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

Introduction: Elders in old age homes are mainly those who have been abandoned by their family and have one or more physical or mental disabilities. It is a major challenge for the dental professional to plan oral health strategy for this group of patients. Aim of the Study: Aim of the present study is to observe and determine the acceptance of new dental prosthesis among the elderly residing as inmates of 3 old age homes in Mangalore City. Materials and Methods: This cross-sectional study was conducted using a survey proforma. Information regarding their experience with the new denture, 1-month, 3 months and 6 months after denture insertion was gathered. Statistical analysis of the data was done using the Chi-square test with the P < 0.05 considered significant. Results: One hundred and eighty-three residents out of a total of 400 residents in 3 old age homes were denture wearers. Among them, 101 (55.2%) were females, and 82 (44.8%) were males. Dental prosthesis whether worn regularly, discomfort, retention, cleansing of denture during a period of 1-month, 3 months and 6 months was found to be significant satisfaction with the prosthesis, denture adhesives used, food accumulation during a period of 1-month, 3 months and 6 months was found to be nonsignificant. Conclusion: The emotional makeup of the patient must be taken into consideration during the entire procedure. We must understand that the success of the prosthesis depends mainly on the patient′s confidence in the dentist rather than the quality of the prosthesis.

Endodontic rehabilitation of grossly mutilated teeth is challenging. It requires reconstruction of the tooth under proper isolation before the commencement of the endodontic procedure. The study was designed to assess the 5-year performance of projector system-based endodontic restoration. Two patients diagnosed with pulpal necrosis and chronic periradicular periodontitis were provided with “Projector Endodontic Instrument Guidance System-” (PEIGS) based endodontic treatment. After access cavity preparation, the canals were cleaned, shaped, and further enlarged to receive the projectors with a snug fit after effective etching. The incremental composite buildup was performed in a standardized manner. On successful curing, the files and the projectors were retracted sequentially. This was followed by a conventional root canal therapy. A 5-year follow-up showed an intact tooth structure and patient compliance in both cases. Although a technique sensitive procedure, the PEIGS provides promising results.

Background: The role of Gram-negative anaerobic periodontal pathogens in periodontal diseases has led to the loss of tooth-supporting structures. These diseases can be prevented by the inhibition of bacterial biofilm on the tooth surfaces. Many treatment modalities have been tried to prevent periodontal diseases. With the rise in resistance to synthetic antimicrobials, there is a requirement to develop natural antimicrobials for the control of periodontitis., Aim: The aim of the study was to evaluate and compare the efficacy of garlic ( Allium sativum ) and guava ( Psidium guajava ) extracts on Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans using time-kill assay., Materials and Methods: Aqueous garlic extract (AGaE), ethanolic garlic extract (EGaE), aqueous guava extract (AGuE), and ethanolic guava extract (EGuE) were prepared. Time-kill assays were performed on P. gingivalis and A. actinomycetemcomitans . The aqueous and ethanolic extracts of guava and garlic were compared to assess the maximum bactericidal potency., Results: The comparison of time-kill assay of AGaE and AGuE on P. gingivalis showed a statistically significant difference at 2 h ( t = 5.29, P < 0.01), 4 h ( t = -4.867, P < 0.01), and 6 h ( t = -3.647, P < 0.001). The comparison of time-kill assay of EGaE and EGuE on A. actinomycetemcomitans showed a statistically significant difference at 2 h ( t = 4.54, P < 0.01) and highly significant difference at 4 h ( t = 6.57, P < 0.001)., Conclusions: The, judicious use of these phytomedicinal products could be cost-effective and also the adverse effects caused due to the long-term usage of synthetic antimicrobials can be avoided., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Contemporary Clinical Dentistry.)

Functional appliances are widely used for regulating and directing growth in which commonly used are Frankel regulator and twinblock. Frankel regulator expands the orofacial arena for allowing growth by passive expansion, whereas twin block aids sagittal correction in retrusive mandible. Heres, an attempt to bring about both the changes in a single appliance where sagittal correction as well as keeping away constricted musculature is desired. In this appliance, passive and active expansion has been used simultaneously for better results. In the hindsight of the results, we could get in this case using Twinkle R 3D appliance, we hope that this appliance will be helpful in many more similar cases and act as adundum in clinician's armamentarium., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Contemporary Clinical Dentistry.)

Aim of the Study: This study aims to evaluate the effects three different conditioning agents on the shear bond strength of resin-modified glass ionomers to human dentin., Materials and Methods: One hundred and twenty recently extracted, caries-free premolars and molars will be cleaned of debris and disinfected in a 0.5% solution of sodium hypochlorite and sterile water for 30 min. The occlusal surface of each tooth will be reduced using conventional model trimmer with water to produce the dentin surface. Then, three different resin-modified glass ionomer cements (GICs) were triturated and mixed according to the manufacturer's instructions, 10 specimens will be made of each group. The excess restorative material will be removed from matrix band dentin interface with a sharp number 25 bard parker blade. Samples were shear tested with Instron universal testing machine with a crosshead speed of 0.5 mm/min. A shearing bar beveled to a 1 mm thick contact surface area will be placed at the junction of dentin and plastic band matrix. The load required for the failure will be recorded in pounds and converted to megapascals., Results: Statistical analysis was done with analysis of variance and Tukey's test. Ketac primer as conditioning agent along with Fuji II LC as restorative material had the highest shear bond value whereas intact smear layer which was unmodified dentin had the least value., Conclusion: Within the limitations of the present study, it can be concluded that surface conditioning of dentin resulted significantly higher bond strength than unconditioned dentin surfaces., Clinical Significance: Resin-modified glass ionomers have several advantages compared to chemically cured GICs. The advantages include command cure, ease of handling, improved physical properties, and esthetics. Resin.modified glass ionomers have been marketed as direct restorative materials for Class V lesions as well as liners, bases, and luting agents. Several conditioning agents have been evaluated to condition dentin before the application of conventional glass ionomers and resin-modified glass ionomers. These have mainly included polyacrylic acid, citric acid, phosphoric acid, and ethylenediamine tetra.acetic acid. Of late, manufactures have recommended other conditioners to replace polyacrylic acid which includes Ketac primer as one of the conditioning agents., Competing Interests: There are no conflicts of interest.

Context: Periodontal disease is an immuno-inflammatory disease that is initiated by the interaction between microbial plaque and the periodontal tissues. The data available on the association of periodontal diseases with the lipid profile are conflicting. Therefore, a need for a study in this area was felt., Aims: To evaluate the lipid profile in the serum of patients with chronic periodontitis and chronic periodontitis with Type II diabetes mellitus (DM) patients and to compare it with healthy controls, to see whether they can serve as potential markers for chronic periodontitis and also to assess whether periodontitis can have systemic effects., Settings and Design: This study is a cross-sectional study., Subjects and Methods: This cross-sectional study was conducted involving 300 participants in the age group of 30-60 years from October 2010 to May 2015. Five milliliters of venous blood was collected from each of the study participants, from the antecubital vein. Lipid profile was assessed using the ERBA commercially available kit., Statistical Analysis: Statistical analysis was carried out using SPSS software version 17. Multigroup comparison was carried out using ANOVA. The honest significant difference Tukey's test was used in conjunction with ANOVA to find means which are significantly different from each other., Results: When the lipid profile was estimated, total cholesterol (TC) levels were seen to be significantly higher ( P < 0.001) in the DM with periodontitis group. High-density lipoprotein (HDL) levels were seen to be significantly higher ( P < 0.001) in the control group. Mean serum low-density lipoprotein (LDL) and very LDL (VLDL) levels were seen to be significantly higher ( P < 0.001) in the DM with periodontitis group. The triglyceride (TGL) values were also significantly higher ( P < 0.001) in the DM with periodontitis group. The HDL and LDL levels were seen to be nonsignificant between chronic periodontitis and chronic periodontitis with diabetic group., Conclusions: The findings of the study showed that the lipid profile was significantly altered in patients with chronic periodontitis as compared to healthy controls. There was a potentiated difference in the values for TC, VLDL cholesterol, and TGL in patients with chronic periodontitis when compared to patients with Type II DM. HDL cholesterol and LDL cholesterol did not show a significant difference., Competing Interests: There are no conflicts of interest.

Introduction: Sella turcica is an important cephalometric structure and attempts have been made in the past to correlate its dimensions to the malocclusion. However, no study has so far compared the size of sella to the jaw bases that determine the type of malocclusion. The present study was undertaken to find out any such correlation if it exists., Materials and Methods: Lateral cephalograms of 110 adults consisting of 40 Class I, 40 Class II, and 30 Class III patients were assessed for the measurement of sella length, width, height, and area. The maxillary length, mandibular ramus height, and body length were also measured. The sella dimensions were compared among three malocclusion types by one-way ANOVA. Pearson correlation was calculated between the jaw size and sella dimensions. Furthermore, the ratio of jaw base lengths and sella area were calculated., Results and Conclusion: Mean sella length, width and area were found to be greatest in Class III, followed by Class I and least in Class II though the results were not statistically significant. 3 out of 4 measured dimensions of sella, correlated significantly with mandibular ramus and body length each. However, only one dimension of sella showed significant correlation with maxilla. The mandibular ramus and body length show a nearly constant ratio to sella area (0.83-0.85, 0.64-0.65, respectively) in all the three malocclusions. Thus, mandible has a definite and better correlation to the size of sella turcica.

Background: Diabetes Mellitus is a metabolic syndrome, affecting the oral health in various ways with dental caries being one of the most common problems encountered. Saliva is one of the most abundant secretions in the human body with a variety of natural protective and defence molecules bathing the oral cavity maintaining equilibrium. Its collection is easy and non-invasive., Aims: To compare and evaluate salivary alkaline phosphatase levels and calcium ion levels between caries active type II diabetes mellitus patients and non-diabetics., Materials and Methods: This study was carried out on caries-active age and gender matched 60 non-diabetic and 60 patients with known Type II diabetes mellitus subjects of age group 25-50 years with DMFT index >10. Saliva sample was collected to analyse for alkaline phosphatase enzyme and concentration of calcium ions using Agappe kits., Statistical Analysis: Student 't' test was used to correlate the salivary electrolyte concentration in non- diabetic and diabetic patients with dental caries. A 'P' value of 0.05 or less was considered significant. Results are presented as mean ± standard deviation (X ± SD)., Results: The alkaline phosphatase (ALP) activity in saliva was higher in diabetic patients when compared to that of non-diabetic patients with salivary calcium ions were significantly higher in non-diabetic individuals., Conclusion: Diabetes Mellitus patients are more prone to dental caries, hence require intervention to improve the quality of saliva.

Introduction: The hyoid bone and its relation with the pharyngeal space in health and disease has been an intriguing subject for years., Aim: This study attempts to evaluate the hyoid bone position and to ascertain any correlations with pharyngeal airway space in skeletal class I, II, and III malocclusions., Materials and Methods: McNamara's airway analysis was carried out to assess the upper and lower airway widths and Hyoid triangle analysis by Bibby and Preston was carried out to determine the position of the hyoid bone., Conclusion: A positive correlation was found between the lower airway and horizontal distance from the hyoid bone to the retrognathion in class I skeletal pattern with average growth pattern.

Hyperdontia amounts to an odontostomatologic anomaly wherein, there is an increase in tooth number irrespective of the location. This case report represents a form of hyperdontia characterized by bilateral multiple supernumerary teeth in both the jaws without any evident familial history.

Background: There is always a need to assess whether small changes in bracket prescription can lead to visually detectable differences in tooth positions. However, with little clinical evidence to show advantages of any of the popularly used bracket systems, orthodontists are forced to make clinical decisions with little scientific guidance., Aim: To compare the orthodontic cases finished with Roth and MBT prescription using American Board of Orthodontics-Objective Grading System (ABO-OGS)., Settings and Design: Department of Orthodontics, Post-graduate dental college, retrospective cross-sectional study., Materials and Methods: Forty patients selected were divided into two groups of 20 patients each finished with straight wire appliance using Roth and MBT prescription, respectively. The examiner ability was assessed and calibrated by one of the ABO certified clinician to grade cases using the OGS., Statistical Analysis: Unpaired student t-test was used and P < 0.05 was accepted as significant., Results and Conclusions: MBT bracket group had a lower score of 2.60 points in buccolingual inclination and lower score of 1.10 points in occlusal contact category that was statistically significant when compared with Roth group. The difference in total ABO-OGS score was 2.65 points showing that the outcome for the MBT prescription was better than that of the Roth prescription, which is statistically significant, but with little or no clinical significance. It can be concluded that use of either one of the Roth and MBT bracket prescriptions have no impact to the overall clinical outcome and quality of treatment entirely depends on clinician judgment and experience.

Aim: To study the correlation between the caries status and the salivary antioxidant levels among asthmatic children., Settings and Design: One hundred children within the age group of 6 12 years were selected and equally subdivided into children having a history of asthma and their healthy siblings., Materials and Methods: Salivary antioxidant levels were assessed using spectrophotometric method, and the caries status was recorded using DMFT (Decayed, missing and Filled Teeth Index) and dft (decayed, filled teeth index) index., Result: The salivary antioxidant levels were reduced among the asthmatic children which was statistically highly significant, whereas the caries prevalence was reduced, but not statistically significant.

Objective: Verrucous lesions of the oral cavity can be of varied histopathology. The present study evaluates the clinico-pathological features of verrucous lesions of the oral cavity and analyzes the treatment outcomes., Materials and Methods: This is a retrospective study of 15 consecutive patients who presented with verrucous lesions of the oral cavity, during the 5-year period from January 2006 to December 2010. Demographic, clinico-pathological features, treatment details, and outcomes were analyzed., Results: Fifteen patients with verrucous lesions of the oral cavity were treated with surgery as the primary modality. The mean age was 62.8 years (range 35-85 years). Wide excision of the primary lesion with adequate mucosal and soft-tissue margins was carried out. Free-flap reconstruction was done in eight patients. All patients remain loco-regionally controlled with good functional speech and swallowing outcome., Conclusions: Verrucous lesions of the oral cavity are a distinct clinical entity with varied histopathology. A surgical excision with wide margins and appropriate reconstruction is necessary to optimize the disease and functional outcome.