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Objective: CBCT (cone beam computed tomography) analysis of condyle morphometry, to investigate the gender differences, symmetry and relationship with mandibular size. Materials and methods: This is a retrospective study. 800 CBCT scan obtained for the measurement of condyle in anterior-posterior and medio-lateral aspect using OnDemand 3D software. Participants were Saudi nationals of age above 18 years. 395 Males and 405 Females with the mean age of 38.2 ± 10.5 years. Right and left anterior-posterior width and medio-lateral width of the condyle were measured. Condyles were not isolated on the CBCT for volume measurement. Results: Mean right and anterior-posterior condyle width was 9.02 mm and 8.74 mm in males whereas in females it was 9.01 mm 8.69 mm respectively. For males mean medio-lateral width of the condyle in right and left side was 17.40 mm and 16.95 mm. For females, mean medio-lateral width of the condyle in right and left side was 17.14 mm and 16.93 mm. The prediction rate of gender was 57.2% for males and 53.3% for females. Statistically significant differences (p

Introduction This research aimed to investigate the effect of Nano-Bio Fusion Gingival Gel ([NBFG] NanoCureTech, Gangdong-gu, Seoul, Korea) as an aid along with oral hygiene advice and routine scaling in patients with malocclusion to control treatment-induced gingivitis and periodontitis in patients undergoing fixed orthodontic treatment. Methods A split-mouth design, prospective analysis after application of NBFG in 32 subjects with fixed orthodontic treatment-induced gingivitis was conducted. Patients applied NBFG to their gingiva twice daily, after brushing, for 90 consecutive days. Outcomes measured included: the plaque index (PI), papillary bleeding gingival index (PBI), probing depth (PD), and clinical attachment loss using standard assessment. PI, PBI, PD, and clinical attachment loss were measured at baseline, on the seventh day of gel application, at the next visit at the orthodontic clinic (28th day), and after 90 days. Results From baseline to the seventh day to the 90th day, the treatment group showed significant improvement in PI, PBI, and PD over time compared with the placebo group. Conclusions NBFG showed positive clinical effects in patients undergoing fixed orthodontic treatment. Clinical outcomes were measured in a comparatively short period.

Objective. To investigate the correlation of periodontal parameters and bite force in different stages of periodontitis after phase I periodontal therapy. Methods. Periodontal clinical parameters such as mobility, attachment loss, gingival recession, and percentage of bone remaining were recorded at the mandibular first molar region after phase I therapy in subjects categorized according to the stage of periodontitis. Corresponding bite force was recorded at the first mandibular molar region using a bite force device after phase I therapy. ANOVA test was used to assess the significant difference among different groups. Pearson correlation coefficient was used to assess the correlation between measured variables. Results. The ANOVA test represents that there is no statistical significant difference between the bite force in stage I, stage II, and stage III type of periodontitis. A strong positive correlation was found ( r = 0.537 ) between bite force and percentage of remaining alveolar bone support whereas negative correlation was observed in measured parameters such as mobility ( r = − 0.0181 ), attachment loss ( r = − 0.608 ), and gingival recession ( r = − 0.435 ). Conclusion. Among all periodontal clinical parameters, the percentage of remaining alveolar bone is the strong predictor of bite force and mobility; attachment loss and gingival recession cannot predict the bite force in the first molar region. Bite force is variable in different stages of periodontitis.

Visual inspection and gingival indices have been traditionally used for diagnosis of gingival inflammation. These methods are prone for subjective variability. Thus, the study is aimed at evaluating gingival inflammation quantitatively by using CIELab colour space value obtained from digital photographs. An experimental study was conducted with 27 patients each in group A (gingivitis) and group B (chronic periodontitis, CP). Preoperative and postoperative (1 month) photographs of maxillary anterior sextant were recorded to evaluate CIELab coordinate values. Simultaneously, clinical parameters such as bleeding on probing (BOP) and periodontal probing depth (PPD) along with indices such as plaque index (PI), gingival index (GI), and sulcus bleeding index (SBI) were evaluated before and after the nonsurgical periodontal therapy. Data was presented as the mean ± SD , and a paired t -test was used for the testing hypothesis with p < 0.05 considered as significant. Data analysis was carried out with Statistical Package for the Social Sciences (SPSS) version 21. A significant reduction ( p < 0.001 ) is seen in all the clinical parameters and indices before and after the intervention in chronic periodontitis patients. Similar results were seen in gingivitis patients ( p < 0.001 ) except for PPD. A significant ( p < 0.001 ) reduction in postoperative values of the a ∗ and b ∗ coordinates was seen in CP patients; whereas, only the a ∗ coordinate value reported a significant ( p < 0.001 ) reduction in the gingivitis group of patients. The Δ E of the gingivitis and chronic periodontitis groups was 2.25 and 2.96, respectively. Within the confinements of the study, estimating the gingival colour with the help of CIELab values taken via digital photographs can be an excellent valuable tool to assess the gingival colour as a sign of gingival inflammation.

This meta-analysis aims to compare Apert syndrome (AS) patients with non-AS populations (not clinically or genetically diagnosed) on craniofacial cephalometric characteristics (CCC) to combine publicly available scientific information while also improving the validity of primary study findings. A comprehensive search was performed in the following databases: PubMed, Google Scholar, Scopus, Medline, and Web of Science, an article published between 1st January 2000 to October 17th, 2021. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to carry out this systematic review. We used the PECO system to classify people with AS based on whether or not they had distinctive CCC compared to the non-AS population. Following are some examples of how PECO has been used: People with AS are labeled P; clinical or genetic diagnosis of AS is labeled E; individuals without AS are labeled C; CCC of AS are labeled O. Using the Newcastle–Ottawa Quality-Assessment-Scale, independent reviewers assessed the articles' methodological quality and extracted data. 13 studies were included in the systematic review. 8 out of 13 studies were score 7–8 in NOS scale, which indicated that most of the studies were medium to high qualities. Six case–control studies were analyzed for meta-analysis. Due to the wide range of variability in CCC, we were only able to include data from at least three previous studies. There was a statistically significant difference in N-S-PP (I2: 76.56%; P = 0.014; CI 1.27 to − 0.28) and Greater wing angle (I2: 79.07%; P = 0.008; CI 3.07–1.17) between AS and control subjects. Cleft palate, anterior open bite, crowding in the upper jaw, and hypodontia occurred more frequently among AS patients. Significant shortening of the mandibular width, height and length is the most reported feature in AS patients. CT scans can help patients with AS decide whether to pursue orthodontic treatment alone or to have their mouth surgically expanded. The role of well-informed orthodontic and maxillofacial practitioners is critical in preventing and rehabilitating oral health issues.

Background: Mandible is considered as one of the stronger bones of skull available for gender identification. Mandibular measurements can be used for the identification of gender either on dry mandible or through panoramic radiography or cone-beam computed tomography (CBCT). Aim: To determine the gender from mandibular measurement using CBCT. Materials and Methods: The Morphometric analysis was performed on 200 CBCT scans of the subjects using OnDemand 3D software (Seoul, Korea). Morphometry of mandibular is measured by estimation of the angles formed at different locations on mandible to predict the gender. Statistical analysis was performed; independent samples “t-” test was used to compare the mean values between males and females. Discriminant function analysis was used for gender prediction. Results: The subject's age ranged from 18 to 60 years with an equal number of males and females. The mean angle formed by the intersection of lines from the left and right gonion to menton in males was 129.9 ± 11.9 and it was 126.7 ± 12.6 in females. The mean linear distances from the right gonion to menton in both males and females were 86.8 ± 5.3 and 82.6 ± 6.2, respectively. The mean linear distances from the left gonion to menton were 49.5 ± 5.1 in males and 47.7 ± 3.9 in females. The mean linear distance from the right gonion to left gonion was 47.7 ± 4.4 in males and 46.6 ± 4.2 in females. The Box's M statistics was applied to verify the applicability of mandibular measurements in gender prediction. The values indicate that gender can be predicted using these four variables, which is statistically significant (P = 0.000). The overall prediction accuracy of this model was 67%, with 66.7% in males and 67.3% in females being correctly classified. Conclusion: The angle formed by the intersection of lines from the left and right gonion to menton (Gn-M0) helps provide anthropological data, which can be used in dental and medicolegal practices.

A high rate of nerve injury and related consequences are seen during implant placement in the posterior mandibular arch. An approach has been proposed to avoid nerve injury by dodging the inferior alveolar nerve (IAN) while placing an implant. A prospective study with a total of 240 CBCT (cone beam computed tomography) images of patients with three dentate statuses, namely, edentulous (group I), partially edentulous (group II) and dentate (group III) were included in the study. The nerve path tracing was done on CBCT images with On-demand 3D software. The three dimensions, i.e., the linear distance from the outer buccal cortical plate to the inferior alveolar nerve (BCPN), linear distance from the outer lingual cortical plate to the inferior alveolar nerve (LCPN) and linear distance from the midpoint of the alveolar crest to the inferior alveolar nerve (ACN) were assessed. The data were presented and analyzed between variables using one-way ANOVA and independent t-test in SPSS version 21.LCPN of the right 1st premolar region (p &lt, 0.05) was significantly different among the groups with edentulous subjects recorded with the minimum value (6.50 &plusmn, 1.20 mm). Females were found to have significantly (p &lt, 0.05) less available bone (6.03 &plusmn, 1.46 mm) on the right side of the mandibular jaw compared to males in edentulous group of patients. On comparing age groups for partially edentulous subjects, LCPN of the right 1st premolar region had significantly (p &lt, 0.38 mm) in subjects with age &ge, 54 years. The IAN follows a lingual course in the molar region and later flips to the buccal side in the premolar region. The LCPN dimension in the 1st and 2nd premolar region was found to be more than 6 mm irrespective of age, gender and side of the jaw. Thus, it can be considered as a suitable site for placing implants while bypassing the IAN with CBCT assessment remaining as the mainstay in the pre-surgical phase.

To noninvasively determine the relationship between the thickness of the buccal bone and attached gingiva of the maxillary premolars.128 maxillary premolars in 32 patients were assessed for measurement of buccal bone thickness and corresponding attached gingival thickness at 3 mm apical to cemento-enamel junction. Buccal bone thickness was measured on cone-beam computed tomography scans and attached gingival thickness by ultrasound unit. Pearson's correlation coefficient was calculated to assess the correlation between buccal bone and attached gingival thickness at each tooth type.The mean buccal bone thickness at the maxillary premolars was 1.07 mm. The 1st premolars had a buccal bone thickness 1 mm at 68% of all sites, and the 2nd premolars had a buccal bone thickness of 1.0-2.0 mm at 32% of all sites. The 1st premolars had a gingival thickness 1.2 mm at 55% of all sites, and the 2nd premolars had a gingival thickness of 1.1-1.3 mm at 45% of all sites. The correlation between buccal bone and attached gingival thickness was moderately positive (r = 0.406; P .001).The relationship between buccal bone thickness and gingival thickness is independent of each other in the maxillary right first premolar, whereas a moderate correlation with a dependent relation exists in the maxillary right second premolar, maxillary left first premolar, and maxillary left second premolar.Soft tissue and hard tissue associated with volumetric changes in maxillary premolar region can be unfavorable for both aesthetic and implant placement. In fact this study highlighted the relationship between the thickness of attached gingiva and corresponding buccal bone in maxillary premolar region so to enable for proper planning of implant therapy following extraction.

Background: Recently quantitative evaluation of gingival zenith position was evaluated in different facial forms suggesting clinicians may need to evaluate patients facial form and then decide to distalise the Gingival Zenith position in relation to Vertical Bisected Midline (VBM). The aim of the study was to quantitatively evaluate the gingival zenith width in convex, concave and straight facial profiles for Saudi, Indian and Bangladeshi nationals. Materials/methods: 114 subjects of each Saudi, Indian & Bangladeshi nationality were grouped into convex, concave and straight profile based on angle of convexity. Gingival zenith position (GZP) on #11 and #21 was evaluated on the scanned dental plaster model using CBCT. Inter and Intra group comparison was done using one-way ANOVA test. Results: Mean GZP values ranged from 0.84 mm to 1.10 mm, 0.75 mm to 1.02 mm and 0.87 mm to 1.14 mm for Saudi, Indian and Bangladeshi subjects respectively. Statistically significant (p

An oral assessment is a direct way to assess students' learning outcomes by questioning them. The format of oral examinations (viva voce) is not uniform. Unlike interviews, which usually have structured question lists, oral assessments usually do not have a question structure. Structured viva voce overcomes the weaknesses of traditional viva voce The aim of this study was to assess the reliability of structured viva voce as a formative assessment of dental students. A sample of 65 third-year and 70 fourth-year dental students at one dental school in India were subjected to structured viva voce examinations with questions derived from the subject of periodontics. Each examinee answered five questions (two open and three closed) asked by trained unbiased examiners. The structured viva voce examinations were conducted on the seventh and 14th days after the last lecture of a one-month lecture series. Scores were tabulated into three domains of Bloom's taxonomy: knowledge, comprehension, and application. Regarding knowledge, the mean scores were 1.24±0.59 (seventh day) and 1.66±0.64 (14th day), and the difference was statistically significant (p

OBJECTIVE: This study aimed to assess the feasibility of reusing nickel–titanium (NiTi) alloy wires after 6 weeks of intraoral use by evaluating the changes in the load-deflection properties and surface characterization of these alloy wires after cold sterilization by immersion in 2% of acidic glutaraldehyde for 10 h. MATERIAL AND METHODS: Twenty wires each in three groups of G1-as-received wires (ARW), G2-unsterilized used wires, and G3-sterilized used wires (SUW) were tested by the three-point bending test and scanning electron microscopy (SEM). The data were subjected to statistics, one-way analysis of variance, and Bonferroni posthoc test for comparison. RESULTS: Recycling of NiTi wires produced statistically insignificant changes in both the loading and unloading properties of the wires. The forces needed to twist the used wires, that is, G2-(UUW) and G3-(SUW) were lower than G1-(ARW), suggesting lowering of the stiffness of the wires. Superelasticity is well-maintained by G2-(UUW) and G3-(SUW) although there is an insignificant lowering of the forces exerted by them during loading and unloading. SEM demonstrated no increase in the pitting of surfaces in both G2-(UUW) and G3-(SUW); multiple areas were seen to be more smoothened over G2-(UUW) and G3-(SUW) NiTi wires surfaces. CONCLUSION: The findings of this study support the reuse of NiTi wires after 6 weeks of use in oral conditions followed by cold sterilization by immersion in 2% acidic glutaraldehyde for 10 h.

Background: The combination of biomaterials, bone graft substitutes along with guided tissue regeneration (GTR) has been shown to be an effective modality of periodontal regenerative therapy for infrabony defects. Therefore, the present randomized controlled clinical study was undertaken to evaluate the effectiveness of hyaluronic acid (HA) in combination with bioresorbable membrane for the treatment of human infrabony defects. Materials and Methods: Twenty four infrabony defects in 20 systemically healthy patients were randomly assigned to test (HA in combination with bioresorbable membrane) and control (bioresorbable membrane alone) treatment groups. Probing pocket depth (PPD), relative attachment level, and relative gingival margin level were measured with a computerized Florida disc probe at baseline and at 6 months follow-up. Radiographic measurements were also evaluated at baseline and at 6 months of postsurgery. Results: At 6 months, the mean reduction in PPD in test group and control group was 4.52 mm and 2.97 mm, respectively. Significantly higher clinical attachment level with a gain of 2.20 mm was found in the test group as compared to control group. In addition, statistically significant greater reduction of radiographic defect depth was observed in the test group. Conclusion: Regenerative approach using hyaloss in combination with GTR for the treatment of human infrabony defects resulted in a significant added benefit in terms of CAL gains, PPD reductions and radiographic defect fill, as well as LBG, compared to the GTR alone.

Researchers have found that Chemically Modified Tetracyclines (CMTs) act through multiple mechanisms, affecting several parameters of osteoclast function and consequently inhibit bone resorption by altering intracellular calcium concentration and interacting with the putative calcium receptor; decreasing ruffled border area; diminishing acid production; diminishing the secretion of lysosomal cysteine proteinases (cathepsins); inducing cell retraction by affecting podosomes; inhibiting osteoclast gelatinase activity; selectively inhibiting osteoclast ontogeny or development; and inducing apoptosis or programmed cell death of osteoclasts. Thus TCs/CMTs, as anti-resorptive drugs, may act similarly to bisphosphonates and primarily affect osteoclast function. Researchers have evaluated the influence of various chemically modified tetracyclines from CMT-1 to CMT-10 on collagenases and gelatinases through in vitro or animal studies and concluded that all the CMTs except CMT-5 inhibited periodontal breakdown through MMP inhibition in the following order of efficacy: CMT-8>CMT-1>CMT-3>CMT-4>CMT-7. Thus the non-antimicrobial actions of the chemically modified analogues of tetracyclines have shown remarkably better mechanisms to those of agents with established anti-inflammatory/antioxidant potential. These findings clarify the multi-faceted actions of tetracyclines which are unique amongst antimicrobials, with therapeutic applications in periodontal and metabolic diseases. Hence, the present review describes the role of chemically modified tetracyclines in the management of periodontal diseases.

The aim of this study is to investigate the bacterial adherence on 5, 10 and 15 nm nanosilver-impregnated resorbable guided tissue regeneration (GTR) membranes. GTR membranes were incorporated with 5 (NS-GTR-5), 10 (NS-GTR-10), and 15 nm (NS-GTR-15) nanosilver in the test group. The control group contained GTR membranes incorporated with 25% metronidazole (M-GTR) and plain membranes (GTR-C). Qualitative evaluation of microbial adherence to the GTR membranes was performed using four organisms-Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis, and Streptococcus mutans-since these organisms are reported to have strong adherent capabilities to collagen membranes. The main results have been obtained: The mean bacterial adherence scores were significantly greater in the GTR-C group when compared to those in the M-GTR and NS-GTR-5, NS-GTR-10, and NS-GTR-15 groups. M-GTR showed higher adherence scores than NS-GTR-5, NS-GTR-10, and NS-GTR-15 for all microorganisms; the differences were statistically significant. We have concluded that collagen membranes impregnated with 5- and 15 nm nanosilver exhibited an apparent antibacterial effect against anaerobic oral pathogenic bacteria and aerobic bacteria. This outcome indicates that nanosilver-impregnated GTR membranes may be useful in periodontal regeneration therapy.