Background: The most common oral hygiene aid used to improve the oral health of an individual is toothbrush and it is often neglected to maintain in a proper aseptic condition, which could probably result in contamination by various micro-organisms. Aims: 1) To assess the microbial contamination of the hard deposit on the toothbrush head, between the bristle tufts, after 1 and 3 months of use. 2) To assess the microbial contamination of the hard deposit on the toothbrush head, between the bristle tufts, which were kept in the bathrooms with and without attached toilet. Setting and Design: An in vitro study. Materials and Methods: Twenty toothbrushes kept in the bathrooms with an attached toilet and 20 toothbrushes kept in the bathrooms without an attached toilet were collected from the participants, making it a total of 40. Among these 20 toothbrushes in each group, 10 were used for 1 month duration and 10 were used for 3 months duration. Results: Streptococcus mutans, Staphylococcus aureus, Pseudomonas, Lactobacillus, Klebsiella, Candida species were isolated in 1 month and 3 months used toothbrushes kept in the bathrooms without attached toilet. Escherichia coli was found in 3 months used toothbrushes kept in the bathrooms with attached toilet. Micro-organisms were found in isolated form in toothbrushes used for 1 month, whereas in toothbrushes used for 3 months they are found in clumps. Conclusion: Hard deposit on the toothbrush head between bristle tufts is a nidus for growth of micro-organisms, which not only affects the oral health but also affects the general health of an individual.

Aims and Objectives: Psychological conditions, particularly psychosocial stress, have been implicated as risk indicators for periodontal disease. The aim of the present study was to explore the role of psychosocial stress that influences the periodontium with the use of a questionnaire data and serum cortisol level. Materials and Methods: In this study 47 subjects, both male and female, were taken and divided into two groups. Group I comprised of 16 chronic periodontitis subjects. Their stress level was evaluated using a standard questionnaire method (social readjustment rating scale). Plaque index (PI), gingival index (GI), periodontal disease index (PDI) and serum cortisol level were also measured. Group II comprised of 31 stressed subjects and their clinical parameters PI, GI, PDI and cortisol level were recorded. Statistical Analysis Used: Spearman's rank correlation coefficient and unpaired 't' test. Results: In group I statistically significant correlation (P<0.05) was found between cortisol and PDI; and cortisol and PI. In group II positive correlation was found between stress, cortisol, PI, GI and PDI. A statistically significant correlation was found between cortisol and smoking. Conclusion: Stress may be a contributing factor in periodontal disease.

Aim: The aim of the study was to evaluate the ability of 17% ethylenediaminetetraacetic acid (EDTA) solution and 19% EDTA gel to remove debris, and smear layer produced during root canal preparation with two NiTi files systems, Mtwo and Protaper. Materials and Methods: Twenty freshly extracted human anterior teeth with single root canal were collected. The crowns were sectioned at the cemento-enamel junction, and working length was measured. These samples were randomly divided into four groups of five samples each. In each group, 2ml of 3 % sodium hypochlorite solution was used with first instrument. The groupings were as follows. Group 1: 2 ml of 17% EDTA solution and 2 ml of 3% NaOCl were used alternatively each time a new file was employed. This group was prepared with Mtwo rotary files. Group 2: The samples in this group was prepared with Mtwo rotary files. EDTA gel (19%) was used and the samples were irrigated with 2 ml of 3% NaOCl. NaOCl and EDTA gel were used alternatively. Group 3: Five samples were prepared with Protaper file. Irrigation regime was the same as in Group 1. Group 4: Five samples were prepared with Protaper files and irrigation regime was the same as in Group 2. SEM study was done and the collected data were submitted for statistical analysis. Results: There was no statistically significant difference with the varied instruments used (Mtwo and Protaper files), and 17% EDTA solution and 19% EDTA gel. Conclusion: Both the NITI instruments produced a similar dentin surface on root canal wall when used with EDTA gel and EDTA solution

Background: The biology of oral squamous cell carcinoma (OSCC), including its progression from dysplasia to carcinoma, "field effects", genetic changes in tumor associated mucosa (TAM) and effect of matrix metalloproteinases in breaking down of matrix proteins to facilitate invasion, has been well documented. However, what remains to be done is to extrapolate this knowledge to improve patient care. Aim: The aim of this study was to observe the extracellular matrix (ECM) changes with the routine histochemical stains available to most histopathologists. Materials and Methods: The study includes 72 cases of OSCC in which the tumor and adjacent normal appearing areas were sampled to study the ECM changes with hematoxylin and eosin (H and E) and Verhoeff's-Van Gieson elastic stain (VVG). Results: Basophilic fragmentation of collagen (H and E) and clumped short elastic fibers (VVG) were seen in 12 (16.7%) cases. Of the remaining cases, 18 (25%) had a dense lymphocytic infiltrate and had no demonstrable elastic fibers. Those cases with H and E changes were further studied and compared with normal mucosa for ultrastructural changes. The ultrastructural study demonstrated an increase in oxytalan, elaunin and elastic fibers and decrease in collagen fibers with some transformation changes associated with OSCCs and lymph node metastasis. Conclusion: Changes in transformation of collagen to elastic fibers and also the loss of both the fibers in areas of lymphocytic infiltration possibly indicate degradation of ECM fibers by factors released from the lymphocytes or tumor cells and the limiting effect on the tumor by ECM remodeling.

Context: To evaluate the effect of widely used endodontic irrigating solutions on root dentin microhardness and surface roughness. Materials and Methods: One hundred twenty, non-carious extracted human permanent incisor teeth were selected. The crowns of the teeth were sectioned and the roots were separated longitudinally to get 240 specimens. These specimens were then divided into six groups according to the irrigating solutions used. The solutions used were 5% and 2.5% NaOCl solutions, 3% H₂ O₂ , 17% EDTA solution, 0.2% chlorhexidine gluconate, and distilled water. Then, the specimens were subjected to microhardness and roughness testing. The data were analyzed using ANOVA and Tukey's multiple comparison tests. Results: The results of this study indicated that all irrigation solutions, except 0.2% chlorhexidine gluconate, decreased the microhardness of root dentin, and 3% H₂ O₂ and 0.2% chlorhexidine gluconate had no effect on surface roughness. Conclusions: Within the limitation of this study, it is concluded that 0.2% chlorhexidine gluconate seems to be an appropriate irrigation solution, because of its harmless effect on the microhardness and surface roughness of root canal dentin.

Background: Lateral cephalometric standards of normal Central Indian adults having class I occlusion and acceptable facial profile were studied using the Burstone and Legan comprehensive cephalometric analyses that are specific for orthognathic surgery. Aim: To study normal dentofacial patterns of adult population belonging to Central India. Materials and Methods: Cephalometric radiographs of 76 Central Indian adults (38 males and 38 females) having class I occlusion with acceptable facial profile were analyzed, and the mean values of their hard and soft tissue measurements were compared with those of Caucasian adults as reported in the literature. Results: The Central Indian males demonstratedgreater anterior cranial base length and ramal length and a reduced chin depth. The inclination of the upper and lower incisors was also greater. The females demonstrated greater posterior cranial base length, increased upper anterior and posterior facial heights, and an increased maxillary length. Both mandibular body and ramal lengths were increased and there was greater mandibular protrusion and a reduced chin depth. The lower incisors were found to be proclinated. Conclusion: This study reveals that some of the cephalometric parameters in the Central Indian population are significantly different than that of the Caucasian population, especially in the females.

Background: Oil pulling has been used extensively as a traditional Indian folk remedy without scientific proof for many years for strengthening teeth, gums and jaws and to prevent decay, oral malodor, bleeding gums and dryness of throat and cracked lips. Aim: The aim of this study was to evaluate the antibacterial activity of sesame oil and lignans isolated from sesame oil on oral microorganisms and to check whether saponification or emulsification occurs during oil-pulling therapy. Materials and Methods: The in vitro study was carried out in three different phases: (1) Antibacterial activity of the lignans and sesame oil were tested by minimum inhibitory concentration assay by agar dilution method and agar well diffusion method, respectively. (2) Increase in free fatty acid level of oil and the quantity of sodium hydroxide (NaOH) used up in the titration are good indicators of saponification process. This was assessed using analytical tests for vegetable oils. (3) Swished oil was observed under light microscope to assess the status of the oil, presence of microorganisms, oral debris and foreign bodies. Results: Sesamin and sesamolin isolated from sesame oil did not have any antibacterial effect against oral microorganisms like Streptococcus mutans, Streptococcus mitis and Streptococcus viridans. Emulsification of sesame oil occurs during oil-pulling therapy. Increased consumption of NaOH in titration is a definite indication of a possible saponification process. Conclusion: The myth that the effect of oil-pulling therapy on oral health was just a placebo effect has been broken and there are clear indications of possible saponification and emulsification process, which enhances its mechanical cleaning action.

Background: One of the major direct or indirect targets of ultraviolet exposure of skin is the melanocyte or the melanin -forming cell. Epidermal melanocytes act as a trap for free radicals. Based on the protective role of melanocytes in medical literature, the role of melanin pigmentation in gingiva needs to be elucidated. Periodontal pathogens and their products demonstrate the ability to induce the generation of reactive oxygen species. Hence purpose of this study was to unravel the protective role of melanin (if any) against the gingival inflammation. Materials and Methods: A total of 80 subjects; 20 in each group were selected. The selection of subjects regarding gingival pigmentation was based on Dummett's scoring criteria 0, 3. A complete medical, dental history and an informed consent were obtained from the patients. After evaluation of clinical parameters the GCF was collected using microcapillary pipettes at the selected sites. IL-1β levels were quantitated using ELISA. Results: In non-pigmented healthy and gingivitis groups, there was a positive correlation between plaque index, gingival index and bleeding index versus IL-1β level: indicating an increase in the biochemical mediator of inflammation corresponding to an increase in the clinical parameters of inflammation. Also a positive correlation was found between the gingival index and bleeding index versus the IL-1β levels in the pigmented healthy group. The pigmented gingivitis groups showed a negative correlation between the plaque index, gingival index and bleeding index. Conclusions: The clinical markers of inflammation such as gingival index, bleeding index was of low numerical value in pigmented group than in the non-pigmented group, supposedly due to the protective action of melanin. The negative correlation of clinical markers of inflammation to the IL-1β levels in the pigmented gingivitis group could possibly be attributed to the protective role of melanins.

Background and Objectives: One of the most difficult problems encountered in orthodontic treatment with fixed appliance is the control of enamel demineralization around the brackets. Fluoride-releasing bonding adhesives were introduced to aid in the prevention of demineralization adjacent to orthodontic brackets. Hence, an in vitro study was conducted to evaluate and compare demineralization adjacent to the orthodontic bracket and the bond strength using fluoride-releasing adhesive and conventional adhesive. Materials and Methods: One hundred and twenty healthy extracted premolars were selected for the study and were divided into two groups, each group consisting of 60 teeth. Both groups were further divided into three subgroups consisting of 20 samples each. Samples of subgroups A and B were bonded with two prototypes of fluoride-releasing adhesives (i.e. Rely-a-bond and Tru-bond). Samples of subgroup C (ortho-one) were bonded with conventional non-fluoride-releasing adhesive. Group I samples were subjected to demineralization in an acidic medium (methyl cellulose buffered with acetic acid at a pH of 4.5) for 4 weeks, which were later observed under a stereomicroscope. Group II samples were tested for shear bond strength using the Instron Universal testing machine. Results: Both fluoride-releasing adhesives showed statistically significant lower enamel demineralization around the bracket when compared with the conventional adhesive. There was no statistically significant difference on comparing the demineralization between the two prototypes of fluoride-releasing adhesive. Evaluation of shear bond strength revealed that there was no significant difference between the subgroups. Conclusion: Fluoride-releasing adhesives might aid in the prevention of demineralization adjacent to the orthodontic bracket with acceptable bond strength.

Aim and Objective: The present study was aimed at assessing the rapid microwave-assisted tissue processing and staining to determine if it can replace standard formalin-fixed and paraffin-embedded processing and staining technique. Materials and Methods: The study group consisted of 15 oral mucosal biopsies. The specimens were fixed in 10% formalin for 24 hours to ensure adequate fixation and their gross features were recorded, photographed, and then the specimens were cut into equal halves to be processed by both conventional and microwave histoprocessing methods and then subsequently stained with H and E by microwave and conventional methods. The stained slides in each group processed by both microwave and routine methods were randomly numbered for a blind study and circulated among six observers. All the observers were asked to grade each parameter into Excellent/Good/Average/Poor in a data sheet comprising a total of six parameters. These gradings were given a numerical value of 4, 3, 2 and 1, respectively. The parameters included in the data sheet were cellular clarity, cytoplasmic details, nuclear details, color intensity, interface of epithelium and connective tissue. Wilcoxon-matched pairs signed rank test (non-parametric) was used to calculate the test of significance (P value). Results: The total processing time involved in microwave was 42 minutes and 270 minutes for the conventional method. H and E staining in microwave took 33 minutes and 40 minutes for conventional method. Conclusions: The individual scores by different observers regarding the various parameters included in the study were statistically insignificant, the overall quality of microwave-processed and microwave-stained slides appeared slightly better than conventionally processed and stained slides.

Background: Peripheral ossifying fibroma (POF) is a lesion of gingival tissue that predominantly affects women and is usually located in maxilla, anterior to molars. The definitive diagnosis is established by histopathological examination, which reveals the presence of cellular connective tissue with focal calcifications. Objective: This study hypothesizes the histogenesis of POF by analyzing the diverse spectrum of mineralized components with a polarizing microscope. Materials and Methods: A retrospective study was undertaken which involved a detailed review of clinical, radiographic and histopathological features of 22 cases of POF, retrieved from departmental archives. These cases were subsequently stained with a histochemical stain (van Gieson) and observed under a polarizing microscope. Results: The study revealed that the most common age of occurrence was in second and third decades with a strong female predilection (73%), Interdental papilla of the maxillary anterior region was the most commonly afflicted site. About 90% cases showed no radiographic features.Histopathological examination showed that 73% cases consisted of a fibrocellular connective tissue stroma surrounding the mineralized masses. 50% mineralized masses comprised of woven bone, 18% showed combination of lamellar bone and cellular cementum, 18% showed only cementum (cellular and acellular), and remaining 13.6% exhibited a mixture of woven and lamellar bone under polarizing microscope. Conclusion: The study supports the theory that POF develops from cells of periodontal ligament (PDL)/periosteum as undifferentiated mesenchymal cells having an inherent proliferative potential to form bone or cementum, whose nature can be confirmed by polarizing microscope.

Background: Histopathology is a gold standard diagnostic tool for many lesions. Interpretation of tissue sections is a pivotal step in giving the diagnosis. Usually, initial tissue sections may not show complete features of the lesion, so deeper sections of the specimen may play a significant role at times for final diagnosis. In small biopsy specimens, deeper sectioning is routinely used in many laboratories to enhance the sensitivity and accuracy of the diagnosis. Aim: To analyze the percentage of deeper sections taken and its significance in the final diagnosis of oral lesions. Materials and Methods: A total of 500 cases from the files of Department of Oral and Maxillofacial Pathology, Vishnu Dental College, Bhimavaram, Andhra Pradesh were analyzed, and cases of deeper sections were selected. The present retrospective study involves comparison of initial histological findings with those seen in deeper tissue levels of same specimen. Results: 40 cases (8%) were selected for our analysis. Out of these, 19 cases (47.5%) required deeper sections as the initial sections were superficial and undiagnostic. 21 (52.5%) cases were advised for additional sections to confirm, rule out or clarify certain diagnoses, out of which 15 (37.5%) disclosed additional pathological findings, whereas 6 cases (15%) showed the same histological features. Conclusions: Diagnostic laboratories must balance the utility of deeper levels with the additional time required and expense incurred and the impact on patient care. Deeper sections are inevitable in certain situations and periodical auditing of laboratory work will reduce the need for additional sections and delay in the dispatch of biopsy report.

Background: Intracanal medicaments have an antibacterial effect on the root canal flora. The effectiveness of such vehicles has to be tested and substantiated against the normal bacterial flora. The various vehicles that were tested for their effectiveness were commercially prepared calcium hydroxide (Metapex), saline, glycerine, CMCP, and Rexidine-M gel. The bacterial cultures tested for sensitivity were aerobes (Staphylococcus aureus, Streptococcus viridans, Streptococcus pyogens, Enterococcus faecalis), anaerobes (Lactobacillus, Bacteroides melaninogenicus) and a commonly found fungus (Candida albicans). One hundred and twenty-five samples were divided into five experimental groups consisting of 21 samples each and one control group of the same size. Aim: The aim of this study was to investigate in vitro the influence of four different vehicles on the effectiveness of calcium hydroxide against the commonly found aerobic and anaerobic bacteria in endodontic infections. Materials and Methods: The samples were taken and transported using standardized techniques and pure growth of each bacterium was isolated. Petri dishes were prepared for the various calcium hydroxide combinations for each bacterium and incubated. The inhibition zone was recorded at three intervals of 24, 96and 168 hours. Results were tabulated and sent for statistical analysis. Results and Conclusions: It was seen that calcium hydroxide and CMCP combination showed the maximum zone of inhibition, and maximum inhibitory effect was seen at 24 hours. The bacteria most susceptible was found to be S. aureus and the least susceptible was E. faecalis. Further clinical studies are required to substantiate these results.

Context: Materials used for the fabrication of interim restorations must satisfy biological, esthetic, and functional needs. Strength and wear resistance are two important physical properties contributing to clinical efficiency. Aim: The objective of this in vitro study was to evaluate and compare the flexural strength and hardness of five resins used for the fabrication of interim fixed partial dentures. Materials and Methods: Five groups containing ten specimens of each material were fabricated in customized brass split molds with dimensions 65×10×2.5 mm. The materials subjected to this study were Revotek LC™ (group RLC), Protemp II™ (group PSC), Acry-lux V™ with regular monomer (group AHC), Acry-lux V™ with self-cure monomer (group ASC), DPI™ self-cure tooth molding powder (group DSC). The specimens were polymerized according to the manufacturers' instructions and were evaluated for flexural strength using a universal testing machine and for hardness using a microhardness tester. Statistical Analysis: The mean of the five groups was compared using one way analysis of variance (ANOVA) and pair-wise comparison was done using Tukeys honesty significance difference (HSD) test. P≤.05 was considered to be statistically significant. Results: Flexural test results showed that group AHC (79.8950 MPa) had the highest flexural strength followed, in descending order, by group PSC (77.9700 MPa), group ASC (63.7150 MPa), group RLC (58.8110 MPa), and group DSC (51.9840 MPa). Statistically, the difference was found to be highly significant among all the groups. The hardness tests showed that group AHC (17.6900 KHN) had the highest hardness value followed, in descending order, by group PSC (15.9400 KHN), group RLC (12.6000 KHN), group ASC (11.2500 KHN), and group DSC (8.7700 KHN). Statistically, the difference was found to be highly significant among all the groups. Conclusion: Group AHC, representing a heat-polymerizing resin, showed the highest flexural strength and hardness values as compared to auto-polymerizing resins and light-polymerizing resin.

Introduction: Remineralization as a treatment procedure has received a lot of attention both from clinicians as well researchers. The objective of this in vitro study was to find out the efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) in remineralizing enamel surface on which artificial caries lesion had been created. The changes were analyzed using DIAGNOdent® (KaVo) and scanning electron microscope (SEM). Materials and Methods: Ninety maxillary premolars were selected and divided into three groups of 30 teeth each: A (artificial saliva), B (CPP-ACP), and C (CPP-ACPF). All the samples were assessed using DIAGNOdent® at the baseline and after demineralization and remineralization. Three samples were randomly selected from each group after remineralization for surface evaluation using SEM. Results: Statistical analysis showed that group B {CPP-ACP (4.1±1.8)} and group C {CPP-ACPF (4.8±1.2)} had a significantly higher amount of remineralization than group A (1.7±0.7). Conclusion: All the three groups showed a statistically significant amount of remineralization. However, because of the added benefit of fluoride (NaF 0.2%), CPP-ACPF (Tooth Mousse-Plus®) showed marginally more amount of remineralization than CPP-ACP (Tooth Mousse®).

Background: Absorbable synthetic biopolymers have been used as bone filler in Periodontology, proving effective stimulants to bone regeneration. Aim: Copolymerized polylactic and polyglycolic acid is used as a bone filler and polyglactin 910 as a guided tissue regeneration (GTR) membrane to achieve regeneration in periodontal infrabony defects. Materials and Methods: Forty patients with two- or three-walled infrabony defects were selected and randomly divided into two groups. Group A included patients treated with polylactic-polyglycolic acids 50:50 (Fisiograft^® ,Ghimsa SPA,Via Fucini, Italy) alone and Group B included patients treated with polylactic-polyglycolic acids (PLA-PGA)50:50 in conjunction with polyglactin acid 910 (Vicryl Mesh^® Johnson&Johnson , U.S.A ). Evaluation of clinical parameters probing depth and attachment level and radiographs was done preoperatively and 12 and 24 weeks postoperatively. Results: Both the groups showed statistically significant mean reduction in probing depth and gain in clinical attachment level and linear bone fill. Conclusions: Within the limit of this study, both the treatment modalities are beneficial for the treatment of infrabony defects.

Background: Elastomeric ligatures have constituted a versatile method of securing the archwire to bracket slot, though self-ligating brackets have been a recent innovation. Coating elastomeric ligatures with a hydrophobic polymeric substance has been suggested as a methodology in reducing friction at the archwire-bracket interface and in repelling salivary adherends. A new polymeric coated ligature tie - Super Slick Ties™ (SST), manufactured using Metafasix technology, has been marketed by TP laboratories for potential reduction in treatment time. Aim: The basic in vitro design is to compare the frictional characteristics of the coated ligatures with those of uncoated ligatures in four different archwires, namely, stainless steel, NiTi, TMA, and Timolium. Materials and Methods: Four archwires used are stainless steel archwires, TMA archwires, Timolium, NiTi archwires, and two types of elastomeric ligatures (the coated and uncoated ligatures) were used. The wires used were of 0.019 × 0.025 dimension. The evaluation of friction between the brackets and the archwire was carried out as per the test protocol described by Tidy. The values for kinetic friction were obtained and tabulated. Mean and standard deviation were calculated. Paired Student's "t" test was performed to analyze the significance of difference between means. Results: The results indicate a significant difference in friction produced when coated and conventional uncoated ligatures were used. Conclusions: SST produced lower levels of friction (11%) for all archwire materials when compared to conventional uncoated ligatures (Dispense-A-Stix) and both conventional uncoated ligatures and coated ligatures gave a rank order of coefficient of kinetic friction (μkf) among archwires, with stainless steel archwires exhibiting the least and TMA ^TM showing the highest.

Introduction: Elastomeric ligatures reduce chairside time but increase friction. Polymeric coatings and 45° angulations have been introduced to the ligature modules to combat its disadvantages and reduce friction. This in vitro study compared the frictional characteristics of six different types of the most commonly used elastomeric modules. Materials and Methods: Thecoefficient of friction for six ligation methods: the non-coated Mini Stix^† and coated Super Slick Mini Stix™ (TP Orthodontics), 45° angulated but non-coated Alastik Easy-To-Tie™ (3M Unitek) elastomerics and non-angulated non-coated Alastik QuiK-StiK ^* , 0.110'- and 0.120'-diameter elastomerics™ (Reliance Orthodontics) were measured in dry conditions utilizing a jig according to the protocol of Tidy. Results: A significant difference was observed between the various types of elastomeric ligatures (P<.01). Among the six types of elastomeric ligatures, the 45° angulated elastomeric ligatures produced the least friction, followed by the coated Super Slick^† elastomers. No difference in the friction was noted when the diameter of the elastomeric ligatures was varied. Conclusions: Polymeric surface coatings and introduction of angulations into elastomeric ligatures reduce the friction during sliding; however, the diameter of the ligature made no difference to sliding friction.

Introduction: Even after the invention of the modern injection techniques, palatal injection still remains a painful experience for patients, and this pain is attributed to the presence of rich nerve complement and displacement of palatal mucosa during anesthesia. Objective: The aim of the present study was to demonstrate if lidocaine HCl could provide palatal anesthesia if given buccally during maxillary tooth removal without the need for a palatal injection. Materials and Methods: The study group consisted of 75 patients, and 25 were controls. All the patients in the study group had unilateral extractions. In 75 patients, 2 ml of 2% lidocaine HCl with 1:80,000 epinephrine was injected into the buccal vestibule of tooth indicated for extraction without palatal injection. After 8 min, the extraction of maxillary tooth was carried out. Twenty-five subjects in the control group underwent same protocol with palatal injection. All the patients completed a faces pain scale (FPS) and a 100 mm visual analog scale (VAS) after extraction. Statistical Analysis Used: Unpaired t test and Chi-square test. Results: According to VAS and FPS scores, when comparison was carried out between permanent maxillary tooth removal with and without palatal injection, the difference in the pain levels were not statistically significant (P>0.05). Conclusion: The extraction of permanent maxillary tooth is possible by depositing 2 mL of lidocaine to the buccal vestibule of the tooth without the need for palatal anesthesia.

Aim: Evaluation of microleakage in endodontically treated teeth that have been coronally sealed with eugenol and noneugenol containing zinc oxide cement, with and without the use of cavity varnish. Materials and Methods: The crowns of single rooted teeth were removed at the cementoenamel junction (CEJ) and the root canals were prepared and obturated with gutta-percha points and zinc oxide eugenol (ZOE) sealer using lateral condensation technique. The samples were randomly divided into four groups-group 1, coronal seal was obtained with ZOE cement; in group 2, three coats of cavity varnish followed with coronal seal of ZOE cement; in group 3, Litark a (noneugenol cement) was placed in the prepared cavity as in group 1; and in group 4, cavity varnish and Litark were placed instead of ZOE as in group 2. The specimens were immersed in 2% methylene blue dye and examined under traveling microscope for evidence of dye penetration of the material. Statistical Analysis: In this study, Kruskal-Wallis test, Mann-Whitney U, and Wilcoxon W tests were used. Results: Kruskal-Wallis test with P=0.000 indicated that a significant difference exists between the four groups. Mann-Whitney U test and Wilcoxon W test showed a significant difference at 0.05 levels as follows: group 1 with group 3 and 4, group 2 with group 3 and 4, and group 3 with group 4. There was no significant difference at 0.05 levels between group 1 and group 2. Conclusion: Group 4 showed significant less amount of dye penetration as compared with other groups.

Background: Platelet-rich plasma (PRP) contains high levels of polypeptide growth factors that may enhance periodontal regeneration when combined with graft materials. Aim: The purpose of this study was to compare the efficacy of autologous PRP in combination with β-tricalcium phosphate (β-TCP) versus β-TCP alone in the treatment of human infrabony defects. Materials and Methods: Using a split-mouth design, 20 patients showing clinical evidence of almost identical bilateral infrabony defects were randomly selected. The right infrabony defects of the patient were designated as Group A and treated by the placement of β-TCP alone. The left infrabony defects of the same patient were designated as Group B and treated by the placement of PRP mixed with β-TCP. Clinical assessment of probing pocket depth and attachment level and radiographic evaluation of the defect depth were done preoperatively and at 12, 24 and 36 weeks postoperatively. The relative efficacy of two treatment modalities was evaluated using paired Student's t-test and the comparative evaluation between the two groups was done using independent Student's t-test. Results: Both the groups exhibited a highly significant reduction in probing pocket depth, gain in clinical attachment level and linear bone fill at the end of 36 weeks postoperatively. Comparative evaluation between the two study groups revealed a significant reduction in probing pocket depth (P = 0.036*), mean gain in clinical attachment level (P = 0.042*) and linear bone fill (P = 0.014*) in Group B as compared to Group A. Conclusions: Combination of PRP and β-TCP led to a significantly more favorable clinical and radiographic improvement in infrabony periodontal defects.

Introduction: Oral submucous fibrosis (OSMF) is a chronic, progressive, scarring disease that predominantly affects the people of south-east Asian origin. Aim: The present study is aimed at comparing and correlating the mast cell density (MCD) and micro vascular density (MVD) in normal mucosa and different grades of OSMF and to analyze their role in the disease progression. Materials and Methods: MCD was assessed immunohistochemically using anti mast cell tryptase and MVD was assessed using anti-factor VIII related von Willebrand factor. Results: The one way comparison of MVD and MCD in normal mucosa and among different grades of OSMF showed a significant increase in MCD and MVD among OSMF cases. Correlation analysis using Pearson correlation coefficient, showed positive correlation between MCD and MVD i.e. as MCD increases there is an exponential increase in MVD. Conclusion: The increase in MVD and MCD reveals their role in the pathogenesis of OSMF, a lesion characterized by progressive fibrosis in early stages and failure of degradation or remodeling in the advanced stages.

Scientific advances in the creation of restorative biomaterials, in vitro cell culture technology, tissue grafting, tissue engineering, molecular biology and the human genome project provide the basis for the introduction of new technologies into dentistry. Non-vital infected teeth have long been treated with root canal therapy (for mature root apex) and apexification (for immature root apex), or doomed to extraction. Although successful, current treatments fail to re-establish healthy pulp tissue in these teeth. But, what if the non-vital tooth could be made vital once again? That is the hope offered by regenerative endodontics, an emerging field focused on replacing traumatized and diseased pulp with functional pulp tissue. Restoration of vitality of non-vital tooth is based on tissue engineering and revascularization procedures. The purpose of this article is to review these biological procedures and the hurdles that must be overcome to develop regenerative endodontic procedures.

Periodontitis is an inflammatory disease which manifests clinically as loss of supporting periodontal tissues including periodontal ligament, cementum, and alveolar bone, and periodontal therapy is aimed at achieving complete regeneration of these structures. To date, this goal has been tried to accomplish using various bone grafts, growth factors, and barrier membranes. Stem cells are the most fascinating area of biology today and have been used clinically in the field of medicine to treat many incurable diseases. Various human and animal studies have confirmed the presence of stem cells in dental tissues including periodontal ligament. This has opened new avenues aiming toward complete periodontal regeneration using cell-based therapies. This review provides an overview of various types of stem cells in medicine and dentistry and their potential uses especially pertaining to periodontal regeneration.

The demand for esthetic restorations has resulted in an increased use of dental ceramics for anterior and posterior restorations. A few decades ago, all-ceramic restorations were restricted to treatment in the anterior region, but now all-ceramic restorations can be made anywhere in the dentition. The properties of traditional ceramic materials, however, have limited their use to single crowns; larger restorations have been inadvisable because of insufficient strength. In attempts to meet the requirements for dental materials and improve strength and toughness, several new ceramic materials and techniques have been developed during the past few decades The paper reviews the current literature on dental zirconia with respect to survival, properties, marginal fit, cementation, esthetics and suggests clinical recommendations for their use.

Dental insurance is insurance designed to pay the costs associated with dental care. The Foreign Direct Investment (FDI) bill which was put forward in the winter session of the Lok Sabha (2008) focused on increasing the foreign investment share from the existing 26% to 49% in the insurance companies of India. This will allow the multibillion dollar international insurance companies to enter the Indian market and subsequently cover all aspects of insurance in India. Dental insurance will be an integral a part of this system. Dental insurance is a new concept in Southeast Asia as very few countries in Southeast Asia cover this aspect of insurance. It is important that the dentists in India should be acquainted with the different types of plans these companies are going to offer and about a new relationship which is going to emerge in the coming years between dentist, patient and the insurance company.

Eruption cyst is a benign cyst associated with a primary or permanent tooth in its soft tissue phase after erupting through the bone. It is most prevalent in the Caucasian race. Intraoral examination of four patients revealed eruption cyst. Among these, in three patients it occurred in the maxillary arch and one had it in the mandibular arch. All were associated with permanent tooth. Surgical treatment was done in three cases and in one case the cyst disappeared gradually and tooth erupted in normal pattern. Four cases of eruption cyst from India are presented and literature on this condition is reviewed. It is clinically significant in that knowledge among general dentists is very essential regarding this developmental disturbance to reach the correct diagnosis and to provide proper treatment.

Differences in the balance of shape, size, and position of body organs are immediately perceived as "looking wrong" and this perception can subject the individual to significant peer ridicule and social ostracism, often expressing as intense shame and anguish in the attitude of the afflicted. Rehabilitation of such patients can be remarkably beneficial on the individual's self-esteem and body image. The onus of the deed lies in the hands of a team that combines artistic excellence with surgical expertise, by combining the skills of anaplastologists, surgeons, and prosthodontists. This is a review of a few surgical and prosthetic considerations in the management of auricular defect and a case description of management of a patient of microtia following similar guidelines in fabrication of the epithesis.

The odontogenic keratocyst (OKC), first described by Phillipsen in 1956, has metamorphosized as a keratocystic odontogenic tumor (KCOT) as reported in WHO classification of head and neck tumors in 2005. KCOT is a benign intraosseous neoplasm of the jaw and its occurrence in maxilla is unusual and its appearance in maxillary antrum along with maxillary impacted third molar is very uncommon. This article reports a case of KCOT associated with impacted maxillary third molar in right maxillary antrum and describes its rare site of occurrence.

The most challenging and appreciated area in the field of Prosthodontics is the rehabilitation of maxillary defects. Tumors of the head and neck are the common cause for acquired maxillofacial defects. Surgical consequences predispose the patient to hypernasal speech, fluid leakage into nasal cavity, impaired masticatory function, and cosmetic deformity. The Prosthodontists play a significant role in the intervention and improve the quality of life of such patients. The current article describes two clinical case reports of completely edentulous patients with acquired maxillary defects.

Orofacial manifestations of Van der Woude syndrome (VWS) include cleft lip or palate, lower lip pits, hypodontia, hypernasal voice, cleft or bifid uvula, syngnathia, narrow high arched palate, and ankyloglossia. Extraoral manifestations include limb anomalies, popliteal webs, accessory nipples, congenital heart defects, and Hirschsprung disease. We report an interesting case of VWS with characteristic orofacial features along with an unusual additional finding of fusion of primary mandibular left lateral incisor and canine in a 7-year-old boy.

The objective of the article is to highlight and make people aware of a rare abscess which is often missed or misdiagnosed. As only a few cases have been reported, the authors feel that reporting such a case would help in proper management of the disease. We are presenting a 6.5-year-old male child with 3 weeks history of right facial swelling in the parotid region, with low-grade fever and trismus. Submasseteric abscess is a rare abscess which is often misdiagnosed as a parotid abscess or parotitis. Only a few cases have been reported. The cause is mostly dental in origin. Intravenous antibiotics often fail to alleviate the symptoms as this is a closed space and needs prompt drainage. Therefore, awareness of this complication of dental infections is vital for proper diagnosis and timely management.

A rare case report of multiple natal teeth in both maxillary and mandibular dental arches in a 21-day-old baby and its management is being presented here.

The solitary or traumatic bone cyst (TBC) is an uncommon non-epithelial lined cavity of the jaws. The lesion is mainly diagnosed in young patients most frequently during the second decade of life. The majority of them are located in the mandibular body between the canine and the third molar. Clinically, the lesion is asymptomatic and is often accidentally discovered on routine radiological examination. The definite diagnosis of traumatic cyst can only be determined at surgery. Often, the material for histological examination may be scanty or non-existent. We present a documented case of a solitary bone cyst involving the body of the mandible. A brief review of literature regarding the main characteristics of the lesion is provided.

Objectives: This study aims to compare the curve of Spee in human permanent healthy dentitions in two age groups to the disclusion in the premolar and molar region during protrusion. Materials and Methods: Sixty subjects were chosen and equally divided into two age groups of 18-25 years and 35-44 years. The left side of the mandibular dental casts was photographed using a digital camera to measure the curve of Spee. The canine cusp, mesiobuccal cusp of the first molar and the distal cusp of the second molar were marked and joined to form an arc. Using AUTOCAD software, the radius for this arc was obtained. A protrusive interocclusal record was made using rigid bite registration material to measure the amount of posterior disclusion during edge to edge protrusion. A dial gauge with an accuracy of 1/100 of a millimeter was used to measure the distance between the cusp tip indentations at the region of the buccal cusp of the mandibular 2nd premolar and distobuccal cusp of mandibular 1st molar. The results obtained were statistically analyzed. Results: The radius of curve of Spee increased nonsignificantly with age. The mean disclusion values measured in premolar and molar region showed a nonsignificant decrease with age. Conclusion: As age advances, there is a flattening of the curve of Spee and a concurrent reduction in the disclusion values during protrusion.

Context: Anxiety is a subjective state of feelings. Dental anxiety is often reported as a cause of irregular dental attendance, delay in seeking dental care or even avoidance of dental care, resulting in poor oral health related quality of life. Aim: To assess the prevalence and socio-demographic correlates of dental anxiety among a group of adult patients attending a dental institution in Vadodara, Gujarat. Patients and Methods: A total of 150 adult patients waiting in the out-patient Department of Oral Diagnosis of K.M. Shah Dental College and Hospital were included in the study. Subjects were selected by convenience sampling. Dental anxiety was assessed by using Modified Dental Anxiety Scale (MDAS) and self-designed, semi-structured questionnaire incorporating various demographic variables, type and nature of dental treatment. Statistical analysis was done using SPSS version 16. Descriptive analysis, unpaired t-test, one-way analysis of variance (ANOVA) test and multiple logistic regression were applied for statistical analysis. Results: 46% of the participants were dentally anxious. Females were found to be significantly more anxious than males. Subjects residing in villages had significantly more score than those residing in city. Relative influence of age, education, type of dental treatment, and previous dental visit were not significantly associated with dental anxiety. However, those subjects who had past negative dental experience were found to be significantly more anxious. Conclusions: The study shows that dental anxiety was high among study subjects. It is recommended that this issue should be given due importance and addressed in a practical and meaningful manner.

Background: Acrylic resin dentures are susceptible to fracture after clinical use, which is a problem of concern in prosthodontics. Impact failure outside the mouth and flexure fatigue failure in the mouth are two most important causes of fracture of denture base. Aim: This study evaluated the transverse deflection and transverse strength of four commercial brands of heat cure acrylic resin (Stellon, Acrylin-H, Trevalon and Trevalon-HI). Materials and Methods: An experimental design was adapted. Twenty-four rectangular strip specimens, six for each group, were prepared. Strips were finished on the edges and equally from the both the molded surfaces to make strips of specific dimensions. The tests were conducted mainly in accordance with the American Dental Association Specification no. 12/ISO: 1567-1981 (ISO: 6887-1986) for denture base polymer. The transverse deflection and transverse strength were measured by Instron testing machine. Intergroup differences were assessed using student "t" test. Results: The heat cure denture base material D (Trevalon "HI") had the minimum mean value of transverse deflection under different loads. Trevalon "HI" also had minimum value of mean transverse strength among different brands of acrylic resins. There was no statistically significant variation between Stellon, Acrylin-H and Trevalon, but variation was significantly higher with D (Trevalon "HI") vs. Stellon, Acrylin-H and Trevalon. Conclusion: The heat cure denture base material D (Trevalon "HI") was the strongest and C (Trevalon) was the weakest among all materials used in this study. The study showed that the deflection of various denture base resins (A to D) increases proportionately with the increase in load.

Keratocystic odontogenic tumor (KCOT), also known as odontogenic keratocysts, as defined by World Health Organization (WHO), are known for their peculiar behavior, varied origin, debated development, unique tendency to recur, and disputed treatment modalities. We present a case of KCOT involving symphysis menti, right and left halves of the body of mandible in an 11-year-old girl treated with enucleation and open dressing (bismuth, iodoform, paraffin paste) with long-term follow-up.

Ocular complications from facial nerve paralysis can be quite devastating. Facial nerve paralysis results in cosmetic as well as functional problems. Paralysis of the upper eyelids leads to lagophthalmos, which results in incomplete closure of the lid over the cornea, leading to potential complication of corneal ulceration. The management of the affected eye in patients with facial palsy has been improved. Previously, ointment, eye drops, taping, partial or complete tarsorrhaphy was the primary treatment for inability to close the eyelid. Other mechanical techniques for reanimating lid closure are palpebral springs, encircling the upper and lower eyelids with silicone or fascia lata and temporalis muscle transfer. The most popular and widely used static procedure in facial nerve palsy is the upper eyelid gold weight implant. Gold eyelid implants are designed for the gravity assisted treatment of the functional defect of lagophthalmos resulting from facial paralysis. We report a case of a patient with facial paralysis who underwent gold weight implantation of the upper eyelid for correction of paralytic lagophthalmos.