Aims: To analyze differences in salivary pH before eating, and at 5, 30, and 60 minutes after eating before brushing teeth, and after brushing teeth in elderly using removable partial dentures. Materials and methods: This is a quasi-experimental study with a pretest–posttest control group design. The study included a total of 22 participants who were required to eat rice. The participant provided saliva samples before eating, and for 3 consecutive days after eating with different time intervals before and after brushing the teeth. The time intervals were categorized as 5 minutes after eating (T0), 30 minutes after eating (T1), and 60 minutes after eating (T2). On the first day, saliva samples were taken before eating, at T0 before brushing teeth, and after brushing teeth. The exact process was repeated on the 2nd and 3rd days with T1 and T2. Saliva was collected in sterile tubes, stored in a cooler box, and measured with a pH meter. The data were analyzed using the general linear model (GLM) repeated measures analysis of variance (ANOVA) (p < 0.05), one-way ANOVA test (p < 0.05), and independent t-test (p > 0.05). Results: There was a significant difference in the group after eating before brushing their teeth with an average pH of 5.86 ± 0.22 (T0); 6.48 ± 0.12 (T1); and 6.64 ± 0.15 (T2) and after eating after brushing your teeth with an average pH of 7.26 ± 0.07 (T0); 7.30 ± 0.06 (T1); and 7.32 ± 0.04 (T3), respectively. There wasn't any significant difference in the pH between the upper and lower jaw of removable partial dentures in each time group. Conclusion: Salivary pH is typically acidic in the morning. Eating causes a decline in saliva pH, and the elderly have limited saliva buffering capacity to restore pH to neutral. Brushing teeth 5 minutes after eating brings salivary pH back to neutral. There were no significant differences in salivary pH between elderly individuals using upper or lower-jaw removable partial dentures. These findings emphasize the crucial role of timely toothbrushing in preserving oral health among the elderly. Clinical significance: There were significant findings in the acidity of salivary pH in the elderly using removable partial dentures and the correct time to brush their teeth after meals. Understanding this could help prevent carries and determine the right time to brush their teeth.

Background: Anxiety impacts both physical and mental health with symptoms including nervousness, palpitations, sweating, and dizziness, thereby affecting cardiovascular, respiratory, digestive, and nervous systems. Brainwave entrainment (BWE) is the capacity of the brain to synchronize its own frequencies with the rhythm of an externally applied stimulus. Patients undergoing dental treatment experience increased anxiety both preoperatively and intraoperatively. This, in turn, may lead to increased perception of pain as well as instability of vital signs throughout the procedure. There are numerous nonpharmacological adjuvants employed for management of dental anxiety; however, this study is an attempt to assess the effect of BWE on anxiety in patients undergoing root canal therapy. The purpose of this study was to assess the effect of BWE on systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) values both before and during root canal treatment in population experiencing moderate to severe anxiety assessed using Corah's Dental Anxiety Scale. Materials and methods: Forty participants were included in this pilot study and were divided into four groups (three entrainment groups and one control group). The three entrainment groups include alpha (10 Hz), theta (7 Hz), and delta (1 Hz) groups subjected to audiovisual entrainment in the corresponding frequencies. All participants were subjected to 10 minutes of preoperative entrainment except for the control group. The second entrainment session was applied, following administration of local anesthesia and rubber dam isolation, for 10 minutes following which the intratreatment vital sign values were recorded. In case of control group, no entrainment sessions were applied but simply the vital signs were recorded 10 minutes before and after initiation of treatment (preoperative and intraoperative, respectively). Results: Delta entrainment group exhibited significantly lower HR values both pre- and intraoperatively (p < 0.05). There were no significant differences with regard to SBP and DBP values. Conclusion: Brainwave entrainment (BWE) can be considered an effective nonpharmacological aid for management of anxiety in patients requiring dental treatment.

Aim: To evaluate and compare various patterns of arch forms between Odia and Bengali ethnic populations. Materials and methods: A total of 100 Odia and 100 Bengali students between the ages of 18 and 24 years were selected for this study. Both groups comprised of 50 males and 50 females each. The transverse and sagittal measurements of the dental arches were determined on maxillary and mandibular casts. The reference points were determined as a mid-incisal edge on the labial side, canine cusp tips, mesiobuccal cusps of the first molars, and distobuccal cusp tips of the second molars. Data was recorded and statistically analyzed. Results: The males in both groups showed wider arch forms compared to the females. The transverse measurements (L66, L77) and anteroposterior measurements (L61, L71) were statistically nonsignificant. The Odia subjects reported wider arch form compared to the Bengalis. Conclusion: In conclusion, the arch forms of the Bengalis are narrower than those of Odia. The Odia subjects reported wider arch form compared to the Bengalis. Clinical significance: To achieve a stable, functional, and esthetically pleasing occlusion, it is essential to choose an appropriate arch form for treating malocclusion. Clinically, after determining the patient's pretreatment arch form, wider archwires should be chosen from the available variations for Bengali patients.

Aim: To evaluate and compare the fracture resistance and microleakage of tooth fragment reattachment using light-cure and dual-cure flowable composites under different pretreatment conditions. Materials and methods: The present in vitro study was conducted on 64 extracted caries-free premolars that were divided into eight groups depending upon the pretreatment condition and the composite material used for reattachment. Fracture resistance and microleakage following reattachment were evaluated. Data was analyzed using Statistical Package for the Social Sciences (SPSS) 16.0 for Windows (SPSS Inc., Chicago, Illinois, United States of America, 2001). Student t-test and analysis of variance (ANOVA)/Kruskal–Wallis test were. The level of significance was set at p ≤ 0.05. Results: Fracture resistance was significantly greater, and microleakage was significantly lesser when rehydrated fracture fragments were preconditioned with ethylenediaminetetraacetic acid (EDTA) before reattachment. Conclusion: Dual-cure composite resin (Fill-Up, Coltene) proved to be a better material for increasing the fracture resistance of reattached fracture fragments. Clinical significance: Fragment reattachment has been recommended to restore uncomplicated crown fractures if the fracture fragment is available since it serves as an esthetic and biological restoration that is quick and easy to place, cost-effective, and conservative. Fragment bonding is affected by the restorative material used for reattachment as well as the condition of the fractured dentin. Rehydration of dentin and pretreating it with EDTA, as well as using dual-cure composites to reattach fractured fragments, can significantly improve the strength and decrease microleakage following fragment reattachment.

Aims: The study was conducted with the aim of evaluating the mechanical properties of experimental dental composite resins (EDCR) containing nanohydroxyapatite, zirconia, and glass filler particles. Materials and methods: The experimental dental composite resin's organic matrix was a combination of urethane dimethacrylate (UDMA) and triethylene glycol dimethacrylate (TEGDMA). Camphorquinone (CQ) and dimethylaminoethyl methacrylate (DMAEM) were added as photoinitiators. Ethyl-4-(dimethylamino) benzoate (EDMAB) was added as an accelerator, and butylated hydroxytoluene (BHT) was added as an inhibitor to the organic matrix. A combination of barium aluminum fluoride glass (5–20 nm), zirconia (4–11 nm), and hydroxyapatite (20–80 nm) were added as fillers in varying percentages. The Taguchi method of optimization was used to obtain a composite with optimum flexural strength (FS). A regression model was developed. American Society for Testing and Materials (ASTM) Standard D 790–03 was used to prepare the specimen for testing the FS. Results: Experimental dental composite resin with 23.7% of zirconia, 27.5% of nanohydroxyapatite, and 20% of glass filler particles gave the optimum FS of 164.44 MPa. The confirmatory experimental test of EDCR gave an FS of 168 MPa. The model developed with a regression equation for the FS was FS = 2205 − 339Z + 25.6H + 3.53ZH − 1.94G + 2.41Z² − 1.58H² The difference between the R-square (99.9) and adjusted R-square values (99.8) is <0.2; this shows that the model is acceptable. Conclusion: The EDCR developed after Taguchi's method of optimization had FS superior to that of the commercially available composite resins. The regression model obtained for the FS can be used globally to develop a composite resin with zirconia, hydroxyapatite, and glass nanofiller particles. Clinical significance: Restoration of lost tooth structure with a biomimetic material is the need of the hour. Our experimental dental composite incorporates nanohydroxyapatite filler particles, which provide FS similar to that of a natural tooth.

Aim: The present study aims to compare and evaluate the effectiveness of a bioresorbable collagen membrane (CM) (bioguide) and an advanced platelet-rich fibrin (A-PRF) when combined with the vestibular incision subperiosteal tunnel access (VISTA) technique to treat Cairo's root type 1 (RT1) and RT2 gingival recession abnormalities. Materials and methods: The clinical trial was a split-mouth randomized clinical trial that included 44 sites within the age-group 18–50 years with the bilateral Cairo RT1 or RT2 gingival recession defect. Recession defects at antagonist sites in each patient were categorized into group I (VISTA + bioresorbable CM) and group II (VISTA + A-PRF) and comparative evaluations were made. Gingival index (GI), the width of keratinized gingiva (WKG), pocket probing depth (PPD), recession height (RH), mean clinical attachment level (CAL), gingival thickness (GT), and mean root coverage (MRC) were recorded and statistically analyzed at baseline and 6 months posttreatment. Results: A statistically significant difference in MRC was detected during the follow-up period of 6 months with 76.95 ± 17.11 in group I and 86.09 ± 17.11 in group II. Analysis of GT demonstrated improvement in both groups (72.4% in group I and 76.6% in group II) from baseline to 6 months posttreatment. Conclusion: The VISTA along with A-PRF and CM has resulted in better outcomes with more promising results observed in the A-PRF group. Clinical significance: The ultimate goal of the root coverage procedure is to reduce sensitivity, improve esthetics, protect the root surfaces, promote periodontal health, and enhance oral function. The use of VISTA with A-PRF and CM provides reduced trauma and better healing properties negating the use of two surgical sites.

Aim: This study highlights the importance of knowing the exact morphometric relation of maxillary sinus (MS) with roots of maxillary posterior teeth by using three-dimensional (3D) imaging as a modality in north Indian population. Materials and methods: Using a Planmeca cone beam computed tomography (CBCT) machine, retrospective data collection was carried out on a group of patients. The study examined 2,000 maxillary posterior teeth from 300 CBCT scan patients based on inclusion and exclusion criteria. The vertical relationship between maxillary posterior teeth and maxillary sinus floor (MSF) was assessed using the Kwak et al. classification for multirooted teeth and the Razumova et al. classification for fused roots. Chi-squared testing and statistical comparison were performed on the data using the Statistical Package for Social Sciences (SPSS). A p-value of < 0.05 was deemed statistically significant. Results: The premolars (PM) with fused roots showed the type I vertical relationship with MSF reported by Razumova et al., whereas the PMs with separated roots revealed the type I vertical relationship reported by Kwak et al. In the fused roots category, type I was found to have the highest Chi-square comparison score for 24 tooth sites. Molars with divided roots exhibit the Kwak et al. type I vertical relationship. For tooth site 17, type I was found to be substantially more distributed on Chi-square comparison. In molars with fused roots, the vertical relationship of Kwak et al. type III was noted. Conclusion: Notably, this research methodology seems comprehensive and all-inclusive, addressing a gap in the existing literature. Dentistry can greatly benefit from the study of unique anatomical variations and their effects. Clinical significance: Notably, this study provides a precise description of the position and relationship between roots of maxillary posterior teeth with a critical structure (i.e., MS), which surgeons can use for immediate implant placement in that region.

Aim: The present study was designed to investigate the anterior and overall tooth size discrepancy in patients seeking orthodontic treatment irrespective of the malocclusion in the South Trivandrum population. Materials and methods: Good quality study models of both maxillary and mandibular arch of 55 subjects from the age of 13–30 years were selected randomly irrespective of malocclusion. A digital Vernier caliper was used to measure the mesiodistal tooth width. Bolton's anterior ratio and overall ratio were determined. Results: For the present study descriptive statistical analysis is being used. A clinically significant anterior discrepancy was found in only one-third, while the overall discrepancy was encountered in almost two-thirds of our sample. 69.1 and 32.7% of the sample had higher anterior and overall ratios, respectively compared to Bolton's ratio indicating larger mandibular tooth size. Conclusion: Mandibular anterior excess was found in more than double the subjects with maxillary excess. Clinicians should be aware of this discrepancy that may influence orthodontic treatment goals and outcomes substantially. Thus, the Bolton tooth-size index must be a primordial tool in the quotidian orthodontic diagnosis process and treatment planning. Clinical significance: Orthodontic treatment may vary from patient to patient but once we reach the finishing stage, it's almost similar in most of the cases. In pursuit of achieving an ideal and optimal occlusion, the orthodontic community has always looked to the six keys of normal occlusion laid down by Andrews. Unfortunately, tooth size imbalances were not critically looked at by Andrews prompting McLaughlin and Bennett to include a seventh key to address the issue of tooth size imbalances.

Aim: The present study aimed to evaluate and compare the conventional techniques with the advanced axiographic technique in recording condylar guidance to validate the most accurate method in obtaining condylar guidance values in a horizontal and vertical relationship of the mandible to the maxilla. Materials and methods: Completely edentulous subjects referred to the Department of Prosthodontics for receiving complete denture prostheses were considered to participate in the study. The condylar guidance was recorded using the Gothic arch tracing technique, interocclusal bite recording technique, and axiographic technique to program the articulator to achieve balanced occlusion. Results: The data on various study parameters were obtained and summarized using appropriate statistical measures. No significant difference was observed in recording condylar guidance amongst the extraoral Gothic arch tracing, interocclusal bite record, and axiographic tracings. The mean difference between the extraoral Gothic arch tracing and the interocclusal bite record is 1.19°. The mean difference between the extraoral Gothic arch tracing and the axiographic tracings is 0.96°. The mean difference between the interocclusal bite record tracing and the axiographic tracings is 0.23°. Conclusion: The interocclusal bite record and axiographic techniques can replace the use of the Gothic arch tracing method, which helps in accurately programming the semi-adjustable articulator and will ease the procedure, which is less time-consuming cumbersome which can facilitate providing designed occlusion in complete denture prosthesis. Clinical significance: To develop the planned disocclusion, group function occlusion or balanced occlusion in indirect restorations, and programming of the articulator to appropriate condylar guidance, which is a critical step. The simple interocclusal records technique and axiographic technique can be used to replace Gothic arch tracing; thereby, it can not only reduce the clinical step but also adapt easier and simpler clinical procedures in programming articulators.

Aim: To assess scalpel and laser techniques of depigmentation by clinical parameters and digital photographic analysis. Materials and methods: In this split-mouth clinical study, 64 sites with gingival hyperpigmentation were selected. Group I was scalpel and group II was diode laser. Clinical parameters, that is, the Dummett oral pigmentation index (DOPI) and the Hedin melanin index (HMI) were recorded. Standardized digital photographs of pigmented areas were taken, and red, green, and blue (RGB) image statistics were done using Adobe Photoshop software. The patient's perception of pain was recorded on the visual analog scale (VAS) scale, and the repigmentation and time of the competition of the procedure were assessed. The timeline of the study was baseline, 3, and 6 months. Statistical analysis was done using the paired t-test and the student t-test. Results: Dummet oral pigmentation index (DOPI) and HMI showed highly statistically significant differences during the timelines, but no significant difference was between the groups. The digital analysis by RGB method showed statistically significant and clinically significant results in melanin reduction preoperatively and postoperatively. Comparative pain assessment and duration of the procedure were highly significant in laser compared to a scalpel. The repigmentation rate showed a high recurrence rate in the laser group. Conclusion: The RGB values suggest effectiveness in evaluating differences in hue on surgical techniques for hyperpigmentation of gingiva. The rate of repigmentation is less in the scalpel technique. Both surgical and diode lasers were efficient for depigmentation of the gingiva and did not result in any postoperative complications. Clinical significance: The scalpel and laser technique showed significant results so it can be used efficiently to restore the pink esthetic. Laser therapy in terms of pain perception and duration is better. The digital photographic analysis method (RGB values) and clinical evaluation (indices) can be used to assess the patient preoperatively and postoperatively.

Aim: This study aims to assess and compare the remineralization potential of cheese and GC tooth mousse on demineralized human enamel using Vickers microhardness testing. Materials and methods: Fifty enamel sections (4 × 4 × 1 mm) were prepared from the buccal surfaces of sound human premolars. The baseline surface microhardness was evaluated using Vickers indenter. Enamel specimens were randomly divided into three groups—group I (control group), group II (cheese), and group III (GC tooth mousse). Group I specimens were kept in artificial saliva whereas group II and III enamel specimens were treated with cheese and GC tooth mousse respectively for 5 minutes twice daily for 21 days. Posttreatment surface microhardness measurements of all specimens were revaluated on the 7th, 14th, and 21st day. Results: There were statistically significant increases in the posttreatment surface microhardness values in both group II [cheese—198.04 ± 10.3 Vickers hardness number (VHN)] and group III (GC tooth mousse—228.4 ± 12.9 VHN) at the end of 21st day of remineralization (p < 0.001). Conclusion: Surface microhardness values of demineralized human enamel exhibited significantly increased values after exposure to both cheese and GC tooth mousse. Hence, we can conclude that cheese and GC tooth mousse showed significant remineralization potential on demineralized human enamel. Clinical significance: Cheese is a better cost-effective alternative available to children and has beneficial effects on their general health and can also have a remineralization effect on their teeth.

Aim: To evaluate and compare the degradation time of leukocyte-platelet rich fibrin (L-PRF) and advanced platelet rich fibrin+ (A-PRF+) alone and with incorporation of antibiotics (amoxicillin, ofloxacin, and gentamycin). Materials and methods: Blood samples were collected from three volunteers in glass test tubes without anticoagulants. The tubes were immediately centrifuged for preparation of L-PRF and A-PRF+ using respective protocols. The antibiotics added to blood samples were 0.5 mL of amoxicillin, ofloxacin, and gentamycin prior to centrifugation. PRF were made into membranes and in vitro degradation test of the prepared PRF membranes was conducted by placing the PRF membrane in 10 mL of pH 7.4 phosphate-buffered saline (PBS) on a Petri dish kept at 37°C. The values were interpreted in percentage and expressed as accumulated weight losses of the membrane. Statistical analysis used were one-way analysis of variance (ANOVA) and independent sample t-test. Results: There is no significant difference in degradation percentage between L-PRF and A-PRF+ groups. A-PRF+ was found to have a slightly longer period of degradation than L-PRF. There is a significant difference in degree of percentage degradation between A-PRF+ and gentamycin vs all other groups, that is, with addition of gentamycin, A-PRF+ resisted degradation for a longer period of time than other antibiotics. Conclusion: Within the limitations of the study, A-PRF+ is found to degrade at a faster rate when compared to L-PRF. A-PRF+ incorporated with gentamycin resisted degradation for a longer time when compared to other antibiotics. Clinical significance: The platelet concentrates had been pioneered to be used in regenerative medicine for a decade. It is known that platelet rich fibrin (PRF) undergoes degradation resulting in gradual release of growth factors. However, the degradation time of each type of PRF is not well documented to date. Depending on the differences in degradation time, different types of PRF can be used in diverse periodontal procedures.

Aim: The study's aim was to compare the efficacy of 3% neem, 50% white vinegar, and a 40 mg/mL concentration of green tea, 0.2% chlorhexidine (CHX) gluconate, as disinfectants in reducing the number of Streptococcus mutans (S. mutans) in toothbrushes. Materials and Methods: The study was a parallel-arm, double-blinded, randomized, in vivo comparative experiment with 50 young adults selected at random by simple random sampling. The participants were divided into five experimental groups—group I with 3% neem extract, group II with 50% white vinegar, group III with 40 mg/mL of green tea extract, group IV with 0.2% CHX, and group V with plain water as the control. The participants were trained to immerse the toothbrush in the test solutions for 20 minutes after brushing daily for 7 consecutive days. All of the toothbrushes were tested for baseline values prior to intervention. The toothbrush bristles were collected after 7 days and underwent microbial analysis. The mean bacterial count for S. mutans was determined. Results: The Statistical Package for Social Sciences (SPSS) software version 2.1 was used to conduct the statistical analysis. Paired t-test and analysis of variance (ANOVA) were the two statistical tests utilized. All of the groups, with the exception of the control group, saw a statistically significant (p < 0.001) decrease in the number of S. mutans. The reduction in S. mutans is significantly different between groups I, II, III, and IV (p < 0.001). In group V, there were no significant changes. Conclusion: The bacterial counts of S. mutans in toothbrush bristles were successfully reduced using both herbal products and synthetic disinfectants. However, when compared to the other groups, 50% white vinegar performed the best. Clinical significance: It is essential for every individual to disinfect their toothbrush, either using herbal or synthetic solutions, in order to uphold good oral hygiene and systemic health, especially in immunocompromised patients.

Aim: To evaluate the impact strength (IS) of poly(methylmethacrylate) [P(MMA)] denture resin incorporated with polyetherether ketone (PEEK) microparticles at 0, 5, 10, 15, and 20 wt% concentrations. Materials and methods: The study groups were divided into groups I, II, III, IV, and V reinforced based on the five PEEK incorporations. A total of 50 bar-shaped heat-cured resin samples (80 × 10 × 4 mm³) were prepared for the five groups based on the PEEK concentrations with 10 samples in each group. These samples were tested for their IS using Charpy's impact tester. The obtained data were recorded and statistically analyzed. Results: A new hybrid polymer P(MMA-PEEK) has resulted. The IS of group V (5.44 J/mm²) was the highest followed by the group IV sample with 15% (4.94 J/mm²), group III (4.66 J/mm²), and group II PEEK (4.10 J/mm²). The IS of group I was the lowest (3.93 J/mm²). There were also significant differences (p < 0.001) among the studied groups. Conclusion: The incorporation of PEEK microparticles with P(MMA) has increased the IS of the heat-polymerized acrylic resin. P(MMA-PEEK) with 20 wt% PEEK microparticles exhibited the highest IS when compared to neat P(MMA). Clinical significance: Denture fractures occur due to an accidental fall or by inadvertent occlusal loads. The incorporation of PEEK microparticles in P(MMA) ensued in a new hybrid polymer P(MMA-PEEK) with improved IS. This polymer reduces the risk of denture fracture and prolongs the clinical serviceability of dentures in the senile geriatric population.

Aim: To elucidate the clinical and radiographical success rate of triple antibiotic paste (TAP) using lesion sterilization and tissue repair (LSTR) therapy in primary molars. Materials and methods: Electronic databases and gray literature were screened from 1^st January 2004 to 30^th September 2020 for randomized controlled trials (RCTs), and clinical trials that assessed the success of LSTR therapy in primary molars were chosen for the review. Two independent reviewers were involved in the selection of studies, extraction of data, assessment of bias using Cochrane Collaboration's tool in accordance with Review Manager software, and revised, validated version of methodological index for nonrandomized studies (MINORS) criteria, clinical and radiographic success of TAP. Results: Eight studies were selected for qualitative analysis where the risk of bias varied from low to unclear according to the Cochrane tool's domains. Overall, studies showed a high risk of bias and a low level of evidence. Included studies demonstrated clinical success rate ranged from 83.3 to 100% at 12 months, 82.3 to 84.2% at 18–21 months, and 82.7% at 24–27 months, while radiographic success rate ranged from 45.8 to 90% at 12 months, 40.7 to 76.4% at 18–21 months, and 36.7% at 24–27 months recall visits. Conclusion: Lesion sterilization and tissue repair (LSTR) therapy using TAP showed favorable clinical success but a low radiographic success rate in primary molars. Clinical significance: Lesion sterilization and tissue repair (LSTR) therapy can be a suitable alternative treatment option to salvage a tooth with a poor prognosis. Literature supports the rationale of employing LSTR therapy in such situations, thereby restricting the need for the premature extraction of a primary tooth.