Aim: Restoration of normal function and jaw movements in patients with temporomandibular joint (TMJ) ankylosis has been a challenge. Various techniques have been provided for its treatment; but the results have been variable. The purpose of this paper is to present an easy and versatile method for the treatment of TMJ ankylosis and to decrease postoperative complications such as reankylosis. Materials and Methods: This paper is a review of surgical outcome of interposition arthroplasty with temporalis fascia in 17 patients of unilateral TMJ ankylosis who underwent the above procedure. The review is based on the pre-, intra- and post-operative evaluation of these seventeen patients who were treated between 2008 and 2013. The follow-up time was 1–5 years. Results: Reankylosis was seen in only one of the patients; the remaining patients had satisfactory mouth openings. Conclusion: Surgical treatment of TMJ ankylosis with interposition of temporal fascia is an effective and easy procedure for prevention for reankylosis. The autogeneous nature and proximity to the joint are the main advantages of the temporal fascia flap when compared with other interpositional materials.

Background: Oral health education and promotion have emerged as a strong force against the traditional, dominant, and curative model of health practice. In pediatric dentistry, the utilization of an entertaining, easy to understand, and practical educational material is warranted. Behavioral vaccine is a simple, scientifically proven practice that is repeated to increase well-being. Aim: The aim of this study is to compare the effectiveness of conventional (instructional) dental hygiene program and “Good Behavior Game” (GBG) (contingency dental hygiene program – a behavioral vaccine) on the practice of oral hygiene among 5–7-year-old schoolchildren. Study Design: A total of sixty children aged 5–7 years were divided into two groups. Each group had thirty children. Materials and Methods: A pretest estimation of debris index-simplified (DI-S) was carried out. Children in Group A were given oral health education through instructional oral hygiene program. Children in Group B were allowed to participate in GBG daily for a week. The DI-S was recorded on the 8^th day and 3 months after the intervention in both the groups. Results: In Group B, the good oral hygiene score dramatically increased from 10% to 93.3% 1 week after the intervention. There was a relative decrease in percentage of children who scored fair and poor also. At the end of 3-month follow-up, 90% of children had good oral hygiene. In Group A, there was a significant improvement in oral hygiene after 1 week, but it was not significant after 3 months. Conclusion: The present study was undertaken to advance the area of behavioral vaccine as an alternative for teaching basic oral health concepts in children. In this study, the GBG was found to be an effective intervention aid for educating children.

Aim: The aim of the current study was to compare the effect of WaveOne and Reciproc files in reciprocation versus reverse full rotation movements on cervical dentin thickness by virtue of cone beam computed tomography (CBCT) analysis in curved mesial canals of mandibular first molars. Methods: Mesiobuccal canals of 60 mandibular molars were randomly divided into 4 groups (n = 15): Group 1; WaveOne/Reciprocation, Group 2; WaveOne/Full-Rotation, Group 3; Reciproc/Reciprocation, and Group 4; Reciproc/Full-Rotation. Pre- and post-instrumented CBCT scans were prepared for assessment of cervical dentin thickness changes (2 mm, 4 mm below the highest point of the root furcation) in both groups. Data statistically analyzed using two-way ANOVA test. Results: There was no statistically significant difference between four experimental groups in terms of remaining dentin thickness at 2 and 4 mm levels below the highest point of the furcation (P > 0.05). No separation of instruments occurred in any group. Conclusion: WaveOne and Reciproc files with two different motions have similar effects on cervical of root canals in terms of dentin thickness changes.

Background and Objectives: Epinephrine is volatile and unstable on exposure to air. Addition of sodium metabisulfite as an antioxidant has been effective, but there are no clear-cut consensus on its efficiency in retarding the oxidation that sets in once the anesthetic vials are kept open with a needle in situ. There is a paucity of scientific data regarding the risks of reuse of anesthetic vials following the use of cartridges, a common practice in western countries. It is our endeavor to shed light on the constant change in pH, drug deterioration, and instability that sets in an anesthetic vial with a needle in situ. Methods: Twenty sets of identical local anesthetic vials (lidocaine 2% with 1:80,000 adrenaline) were collected. The samples were divided into four individual groups followed by a segregation of 5 subsamples at varying time intervals from each individual group. pH was measured using pH meter. Results: Change in the pH of the solution was noted as days progressed in open local anesthetic vials when compared to closed vials. However, the decreased pH remained constant following a brief time interval after complete conversion of sulfite to sulfate. Conclusions: Local anesthetic vials with needle pricked in for a longer duration can alter the pH, concentration of the vasoconstrictor and deteriorate the properties of local anesthetic solution. This can manifest clinically as delayed onset of action, increased burning sensation, and pain on administration.

Objectives: To evaluate the treatment outcome of large periapical cystic lesions treated by combining two novel, conservative approaches, “SealBio” and “Surgical Fenestration”. Materials and Methods: Five cases (4M:1F, age range 14-38 years, mean age 24.5 years) of large periapical cystic lesions, diagnosed on clinical and radiographic examination, were included in the study. After informed consent, endodontic treatment was initiated; chemo-mechanical preparation and intra-canal dressing of calcium hydroxide was given. At the next sitting after one week, further disinfection root canals was done by “apical clearing”, “apical foramen widening” and irrigation. A cotton pellet was kept in the access cavity. After local anaesthesia, full thickness muco-periosteal flap was reflected and the thinned out bone was removed with bone rongers, a small piece of cystic lining was excised and the cystic cavity was copiously flushed with Betadine solution. The remaining cystic lining was gently curetted and the flap was sutured back. “SealBio” was performed after gentle irrigation with saline and intentional over instrumentation. A calcium sulphate based cement was pushed in the cervical third of the canal and the access opening was sealed with glass ionomer cement. Patient was prescribed antibiotics and anti-inflammatory drugs for 5 days and sutures were removed after 7 days. Patients were followed up clinically and radiographically at regular intervals. Conclusions: In this pilot study, treatment outcome after combined technique of “SealBio” and “Surgical fenestration” was found to be highly effective in healing of large periapical cystic lesions. It was simple to perform and very conservative treatment; it required minimal bone removal, obviated the need for complete cyst enucleation, apicectomy and retrograde filling.

Background: Resin composite is an option for the restoration of primary teeth, and new materials with simplified procedures are increasingly being suggested. Aims: This study aims to evaluate the microtensile bond strengths and fracture modes of flowable composites on primary dentin with application of different adhesive strategies. Materials and Methods: Sixty extracted noncaries primary molars were abraded from buccal surfaces to expose dentin surface. The teeth were randomly divided into three groups as follows: Group 1, Vertise™ Flow (Kerr) (self-adhering flowable composite); Group 2, G-aenial Universal Flo^® (GC Europe) (used with one-step self-etch system); Group 3, Tetric^® N-Flow (Ivoclar/Vivadent) (used with two-step total etch system). Then, the flowable composites were applied to buccal dentin surfaces with the help of guide mold. Samples were embedded in acrylic blocks and sectioned to form dentin-composite sticks with a surface area of approximately 1 mm². Finally, a total of 180 sticks were obtained to give each group of 60 sticks. Microtensile bond strengths were measured using a universal testing machine (1 mm/min). Fracture modes were evaluated with scanning electron microscopy. Statistical Analysis: Microtensile bond strengths data were analyzed by Kruskal–Wallis nonparametric test. Results: The microtensile bond strengths of G-aenial (15.5 megapascals [Mpa]) and Tetric (13.0 MPa) were statistically significant higher than Vertise (2.3 MPa). It was recorded that most of fractures in G-aenial was 40% cohesive, Tetric was 53.3% mixed, and Vertise was 83.3% adhesive. Conclusions: The self-adhering flowable composite Vertise™ Flow had the lowest and G-aenial Universal Flo^® had the highest microtensile bond values.

Background: Conventional periodontal therapy with various bone grafts has limited scope and the results are not predictable. To improve their utility, the hybridization of bioceramics and biodegradable polymers has been widely adopted to reform the mechanical properties of bone grafts. One such biodegradable polymer is POC (Poly 1,8 octanediol). Secondly, citric acid is considered as the key material in bone mineralization, which is related to the overall stability, strength and fracture resistance of bone. Hence citric acid is incorporated in a polymer and Nano hydroxyapatite to form a composite graft, for periodontal bone regeneration. This study attempts to evaluate the efficacy of citric acid based Nano-hydroxyapatite composite graft for the treatment of intrabony defects in chronic periodontitis patients over 12 months. Methods: A split mouth study, which consists of 10 systemically healthy patients, were randomly treated with Citric acid based Nano hydroxyapatite composite graft (test sites, n=18) or with Nano hydroxyapatite alone (control sites, n=15). Plaque index, gingival index, gingival bleeding index, probing pocket depth (PPD), clinical attachment level (CAL), bone probing depth (BPD) and hard tissue parameters such as amount of defect fill, percentage of defect fill, and changes in alveolar crest were assessed over a period of 12 months. Statistical analysis used was student's t-test and One-Way ANOVA. Results: Both test and control sites demonstrated statistically significant reduction of PD, BPD, gain in CAL and radiographic bone fill. Nevertheless the test sites showed Statistically significant improvements in all the parameters as compared to control sites at 12 months. Conclusion: Citric acid based Nano hydroxyapatite composite graft can be considered as a newer material for periodontal regeneration.

Introduction: Sense of coherence (SOC) is hypothesized to be an important psychological factor that enables people to cope with stressors and successfully maintain and improve health. Very few publications report on the relationship between “salutogenesis,” as measured by the concept of SOC and oral health status. However, little is known about the relationship between the mother's SOC and dental caries of their children. Aims and Objectives: The aim of the present study was to explore the impact of mother's SOC level on dental caries status of their children. Materials and Methods: A school-based cross-sectional study was conducted with the children aged 4–8 years attending public school (n = 200). Questionnaires were applied to mothers to obtain level of SOC. Dental caries status in children was assessed using decayed, missing, filled tooth surfaces (DMFS) and/or dmfs index. One-way analysis of variance F-test and post hoc Tukey test were used to assess the effect of mother's SOC level on their children's caries dmfs index. Results: Mean of dmfs and/or DMFS in children showed statistically significant relation with their mother's SOC level (P < 0.01). On intergroup comparison, significant (P < 0.01) difference was found when mean of dmfs and/or DMFS with mothers having low SOC and high SOC was compared. However, there was no significant relation when mean was compared to mothers with medium and low SOC. Conclusion: Dental caries of children gets influenced by mother's SOC level. There was an inverse relationship between mother's SOC level and their children dental caries status.

Aim: The aim of the study was to evaluate the effect of different irrigating solutions used in final irrigation on depth of sealer penetration into dentinal tubules. Materials and Methods: Thirty recently extracted, human mandibular premolar teeth with single canals were randomly divided into two groups, and one of the two irrigants was used in each group - Group A (Chitosan) and Group B (Ethylenediaminetetraacetic acid). All the teeth were obturated with gutta-percha and AH 26^® sealer labeled with fluorescent dye. The teeth were sectioned at distances 2, 5, and 8 mm from the root apex. Maximum depth of sealer penetration was measured using confocal laser scanning microscopy. Statistical Analysis: Statistical analysis used One-way analysis of variance and t-test. Results: At coronal third depth, the sealer penetration was greater in ethylenediaminetetraacetic acid (EDTA) group; however, depth of sealer penetration was greater at apical third in chitosan group. Conclusion: Final irrigation with EDTA and chitosan after the use of sodium hypochlorite affected sealer penetration.

Introduction: Titanium has become the material of choice with greater applications in dental implants. The success of the dental implant does not only depend on the integration of the implant to the bone but also on the function and longevity of the superstructure. The clinical condition that demands long-term interim prosthesis is challenging owing to the decreased bond between the abutment and the veneering material. Hence, various surface treatments are done on the abutments to increase the bond strength. Aim: This study aimed to evaluate the bond strength between the abutment and the provisional veneering materials by surface treatments such as acid etching, laser etching, and sand blasting of the abutment. Materials and Methods: Forty titanium alloy abutments of 3 mm diameter and 11 mm height were grouped into four groups with ten samples. Groups A, B, C, and D are untreated abutments, sand blasted with 110 μm aluminum particles, etched with 1% hydrofluoric acid and 30% nitric acid, and laser etched with Nd: YAG laser, respectively. Provisional crowns were fabricated with bis-acrylic resin and cemented with noneugenol temporary luting cement. The shear bond strength was measured in universal testing machine using modified Shell–Nielsen shear test after the cemented samples were stored in water at 25°C for 24 h. Load was applied at a constant cross head speed of 5 mm/min until a sudden decrease in resistance indicative of bond failure was observed. The corresponding force values were recorded, and statistical analysis was done using one-way ANOVA and Newman–Keuls post hoc test. Results: The laser-etched samples showed higher bond strength. Conclusion: Among the three surface treatments, laser etching showed the highest bond strength between titanium alloy implant abutment and provisional restorations. The sand-blasted surfaces demonstrated a significant difference in bond strength compared to laser-etched surfaces. The results of this study confirmed that a combination of surface treatments and bond agents enhances the bond strength.

Background: Marginal leakage is the important factor influencing the maintenance of dental esthetic. Aim: The purpose of this study was to evaluate the relationship between the preparation techniques and type of polymerization techniques on microleakage of composite laminate veneers. Materials and Methods: Ninety-one same sized, caries-free human maxillary central incisors were randomly assigned to 13 groups (n = 7) and were designed with four different preparation techniques (window type, feather type, bevel type, and incisal overlap type). One group determined as control group and any preparation was applied. Nanohybrid resin composite was used for restoration. Composite laminate veneers polymerized with three different techniques (direct light curing, indirect polymerization with a combination of pressure, light and heat using a light cup and heat cup, direct polymerization, and additionally heat cured in an oven). The specimens were thermocycled, and then immersed in 5% basic fuchsine solution. Following 24 h, all specimens were immersed in 65% nitric acid solutions for volumetric dye extraction test. Samples diluted with distilled water and centrifuged and microleakage determined by a spectrophotometer. Statistical Analysis Used: Data were analyzed with two-way ANOVA and Tukey honest significant difference post hoc multiple comparisons test (P < 0.05). Results: For comparing the microleakage value of preparation and polymerization techniques, Window type preparation showed a significant difference in direct polymerization + additional cured group (P < 0.05). Control group was statistically different from the other groups (P < 0.05). Conclusions: Window type laminate preparation can be preferred in indirect polymerization technique because it caused less leakage in this present study.

Aims: The aim of this study was to evaluate the marginal fit and surface roughness of complete cast crowns made by a conventional and an accelerated casting technique. Settings and Design: This study was divided into three parts. In Part I, the marginal fit of full metal crowns made by both casting techniques in the vertical direction was checked, in Part II, the fit of sectional metal crowns in the horizontal direction made by both casting techniques was checked, and in Part III, the surface roughness of disc-shaped metal plate specimens made by both casting techniques was checked. Materials and Methods: A conventional technique was compared with an accelerated technique. In Part I of the study, the marginal fit of the full metal crowns as well as in Part II, the horizontal fit of sectional metal crowns made by both casting techniques was determined, and in Part III, the surface roughness of castings made with the same techniques was compared. Statistical Analysis Used: The results of the t-test and independent sample test do not indicate statistically significant differences in the marginal discrepancy detected between the two casting techniques. Results: For the marginal discrepancy and surface roughness, crowns fabricated with the accelerated technique were significantly different from those fabricated with the conventional technique. Conclusions: Accelerated casting technique showed quite satisfactory results, but the conventional technique was superior in terms of marginal fit and surface roughness.

Background: The process of cleaning and shaping the canal is not an easy goal to obtain, as canal curvature played a significant role during the instrumentation of the curved canals. Aim: The present in vivo study was conducted to evaluate procedural errors during the preparation of curved root canals using hand Nitiflex and rotary K3XF instruments. Materials and Methods: Procedural errors such as ledge formation, instrument separation, and perforation (apical, furcal, strip) were determined in sixty patients, divided into two groups. In Group I, thirty teeth in thirty patients were prepared using hand Nitiflex system, and in Group II, thirty teeth in thirty patients were prepared using K3XF rotary system. The evaluation was done clinically as well as radiographically. The results recorded from both groups were compiled and put to statistical analysis. Statistical Analysis: Chi-square test was used to compare the procedural errors (instrument separation, ledge formation, and perforation). Results: In the present study, both hand Nitiflex and rotary K3XF showed ledge formation and instrument separation. Although ledge formation and instrument separation by rotary K3XF file system was less as compared to hand Nitiflex. No perforation was seen in both the instrument groups. Conclusion: Canal curvature played a significant role during the instrumentation of the curved canals. Procedural errors such as ledge formation and instrument separation by rotary K3XF file system were less as compared to hand Nitiflex.

Background: Propolis is a resinous substance produced by honeybees which has many therapeutic properties because of its unique composition. It has been widely used since many years for different medicinal purposes. Aim: The aim of this study was to investigate the effects of one-stage full mouth disinfection (OSFMD) using 20% propolis hydroalcoholic solution in chronic periodontitis patients. Materials and Methods: Thirty patients diagnosed with chronic periodontitis and presenting three or more nonadjacent teeth with deep pockets were selected for the study. Clinical parameters including gingival index, plaque index, bleeding on probing, probing pocket depth, and clinical attachment level were recorded at baseline in all the patients followed by subgingival plaque sampling. All the thirty patients were randomly allocated into two groups; 15 patients (control group) were subjected to scaling and root planning (SRP) alone, and in remaining 15 patients (test group), SRP was done followed by OSFMD using 20% propolis hydroalcoholic solution after 24 h. All the patients were kept at periodic recall, and clinical and microbiological parameters were again taken at 4 weeks and 12 weeks. Results: There was a significant improvement for all the clinical parameters, with higher probing depth reduction and attachment gain in the test group when compared to the control group. Furthermore, the microbiological counts of the periodontopathogens were found to decrease considerably more in the test group. Conclusion: SRP followed by OSFMD with propolis extract after 24 h was more effective than SRP alone in chronic periodontitis patients.

Context: Today, attention has increasingly been focused on the studies which include patient-centered consequences. Aims: The study aims to investigate the attitude of parents and children toward the application of stainless steel crown (SSC) on primary molars. Settings and Design: This cross-sectional descriptive study included eighty 4–6-year-old children having treated with SSC over the past 3–6 months. Subjects and Methods: Eventually, a validated child- and parent-centered self-report questionnaire was filled, having 14 questions about demographic information, six questions about childrens' attitude, and eight questions about parents' attitude. Statistical Analysis Used: Data analysis was conducted using t-test and one-way ANOVA at significant level P < 0.05. Results: In general, the score of children's attitude was positive, and the mean of attitude scores was obtained to be 9.9 ± 2.6; attitudes of 82.43% of children were good. Parents had neutral attitude; the mean of their attitude was obtained to be 20.2 ± 4.8. Only 53% of the parents scored good attitudes. Conclusions: The attitude score of children toward SSC was good and independent of age, gender, career, and education of the parents. Although the parents were not satisfied with how it appeared, the majority of them reported that their child had well accepted the crown.

Aim: This study aimed to comparatively analyze, under scanning electron microscope (SEM), the effect of the use of QMix^® and SofScale^™ as an adjunct to scaling and root planing (SRP) on periodontally compromised root surfaces. Settings and Design: This study was carried out in K. M. Shah Dental College and Hospital, Vadodara. Methodology: This was a single-blinded in vitro study which compared QMix^® and SofScale^™ as an adjunct to SRP on periodontally compromised root surfaces under SEM. Statistical Analysis Used: Statistical analysis was done using a nonparametric Mann–Whitney U-test to test the null hypothesis that there is no difference between the test and control groups. Results: The sum of ranks for QMix^® was 306.50 and the sum of ranks for SofScale^™ was 513.50. The group which was treated with QMix^® showed statistically significant results (P = 0.004) as compared to group which was treated with SofScale^™.Conclusion: Comparative analysis showed that QMix^® had significantly better smear layer removal ability as compared to SofScale^™. However, uniform root surface was achieved with both QMix^® and SofScale^™.

Aim: The aim of this study was to evaluate root surface alterations in terms of location, length, and depth of root resorption in the gingival, middle, and apical third of the mesial and distal surfaces of the root in healthy and periodontally affected teeth with chronic periodontitis. Materials and Methods: Teeth diagnosed with differing severity of chronic periodontitis, as assessed by clinical and radiographic parameters of bone destruction, were observed under a scanning electron microscope. Existence and location of root resorption areas, as well as length and depth of the resorption on each radicular third of the teeth, were determined. Results: Totally 27 teeth (60%) among all the groups exhibited root resorption. The number of teeth showing root resorption in each group was divided into the following groups; Group I: 2 teeth (13.33%); Group II: 11 teeth (73.33%); and Group III: 14 teeth (93.33%). The most affected teeth were the mandibular incisors. The apical one-third of the root was the most affected and the gingival third of the root was the least affected with respect to the length and depth of the root resorption. The mesial surface of the root was more commonly affected when compared to the distal surface of the root. Conclusion: It may thus be concluded that the existence and extent of root resorption depend on the severity of periodontal destruction.

Aim: Periodontists frequently experience inconvenience in accurate assessment and treatment of furcation areas affected by periodontal disease. Furcation involvement (FI) most commonly affects the mandibular molars. Diagnosis of furcation-involved teeth is mainly by the assessment of probing pocket depth, clinical attachment level, furcation entrance probing, and intraoral periapical radiographs. Three-dimensional imaging has provided advantage to the clinician in assessment of bone morphology. Thus, the present study aimed to compare the diagnostic efficacy of cone-beam computed tomography (CBCT) as against direct intrasurgical measurements of furcation defects in mandibular molars. Subjects and Methods: Study population included 14 patients with 25 mandibular molar furcation sites. CBCT was performed to measure height, width, and depth of furcation defects of mandibular molars with Grade II and Grade III FI. Intrasurgical measurements of the FI were assessed during periodontal flap surgery in indicated teeth which were compared with CBCT measurements. Statistical analysis was done using paired t-test and Bland–Altman plot. Results: The CBCT versus intrasurgical furcation measurements were 2.18 ± 0.86 mm and 2.30 ± 0.89 mm for furcation height, 1.87 ± 0.52 mm and 1.84 ± 0.49 mm for furcation width, and 3.81 ± 1.37 mm and 4.05 ± 1.49 mm for furcation depth, respectively. Results showed that there was no statistical significance between the measured parameters, indicating that the two methods were statistically similar. Conclusion: Accuracy of assessment of mandibular molar FI by CBCT was comparable to that of direct surgical measurements. These findings indicate that CBCT is an excellent adjunctive diagnostic tool in periodontal treatment planning.

Aims and Objectives: The study was conducted to evaluate the Colonization & Inhibition of Candida albicans in selected commercially available denture lining materials material by mixing them with varying concentrations and doses of tea tree oil. Materials and Methods: Five test discs of 10mm diameter and 1.5mm thickness were prepared using commercially available soft denture lining materials (Viscogel and GC-soft). Tea tree oil of varying concentrations (10%, 20%, 30%, and 40%) and doses (0.5 ml, 1.0 ml, 1.5 ml, 2.0 ml) were added during manipulation. Test discs kept in sterile artificial saliva were inoculated with Candida albicans (ATCC-2091 strain) and incubated for 6 weeks. These discs were fixed, dehydrated air dried and stained using 0.03% acridine orange stain and observed under Fluorescent microscope to count the colonies on the surface of each disc to evaluate the colonization. To evaluate inhibition, test discs were placed on the top of Sabouraud's dextrose agar inoculated with Candida albicans (ATCC-2091 strain). After incubation at 370C for 48 hours, the zone of Inhibition formed around the samples was measured. Results: The GC soft liner had higher mean colonization and lesser zone of inhibition of C.albicans when compared to Visco-gel soft liner (P < 0.001) and highest zone of inhibition observed with 2 ml volume and 40% vol/vol concentration of melaleuca alternifolia (P < 0.05). Interpretation and Conclusion: By the addition of Tea Tree oil, Viscogel had good acquired good antifungal properties than GC-soft lining materials.

Objectives: The aim of this study was to evaluate the effects of time elapsed since bleaching and different bleaching regimens on the microtensile bond strength of resin composite to enamel. Methodology: Forty flattened buccal enamel surfaces were divided into four groups: An unbleached (control) group and three bleaching groups. Control group specimens were not subjected to a bleaching regimen (Group 1), while those in the bleaching groups were bleached as follows: opalescence 10% (Group 2), whiteness perfect 16% (Group 3), and whiteness hydrogen peroxide 35% (Group 4). Thereafter, the bleached specimens were divided into three subgroups (n = 4 teeth each) for restoration according to predetermined posttreatment time intervals (immediately, 1 week, and 2 weeks). Bonded specimens were then sectioned and subjected to μTBS testing. The data were analyzed using Kruskal–Wallis and Mann–Whitney U-tests at α = 0.05. Results: There was a significant difference in the μTBS of the resin composite to enamel in groups that were bonded immediately after bleaching and in the control group (P < 0.05). Compared to the control group, the μTBS in Groups 2, 3, and 4 decreased significantly 1-week postbleaching (P < 0.05). No significant difference in μTBS was observed between the bleached and unbleached groups 2 weeks after treatment (P > 0.05). Conclusions: Adhesive restorative procedures could not be performed immediately or after 1 week irrespective of the type or concentration of bleaching system used. Composite restorations on bleached enamel surfaces should be performed after an interval of at least 2 weeks.

Background: Removal of smear layer from the root canal walls is important for long-standing endodontic success. Aim: The aim of this study is to evaluate and compare smear layer removing ability among 17% ethylenediaminetetraacetic acid (EDTA), Q-MIX, and phytic acid by scanning electron microscopy (SEM). Materials and Methods: This in-vitro experimental study assessed smear layer removal using three different irrigants. Thirty single-rooted freshly extracted human permanent premolars were collected, disinfected, and decoronated to a standardized root length of 13 mm. Root canals were cleaned and shaped till F2 universal rotary protaper at working length 1 mm short of the apex. They were randomly divided into three groups, and final irrigation was done accordingly. Group 1 (n = 10): with 1 ml of 17% EDTA, Group 2 (n = 10): with 1 ml of Q-MIX, Group 3 (n = 10): with 1 ml of phytic acid. Samples were then longitudinally sectioned and evaluated under SEM at coronal, middle, and apical levels. Statistical Analysis: Two-way analysis of variance and Tukey's post hoc test were performed. The level of significance was set at 0.05. Results: Smear layer removing ability among irrigants and sections in descending order: 17 EDTA > Q-MIX > phytic acid; coronal > middle > apical. Conclusion: 17% EDTA showed better and promising results followed by Q-MIX and then phytic acid.

Background: Gingival recession involves both soft tissue and hard tissue loss. In this evolutionary era of dentistry, newer techniques have evolved for complete coverage of isolated recession defects. Since 2012, vestibular incision subperiosteal tunnel access (VISTA) technique was used with various regenerative membranes to treat multiple recession defects (MRDs). Platelet-rich fibrin (PRF) membrane, a pool of growth factors but have any added advantage to recession coverage techniques is controversial. Thus, in this case series, we compare the effect of VISTA with or without PRF-membrane for the treatment of Classes I and III MRDs. Subjects and Methods: Four patients between of age 30 and 40 years (two patients having bilateral Class I and another two having bilateral Class III MRDs) were selected from the Department of Periodontics, ITS Dental College, Greater Noida and designated as Case I–IV simultaneously. Recession defects at antagonist sites in each patient were corrected by VISTA approach with or without PRF-membrane. Recorded clinical parameters included recession depth, recession width, pocket probing depth, and clinical attachment level (CAL) at baseline and 6 months postoperatively. Results: Patients having Class I recession defects showed almost complete root coverage with VISTA technique alone and reflected no added advantage of PRF-membrane. However, patients with Class III recession defects treated with VISTA + PRF-membrane showed more reduction in recession depth and gain in CAL as compared to sites treated with VISTA only. Conclusion: VISTA alone is a convenient technique for treatment of Class I MRDs. Addition of PRF-membrane for Class III recession defects give better outcome in term of reduction of recession depth and gain in CAL 6 month postoperatively.

Dentofacial anomalies may guide us to the diagnosis of many congenital and hereditary syndromes. A 9-year-old boy was diagnosed with Nance–Horan syndrome. This syndrome is an extremely rare X-linked genetic disorder which is entirely expressed in males with semi-dominant transmission which results from mutations occurring in male gametes. It is characterized by facial dysmorphism such as long face, prominent nose and mandibular prognathism, ocular abnormalities such as congenital cataract, microcornea, microphthalmia and strabismus, and dental anomalies including mulberry molars and screwdriver-shaped incisors. Heterozygous females inherit this disease and also suffer from this syndrome but in a milder form. Approximately one-third of the affected males show signs of developmental delay and intellectual abnormalities. This syndrome is very rare and the incidence of the disease has not been established so far. The present article describes the clinical and radiological features and the genetic implications of this syndrome.

The restoration of normal function and esthetic appearance with a dental prosthesis is a major challenge in the rehabilitation of patients who have lost their teeth and surrounding bone because of surgery for oral cyst or tumor. Rehabilitation with fixed or removable prosthesis is even more challenging when the edentulous span is long and the ridge is defective. Anatomic deformities and unfavorable biomechanics encountered in the region of resection add to the misery. In such situation, a fixed-removable prosthesis allows favorable biomechanical stress distribution along with restoration of esthetics, phonetics, comfort, hygiene, and better postoperative care and maintenance. This article describes rehabilitation of two cases with mandibular defects with an attachment-retained fixed-removable hybrid prosthesis.

Managing patients with rare genetic disorders is a challenge that dentists face often. Robinow syndrome (RS) is one such rare genetic disorder with <200 cases reported worldwide. RS demonstrates multiple craniofacial abnormalities and orodental disorders, which need to be taken into consideration by a dental practitioner while rendering dental care.

Arteriovenous malformations (AVMs) are rare congenital vascular malformations accounting only 1.5% of all vascular anomalies with 50% occurrence in the oral and maxillofacial region. It usually results from birth defects of the vasculature. A literature search revealed only few case reports of AVMs in the facial region. Lack of meticulous diagnosis, scarcity of knowledge, and paucity of literature can result in their exsanguinations leading to fatal hemorrhagic incidents after various dental procedures such as tooth extraction, surgical intervention, puncture wound, or blunt injury in involved area. The present case describes the accidental diagnosis of asymptomatic high-flow AVMs in the facial region of pediatric patient reported primarily for the treatment of periapical abscess. This case report is unique because although there was no history of bleeding episodes, thorough examination and investigations diagnosed it as high-flow vascular malformation. It is important for the dental practitioner to be aware of AVM which may be present in the head and neck region that can produce fatal bleeding episodes during various dental procedures. Proper diagnosis of AVMs through complete history, precise clinical examination, and advanced imaging modalities can help in preventing serious life-threatening complications.

This rare case report describes prosthodontic complications resulting from a dental implant was placed surgically more distally in the area of the missing mandibular first molar with a cantilever effect and a crest width of >12 mm in a 59-year-old patient who had a history of bruxism. Fracture of abutment is a common complication in implant was placed in area with high occlusal forces. Inability to remove the broken abutment may most often end up in discarding the implant. Adding one more dental implant mesially to the previously placed implant, improvisation of technique to remove the broken abutment without sacrificing the osseointegrated dental implant, fabrication with cemented custom-made abutment to replace the broken abutment for the first implant, and the use of the two implants to replace a single molar restoration proved reliable and logical treatment solutions to avoid these prosthodontic complications.

One of the most preferred compliance free fixed functional appliances in nongrowing patients is Twin Force Bite corrector (TFBC). The aim of this case report is to evaluate the effectiveness of TFBC in the treatment of an adult Class II case. A 16-year 1-month-old boy having skeletal and dental Class II relationship was selected. Roth 0.018 × 0.025 inch slots brackets were attached; a fixed lingual arch in the mandibular dental arch and a Nance appliance in the maxillary dental arch were used to increase anchorage. The TFBC therapy used for sagittal activation and stimulation of forward mandibular growth lasted for 3 months. The post-TFBC treatment lasted 6 months and the total treatment time was 9 months. Treatment of a young adult Class II malocclusion with TFBC resulted in a Class I molar occlusion, an ideal overjet, overbite, and incisor angulation in a short time and maintained in the 10-year follow-up.

Necrotizing ulcerative gingivitis (NUG) is a typical form of periodontal diseases. It has an acute clinical presentation with the distinctive characteristics of rapid onset of interdental gingival necrosis, gingival pain, bleeding, and halitosis. Systemic symptoms such as lymphadenopathy and malaise could be also found. There are various predisposing factors such as stress, nutritional deficiencies, and immune system dysfunctions, especially, HIV infection that seems to play a major role in the pathogenesis of NUG. The treatment of NUG is organized in successive stages: first, the treatment of the acute phase that should be provided immediately to stop disease progression and to control patient's feeling of discomfort and pain; second, the treatment of the preexisting condition such as chronic gingivitis; then, the surgical correction of the disease sequelae like craters. Moreover, finally, maintenance phase that allows stable outcomes. This case report describes the diagnosis approach and the conservative management with a good outcome of NUG in a 21-year-old male patient with no systemic disease and probable mechanism of pathogenesis of two predisposing factors involved.

The everyday practice of dentistry relies heavily on achieving adequate local anesthesia. Even though the safety record of local anesthetic agents is high, complications do occur. Palate is a favorable site for soft-tissue lesions. Various factors such as direct effects of the drug, blanching of the tissues during injection, relatively poor blood supply, and reactivation of the latent forms of herpes can all promote to tissue ischemia and a lesion in the palate. Among various complications, anesthetic necrotic ulcer is a rare and uncommon condition occurring mostly in the hard palate possibly after a local anesthetic infiltration. The ulceration is often deep and shows spontaneous but delayed healing. If proper treatment is not instituted on time, the necrosis can reach deep into the bone causing sequestrum formation and ultimately leading to palatal perforation. Here, we report a case of palatal perforation in a male patient followed by surgical interventions and follow-up.

Mesenchymal neoplasms of salivary gland including adipocytes are relatively uncommon entity classified as monophasic and biphasic. Sialolipoma, a biphasic mesenchymal salivary gland neoplasm, with a prominent vascularity designated as sialoangiolipoma (SAL) is a recently discussed entity with debates on the hamartomatous nature of the lesion. We have endorsed the hamartomatous nature through evaluating the immunoexpression of Ki-67 and endoglin in SAL in hard palate of a 60-year-old patient. To the best of our knowledge, this would be the second case of SAL in hard palate in a global platform.