Introduction: Tooth coloured restorative materials are subjected to various physical, mechanical conditions in oral conditions. Many newer composites with improved physical and mechanical properties are introduced for clinical use. There are not many clinical studies on recent composites. The aim of this study was to compare the mechanical properties of five commercially available nano composite restorative materials. Materials and Methods: Specimens of five nano posterior composite SureFil SDR, ClearFil Majesty, Ever X, Tetric Evo Ceram bulk fill and Filtek Z350 were tested in the study. All samples were prepared According ISO 4049 and polymerized with a LED light for 40 seconds and subjected to mechanical tests for compressive strength, flexural strength, flexural modulous and nano hardness. Statistical Analysis: Results obtained were subjected to one way ANOVA and Turkey's post hoc test at significance (p <0.05). Results: There was significant differences among composites restorative resins tested. CFM Nano hybrid composite exhibited highest hardness values. Flexural strength, flexural modulous and hardness properties of Ever X and Z350 were almost similar. Compressive strength value of Ever X was high compared with other four composites. SDR exhibited least values when compared with other composites. Conclusion: Differences in compressive strength, hardness, flexural strength and modulous is due to differences in percentage and type of filler particles in all composite resin material tested.

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Aim: To compare the incidence of apical root crack formation after root canal preparation at different instrumentation lengths using ProTaper Universal (PTU), ProTaper Next (PTN) and ProTaper Gold (PTG) file systems. Subjects and Methods: Eighty-four mandibular first premolars with single and straight root canal were mounted in resin block after simulating periodontal ligaments. 1–2 mm of root apex was exposed followed by sectioning of 1 mm of root tip for better stereomicroscopic visualization. While the Control group was left unprepared, experimental groups were instrumented up to root canal length (RCL) and (RCL-1 mm) respectively using PTU, PTN and PTG. After staining the root apex with 1% methylene blue dye, stereomicroscopic images were obtained for evaluating apical root cracks. The data were analyzed using Chi-square, phi and Cramer test. The significance level was set at P < 0.05. Results: Significantly less dentinal defects were seen between PTG and PTU while there was no significant difference between PTU-PTN and PTN-PTG. Furthermore, samples instrumented up to RCL-1 mm showed lesser cracks as compared with samples instrumented up to RCL. Conclusion: PTG produced least number of cracks followed by PTN and PTU. Furthermore, instrumenting short of RCL reduced the crack formation risk.

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Objective: The purposes of this study were to determine the midpalatal suture (MPS) opening depth and to assess its relation with the zygomaticomaxillary suture (ZMS) by age with using cone beam computed tomography (CBCT). Materials and Methods: In this cross-sectional study, 167 CBCT scans of patients aged 7–25 years (mean age: 16.04 ± 5.17 years) were selected based on predefined criteria and categorized into four age groups. The mean percentages of the depth of MPS opening at anterior, middle, and posterior regions in the coronal and closure status of ZMS in axial views were determined by a maxillofacial radiologist. Results: The mean percentages of MPS opening depth at anterior, middle, and posterior regions were 98.20%, 89.27%, and 71.44%, respectively. In these regions, 20–25-year age group showed a significant difference compared with first- and second-age groups. A significant difference was observed in the frequencies of complete MPS opening in different age groups in the middle (P = 0.017) and posterior (P = 0.001) regions. About 80.20% patients had open ZMS bilaterally. The percentages of opening depth in the three regions were 97.8%, 91.8%, and 75.6%, respectively, when ZMS was open on both sides. Conclusion: Percentage of opening depth of this suture decreased by age. MPS closure starts from the posterior region. ZMS in younger people is usually open on both sides; however, it can be closed on one or both sides by age. An association was observed between bilateral closure or opening of ZMS and mean percentage of MPS opening in the middle and posterior regions.

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Aim: This study aimed to quantitatively compare the remineralization potential of casein phosphopeptide-amorphous calcium fluoride phosphate (CPP-ACFP) and Novamin on artificially induced enamel subsurface lesions using scanning electron microscope-energy dispersive X-ray (SEM-EDX). Materials and Methods: Enamel specimens were prepared from seventy caries-free premolars and were kept for demineralization for 4 days. Following demineralization, enamel specimens were assigned to three groups: (1) Control group, (2) Group with CPP-ACFP-containing toothpaste, and (3) Group with Novamin-containing toothpaste. Further, both the experimental groups (CPP-ACFP group and Novamin) were then divided into three subgroups based on the duration of re-mineralization as follows: (a) 7 days, (b) 14 days, and (c) 21 days. Enamel specimens of experimental groups were then subjected to SEM-EDX to evaluate mineral content after treating with CPP-ACFP and Novamin. Results: Both the experimental groups showed very high significant differences between Ca/P ratios of remineralized samples. Conclusion: Even though both CPP-ACFP and Novamin showed remineralization potential, remineralization was found to be higher in the samples treated with CPP-ACFP.

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Introduction: Tissue conditioners are used to improve the health of the soft tissues of denture-bearing areas. However, leaching of plasticizers from tissue conditioners results in deterioration, which necessitates frequent replacement. The life of these liners varies, but it can be extended by the use of a coating material. Aim: To evaluate the surface roughness of a tissue conditioner with monopoly coating, subjected to denture cleanser and disinfectant. Materials and Methods: Sixty disk-shaped specimens of Visco-gel were made and divided into six groups of 10 each (control 1 [C1], control 2 [C2], control 3 [C3], group 1 [M1], group 2 [M2], and group 3 [M3]). Specimens of the control group were not coated with monopoly, while the specimens of the groups 1, 2, and 3 were coated with monopoly. Specimens of C1 and M1 were immersed in distilled water. Specimens of C2, C3, M2, and M3 were immersed into solution of denture cleanser for 8 h at room temperature and immersed in distilled water for the remainder of the 24-h period. C3 and M3 specimens were treated with disinfectant for 10 min before testing the surface roughness. The surface roughness was measured on 1^st, 3^rd, 5^th, 7^th, and 14^th day, using a contact profilometer. Student's paired t-test was used to compare the mean Ra values within each group. In the present study, P < 0.05 was considered as the level of significance. Results: The mean surface roughness values of M1, M2, and M3 groups were less than C1, C2, and C3, respectively. Among all the groups, M1 showed the least surface roughness values. Conclusion: Monopoly-coating agent prevents the deterioration and reduces the surface roughness of the tissue conditioner.

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Introduction: Cleft lip and palate deformities are one of the most common birth defects. The alveolar cleft requires bony repair to allow proper eruption of dentition. The purpose of this study is to evaluate success in the repair of alveolar clefts with iliac bone grafts. Aim: The aim of this study is to restore the function and form of both arches with a proper occlusal relationship and eruption of tooth in the cleft area. Subjects and Methods: Five patients were selected irrespective of sex and socioeconomic status and whose age was within the mixed dentition period. The iliac crest is grafted in the cleft area and subsequently evaluated for graft success using study models, periapical, and occlusal radiographs. Results: At the time of evaluation, teeth were erupted in the area and good alveolar bone levels were present. Premaxilla becomes immobile with a good arch form and arch continuity. There are no major complications regarding pain, infection, paresthesia, and hematoma formation at donor site without difficulty in walking. There is no complication regarding pain, infection, exposure of graft, rejection of graft, and wound dehiscence at the recipient site except in one case.Conclusions: Long-term follow-up is required to achieve maximum advantage of secondary alveolar grafting; the age of the patient should be within the mixed dentition period, irrespective of sex and socioeconomic status. It may be unilateral or bilateral.

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Aim: The study was aimed at evaluating the efficacy of cryosurgery in the management of oral mucosal lesions. Time taken for healing, postoperative pain, secondary infection, and recurrence of lesion was evaluated. Materials and Methods: A total of 30 patients with oral mucosal lesions were included in the study. The patients were evaluated for pain and postoperative infection which was documented on the 1^st, 3^rd, 7^th, 21^st day after the procedure. Other parameters such as healing time and scarring were assessed at 21^st day. Recurrence of the lesion was evaluated in the 3^rd and 6^th postoperative month. All these data were statistically evaluated. Results: The pain and swelling which reduced mainly during the 7^th postoperative day which was highly significant. The discomfort of the patient was relatively less. Only three patients showed delayed healing out of all patients. Recurrence of lesion was noted in two cases which conclude to about 6.7%. Conclusion: The cryosurgery is overall a better modality for treatment of oral lesions as it is more reasonable with adequate success. The procedure is relatively more acceptable and has shown to have a faster recovery.

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Aim: The aim of this study was to assess the oral health knowledge, behavior, and practices related to use of miswak (chewing stick) in population of Aseer Region, Saudi Arabia. Subjects and Methods: Of the 2023 participants, 1666 (83.3%) were females and 334 (16.7%) were males. The questionnaires having 10 online questions were used to assess the knowledge of oral hygiene methods, including frequency, reason, and methods for miswak use. Statistical Analysis Used: The survey data were collected and organized into Microsoft Excel spreadsheets (Microsoft Inc., USA) and were statistically analyzed utilizing the Statistical Package for the Social Sciences version 20.0 software (IBM Inc., USA). The statistical test used here was the Chi-square test, and P < 0.05 was considered to be statistically significant (P < 0.05). Results: Participants responded regarding the primary oral hygiene methods; 46.5% respondents used toothbrushes, 44.5% used both toothbrushing and miswak, and 8% used only miswak as their primary tooth cleaning method. 28.2% respondents cleaned their teeth with tooth brush or miswak at least once a day, 37.6% twice, 28.4% whenever required, and 5.9% infrequently. Majority of the participants, i.e. 70.2% were using miswak with taper and as a brush to clean all tooth surfaces. About 84.7% feel fresh, and teeth are whiter after the use of miswak. Nearly, 84.7% prefer to continue using miswak in combination with other teeth cleaning methods, which may have more benefits. Conclusions: In our study, most common type of oral hygiene method employed is toothbrush and in combination with miswak. Chewing stick use was common among participants with religious advice being the dominant reason for usage.

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Background: Candida Associated Denture Stomatitis is the prevalent fungal pathosis in denture wearers, especially in immunocompromized patients. Existing antifungal agents are ineffective since the Candida species become resistant and also, they become toxic. Origanum vulgare is a herbal plant with high anti-fungal activity against Candida of blood and urine origin. However, it has never been explored against Candida from oral cavity. Materials & Methodology: Dry leaves of the plant were purchased and authenticated. Oil extraction was done using Hydro-distillation method. Clinical isolates of Candida from denture wearers was speciated using CHROMagar. Well Diffusion test was used to confirm the antifungal activity. Hydro-distillation & Maceration methods of extraction were compared. MIC/MFC was determined using CSLI guidelines. Infra-Red Spectroscopy was used to identify the active functional group. Results: O.vulgare showed 30±3mm of zone of inhibition as against 19mm for fluconazole. The suitable extraction method was Hydro-distillation. MIC & MFC were found to be 0.024% and 0.097% respectively which was much lesser than for fluconazole (0.25%). The active functional group had chemically similar structure as Carvacrol, usually found in antifungal herbs. Conclusion: within the limitations of the study, it was concluded that (a)O.vulgare is anticandidal for clinical isolates of oral Candida, (b) Hydro-distillation is an effective method as compared to Maceration (c) MIC & MFC are much lower than that of fluconazole (d) the major functional group was structurally similar to Carvacrol.

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Objective: To identify and compare the species variation and Colony Forming Units of the species and antifungal susceptibility from oral rinse samples of individuals in poorly-controlled, moderately-controlled and well controlled diabetes patients with control group. Subjects and Methods: Study group comprised of well-controlled, moderately-controlled and poorly controlled Type II diabetic patients grouped according to the level of glycated hemoglobin concentration with 50 patients in each group and 50 healthy individuals. Oral rinse samples were collected in a sterile container with phosphate-buffered saline and then transported immediately for various mycological investigations and antifungal susceptibility tests. Statistical analysis was performed. Results: There was a significant difference in frequency of Candida in poorly controlled diabetes when compared to moderately controlled diabetes, well controlled diabetes and normal patients (P = 0.045). A higher number of colony count was seen among poorly controlled diabetes than well controlled, moderately controlled and non diabetic subjects. A comparatively low number of non-albicans were seen in healthy individuals. C. albicans showed an increased resistance to fluconazole in DM patients in comparison to control group (P = 0.001). Other species showed a variable sensitivity pattern. Conclusion: The decreased immunity and change in oral habitat in diabetic patients creates a diversification in various species of Candida. These non albicans vary in their susceptibility and pathogenesis. A definite identification of these diverse species in the oral cavity of such patients and their susceptibility mandates proper management to avoid recurrence and drug resistance.

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Marking dental prosthesis has always been considered an important part of forensic dentistry. Denture identification systems are important not only for patients in health-care facilities, old-age homes, and hospitals but also in medico-legal cases. In India, no standardized method is being followed for labeling of the dentures. This article proposes a technique of denture marking that gives permanent, unique, and global identification to all the Indian nationals using Aadhaar - a universally accepted identity for Indian nationals. The information on the card can be printed on a piece of paper or a plastic card and the Aadhaar card quick read code/number can be easily and cost-effectively used for marking all the newly constructed or existing prosthetic devices.

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Platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) have been successfully used for inducing pulp regeneration in nonvital teeth. This case report highlights the difference between the outcomes of using PRF and PRP for pulp regeneration in a 13-year-old male patient, who had reported with endodontic treatment failure in his upper incisors. Gutta-percha and sealant were removed, and triple antibiotic paste (TAP) was placed in all the root canals and sealed with cavit. Subsequently, after TAP removal, 11 and 12 were treated with PRF, while 21 and 22 were treated with PRP. A resorbable matrix was placed over the PRF/PRP, over which mineral trioxide aggregate and glass ionomer cement were placed. After 2 years, all the upper maxillary incisors revealed dentinal wall thickening, root lengthening, and apical closure. However, apical bridge formation occurred only in incisors treated with PRF.

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Context: Achieving a high degree of conversion (DC) is one of the major concerns during photopolymerization of bulk-fill composites. Aims: To evaluate the effect of light energy densities (11.2 J/cm² and 20 J/cm²) on the DC and variation of DC in the 24-h postcuring of four bulk-fill composites: SDR, Venus Bulk Fill, MI FIL, and Tetric N-Ceram Bulk Fill at simulated clinically relevant filling depths. Settings and Design: This was an in vitro comparative study. Subjects and Methods: A total of twenty samples were prepared using a teflon mold. VALO curing light was used with two light intensity modes of 1000 mW/cm² for curing time of 20 s and 1400 mW/cm² for curing time of 8 s. The energy density was calculated as follows: energy density (J/cm²) is the light intensity (mW/cm²) applied during a certain time (s) divided by 1000. The DC was measured at two time intervals: immediately postcure and after 24-h storage in artificial saliva using an Fourier-transform infrared spectroscopy equipped with attenuated total reflectance accessory. Statistical Analysis Used: ANOVA and Bonferroni test at P < 0.05. Results: High energy density (20 J/cm²) leads to higher DC. Thickness, type of composites, and postcuring phase strongly influence the DC. DC values of the top surface for all the bulk-fill materials investigated were found significantly greater (P < 0.005) than those of their bottom surface. Among composites, SDR showed highest DC. DC strongly increased after 24-h postcure by 32% on top surface and 76% on bottom surface. Conclusions: Energy density more than 20 J/cm², derived by increasing curing time and low power density, helps obtain a high DC of bulk-fill composites for adequate clinical performance.

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Background: The success of endodontic treatment depends on the knowledge of root canal system. The root canals have complex morphology and wide individual variations. The aim of this study was to evaluate the root canal morphology of the maxillary first molars among residents of the Moscow region using cone-beam computed tomography (CBCT) scanning. Materials and Methods: Three hundred CBCT images of patients aged 20–70 years old were analyzed to study the root canal system (the number of canals and the configuration according to Vertucci's classification) of the maxillary first molars. The prevalence of a second mesiobuccal (MB2) in the mesiobuccal root (MB) was recorded in each age group. Results: three separated roots of the maxillary first molar were observed in 100% of cases. MB2 canals were found in 59.8% of cases. A second distobuccal canal was observed in 0.5% of cases. The canal morphology in the MB root was 40.2% in Type I, 22.4% in Type II, and 37.3% in Type IV. Conclusion: The prevalence of MB2 canals was 59.8%, and the most common canal morphology was Vertucci's Type I. Using CBCT scanning is a useful technique to evaluate and analyze the root canal system.

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Objective: The objective of this study was to determine whether an adhesive containing antibiofilm agent octafluoropentyl methacrylate (OFPA) has an acceptable bond strength as an orthodontic adhesive. Methods: Sixty human premolars were divided into four groups. In Groups 1 and 2, brackets were bonded to the teeth using experimental nanohybrid adhesive containing OFPA (ENH-OFPA) and Transbond XT (TXT) was used in Groups 3 and 4. In Groups 1 and 3, the samples were stored in water at 37°C for 24 h and in Groups 2 and 4 thermocycled between 5°C and 55°C. The entire samples were debonded utilizing a universal testing machine. Two-way ANOVA test employed to compare the shear bond strength (SBS) between two adhesives. Independent Student's t-test was utilized to compare the SBS at 24 h and followed thermocycling in each adhesive group. Adhesive remnant index (ARI) evaluated in different groups using Chi-square test. Results: The mean value for SBS in ENH and TXT groups were 8.13 MPa and 8.10 MPa, respectively. The inference of P = 0.260 was observed and concluded to be nonsignificant for adhesives in terms of SBS. Statistically, differences that observed in SBS at 24 h and following thermocycling in TXT (P = 0.288) and ENH-OFPA (P = 0.145) groups did not consider to be significant. Comparing ARI scores with bracket failure mode resulted in no significant difference (P = 1) between two adhesives in both 24 h and following thermocycling. Conclusion: Adding OFPA does not compromise SBS of the experimented orthodontic adhesive.

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Successful endodontic treatment requires knowledge of the root canal anatomy, cleaning, and shaping followed by three-dimensional filling of the root canals. With the advent of newer diagnostic aids such as cone-beam computed tomography (CBCT) and magnifying tools such as dental operating microscope and loupes, it has become easier for an operator to identify the root canal anatomy of teeth and reduce the risk of procedural accidents and failures. Variations in root canal configuration require modification in access cavity preparation, disinfection, and obturation of the canals. Mandibular premolars are identified to have unusual root and canal anatomy which increases the risk of endodontic failure when additional canals remain undiagnosed. The present case report elaborates successful endodontic management of a mandibular second premolar with Type IX root canal configuration using CBCT as a diagnostic tool.

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Sarcomatoid carcinoma (SC) is an unusual and aggressive variant of squamous cell carcinoma, which frequently recurs and metastasizes, and is associated with poor survival rate. For this reason, its accurate diagnosis is very important. It is considered to be a biphasic tumor made up of epithelial as well as spindle cell component, but of epithelial origin. The diagnosis often represents a clinicopathologic challenge, and immunohistochemistry plays a key role in the histopathological diagnosis. The reported cases in oral cavity are limited. Here, we present two cases of SC where the use of immunohistochemistry allowed us to achieve a conclusive diagnosis.

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Context: Variability of the soft-tissue drape in humans has complicated the accuracy of evaluating soft tissue profiles in diagnosis and treatment planning. Aims: The objective of the present study is to establish soft-tissue cephalometric norms for South Indian population using Arnett Bergman Soft tissue analysis. Settings and Design: This study was conducted at the Department of Orthodontics and Dentofacial Orthopaedics. Subjects and Methods: Lateral cephalograms of 60 individuals (30 males and 30 females), age ranging between 18 and 25 years, with orthognathic facial profiles were obtained in natural head position. True vertical line was drawn through subnasale parallel to the vertical reference plane. Measurements were done according to soft-tissue cephalometric analysis. Statistical Analysis Used: Student's t-test was used to compare the means between two groups. Results: The results of the study showed significant gender dimorphism, with men having thicker soft-tissue structures, larger vertical dimensions, deep-set midface structures, more upright incisors, and deeper inferior labial sulci than women. When compared with the standard norms, the South Indian population had significantly protruded dentition, thinner soft-tissue drape, shorter vertical face heights, prominent forehead and midface with retusive lower facial thirds and convex profiles as compared to Caucasians. Conclusions: Significant gender dimorphism was evident in the local population suggesting the need for separate set of norms for males and females. Distinct ethnic differences were found between Caucasians and the Indian population that were statistically significant, highlighting the importance of defining separate set of norms for ethnic groups. The norms obtained should be used as reference when planning treatment of a specific ethnic group.

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Background: The occurrence of secondary caries is the most common reason for the restorations failures. Aim: The aim of the study was to evaluate and compare the anticaries effect of copper ions on the teeth restored with glass ionomer cement (GIC) and composite restorations in the cavity prepared by galvanic and sintered burs. Materials and Methods: A total of 40 premolars were divided into two halves buccolingually. Class V cavity was prepared with sintered diamond burs and galvanic diamond bur. Cavities were restored with either GIC or composite resin. The monospecies artificial microbial caries model was selected for induction of secondary caries. The lesions were measured at junction of restoration by confocal laser scanning microscope. Results: The results were statistically significant (P < 0.001) and suggested that the width of lesion was lowest in cavity prepared by sintered bur and restored with composite resin. Conclusion: The use of different burs in combination with various restorative materials influence the occurrence and width of caries lesion.

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Background: Indirect pulp treatment (IPT) is a minimally invasive procedure based on the application of a protective liner on the affected dentin, thereby preserving the pulp vitality. Aim: This study aims to evaluate and compare the clinical and radiographic outcomes of IPT when a layer of calcium hydroxide (Dycal), mineral trioxide aggregate (MTA), or Biodentine was placed over the affected dentin in primary molars. Materials and Methods: A clinical trial with sample size of 45 primary molars between the age group of 4–9 years, of which 15 teeth were considered, each for Group I (Dycal), Group II (MTA), and Group III (Biodentine). Measurements on digitized radiographs were made at baseline, 3, and 6 months using Corel Draw software. Results: One-way ANOVA and post hoc tests indicated a statistically significant difference in dentin thickness (P < 0.05) in all the groups. Within Group I, the thickness of dentin was 0.066 ± 0.009 mm at 3 months and 0.099 ± 0.011 mm at 6 months. In Group II, 0.081 ± 0.010 mm at 3 months and 0.123 ± 0.016 mm at 6 months. In Group III, 0.102 ± 0.021 mm at 3 months and 0.154 ± 0.022 mm at 6 months. Conclusions: Clinically, 100% success rate was observed in all the groups whereas radiographically, Biodentine was superior to both the groups.

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Introduction: Sodium hypochlorite (NaOCl) is widely used endodontic irrigant with its array of advantages and disadvantages. Addition of herbal agents to NaOCl might help in enhancing its efficacy. Materials and Methods: NaOCl was prepared using chlorinated lime, anhydrous sodium carbonate, and distilled water to obtain 6% fresh solution. Then, this solution was evaluated for its pH and chlorine content. The fresh herbal extract of Cymbopogon citratus (lemongrass), Mentha piperita (peppermint), and Ocimum sanctum (tulsi) was prepared from plant leaves. After which, various permutation and combinations were made, and it was found that 9:1 ratio was the most effective combination. The pH and percentage of free chlorine were evaluated and analyzed. Results: No statistical significant difference was found in pH content. However, significant difference was found between the groups for chlorine content (P < 0.05) of herbal NaOCl. Conclusion: The current study presents a simplified method for preparation of herbal irrigating solution.

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Introduction: Impression making is one of the most important steps in prosthodontic rehabilitation of edentulous patients. Zinc oxide eugenol (ZOE) impression paste is the most commonly used material for complete denture wash impression due to its cost-effectiveness and ease of manipulation, while providing the advantage of ability to record fine minute tissue details. Rheological property like flow is a critical factor influencing the success of any impression material, especially in intraoral conditions. Therefore, with so many brands of commercially available impression materials flooding the markets, the aim of this study was to evaluate and compare the flow property of four commercially available ZOE impression materials under simulated intraoral condition. Materials and Methods: The testing method used was according to the American Dental Association (ADA) specification no. 16 for ZOE impression pastes. Results: At room temperature, maximum flow was seen with Denzomix followed by Dental Product of India (DPI), Neogenate, and Cavex in descending order, respectively, at 30 s, 1 min, and 10 min of load application. At 37°C in saliva, maximum flow was seen with Denzomix followed by Neogenate, DPI, and Cavex in descending order, respectively, at 30 s, 1 min, and 10 min of load application. Of the four ZOE impression pastes, only the flow of Cavex was considerably less than ADA specified value. Interpretation and Conclusion: Results obtained from this study showed that there is considerable variation in the flow values of different commercially available ZOE impression materials. Change in temperature and presence of saliva had a significant influence on the flow of ZOE impression materials.

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Background: Oral lichen planus (OLP) is a chronic disease of established immune-mediated pathogenesis. It most commonly, protractedly, and persistently involves the mucosa of the oral cavity. Antigen-specific and nonspecific mechanisms play a role in its pathogenesis, leading to T-cell accumulation in superficial lamina propria, intraepithelial T-cell migration, and keratinocyte apoptosis in OLP. Previous studies have indicated the possibility of serum lipid derangement in chronic inflammatory diseases such as systemic lupus erythematosus and psoriasis, which in turn results in elevated cardiovascular disease risk. Inflammation causes disturbances in lipid metabolism such as decrease in high-density lipoprotein-cholesterol (HDL-C) and increase in very low-density lipoprotein (VLDL)-cholesterol and hypertriglyceridemia due to direct effect on T-cell responses. Prolonged dyslipidemia, due to chronic inflammatory condition, enhances the formation of atherosclerotic plaques and thereby augments the risk of cardiovascular disease in such patients. With this background, a possible correlation between OLP and serum lipid level derangement can be anticipated. Hence, this study was taken up to probe into an association between the two. Aims: To determine and compare the serum lipid levels in OLP patients and healthy controls, to inquire into the possible association of OLP with alterations in serum lipid profile patterns, and to determine if the clinical characteristics of OLP differed with alterations in serum lipid profile patterns. Subjects and Methods: Sixty patients comprising 30 cases and 30 controls were enrolled for the study. Thirty cases of clinically and pathologically diagnosed OLP and 30 age- and sex-matched controls were subjected to blood examination for the assessment of serum lipid level, i.e., HDL, LDL, VLDL, and triglyceride. The obtained data were compared with standard values to assess any alterations of the serum lipid levels. Statistical Analysis Used: Cramer's V-test was performed for all the tests to measure association between two nominal variables. A P ≤ 0.05 was considered statistically significant. Results: Dyslipidemia was observed in 13 (46.67%) cases as against 7 (23.33%) controls. Thus, a significant number of cases were found to have an associated serum dyslipidemia. However, pertaining to individual serum lipid levels in cases and controls, the association was found to be statistically insignificant. Conclusions: The current study suggested an evident association between dyslipidemia and OLP. We recommend imminent studies on a larger population to additionally substantiate a positive association between the two.

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The curved and dilacerated roots in the posterior teeth often present the major challenge to the clinicians during the endodontic treatments. The efficient biomechanical preparation is also affected by improper instrumentation in the curved or the constricted canals. The use of conventional instruments and techniques in the dilacerated roots may develop ledges, fractured instruments, and canal blockages which further complicate the endodontic treatments. The introduction of ProTaper Universal rotary instruments has made a significant impact in the biomechanical preparation of root canals systems. However, the fracture rate of these files and inconvenience to treat the posterior teeth in reduced mouth opening conditions limits their successful usage in endodontic treatments. The ProTaper Next rotary instruments have noted advantages such as increased flexibility, higher strength, and wear resistance over the conventional rotary endodontic systems. The current case series discusses the endodontic treatment of three severely curved root canal systems successfully treated with ProTaper Next rotary endodontic system.

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The current era of orthodontics has evolved from regular dental corrections to achieve the most needed harmony between functional stability and esthetics enhancement of craniofacial structures. The “desire” for attaining this harmony led to the birth of orthognathic surgeries. The orthognathic approach has undergone a paradigm shift through the years, from correcting the skeletal component to addressing the soft tissues, thus optimizing esthetic outcome. This present case report is of a patient with skeletal Class II malocclusions with vertical maxillary excess (VME), managed by multidisciplinary treatment approach. The treatment progressed through presurgical orthodontics with premolar extraction followed by bi-jaw surgery. The outcome resulted in a phenomenal change in the profile by establishing a Class I skeletal base with a stable occlusion.

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Impaction of the tooth in primary dentition is very less common than the permanent dentition. Impaction of teeth in primary dentition may create various problems in occlusion and also in developing dentition. Clinical and radiographic evaluation of such cases may benefit the patient as well as the clinician. Among primary tooth impaction cases, second primary molars are not frequently reported along with late formation of its succedaneous tooth. Nevertheless, the purpose of this report was to describe a case of a rare entity of reverse dentition caused by the impaction of the mandibular primary second molar associated with delayed formation of the second premolar.

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The term “synovial sarcoma (SS)” is a histological error, a misnomer as it neither arises from nor differentiates toward synovium. Head and neck region is the most commonly affected region after extremities, representing 5% of all cases. This case report focuses to discuss a case of a SS that was diagnosed after an inadvertent root canal therapy. A 46-year-old male came to the outpatient department with a chief complaint of pain and swelling in his upper right back tooth region since 15 days. An ulceroproliferative mass of was observed protruding from the gingivobuccal sulcus from 11 to 15 tooth region obliterating the vestibule.

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Dental fractures comprise the most frequent form of traumatic dental injury and often require an immediate procedure for their treatment. The repositioning of fractured crown fragments using the bonding fragment technique offers several advantages, including the reestablishment of function, esthetics, shape, shine, and surface texture, in addition to the maintenance of the original contour and alignment of the teeth. The aim of this article is to describe a therapeutic approach used with a patient who suffered varying degrees of crown fractures in three teeth that were treated with adhesive fragment reattachment. The natural crown bonding technique, using tooth fragments and a direct composite resin, successfully restored all of the fractured anterior teeth. The clinical examinations showed good esthetics and periodontal health after a 14-month follow-up, proving that the technique is a good option for tooth fractures.

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Background: Calcifications can occur in the dental pulp as discrete bodies known as pulp stones. Their etiology remains obscure. They were believed to be formed as a result of local irritating factors within the pulp; however, a few authors now suggest that they may be a part of systemic biomineralization process that affects many body parts such as kidneys, gall bladder, joints, arteries as well as pulp leading to formation of stones. Aim: This retrospective case–control study was taken up to (i) determine the prevalence of pulp stones as well as pulp chamber narrowing in patients with gallbladder stones as well as the controls (ii) whether any correlation exists between the prevalence of pulp stones and gallbladder stones so as to test the hypothesis that pulp stones and gallbladder stones may be a part of a common systemic calcification process. Setting and Design: This retrospective case–control study was conducted in the Department of Gastroenterology and Department of Radiodiagnosis, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar. A total of 200 individuals were taken up for the study. Group I consisted of 100 patients (cases) with confirmed diagnosis of gallbladder stones. Group II included the control group in which individuals who were the close relatives of the patients with gall bladder stones were taken (n = 100), so as to eliminate the common confounding factors in these two groups such as diet, air, water, environment, genes, and age, which could affect the formation of pulp stones could not be the reason for the formation of pulp stones. Materials and Methods: Standard bitewing radiographs were taken for all the patients in each group and presence or absence of pulp chamber narrowing and pulp stones were observed. Statistical Analysis Used: McNemar's statistical test was used to find the difference between the two groups, and the P value was determined. Coefficient of association using the Phi coefficient was used to determine if there was any association between the two groups. Results: In Group I, 37% of the patients with gallbladder stones showed the presence of pulp stones; whereas in the Group II which was the control, 57% of individuals showed the presence of pulp stones. McNemar's test of significance calculated with one-degree freedom (1-df) showed that P = 0.01, thereby showing that there was a significant difference between these two groups. Conclusion: According to the study, a negative correlation between pulp stones and gallbladder stones was found and they are not related to each other.

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Background: Majority of general dental practitioners provide fixed dental prosthesis in India. The aim of this study was to gather information on selection, usage, and materials and methods employed in interocclusal records and their communication with the dental laboratory for restorative procedures practised by dentists in Indore district to evaluate and to improve the quality of current practice. Aim and Objectives: The purpose of this cross-sectional study was to understand and to evaluate dental practitioner's knowledge on interocclusal recording materials, its usage, their clinical implications, and their correlation with the laboratory in restorative procedures practiced by the dental practitioners in Indore district. Materials and Methods: A questionnaire comprising 11 questions were framed and circulated among general dental practitioners except prosthodontists, and the results were statistically analyzed. Results: Most of the practitioner's preferred wax (54.6%) as an interocclusal recording material over polyvinylsiloxane and polyether. Most of the dentists preferred full arch interocclusal record (27.8%). About 51.5% clinicians trimmed the interocclusal record before sending to the laboratory. Conclusion: From this survey, it has been concluded that the practitioner's attitude toward the use of interocclusal record materials is found to be deviated from well-acknowledged prosthodontic quality guidelines.

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Background: High-power level lasers used in health sciences have important photothermal effect. The maximum absorption of the diode laser correlates with the absorption range of hemoglobin, suggesting that red color may be the required chromophore. Hence, we hypothesized that by providing artificial external red chromophore, we can improve the cutting efficiency of diode laser in noninflamed tissue. The aim of the present study was to assess the efficacy and collateral thermal damage produced by a 940 nm diode laser on stained and unstained porcine tissue sample. Materials and Methods: Eight porcine meat samples of specific dimensions were divided into four groups of two pieces each. Group I was stained with beetroot extract, Group II stained with 3% erythrosine dye, Group III stained with hibiscus extract, and Group IV left unstained. A 940 nm diode laser was used at 1.2 W in an intermittent wave mode, to make a standardized dimension incision in all the samples. One sample from each group was stored in 10% formalin and sent for histopathological examination to evaluate the depth and width of incision and amount of lateral thermal damage. The other sample from each group was observed under video profilometer to evaluate the surface characteristics. Results: Staining of tissues with external chromophore using 3% erythrosine dye improved the efficacy of 940 nm diode laser, as evidenced from the sharper, wider cuts and clean incision with minimal charring as compared to beetroot, hibiscus, and saline. Conclusion: The use of staining can be an adjunct to the lasers in improvement of efficacy.

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Background: Epidemiological studies have shown that individuals with chronic periodontitis have a significantly higher risk of developing cardiovascular complications, which might be attributed to the increased production of inflammatory cytokines initiated by the complex microbiota in dental biofilm. Aim: The study aims to evaluate the association between chronic periodontitis and C-reactive protein (CRP) levels in a group of hypertensive individuals in Nigeria. Materials and Methods: The investigator enrolled 50 hypertensive patients with chronic periodontitis into the study from the medical outpatient clinic of a teaching hospital in Lagos, Nigeria. Full-mouth periodontal examination was done to assess the participant's periodontal status, with probing depths and clinical attachment levels of six sites on all teeth. The investigator defined periodontitis as at least one interproximal site with probing depth ≥4 mm. Classification of participants into three groups was done based on their severity of periodontitis; mild (n = 16), moderate (n = 27), and severe (n = 7) periodontitis. Their CRP serum levels were measured, and the association with the severity of periodontitis was determined. P was found to be ≤ 0.05. Results: The median CRP levels were 1.0 (0.6, 2.2), 2.4 (1.1, 4.8), and 4.1 mg/L (3.3, 9.4) for mild, moderate, and severe chronic periodontitis, respectively. The association between the serum CRP levels and severity of periodontitis was statistically significant (P = 0.006). Conclusion: There was an association of elevated serum CRP level with increased severity of chronic periodontitis in hypertensive individuals. This preliminary finding among Nigerians suggests that chronic periodontal inflammation may contribute to systemic inflammatory burden in hypertensive patients.

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Background: Presurgical nasoalveolar molding (PNAM) has been used for aligning and not only for approximating the maxillary alveolar segments preoperatively but also for improving the nasal symmetry and therefore facilitates primary surgical repairs in cleft patients. Aim: This study was conducted to compare the efficacy and efficiency of Grayson's technique with Figueroa's modified presurgical nasoalveolar technique in complete unilateral cleft lip and palate (UCLP) infants. Materials and Methods: Twenty-two infants aged 10–15 days were randomly divided into two equal groups: Group I treated with Grayson's PNAM technique and Group II with Figueroa's PNAM technique. Results: When we compared nasal asymmetry values preoperatively and postoperatively of Group I and Group II, it was found that the nostril height increased significantly on the cleft side and nostril width decreased significantly postoperatively on the cleft side. When we compared nasal asymmetry values postoperatively of Group I with Group II, all the values were nonsignificant. When we compared the digital maxillary cast analysis outcomes preoperatively and postoperatively in Group I and Group II, it was found that there was a significant reduction in the alveolar gap and there is a significant increase in the arch width. When we compared the efficiency of Group I with Group II, it was found that Group II was more efficient than Group II. Conclusion: This study showed a morphological improvement in nasal symmetry and maxillary alveoli of infants with UCLP treated with both Grayson's PNAM technique and Figueroa's PNAM technique with Grayson's PNAM technique being more efficient.

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An optimally created occlusion will be better able to deal with the forces generated in function and parafunction. This case report will highlight the full-mouth rehabilitation of a patient with worn out dentition in the minimally invasive way which offers the users a more systematic and a precise treatment. Clinical Relevance: It gives us an idea of a treatment modality for full-mouth rehabilitation whereby the anterior teeth cause a uniform disocclusion of the posterior teeth during excursive movements, thereby protecting the teeth from the harmful effects of the cuspal interference.

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Background: The search for an ideal biomarker which can determine the current disease status that predicts the sites and individuals with increased susceptibility to periodontal disease has been going on since a long time. One such group of molecules which have been investigated recently are the trefoil factors, and the present study aims to determine the role of salivary trefoil factor 3 (TFF3) in periodontitis and gingivitis patients. Materials and Methods: A total of fifty participants, of which 25 were diagnosed with moderate-to-severe periodontitis and 25 with chronic gingivitis were included in the study. The routine periodontal parameters were recorded at baseline and at 6 weeks which included plaque index, gingival index, bleeding index, probing depth, and clinical attachment level. The saliva samples were collected from both the groups at baseline and 6 weeks after nonsurgical periodontal therapy and analyzed by enzyme-linked immunosorbent assay to estimate the concentration of trefoil factor 3. Results: All the periodontal parameters improved at 6-week reevaluation in both the groups. There was a significant change in the TFF3 levels in the periodontitis group from baseline to 6 weeks, and the concentrations were found to be higher following nonsurgical therapy, whereas the quantum of change in the gingivitis group was negligible. The levels of TFF3 remained unchanged in those periodontitis participants who required surgical intervention at the 6^th-week reevaluation. Conclusion: The estimation of TFF3 levels may aid in decision-making in the treatment strategy of patients with moderate-to-severe periodontitis.

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Objectives: It was aimed to investigate the temperature changes in primary teeth pulp chamber during the curing/setting of bulk-fill restorative materials with different nanoparticle contents. Methods: Twenty-five extracted, primary mandibular second molars were prepared as a Class II cavity. Five bulk-fill restorative materials consisting of Equia Fil (HVGIC), glass carbomer (GC) cement, Sonic Fill (SF), X-tra Fil (XF), and Quix Fil (QF) were tested. The measurement of the pulp chamber temperature changes (starting temperature 37°C) during setting/curing was performed with a J type thermocouple. The data, differences between highest and initial temperature values, were recorded and analyzed by one-way ANOVA. Results: The temperature changes in the pulp chamber were in EF (2.81°C), GC (7.92°C), SF (3.33°C), XF (3.43°C), and QF (3.02°C). There were statistically significant differences between temperature changes in groups (P < 0.05). Conclusion: The tested bulk-fill resin composites and high-viscosity glass ionomer cement do not increase the intrapulpal temperature in primary teeth during the curing/setting.

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