Aim: The aim of the present preliminary study was to determine sugar concentration in infant follow-on formulas most widely consumed in Peru. Materials and methods: In this descriptive and observational study, the sample was represented by five brands of infant follow-on formulas most consumed in Peru (A, Similac 2; B, Enfamil 2^®; C, NAN 2^®; D, Baby Lac Pro 2^®; and E, Lacti Kids Premium 2®); with two samples of each, collected at two different locations in the Peruvian capital. Subsequently, the concentration of total and individual sugars (lactose, sucrose, glucose, fructose, and maltose) was determined using the high-performance liquid chromatography (HPLC) method in a specialized laboratory. For the comparison of means, Welch's robust analysis of variance (ANOVA) test for equality of means and Tukey's post hoc test were used. The significance level was p < 0.05. Results: The total sugars concentration per 100 gm of the five infant follow-on formulas showed a mean of 38.9 ± 11.03 gm, being Similac 2, the infant follow-on formula, with the highest concentration of 50.33 ± 0.11 gm and Enfamil 2, the lowest with 22.75 ± 0.06 gm. The average sugars recorded in the laboratory were compared with those on the product label for Similac 2 (50.3 and 53.1 gr), NAN 2 (46.5 and 51.5 gr), Baby Lac Pro 2 (41.5 and 57.0 gr), Lacti Kids Premium 2 (33.3 and 57.0 gr) and Enfamil 2 (22.8 and 56.0 gr). Furthermore, when comparing the infant follow-on formulas, significant differences were observed between all sugar concentrations (p < 0.001), with the follow-on formula with the significantly higher sugar concentration being Similac 2 (p < 0.001) and the one with the significantly lower concentration being Enfamil 2 (p < 0.001). Regarding individual sugars, per 100 gm analyzed, fructose and maltose registered values <0.70 g. Similar values were obtained for glucose except for Enfamil 2 (1.07 ± 0.01gr) and Baby Lac Pro 2 (0.72 ± 0.01gr) and for sucrose except for Lacti Kids Premium 2 (11.92 ± 0.01gr) and Similac 2 (9.94 ± 0.08 gr). On the other hand, the highest lactose value found was in NAN 2 (46.51 ± 0.08 gr), and the lowest value obtained was in Lacti Kids Premium 2 (21.42 ± 0.01 gr). Conclusion: There is a variability of sugar concentrations in infant follow-on formulas, being these values lower than those referred to on product labels. The formula with the lowest discrepancy was Similac 2, while the formula with the highest discrepancy was Enfamil 2, with Similac 2 and Enfamil 2 being significantly the formulas with the highest and lowest sugar concentration, respectively. In addition, among individual sugars, lactose, and sucrose stood out in greater proportion compared to other free sugars. Clinical significance: It is important that institutions responsible for infant nutritional safety encourage and promote the use and practice of breastfeeding during early life and provide adequate guidance regarding daily doses of infant follow-on formulas since, according to the World Health Organization (WHO), the high consumption of free sugars contained in these formulas can put infants’ oral health at risk.

Aim: To clinically evaluate the effectiveness of 0.5% nano-chitosan mouth rinse on salivary pH and antimicrobial activity against salivary Streptococcus mutans (S. mutans) count and to ascertain its functionality as an anticaries mouth rinse in children. Materials and methods: A total of 42 participants with decayed, missing due to caries, and filled teeth (DMFT) index ≥4 and simplified oral hygiene index (OHI-S) score ≥1.3 in the age range of 7–12 years were recruited for the study after taking informed consent. Unstimulated saliva was collected, and baseline pH was calculated using pH strips. Children were asked to rinse 10 mL of nano-chitosan for 60 seconds once daily for about 10 days. The subjects were recalled for evaluation once the rinsing regimen was completed on the 11th day. The postrinse saliva sample was collected, and its pH was noted down. The bacterial count was determined by inoculating salivary samples on Mutans-Sanguis agar before and after mouth rinsing. Statistical analysis was done using a correlation test and paired t-test. Results: Statistically significant increase in salivary pH and a decrease in S. mutans count was observed after rinsing with nano-chitosan in comparison to baseline values. Conclusion: Nano-chitosan mouthwash was effective in altering the pH to a more desirable state and reducing the salivary S. mutans count. It may therefore be considered as a potential anticaries mouthwash. Clinical significance: Amidst the proliferation of numerous anti-Streptococcus preventive agents, there is much effort being put into developing safe, easily available, and natural alternatives to conventional mouth rinses. The introduction of a natural mouth rinse such as chitosan, which has lucrative properties, can be a valuable additive to the existing mechanical plaque control measures.

Aim: The goal of this study was to find out the impact of vitamin D deficiency on gingival, plaque, and calculus indices (CalI) and prostaglandin E2 (PGE2) levels in unstimulated saliva. Materials and methods: This study was a case-control type, and the total sample was 80 women aged 20–30 years—the first group consisted of 40 women with vitamin D levels below 10 ng/mol, and the second group consisted of 40 women with vitamin D levels 30 ng/mol or more. The College of Dentistry/the University of Baghdad Ethical Committee provided a consent form. Oral health status assed by using the plaque index (PlI) of Silness and Loe (1964), Ramfjord's CalI (1959), and Loe and Silness’ gingival index (GI) (1963). A collection of unstimulated saliva was done to measure salivary PGE2. Results: Current study data revealed that the GI and PGE2 were higher in the study group, with statistically highly significant (p < 0.01) and significant (p < 0.05) differences, respectively. Both plaque and CalI were found higher in the study with no significant difference (p > 0.05). Conclusion: This study reported an increase in the salivary PGE2 and GI among vitamin D deficient women. Clinical significance: To preserve oral health, healthcare providers must raise awareness. Controlling vitamin D levels for oral health is a matter that should not be ignored, particularly in early life.

Aim: This study aimed to compare the efficacy of conventional syringe irrigation (CSI), erbium-doped yttrium aluminum garnet (Er:YAG) light amplification by the stimulated emission of radiation (laser), and shock wave enhanced emission photoacoustic streaming (SWEEPS) for smear layer removal. Materials and methods: In this ex vivo study, the smear layer was removed from the root canals of 36 extracted single-canal teeth in six groups by using the following modalities—ethylenediaminetetraacetic acid (EDTA) + sodium hypochlorite (NaOCl), NaOCl + EDTA + Er:YAG laser, NaOCl + EDTA + SWEEPS, distilled water + Er:YAG laser, distilled water + SWEEPS, and distilled water alone. In all laser groups, Er:YAG laser (Fontana, Slovenia) was used with 20 mJ energy for 20 seconds. The laser was irradiated with 0.3 W power with 50 µseconds pulse width and 15 Hz frequency for 20 seconds with air and water spray in off mode. The amount of smear layer was quantified under a scanning electron microscope (SEM) at ×1000 magnification using a 5-point scoring system. Data were analyzed by the Kruskal–Wallis test. The p-value was set at <0.05. Results: A significant difference was noted in smear layer removal between the EDTA groups and distilled water groups (p < 0.001). However, the difference was not significant between the EDTA groups with each other or between the distilled water groups with each other (p > 0.05). In EDTA groups, laser activation of irrigant and use of SWEEPS mode showed better smear scores in the middle and apical thirds. Conclusion: According to the limitation of the present study, Er:YAG laser and SWEEPS technique can remove the smear layer effectively in the presence of EDTA. SWEEPS mode of Er:YAG laser can serve as a suitable alternative to the conventional Er:YAG laser and CSI for smear layer removal from the hard-to-reach areas of the root canal system. Clinical significance: Using Er:YAG or SWEEPS technique was comparatively efficient in cleaning the smear layer, and it can be used for effective removal of the smear layer for clinical usage.

Aim: To evaluate mastoid pneumatization in cone-beam computed tomography (CBCT) scans. Materials and methods: The prevalence of mastoid pneumatization was evaluated among a sample of 300 CBCT scans in this retrospective study. Relevant details, such as age and gender were recovered from the institutional database. The scans were evaluated for pneumatization of the mastoid process and correlated with gender and age. Results: About 30.83% of the scans showed pneumatization of the temporal region of the temporomandibular joint (TMJ). No significant correlation of pneumatization with age and gender was found. Conclusion: Excessive pneumatization of mastoid can involve temporal regions of the TMJ in a significant number of populations. This study also marks the usefulness of CBCT in evaluating the temporal bone of the skull. Clinical significance: Cone-beam computed tomography (CBCT) scan is a very useful tool in delineating temporal bone anatomy with high precision and lower radiation and cost. This study helps in the evaluation of extensive pneumatization of mastoid extending to TMJ, which can act as the path of least resistance to the spread of infections and tumors and can also pose surgical challenges.

Aim: To study the mechanism of action of clove and ginger-mediated titanium oxide nanoparticles (TiO₂ NPs)-based dental varnish against Streptococcus mutans (S. mutans) and Lactobacillus species. Materials and methods: Plant extract was prepared from ginger and clove, which was purchased locally and processed in a mixer grinder to create a fine powder. A total of 100 mL of distilled water was used to dissolve 0.5 gm of each of the powders, followed by cooking on a hotplate for 10 minutes at 60°C until it bubbled. The extract was collected, filtered, and stored. Dental varnish is prepared using a titration of 6.26 mm of titanium dioxide powder in 60 mL of distilled water was prepared followed by the addition of 40 mL of plant extract into an orbital shaker. Varied concentrations of dental varnish (25, 50, 100 μL) were introduced into culture well plates consisting of S. mutans and Lactobacillus followed by incubation. Antibacterial properties were analyzed through the recording of zones of inhibition, minimum inhibitory concentration (MIC), and minimum bacterial concentration. Results: The results have demonstrated that when concentration rises, optical density values fall, demonstrating a bactericidal action. The results show a great difference between the values of optical density of the test samples at various concentrations in the order of 25, 50, and 100 μL being the highest when compared with control and antibiotic groups against Streptococcus and Lactobacillus. The results have proved that the greenly generated dental varnish has demonstrated good antibacterial and antibiofilm properties. Conclusion: The results demonstrated that a dental varnish formulation based on TiO₂ NPs mediated by clove and ginger has proved to have an effective antibacterial action and should be further evaluated through in vivo studies too. Clinical significance: Due to their effective antibacterial qualities, titanium dioxide nanoparticles have been used to create a dental varnish that works well when combined with natural compounds like ginger and clove. This varnish can be improved with further testing using in vivo simulations.

Aims: The aim of this study was to compare the fracture resistance of endodontically treated teeth restored with fiber-reinforced composite core and crown using different postmaterials at different ferrule heights. Materials and methods: A total of 49 extracted single-rooted lower premolar teeth were grouped into control (sound teeth), prefabricated fiber posts—IA (no ferrule), IB (2 mm ferrule), IC (3 mm ferrule), and prefabricated metal posts—IIA (no ferrule), IIB (2 mm ferrule), IIC (3 mm ferrule), with seven teeth for each group. After root canal treatment, posts were cemented, fiber-reinforced composite cores were built-up, and then metal crowns were cemented. Teeth were subjected to thermal cycling and compressive load until fracture. Results: The control group exhibited the highest mean [standard deviation (SD)] fracture resistance [1041.31N (± 278.40)]. For comparison of the mean fracture resistance between fiber and metal posts at different heights of ferrule restored with fiber-reinforced composite cores, a significant difference was observed at 0 mm ferrule (p = 0.003). The association between fracture mode and types of prefabricated post was significant at 0 mm ferrule (p = 0.026). All teeth in fiber posts group had favorable fracture mode. Conclusion: In the presence of ferrule, the fracture resistance of endodontically restored teeth with fiber posts and fiber-reinforced composite cores was comparable to those restored with metal posts. The favorable fracture mode occurred in teeth restored with fiber posts and fiber-reinforced composite cores, either with or without the ferrule. Clinical significance: The fiber-reinforced composite cores increased the fracture resistance of tooth restored using fiber post with the presence of ferrule and resulted in favorable fracture mode in teeth with or without the ferrule. In the clinical situation, this material has the potential to be used for a core material in combination with the use of fiber posts for endodontically teeth with compromised coronal tooth structure.

Aim: To compare the effects of AdvanSync and Forsus appliance on mandibular anterior teeth in the correction of Class II malocclusion using cone-beam computed tomography (CBCT). Materials and methods: A total of 20 patients with skeletal Class II malocclusion (age—13–29 years) were divided into two groups of 10 patients each (group I—AdvanSync, group II—Forsus). CBCT scans were taken at T0 (prefixed functional therapy) and at T1 (after 6–12 months of fixed functional therapy) to evaluate apical root resorption, changes in tooth inclinations, marginal bone height, and labio-lingual bone thickness at the mid-root and apical level in mandibular anterior teeth. Measured data were analyzed using the Wilcoxon signed-ranked test and Mann–Whitney U test. Results: Between the groups, parameters like root resorption and incisor inclination showed no significant changes, while parameters like bone height and thickness showed statistically significant differences (p < 0.05). The marginal bone height on the labial side of the canine decreased significantly for the Forsus group. At the mid-root level, the bone thickness was reduced on the labial side of the central incisors in the AdvanSync group, while it increased on the lingual side of lateral incisors for the Forsus group. At the apex, deposition was seen in the labial aspect of canines in the AdvanSync group, whereas it was on the lingual side of lateral incisors in the Forsus group. Conclusion: Fixed functional therapy causes a significant amount of root resorption, proclination, and changes in the alveolar bone height and thickness in the mandibular anterior region, irrespective of the type of appliance. Clinical significance: Both appliances are effective in the correction of Class II malocclusion with similar results. Adverse effects seen with fixed functional appliances should be minimized, which shows that proper case selection is necessary to achieve better treatment results.

Aim: The present ex vivo study was designed to assess the in vitro effects of low-level laser therapy (LLLT) on the viability and proliferation of gingival mesenchymal stem cells (GMSCs). Materials and methods: Gingival explants were obtained from the gingival collar of teeth advised for minor gingival surgical procedures. Following processing, the GMSCs were irradiated with a 660 nm diode laser according to the following groups. Group I—1 J/cm², 25 mW, and 40 seconds; group II—2 J/cm², 50 mW, and 10 seconds; and group III—no irradiation (control group). 3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide (MTT) assay was done to assess the rate of cell proliferation by measuring the absorbance values using a spectrometer. The mean values of absorbance in each of the three groups were considered for statistical analysis separately at 12 and 24 hours, respectively. Results: The absorbance values of tetrazolium reduction were directly proportional to the rate of cell proliferation. Both groups I and II showed statistically significant differences in the absorbance rates from 12 to 24 hours after irradiation. Both at 12 and 24 hours after irradiation, group I exhibited a greater absorbance value compared to group II and this difference was statistically significant (p < 0.05). Conclusion: Low-level laser therapy (LLLT) using 660 nm diode laser with different energies showed a positive effect on in vitro proliferation of GMSCs. The rate of proliferation was comparatively more significant at 12 hours and lower energy. Clinical significance: This study provides a basis for the probable application of LLLT as a tool in tissue engineering using GMSCs.

Aim: The aim of the current research was to evaluate the impact of dissimilar implant abutment geometry on the retention of implant-supported cemented prosthesis. Materials and methods: A total of 60 specimens were utilized in the current research. Similarly designed implant abutments having a height of 6.0 mm and 6° taper were allocated to one of the following three groups (20 specimens in each group)—group I—control group, group II—abutment with sandblasting management, and group III—abutments having circumferential grooves. Each specimen was implanted in self-curing acrylic resinous blocks. Every implant abutment was positioned in the respective analog. Alike nickel-chromium (NiCr), cast copings were primed to adapt to every abutment. Individual copings were cemented to relevant abutments using zinc phosphate employing the typical measures. The specimens were consequently subjected to assembly in the Instron universal test equipment and dragged out at a crosshead speed of 0.5 mm/minute in anticipation of the metal coping debonding off the abutment. Results: 1016.44 ± 0.14 was the greatest mean retentive potency noted in abutments having circumferential grooves in pursuit by abutments with sandblasting management at 879.02 ± 0.18 and 358.36 ± 0.26 for the control group. A statistically noteworthy dissimilarity was noted among the three groups with a p-value < 0.001. Conclusion: Within the study limitations, the current research arrived at a conclusion that better retentive potency was noted in abutments having circumferential grooves compared to abutments with the sandblasting group as well as the control group. Clinical significance: Many factors influence the retentive capacity of the cement-retained prosthesis. To attain ample retention for implant crowns, surface amendment of the abutments is essential when choosing a cemented prosthesis.

Aims: This study aims to evaluate the visfatin levels in periodontally healthy persons and subjects with chronic periodontitis and their change in levels with regard to nonsurgical periodontal therapy (NSPT). Materials and methods: A total of 30 individuals with healthy periodontium and 30 patients with chronic periodontitis in the age range of 25–65 years and with normal body mass index (BMI) were selected for the study. Scaling and root planing were done for chronic periodontitis patients and were reviewed after 2 months. Periodontal clinical parameters were noted, and salivary and serum samples were collected and stored during the first visit and review. Visfatin levels in the samples were evaluated using enzyme-linked immunosorbent assay (ELISA). Results: Chronic periodontitis patients had elevated levels of serum (38.1 ng/mL vs 16.42 ng/mL) and salivary (57.86 ng/mL vs 19.94 ng/mL) visfatin in comparison to healthy controls. In periodontitis patients, serum (38.1 ng/mL to 20.32 ng/mL) and salivary (57.86 ng/mL to 19.62 ng/mL) levels of visfatin were reduced in response to NSPT. Conclusion: The elevation in serum visfatin and salivary visfatin levels in chronic periodontitis patients and its reduction in response to NSPT makes visfatin a probable disease marker and a potential therapeutic target for assessing treatment efficacy. Clinical significance: Visfatin, being an adipocytokine, is closely related to the process of inflammation cascade. Its association with periodontal inflammation and health, as seen in the present study, shows that visfatin may be utilized as a marker in the diagnosis of periodontitis and in the evaluation of treatment efficacy.

Aim: The aim of the current research was to appraise the effectiveness of three radicular surface biomodification agents on the regeneration of periodontal tissues. Materials and methods: A total of 60 human permanent mandibular premolars with a solitary root that was subjected to extraction owing to complex periodontal pathosis were chosen for the purpose of this research. Decoronation and longitudinal splitting of the sample tooth were performed to create sections that were shaped into a rectangle having estimated proportions of 4 × 2 × 1 mm employing slow-speed diamond bur beneath water irrigation. Next, the chosen teeth were allocated at random using a simple random technique into one of the following three groups—group I, application of Carisolv^™ root biomodification agent; group II, application of ethylenediaminetetraacetic acid (EDTA) root biomodification agent; group III, application of a mixture of tetracycline isomer, acid, detergent (MTAD™) root biomodification agent. Each sample was evaluated and observed beneath the scanning electron microscope (SEM) at 1000× magnifying power to appraise alterations on the radicular surfaces. Results: Carisolv^™ radicular biomodifiers exhibited the greatest radicular surface biomodification at 2.92 ± 0.12, in pursuit by EDTA radicular biomodifiers at 3.38 ± 0.09, finally followed by MTAD™ radicular biomodifiers at 3.52 ± 0.14. A statistically significant disparity was noted among the groups. Conclusion: The current research arrived at a conclusion that the Carisolv^™ radicular biomodifiers exhibited the highest radicular surface modifying properties in comparison to EDTA and MTAD™ radicular biomodifiers. Clinical significance: Alterations in radicular surfaces in the surroundings of periodontal disease and the existence of periodontal pockets hamper the periodontal tissue's regenerative process. Periodontal management should thus produce a radicular surface well-suited for the cells that arbitrate repair as well as the periodontal regenerative process.

Background and aim: Choice of the most suitable obturation materials and post–core systems for endodontically treated teeth (ETT) is challenging and should be performed by understanding their areas of applications, advantages, amount and characteristics of remaining tooth structure, and esthetic needs. Case description: The use of mineral trioxide aggregate (MTA) with customized glass fiber post in nonsurgical ETT retreatment of single-rooted teeth is recommended to treat apical root pathosis with open apexes. A combination of those materials can provide impressive results in the anterior esthetic zone and in the presence of immature and wide canals. Conclusion: This report demonstrated the use of MTA and customized glass fiber posts for nonsurgical root canal (RC) retreatment of maxillary anterior teeth for a young male patient. Clinical significance: This technique is simple, effective, less invasive, and suitable for apical apexification and to restore wider ETT canals.

Objective: This study was conducted to explore authorship characteristics and publication trends of all orthodontic randomized controlled trials (RCTs), systematic reviews (SRs), and meta-analyses (MAs) published in South Asian Orthodontic Journals (SAOJ) from 2015 to 2022. Materials and methods: Appropriate search strategies were developed to search for all articles published from January 2015 to July 2022. Asian Pacific Orthodontic Society (APOS) Trends in Orthodontics, Bangladesh Journal of Orthodontics and Dentofacial Orthopedics (BJODO), The Journal of Indian Orthodontic Society (JIOS), Orthodontic Journal of Nepal (OJN), and Pakistan Orthodontic Journal (POJ) are the only five orthodontic journals that meet these requirements. The initial search yielded 39 results, but after the inclusion criteria were applied, the final number of articles was reduced to 31. For each article, various authorship characteristics were recorded. All parameters’ frequency distributions were investigated and tabulated. Results: More than half of the included publications (51.7%) were SRs, followed by RCTs (45.1%), and Mas (3.2%) published in SAOJ. JIOS appeared to outnumber other journals with the most publications, followed by APOS trends in Orthodontics, OJN, and BJODO. Almost 80.4% of articles were acknowledged by educational institutes. Authorship status of the publications authored by two researchers in JIOS and OJN, three in APOS Trends in Orthodontics, and four or more in JIOS. Conclusion: From 2015 to 2021, the amount of level-1 evidence orthodontic literature published in SAOJ increased dramatically. This implies that journals are becoming more interested in evidence-based orthodontic studies, as well as a trend for orthodontic authors to conduct and publish their work. Clinical significance: Academicians, clinicians, and researchers all face challenges in keeping up with the literature as a large number of studies are published in dentistry. RCTs, MAs, and RCTs aid in the summarization of the outcomes of various intervention trials and are thus valuable methods for evidence-based research.

Background: Various surface treatments have been carried out to improve the stability of the orthodontic mini-implants (OMIs) and reduce the failure rate. The current review aimed to systematically analyze and report on the evidence about the survival rates of OMIs that are subjected to surface treatment. Objective: To report on survival rates of OMIs subjected to surface treatment. Materials and methods: Search—a complete search on the survival rate of surface-treated OMIs across the following electronic databases PubMed, Cochrane, Google Scholar, and a manual search of orthodontic journals was performed till December 2022. Studies were selected on the basis of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Four randomized controlled trials (RCT) and three prospective clinical trials (PCTs) were included in this review. A total of 379 mini-implants were assessed, out of which 193 OMIs were surface treated. Of the seven studies assessed, four RCTs had a moderate/unclear risk of bias (ROB). Out of three prospective studies, two were of poor quality, and one was moderate. All studies reported higher survival rates of surface-treated OMIs than the nontreated OMIs. No significant differences between surface-treated and nontreated OMIs were noted for insertion torques and mobility. Conclusion: Surface treatment of OMIs significantly improved the survival rate. Insertion torques and mobility were not affected by the surface treatment of OMIs. These results should be interpreted with caution as the overall ROB in the studies included was moderate to high.