Aim: To determine the antibacterial effect of α-mangostin on the growth of Peptostreptococcus. Materials and methods: This study was included in a laboratory experimental study with a posttest-only control group design using three groups—the positive control group with amoxicillin administration, the negative control group with aquades administration, and the treatment groups by giving α-mangostin at eight different concentrations. Results: The 100% concentration α-mangostin group was the treatment group with the best results in inhibiting the growth of Peptostreptococcus bacteria, but those results were still below the positive control group using amoxicillin. Conclusion: α-mangostin has the potential as an additional alternative medicine to reduce the amount of growth of Peptostreptococcus. Clinical significance: The overall results of this study indicate that α-mangostin with a concentration of 100% can be used as an additional drug in the tooth socket which acts as an antibiotic after tooth extraction because the area of inhibition zone exceeds 18 mm and is included in the sensitivity category.

Aims: The present study was performed to determine the incidence, location, dimension, and type of maxillary sinus septa in the posterior maxilla using cone-beam computed tomography (CBCT) imaging for implant placement. Materials and methods: The inclusion and exclusion criteria resulted in a total of 100 participants. The Hyperion X9 CBCT scanner was used to do the CBCT, and the pictures were reconstructed using NNT image reconstruction software. The iRYS 8.0 and NNT viewer were used to evaluate the incidence, location, dimension, and type of maxillary sinus septa in the dentulous and edentulous posterior maxilla. Complete septa were further classified into septa with or without compartmentalization of the maxillary sinus into two separate cavities based on CBCT cross-sectional images. A measuring tool in the software Statistical Package for the Social Sciences (SPSS) was used to determine the average height and width of all septa. Results: Incidence of septa was comparatively higher in edentulous compared to dentulous and the most common type of septa found was incomplete septa. The mean height of septa among dentulous and edentulous individuals was 8.18 ± 3.39 and 8.63 ± 3.76 mm, respectively. The mean width of septa among dentulous and edentulous were 1.81 ± 0.49 and 2.27 ± 1.11 mm. A significant difference was reported for the anteroposterior width of the maxillary sinus (p < 0.05); dentulous having 32.03 ± 2.83 mm and edentulous having 31.11 ± 2.43 mm diameter. Conclusion: Within the study's constraints, it was discovered that when the septa are in near proximity to the sinus floor, it is recommended to eliminate the septa to avoid rupture of the Schneiderian membrane and get ahead with the augmentation. Prospective research is required to back up the conclusions stated. Clinical significance: Septa, or bony convolutions from the sinus floor, can be found during sinus augmentation treatments and implant planning in the atrophic posterior maxilla. Intraoperative difficulties are frequently caused by a lack of factual understanding about the maxillary sinus prior to executing a sinus lift treatment. Thus there is a need for a better understanding of presurgical evaluation of the maxillary sinuses.

Aim: To analyze the effects of injecting platelet-rich plasma (PRP) submucosally on the levels of interleukin-1 (IL-1), IL-6, and tumor necrosis factor-α (TNF-α) present in the gingival crevicular fluid (GCF) during microimplant assisted retraction, by using a split-mouth randomized clinical study design. Materials and methods: A total of 20 subjects (male or female), in the age-group of 16–25 years, diagnosed with a bimaxillary dentoalveolar protrusion, crowding that is <4 mm and required to undergo extraction of first premolars, were included in this study. Exclusion criteria—periodontally compromised dentition, smoking or alcoholism, blood dyscrasias, and individuals who have undergone fixed orthodontic treatment in the past. A submucosal injection of autologous PRP was administered to the intervention side. Before the start of retraction (T0) and 28 days after retraction (T1), GCF was taken from the canine's distobuccal sulcus on control and intervention days. Enzyme-linked immunosorbent assay was used to measure biomarker levels. Results: At T1, it was discovered that the intervention side had greater levels of IL-1 and TNF than the control group, and the difference was statistically significant. Levels of IL-6 were not observed to be impacted. Additionally, the mean total retraction on the intervention side was 1.5 times faster than on the control side, and it was statistically significant with a p-value of 0.001. The PRP injection was not accompanied by any swelling or pain in any of the subjects. Conclusion: In the GCF, injection of PRP increases the expression of IL-1 and TNF. Levels of IL-6 are unaffected. Clinical significance: The results of this study indicate that PRP leads to an increased expression of inflammatory biomarkers that are responsible for bone remodeling, which in turn can lead to accelerated tooth movement.

Aim: The present study aimed to find whether excessive occlusal force has any influence on the severity of periodontal disease and whether the occlusal correction done based on T-Scan evaluation has any influence on healing after periodontal therapy. Materials and methods: A total of 30 generalized chronic periodontitis patients contributing 692 teeth were selected for this randomized controlled clinical trial. Occlusal force analysis using T-Scan revealed 538 teeth with high occlusal force among 30 patients and were randomly assigned as either flap surgery (group I—14 patients contributing 262 teeth) or flap surgery with coronoplasty (group II—16 patients contributing 276 teeth). The clinical parameters including probing pocket depth (PPD), clinical attachment level (CAL), teeth mobility, and occlusal force percentage were recorded at baseline and 3 months. Paired t-test and independent t-test were done to compare PPD, CAL, and occlusal force within and between the groups, respectively. Mann–Whitney U test and Wilcoxon signed-rank test were done to compare mobility between and within the groups, respectively. Pearson correlation was used to correlate occlusal force and CAL. Results: Occlusal force was high among the teeth with severe CAL (7.621 ± 1.822) compared to moderate (5.897 ± 1.113) and mild (5.715 ± 1.134) CAL. There was a moderate positive correlation between occlusal force and severity of periodontitis (r = 0.608). The within-group comparison showed that there was significant reduction in occlusal force and all the clinical parameters assessed in both groups (p = 0.000). Intergroup comparison revealed that there was significant reduction in teeth mobility in group II compared to group II (p = 0.003). There was no statistically significant difference in terms of CAL (p = 0.356) and PPD (p = 0.369) between both groups. Conclusion: The study results revealed that there was a significant relationship between occlusal force and severity of periodontitis, and occlusal adjustment along with flap surgery resulted in significant reduction in teeth mobility but not in terms of clinical attachment loss and PPD. Clinical significance: Occlusal force analysis using T-Scan system provides a valuable aid in treating periodontal disease.

Aim: The present study aimed to evaluate the canal transportation and centering ratio of VDW.ROTATE compared with ProTaper Gold, 2Shape, and One Curve nickel-titanium (NiTi) rotary systems in simulated curved canals. Materials and methods: A total of 60 simulated canals were divided into four groups of 15 canals according to the file system used to prepare the canals, which were group I for VDW.ROTATE, group II for ProTaper Gold, group III for 2Shape, and group IV for One Curve. Each canal was prepared to an apical size of 25 for all groups. Transportation measurements were taken at five different levels: level 1, at a distance of 5 mm from the canal orifice; level 2, at 7 mm from the canal orifice; level 3, at the curve's beginning; level 4, at the curve's crest; and level 5, at 1 mm from the preparation's terminus. Pre- and postoperative images of the simulated canals were acquired in a standardized approach using a digital microscope. Photoshop CS5 was used to combine the images. Digimizer Image Analysis Software was utilized to calculate the canal shape. Results: The results of analysis of variance (ANOVA) showed that there was no significant difference (p > 0.05) regarding canal transportation and the centering ratio at levels 1, 2, and 3. While there was a significant difference (p < 0.05) among the groups at the last two levels. The Tukey test showed that VDW.ROTATE file produced significantly (p < 0.05) more centered preparation than other tested files at levels 4 and 5, followed by the ProTaper Gold file, 2Shape, and One Curve. Conclusion: VDW.ROTATE produced more centered canal preparation than ProTaper Gold, 2Shape, and One Curve at the apical region. Clinical significance: The tested NiTi endodontic instrument can be used safely without serious preparation errors during the shaping of root canals.

Background: “Sexual dimorphism” is an organized variance in shape and structure among males and females belonging to the same species. Permanent teeth have been extensively studied for this purpose but little light has been shed on the significance of sexual dimorphism with regards to primary teeth. The extent and pattern of “sexual dimorphism” are unique and differ from one population to another. Hence, there is also a need to assess these variations among different ethnic groups. Objective: To determine sexual dimorphism using odontomorphometric and facial anthropometric traits in the ethnic Tamil pediatric population. Materials and methods: The study was conducted among a sample of 100 pediatric patients aged between 2 and 6 years. A digital vernier caliper was utilized to measure the mesiodistal width of all the deciduous teeth. Facial anthropometric measurements of bitemporal width, bizygomatic width, and bigonial width were also measured using the digital vernier caliper. Result: Significant sexual dimorphism was seen in relation to maxillary and mandibular right canine, first molar, and mandibular right central incisor (p < 0.05). Significance was also seen in the facial measurements, the intertemporal, interzygomatic, and intergonial width (p < 0.05). However, using Pearson's correlation a negative correlation was seen between odontometric and anthropometric traits. Conclusion: Analysis of significant traits in a specific population has significant impacts on forensic applications like gender determination and identification. However, the study has to be carried out on a larger sample size for further validation.

Aim: The aim of the study is to measure interradicular bone width (IRBW) in the maxillary posterior first molar region in three different facial types. Materials and methods: The study consists of randomly selected 150 patients aged 18–45 years, including both males (n = 60) and females (n = 90), abiding by inclusion and exclusion criteria. The subjects were categorized according to different facial types group I (n = 50): vertical, group II (n = 50): average, and group III (n = 50): horizontal based on cephalometric measurements. High-definition full skull cone-beam computed tomography (CBCT) with facial scan was taken and subjected to metric measurements using Dolphin software. Descriptive statistics and one-way analysis of variance (ANOVA) were done to find out the mean IRBW and intergroup differences (p < 0.05). Results: IRBW showed increased thickness for group I in the proximal-middle (PM-M) region (2.353 mm) and for group III in the middle-middle (M-M) region (2.195 mm). Males (2.352 mm) showed higher IRBW than females (2.232 mm). One-way ANOVA did not show a statistically significant difference between the three groups (p < 0.05). Conclusion: There was no significant difference in maxillary IRBW between the three groups with mean IRBW highest for subjects with vertical growth pattern between maxillary second premolar and first molar and highest for horizontal growth pattern subjects between first and second maxillary molar among all three groups. Males showed a comparatively greater IRBW than females. Clinical significance: This study helps to get an overview of IRBW in different growth patterns so that mini-implants can be placed with precaution in these patients and choose a site with good bone to claim its success. A good thickness of bone is required for the success of mini-implant, and information on which can be obtained with the growth pattern of the subjects themselves.

Aim: To assess the expression of calretinin, (29 kDa calcium-binding protein of the EF-hand family), in different histopathological types of ameloblastoma with an objective to evaluate the pattern of its expression in terms of distribution, intensity, and localization as it is to be expressed during tumorogenesis of odontogenic epithelium. Materials and methods: A total of 32 tissue blocks comprising 17 conventional ameloblastomata (follicular-5, plexiform-8, and acanthomatous-4), unicystic-8, desmoplastic-5, and peripheral-2 were retrieved and evaluated immunohistochemically for the presence, localization, distribution, and intensity of calretinin expression. The results were tabulated and statistically analyzed using the Chi-squared and Fisher's exact test to compare the calretinin expression between the subgroups. Results: Around 94.11% of conventional, 100% of unicystic, 80% of desmoplastic, and 0% of peripheral ameloblastoma (PA) cases showed positive calretinin expression. The staining distribution showed statistically significant levels at p = 0.007. A predominant diffuse distribution pattern was shown by the plexiform variant followed by unicystic ameloblastoma (UA). Desmoplastic ameloblastoma (DA) showed a focal distribution pattern with mild to moderate intensity observed only in the stellate reticulum-like cells. The staining intensity was statistically insignificant among the subgroups. However, staining localization in stellate reticulum-like cells showed varied patterns among the variants with a statistically significant value of p = 0.004. Conclusion: Calretinin can be considered a distinct diagnostic immunohistochemistry (IHC) marker for all variants of ameloblastomas, particularly UA, and it also aids in understanding the biological behavior of ameloblastomas. Clinical significance: Calretinin is not only expressed during odontogenesis but also in pathological conditions like cystic and malignant odontogenic tissues due to its extensive distribution. Hence, any of these imply that calretinin may be useful in the diagnosis of odontogenic tumors, especially in ameloblastomas.

Aim: The aim of the present study is to evaluate the impact of centrifugation protocols and release profile of platelet-derived growth factor (PDGF) isoforms among platelet-rich fibrin (PRF) variants that were prepared using different relative centrifugation forces (RCF) and centrifugation times. Materials and methods: The PDGF isoforms (PDGF-AA, PDGF-BB, and PDGF-AB) release was evaluated using enzyme-linked immunosorbent assay (ELISA) (Quantikine ELISA kits (R&D Systems, Inc, Minneapolis, Minnesota, United States of America). Results: The highest reported PDGF isoforms released from platelet concentrates (PCs) was PDGF-BB, followed by PDGF-AB and PDGF-AA. I-PRF released significantly higher growth factors (GF) when compared to A-PRF (p < 0.001) and L-PRF (p < 0.005). Conclusion: The current study indicated that a systematic reduction in the applied RCF increased GF levels. Thus, the determined GFs PDGF-AA, -AB, and -BB were the lowest in L-PRF, which was prepared within the high RCF range. However, reductions in RCF significantly increased PDGF isoforms in I-PRF than in A-PRF and L-PRF. Clinical significance: The differences in the centrifugation protocol have an influence on the release profile of PDGF isoforms among PRF variants. I-PRF prepared with low RCF range can be recommended for fast delivery of PDGF isoforms and may prove clinically beneficial for future regenerative procedures.

Aim: To assess various rotary file systems’ centering ability and canal transportation in the curved root of mandibular molars in rotary and reciprocating motions using cone-beam computed tomography (CBCT). Materials and methods: A total of 60 extracted mandibular molars having 30° curved roots were decoronated. After initial biomechanical preparation, samples were divided into three groups and two subgroups based on the file systems and kinematics used to prepare the canal: Vortex Blue files from groups Ia and Ib, Mtwo files from groups IIa and IIb, and ProTaper Next files from groups IIIa and IIIb were employed in rotary and reciprocating motion, respectively. Pre- and postinstrumentation scans using CBCT were carried out to evaluate the canal transportation and centering at three canal levels. The one-way analysis of variance (ANOVA) test and associated post hoc test were used to analyze the results. Result: In the rotary motion, Vortex Blue file showed the highest centering ability (1.24 ± 0.54) at 6 mm root level with a statistically significant difference between ProTaper Next (p = 0.005), while for canal transportation, Vortex Blue file showed the highest value (0.14 ± 0.16 mm) at 3 mm root apex with statistically significant difference between ProTaper Next file (p = 0.027). In the reciprocating motion, no statistically significant differences were found between the three file systems in the centering ability and canal transportation at three canal levels (p > 0.05). Conclusion: The Vortex Blue file showed the most significant apical transportation in rotary motion. The Mtwo and ProTaper Next files caused the highest canal transportation at the middle and coronal third of the root region, respectively, in both motions. Clinical significance: The rotary files showed roughly the same level of canal preparation when used in a reciprocating motion, but when used in a rotary motion, the file design has a bigger influence on canal preparation than the motion.

Aim: To assess the efficacy and effectiveness of removing Activ gutta-percha (GP), RealSeal Resilon, and GuttaFlow 2 obturation materials from root canals using a new nickel–titanium (NiTi) retreatment system (D-RaCe). Materials and methods: Root canal cleaning and shaping were done in 60 single-rooted extracted premolars till apical size 30 with 6% taper. Prepared teeth were randomly divided to be obturated with either Activ GP which is glass-ionomer-based system (n = 20), RealSeal Resilon system (n = 20), or GuttaFlow 2 the polyvinylsiloxane-based system (n = 20). The obturated root canals were then removed with D-RaCe NiTi retreatment system. Residual filling assessment in all the canal thirds, that is, coronal, middle, and apical was done by taking digital radiographs of prepared teeth in buccolingual and proximal axes. The residual percentage of filling material in each canal third and total canal area was calculated. Data collected was analyzed statistically with one-way analysis of variance (ANOVA) followed by Tukey's post hoc and student t-test for multiple comparisons. Results: It was observed that whatsoever the sealer type used, complete filling removal was not achieved from the root canals. Significant findings regarding remaining filling material were found in the apical third (p < 0.05) compared to coronal and middle third. When comparing the sealers, GuttaFlow 2 had the highest mean percentage of remaining material when compared to both Activ GP and Resilon groups. Retreatment time for Activ GP was more when compared to Resilon and GuttaFlow 2 and the difference was statistically significant (p < 0.01). Conclusion: Within the limitations of the study assessment of residual material was done by gross radiographic criteria, and it was found that Activ GP and RealSeal Resilon were more effectively removed from root canals than GuttaFlow 2 although it took more time for the removal of Activ GP. Clinical significance: D-RaCe retreatment system was found to be a safe and effective system in negotiating and removal of root canal the filling material and simultaneously reaching the working length of root canals. However, complete removal was not achieved for both bonded and nonbonded obturation materials.

Aim: To evaluate the shear bond strength (SBS) of framework materials such as cobalt–chromium (Co–Cr), titanium (Ti) alloy, and bio-high-performance polymer (BioHPP) veneered with indirect composite material. Materials and methods: A total sample size of 60 samples with 20 samples in each group; group I: Co–Cr, group II: Ti alloy, and group III: BioHPP are veneered with indirect composite (Bredent). The bond strength was evaluated using the shear bond test, INSTRON universal testing machine. The data was analyzed using Statistical Package for the Social Sciences (SPSS) software, and p < 0.05 was considered statistically significant. Results: Kruskal–Wallis analysis revealed significantly higher SBS by BioHPP compared to Ti and Co–Cr. Post hoc analysis revealed a significant difference in the SBS between the Co–Cr and the Ti group and also between the Co–Cr and the BioHPP group. However, the mean SBS between the Ti and the BioHPP group was not statistically significant, though the BioHPP group had higher bond strength. Conclusion: Bio-high-performance polymer (BioHPP) treated with aluminum oxide and visio-lign bonding agent application has higher bond strength than Co–Cr and Ti and can be used as an appropriate substitute. Clinical significance: The material that had good bond strength with indirect composite provides excellent esthetics; the indirect composite material has the ability to be repaired easily, and abrasion is similar to that of natural tooth substance.

Aim: To evaluate the efficacy of computer-aided static navigation on the accuracy of guided endodontic root canal treatment along with other parameters like mean volumetric tooth substance loss, deviation, time, etc. Materials and methods: This systematic review and meta-analysis were registered in Prospero (Registration number database: CRD42021257249). Four different databases—PubMed, Cochrane, Google Scholar, and Science Direct were searched with specific Pico's criteria and keywords from 2015 to May 2021. Only in vitro or ex vivo studies were included in this systematic review and case series, case reports, and clinical studies were excluded. Two reviewers (RJ and RR) independently screened titles and abstracts. The current research information system (CRIS) scale was used to assess the risk of bias assessment. Meta-analysis was performed using Windows-based “MedCalc Statistical Software” version 19.6.1 (2020). To assess the overall success rate, a single-proportion meta-analysis was performed. Heterogeneity among the selected studies was assessed using the Q test (p-value < 0.05) and I² statistic. Results: A total of 11 articles were selected for final qualitative and quantitative analysis. The success rate of computer-aided static navigation was 95.48% with moderate heterogeneity (I² = 64.3%). When a computer-aided static navigation system was compared to conventional root canal access, it was found to be statistically significant (p = 0.0014). Conclusion: Computer-aided static navigation has a high accuracy rate of about 95.48%. Existing literature lacks clinical studies and randomized controlled trials with larger sample sizes are needed to further evaluate the accuracy of computer-aided navigation. Clinical significance: Computer-aided static navigation proves to be a safer and more reliable option in guided endodontic access, especially in cases of calcified canals.

Aim: The aim of this review was to examine the different methods used for diagnosing pulpal pathologies in primary teeth. Background: Accurate diagnosis of pulpal pathologies in primary teeth is essential as it not only facilitates early identification and treatment of dental pathologies but also plays a crucial role in guiding the proper development of permanent teeth. A comprehensive evaluation involving various diagnostic methods is necessary to ensure appropriate treatment decisions and optimal care for pediatric patients. Review results: The present study findings indicate the use of various diagnostic techniques, including visual-tactile examination, radiographic assessment, evaluation of pain characteristics, mechanical tests, examination of soft tissues, operative diagnosis, and sensitivity/vitality tests. These methods play a significant role in determining the condition of the dental pulp. Conclusion: Based on the study findings, it is clear that employing a comprehensive approach that incorporates these diagnostic tools is essential for achieving an accurate diagnosis. This, in turn, enables appropriate treatment decisions for addressing pulpal pathology in primary teeth. Clinical significance: Understanding and utilizing a wide range of diagnostic methods for pulpal pathologies in primary teeth enables clinicians to make informed treatment decisions and provide optimal care, ensuring proper dental development and long-term oral health for pediatric patients.

Aim: The aim of the study was to evaluate and compare the crestal bone levels surrounding the implants on 0, 90th, and 180th day using the flapless soft tissue punch technique with and without repositioning of the punched soft tissue back at the osteotomy site after the surgery. Flapless implant surgery is a boon to dentistry, which comprises a marginally invasive procedure for the placement of the implant. In recent times, it has been widely used for flapless implant placement either by using a soft tissue punch or a direct drill method. Flapless implant surgery with soft tissue punch has been seen to minimize the crestal bone loss when compared to the direct drill method or conventional technique. Materials and methods: Seven subjects with bilateral posterior edentulous sites were selected for this study which were segregated into two groups. In group I, placement of implants was done using flapless soft tissue punch technique without repositioning of punched soft tissue back at osteotomy site, and in group II, seven implants were placed using flapless soft tissue punch technique with repositioning of punched soft tissue back at osteotomy site. For measuring the crestal bone height, digital radiographic images were obtained at 0, 90th, and 180th day and changes were evaluated using CorelDRAW software. Results: On intragroup comparison, there was a significant crestal bone loss seen in both groups I and II, from 0 to 180th days (p = 0.001). On intergroup comparison, no statistically significant difference in crestal bone height measurements was found between groups I and II from 0 to 180th days. Conclusion: Hence, it is concluded that the flapless soft tissue punch technique with repositioning produced faster healing, less scar formation, and minimal bleeding. However, in terms of crestal bone changes, it showed similar results to the flapless soft tissue punch technique without repositioning. Clinical significance: The soft tissue punch technique can be implemented as an appropriate protocol, showing clinician's ease, less time-consuming, and improved patient compliance owing to the faster healing and less scar formation with minimal crestal bone loss.