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BackgroundArtificial intelligence (AI) models are being increasingly studied for the detection of variations and pathologies in different imaging modalities. Nasal septal deviation (NSD) is an important anatomical structure with clinical implications. However, AI-based radiographic detection of NSD has not yet been studied. ObjectiveThis research aimed to develop and evaluate a real-time model that can detect probable NSD using cone beam computed tomography (CBCT) images. MethodsCoronal section images were obtained from 204 full-volume CBCT scans. The scans were classified as normal and deviated by 2 maxillofacial radiologists. The images were then used to train and test the AI model. Mask region-based convolutional neural networks (Mask R-CNNs) comprising 3 different backbones—ResNet50, ResNet101, and MobileNet—were used to detect deviated nasal septum in 204 CBCT images. To further improve the detection, an image preprocessing technique (contrast enhancement [CEH]) was added. ResultsThe best-performing model—CEH-ResNet101—achieved a mean average precision of 0.911, with an area under the curve of 0.921. ConclusionsThe performance of the model shows that the model is capable of detecting nasal septal deviation. Future research in this field should focus on additional preprocessing of images and detection of NSD based on multiple planes using 3D images.

Abstract The interpretation of the signs of Temporomandibular joint (TMJ) osteoarthritis on cone-beam computed tomography (CBCT) is highly subjective that hinders the diagnostic process. The objectives of this study were to develop and test the performance of an artificial intelligence (AI) model for the diagnosis of TMJ osteoarthritis from CBCT. A total of 2737 CBCT images from 943 patients were used for the training and validation of the AI model. The model was based on a single convolutional network while object detection was achieved using a single regression model. Two experienced evaluators performed a Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)-based assessment to generate a separate model-testing set of 350 images in which the concluded diagnosis was considered the golden reference. The diagnostic performance of the model was then compared to an experienced oral radiologist. The AI diagnosis showed statistically higher agreement with the golden reference compared to the radiologist. Cohen’s kappa showed statistically significant differences in the agreement between the AI and the radiologist with the golden reference for the diagnosis of all signs collectively (P = 0.0079) and for subcortical cysts (P = 0.0214). AI is expected to eliminate the subjectivity associated with the human interpretation and expedite the diagnostic process of TMJ osteoarthritis.

Background: Sickle cell disease (SCD) is the most common hereditary hemoglobinopathy, which delays growth leading to an altered skeleton and craniofacial pattern. Palatal rugae patterning has been considered the regulator of the development of the palate. The purpose of the research work was to study the morphology of the palate, rugae pattern, and its dimensions in SCD children and compare them with healthy normal children, and to evaluate its role as minor physical anomalies (MPAs). Methods: A cross-sectional case-control study was designed as per STROBE guidelines. The sample comprised 50 children diagnosed with sickle cell disease (Group SCD) and 50 normal healthy children as control (Group C) belonging to the same age group (10–18 years). Dental impressions were made, followed by the pouring of dental casts. The length of the palatal rugae was measured and categorized into primary (>5 mm), secondary (3 mm–5 mm), and fragmentary rugae (

ABSTRACTBackground A majority of dental school students do not undergo hands-on clinical training in implantology in the undergraduate curriculum. Training is usually restricted to pre-implant evaluation and post-implant prostheses. Virtual implant planning software (VIPS) provides an alternative opportunity for undergraduate students to experience implant planning much before gaining hands-on experience. However, not many studies have the contribution of VIPS to the knowledge acquisition of students. We conducted a preliminary study to evaluate the knowledge acquisition of the students when exposed to a hands-on session of VIPS. We also evaluated students’ satisfaction levels, when exposed to hands-on training in fully guided implant planning software.Methods A two-part theory lecture on fully guided implant planning was delivered to 90, 5th (final)-year dental undergraduate students by the oral radiology faculty. The students were then randomly divided into three groups. Group A was exposed to didactic lectures only. Group B was shown a video for fully guided implant planning in addition to the didactic lecture. Group C was shown a video for fully guided implant planning in addition to a didactic lecture and then performed a hands-on session of virtual implant planning under faculty guidance. Students from all groups were given an MCQ-based test. After the completion of the test students from group A and B also received VIPS hands-on training. Students from all three groups answered and a feedback questionnaire regarding their satisfaction levels with VIPS.Results The overall test score of students in Group C was higher than their colleagues in both Groups A and B and the differences were statistically significant (p = 0.01). More than 85% of the students were satisfied with the teaching approach.Conclusions The utilization of VIPS in the training of dental undergraduate students improves their performance confirming better knowledge acquisition and content mastery.

Irrigation is one of the steps that is very crucial in a high-quality endodontic treatment. Hence, irrigant with good substantivity is essential which must not only be effective for the dissolution of the organic tissues but also effectively eliminate bacterial contamination. The aim of the study was to investigate and compare the antimicrobial efficacy of gentamicin, amoxicillin, and metronidazole (GAM) antibiotic solution, chitosan and their combination (GAMC), and analyze their sustained release property. Mueller–Hinton agar medium was inoculated with E. faecalis. The medicaments were then poured at the center of the plate in the prepared wells and incubated at 37°C. Antibacterial property of each medicament was evaluated by measuring the diameter of the zone of inhibition at the end of 48 hours. The substantivity of GAM antibiotic solution and the GAMC was checked using an ultraviolet spectrophotometer. The GAMC demonstrated the strongest antimicrobial activity and good sustained-release properties. Distilled water showed no activity, and chlorhexidine acted as the positive control. Conclusion: The combination of gentamicin, amoxicillin, and metronidazole (GAM) solution with chitosan (GAMC) can be used as an alternative intracanal irrigant as it was found to be a potent antibacterial agent.

A novel needle that can be used to retrieve endodontic separated instruments (SIs) from the root canal of a tooth is described in this article. The needle tip is fabricated with a thermomechanically treated NiTi alloy exhibiting both shape memory and super-elasticity. The alloy demonstrates martensitic phase at certain low temperatures (25°C or less) and austenitic phase at certain slightly higher temperatures (35°C or more). These properties facilitate the needle to be straight at room temperature but incorporate a specific snakelike shape when inserted in the root canal of the tooth from which the endodontic SI is to be removed. The suggested lengths for the needles are 21, 25, and 31 mm with five different sizes of the lumina (the internal diameter is 0.25, 0.40, 0.60, 0.80, or 1 mm). The wall thickness of the needle is 0.20 for the last 3 mm of the needle then gradually increases to 0.35 for the coronal aspects. The design of this needle has the US patent application number US 2020/0129268 A1, April 30, 2020.

This study aimed to investigate the antibacterial [minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC)] and antibiofilm activity [log10 colony forming unit/mL (CFU/mL) and biofilm disruption] of copper-doped phosphate glass (CDPG) against Streptococcus oralis, Enterococcus faecalis, Lactobacillus casei, Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. Methods: the antibacterial activity was determined using microbroth dilution and time-kill assay. The antibiofilm activity was investigated using crystal violet and confocal laser scanning microscopy. Bacteria growing in absence of CDPG were used as controls. Results: the MIC was ≥125 mg of CPDG/mL; the log10 CFU/mL reduction ranged from 2.66–3.14 to 6.23–9.65 after 4 and 24 h respectively. Generally, no growth was observed after 24 h of treatment with CDPG; the MBC was 250 mg/mL for L. casei and S. oralis while 500 mg/mL for the rest of the bacteria. The highest and lowest antibiofilm activity was observed against S. oralis and E. coli respectively. Three patterns of complete biofilm disruption were seen: (i) large areas with E. fecalis and S. oralis, (ii) medium-size pockets with S. aureus and P. aeruginosa, or (iii) small areas with E. coli and L. casei. Conclusion: CDPG can be potentially used as an antibacterial and an antibiofilm agent against oral biofilm-forming bacteria.

Introduction: Recently, silver nanoparticles were indicated for root canal irrigation. The cytotoxicity evaluation of these agents helps to ascertain confident clinical use. This article aims at evaluating the cytotoxic effect of fungal-derived nanosilver particle irrigant on human periodontal ligament fibroblast (hPDLF) cells using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Materials and Methods: The test “nanoparticle” irrigant was produced using the fungi “Fusarium semitectum.” The cells were cultured in Dulbecco's Modified Eagle's Medium solution and adjusted to 5 × 103 cells/ml. About 100 μl of cells were seeded into a 96 well microplate and 100 μl test irrigant ranging from 5 to 640 μg/ml concentrations was added to a microplate and incubated at 37°C, 5% CO2 humidified conditions for 24 h. Untreated cells were used as a control group. About 5 mg/ml MTT was added to the plates and incubated at 37°C in 5% CO2 conditions for 4 h. The viability of cells and the percentage inhibition of cell were determined. Results: The 50% inhibition of cells was found to be around 320 μg/ml concentration. Cytotoxicity was found to be dose dependent and increased with higher concentrations of the nanosolution. Conclusion: Fungal-derived nanosilver irrigant is safe to hPDLF cells “in vitro” at a concentration of

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.

Background: The accumulation and maturation of bacterial plaque at the gingival margin is widely recognized as the primary etiological factor in the development of chronic periodontitis. With the rise in bacterial resistance to antibiotics, there is considerable interest in the development of other classes of antimicrobials for the control of infection. Aim: The aim of this study was to evaluate the efficacy of Psidium guajava (guava) and Allium sativum (garlic) on Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans.Materials and Methods: Aqueous guava extract (AGvE), ethanolic guava extract (EGvE), aqueous garlic extract (AGE), and ethanolic garlic extract (EGE) were prepared. The inhibitory effects of these extracts for the periodontal pathogens were tested by agar well diffusion method. Minimal inhibitory concentration (MIC) of the aqueous and ethanol extracts of guava and garlic was determined by macrobroth dilution method. Minimum bactericidal concentration (MBC) was done to observe the bactericidal effect of the guava and garlic extracts against the organisms. Results: Of the AGE, 25, 50, and 75 μL showed 16, 20, and 25 mm zone of inhibition, respectively, on P. gingivalis. The AGE showed greater bacteriostatic activity against the P. gingivalis with MIC determined at 16.6 μL/mL. MIC determined for AGvE and EGvE was at 75 μL/mL concentration for P. gingivalis, whereas EGvE showed the activity at 75 μL/mL on P. gingivalis. MIC determined for AGvE was at 50 μL/mL, whereas MIC determined for EGvE was at 3.12 μL/mL for A. actinomycetemcomitans.Conclusion: P. guajava and A. sativum displayed a significant antibacterial effect. A. sativum was found to be most effective against P. gingivalis, whereas P. guajava showed the highest efficacy on A. actinomycetemcomitans.

Objectives: The volume of the inferior turbinates (IT) and the lining of the maxillary sinuses are important parameters when assessing sino-nasal diseases. However, no radiographic studies have investigated the correlation between these parameters. The present study was conducted to analyze the association between IT volumes and thickness of maxillary sinus mucosal lining. Materials and methods: A retrospective evaluation of the cone-beam computed tomography (CBCT) scans of 100 adult subjects was carried out by two radiologists. The scans were assigned to two groups (Group 1 & 2) based on the radiographic evidence of maxillary sinus lining in the CBCT scans. Group 1 consisted of 50 CBCT scans of subjects with no evidence of maxillary sinus mucosal lining, whereas Group 2 consisted of 50 subjects with evidence of maxillary sinus mucosal lining. The scans in the Group 2 were further sub-classified into five categories, based on the thickness of the maxillary sinus mucosal lining. Vesalius 3D software was used to evaluate the total volume of inferior nasal turbinates by the two radiologists and a mean volume was obtained for each study subject. Results: The intraclass correlation coefficient (ICC) between the volumetric estimations performed by the two radiologist was 0.87. Analysis of the results revealed that there was no significant gender-based difference (Group 1, P = 0.67 and Group 2, P = 0.95) in the total turbinate volume in either of the study groups. The total turbinate volume did not show any significant correlation (Group 1, r = 0.24 and Group 2, r = 0.12) with the age. There was a significant increase (P = 0.001) in the total turbinate volume of the subjects in Group 2 compared to Group 1. Regression analysis revealed that the thickness of sinus lining correlated significantly (P = 0.001) with the total turbinate volume. Conclusion: An increase in the total turbinate volume has been associated with an increase in the thickness of the maxillary sinus mucosal lining. The data from this study will be useful for post-operative follow-up of inferior turbinates and maxillary sinus lining after the turbinate volume reduction procedures.

One of the most distressing aspects of periodontitis is the unesthetic appearance of maxillary and mandibular anteriors. The elongation of the crowns due to root exposure and increased interdental spacing results in unesthetic appearance. Surgical procedures for gingival recession coverage do not have acceptable results in cases of severe gingival recession. So nonsurgical methods like gingival veneers should be considered as a treatment modality in such cases. This article aims to revisit the gingival veneer: its uses, advantages, disadvantages, and its fabrication. The case discussed here highlight clinical situation where the gingival veneer prosthesis helped in achieving optimum esthetics and patient satisfaction thus proving to be a feasible and simple treatment modality in certain clinical cases. This may offer a good interim solution for patients who may wish to have time to consider their options of more advanced and complex treatment.

Cysticercosis is a condition in which a human acts as the intermediate host of Taenia solium, a pork tapeworm. The larvae infestation sites frequently include cerebral tissue, ocular organs and muscles. The present case report describes a rare incidence of cysticercosis cellulosae in the labial mucosa of upper lip