Aim: The aim of this study was to compare the rate of canine retraction, the anchorage loss, and the change in the inclination of the first molars between molar and mini-implant anchorage. Objective: (1) To compare the rate of canine retraction between conventional molar anchorage and mini-implant anchorage in the maxilla and mandible. (2) To compare the amount of anchor loss between mini-implant-anchored and molar-anchored sides during canine retraction in the maxilla and mandible. Materials and Methods: Ten patients were included in the study. The implants were loaded immediately by applying a force of 100 g. Measurements were made in the pre-retraction and post-retraction lateral cephalograms. A line drawn vertically from the sella-nasion plane through the distal pterygomaxillary point was used as a reference line. Results: The mean rates of canine retraction were 0.95 and 0.82 mm/month in maxilla on the implant and molar sides, respectively, and were 0.81 and 0.76 mm/month in mandible on the implant and molar sides, respectively. The mean anchorage loss was 0.1 mm on the implant side and 1.3 mm on the molar side of the maxilla and 0.06 mm on the implant side and 1.3 mm on the molar side of the mandible. The mean change in molar inclination was 0.3° on implant side and 2.45° on molar side of the maxilla and was 0.19° on implant side and 2.69° on molar side of the mandible. Conclusions: Implant anchorage is an efficient alternative to molar anchorage.

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Background: A considerable number of agents are effective in the treatment of dentin hypersensitivity (DH). The present 2 months' randomized clinical trial compared the desensitizing efficacy of dentifrice containing 5% fluoro calcium phosphosilicate versus 5% calcium sodium phosphosilicate in participants with sensitive teeth. Materials and Methods: A total of 60 participants above 18 years of age with a history of DH who displayed a visual analog scale (VAS) score of ≥ 4 to both subjective and thermal sensitivity in at least two teeth at the qualifying as well as baseline visit were considered eligible. Participants were randomly allocated to one of the following dentifrices: 5% fluoro calcium phosphosilicate; 5% calcium sodium phosphosilicate; and a standard dentifrice containing fluoride. Sensitivity scores (VAS) were measured at baseline, immediately after scaling and root planning, at 15, 30, and at 60 days. Results: A statistically significant reduction in symptoms for all treatment groups from baseline to 15, 30, and 60 days for both measures of sensitivity was observed. A significant reduction in DH with time for all the variables during the 8 weeks of the active phase of the study independent of treatment groups was noted. However, the fluoro calcium phosphosilicate group showed a higher degree of effectiveness in reducing DH, followed by calcium sodium phosphosilicate then standard fluoride dentifrices. Conclusion: Under the conditions of a clinical trial, the fluoro calcium phosphosilicate group showed a comparable reduction in the symptoms of DH.

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Aim: The study aimed to correlate the position of mandibular foramen with occlusal plane as a clinical guide for inferior alveolar nerve block (IANB) injection in children from 3 to 13 years of age. Materials and Methods: The study was carried out on 180 children visiting our department and required orthopantomogram as a routine diagnostic aid. Mandibular casts were obtained and radiographs were digitally analyzed to obtain linear and angular measurements. Statistical Analysis: The measurements were correlated with the position of mandibular foramen with Karl Pearson's correlation test. Results: The results of the study suggest that the needle for IANB should be placed below the occlusal plane in 3–4-year-old children (1.26 mm approximately), almost at the level of occlusal plane in 5–7 years (0.33 mm), above the occlusal plane in 7–9 years (1.54 mm), 9–12 years (1.64 mm), 11–12 years (1.98 mm), and 12–13 years (2.9 mm), respectively. The distance of the mandibular foramen from anterior border of mandible was greater than that from posterior border. The gonial angle values decrease with increasing age. Conclusion: The bony landmarks within the jaws keep changing their relative positions along with the skeletal growth. It is therefore necessary to modify the placement of needle during local anesthesia techniques with advancing age.

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An arteriovenous malformation (AVM) is a vascular malformation characterized by anomalous communications between arteries and veins without the normal intervening capillary bed. AVMs of jaw are extremely rare conditions that can give rise to dreadful complications if handled carelessly. Fifty percent of all intraosseous AVMs occur in the maxillofacial region and are extremely infrequent in the mandible. Only six cases of extraosseous submandibular AVMs have been mentioned in the literature. Three cases of AVMs involving the mandible, with a massive case involving both the mandible and submandibular region is reported. To the best of our knowledge, only one case is documented as a combined AVM involving both the mandible and submandibular region in literature.

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Background: Charcoal toothbrushes have been marketed widely claiming lesser bacterial contamination owing to the presence of activated charcoal. Aim and Objective: The aim of this study was to evaluate the bacterial contamination and antimicrobial efficacy of charcoal bristles compared to noncharcoal bristles in used toothbrushes. Materials and Methods: A total of 50 patients met inclusion criteria which were given standard brushing instructions on the use of a charcoal toothbrush and were asked to return the used brushes after 1 week of usage. After a washout period of 1-week, the participants were then provided with noncharcoal toothbrush and given similar brushing instructions to both groups and were instructed to return the brush after another week of usage. Bristles of the used toothbrushes were sectioned and placed in a 5 ml of saline, and 0.1 ml was inoculated on blood agar plates, which were then placed in a gas pack jar for anaerobic culture. Colony forming units (CFU) were measured after 48 h of incubation. To evaluate the antibacterial efficacy of charcoal bristles, the zone of inhibition was evaluated for charcoal versus noncharcoal after 24 h of incubation. Data collected were analyzed using a paired sample t-test. Results: The mean CFU count for noncharcoal bristles was almost double that of charcoal bristles. About 10 mm of the zone of inhibition was found around charcoal bristles as compared to 3 mm for noncharcoal bristles. Conclusion: This study shows the statistically significant difference in bacterial counts between bristle types and lower CFUs in the charcoal bristles compared with noncharcoal bristles, after 1 week of use. The zone of inhibition that was found around charcoal tooth bristles supported the antimicrobial properties of the charcoal toothbrush.

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The objective of this article is to highlight the importance of having a thorough knowledge about the root canal anatomy and the possible anatomical variations in maxillary second molar. This case report presents the endodontic management of the left maxillary second molar with four roots and four canals. A cone-beam computed tomography (CBCT) imaging was performed to ascertain this complex root canal anatomy. The CBCT findings revealed that the distobuccal canal and the distopalatal canal of the left maxillary second molar exhibits Vertucci Type VI root canal anatomy. This case report demonstrates the usefulness of CBCT in the understanding of complex root canal anatomy of maxillary second molar and its potential use as an endodontic diagnostic tool.

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The rationale for implant full-mouth rehabilitation is believed to present the better quality of life to the older population. This type of modalities preserves the soft and hard tissue of oral cavity. It is also helpful to check the temporomandibular joint disease. Literature exposes that implant full-mouth fixed rehabilitation is one of the taxing procedures in the field of prosthodontics. The current clinical report discusses a customized biomechanical approach for the fabrication of implant complete-mouth rehabilitation. A systematic approach in managing this patient can lead to a predictable and favorable prognosis. This article also presents the stages of prosthodontic rehabilitation from diagnosis to final treatment planning as a customized radiographical Gutta Percha template, precise implant surgery of 12 implants (ADIN, Dental Implant System, Israel) over the both the arches and provisional restorations with group function occlusion. Lastly, full-mouth restorations were fabricated as cement-retained (open hole) metal-ceramic restoration. Advocated patient is absolutely happy with customized implant full-mouth rehabilitation.

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Background: The aim of this study was to compare the clinical and radiographic outcomes of partial and complete caries removal (CCR) in permanent teeth with deep carious lesions. Materials and Methods: One hundred and forty-three patients of age group 14–54 years with mature permanent molars having deep carious lesions were divided into two groups: partial caries removal (PCR) and CCR. A layer of soft, wet carious dentin was left adjacent to pulpal wall in PCR group, whereas in CCR group, complete infected caries was removed with the help of caries-detector dye. Teeth were restored with composite resin (Tetric N-Ceram; Ivoclar Vivadent), with base of resin-modified glass ionomer cement (RMGIC) and patients were recalled at 1, 3, 6, 12, and 18 months. Success was defined as absence of signs and symptoms of irreversible pulpitis (spontaneous pain, fistula, and swelling) and absence of periapical alterations (radiolucency at furcal or periapical region). Results: Pulp exposure occurred in 13 (9.55%) cases of CCR group. Statistical significant difference (P = 0.001) in terms of pulp exposure was found between two groups. After 18 months, 123 teeth were evaluated (CCR = 56 and PCR = 67) and the success rate in CCR group (98.21%) and the PCR group (92.53%) did not differ significantly (P = 0.115). Conclusion: PCR could be as an elective treatment option for the mature permanent teeth with deep carious lesions.

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Background: A retrospective study is conducted to evaluate the mental foramen size and ramus height using digital panoramic radiograph to see if these parameters could be used to determine a correlation with age and gender in dentate subjects and to show its relevance in forensic odontology. Aim: To determine if there is an interrelation between two mandibular parameters (mental foramen, ramus height) in gender and age assessment. Materials and Methods: Five hundred and forty-five high-quality radiographs of patients aged 20 years and above were selected to see superior and inferior aspects of the mental foramen and the ramus height. Statistical Analysis: Data obtained were analyzed using the SPSS 20 version software. The mean and standard deviations were calculated for each clinical parameter, and one-way ANOVA statistical test of significance was used to compare superior and inferior aspects of mental foramen and ramus height with age groups and gender for both right and left sides. Statistical significance was set at P < 0.05. Results: Highly significant relationship was observed, and it was also found that as the age advances, the mental foramen and ramus height increase on both the right and left sides; whereas the mental foramen and ramus height increase among males as compared to females on both the right and left sides. Conclusion: There were significant changes in the dimensions of mental foramen and ramus height as age advances. The results concluded that ramus height and the mental foramen can be used effectively in the identification of gender using digital panoramic radiography.

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Background: Endodontic therapy treats inside of the tooth and its success is based upon the triad of thorough canal debridement, effective disinfection, and obturation of the canal space. Thus, one of the most important steps is biomechanical preparation, which is the key stage of endodontic treatment with a predictive success factor if performed properly. Aim: The aim of the study is to evaluate and compare the cleaning efficiency of different file systems in terms of remaining dentin thickness. Materials and Methods: A total of thirty permanent extracted anterior teeth were taken for the study and was divided into three groups – Group I – Manual Protapers, Group II – Rotary Mtwo, and Group III – Reciprocating WaveOne file systems. Pre-cone-beam computed tomography (CBCT) scan was taken followed by biomechanical preparation by the respective file groups. Post-CBCT scan was taken and the pre- and post-CBCT scans were compared for remaining dentin thickness. Data were analyzed with ANOVA (P = 0.001). Statistical Analysis Used: ANOVA test was used in this study. Results: Protaper showed minimum reduction in dentin thickness followed by Mtwo and WaveOne showed maximum reduction in dentin thickness, but the intergroup comparison was found to be highly insignificant. Conclusion: WaveOne is a highly recommended rotary endodontic instrument which does not cause significant lowering in remaining dentin thickness after biomechanical preparation.

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Context: Supernumerary teeth/tooth (ST) is a developmental anomaly of dentition. Variation in developmental and eruption pattern of ST can lead to the development of numerous complications in oral cavity. Aim: The aim of this study was to investigate prevalence, characteristics, and morphology of ST among patients visiting a dental institution in Rajasthan, India. Materials and Methods: During 1-year study, clinical examination of 9248 participants was performed. Morphology, type, location, number, position of eruption, state of eruption of ST, and associated complications were determined. Correlations between location of ST based on position of eruption, state of eruption, and associated complications were also determined using Chi-square test. Results: The frequency of presence of ST in the studied population was 0.63% (58 participants). In these 58 participants, eighty-two supernumeraries were found. Forty-six participants (79.32%) presented with one ST. Males were more affected than females (2.05:1), and the maxilla was the most commonly affected region. Among 82 identified supernumeraries, we noted highest incidence of parapremolars (39.02%) and conical morphology (46.35%). The most common position of eruption was normal (68.30%) and most of these 82 teeth were erupted in oral cavity (57.31%). These ST have led to various endodontic, orthodontic, periodontal, and other complications in the studied population. The relation of varying complications with different location of supernumerary was found to be highly significant (P = 0.000). Conclusion: ST are best detected and diagnosed by thorough clinical examination and radiographic investigation. Early detection and adequate treatment plan should eradicate the potential future complications caused by ST.

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Purpose: The purpose of the study is to determine the amount of marginal discrepancy produced by Co-Cr copings fabricated using various fabrication methods which include direct metal laser sintering (DMLS), computer-aided milling, traditional casting, and ringless casting and compare the values obtained between each fabrication technique and to evaluate if the fabrication technique can produce prosthesis that is within the standards of clinical acceptance of marginal discrepancy. Materials and Methods: Ten metal copings were fabricated by DMLS, computer-aided milling, traditional casting, and ringless casting. Marginal gap at the buccal, lingual, mesial, and distal areas was measured using silicone replica technique. A digital microscope was used to measure the silicone layer. Statistical analysis was done using one-way ANOVA test and post hoc Bonferroni test to test the difference between the fabrication method and categories of measured points, respectively. Results: The values indicate that the marginal gap was least for the copings fabricated using ringless casting followed by traditional casting and DMLS. The widest gap was seen in copings fabricated using computer-aided milling. Analysis of results showed statistically significant difference between copings fabricated using computer-aided milling and traditional casting (P = 0.029 and 0.043 – mesial and distal, respectively) and computer-aided milling and ringless casting (P = 0.002 and 0.001 – mesial and distal, respectively). Conclusion: Even though the marginal gap was found to vary with the fabrication method, all measurements of marginal gap of all groups were well within the standard clinical acceptance of 120 μ.

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Background: The chemomechanical plaque control measures are helpful in controlling dental plaque and thus caries, especially in pediatric age group. Aim: This study aims to compare effectiveness of herbal mouthrinse containing Terminalia chebula to that of 0.2% chlorhexidine against children's salivary mutans streptococci levels. Settings and Design: A double-blind, randomized, controlled study design will be framed for conducting this study. Methods: A total of 45 participants were randomly categorized in Group 1, Group 2, or Group 3 (control group, experimental group, or negative control). Baseline unstimulated saliva was collected. All the participants were instructed regarding the use of mouthrinse for 2 weeks. After 2 weeks, again unstimulated saliva was collected. After collection, saliva samples were sent for microbiological analysis. Statistical Analysis: The mean colony-forming units (CFU/ml) were determined. Paired t-test, ANOVA test, and post hoc test were applied for statistical analysis. Results: Statistically significant difference in CFU count has been observed in 0.2% chlorhexidine and Oratreat groups at 15 days as compared to baseline (P < 0.001). At 15 days, reduction in CFU count has seen more in Oratreat group as compared to 0.2% chlorhexidine group, and the difference is statistically significant (P < 0.001). Conclusion: 0.2% chlorhexidine and Oratreat mouthwash reduce the salivary Streptococcus mutans count. Oratreat herbal mouthwash has proved to be better as compared to 0.2% chlorhexidine mouthwash.

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Background: A furcation perforation is mid-curvature opening into periodontal ligament space which is a worst possible outcome in root canal treatment. Perforations should immediately be repaired with a biocompatible material to seal the communication between perforation site and gingival sulcus. Aim: The aim of this study was to evaluate the push-out bond strength of glass ionomer cement, hydroxyapatite, mineral trioxide aggregate, and biodentine (BD) when used in repairing furcal perforations with and without blood contamination in permanent molars. Materials and Methods: A total of 120 human extracted molars were collected and divided on the basis of perforation repair materials and blood contamination status (n = 15). All the materials were subjected to universal testing machine to a load cell from 0 N to 100 KN at a crosshead speed of 1 mm/min. Statistical Analysis: The data obtained were subjected to statistical analysis using SPSS version 20.0. Results and Conclusion: The push-out bond strength was maximum in BD contaminated with blood and least for the hydroxyapatite contaminated with blood. A significant difference was found between all the perforation repair materials.

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Aim: This study evaluated the antibiofilm efficacy of calcium hydroxide-based sealer incorporated with chitosan nanoparticles (CS-NPs) and zinc oxide nanoparticles (ZnO-NPs) against two strains of Enterococcus faecalis (ATCC 29212, OG1RF). Materials and Methods: The materials tested were Apexit Plus sealer in the commercial unmodified form and two modified forms with CS-NP and ZNO-NP, respectively. Crystal violet assay and confocal laser scanning microscopy (CLSM) study were used to assess the bacterial viability of biofilms grown in wells of microtiter plate and glass slides, respectively. Two E. faecalis strains (ATCC 29212, OG1RF) were used for the study. Results: The crystal violet assay done on E. faecalis strain ATCC 29212 showed a significant decrease in the optical density (OD) value with ZNO-NP-incorporated calcium hydroxide sealer when compared with CS-NP. In the case of E. faecalis strain OG1RF, only ZNO-NP-incorporated calcium hydroxide-based sealer showed reduction in the OD value. In CLSM study done on E. faecalis strain ATCC 29212, only ZNO-NP-incorporated calcium hydroxide-based sealer showed reduction in the thickness of biofilm. No groups of OG1RF strain showed reduction in the thickness of biofilm. Conclusion: The incorporation of nanoparticles (ZnO and CS) into calcium hydroxide-based sealers significantly enhances the antibiofilm efficiency against E. faecalis strain ATCC 29212 but has questionable effectiveness against E. faecalis strain OG1RF. The present study demonstrates that ZNO-NP shows better antibiofilm efficacy than CS-NP against both strains of E. faecalis.

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Background: Radiographs form an invaluable adjunct in diagnosis, treatment planning, and postoperative evaluation during patient management in the dental office where intraoral periapical (IOPA) radiographs are the ones most commonly used. However, certain conditions render the placement of film difficult. In such cases, a panoramic radiograph may be taken, but it has the disadvantage of higher radiation exposure and cost. Extraoral periapical (EOPA) technique allows radiographs to be taken on an IOPA film by placing it extraorally. We aimed to evaluate its diagnostic accuracy compared to intraoral bisecting angle technique. Materials and Methods: Forty-five patients were randomly selected. Ninety radiographs were taken; two for each patient. First image was obtained by intraoral bisecting angle technique and second by EOPA technique. A scale was devised for the comparison of radiographs taken by the two techniques. Two experienced oral radiologists rated them based on the scale followed by statistical analysis. Results: Patients reported increased compliance with the EOPA technique. 84.40% of the EOPA radiographs (EOPARs) were diagnostically acceptable; sensitivity and specificity was 84% and 55%, respectively. Conclusion: EOPAR is beneficial in cases where intraoral film placement is difficult, and a radiograph is necessary for patient management, even though it demonstrates comparatively lesser diagnostic accuracy.

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Background: The World Health Organization considers sealing the pit and fissures as a primary preventive measure and is one of the most effective, least invasive means to ensure the complete protection of the occlusal surface from the carious phenomenon. In vitro tests play a vital role in providing the necessary information regarding the efficacy of newer brands of sealants in a short period. Therefore, the aim of the present study was to evaluate and compare the viscosity and length of resin tag of conventional and hydrophilic sealant on permanent molars. Materials and Methods: Twenty extracted third molars were randomly divided into two groups: Group I: Conventional sealant (Clinpro 3M ESPE) and Group II: Hydrophilic sealant (UltraSeal XT Hydro). Occlusal surfaces of each tooth were pretreated with the acid etchant, and the respective sealants were placed. Both the groups were then subjected to thermocycling and sectioned longitudinally. The sectioned tooth specimens were examined under scanning electron microscope for resin tag length measurements. Viscosities were evaluated using an Anton Paar viscometer. Independent t-test was used to compare the difference in mean resin tag length of Group I and Group II sealants. Results: Viscosity measurements of Group I and Group II were found to be 0.9 mega Pascal (MPa) and 0.7 MPa and the mean resin tag length of Group II (10.03 ± 1.00 μm) was found to be higher than Group I (7.46 ± 0.95 μm) and was found to be significant statistically (P = 0.001). Conclusion: Based on the results of the present study, it can be concluded that Group II sealant exhibited lower viscosity and formed resin tag of sufficient length than that of Group I sealants. Therefore, hydrophilic sealant showed better results as compared to a conventional sealant.

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Background: Over many years, numerous products have been suggested for the relief of dentin hypersensitivity (DH). Calcium sodium phosphosilicate is one desensitizing agent that has remineralizing potential. Available in toothpaste and mouthwash delivery vehicle, this study was carried out to compare the effectiveness on dentinal hypersensitivity (using the Airblast test and Cold test) and on tooth remineralization (using DIAGNOdent pen) in a 4-week period. Materials and Methods: Out of the 45 patients screened, 28 patients who fulfilled the inclusion criteria and who willingly signed the consent form were selected and were randomly allocated into two groups – toothpaste and mouthwash. The tooth numbers and specific site of dentinal hypersensitivity for every patient were noted and the air blast test, cold test, and DIAGNOdent scores were recorded at baseline visit. The patients were instructed about the use of the product and were asked to come on the 30^th day for re-evaluation. Results: Within-group comparison showed a significant reduction (P < 0.05) in the air blast score (toothpaste – 68.53% and mouth rinse – 48.52%), cold test score (toothpaste – 56.38% and mouth rinse – 38.87%), and DIAGNOdent score (toothpaste – 20.35% and mouth rinse – 9.49%). In-between group comparison showed no statistically significant difference (P > 0.05). Conclusion: Desensitizing mouthwash is as effective as toothpaste in reducing DH with a fair remineralization potential comparable with that of the toothpaste.

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Introduction: Periodontal diseases are caused by pathogenic bacteria locally colonized in the dental biofilm creating infection; the main etiological factor is represented by dental plaque and in particular by anaerobic Gram-negative bacilli. For that reason, the first phase of periodontal treatment is always represented by the initial preparation which primarily aims at the elimination or reduction of bacterial infection and the control of periodontal plaque-associated inflammation. Yet, another innovative causal therapy is represented by the irradiation of periodontal pockets with LASER. The aim of this randomized clinical study is to compare and to detect the presence of periodontal pathogens in chronic periodontitis patients after nonsurgical periodontal therapy with and without diode LASER disinfection using BANA test. Materials and Methods: This randomized clinical trial includes 20 patients having chronic periodontitis. From each patient, one test site and one control site were selected and assessed for gingival index (GI), oral hygiene index (OHI), pocket probing depth and clinical attachment level (CAL), and presence of BANA pathogens. The test site underwent scaling and root planning along with diode LASER therapy as an adjuvant while the control site received scaling and root planning alone. Patients were recalled for review after 2 weeks and 2 months where periodontal parameters were assessed and plaque samples were collected and analyzed for BANA pathogens. Results: The test site where LASER was used as an adjuvant showed significant reduction in pocket probing depth, CAL, OHI, GI, and periodontal pathogens which shows that the amount of recolonization of microbes is less when LASER is used as an adjuvant to conventional therapy. Conclusion: Diode LASER as an adjuvant to SRP has shown additional benefits over conventional therapy in all the clinical parameters evaluated and this can be associated in the treatment of periodontal therapy. BANA-enzymatic kit is a simple chair side kit which can be reliable indicator of BANA positive species in dental plaque.

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Aim: This study evaluated the effect of staining and subsequent bleaching on the color stability and surface roughness of three resin composites. Materials and Methods: One hundred and eight customized plastic disks from a plastic mold with an outer diameter of 10 mm and thickness of 1.02 mm were fabricated. Samples were divided into three groups of 36 specimens each – Group I (Estelite^® α – Supranano), Group II (Filtek™ Z250 XT – Nanohybrid), and Group III (Filtek™ P90–Silorane). Subsequently, baseline surface color and roughness values were tabulated using spectrophotometer and profilometer, respectively. The specimens were then subjected to staining with coffee and turmeric for a period of 3 h/day for 40 days and following this, bleaching of the samples was done using a bleaching agent carbamide peroxide gel 15% for 8 h/day for 14 consecutive days. Results: Estelite^® α performed better by maintaining color stability with minimal roughness compared to Filtek™ P90 and Filtek™Z250 XT. Turmeric had a greater potential to stain composites compared to coffee in all the groups.

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Statement of the Problem: Disinfection of complete dentures is very crucial to prevent cross-contamination and infection. Microwave disinfection is a quick, easy, and effective means to disinfect dentures. However, the effect of repeated microwave cycles on the surface hardness property of heat-cured polymethyl methacrylate (PMMA) resin is not known. Materials and Methods: A total of 60 samples of heat-cured PMMA resin were fabricated for surface hardness. Each group was divided into four groups, according to the number of microwave cycles (MWC) applied for disinfection: control group (no disinfection) 0MWC, 1MWC group, 3MWC group, and 5MWC group. Results: No significant change on the surface hardness of a heat-cured denture base resin on repeated microwave disinfection. Conclusion: The repeated microwave disinfection showed statistically nonsignificant change on the surface hardness of the PMMA resin. Microwave disinfection can be safely used in regular practice to avoid cross-contamination and can also be suggested to patients for the regular denture hygiene.

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Purpose: This study evaluated the natural tooth color space of the Indian population and compared it with the manufacturer's shade systems. Materials and Methods: Maxillary central incisors of individuals aged 18–30 years and shade tabs of Vita Lumin vaccum (VL), Vitapan 3D master (V3D), and Shofu's Vintage Halo (SVH) shade guide were digitally photographed under standardized conditions. L*a*b* values from middle part of tooth and shade tab were attained using Adobe Photoshop 7.0 software. Comparative evaluation between the natural teeth and shade tabs was done, and color differences were noted and analyzed using appropriate software. Results: The L*a*b* values of the Indian population displayed a broader range than the shade guides. The mean Δ E* for VL shade guide was 7.22, 7.99 for SVH, and 8.39 for V3D, which was statistically significant. Color space of the Indian population on displayed an elongated cone with an irregular base. The plots of all the three shade guides were narrower and shorter and deficient in the blue–green region as compared to the population. Conclusions: Within the limitations of this study, the mean color difference between the Indian population and the three shade guides was above the acceptability thresholds (ΔE* = 2.7–6.8). VL, V3D, and SVH shade guides were deficient in their coverage and therefore can be considered inconsistent.

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Background: The presurgical nasoalveolar molding (PNAM) technique gave a new perspective to presurgical infant orthopedics. Nasal reconstruction presents a challenge for the treating surgeons in case of patients with unilateral cleft lip and palate (UCLP). PNAM facilitates the reshaping of the nasal cartilage and molding of maxillary arch preoperatively. Aims and Objective: The aim and objective of the present retrospective study was to analyze two-dimensional nasal changes before and after PNAM in patients with complete UCLP. Materials and Method: Twenty-two ULCP patients who underwent PNAM before lip surgery were considered in this study. A series of standard basilar view photographs in 1:1 ratio were taken and linear measurements were done digitally. Results: After PNAM therapy, there was a significant increase in nostril height (P = 0.003) and highly significant increase in columella length (P = 0.001). There was also a highly significant decrease in nostril width (P = 0.001) and a significant decrease in nasal basal width (P = 0.02). Conclusion: There was a significant increase in nostril height and columella length and a significant decrease in nostril width and nasal basal width on the cleft side when treated with PNAM therapy in patients with complete UCLP. Hence, this therapy helps in improving the nasal symmetry in such patients and also aids in surgical procedures.

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Introduction: Bacteria residing in the oral cavity penetrate freely through the resultant fissures under the fillings, which might lead to the development of secondary caries. Nowadays dentistry, different nanotechnological materials with antibacterial activity are being developed for oral cavity disinfection. Aim: This study aims to investigate the antibacterial activity of a new cavity disinfectant NanoCare Plus Silver Gold^® (NanoCare) in comparison to (0.2%) chlorhexidine (CHX) gluconate disinfectant against Streptococcus mutans growth and colony count using Agar well diffusion method and contact test, respectively, and also, to assess the nanoparticles (NPs) size distribution and Zeta potential of a NanoCare disinfectant. Materials and Methods: A total of 36 samples of cavity disinfectants were divided into two main groups (G) (n = 18); G1: NanoCare, and G2: CHX. Each group was subdivided into two subgroups (C) (n = 9) according to the antimicrobial test that the samples were subjected to. Results: A chlorohexidine group demonstrated the higher mean inhibition zone values than NanoCare group where P ≤ 0.05, as well both groups had a significant decrease in bacterial colony count where P ≤ 0.001. The particles size distribution in NanoCare sample was found that 99% of particles number with an average size of 29.07 nm and 1% was 136.7 nm, while the Zeta potential value was −6.5 mV. Conclusions: NanoCare cavity disinfectant displayed good antibacterial property against S. mutans. The innovative incorporation of NPs into this cavity disinfectant could be used to improve the antimicrobial capacity of the material and help to decrease secondary caries risk.

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Background: To enhance the bioactivity of hydroxyapatite (HA), various ions have been incorporated into its porous structure such as zinc. Zinc has shown to have a stimulatory effect on osteoblastic cells. This study attempts to evaluate the efficacy of an indigenously prepared zinc incorporated nanohydroxyapatite (ZINH) bone graft in the treatment of intrabony defects. Materials and Methods: A split-mouth study, which consists of 11 systemically healthy subjects with 45 sites, were randomly treated with ZINH or with nanoHA alone. Plaque index, gingival index, gingival bleeding index, pocket depth (PD) and clinical attachment level (CAL) were assessed at baseline, 3, 6, 9, and 12 months. Bone probing depth (BPD) and radiographic parameters were assessed at baseline, 6, and 12 months. Statistical analysis used was student's t-test and one-way analysis of variance. Results: At 12 months, PD and BPD reduction was more in test (4.37 ± 0.989 mm and 3.36 ± 0.446 mm) than control (2.81 ± 0.084 mm and 2.15 ± 0.159 mm). Gain in CAL for test (3.08 ± 0.148 mm) was higher than control (2.33 ± 0.278 mm). Furthermore amount and percentage of bone fill was higher in test (1.92 ± 0.702 mm, 54.7 ± 20.286, respectively) than control (1.38 ± 0.650 mm, 40.2 ± 20.972, respectively). Statistically significant improvements in all parameters were seen in the test sites at 12 months. Conclusion: ZINH bone graft can be considered as a prospective bone regenerative material.

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Background: The aim of this study was to evaluate the microleakage value under orthodontic brackets bonded with a nano-filled composite and to compare the results with a conventional adhesive using two different bonding systems. Materials and Methods: Forty human premolars were used in this cross-sectional study. The samples were randomly divided into four equal groups of ten: Group I: Acid etch plus Transbond XT primer and Transbond XT adhesive, Group II: Acid etch plus Transbond XT primer and nanocomposite (Filtek Z350), Group III: Scotchbond™ Universal primer plus Transbond XT, and Group IV: Scotchbond™ and nanocomposite. Sections were prepared for microleakage evaluation at the occlusal and gingival margins. Statistical analysis was performed to compare the microleakage values among the groups using analysis of variance (ANOVA). Statistical Analysis: Microleakage values were analyzed with two-way ANOVA test. Intraexaminer error was evaluated by the Kappa statistic. The level of significance was considered at P < 0.05. Results: Gingival side displayed statistically higher microleakage (P < 0.001). The nanocomposite Filtek Z350 generally represented higher microleakage when compared with the Transbond XT at both occlusal and gingival sides of the brackets (P < 0.001). More microleakage values were observed in brackets bonded using acid etch compared with Scotchbond. Comparison of microleakage among all the four groups revealed that Group II and Group III had the most and the least microleakage values, respectively, at the enamel–adhesive interface. Microleakage values for groups bonded with nanocomposite were significantly higher. Conclusion: This investigation clearly reveals the outstanding superiority and efficiency of a Transbond XT adhesive combined with a Scotchbond primer over that obtained using a Filtek Z350 nanocomposite in any combination with the used primers to limit microleakage under bonded brackets.

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Context: Early detection of peri-implant bone defects is highly important to prevent further bone loss and implant failure. Aims: This study aimed to assess the diagnostic accuracy of three cone-beam computed tomography (CBCT) systems and periapical radiography for detection of fenestration around dental implants. Methods: Thirty-one titanium implants were placed in the bovine ribs, in which peri-implant fenestration were simulated. Using a round fissure bur, fenestration defects were created in the apical-third region of implants. CBCT and PA radiographs were obtained before and after creating the defects. The results were analyzed using Chi-square test; kappa coefficient; Cochran's Q-test; McNemar's test; and sensitivity, specificity, positive predictive value, and negative predictive value; and receiver operating characteristic curve. Results: A significant agreement was noted between the two observers in the detection of defect-free samples in all imaging systems (P < 0.05). In detection of samples with defects, a significant agreement was observed between the two observers in use of Cranex three-dimensional and NewTom 3G systems (P < 0.05), but the agreement was not significant for detection of defects in use of Promax 3D (P > 0.05). The results showed no significant difference among the four imaging systems in detection of defect-free samples while the difference was significant among the four groups for detection of defects (P < 0.05). NewTom had the highest sensitivity (75.81%) and specificity (100%) for detection of fenestration. Conclusions: Within the limitations of CBCT systems different kVp used by different systems, artifacts and noises that influences image quality, difference in diagnostic value of different CBCT systems is due to the differences in type of detector and voxel size. In terms of the type of detector, our results showed that NewTom 3G, which has a higher (kVP) than other systems and the highest accuracy for detection of fenestration.

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A 3 year old female patient with history of congenital hydrocephalus and epileptic episodes since a week was referred to the department from Dhiraj general hospital for dental opinion. The patient was non ambulatory. On initial clinical examination grade II mobility was present with lower anterior teeth along with lower lip laceration and an extra oral swelling on the left side of the face. Pharmacological management was opted for this patient as regular chair side management was not feasible. The necessary investigations were completed. When the patient was taken under general anaesthesia for treatment, a radical symptomatic and preventive treatment was opted. Such cases pose a challenge to the Pedodontist's decision making skills and must be dealt considering the long term health benefits.

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Gorlin-Goltz syndrome (GGS) is an autosomal dominant disorder with a high degree of penetrance and variable expressivity. It is a rare phakomatosis characterized by multiple odontogenic keratocysts (OKCs), bifid ribs, and other abnormalities. The incidence of the GGS is estimated at 1 in 57,000–1 in 256,000 in the general population. The OKC is frequently the presenting manifestation of this syndrome. We report a case of a 25-year-old male patient, presenting with a swelling in the right side of the face which was diagnosed as GGS by correlating the clinical findings, histological findings, and evaluating the various tools of imaging. In the case of GGS, it is of great importance to make an early diagnosis since the severity of complications such as maxillofacial deformities related to the jaw cysts can be avoided.

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Syndromes, especially if they occur early in the growth phase can be very debilitating and cause severe restriction of function. Juvenile hyaline fibromatosis is one such disorder. Our case report presents a girl child who was diagnosed with this debilitating condition. The case presented with both – general characteristic features of this condition such as subcutaneous nodules and flexion deformity of the joints, as well as local manifestation in the form of gingival overgrowth. Thorough clinical and radiological investigations were done to arrive at the diagnosis which was supported conclusively with histopathology of the biopsied gingival lesions. A combination of both medicinal as well as surgical therapeutic modalities was used. This case report is an effort to comprehensively document the etiology, clinical features, and prognosis of this syndrome. There being no permanent cure for the condition, the case report highlights the unique management protocol employed by us in the form of intralesional steroid therapy with endocrine consultation and the local surgical gingival excision carried out in an attempt to optimize the quality of life for our patient.

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Background: Conventional acrylic resin is prone to microbial colonization and may cause inflammatory and allergic response. Aims: This study aims to research the initial microbial adhesion in situ and tissue response to an acrylic resin used in prosthodontics. Materials and Methods: Disks of a commercial acrylic resin were prepared and included on the surface of individual intraoral splints fabricated for 50 participants. The splints were used for 4 h, under clinical conditions. Beforehand, each participant was swabbed to provide a control for microbiological comparison. A cytological control sample was also taken from the palate. After the time elapsed, each splint was removed and growth of anaerobes, aerobes, Pseudomonas, oral streptococci, staphylococci, yeasts, and Streptococcus mutans was determined by plate counts and compared to the oral microbiome. A cytological sample was taken from the contact zone, stained using the Papanicolaou technique, analyzed in light microscopy, and classified accordingly. Means and standard deviations were calculated, and a nonparametric Wilcoxon test was employed to compare experimental groups. The significance level was set at 0.05 (95% confidence interval, and statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 20.0. Results: Nuclear-cytoplasm ratio increase was found in 84% of the smears retrieved from the contact zone. Over 60% showed nuclear alterations. With exception to yeasts and Pseudomonas, all microbial groups colonized the resin. No statistically significant differences were found between the oral microbiome and the acrylic resin's colonization except regarding yeasts (P > 0.05). Conclusions: Cellular alterations were found but a diagnosis of inflammation is inconclusive. Microbial adhesion to the acrylic resin was substantial, with multiple species adhering.

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The skeletal Class II occurs when there is a marked discrepancy in the position and relationship between the maxilla and the jaw, resulting in patients with labial incompetence, convex profile and an Angle Class II malocclusion, to the consultation there is a female patient of 12 years of age presenting these characteristics, in addition to a marked proclination of incisors, and clicking when opening the mouth. The objective of this case report was to improve the profile of the patient, get Class I molar and canine, correct the incompetence labial, and improve dental occlusion. The treatment plan included dental extraction of the upper and lower first premolars, accompanied by retraction of canines and upper anteroposterior segment. Thanks to the application of the ROTH technique through the use of elastic chains and retraction arches, the initial objective was achieved, improving the esthetics and function of the facial structures.

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