Aims and Objectives: The study aims at determining pulp response of two high fluoride releasing materials silver diamine fluoride (SDF) and Type VII glass ionomer cement (GIC) when used as indirect pulp treatment (IPT) materials. Materials and Methods: Deep Class V cavities were made on four first premolars indicated for extraction for orthodontic reasons. SDF, Type VII GIC, and calcium hydroxide base are given in three premolars, and one is kept control. Premolars were extracted 6 weeks after the procedure and subjected to histopathological examination to determine the pulp response. The results were analyzed using Chi-square test. Results: No inflammatory changes were observed in any of the groups. Significantly more number of specimens in SDF and Type VII GIC groups showed tertiary dentin deposition (TDD) when compared to control group. No significant difference was seen in TDD when intergroup comparison was made. Odontoblasts were seen as short cuboidal cells with dense basophilic nucleus in SDF and Type VII GIC group. Conclusion: The study demonstrated TDD inducing ability of SDF and Type VII GIC and also established the biocompatibility when used as IPT materials.

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Free gingival grafts have been used in periodontal procedures to augment attached gingiva and cover denuded root surfaces. However, there are few limitations of the same such as esthetic mismatch, mal-alignment of muco-gingival junction formation and bulky appearance. Several modifications have recently been proposed to minimize some of the unfavorable aspects of free gingival grafts. Three cases presenting with Millers Class I/II gingival recession were treated by each different modifications. Satisfactory root coverage and better color match as a compared to free gingival graft was obtained in all the three cases. When indicated these modifications can be advantageous over conventional free gingival grafts in management of Millers Class I/II gingival recession.

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Ectodermal dysplasia (ED) represents a group of inherited conditions characterized by anomalies in two or more structures of ectodermal origin, which can be presented as problems related to hair, nail, teeth, sweat glands, and sebaceous glands. Based on clinical findings, there are two major types of this disorder: (1) Hypohidrotic/anhidrotic and (2) hidrotic ED. The anhidrotic/hypohidrotic ED (HED) is the more severe form and is associated with more dental defects. This article presents with prosthetic rehabilitation including removable partial and complete denture and implant supported overdenture of two male children of a family presenting with HED.

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Aims: To determine the average condylar inclination using ultrasonic axiograph; to determine the average condylar inclination using protrusive interocclusal bite records; to compare whether there is any marked difference in the values obtained by these techniques. Settings and Design: This clinical study compares the mean horizontal condylar inclination of the ultrasonic axiograph (Axioquick system) and the manual programming using protrusive interocclusal records. Materials and Methods: The study was conducted on a group of 30 subjects reporting to Department of Prosthodontics. Axioquick software system of SAM III (School Articulator Munich) fully-adjustable articulator was used, and interocclusal recording of condylar inclination is the manual method used in semi-adjustable articulators using Aluwax. The condylar inclination of the articulator was adjusted and set using protrusive interocclusal record. Statistical Analysis: The horizontal condylar inclination values of both methods were collected, and the mean of right and left condylar inclination was compared using paired t-test. Results: A statistically significant difference exists between Axioquick system and the manual method of programming articulator with protrusive interocclusal records (P ≤ 0.001). Conclusions: Within the limitations of the present study, the following conclusions were drawn: The average condylar inclination by axiograph is 42.125°. The average condylar inclination by interocclusal record is 33.25°. Comparison of both values shows a difference of 8.88° ± 4.03° that showed a significant difference (P < 0.001).

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Langerhans cell histiocytosis (LCH) is a group of idiopathic disorders characterized by proliferation of bone marrow derived Langerhans cells and mature eosinophils. Their clinical features simulate common oral findings such as gingival enlargement, oral ulcers, and mobility of teeth, along with nonspecific radiographic features; hence, diagnosing such lesions becomes difficult for the oral physicians. These lesions are commonly seen in childhood; however, we are reporting a case of LCH in 29-year-old adult male. A provisional diagnosis of giant cell granuloma was considered based on history and examination, although the lesion was histologically proven to be LCH and was confirmed with immunohistochemical staining of S100 protein and CD1a antigen. The purpose of this paper is to enhance the understanding of diverse, nonpathognomical oral presentation of LCH that is easily misdiagnosed and overlooked by dentist.

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Introduction: Dental treatment is usually a poignant phenomenon for children. Projective scales are preferred over psychometric scales to recognize it, and to obtain the self-report from children. Aims: The aims were to evaluate treatment related fear using a newly developed fear scale for children, fear assessment picture scale (FAPS), and anxiety with colored version of modified facial affective scale (MFAS) - three faces along with physiologic responses (pulse rate and oxygen saturation) obtained by pulse oximeter before and during pulpectomy procedure. Settings and Design: Total, 60 children of age 6-8 years who were visiting the dental hospital for the first time and needed pulpectomy treatment were selected. Children selected were of sound physical, physiological, and mental condition. Two projective scales were used; one to assess fear - FAPS and to assess anxiety - colored version of MFAS - three faces. These were co-related with the physiological responses (oxygen saturation and pulse rate) of children obtained by pulse oximeter before and during the pulpectomy procedure. Statistical Analysis Used: Shapiro-Wilk test, McNemar's test, Wilcoxon signed ranks test, Kruskal-Wallis test, Mann-Whitney test were applied in the study. Results: The physiological responses showed association with FAPS and MFAS though not significant. However, oxygen saturation with MFAS showed a significant change between "no anxiety" and "some anxiety" as quantified by Kruskal-Wallis test value 6.287, P = 0.043 (<0.05) before pulpectomy procedure. Conclusions: The FAPS can prove to be a pragmatic tool in spotting the fear among young children. This test is easy and fast to apply on children and reduces the chair-side time.

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Background: Today, most approaches to caries viewed that catastrophic change in normal plaque biofilm is responsible for the disease. The behavior and composition of the biofilm are a reflection of the oral environment; the caries is a reflection of adverse changes occurring in that environment. Thus, it is important to identify the pathogenicity of the plaque biofilm so as to predict the caries risk. The recently developed three-tone plaque disclosing agent was used to test its ability in identifying the pathogenicity of plaque. Aim: To assess the efficacy of three-tone plaque disclosing agent in identifying the plaque pathogenicity and correlate with the clinical caries status and microbiological findings. Materials and Methods: Sixty children of 6-13 years age group of both sexes were clinically examined for caries and plaque scores, and then disclosing agent was applied; the color stained plaque samples were collected and cultured for microbiological assessment, and the data were analyzed based on the caries status of the children. Results: There was a significant difference between the pathological plaque of caries active and caries free group (P < 0.05). The pathological plaque scores and the total colony counts, Streptococcus counts and mutans streptococci counts increased with the increase in caries. Conclusion: Three-tone plaque disclosing agent was effective in identifying pathological plaque and can be used as one of the chairside adjuvants in caries risk assessment.

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Williams syndrome is a multisystemic rare genetic disorder caused by deletion of 26-28 genes in the long arm of chromosome 7. It is characterized by developmental and physical abnormalities including congenital cardiovascular abnormalities, mental retardation, neurological features, growth deficiency, genitourinary manifestations, gastrointestinal problems, musculoskeletal problems, unique behavioral characteristics, and dental problems. Dental abnormalities include malocclusion, hypodontia, malformed teeth, taurodontism, pulp stones, increased space between teeth, enamel hypoplasia, and high prevalence of dental caries. Authors report a 17-year-old female patient with underlying Williams syndrome. Oral features and problems seen in the patient are listed. Malocclusion and screwdriver shaped teeth were noticed. Generalized widening of the periodontal ligament space with vital teeth was seen. This finding has not been reported in cases of Williams syndrome earlier. Precautions taken during dental treatment in patients with Williams syndrome are also discussed.

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Context: Systemic conditions, especially chronic infections, have a direct impact on the general health and well-being of an individual. Similarly, the long-standing inflammatory changes seen during periodontitis have been associated with the altered diabetic control, preterm, low birth weight infants, and cardiovascular disease. Being a low-grade infection, the signs may not be as severe as seen in other systemic conditions, but they definitely cannot be ignored. Aims: The present study was designed to compare clinical, hematological, and systemic inflammatory markers in patients with chronic periodontitis. Subjects and Methods: A total of 90 chronic periodontitis patients were selected for the present study from the outpatient department of the Department of Periodontology, and the various clinical and hematological parameters were then assessed. Statistical Analysis Used: Z-test was used to compare the probing depth, clinical attachment loss, hematological parameter, and interleukin-6 values between Group A and Group B. Mann-Whitney U-test was used to compare gingival index, plaque index, and bleeding on probing between Group A and Group B. Results: The results of the study were based on the comparison of the clinical, hematological, and systemic inflammatory markers in smokers and nonsmokers with chronic periodontitis and came out to be statistically highly significant. Conclusions: With the resurgence of emphasis on significance of oral diseases related to systemic health, the medical professionals also need to familiarize themselves with the oral cavity and the oral-systemic inter-relationships to treat or reduce the morbidity of the underlying medical condition. Furthermore, the oral health care professionals must reach out to the medical community and the general public to improve patient care through education and communication about the oral health-systemic health link.

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Context: The goal of any radiologist is to produce the highest quality diagnostic radiographs, while keeping patient exposure as low as reasonably achievable (ALARA). Aims: The aim of this study was to describe the reasons for radiograph rejections through a repeat film analysis in an Indian dental school. Settings and Design: An observational study conducted in the Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal. Materials and Methods: During a 6-month study period, a total of 9,495 intra-oral radiographs and 2339 extraoral radiographs taken in the Radiology Department were subjected to repeat film analysis. Statistical Analysis Used: SPSS Version 16. Descriptive analysis used. Results: The results showed that the repeat rates were 7.1% and 5.86% for intraoral and extraoral radiographs, respectively. Among the causes for errors reported, positioning error (38.7%) was the most common, followed by improper angulations (26.1%), and improper film placement (11.2%) for intra-oral radiographs. The study found that the maximum frequency of repeats among extraoral radiographs was for panoramic radiographs (49%) followed by lateral cephalogram (33%), and paranasal sinus view (14%). It was also observed that repeat rate of intraoral radiographs was highest for internees (44.7%), and undergraduate students (28.2%). Conclusions: The study pointed to a need for more targeted interventions to achieve the goal of keeping patient exposure ALARA in a dental school setting.

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Aim: To evaluate the effectiveness of different techniques in removing calcium hydroxide (Ca(OH) ₂ ) from the root canal. Materials and Methods: Twenty-four freshly extracted mandibular premolars were instrumented using ProTaper rotary instruments. The teeth were longitudinally split into two halves, cleaned of debris. The two halves were then reassembled and filled with Ca(OH) ₂ and were divided into four groups. In Group I, the teeth were irrigated with 5 mL of 2.5% sodium hypochlorite (NaOCl) and 5 mL of 17% of ethylenediaminetetraacetic acid. In Group II, the teeth were irrigated with 5 mL of 2.5% NaOCl and a rotary ProTaper F3 instrument was used. In Group III, the teeth were irrigated with 5 mL of 2.5% NaOCl and agitated using an ultrasonic unit. In Group IV, the teeth were irrigated with 5 mL of 2.5% NaOCl and a CanalBrush was used to remove Ca(OH) ₂ . The roots were disassembled, and photographs were taken. The amount of residual Ca(OH) ₂ was calculated using an image analysis software as a percentage of the total canal surface area. The data were analyzed using one-way analysis of variance and post-hoc Tukey test. Results: CanalBrush and ultrasonic techniques showed significantly less residual Ca(OH) ₂ than irrigants and rotary techniques. There was no significant difference between the rotary and irrigant techniques. Conclusion: None of the techniques used were completely able to remove Ca(OH) ₂ from the root canals. But the CanalBrush and ultrasonic techniques were significantly better than the rotary instrument and irrigant groups.

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Background and Objectives: A normal airway is required for the normal growth of the craniofacial structures. The present study was designed to evaluate and compare the airway in Class I and Class II skeletal pattern and to see if there is any association between the airway and maxillomandibular relationship. Materials and Methods: Peripheral nervous system computed tomography scans of 30 patients were divided into two groups as Class I (ANB ≤ 4.5°), Class II (ANB ≥ 4.5°). The Dolphin three-dimensional version 11 was used to assess the airway. Statistical Analysis: Correlations between the variables were tested with the Pearson correlation coefficient. Independent sample t-test was performed to compare the averages between the two groups. P <<b> 0.05 was considered as statistically significant. Results: The ANB angle was negatively correlated with all the airway parameters. The airway area and volume was significantly reduced in Class II subjects compared to Class I. Conclusion: The results suggest a strong association between the airway and skeletal pattern showing a reduced airway in Class II patients with a high ANB angle.

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Aim: The present clinical trial was designed to investigate the effectiveness of subgingivally delivered satranidazole (SZ) gel as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. Materials and Methods: Seventy subjects with probing depth (PD) ≥5 mm were selected. Thirty-five subjects each were randomly assigned to SRP + placebo (Group 1) and SRP + SZ (Group 2). The clinical outcomes evaluated were plaque index, gingival index, clinical attachment level (CAL), and PD at baseline; 1 month, 3 months, and 6 months interval. Furthermore, microbial analysis using polymerase chain reaction was done to estimate the number of sites harboring periodontopathogens. Results: Sixty four subjects were evaluated up to 6 months. At 6 months, the Group 2 resulted in greater mean reduction (4.10 mm) in PD as compared to Group 1 (1.49 mm), and also a greater mean CAL gain (4.20 mm) in Group 2 as compared to Group 1 (1.13 mm). These subjects also showed a significant reduction in the number of sites harboring periodontopathogens. Conclusion: The use of 3% SZ gel, when used as an adjunct to nonsurgical periodontal therapy in subjects with periodontitis, achieved better results than initial periodontal treatment alone.

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Aims: The aim of this study was to evaluate the effect of metal primers and sandblasting on the shear bond strength (SBS) of heat cured acrylic denture base resin to cobalt-chromium (Co-Cr) alloy. Materials and Methods: A total number of 40 disk shaped wax patterns (10 mm in diameter and 2 mm in thickness) were cast in Co-Cr alloy. Samples were divided into 4 groups depending on the surface treatment received. Group 1: No surface treatment was done and acts as control group. Group 2: Only sandblasting was done. Group 3: Only metal primer was applied. Group 4: Both metal primer and sandblasting were done. After surface treatment samples had been tested in Universal Testing Machine at crosshead speed of 0.5 mm/min in shear mode and scanning, electron microscope evaluation was done to observe the mode of failure. Statistical Analysis: All the observations obtained were analyzed statistically using software SPSS version 17; one-way analysis of variance (ANOVA) and post-hoc Tukey test were applied. Results: The one-way ANOVA indicated that SBS values varied according to type of surface treatment done. The SBS was highest (18.70 ± 1.2 MPa) when both sandblasting and metal primer was done when compared with no surface treatment (2.59 ± 0.32 MPa). Conclusions: It could be concluded that the use of metal primers along with sandblasting significantly improves the bonding of heat cured acrylic denture base resin with the Co-Cr alloy.

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Background and Objective: Transmucosal analgesic delivery is a promising approach to periodontal postoperative pain management. The purpose of this clinical trial is to appraise the effectiveness of transmucosal drug delivery system with meloxicam films and to identify its minimum effective dosage via this route after periodontal flap surgery. Materials and Methods: The analgesic mucoadhesive films were formulated using meloxicam and hydroxypropyl methyl cellulose polymer by solvent casting method. The sample size consisted of 60 chronic periodontitis patients who require periodontal flap surgery. The subjects were randomized using lottery method into four groups (Group A - 45 mg; B - 30 mg; C - 20 mg; D - 10 mg meloxicam per film). After periodontal flap surgery, the respective meloxicam mucoadhesive films were placed over the surgical site and were removed on 4 ^th day of postsurgery. The primary outcome measure was postsurgical pain level and recorded at 1 ^st , 2 ^nd , 3 ^rd , 4 ^th , 5 ^th , 24 ^th , and 48 ^th h using a 0-10 mm visual analog scale with markings from 0 = no pain to 10 = extreme pain. Results: The postoperative pain control observed in Groups A and B was found to be effective, and the patient comfort level was very satisfactory. Whereas in Group C, it was found to be high in the first 3 h postsurgically, after which adequate pain relief was seen. Group D exhibited inadequate pain relief. No adverse reactions were noted after applying the film in any of the groups. Conclusion: Transmucosal delivery of meloxicam was found to be effective and safe in postsurgical pain control of periodontal flap surgery. The minimum effective dosage via this route for meloxicam was found to be with 30 mg mucoadhesive films.

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Introduction: Recording of the maxillomandibular relationship (MMR) in implant complete arch restorations usually necessitates removal of the healing abutments to attach the record bases, which makes the procedures tedious and time-consuming. Materials and Methods: This article describes the procedure of recording of MMR for complete mouth rehabilitation with the help of the putty elastomeric record base cum occlusion rim reinforced with the acrylic resin framework. This technique records the MMR without removing the healing abutments from mouth and without attaching the acrylic-resin record base with wax occlusion rim. Results: The use of putty-elastomeric occlusion rim provides stable interocclusal records for implant supported complete arch (or mouth) rehabilitation. Conclusion: Maxillomandibular relationship records made with the present technique is less time-consuming and accurate with less chances of distortion of the MMR records.

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Introduction: Estimation of the mesiodistal dimensions of the unerupted canines and premolars in the early mixed dentition is a necessary diagnostic aid in space management. Tanaka-Johnston analysis was developed for North American children. Anthropological study reveals that tooth size varies among different ethnicities. The present study was performed to evaluate the validity of Tanaka-Johnston method of mixed dentition arch analysis in Mumbai school children. Aims: (1) To determine the correlation between the sum of the mesiodistal widths of the permanent mandibular incisors and combined mesiodistal widths of the permanent mandibular and maxillary canines and premolar in Mumbai school children. (2) To examine the applicability of Tanaka-Johnston method of prediction. Materials and Methods: Dental casts of maxillary and mandibular arches of 300 children, 147 boys and 153 girls within the age group of 12-15 years, with permanent dentitions were fabricated. The mesiodistal crown dimensions of teeth were measured with a dial caliper. Tanaka-Johnston method of mixed dentition arch analysis was performed for the study population, and statistical analysis was done. Statistical Analysis Used: Descriptive statistics including the mean, standard deviation, range, and standard error were calculated and tabulated. Results: Tanaka-Johnston's equation when applied to the data available for Mumbai school children, it was observed that it slightly overestimates the tooth size. Conclusions: (1) There was a positive correlation between the width of mandibular incisors and mandibular and maxillary canines and premolars. (2) The Tanaka-Johnston prediction method was not accurate for a sample of Mumbai school children.

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Maxillary second molar impaction in the adjacent ectopic third molar is a rare condition that practitioners might face in the field of pediatric dentistry and orthodontics. The early diagnosis and extraction of the adjacent ectopic third molar have been advocated, and prior research has reported a high rate of spontaneous eruption following third molar removal. However, some challenges in the daily practice are that the early diagnosis of this type of tooth impaction is difficult with conventional radiographic examination, and sometimes the early surgical removal of the maxillary third molar must be postponed because of the risks of damaging the second molar. The objective of this study is to report a case series of five young patients with maxillary second molar impaction and to discuss the difficulty of early diagnosis with the conventional radiographic examination, and unpredictability of self-correction.

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Context: Facial measurements serve as a valuable tool in the treatment planning of maxillofacial rehabilitation, orthodontic treatment, and orthognathic surgeries. The esthetic guidelines of face are still based on neoclassical canons, which were used in the ancient art. These canons are considered to be highly subjective, and there is ample evidence in the literature, which raises such questions as whether or not these canons can be applied for the modern population. Aims: This study was carried out to analyze the facial features of Indian and Malaysian women by using three-dimensional (3D) scanner and thus determine the prevalence of neoclassical facial esthetic canons in both the groups. Subjects and Methods: The study was carried out on 60 women in the age range of 18-25 years, out of whom 30 were Indian and 30 Malaysian. As many as 16 facial measurements were taken by using a noncontact 3D scanner. Statistical Analysis Used: Unpaired t-test was used for comparison of facial measurements between Indian and Malaysian females. Two-tailed Fisher exact test was used to determine the prevalence of neoclassical canons. Results: Orbital Canon was prevalent in 80% of Malaysian women; the same was found only in 16% of Indian women (P = 0.00013). About 43% of Malaysian women exhibited orbitonasal canon (P = 0.0470) whereas nasoaural canon was prevalent in 73% of Malaysian and 33% of Indian women (P = 0.0068). Conclusions: Orbital, orbitonasal, and nasoaural canon were more prevalent in Malaysian women. Facial profile canon, nasooral, and nasofacial canons were not seen in either group. Though some canons provide guidelines in esthetic analyses of face, complete reliance on these canons is not justifiable.

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Background: Considering an increase in elderly population in recent years, it has become necessary to pay attention to this group so that they can have a higher quality of life (QoL). Oral health is one of the factors affecting the QoL of the elderly. Aims: The purpose of this study is to evaluate the effect of oral health on the QoL of the elderly population in Babol, Iran. Materials and Methods: In this study, we used the multi-stage cluster sampling technique to select 300 elderly subjects, over 65 years of age, living in Babol. Oral health-related QoL was evaluated by the Persian version of oral health impact profile (OHIP-14) questionnaire. Data were collected on gender, age, occupation, education, the date of the last dental visit, use of prosthetic appliances, and dental treatment needs, including the periodontal, prosthetic, and surgical needs, by interview and examination. Statistical Analysis Used: Data were analyzed with SPSS software program using Mann-Whitney and Kruskal-Wallis tests. Results: The mean age of the subjects was 71.4 ± 5.6 years, with 183 males (61%) and 117 females (39%). The mean score of OHIP-14 questionnaire was 22.4 ± 8.2, with a range of 5‒50. The highest score was achieved on the psychological discomfort domain. There was no significant difference in OHIP-14 scores according to gender, with significantly lower scores in subjects with academic education. The subjects wearing prosthetic appliances had lower OHIP-14 scores compared to those who did not wear prosthetic appliances. OHIP-14 scores were lower in the dentate individuals compared to the edentulous individuals. There was no correlation between the age and the OHIP-14 score. Conclusion: In general, the results of the present study showed a moderate oral health-related QoL in the elderly living in Babol, who have orodental problems.

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Introduction: oral appliance for the treatment of OSA is considered as an effective, low-risk alternative to CPAP. Demand for oral appliance increases as an alternative for those who cannot tolerate CPAP and refuse surgery. Oral appliances uses the traditional methods to advance the mandible thus modify the posture and their by enlarge the airway or otherwise reduce the collapsibility. Aims and Objectives: The main objective of this study was to evaluate the efficacy of custom made oral appliance on sleep characteristics of OSA patients. Materials and Methods: Polysomnography was done on 15 patients of 24-60 years of age before (T1), and after the delivery of the custom made oral appliance (T2). Statistical Analysis: Paired t tests were performed to determine the significance of change in the polysomnographic and cephalometric variables. P < 0.05 was considered as significant. Results: All patients with oral appliance showed an improvement in sleep parameters with an increase in sleep efficiency, and desaturation index with the use of oral appliance. ESS and cephalometric findings showed improvement in the sleep apnea in concordance with the sleep parameters. Conclusions: Custom made oral appliance is a useful treatment option for improving quality of sleep and can be considered as an alternative treatment modality.

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Aims: The aim of this study was to assess oral health-related quality of life (OHRQoL) using short form (SF) of child oral health impact profile (COHIP) in children aged 11-15 years who sought orthodontic treatment. A comparison was done between these children and age-matched peers who never had or sought orthodontic treatment. Methodology: This cross-sectional study included 227 children aged 11-15 years. A total of 110 participants had sought orthodontic treatment at KSR Institute of Dental Science and Research (orthodontic group) and 117 participants from a nearby school who had never undergone or sought orthodontic treatment (comparison group). OHRQoL was assessed with the SF of the COHIP, and malocclusion severity was assessed with the index of orthodontic treatment needs. Data presentation and statistical analysis were performed with the Statistical Package for the Social Sciences Software (Version 19, SPSS, Chicago, IL, USA). The Chi-square test and Fischer exact tests were used to analyze the qualitative data. Results: Children with little to borderline treatment needs have a better quality of life when compared to children with definitive treatment needs (P = 0.049). No statistically significant difference in COHIP-SF scores was found between boys and girls (P > 1.000). In the orthodontic group, children with little to borderline treatment needs were 4.8 times (P = 0.037) more likely to report better OHRQoL when compared to children with definitive treatment needs. Conclusion: Children who sought orthodontic treatment had lower quality of life scores than those who never had or never sought treatment.

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Background and Aim: Convergence angle (CA) is one of the major determinant factors in the retention of single as well as multiple units. Hence, the aim of the present study was to determine the effect of preparation convergence on the retention of multiple unit restorations. Materials and Methods: Nickel-chromium alloy single crowns as well as three, six and nine multiple unit fixed partial dentures (FPDs) were casted for standardized milled dies that simulate canine, premolar and molar teeth machined with two different degrees of convergence, 12 (n = 55) and 20 (n = 55). The dies were threaded on rectangular metal platforms with the help of retainer shaft in the proper position to model either single or multiple preparations. The casted crowns and FPDs were cemented and retention tested by securing the units in an Instron universal testing machine. The tabulated values were analyzed statistically using Mann-Whitney test. Results: Single and multiple units with 12° CA needed greater force to dislodge compared to 20°, but this difference was not statistically significant for single units of premolar (P > 0.05). Irrespective of the angle, there was a simultaneous statistically significant increase in retention as the number of units increased in FPDs, except for the difference between 3 and 6 units in 20° group (P > 0.05). Conclusion: This study highlights the importance of emphasizing on CA, during canine and molar preparation for single units as well as preparation of canines for 6 units FPDs.

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Context: Addiction results in a range of health problems especially in the oral cavity. Aims: This study assessed the oral health status among women with a history of drug abuse in Tehran, Iran. Settings and Design: A cross-sectional study was conducted through structured interviews and clinical examinations of women at three rehabilitation centers in Tehran. Materials and Methods: Data on background characteristics, addiction history, knowledge, attitudes and behaviors, and oral health indices were collected. Statistical Analysis Used: We used MANOVA test and multiple logistic regression models to analyze the data. Results: We assessed 95 participants aged 37.88 ± 10.65 years. The most commonly reported drugs used prior to treatment were opiates (77.2%). The mean knowledge and attitude score among the patients was 80.83 ± 12.89 (37.5-100). Less than half of the dentate women reported tooth brushing as "rarely or never" (44.2%). Most of them (81.8%) had never used dental floss and 76.1% were daily smokers. The mean score of dental caries index (decayed, missed and filled teeth) of the participants was 20.2 ± 7.18 and 17 subjects were edentulous (17.9%). Factors such as age, drug type, duration of addiction, time of last dental visit, and frequency of brushing were associated with oral health status among these women. Conclusions: Women with a history of drug abuse in our study suffered from poor oral health. Although they had an acceptable level of knowledge and attitude toward oral health, their oral health, and hygiene was poor. These results call for more attention in designing and implementing oral health programs for addicts.

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Dens invaginatus (DI) is a developmental anomaly that results from an infolding of the dental papilla during tooth development and simulates the appearance of a tooth within another tooth. It shows a wide spectrum of variations in morphology and usually affects the maxillary lateral incisors. This study presents an unusual case of an Oehlers' Type I DI involving the bilateral mandibular first and second premolars, which presented as an incidental radiographic finding in the first premolars and was associated with a periapical lesion in the second premolars which was successfully treated using nonsurgical endodontics.

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Background: Multiple approaches have been used to replace lost, damaged or diseased gingival tissues. The connective tissue graft (CTG) procedure is the golden standard method for root coverage. Although multiple sites often need grafting, the palatal mucosa supplies only a limited area of grafting material. To overcome this limitation, expanded mesh graft provides a method whereby a graft can be stretched to cover a large area. The aim of this study was to evaluate the effectiveness and the predictability of expanded mesh CTG (e-MCTG) in the treatment of adjacent multiple gingival recessions. Materials and Methods: Sixteen patients aged 20-50 years contributed to 55 sites, each site falling into at least three adjacent Miller's Class 1 or Class 2 gingival recession. The CTG obtained from the palatal mucosa was expanded to cover the recipient bed, which was 1.5 times larger than the graft. Clinical measurements were recorded at baseline and 3 months, 12 months postoperatively. Results: A mean coverage of 1.96 mm ± 0.66 mm and 2.22 mm ± 0.68 mm was obtained at the end of 3 ^rd and 12 ^th month, respectively. Twelve months after surgery a statistically significant increase in CAL (2.2 mm ± 0.68 mm, P < 0.001) and increasing WKT (1.75 ± 0.78, P < 0.001) were obtained. In 80% of the treated sites, 100% root coverage was achieved (mean 93.5%). Conclusions: The results of this study demonstrated that multiple adjacent recessions were treated by using e-MCTG technique can be applied and highly predictable root coverage can be achieved.

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Background and Aims: Dental materials that are used in dentistry should be harmless to oral tissues, and should, therefore, not contain any leachable toxic and diffusible substances capable of causing side effects. This study was intended to investigate the effects on salivary nitric oxide (NO) and uric acid (UA) levels after application of dental composite filling materials to healthy volunteers. Materials and Methods: A total of 52 individuals (32 female and 20 male) participated in the study. Filtek Z250 composite filling material (3M ESPE, St Paul, MN, USA) was applied to healthy volunteers. Saliva samples were collected before restoration (baseline) and 1 h, 1-day, 7 days, and 30 days after restoration. NO concentrations were measured using the Griess reaction method, and UA was measured using an enzymatic method. Data were analyzed using repeated measures ANOVA and the Bonferroni post-hoc test (α =5%). Results: NO values increased statistically significant after 7 days (P < 0.05). In addition, lower UA levels were determined compared to the baseline levels, but the difference was not statistically significant (P > 0.05). There was no correlation between NO and UA levels in saliva (P > 0.05). Conclusion: Composite resins activated the antioxidant system in saliva. However, further studies are now needed to confirm our findings and to permit a definitive conclusion.

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Introduction: The purpose of this study is to compare the efficiency of culture methods in detecting microorganisms appearing in the bloodstream after various oral surgical procedures and effect of preoperative antibiotics and antiseptic rinses on bacteremia. Materials and Methods: The prevalence of bacteremia at various intervals of time (pre- and post-surgical) was studied in three different groups presenting with indications to surgical intervention. Two of the groups were given presurgical prophylaxis (systemic antibiotic and antiseptic rinse) while, in one group, no prophylactic measure was adopted. Blood samples were withdrawn from the subjects at specifi c pre- and post-surgical time intervals, and microbiological analysis was done. The fi ndings were compared with a control group involving healthy individuals and a group involved in maxillofacial trauma where the breach of oral mucosal integrity was not surgically planned. Results: The presence of bacteremia was not observed in all five groups at baseline while postsurgery (30 min, 60 min, and 90 min) in only three groups (preoperative antibiotic, without prophylaxis, and 1% Povidone iodine rinse). At all postsurgery periods (30 min, 60 min and 90 min), the presence of bacteremia was evident highest in without prophylaxis group followed by 1% Povidone iodine rinse and preoperative antibiotic the least.

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Background: Mandibular premolars are of the most difficult teeth to treat endodontically. Aims: To compare the root canal morphology of mandibular premolars between two genders in an Iranian population. Settings and Design: Totally, 230 cone-beam computed tomography images of the mandibles belonged to 115 males and 115 females were evaluated in the three spatial planes. Materials and Methods: The total number of roots and canals in the mandibular premolars was counted, and the difference between males and females were analyzed. Statistical Analysis: Data were analyzed using Chi-square test. The significance level was set as P < 0.05. Results: The majority of mandibular first and second premolars had one root (85.7% and 94.8%, respectively) and one canal (63.9% and 78.3%, respectively). The number of roots in the mandibular first premolars had statistically significant difference between two genders (P = 0.001). There was no significant difference between two genders in the number of roots (P = 0.208) and canals (P = 0.498) in the mandibular second premolars. Conclusion: According to the results of this study, the root canal morphology in the mandibular first premolars had statistically significant difference between two genders.

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Background: A major challenge in clinical periodontics is to find a reliable molecular marker of periodontal tissue destruction. Aim: The aim of the present study was to assess, whether any correlation exists between salivary immunoglobulin A (IgA) level against lipopolysaccharide of Porphyromonas gingivalis and clinical periodontal parameters (probing depth and clinical attachment loss). Materials and Methods: Totally, 30 patients with chronic periodontitis were included for the study based on clinical examination. Unstimulated saliva was collected from each study subject. Probing depth and clinical attachment loss were recorded in all selected subjects using University of North Carolina-15 periodontal probe. Extraction and purification of lipopolysaccharide were done from the standard strain of P. gingivalis (ATCC 33277). Enzyme linked immunosorbent assay (ELISA) was used to detect the level of IgA antibodies against lipopolysaccharide of P. gingivalis in the saliva of each subject by coating wells of ELISA kit with extracted lipopolysaccharide antigen. Statistical Analysis: The correlation between salivary IgA and clinical periodontal parameters was checked using Karl Pearson's correlation coefficient method and regression analysis. Results: The significant correlation was observed between salivary IgA level and clinical periodontal parameters in chronic periodontitis patients. Conclusion: A significant strong correlation was observed between salivary IgA against lipopolysaccharide of P. gingivalis and clinical periodontal parameters which suggest that salivary IgA level against lipopolysaccharide of P. gingivalis can be used to predict the severity of periodontal destruction in chronic periodontitis patients.

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