Decalcification of enamel, appearing as white spot lesions (WSLs), around fixed orthodontic appliances is a major challenge during and after fixed orthodontic treatment by considering the fact that the goal of orthodontic treatment is to enhance facial and dental esthetic appearance. Banded or bonded teeth exhibit a significantly higher rate of WSLs compared to the controls with no braces as fixed appliances and the bonding materials promote retention of biofilms. These lesions are managed in the first step by establishing good oral hygiene habits and prophylaxis with topical fluorides, including high-fluoride toothpastes, fluoride mouthwashes, gels, varnishes, fluoride-containing bonding materials, and elastic ligatures. Recently, other materials and methods have been recommended, including the application of casein phosphopeptides-amorphous calcium phosphate, antiseptics, probiotics, polyols, sealants, laser, tooth bleaching agents, resin infiltration, and microabrasion. This article reviews the currently used methods to manage enamel demineralization during and after orthodontic treatment and the risk factors and preventive measures based on the latest evidence.

Context: Improving bonding strength to fluorosed teeh. Aims: To determine the effect of deproteinization using 5.25% sodium hypochlorite (NaOCl) prior to acid etching on shear bond strength of orthodontic brackets bonded to fluorosed teeth. Settings and Design: In vitro experimental study. Methods and Material: Forty freshly extracted human mandibular first premolars with TFI 4 were selected and divided into two groups of 20 each. In Group I the teeth were acid etched with 37% phosphoric acid and bonded with composite. In Group II the teeth were deproteinized with 5.25% NaOCl prior to acid etching with 37% phosphoric acid and were bonded with composite. Samples were then subjected to shear bond test by Instron Universal Testing machine. The sample from each group were selected for the SEM study (prior to bonding) to analyze the etching patterns achieved. Statistical Analysis Used: Data was checked for normality by Shapiro Wilk Test, to compare the two groups unpaired t test was used. P value was predetermined at ≤ 0.05. Results: The S BS of Group II (11.75 ± 2.83 MPa) was higher than Group I (7.44 ± 2.43 MPa) and the difference was statistically significant (P = 0.000). On SEM the etching pattern was more of type 1 and 2 in Group II. Conclusions: Deproteinization using 5.25% NaOCl prior to acid etching significantly increases the shear bond strength of brackets bonded to fluorosed teeth and can be used as a convenient and effective option in orthodontic bonding to fluorosed teeth.

Aims and Objectives: To find out the effect of nonsurgical periodontal therapy on serum zinc (Zn), magnesium (Mg), and copper (Cu) concentration and glycemic status in type 2 diabetes with chronic periodontitis (CP). Materials and Methods: One hundred and twenty patients were included in this study, which was further divided into three groups. Group 1 consisted of forty patients with CP, Group 2 consisted of forty patients of CP with controlled diabetes, and Group 3 consisted of forty patients of CP with uncontrolled diabetes. Periodontal parameters such as plaque index, gingival index, bleeding on probing, pocket depth, and clinical attachment levels (CALs) were evaluated. Blood samples were collected to assess the levels of fasting blood sugar, glycosylated hemoglobin, Zn, Mg, and Cu. All parameters were evaluated at baseline and 3 months after nonsurgical periodontal therapy. Results: The results showed statistically significant reduction in all the clinical parameters within the groups except for the CAL in group 1 patients (P = 0.05). The glycemic status also showed a statistically significant reduction after treatment (P < 0.001). The intragroup comparison was taken between the values of micronutrients, showed substantial increase in the levels of both Zn and Mg and decrease in the level of Cu after nonsurgical periodontal treatment (P < 0.001). Conclusion: Patients with diabetes and periodontitis had altered metabolism of Zn, Mg, and Cu contributing to the progression and complication of diabetes mellitus and periodontitis. Nonsurgical periodontal treatment improved the variation and concentration of plasma micronutrients and also the periodontal status and glycemic level.

Introduction: Pulpectomy of primary teeth is mostly carried out with hand files and broaches which is tricky and time consuming procedure. The development of new design features like varying tapers, non-cutting safety tips and varying length of cutting blades have resulted in new generation of rotary instruments. Aim: To compare and evaluate cleaning efficacy, canal preparation and volumetric filling using conventional files and rotary V Taper files through cone beam computed tomography. Materials and Method: Thirty extracted primary molars were selected. The teeth were randomly divided into three groups each containing 10 teeth i.e. 30 canals in each group. Group A was instrumented with K files; Group B rotary V Taper files and Group C was Hybrid group. Sodium hypochlorite (1%) was used for irrigation. Root canal filling was done with Zinc Oxide Eugenol cement in all groups. The volumetric analysis i.e. Percentage of Volume (POV) of the root canal filling in primary molars was done through CBCT Software. Result: In present study, p- value was found to be significant (<0.05). Almost 100% of canals of hybrid group were fully filled and 63.3% of canals of hand filing group were partially filled. The filling was found to be dense and no. of voids was least in hybrid group. Conclusion: Clinical time required in primary molar endodontics, especially with unpredictability and difficulty of canal morphology, is inevitable. The study confirms superior ability of rotary-file systems to shape severely curved canals with less time and significant decrease in procedural errors like partial filling, voids and inappropriate canal preparation.

Background: Mandibular first molars typically have two roots but sometimes a supernumerary root presents distolingually called as radix entomolaris (RE). Aim: The present study evaluated the prevalence of permanent mandibular first molars featuring a distolingual root in Haryana (North India). Materials and Methods: Five hundred patients possessing bilateral mandibular first molars were selected for this study. The intraoral periapical radiographs were taken. The radiographs of these patients were evaluated under optimal conditions. A total of 1000 mandibular first molars were screened, and the incidence of three-rooted mandibular first molars, RE and the correlation between left and right side occurrence and between either gender were recorded. Statistical Analysis: The binary logistic regression test and Pearson's Chi-square test were used for statistical analysis. Results: The prevalence of three-rooted permanent mandibular first molars was 13% of the patients examined and 8.3% of the teeth examined. There was no statistically significant difference between gender and side of occurrence (P ≥ 0.05). The bilateral incidence of a symmetric distribution was 27.6 (18/65) among the RE teeth examined. Conclusion: RE is considered as an Asiatic trait. The occurrence of this macrostructure in the Haryana (North India) population was found to be 13%. The clinician must thoroughly examine the radiographs before the initiation of endodontic therapy.

Objective: To compare the efficacy of three different herbal products (Tooth and Gums Tonic, Hiora-GA gel, and Spirogyl Gum paint) in reducing plaque, gingival inflammation and bacterial count in comparison with chlorhexidine M gel among participants with moderate to severe periodontitis. Materials and Methods: A total of eighty participants with moderate to severe periodontitis were initially recruited after obtaining their informed consent. All participants were offered scaling and polishing on the first visit to remove visible calculus. Then, these participants were randomly divided into four groups of twenty participants each using block randomization method. Participants in Group 1, 2, 3, and 4 were given chlorhexidine M gel, Hiora-GA gel, Spirogyl Gum paint, and Tooth and Gums Tonic, respectively. All participants were instructed to brush their teeth twice day with a soft bristled toothbrush and their regular fluoridated toothpaste. They were instructed to apply the respective gels twice a day according to the manufacturer's guidelines. The posttreatment follow-up examinations for gingival and plaque changes were assessed after 30, 60, and 90 days by three trained and calibrated investigators using gingival and plaque index. The investigators and statistician were blind about group allocation. The supragingival plaque samples were collected before and 90 days after treatment from the buccal surfaces of maxillary right first permanent molar of each participant for microbial analysis. Results: The mean plaque, gingival scores significantly decreased at different intervals following intervention in all groups. The bacterial counts also significantly reduced postintervention with no significant difference in the efficacy of these products compared to chlorhexidine. Conclusion: All three herbal products were found to be effective when used along with oral prophylaxis. Hence, they can all be used as alternates to chlorhexidine in the management of periodontal diseases.

Background: Microleakage is one of the most frequently encountered problems in posterior tooth-colored restorations. Efforts to decrease this problem with resin restorations include techniques for reducing the ratio of bonded to unbonded restoration surfaces and following strategic incremental placement techniques to reduce residual stress at tooth-restoration interface which reduces the C-factor, hence microleakage. Aim: The present study aimed to evaluate microleakage associated with three placement techniques for compomer restorations in primary molars. Design and Methodology: This in vitro experimental study assessed the microleakage associated with bulk-fill, horizontal-incremental, and oblique-incremental compomer placement techniques in primary molars. Ninety specimens were divided into three groups of thirty for each of the placement techniques. Results: Nearly 86.6% of the specimens presented with microleakage involving the entire axial wall and pulpal floor in the bulk-fill group, whereas 56.6% and 46.6% of the specimens in the horizontal-incremental and oblique-incremental groups showed microleakage up to two-third and one-third of the axial walls, respectively. A significant difference in scores was observed between groups (P < 0.001). Conclusion: Microleakage was observed with all the three techniques but was comparatively lower with the incremental placement techniques. The oblique-incremental technique offered the least microleakage.

Background: Osteoporosis is a disease that is seen commonly with increasing age. The purpose of this study was to compare the bone quality of pre- and post-menopausal women using the quantitative indices determined by measurements on panoramic radiographs (mental index, inferior and superior panoramic mandibular indices, antegonion index [AGI], and gonion index) and to determine the effects of serum calcium and serum estradiol levels on alveolar bone loss. Materials and Methods: Sixty female patients in the age group of 25–55 years were included in the study. The patients were divided into three equal groups, i.e., control Group A (twenty - premenopausal women), study Group B (twenty - postmenopausal women with healthy periodontium), study Group C (twenty - postmenopausal women with periodontitis). Quantitative indices were measured on digital panoramic radiographs of the patients and serum calcium and estradiol levels were determined. Results: Correlation of serum calcium with radiomorphometric indices of all the groups showed statistically nonsignificant differences. On correlating mean estradiol levels with radiographic indices of patients of Group A and Group B showed statistically nonsignificant differences. On correlating mean estradiol levels with radiographic indices of patients of Group C patients showed statistically significant difference with positive correlation with cortical width (P = 0.04) and AGI (P = 0.02) while statistically nonsignificant correlation with other indices. The statistical tests used for the analysis of the result were one-way ANOVA, multiple comparison Tukey test, Chi-square test, Student's t-test. Conclusion: There is a little evidence of correlation of these indices with serum estradiol and calcium levels, and therefore, detailed further research about this correlation is required.

Context and Objective: Simvastatin is a widely used cholesterol-lowering drug, which has been found to have a number of pleiotropic effects. The aim of this study was to evaluate the antimicrobial effectiveness of simvastatin against selected oral streptococci as determined by the minimum inhibitory concentration (MIC). Methods: Streptococcus mutans, Streptococcus sanguis, Streptococcus anginosus, and Streptococcus salivarius were the test microorganisms. The serial dilution method was used to determine the MIC of simvastatin against these organisms. The MIC was defined as the lowest concentration of simvastatin that completely inhibited growth of the test organisms. Results: The data indicate that simvastatin inhibits the growth of the test organisms, with MIC's ranging from 7.8 to 15.6 μg/ml. Conclusions: Simvastatin has MIC's against the selected bacteria that compare favorably with reported values for topical agents such as essential oil, chlorhexidine gluconate, and triclosan. The levels of simvastatin required to inhibit bacterial growth of oral bacteria exceed the reported levels of the drug found in plasma or crevicular fluid of patients who are treated with this cholesterol-lowering drug. However, clinical studies are warranted to investigate the potential use of simvastatin as a novel antiplaque agent that could be used in local drug delivery to the oral cavity of those patients who are prescribed this cholesterol-lowering drug.

Aims and Objectives: The purpose of the study was to assess the skeletal and dental effects of fan-type rapid maxillary expansion (RME) appliance and Hyrax RME appliance on the craniofacial structures. Materials and Methods: The sample of the study included 12 patients with constricted maxillary arches. Acrylic bonded type of attachment was used for both groups. Changes in sagittal, vertical, and transverse relationship were assessed with lateral and frontal cephalograms, respectively. Intercanine and intermolar widths were measured with stone models. Pre- and immediate post-treatment records were statistically analyzed with Wilcoxon signed-rank test. The differences between the groups were evaluated using Mann–Whitney U-test. Since the data pertaining to intercanine width and intermolar width were normally distributed, parametric test of signifi cance (unpaired t-test) was used to compare them. Results: Results showed that Hyrax presented with signifi cantly greater increments for both nasal cavity width and maxillary width when compared to fan-type RME. Both groups had retroclination of incisors. The increase in the intercanine width was almost similar in both groups. Conclusion: Fan-type RME caused only minimal expansion of the intermolar width when compared to the Hyrax. The ratio between the intercanine and intermolar width expansion was nearly 4:1 in the fan-type RME and 0.75:1 in Hyrax.

Objective: The objective of this study was to compare the surface morphology and dimensional stability of the bracket slot at the onset of treatment and after 12 months of intraoral exposure. The study also compared the amount of calcium at the bracket base which indicates enamel loss among the three orthodontic brackets following debonding after 12 months of intraoral exposure. Materials and Methods: The sample consisted of 60 (0.022” MBT) canine brackets. They were divided into three groups: self-ligating, ceramic bracket with metal slot, and stainless steel (SS) brackets. The slot dimensions, micromorphologic characteristics of as-received and retrieved brackets were measured with a stereomicroscope and scanning electron microscope (SEM), respectively. The amount of calcium at the bracket base which indicates enamel damage was quantified using energy-dispersive X-ray spectrometry (EDX). Results: The results showed statistically significant alterations (P < 0.05) in the right vertical dimension, internal tie wing width (cervical), right and left depth of the slot (Kruskal–Wallis test). Multiple comparison using Mann–Whitney test showed that ceramic brackets underwent (P < 0.05) minimal alterations in the right vertical dimension, internal tie wing width (cervical), right and left depth of the slot (0.01 mm, −0.003 mm, 0.006 mm, −0.002 mm, respectively) when compared with the changes seen in SS and self-ligating brackets. SEM analysis revealed an increase in the surface roughness of ceramic with metal slot brackets and self-ligating bracket showed the least irregularity. The presence of calcium was noted on all evaluated brackets under EDX, but ceramic with metal slot brackets showed a significantly greater amount of enamel loss (P = 0.001). Conclusion: Ceramic brackets were found to be dimensionally stable when compared to SS and self-ligating. Self-ligating bracket showed minimal surface irregularity. Ceramic with metal slot brackets showed a greater amount of enamel loss following debonding.

Background: Growing evidence shows that dental pulp (DP) tissues could be a potential source of adult stem cells for the treatment of devastating neurological diseases and several other conditions. Aims: Exploration of the expression profile of several key molecular markers to evaluate the molecular dynamics in undifferentiated and differentiated DP-derived stem cells (DPSCs) in vitro. Settings and Design: The characteristics and multilineage differentiation ability of DPSCs were determined by cellular and molecular kinetics. DPSCs were further induced to form adherent (ADH) and non-ADH (NADH) neurospheres under serum-free condition which was further induced into neurogenic lineage cells and characterized for their molecular and cellular diversity at each stage. Statistical Analysis Used: Statistical analysis used one-way analysis of variance, Student's t-test, Livak method for relative quantification, and R programming. Results: Immunophenotypic analysis of DPSCs revealed >80% cells positive for mesenchymal markers CD90 and CD105, >70% positive for transferring receptor (CD71), and >30% for chemotactic factor (CXCR3). These cells showed mesodermal differentiation also and confirmed by specific staining and molecular analysis. Activation of neuronal lineage markers and neurogenic growth factors was observed during lineage differentiation of cells derived from NADH and ADH spheroids. Greater than 80% of cells were found to express β-tubulin III in both differentiation conditions. Conclusions: The present study reported a cascade of immunophenotypic and molecular markers to characterize neurogenic differentiation of DPSCs under serum-free condition. These findings trigger the future analyses for clinical applicability of DP-derived cells in regenerative applications.

Introduction: Importance of good smile cannot be underestimated in enhancement of beauty, self-confidence and personality of a person. Health and appearance of gingiva is an essential part of attractive smile. Gingival pigmentation gives rise to unesthetic smile line. In present world, with increasing awareness to esthetic, people have become highly concerned about black gums. Various treatment modalities like abrasion, scrapping, scalpel technique, cryosurgery, electrosurgery and laser are available for treatment of gingival pigmentation. The present study was conducted with an objective of comparing efficacy of gingival depigmentation by cryosurgery and scalpel technique. Method: A Randomized control split mouth study was conducted for 25 patients with gingival pigmentation. Gingival pigmentation Index (GPI) for pigmentation and Visual Analoug Scale (VAS) for pain was evaluated for both test (Cryosurgery) and control sites (Scalpel technique) at baseline, 1month, 3months and 6 months. Results: GPI score was 3 and 2 for 21/25 and 4/25 control sites and was 22/25 and 3/25 test sites respectively at baseline. Both the groups showed significant reduction in GPI score i.e., 0 at 1 and 3 months interval after treatment. GPI score increased to 1 for 5/25 sites treated with scalpel technique and 2/25 sites treated with cryosurgery at 6 months interval (P=0.0691). This indicates recurrence rate for pigmentation is higher after scalpel treatment. VAS Score was 3 for 10/25 sites treated with scalpel and was 2 for 12/25 sites treated with cryosurgery (P<0.001). Conclusion: It can be concluded that cryosurgery can be effectively and efficiently used for depigmentation by keeping patients acceptance and comfort in mind and also the long term results and ease of use when compared to scalpel technique.

Context: Periodontal disease is an immuno-inflammatory disease that is initiated by the interaction between microbial plaque and the periodontal tissues. The data available on the association of periodontal diseases with the lipid profile are conflicting. Therefore, a need for a study in this area was felt. Aims: To evaluate the lipid profile in the serum of patients with chronic periodontitis and chronic periodontitis with Type II diabetes mellitus (DM) patients and to compare it with healthy controls, to see whether they can serve as potential markers for chronic periodontitis and also to assess whether periodontitis can have systemic effects. Settings and Design: This study is a cross-sectional study. Subjects and Methods: This cross-sectional study was conducted involving 300 participants in the age group of 30–60 years from October 2010 to May 2015. Five milliliters of venous blood was collected from each of the study participants, from the antecubital vein. Lipid profile was assessed using the ERBA commercially available kit. Statistical Analysis: Statistical analysis was carried out using SPSS software version 17. Multigroup comparison was carried out using ANOVA. The honest significant difference Tukey's test was used in conjunction with ANOVA to find means which are significantly different from each other. Results: When the lipid profile was estimated, total cholesterol (TC) levels were seen to be significantly higher (P < 0.001) in the DM with periodontitis group. High-density lipoprotein (HDL) levels were seen to be significantly higher (P < 0.001) in the control group. Mean serum low-density lipoprotein (LDL) and very LDL (VLDL) levels were seen to be significantly higher (P < 0.001) in the DM with periodontitis group. The triglyceride (TGL) values were also significantly higher (P < 0.001) in the DM with periodontitis group. The HDL and LDL levels were seen to be nonsignificant between chronic periodontitis and chronic periodontitis with diabetic group. Conclusions: The findings of the study showed that the lipid profile was significantly altered in patients with chronic periodontitis as compared to healthy controls. There was a potentiated difference in the values for TC, VLDL cholesterol, and TGL in patients with chronic periodontitis when compared to patients with Type II DM. HDL cholesterol and LDL cholesterol did not show a significant difference.

Introduction: Single-nucleotide polymorphisms (SNPs) in interleukin 1β (IL-1β) gene have been known to be associated with increased susceptibility to chronic periodontitis among various ethnic populations. SNPs are more commonly observed at loci + 3954 and − 511. The aim of this study was to evaluate the role of IL-1β gene polymorphism at loci +3954 and − 511, and its association with severe chronic generalized periodontitis among the ethnic Malay, Chinese, and Indians within the Malaysian population. Materials and Methods: Saliva samples from 120 subjects (60 cases and 60 controls) in the age group of 25–50 years were collected for isolation of genetic material using Norgen technique. Clinical attachment loss of ≥5 mm was considered as severe chronic generalized periodontitis. SNP's at loci +3954 and − 511 were identified and analyzed using Kompetitive Allele Specific Polymerase Chain Reaction Genotyping System (KASP^™). Differences in the allele/genotype frequencies were assessed by Chi-square test (P < 0.05). Results: On the comparison between cases and controls of IL-1β genotype polymorphism (+3954 and − 511), the difference in the genotype frequencies was statistically insignificant in all the three ethnicities. The genotype frequency in both groups in all three ethnicities of the Malaysian population was similar. Conclusion: IL-1β genotype polymorphism at +3954 and − 511 was found to be not associated with severe chronic generalized periodontitis among the three ethnicities in Malaysia. Studies with larger sample size should be done to confirm the findings of this study.

Background: The purpose of this study was to compare the clinical and radiographic outcomes of fresh Aloe vera barbadensis plant extract and mineral trioxide aggregate (MTA) as pulpotomy agents in primary molar teeth. Materials and Methods: Pulpotomy procedure was performed in sixty primary molar teeth which were randomly allocated to two groups, i.e., Aloe vera pulpotomy (Group A) and MTA pulpotomy (Group B). All the pulpotomized teeth were evaluated clinically and radiographically at 1, 3, 6, 9, and 12 months of time interval using predetermined criteria. Results: The success rates between Groups A and B at the end of the 1^st month were 24.1% and 96.4%, at the end of 3^rd month were 57.1% and 100%, at the end of 6^th month were 75% and 100%, at the end of 9^th month were 66.6% and 100%, and at the end of 12 months were 100% and 100% respectively. The overall success rates at the end of 12-month follow-up period were 6.9% and 71.4%, respectively, after taking dropout patients into consideration, and the difference was statistically significant (P < 0.001). Conclusions: MTA pulpotomy was found to be superior when compared to fresh A. barbadensis plant extract pulpotomy in primary molars.

Background: The occurrence of occupational accidents is common among students and dentists. The present study is aimed to evaluate the prevalence and characteristics of needlestick and sharp instrument injuries among dentistry students. Materials and Methods: A documentary research was carried out with data being obtained from the analysis of 137 medical records of injuries caused by needlestick and sharp instruments occurring in the period from 2012 to 2016 and were analyzed regarding the characteristics of the victim (gender and age) and the accident (year, time, environment, and time interval between exposure and search for care). Data were organized in the Statistical Package for Social Sciences software version 18 and were presented through descriptive statistics. Results: The occurrence of accidents was high (43.1%), with the predominance of female victims (66.1%) and aged up to 23 years (55.9%). The majority of events occurred in the afternoon (54.4%), in the clinical setting (70.7%), and in 75% of the cases, the search for care occurred within 2 h after exposure. Conclusion: Accidents with needlestick and sharp instruments have high frequency and involve mainly female students. They are more common in the afternoon and in the clinical setting and the time interval was between exposure and the search for care complied with recommendations of the Brazilian legislation.

Objective: The study aimed to evaluate the effectiveness of freeze dried powdered probiotics on gingival status and plaque inhibition among 12–15-year-old schoolchildren. Materials and Methods: This randomized controlled trial was conducted among 12–15-year-old schoolchildren in Jaipur. Commercially available freeze dried probiotics containing Lactobacillus acidophilus, Bifidobacterium longum, Bifidobacterium bifidum and Bifidobacterium lactis (Prowel, Alkem Laboratories), lactic acid bacillus only (Sporolac, Sangyo), and a placebo powder calcium carbonate 250 g (Calcium Sandoz, Novartis) were assigned to two intervention groups and a placebo group each comprising 11 schoolchildren. All subjects were instructed to mix the powder in 30 ml of water and swish once daily for 3 min, for 3 weeks. Periodontal clinical parameters were assessed by examining the subjects for Turesky-Gilmore-Glickman plaque index (PI) (Modification of Quigley-Hein PI) and gingival index at baseline, 7^th day, 14^th day, and 21^st day. Results: For both the probiotic groups, a statistically significant reduction (P < 0.05) in gingival status and plaque inhibition was recorded up to 2^nd week of probiotic ingestion. However, no significant difference was observed in the placebo group. Conclusion: The use of probiotic mouth rinses improves the oral health in children by significantly reducing the plaque and gingival scores. Further studies are warranted to prove or refute the long-term effects, means of administering probiotics and the dosages needed to achieve different preventive or therapeutic purposes.

Introduction: Pulpotomy is a regular procedure in the management of inflamed primary teeth. Diverse materials have been reviewed for the pulpotomy, some of them being formocresol, glutaraldehyde, ferric sulfate, and mineral trioxide aggregate (MTA). Aims: The aim was to evaluate and compare clinically and radiographically the effects of MTA as a pulp dressing after coronal pulp amputation (pulpotomy) in primary molars. Settings and Design: Sixty primary molars of thirty healthy children using split mouth design aged between 4 and 6 years were treated by pulpotomy technique. Subjects and Methods: Sixty primary mandibular molars of thirty healthy children aged between 4 and 6 years were treated by pulpotomy technique. The teeth on the right side were assigned to MTA (Group A) and the left side for the formocresol (Group B). The children were then examined clinically and radiographically every 6 months. Statistical analysis used: Chi-square test using the SPSS version 19.0 was used to compare between the two groups. Results: Results showed that both MTA and formocresol have the same outcome on the primary molars, with Chi-square value being 1.1483 (P ≥ 0.05). None of the teeth in any children in the study showed any clinical pathology. Conclusion: The principle conclusions of this study are that there are no significant differences in MTA and formocresol. The success rate of MTA and formocresol pulpotomy can be considered comparable till this therapy influences the development and growth of the permanent teeth.

Background: A new epidemiological index is introduced for full assessment of dental caries which is known as caries assessment spectrum and treatment (CAST). “Spectrum” is considered backbone of this index as it covers from no lesion to advanced stage progression of caries. We aimed to evaluate and compare the status of caries in primary and permanent molars of 7–8-year-old schoolchildren of Shimla using CAST index and to find if any correlation exists between the status of caries in evaluated teeth. Methods: Three hundred and one schoolchildren with age group of 7–8 years were selected from schools in Shimla. CAST codes were determined for primary molars and first permanent molars. The distribution of CAST codes in the examined molars is correlated with the help of Spearman's rank correlation coefficient. The level of statistical significance was established at P< 0.05. The intraexaminer reliability was determined by the unweighted kappa coefficient. Results: Caries was assessed in 6.3%–12.3% of the permanent molars in contrast to primary molars, in which caries was near about 50%. The correlation was stronger for first and second deciduous molars for the right side of the mouth than the left side (r = 0.293 and 0.257 in the maxilla and 0.503 and 0.319 in the mandible [P < 0.001], respectively, while correlation for teeth in opposite jaws was moderate [r = 0.20–0.47]). The intraexaminer reliability was examined (k = 0.90 for the primary and 0.85 for permanent molars). Conclusion: The correlation between primary and permanent molars regarding the caries status in primary molars is weak while strongest correlation was present on the right side of the mouth for first and second deciduous molars. The study also showed the applicability of the CAST index in epidemiological surveys.

Pycnodysostosis is an uncommon autosomal recessive sclerosing bone disorder which is characterized by short stature and generalized diffuse osteosclerosis. Patients usually have a large head with separated sutures, open fontanels, aplasia of frontal sinuses, obtuse mandibular gonial angle, and acroosteolysis of the distal phalanges. This case report showed a 25-year-old female with features pathognomonic of pycnodysostosis. The emphasis is mainly on the early diagnosis as it has an important role in the general health of such patients and prevention of complications.

Treatment of skeletal Class III patients at younger age is highly unpredictable. The patient may respond well to the treatment or may show excessive mandibular growth during growth spurt which may require orthognathic surgery later on. If not treated at earlier stages of life, the condition may worsen with time. This case report will present the comprehensive orthodontic management of a 9-year-old prepubertal girl in late mixed dentition with prognathic mandible. Chin cup therapy was started and continued for 3 years. After chin cup therapy, maxillary and mandibular dentition were bonded with standard edgewise appliance. After leveling and alignment, Class III elastics were started. Fixed orthodontic treatment was completed in 3 years. At the end, good Class I molar and canine relationship with normal overjet and overbite were achieved. The total treatment time of orthopedic and orthodontic correction was 6 years, 2 months. The patient revealed the same Class I molar and canine relationship after 6 years of treatment. Redirection of mandibular growth pattern from hyperdivergent to normodivergent advocates the use of chin cup as a viable treatment regimen for the management of prognathic mandible in prepubertal patients.

Oral submucous fibrosis (OSMF) is a chronic progressive debilitating disease of oral cavity leading to the stiffness of oral mucosa, burning and trismus resulting in marked rigidity, and an inability to open the mouth. As the medical treatment of OSMF is yet not standardized, the purpose of the present case study was to explore the effectiveness of osteopathic manipulative treatment (OMT) in patients with OSMF. A 30-year-old male presented with a complaint of reduced mouth opening with burning sensation while eating spicy food for 4 years. The patient had undergone pharmacological treatment for the same in the past, got relief in the burning sensation, but did not get any significant improvement in mouth opening. Radiological features were noncontributory. The patient was treated with OMT techniques for twice a week for 4 weeks followed by the home exercise program. The patient showed a significant increase in mouth opening from approximately 10 mm to 22 mm of mouth opening at the end of the treatment sessions.

Congenital soft-tissue tumors of oral cavity are mostly hyperplastic and benign in nature. This article presents an unusual case of congenital subcutaneous hamartoma of incisive papilla in a 2-year-old female child causing feeding and breathing difficulty. Total excisional biopsy was done under local anesthesia. Histopathology of tissue in reticulin-stained slide showed the presence of immature muscle fibers whereas Masson's trichrome stain revealed collagen fibers and smooth muscles confirming the diagnosis of oral midline subcutaneous smooth muscle (leiomyomatous) hamartoma of incisive papilla. It is important for dental professionals to be aware of this oral lesion present from birth mimicking overgrowth of incisive papilla, by its presentation, differential diagnosis, histopathology, and management.

Congenitally missing teeth is a common feature for the third molars. However, missing teeth, macrodontia and radiculomegaly occurring in a single patient is very rare. This article describes a case of agenesis of mandibular second premolars, radiculomegaly with dilacerations of a canine tooth together with elongated roots of other canines. All these features had been discerned through diagnostic radiographs taken during a routine treatment planning.

Temporomandibular joint (TMJ) dislocation in children is extremely rare. In our case, an 18-month-old child presented with a history of inability to close her mouth. To confirm the clinical diagnosis, a computed tomogram was taken. Clinical examination and X-ray of the TMJ revealed bilateral TMJ dislocation. Bilateral TMJ reduction was achieved manually after giving analgesia and procedural sedation. This is one of the few case reports of an acute dislocation in a toddler.

We present the management of a case of Type II dens invaginatus in a mandibular premolar with a large invagination in the coronal third of the root on mesial aspect of the crown in proximity of cementoenamel junction significantly compromising the strength of the crown structure. We describe in detail the various measures taken to assess the internal tooth structure destruction and enhance the fracture resistance of the involved premolar. The case has a long-term follow-up of 36 months showing clinical and radiographic signs of healing. We highlight use of a simple “foil coated fiber postblocker technique” for root reinforcement in the first premolar. Successful management of teeth with dens invaginatus can be effectively done using with careful treatment planning and selection of reinforcing adhesive restorative materials.

Twin Block appliance has been widely used for the treatment of Class II malocclusions in growing subjects, due to its versatility and its highly compliance nature. There are certain clinical indications where functional appliances can be used successfully in Class II malocclusion as in a growing patient. In using these appliances, the main concern is compliance of patients. This appliance simplifies the progression of treatment with fixed orthodontic braces later on. In this case, a 14-year-old adolescent was treated with Twin Block appliance followed by fixed appliances for finishing and detailing. The design and treatment effects are demonstrated in this case report.

In maxillary defects, role of a prosthodontist is to rehabilitate the intra- and extra-oral structures and to endow with the normal function of mastication, speech, deglutition, and esthetics. Malignancies are common in the oral region and are treated usually through surgical intervention. Surgical intervention creates anatomical defects creating communication between oral and nasal cavity. Patients pose difficulties while performing normal functions such as swallowing and speaking, due to this communication. To overcome the problems encountered by the patient, obturators are fabricated. The main problem with rehabilitation of large defect is the weight of prosthesis; the prosthesis becomes very bulky and nonretentive due to its weight. Hollow obturators are fabricated to conquer this tribulation by different techniques. This case report describes a simplified method of fabrication of a definitive hollow bulb obturator for rehabilitation of a maxillary defect (Aramany's class I) by insertion of balloon.

This case report highlights the management of a case of bilateral complete and incomplete fusion of maxillary incisors in a 10-year-old child. A mock-up was done on the diagnostic cast. Pretreatment esthetic evaluation was done using bis-acryl composite temporaries which were transferred intraorally from the diagnostic cast using a putty index. An incisal overlap veneer preparation was done, following which, an IPS e-max veneer was cemented. A digital mock-up was carried out using the Adobe Photoshop and Corel Draw softwares to aid in laboratorial fabrication of the veneer.

Juvenile Paget's disease (JPD), a rare genetic skeletal disorder characterized by accelerated bone turnover with elevated levels of serum alkaline phosphatase, presents in early childhood. We report a female patient with typical features of JPD with dental finding who remained undiagnosed until 18 years of age. Scarcity of this disease in the Indian literature and need for timely diagnosis to avert progression of disease thus incited us to report this case.

One of the rarest entities of fibro-osseous lesions that arise within the craniofacial bones is Juvenile ossifying fibroma (JOF). It is an intraosseous expansile lesion of the jaw that imitate odontogenic lesions. WHO has described two distinct histopathological variants of JOF; trabecular and psammomatoid. Histologically, they are characterized by the presence of fibrous connective tissue stroma along with osteoblastic and osteoclastic cells. Clinical, characteristics show an early age of onset, typical histological patterns, high rate of aggressive behavior and recurrence. This article presents a rare clinical case of the trabecular variant of JOF, its clinical, radiological, histological, and treatment aspects.

Actinomyces spp. are located without displaying any pathogenic effect in the oral flora. However, the disruption of oral microenvironmental balance, mucosal tissue integrity, and defense system can cause microorganisms to settle on deep periodontal tissues and to induce pathologic reactions. The present case report describes erythematous and desquamative lesions with pseudomembrane limited to the gingiva. In the histopathologic examination, Actinomyces colonies were isolated from the gingiva. On the basis of histopathologic and laboratory findings, the lesions were diagnosed as Actinomyces- associated lesions of the gingiva. No condition that caused immuno suppression was present in the patient. Nevertheless, local effect of the chlorhexidine mouthwash usage for a period may induce irritation of the oral keratinized tissue. The localized form of actinomycotic lesions occurs seldom in the gingival tissues. In rare cases like this, the practice of differential diagnosis with a multi-disciplinary approach is very important for the accurate diagnosis and appropriate treatment planning.

Hemangioma is a benign vascular tumor that affects 3%–10% of the population and usually does not require specific treatment due to spontaneous regression. The purpose of this paper is to present a case report of a child having been born prematurely and diagnosed with hemangioma in the head and neck, emphasizing the dentofacial changes and treatment used to provide care. Severe fibrous scars were found in the perioral region and below the ear that limited the patient's ability to open her mouth. The child exhibited anterior open bite as well as dental caries in the lower jaw, hypomineralization, and enamel hypoplasia. Treatment consisted of dietary and oral hygiene orientations, dental prophylaxis, topical 1:23% acidulated phosphate fluoride gel, removal of the carious tissue, sealing with glass ionomer cement, and extraction. Dentists need to have knowledge on hemangioma for a proper diagnosis and the optimization of dental treatment.