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Abstract Background In dentistry, nosocomial infection poses a great challenge to clinicians. The microbial contamination of water in dental unit waterlines (DUWLs) is ubiquitous. Such infected DUWLs can transmit oral microbes in the form of aerosols. Previous studies have suggested treating DUWLs with various disinfectants to reduce cross-contamination. The literature lacks a comparative evaluation of the effect of the use of 0.2% chlorhexidine (CHX) and 0.1% sodium hypochlorite (NaOCl) in DUWLs on aerosolized bacteria generated during dental procedures. Objective To compare the effect of NaOCl and CHX in DUWLs on aerosolized bacteria generated during restorative and endodontic procedures. Materials and methods A total of 132 patients were equally divided into three groups (n = 44 in each group) according to the content of DUWL as follows. Group I—0.1% NaOCl Group II—0.2% CHX Group III—distilled water (Positive control) One-way ANOVA was performed and the Kruskal–Wallis test was used for intergroup comparison. Results For the restorative procedure, inter-group comparison of mean colony-forming units (CFU) scores showed a statistically significant difference between the groups (p - .001) with the score of group 3 higher than group 2 followed by group 1. For the endodontics, an inter-group comparison of CFU scores showed a statistically significant difference between the groups (p - .003) with the mean score in group 1 being the lowest and group 3 being the highest. Conclusion The addition of NaOCl or CHX in DUWLs shows an effective reduction in aerosolized bacteria compared to distilled water.

This Systematic Review (SR) was to report on the prevalence of pulp stones in the Saudi Arabian (KSA) population. The electronic databases were searched for scientific research articles during May 2021. The data search was performed in electronic search engines like PubMed, Scopus, Web of science, and Saudi Digital Library, and 6 original research articles which fulfilled the eligibility criteria were assessed for qualitative data. The prevalence of pulp stones among the KSA population ranged from 4.6% to 50.93% among the study participants and it ranged between 10.2%−13.34% in the teeth assessed. The pulp stones were more frequently reported in decayed teeth, periodontal diseases, attrition, teeth with dental restorations, and higher in the molar teeth in comparison with the premolar teeth. The data on the prevalence of pulp stones among the Saudi population will be helpful for clinicians in planning endodontic procedures.

Mehuli Halder,1 Yogesh Chhaparwal,1 Vathsala Patil,1 Komal Smriti,1 Shubha Chhaparwal,2 Kalyana C Pentapati3 1Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India; 2Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India; 3Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, IndiaCorrespondence: Yogesh Chhaparwal, Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India, Tel +91 9986454730, Email yogesh.chhaparwal@manipal.eduBackground: Lingual plate thickness, density, and proximity to the tooth are linked as risk factors for various complications associated with third molar extraction. The present study aimed to assess the lingual plate thickness, and density in the mandibular third molar region using cone beam computed tomography and to estimate its correlation with type and level of impaction, number of roots, age, and gender as the risk factorsMethods: This was a retrospective study on CBCT images of 648 mandibular third molars. The lingual plate thickness at three different root levels – cervical, mid-root, and apex along with the position of the tooth, number of roots, density of lingual plate, age, and gender were evaluated. The measurements were done on Invivo 5-Anatomage software. Statistical comparison of the categorical variables was done by Chi-square test, and Fisher’s exact test, and univariate and multivariate analysis were done using binomial logistic regression.Results: Lingual plate thickness of the third molars at the cervical, mid root, and apex were 1.28 mm, 1.42 mm and .01 mm (mean). A significantly higher proportion of subjects with thin lingual plates at mid-root (p-value=0.01) and apex (p-value=0.05) were in the 21– 30 age group. Lingual bone density was significantly associated with the thickness of the lingual plate at the mid-root. A significantly higher proportion of thinner lingual plates at the mid-root level were associated with mesioangularly placed third molars (p-value=0.002).Conclusion: Our study presented that lingual plate thickness has a strong association with age, angulation, and the number of roots. Knowledge about these risk factors is imperative during the management of third molar impactions.Keywords: lingual plate, third molar, bone density, mandible, cone-beam computed tomography

Abstract Background Acquisition of psychomotor skills is of utmost importance for competent preclinical restorative dentistry. Recent advancements in haptic feedback technology have been incorporated into preclinical dental education to augment the conventional phantom head-based training. Objective This systematic review aims to assess the effectiveness of haptic feedback device, Simodont, in improving the skill development and learning outcomes of dental students during their preclinical training. Materials and methods Electronic databases Web of Science, Scopus, PubMed were searched for relevant studies since inception up until March, 2023. Only English language studies that assessed the effectiveness of haptic feedback devices in preclinical dental education were included. We excluded studies that did not use Simodont as the haptic feedback device or did not involve preclinical restorative work. Study quality was assessed using the revised Cochrane risk of bias tool and ROBINS-I. The primary goal of the study is to evaluate the efficacy of Simodont as a complementary training modality for dentistry students. Results Results from 9 high-quality studies were analyzed and synthesized to evaluate the overall impact of haptic feedback devices on various aspects of preclinical training. The studies were conducted on 826 undergraduate dental students enrolled in various years of their training across dental colleges and universities in different parts of the world. A majority of studies showed some concerns regarding risk of bias. Haptic feedback devices added a new layer to Virtual Reality (VR) through the perception of touch and force feedback. It assisted junior dental students improve their psychomotor skills and movement skills. Instantaneous feedback on the students' performance helped enhance their self-assessment and correction, and also eliminated the subjectivity of evaluation. Data derived from virtual simulators helped stratify dental students and predict their clinical performance, providing an opportunity to tailor the learning process to meet individual diversity in students' expertise. Conclusion Based on the limited evidence available, Simodont was effective in preclinical training of dental students, offering advantages such as unlimited reproducibility, objective evaluation of preparation by computer assessment, and cost reduction. And further studies are warranted to explore the incorporation of patient's oral environment simulation for better skill training.

ABSTRACT: Objectives: The presence of red-complex bacteria (RCB) has been associated with the occurrence of not only periodontal disease but also other systemic diseases, thereby potentiating an oral–systemic relationship. This study aimed to explore the levels of periodontal RCB in pregnant preeclamptic women with periodontal disease, potentiating the pathophysiology of a bacterial association in both periodontitis and preeclampsia. Methods: Six hundred pregnant women (aged 20 to 35 years) in their third trimester were selected and divided into 3 groups comprising a control group (systemically and periodontally healthy pregnant women), group A (preeclamptic women with chronic periodontitis), and group B (preeclamptic women without chronic periodontitis). Demographic variables and periodontal parameters were recorded. Other variables such as systolic blood pressure (SBP) and diastolic blood pressure (DBP) and the urine protein content were also estimated. RCB, namely Porphyromonas gingivalis (Pg), Treponema denticola (Td), and Tenerella forsythia (Tf), were assessed in both subgingival plaque samples and placental samples of all the pregnant participants in the study. Results: The mean weight, mean body mass index, mean SBP, mean DBP, and mean urine protein content were significantly elevated in group A and group B when compared to the control group. Preeclamptic women with chronic periodontitis (group A) had higher levels of plaque index, probing pocket depth, bleeding on probing, and clinical attachment level as compared with the other groups. The numbers of the RCB were found to be elevated in group A, out of which Pg was found to be more prevalent. Conclusions: Our findings indicate that the periodontal indices, blood pressure, and urine protein content were found to be higher in preeclamptic women with periodontitis. Hence, reducing the periodontal bacterial load in pregnant women via good oral hygiene maintenance would further reduce the putative risk of adverse pregnancy outcomes including preeclampsia in these women.

Background and Aim: The purpose of this review was to provide an overview of the use of electromyography (EMG) in dentistry over the past several years, as well as related research. EMG is a sophisticated technique used to detect and analyze muscle activity. EMG was primarily utilized in medical sciences in the past, but it is now widely utilized in both the medical and dental fields. Materials and Methods: Electronic search was conducted in EMBASE, PubMed, Scopus, Web of Science, and Google Scholar to find all clinical studies regarding applications of EMG in dentistry. Results: This review included 31 papers in all. According to the results, neuromuscular activity may be recorded using EMG for both diagnostic and therapeutic purposes. It could be used in dentistry to evaluate parafunctional habits such as clenching and bruxism as well as muscle activation during actions like chewing and biting. In recent years, the use of EMG in treatment of temporomandibular joint (TMJ) and myofascial pain disorders has significantly increased. Conclusion: EMG has a variety of applications in dentistry for monitoring, diagnostic, and therapeutic purposes.

Abstract Objective The study aims to evaluate the wear surface using 3D surface roughness and other material characterization of zirconia fabricated using photopolymerization based Lithography-based Ceramic Manufacturing (LCM). Method LCM technology was used to fabricate zirconia specimens of size 10 × 10 × 2mm3. Scanning Electron Microscope, 3D–profilometer, X-ray Diffraction, and hardness test characterized the samples before and after wear and Coefficient of friction (COF) was monitored. Result The COF was around 0.7 and did not differ much between the horizontally and vertically printed specimens. However, the surface roughness after wear for horizontally printed specimen was 0.567 ± 0.139 μm, while that for vertically printed specimen was 0.379 ± 0.080 μm. The reduced valley depth and the dale void volume were low for the vertically printed zirconia specimen, indicating lesser voids and low fluid retention. In addition, it was observed that the hardness value of the vertically printed sample was better. The scanning electron microscopic images and 3D surface profiles of the zirconia specimens depicted the surface topography and revealed the wear track. Conclusion The study shows that zirconia fabricated using LCM technology possesses surface roughness of about 0.5 μm with no machining scars that are usually associated with CAD/CAM dentistry and also indicating agreement with clinically acceptable values for minimal surface roughness of dental restorations. Dental restorations using LCM fabricated zirconia redues the requirement of post-processing work flow that is part of CAD/CAM dentistry.

Objectives: The oral microbiological environment may be implicated in the corrosion of orthodontic metals. This study aimed to examine the prevalence of sulfate-reducing bacteria (SRB) in orthodontic patients undergoing fixed appliance treatment. Methods: Sixty-nine orthodontic and 69 healthy non-orthodontic participants were enrolled in the study. Supragingival and subgingivaloral biofilm were collected and tested for the presence of SRB. The DNA extraction, polymerase chain reaction (PCR), and 16sRNA Sanger sequencing method was performed from the SRB-positive samples. The sequenced PCR products were analysed and compared with databases to identify the bacterial genus. Results: Amongst 69 orthodontic patients, characteristic black precipitates developed in 14, indicating the presence of iron sulfides which demonstrates the likelihood of SRB. Alternatively, 2 out of 69 showed the presence of SRB in healthy non-orthodontic participants (controls). Desulfovibrio spp was confirmed by analyses of 16sRNA sequencing, which revealed that the SRB prevalence was 20% in the examined participants with orthodontic appliances. Conclusions: The prevalence of SRB was found to be significantly higher amongst orthodontic patients compared to non-orthodontic participants. Presence of stainless steel in the oral environment may have facilitated the colonisation of SRB.

Background: Variations in pneumatization. of the sphenoid sinus can affect suprasellar, parasellar, and middle cranial fossa procedures. A 3-D imaging modality, like cone beam computed tomography (CBCT), overcomes superimpositions and magnification to provide an efficient evaluation of anatomical components across multiple planes. Objective: The purpose of this study is to conduct an epidemiological assessment inspired by the classifications provided by Gibelli et al. and Bilgir et al. on the morphological variants of the sphenoid sinus pneumatization using CBCT in a South Indian population. Materials and Methods: Around 154 CBCT images of sphenoid sinuses devoid of pathologies were examined. Descriptive analysis and Pearson Chi-square test were evaluated using SPSS 22.0 software. Results: Patients had a prevalence of 5.84% presellar, 27.2% sellar, and 51.9% postsellar posteroanterior pneumatization but no conchal pneumatization. About 14.2% showed aberrant pneumatization involving the pterygoid, anterior clinoid, and dorsum sellae. Conclusion: A thorough understanding of surgical anatomy and its variances is necessary to perform surgery with minimal possibility of human error and morbidity. To achieve this, a comprehensive classification of sphenoid sinus pneumatization is required as there is a disparity among the various study results presented in the previous literature.

Background: Intraosseous anastomosis (IA) found in the lateral wall of the maxillary sinus (MS) is a potential site for bleeding during surgeries. Objectives: To investigate the position of IA in male and female, and dentulous and edentulous patients in relation to the MS floor and volume of MS. Methods: The study is comprised of 60 cone-beam computed tomography (CBCT) scans of the maxilla. Distances from the floor of the MS to the IA canal and from the MS floor to the alveolar crest were measured. The canals are classified into three types. The volume of the MS and its relation to the IA was assessed. Results: Statistical difference was noted in the position of the IA in relation to second premolar and in dentulous and edentulous patients. Intraosseous was the most common type of canal. The difference in volume did not affect the position of the canal. Conclusions: IA was closer to the floor of the MS in the second premolar region in females. Knowing the type and position of the canal helps prevent complications during surgery.

Background: Temporomandibular disorder (TMD) is a comprehensive term used to describe a diverse range of disorders with multiple causes. Psychological factors exhibit variability across different cases based on the diagnostic subgroup of temporomandibular disorders (TMD). Objectives: To compare the effectiveness of cognitive behavioral therapy (CBT) in TMD patients to the standard therapy (STD). Methods: Patients underwent psychological assessment by Beck's Inventory of Depression (BDI) and stress symptom rating scale (SSRS). They were randomly divided into STD therapy and CBT. Pre- and post-treatment pain was evaluated by VAS. BDI and SSRS scale scores were done pre- and post-CBT and STD treatment. Descriptive statistics and non-parametric tests were performed to compare the variables pre- and post-CBT and STD treatment. Results: Varying degrees of depression and stress 53.3% and 60%, respectively, were observed in patients with TMDs. A statistically significant difference was seen in the BDI and VAS scores post-CBT (P < 0.001) as compared to SSRS scores. Conclusion: Patients with TMDs are under considerable stress and anxiety. The addition of CBT to standard treatment regimens will enhance the treatment efficacy and help patients to cope with daily activities, ease muscle tension, and improve their quality of life.

Background: Gender determination is a standard practice in forensic science as it forms the prime phase in the reconstruction of a post-mortem profile. The maxillary sinus (MS) is the largest among the paranasal sinuses with characteristic morphological features. Cone-beam computed tomography (CBCT) imaging, widely popular now for its imaging accuracy, may be considered for recording morphometric measurements of maxillary sinuses for gender determination. Aim: To compare and analyze the applicability and accuracy of measurement parameters (length, width, height, and volume) for the evaluation of sexual dimorphism of MS. Methods: CBCT scans were used to measure the height, length, width, and volume of MS in 60 patients to identify an individual's gender for forensic evaluation. The parameters were analyzed using discriminant function analysis and independent t test to compare these values in both genders. Results: Combined measurements of all study parameters were analyzed, and an overall accuracy rate of 61.67% was observed. Conclusion: Morphometric measurement parameters of MS attained using CBCT seem to have a moderately good prediction value.

Background: Panoramic radiography is a routinely advised extraoral radiograph in a dental practice due to its diverse implications in the field of oral and maxillofacial diagnosis. The visibility of normal structures in the panoramic radiographs is of paramount importance as their margins should be delineated clearly from pathological structures that will aid in the correct diagnosis and treatment planning. Aims and Objective: The study aimed to compare the subjective image quality of selected anatomical landmarks on CCD-based panoramic images with and without processing. The objective was to highlight the importance of processed images, which are frequent in day-to-day practice. Materials and Methods: The study comprised 60 subjects with a complete complement of permanent teeth excluding third molars. Selected subjects were clinically examined, and a digital panoramic examination was done. The radiograph obtained was assessed for the subjective image analysis based on the visibility of six major anatomical landmarks using a 3-point scale, and the overall image assessment was done using a 4-point scale. The data was tabulated for statistical analysis. Results: Digital panoramic radiographs with post-processing showed superior visibility with regard to the six anatomical landmarks as well as for overall image assessment which was found to be statistically significant (P

Background: Current education systems including dental education are focusing on communication, leadership, and team-building skills; hence, it is imperative to understand the students' perspectives and willingness to learn communication skills during their professional course. Aim: The aim of the study was to assess the attitude towards learning communication skill among dental interns in Davanagere city. Methods: A cross-sectional questionnaire survey in a dental college setting was conducted among 125 dental interns of Davanagere city. Data were collected pertaining to age, gender, academic performance in the final-year BDS, self-perceived level of communicating skill, and attitude towards learning communication skill using a pretested study pro forma and Dental Communication Skills, Attitude Scale questionnaire. Statistical Analysis: Descriptive statistics were generated in terms of percentages and mean attitude scores. Student's unpaired t-test, one-way ANOVA test, and Pearson's correlation test were used for the analysis of data. The significant level was set at P < 0.05. Results: The mean positive attitude score of the interns was 51.71 ± 5.10, and the mean negative attitude score was 28.15 ± 4.67. There was no significant difference (P > 0.05) in the mean attitude scores between males and females. Dental interns' attitude towards learning communication skill was not related to their self-reported communication skill and academic performance (P > 0.05). Conclusion: Dental interns had a high positive attitude towards learning communication skill which were not related with their self-reported communication skill and academic performance.

Context: The existing situation of the coronavirus disease 2019 (COVID-19) pandemic has created enormous pressure and anxiety among dental students practicing in dental institutions. Aim: The aim of this sentence was to evaluate the awareness and knowledge of safety measures and disinfection protocol during the COVID-19 pandemic among dental students. Materials and Methods: Institutional ethical committee cleared the questionnaire format for the survey then this Google Forms was forwarded to dental students all over Maharashtra. The questionnaire was divided into four sections: Section A recorded sociodemographic details. Section B recorded knowledge about COVID-19. Section C recorded awareness of measures. Section D recorded awareness of disinfection protocols in the dental setup. Results: A total of 707 dental students from different colleges in Maharashtra participated in the study. A total of 200 postgraduate (PG) students (95.2%) and 458 (92.2%) undergraduate (UG) students correctly marked the incubation period for COVID-19 as 7–14 days. Ninety-nine percent of students are aware of personal protective equipment (PPE) kit to be used while treating patients as well as they are well known for the components of the PPE kit. Most of the PG (93.8%) and UG (82.9%) students understand the need for an oral rinse with mouthwash by the patient before treatment. Awareness and knowledge regarding safety measures and disinfection protocols were adequate among PG students. Conclusion: COVID-19 pandemic brought new challenges and responsibilities to institutions providing dental education. Upliftment of knowledge can lead to a positive attitude in resuming back to the dental practice in the respective institute.

Aim: This study aims to know the efficacy of remineralization of four fluoride varnishes on artificial demineralized lesions in primary teeth. Materials and Methods: A total of 60 human primary anterior teeth coated with nail varnish leaving a window of 3 mm × 3 mm were subjected to demineralization for 72 h. These teeth were then sectioned into two equal parts with a diamond disc. These 60 sections obtained were then evaluated under the stereomicroscope and the demineralization depth was noted. These 60 sections were divided into four groups: Group 1: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP); Group 2: Sodium fluoride (NaF) with xylitol-coated calcium and phosphate (CXP); Group 3: Nano-hydroxyapatite; Group 4: NaF and subjected to remineralization respectively for 5 days. The specimens were again evaluated under the stereomicroscope for the remineralization depth. Results: All the four varnishes showed remineralization with artificial carious lesions. CPP-ACP showed the highest remineralization depth followed by NaF with CXP, NaF, and Nano-hydroxyapatite. Conclusion: CPP-ACP can be used as an agent at its best for remineralizing and extending the life of the tooth.

Introduction: Genetic polymorphisms of genes regulating amelogenesis can alter susceptibility to Early Childhood Caries (ECC). This systematic review aims to analyze associations between single-nucleotide polymorphisms of enamel formation genes and ECC. Methods: Search was conducted across PUBMED, CINAHL, LILACS, SCOPUS, EMBASE, Web of Science, Genome-Wide Association Studies databases from January 2003 to September 2022. This was supplemented by hand search. Totally 7124 articles were identified and 21 articles that satisfied the inclusion criteria proceeded to data extraction. Quality assessment was done using the Q-Genie tool. Results: Quantitative synthesis revealed that homozygous genotype AA of rs12640848 was significantly higher in children with ECC with an odds ratio of 2.36. Gene-based analysis revealed significant association between six variants of AMBN, four variants of KLK4, two variants of MMP20, and a single variant of each of MMP9 and MMP13 genes and ECC. The Bonferroni corrected-log10 P value of amelogenesis gene Cluster was 2.25 (0.05/88 = 5.6 × 10−4). Search Tool for Retrieval of Interacting Genes and Proteins plot constructed to comprehend the protein-protein interaction revealed the presence of four functional clusters. Gene function prediction using Multiple Association Network Integration Algorithm revealed that physical interaction between these genes was 69.3%. Conclusion: Polymorphisms of genes regulating amelogenesis can influence the susceptibility to ECC. AA genotype of rs12640848 may increase the susceptibility to ECC. Gene-based analysis revealed a significant association between multiple polymorphisms of genes regulating amelogenesis and ECC.

Background: History of rheumatoid arthritis (RA) increases risk of periodontal diseases. A pro-inflammatory condition noted in periodontitis is considered a trigger for RA. Thus, periodontal treatment aimed at attenuating the pro-inflammatory state could aid in potentially reducing the risk of RA. Aims: The objective of this research was to assess the effect of periodontal therapy on rheumatoid factor, Disease Activity Score-28, anti-citrullinated protein antibody, and C-reactive protein levels in patients with chronic periodontitis (CP) and RA. Materials and methods: The sample consisted of 28 patients with CP and RA. The study was designed to be a double-blind, randomised controlled clinical study. The samples were randomly categorised to either the treatment group (n = 13) or the control group (n = 15). CP status (plaque index, bleeding on probing, probing pocket depth, clinical attachment loss), clinical rheumatologic status (Disease Activity Score), and biochemical status (C-reactive protein, anti-citrullinated protein antibody, and rheumatoid factor) were assessed at baseline and at follow-up at 8 to 12 weeks. Results: The treatment group showed a highly statistically significant reduction in bleeding on probing (P < .005), probing pocket depth (P < .001), plaque index (P < .001), and C-reactive protein (P < .001); a gain in the clinical attachment loss (P < .001) and an improvement in Disease Activity Score-28 (P = .001) were observed at reassessment following nonsurgical periodontal treatment as compared to the control group. However, blood serum anti-citrullinated protein antibody (P = .002) and rheumatoid factor levels (P = .351) were found to increase from baseline to 8 to 12 weeks following subgingival scaling and root planing. Conclusions: Reduction of inflammation in the periodontium by nonsurgical periodontal therapy did not reduce anti-citrullinated protein antibody and rheumatoid factor levels. However, it has shown improvement in periodontal conditions, and remarkable changes were observed in the clinical Disease Activity Score and C-reactive protein levels of individuals with RA.

Objective: This study assessed the influence of chitosan nanoparticles on the fluoride-releasing ability of 4 glass ionomer cement (GIC) through an in vitro analysis. Methods: Four types of GIC (type II light cure universal restorative, type II universal restorative, GC Fuji VII, and type IX) were modified with nanochitosan particles; 10% chitosan was added to the glass ionomer liquid. Six specimens for each of the 4 groups were created, using expendable Teflon moulds. Discs of each type of GIC (n = 6) were immersed in deionised water at various time intervals. Electrodes selective for fluoride ions were employed to analyse the amount of released fluoride at 1, 7, 14, 21, and 28 days. Results: Chitosan-modified GICs showed greater fluoride release than conventional GICs at all time points. All samples showed an initial high release of fluoride that tapered off with time. The total amount of fluoride released increased from the 1st day to the 28th day on adding chitosan to all the 4 types of GIC. Amongst those, type IX high-strength posterior extra with chitosan released a considerably higher quantity of fluoride at all time intervals. Conclusions: In all the experimental groups, adding chitosan to the glass ionomer liquid had an accelerating effect on its fluoride-releasing property.

Intra-osseous vascular lesions occur rarely in jaw bones. Intra-osseous hemangioma of the facial bones is even rarer and occurs more predominantly in the mandible than the maxilla. Diagnosis of these lesions is challenging due to inconsistent clinical and radiographic presentation. Here, we present a rare case report of a boy, aged 16 years, with an intra-osseous cavernous hemangioma of the left maxilla.

Contact stomatitis or stomatitis venenata is defined as an oral mucosa contact allergy caused by persistent contact with a pathogenic substance. Arsenic album 30 was advised as a “preventive and prophylactic remedy” against coronavirus disease-19 (COVID-19) by The Ministry of AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy), Government of India. We present a case of a 68-year-old man who suffered ulcers on the left buccal mucosa and tongue after taking arsenic album 30c for 10 days sublingually. This is, to the best of our knowledge, the first recorded incidence of allergic contact stomatitis caused by a homeopathic drug used to treat COVID-19. This case report emphasizes the need for obtaining a history, being aware of the composition of any new items, and reporting allergies or medicines provided to the patient.

Tuberculosis of the maxillary sinus is uncommon. Primary tuberculosis involving the sinus is very rare, and it is generally secondary to pulmonary involvement. The clinical presentation of this condition is vague and not pathognomonic. This may result in an incorrect diagnosis leading to complications. An unusual presentation of primary tuberculosis affecting the maxillary sinus in a 54-year-old male is discussed in the present case report.

Statement of the Problem: Saliva is a precious oral fluid that contributes to oral health and when its quantity is diminished, it hampers the quality of life. Individuals suffering from diabetes have a complaint of reduced salivation due to the consumption of xerogenic drugs and autonomic neuropathy. Purpose: Our study aims to evaluate the effectiveness of the transcutaneous electric nerve stimulation (TENS) device on the salivary flow rate with respect to age and gender in Jaipur population. Materials and Method: A descriptive observational study was carried out on individuals in Jaipur at the Department of Oral Medicine and Radiology at Rajasthan Dental College and Hospital during a period of 7 months. The study consisted of 200 individuals who were divided into two groups. Unstimulated and stimulated saliva were collected for 5 minutes in a graduated beaker. Stimulated saliva was collected after keeping the TENS unit activated at 50Hz. Kolmogorov-Smirnov, Shapiro-Wilks normality tests and Mann Whitney U test were done. The p value

Objectives: Dental caries is a common chronic disease amongst children and are typically evaluated using the DMFT/deft index (decayed, missing, and filled teeth for permanent dentition/decayed, extracted, and filled teeth for primary dentition). To address the limitations associated with these indices, alternative assessment tools such as the Caries Assessment Spectrum and Treatment (CAST) index and Ora test have been developed. These methods aim to estimate caries activity within the oral cavity more accurately. The objective of our study was to evaluate and correlate caries activity in 5-to-8-year-old children using Ora test and CAST index. Materials and Methods: Thirty schoolchildren between the ages of 5 and 8 years were selected and allocated into two groups (n=15) with DMFT/deft scores of 5 (group B). Two separate blinded examiners administered the assessments by first determining CAST scoring, which was followed by Ora test. Statistical analysis was performed using Pearson correlation test and significance was set at P≤0.05. Results: The mean time for color change of Ora test, was 118.53±23.28 minutes in group A and 53.33±15.07 minutes in group B. CAST severity scores were 3.67±2.08 and 15.7±9.70 for groups A and B, respectively. Time taken for color change in Ora test and CAST scores showed a significant negative linear relationship (P=0.039). Conclusion: Based on the negative correlation between CAST scores and Ora test, it may be postulated that microbial activity is directly related to caries activity in 5-to-8-year-old children.

In humans, especially in childhood, the more prevalent disease is dental caries. Dental caries can extensively destroy the tooth structure. Extensive loss of the tooth structure and premature loss of the primary tooth can lead to loss of vertical dimension, developing habits such as tongue thrusting and mouth breathing that may lead to malocclusion in future. The treatment of mutilated primary teeth should adequately reestablish the anatomy of the tooth, which helps to maintain the mastication, phonation, esthetics, and acts as a natural space maintainer. It is always challenging for the pediatric dentist to satisfactorily restore these teeth to maintain space, esthetics, and function. In recent years, both children and their parents have given priority to esthetics over primary dental care. This demands the innovation and the development of newer treatment options that should be biological and conservative. Hence, natural teeth are increasingly being used as a restorative material to treat damaged teeth with this desire for innovation. As a result, here we report a case of a severely mutilated primary tooth of a 2½-year-old child treated with the technique of biological restoration. This biological restoration procedure involves bonding a sterile dental structure to a tooth that needs treatment.

Introduction: In our study, we have compared the efficacy of dentin bone graft for purpose of ridge preservation and have compared it with autogenous bone graft (ABG). A total of 15 patients were included in this study requiring extraction of bilaterally impacted third molar. On the one side, the socket was filled with processed dentin graft prepared after extraction of the third molar, and on the other side, the socket was filled with ABG harvested from external oblique ridge. The two were compared on the basis of various soft tissue and hard tissue parameters. Aims: This study aimed to evaluate and compare the efficacy of the dentin autograft with ABG for preservation of socket defect after removal of mandibular third molars clinically and radiographically. Materials and Methods: A total of 15 patients were included undergoing extraction for bilaterally impacted third molar. The socket on one side after extraction was filled with processed dentin from the same extracted tooth, and the other side of the socket was filled with ABG harvested from the external oblique ridge. Results: It was seen that dentin graft had the regenerative properties and showed potential for ridge preservation. Conclusions: Ridge preservation is essential for placement of implant and other prostheses. Preservation of ridge immediately after extraction bypasses the need for extensive ridge augmentation procedure. Hence, dentin graft can be used for this purpose as it has potential for bone regeneration.

Introduction: Root canal fillings using Gutta-percha and root canal sealers are considered the gold standard in endodontics. Bondable root canal sealers help in strengthening the root by penetrating into the dentin. Aim: The aim was to compare and evaluate the fracture resistance of root dentin following the application of AH Plus sealer, MTA Fillapex sealer, and BioRoot RCS sealer. Materials and Methods: Decoronation was performed on 70 extracted single-rooted premolars at the cementoenamel junction. The samples were divided into three experimental and two control groups. Fourteen samples served as the negative control (Group 4), which were left unprepared. The remaining 56 samples were prepared with ProTaper rotary files up to F3. The roots were obturated using cold lateral compaction using Gutta-percha and AH Plus sealer (Group 1), MTA Fillapex (Group 2), and BioRoot RCS (Group 3). Group 5 served as the positive control group. A universal testing machine was used to compress the samples until fracture occurred. One-way analysis of variance with post hoc Tukey's test was used to analyze the data. Results and Discussion: The highest resistance to fracture was shown by Group 4 (negative control), followed by Group 1 (AH Plus), Group 3 (BioRoot RCS), Group 2 (MTA Fillapex), and the least by Group 5 (positive control). There was a statistically significant difference between all the groups (P = 0.00) except between AH Plus and BioRoot RCS (P > 0.05). Conclusion: Samples in all the groups fractured when vertical force was applied. The maximum resistance to fracture was shown by the roots which were neither instrumented nor obturated. AH plus sealer showed the highest resistance to fracture among the three experimental groups, followed by BioRoot RCS and MTA Fillapex.

Background: Surgical site infection (SSI) is one of the common postoperative complications observed after various periodontal surgeries, and sutures play a vital role in its causation. Thus, the aim of this study is to evaluate and compare the efficacy of a novel tetracycline-coated suture with triclosan-coated and nonantibacterial-coated sutures on bacterial load reduction to prevent SSI by measuring the zone of inhibition. Materials and Methods: Twenty systemically healthy individuals with moderate chronic periodontitis were included in this study. Fresh unstimulated saliva was collected from each patient and inoculated on three different blood agar plates. Sutures were divided into three groups (Group A: Tetracycline-coated suture, Group B: Triclosan-coated suture, Group C [control group]: Nonantibacterial-coated suture). The antibacterial efficacy of each suture was evaluated by performing agar diffusion test. The zone of inhibition around each suture was calculated, and statistical analysis was performed for the same using Kruskall–Wallis ANOVA test and Mann–Whitney U-test. Results: On intergroup comparison, there was a statistically highly significant difference seen for the zone of inhibition between the groups (P < 0.01) with the highest values in Group A (14.45 mm), followed by Group B (1.4 mm) and least in Group C (0 mm). Conclusion: Tetracycline-coated suture is more efficacious than triclosan-coated suture to reduce bacterial load and further prevent SSIs. However, in vivo clinical trial is must to prove the same.

Context: Gingival recessions are commonly seen in the dentally cognizant population as well as those with limited access to dental attention. When root coverage is planned, the ultimate goal is to obtain complete root coverage, thus restoring the lost gingival unit covering the root. Aims: To determine the efficacy of sticky bone and concentrated growth factor (CGF) membrane along with a coronally advanced flap (CAF) as compared to CAF alone in treating Miller's Class I and Class II gingival recessions (Cairo RT1). Settings and Design: The current study was a randomized double-blind controlled trial on 15 subjects using a split-mouth design. Materials and Methods: Fifteen subjects who were systemically healthy and had recession sites (30 sites) were randomly assigned to two groups: Group A (test group = CAF + CGF + sticky bone) and Group B (control group = CAF alone). Clinical outcome was assessed with parameters such as recession depth, recession width, keratinized gingival width, gingival mucosal thickness, and relative attachment level (RAL), and these were assessed at baseline and 1, 3, and 6 months. Results: A distinct improvement was observed in the depth and width of recession, RAL, keratinized gingival width, and mucosal thickness of the gingiva in the two groups from baseline to 6 months. Statistical significance was not seen on intergroup comparisons. Conclusions: Thus, clinical outcomes revealed noticeable improvement for both the groups. However, statistically, the efficacy of CGF and sticky bone was not perceived to be superior to that of CAF alone.

Context: Oral submucous fibrosis (OSMF) is a chronic insidious oral potentially malignant disorder characterized by increased collagen deposition and reduced collagen degradation causing burning sensation and difficulty in mouth opening. Aim: To assess the efficacy of topical Tulsi (Ocimum sanctum) paste for the management of OSMF. Settings and Design: Institution-based clinical trial. Materials and Methods: The study included a total of 60 OSMF patients categorized into three Groups A, B and C (20 in each) depending on the severity according to Lai DR et al. classification. The patients were advised for topical Tulsi paste application and were evaluated for the reduction in the burning sensation and improvement in mouth opening every month for 3 subsequent months using the numeric pain rating scale (NRS) and a Vernier calliper, respectively. Statistical Analysis: The baseline and 3-month recordings were subjected to inter- and intra-group statistical analysis using Kruskal–Wallis analysis of variance (ANOVA), Mann–Whitney U, one-way ANOVA, Tukey's multiple post-hoc and Wilcoxon matched-pairs tests. Results: There was a reduction in the burning sensation and improvement in the mouth opening in all three groups. The reduction in the burning sensation was statistically significant among all the groups (P < 0.05) and the NRS scores after 3 months among the three groups were not statistically significant (P > 0.05). There was a statistically significant difference (P < 0.05) in the improvement of mouth opening between Group A and B; A and C; but not between B and C. Conclusion: Tulsi paste showed a significant reduction in the burning sensation and improvement of the mouth opening thereby proving to be a safe and promising medicament for OSMF.

Background: Dental caries is one of the most common concerns in oral health of children. Arresting these lesions is a treatment which is gaining momentum as against conventional restorative approaches. Aim: The aim is to evaluate the efficacy of nanosilver fluoride (NSF) as a caries arresting agent in primary teeth or first permanent molars in children. Design: The protocol for the systematic review has been registered with PROSPERO database (CRD42020162386). Several databases, such as PubMed®/MEDLINE, Web of Science™, Scopus®, Google Scholar, LILACS, Cochrane Library, ProQuest, and BBO, were searched for randomized controlled trials (RCTs) which evaluated the arrestment of caries, in primary teeth and first permanent molars in children, with a minimum follow-up of 6 months. The Risk of Bias tool by Cochrane reviews system software, Revman 5.4.1, was used for quality assessment of the included RCTs. The quality evaluation was done using the GRADE approach. Heterogeneity was assessed using Cochrane's Q and I2 statistics. Results: Five studies were included for qualitative and quantitative analysis. The Risk Ratio for NSF versus active control group was assessed to be 1.09 (0.93-1.28) with 95% Confidence Interval and for placebo control was 0.49 (0.35-0.67). Conclusion: NSF shows promise as a caries arrestment agent when applied in primary teeth. PROSPERO Registration: This review was registered with the PROSPERO database (CRD42020162386)

Background: In this COVID era, it's critical to promote nonaerosol procedures. Atraumatic restorative treatment (ART) is one of them, and it's particularly effective in children for lowering anxiety, enhancing dental health, and giving restorative care. Aim: The aim of this study was to assess the survival rate of ART compared with conventional treatment procedures in primary dentition. Materials and Methods: The review was done in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analysis statement and is been registered in PROSPERO (CRD42021213729). The studies included comprised clinical investigations with randomized controlled trials (RCTs) which compared the survival rate of ART and conventional restorative treatments using the same or different restorative materials to treat carious lesion. RCTs in which ART was compared with conventional treatment on patients in the age group of 6–10 years with minimum follow-up of 6 months. Studies available as open access and free full text in PubMed, DOAJ, and Google Scholar databases, and published in English Language only were included in the study. Cochrane's collaboration tool for RCTs was used for the assessment of risk of bias. Results: The survival rate of single surface and multiple surface in primary dentition treated according to the ART compared with conventional treatment was found to be similar. Conclusion: The ART approach is equally helpful in managing dental caries in children and this method may be considered a useful intervention in clinical practice to enhance the dental health of children.

Background: Mouth dissolving film (MDF) is a fast-dissolving drug delivery system that provides a practical means to administer drugs not just to special populations with swallowing difficulties but also to the general public. MDFs are novel dosage forms that dissolve and disintegrate quickly within the mouth. Aim: To assess the efficacy of lornoxicam mouth dissolving film as a potent analgesic and drug delivery system and compare it with the aceclofenac tablet in the management of post-extraction pain. Methodology: The study group comprised 60 subjects of either sex of age group 20–50 years who were divided into an experimental group (group A) and a control group (group B). Group A was administered lornoxicam MDF and group B was administered aceclofenac tablets. Pre-treatment and post-treatment pain assessments were recorded using a visual analog scale (VAS) and an oral pain scale (OPS). Results: In a comparison of the mean value of pre-treatment VAS and VAS after 24 h, the percentage of pain reduction in group A was 86.66%, and in group B was 75%. When comparing the mean value of pre-treatment OPS and OPS after 24 h, the percentage of pain reduction in group A was 93.33% and in group B was 75%. These results were statistically significant, with a P value of 0.00 in both groups. Conclusion: Lornoxicam as an MDF showed promising results in managing post-extraction pain. The potential delivery of lornoxicam through the MDF was safe, with better patient compliance, and no reported cases of adverse effects.

Aim: The aim of the study is to systematically assess the impact of low-temperature degradation (LTD) simulation in an autoclave on mechanical and microstructural properties of infiltrated monolithic zirconia compared to the noninfiltrated zirconia. Settings and Design: Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines. Materials and Methods: An electronic search was done within these databases: PubMed, Scopus, and Web of Science, Science Direct, Embase, Wiley, Google Scholar for articles published between 2000 and March 2021. Search results that met eligibility criteria were categorized into two groups based on properties assessed of infiltrated monolithic zirconia exposed to LTD (also called aging simulation) – (a) mechanical (flexural strength and fracture toughness) and (b) microstructural properties (phase transformation rate and m content). Statistical Analysis Used: Qualitative analysis. Results: The search identified 272 preliminary results. After discarding duplicates, and screening of titles, abstracts, and full texts, 10 articles finally met inclusion criteria. Data were collected on author's details and their countries, journal and year of publication, type and percentage of infiltration, aging protocol (duration and temperature), mechanical, and microstructural properties. All the included studies invariably revealed better aging resistance without a change in mechanical properties for infiltrated monolithic zirconia as compared to noninfiltrated species. Conclusion: Infiltration within monolithic zirconia can reduce degradation and simultaneously maintain their mechanical properties by preventing water entry into grain contours. The final m content was less for infiltrated Zirconium, indicating a lesser phase transformation and better aging resistance. Other Information: Systematic review protocol registered at PROSPERO CRD42021248153.

Aim: This study aimed to evaluate the influence of humidity on the bond strength of AH Plus, BioRoot RCS, and Nanoseal-S sealers. Materials and Methods: Sixty root slices, each 1 ± 0.1 mm thick, were prepared from the middle-third of 20 mandibular premolars. Three holes, 0.8 mm wide each, were drilled on each slice. These holes were subjected to standardized irrigations and dried. Each hole in each slice was filled with the three individual sealers, AH Plus, BioRoot RCS, and Nanoseal-S. The samples were then stored in saline for 7 days at 37°C. The push-out bond strength of each sealer in each hole of all samples was tested. The differences in push-out bond strengths between the three sealer samples were assessed using the unpaired t-test and post hoc Turkey's HSD test. The significance level was set at 5%. Results: The results of the post hoc Tukey's HSD test (P < 0.05) indicated that the mean and median push-out bond strength were highest for BioRoot RCS, irrespective of the moisture conditions. Conclusion: Humidity conditions did not influence the bond strength of AH Plus, BioRoot RCS, and Nanoseal-S sealers.

Context: Oral lichen planus (OLP) is a relatively common chronic inflammatory condition of the oral mucosa. OLP is currently managed by various treatment protocols, the most common being topical and systemic corticosteroid therapy. Low-level laser therapy (LLLT), or photo-biomodulation, is gaining popularity as a palliative treatment for OLP. Aim: The present study was aimed to compare the efficacy of LLLT, topical corticosteroid therapy, or a combination of both in the management of OLP. Settings and Design: Thirty patients who were clinically and histopathologically diagnosed as OLP were randomly selected and divided into three groups: Group 1 (n = 10) received topical corticosteroid therapy (TCT); Group 2 (n = 10) received LLLT; and Group 3 (n = 10) received combination of both the therapies. Materials and Method: Each group of patients received treatment in five sessions of their respective therapy over the course of 15 days, with a three-day interval between each follow-up. The VAS (visual analogue scale) was used to collect data on pain. The percentage of healing was calculated using the WHO oral mucositis assessment scale, the global healing index, and the WU et al. (2010) disease grading system. Results: A reduction in scores in VAS, WHO oral mucositis assessment scale, global healing index, and WU et al. (2010) disease scoring system with the combination of LLLT and topical corticosteroid therapy was observed. Conclusion: Both LLLT and TCT were effective against the symptom control and improvement in clinical manifestation of oral lichen planus, nevertheless; a combination of the two was found to be more beneficial in treatment of symptomatic OLP.

Objective: This study aimed to compare the efficacy of diode laser, EndoActivator, passive ultrasonic irrigation (PUI), and manual dynamic activation (MDA) in the debridement of root canal isthmus using a stereomicroscope. Materials and Methods: A total of 65 extracted mandibular first molars were selected for the study. The access cavity preparation was done and the working length was determined. All teeth were prepared using ProTaper rotary system up to F2. The samples were randomly divided into five groups (n = 13) used in the study. Group 1: Diode laser (n = 13): samples were irrigated using a diode laser having a wavelength of 980 nm. Group 2: EndoActivator (n = 13): the samples were irrigated using EndoActivator sonic device. Group 3: PUI (n = 13): samples were irrigated using an ultrasonic device. Group 4: MDA (n = 13): samples were irrigated manually by placing a master gutta-percha cone of F2 size. Group 5: Conventional needle irrigation (n = 13): no activation of irrigant. Following irrigant activation, the mesial roots were sectioned 4 mm from the apex and the isthmus cleanliness was observed under a stereomicroscope at ×20. Statistical analysis was done using ANOVA and post hoc Tukey's test. Results: EndoActivator showed the least amount of debris when compared to diode laser, passive ultrasonic irrigant, and MDA. MDA showed more amount of debris at the isthmus level. Conclusion: EndoActivator showed the least amount of debris at the isthmus level of mandibular molars when compared to diode laser, passive ultrasonic irrigant, and MDA.

Background and Objective: Most patients with oral cancer receive chemoradiotherapy with or without surgery for treatment and develop oral mucositis, a debilitating adverse. Currently, there is no standard regimen for the management of radiation-induced mucositis. This study aims to evaluate the effect of honey on radiation-induced mucositis. Methods: The study consisted of 204 subjects of both genders, diagnosed and treated by radiotherapy for head and neck carcinoma and who had developed oral mucositis. The control group (n = 102) received 0.9% normal saline while the interventional group (n = 102) received honey as a topical application. Both groups were evaluated by the World Health Organization oral mucositis assessment scale at baseline (I visit) and four follow-up visits. Results: A decrease in the progression of the lesion and symptomatic relief were found in the interventional group. There was neither symptomatic relief nor a decrease in mucositis grade in the control group. Conclusion: Within the limits of this study, the results showed that the topical application of honey could be used to alleviate the symptoms in the management of radiation mucositis as it is easily available, simple, and economical.

Background: The acceptance and availability of effective vaccines are crucial for the success of vaccination programs. Medical doctors and students are the epitome of shaping the public interest in vaccines. Aim: To evaluate the general public's attitudes, including dental students and health care professionals, at the national level towards COVID-19 vaccines and explore the potential drivers for students' acceptance levels. Methods: A national-level cross-sectional study was carried out in May-June 2021 using an online questionnaire. The sample was categorized based on age, gender, academic level, and location. The dependent variable was the willingness to take the COVID-19 vaccine. The independent variables included demographic characteristics, COVID-19-related experience, and the drivers of the COVID-19 vaccine-related attitude suggested by the WHO SAGE. Results: The number of people who answered the questionnaire was 1271. The males accounted for 38.9%, and females were 61.1%. The age group, 18-45 years with 14.7%, has the highest percentage of people who have not taken vaccination. In context to gender, 13.5% of males and 13.1% of females have not taken vaccination. The percentage of vaccination hesitancy is highest in rural areas with 19.5%. The health care professionals were vaccinated with the highest percentage of 89.8%. Conclusion: The vaccination acceptance level of the population for COVID-19 vaccines was good, approximately 63%, and their worrisome level of vaccine hesitancy 27% was governed by demographic, social, and economic factors. The media and social media, public figures, insufficient knowledge about vaccines, and mistrust of governments and the pharmaceutical industry were major hurdles to vaccination.

Objective: The objective of this study was to evaluate the short-term efficacy and safety of the topical application of amlexanox paste with triamcinolone acetonide paste and tacrolimus paste in the treatment of oral erosive lichen planus. Study Design: This study was a randomized double-blinded placebo-controlled clinical trial. Forty patients aged 18–70 years with erosive oral lichen planus received amlexanox 5% paste (n = 10), triamcinolone acetonide 0.1% paste (n = 10), tacrolimus 0.03% paste (n = 10), and glycerin as placebo (n = 10) for 15 days. Outcome measures included pain using visual analog scale (VAS) scores, and the erosive area in cm2 was evaluated both before (baseline) and during the trial (i.e., days 7 and 15). Results: After 15 days of treatment, all the groups showed significant reductions in erosive areas and VAS scores (P

Aim: This study aims to study the viable property of periodontal ligament (PDL) cells in the avulsed teeth using Hank's balanced salt solution (HBSS) storage medium with levodopa (L-dopa) and without L-dopa. Materials and Methods: The study samples included 40 freshly extracted, noncarious, non-impacted human teeth with closed apices. The teeth were then randomly divided into four groups containing four different experimental storage solutions, namely Group 1: Deionized water; Group 2: Deionized water with L-dopa (1 μg/μl); Group 3: HBSS; and Group 4: HBSS with L-dopa (1 μg/μl). All the teeth were stored in different test solutions for 60 min. Collagenase assay was performed followed by analyses of the number of viable PDL cells using a hemocytometer under a light microscope at ×20 magnification. The mean and standard deviation (SD) of viable PDL cells of all the four groups obtained were evaluated using Kruskal–Wallis test. P < 0.001 was considered statistically significant. Comparison between the four groups was done using Mann–Whitney test and U

Mucocele is a common salivary gland lesion which most commonly occurs on the lower lip. Several treatment options are available for its elimination with surgery being the most commonly used method. A 49-year-old male presented with a small, round, painless swelling on the left buccal mucosa since 6 months. A clinical diagnosis of oral mucocele on the left buccal mucosa was made. Due to the inaccessibility of the posterior buccal mucosa region, sclerotherapy with sodium tetradecyl sulfate was planned. The patient did not show any obvious reduction in the size of swelling after 1 week of therapy. Therefore, a second injection was planned. After another 1 week, complete resolution of the lesion was seen with no complications. No recurrence of the lesion has been seen after 6 months of therapy. Due to the various drawbacks of surgical management of oral mucocele, sclerotherapy can be an effective alternative.

Periapical granulomas (PGs) respond well to endodontic treatment. In case of refractory response to the treatment apicectomy and finally, extraction is the treatment of choice. Herein, we present a case of endodontically failed PG with an excessive amount of Mott cells (MCs). MCs are plasma cells with spherical aggregates in their cytoplasm. The extensive accumulation of MCs in a periapical lesion is hitherto underreported and might elucidate the cause of refractory treatment outcomes of certain periapical lesions. The lesion was diagnosed with immune PG with multiple MCs. To the best of our literature search, there have been only two similar reports till date. Additional case reports and long-term follow-up are necessary to understand the nature and significance of such lesions. This article aspires to further the awareness regarding such unique presentation to aid appropriate diagnosis and also highlights the importance of subjecting apicectomy specimen to histopathological examination.

Background/Aim: Myths related to oral diseases and oral health-related practices are very common among the population. Inadequate knowledge along with the persisting myths regarding the etiology, course and outcome of oral diseases makes it difficult to initiate health behavioural changes. Present study scrutinizes various myths and misconceptions regarding oral health among the outpatients. The aim of this study was to assess myths and misconceptions about oral health and imparting education regarding the same.

Background/purpose: In the recent years artificial intelligence (AI) has revolutionized in the field of dentistry. The aim of this systematic review was to document the scope and performance of the artificial intelligence based models that have been widely used in orthodontic diagnosis, treatment planning, and predicting the prognosis. Materials and methods: The literature for this paper was identified and selected by performing a thorough search for articles in the electronic data bases like Pubmed, Medline, Embase, Cochrane, and Google scholar, Scopus and Web of science, Saudi digital library published over the past two decades (January 2000–February 2020). After applying the inclusion and exclusion criteria, 16 articles were read in full and critically analyzed. QUADAS-2 were adapted for quality analysis of the studies included. Results: AI technology has been widely applied for identifying cephalometric landmarks, determining need for orthodontic extractions, determining the degree of maturation of the cervical vertebra, predicting the facial attractiveness after orthognathic surgery, predicting the need for orthodontic treatment, and orthodontic treatment planning. Most of these artificial intelligence models are based on either artificial neural networks (ANNs) or convolutional neural networks (CNNs). Conclusion: The results from these reported studies are suggesting that these automated systems have performed exceptionally well, with an accuracy and precision similar to the trained examiners. These systems can simplify the tasks and provide results in quick time which can save the dentist time and help the dentist to perform his duties more efficiently. These systems can be of great value in orthodontics.

Background/purpose: Artificial intelligence (AI) has made deep inroads into dentistry in the last few years. The aim of this systematic review was to identify the development of AI applications that are widely employed in dentistry and evaluate their performance in terms of diagnosis, clinical decision-making, and predicting the prognosis of the treatment. Materials and methods: The literature for this paper was identified and selected by performing a thorough search in the electronic data bases like PubMed, Medline, Embase, Cochrane, Google scholar, Scopus, Web of science, and Saudi digital library published over the past two decades (January 2000–March 15, 2020).After applying inclusion and exclusion criteria, 43 articles were read in full and critically analyzed. Quality analysis was performed using QUADAS-2. Results: AI technologies are widely implemented in a wide range of dentistry specialties. Most of the documented work is focused on AI models that rely on convolutional neural networks (CNNs) and artificial neural networks (ANNs). These AI models have been used in detection and diagnosis of dental caries, vertical root fractures, apical lesions, salivary gland diseases, maxillary sinusitis, maxillofacial cysts, cervical lymph nodes metastasis, osteoporosis, cancerous lesions, alveolar bone loss, predicting orthodontic extractions, need for orthodontic treatments, cephalometric analysis, age and gender determination. Conclusion: These studies indicate that the performance of an AI based automated system is excellent. They mimic the precision and accuracy of trained specialists, in some studies it was found that these systems were even able to outmatch dental specialists in terms of performance and accuracy.

Background: Various techniques have been employed to enhance the root canal disinfection rate using sodium hypochlorite (NaOCl) as an irrigant. Photon initiated photo-acoustic streaming using lasers is a newer method of endodontic disinfection. Aim: The aim of this study is to evaluate and compare the efficacy of photo-initiated photoacoustic streaming and conventional irrigation technique using 2.5% NaOCl for root canal disinfection in primary teeth. Setting and Design: Laboratory setting and ex-vivo design. Materials and Methods: Twenty extracted primary teeth were selected in which Enterococcus faecalis incubation was done in the root canals and bacterial counts were obtained before the intervention. The teeth were randomly allocated into two groups. Group I samples were irrigated with conventional syringe method using 2.5% NaOCl and Group II samples were irrigated using photon-initiated photo-acoustic streaming method with erbium-doped yttrium aluminum garnet laser (wavelength - 2940 nm). Postintervention samples were obtained, and bacterial colony count was done. Wilcoxon Signed- Ranks Test and Mann–Whitney test were applied to test the intragroup and intergroup differences in the bacterial counts. Results: Postintervention results showed no bacterial growth in the canals irrigated using Laser (P = 0.004) whereas, fewer bacterial colonies were observed in NaOCl group (P = 0.005). There was statistically significantly higher reduction in E. faecalis counts in Laser Activated irrigation (LAI) group compared to NaOCl group (P < 0.05). Conclusion: Total elimination of E. faecalis counts was obtained by the use of laser activated NaOCl irrigation in the infected root canals, hence, it can be considered as an effective method for pediatric endodontic disinfection.

Background: Ideal pulpectomy for primary dentition demands fast, simple procedures, with short treatment times and minimal appointments. Recently, exclusive pediatric rotary files are available for use in primary teeth. There is a paucity of literature on the clinical efficacy of pediatric rotary files. Hence, this study was planned to evaluate and compare pediatric rotary files and K-files. Aim: The aim of this study was to evaluate and compare instrumentation time, obturation time, and radiographic quality of obturation using rotary systems (Kedo-S; Pro-AF Baby GOLD files) and manual (K-files) technique in primary molar pulpectomies. Materials and Methods: Forty-five primary mandibular molars from 42 children aged 5–9 were selected. Single-visit pulpectomy was performed after dividing selected teeth into three equal groups: (i) K-files, (ii) Kedo-S files, (iii) Pro-AF Baby GOLD files. Instrumentation and obturation times were recorded during the procedure. Immediate postoperative radiographs were taken and evaluated later for obturation quality by two independent evaluators blinded to the instrumentation technique. The results were then statistically analyzed. Results: Kedo-S (Group II) files required the least instrumentation time followed by Pro-AF (Group III) and K-files (Group I). The superior quality of obturation in lesser time was achieved using Pro-AF files (Group III) followed by Kedo-S (Group II) and K-files (Group I). Conclusion: Pediatric rotary files are efficient alternatives to hand instrumentation and can be considered as the standard of care in pulpectomies of primary teeth.

Aim: The aim of this study was to compare the NeoEndo and WaveOne retreatment systems concerning the effective removal of epoxy resin-based sealer and gutta-percha during the retreatment of straight root canals. Materials and Method: Sixty extracted, human mandibular first premolars with single straight roots were selected based on cone-beam computed tomography (CBCT) evaluations. The root canals were instrumented with the ProTaper system up to the F3 file and filled with gutta-percha and epoxy resin-based sealer using the cold lateral condensation technique. After 1 month, the samples were randomly divided into two groups (n = 30) according to the retreatment system used: NeoEndo and WaveOne. A CBCT device scanned specimen after the root filling and retreatment procedures, and the decrease in the volume of filling material after each retreatment protocol was measured. The results were analyzed using the paired t-test and additional box-and-whisker plots. Results: The WaveOne removed significantly more material than the NeoEndo (P = 0.005) system. Conclusion: The WaveOne system was more effective than the NeoEndo retreatment system during the removal of filling material.