupta, Sanjay Jamdade, Sankalp

L.E

Mittal, Shekhar Kapoor, Shivani Bhatt, Sonali Gandhi, Sujit

Pardeshi, Sumeet Rajpal, Vijay Deshmukh, Vikas Jindal, Viney

IDA

Aggarwal, Vipul Srivastava, Virinder Goyal, Vishal Sharma, Vivek

Gaur, Vivek Sharma & Yamir Gopal amongst others without whose
help & support, L.E.D. Journal wouldnt have seen the light of the
day. Thats quite a list, but Yes, you ALL made it HUGELY
POSSIBLE for me to come up with this. I earnestly express my
sincere heartfelt gratitude for ALL of you.
I am extremely grateful to Dr. Alias Thomas, President, IDA

Head Office, Dr. Ashok Dhoble, Honorary Secretary General, IDA

Vol. 1 Issue 1

L.E.D. E-Journal

Page 17

Head Office, Dr. Pankaj Shiv, President, IDA Punjab State, Dr.
Sachin Dev Mehta, Honorary Secretary, IDA Punjab State for
extending warm welcome and bestowing us with best wishes on the
start of this New venture.
I am especially indebted to Dr. A. Kumarswamy, Dr. Abi M.

nch

Thomas (Principal, Christian Dental College, Ludhiana), Dr. Ajay

Chhabra (Principal, Bhojia Dental College, Baddi), Dr. D.S.Kalsi
(Principal, Baba Jaswant Singh Dental College, Ludhiana), Dr.

Harsimran Singh Sethi, Dr. Jaidev Singh Dhillon (Principal, Gian

nal

Sagar Dental College, Ram Nagar), Dr. KBS Kuckreja, Dr. Navjot

Bra

Singh Khurana, Dr. Neeru Singh (Principal, Desh Bhagat Dental

College, Muktsar), Dr. Puneet Girdhar (Ex-Vice President, IDA HO),

Dr. Rajan Jairath, Dr. Rajesh Bhanot (Principal, Sardar Kartar
Singh Sarabha Dental College, Ludhiana),

Dr. SPS Sodhi

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(Principal, DIRDS, Faridkot), Dr. Vandana Chhabra (PresidentElect, IDA, Ludhiana Branch), Dr. Vikas Jindal (Member, Dental

na

Council of India, Punjab), Dr. Virinder Goyal & Dr. Vivek Saggar in
for writing beautiful foreword for L.E.D. Ludhiana.

I sincerely thank Dr. Aman Goyal, Dr. Atamjeet Singh, Dr.

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E-J

Rajan Bir Singh Thind & Dr. Tarun Kumar for bringing in the
sponsors and at the same time, I thank our sponsors, M.D. Dental,
T & G, A.K. Dental Designs & Parm Projects without whose initial
help, this project wouldnt have been possible.

I would like to appreciate the efforts of Nishtha Computers,

Lud

.D.

Satya Printing, Creative Publishing, Raju Cyber Print & Gagan

Printing for helping me in initial designing and testing of the
templates for picking up the right compatible size for the EJournal. The efforts of Dr. Navjot Singh Khurana & Dr. Manjot

L.E

Singh are heavily due for helping me in the designing of the Cover
Page of both E-Journal & E-Newsletter. I would like to acknowledge

IDA

the great help imparted by S. Jagmohan Singh & S. Harwinder

Singh of Big Ideas Inc. in designing the cover page. I would be
failing if I dont mention the last 2 late night efforts well into early
morning before the launch by Creative Publishing & Raju Cyber
Print for final E-binding of the templates for a perfect output PDF
file.

Thank You One & All Once again.Dil Se

Vol. 1 Issue 1

L.E.D. E-Journal

Page 18

Messages from IDA, Head Office & Punjab State

Dr. Alias Thomas, President, IDA Head Office

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Regards,
Dr. Alias Thomas
President, IDA

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Im very happy to reach out to all of you through this

novel venture by IDA Ludhiana Branch.
This genuine step is indeed a very flattering one; even
weve to keep us abreast with the changing times. E
media is the in thing of todays generation. It is an
easy,
nature
friendly,
economical
mode
of
communication in todays world, where everyone is
busy, time bound, & do not have time for extensive
reading & speculation.
A journal is the mouthpiece of any Organization,
showcasing the latest updates in Dentistry, & its my
ardent wish that all the IDA branches continue in the
same trend.
My Congratulations once again to IDA Ludhiana
Branch.

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Dr.Ashok Dhoble, Hon. Sec. Gen., IDA Head Office

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Lud

IDA

L.E

.D.

E-J

I am happy to know that IDA Ludhiana Branch is

launching an E-Journal which will be the first in
Punjab by any IDA Branch with a secured, encrypted
PDF format available on the IDA Ludhiana website and
across emails. This will be a boon for members where
the newsletter will become a common link between
members, office bearers and IDA head office.
It is encouraging to know that you plan to feature
quality content material in the form of case reports,
dental articles, entertainment, quiz, kids corner etc
and slowly and effectively expand to make this a fullblown journal eventually. Although challenging, I am
sure your team will maintain high standards of quality
that a journal should have besides being innovative and
helpful, so that dentists can continually improve their
skills. IDA Members, members from the scientific
community and the dental trade industry should be
encouraged to contribute their articles etc to ensure
continued success of the journal. Your editorial team,
authors and readers are the strength of your
newsletter. I wish the collective contribution of all of
them will take your E-Journal on a long journey to
success and greater heights.
Congratulations to Dr. Bhavdeep Ahuja, Editor-in-chief
of this E-Journal and to the entire publication team
and branch members on this special occasion.
Yours sincerely,
Dr. Ashok Dhoble.
Hon. Secretary General.

Vol. 1 Issue 1

L.E.D. E-Journal

Page 19

Dr. Pankaj Shiv, President, IDA Punjab State

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Dr. Pankaj Shiv

President,
IDA Punjab State

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Dear Dr. Bhavdeep.

It gives me immense pleasure in congratulating
and extending my best wishes to you on the
moment of launch of E-Journal of IDA Ludhiana
branch. This will help IDA get rid of huge
publishing and printing expenses as well as other
energy consuming exercises such as postage etc
and give immense opportunity for knowledge
sharing. Please accept my best wishes and
support in any form, which I can extend on behalf
of myself as well as Team IDA Punjab.

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Dr.Sachin Dev Mehta, Hon. Secy. IDA Punjab State

hia

Lud

.D.

E-J

It gives me immense pleasure to congratulate

Ludhiana IDA branch on coming up with an
innovative idea of E-journal of IDA Ludhiana
branch. I would like to congratulate Dr. Bhavdeep
Singh Ahuja Good luck and prosperity as he has
set out to make his fondest dream come true.
Any member who is taking an initiative and
bringing up new ideas in our or any field should
be encouraged and full co-operation be given to
achieve new goals.
IDA Punjab State stands for and with progress
of every IDA branch. Success of individual
branches leads to a progressive state.

Vol. 1 Issue 1

IDA

L.E

Regards
Dr. Sachin Dev Mehta
Secretary IDA Punjab State

L.E.D. E-Journal

Page 20

From the Desk of the Top 3, IDA Ludhiana 2016

President, IDA Ludhiana, Dr. Tarun Kumar

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DearFriends,
I want to express my sincere thanks to all of you for bestowing this
honouruponme.Wehaveaveryyounganddynamicexecutiveteam
whichisfullofenergy.Atthefirstexecutivemeeting,itwasdecided
to start a newsletter of IDA Ludhiana. It will give a platform to all
members to express their opinions. We are on verge of holding our
firstContinuingDentalEducationprogrambyDr.VivekGaur.Wehave
plentyinstoreforyouthisyear.Istronglybelievetostrengthenthe
association we need to increase our membership base so presently
wearefocusingonbringingnewmemberstoourfold.HopeIandmy
team are able to live up to your expectations. We are counting on
your support and blessings. I really want to thank Dr. Bhavdeep for
turning this newsletter into a reality. What started as a dream for a
NewsletterisbeingnowlaunchedasafullfledgedEJournalcoupled
with a ENewsletter. Your suggestions and criticism are always
welcome.
Bye.........
Tarun

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Hony. Secretary, IDA Ludhiana, Dr. Rajan Bir Singh

Thind

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Lud

L.E

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E-J

1988wastheyearwhenijoinedBDSandinthesameyear,Ijoined
IDA as a Student Member. In 1993, I became a full member of IDA
Ludhiana Branch and after so many years on 3rd January, 2015, I
becametheHony.SecyofIDALudhianaBranch;thebranchwhichhad
conducted2NationalconferencesandmanyPunjabstateconferences
was in bad shape with only 35 IDA members. Under the dynamic
leadership of Dr. Jaidev Singh Dhillon, we took the membership to
250. My personal aim was to increase the level of dentistry in
Ludhiana by bringing world class speakers to Ludhiana and thus, we
conducted20CDEswithgoodnumberofparticipantsin2015andall
thankstothecooperationofdentalsurgeonsofLudhiana.
Circa 2016, Dr. Tarun Kumar took over as President and we are
launching this IDA Ludhiana Branch EJournal, a dream which was
startedasanENewsletterof4pages.IfeelcontentedandThankthe
Almighty that we have been able to tread on the chosen path. We
unanimously chose the Literary Dynamite of IDA Ludhiana, Dr.
BhavdeepS.AhujaastheEditorinChiefofthesamewhosewritten&
managerialskillsareexemplaryforallofus.Iwishhimallthesuccess
&luckinthisnewendeavour.
Regards
RajanBirSinghThind

IDA

Hony. Treasurer, IDA Ludhiana, Dr. Abhijit Kathpal

ItisamatterofgreatpleasuretobeapartofEJournalteamof
IDALudhianawithDr.BhavdeepS.AhujaasthefounderEditorin
Chief.
We as practicing dental surgeons are evolving every day in our
ownway.ThisEjournalwouldgiveauniformplatformtoall,to
putforthandsharepersonalexperiencesinourfieldwithothers.
Thiswouldnotonlyaddtothepracticalknowledgeoftheentire
dentalfraternitybutalsoincreasethegeneralawarenesstakingus
allahead.
I laud the efforts of team IDA Ludhiana for taking this initiative
andwishittheverybest.

Dr.AbhijitKathpal

Vol. 1 Issue 1

L.E.D. E-Journal

Page 21

nch

A Foreword is usually a short piece of writing sometimes placed

at the beginning of a book or other piece of literature like a

Journal. Typically written by someone other than the primary

author of the work, it often tells of some interaction between the

nal

writer of the foreword and the book's primary author. The

Bra

foreword may cover the story of how the work of art came into

being or how the idea for the same was developed, and may
include thanks and acknowledgments to people who were helpful

our

to the author during the time of writing.

A Journal or a book is lucky if it gets a foreword from

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one or two eminent personalities. L.E.D. E-Journal is blessed

that not one or two or three, but 17 Eminent Dentists of
Ludhiana/Punjab/India have written a foreword for it. I would

E-J

wish to personally thank each one of you with a Jadoo ki

hia

Jhappi as a token of gratitude as my associate Editor Dr.

Harsimran Singh Sethi aptly puts it to be the sweetest way of
thanking someone in kind. I stand with folded hands to

Dr.
Dr.
Dr.
Dr.

Harsimran Singh Sethi

Jaidev Singh Dhillon
KBS Kuckreja
Navjot Singh Khurana
Neeru Singh
Puneet Girdhar
Rajan Jairath
Rajesh Bhanot
SPS Sodhi
Vandana Chhabra
Vikas Jindal
Virinder Goyal
Vivek Saggar

L.E

5. Dr.
6. Dr.
7. Dr.
8. Dr.
9. Dr.
10. Dr.
11. Dr.
12. Dr.
13. Dr.
14. Dr.
15. Dr.
16. Dr.
17. Dr.

A. Kumarswamy
Abi. M. Thomas
Ajay Chhabra
D.S.Kalsi

Vol. 1 Issue 1

IDA

1.
2.
3.
4.

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thank each one of the following from the core of my heart.

L.E.D. E-Journal

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Dr.A. Kumarswamy, Member, Editorial Board, L.E.D.

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Continuing Dental Education is extremely essential to keep the

flame of learning burning bright. Any medium or podium of
sharingiswelcome.Thecliniciantodayiseagertopickupvaluable
tips&tricksfromseniorexpertstoenhancetheirpracticeskills.
In this endeavour, an option like IDA Journal is always very
welcome.Reviewofliterature,casereports,techniques,material
science,productprofiles,andtherestformthevaluedsubstance
and content of any journal. In my travels across the country, I
havefoundPunjabtobeabeehiveofscientificactivitiesoverthe
pastfewyears.
YoungsterslikeDr.BhavdeepAhujahavedoneourfraternity
proudbyembarkinguponstimulatingprojectslikethisEJournal.
He comes across as a very committed, unbiased and unabashed
evaluator of scientific evidence and merit. His respect for
literature&faithinexpertsexperiencewillpavethewayforan
excellent publication of which not only IDA Ludhiana but the
entirefraternitywillbeproud.

GoodLuck,Bhavdeep,mayyourtribeincrease.

BestWishes
Kumar

Dr.Abi M. Thomas, Principal, CDC, Ludhiana

Lud

IDA

L.E

.D.

Victorybelongstothemostpersevering.NapoleonBonaparte

I am privileged to be a part of Ludhiana IDA, because it has

wonderful leadership and the hallmark, I would say is
perseverance. This aspect can be seen in membership drive,
regularmeetings,continuingeducationalmeetingsetc.
To crown this aspect is the concept of the IDA LUDHIANA E
JOURNAL. It is going to give a platform for all the clinicians to
publish their clinical expertise and a systematic approach to
record,observeandfollowuptheircases.Iamsurethisjournalis
goingtotakeIDALudhianatonewdimensions.
I wish Dr. Bhavdeep Ahuja and the whole team my heartiest
congratulations and best wishes for this wonderful initiative to
havethevictorywiththeirperseverance.
Dr.AbiM.Thomas
Principal
ChristianDentalCollege

Vol. 1 Issue 1

L.E.D. E-Journal

Page 23

Dr.Ajay Chhabra, Principal, Bhojia Dental College

Baddi

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During the past few years many changes have occurred in the
clinical practice of dentistry. Discoveries have been made in the
etiology,preventionandtreatmentofdifferentoraldiseases.21st
Century dentistry is no longer the most dreaded experience
anyone can imagine, but mostly a pain free, efficient procedure
with a predictably successful outcome. Today's dentistry is
undergoingconstantchangeswithscienceandtechnologydriving
toitshigherlevel.Advancementindentalmaterials,productsand
techniques increasingly offer newer and better ways of creating
more pleasing, natural looking smiles. Further, advancements in
cost effective technology have made dental practice somewhat
smootherandmuchmorecomfortableinsofarasthepatientsare
concerned.
The purpose of issue of the journal is to inform our dental
colleaguesabouttheadvancementsoftheoriesandtechniquesof
moderndentistry.Thisissuehadbeenmadecompletedupdated
and expanded provide the latest clinics relevant, evidence based
knowledge.
I hope readers share our excitement about the truly new and
improved dentistry and our commitment to its practice. Dr.
Bhavdeepisaremarkableindividual,whoistailormadeforsuch
newerinitiativeswhicharejustperfectforhim.
BestWishes
AjayChhabra

Dr.D.S.Kalsi, Principal, BJS Dental College Ludhiana

Vol. 1 Issue 1

Lud

IDA

L.E

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Ludhiana branch of IDA Punjab has painstakingly carved a name

for itself in the country as being one of the consistently best
performing branches of the IDA family. Bagging honours at the
national and international level seems to now have become a
habit; and as habits die hard, the IDA Ludhiana branch has
decided to add another feather in its cap by undertaking to
publishtheIDALudhianaEJournal.Thisisabigventurebothin
termsoffinancesandmanhoursrequiredtobeputintoseethis
endeavourthrough.Pastthefirstfewweeksafterthepublication
ofthefirstissueofthejournal,thefreshnessofthisnovelidea
willbegintofade;thisiswhenthegritanddeterminationofthe
office bearer team will become more important than ever
before.Howeverthankfully,thenamesontheofficebearerslist
aremorethanreassuring.Theyareallyoungenergeticindividuals
keen to prove if anybody can do it they certainly can. The
presentPresidentoftheIDALudhianabranchDr.Tarun,Secretary
Dr. Rajanbir Thind and Treasurer Dr. Abhijit Kathpal are well
knownfortheirenterprisingqualitiesandsteadfastness.
The Editorinchief of the IDA Ludhiana EJournal, Dr. Bhavdeep
S. Ahuja is another highly gifted professional in the list whose
talents and capabilities extend far beyond dentistry. His friends
and colleagues have long enjoyed and benefited from his
recommendations, views and reviews that he eagerly posts at
L.E.D. E-Journal

Page 24

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variousoccasions.Withthejournalwillingtoacceptvariedinputs
in the form of case reports, reviews, presentations et; it will
certainly require a huge effort at editing. Our editorinchief, Dr.
Bhavdeep,asIknowhim,isfullycapableofhandlingthisall.
I, on behalf of all members of the IDA Ludhiana branch and our
sister branches extend good wishes to the office bearers of the
LudhianaIDAforthisnobleproject.IamsuretheIDALudhianaE
Journalwillimmenselybenefitoneandall.Iamalsocertainthat
the IDA Ludhiana Journal will receive whole hearted support
from all our colleagues and friends in the form of contributions
bothacademicandotherwise.

Dr.DSKalsi
PrincipalandProfessorofPeriodontology,
BJSDentalCollege,Ludhiana.

Dr.Harsimran Singh Sethi, Associate Editor, L.E.D.

Vol. 1 Issue 1

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IDA

L.E

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E-J

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Ireallyfeelprivilegedhavingbeenassignedthetaskofwritingthe
foreword for this new endeavor initiated by the IDA Ludhiana
Branch. At this moment, I would first of all, like to congratulate
wholeteam,especiallythePresidentofIDALudhianaBranchand
ourdynamicEditorinChief.
ResearchisimperativeforthegrowthinanyfieldofscienceandI
really appreciate the thought process of our President for taking
up such a prodigious effort to uplift the dental treatment
standardsinthecityofLudhiana.Thissetsaplatformforallofus
tocommunewiththerestofthestate/nation/worldthroughthe
medium of this EJournal. It would allow for sharing the
knowledge of experts from various fields all over India including
Ludhianaandhelpingusincorporatetheirskillsintoourpractices
aswellasenlightenothersastowhatwearecapableof.
IhadtorefertheEditorasdynamicearlyonbecauseofmylackof
properEnglishskills,butwhatIwantedtoemphasizewas,thathe
truly is a DYNAMITE. Handing him over the task of being the
Editorinchief,weallcanberestassuredthatthejournalwould
do wonders in relation to the quality of the content and the
standards of peer reviewing process. Following his facebook
updates (that I am a fan of) and credentials, one can expect
profoundinformationandindepthprocessingofeachandevery
scientificpieceofworkbeforebeingpublishedandincludedinto
thejournal.
WISHING TEAM IDA LUDHIANA ALL THE BEST FOR THIS NEW
VENTURE!!

Dr.HarsimranSinghSethi

L.E.D. E-Journal

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Dr.Jaidev Singh Dhillon, Principal, Gian Sagar Dental

College, Ram Nagar

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It is indeed good to know that IDA Ludhiana branch is shortly

launching its EJournal. Like as always, IDA Ludhiana is taking a
stepforwardandshowingthewayforacademicandprofessional
development.
Dr. Tarun is a dynamic president and Dr. Bhavdeep is the best
choicetobetheeditorofthisjournal.
Havingknownhimformorethanadecade,Iamconvincedofhis
sincerity and hard work. His indepth knowledge of all topics of
dentistryandinsightsoftheplanningneededtorunajournalare
wellknown.
I'm on the panel of many specialty journals and editor of a few
indexed journals also but the joy of being associated with IDA
LudhianaEJournalisspecial.Itwillbetheonsetofanincredible
journeyofsharingclinicalknowledgeandalearningplatformfor
allespeciallyouryoungerdentists.
I wish all the Best to Bhavdeep and I'm sure this will be a great
success.
JaiIDALudhiana.

BestWishes
JaidevSinghDhillon

Dr.K.B.S.Kuckreja, Member, Editorial Board, L.E.D.

Vol. 1 Issue 1

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IDA

L.E

.D.

E-J

IDA Ludhiana branch has been a trendsetter of sorts for dental

fraternityofPunjabandIndia.ThesettingupofEJournalofIDA
Ludhiana Branch is another step in sharing our evidence based
scientificandclinicalknowledge.Thisistheneedofthehour.The
coming together of diverse minds representing various clinical
specialtiescaninspirenewbenchmarksforclinicaltreatments.We
arelivinginadigitalworldandwishtohaveaninstantaccessto
knowledge,dataandEJournal,willfillourvoidstoupdateusand
help us contribute to shared pool of knowledge. This is also an
excellentplatformforsharingourproblemswhichmaybeclinical,
social,medicolegalandorganizational.
Todayitismyprivilegetointroducetoyou,TheEJournalofIDA
Ludhiana, new forum of our profession. Preparation of a new
publicationtakestimeandwholelotofeffortandthefirstissueof
this journal embodies industrious work by the EditorinChief, Dr
Bhavdeep S. Ahuja and generous support from the Branch
Executive committee. My sincerest appreciation is extended to
CoEditorsandMembersofEditorialCommittee.Isincerelywish
thatthisacademicandclinicaljournalwouldbeopentoalldental
andoralprofessionalsandtheirthoughtsandcasescanberapidly
reported,interdisciplinaryconnectionbepromotedandpurityof
evidencebasedscientificandclinicalknowledgerespected..
IwishtoconcludebyquotingfamouswordsofMattieStepanek,
Unityisstrengthwhenthereisateamworkandcollaboration
wonderfulthingcanbeachieved.

DrK.B.S.Kuckreja

L.E.D. E-Journal

Page 26

Dr.Navjot Singh Khurana, Associate Editor, L.E.D.

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At the outset, I would like to take this opportunity to

congratulatetheofficebearersofIDALudhianaBranchforthisunique
endeavor. Credit is due to the President and Secretary not only for
comingupwithsuchaninnovativeideabutalsoforchoosingtheright
person in Dr. Bhavdeep S. Ahuja to nurture this dream. I can
confidentlysaythattherecouldnothavebeenamoresuitableperson
thanBhavdeepforthechallengingandthanklessjoboftheeditor.
IhopethisEJournalhelpsincreasethespiritofbrotherhoodand
unityamongstourfraternityinmorewaysthanone.
The articles by the leading lights of the profession will give us
exposure to the rapidly advancing world of dentistry. The case
presentations by our own members will motivate our fellow
colleagues, especially our dynamic and talented youngsters to learn
more and challenge themselves to do better work. It will also help
increasetheconfidencelevelofourmembersandmakethembelieve
thattheyareinnowayinferiortodentistsdoinghighprofileworkin
metropolitancities.
Allthosewhohavereaddentaljournalsatanytimeintheirlife
would tend to agree with me that weve never been able to read
more than a couple of articles before putting the journal down.
Boredom invariably sets in after that. Another innovative concept,
Kidscorner,isnotonlygoingtogoalongwayinkeepingusengrossed
and our interest alive but will also provide our kids with a forum to
shed their inhibitions and showcase their talents, something which
theynormallygettodoonlyonceayearattheAGM.
Atthecostofrepetition,Iwouldagainlikeextendmybestwishesto
thePresident,Secretaryand,lastbutnottheleast,Dr.Bhavdeepand
onceagaincongratulatethemforaddinganotherfeatherinthecapof
IDALudhianaBranch.
Navjot

Lud

Dr.Neeru Singh, Principal, Desh Bhagat Dental

College, Muktsar

Vol. 1 Issue 1

IDA

L.E

.D.

Thebiggestobligationweallhaveafteraccumulatingtheknowledge
and skills in our professional life is to pave and craft new ways to
dissipate and share it with our fellow doctors and new budding
doctors.IamextremelyelatedandequallyproudthatDr.Bhavdeep
Ahujawhohastakentheinitiativeandleadinthisdirectionandisat
thebrinkofstartinganEJournalfortheIDA,Ludhianabranch.
Iamsureweallaregoingtobenefitfromthisendeavorandsupport
thecauseoffurtheranceofdentaleducationbynotonlyreadingand
imbibingliterature,butalsoshareourexperiencesandcontributein
thetext.
IhaveknownBhavdeepsincehisdentalcollegedaysandamhumbled
thatIhavecontributedinasmallwayinshapinghisfutureandgiving
himtheearlylessonsindentistry.
I hope the zeal and vigor of the this academic thought which has
peculateddownintheformofthisjournalachievesgloriousheights
andaddsanewdimensionintothepracticeofmainstreamdentistry
inthecity
Everygreatdestinationisaccomplishedbytakingthefirstsmallstep.
BestWishes
Dr.NeeruSingh

L.E.D. E-Journal

Page 27

Dr.Puneet Girdhar, Ex-Vice President, IDA Head

Office

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CongratulationsDr.Bhavdeep.Youmadeitagain.WhenIbecame
SecretaryofIDAPunjabState,alotofpositivedirectionswere
initiatedbyyouinbringingthedentistdirectory.
IhadbecomeStateSecretaryasamemberofIDALudhiana
branchandprogressofIDAbranchisalwayshearteningfor
me.ThehardworkofthosewhoteamedIDAinpastnevergoesin
waste.
Thereisnobettercommittedindividualforthisjobthan
Bhavdeepandhishardworknoboundsinsuchuntiringefforts.
WhosoeverthoughtofhimastheEditorinChiefneedstobe
applaudedaswellforthesame.Wishingyouallthesuccessyou
haveeverdreamedofinyourenterprisingnewstartup.

BestWishes
PuneetGirdhar

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Dr.Rajan Jairath, Professor & Head, Deptt. of

Orthodontics, CDC, Ludhiana

Vol. 1 Issue 1

hia

Lud

IDA

L.E

.D.

E-J

Itpleasuresusnoendtoseeourchildtakethefirstbabystep,we
waitwitheageranticipationforthisday.Today,thatbeautifulday
hasdawnedforIDALudhianaBranch.Undertheableguidanceof
President, Tarun Kumar, Hon. Secy. Dr Rajanbir S. Thind and the
verytalentedDr.BhavdeepS.Ahuja,IDALudhianaBranchenters
intoanewera,inkeepingwiththetimes.
It is an honour to write this foreword. As such, I
remember the tireless work done by the Past Presidents of IDA
Ludhiana Branch and the wholesome participation of each and
everymemberovertheyears.Thisisyourbranch,yourbabyand
all of us have to take care of it and make sure, it goes the right
wayforward.Theeldersarealwaystheretoguideandhelp.
Letsaimforhigherhorizons!!!!
AlwaysthereforIDALudhianaBranch.

BestWishes
RajanJairath

L.E.D. E-Journal

Page 28

Dr.Rajesh Bhanot, Principal, SKSS Dental College,

Ludhiana

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Itgivesmeagreatpleasureandasenseofsatisfactioninwriting
thisforewordtothismaidenissueofIDALudhianaBranchJournal
compiled and edited by Dr. Bhavdeep S. Ahuja, Editor for two
reasons. First all the contributions are by both junior & senior
colleagues.Iamextremelyproudofuniqueendeavoursespecially
by my junior colleagues. Secondly, Scientific knowledge duly
authenticated is always to be shared, only then it reaches up to
the bottom and its benefit goes to the masses. It further widens
thechannelofresearch.Itisastepintherightdirection.
Thedesignandpresentationofthisjournalisclearlucid&precise,
so congratulations to Dr. Bhavdeep S. Ahuja, EditorinChief &
other team members for this wonderful job. You have
accomplishedamilestone.Allthebestinyourendeavours.Three
CheersforIDALudhianaBranch.

DrRajeshBhanot
Principal,
SKSSDentalCollege&Hospital,Ludhiana

Dr.S.P.S. Sodhi, Principal, DIRDS, Faridkot

Vol. 1 Issue 1

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IDA

L.E

.D.

E-J

Dentistrytodayhasbeendemandinghigherlevelofexcellencein
skills and treatment because of increasing patient awareness;
hence it is must for the dental professionals to remain abreast
withtherecentresearches,advancementsbyconstantlearning.

Imustsay"Youaregrowingonlyifyouarelearning".

Whyanotherjournalinthefieldofdentistry?
Probably this question can be better answered by this quote
"NOTHINGCANBECHANGEDBYCHANGINGTHEFACE,BUTMANY
THINGSCANBECHANGEDBYFACINGTHECHANGE."

IDALudhianaEJournalasamonthlyissueisanexcellentattempt
tofulfillthisneed.IcongratulatePresidentIDA,Ludhianabranch
Dr.Tarunandhisdedicatedteamforthisendeavour.
The batton of this publication is in the hands of a person having
academicexcellence,managerialskillanddevotionDr.Bhavdeep
SinghAhuja.
I am sure the EJournal shall soon become popular amongst the
professionals. My sincere and special appreciation to Dr.
Bhavdeep Singh Ahuja, Editor in Chief for his painstaking and
tireless effort to start this publication. He has conceived this E
Journal with a broad vision and I wish his entire team a great
success.
BestWishes
Dr.S.P.S.Sodhi
Principal,
DasmeshInstituteofResearch&DentalSciences,Faridkot

L.E.D. E-Journal

Page 29

Dr.Vandana Chhabra, President-Elect, IDA Ludhiana

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It gives me immense pleasure to introduce you to the IDA Ludhiana

Journal.Itispublishedataveryspecialtimewhenthereisanupsurge
ofinterestinscience&researchinourprofessionalfield.Wecanall
benefit from the development of the thinking & dialogue in our
community about research & our developing relationship with the
worldofscience.Manypractitionershavecontributedtothecreation
&successofthisjournal.Iamverypleasedthatthisisthefirststepof
a continuing project of IDA to publish e Journal, which will be
effectivelybridgethegapbetweenscientificesoteric&practitioners
dailyneedforrelevantknowledge.
VeryspecialthanksgotoDr.Bhavdeep,EditorinChiefofthisjournal
who has worked for long time to see this journal come to fruition,
also Dr. Tarun, President and Dr. Rajan Thind, Secretary who have
workedtopullthisjournaltogetherinthelastmonths.
Itismyhopethatthisfinecollectionofarticlesandcasereportswill
beavaluableresourceforthereaders
BestWishes
VandanaChhabra
PresidentElect,IDALudhianaBranch

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Dr.Vikas Jindal, Member, Dental Council of India,

Punjab & Vice-President, Punjab Dental Council

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E-J

Ihavebeenimpressedwiththeurgencyofdoing.
Knowingisnotenough;wemustapply.
Beingwillingisnotenough;wemustdo!
LeonardodaVinci(14521519)andJohannWolfgangvonGoethe
(17491832)

Lud

IDA

L.E

.D.

ItgivesmeimmensepleasuretopentheforewordoftheEjournalof
IDA Ludhiana branch which is being published under the able
guidanceofoneofthemostinnovative,intelligent,conscientiousand
dedicated EditorinChief, I have known so far, who magnanimously
callshimselfas,Yourstruly.
IhaveknownDr.Bhavdeepforovertwodecadesandhaveseen
him grow as a speaker par excellence at various national and
international forums and as an astute clinician too. Ever since the
responsibilityofthisEjournalhasbeenbestoweduponhim,hehas
beenworkingtirelesslytowardsachievingofthisgoal.So,welcometo
the first issue of EJournal of IDA Ludhiana branch. The Journal will
publishoriginalworksandarticlesrelatedtoclinicalexperienceofthe
brethrenofourfacultyontheevidenceandopinionbehindnewand
existingtherapies.Afurtheraimwillbetodefinetheusageofthese
therapiesintermsofultimateuptakeandacceptancebythepatient
and healthcare professionals. This is an area that to date has been
somewhatneglected,andthePresidentDr.Tarun&SecretaryDr.RBS
Thind are to be congratulated for the launch of a new title that
addressesthesevitalissuesinanerawhenevidencebaseddentistry
is becoming ever more important. The content of the journal, I am
sure will be a broad one and, in this respect, represents a
considerablehelpandknowledgetoallinvolved.
Iamsurethisjournalisgoingtoachievegreaterheightsandwishthe
entireeditorialteammybestwishesforthesame.
Dr.VikasJindal

Vol. 1 Issue 1

L.E.D. E-Journal

Page 30

Dr.Virinder Goyal, Professor & Head, Deptt. of

Pedodontics, DIRDS, Faridkot

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IDA Ludhiana branch would like to present, with great pleasure, the
inauguralvolumeofthisnewscholarlyjournal.Thisjournalisdevoted
from theoretical aspects to applicationdependent studies and the
validationofemergingtechniques.
Thisnewjournalisenvisionedandfoundedtorepresentthegrowing
needsofdentalscienceasanemergingandincreasinglyvitalfield.Its
mission is to become a voice of the dental community, addressing
researchers and practitioners in areas ranging fromRestorative
Dentistry (Operative Dentistry, Dental Materials, Prosthodontics and
Endodontics), Preventive Dentistry (Periodontics, Orthodontics,
PediatricDentistry,PublicHealthandHealthServices),OralMedicine,
OralSurgeryandOralPathology.
TheIDALudhianaaimstoadvancethepracticeofdentistry
andcareofpatientsamongmembersoftheAssociationanddentists
intheregionthroughthedisseminationofinformationandresearch
findings in the field of dental science and technology.The Journal is
intendedasaforumforpractitionersandresearcherstosharedental
techniques and solutions in the area, to identify new issues and to
shape future directions for research. This inaugural volume is
devoted to dental research and the application of such research,
whichnaturallycomplementeachother.
Many researchers, Practitioners, faculty and institutions
have contributed to the creation and the success of this dental
Journal. I would like to congratulate everybody within that
community who supported the idea of creating a new journal on
DentalScience.Iamcertainthatthisveryfirstissuewillbefollowed
by many others, reporting new developments in the Dental science
field. This issue would not have been possible without the great
support and effort of the chief editor Dr. Bhavdeep Singh and all
Editorial Board members, and I would like to congratulate to all of
them. I would also like to express my gratitude and heartiest
congratulationstothePresidentDr.TarunKumar,SecretaryDr.Rajan
bir singh and all EC Members of IDA Ludhiana Branch, in particular
andallhavewhocontributedateverystageoftheproject.
It is my hope that this fine collection of articles will be a
valuableresourceforreadersandwillstimulatefurtherresearchinto
the vibrant area of Dental science andwill addresses timely
professionallearningissues.

Dr.Vivek Saggar, Member, Editorial Board, L.E.D.

Vol. 1 Issue 1

IDA

L.E

ThelaunchofanewjournalalwaysraisesaquestionOnemore?

ButthismonthlyEjournal&Newsletter,Ibelieveisaspecialinitiative
whichdistinguishesitselffromotherIDApublications.Everyonetoday
ismoreinterestedinlocalhappenings&developments.Thisjournal&
newsletterwouldprovideaperfectplatformtopromotelocaltalent
as well as showcase nationally & internationally, professional
excellenceofLudhianadentists!
It is a great initiative which needs to be lauded & appreciated
wholeheartedly. My good wishes are with the team & pray for the
grand success of this Journal & newsletter. I am sure this journal
would be a trendsetter and would bring the Ludhiana IDA family
together!

L.E.D. E-Journal

Page 31

PREFACE
With the dawn of a New Year 2016, IDA Ludhiana has
taken another bold and new initiative, the launch of a premier EJournal/Newsletter. This is the first of its kind in IDA Punjab

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amongst the 21 IDA Punjab State branches and probably one of

the very few in North India as well.

It is a dream project of the New Incoming IDA

Ludhiana President, Dr. Tarun Kumar and a vision of the other

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Big Two of the IDA Ludhiana right now along with the President

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The Honorary Secretary, Dr. Rajan Bir Singh Thind & the

Honorary Treasurer, Dr. Abhijit Kathpal. I would be lying, if I

dont admit that I was at first shocked when they first announced
me

as

the

Editor-in-Chief

of

the

IDA

Ludhiana

E-

our

Newsletter/Journal in the 2nd Executive Meeting of IDA Ludhiana

Branch. After having reposed so much faith by them and the

na

whole Executive committee, for such a premier thing, I felt as if

the whole world was at my feet & I now better deliver the goods.

E-J

The initial plan was to launch a Local Newsletter only with

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gradual evolving into a full time Journal; but as things went on

from one step to another, I suddenly felt my foot in the door as it
from a newsletter initially, it started taking the shape of a Mini
Journal with all my good friends and references contributing to

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the new venture and surprisingly into a full blown Journal and

.D.

my journey changed from a miniscule task to a mammoth one.

It was indeed a Herculean task for me to plan the lay out,

design the same, and at the same time, request for articles from
good friends, references; take care of the other initially planned

L.E

sections and fortunately for me, all planned things worked out
pretty well.

IDA

Amongst all, the most difficult part was editing out the

scientific content, for which my one foot was in my clinic and

other at the designing office for getting templates made according
to the author submission; editing them and then repeating the
same process all over again till it reached perfection. A 3-4 page
newsletter would have been a pretty easy task; but IDA Ludhiana
known for its courageous attitude chose the hard way and

Vol. 1 Issue 1

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Page 32

instead has come out with almost a full fledged Journal with
awesome Scientific & literary fest of sorts.
Amongst the most interesting part was the selection of the
title of the Newsletter/Mini Journal. The call for title was made
from IDA Ludhiana Members and pretty interesting titles came up

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and the number of title suggestions received was above 70. The
winning title L.E.D. (Lets Enjoy Dentistry) Ludhiana was

eventually decided by the maximum votes for a particular title

received from selected Executive Members & a few seniors in the
choice).

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profession (they were requested to send 3 titles as per their

Briefly walking through with you about the content of the

L.E.D. Ludhiana, it has a Scientific Section, events from IDA

our

Ludhiana Branch, Kids Corner, Entertainment zone and the

Corner aka HeartSpeak Dil ki Baat. Heartspeak Dil ki Baat

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is a relatively new entity introduced wherein 3-4 experts/Senior

Pros will give you a heart to heart talk about any current issue,
be it Dentistry or any current burning issue.

E-J

I want to really thank the presently, BIG 3 of IDA Ludhiana

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from the core of my heart - President, Dr. Tarun Kumar, Hon.

Sec., Dr. Rajan Bir Singh Thind & Hon. Treasurer, Dr. Abhijit
Kathpal for giving me an absolute FREEHAND in doing whatever
whatsoever.

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I could for the Journal with absolutely NO INTERFERENCE

.D.

I would be failing in my duty, if I dont thank my dear

friends, seniors & peers in profession viz. Dr.s A. Kumarswamy,

Ajay Kakar, Aman Goyal, Atamjeet Singh, Gautam Madan,

L.E

Harsimran Singh Sethi, Kanwal Bir Singh Kuckreja, Kirandeep

Gill, Mona Kakar, Navdeep Saini, Navjot Singh Khurana, Rajan

IDA

Jairath, Ratandeep Singh Ahuja, Rohit Gupta, Rolly Jairath &

Sanjay Jamdade amongst others without whose help & support,
L.E.D. Ludhiana wouldnt have seen the light of the day.
So, here I, present before you, the IDA Ludhiana

Premier Venture, its first Journal - L.E.D. Ludhiana Lets

Enjoy Dentistry and have some Fun.

Vol. 1 Issue 1

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Page 33

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Vol. 1 Issue 1

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IDA

L.E

.D.

E-J

Happy Makar Sankranti

L.E.D. E-Journal

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1st December World AIDS Day

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The Past (2015) & the Future (2016)

E-J

New Horizons & New Beginnings

Vol. 1 Issue 1

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IDA

L.E

.D.

26th January Happy Republic Day

L.E.D. E-Journal

Page 35

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Your (the readers) opinion matters to us the most. For striving to improve

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continuously, we solicit your earnest support in the form of suggestions. The

suggestionscanbebrickbatsorbouquets.Bothwilllappedupinequalmeasureby
us.Theremightbeareaswhere,intryingtonotputawrongfootforward,wehave

our

treaded the safe path/zone, however, in certain other sections; we might have
ruffled quite a few feathers. We do request you to just put in a few lines at the

2.

Thelayout

3.

Thecontent

4.

OthersectionsoftheJournal

5.

TheNewsletter

6.

ThecontentsoftheNewsletter

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Thedesign

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1.

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Editorsemaildrbhavdeep@gmail.comregardingwhatisyouropinionabout:

Thesuggestions/feedbackbythememberswouldbepublishedwithduecreditsin

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.D.

thenextissueoftheL.E.D.Journal.However,iftheBranchMemberwishestokeep
his/heridentitysecret/hidden,thesamewouldbegivenarespectandthefeedback
publishedundertheheadingAnonymous.

Pleasegetgoing,pickupyourfingerandtypeoutyoufeedback/suggestionsto

IDA

L.E

theEditor,Dr.BhavdeepSinghAhujaatdrbhavdeep@gmail.com.

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Page 36

From the EDITORs Desk

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Dr. Bhavdeep Singh Ahuja graduated in 1998 & has specialized in Implants from
BioHorizons Inc. USA in 2004-05 & in Advanced Course from LACE-ICOI, USA
in 2006. Apart from Dentistry, he holds a Triple M.B.A. in Hospital Management,
Human Resources & Marketing from three premier Institutes/Universities of
India viz. the IIMM, IGNOU & Annamalai University. He holds a Post Graduate
Diploma in Medical Law & Ethics (NLSIU), Clinical Research, Cyber Law,
Disaster Management, Financial Management, Bioinformatics amongst many
more from different Universities. He is a Certified Health Care Waste Manager
from IGNOU & is qualified in Consumer Law as well. He is an academically
oriented dentist & has many Original Scientific Publications to his credit in
many International & National journals. Presently, he is into 17th year of Clinical
Practice in Ludhiana, Punjab.

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Dear Peers in Profession, Colleagues & My Dear Friends,

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With the dawn of a New Year 2016, IDA Ludhiana has taken giant
strides; the perfect example being this E-Journal for Dentistry.

Since we all are subscribed to either in print or online, a

our

plethora of scientific content around us every month and also

from IDA head office so much so that occasionally, some are
rarely opened as well and go to your store or the raddi waalah in

na

3 months time.

Now, the question which will ponder everyone is what is so

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different about L.E.D. Journal:

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Will it be lying in your inboxes in your private email?

Will it keep lying on IDA Ludhiana website unattended & unread?

Will the L.E.D. E-Journal be a 100 crore or a 200 Crore movie as
they say in Bollywood? or

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Will it be one of the also ran or also published journals?

.D.

Will it really have any practical utility to the General Practitioners

which form the bulk of Dentist Practice of Ludhiana?
Will it have only long & boring scientific content or will there be
something different also?

L.E

Will I get updated really as the manufacturers (IDA Ludhiana

IDA

Branch Bigwigs) or the Big guns in the foreword claimed?

Is it really going to enhance my dental practice in any way?
Will your spouses or kids have something to look forward to
L.E.D. E-Journal?

What will be the eventual fate of L.E.D. E-Journal?

My take is that the answer for the majority of the
questions would be lying in the hands of Mango People or the
Aam Junta or the Common Dentist who are our target
Vol. 1 Issue 1

L.E.D. E-Journal

Page 37

audience. We have done a lot of hard work and the rest lies in the
hand of the readers.
My answers would seem like a typically clichd response as if,
it is a voice of every small time producer who wants to make it big
in Bollywood. However, long does a film take in making, however,

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big the project, the star cast & the budget; its the Mango People

which decide the fate on a particular Friday, in our case, the

Eventful Sunday, 20th March.

No matter, how much have we worked hard, it is a given

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that, if the content is not up to the mark, it would be rejected

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impromptu. If we cant deliver what we promised, the whole

journey is going to be one full of flaws and however, positive the

reviews might be, its ultimately the solid content which does the

our

talking eventually. I am pretty confident about the content myself,

since, I have myself lectured on totally different (almost Non-

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dental) topics in Dentistry at various platforms & forums (read

conferences) and I feel that I have the vision of a common man
who dares to see the things in an unflinched, uncomplicated,

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compact and yet, a simplified way.

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L.E.D. E-Journal promises to have something for

everyone. I am a big fan of Bollywood myself, in particular the

Manmohan Desai cinema of 80s which, without overall binge of
anything in large had a dash of action, a tinge of romance, a bing

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of suspense, a hue of mystery, a tincture of tragedy, all rolled into

.D.

one and served as a sumptuous dish and lapped up quickly by

the hoi-polloi (The Aam Junta). The apt word which I have been
using for the combination of the above is a Masalathon which I

L.E

feel fully describes the L.E.D Journal in one word. We are more
like a commercial movie with a solid script. However, we still need

IDA

your support for this venture and your bouquets & brickbats both
would be welcome in equal measure.

Positively speaking & hoping that luck is in tow, we are

starting from the shallow zones & for us the only way is UP, UP &
only UP. However, for my well-wishers, it is a no-brainer, that we
are here to STAY.

Thank You, See you in next issue!!!!!

Bhavdeep
Vol. 1 Issue 1

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IDA

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Page 39

Practice Management
Need of the hour

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India's leading practice management Guru, Dr Sujit Pardeshi is a well-known

dentist, author, management trainer and public speaker. He is certified
National Trainer of Junior Chambers International University, California USA
for soft skills & management skills. He is conferred the status of Designer
Trainer by Junior Chambers International. He has also completed his MBA in
human resource management. His two days practice management & soft skill
training course Dent-XL designed exclusively for dentists is very popular
across the country and is the 'only one of its kind' course. He can be reached
at www.drsujitpardeshi.com or +91 72 76 75 79 75.

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INTRODUCTION

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Author: Dr. Sujit Pardeshi

Practice management is an art as well as a science, just like

dentistry. It is a skill that must be acquired and nurtured by

our

every practicing dentist. After being conducted many lectures and

courses on this subject across the country Ive overheard this

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sentence, Why I need to learn practice management? I know it

already or I already have a great practice and I dont need
practice management. This is the commonest reaction of many

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dental practitioners when you talk about practice management

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with them. They think that practice management comes naturally

with time and you get better as you practice for more number of
years. This is terribly wrong. The problem with the experiencebased learning is you have to spend lot of time and efforts before

Lud

.D.

you acquire the expertise. You may get it right in the end but the
price paid for it might be too much. And because the loss is not
quantifiable easily, you normally tend to ignore it. I firmly believe
that practice management is an art which must be acquired

L.E

professionally and proactively. A small professional touch can

make a big difference in the outcome. Dental practice is a

IDA

profession from which you make living, you make life, get
recognition and create wealth. So earlier you learn the art of
practice management, faster youll be able to achieve everything
you desire. Practice management is not only about making more
money but it is all about living a great life. A life maintaining the
much needed BALANCE in everything you do and enjoying it to
the fullest.

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One of the biggest benefits of learning the art of

practice management is things become very easy to handle, to
manage and to execute. Many practitioners find it difficult to
manage things like handling staff, patients & their objections,
financial side of dental practice, managing time etc in routine

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practice. It ultimately adds lot of stress to their life which

invariably affects their health as well as family life and in spite of

working very hard, they are not internally happy. No wonder,

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dentists are few of the most stressed people of the society.

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DENTISTRY in 21st CENTURY

Dentistry has become more demanding and challenging in this

modern age. The advances in technology and modernization have

our

completely changed the way dental practice is done. The

increased awareness about dental care among the patients has
more

challenges

to

the

profession

in

this

na

added

era

of

information. Patients today are more informed but less loyal,

more skeptical but less trusting which makes a dentists job even

hia

E-J

tougher. It has become mandatory to keep yourself updated with

every new thing. The modernization of dental clinic has also
added more expenses on a daily basis. The increasing material
cost, purchasing the latest equipments, increasing expenses on
staff salary, data maintenance, record keeping and lab expenses

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.D.

adds lot of overheads to the expenditure. Practicing dentistry is

really becoming difficult with every passing day.

THE VILLON - COMPETITION

L.E

Increasing number of dentists resulting in cut-throat competition

dentists

are

IDA

is the biggest problem now days. In our country, almost 25000

graduating

every

year.

There

is

tremendous

competition and struggle for survival. In order to reduce the

overheads & also to attract more number of patients, the easiest
way for a general dental practitioner is to lower the treatment
charges. This is not only reducing the quality of dental treatments
for the patients but also spoiling the name of the profession. Just
to have more patients and flourishing practice, dentists are
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unfortunately using even unethical ways to attract patients. In

such situation, nobody is winning. Everyone is searching for
possible ways to overcome this. Unfortunately, there is no light
seen at the end of the tunnel.

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THE REAL SECRET

I strongly believe that instead of entering into this rat race of

competition, it is always better to grow yourself clinically as well

as personally. Indeed, you should focus so much on self

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development so as to reach a height where you should become

incomparable & your practice should become competition proof. It

our

might sound very difficult but it is certainly achievable.

The problem is every practicing dentist concentrate only on

na

improving clinical skill but one should never ignore the marketing
and management part of a successful dental practice. We spend

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lot of years, money and efforts for learning professional skills.

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Lud

.D.

What about marketing and management?

The diagram above wonderfully explains the importance of all the

L.E

3Ms for successful dental practice. Marketing is the soul of every

business and dentistry is not immune to it. Effective marketing

IDA

would help patients to choose you for their dental problems over
others. Once the patient comes to your clinic, it must be
remembered that unless patient accepts your treatment plan you
cant show your clinical expertise to him. This role is played by
2nd M i.e. management. An important part of management is
conducting successful patient consultation using the soft skills
effectively. As the diagram shows, it is the soft skills coupled with

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Page 42

your effective marketing makes the base of the triangle and on

this foundation, the apex of treatment opportunity lies. This
means that none of these three things is less important.
Professional mastery is what ultimately makes patient happy at
the end of treatment but it all begins with soft skills or

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management & marketing.

SUMMARIZING

It is your imperial duty to do the best possible treatments for the

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patients but at the same time learn to balance personal and

financial life along with your profession. Many dentists are very
good clinicians but not so good businessman simply because they
do not understand the business of dentistry as it is never taught

our

professionally in dental schools. So you must learn all the

principles of practice management in order to have a great career

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in this wonderful profession. Practice management is really the

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need of the hour!

P.S. Any feedback/compliments/queries for the Author should be

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emailed to the Editor-in-Chief, Dr. Bhavdeep Singh Ahuja at his

Vol. 1 Issue 1

IDA

L.E

.D.

email id: drbhavdeep@gmail.com

L.E.D. E-Journal

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Vol. 1 Issue 1

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L.E

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Pehla Gyaan

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nch

Dr. Gautam Madan is an Oral and Maxillofacial surgeon in private practice in

Ahmedabad and practices the full spectrum of Oral and Maxillofacial surgery
as well as advanced dental Implant procedures. He runs a large multi-specialty
dental clinic at Ahmedabad with in-house OT setup and hospital facilities. He
is also attached to many hospitals and clinics in Ahmedabad. He has a passion
for teaching and is an invited speaker at state and national level. He has many
research articles published in reputed state, national and international
journals. He has designed and patented a dental implant and is in the process
of developing it. He is active in IDA and just completed his term as President
of IDA Gujarat and is currently the central council member of IDA Head
Office. Dr. Gautam Madan is fond of writing and has written 4 books and
published them in an e-book format on Amazon Kindle and other platforms.

28 Hours a Day

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Be the Master of Your time Part I

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INTRODUCTION

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Effective Strategies to do more & take control of your life

Author: Dr. Gautam Madan

Are you among the 90% of people who feel stressed out?

na

Do you too feel you have too much work to do and so little time?
Is the clock your enemy?

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Do you feel 24 hours per day are not enough?

hia

Congratulations.

Not because you are stressed from too much work and lack of
time.

.D.

say:

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But I congratulate because you have risen above the average who
I am definitely going to take a course on time management... just
as soon as I find the time for it!

You are special: You are among the rare 2% of people: people who
for it.

IDA

L.E

come to know they have a certain problem AND they take action

This article is full of practical suggestions to help you manage

your time better. You know the value of time: you want time to
work for you and not the reverse. You need to manage your time
well to be successful in life.

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Henry Ford once very aptly remarked: It has been my

observation that most people get ahead during the time that
others waste.
So we will too not waste more time in introduction, and let us get
day for you, let us find 28 hours per day!
WHY DO PEOPLE NEED 28 HOURS PER DAY?
1. To achieve goals.

nal

2. To feel a sense of control.

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3. To reduce stress.

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serious about time management. Let us find 4 more hours per

4. To allocate time to activities those are important.

5. To feel a sense of balance.

our

6. To reduce effort.

8. To feel that you have a choice.

9. To be efficient.

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EXERCISE 1:

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7. To enjoy life.

1. Take some time to think over the reasons I have given in

this chapter as to why you should be efficient in managing

Lud

your time.

.D.

2. Select which ones apply to you, you can even think of some
new reasons.

L.E

3. Write this down in two places.

4. One write it on a piece of paper, or a diary, or on your

IDA

Smartphone which you carry at all times and two write it

down in a special book you will use to do the exercises
mentioned at the end of each Phase.

5. This is your prime motivation, and you need to keep this

with you all the time, refer it again and again. Maybe every
hour, or at least twice a day: when you start your day and
when you finish your day.
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TIME MANAGEMENT AND YOU

Time is a human invention.
We have not only invented time and its various measurements
(seconds/ milliseconds, days, centuries, millenniums); but we're

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also able to give meaning in the usage of time when an experience

was felt or when a task was done.

The concept of time has been instrumental in the progress of

human society. We have birthdays, wedding dates, anniversaries,

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and other special dates to recognize important events, as they

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signal significant changes or developments in our lives. Medicines

and food products have expiration dates, which give us the time
period to use them within their period of potency and safety.

We have created working periods in which human efficiency and

our

environmental conditions are considered to maintain balance.

The importance of rest and sleep and our body cycle is considered

na

in the creation of our work, play, and learning schedules. Thus,

we are able to measure and define things according to their

E-J

proper space in what we measure as time.

hia

The improper use of time, the wrong utilization of resources, or

the undertaking of unnecessary tasks within a given period might
cause delays or time wastage. Most people also commit mistakes
because they're not able to accurately perceive the proper time to

Lud

do a given work, or because of unforeseen circumstances and

.D.

delays. In these cases, we must consider the best ways to utilize

our time. We must expect the limits of time in defining our tasks
and goals.

Time is constant: 60 seconds per minute, 60 minutes per hour,

L.E

24 hours per day, 7 days a week (24/ 7). However, the usage of

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time differs among each individual. Some might control the time
in time the capacity to control their lives, and others may find
themselves a slave of time. Some might have no time at all to
relax and create a stress-free lifestyle. But the bottom-line is not
to make time an enemy.

One must have time to think of things in order, to plan ways to

minimize waste of time, energy, and valuable resources. Effective
time management involves patience and practical thinking. Time
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and the natural changes in the environment may be modified but

in the end, we should follow the natural order of things.
Remember that Haste makes waste.
Yet you must also think about the saying There's no day but
today.

nch

One who is able to prepare for a number of possibilities upon

entering a situation may have more time to think of the moves

and decision to take to minimize the possibilities of errors.

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time effectively:

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Here are the necessary pre-requisites to help you manage your

1. Think of goals and aims as necessary: You should start

with a positive outlook. You must be excited with the

our

challenges and tasks that you have to do to give you the right
start or motivation. These achievements or aims can be

na

reached by becoming realistic and by knowing your directions.

Think of the scenarios of success but you should also
recognize the fact that these roads have to be traversed in a

E-J

given time. This way, you are not only looking at the possibility

hia

of success, but you are also giving yourself the right motivation
and the proper time to prepare for a fresh start and achieve
your goals at the soonest possible time.

Lud

2. Think of the time frame in achieving goals and aims: Time

.D.

frames are the periods you are giving yourself to finish a task.
These are just estimates or approximations since you are not
the sole factor that will contribute in finishing the given task.

L.E

Be wary of the processes in your environment; for example, if

you are to write a book or an article, consider the time you are

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giving yourself for this activity. However, since you are also
doing other things, you cannot devote your entire time in doing
this. Think of the flow of things or the movement of time in
your daily life as you move forward in achieving your desired
goals. Think of your other activities that might affect the time
factor in finishing given tasks. You might be spending too
much time on a very idle activity (like too many late night
parties or a whole day in front of your computer surfing the net

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or playing online games) that will give you less time to go on

with your plan towards self-fulfillment and success.
3. Be realistic and expect changes: Time Management involves
flexibility and open-mindedness. Do not expect that you can

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finish a task in what you've considered as your time frame

unless everything is laid down perfectly. You should allot some

allowance in your time frame, probably for the sake of the

unforeseen or unexpected circumstances. Remember that

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contradicting factors bring development so don't be upset with

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these changes since everything is undergoing a sort of a

synthesis. For example, you might have made your business

plan and a lot of careful considerations have been completed,
including the period in which you expect your business to give

our

you financial and personal satisfaction. However, during the

course of execution, there are other factors or changes, which

na

you have not included in your feasibility study. In this case,

time should not be wasted in complaining about things or

E-J

about people surrounding your path. Instead of becoming

hia

immobile or paralyzed with the situation, cope up and be

flexible by accepting such changes. Level the playing field with
innovative strategies based on the situation and knowledge you
will acquire from your experience in doing the task. Maximize

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your time by examining your errors and by moving on with

.D.

solutions that will sustain whatever efforts you have given to

traverse difficult situations and challenges.

4. Know your work style: You are a time clock too. You work

L.E

with your habits, your body cycles, and bodily rhythms. You
sleep, eat, exercise, read a book, or cook with either efficiency

IDA

or sloppiness. Of course you wouldn't want to be caught like a

snail and be crushed with pressures because of limited time,
so it would be better if you will give yourself some time to think
about yourself. Know how fast you can work on things. And if
it's not as good as others, try to make some improvements.
This may be difficult since habits and lifestyles have become
personal markers themselves that give you the idea of your

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daily routines or tasks. Taking three meals a day will remind

you of other things you must do after eating like brushing your
teeth or going to the toilet or having a 15-minute nap. Your
sleeping habits and work efficiency are based on what you've
grown-up with as an individual you may either stay late at

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night or sleep early, as what you've been taught or what your

household has been doing since you're a child. Finally,

examine yourself and know how fast you can work on things,

like typing words in a computer, filing office data, writing a

nal

term paper, or even reading a book. You don't need to know

Bra

the exact time but at least, you will have an approximate

measurement of how long you can finish such task.

5. Know your environment or workplace: Your house has a

our

time of its own, your office has schedules, and your

neighbourhood has activities to offer. You are surrounded by

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these time schedules. It would be better if you would be

conscious of the time flow in your surroundings. The daily

E-J

tasks in your house are definitely main factors in determining

hia

your personal time. More so, your working hours are defined
by the nature of your work and your workplace. The activities
by the people around you may affect your strategies and daily
endeavours. Finally, you are not alone in your workplace and

Lud

other people are also wary of their time and schedules. All of

.D.

these would affect your time frames and you must be insynched with all of these to manage your limited time hasslefree.

L.E

6. Make Plans: Planning, like in any other preparations, is a way

of saving time for errors. Mistakes usually happen because of

IDA

unexpected and unforeseen factors such as wrong estimates of

resources or the entry of new variables in solving a problem.
However,

unforeseen

with

the

proper

circumstances

plan

can

be

and

preparation,

expected

as

these

well

as

minimized. In such way, you may still finish the task in a given
time. By considering the above-mentioned factors, you are not
only giving yourself a period to reflect on how time flows in

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your life; you are also recognizing the factor that affects time &
its fluidity. You will not be drowned because of the seemingly
uncontrollable flow but you can now swim with the waves that
time brings about.

nch

EXERCISE 2:

1. Read & Re-read the 6 pre-requisites for time planning and

note down in your diary whatever ideas & thoughts which

Bra

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arise.

2. Make a time diary for all that you do for 7 days. Each and
everything should be noted. For example: time you take for
lunch, time you spend in the loo, time taken by you to

our

commute, time taken in the elevator to reach your home or

office. This shall be very useful as you shall see in the

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coming parts of the article.

3. This is the You are here as seen on maps, and you can
where you are currently.

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find the correct path to your destination only if you know

Dear Readers: Important Announcement

The above Scientific Article by Dr. Gautam Madan will be published in 5

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.D.

parts Part I, II, III, IV & V. The above is Part I.

Check out L.E.D. Issue Feb. 2016 Vol. 1 Issue 2 for the IInd part of the
above article.

{Dear Readers: The above article is specially adapted from the

L.E

book titled 28 Hours Hours a Day- Effective Time Management

Strategies To Do More and Take Control of your Life by Dr Gautam
ebook

is

IDA

Madan and is published here with his permission. The complete

available

from

amazon

and

the

link

is

given

below:http://www.amazon.com/Hours-Effective-ManagementStrategies-Control-ebook/dp/B00ATO8CY8 }.

P.S. Any feedback/compliments/queries for the Author should be

emailed to the Editor-in-Chief, Dr. Bhavdeep Singh Ahuja at his
email id: drbhavdeep@gmail.com
Vol. 1 Issue 1

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Doosra Gyaan

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nch

Dr. Ajay Kakar is a Periodontist from N.H.D.C. Mumbai, 1985. He is the

currently, the President of International Academy of Periodontology. He
is a Clinical Associate Professor in Stony Brook, SUNY-USA & a faculty
in Manchester University for the Distance Education Program. He is the
author of a handbook on Splinting (Management of Mobile & Migrating
Teeth) published in an International Journal. He is a genius with a
thorough & detailed knowledge on Computers and has written a book as
well for the beginners. He is the founder director of Bite-In and is a
clinician par excellence with current practice in Le-Visage Dental Clinic,
Chembur, Mumbai, with practice limited to Periodontology & Implants.

Diagnosing Periodontal Disease

Author: Dr. Ajay Kakar

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INTRODUCTION

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Easy or Tough

Periodontal disease and the periodontium is usually an anathema

our

to the general dental clinician. The removal of plaque and

calculus is a not a procedure any clinician looks forward to. In

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fact, scaling is a procedure that is consigned to the newcomers in

an established dental office and one does not look upon scaling as

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a procedure that requires stringent quality checks. It is almost a

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foregone conclusion that a couple of sittings with an ultrasonic

scaler eliminates all plaque and calculus.

Nothing could be further than the truth. Periodontal

disease is a vexing and complex problem in terms of identification

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and approach. It is quite a straightforward disease in terms of

.D.

etiology and pathogenesis. There are a certain group of bacteria

which are pathogenic and if they establish in a gingival sulcus
they can lead to periodontal damage which is an infective process.
Of course, this will take place only if the host response has been
level

or

some

predisposing,

overriding

factor

led

to

the

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L.E

blunted due to either physical trauma at a macro or microscopic

establishment of the infective bacteria. Along the process severe
inflammatory damage leads to destruction of the periodontal
tissues (Fig.1). From the perspective of the clinician, it is
important to be able to relate to this infective colonization in
terms of clinical signs and symptoms. It is very rare that patients
would walk in to a dental office with a complaint of pain which is
an outcome of periodontal disease.
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Fig-1: A classical case of periodontal disease with heavy

plaque and calculus deposits

It has been well documented that the progression of periodontal

our

disease is from an initial generalized inflammation limiting itself

to the gingival marginal tissue which in a very few percentage of
progresses

Periodontitis.

to

its

more

advanced

form,

known

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cases

as

E-J

Even though periodontal disease, in its phase as gingivitis

hia

is more often than not, quite generalized and afflicts the entire
dentition, of course with more pronounced focus areas of
inflammation, the more advanced form periodontitis tends to
lurk in isolated lesions and rears its ugly head only when well

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established and probably beyond repair.

.D.

Controlling advanced periodontitis, is more of identifying

and following up the severely afflicted sites much more than

doing any kind of complex therapy.

The major component of

periodontal disease is removal of all primary local factors and

L.E

aggravating local factors. It has to be realized that plaque and

calculus tend to re-establish in sites which are not well cleansed.

IDA

One very peculiar characteristic of advanced periodontitis is its

extremely local destructive pattern. It has been observed for a
number of years now that extensive periodontal lesions co-exist
adjacent to almost completely healthy gingival tissue with barely
a 2 mm sulcus. This peculiarity of advanced periodontitis is a
clinical nightmare. Completely healthy teeth coexist adjacent to
an extremely damaged periodontal tooth. (Fig. 2, Fig. 3, Fig. 4)
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Fig-2: A graduated periodontal probe place alongside the

mesio buccal site of a lower canine

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Fig-3: A graduated periodontal probe showing the depth of

the lesion

Fig-4: A healthy gingival sulcus of just about 2 mm next to

the deep infected lesion
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Not only do such teeth co-exist adjacent to each other, more often
than not, an extensive lesion co-exists with a completely healthy
sulcus right next to it on the very same tooth.
Barring the third molars which are not considered, the oral
cavity has 28 teeth. Each of these 28 teeth has an oral surface

nch

and a facial surface and it is potentially possible to identify and

group the oral and facial surfaces into three zones. These zones

can be the distal, the middle and the mesial zone on both the
surfaces.

This approach requires management of six potential

nal

sites on each tooth. Extrapolating the maths to 28 teeth means

This is the major problem with advanced

Bra

168 potential sites.

periodontal disease.

Treating advanced periodontal disease is not just treating 28

our

potential candidates for disease. It means treating 168 potential

sites where the destructive process could be taking place. The key

na

in this treatment is not just the initial removal of the offending

agent, i.e. the plaque and the calculus, but also to assure that the
bacteria will not recolonize in the same site. This requires

E-J

stringent effort to revisit the afflicted sites on multiple occasions

hia

and reinforce all the initial therapy along with local therapy in the
form of scaling, root planning and sustained drug delivery.
Achieving this end result is possible only if all the sites from

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diagnosed.

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among the potential 168 sites are accurately identified and

Fig-5: A graduated periodontal probe in the vestibule along

the disto buccal site of a upper canine
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This diagnosis is not very complicated in terms of equipment or

technique. All that is required is a good and appropriate

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na

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our

nal

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graduated periodontal probe. (Fig. 5, Fig. 6)

hia

Fig-6: A graduated periodontal probe showing the depth of

the lesion

The probe is the tool with which the amount of external

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destruction, termed recession and the depth of the lesion can be

.D.

measured i.e. the periodontal pocket.

These two scores when

clubbed together generate the loss of clinical attachment at the

particular site.

In addition to the recession and depth of the

lesion, the bleeding from the lesion and suppuration has to be

L.E

recorded. The fourth factor which has to be also recorded is the

IDA

mobility of the tooth. These four measurements are the key to the
diagnosis and severity of periodontal disease. Thereby, for each
site, there are four measurements to be recorded which totals to
672 measurements. In addition there are 28 scores to be recorded
for the mobility of the individual teeth making a final tally of 700
measurements. Since the number of sites to be examined and
recorded, are very large in number, a lot of diligence and patience

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is essential.

It is also a tedious task to record 700 values

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manually and analyze the same. (Fig.7, Fig. 8)

Fig-7: A graphic of a detailed periodontal examination with

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Perio Pal software

Fig-8: The data table of a detailed periodontal examination

with Perio Pal software

Computer technology plays a major role in this situation. There

are a number of excellent periodontal software tools available on
the market. One of the best tools is Perio Pal which allows all the

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above recording to be done. This data can be keyed in digitally or

can even be directly voice recorded by the clinician. Once
recorded, this data is presented in various tabular as well as
graphic forms which allows an over all perspective of the entire
In addition, the software allows these measurements

can be compared over various time frames.

nch

dentition.

The above information when accurately measured and

subsequently processed is the pathway to achieving a proper and
precise

diagnosis

of

the

extent,

severity

and

location

of

nal

periodontal destruction. Only when an accurate diagnosis is

be

applied

combat

periodontal

disease

effectively

and

na

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predictably.

to

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available, it will be possible for the right therapy components to

P.S. Any feedback/compliments/queries for the Author should be

Vol. 1 Issue 1

Lud

IDA

L.E

.D.

email id: drbhavdeep@gmail.com

hia

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emailed to the Editor-in-Chief, Dr. Bhavdeep Singh Ahuja at his

L.E.D. E-Journal

Page 59

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Teesra Gyaan

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Dr. Komal Majumdar has completed her Clinical Mastership in Oral

Implantology at Stony Brooks School of Dental Medicine. She is a
Diplomate at both the ICOI and ISOI. She has completed her PG
(Cert) in Endodontics from IGNOU, at GDC Mumbai. She maintains a
successful private practice in Navi Mumbai for the past 15 years.

nch

Dr. Sonali Luthra Gandhi has graduated from the prestigious Dr. D. Y.
Patil School of Dentistry, Navi Mumbai. She has been in private
practice since 2013. She is an active member of the Indian Academy
of Aesthetic and Cosmetic Dentistry (IAACD). She is also one of the
Course Directors at IMPLANTRAIN.

Sometimes Implant Is Not the Answer !!!!!!!

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A Case Report of Crown Lengthening Procedure in the Maxillary Anterior Region

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Author: Dr. Sonali Luthra Gandhi

Co-Author: Dr. Komal Khatri Majumdar

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ABSTRACT

Crown lengthening has been traditionally utilized as an adjunct

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to restorative dentistry, typically in situations where subgingival

caries or fractures require the exposure of sound tooth structure
and reestablishment of the biologic width space. With the
popularity

of

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increasing

aesthetic-oriented

treatment,

an

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understanding of the therapeutic synergies brought about by an

interdisciplinary approach has developed. As a result, crown
lengthening procedures have become an integral component of
the aesthetic armamentarium and are utilized with increasing

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frequency to enhance the appearance of restorations placed

.D.

within the aesthetic zone. This article discusses a case report in

which the natural teeth were restored by doing a crown
lengthening procedure in the maxillary anterior region there by

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attaining enough ferrule for retention as well as achieving esthetic

gingival contours.

IDA

INTRODUCTION

Crown-lengthening surgery has been categorized as esthetic or

functional.

The

term

functional

relates

to

exposure

of

subgingival caries, exposure of a fracture or both. Often, the

discussion of crown lengthening in the anterior sextants is
presented in the context of esthetic surgery. Indeed, functional
and esthetic therapy can converge in the esthetic zone when
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subgingival caries does not extend greatly or at all to the root.

Without functional crown lengthening, the restorative margins
may extend deep into the periodontal tissues and possibly invade
the biologic width. This then would cause a resorptive response
probably to a greater degree than anticipated.

nch

by the body, leading to uncontrollable loss of alveolar bone,

Following criteria must be taken into consideration for the
procedure:
Biological Width

2.

Ferrule

3.

Gingival Zenith Level (Anterior region)

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nal

1.

1. Biological Width:

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Biological width is defined as the dimension of the soft tissue,

which is attached to the portion of the tooth coronal to the crest

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of the alveolar bone. This term was based on the work of Gargiulo
et al (1961), who described the dimensions and relationship of the
dentogingival junction in humans. They reported the average

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length of the dentogingival junction to be 2.04 mm (Fig-1). They

hia

identified the subcomponents of the dentogingival junction as the

connective-tissue attachment (mean value:1.07 mm) and the
epithelial attachment (mean value: 0.97 mm).There is general
agreement that placing restorative margins within the biologic

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width frequently leads to inflammation, clinical attachment loss,

.D.

and bone loss.In contemporary practice, it generally is accepted

that a 3-mm distance would significantly reduce the risk of

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margins.

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periodontal attachment loss induced by subgingival restorative

Fig-1: Biological width

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2. Ferrule:
The

Journal

of

Prosthetic

Dentistrys

2005

Glossary

of

Prosthodontic Terms defines a ferrule as a metal band or ring

used to fit the root or crown of a tooth.11 Sorensen and
Engelman12 redefined the ferrule effect as a 360-degree metal

nch

collar of the crown surrounding the parallel walls of the dentine

extending coronal to the shoulder of the preparation.

The dentist should retain as much coronal tooth structure as

possible when preparing pulpless teeth for complete crowns to

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maximize the ferrule effect. A minimal height of 1.5 mm to 2 mm

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(Fig-2) of intact tooth structure above the crown margin for 360

degrees around the circumference of the tooth preparation

appears to be a rational guideline for this ferrule effect. Surgical

our

crown lengthening or orthodontic extrusion should be considered

with severely damaged teeth to expose additional tooth structure

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to establish a ferrule.

Fig-2: Ferrule

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.D.

3. Gingival Zenith Level:

In the esthetic region especially in the maxillary anterior region it

is not only important for us to provide a restoration that is
functionally stable but also it should be esthetic and should give
patient

L.E

the

beautiful

smile.

One

significant

feature

of gingival morphology is the gingival line, which is defined as the

IDA

line joining the tangents of the gingival zeniths of the central

incisor and canine (Fig.-3.1). The gingival zenith of the lateral
incisor is 1-2mm below the gingival line. The gingival zenith is the
most apical aspect of free gingival margin. The gingival zenith is
located distal to the long axis of the central incisor and canine
whereas it is located along the long axis in the mandibular incisor
and maxillary lateral incisor (Fig.-3.2).

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(GZ Gingival Zenith),

(ZL Zenith Line)
(LA Long Axis)

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(CW Crown Width),

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Fig-3.1: Gingival Zenith Line

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(LI-GZ Lateral Incisor Gingival Zenith)

CASE REPORT

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Fig-3.2: Gingival Zenith in Relation to the Long Axis of the

tooth

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This case was done in the authors private practice. All clinical
procedures were fully explained to the patient, who signed an
informed consent form authorizing treatment and publication of

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the case.

DIAGNOSIS

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The patient, a 43 years old female, in good health conditions

without any history of any chronic disease came to the private
practice with a chief complaint of decementation of old prosthesis.
Clinical Examination revealed fractured restorations with relation
to 11, 21 and 22. Further examination showed the presence of
cast posts in all three teeth with no ferrule and residual caries
around them with uneven gingival margins.

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Fig-4.1: Preoperative

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Fig-4.2: Decementation of old Prosthesis; Uneven Gingival

Margins

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Radiographic examination (Intraoral Periapical) revealed well done

root canal treatment in relation to 11, 21, and 22 with no
radiolucency

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periapical

with

intact

TREATMENT

dura

and

no

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periodontal ligament space widening.

lamina

The first line of treatment was to remove all the residual caries
and restore the teeth using composite (3M Filtek Z350) using the

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old cast posts since there was no damage done to them.

The next line of treatment was the crown lengthening procedure.
The crown lengthening procedure was to be done for added
ferrule for the retention of new prosthesis and to match the

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gingival levels of the adjacent teeth. The gingival zenith levels

were checked and bone sounding was done to check the biological

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width. Markings were done to design the flap. Internal Bevel and
Sulcular incisions were given with a 15 No. Surgical Blade and
the gingival tissue was removed. An apical repositioned flap with
minimal exposure was done for the osseous recontouring. This
was done with a round bur and continuous saline irrigation to
achieve biological width and to maintain harmony between the

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periodontal and dental tissues. Once this was done closure was
achieved with horizontal mattress sutures (silk, fine thread).
The crown lengthening procedure revealed new defects which
were then restored using composite (3M Filtek Z350) and new
finish

lines

were

made.

Immediately

teeth

were

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provisionalised with acrylic crowns.

the

The patient was recalled after 7 days and the sutures were

removed. After 7 weeks the provisionals were removed and

impressions were made and sent to the laboratory for the

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fabrication of the final prosthesis.

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max crowns.

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Finally after 8 weeks the teeth were restored with individual E-

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Fig-5.1: Probing depth and bone sounding

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Fig-5.2: Probing depth and bone sounding Upside View

Fig-5.3: Checking for Gingival Zenith Levels

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Fig-5.5: Flap Design

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Fig-5.4: Checking for Gingival Zenith Levels Upside View

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Fig-5.7: Internal Bevel Incision

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Fig-5.6: Flap Design Upside View

Fig-5.8: Internal Bevel Incision Frontal View

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Fig-5.9: Sulcular Incision

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Fig-5.10: Sulcular Incision Frontal View

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Fig-5.11: Tissue Removal Upside View

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Fig-5.12: Tissue Removal Frontal View

Fig-5.13: Apical Repositioned Flap with Minimal Exposure;

Osseous Recontouring with continuous Saline irrigation
Upside view
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Fig-5.14: Apical Repositioned Flap with Minimal Exposure;

Osseous Recontouring with continuous Saline irrigation

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Frontal View

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Fig-5.15: Result after Crown Lengthening Procedure

View

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Fig-5.16: Result after Crown Lengthening Procedure Upside

Fig-5.17: Defects Restored and New Finish Lines Prepared

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Fig-5.18: Defects Restored and New Finish Lines Prepared

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Upside View

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Fig-5.19: Immediate Provisionalisation

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Fig-5.20: Immediate Provisionalisation Upside View

Fig-5.21: Healing after 7 days; Harmonious Smile

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Harmonious Smile

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Upside View

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Fig-5.22: Healing after 7 days;

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Fig-5.23: Healthy Periodontium

Fig-5.24: Final Prosthesis

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CONCLUSION

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Fig-5.25: Final Prosthesis Frontal View

In contemporary dentistry, dentists are confronted on a daily

basis with clinical decision making regarding dentition affected

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with significant caries or subgingival fractures. The dentist

weighs the clinical findings and patients concerns in the balance

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to determine if the tooth should be extracted or restored. We are,

of course, in an age of dental implants, an era in which heroic

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efforts to salvage extensively damaged teeth are fading. This,

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however, does not mean that dentists should abandon tools

commonly used to preserve the natural dentition, tools such as
complex restorative treatment, possible concomitant endodontic
therapy and periodontal therapy. Moreover, if the patient wishes

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to retain part or all of his or her own dentition, providing the

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outcome of these treatment options are predictable, the dentist

should consider honoring those wishes.

REFERENCES

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1. Orban R, Sicher H. The oral mucosa. J Dent Educ 1946;10:94.

2. Listgarten, MA. Normal development, structure, physiology, and

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repair of gingival epithelium. Oral Sci Rev 1972;1:3-67.

3. Schroeder HE, Listgarten MA. Fine structure of the developing

epithelial attachment of human teeth. Monogr Dev Biol 1971;2:1134.

4. Weiss MD, Weinmann JP, Meyer J. Degree of keratinization and

glycogen content in the uninflamed and inflamed gingival and
alveolar mucosa. J Periodontol 1959;30:208.

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5. Schroeder H. Differentiation of Human Oral Stratified Epithelia.

Switzerland: Kager, 1981.
6. Squier CA. Keratinization of the sulcular epithelium: A pointless
pursuit? J Periodontol 1981;52(8):426-429.
7. Geisenheimer J, Han SS. A quantitative electron microscope study
desmosomes

and

hemidesmosomes

in

epithelium. J Periodontol 1971;42(7):396-405.

human

crevicular

nch

of

8. Spray JR, Garnick JJ, Doles LR, Klawitter JJ. Microscopic

demonstration of the position of periodontal probes. J Periodontol

1978;49(3):148-152.

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9. Listgarten MA. Periodontal probing: What does it mean? J Clin

Periodontol 1980;7(3):165-176.

10. Armitage GC, Svanberg GK, Loe H. Microscopic evaluation of clinical

measurements of connective tissue attachment levels. J Clin

our

Periodontol 1977;4(3):173-190.

11. Gargiulo AW, Wentz FM, Orban B. Dimensions of the dentogingival

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junction in humans. J Periodontol 1961;32:261-267.

12. Rosenberg ES, Garber DA, Evian CI. Tooth lengthening procedures.
Compend Cont Educ Dent 1980;1(3):161-173.

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13. Ochsenbein C, Ross SE. A re-evaluation of osseous surgery. Dent

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Clin North Am 1969;13(1):87-102.

14. Ingber JS, Rose LF, Coslet JG. The biologic widtha concept in
periodontics

and

restorative

1977;70(3):62-65.

dentistry.

Alpha

Omegan

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15. Oakley E, Rhyu IC, Karatzas S, et al. Formation of the biologic

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width following crown lengthening in nonhuman primates. Int J

Periodont Rest Dent 1999;19(6):529-541.

16. Kois JC. Altering gingival levels: The restorative connection. Part I:
Biologic variables. J Esthet Dent 1994;6(1):3-9.

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17. Lee EA, Jun SK. Achieving aesthetic excellence through an outcomebased restorative treatment rationale. Pract Periodont Aesthet Dent

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2000;12(7):641-648.

18. Lee EA, Jun SK. Aesthetic design preservation in multidisciplinary

therapy: Philosophy and clinical execution. Pract Proced Aesthet
Dent 2002;14(7):56

P.S. Any feedback/compliments/queries for the Author should be

emailed to the Editor-in-Chief, Dr. Bhavdeep Singh Ahuja at his
email id: drbhavdeep@gmail.com
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Chautha Gyaan

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Dr. K. Varsha Rao is a dental graduate from Mumbai. She has

done her P.G. Certificate in Oral Implantology from the Manipal
University. She completed her Clinical Mastership in Oral
Implantology from the Stony Brooks School of Dental Medicine.
She also holds Certificate of Merit in Implantology & Oral
Rehabilitation from the New York University. She also holds a
Certificate in Aesthetic Dentistry.

BRB Technique Style Italiano !!!!!!!

A Case Report on the BRB technique for Anterior Restorations

INTRODUCTION

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Author: Dr.K.Varsha Rao

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When a patient walks into the practice for restoration of a

carious, fractured anterior tooth or diastema, the most common
method that is usually done is the putty matrix technique. It can

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be done either by making a wax mockup of the final result or by

doing a free hand composite with spot bonding directly on the

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teeth concerned The benefits of this matrix are a creation of

lingual contour which minimizes later adjustments for occlusion,
incisal edge determination to enable precise placement of dentin

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and enamel shades, incisal thickness determination to allow the

placement of translucent shade, placement of final facial
increment in single increment. Some initial facial anatomy can
also be carved into the facial aspect of restoration before curing
which will reduce the time spent on finishing and polishing.

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However, to produce this classical matrix an impression and wax

a model of the desired restoration is necessary. This article is a
case report on a new technique called BRB Technique
(Bertholdo/Ricci/Barrotte) which I came across on the Syle

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Italiano website. It is a simple way to produce the lingual matrix

CASE REPORT

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without laboratory steps needed.

This case was done in the authors private practice. All clinical
procedures were fully explained to the patient, who signed an
informed consent form authorizing treatment and publication of
the case.

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Fig-1a: Pre-Operative

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CHIEF COMPLAINT

32 year old female patient reported to the office with the chief
complaint of wanting to close space between tooth no.21 and 22

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(Fig. 1a & 1b)

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Fig-1b: Pre-Operative Upside View

CLINICAL EXAMINATION

Clinical examination revealed a diastema between tooth no. 21

and 22 which was closed earlier with composite resin material .A

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very small part of the earlier restoration was still present on tooth

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no.22.

TREATMENT PLAN

Since the patient had to attend a social event the very next day
and time was a concern, it was decided to use the BRB
(Bertholdo/Ricci/Barrotte) technique to fabricate a lingual matrix
which was then used to build tooth no.22.

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CLINICAL PROCEDURE

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Fig-2a: Frontal View

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At very same appointment a putty matrix with addition silicone

material is made (Fig.2a & 2b).

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Fig-2b: Upside View

The lingual matrix thus prepared is then modified using a bur to

create the appropriate lingual anatomy, in this case that of a

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lateral incisor (Fig. 3a & 3b).

Fig-3a: Frontal View

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Fig-3b: Upside View

Since this was mostly an additive procedure, preparation was

kept to a minimum. Rough (Black) disc from Shofu was used to
create some surface roughness on the tooth surface. Tooth
cleaned

with

slurry

our

no.21were

of

pumice

and

0.12%

Chlorhexidine. The tooth was isolated using a rubber dam with a

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wingless clamp on 24 and a wedjet between the two central

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Fig-4a: Frontal View

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incisors (Fig. 4a & 4b).

Fig-4b: Upside View

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The adjacent tooth was isolated with Teflon (plumbers tape) and
the entire tooth was etched with Uni-Etch (Bisco) 37% Phosphoric

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Fig-5a: Frontal View

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acid (Fig. 5a & 5b).

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Fig-5b: Upside View

Prime and Bond NT (Dentsply) was used as the bonding agent in

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this case as the adhesive (Fig. 6a & 6b).

Fig-6a: Frontal View

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Fig-6b: Upside View

The lingual matrix is then kept in place to get a lingual extent

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reference point (Fig. 7a & 7b).

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Fig-7a: Frontal View

Fig-7b: Upside View

A2 shade from Grandio (Voco), a Nano-hybrid composite was then

used for the free hand buildup (Fig. 8a & 8b).

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Fig-8a: Frontal View

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Fig-8b: Upside View

The restoration was then finished and polished using Soflex discs

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(3M ESPE) and the Enhance kit (Dentsply) (Fig. 9a & 9b).

Fig-9a: Upside View

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CONCLUSION

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Fig-9b: Frontal View

This is an easy to implement procedure to make chair side lingual

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matrices .It cannot replace the indirect technique of making putty

matrix as that is more precise, but can be used in situations

REFERENCES

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where we dont have time for making the same.

1. Esthetic Restorations, The Putty Matrix Technique, Arshad

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Hasan and Omer Shahid

.D.

2. http://www.styleitaliano.org/brb-matrix

3. Direct Class IV Composite restorations from Treatment Planning

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to Successful Results by Laurie St-Pierre, DMD, MS

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P.S. Any feedback/compliments/queries for the Author should be

emailed to the Editor-in-Chief, Dr. Bhavdeep Singh Ahuja at his
email id: drbhavdeep@gmail.com

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Paanchwaa Gyaan

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PHOTODONTICS - I

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Dr. Mayur Davda is the pioneer of training and research at dental photography
school and has extensively lectured on documentation at various dental
associations and universities across India. He has a long list of firsts to his
credit like, the first dentist to exhibit at Indias most prestigious art gallery
The Jehangir, first dentist to exhibit at Kalaghoda art festival, first dentist
to be interviewed by Better Photography and Smart Photography magazines &
first dentist to be interviewed on national television just to name a few.
Considered as one of the finest dental photography experts in the world he
has also participated in Portugal dental congress dental photography art
exhibition and the only one to represent India. He has won several awards for
fine art and wildlife photography and was invited by the Consulate General of
Turkey on the National day (2015) for commendable contribution in the field
of photography. Famdent Awards has honored him as the highly commended
Indian dental talent of the year 2015. He is currently the photomentor for
GPS smile design (Las Vegas, USA) and CANON India. To know more about Dr.
Mayur Davda you can visit www.mayurdavda.com

ABSTRACT

Author: Dr. Mayur Davda

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Why Dental Photography is an Indispensable part of Dentistry

A pictorial documentation of every case has many advantages.

Right from the first step of diagnosis to the last steps of postoperative analysis and maintaining records dental photography

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has a vital role to play in the life of every dental practitioner. As of

today there are more than 50 applications of photography in
dentistry. When a branch of dentistry affects every other branch
of dentistry so deeply, it should not be underestimated.

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Inculcating dental photography into the formal education of every

dental professional is the need of the hour.

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INTRODUCTION

Despite all the hard work that goes into every case one aspect
seems to be missing among many dentists across the globe
Documentation. This in turn leads to untoward consequences the
most important being a loss of opportunities. Following are the
most common reasons given by dental practitioners for not
documenting cases on a routine basis:
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1. Expensive equipment
2. Confusion about the best equipment for dental photography
3. Complicated settings of a camera / Inability to understand
the meaning of settings and buttons

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4. Heavy / bulky equipment

5. Lack of time

6. Lack of professional training in dental photography and

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documentation.

Diagnosis

OPERATIVE

POST
OPERATIV
E

Recording Steps

Patient

Scope Of Improvement
Shade Matching

Education

Lab Communication

Practice

(Business)

Marketing

Educating

Keeping

Dental

Assistants

Research /

Conducting

Thesis

Dental Courses

Discussions/

Artistic Value

Presentation

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Your

Record

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Leveraging

Results

At Ones Own Work For

Self Criticism

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Planning

and Post

Operative

Taking A Closer Look

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Treatment

Proof

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Analysis and

OTHER

Progress Monitoring By Medico Legal Comparing Pre

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PRE
OPERATI
VE

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DISCUSSION Uses of Photography in Dentistry

Smile Designing

Publications

Stock
Photography

Sharing On

Creating an

Point

Communication

Social

Image Bank

Especially in

Networks

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Interdisciplinary

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Reference

Universities

Showing

For Aiding The

Dental

Forensic

Treatment

Pathology Labs To

Insurance

Odontology

Options To

Reach A Diagnosis In

Patients

Adjunct To The

Specimen Provided

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This article intends to put more light to the fact that dental
photography and documentation is extremely vital in dentistry
today. Practicing dental photography can not only raise ones
standard as a dental professional (be it a dentist, dental

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other avenues in the fields of dental industry.

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hygienist, dental associate, dental ceramist) but also open up

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A Few Uses of Dental Photography can be seen here:

(Serial Numbered in the Photograph Above)

1. Trial RUN after smile designing a trial run helps the patent

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final prosthesis

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and dentist decide what all changes need to be made in the

2. The bog performance and online / social media visibility of

an article or a write up increases as we add more and more

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images to our blog / social media write up

3. Patient education about the need to undergo dental

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prophylaxis on a daily basis along with a few fillings

4. Glamour photography and artistic value add up to your

operatory values

5. Ground section seen at high magnification helps in

histopathological studies

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6. Use of Grey card Shade matching using an 18 % grey card

which is a universal standard for a neutral color. Without a
grey card shade matching and lab communication is
absolutely meaningless.

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7. Facial analysis
8. Pre and post-operative comparison for self-criticism and
marketing

9. Trans illumination to appreciate the incisal one third

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translucency and crack propagations

MYTH BUSTER

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10. Dead light used in forensic odontology photography

1. An ideal camera for dental photography is a DSLR and

contrary to popular belief, it is neither expensive nor heavy.

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2. It can be aid that these problems are faced by a dental

professional when choice of equipment is not accurate. (For

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example: buying a high end full frame camera which is an

overbuy for a dentist and heavy)

3. If we consider a simple comparison with mobile phones one

might notice that an average DSLR costs almost as much as a
basic android phone.

4. When one compares with an iOS product it is equal to one

DSLR plus one macro lens
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5. It is significant to state at this point of time that on an

average one uses a mobile device for not more than 5 years at
an average however a DSLR and a Macro lens once purchased
lasts for a life time.
6. It would hence be wise to conclude that DSLR and dental

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photography equipment is neither expensive nor heavy.

7. About understanding camera settings and buttonsYes, it

can be said that DSLR look very complicated but once a
dental professional understands the basics well it all becomes

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easy and less time consuming.

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8. It is advised that one reads articles or join a professional

course on dental photography to learn the basic settings.

9. Once the basics of exposure are well understood to takes less

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than 5 second to record one image.

A good source to learn about dental photography would be

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www.dentalphotographyschool.in

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CONCLUSION
Dental photography has tremendous penetration and use in
dental industry and its potential shouldnt be underestimated.
With more than 50 applications in dentistry it is high time that
formal education on dental photography is taken seriously by

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universities across the globe and followed by dental professionals

on a routine basis.

Proper documentation can open up newer avenues for every

Dear Readers: Important Announcement

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in dentistry.

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dental professional and make them reach the highest standards

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Its with extreme pleasure to announce that Dr. Mayur Davda, the Dentist
Photography Guru of India has consented to write a dedicated column on

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Photography for every issue of our EJournal.

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The above article by Dr. Mayur Davda will be published as a series of

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Scientific Articles.

The above is Scientific Article I.

Article.

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Check out L.E.D. Issue Feb. 2016 Vol. 1 Issue 2 for the IInd Scientific

P.S. Any feedback/compliments/queries for the Author should be

emailed to the Editor-in-Chief, Dr. Bhavdeep Singh Ahuja at his

Vol. 1 Issue 1

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email id: drbhavdeep@gmail.com

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Chhathaa Gyaan

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Dr. Roheet Khatavkar has graduated from Nair Hospital Dental

College, Mumbai in 2006 and completed his Masters in Endodontics &
Conservative Dentistry from Rangoonwala Dental College, Pune in 2010.
He completed his Masters in Oral Laser Application from University of
Vienna Austria in 2011. He has published a number of articles and
research work in various National & International Journals. He has
conducted a number of lectures & hands-on courses on Basic Clinical &
Advanced Endodontics across the country. He has been a contributor
to Grossman's Endodontic Practice 12th Edition, 2010. He is passionate
about Clinical Micro-Endodontics and documentation and presently
maintains a private practice in Mumbai.

ACCESS TO SUCCESS
Part - I

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INTRODUCTION

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Author: Dr. Roheet Khatavkar

Access cavity preparation is the first step towards a

morphology,

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successful root canal therapy. Knowledge of pulp chamber

along

with

an

examination

of

preoperative

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radiographs, should be integrated when designing the access

cavity to a tooth. The importance of adequate access cannot be
overstated for intracanal preparation and obturation in both

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routine and complex clinical situations. This article deals with

how technological developments in the field of endodontics can be
used in the steps of gaining access & canal location; thereby
making successful endodontic therapy more predictable for the
clinician.

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By definition, access cavity is a cavity prepared in the crown

of the tooth, which exposes the pulp chamber and provides a
pathway to the root canal(s).

The objectives of access cavity preparation are:

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1. To remove the pulp chamber roof, including all overlying

dentin.

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2. To achieve straight-line access into the orifice and the apical

foramen or to the initial curvature of the canal

3. To develop the shape of tapering funnel from the coronal

opening to the root canal orifice(s).

4. The internal walls are flared and smoothed to eliminate any

coronal interference during subsequent instrumentation.
5. To conserve sound tooth structure as much as possible.

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The ideal access cavity (Or Access Opening) is one that

reflects the walls of the pulp chamber on the occlusal surface.
The goal is to be able to look into the completed access with a
mouth mirror and all the orifices can be visualized without

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moving the mirror.

Pre-operative Radiographs are a must before attempting to

start Access Openings. Great variance in overall tooth size,

morphology & arch position means that no two access openings

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are identical, although common access guidelines have been

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established depending on the location of the tooth. Generally, the

approximate shapes of access cavity preparations for teeth are

Triangular for maxillary Incisors, Ovoid in case of Maxillary

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Canines, Premolars & Mandibular incisors & premolars. Maxillary

& Mandibular molars typically have a triangular or Rhomboidal

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access opening. It is however advisable to have rounded outlines

for these access openings rather than Sharp angles; thus creating
a Rounded Triangular or a Rounded Rhomboidal Outline.

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Sometimes; however this outline may have to be modified for the

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convenience of a canal anatomy, radicular dilacerations, crown

angulations or insertion of endodontic instruments.
Studies concerning Pulp chamber anatomy have revealed that
the walls of the pulp chamber are always concentric to the

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external surface of the crown at the level of CEJ. Hence, running

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an explorer on the crown of the tooth at the level of the CEJ might
reveal any aberrant change in the internal anatomy of the
chamber.

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NEWER ADVANCES in GAINING ACCESS

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Digital Radiographs obtained through Radio Visuo Graphy

(RVG) with the help of associated software can be used to enable

the clinician to gauge the size of the pulp chamber. A line drawn
from the widest aspect of the pulpal floor which flares out
towards the occlusal will give the clinician a guideline to the
extent of the access opening occlusally. (Fig. 1)

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Fig. 1 Dotted Line Showing

Flaring required for achieving
straight-line access.

Access can be gained into the pulp chamber using a

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high speed diamond or carbide round bur. However instead of

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achieving a drop; performed as a routine it is preferable to move

the bur in a sweeping motion till the depth is reached. The Pulp

Out Bur (Essential Dental Systems) is one such bur designed

with a stopper placed at 7mm to guide the clinician to the depth

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of the pulp chamber without endangering the furcation area.

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Fig. 2a A cross-section showing Endo-Access Bur in Pulp

Chamber of Mandibular Molar

Another alternative is the Endo Access Bur (Dentsply

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Maillefer) developed by Dr. Howard Martin can be used to gain

access as well as smoothen the walls of the pulp chamber. A

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number of safe-ended burs like the Endo-Z Bur (DentsplyMaillefer), the diamond Diamendo (Dentsply-Maillefer), LA Axxess
diamond (Sybron Endo) Brasseler H2694K, Meisinger HM 23R
have also been designed. (Fig. 2a & 2b)

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Fig. 2b

From Left: i. EndoAccess Bur ii. EndoZ Bur iii. Diamendo iv. LA

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Axxess

Ultrasonics in the form of either the Start-X Series Tips

(Dentsply, Tulsa, Oklahoma) or CAP Tips (Satelec) designed
specifically for access Cavity Preparation or modification are

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Sturdy and can rapidly cut gross dentin obstructions like

restrictive triangles of dentin, isthmus areas, pulp stones or

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calcifications to reveal hidden or additional canals without

causing unnecessary destruction of tooth structure. The ProUltra

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ultrasonic instruments (Dentsply, Tulsa, Oklahoma) designed to

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function dry or the BUC-1 Tip; CRP-2D (Sybron Endo) or the Carr

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(Fig. 3)

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CKT1-D Tips may also be used to refine the access cavity walls.

Fig. 3 Start-X Tips 1-5 by Dentsply designed specifically

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for access refinement

After gaining visual access to the chamber a fine endodontic

explorer like the DG-16 (Hu-Freidy) or JW -17 (Designed by Dr.

John West) can be used to explore the floor of the pulp chamber.

DEALING with PULP STONES

Occasionally, the clinician may encounter a single/ multiple pulp

stones which may be free or attached to 1 or more walls of the
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pulp chamber. (Fig. 4).The presence of a pulp stone can be easily

confirmed with a good radiograph forewarning the clinician of

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probable hindrances in the access to success (Fig. 5)

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A. Mandibular molar with large Pulp Stone

stone

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B. Pro Ultra Endo 1 Tip used to remove larger portion of

C. Pro Ultra Endo 3 Tip used to sand away finer portions

D. 3 Orifices clearly seen after removal of stone

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Fig. 5 Large Pulp Stone

seen in Chamber of
Mandibular 2nd Molar

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E. Cleaning Shaping done.

Conventionally; a round bur running at slow speeds was used to

dislodge or remove the stone or by wedging with the tip of an
explorer. The pulp stones sometimes can be vibrated or teased
out by the CPR 2D or BUC 1 tips or the ProUltra ENDO3 or
specially designed tips like the BUC-2, with its disk-like radiused
tip or BUC-2A (1.0mm diameter) or the Zirconium Nitride Coated

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ProUltra ENDO 1 can be used to smoothly and safely plane

attached pulp stone. The newer SINE Tips (Sybron Endo) Nos. 3&
4 (Round-Diamond); 5 & 6 (Pear-Diamond) can also be used in
the same manner. In general the small diameter Round Diamond
tips are less aggressive & more precise than the larger Round or

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Pear-shaped ones. More Sturdy Tips like the Start-X 5 Can be

used to sand away the pulp stones and refine access cavity walls
at the same time

Krasner & Rankow have after having studied 500 extracted,

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permanent teeth, proposed several anatomic laws regarding the

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pulp chamber floor as follows:

1. Law of symmetry 1: Except for maxillary molars, the orifices

of the canals are equidistant from a line drawn in a mesial

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distal direction through the pulp-chamber floor. (Fig. 6 & 7)

2. Law of symmetry 2: Except for the maxillary molars, the

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orifices of the canals lie on a line perpendicular to a line drawn

in a mesial-distal direction across the center of the floor of the

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pulp chamber. (Fig. 6 & 7)

Fig. 6 A
Diagrammatic
Representation by
Krasner & Rankow

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Mandibular 2nd Molar

with
3 Orifices
Fig. 6 B

3. Law of Color Change: The color of the pulp-chamber floor is

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always darker than the walls. (Fig. 6 B & Fig. 7 B)

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Fig. 7 B
Mandibular 2nd Molar with
4 Orifices

Fig. 7 A
Diagrammatic
Representation by
Krasner & Rankow

4. Law of orifice location 1: The orifices of the root canals are

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always located at the junction of the walls and the floor.

5. Law of orifice location 2: The orifices of the root canals are

located at the angles in the floor-wall junction.

6. Law of orifice location 3: The orifices of the root canals are

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located at the terminus of the root developmental fusion lines.

Following these laws as guidelines helps the clinician in

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easily locating the Canal orifices in most of the cases.

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Dear Readers: Important Announcement

The above article by Dr. Roheet Khatavkar will be published in 2 parts Part I & II. The above is Part I.

above article.

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Check Out L.E.D. Issue Feb. 2016 Vol. 1 Issue 2 for the IInd part of the

P.S. Any feedback/compliments/queries for the Author should be

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emailed to the Editor-in-Chief, Dr. Bhavdeep Singh Ahuja at his

Vol. 1 Issue 1

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email id: drbhavdeep@gmail.com

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Saatwaa Gyaan

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Dr. Aslam Inamdar graduated from Nair Dental College and Hospital in
2001. He is the director of Dr. Inamdar's Dental Studion and maintains
practice at two clinics in Mumbai. His keen interest is in esthetic
dentistry and dental implants. He is currently pursuing Masters in Dental
Implantology from Stony Brooks School of Dental Medicine, New York.
He is one of the pioneer dentists who successfully implemented DSD in
routine dental practice & is also a co-trainer of DSD with Dr. Rajiv Verma.
He received the BEST COSMETIC DENTIST of 2015 at Famdent
Excellence in Dentistry Awards.

DIGITAL SMILE DESIGN (DSD)

Making Smiles, Transforming Lives

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INTRODUCTION

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Author: Dr. Aslam Inamdar

Digital Smile Design (DSD) is a Dr. Christian Coachman

Concept, who along with Mr. Livio Yoshinaga, took the smile

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design concepts in the dental world to the next level. DSD is a

game changer, as it allows the patient to visualize his/her new
functional,

aesthetically

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accurate.

mouth; a Smile,

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smile/teeth in his/her own

acceptable

&

which

is

mathematically

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DSD has tremendous applications in dentistry from

a simple smile design tool to a full blown treatment planning

methodology. Today it is being used in fabrication of complete
dentures,

planning

for

orthodontic

treatments

with

orthodontic software like Dolphin, planning for orthognathic

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surgeries, in implantology planning along with CBCT, in full

mouth rehabilitation cases, in periodontics for perfect crown
lengthening procedure, in fixed prosthodontics and cosmetic

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dentistry etc.

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CASE REPORT
A young, middle aged housewife came with chief complaint of

sensitivity and discoloration in upper central incisors. Clinical

and radiographic examination revealed caries and pulpitis

with 11& 21.It was also noted that she was not happy with
her smile and shape of central incisors.
TREATMENT PLANNING

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Her chief complaint was resolved with root canal treatment for
11 & 21. For esthetic restorations of 11 & 21, an option of
PFM or Metal free crowns was given to patient. Since patient
was keen on enhancing her smile along with above treatment
plan, patient was informed about

DSD and the biggest

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advantage of TEST DRIVE incorporating Visagism concept.

Patient decided to go for TEST DRIVE so that she could
visualize her new look before deciding whether to go ahead

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with the esthetic treatment.

Fig. 1a1d: Extraoral & Intraoral Photographs

DSD

protocol,

clinical

extraoral

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per

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As

and

intraoral

photographs were recorded with a DSLR camera. (Fig.1a-d)

Study models of upper and lower teeth were prepared. Patient

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and her husband were interviewed for V isagism concept.

Fig. 2a: DSD with Power Point Software

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Fig. 2b: DSD with Power Point Software

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Fig. 2c: DSD with Power Point Software

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Fig. 2d: DSD with Power Point Software

Fig. 2e: DSD with Power Point Software

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DSD was done on Microsoft Power Point 2010 Software

(Fig. 2a2e).

Fig. 3: DSD Maths for Tooth No. 14 24

Mathematically accurate wax up was handmade as per the

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DSD Maths for Upper 10 teeth from 14 to 24 (Fig. 3). Wax was
added on the labial surfaces of 12 & 22 to maintain the labial

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curve. Minimal was added on the distal line angle of 11 & 21

as they were labially placed due to the mesio-distal rotation.

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On the Test Drive day, a silicone index was

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prepared on the wax mock up. The silicone index was trimmed
around gingival borders of wax imprints to enable accurate
transfer and minimal adjustments of Test Drive.

Spot Etching was done with 37% Phosphoric acid on all

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10 teeth without any preparation and single bond was applied

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and cured with light. The silicon index was filled with BisGMA
acrylic (Cool Temp Self Cure Composite, Shade A1) and was
seated on the existing teeth in the patients mouth. Excess was

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removed before setting. After setting time, the silicone index

was removed. Fine adjustments were done and GC one coat

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bond was applied to block porosities &give a natural shine.

The photographs were repeated as per DSD protocol. The
before and after photographs were shown to patient on a big

TV screen in the clinic. (Fig. 4a 4d)

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Fig. 4a 4d: After Result Photographs

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The patient and her family were thrilled with her new
personalized smile. The further course of treatment along with
options of materials was discussed with the patient at this

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point of time.

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From Here to

From Here to

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Here

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ADVANTAGES of DSD

Here

Final View

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From Here to

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From Here to

1. It gives clinician a definitive road map of final outcome of

treatment before initiating any permanent changes in
patient's mouth.

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2. Involvement of necessary inter-disciplinary team members

is considered before Test Drive.

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3. The treatment time, cost, choice of materials can be

evaluated before initiating treatment.

4. DSD helps in creating symmetrical and iconic smile.

5. Visagism

concept

helped

in

creating

an

internal

personality based smile.

6. The patient is involved in the process of treatment

planning that gives a huge feel good factor to the patient
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and family members.

7. Any minor changes can be incorporated in the definitive
treatment.

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SUMMARY
DSD is a triple concept, which involves maths, science & art.
Today with the CAD-CAM machines, DSD can be reproduced
accurately. Whatever we plan, whatever we show to the patient
as a TEST DRIVE can be 100% copied in to the final treatment.

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Isn't that amazing??

My Take-(Dr. Rajiv Verma, DSD Master

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Lecturer Asia.)

&

DSD

I congratulate Dr. Aslam lnamdar, one of our DSD Team

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Members, for an excellent attempt in providing an option to

his patient to visualize her new mathematically accurate
teeth/smile even before actually starting the treatment. End

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result predicted even before the beginning, this is the power of

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DSD. I would like to give wax up credit to a young technician

Mr. Pradip Chiwade for his decent work, considering a fact

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that all are pretty new to the DSD concept.

{Dear Readers: The above article was first published in Orosphere October
2015 issue and has been republished with prior permission from the author
Dr.

Aslam

Inamdar

&

the

Publishing

House,

Orosphere.

The

IDA

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acknowledgment is due to IDA Jalgaon Branch as well.}.

P.S. Any feedback/compliments/queries for the Author should be

emailed to the Editor-in-Chief, Dr. Bhavdeep Singh Ahuja at his
email id: drbhavdeep@gmail.com

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Aathwaa Gyaan

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Resorbed Ridges
A True Challenge to Treat

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Dr. Rohit Gupta completed his graduation from, Indias most prestigious
& old institution, G.D.C.H. Patiala in 1999. He completed a certification
course in orthodontics in year 2002. In 2006, he trained in implants at
the Advanced Training Program in Surgical Implantology & Prosthodontics
& in 2009, he did a P.G. Certificate Course from American Academy of
Implant Dentistry, Chicago (USA). He is a Member of AOI & a Member
of AAID. He owns the state of art clinic in Ludhiana & has been into
clinical practice since 15 yrs. He has lectured about Endodontics and
Implantology at many forums.

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INTRODUCTION

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Author: Dr. Rohit Gupta

As the average life span of the population is increasing, more

number of people are visiting dentists for replacing missing teeth

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which may have been lost due to caries, failed endodontics,

fracture of teeth, or periodontal reasons. As the tooth is lost the

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alveolar bone supporting the tooth starts to resorb, and if the

time span between losing a tooth and replacing with an implant
increases more is the bone loss. The bone loss can be horizontal,

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vertical or both. Bone augmentation or bone manipulation has to

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done to place the implants in ideal position to restore the missing

teeth in normal contour, function, esthetics and health.

Case Report

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A 66 years old male reported to our office with chief complaint of

inability to chew food. He used only his anterior teeth for biting
on food. He had a desire of fixed teeth only. On clinical
examination and radiographic examination, numerous findings

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were noted viz. below:

1. Patient had a deep bite,
(44-48),

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2. Missing Mandibular molars and premolars bilaterally (34-38) &

3. A buccal sinus tract along 41.

4. In the maxillary arch, a palatally placed root piece of 12,

5. Fractured 13 & 22,

6. Missing 15,16,17 &

7. Missing 26,27. [Fig. 1-5]

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Intraoral examination revealed thin mandibular ridges. The ridge

width on right posterior region was 3.3mm while that on left side

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Fig-2. Occlusal View

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Fig-1. Frontal View

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was 2mm. [Fig.1-5]. A pre-operative OPG was also done. [Fig. 6]

Fig-3. Occlusal View Upside down

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Fig-4. Occlusal View of Mandible

Fig-5. Occlusal View of Mandible Upside down

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Note the ridge width of the Mandible

Fig-6. Pre-Operative OPG

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MEDICAL HISTORY
Patient reported as a well-controlled diabetic, mild hypertensive.
No

significant

health

problem

and

history

of

any

other

medications.

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DIAGNOSTIC SETUP

Study models were made and mounted on the articulator. The

mounting concluded minimal vertical height for the prosthesis.

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[Fig. 7]

Fig-7. Mounting of Study Models on Articulator

Various treatment planning modalities could be implemented like

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extracting all the teeth in mandible and providing full fixed

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implant supported prosthesis but a few teeth were restorable. So

the apt plan was to provide implants in mandibular posterior
region and restore the lower anterior with crowns and bridges.

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The maxillary arch was decided to be restored with fixed bridge.

Vertical dimension of occlusion was determined for the patient

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using bite blocks and the records were transferred on the

articulator. So with the end result in mind, a diagnostic wax up
was constructed on the articulator on the predetermined vertical
[Fig.8-11]. A radiographic stent was constructed using this wax
up and patient was sent for the CT scan [Fig.12-15].

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Fig-8-9. Established Vertical Height & Diagnostic Was up of

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Occlusion

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Fig-10-11. Try in of the Wax up & Occlusal view of the try-in

Fig-12. CT Scan of Right Mandible (1st Molar Area)

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Radiographic Stent & Ridge relation to the molar

Fig-13. CT Scan of Right Mandible (Premolar Area)

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Fig-14. CT Scan of Left Mandible showing a very thin ridge

Fig-15. CT Scan of Left Mandible (Molar Area)

TREATMENT REGIMEN

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1. After viewing the CT scan it was decided to do three implants

and simultaneous grafting on right side but only grafting on
the left side of mandible.

2. Tooth No. 12, 13 and 22 were extracted.

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3. Patient was put on antibiotic regimen (Augmentin 625mg to be

taken twice daily) 24 hrs before surgery.

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4. The radiographic stent was converted into surgical stent and

three implants (Tapered Internal Biohorizons) 3.8 X 9mm were
inserted in right side of mandible.

5. The buccal bone was augmented using TCP (tri calcium

phosphate)

bone

graft

particles

mixed

with

irradiated

cancellous bone (Rocky Mountain) and PRP.

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6. Before placing the graft the host cortical bone was perforated
in between the implant site with round carbide bur. Then it
was covered with resorbable collagen membrane and primary
closure was obtained.
made and full thickness flap was reflected.

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7. Similarly on the left side of mandible, crestal incision was

8. The cortical plate was perforated with a round carbide bur and

a mix of TCP, irradiated cancellous bone (Rocky Mountain) and

membrane.

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PRP was placed and was covered with resorbable collagen

obtained.

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9. The periosteum was released and tension free closure was

10. Patient was advised a soft diet, Chlorhexidine mouth rinses

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and anti-inflammatory drugs.

11. Post operative instructions were given to the patient. The

report to the dental office.

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patient was informed that in case of any discomfort he must

12. On next recall after 15 days, sutures were removed. The

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healing took place uneventfully.

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13. After 6 months post operative CT scan was done which had

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optimal bone growth [Fig.16-20].

Fig-16. Six (6) months Post Operative Healing showing good

width of bone in the mandible

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Fig-17. Panoramic Image after Six (6) months

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Fig-18. Implants in Right Mandible in Premolar Area

Fig-19. Bone growth Buccal to Implants

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Fig-20. Left Mandible showing increase in width of bone

14. After 6 months three implants (Tapered Internal Biohorizons)

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were placed in left side of mandible. Two implants of

3.8x10.5mm in the 34 and 35 and on implant of 3.8x9mm in

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the 36 region.

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15. The implants were allowed to heal for further 3 months.

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Fig-20. Implant uncovered in Right Mandible after 8 months

16. While the implants were healing patient was instructed to wear
an acrylic bite plate. This bite plate was constructed at the
established vertical dimension of occlusion.

17. Patient wore this plate for 8 weeks and was comfortable at this
vertical plane of occlusion.

18. The prosthesis was made at this established plane of

occlusion.
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19. Three splinted cementable porcelain fused to metal crowns

were given bilaterally in the posterior mandible.
20. Mandibular anterior segment was restored with PFM bridge
and maxillary arch was restored with porcelain fused to metal

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bridge.

Fig-21. Finished Case Gingival Porcelain wasnt given on

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Lateral Incisors as the patient had a low lipline

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Fig-22. Final View a Happy & a smiling Patient

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21. Occlusal scheme given to the patient was group function.

22. Patient was also given a hard acrylic maxillary night guard to
be worn at night to guard the implant site from parafunctional
forces.

23. Final Result A Smiling and a happy patient [Fig.21-22].

24. Anterior Guidance, Right & left lateral Excursions were carried
out to check for any interferences [Fig.23-25].

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Fig-23. Anterior Guidance

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Fig-24. Right Lateral Excursion

Fig-25. Left Lateral Excursion

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Fig-26. Occlusal View Mandible

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Fig-27. Occlusal View Mandible Upside View

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Fig-28. Occlusal View Maxilla

Fig-29. Occlusal View Maxilla Upside View

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Fig-30. Smiling Patient

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DISCUSSION

The goal of any therapy is to restore the patient to normal

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contour, function, comfort, esthetics, speech and health. In all

the cases before placing implants the prosthesis should be
designed first so that key implant positions can be determined

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and the force factors for the case should be planned. Determining

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the force factors of the patient help us to decide the number and
size of implants and type of prosthesis to be given.

In this case from the wax up and the radiographic

stent, we determined the ideal position of the implants. From the

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wax up and radiographic stent, it was decided that on left side of

mandible the buccal bone deficiency was large and to restore the
arch form of the patient we have to graft the ridge first and then
place the implants, whereas on right side of mandible we did

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simultaneous placement of implants and grafting.

P.S. Any feedback/compliments/queries for the Author should be

emailed to the Editor-in-Chief, Dr. Bhavdeep Singh Ahuja at his
email id: drbhavdeep@gmail.com

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Nauwaa Gyaan

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Dr. Harsimran Singh Sethi did his postgraduation in Pediatric Dentistry from
Christian Dental College, Ludhiana. He presently runs a practice devoted to
children by the name of UR TINYs DENTIST at Ludhiana. He is working as an
Asst. Prof. in the Dept. of Pediatric Dentistry, MGS Dental College, Sgnr. He is
actively involved in research and has publications in leading indexed journals and
is also on the reviewer board of certain national and international journals.

MAYNES SPACE MAINTAINER

A Useful Tool

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Author: Dr. Harsimran Singh Sethi

INTRODUCTION

Space maintainers are usually indicated for early loss of

deciduous teeth to prevent a mesial collapse of the arch. They

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help us to maintain the space for the erupting permanent tooth.

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While the story for anterior tooth loss is entirely

different, band and loop space maintainers have proven to be gold
standards for space maintenance in the first and second primary
molar area. However, even band and loop space maintainers pose

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few problems. One of them is the recurrent food lodgment

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eventually when remodelling of the buccal bone takes place.

THE APPLIANCE

Maynes space maintainer is a modification of band and loop

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space maintainer in that the buccal arm of the appliance is

lacking. Only the lingual arm is present. It was discovered based
on the logic that loss of space usually happens in the
mesiolingual direction following extraction. So only the lingual
arm seemed to be functional. However, it was seen that the

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appliance lost its rigidity and became amenable to easy movement

by the child; eventually leading to the appliance been dislodged

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and broken more frequently.

Fig. 1: The Maynes Appliance

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CASE STUDY
In the present case, the child presented with a grossly decayed
mandibular first molar at the age of 7 years which required
extraction.
We fabricated a Maynes space maintainer with band
on the first permanent molar and a composite dimple to stabilise
the free end of the appliance which rested onto the canine. This

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helped to provide rigidity to the appliance and proved

comfortable for the patient also. Choosing the first permanent

molar as the abutment was a critical decision because in many

cases it is seen that the first premolar usually erupts later than

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the second especially following early loss of first deciduous molar.

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Fig. 2: The Maynes Space Maintainer

Fig. 3: The Composite Dimple attached to the free end of the

appliance.

P.S. Any feedback/compliments/queries for the Author should be

emailed to the Editor-in-Chief, Dr. Bhavdeep Singh Ahuja at his
email id: drbhavdeep@gmail.com

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Daswaa Gyaan

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Dr. Bhavdeep Singh Ahuja graduated in 1998 from Punjabi University,

Patiala. He has specialized in Implants from BioHorizons Inc. USA in
2004-05 & in Advanced Course from LACE-ICOI, USA in 2006. Apart
from Dentistry, he holds a Triple M.B.A. in Hospital Management, Human
Resources & Marketing from three premier Institutes/Universities of
India viz. the IIMM, IGNOU & Annamalai University. He holds a Post
Graduate Diploma in Medical Law & Ethics (NLSIU), Clinical Research,
Cyber Law, Disaster Management, Financial Management, Bioinformatics
amongst many more from different Universities. He is a Certified Health
Care Waste Manager from IGNOU & is qualified in Consumer Law as well.
He is an academically oriented dentist & has many Original Scientific
Publications to his credit in many International & National journals.
Presently, he is into 17th year of Clinical Practice in Ludhiana, Punjab.

Managing Better An Art & a Science - I

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A few Rules None too Many

Author: Dr. Bhavdeep Singh Ahuja

INTRODUCTION

our

Lets define Marketing!!!

Marketing is about creating satisfactory exchanges via effective and

communication

with

consumers

and

building

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integrated

relationships with customers and with other publics who could

impact organizational performance by means of effective corporate

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communication.

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However; Marketing is not selling.

Who says that?

None other than the guru of all marketing gurus, Philip Kotler.

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much more than selling.

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Selling, of course, is part of marketing, but marketing includes

Peter Drucker observed that the aim of marketing is to make
selling superfluous. What Drucker meant is that marketings task
is to discover unmet needs and to prepare satisfying solutions.

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When marketing is very successful, people like the new product,

word-of-mouth spreads fast, and little selling is necessary.

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Marketing cannot be equivalent to selling because it starts long

before the company has a product. Marketing is the homework
that managers undertake to assess needs, measure their extent
and intensity, and determine whether a profitable opportunity
exists. Selling occurs only after a product is manufactured.
Marketing continues throughout the products life, trying to find
new customers, improve product appeal and performance, learn
from product sales results, and manage repeat sales.
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Marketing is creative, exciting and dare-I-say fun.

Brainstorming ideas late into the night, Throwing ideas around,
watching them get better and bigger by the minute - how cool is
that? Seeing your ad in print for the first time, or watching the
results of an email campaign right after you hit the send button - it

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is pure adrenaline. There was a time when brilliant creative was

appreciated for being brilliant creative.

Marketing folks are, for the most part, not too fond of

process, reporting or anything that might limit creativity. At least

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that's how most non-marketers view marketing people. Some

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marketers would certainly classify themselves as "right-brain"

types, not inclined to documentation, data or discipline. Not

everyone fits this description, and it might be hard for some of you
to hear. Marketing is one of the last disciplines to apply process,

The RULES

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effectiveness.

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automation and technology to improve both efficiency and

1. Rule 1: Rule 1 says Rules are meant to be broken.

be Continued)

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(to

REFERENCES

1. Phillip Kotler, Gary Armstrong, John Saunders, Veronica Wrong et

al. Principles of Marketing, 2nd European Edition
Twelfth Edition

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2. Phillip Kotler, Kevin Lane Keller et al. Marketing Management,

3. Laura Lowell; 42 rules of marketing
4. The

Expert

Guide

to

Affiliate

Marketing;

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http://Rags2RichesSystem.biz

IDA

Dear Readers: Important Announcement

The above article by Dr. Bhavdeep S. Ahuja will be published in many parts.
The above is Part I.

Check out L.E.D. Issue Feb. 2016 Vol. 1 Issue 2 for the IInd part of the above
article.

P.S. Any feedback/compliments/queries for the Author should be

emailed to the Editor-in-Chief, Dr. Bhavdeep Singh Ahuja at his
email id: drbhavdeep@gmail.com
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for

Your honest opinion is of immense value to us. For encouraging the

same, we are starting an award for Best Feedback Series every

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month. Send your feedback to the Editor in-Chief, Dr. Bhavdeep

Singh Ahujas email at drbhavdeep@gmail.com regarding what is

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your overall opinion on E-Journal L.E.D. (Lets Enjoy Dentistry) or on

the current issue or any particular section of it. The feedback can be
like a performance appraisal, critique review, criticism, applause,

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appreciation etc. In short both, bouquets and brickbats are welcome

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in equal measure by us. We would be happy to publish with due

credits (both critique review and admiration), the award winning
feedbacks in the next issue of the Publication. However, if the
Branch Member wishes to keep his/her identity secret/hidden, the

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feedback would be published under the heading Anonymous. The

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best feedback (every month) stands to win a surprise gift at the next
CDE/GBM of IDA Ludhiana Branch. So, if you want to win a prize,
get going, type out your honest feedback and send it to the Editor-in-

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Chief, Dr. Bhavdeep Singh Ahujas email at drbhavdeep@gmail.com.

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E-Journal

1. Author Guidelines

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2. Dental Council of India Revised Code of Ethics

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* New from this Issue

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L.E.D. E-Journal January 2016 Vol. 1 Issue 1

APPENDICES Index

1.
2.

Author Guidelines
DCI - Revised Code of
Ethics

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Details

Page No.
From To
For Publishing 128 132
Dental Council 133 142

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Title

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S. No.

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of India

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Author Guidelines
The Editor invites contributions for the IDA Ludhiana Branch E-Journal:
1.
2.
3.
4.

Systemized Review articles

Original Research articles
Short Communications
Clinical Case Reports

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Review articles: These provide an in-depth review of a specific topic by

systematic critical assessments of literature and data sources.
Appropriate use of tables and figures is encouraged. Where relevant, key
messages and salient features may be provided up to 4000 words
excluding references and abstract.

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Research articles: These scientific reports give results of original

research. These should have a structured abstract (consisting of
Background, Aims, Methods, Results & Conclusions) and should follow
the IMRAD (Introduction, Methods, Results and Discussion) format (upto
2500 words).

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Short Communications: These are brief reports on research (approx.

1200 to 1500 words). A short report may include up to 3 tables or figures
and 15 to 20 references.

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Clinical case reports: Previously undocumented disease process, a

unique unreported manifestation or treatment of a known disease
condition. (approx. 700 to 1200 words) will be given priority.

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Covering Letter
The covering letter should outline the importance of the paper and its
appropriateness for publication in the Journal. It should specify the
section of the Journal for which the submitted article is to be considered.
It should also explain, with reasons, if there is any deviation from the
IMRAD format. If the work has been previously published in part or
whole (e.g. as an abstract or proceedings of a conference), this must be
stated. Any conflicts of interest, or their absence, must be stated in
writing.

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Title Page
This should contain the title, running title, 3-5 Keywords, names of all
the authors (without degrees or diplomas), names and full location of the
departments and institutions where the work was performed, name of
the corresponding author, acknowledgement of financial support and
abbreviations used. Superscripted numbers should be used after each
authors name and the department and institution corresponding to each
number should be specified on the page. Names of authors should
appear in the order of authorship

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The title should be brief but complete and should represent the major
theme of the manuscript. It should include the animal species if
appropriate. A subtitle can be added if necessary. Abbreviations should
not be used. The short title should not exceed 60 characters (including
inter-word spaces). It will be used as a running head. The name,
telephone and fax numbers, and complete e-mail and postal addresses of
the author to whom communications and requests for off prints are to be
sent should be mentioned in the title page. In general, the use of
abbreviations is discouraged unless they help in improving the
readability of the text. The expanded form of each abbreviation should
precede its first use in the text unless it is a standard unit of
measurement.

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Abstract
The abstract (250 words) should be structured and a concise and
accurate summary of the article and should not contain abbreviations,
tables, figures, footnotes or references. It should not draw conclusions
stronger or more expansive than those in the body of the paper. Briefly,
the background should explain why the study was done, the methods
provide how the study was done, the results provide the salient results
along with important data and the conclusions briefly highlight the
message of the study.

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Introduction
The introduction should state why the study was carried out and what
the specific aims of the study were. It should describe the background for
the study (the available knowledge), its importance and its goals. It
should be brief but complete enough for the reader to understand the
reasons for the study without having to read previous publications on
the subject.

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Methods
The validity of a study is judged by the methods used. These should be
described in sufficient detail to permit evaluation and duplication of the
work by others. The following should be described in this section:

Study design

Setting

Selection of participants (Sampling Technique)

Interventions (Randomization & blinding, if applicable)

Methods of measurement

Data collection and processing

Loss of data such as dropouts or patients lost to follow up

Statistical methods used

Ethical guidelines followed by the investigators

Consort guidelines in cases of randomized control trials

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Results
These should be concise and include only the tables and figures
necessary to enhance understanding of the text. Suitable labels referring
to the specific tables and figures must be mentioned in the text. Results
should be presented in a logical, sequential order that parallels the
organization of the methods section. The text should be used to highlight
the most important aspects of the figures and tables, and to convey
unique information. Data presented in tables and figures should not be
duplicated in the text. Drug names, wherever used, should be generic. If
the use of proprietary names is deemed a must for the study, generic
names should be mentioned in parentheses. Units of Measurement SI
units should be used. Temperature should be expressed in degrees
Celsius and blood pressure in mmHg.

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Discussion
The discussion should summarize how the study findings add to the
current knowledge, provide explanations for the findings, compare the
studys findings with available studies, discuss the limitations of the
study and the implications for future research. Only those published
articles directly relevant to interpreting the results and placing them in
context should be referenced. Do not repeat the results in the discussion.
This section should conclude with a brief summary statement. The
conclusion should be based on and justified by the results of the study.
The particular relevance of the results to healthcare in India should be
stressed. Conclusions regarding cost-benefit should be drawn only if a
specific economic analysis formed a part of the study design.

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References
References should be numbered in the order in which they appear in the
text and these numbers should be inserted above the lines
(superscripted) on each occasion the reference is cited (e.g. Sinha12
confirmed other reports13,14...). References included at the end of a
sentence or part of a sentence should be placed after the punctuation
mark. (Superscripting of the references is excusable/can be done away in
some cases) References cited only in tables or in legends to figures
should be numbered in accordance with the sequence established by the
first identification in the text of the particular table or figure. Avoid using
abstracts as references. For papers accepted but not yet published
mention the name of the journal, the year of publication and add in
press in parentheses. Information from papers submitted for publication
but not accepted should be cited in the text as unpublished observations
with written permission from the source. Avoid citing a personal
communication unless it is essential; such citations must list in
parentheses in the text the name of the person and date of
communication. Written permission, obtained from the author of such
communications for their use in the manuscript, must be submitted to
the Journal. Do not include personal communications in the list of
references. At the end of the article, the full list of references should
include the names of authors, the full title of the journal article or book
chapters; the title of journals abbreviated according to the Index Medicus
style (www.nlm.nih.gov/bsd/uniform_requirements.html) the year of
publication, the volume number and the first and final page numbers of
the article or chapter. If there are six or fewer authors in the study being
cited, the names of all the authors should be given. If there are more
than six authors, the names of the first six authors should be given
followed by et al. The authors should check that the references are
accurate; lack of accuracy may result in the rejection of an otherwise
adequate manuscript.

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Tables
These should be typed in double space, each table on a separate page
with the table number (in Roman numerals) and title above the table,
and explanatory notes below the table. Tables should be so arranged that
comparisons of interest are horizontal (across columns) and from left-toright. The numbers of observations for each column or row (n) and
marginal totals should be provided where appropriate. All abbreviations
and symbols in the table must be explained in the footnote(s) to the
table, even if the expanded forms have already been mentioned in the
text. The units of measure must be mentioned.

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Figures
Each image should be less than 400 kb in size. Size of the image can be
reduced by decreasing the actual height and width of the images (keep
up to 1024x760 pixels or 5 inches). All image formats (jpeg, tiff, gif, bmp,
png, eps, etc.) are acceptable; jpeg is most suitable. Do not zip the files.

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Legends to figures
These should be typed in double space on a separate sheet and figure
numbers (in Arabic numerals), should correspond with the order in
which the figures are presented in the text. The legend must include
enough information to permit interpretation of the figure without
reference to the text. Any labels or abbreviations within the figure must
be explained in the legend.
Authors
All authors should have participated sufficiently in the work to take
public responsibility for the content. All authors must sign an
undertaking accepting responsibility for the submitted manuscript.
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Authors are required to state their exact contribution to the study; the
Journal may print this information. The order of authorship should be
decided by all the authors. The journal strongly discourages alterations
in the sequence or deletion/addition of authors at any time after
submission of the manuscript.

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Acknowledgements
All contributors who do not meet the criteria for authorship should be
listed in an Acknowledgements section. Examples of those who might be
acknowledged include a person who provided purely technical help, or
statistical or writing assistance. Financial and material support should
also be acknowledged.

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Conflict of interest
A conflict of interest exists when a financial or personal relationship of
the author may inappropriately influence his or her actions. Conflicts
may be personal, commercial, political, academic, or financial. Some
examples of financial conflicts of interest include employment; research
funding (received or pending), stock or share ownership, payment for
lectures or travel, consultancies and non-monetary support. Conflicts, or
their absence, must be stated in writing by all authors at the time of
submission of the article. The Journal may use information disclosed in
conflict of interest and financial interest statements as a basis for
editorial decisions. Sources of full or partial funding or other support for
the research must be declared.

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Copyright
Authors must agree in writing to transfer to the Journal the copyright for
all material submitted, in case of its publication by the Journal. The
published manuscript may not be reproduced elsewhere, wholly or in
part, without the prior written permission of the Journal.

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Plagiarism
Plagiarism is the use of others published and unpublished ideas or
words (or other intellectual property) without attribution or permission,
and presenting them as new and original rather than derived from an
existing source. This applies to all forms of documents, published (print
or electronic) or unpublished. Authors should make sure that their
manuscripts are free from plagiarized material. Providing a reference to
the material quoted verbatim from previously published material does
not absolve the user of plagiarism. Detection of plagiarism would lead to
rejection of the manuscript and debar the publication of any material
from the concerned authors for at least three years. The Journal may
also send this information to the head of the institution where the
authors work with a request for an inquiry in the matter. The Journal
may also publish such correspondence in its pages to inform its readers
of scientific misconduct.

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Editorial Process
A manuscript will be reviewed for possible publication with the
understanding that it is being submitted to L.E.D. E- Journal alone at
that point in time and has not been published anywhere, simultaneously
submitted, or already accepted for publication elsewhere. The journal
expects that authors would authorize one of them to correspond with the
Journal for all matters related to the manuscript. All manuscripts
received are duly acknowledged. On submission, editors review all
submitted manuscripts initially for suitability for formal review.
Manuscripts with insufficient originality, serious scientific or technical
flaws, or lack of a significant message are rejected before proceeding for
formal peer-review. Manuscripts that are unlikely to be of interest to the
L.E.D. E- Journal readers are also liable to be rejected at this stage itself.
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Manuscripts that are found suitable for publication in L.E.D. E- Journal

are sent to two or more expert reviewers. During submission, the
contributor is requested to provide names of two or three qualified
reviewers who have had experience in the subject of the submitted
manuscript, but this is not mandatory. The reviewers should not be
affiliated with the same institutes as the contributor/s. However, the
selection of these reviewers is at the sole discretion of the editor. The
journal follows a double-blind review process, wherein the reviewers and
authors are unaware of each others identity. Every manuscript is also
assigned to a member of the editorial team, who based on the comments
from the reviewers takes a final decision on the manuscript. The
comments and suggestions (acceptance/ rejection/ amendments in
manuscript) received from reviewers are conveyed to the corresponding
author. If required, the author is requested to provide a point by point
response to reviewers comments and submit a revised version of the
manuscript. This process is repeated till reviewers and editors are
satisfied with the manuscript.
Manuscripts accepted for publication are copy edited for grammar,
punctuation, print style, and format. Page proofs are sent to the
corresponding author. The corresponding author is expected to return
the corrected proofs within three days. It may not be possible to
incorporate corrections received after that period. The whole process of
submission of the manuscript to final decision and sending and receiving
proofs is completed online.

Signatures
(Digital)

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Copyright form
The undersigned author transfers all copyright ownership of the
manuscript (Title) to (IDA Journal Ludhiana print and online version)
bothin the event the work is published. The undersigned author
warrants that the article is original, is not under consideration for
publication by another journal and has not been previously published. I
sign for and accept responsibility for releasing this material on behalf of
any and all co-authors.
I declare that there is neither a direct quote from any other copyrighted
material or author nor are there any tables or pictures.
The laboratory work is done by (Name of the Laboratory) and the name,
credential and address have been duly attributed at the end of the
article. {If Applicable}
Appropriate references to the various published articles from scientific
publications with the name of the author and name of publication are
given at the end of the article in a numbered fashion as well as the
appropriate reference numbers are mentioned.
We give the rights to the corresponding author to make necessary
changes as per the request of the journal, do the rest of the
correspondence on our behalf and he/she will act as the guarantor for
the manuscript on our behalf.
All persons who have made substantial contributions to the work
reported in the manuscript, but who are not contributors, are named in
the Acknowledgment and have given me/us their written permission to
be named. If I/we do not include an Acknowledgment that means I/we
have not received substantial contributions from non-contributors and
no contributor has been omitted.

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Revised Dentists (Code of Ethics) Regulations 2014

DENTAL COUNCIL OF INDIA

NOTIFICATION

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New Delhi, the 27th June, 2014

No. DE-97-2014.In exercise of the powers conferred by Section 20 read with Section 17A of the Dentists Act, 1948
(16 of 1948), the Dental Council of India with the previous sanction of the Central Government, in supersession of the
Dentists (Code of Ethics) Regulations 1976, except as respects things done or omitted to be done before such
supersession, hereby makes the following Dental Council of India (Code of Ethics) Regulations :
1.
Short title and Commencement :
1.1 These regulations may be called the Revised Dentists (Code of Ethics) Regulations, 2014.
1.2 They shall come into force on the date of their publication in the Official Gazette of India.
2.
Definitions :
In these regulations, unless the context otherwise requires;
2.1 Act means the Dentists Act, 1948 (16 of 1948);
2.2 Council means the Dental Council of India;
2.3 Dentist means any person with a register able dental degree (in Part A or Part B of the State Dental Register)
either by virtue of a prior registration with the Council or one who has been conferred a Bachelor of Dental
Surgery (BDS) from any university recognized by the Council and shall be referred to as a Dentist or Dental
Surgeon;
2.4 Post graduate dental degree refers to any postgraduate qualification such as M.D.S. in any discipline of
dentistry received by convocation from a University recognized by the Dental Council of India or any other
post graduate qualification equivalent to MDS that is recognized by the Council;
2.5 All expressions used and not defined in these regulations shall have the meanings assigned to them in the
Act and the regulations made there under from time to time.
3.

CHAPTER 1
Code of Dental Ethics
A. Declaration :
Every dentist who has been registered (either on Part A or Part B of the State Dentists Register) shall, within
a period of thirty days from the date of commencement of these regulations, and every dentist who gets
himself registered after the commencement of these regulations shall, within a period of thirty days from
such registration, make, before the Registrar of the State Dental Council, a declaration in the form set out for
the purpose in the Schedule to these regulations and shall agree to have read, understood and thence to
abide by the same.

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Revised Dentists (Code of Ethics) Regulations 2014

B.
3.1

3.2

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3.3

Duties and Obligation of Dentists in General

Character of Dentist / Dental Surgeon
In view of the important role of a Dentist/ Dental Surgeon as a health professional educated and trained in
surgical and medical treatment of diseases of the Oral cavity, he shall:
(3.1.1) Be mindful of the high character of his mission and the responsibilities he holds in the discharge of
his duties as an independent health-care professional and shall always remember that care of the
patient and treatment of the disease depends upon the skill and prompt attention shown by him and
always remembering that his personal reputation, professional ability and fidelity remain his best
recommendations;
(3.1.2) Treat the welfare of the patients as paramount to all other considerations and shall conserve it to
the utmost of his ability;
(3.1.3) Be courteous, sympathetic, friendly and helpful to, and always ready to respond to, the call of his
patients, and that under all conditions his behaviour towards his patients and the public shall be
polite and dignified;
Maintaining good Clinical Practices :
The Principal objective of the Dental profession is to render service to humanity with full respect for the
dignity of profession and man. Dental Surgeons should merit the confidence of patients entrusted to their
care, rendering to each a full measure of service and devotion. They should try continuously to improve
medical knowledge and skills and should make available to their patients and colleagues the benefits of
their professional attainments. The Dentist/ Dental Surgeon should practice methods of healing founded
on scientific basis and should not associate professionally with anyone who violates this principle. The
honoured ideals of the dental profession imply that the responsibilities of the Dental Professionals extend
not only to individuals but also to Society.
(3.2.1) The Principal objective of the Dental profession is to render service to humanity with full respect
for the dignity of profession and man. Dental Surgeons should merit the confidence of patients
entrusted to their care, rendering to each a full measure of service and devotion. They should try
continuously to improve medical knowledge and skills and should make available to their patients
and colleagues the benefits of their professional attainments. The Dentist/ Dental Surgeon should
practice methods of healing founded on scientific basis and should not associate professionally
with anyone who violates this principle. The honoured ideals of the dental profession imply that
the responsibilities of the Dental Professionals extend not only to individuals but also to Society.
(3.2.2) Membership in Dental and Medical Associations and Societies: For the advancement of his/her
profession, a Dental Surgeon should be encouraged to affiliate with associations and societies of
dental, oral and allied medical professionals and play a proactive role in the promotion of oral health
in particular and health of an individual in general.
(3.2.3) A Dentist/Dental Surgeon should enrich his professional knowledge by participating in professional
meetings as part of Continuing Dental and Medical Education programs/Scientific Seminars/Workshops
as stipulated by the regulations made by the statutory bodies from time to time and should register
any mandatory requirements with the state registration bodies or any other body as stipulated.
Maintenance of Dental/Medical records :
(3.3.1) Every Dental surgeon shall maintain the relevant records pertaining to his out- patients and inpatients
(wherever applicable). These records must be preserved for a minimum period of three years from
the date of commencement of the treatment in a format determined by the Council or accepted as a
standard mode of documentation.
(3.3.2) If any request is made for medical or dental records either by the patients/authorized attendant or
legal authorities involved, the same may be issued to the competent authority within 72 hours after
having obtained a valid receipt for all documents. It is prudent to keep certified photocopies /
carbon copies of such submissions.
(3.3.3) A Registered Dental practitioner shall maintain a Register of Medical Certificates giving full details
of certificates issued. When issuing a medical certificate he shall always enter the identification
marks of the patient and keep a copy of the certificate. He shall not omit to record the signature and/
or thumb mark, address and at least one identification mark of the patient on the medical certificates
or report. The medical certificate shall be prepared as in Appendix 2 of this document, Revised
Dentists Code of Ethics Regulations, 2012.
(3.3.4) Efforts shall be made to digitalize dental/ medical records for quick retrieval.
Display of Registration Numbers :
(3.4.1) Every Dental practitioner shall display the registration number accorded to him by the State Dental
Council in his clinic and in all his prescriptions, certificates and money receipts given to his patients.
(3.4.2) Dental Surgeons shall display as suffix to their names only recognized Dental degrees which are
recognized by the Council or other qualifications such as certificates/diplomas and memberships/

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honours/ fellowships which are conferred by recognized Universities/ recognized bodies approved
by the Council and obtained by convocation in person or in absentia. Any other qualifications
such as medical degrees, doctorates, post-doctoral degrees or any degree that has bearing on the
persons knowledge or exemplary qualification may be used as suffix in a manner that does not
convey to the observer or patient a false impression regarding the practitioners knowledge or
ability as a dental professional. Abbreviations of memberships in association or organizations of
professionals should not be used as abbreviations in a manner that is misleading to the public
[refer to Article 8.9.3 of this document, Revised Dentists Code of Ethics Regulations, 2012 for
relevant details].
3.5 Prescription of Drugs :
Every dental surgeon should take care to prescribe and administer drugs in a responsible manner and
ensure safe and rational use of drugs. He should as far as possible, prescribe drugs in a generic form.
3.6 Highest Quality Assurance in patient care :
Every Dental practitioner should ensure quality treatment that does not compromise the outcome of treatment.
He must be vigilant about malpractice by other practitioners that may jeopardize the lives of others and which
are likely to cause harm to the public. All practitioners should be aware of unethical practices and practices by
unqualified persons. Dentists/ Dental Surgeons shall not employ in connection with their professional practice
any attendant who is neither registered nor enlisted under the Dentists Act and shall not permit such persons
to attend, treat or perform operations upon patients wherever professional discretion or skill is required.
3.7 Exposure of Unethical Conduct :
A Dental Surgeon should expose, without fear or favour, incompetent or corrupt, dishonest or unethical
conduct on the part of members of the profession. It is the responsibility of the dental surgeon to report to
the competent authorities instances of quackery and any kind of abuse including doctor-patient sexual
misconduct, misuse of fiduciary relationship, child abuse and other social evils that may come to their
attention.
3.8 Payment of Professional Services :
The Dental Surgeon, engaged in the practice of his profession shall give priority to the interests of
patients. The personal financial interests of a dental surgeon should not conflict with the medical interests
of patients. A dental practitioner should announce his fees before rendering service and not after the
operation or treatment is under way. Remuneration received for such services should be in the form and
amount specifically announced to the patient at the time the service is rendered. It is unethical to enter into
a contract of no cure - no payment. Dental Surgeons rendering service on behalf of the State shall refrain
from anticipating or accepting any consideration. While it is not mandatory to offer free consultations to
fellow dental or medical professionals and their immediate family, it will be deemed a courtesy to offer free
or subsidized consultations and treatment to them in situations where no significant expenses are incurred.
3.9 Observation of Statutes :
The Dental Surgeon shall observe the laws of the country in regulating the practice of his profession
including the Dentists Act 1948 and its amendments and shall also not assist others to evade such laws.
He should be cooperative in observance and enforcement of sanitary laws and regulations in the interest
of public health. He should observe the provisions of the State Acts like Drugs and Cosmetics Act, 1940;
Pharmacy Act, 1948; Narcotic Drugs and Psychotropic substances Act, 1985; Environmental Protection
Act, 1986; Drugs and Magic Remedies (Objectionable Advertisement) Act, 1954; Persons with Disabilities
(Equal Opportunities and Full Participation) Act, 1995 and Bio-Medical Waste (Management and Handling)
Rules, 1998 and such other Acts, Rules, Regulations made by the Central/State Governments or local
Administrative Bodies or any other relevant Act relating to the protection and promotion of public health.
3.10 Signing Professional Certificates, Reports and other Documents :
A Registered Dental Surgeon involved independently in the treatment of dental and oral surgical problems
may be called upon to sign certificates, notifications, reports etc. He is bound to issue such certificates and
to sign them. Documents relating to disability, injury in the oral and maxillofacial region and deaths occurring
while under the care of such dental surgeons should be signed by them in their professional capacity for
subsequent use in the courts or for administrative purposes etc. Such documents, among others, include
the ones given at Appendix 4. Any registered dental surgeon who is shown to have signed or given under
his name and authority any such certificate, notification, report or document of a similar character which is
untrue, misleading or improper, is liable to have his name deleted from the Register.

CHAPTER 2
DUTIES OF DENTAL PRACTITIONERS TO THEIR PATIENTS
4.1 Obligations to Patients
(4.1.1) Though a Dental Surgeon is not bound to treat each and every person asking his services, he
should attend emergencies reporting to the clinic and should be mindful of the high character of

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his/her mission and the responsibility he discharges in the course of his professional duties. The
Dental Surgeon should see patients at their hour of appointment as far as possible unless he is
unable to do so due to unforeseen delays. He should never forget that the health and the lives of
those entrusted to his care depend on his skill and attention. A Dental Surgeon should endeavour
to add to the comfort of the sick by making his visits at the hour indicated to the patients. A Dental
surgeon advising a patient to seek service of another Dental Surgeon or physician is acceptable.
However in the case of medical emergency a Dental Surgeon must institute standard care including
resuscitation in case of cardiac episodes, for which all dental surgeons must be adequately trained
in basic life support.
(4.1.2) A Dental Surgeon can refuse treatment using his discretion but it should not be on the basis of any
discrimination of colour, caste, religion, nationality or the presence of ailments such as HIV or other
contagious diseases. However in keeping with the dictum of medical care, the dental surgeon must
continue to treat if he/she has accepted the patient for treatment. Treatment can be terminated on the
wishes of the patient or with the resolution of the complaint for which the patient sought treatment.
Treatment can also be terminated if the patient is in need of additional or expert care for which the Dental
surgeon is not equipped to treat or if it falls outside the range of his expertise. In such instances, the
patient should be referred to such specialists or higher centres where treatment is possible.
(4.1.3) A Dental Practitioner having any incapacity detrimental to the patient or which can affect his
performance vis-a-vis the patient is not permitted to practice his profession.
Confidentiality :
Confidences concerning individual or domestic life entrusted by patients to a Dental Surgeon and defects
in the disposition or character of patients observed during professionally attending to a patient should
never be revealed unless such a revelation is required by the laws of the State. Sometimes, however, a
clinician must determine whether his duty to society requires him to employ knowledge, obtained through
confidence as a health care provider to protect a healthy person against a communicable disease to which
he is about to be exposed. In such instance, the Dental Surgeon should act as he would wish another to act
toward one of his own family in like circumstances.
Prognosis :
The Dental Surgeon should neither exaggerate nor minimize the gravity of a patients disease. He should
ensure himself that the patient, his relatives or his responsible friends have such knowledge of the patients
condition as will serve the best interests of the patient and the family.
The Patient must not be neglected :
A Dental surgeon is free to choose whom he will serve. He should, however, respond to any request for his
assistance in an emergency. Once having undertaken a case, the Dental Surgeon should not neglect the patient,
nor should he withdraw from the case without giving adequate notice to the patient and his family. He shall not
wilfully commit an act of negligence that may deprive his patient or patients from necessary Dental/Medical care.

CHAPTER 3
DUTIES OF DENTAL SURGEONS AND SPECIALISTS IN CONSULTATIONS
5.1 Consultation Etiquettes:
(5.1.1) A Dental Surgeon should ordinarily be able to deal with all common diseases of the Oral cavity by
virtue of his qualification and training. However, if the patient requires expert care of a specialist,
appropriate references to Dental or Medical specialists may be made according to the nature of the
problem. It is the duty of a specialist to refer the patient back to the patients original dentist after
the treatment for which the referral was made. While the specialist can collect his or her fees it
would be unethical to pay commissions or any kind of gratuity to the referring dental surgeon.
(5.1.2) A Dental Surgeon shall not receive from the radiologist, laboratory or dispensing chemist any kind
of commission in the form of money, gifts or gratuity for referrals. All referrals for investigation
should be judicious, justifiable and done in the best interests of the patient to arrive at a diagnosis.
5.2 Consultation for Patients Benefit:
In every consultation, the benefit to the patient is of foremost importance. All Dental Surgeons engaged in
the case should be frank with the patient and his attendants.
5.3 Punctuality in Consultation:
Punctuality for consultations should be observed by a Dental Surgeon except in the case of unavoidable
professional delays which are justifiable.
5.4 Opinions and Disclosure:
(5.4.1) All statements to the patient or his representatives made by any Consulting Healthcare Professional
and/or the paramedical staff(nurses, etc.,) should take place in the presence of the Dental Surgeon,
except as otherwise agreed. The disclosure of the opinion to the patient or his relatives or friends
shall rest with the Dental Surgeon.

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5.6

5.7

CHAPTER 4
RESPONSIBILITIES OF DENTAL SURGEONS TO ONE ANOTHER
6.1 Dependence of Dental Surgeons to each other:
A Dental Surgeon should consider it as a pleasure and privilege to render gratuitous service to other
dentists, physicians and their immediate family dependants. However there is no mandatory bar on one
accepting fees particularly when it involves expensive materials and time.
6.2 Conduct in Consultation:
In consultations, no insincerity, rivalry or envy should be indulged in. All due respect should be observed
towards the Dental Surgeon/physician in-charge of the case and no statement or remark be made, which
would impair the confidence reposed in him. For this purpose no discussion should be carried on in the
presence of the patient or his representatives.
6.3 Consultant not to take charge of the case:
When a specialist Dental Surgeon has been called for consultation, the Consultant should normally not
take charge of the case, especially on the solicitation of the patient or friends. The Consultant shall not
criticize the referring Dental Surgeon. He shall discuss the diagnosis treatment plan with the referring
Dental Surgeon.
6.4 Appointment of Substitute:
Whenever a Dental Surgeon requests another Dental Surgeon to attend his patients during his temporary
absence from his practice, professional courtesy requires the acceptance of such appointment only when
he has the capacity to discharge the additional responsibility along with his other duties. The Dental
Surgeon acting under such an appointment should give the utmost consideration to the interests and
reputation of the absent Dental Surgeon and all such patients should be restored to the care of the latter
upon his return.
6.5 Visiting another Case:
When it becomes the duty of a Dental Surgeon occupying an official position to see and report upon a
condition and appropriate treatment, he should communicate to the Dental Surgeon in attendance so as to
give him an option of being present. The Medical Officer/Dental Surgeon occupying an official position
should avoid remarks upon the diagnosis or the treatment that has been adopted.

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(5.4.2)
Differences of opinion should not be divulged to the patient unnecessarily but when there is
irreconcilable difference of opinion the circumstances should be frankly and impartially explained to the
patient or his relatives or friends. It would be up to them to seek further advice, if they so desire.
Treatment after Consultation:
No decision should restrain the attending Dental Surgeon from making such subsequent variations in the
treatment if any unexpected change occurs, but at the next consultation, reasons for the variations should
be discussed/ explained. The same privilege, with its obligations, belongs to the consultant when sent for
in an emergency during the absence of attending Dental surgeon. The attending Dental Surgeon may
prescribe medicine at any time for the patient, whereas the consultant may prescribe only in case of
emergency or as an expert when called for.
Patients Referred to Specialists:
When a patient is referred to a specialist by the attending Dental surgeon, a case summary of the patient
should be given to the specialist, who should communicate his opinion in writing to the attending Dental
surgeon.
Fees and other charges:
(5.7.1) A Dental Surgeon or the Clinic run by him shall clearly indicate the cost of treatment for the procedure
and make an estimate of all costs likely to be incurred. Any increase in subsequent cost should be
justified by the Dental surgeon. There is no bar on the display of fees and other charges in the Dental
Clinic. Prescription should also make it clear if the Dental Surgeon himself dispensed any medicine.
(5.7.2) A Dental Surgeon shall write his name and designation in full along with the recognized dental
degrees and the registration particulars in his prescription letter head.
Note: In Government hospitals where the patient-load is heavy, the name of the prescribing doctor must be
written below his signature.

CHAPTER 5
DUTIES OF DENTAL SURGEONS TO THE PUBLIC AND TO THE PARAMEDICAL PROFESSION
7.1 Dental Surgeons as Citizens:
Dental Surgeons, as good citizens, possessed of special training should disseminate advice on public
health issues. They should play their part in enforcing the laws of the community and in sustaining the
institutions that advance the interests of humanity. They should particularly co-operate with the authorities
in the administration of sanitary/public health laws and regulations.

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7.3

Public and Community Health:

Dental Surgeons, especially those engaged in public health dentistry, should enlighten the public concerning
oral health and prevention of oral diseases such as dental caries, periodontal health, precancerous lesions
and oral cancer. At all times the dental surgeons should notify the constituted public health authorities or
hospitals of every case of communicable disease under his care, in accordance with the laws, rules and
regulations of the health authorities.
Pharmacists /Nurses:
Dental Surgeons should recognize and promote the practice of different paramedical services such as
Dental Hygienist, Dental Mechanic, Pharmacy and Nursing as professions and should seek their cooperation
wherever required.

CHAPTER 6
UNETHICALACTS:
A Dental Surgeon shall not aid or abet or commit any of the following acts which shall be construed as unethical.
For the purpose of this regulations a dental surgeon refers to all registered practitioners whether they are in
individual private practice, attached to hospitals, teaching hospitals or employed by others whether they are
corporate or otherwise:
8.1 Advertisement:
The global position on the issue of Ethics of Advertisement by Dental/Medical professionals has drastically
changed over the last few decades. A Dentist or a group of Dentists may advertise provided that they
maintain decorum, keeping in mind the high moral obligations and the value that society places on the
important nature of their work and the moral character and integrity expected of them. Dental Surgeons are
expected to exhibit integrity, honesty, fidelity and selfless service. Monetary commitments can only be
secondary to the welfare of his patients. Under these circumstances it is unethical:
(8.1.1) To indulge in demeaning solicitation and false promises through advertisements or direct marketing
of individuals, clinics or hospitals in contravention of the National Advertising Council or any
other body regulating advertising in the country;
(8.1.2) To advertise, whether directly or indirectly or being associated or employed with any organization
or company including corporate bodies that indulges in such activities in a manner which gives
unfair professional advantage by cold targeting vulnerable groups and conducting camps and
other promotional activity in schools, colleges, old age homes and distributing handbills, claim
vouchers and other business promotional activities. Registered charitable organizations including
registered body of Dental or Medical persons which provide fully free dental care and treatment out
of altruism are however exempted;
(8.1.3) To be associated with or employed by those who procure or sanction such false and misleading
advertisements or publication through press reports that promise inducements, rebates and false
benefits;
(8.1.4) To employ any agent or canvasser for the purpose of obtaining patients in a manner that is
commercial; or being associated with or employed by those who procure or sanction of such
employment;
(8.1.5) To use or exhibit any disproportionately large sign, other than a sign which in its character, position,
size and wording is merely such as may reasonably be required to indicate to persons seeking the
exact location of, and entrance to, the premises at which the dental practice is carried on, and
nowhere else;
(8.1.6) To allow the Dental Surgeons name to be used to designate commercial articles such as tooth
paste, tooth brush, tooth powder, mouth washes liquid cleaners, or the like except if such articles
are fabricated in the dental clinic e.g. dentures, crowns, bridges, etc.;
(8.1.7) To permit publication of the Dental Surgeons opinion on any procedure, equipment, in the general
or lay papers or lay journals except when validated or supported by evidence based studies;
(8.1.8) To indulge in surrogate advertisements in the garb of educating the public through TV programs,
magazines or periodicals. Any public information disseminated to the public in good faith and
intention should not carry addresses telephone numbers, e-mail addresses etc., of the Dental
Surgeon or the clinic employing him to attract patients to their establishment;
(8.1.9) To advertise in the electronic media, such as in television programs, that display names, addresses
and telephone number of dentists as on-screen scrollers, or, of the clinics employing such dentists,
etc.
8.2 Soliciting:
Soliciting of patients, directly or indirectly, by a Dental Surgeon, by a group of Dental Surgeons or by
institutions or organizations is unethical except when permitted under the provisions mentioned later (vide
8.2.1 to 8.2.10 of this document, Revised Dentists Code of Ethics Regulations, 2012). A Dental Surgeon shall

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not make use of himself (or his name) as subject of any form or manner of advertising or publicity through any
mode either alone or in conjunction with others which is of such a character as to invite attention to him or to
his professional position, skill, qualification, achievements, attainments, specialties, appointments,
associations, affiliations or honors and/or of such character as would ordinarily result in his self-aggrandizement.
A Dental Surgeon shall not give to any person, whether for compensation or otherwise, any approval,
recommendation, endorsement, certificate, report or statement with respect of any drug, medicine, nostrum
remedy, surgical, or therapeutic article, apparatus or appliance or any commercial product or article with
respect of any property, quality or use thereof or any test, demonstration or trial thereof, for use in connection
with his name, signature, or photograph in any form or manner of advertising through any mode nor shall he
boast of cases, operations, cures or remedies or permit the publication of report thereof through any mode.
A Dental Surgeon is however permitted as an ethically acceptable practice to make a formal announcement
in press regarding the following:
(8.2.1) On starting practice.
(8.2.2) On change of type of practice.
(8.2.3) On changing address.
(8.2.4) On temporary absence from duty for a prolonged period of time.
(8.2.5) On resumption of practice after a break a prolonged period.
(8.2.6) On succeeding to another practice.
(8.2.7) About the availability of new equipment or services without boastful claims of being the best or
first especially if such services are already available in other facilities.
(8.2.8) Through insertion in Telephone directories, Yellow pages or on the internet is permissible and will
only serve as public information. However any claim to superiority or special skills over others will
be construed as unethical practice.
(8.2.9) Through maintenance of websites about dentists or dental clinics where all information is factual
will not be construed as unethical practice. Websites can also carry details of treatment facilities
available and the fees for the same. This will in fact help patients to make informed choices through
a transparent system. However websites should not make claims or statements that are not factual
and therefore misleading to the public.
Publicity and Signage:
(8.3.1) Printing of self-photograph, or any such material of publicity in the letter head or on sign board of
the consulting room or any such clinical establishment shall be regarded as acts of self-advertisement
and unethical conduct on the part of the physician. However, printing of sketches, diagrams,
picture of human system shall not be treated as unethical;
(8.3.2) Using or exhibition of any sign, other than a sign which in its character, position, size and wording
is merely such as may reasonably be required to indicate to persons seeking the exact location of,
and entrance to, the premises at which the dental practice is carried on is considered unethical.
These include:
(8.3.2.1) Use of sign-board with the use of such words which trivialize the dignity of the profession
or notices in regard to practice on premises other than those in which a practice is actually
carried on, or show cases, or flickering light signs and the use of any sign showing any
matter other than his name and qualifications as defined under Clause (j) of Section 2 of
the Act;
(8.3.2.2) Affixing a sign-board on a Chemists shop or in places where the dentist does not reside
or work.
(8.3.3) A Dental Surgeon shall not claim to be a specialist either through displayed signs on the name
board and / or the office stationary (visiting cards, letterheads, etc.,) unless he has a special
qualification (which is recognized by the Council) in that Specialty. A Dental Surgeon can however
practice all branches of Dentistry provided he shows adequate qualification, competence and bona
fide training in the concerned branch or branches.
Patent and Copyrights:
A Dental Surgeon may patent surgical instruments, appliances and medicine or Copyright applications,
methods and procedures. However, it shall be unethical if the benefits of such patents or copyrights are not
made available in situations where the interest of large population is involved.
Running an Open Shop (Dispensing of Drugs and Appliances by Physicians):
A Dental Surgeon should not run an open shop for sale of medicine for dispensing prescriptions prescribed
by doctors other than him or for sale of dental medical or surgical appliances. It is not unethical for a Dental
Surgeon to prescribe, supply or sell drugs, remedies or dental appliances in his clinic as long as there is no
exploitation of the patients. Drugs prescribed by a Dental Surgeon or brought from the market for a patient
should explicitly state the proprietary formulae as well as generic name of the drug.

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Rebates and Commission:

(8.6.1) A Dental Surgeon shall not give, solicit, or receive nor shall he offer to give solicit or receive, any
gift, gratuity, commission or bonus in consideration of or return for the referring, recommending or
procuring of any patient for dental, medical, surgical or other treatment. A Dental Surgeon shall not
directly or indirectly, participate in or be a party to act of division, transference, assignment,
subordination, rebating, splitting or refunding of any fee for medical, surgical or other treatment.
(8.6.2) Provisions of Section 8.6.1 (of this document, Revised Dentists Code of Ethics Regulations, 2012)
shall apply with equal force to the referring, recommending or procuring by a physician or any
person, specimen or material for diagnostic purposes or other study / work. Nothing in this section,
however, shall prohibit payment of salaries by a qualified physician to other duly qualified person
rendering medical care under his supervision.
8.7 Secret Remedies:
The prescribing or dispensing by a physician of secret remedial agents of which he does not know the
composition, or the manufacture or promotion of their use is unethical and as such prohibited. All the drugs
prescribed by a dental surgeon should always carry a proprietary formula and clear name.
8.8 Human Rights:
The physician shall not aid or abet torture nor shall he be a party to either infliction of mental or physical
trauma or concealment of torture inflicted by some other person or agency in clear violation of human
rights.
8.9 Unethical Practices:
The following shall also be the unethical practices for a Dentist:
(8.9.1) A Dental Surgeon shall not employ a Dentist / Dental Surgeon in the professional practice or any
other professional assistant (not being a registered dental hygienist or a registered dental mechanic)
whose name is not registered in the State Dentists Register, to practice Dentistry as defined in
Clause (d) of Section 2 of the Act. He may however retain the services of a medical practitioner or
anaesthetist as necessary;
(8.9.2) Signing under his name and authority any certificate which is untrue, misleading or improper, or
giving false certificates or testimonials directly or indirectly to any person or persons;
(8.9.3) Use of abbreviations after the Dental Surgeons name except those indicating dental qualifications
as earned by him during his academic career in dentistry and which conform to the definition of
recognized dental qualification as defined in Clause (j) of Section 2 of the Act, or any other
academic qualifications from a recognized university obtained through a convocation indicating
exemplary achievement. Any degree conferred on an honorary basis should be suffixed with the
words Honoris Causa. Such unacceptable abbreviations include, but not necessarily restricted
to the following which are not academic qualifications:
(8.9.3.1) R.D.P. for Registered Dental Practitioner;
(8.9.3.2) M.I.D.A. for Member, Indian Dental Association;
(8.9.3.3) F.I.C.D. for Fellow of International College of Dentists;
(8.9.3.4) M.I.C.D. for Master of International College of Dentists;
(8.9.3.5) F.A.C.D. for Fellow or American College of Dentists;
(8.9.3.6) M.R.S.H. for Member of Royal Society of Hygiene;
(8.9.3.7) F.A.G.E. for Fellow of Academy of General Education, etc.;
(8.9.4) Submission of false information in declaration form at the time of assessment of Dental College.
(8.9.5) Serving as (Duplicate faculty) i.e. working simultaneously in two/more Dental Colleges.
(8.9.6) Conviction for any crime by any court will constitute unethical act.
8.10 Naming and Styling of Dental Establishments:
A Dental Surgeon or a group of Dentists/ Dental Surgeons shall refer to their establishment as a dental
clinic. It may however be referred to as a dental hospital if the practice involves surgical treatment of oral
and dental diseases under local or general anaesthesia and if the patients need to be maintained as an inpatient for part of a day or for several days for post-operative care provided the hospital fulfils the statutory
requirements for such hospitals or establishments in the respective States.
8.11 Contravention of Statutory Provisions:
A Dental Surgeon shall not contravene any of the acts referred to in Article 3.9 of this document, Revised
Dentists Code of Ethics Regulations, 2014, and named in Annexure 3 of the same document and the rules
made there under as amended from time to time, involving an abuse of privileges conferred there under
upon a dentist, whether such contravention has been the subject of criminal proceedings or not.
8.12 Signing of Certificates:
A Registered Dental Surgeon is bound by law to give, or may from time to time be called upon or requested
to give certain certificates, notification, reports and other documents of similar character signed by them in

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their professional capacity for subsequent use in the courts, or elsewhere for administrative purposes, etc.
Such documents, among others, include the ones given at Appendix 4 of this document, Revised Dentists
Code of Ethics Regulations, 2014. A Dental Surgeon shall not sign under his name and authority any
certificate which is untrue, misleading or improper, or give false certificates or testimonials directly or
indirectly to any person or persons. He shall however deem it his duty to sign all necessary certificates
relating to health of the patients.
8.13 Doctor-Patient Sexual Misconduct:
A Dental Surgeon shall not be involved in immorality involving abuse of professional relationship and
involve in sexual misconduct with a patient by misusing fiduciary relationship.
8.14 Abiding by all Laws of the Land:
A Dental Surgeon shall not aid or abet in any violation of the laws of the land or be involved in any matter
that is against public policy. He shall not be convicted by a court of law for offences involving moral
turpitude/ criminal acts.
8.15 Relationship with Pharmaceutical Companies and Medical and Dental Industry:
8.15.1Gifts, Travel, Hospitality, Monetary Grants:
A Dental Surgeon shall not receive any gift from any pharmaceutical or allied health care industry
and their sales people or representatives. A Dental Surgeon shall not accept any travel facility
inside the country or outside, including rail, air, ship, cruise tickets, paid vacations etc. from any
pharmaceutical or allied healthcare industry or their representatives for self and family members for
vacation or for attending conferences, seminars, workshops, CDE/CME program etc., as a delegate.
A Dental Surgeon shall not receive any cash or monetary grants from any pharmaceutical and allied
healthcare industry for individual purpose in individual capacity under any pretext. Funding for
medical research, study etc. can only be received through approved institutions and Professional
Organizations by modalities laid down by law / rules / guidelines adopted by such approved
institutions, in a transparent manner. It shall always be fully disclosed.
8.15.2Dental / Medical Research:
A Dental Surgeon may carry out, participate in, and work in research projects funded by
pharmaceutical and allied healthcare industries. A Dental Surgeon is obliged to know that the
fulfillment of the following items [8.15.2.1 to 8.15.2.7 of this document, Revised Dentists Code of
Ethics Regulations, 2012] will be an imperative for undertaking any research assignment / project
funded by industry - for being proper and ethical. Thus, in accepting such a position a Dental
surgeon shall:
(8.15.2.1)Ensure that the particular research proposal(s) has the due permission from the competent
concerned authorities.
(8.15.2.2)Ensure that such a research project(s) has the clearance of national/state/ institutional
ethics committees/bodies.
(8.15.2.3) Ensure that it fulfils all the legal requirements prescribed for medical research.
(8.15.2.4) Ensure that the source and amount of funding is publicly disclosed at the beginning
itself.
(8.15.2.5) Ensure that proper care and facilities are provided to human volunteers, if they are
necessary for the research project.
(8.15.2.6) Ensure that undue animal experimentations are not done and when these are necessary
they are done in a scientific and a humane way.
(8.15.2.7) Ensure that while accepting such an assignment a Dental Surgeon shall have the freedom
to publish the results of the research in the greater interest of the society by inserting
such a clause in the MOU (Memorandum of Understanding) or any other document /
agreement for any such assignment.
8.15.3 Maintaining Professional Autonomy:
In dealing with pharmaceutical and allied healthcare industry, a Dental Surgeon shall always ensure
that there shall never be any compromise either with his/her own professional autonomy and / or
with the autonomy and freedom of the medical institution.
8.15.4 Affiliation:
A Dental Surgeon may work for pharmaceutical and allied healthcare industries in advisory
capacities, as consultants, as researchers, as treating doctors or in any other professional capacity.
In doing so, a medical practitioner shall always:
(8.15.4.1) Ensure that his professional integrity and freedom are maintained.
(8.15.4.2) Ensure that patients interest is not compromised in any way.
(8.15.4.3) Ensure that such affiliations are within the law.
(8.15.4.4) Ensure that such affiliations/employments are fully transparent and disclosed.

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Revised Dentists (Code of Ethics) Regulations 2014

8.15.5

Endorsement:
A Dental surgeon shall not endorse any drug or product of the industry publically. Any study
conducted on the efficacy or otherwise of such products shall be presented to and / or through
appropriate scientific bodies or published in appropriate scientific journals in a proper way.

CHAPTER 7
PUNISHMENTS AND DISCIPLINARYACTIONS:
A Dental Surgeon shall not aid or abet or commit any acts which shall be construed as unethical.
9.1 It must be clearly understood that the instances of offences and unethical conducts which are given above
do not constitute and are not intended to constitute a complete list of the infamous acts which calls for
disciplinary action, and that by issuing this notice the Dental Council of India and or State Dental Councils
are in no way precluded from considering and dealing with any other form of professional misconduct on
the part of a registered practitioner. Circumstances may and do arise from time to time in relation to which
there may occur questions of professional misconduct which do not come within any of these categories.
Every care should be taken that the code is not violated in letter or spirit. In such instances as in all others,
the Dental Council of India and/or State Dental Councils have to consider and decide upon the facts
brought before the Dental Council of India and/or State Dental Councils.
9.2 It is made clear that any complaint with regard to professional misconduct can be brought before the
appropriate Dental Council for Disciplinary action. Upon receipt of any complaint of professional misconduct,
the appropriate Dental Council would hold an enquiry and give opportunity to the registered Dental
practitioner to be heard in person or by pleader. If the Dentist/ Dental Surgeon is found to be guilty of
committing professional misconduct, the appropriate Dental Council may award such punishment as deemed
necessary or may direct the removal altogether or for a specified period, from the register the name of the
delinquent registered practitioner. Deletion from the Register shall be widely publicized in local press as
well as in the publications of different Medical and Dental Associations/ Societies/Bodies.
9.3 In case the punishment of removal from the register is for a limited period, the appropriate Council may also
direct that the name so removed shall be restored in the register after the expiry of the period for which the
name was ordered to be removed.
9.4 Decision on complaint against delinquent Dental Surgeons shall be taken within a time limit of 6 months.
9.5 During the pendency of the complaint the appropriate Council may restrain the Dental Surgeon from
performing the procedure or practice which is under scrutiny.
9.6 Professional incompetence shall be judged by peer group as per guidelines prescribed by State Dental
Council. For this purpose the State Dental Council shall institute an Ethics Committee consisting of qualified
persons of integrity and good name from amongst prominent registered Dental Surgeons in the State.
9.7 Where either on a request or otherwise the State Government or any competent authority is informed that
any complaint against a delinquent practitioner has not been decided by a State Dental Council within a
period of six months from the date of receipt of complaint by it and further the State Government or any
competent authority has reason to believe that there is no justified reason for not deciding the complaint
within the said prescribed period, the State Government or any competent authority may.
(9.7.1) Impress upon the concerned State Dental Council to conclude and decide the complaint within a
time bound schedule.
(9.7.2) May decide to refer the said complaint pending with the concerned State Dental Council straightaway
or after the expiry of the period which had been stipulated by the Regulation in accordance with
para (9.7.1 of this document, Revised Dentists Code of Ethics Regulations, 2012) above, to itself
and refer the same to the Ethical Committee of the State Dental Council for its expeditious disposal
in a period of not more than six months from the receipt of the complaint with the State Government.
9.8 Any person aggrieved by the decision of the State Dental Council on any complaint against a delinquent
Dental Surgeon, shall have the right to file an appeal to the State Government within a period of 60 days
from the date of receipt of the order passed by the said State Dental Council. Provided that the State
Government may, if it is satisfied that the appellant was prevented by sufficient cause from presenting the
appeal within the aforesaid period of 60 days, allow it to be presented within a further period of 60 days.

E.D

Col. (Retd.) Dr. S.K. OJHA, Officiating Secy.

[ADVT. III/4/Exty./98/14]

Foot Note : The Principal Regulations, namely, the Dentists (Code of Ethics) Regulations, 2014, were published in
Part II, Section 3, Sub-sec (1) of the Gazette of India, Extraordinary, on 21.08.1976.

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