Aim and objective: To design a simple low weight and energy consumption chewing machine, able to implement main characteristics of the masticatory process during testing and study some modern materials from various groups: polymers, composites, and metals. Materials and methods: A chewing machine that allowed imitating to a high degree of approximation to the real masticatory process in an abrasive medium the movement of test dental crowns made of polymers PEEK and PMMA, metals ZrO₂ and Zirconia Prettau, and composites Trinia and Ambarino was designed for research. Dental crowns made of the test material were glued to incisal pins, which were screwed into the rods fixed on the carriage. The lower rods with the attached incisal pins and dental crowns were placed in a container with abrasive material. The carriage, alongside the rods and incisal pins with crowns, performed the reciprocating motion, for which a slider-crank mechanism with an electric drive was used. The press force on the test samples during each cycle was controlled using strain-gauge instrumentation and recorded in the computer memory. Results: It was found that at the end of the study, the difference between relative changes before and after the experiment in the weight of dental crowns made of Trinia composite was 5.32% less than dental crowns made of Ambarino; PMMA polymer was 6.057% less than dental crowns made of PEEK; zirconium dioxide ZrO₂ was 0.46% less than dental crowns made of Prettau zirconium. Conclusion: An effective design of low energy consumption and weight chewing machine has been developed, which helped to study the wear resistance of some widely used materials. Clinical significance: The research findings allow a more reasonable approach to the choice of materials to develop various dental structures.

Aim and objective: This study aims to assess gingival crevicular fluid levels of sclerostin before and after nonsurgical periodontal therapy in smokers and nonsmokers with chronic generalized periodontitis. Materials and methods: Subjects with generalized chronic periodontitis were divided into two groups: Group I—nonsmokers with chronic periodontitis (n = 18) and group II—smokers with chronic periodontitis (n = 18). Baseline clinical parameters were recorded and a GCF sample was collected for assessment of sclerostin levels. All the patients received nonsurgical periodontal therapy. GCF sampling and clinical periodontal measurements were repeated 4 weeks after completion of SRP. Sclerostin levels were analyzed using an enzyme-linked immunosorbent assay (HUMAN SOST ELISA KIT). The data were tested statistically by the Student's t-test: Intragroup analysis was done using paired t-test and intergroup was done using independent t-test. Results: Probing pocket depth and clinical attachment loss were decreased significantly in both smokers and nonsmokers after nonsurgical therapy. The levels of sclerostin were higher in the smoker group when compared with nonsmokers. The mean sclerostin levels in smokers and nonsmokers at baseline were 354 ± 141 and 164.87 ± 59.8 pg/mL, respectively. There is a significant decrease in sclerostin levels from (164–136 pg/mL) in nonsmokers after nonsurgical therapy (p = 0.001). Conclusion: Sclerostin levels were significantly higher in smokers when compared with nonsmokers at the baseline and exhibited persistent higher levels even after periodontal therapy in smokers. Clinical significance: Sclerostin is an osteocyte secreted soluble antagonist of the wnt/β catenin signaling pathway which is a requisite for osteoblast development and osteogenesis. Increased sclerostin levels in smokers increase and hasten periodontal destruction. Therefore, sclerostin can be a promising therapeutic target for control of osteoclastic activity and promotion of osteogenesis in chronic periodontitis and more so in smokers.

Aim and objective: The study aimed to compare temperature increase on the external root surface in coronal third, middle third, and apical third of teeth during mechanical instrumentation and thermoplasticized gutta-percha obturation using resistance temperature detector (RTD) probes. Materials and methods: A total of 72 extracted mandibular premolar teeth were selected based on predetermined inclusion and exclusion criteria and randomly divided into two groups for measuring the temperature change by placing probes at coronal third, middle third, and apical third of external root surface during instrumentation with PTG and WOG, respectively. Both the groups were further subdivided into two subgroups consisting of 18 teeth each and temperature was recorded at three-thirds during thermoplasticized obturation with RTD during the Thermafil obturator system and E&Q injection system. The recorded temperature was statistically analyzed to evaluate the highest temperature rise during different procedures. Results: The temperature rise during biomechanical preparation was higher with ProTaper Gold, at the middle third of root surface, followed by an apical and coronal third than WaveOne Gold. Among both thermoplasticized obturation, temperature rise with E&Q injectable system was highest, at apical third, followed by the middle and coronal third, than Thermafil system. Conclusion: For biomechanical preparation of root canal, reciprocating WaveOne Gold system with Thermafil carrier-based obturation system should be preferred for biomechanical preparation and obturation, respectively, during root canal treatment, with respect to safety regarding temperature rise on the root surface. Clinical significance: Biomechanical preparation and thermoplasticized obturation could lead to temperature alteration irrespective of the type of techniques. Although clinically it has been seen that the temperature alteration is within the safer range; however, it is advised that the clinician should wisely choose the appropriate instrumentation and obturation techniques to minimize the temperature application in specific clinical cases.

Aims and objectives: Premature loss of primary molars in children predisposes to future orthodontic treatment needs, which may affect the child both nutritionally and psychologically. The main aim of this study was to evaluate the prevalence of premature loss of primary molars in 5–9-year-old school children of Highly Endemic Fluoride District from Telangana state, India. Materials and methods: A single calibrated examiner performed all clinical examinations under natural light using a mouth mirror and probe. A total of 1,124 children (562 boys and 562 girls) aged between 5 years and 10 years were included in the study. Data including age, carious teeth, and missing teeth were collected. These data were then statistically analyzed. Results: The results showed that 7.82% of sample children had an early loss of primary teeth with boys showing an increased incidence of loss of primary teeth (5.33%) and the children in the age group of 7–8 years had greater prevalence. The most common missing tooth was the primary first molar (58.4%) followed by the primary second molar (41.5%). Conclusion: In endemic fluoride areas, the prevalence of early loss of primary teeth was less when compared with other studies done in non-fluoride areas. Clinical significance: Educational and preventive programs about oral health should be implemented in schools which would further reduce premature loss of primary teeth and eventually reduce malocclusion problems in children.

Aim and objective: This study aimed to assess the impact of the immediate and delayed clinical placement of implants on the crestal bone. Materials and methods: In this study, a total of 30 implant areas in 30 patients were analyzed. The study group constituted 14 male and 16 female participants in the age range of 20–40 years. A random allocation of the patients into one of the two groups (15 per group) was done as group I: immediate implant placement and group II: delayed implant placement. In both the groups, plaque index, gingival index, probing depth (PD) as well as crestal bone height was calculated at baseline, 3rd month, and 6th month. The statistical analysis was performed with Statistical Package for Social Sciences. The Student's t-test was used for comparison between the two groups. Results: The group that received immediate implants depicted somewhat greater mean baseline plaque score and at 3 months (2.69 ± 0.18 and 3.82 ± 0.02) in comparison with the group that received delayed implants (2.54 ± 0.10 and 3.78 ± 0.03). Somewhat higher mean gingival score at baseline, 3 months, and 6 months (1.10 ± 0.09, 1.48 ± 0.30, and 1.36 ± 0.22) were seen with delayed implant placement in contrast to immediate implant placement (1.02 ± 0.21, 1.28 ± 0.16, and 1.34 ± 0.24). The immediate implant group exhibited a somewhat higher mean PD score at baseline and 3 months (2.87 ± 0.12 and 3.42 ± 0.09) in comparison with the delayed implant group (2.04 ± 0.07 and 3.31 ± 0.13). Delayed implant group had faintly advanced loss of bone (0.20 ± 0.02, 1.34 ± 0.11, 1.10 ± 0.13) when compared with the immediate implant group (0.14 ± 0.08, 1.08 ± 0.01, 0.98 ± 0.04) at baseline, 3rd, and 6th month in that order. A statistically significant dissimilarity was present at the 3 months interval among both the groups. Conclusion: This research concluded that immediate implant placement is significantly better than delayed implant placement. Preservation of crestal bone with prevention of collapse of the architecture of gingiva is achieved through immediate implant placement. The therapy time, preservation of esthetically acceptable gingiva as well as enhanced patient comfort is among the other advantages. Clinical significance: Implants provide a basis for prosthetic support. Recently, immediate implant placement has become increasingly popular due to short treatment duration and higher patient contentment.

Aim and objective: To evaluate the clinical efficacy of resin-modified glass ionomer cement (RMGIC), mineral trioxide aggregate (MTA), and calcium hydroxide (CH) when used as a direct pulp capping (DPC) material on carious exposure of human permanent teeth. Materials and methods: Forty-five participants in the age group of 15–52 years, with deep carious lesions diagnosed with reversible pulpitis, were selected and divided into three groups, i.e., group I: RMGIC, group II: MTA, and group III: CH. Recall evaluation after 24 hours, 3 weeks, 3 months, and 6 months was carried out for recording self-reports from participants, a clinical inspection of the tooth, evaluating radiographs, testing vitality, palpation, percussion, mobility, and probing depths. Results: Of the 45 participants, 42 presented without any abnormal signs or symptoms. Three participants presented with symptoms of irreversible pulpitis, which indicated DPC failure. Chi-square test gave a p value > 0.05. Conclusion: There was no significant association between different parameters and the DPC materials used in the study. Clinical significance: Carious pulp exposure poses a challenge to the endodontist and maintaining the vitality of the pulp by DPC is one of the treatment modalities. This study has attempted to compare the efficacy of commonly used pulp capping materials like MTA and CH in addition to RMGIC, which has routinely been used for restorations.

Aim and objective: The present study aimed to evaluate the effect of tranexamic acid on the stability of platelet-rich fibrin (PRF) and its influence on connective tissue healing in Wistar rats. Materials and methods: This experimental study included 12 male Wistar rats in three groups; group I–control (saline), group II–untreated PRF, and group III–PRF treated with tranexamic acid (PRF + TXA). Platelet-rich fibrin membrane was prepared by drawing blood from each rat and the prepared membrane was cut into two halves wherein one half was treated with tranexamic acid. After anesthetizing the animal, a linear incision was made on the mid-posterior part of the dorsal side of the body to expose the muscle and three sites were prepared. Sterile saline was applied in the control site, untreated PRF membrane was placed in group II site, and PRF + TXA in group III site. Six rats were sacrificed at 14 days and the other six at 28 days. Specimens were subjected to histological evaluation for measuring the remaining PRF and immunohistochemical analysis for evaluating vimentin expression for assessing connective tissue healing. Results: Histopathological evaluation revealed that group III had more area of aggregation of PRF bundles at 28 days than group II. On immunohistochemical imaging, the intensity and proportionality score of vimentin expression was more in group III at 28 days. Conclusion: From the study, it can be concluded that tranexamic acid is effective in delaying the degradation of the PRF membrane and has a positive influence on connective tissue healing. Clinical significance: Improved stability of PRF observed with the addition of tranexamic acid will have wider applications in regenerative therapy using PRF.

Aim and objective: To assess the various smile parameters like smile arc, gingival visibility, dental and facial midlines, gingival zenith, the relation between the upper incisors and the lower lip using digital photography. Materials and methods: Using a convenient sampling technique a sample size of 120 (60 males and 60 females) was drawn. Both close-up and facial photographs were captured using DSLR [Single-lens reflex digital camera (NIKON)], Lens mount NIKON F mount (with AF contact). Smile arc, gingival visibility, dental and facial midlines, gingival zenith, the relation between the upper incisors and the lower lip were the parameters that were assessed in this study. Results: The mean age of the male participants was 21.97 and the mean age of female participants was 22.20. About 81.7% of the total study population had convex smile arc, 53.3% of participants had type II gingival visibility for a forced smile, whereas 52.5% had type II for a natural smile. About 64.2% of the subjects had right side deviation of the dental midline, in 21.7% of the subjects the dental midline coincided with the facial midline. In 81.7% of the participants, the gingival zenith followed the ideal pattern. In 78.3%, the smile arc slightly touched the upper anteriors. Conclusion: Within the limitations of the present study, it can be concluded that the various smile parameters like smile arc, gingival visibility, dental and facial midline and gingival zenith assessed can be used to rehabilitate the smile of dentate patients, partially dentate, and/or can help rehabilitate an edentulous mouth. Clinical significance: Dental photography offers the dental professional an array of the possibility of visual reconstruction of the various stages of treatment. With digital photography as an aid, the dentists can design and correct the smile for the utmost satisfaction of the patients.

Aim and objective: This research aimed to assess the diagnostic efficiency of four different methods in the estimation of root canal working length (WL). Materials and methods: Eighty human premolars, having a solitary root were chosen for this study. 5.25% sodium hypochlorite solution was used to disinfect the recently extracted teeth for a period of 24 hours. These teeth were then allocated at random into four groups consisting of 20 teeth each. Group I: Working length determination by tactile method, Group II: Digital radiographic method, Group III: Electronic apex locator (EAL), Group IV: Endodontic motor with integrated apex locator. The actual WL was estimated for every sample. The values procured by the four techniques were cross-tabulated with the levels of coincidence of authentic WL values. Results: The WL measurements with an EAL (21.56 ± 0.862) had more or less satisfactory coincidence with the actual WL (21.84 ± 0.486), pursued by endodontic motor with an incorporated apex locator (20.96 ± 1.010), digital radiographic technique (20.74 ± 1.030), and tactile method (20.42 ± 1.002). However, the difference between these experimental groups was not significant statistically. Conclusion: This study has some limitations, within which it may be concluded that the WL of root canals as estimated by the EAL implicated that these values were nearer to the actual WL than the values procured from endodontic motor with incorporated apex locator, digital radiograph, and tactile techniques. Clinical significance: Establishing an accurate WL is among the elementary factors for the success of endodontic therapy. Instrumentation which is excessively short of or goes past the apex unfavorably influences the victory of endodontic treatment. Estimating the appropriate technique to precisely measure the WL would be advantageous for dental clinicians.

Aim and objective: The present research aimed to assess the cytocompatibility of a novel dental restorative composite resin (DRC) copolymer containing dipentaerythritol penta-/hexa-acrylate (DPEPHA) as comonomer by tetrazolium assay. Materials and methods: Twenty-seven photopolymerized specimens (n = 9 per group) were divided into a control G0 group (specimens without DPEPHA) and two trial groups [specimens with 20 wt% (G20) and 40 wt% (G40) DPEPHA]. Eluates from the specimens were extracted and filtered. L929 mouse fibroblasts were employed and an MTT assay was executed. Parametric tests and multiple comparison tests were utilized to analogize the average optical density (OD) and fibroblastic viability among and between the study groups, respectively. Results: A significant difference was apparent (p = 0.000) when the means of OD and cell viability of the groups were compared. The assessed parameters were higher for the trial groups than the control. The novel copolymer P(GEU-Co-DPEPHA) (trial groups) possessed higher OD and fibroblastic viability than the P(GEU) (control). Conclusion: The novel copolymer P(GEU-Co-DPEPHA) formed by the addition of DPEPHA in propriety DRC matrix was cytocompatible with L929 fibroblasts. Clinical significance: P(GEU-Co-DPEPHA) is cytocompatible with the mammalian fibroblasts. Hence, the substitution of this crosslinking comonomer would improvise the physicomechanical properties of the DRCs without compromising biocompatibility.

Aims and objectives: The study aimed to record the distance between the inner and outer canthus of the eye and to compare it with the distance between the base of the nose to the lower border of the lower lip which can later be used to measure vertical dimension in occlusion. Materials and methods: Two hundred dental students comprising males and females between 18 years and 25 years of age-group constituted the samples for this study. The intercanthal distance (distance between medial and lateral canthus of the eyes) and subnasale (base of the nose) to the lower border of lower lip distances were measured by the digital caliper when the patient closed in centric occlusion. In this manner, measurements were made in all the samples and data obtained were tabulated for further analysis. Results: The coincidence of occlusal vertical dimension with intercanthal width among the male and female categories was 76 for males and 107 for females out of the total of 183. A 91.5% accuracy was observed in both sexes which suggests that intercanthus distance can be used as a guide to developing active vertical dimension in edentulous subjects. This was done by adjusting the height of the occlusal rims and measuring the distance between the base of the nose to the inferior border of the lower lip till it equals the intercanthus distance. This method was later verified by clinical judgment. Conclusion: Within the limitations of the study, it was concluded that the intercanthus distance can be used as a guide to developing active vertical dimension in edentulous subjects. Clinical significance: The distance between the outer and inner canthus can be a reliable landmark, which can be used for anthropometric measurements to record vertical dimension in edentulous patients requiring complete dentures along with other existing methods.

Aim and objective: The present study was conducted to compare the amount of fluoride released in the saliva after placement of fluoride-releasing pit-and-fissure sealants and glass ionomer fissure sealants at different time intervals. Materials and methods: The study includes 160 children divided into four groups. Two pit-and-fissure sealants and two glass ionomer cements are tested for fluoride release. Salivary fluoride levels were estimated at baseline and at intervals of 24 hours, 7 days, and 30 days. Results: The mean baseline salivary fluoride levels were 0.2535, 0.2533, 0.2845, and 0.2635 for group I to group IV, respectively, with no significant differences between the groups. However, an initial salivary fluoride burst effect and peak salivary and plaque fluoride levels at 24 hours were observed in all the groups, i.e., 0.383, 0.34, 0.530, and 0.46 for group I to group IV, respectively. Conclusion: Fluoride-releasing fissure sealants may act as a source of fluoride in saliva facilitating the prevention of pit-and-fissure caries. Clinical significance: Fluoride-releasing fissure sealants may act as a source of fluoride in saliva, which can be useful in the prevention of dental caries.

Aim and objective: The main aim of the study was to assess the absolute telomere length (aTL) in female beedi workers using real-time polymerase chain reaction (RT-PCR) and to compare the aTL with female non-beedi workers. Materials and methods: A cross-sectional study was carried out among age-matched 20 female non-beedi workers and 20 female beedi workers were enrolled for molecular analysis. The workers were in the age-group of 20–35 years and were workers exposed from 1 to 3 years. Saliva samples were collected from workers and control subjects for molecular analysis. The genomic DNA was extracted from saliva and aTL was estimated using real-time polymerase chain reaction. Results: The mean and standard deviation of average absolute TL/each chromosome end for the control group and study group were 0.75 ± 0.94 and 1.45 ± 2.76 kb. There was no statistically significant difference between the control group and the study group (Z = −0.112, p = 0.911). Conclusion: The present study revealed that there is no significant association in average absolute TL in early exposed female beedi workers when compared with female non-beedi workers. Furthermore, horizons are to be expanded for the population to prevent any occupational health hazards. Clinical significance: Telomere length is a biological clock that decides the lifetime of a cell and organism. Determination of TL is a better tool to detect genomic damage. Unburnt tobacco has been related to several health issues in beedi employees. The importance is to predict the genetic liability by estimating the aTL in beedi workers at early exposure to tobacco dust (TD).

Aim and objective: To report a case of surgical management and postsurgical rehabilitation COVID-19-related mucormycotic osteomyelitis of the maxilla. Background: Patients with the SARS-CoV-2 infection, also termed the COVID-19 illness, have been found to be afflicted with other associated bacterial and fungal diseases which have been termed as co-infections. In this regard, mucormycosis, a fungal infection, has been found to occur in these patients especially with a lowered immune response and has been found to cause osteomyelitis of the jaw bones. Case description: We present a case of mucormycosis in a COVID-19-affected patient that occurred in August 2020 denoted the first wave of disease in India, causing extensive osteomyelitis of the left maxilla. The patient presented clinically with odontalgia and tooth mobility in the upper anterior region. Clinical examination revealed the presence of abscesses in the attached gingiva in relation to tooth numbers 13,12, 11, 22, 23,24 and 25. A deep horizontal cleft was observed in the mucogingival junction in relation to 23 discharging pus. Computed tomography (CT) imaging revealed a diffuse radiolucency extending from the alveolar ridge of the upper anterior teeth to the left maxillary sinus, breaking the floor of the sinus. We have performed extensive medical and surgical management of this patient including postoperative prosthetic rehabilitation which is documented in the present case report. Clinical significance: Our observation of maxillary osteomyelitis secondary to mucormycosis in the first COVID wave in India makes our case extremely rare and important as this highlights that COVID-19 complications were significant but under-evaluated in the first wave of the disease.

Aim and objective: The aim of this case report is on an interdisciplinary orthodontic and surgical treatment approach of facial asymmetry due to congenital hemifacial microsomia (HFM). Background: Hemifacial microsomia is the second common congenital craniofacial deformity after cleft lip and palate, which presents with different clinical characteristics, including an extremely variable asymmetrical presentation. And there is no standardized treatment protocol for this type of asymmetry hence individualized treatment plan for every patient can result in the best esthetic and functional stability. Case description: This case study emphasizes on an adult patient who has congenital HFM with class I skeletal malocclusion involving asymmetry from the supraorbital level to the lower border of the face. Pre-surgical orthodontics is done initially by aligning the teeth and placing asymmetrical bite block, followed by LeFort I osteotomy with differential impaction (transverse) and bilateral sagittal split osteotomy with rotation along with advancement genioplasty, and finally, post-orthodontic settling done. Conclusion: A team effort of surgical orthodontists and surgeons with the aid of advanced imaging and software technology made us make an amazing change in patient's life both esthetically and functionally. Clinical significance: This new innovative method is both a time-saving and conservative method both for patients and dentists.