Aim: This study aimed to assess the status of learning methods, knowledge, and awareness about online learning, the need for learning methods during the pandemic as well as the impact of the pandemic on the learning of clinical skills of dental students at dental educational institutions in the North of Vietnam. Materials and methods: A 23-online-questionnaire survey was sent to 935 dental students. Response data were recorded, coded, and analyzed using tests [Chi-square and one-way analysis of variance (ANOVA)] in statistical software, and a p-value of <0.05 was considered statistically significant. Results: The response rate was 95.8% (n = 896). A total of 96.5% reported that their school offered online classes, of which 72.2% were live-only classes with instructors, and 27.6% were a combination of the one and by prerecorded video. Regarding learning needs, 49.4% reported that they prefer face-to-face learning methods (n = 443), while 44.1% preferred a combination of both face-to-face and online methods (n = 395). Around 96.3% believed that the pandemic had affected the learning of clinical skills. Around 53% wanted to be taught clinical skills in a face-to-face manner equipped with personal protective equipment (PPE), while 35.8% wanted to be taught online. Conclusion: The ”offline learning” method was still the first choice for dental students. In addition, the impact of the pandemic on learning methods, especially in clinical practice, was enormous. Online learning is increasingly chosen by young people, and blended learning will be a trend of the present and the future, especially during the pandemic. Clinical significance: A reference for dental educational planners to improve the experience of teachers and students in the learning methods.

Aim: To evaluate and compare the expression pattern of microribonucleic acid [micro-RNA (miR)]-221, 222, and 223 in the saliva of patients with periodontal disease and to determine the potential diagnostic marker for periodontitis. Materials and methods: For the present study, 25 healthy and 25 patients with periodontal disease were involved. Demographic and clinical parameters were recorded. Unstimulated whole saliva was collected from all the individuals. From the saliva samples, miR was isolated with a miRNeasy isolation advanced kit. Real-time polymerase chain reaction was used to quantify miR-221, 222, and 223 and to analyze the expression levels. Target gene prediction for the miRs was performed with miRTargetLink 2.0 bioinformatic online tool. The data obtained was statistically analyzed. Results: The expression analysis revealed that miR-221-5p, miR-222-5p, and miR-223-5p were upregulated by 5.71, 3.05, and 19.84 fold in periodontal disease patients with the p-value of <0.01. Compared to the other miRs, miR-223 was positively and significantly correlated with the probing pocket depth (PPD) and clinical attachment level. With a diagnostic accuracy of 86% and an area under the curve (AUC) of 0.859, miR-223-5p exhibited high sensitivity and specificity to distinguish periodontitis patients from healthy individuals with a p-value of <0.01. Conclusion: The findings of the present study demonstrate that miR-223-5p may be associated with the pathogenesis of periodontal disease. It could serve as a diagnostic marker and potentially predict the onset and severity of periodontitis. Clinical significance: Biomarkers that indicate early diagnosis must be identified to reduce the incidence of periodontal disease, as miRs can target multiple genes and influence various regulatory networks, making them highly promising molecules that can serve as diagnostic markers and dynamic miR-based therapeutic agents for the management of periodontal disease.

Aim: To assess fracture resistance of endodontically treated teeth restored with different restorative materials, namely Biodentine, flowable composite (FC), resin-modified glass ionomer cement (RMGIC), and packable composite (PC), in simulated cervical resorption cavities. Materials and methods: A total of 75 human maxillary permanent central incisors with one root and a single canal were prepared using ProTaper nickel-titanium rotary files till apical size (F4) was achieved, with subsequent obturation by same size gutta-percha cone and Sealapex root canal sealer. A surveyor was used to simulate resorptive cavity on the labial surface at the intersection of the long axis of the maxillary central incisor and cementoenamel junction (CEJ). Preparations were then divided into and restored with the following restorative materials (n = 15): group I—cavity only (control group), group II—PC, group III—FC, group IV—Biodentine, and group V—RMGICs (light-cured RMGIC). Periodontal ligament simulation was done, and acrylic blocks were used for mounting the teeth. Samples were then assessed for wear resistance and subjected to a Universal Testing Machine for fracture resistance testing, and the collected data were then evaluated using statistical analysis using the analysis of variance (ANOVA) and post hoc Bonferroni tests. Results: Statistically significant changes were seen in samples with simulated invasive cervical resorption (ICR) lesions in endodontically treated teeth filled with or without adhesive restorative materials (p < 0.001). Biodentine was found to have maximum fracture resistance, followed by those cavities that are restored with FC, RMGIC, and PC, in that order. Conclusion: All the tested restorative materials performed satisfactorily in simulated cervical resorption cavities. Clinical significance: The current study provides clinically relevant knowledge about the different adhesive restorative materials available in terms of wear and fracture resistance of endodontically treated teeth, providing in-depth insight regarding the effective and efficient management of cervical resorption cases.

Aim: The present study aimed to comparatively evaluate the efficacy of varying concentrations of chemically synthesized zinc oxide nanoparticles (CSZnO-NPs) and biologically synthesized ZnO-NPs (BSZnO-NPs) incorporated separately in soft denture liners against Candida albicans (C. albicans). Materials and methods: The sample size for this experimental comparative in vitro study was 120. ZnO-NPs were biologically synthesized from Azadirachta indica (A. indica) (neem) leaves and characterized by ultraviolet visible (UV-vis), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and X-ray powder diffraction (XRD). CSZnO-NPs were procured from Sigma Aldrich. CSZnO-NPs and BSZnO-NPs were then incorporated separately into soft liner in concentrations of 0 (control), 3, 5, 7, 9, and 11 wt% for the purpose of comparison. The disk diffusion method was used to evaluate antifungal activity and the zones of inhibition (ZOI) were measured. Data was compiled and analyzed using the Statistical Package for the Social Sciences (SPSS) software version 20. Inferential statistics used were analysis of variance (ANOVA) and independent t-test. A p-value of <0.05 was considered significant. Results: Characterized BSZnO-NPs subjected to SEM showed particles of <100 nm in size with spherical morphology, UV-vis spectroscopy showed the absorption peak at a wavelength of 220 nm, XRD showed a good crystalline structure formation, and FTIR showed the presence of functional groups. For antifungal evaluation, the mean ZOI were measured, and an ANOVA test was performed, which showed a significant difference (p < 0.0001) between the concentrations of CSZnO-NPs and BSZnO-NPs incorporated in soft liners, respectively. Least significant difference (LSD) post hoc analysis showed a significant difference (p < 0.001) between the various concentrations, with the most significant difference seen at 7 wt% of CSZnO-NPs and 9 wt% of BSZnO-NPs. On performing an independent t-test, it was inferred that 3, 5, 7, and 11 wt% incorporation of CSZnO-NPs showed significantly higher ZOI against C. albicans as compared to the respective concentrations of BSZnO-NPs. At 9 wt%, there was no significant difference between the two groups. Conclusion: In conclusion, the optimal antifungal concentration of CSZnO-NPs and BSZnO-NPs is 7 and 9 wt%, respectively, when incorporated into the soft liner. Overall, CSZnO-NPs proved to be more efficacious than BSZnO-NPs against C. albicans. Clinical significance: Incorporation of optimal concentrations of CSZnO-NPs or BSZnO-NPs into soft denture liner is efficacious in combating the incidence of denture stomatitis (DS). Valuing the advantages of green synthesis, BSZnO-NPs can also be recognized for their antifungal efficacy.

Aim: The purpose of the present study was to compare the plaque removal ability of two different dental floss devices. Materials and methods: A total of 30 participants were included in the current in vivo split-mouth investigation. The chosen group of individuals ranged in age from 18 to 40 years. All of the participants were told to brush using a modified bass method. All participants (split-mouth) were divided into two groups as follows: group I—conventional dental floss and group II—water flossers. Each side's plaque index was calculated, and the results were contrasted with the baseline score. The type of floss used on either side of the mouth was blinded by the examiner who recorded the plaque index before and after the trial. A canine and a premolar, respectively, were chosen for analysis. The Rustogi Modified Navy Plaque Index (RMNPI) consists of nine sections that must be scored. Then, sections were joined to produce data for the proximal and marginal regions. Results: In the conventional dental floss group, on the canine region, before the intervention, the plaque score was 1.30 ± 0.01 and after the intervention was 0.42 ± 0.10. On premolar region, before intervention the plaque score was 1.22 ± 0.03 and after intervention was 0.36 ± 0.03. In the water flosser group, on the canine region, before intervention the plaque score was 1.28 ± 0.04 and after intervention was 0.26 ± 0.13. On the premolar region, before intervention the plaque score was 1.32 ± 0.01 and after intervention was 0.24 ± 0.10. Conclusion: The current study concluded that a water flosser was just as effective as conventional dental floss at removing interdental plaque after a single use. Clinical significance: It is generally recognized that dental plaque plays a role in the development of many dental disorders. In order to remove plaque and avoid gingivitis and periodontitis in addition to regular brushing, regular cleaning is required, especially in the interdental spaces. The technique of choice for these areas is ordinarily flossing.

Aim: The aim of this study is to evaluate the effects of frequently consumed beverages on the color depth penetration and surface roughness (Ra) of a universal single-shade composite, namely Palfique Omnichroma. Materials and methods: A total of 84 Palfique Omnichroma (Tokuyama Dental Corporation, Japan) composite disks were fabricated and randomly divided into three groups of 28 specimens each, according to the solutions—group I—tea, group II—coffee (test groups), and group III—artificial saliva (control group). Initial color and Ra were measured. The samples from each group were immersed for 15 minutes twice a day for 15 days, and then final measurements were recorded. The color change (ΔE) assessment was done using a reflectance spectrophotometer. The Ra measurements were analyzed with a contact stylus profilometer. One-way analysis of variance (ANOVA) with post hoc Tukey's test and paired t-test were used for statistical analysis of Ra and ΔE. Results: Tea group resin specimens produced the most discoloration, followed by the coffee group, whereas artificial saliva exhibited the least ΔE after immersion for 15 days in the composite resin evaluated. Maximum Ra has been observed in the group of specimens subjected to coffee, followed by the tea group. The least Ra was exhibited by the artificial saliva group. Conclusion: The evaluated staining beverage solutions and immersion time may have an impact on the composite resin's color stability and Ra. However, there are many other factors that affect how composite resin interacts with beverages. Clinical significance: Consumption of colorant beverages may have an impact on the resin composite's esthetic and physical characteristics. The study emphasizes the properties of the evaluated composite resin, thereby assessing the quality of restoration and aiding the clinician's decision of material choice.

Aim: This study aimed to evaluate the effect of transresveratrol on postextraction complications, including pain, swelling, and alveolar bone density. Materials and methods: A total of 10 extraction sockets were included in this study based on specific criteria. The sockets were randomly divided into two groups—group I received transresveratrol packed in a collagen membrane, while group II received collagen membrane alone. Pain, swelling, and alveolar bone density were assessed. Data entry and analysis were performed using Microsoft (MS) Excel and Statistical Package for the Social Sciences (SPSS) version 22 software. Statistical analysis included mean, standard deviation, proportions, and the independent t-test. A p-value of <0.05 was considered statistically significant. Results: The mean age of the study population was 25.2 ± 1.64, with 60% males and 40% females. Comparison of pain and swelling between the two groups revealed significant differences on days 1, 3, and 7 (p < 0.05). However, the comparison of alveolar bone density on cone-beam computed tomography (CBCT) systems after 3 months showed differences but was not statistically significant (p = 0.44). Conclusion: This study concludes that using transresveratrol has a beneficial effect on postextraction swelling, pain, and alveolar bone density. Clinical significance: The findings of this study suggest that incorporating transresveratrol into the treatment of mandibular third molar extractions may help reduce postoperative complications such as swelling and pain. However, further research is needed to evaluate its impact on alveolar bone density fully.

Aim: To evaluate and compare pain perception and time taken for Carie-solve and a conventional technique for caries removal in children. Materials and methods: A total of 20 children with cavitated lesions on both sides in primary teeth of 6–12 years of age were included in the study. In this split-mouth study, randomization was done using the “flip the coin” technique. The total sample size was divided into groups I and II. Airotor was used for group I, whereas Carie-solve was used for another group II. Time taken for both techniques and pain perception were measured and compared using a stopwatch and Wong–Baker Pain Scale. The results were statistically analyzed using the Mann–Whitney U test to compare the two techniques. Results: The mean value of the pain score for the conventional technique was 3.8, and chemomechanical caries removal (CMCR) was 1. On the other hand, the mean time required for caries removal with the CMCR method was 8.87 ± 2.97 seconds and 3.97 ± 0.94 seconds for the conventional method. There was a significant difference in pain perception and time required in both methods of caries removal with a p-value (p = 0.0001). Conclusion: Removal of carious tissue with Carie-solve proved to be efficient, easy to perform, and acceptable for patients; however, the time required for the Carie-solve was much greater than conventional. Clinical significance: An alternative approach for caries removal, which will reduce the child's fear, is required to make future treatments a lot easier as well as instill a positive dental attitude in a child. Carie-solve is one such alternative, which might be helpful in reducing the pain perception of kids associated with the use of high-speed rotary instruments but is also effective in removing the infected dentin.

Aim: The aim of the present study is to prepare a novel 1% green-synthesized titanium dioxide (TiO₂) nanoparticle-infiltrated orthodontic adhesive and evaluate its cytotoxic activity against human gingival fibroblast (HGF) cell lines. Materials and methods: About 1% (w/w) green-synthesized TiO₂ nanoparticle-infiltrated adhesive was prepared. To prepare the adhesive, 0.04 gm of the preprepared TiO₂ nanoparticles was combined with 4 mL of dichloromethane (DCM) in a beaker covered with aluminum foil to prevent exposure to light. To this, 4 gm of orthodontic adhesive (Enlight, ORMCO) was mixed and manually stirred continuously. The mix was then subjected to mechanical stirring at 500 rpm using an orbital shaker for 24 hours. The obtained adhesive infiltrated with TiO₂ nanoparticles was characterized using scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM/EDX) and Fourier-transform infrared spectroscopy (FTIR). The cytotoxicity of the material was evaluated against HGF using the 3-(4,5-dimethylthiazol-2-yl)—2,5-diphenyltetrazolium bromide (MTT) assay on days 1, 3, 5, 7, and 14. Results: SEM analysis displayed uniform distribution of TiO₂ nanoparticles in the adhesive matrix. The nanoparticle dimensions ranged from 25 to 75 nm. EDX analysis confirmed the presence of titanium and oxygen ions. FTIR evaluation also showed the presence of titanium functional group. On evaluation of human fibroblast cell viability, it was observed that the percentage of viable cells increased to 100% by day 14. TiO₂-infiltrated adhesive showed decreased cytotoxic activity when compared to conventional adhesive but was statistically not significant (p > 0.05). Conclusion: SEM/EDX and FTIR confirmed the presence of TiO₂ nanoparticles in the prepared orthodontic adhesive. No significant cytotoxic effects were observed on days 3, 5, 7, and 14 after curing when evaluated against HGF using MTT assay. Clinical significance: One challenge that patients undergoing orthodontic therapy face is the development of white spot lesions (WSL) due to demineralization of surrounding enamel. TiO₂, in particular, has potent antibacterial efficiency. Hence, infiltration of TiO₂ nanoparticle into orthodontic adhesive would help improve the antibacterial properties of the adhesive, thereby reducing the formation of WSLs.

Aim: The aim of this study was to evaluate the smear layer removal and microhardness alteration potential of two different antioxidants as final irrigants on root dentin. Materials and methods: The study aimed to investigate the effects of different irrigants on smear layer removal and microhardness alteration in 90 single-rooted mandibular premolars that were decoronated and instrumented till F2 using ProTaper Gold rotary files with 5.25% sodium hypochlorite (NaOCl) irrigation. The teeth were divided into two groups—the smear layer removal group and the microhardness group. In the smear layer removal group, 45 teeth were randomly assigned to three subgroups based on the final irrigation protocol: group I—ethylenediaminetetraacetic acid (EDTA) (positive control), group II—glutathione, and group III—gallic acid. After the final irrigation, the root canals were thoroughly rinsed with 10 mL of distilled water. Subsequently, the roots were split and observed under a scanning electron microscope (SEM) to assess smear layer removal effectiveness. In the microhardness group, all 45 roots were split into two halves and mounted in acrylic blocks. One-half of each root was used for baseline microhardness measurement, while the other halves were exposed to the experimental irrigants to compare pre and postvalues. The microhardness alteration was then evaluated using a Vickers microhardness tester. Appropriate statistical tests were employed to analyze the data obtained from both the smear layer removal and microhardness tests. Results: In smear layer removal EDTA performed better than glutathione and gallic acid in the coronal third. In the middle third EDTA and glutathione performed equally followed by gallic acid. In the apical third glutathione performed better than EDTA followed by gallic acid. In microhardness alteration analysis, all the tested samples showed alteration in microhardness. Conclusion: Glutathione showed better smear layer removal and less alteration in microhardness and it is as effective in performance as EDTA. Clinical significance: The primary objective of this study was to explore alternative final irrigants to replace EDTA in root canal irrigation. Results obtained from glutathione to gallic acid were found to be effective in terms of smear layer removal and showed comparable results to EDTA. Interestingly, glutathione demonstrated the ability to reverse the adverse effects of NaOCl on root dentin and induced minimal microhardness alteration when compared to the other tested irrigants. These findings suggest that glutathione holds promise as a potential substitute for EDTA in root canal procedures, offering similar smear layer removal capabilities while also exhibiting the added advantage of mitigating NaOCl-induced damage to root dentin.

Aim: To assess and compare the effectiveness of two interactive educational methods in teaching tobacco cessation counseling (TCC) in dental practice among the clinical dental students of a dental school in Virajpet, Karnataka. Materials and methods: An interventional single-blind study was conducted among all the third- and final-year Bachelor of Dental Surgery (BDS) students of a dental school. A total of 74 students participated. There were two groups—in one group, problem-based learning (PBL) method, and in the other group, roleplay (RP) method was used for TCC training. Questionnaire was used to assess the knowledge and attitude on TCC before and after training. There were six knowledge-based and 10 attitude-based questions. Descriptive statistics included mean, standard deviation, frequency, and percentage. Inferential statistics included the Chi-squared test. Statistical Package for the Social Sciences (SPSS) was used for the analysis. Results: In both the groups before training, the majority of the students reported a lack of knowledge and confidence in conducting the TCC. There were no statistically significant differences in knowledge- and attitude-based questions between RP and PBL groups in pre- and posttest results. Pretraining results showed a lack of knowledge, confidence, and time among the students in conducting TCC. Knowledge and attitude both had shown a statistically significant difference between pre- and post-training in TCC in both groups. Conclusion: The study reveals there is a need to develop innovative and educational initiatives. It is very important for the students to know how to overcome the gap between the theoretical knowledge and the practical aspect of TCC. Clinical significance: Dentists play an important role in promoting a healthy lifestyle by incorporating tobacco cessation programs into their practice. Using different methods in training will develop skills that will lead to lifelong learning and better preparation of students for their professional careers.

Aim: To assess soft tissue (ST) responses to camouflage orthodontic treatment in patients with class II skeletal patterns. Materials and methods: Based on the inclusion and exclusion criteria, pre- and posttreatment cephalometric radiographs of 37 young adult patients were imported, digitized, and superimposed. The posttreatment values were inserted in the “Goals” tab of the “Treatment Simulation” section of the Dolphin imaging software. The Dolphin imaging software predicted a posttreatment cephalogram. The Dolphin measurement function was used to record the values of ST changes from the actual posttreatment and the predicted treatment outcomes. The discrepancies in ST changes between predicted and actual values were calculated. Results: Soft tissue (ST) subnasale to H-line, upper lip strain (ULS), and inferior sulcus (IS) to H-line (IS–H-line) showed statistically significant differences from the actual changes. The prediction of all the parameters except for ULS and IS to H-line was underestimated. Conclusion: This study showed that the most accurate prediction was found in nose prominence (NP) and superior sulcus depth (SSD), and the most inaccurate prediction was found in ST subnasale to the H-line. Therefore, with caution, Dolphin imaging software can be used for ST prediction and patient education. Clinical significance: Treatment forecast is crucial and beneficial in borderline and camouflage cases to predict the posttreatment changes to the face and develop alternate treatment plans, especially in patients with esthetic concerns.

Aim: The aim of the study was to evaluate the effectiveness of pretreatment with 5.25% sodium hypochlorite (NaOCl) and ozone gas from microleakage on pit and fissure sealants in primary molars. Materials and methods: A total of 36 noncarious primary molars were decoronated at the cementoenamel junction. These crowns were divided into three groups—NaOCl (n = 12), ozone (n = 12), and control (n = 12). Pretreatment of pits and fissures was done with 5.25% NaOCl for 60 seconds, ozone gas at 100 ppm for 30 seconds, and no pretreatment in the control group. Then, etching, bonding, and sealant application were done. Later, these crowns were subjected to thermocycling. A dye penetration test was done to assess the extent of microleakage using a stereomicroscope. Statistical analysis was done using the Kruskal–Wallis test in G*Power software. Results: The mean microleakage score in the NaOCl group was 2.58, ozone 2.67, and control was 2.75. Comparison between groups showed no significant difference (p = 0888). Conclusion: Pretreatment with ozone gas at 100 ppm and 5.25% sodium showed no statistically significant reduction in microleakage compared to the control group. Clinical significance: Pretreatment of enamel or dentine before sealant placement is hypothesized to remove the hybrid layer, which decreases microleakage and improves the intraoral longevity of sealants. Various mechanical and chemical methods have been used and showed certain promising outcomes. However, in the present study, a comparison of newer material ozone gas against conventional material NaOCl showed no demonstratable reduction in microleakage in primary molars.

Aim: The aim of the present study is to correlate the prevalence of dental caries with the body mass index (BMI) among tribal schoolchildren of 6–16 years in Shantivan, Nere, Raigad district, Maharashtra, India. Materials and methods: This was an observational study conducted to evaluate the association between dental caries and BMI on 384 randomly selected data samples from survey-based forms obtained from 6 to 16-year-old schoolchildren of both genders. Basic anthropometric non-invasive measurements like height, weight, head circumference, and mid-upper arm circumference were measured along with an assessment of dental caries and oral hygiene according to the World Health Organization (WHO) Oral Health Assessment Form for Children, 2013. Results: Among 384 subjects, 45.6% were males and 54.4% were females having a mean age of 11.38 ± 2.97 years. The level of significance was kept at p < 0.05. There was no significant association evident between decayed, missing, and filled permanent teeth (DMFT) and BMI (p > 0.05) while there was a significant association seen between decayed, missing, and filled deciduous teeth (dmft) and BMI (p < 0.05). Conclusion: Within the limitations of the current study there is a higher prevalence of dental caries in tribal children at Shantivan, Nere, Maharashtra, India. Caries experience was reportedly more prevalent in underweight tribal children and was observed to be directly proportional to the severity of underweight condition in the present study. The findings indicate that having a low BMI raises the likelihood of developing dental caries. Clinical significance: Assessment of nutritional status in children provides a new avenue to explore with a more targeted approach that can be implemented for prevention of dental caries in such children with low BMI or malnourishment. An overall strategy can thus be designed to focus on nutrition and its effect on the oral health of the identified individuals in day-to-day practice, thereby, aiding the clinician in designing a more comprehensive oral healthcare plan.

Aim: The goal of this literature review and meta-analysis was to compare piezoelectric surgery to conventional surgery on parameters of both implant stability and marginal bone loss (MBL) for implant site preparation (ISP). In dental implant patients, what is the effectiveness of ISP by piezoelectric surgery in comparison to conventional drilling (CD) in terms of primary and secondary stability and MBL? Background: An electronic search was conducted in PubMed, Cochrane Library, Scopus, and Google Scholar library databases following the search algorithm, “ISP or piezoelectric surgery or conventional surgery” and “piezoelectric surgery or conventional surgery.” A manual search for eligible studies was also performed in the Journal of Implant Dentistry, Quintessence International, Clinical Implant Dentistry and Related Research, and International Journal of Oral and Maxillofacial Journal. Review results: A total of 93 articles were retrieved, among which 92 were from PubMed and one was obtained by manual search. After removing duplicates 12 articles were screened and seven were finally selected for qualitative and statistical analyses. Among the above studies, piezoelectric surgery (p = 0.0964) and conventional surgery (p = 0.8525) found nonsignificant p-values with comparable results. Conclusion: Piezoelectric surgery provides a reliable alternative to traditional drilling for implant bed preparation, yielding implant stability quotient (ISQ) and MBL values that are comparable. More high-quality research is needed to evaluate the long-term stability and bone loss values of these two approaches. Clinical significance: Both methods are useful in ISP. However, piezoelectric surgery reduces bone destructive inflammatory response during osseointegration.