Background: Trauma to the inferior alveolar nerve (IAN) is one of the complications during surgical procedures in the posterior mandible. Most of the time, this is due to inaccurate assessment of an operator from conventional radiographs. Lately, with the availability of advanced imaging techniques such as cone beam computed tomography (CBCT), precise location of anatomic structures has become a reality. This study was designed to evaluate the course and position of IAN in relation to the alveolar crest, buccal cortical bone, lingual cortical bone, and inferior border of the mandible using CBCT in South Indian population. Materials and Methods: A total of 139 CBCT scans were assessed using sagittal section done at every 5-mm interval beginning 1 mm posterior to the mental foramen extending till the anterior border of the ramus. Measurements were made on sectional images as CN – alveolar crest to the nerve, BN – buccal cortex to the nerve, LN –lingual cortex to the nerve, and IN – inferior border to the nerve. Results: IAN showed a wavy pattern from posterior to anterior in relation to the alveolar crest and was positioned inferiorly in males when compared to females at Section one of CN1 (P = 0.004). IAN was more away from the lingual cortex in dentulous compared to partially dentulous group (P = 0.003). Females showed more bone present lingual to nerve near the first molar region. Gender and presence or absence of dentition had an influence on overall results. Conclusion: There is a considerable variation in the position of IAN throughout its course in the mandible. Henceforth, advanced diagnostic images such as CBCT should be strongly recommended in evaluating the position of IAN preoperatively before advanced implant surgical techniques, nerve repositioning, and any other surgical procedures.

Objectives: Mucous retention cysts (MRCs) of the maxillary sinuses are incidental findings in radiographs of the oral and maxillofacial structures. These cysts usually appear as rounded, dome-shaped, and soft-tissue masses, most often on the floor of the maxillary sinus. The aim of this study was to determine the prevalence of maxillary antral MRC and the effect of seasonal variation, sex and age in cone beam computed tomography (CBCT) images. Materials and Methods: In this simple, nonrandomized, cross-sectional study, CBCT images of patients were reviewed to evaluate the prevalence of MRCs and its location in the antrum, uni or bilateral, size, and season in which MRC occurred. The findings were analyzed using Statistical software SPSS and t-tests (P > 0.05). Results: A total of 765 CBCT images were evaluated (380 males and 385 females); 180 were suggestive of MRCs, 110 occurred in males (28.9%) while 70 (18.2%) occurred in females, which resulted in a prevalence of 23.5%. The peak prevalence of MRC was found in spring (41.6% of all radiographs), but there was no significant statistical difference between the occurrence of MRCs in different seasons (P > 0.05). Conclusion: This study showed no significant difference between the occurrences of MRCs in different seasons. There was no significant difference between male and female and different decades of life. Furthermore, there was no significant difference between the involvement of right and left maxillary sinuses and different walls of the antrum.

Background: The objective of the study was to estimate the fluoride content in regular food items available, including fish, in a coastal area of the South Karnataka state of India. Materials and Methods: Fish and food samples were collected from a local market, i.e., Deralakatte, Mangalore of Karnataka State, India. Commonly consumed different species of fish (eight types are included in the study) and popular food items (twelve types) were collected through a random sampling strategy and then processed for the study. The flesh and bones of fish were separated from individual fish. Samples of flesh, bones, and food (nonfish, vegetarian food consumed by a proportion of Karnataka population) were homogenized separately, dried, and the pH of the processed samples was adjusted to neutrality (pH 7.0). Fluoride anion was determined using a fluoride ion selective electrode (ISE, Nico2000 Ltd., UK). Although the ingredients of the different fish and food items explored differed, the same processing technique and analytical laboratory bench-work procedure were performed for each sample, i.e., as per published research elsewhere. This ensured the accurate estimation of fluoride for each food item. Results: Concentrations of fluoride in foods (Nonfish, vegetarian food) was estimated to ranging from 0.85 to 7.09 ppm and that in fish samples ranged from 1.45 to 2.30 ppm. The highest concentration was estimated 3.16 ppm in Rohu fish flesh, and 7 ppm in rava dosa (a vegetarian food). Conclusion: In conclusion, the Rohu (Labeo rohita) fish species were found to contain higher concentrations of bone fluoride. Fluoride determined in fish flesh was also high in concentration 2.28 ppm. Among the regular food items, rava dosa (a thin and crispy crepe made from rava and rice flour) preparation has a higher level of fluoride. These values would provide valid information regarding the future development of recommended dietary allowance strategy for a population.

Purpose: The purpose of this study is to evaluate the efficacy and retentiveness of various communication methods among speech and hearing impaired patients and dental practitioners. Materials and Methods: A group of 33 school participants were selected for this study. An experimental task required the participants to follow routine dental instructions in the form of videotape and photographic charts and answer the questionnaire based on visual instructions. School participants were visited two times at an interval of 1 month. Participants were randomly divided into three groups, each consisting of 11 school participants, irrespective of gender and age. Group 1 received visual instructions without showing video and charts, Group 2 received video instructions, and Group 3 received photographic instructions. The questionnaires were assessed immediately and after 1 month. Results: The study results were assessed in terms of improvement in knowledge concerning communication skills and long-term retention of the instructions for 1 month. ANOVA followed by post hoc Tukey test revealed a significant difference between Group 1 and other groups. However, there was no statistically significant difference between Group 2 and Group 3. The paired t-test revealed that there was a significant difference between the two visits in Group 1. However, there was no significant difference between visit 1 and visit 2 in Group 2 and Group 3. Conclusion: Health-care workers and patients with special needs like hearing-impaired patients should overcome communication barriers that may hinder proper diagnosis and treatment planning.

Background: Among the number of vital bleaching techniques currently available to the clinicians, home bleaching and in-office bleaching are widely used in dental practice. Aim and Objectives: The aim of this in vivo study was to compare the clinical performance, durability, and related tooth sensitivity with two vital bleaching procedures (in-office and at-home bleaching), in a split-mouth design. Patients and Methods: Thirty adult participants having teeth shade mean of A2 or darker were selected for the study. One-half of the maxillary arch of each patient received in-office bleaching with 35% hydrogen peroxide gel, and the other half received 16% carbamide peroxide night guard bleaching. Shade evaluation was done with shade guide and spectrophotometer at 1, 2, 3, and 4 week intervals during bleaching and postoperatively at 3 and 6 month intervals. Tooth sensitivity was recorded using the visual analog scale during the experimental period. Statistical Analysis: Collected data of color and sensitivity readings were subjected to statistical analysis using SPSS/PC version 20 software. Intergroup comparison through unpaired t-test and within the groups using paired t-test was done. Results: At-home and in-office bleaching procedures are equally effective in producing tooth whitening. Color evaluation after 3 and 6 months showed more color decline for in-office bleaching procedure. For sensitivity parameter also, in-office procedure recorded higher sensitivity compared to home bleaching (P < 0.05). Conclusion: Both the bleaching procedures are equally effective in producing tooth whitening. In-office bleaching recorded higher levels of tooth sensitivity and greater color rebound than home bleaching.

Purpose/Objectives: The objective of this study is to study the prevalence and associated risk determinants of early childhood caries (ECC) among preschool children. Materials and Methods: A cross-sectional descriptive study was designed to assess the ECC prevalence and associated risk factors among preschool children in Anganwadi of Nellore district using a standardized questionnaire. Results: A total of 550 study participants of age 2–6 years are enrolled in this cross-sectional study. Mean age of the participants was 4.39 ± 0.89 years. Most of the study participants (38%) were in the age of 5 years. When gender wise comparison was made girls represented 62% and boys 38% of the total population. When the risk factors were assessed for their association with caries experience, socioeconomic status, mother's schooling at child's birth, duration of using bottle, and bottle feeding while sleeping and plaque scores showed significant association with caries experience. Conclusion: ECC was more prevalent among 5-year-old children as compared to other age groups and moreover demographic factors such as mother's occupation, education, socioeconomic status, developmental characteristics such as enamel hypoplasia, feeding habits like prolonged and nocturnal bottle feeding and clinical parameters like plaque scores showed significant correlation with ECC.

Context: Bad breath causes embarrassment and affects interpersonal social communication. Morning breath odor is a commonly encountered oral problem which should be rectified with effective oral hygiene measure. Aim: The aim of this study was to assess and compare the effectiveness of different oral hygiene regimens on the reduction of morning bad breath, plaque formation, and gingivitis in healthy young adults. Settings and Design: A four-step, crossover clinical trial was conducted among 40 young adults aged 18–22 years residing in one of the nongovernmental organizations in New Delhi. Materials and Methods: Study participants were divided into four groups, which underwent intervention for 7 days each. Group 1: tooth brushing; Group 2: tooth brushing and mouthwashing; Group 3: tooth brushing and tongue scraping; and Group 4: combination of all. A washout interval of 14 days was employed in between the groups. Breath scores were measured at three time intervals whereas oral health status was recorded at the beginning and the end of each interventional period. Statistical Analysis Used: Appropriate tests such as paired t-test, ANOVA test, and Pearson correlation tests were used in the study. Results: The highest reduction in mean value of breath scores (2.03 ± 0.69) was found in Group 4 followed by Group 3. Similarly, Group 4 showed the highest reduction in mean value of plaque score (0.79 ± 0.19) and gingival score (0.54 ± 0.23) followed by Group 2. Conclusion: Combination of mechanical and chemical oral hygiene measures is an effective regimen for the reduction of morning bad breath.

Context: Ideal interaction of dental and facial beauty proportions highly influences a harmonious facial appearance. Racial anatomical variations have been significantly noted and using these norms during prosthodontic rehabilitation will be greatly helpful in successful treatment outcome. Aim: The present study aims to correlate various facial landmarks (interpupillary distance [IPD], intercanthal width, bizygomatic width [BZW], and interalar width) with intercanine distance (ICaD) in Indian young adults to determine the mesiodistal width of the maxillary anterior teeth in edentulous patients. Setting and Design: This is an observational cross-sectional study. Materials and Methods: This study was conducted in 500 individuals ranging in age from 18 to 28 years. IPD, intercanthal width, BZW, and interalar width were measured with a digital caliper (accuracy - 0.01 mm). A “T-” shaped flat metal plate called “canine tip marker” was made to mark the tips of the maxillary canines, which were further measured with the digital caliper. The data were summarized in table form and were statistically analyzed. Statistical Analysis Used: Student's t-test and ANOVA test were used. Results: A significant correlation (P < 0.001) was found between these landmarks with ICaD, in which interalar width shows highest degree of correlation (r = 0.639). ANOVA test showed that maximum number of individuals had < 5% variability range between actual values and calculated values of ICaD for all extraoral facial landmarks except intercanthal width. Conclusion: Combination of various facial and oral factors should be considered while selecting artificial teeth. Regression equations obtained can be well used during teeth selection to achieve a significant result.

Introduction: Dental caries is a multi-factorial, infectious disease, the prevention of which is based on multifaceted approaches. Chewing sugar-free gum has potential beneficial effects on dental health. Objectives: The aim of this study is to assess and compare the effectiveness of xylitol and polyol chewing gums on salivary Streptococcus mutans in 12–15 years old schoolchildren residing in hostels in Belgaum city. The acceptability of the two chewing gums was also assessed. Materials and Methods: Sixty children of 12–15 year age groups from three hostels, who fulfilled all the inclusion criteria, were included in this triple blind randomized controlled field trial. They were then randomly allocated into one of the three groups using lottery method. Xylitol chewing gum, polyol chewing gum and control group (no chewing gum). Patients were instructed to chew one pellet two times a day after meals for 5 min each for 30 days. Salivary samples were collected at baseline, 30 days after chewing gum use and 30 days after discontinuation, for microbiological analysis. The data were subjected to statistical analysis using SPSS software version 18. Results: Chewing 100% xylitol chewing gum 2 times a day for 5 min for 30 days can successfully reduce salivary S. mutans counts. The xylitol gum has shown a maximum benefit against salivary S. mutans when compared to polyol gum and control group. Conclusion: Xylitol-containing chewing gums can be used as an adjunct to regular home care preventive procedures to prevent dental caries.

Background: Periodontal disease, also generally called periodontitis or gum disease, is a chronic infection-induced inflammatory disease that causes tooth loss if not properly treated, and is considered as a modifying factor in systemic health. Gingival crevicular fluid (GCF) matrix metalloproteinase-8 (MMP-8) is an inflammatory marker found in periodontal pathologic conditions. Gingivitis, a nondestructive type of periodontal disease, can progress to periodontitis if left untreated. Therefore, assessing the level of MMP-8 with comfortable methods and no tissue intervention can determine the progression of the periodontal disease for a better treatment. Objective: The purpose of the present study is to determine the relationship between MMP-8 in GCF and periodontal disease. Setting and Design: This is a cross-sectional study that took place in West Sumatra, Indonesia from June to December 2013. Materials and Methods: This study involves 60 respondents who are divided into three groups based on the periodontal disease index. The samples consist of 20 healthy individuals, 20 with mild gingivitis, and 20 periodontitis initial. GCF was collected from each group. MMP8 level in GCF was tested by using ELISA technique. Statistical Analysis: Data were analyzed with SPSS version 17 Software. ANOVA test was used to determine the differences in average levels of MMP-8. Bonferroni post hoc test was used to discover which spesific means differed. Results: The level of MMP-8 is significantly different between the healthy group and mild gingivitis group, between the healthy group with mild periodontitis group, and also between groups with mild gingivitis and mild periodontitis (P < 0.05). Conclusion: The findings of this study can be used by practitioners of dentistry to establish a proper diagnosis and appropriate treatment of periodontal disease by measuring the scale of MMP-8, to prevent or to minimize further complication in periodontitis patients.

Introduction: Temporomandibular joint dislocation is described as the movement of mandibular condyle out of the fossa beyond its anatomical and functional boundaries causing pain and discomfort. It is often managed by conservative methods, but in long-standing, chronic conditions, surgical treatment is the only option. The goal of surgical treatment is to reposition the condyle and prevent further recurrences. Materials and Methods: This retrospective analysis involving a single center and a surgeon with 19 patients and 23 joint surgeries performed over a 10-year period. Patients who fulfilled inclusion and exclusion criteria and had earlier undergone surgical correction with hook-shaped miniplates and miniscrews fixed with or without bone grafts formed the study group. Results: In all, 12 were female (mean age, 41.9 ± 12.07 years) and the rest 9 were male (mean age, 39.8 ± 13.6 years), ranging from 32 years to 58 years. All patients had the dislocation for an average period of 19.26 ± 12.6 months before the surgery. The mean maximal mouth opening (without pain) preoperatively was 17.78 ± 2.13 mm (12–25 mm) while postoperatively it was 32.28 ± 3.17 mm (27–37 mm). There were no immediate or late surgical complications in the follow-up period that ranged from 8 to 37 months. Discussion: When proper case selection is employed and properly done, using hook-shaped miniplates with or without bone graft is more cost-effective, giving excellent short- and long-term effects. Conclusion: The results in this Indian population are very similar to that reported from other parts of the world.

Context: Dental students commonly face the problem of overhanging proximal margins and unsatisfactory proximal contact points (PCPs) while restoring Class II cavities in posterior teeth. Various matrix band systems are used in dental clinics to avoid such problems. Aims: The aim of this study is to compare the effects of two matrix band systems, circumferential matrix system and sectional matrix system on the PCPs and contours when restoring Class II cavities in posterior teeth. Settings and Design: This was a randomized controlled clinical trial done at College of Dentistry, Qassim University, Saudi Arabia. Subjects and Methods: Total 1200 Class II cavities in teeth were selected for this study. Treatment was done by senior undergraduate students. Cavities were randomly divided into two groups. Group 1: Total 600 cavities were restored using circumferential band system. Group 2: Total 600 cavities were restored using sectional band system. Teeth were restored either with the composite or the amalgam restoration. Contact points were evaluated. The presence or absence of proximal overhangs was assessed. Overhanging margins were categorized as positive overhangs, negative overhangs, and absent overhangs. Statistical Analysis Used: To identify the relationship between matrix band systems and other factors, Chi-square tests (χ²-tests) and Z-tests were used. Pearson correlation coefficient was computed and logistic regression analysis was carried out to assess variables that can affect proximal margins and contact points of final restorations. Results: All optimum contacts 389 (100%) were found in restorations done using sectional band system. A highly significant association was found between open contact points and negative overhanging margins with the use of circumferential matrix band system (P < 0.00). Conclusion: Sectional matrix band system has been found superior to circumferential matrix band system.

Context: Studies have been conducted to measure the fracture resistance of restored teeth with the current restorative materials. However, most of those studies disregard the cavity size as an influencing variable. Aims: To evaluate the fracture resistance of prepared and restored maxillary premolars with medium and large preparations. Materials and Methods: Seventy superior and sound premolars were randomly divided: G1 (control) – sound tooth; G2, G3, and G4 received a Class II mesial-occlusal-distal (MOD) preparation with an occlusal box width 1/3 of the intercuspal distance, and were restored with Filtek Z350 XT, IPS Empress Direct, and Charisma Diamond, respectively; G5, G6, and G7 received a Class II MOD preparation with an occlusal box width 2/3 of the intercuspal distance, and were restored with Filtek Z350 XT, IPS Empress Direct, and Charisma Diamond, respectively. After storage in water, at 37°C, the specimens were subjected to a fracture test under compression in a universal testing machine where the loads were applied vertically and at a speed of 0.5 mm/min. Statistical Analysis Used: Data were analyzed with two-way ANOVA and Tukey's multiple comparison post hoc test (P < 0.05). Results: G1 presented a fracture resistance significantly higher (P = 0.005) than any other experimental groups. Among the experimental groups, only G5 showed a significantly low fracture resistance (P = 0.019) when compared to the other groups. For the other resins, the change in intercuspal distance from 1/3 to 2/3 the intercuspal distance did not significantly reduce the fracture resistance (P > 0.05). Conclusions: The cavity preparation weakens the remaining tooth structure; however, its resistance could be partially restored using direct adhesive restorations.

Introduction: Forensic odontology necessarily involves the application of dentistry along with various other branches of sciences which deals with proper handling, examination, evaluation, and presentation of dental evidences, that aids to investigate a crime and deliver justice. Sex determination is a part of forensic odontology and an essential priority when traditional identification of the deceased becomes impossible. Aim: To determine Sex by analysis of the Amelogenin gene using Polymerase Chain Reaction (PCR) method on Deoxyribose nucleic acid (DNA) isolated from dental pulp, which was exposed to various environmental conditions created artificially to mimic a forensic scenario. Materials and Method: This in-vitro study was conducted by subjecting extracted teeth to various conditions imitating a forensic scene, viz. desiccation at room temperatures, immersion in salt water, burial in soil and even exposing to extremes of temperatures. DNA was extracted from dental pulp tissue and sex determination was achieved by amplification of the amelogenin gene through AMEL gene based primers in PCR. Result: Among all the samples used in this study, DNA could be extracted from all, except from those that were subjected to a temperature of 350 °C. DNA amplification and sex determination of the samples were found to be accurate when compared to sex of the individual which was recorded initially, during collection of teeth samples. Conclusion: This study shows teeth to be a potent source of DNA even in extreme environmental conditions, barring high temperatures and determination of sex by PCR amplification of AMEL markers to be quite reliable.

Purpose: The purpose of this study was to assess and compare the dimensional accuracy of the stone casts made of three extended pour alginate impressions materials (Cavex Colorchange, Kromopan, and Neocolloid) following storage under different storage conditions and pouring at different time intervals. Materials and Methods: A maxillary Frasaco (dentulous) model was selected as a standard model. Index holes of 1 mm depth and 1 mm diameter were made on the palatal cusp tips of right and left first premolars, mesiopalatal cusp tips of right and left third molars and in the midline of the palate, perpendicular to a line joining the index holes made on cusp tips of the first premolars as reference points for measurement. A single uniformly spaced custom tray was fabricated with heat-cure acrylic resin and used to make impressions for the entire study. A total of 210 impressions of the master model were made, seventy impressions were made from each of the alginate material brands and were subjected to three storage conditions (open air, uncontrolled humidity, and 100% controlled humidity) for three different storage time intervals (0, 1, 6 h). Since no storage was done in the immediate-pour group, it contained 10 specimens from each brand. Following the designated storage time interval, all impressions were poured in type IV gypsum. Measurements of stone casts were done in three dimensions, anteroposterior, lateral using Measuroscope and vertical by Dial Gauge. Data were organized in tables and statistical analyses were performed. Three-way ANOVAs were used to check if the material brands, storage time intervals, and conditions affect the measurements. Tukey HSD post hoc tests were used for the multiple comparisons if ANOVA is significant. One sample t-test was used to compare between the casts made of alginate brands and the master model. Significance level was set to α < 0.05 for all tests. Results: Results showed that the material brands, storage time intervals, and conditions do affect the measurements in all three dimensions (all P < 0.05). In addition, all two-way and three-way interactions were significant for all measurements except the interaction of storage time intervals and conditions for B–C (lateral) measurements, and interaction of material brands and storage time intervals for C–D (anteroposteriorly) measurements. When stone casts were compared to the master model, immediate pour, and storage for 1 h in 100% controlled humidity resulted in statistically insignificant changes among all three alginate impression brands. In addition, the specimens made of Cavex Colorchange and Kromopan following storage in uncontrolled humidity condition for 1 h showed statistical insignificance when compared to the master model. Conclusion: Within the limitations of this study, it can be extrapolated that, although this class of alginate impression materials was manufactured for extended pour purposes, clinicians should avoid storage of the studied brands for 6 h. Whenever 1 h to pour is necessary, 100% controlled humidity is the ideal and standardized environment for all three alginate brands. Perhaps, Cavex Colorchange, and Kromopan can be safely stored in uncontrolled humidity condition while maintaining their optimal dimensional accuracy.

Purpose: The purpose of this study was to assess and compare the dimensional accuracy of the stone casts made of three extended pour alginate impressions materials (Cavex Colorchange, Kromopan, and Neocolloid) following storage under different storage conditions and pouring at different time intervals. Materials and Methods: A maxillary Frasaco (dentulous) model was selected as a standard model. Index holes of 1 mm depth and 1 mm diameter were made on the palatal cusp tips of right and left first premolars, mesiopalatal cusp tips of right and left third molars and in the midline of the palate, perpendicular to a line joining the index holes made on cusp tips of the first premolars as reference points for measurement. A single uniformly spaced custom tray was fabricated with heat-cure acrylic resin and used to make impressions for the entire study. A total of 210 impressions of the master model were made, seventy impressions were made from each of the alginate material brands and were subjected to three storage conditions (open air, uncontrolled humidity, and 100% controlled humidity) for three different storage time intervals (0, 1, 6 h). Since no storage was done in the immediate-pour group, it contained 10 specimens from each brand. Following the designated storage time interval, all impressions were poured in type IV gypsum. Measurements of stone casts were done in three dimensions, anteroposterior, lateral using Measuroscope and vertical by Dial Gauge. Data were organized in tables and statistical analyses were performed. Three-way ANOVAs were used to check if the material brands, storage time intervals, and conditions affect the measurements. Tukey HSD post hoc tests were used for the multiple comparisons if ANOVA is significant. One sample t-test was used to compare between the casts made of alginate brands and the master model. Significance level was set to α < 0.05 for all tests. Results: Results showed that the material brands, storage time intervals, and conditions do affect the measurements in all three dimensions (all P < 0.05). In addition, all two-way and three-way interactions were significant for all measurements except the interaction of storage time intervals and conditions for B–C (lateral) measurements, and interaction of material brands and storage time intervals for C–D (anteroposteriorly) measurements. When stone casts were compared to the master model, immediate pour, and storage for 1 h in 100% controlled humidity resulted in statistically insignificant changes among all three alginate impression brands. In addition, the specimens made of Cavex Colorchange and Kromopan following storage in uncontrolled humidity condition for 1 h showed statistical insignificance when compared to the master model. Conclusion: Within the limitations of this study, it can be extrapolated that, although this class of alginate impression materials was manufactured for extended pour purposes, clinicians should avoid storage of the studied brands for 6 h. Whenever 1 h to pour is necessary, 100% controlled humidity is the ideal and standardized environment for all three alginate brands. Perhaps, Cavex Colorchange, and Kromopan can be safely stored in uncontrolled humidity condition while maintaining their optimal dimensional accuracy.

Objective: The aim of this systematic review was to assess the long term remineralizing potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) only in paste form compared with fluoride varnish, and or placebo in both naturally occurring and post-orthodontic white spot lesions in vivo. Data Sources: The literature search covered the electronic databases: PubMed and Google scholar from 2005-2016. Only articles published in English were included. Randomized control trials in which CPP-ACP delivered by paste form were included. All studies which met inclusion criteria underwent two independent reviews. Study Selection: Two ninety five articles were identified from the search after excluding duplications. Abstracts of forty one articles were reviewed independently. Twenty nine articles were excluded after reading abstract. Full text articles were retrieved for fifteen relevant studies. After reviewing articles independently, three articles were excluded after full text reading. Finally twelve studies were selected based on the eligibility criteria. The remineralizing effect of CPP-ACP were compared with placebo and fluoridated toothpaste and fluoride varnish in randomized control trial. Conclusion: A high level evidence of remineralizing potential of CPP-ACP on naturally occurring white spot lesion and WSL post orthodontic treatment was found in comparison with placebo/fluoridated toothpaste and fluoride varnish without any statistically significant difference. Well-designed RCTs are, therefore, required to improve the level of evidence in this area.

Context: India suffers from a heavy burden of oral diseases. Dental implants (DIs) are prescribed widely by the dental practitioners to replace lost natural teeth. There is no estimate, however, to determine the number of DIs or the number of people with peri-implantitis or the failure of implants after placement. In this modeling study, we attempted to estimate the prevalence of adult Indians who would choose DI in the near future and to calculate the peri-implantitis and failure of DI. Materials and Methods: Using the Global Burden of Disease database (2016), the number of dental caries in permanent dentition, periodontal diseases, and edentulism was obtained. Empirical assumptions of patients with anodontia in urban and rural areas who opted for DI, percentage of implants placed, the affordability factors, and mathematical models for DI were formed and executed. Peri-implantitis and survival data from literary evidence were collated. Results: Based on assumptions, 909,643 Indians, (830,231–858,703) would choose DI. Estimated number of peri-implantitis would be 145,543–254,700 and estimated number of failures should be 50,940–79,412 in the near future. Conclusions: In spite of the high economic challenge and the risks or complications of peri-implantitis, DIs are gaining prominence. It is the dentists' burden to face the renewed challenges due to emerge and provide remedial measures.

Photography has always been an integral part of dentistry. The journey goes back to the time when film photography was used only for documentation and referral purpose which has now evolved to digital photography. Its application in dental practice is simple, fast, and extremely useful in documenting procedures of work, education of patients, and pursuing clinical investigations, thus providing many benefits to the dentists and patients. The article describes the added benefits of digital dental photography over film photography, basic armamentarium for obtaining good photographs, and how digital dental photography is beneficial in the field of prosthodontics.

Fibrolipoma is a benign tumor which is classified as a histological variant of conventional lipoma. It rarely occurs in oral and maxillofacial region. When present, it occurs as a soft, smooth surfaced nodular mass that can be pedunculated or sessile. Most of the lesions are less than 3 cm in size, although it may vary. Fibrolipomas mostly affect buccal mucosa and buccal vestibule and cause functional and cosmetic disabilities. Herniation of buccal pad of fat caused by trauma may also mimic lipoma. Hence, accurate histopathological examination of lipomas is important for a correct treatment plan. Here, we present 2 cases of oral fibrolipoma that presented on the retromolar triangle area and alveolar ridge in relation to missing maxillary right first molar.

Little research has been performed on tomographic observations of the dental development anomaly known as enamel pearl. This article presents a clinical case report in which enamel pearl was detected through cone beam computed tomography (CBCT). In this study, a patient was referred to undergo a CBCT of the left maxillary molar region, due to the patient's pain symptoms in this region. The CBCT showed the existence of an enamel pearl in tooth 27. A precise diagnosis made it possible for the patient to begin the preventive treatment against periodontal disease in tooth 27.

This article reports an innovative technique in the treatment of a central incisor with a wide open apex and parallel dentinal walls. Root canal treatment was initiated, and calcium hydroxide intracanal medicament was placed in the canal for a month. The intracanal medicament was removed by instrumentation and irrigation with 3% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. A light body impression of the root canal space was made and replicated the three-dimensional root canal space in a putty impression. Mineral trioxide aggregate (MTA) was condensed into the impression and allowed to set for 24 h in the presence of moisture to obtain a BioRoot inlay. This BioRoot inlay was cemented into the canal. Follow-up of every 6 months for 4 years revealed clinically asymptomatic and satisfactory healing of periapical lesion.

Carcinoma cuniculatum (CC) is a rare variant of squamous cell carcinoma (SCC). Only 27 cases have been published in English. A 50-year-old male, who presented a white nodule with erythematous areas, localized in the lateral border of the tongue with 2 months of duration. The patient presents oral lichen planus lesions on the tongue, commissure, and buccal mucosa. The microscopy evaluation of the nodular lesion of the tongue revealed a malignant epithelial neoplasia characterized by cuniculatum architecture, similar in appearance to “rabbit burrows” and the final diagnosis was of CC. The management of CC needs cooperation between surgeons and pathologists to establish a correct diagnosis and treatment. CC is a rare entity and must be recognized by oral pathologist so that it is not misdiagnosed as verrucous carcinoma or oral SCC (OSCC). Regarding prognosis, CC must be evaluated and distinguished from other variants of OSCC.

Background: Developmental anomalies in the number of teeth can result from disturbances in the developing dental lamina of the tooth. The dental lamina may become hyperactive leading to the formation of a supernumerary tooth or may fail to proliferate leading to the congenital absence of a primary or permanent tooth. Aims: The aim of the study was to assess the prevalence and distribution of hypodontia and hyperdontia in permanent dentition, excluding the third molars in children in Vadodara, Gujarat. Setting and Design: A descriptive, analytical, and cross-sectional study was conducted to determine the above-mentioned aims. Materials and Methods: In the study, panoramic radiographs of 1816 children (967 girls and 849 boys), aged 8 to 14 years were recorded and inspected for anomalies in the number of teeth. Statistical Analysis Used: The data was analyzed using SPSS version 10.00 (Statistical Package for the Social Sciences, Chicago, USA). Descriptive statistics and Chi-square-test were used to compare the results. The level of significance was set at 0.05. Results: The prevalence of hypodontia was 11.01%, and the most frequently absent tooth was the maxillary lateral incisor. There was an increased prevalence of hypodontia in females and in the mandibular arch of the permanent dentition. The prevalence of hyperdontia was 2.97% and the most common supernumerary tooth was mesiodens. There was an increased prevalence of hyperdontia in males and in the maxillary arch of the permanent dentition. Conclusions: There was a high prevalence of hypodontia and a low incidence of hyperdontia in the studied population. Prompt diagnosis of these anomalies can help plan treatment modalities at an early age to establish a functional and esthetic dentition.

Background: Hypertension is an important worldwide public health challenge because of its high frequency and risk of cardiovascular and renal disease. Objective: The objective of this study was to investigate the prevalence of undiagnosed hypertension as well as inadequately controlled hypertension among general population who sought tooth extraction at Army College of Dental Sciences, Secunderabad. Materials and Methods: Only 1200 patients in the age group of 20–60 years who sought tooth extraction were included in the study. Blood pressure (BP) was measured for three times in all patients. The readings were quantized into four categories which included normal, prehypertensive stage, and Stage 1 and Stage 2 of hypertension. The BP was assessed for the following variables – gender, habits of gutkha chewing, smoking and alcohol, regular exercise, age, and effect of local anesthesia. Results: Nearly 24.4% of new cases of hypertension were diagnosed among all participants reported to the dental clinic. After giving local anesthesia, 16.71% increase in BP was observed in Stage 1 and 2.35% increase in Stage 2 hypertension. Conclusion: This study reveals that dentists play an important role in the early diagnosis of hypertension of many dental patients who are unaware of being hypertensive. This role should be emphasized in our specialty as a standard of care to prevent life-threatening complications.