Introduction: Heat shock proteins are biomarkers regulating the degree of differention and aggressiveness in oral carcinogenesis. The study was carried out to evaluate the expression of HSP 70 in histological grades of epithelial dysplasia and oral squamous cell carcinoma using immunohistochemistry. Methodology: A sample of 40, which included 10 (Normal), 15 (epithelial dysplasia) and 15 (oral squamous cell carcinoma) were selected. The biopsy samples were stained using H and E staining and HSP 70 IHC. Results: There was a statistical significant difference in expression of HSP 70 between normal oral mucosal tissue, leukoplakia and OSCC. Discussion and Conclusion: This study concludes the critical role of HSP70 as an oncogene in the development of oral cancer. HSP70 inhibition is, therefore a promising therapeutic approach for cancer treatment.

Aims: The antimicrobial efficacy of intracanal medicaments such as calcium hydroxide, propolis with moxifloxacin, and triple antibiotic paste (TAP) was assessed against Streptococcus spp. and Enterococcus faecalis in chronic apical periodontitis (AP) patients with Type II diabetes mellitus (DM). Settings and Design: This study design was a randomized clinical trial. Subjects and Methods: Forty-five Type II DM patients with single-rooted teeth diagnosed as AP were instrumented, randomly divided into three groups, and medicated with either TAP, propolis with moxifloxacin, or calcium hydroxide. Bacteriological samples obtained from the root canals after instrumentation (S1) in the first treatment session, and after medication (S2) in the second session 1 week later, were assessed for bacterial growth of E. faecalis and Streptococcus spp., by viable colony-forming unit counts. Statistical Analysis Used: Intragroup, intergroup, and pair-wise comparisons were done by Wilcoxon's signed ranked test, Kruskal–Wallis test, and Mann–Whitney test, respectively (P > 0.05). Results: The microbiological analysis showed a significant reduction in microbial count from (S1) to (S2) in all the study groups. However, intergroup comparisons revealed no significant difference in decrease of microbial load between all three groups at the end of 1 week. Conclusions: Within the limitations of the study, it was concluded that antimicrobial efficacy of TAP, propolis with moxifloxacin, and calcium hydroxide were comparable.

Context: 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. Aim: This study was conducted with the aim to investigate the relationship between oral health-related behaviors of autistic children and SOC of their caregivers. Settings and Design: An Exploratory cross sectional study was conducted to investigate the association of oral health-related behaviors of autistic children and their primary caregiver's sense of coherence in Vadodara city, Gujarat. Methods and Results: A cross-sectional study was conducted on a sample of 58 autistic children and their caregivers. The Gujarati version of Antonovsky's SOC scale (13 items) was employed to assess the caregiver's SOC. The outcome variables were the child's oral health-related behaviors, including frequency of sugary snack intake, toothbrushing frequency, and utilization of dental service. Statistical Analysis Used: Multiple logistic regression was used to analyze the relationship between the variables. Results: Autistic children whose mothers (as caregivers) had higher SOC scores had a lower frequency of sugary snack intake and greater utilization of dental services compared with the children whose mothers had lower SOC scores. The other measures of oral health-related behaviors of the child were not significantly associated with the caregiver's SOC. Conclusion: Oral health-related behaviors of autistic children, namely sugary snack intake frequency, toothbrushing frequency, and utilization of dental services, were associated with the SOC of their mothers.

Background: A new elastomeric impression material which is a combination of vinyl polysiloxane (VPS) and polyether (PE) elastomers called “polyvinyl ether silicone” (PVES) has been introduced with predictable accuracy and high-quality impressions. There is insufficient data on mechanical properties of this material. Materials and Methods: A comparative study of mechanical properties of VPS, PE, and PVES was carried out using light- and heavy-body consistencies of the three materials. Three standardized stainless steel molds were made to fabricate study specimens (n = 96). The specimens were tested for elastic recovery, strain under compression, tear energy, and tensile strength (TS) using the universal testing machine. Statistical analysis was done using two-way analysis of variance test. Results: Elastic recovery was higher in VPS as compared to other two materials. Strain under compression was higher for PE followed by PVES. Tensile energy was significantly higher in PVS while TS was higher in VPS, followed by PVES and PE. Conclusion: PVES tested was found to be more flexible with high tensile energy. This material can be preferred in cases with undercut areas favoring the removal of impressions without tear and distortion.

Background: The requisites to long-term success of dental implant are good-quality bone and healthy gingiva. Long-term risk with regard to dental implant is crestal bone loss. The cause of this crestal bone loss is inflammation of surrounding soft tissue and bone. One of the techniques used to prevent crestal bone loss includes the use of biological mediators. Bisphosphonates are antiresorptive drugs that act on osteoclasts and maintain bone density and strength by inhibiting osteoclast activity. Materials and Method: 16 systemically healthy patients aged between 20 and 50 years desirous of replacing single missing posterior tooth with an adequate width and height of edentulous space included in the study. 8 patients were treated with application of bisphosphonate on implant surface and osteotomy site and 8 patients were treated only with implant therapy. Results: Crestal bone level changes were observed both in the study and control group. At 12 months, bisphosphonate-treated group showed less amount of crestal bone loss than control group. Conclusion: Local application of bisphosphonate (sodium alendronate) application around the implant and osteotomy site shows reduction in the amount of crestal bone loss but it is not statistically significant when compared with control group.

Aims: The main aim of this study was to evaluate the melanocyte response following depigmentation by cryosurgery and mucosal excision at both clinical and histopathological levels during 6 months. Subjects and Methods: A total of 15 individuals, aged 25–45 years with hyperpigmentation on the facial aspect of the gingiva present in the esthetic zone were included. A split-mouth approach was used, wherein one side received depigmentation by a scalpel and the other side received cryotherapy, with the choice of the therapy and side chosen by the spin of the coin. For determining the melanocyte assay, a small amount of gingival tissue that was excised was studied under a special staining technique, i.e., Masson–Fontana method for melanin, a histochemistry procedure which determines the activity of melanin both quantitatively and qualitatively. Clinical and histological observations for the intensity of pigmentation were recorded at baseline and 6 months after surgery. Statistical Analysis Used: Paired and unpaired t-test. Results: The mean value of the Dummett Oral Pigmentation Index (DOPI) was 2.44 ± 0.51 at baseline; following depigmentation with scalpel technique, the mean DOPI was 1.05 ± 0.23 at 6 months; and there was a statistically significant difference in the mean DOPI when compared with that of the baseline (P = 0.001). Following depigmentation with cryosurgery technique, the mean DOPI was 0.33 ± 0.48 at 6 months which also varied statistically significantly with that of the baseline (P = 0.001). The mean value of melanin histopathological count (MHC) was 95.53 ± 9.03 at baseline; following depigmentation with the scalpel technique, the mean DOPI was 89.49 ± 7.56 at 6 months, which was not statistically significant (P = 0.795). Following depigmentation with the cryosurgery technique, the mean MHC was 75.38 ± 5.63 at 6 months, which was not statistically significant (P = 0.285). Conclusions: The mean histologic count of the melanocytes, which accounts for the re-pigmentation process has shown low recurrence values in cryosurgery over the scalpel technique even though the difference was not statistically significant.

Objectives: The aim of this study is to compare the depth of cure of two composite materials (SDR and Filtek bulk-fill) cured at variable increment depths (2, 4, and 6 mm) and voltages (180 and 220 volts). Materials and Methods: Each sample of the composite material was packed in a mold of 2 mm, 4 mm, and 6 mm and curing light (quartz tungsten halogen) of optimal intensity was exposed for 20 s at 2 different voltages on each specimen. After curing, the specimens were removed and the composite on the nonexposed end was scraped with a plastic instrument. The remaining composite thickness was measured using a digital Vernier caliper. The reading was divided by half to follow the ISO 4049 method. Independent sample t-test, one-way ANOVA, and linear regression analysis were applied. Level of significance was kept at 0.01. Results: The mean DOC of SDR and Filtek were 1.93 ± 0.82 and 1.77 ± 0.65 mm. Lowering the voltage from 220 to 180 volts reduced the depth of Filtek from 1.87 ± 0.74 to 1.67 ± 0.54 mm, whereas the DOC of SDR remained unchanged at 1.93 mm at the two voltages. The adjusted R² for the depth of cure was 0.93 when the increment thickness, voltage, and restorative material were taken together in the regression model. Conclusions: There was no statistically significant difference between SDR and Filtek for the depth of cure at 2 and 4 mm increments. However, at 6 mm increment, the SDR cured significantly deeper than the Filtek. Around 91% variation in the depth of cure of these composites materials is explained by increment thickness alone.

Aim and Objective: The aim of this study is to compare the efficiency of subgingivally delivered 1% ornidazole and 0.25% chlorhexidine (CHX) gluconate (Ornigreat™ gel) and Aloe vera (AV) gel in the treatment of chronic periodontitis. Materials and Methods: Twenty chronic periodontitis patients with pocket depths ranging from 4 to 6 mm bilaterally at least in one site were included in the study. After a thorough nonsurgical periodontal therapy, 1% ornidazole and 0.25% CHX gluconate (Ornigreat™ gel) and AV gel were subgingivally delivered into the pocket sites, and the clinical parameters such as plaque index (PI), gingival index (GI), bleeding index (BI), and clinical attachment level (CAL) were evaluated at baseline and after 4 weeks. Results: In both the groups, a reduction in PI, GI, and probing depth readings was evidenced after 4 weeks. A significant improvement was noticed in the BI in the AV group when compared with that of Ornigreat™ group. Taking CAL into consideration, though improvement was there in both the groups, it was not appreciable. Conclusion: AV which is an herbal derivative when subgingivally delivered in the pocket site could be an equally effective and affordable substitute for Ornigreat™ gel.

Objectives: The current research was undertaken with an aim to correlate the expression of E-cadherin with histopathological grading in oral squamous cell carcinoma (OSCC) patients. Further, the objectives of the study were to evaluate the qualitative and quantitative expressions of E-cadherin in OSCC and to correlate the number of tumor cells of OSCC, immunopositive for E-cadherin with histopathological grading of OSCC. Materials and Methods: Immunoexpression of E-cadherin antibody was evaluated in previously diagnosed, paraffin-embedded sections of 20 tissues each of well-differentiated and moderately differentiated OSCC, 17 tissues of poorly differentiated OSCC, and 10 tissues of normal oral mucosa; Chi-square test, analysis of variance, and Tukey's honestly significant difference test were employed for statistical analysis. Results: E-cadherin immunoreactivity was inversely correlated to the loss of cell differentiation. There was a significant decrease in expression of E-cadherin (P < 0.0001) in advanced cases of OSCC. Furthermore, there was a significant reduction in intensity of E-cadherin expression with advancing histological grades of OSCC. Conclusion: From the present study, it is concluded that the reduced expression of E-cadherin may be a reliable indicator of increase in the invasiveness of OSCCs.

Background: Routine laboratory procedures and repeated glazed effect the final color of metal-ceramic restorations (MCRs). Clinicians wonder if the color changes after routine laboratory procedures and repeated glazed is clinically acceptable or not. Aims: The aim of this study was to determine the color changes of MCRs after routine laboratory procedures and then glazed for 1, 2, and 3 times. Materials and Methods: Forty-five disc-shaped (10-mm diameter and 1-mm thickness) specimens were fabricated from Cr-Co metal-alloy. Bonding agent, first and second layer of shade A₂opaque porcelain (OP) were applied on the metal specimens. The color of specimens was measured with a spectrophotometer after each procedure and △E₁, △E_2,and △E₃values were calculated. Shade A₂feldspathic porcelain was applied (2-mm thickness) to all specimens. Glaze was applied on the porcelain for 1, 2, and 3 times and then, the color measured after each procedure and △E₄, △E₅, and △E₆values were calculated. Data were analyzed with one-way ANOVA and Duncan test (P < 0.05). Results: △E₁that was obtained between the first layer of OP and bonding agent showed the greatest value. △E₂that was obtained between the second and first layer of OP showed the lowest value. After repeated glazed procedures, the final color of the specimens was changed; but, these changes were clinically acceptable (△E < 5.5). Conclusions: The routine laboratory procedures and glazed for 1,2, and 3 times is effect the color of MCRs; but, the color changes were clinically acceptable (△E < 5.5).

Aims and Objectives: The aim was to evaluate the root resorption in pulpectomized deciduous teeth and its correlation with obturation quality using zinc oxide and eugenol (ZOE), Metapex and Endoflas at the interval of 6 and 12 months. Materials and Methods: A total of 150 infected primary mandibular molars were randomly and equally divided into three subgroups (n = 50 each): Group 1 (ZoE), Group 2 (Metapex), and Group 3 (Endoflas) based on the obturation material preferred. The teeth were clinically and radiographically evaluated at 6 and 12 months' postoperatively by another investigator who was blinded to the type of filling material that was used in each tooth. Kruskal–Wallis test, Mann–Whitney Test, and Wilcoxon Signed-Rank Test was used for statistical analysis. Results: When the obturation quality was assessed, the optimal filling was found in 78% of the cases while the rest have underfilling (9%) and overfilling (13%). The incidence of overfilling was higher in the cases with some root resorption. After 12 months, Group 2 showed maximum variation with the highest incidence (70%) of extensive resorption both interradicular and intraradicular (Grade 3 score) followed by Group 1 (26%) and Group 3 (16%), respectively. Conclusion: Among all the materials, Endoflas showed the highest success rate with least incidence of resorption both outside and within the root canal (hollow tube effect) whereas least success rate was observed with Metapex having the hollow tube effect in majority of the cases (70%) after the follow-up of 12 months.

Objective: YKL-40, an acute-phase protein, is a novel potential inflammatory marker. It is a member of “mammalian chitinase-like proteins.” YKL-40 is secreted by activated neutrophils and macrophages in both acute and chronic inflammation. It is also shown to be produced by vascular smooth muscle and endothelial cells, arthritic chondrocytes, cancer cells, and embryonic and fetal cells. It might play an important role in the initiation or maintenance of pro-inflammatory response. The purpose of the present study was to estimate the concentrations of YKL-40 in the serum of healthy and periodontally affected individuals. Materials and Methods: Serum samples were collected from forty patients of periodontally (Group C) affected sites (probing depth [PD] >5 mm) and gingivitis patients (Group B) affected sites (PD ≤ 3 mm) with bleeding on probing. Comparison with healthy controls was carried out by collecting serum samples from ten healthy volunteers (Group A). 5 ml of blood was collected from the antecubital fossa by venipuncture using a 20G needle with 5 ml syringe and immediately transferred to the laboratory. Serum was extracted from blood and stored at −70°C till the assay procedure, and enzyme-linked immunosorbent assay was performed to determine the concentrations of YKL-40. Results: The mean YKL-40 concentration scores were significantly higher in Group C, i.e. 62.49 ± 8.33 when compared to Group B, i.e. 51.96 ± 4.30 and Group I, i.e. 44.23 ± 4.34, which was statistically significant (P ≤ 0.001). In the present study, mean probing pocket depth was higher in Group C than Group A (P ≤ 0.001). A positive correlation was found between probing pocket depth and concentrations of YKL-40 in serum (r = 0.815), P < 0.001, i.e. when the pocket depth increases, concentration of YKL-40 also increases. Conclusion: In this study the presence of YKL-40 in serum samples was observed both in healthy and chronic periodontitis. In this study, the concentration of YKL-40 was elevated in chronic periodontitis group when compared to healthy group. With increases in the amount of destruction, there is substantial increase in clinical parameter and YKL-40 concentration in serum, which is directly related to pocket depth. This study shows that YKL-40 is a novel biomarker for periodontal disease progression.

Purpose: Sex determination becomes the first priority by a forensic investigator in the process of identification of bodies mutilated beyond recognition due to mass disasters. Sex-determining region Y (SRY) gene is used as a sex-typing marker as the results are said to be 100% accurate. Therefore, an experimental study was conducted to rule out the possibility of the presence of SRY gene in tooth pulp and dentin after being exposed to various environments. Materials and Methods: Twenty extracted teeth of known gender were taken, of which ten were male and ten were female. The tooth samples were subjected to various environmental conditions for 60 days. Results: Among the total twenty samples, DNA isolation was done from all the samples of pulp and dentin. Gender determination using SRY gene was correct in all the samples of the pulp, and no interpretation of SRY was possible from the dentin though the DNA was isolated. Conclusion: The present study has found DNA retrieval can be done from human teeth irrespective of the storage time and environmental conditions for forensic caseworks and SRY gene to be a reliable biomarker for sex determination from the pulp tissue of teeth.

Objective: The objective of this study was to compare the effect of two types of laser irradiation (erbium, chromium-doped: yttrium, scandium, gallium, and garnet [Er,Cr:YSGG] and erbium: yttrium-aluminum-garnet [Er:YAG]) and acid etching on enamel demineralization and shear bond strength (SBS) of orthodontic bracketsastry. Materials and Methods: Ninety premolars were selected, scaled, and polished with no fluoridated pumice, and metal brackets were bonded to them. Then, they were randomly allocated to three groups based on the etching procedure: phosphoric acid etching, Er:YAG (100 mJ, 10 Hz) laser etching, and Er,Cr:YSGG (600 mJ, 20 Hz) laser etching. Teeth to be evaluated for demineralization and SBS were exposed to pH and thermal cycling, respectively. For SBS test, a universal testing machine was used, and adhesive remnant was index scored after debonding. Microhardness of enamel was evaluated with Vickers test. Data were analyzed statistically (α = 0.05). Results: The acid-etched group exhibited significantly higher SBS values compared to the laser groups (P < 0.05); however, the difference between the Er:YAG and Er,Cr:YSGG laser groups was not significant. Microhardness mean values in descending order were as follows: Er,Cr:YSGG, Er:YAG, and acid etched. There were significant differences between the laser and control groups (P < 0.001); however, the difference between the two laser groups was not significant (P = 0.320). There were no significant differences between the three groups in adhesive remnant index scores. Conclusion: Er:YAG and Er,Cr:YSGG laser etching resulted in clinically acceptable SBS; therefore, apart from its other advantages over acid etching, it can be a good appropriate alternative for bonding of orthodontic brackets.

Statement of Problem: Polymethyl methacrylate (PMMA) is the most regularly used material in denture fabrication. Water sorption of denture base PMMA denture base resin has negative effects on physical properties, may lead to harmful tissue reactions in patients, and also has detrimental effects on color stability of the denture base. Purpose: The purpose of this study was to evaluate the effect on water sorption of heat-cured PMMA denture base material after incorporation of 1%, 3%, and 5% by weight of silanized titanium dioxide (TiO₂) nanoparticles. Materials and Methods: For preparation of test samples, TiO₂nanoparticles (PCode: 700339, Sigma-Aldrich, USA) were coated with a layer of trimethoxysilylpropylmethacrylate (PCode: 440159, Sigma-Aldrich, USA) before sonicated in monomer (MMA) (DPI Heat Cure) with the percentages 1%, 3%, and 5% by weight; after sonication, it was mixed with PMMA powder using conventional denture fabrication procedure. Then, we prepared total 40 samples for study; 10 samples for each four groups, i.e. that is one control group and three experimental groups. The first group was prepared from PMMA without addition of TiO₂nanoparticles (control group), the second group with the addition of 1 wt% TiO₂nanoparticles, the third group with 3 wt% TiO₂nanoparticles, and the fourth one with 5 wt% TiO₂nanoparticles (experimental groups). Water sorption test was then conducted on each sample. Results: Each group was evaluated for water sorption test, and it was found that increasing the wt% of nanoparticles, there was a significant decrease in water sorption of denture base resin from 1.74 to 1.46 mean wt%. P value suggested that the difference of mean percent increase across all groups was statistically significant with P= 0.034. Conclusion: The maximum decrease in water sorption was observed in denture base resin incorporated with 5 wt% TiO₂nanoparticles.

Background: Dental caries is the most prevalent and chronic oral disease, particularly in childhood age. Dental caries is a progressive infectious process with multifactorial etiology. Aim: The aim of this study was to examine the prevalence of dental caries and its associated factors among primary school children at Surabaya, as the metropolitan city with the largest Javanese race population in Indonesia. Materials and Methods: A school-based cross-sectional study was conducted at Surabaya in August 2017. Cluster random sampling technique was used to select the children. Structured questionnaire by the World Health Organization (WHO) was used to interview children and/or parents to collect sociodemographic variables. Clinical dental information was obtained by experienced dentist using dental caries criteria set by the WHO. Binary and multiple logistic regression analysis were computed to investigate the factors associated with dental caries. Results: Of 213 children, 50.4% were boys. Majority (99%) of the children cleaned their teeth using toothbrush. The proportion of children having dental caries was 53%. Decay-Missing-Filled (DMF) score was 1, decayed-extracted-filled (def) score was 1.08, and total DMF and def score were 2.07. Toothbrush usage, soda consumption, and educational level of fathers were the associated factors for dental caries. Conclusion: Toothbrush usage, soda consumption, and educational level of fathers were the associated factors for dental caries. Therefore, prevention measures, such as health education on oral hygiene, dietary habits, and importance of dental visit, are obligatory for children.

Introduction: The use of articaine has been claimed to obviate the need for routine palatal local anesthetic injections on account of its better diffusion through soft and hard tissues as compared to other local anesthetic agents. Objective: The objective of the study is to evaluate the efficacy of 4% articaine (with 1:100,000 adrenaline) infiltrated only buccally in the extraction of maxillary premolars for orthodontic reasons. Materials and Methods: A double-blind randomized clinical trial with a split-mouth design, where each patient (n = 100) was part of two groups, was conducted. Experimental Group 1: single buccal infiltration of 4% articaine with 1:100,000 adrenaline (Septanest™ with adrenaline 1:100,000 by Septodont). Control Group 2: routine buccal and palatal infiltrations of 2% lignocaine with 1:200,000 adrenaline (Lox™ 2% with adrenaline 1:200,000 by Neon). The parameters studied were time to onset of anesthesia, pain during the extraction procedure (not during the injecting of the local anesthetic), and frequency of extra amount of local anesthetic injected. Results: The difference was not statistically significant (P > 0.05) between the two groups with respect to all three parameters. This proves that a single buccal infiltration of articaine can be used as an alternative to lignocaine for the extraction of the maxillary premolar teeth in most of the cases. Conclusion: This proves that a single buccal infiltration of articaine can be used as an alternative to lignocaine for the extraction of the maxillary premolar teeth in most of the cases.

Introduction: Restorative resins during their prolonged use are exposed to variety foods and beverages are subjected to wear, degradation, and staining resulting in failure of restoration and require replacement. This study is aimed to evaluate surface roughness and hardness of five commercially available posterior resin composites following exposure to various food-simulating liquids (FSLs). Materials and Methods: Specimens were immersed in distilled water, ethanol, citric acid, and air and later examined using a profilometer, scanning electron microscope for the surface profiles. Hardness was measured by Vickers Hardness test. Statistical Analysis: Results were subjected to two-way ANOVA and Tukey's multiple Post hoc test. Results: There were significant differences in results among the composite resin tested. Inter comparison between materials after treating with FSLs, clear fill majesty (CFM) and Z350 showed better hardness values under the influence of ethanol, followed by Ever X, Tetric Evo Ceram and Sure fill SDR. None of the composites were unaffected by air compared to FSLs. Citric acid had reduced the hardness of CFM and had caused surface roughness on Sure fill SDR and Tetric Evo Ceram. Distilled water reduced hardness of CFM and SureFil SDR. EverX was not affected by any of the FSL either in hardness or surface roughness properties. All composites showed surface irregularities in all media. Ethanol and water had almost similar effect on all composites. Conclusions: Differences in hardness and surface roughness are due to different composition of resin matrix and different filler particles in all composite resin material tested.

Background: The maxillary sinus (MS) is described as a pyramid-shaped cavity of the maxilla. Aim: The aim of this research is to present a strategy for morphological analysis of the MS using three-dimensional (3D) printing acquired through cone-beam computed tomography images. Material and Methods: A cross-sectional exploratory, single-blind study was conducted, including 24 subjects. MSs were reconstructed, and 3D virtual modeling was done bilaterally, obtaining 48 physical models generated on a 3D printer. The statistical analysis used tests of normality and tests using a value of P < 0.05 to establish statistical significance. Results: The mean of the MS volume was 15.38 cm³ (±6.83 cm³). The minimum volume was 5.4 cm³ and the maximum was 30.8 cm³. In a bilateral comparison of the right and left volume of the same individual, there were no significant differences (P = 0.353). In relation to the morphology of the MSs, the most prevalent was pyramidal with a square base with a prevalence of 66.7%. Related to gender, significant differences were observed only for the left volume (P = 0.009), with the mean volume being significantly greater in the men (19.69 cm³) than in the women (12.28 cm³). Conclusion: 3D printing of the MS permitted the more precise observation of anatomical features that cannot be seen on a 2D screen. A classification is presented that allows an analysis of sinus morphology, although it is necessary to conduct studies with larger samples to obtain more conclusive results.

Context: Oral hygiene practices and factors affecting oral health service utilization among the children of 10–16 years of age play a vital role in achieving comprehensive dental care. Aims: This study was done to assess oral hygiene practices, creating oral hygiene awareness, and to analyze the overt hurdles in getting basic and timely dental care among children. Materials and Methods: It was a cross-sectional survey conducted among 200 schoolchildren aged 11–14 years using a pretested, semistructured questionnaire, and clinical examination was done to assess dental caries. Convenience sampling method was used, and the sample size for the study was equal to the total number of participants. The logistic regression analysis along with odds ratios with 95% confidence interval and P < 0.05 was also reported. Chi-square test was used for statistical analysis of dental caries prevalence. Results: Around 70% of the study participants had the habit of brushing their teeth once daily, whereas only 30% of them used to brush their teeth twice daily. The prevalence of dental caries shows an upward trend with increasing age from 11 to 14 years. Cost of dental treatment, transportation, and dental taboos followed by fear of dental treatment are the major constraints for the students in accessing dental treatment. Conclusion: School-based tooth brushing and oral health education programs should be regularly organized to promote healthy tooth brushing practices. The cost-effective and timely transportation services along with proper oral health education in alleviating fear of dental treatment and dental taboos should be provided to these children for enhancing the utilization of dental services.

Background: YKL-40 is a novel potential inflammatory marker in relation to both acute and chronic inflammation. It is secreted by activated neutrophils and macrophages in acute or chronic inflammation. It strongly binds to chitin and heparin. There remains paucity in information regarding the quantification of YKL-40 levels in serum and gingival crevicular fluid (GCF) in patients with periodontal disease. Aim: The aim of this study was to evaluate and estimate the YKL-40 levels in serum and GCF samples collected from patients with or without periodontitis and type 2 diabetes among the South Indian population. Materials and Methods: A total of 40 patients were included who were divided into four groups based on inclusion and exclusion criteria as follows: Group A comprised ten healthy individuals, Group B comprised ten patients diagnosed with chronic periodontitis without type 2 diabetes, Group C comprised ten patients diagnosed with chronic periodontitis with type 2 diabetes, and Group D comprised ten patients diagnosed with only type 2 diabetes. Gingival Index (GI), pocket depth (PD), and clinical attachment level (CAL) were recorded at baseline. Serum and GCF samples were collected at baseline which were subjected to enzyme-linked immunosorbent assay analysis for estimation of YKL-40 levels. Results: All the clinical parameters (GI, PD, and CAL) and the concentration of YKL-40 level in serum and GCF samples were statistically significant among the groups. The amount of YKL-40 in GCF and serum was found to be highly correlated with PD of patients in all the groups. Conclusions: Within the limitations of the sample size, the present study indicates that the measurement of YKL-40 in Serum and GCF samples shows potential as a quantitative indicator of periodontal disease extent.

Objective: The purpose of this study was to evaluate the change in periodontal status of the adjacent second molar of the impacted mandibular third molar after surgical extraction and its association with the third molar condition in the presurgical stages, including position, eruption level, and local complications. Materials and Methods: The study was based on a 6-month follow-up of 38 patients (19 males and 19 females; Mean age: 21.89 ± 2.74) recruited consecutively after surgical extraction of an impacted lower third molar. The third molar's presurgical position, eruption level, and local complications were examined. Periodontal status, including Plaque Index (PI), Gingival Index (GI), and gingival bleeding on probing (BOP), of the teeth in the adjacent sextant was clinically evaluated. The pocket depth (PD) and the distance between the epithelial attachment and the adjacent second molar's occlusal surface were clinically measured; and the distance between the alveolar bone crest and cementoenamel junction (AC–CEJ) of the adjacent second molar was evaluated by the periapical film. All measures were recorded at the time of surgery and 1, 3, and 6 months after surgery. Results: The values of PI, GI, BOP, PD, and EA–OS were significantly reduced after 1, 3, and 6 months compared to baseline data. The AC–CEJ was decreased after 1 month but significantly increased after 3 and 6 months. Presurgical local complications of the impacted third molar mostly were significantly associated with the periodontal status of the adjacent sextant. Conclusion: There was a significant improvement of periodontal conditions of the second molar and adjacent sextant after impacted third molar surgery.

Objective: The objective of this study is to compare the toxicity level of xanthones and tannins derived from mangosteen pericarp extract at specific concentrations against BHK-21 fibroblast cell cultures. Methods: Mangosteen was extracted using a maceration method with ethanol 96%. Xanthones were isolated from the chloroform extract, whereas tannins were isolated using acetone alcohol and serial diluted to 100% concentration. Toxicity levels were monitored after 24 h using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide assay technique by ELISA reader at 620 nm. Results: Viable cells of BHK-21 against xanthone concentration began to decrease (40.24%) at 3.98% xanthones, whereas viable cells of BHK-21 against tannin concentration began to decrease (68.06%) at 2.2% tannins. Conclusion: It is suggested that tannins were more toxic than the xanthones derived from mangosteen pericarp.

Background: Despite their lower strength, glass ionomer cements (GICs) are widely used as restorative materials because of their anti-cariogenic properties, direct adhesion to tooth structure and good biocompatibility. Recently, the addition of nano-hydroxyapatite (nano-HA)-silica to conventional GIC (cGIC) has been shown to improve the strength of cGIC. However, the biocompatibility and cell attachment properties of this material are unknown. Aims: This study aims to evaluate and compare the cytotoxicity and cell attachment properties of cGIC and nano-HA-silica-GIC on dental pulp stem cells (DPSCs). Methods and Materials: Material extracts of nano-HA-silica-GIC and cGIC were prepared into seven serial dilutions and applied to 96 well plates seeded with DPSCs. After 72 h, the cell viability was determined using MTT assay. The DPSCs cell attachment properties were examined under scanning electron microscope (SEM) after 24 and 72 h. Kruskal–Wallis test was used to analyse the data for MTT assay (P < 0.05). SEM images of cell attachment properties were also described. Results: Nano-HA-silica-GIC and cGIC was shown to be slight to non-cytotoxic at all concentrations, except 200 mg/ml. Moderate cytotoxicity has been observed at 200 mg/ml concentration where nano-HA-silica-GIC and cGIC revealed cell viability values of 44.38 and 42.15%, respectively. Nano-HA-silica-GIC demonstrated better cell viability values than cGIC at all concentrations except for 6.25 and 12.5 mg/ml. Nevertheless, the results were not statistically significant (P > 0.05). SEM examination revealed the increasing numbers of DPSCs attached to both groups with prominent filopodia, especially after 72 h. Conclusions: Nano-HA-silica-GIC exhibited good biocompatibility which is comparable to cGIC and favoured the attachment of DPSCs.

Aim: The aim of this study was to assess the effectiveness of two herbal mouthwashes in comparison with Chlorhexidine mouthwash on gingivitis. Materials and Methods: This is a triple-blind randomized controlled clinical trial, where in 60 patients were randomly allocated into three study groups: Triphala mouthwash (Group A), Aloe vera mouthwash (Group B), and Chlorhexidine mouthwash (Group C). All groups were treated with scaling and asked to rinse with respective mouthwashes twice daily for 1 month. Clinical parameters such as plaque index (PI), gingival index (GI), and bleeding index (BI) were recorded at baseline, 15 days, and 30 days, respectively. Results: Our results suggested that Triphala group effectively demonstrated a higher reduction in GI and BI index scores compared to A. vera group (P ≤ 0.005) and the effect is equivocal to the reduction seen with Chlorhexidine group. However, no statistically significant difference was observed between the mouthwashes in reduction of PI scores (P > 0.005). Conclusion: The results of our study evidenced Triphala to be superior in the reduction of plaque, gingival inflammation, and bleeding compared to that of A. vera. However, the results of our study also indicated that Triphala was as effective as chlorhexidine mouthwash in its ability in reducing plaque accumulation, gingival inflammation, and bleeding. Furthermore, Triphala is relatively free of side effects compared to that of chlorhexidine.

Introduction: The treatment of dental tissues before adhesive restorative procedures is an important step in the bonding protocol and determines the clinical success of restorations. Aim: The aim of this study is to evaluate in vitro the influence of diode laser on the shear bond strength of one- and two-step self-etch (SE) adhesives to dentin when the laser is applied over the adhesives before photopolymerization. Methodology: About 20 freshly extracted noncarious intact maxillary premolars were collected, and the buccal and lingual surfaces of the tooth were ground with the help of diamond disk under water coolant till dentin was exposed. The specimens were divided into two groups of 10 each. Buccal surfaces of all the specimens were exposed to diode laser before light curing (test/experimental group) act as control group. In Group I, Clearfil SE with laser was used on the buccal surface, whereas in Group II, G-bond SE adhesive with laser was used on the buccal surface. Shear bond test was measured using an universal testing machine and the values were obtained in megapascals (MPa). Results: P < 0.05 was considered statistically significant. According to the results, it was found that the mean bond strength values of the laser-treated groups were significantly higher than groups not treated with laser. Conclusion: Within the limitations of this study, it can be concluded that mean bond strength Clearfil SE with and without laser was significantly higher than G-bond with and without laser values.

Background: Majority of the Indian population suffers from oral health diseases, especially periodontitis. Clinical manifestations of the disease are most commonly seen after 35 years of age, which if left untreated will ultimately result in loss of the tooth. Materials and Methods: A total of 576 subjects of different age groups were selected from 11 villages of Nuh district by simple random selection. The demographic data and oral hygiene habits along with deleterious habits such as smoking, panmasala, and tobacco chewing were recorded. Community periodontal index of treatment need (CPITN) was recorded with the help of CPITN probe. Results: Deep pockets were observed in 45.6% of the participants and 26.2% of the sextants. Shallow pockets were observed in 38.3% of the participants and 36.4% of the sextants. Calculus had the highest score in15.6% of the participants and 49.15% of the sextants. An inference was drawn from the results that among 576 participants 72.89% of individuals needed TN2 whereas 26.23% of individuals needed TN3 and 0.65% of individuals needed TN1. Conclusions: Severity of periodontal disease increased with age. The severity of periodontitis was observed significantly more in smokers and tobacco chewers as compared to nonsmokers and nontobacco chewers, respectively.

Aim: The aim of this study was to determine the prevalence of periodontal disease in type 2 diabetes mellitus (T2DM) patients of North India. Materials and Methods: A total of 500 patients fulfilling the selection criteria were initially given a health questionnaire to gather information regarding their demographic characteristics, attitude for oral hygiene, and disease status. Based on eligibility 427 patients were finally recruited for statistical analysis. A partial-mouth periodontal examination (PMPE) protocol which assessed one maxillary quadrant and one mandibular quadrant was used to examine three fixed sites per tooth (mesiobuccal, midbuccal, and distobuccal). Gingival Index, Oral Hygiene Index-Simplified, Debris Index-Simplified, Calculus Index-Simplified (CI-S), probing pocket depth, and clinical attachment level were examined. Results: More than 90% (95.1%) of the total diabetic participants had some degree of periodontal destruction. Of the total population, 27.1% of participants had good oral hygiene, 68.8% had fair oral hygiene, and 3.9% had poor oral hygiene status. The prevalence of severe periodontitis in participants with good, fair, and poor oral hygiene status was reported as 0.8%, 17%, and 29.4%, respectively. The prevalence of severe periodontitis in participants with good, fair, and poor oral hygiene status with poor glycemic control (glycated hemoglobin ≥8%) was 2.5%, 28.1%, and 30.7%, respectively. Conclusion: This single-centered cross-sectional study represents that more than 95% of type 2 diabetic patients have some periodontal destruction. These results may act as baseline data to promote the collaborative integrated management of diabetes for reducing its burden on society.

Objectives: The aim of this systematic review is to compare cone-beam computed tomography (CBCT) and two-dimensional radiography in the assessment of facial asymmetry. Methods: Three valid electronic databases (PubMed, Scopus, and Web of Science) were searched for articles published from 1973 to February 2017. Hand searching was done through references of selected articles, internal thesis, and national and international conferences. The titles and abstracts obtained from the search were evaluated by reviewers according to the inclusion and exclusion criteria. Results: The established search strategy identified 2137 articles. A total of 2079 articles were from electronic search in three international databases and 58 articles from hand searching. After eliminating duplicate articles and on the basis of inclusion and exclusion criteria, 13 articles and 1 thesis entered the final analysis. Bayesian meta-analysis was done due to the heterogeneity of articles and the differences related to the methodology of the studies. According to this method, analyzing J-J landmark in two studies showed that there were no statistical differences between posteroanterior (PA) radiography and three-dimensional method with reference standard. Conclusion: The results of the study showed that there was no preference between the two techniques in measuring and diagnosing the landmarks and evaluating asymmetry. It can be concluded that in patients having problems other than asymmetry and need more information for the treatment plan, CBCT is more helpful than PA cephalometry.

Aims: The aim of this systematic review was to compare the effectiveness of temporary anchorage devices (TADs) and conventional segmented arches (CSAs) during incisor intrusion in adult patients with a deep bite and their adverse effects. Settings and Design: Four electronic databases were searched. In addition, articles were manually searched for using the reference lists of relevant articles, grey literature, and peer-reviewed orthodontic journals. Subjects and Methods: Data from the retrieved articles were selected and evaluated by two independent reviewers using a new systematic review software program, DistillerSR. A meta-analysis of raw mean differences was performed. Results: Initially, we retrieved 9600 articles, but the selection process resulted in six articles. The included studies ranged from low to high in quality. Meta-analysis showed that TADs enabled 0.78 mm more upper incisor intrusion than the conventional method (95% confidence interval [CI] = 0.28–1.29). There was no significant anchorage loss difference in the CSA group compared to the TAD group (mean difference [MD] −3.68; 95% CI −7.41–0.05). Furthermore, a significant molar tipping of 1.03° was observed in the CSA group (P = 0.008) compared to the TAD group (MD −1.03; 95% CI −1.79–−0.27). Conclusions: The results of this meta-analysis showed that patients receiving TADs had 0.78 mm greater upper incisor intrusion than patients receiving the conventional treatment. This was statistically significant, but not clinically relevant. No clinical difference was found between TADs and the conventional method of anchorage loss.

Coronally advanced flap (CAF) with connective tissue graft (CTG) is considered as the most predictable method to treat Miller's Class I and II gingival recessions (GR). However, due to the patient's postsurgical discomfort, the difficulty of finding a donor with an adequate tissue thickness, the high costs of acellular dermal substitute among others, the platelet concentrates have been found to scaffold alternative to replace CTG as a part of the CAF treatment for GR. Nevertheless, according to the recent literature, the evidence of success in Class III and IV has been limited for CAF and platelet-rich fibrin (PRF). The purpose of this report is to present a case of multiple Miller's Class III and IV GR treated with CAF and PRF where the potential of PRF to increase gingival thickness and clinical attachment level, and improve soft-tissue healing and clinical appearance was corroborated.

Treatment of Class II subdivision malocclusion is challenging, and orthodontists frequently struggle to determine the choice of treatment. Several treatment modalities have been proposed for correcting these types of malocclusion. Thus, the aim of this case report is to present dentoalveolar and facial outcomes achieved using an unilateral Forsus fatigue-resistant device combined with fixed appliances in an adult female patient presenting with Class II subdivision malocclusion. Treatment outcome was effective producing dental esthetics and functional positive stable results after 3-year, 2-month follow-up.

Smile is an important factor which enhances our beauty. A well-formed complete smile is the basis for facial esthetics. To bring out a beautiful smile, a full set of dentition is necessary. The replacement of missing teeth with implant-borne restorations has become the treatment of choice these days. According to recent reports, the successful implant placement in fresh extraction socket is made possible by modifying the surface of implants. The present case report highlights on the high survival rate of immediate implant loading placed successfully in fresh extraction socket which was confirmed by implant stability quotient (resonance frequency analysis) to assess implant stability noninvasively.

Osteomyelitis is an inflammatory process of both cortical and medullary bone. In the maxillofacial skeleton, it can be seen more commonly in mandible as compared to the maxilla. Here, we present a rare case of osteomyelitis involving the entire maxillae in a 55-year-old male patient highlighting the clinical findings and radiographic features with treatment modalities.

Trauma with an accompanying fracture to the anterior teeth gives an agonizing experience for a young individual due to the physical disfigurement and the psychological impact that is imposed on them. This paper reports a case of complicated crown-root fracture in a young child that was treated by extra-oral fragment reattachment followed by the intentional reimplantation. The tooth was endodontically-treated followed by the placement of fiber-reinforced composite post. The fragments were reattached extra orally following an atraumatic extraction. The tooth was then reimplanted back into the socket followed by splinting. Clinical results were successful after 2 years. This case report demonstrates the importance of modifying a treatment protocol to maintain esthetics up to the completion of the developmental period.

Osteoblastoma is an uncommon osteoblastic tumor that rarely involves facial bones. It is an uncommon lesion that accounts for 1% of all bone tumors and about 3% of all benign bone tumors. Here, we present a case of 35-year-old female with benign osteoblastoma on the right side of the mandible which was growing for the past 3 years. Clinical presentation, radiologic and histologic features, and treatment and follow-up of this patient are discussed in this paper. Proper diagnosis of this lesion is very important because of its similarity to others lesions. There are very few reported cases of this rare entity; the primary aim of this article is to add more cases of this rare phenomenon to literature and provide a descriptive review.