Aim and objective: The aim and objective of this study was to compare the quality of the coronal seal of four different types of restorative material on the endodontically treated teeth. Materials and methods: A total of 112 extracted permanent lower premolars were endodontically prepared and divided into four groups (n = 28). Each group received different types of coronal restoration. Group I, glass ionomer cement Fuji IX (GC International, Japan), Group II, nano-hydroxyapatite-silica glass ionomer cement (Hospital Universiti Sains Malaysia), Group III, Smart Dentin Replacement (SDR™) (Dentsply, Konstanz, Germany), and Group IV, Zmack microhybrid universal resin composite (Zhermack SpA, Italy). Twenty-six samples from each group were then covered with two layers of nail varnish except at the restoration site, while two control samples were totally covered, including the restoration site. The samples were further divided into 2 groups of 13 samples and 1 control, each. They were immersed in the 2% methylene blue dye solution for 7 and 30 days, respectively. All samples were sectioned in a vertical direction, and dye penetration depth was measured. Data analysis was carried out using one-way analysis of variance. Results: A significant difference in sealing ability was observed (p < 0.05) with Group IV demonstrating the best sealing ability followed by Group III, Group II, and lastly Group I in dye penetration tests. The gap width between the dentin wall and restorative material in Groups III and IV was minimal compared to Groups I and II. Conclusion: Group IV (Zmack universal composite) demonstrated better coronal seal compared to silicate glass powder-based restorative materials. Clinical significance: The use of Zmack universal composite in the endodontically treated tooth can be superior in providing better coronal seal and closest adaption to the access cavity wall.

Aim and objective: The aim and objective of this study was to investigate the contact time effect of 1 minute and 3 minutes of 0.5% chitosan nanoparticle as a final irrigation solution on microhardness and surface roughness of root canal dentin. Materials and methods: This study was divided into two experiments, namely microhardness and surface roughness. Both experiments used 56 mandibular premolars, which assigned to 28 teeth of each study. Twenty-eight teeth were then divided randomly into two groups of 14 teeth. Group I was final irrigated using 17% ethylenediaminetetraacetic acid (EDTA) and group II with 0.5% chitosan nanoparticle. Each group was further assigned into two groups of seven each according to the contact time, group I, 1-minute and group II, 3-minute contact time. The microhardness test was carried out using the Vickers microhardness tester while the surface hardness test using the surface roughness measuring instrument. The data from each study were statically analyzed using two-way ANOVA followed by the least significant difference (LSD) test with a significance level of 95%. Results: Contact time of 1 minute using 0.5% chitosan nanoparticles produced the greatest microhardness and lowest surface roughness of root canal dentin, while contact time of 3 minutes using 17% EDTA had the lowest microhardness and highest surface roughness (p < 0.05). Conclusion: The contact time of 1 minute using 0.5% chitosan nanoparticle caused the least effect on the microhardness and surface roughness. Clinical significance: The findings of this study revealed that contact time of 1 minute using 0.5% chitosan nanoparticle caused the least effect on both microhardness and surface roughness. Thus, the contact time of 1 minute is suggested to be employed when using 0.5% chitosan nanoparticle for the final irrigation solution in the clinic.

Aim and objective: The aim and objective of this study was to investigate the factors that influence the choice of specialty and career preferences in dental students and interns in their clinical years. Materials and methods: This cross-sectional study was performed in the 5th-year and 6th-year dental students and interns at Taif University in Saudi Arabia. A self-administered questionnaire was formulated and sent electronically to the students via faculty e-mail. The responses were recorded on a Google spreadsheet, and the data were analyzed using SPSS for Windows. Results: The majority of dental students expressed a preference for pediatric dentistry and restorative and esthetic dentistry. The main factor influencing their choice was the local shortage of dentists in these specialties. Negative experiences of students, their peers, or faculty members also affected the students’ career choices. Conclusion: This study provides baseline data for establishing plans to improve graduate programs in Saudi Arabia. Mentoring initiatives are needed to provide guidance and encouragement for undergraduate dental students when selecting the most appropriate future specialty. Clinical significance: The choice of dental specialty is a challenge for dental students and is affected by many factors. The knowledge of the factors that influence their choice of specialty would help when addressing the requirements of job market.

Aim and objective: A number of research projects are done and papers are published in different disciplines. To evaluate their scholarly effect, a bibliometric study is very useful. The present study is aimed at identifying and characterizing the 100 most cited articles on dental stem cells. Materials and methods: The Science Citation Index-Expanded tool of Scopus database was used to prepare a list and record the 100 most cited articles on dental stem cell studies on October 15, 2019. Assessments of the articles were done to note down the general details and facts required for bibliometric and citation studies. The software named VOSviewer was used to develop and record a network of collaboration among countries, authors, and keywords. Results: The articles were published from 2002 to 2017. The most highly cited article received 333 citations, whereas the least was cited 22 times (mean citations 65.76 ± 57.28). A total of 68 journals were involved in publication of the studies on dental stem cells, which were mostly cited. The United States was leading in publication of articles (n = 32) and China was second with 15 publications. The inspection of the document types revealed that there were 59 original research and 39 review papers. A total of 62 out of the 100 most influential articles were funded by 41 organizations. Seoul National University (South Korea) affiliated the most documents (n = 8). Conclusion: This citation analysis gives an overall general view of the progress and the different kinds of research projects happening in the field of dental stem cell studies. Clinical significance: The top 100 list selected in this present study will benefit the researchers and scientists in marking the significant areas of research in the field, which will guide them in their upcoming studies and research works.

Aims and objectives: The relationship between nutrition and oral health in geriatric patients is controversial and complex. It has been suggested that poor oral health leads to a decreased ability to chew having profound influence on diet, food selection, and therefore affect the nutritional status of an individual. This study aimed to evaluate the effect of edentulousness on the nutritional health of geriatric patients. Materials and methods: A total of 200 completely edentulous geriatric patients were selected for the study. The nutritional status was assessed using the mini-nutritional assessment (MNA) form before the complete denture treatment. The individual scores obtained for each question based on which the total score was determined. Correct responses of each question were calculated in percentage. Results: The results showed statistically insignificant differences in the total MNA scores between males and females in the study. The edentulous patients without complete dentures had significantly lower MNA scores and 88.5% of the study group were at risk of malnourishment. Conclusion: Prosthetic rehabilitation of the edentulous subjects, along with the dietary counseling can improve the nutritional status of geriatric complete denture patients as it will enhance the chewing ability and function. Clinical significance: Early assessment of nutritional status in completely edentulous patients can permit an early nutritional intervention when necessary so as to prevent malnutrition.

Aim and objective: The aim and objective of this study was to investigate the effect of reinforcing metal patterns on the midline fracture resistance of maxillary complete denture bases in various palatal contours. Materials and methods: Sixty maxillary acrylic heat cure denture bases were made. They were subdivided into three groups depending on the palatal vault shape. Further, the groups were subdivided based on the metal pattern design. Three metal pattern designs are used in this study, and the metal patterns are made from 23-gauge stainless steel round wire. The maxillary wax patterns were processed, and metal patterns were reinforced in the packing stage. The denture bases were finished and polished. The samples were checked for inclusion and exclusion criteria. The samples were tested under universal testing machine. The value at which the denture bases fractured were noted down. Results: Variance analysis test has been done to evaluate the significance. Tukey post hoc test was done to evaluate pairwise analysis of metal patterns and different palatal vault on each other. A significant difference (p value < 0.05) was seen in the fracture resistance value of control group and the reinforced metal group denture base. Among the design of the metal pattern, square-shaped pattern had a significant(p value < 0.05) difference in all the palatal vault shape. Conclusion: The reinforced denture bases with metal patterns had a significant increase in fracture resistance values of the denture bases in all the three palatal vault shapes. Therefore, metal patterns can be used to improve the fracture resistance. Clinical significance: Metal patterns can be used in clinical cases where shallow and deep palatal vaults is present to reinforce the complete denture prosthesis. By this method reinforcement can be done at a low cost without effecting the esthetics of the dentures.

Aim and objective: The current study aimed to propose Aquaporin-1 (AQP1) as an endothelial marker and thus explore its role in oral squamous cell carcinoma. Materials and methods: The study included 30 cases of oral squamous cell carcinoma (OSCC) and 10 normal controls. All the sections were subjected to immunohistochemistry using AQP1 antibody. Images were captured, and quantification of blood vessels was done by assessing the mean microvascular density (MVD) using an image analyzer, and statistical data were computed using one-way analysis of variance test. Results: The results demonstrated a significant expression of AQP1 in blood vessels of tumor and showed a significant statistical correlation (p value < 0.05) between mean vascular densities of controls and OSCC cases. Conclusion: The results have demonstrated a strong immunolocalization of AQP1 in the tumor vasculature, thereby proposing it as a selective marker for the endothelium and suggests its possible involvement in tumor angiogenesis, growth, progression, and prognosis. Clinical significance: Angiogenesis is a crucial phenomenon in tumor progression. Aquaporin-1 is a proven marker for the endothelial vasculature, and being a functionally efficient protein associated with the progression of tumor through tumor angiogenesis, its blockade can serve in the downregulation of tumor progression.

Aim: The present study aimed to assess the dimensions of alveolar ridge using different techniques before placement of implant. Materials and methods: Totally 20 patients were chosen for this study. The study was divided into three groups based on the method of measurements of width of alveolar ridge, and all the procedures were performed in all the groups. Group I: Using cone-beam computed tomography (CBCT), group II: ridge mapping dimensions before reflection of surgical flap, group III: direct caliper measurements after surgical exposure of the bone. A transparent acrylic resin stent was made on the study model with reference points. The reference points were seen over the stent through the clear acrylic resin. Results: The mean alveolar ridge dimensions were 4.20 ± 1.80 mm, 3.89 ± 2.24 mm, and 4.24 ± 0.94 mm with the use of CBCT, ridge mapping dimension before surgical flap reflection, and direct caliper measurements after surgical exposure of the bone, respectively, at point 1; and 7.68 ± 1.46 mm, 6.10 ± 1.88 mm, 6.90 ± 1.32 mm, respectively, at point 2. A statistically significant difference was found between the groups at point 2 by an analysis of covariance. Also, the difference between groups I and II was statistically significant. Conclusion: Within the limitations of this study, it was concluded that CBCT and ridge mapping measurements when compared individually with the gold standard surgical open method, CBCT proved to be a highly specific and sensitive method detecting the residual alveolar ridge width in the treatment planning of dental implants. Clinical significance: Implants have become the imminent replacement option for missing teeth. The surgical procedure necessitates a prior knowledge of the surgical site and planning of treatment. Measurement of the residual alveolar bone dimensions is an important precondition for placement of dental implants and their success.

Aim: To evaluate and compare the effectiveness of locking vs conventional 2.0 mm titanium miniplate in the fixation of mandibular fractures and to compare masticatory efficiency. Materials and methods: In this study, 30 patients were selected and randomly divided into two groups (I and II). Both groups I and II consisted of 15 patients who underwent mandibular osteosynthesis using locking and conventional (non-locking) 2-mm miniplates, respectively. Postoperative follow-up was done at first, second, fourth week, and at third month for radiological and clinical assessment of all the patients. Results: In this study, a statistically insignificant result was found in the following parameters: pain, swelling, paresthesia, infection, hardware failure, and postoperative occlusal bite forces. An increase in bite force is recorded at each follow-up (first, second, fourth week, and at third month) for both the groups. When occlusal bite forces were compared, group I showed greater mean bite force than group II at each follow-up, however, the results were statistically insignificant (p value > 05). Conclusion: This study concludes that both locking and conventional miniplates are equally effective in withstanding masticatory load, with locking plates/screw system having added advantage of higher initial stability and stiffness thereby minimizing the duration of IMF. Locking miniplates system was found to have less infection and hardware failure. Clinical significance: In this study, locking plate group was found to be clinically superior because of ease of handling, higher initial stability, and stiffness, hence minimizing the total duration and had less infection and failure.

Aim: To evaluate the viability of human periodontal ligament (PDL) cells in honey when used as a storage media at different time intervals. Materials and methods: Fifty freshly extracted human premolars were divided into four experimental groups: group I: stored in honey immediately after extraction; group II: stored in honey after 30 minutes extraoral dry time; group III: in Hank's balanced salt solution (HBSS) immediately (positive control); and group IV: bench-dried for 8 hours with no media (negative control). Groups I, II and III were further divided into three subgroups, to test viability at different time intervals of 3, 6, and 24 hours. The PDL tissue derived was subjected to the trypan blue dye exclusion test. The number of viable cells was estimated with a hemocytometer and the data were statistically analyzed, and the level of significance was kept at p < 0.05. Results: Groups I and III showed no statistically significant difference in percentage of viable PDL cells after 3 hours (p = 0.339) and 6 hours (p = 0.142), and group II had a statistically lower percentage of viable cells compared to groups I and III (p < 0.001). After 24 hours, group III had highest percentage of viable cells. Group IV had a consistently lower percentage of viable cells. Conclusion: Within the limitations of this study, it appears that honey may be as efficient as HBSS for storage of avulsed teeth up to 6 hours. Clinical significance: Commercial honey meets most requirements of an ideal storage media. Being more readily available, inexpensive, and having several therapeutic properties can make it a popular storage media for short duration of storage.

Aim: In order to reduce orthodontic treatment time, numerous procedures such as systemic and local drug administration, mechanical and physical stimulation, and certain surgical procedures are being used. The aim of this study was to evaluate the clinical and biochemical effects of piezocision in a recently extracted site on the rate of canine retraction. Materials and methods: Patients who required bilateral extraction of maxillary premolars were selected and piezocision was carried out on one side immediately after extraction followed by canine retraction using nearly 150 g of force. The rate of tooth movement was measured on dental study casts. Alkaline phosphatase and acid phosphatase levels in the gingival crevicular fluid (GCF) were used as indicators of bone turnover. Results: The rate of tooth movement was higher on the piezocision side despite recent extractions on both sides. This was supported by concomitant changes in enzyme levels in the GCF. Conclusion: The piezocision in recently extracted site increases the rate of tooth movement compared with that of the non-piezocision site. This increased rate of tooth movement was substantiated with the elevated enzyme levels indicating increased bone turnover with piezocision in a recent extraction site. Clinical significance: Piezocision in a recently extracted site can be used as an aid to accelerate tooth movement, which would reduce the overall treatment duration. The procedure would be highly beneficial especially in adult patients seeking orthodontic treatment.

Aim: To evaluate the prevalence of traumatic dental injuries (TDIs) among children with visual impairment in residential schools of Bengaluru, Karnataka, and the dental perceptions of parents/caregivers on its management. Materials and methods: Two-hundred and twenty-one children with visual impairments within 8–14 years of age were randomly selected from three schools for the visually impaired in Bengaluru, Karnataka, and were examined clinically. Dental perspectives of the parents/care providers of these children with tooth fractures were conducted through a brief, unstructured, and an informal in-depth interview. Results: 36 among the 221 children had characteristic TDIs. Crowding, spacing, and diastema were observed in only 1 child (2.78%) and increased overjet was observed in 23 children (63.89%). 23 (63.89%) children had class I and 13 (36.11%) had class II malocclusions, respectively. The most affected teeth by dental trauma were the maxillary incisors. 13 (36.11%) children had class I fractured teeth, 16 (44.44%) had class II, 5 (13.9%) had class III, and only 2 (5.56%) had class 1V type of fractured teeth. Of the 36 children who had dental fractures, 29 (80.55%) had fractured their teeth due to fall, 2 (5.56%) due to collision, and 5 (13.89%) did not know the cause for their fractured teeth. The parents and caregivers could not give an adequate dental history for their child's traumatized teeth; wherever they could, the parents and caregivers were not willing to provide prompt dental treatments, stating the child's blindness as a reason for their avoidance of dental treatments. Conclusion: In the present study, none of the children received any form of treatment for their fractured teeth and malocclusion. The parents and caregivers of the children were of the popular opinion that the dental treatments were not a priority since the child is visually impaired. Clinical significance: Adequate oral care specifications and preventive procedures are of prime concern which should be instituted early on, with the dental health professionals providing coaching to the school employees and the parents/care providers to encourage quality oral hygiene and guide them in gaining admittance to adequate and timely dental aid.

Aim: To demonstrate the use of multilayered platelet-rich fibrin (PRF) membranes as a barrier membrane in the guided bone regeneration (GBR) procedure. Background: Ridge deformities, defects, and insufficient volume at the intended implant sites are common challenge. Simultaneous implant placement along with GBR gives benefits of reduced treatment cost, time, and need of additional surgical procedure. Platelet-rich fibrin has a versatile nature and is a regenerative tool in both hard and soft tissue surgery. This case report presented an alternative approach using PRF as a membrane (multilayered) in GBR to correct buccal wall defect in conjunction with implant placement. Case description: A 23-year-old male was referred for rehabilitation of edentulous area concerning to 32 and 33 regions. After clinical and radiological evaluation and discussion of various treatment modalities, GBR with simultaneous implant placement was planned. Ridge augmentation was done in defect using sticky bone formed by bio-oss bone granules of particle size 1.0–2.0 mm and PRF membranes after implant placement. A proper surgical procedure was followed and postoperative follow-up was done from time to time. Conclusion: Sufficient bone volume was achieved through GBR as shown clinically at second-stage surgery done after 4 months. Three years’ follow-up reveals stable implant prosthesis and healthy interdental papilla and gingival tissue. The multilayered PRF membrane is safe, more economical, and may be feasible as a barrier membrane and could be used in some selected scenarios. Clinical significance: Platelet-rich fibrin membranes can act as resorbable barrier and allow faster healing, improve bone formation, provide soft tissue regeneration, and improve the soft tissue profile.

Aim: This series of three cases aims to evaluate the clinical outcome of management of grade III furcation involvement in both maxillary and mandibular molars with bone graft and collagen membrane followed up for 18 months. Background: The prevalence of periodontal disease is increasing worldwide. Successful periodontal therapy aims to regenerate the lost periodontal structures. Management of teeth with furcation involvement often poses a challenge to clinicians. There exists dilemma of whether to extract the tooth or to adapt regenerative periodontal measures owing to the lack of predictable outcome. Case description: Three patients, 48-year-old male, 54-year-old male, and 38-year-old female, diagnosed with grade III furcation in 16, 26, and 47, respectively, were treated with osseous graft and guided tissue regeneration (GTR) membrane (Periocol) following curettage and root planing. Postoperative instructions were given to all the patients to use chlorhexidine mouthwash (10 mL of 0.2%) 2 times a day for 6 weeks and to clean the surgical area with 0.2% chlorhexidine-soaked cotton and to avoid brushing the surgical area for 1 week. Follow-up was done for 18 months. A satisfactory functional clinical outcome was observed in all the three patients. Conclusion: Although several factors such as patient-related and surgical site-related could play an influential role in the final outcome of GTR procedure, the present case series reports a satisfactory clinical outcome in periodontally hopeless teeth. Clinical significance: Treatment of periodontally compromised teeth should not only be confined to extraction but also regenerative periodontal therapy in properly selected cases could prove to be beneficial to the patients.

Aim: To review on the current preventive and nonaerosol-generating practices available for a pediatric dentist. Background: Life of a dentist revolves around air turbine drills and ultrasonic devices. COVID-19 spreads through respiratory droplets and through contact routes. Dental instruments generate high amounts of aerosols with contaminated saliva and blood, which would be hazardous to the dentist and the other healthcare workers and which can have serious implications on cross-infection and disease transmission. Air turbine drills help in improved efficiency and reduced chairside time. Until it is safe to go back to full-fledged air turbine tooth preparation, there are some alternative options that can be used to treat patients, which could avoid the use of such aerosol generation. Review results: The treatment modalities include instruments and devices that do not make use of air turbine drills and hence can be called nonaerosol-generating procedures. Some of the procedures include hand scaling, atraumatic restoration treatment, silver diamine fluoride application, extraction, and others. Conclusion: The abovementioned procedures are minimally invasive and can be considered as a best suitable option in this current situation when treatment is required. Clinical significance: This review suggests the treatment modalities to be done considering the COVID-19 pandemic that involves cross-contamination in pediatric dentistry.