Aim: To evaluate the levels of two putative periodontal pathogens, Porphyromonas gingivalis (Pg) and Prevotella intermedia (Pi), in plaque samples of mentally depressed patients. Materials and methods: A total number of 110 patients clinically diagnosed to have mental depression by the psychiatrist, in the age range of 20–50 years, were included. Clinical parameters such as gingival index, plaque index, and clinical attachment level were recorded. Samples of supragingival plaque were sent to the microbiology lab for culturing. Results: Collected plaque samples exhibited elevated amounts of Pi and Pg on culturing. The levels of pathogens (Pg and Pi) were more in patients with greater attachment loss. Conclusion: This preliminary study showed that mental depression might alter the periodontal microflora of mentally depressed individuals towards a more pathogenic one. Clinical significance: Elevated levels of Pg and Pi in plaque samples of mentally depressed individuals can increase the susceptibility to periodontitis, deteriorate mental well-being, and aggravate periodontal destruction.

Aim: The aim of the current study is to check for the anti-inflammatory activity of clove and ginger formulated along with zinc oxide (ZnO) nanoparticles (NPs) in a mouthwash. Materials and methods: A mixture of 1 gm each of ginger and clove powder was dissolved in 100 mL distilled water, heated, and filtered. ZnO NPs were synthesized by mixing 20 mM zinc nitrate [Zn(NO₃)₂] with plant extract and centrifuging the resulting suspension. Mouthwash was prepared by dissolving 0.3 gm sucrose, 0.001 gm sodium benzoate, and 0.01 gm sodium lauryl sulfate in 9.5 mL distilled water and adding 50 µL peppermint oil and 500 µL NP suspension. The solution was shaken, and 10 mL of the resulting mouthwash was obtained. The standard used was diclofenac sodium with dimethyl sulfoxide (DMSO) as a control. The anti-inflammatory activity of the combination of clove and ginger formulation-mediated ZnO NP mouthwash was conducted through bovine serum albumin assay and egg albumin assay. Results: In the bovine serum albumin assay, the various fixations of clove and ginger formulation from 10–50 μL obtained various results of inhibition of 45, 55, 65, 75, and 85%, respectively, in comparison to the standard diclofenac sodium. As a result, when the concentration of the ZnO NPs increased, the inflammatory activity also increased with significant (p < 0.05) values. In egg albumin assay, the various fixations of clove and ginger formulation from 10–50 μL obtained various results of inhibition 50, 65, 70, 70, and 80%, respectively, in comparison to the standard diclofenac sodium. Group stats and independent t-test reveal a significant correlation at 40 μL (p = 0.01) between the test group and the control group showing increased inflammatory activity. Conclusion: The results of the study suggest that ZnO NPs strengthened with ginger and clove extracts may have anti-inflammatory characteristics and be utilized as an alternative formulation to commercially available mouthwash. Clinical significance: Ongoing research and development in the field of dentistry has led to the emergence of alternative methods for improving the efficacy of dental varnishes in preventing dental caries. One promising approach involves incorporating herbal resources and NPs into the formulation. This development is clinically significant as it addresses the limitations of traditional agents and offers a potentially more effective way to prevent tooth decay.

Aim: The present in vitro study aimed to evaluate and compare the remineralization potential of—2% sodium fluoride (NaF), 2% NaF along with Psoralea corylifolia L. (Leguminosae) (Bakuchi), and white mineral trioxide aggregate (MTA) using Vickers hardness number (VHN) and scanning electron microscopy–energy dispersive X-ray analyzer (SEM-EDX). Materials and methods: The present in vitro study was conducted on 45 sound premolars, sectioned into two parts, further embedded in acrylic resins, polished, and divided into three groups of normal, demineralized, and remineralized teeth (n = 15). The remineralized teeth were further subdivided into three groups (n = 15) as remineralized with 2% NaF, 2% NaF, and Psoralea corylifolia L. (Bakuchi) and white MTA. Specimens of each group were treated with the above-mentioned remineralizing agents and then subjected to VHN and SEM-EDX for further evaluation. Results: The test results showed significantly the highest VHN and the emission peak of elements under the EDX test, such as calcium (Ca), phosphorous (P), oxygen, and fluorine (F) with the group remineralized with NaF + Bakuchi (group III-B). Conclusion: Sodium fluoride (NaF) + Bakuchi showed effective results in VHN and SEM-EDX with no antagonist interaction. Thus, Psoralea corylifolia L. has a remineralizing effect on the tooth and can be used as a herbal extract for effective reduction in pathogenic bacteria. Clinical significance: Psoralea corylifolia L. (Bakuchi), when mixed with NaF, has great potential for use in dentifrices and mouthwash and has revealed appreciable results on remineralization of artificially demineralized enamel lesions when compared to the MTA and NaF alone.

Aim: To quantify and compare the variation in the dimensions of the atlas vertebra among patients with classes I, II, and III skeletal bases on a lateral cephalogram. Materials and methods: Lateral cephalograms of 75 patients aged 19–43 years were evaluated. Subjects were divided into three groups (25 each) based on their A point, nasion, B point (ANB) angle. Group I included class I subjects with ANB angle 0–4^°, group II included class II subjects with ANB angle >4^°, and group III included class III subjects with ANB of <0^°. Three linear measurements, that is, the anteroposterior dimension, height of the slimmest part of the posterior neural arch, and height of the dorsal arch were used to assess the dimensions of the atlas vertebra. The data were recorded, tabulated, and statistically analyzed. Results: Mean difference in the anteroposterior dimension of the atlas vertebra was statistically significant with the highest dimension in the class II group followed by classes I and III (p < 0.001) whereas, the mean height of the dorsal arch was found to be the highest in the class III group followed by classes I and II (p < 0.000). Conclusion: There are variations in the anteroposterior dimension and height of the dorsal arch of the atlas vertebra among patients with classes I, II, and III skeletal bases. Clinical significance: Dimensional measurements of the atlas vertebra and its specific variations in patients with different skeletal base patterns performed on a lateral cephalogram itself give an endowment to study the morphology of the atlas vertebra in routine clinical status quo without the requisite of any added diagnostic investigations such as cone-beam computed tomography (CBCT). Understanding of such variances can be integrated during diagnosis and treatment planning to take suitable preventive and interceptive procedures in any developing patterns of malocclusion.

Aim: To assess the antimicrobial efficacy and cytotoxicity of Cocos nucifera (C. nucifera) and Triticum aestivum (T. aestivum) based oral gel formulations. Materials and methods: Cocos nucifera (C. nucifera) and T. aestivum based oral gel preparation was formulated. Antimicrobial activity was assessed against bacterial strains of Streptococcus mutans (S. mutans), Escherichia coli (E. coli), Bacillus, and Staphylococcus aureus (S. aureus) and a brine shrimp lethality assay was performed to assess the cytotoxicity. Results: The antimicrobial activity was comparable to that of the control (amoxicillin), with the highest zone of inhibition of 13 mm at 100 µL. The cytotoxic effects were noted only at higher concentrations. Conclusion: The oral gel formulation has the cumulative effect of both herbs with potent antimicrobial activity and less cytotoxicity. Clinical significance: The herbal gel formulation can be used as an alternative to established medications for the treatment of oral inflammatory lesions and infectious pathologies.

Introduction: With the ongoing development of digital procedures, intraoral scanning devices, and associated workflows are conquering dental practice. The intraoral scan and its digital models (DM) are being considered as a replacement for conventional impressions in pedodontics because of several potential advantages in hygienic handling, the comfort of treatment, transferring of data, analyzing and storing diagnostic models, and manufacturing orthodontic appliances. Material and methods: A total of 22 children of age 5–11 years were divided into two groups; stone model (SM) (group I; n = 22) and DM (group II; n = 22). Two trained examiners recorded the following parameters of intercanine width, intermolar width, arch perimeter, and arch length on both stone and DMs. Results: The present study was carried out to check the accuracy of intraoral scanners in establishing dental measurements in mixed dentition. DMs had a significantly higher intermolar width, while the differences between other parameters were found to be nonsignificant (p < 0.05). Also, SMs showed a lower arch perimeter value (p < 0.05). Conclusion: Intraoral scanners constitute a paradigm change in the evolution of digital dentistry as an effective tool for orthodontic diagnosis and treatment planning. Additionally, intraoral scans have clinically acceptable accuracy, reliability, and reproducibility of the tooth measurements and can be a viable alternative to SMs and calipers for dental arch analysis.

Aim: The present study aims at exploring the prevalence of tooth wear and its impact on the quality of life (QoL) among adults in the Dakshina Kannada population. Materials and methods: A total of 206 dentate adults who visited the outpatient department of a private dental college were included in the study. During clinical examination, an assessment of tooth wear was done using basic erosive tooth index. It was categorized as none, mild, moderate, and severe. The impact of tooth wear on QoL was assessed using the oral health impact profile (OHIP-14). The associations between tooth wear measures and OHIP-14 were analyzed. Results: The basic erosive tooth index low score (range 3–8) was seen in 59 (22.85%). A medium score (range 9–13) was seen in 100 (71.3%), and a high score (14 and above) was seen in 47 (22.8%). Moderate and severe (high) tooth wear had an impact on QoL. Conclusion: Moderate and high tooth wear were noticed in the study population. Tooth wear has an impact on QoL. Along with clinical findings, the impact of tooth wear on QoL needs consideration by the dental professional so that they will be able to provide preventive or restorative management accordingly. Clinical significance: Early detection of tooth wear can be managed effectively and efficiently. This will be able to reduce discomfort, cost, and duration of the treatment needed. The impact on QoL also may be less.

Aim: To compare and measure the maximum bite force of bounded saddle partial dentures made of heat cure acrylic resin and flexible nylon material opposing natural teeth with that of the opposite dentulous side and also to compare the maximum bite force between maxillary and mandibular bounded saddle partial dentures over different adaptation periods. Materials and methods: 10 partially edentulous Kennedy's class III subjects were selected based on the inclusion and exclusion criteria. Tooth bounded saddle removable partial dentures maxillary or mandibular made of heat cure acrylic resin were inserted and the bite force was measured using strain gauge transducer at different adaptation periods starting from 1, 15, 30, and 90 days. The acrylic dentures were replaced with flexible dentures after 90 days and the bite force was recorded at the same adaptation periods. The maximum bite force with acrylic and flexible partial dentures was evaluated. The bite force between the replaced side and opposite dentulous side was also evaluated and interpreted. Results: The mean comparison between acrylic and flexible tooth bounded partial dentures shows that flexible partial denture is having the highest mean p-value <0.001 than acrylic partial denture at different adaptation periods and it is statistically significant. The bite force increased with increased adaptation periods in both the groups. The bite force is higher in dentulous side compared to the replaced side. Conclusion: The flexible denture showed higher maximum bite force values than the acrylic partial denture with increased adaptation period. The maximum bite force in natural dentition side is higher than the replaced artificial teeth. This indicates that presence of physiological human factors influences the bite force and oral sensorimotor of the natural teeth. Clinical significance: Evaluation of bite force in the tooth bounded saddle with removable partial dentures made of different denture base materials helps us to understand better about the biomechanics of the prosthesis. This helps to rehabilitate the patient with proper denture base material to improve their chewing efficiency.

Aim: To evaluate the sealing ability of different types of calcium silicate-based cement (CSC) when used as retrograde filling materials. Materials and methods: A total of 85 extracted single-rooted teeth were decoronated, instrumented, and obturated. A 3 mm root end resection was performed, followed by a 3 mm retrograde cavity preparation. Teeth were randomly divided into five equal groups (n = 15) according to the retro-filling material applied; group I, ProRoot mineral trioxide aggregate; group II, Biodentine; group III, NeoPutty MTA; group IV, Produits Dentaires (PD) MTA White; group V, TheraCal LC, in addition to positive and negative controls. After 24 hours, the roots were covered with nail polish and immersed in methylene blue dye for 24 hours. After longitudinal sectioning using a diamond disk, roots were examined using a stereomicroscope at 8× magnification for dye penetration, and maximum linear dye penetration was measured in millimeters using ZEN 3.4 software. Statistical analysis was performed using a one-way analysis of variance (ANOVA) test followed by Tukey's post hoc test. Results: All tested retro-filling materials showed dye penetration and failed to totally seal the root end. ProRoot MTA and Biodentine showed the least dye penetration, followed by NeoPutty and PD MTA White with a statistically significant difference. TheraCal LC showed maximum dye penetration with a statistically significant difference. Conclusion: Altering the consistency and manipulation of different CSC significantly affects their sealing ability. Clinical significance: Proper sealing of the retrograde cavities is mandatory. ProRoot MTA and Biodentine provided a better sealing ability for retrograde cavities.

Aim: The aim of the present study was to assess the outcome of full-mouth disinfection (FMD) on serum ferritin levels from baseline (0 day) to 90th day in subjects with periodontitis. Materials and methods: A total of 28 periodontitis individuals were selected and randomly allocated into two study groups. The conventional staged scaling and root planing (CSSRP) group consisted of 14 subjects with stage II grade I periodontitis who were scheduled for CSSRP. The FMD group consisted of 14 subjects with stage II grade I periodontitis who were scheduled to undergo FMD. Modified gingival index (MGI), probing pocket depth (PPD), bleeding on probing (BOP), and clinical attachment level (CAL) were the periodontal parameters assessed in the present study, followed by the estimation of serum ferritin levels at baseline (0th day) and 90th day. Results: Increased serum ferritin levels were observed in both the CSSRP group and FMD group at baseline (0th day). On the 90th day, both groups showed a statistically significant decrease in serum ferritin levels following CSSRP and FMD. However, the FMD group showed an additional reduction of serum ferritin levels when compared to the CSSRP group. Serum ferritin was positively correlated with all the periodontal variables in both groups. Conclusion: The present research concluded that FMD showed marginal improvement in serum ferritin levels compared to conventional staged SRP, thus concluding that FMD has an additive effect on serum ferritin levels in decreasing the inflammatory burden. Clinical significance: Serum ferritin can be regarded as a potential diagnostic as well as a prognostic biomarker for assessing the inflammatory status of periodontitis following nonsurgical periodontal treatment (NSPT).

Aim: To assess the knowledge and awareness of smoking-related health risks and smoking cessation methods among medical students in Telangana, India. Materials and methods: A cross-sectional study was conducted in two medical colleges and a self-designed questionnaire consisting of 14 questions was deployed to 455 medical students in their 1st (52%), 2nd (24%), and 3rd years (24%) of study. Except for questions about age, sex, and education which were open-ended, the rest of the 11 questions were categorized into basic knowledge, effects of smoking on different systems, and awareness of cessation methods, and were close-ended with yes/no responses. These responses were analyzed using descriptive statistics. Results: The study found that, on average, medical students were well aware of the risks of tobacco smoking on cancer incidence (98.96%), chronic obstructive pulmonary disease (COPD) (98.33%), immune system (95.66%), fetus development (98%), and mental health (96%). However, knowledge concerning its potential impacts on gastritis (77%), cataract formation (58%), and metabolic diseases like diabetes (61%) was poor. Furthermore, participants had only limited knowledge about smoking cessation methods like counseling (66.30%), and nicotinic drugs (66.83%). Furthermore, participants had poor knowledge of smoking cessation aids such as nonnicotinic drugs (29.28%), telephonic support (20.66%), and mobile applications (24.75%). The 1st-year students had the overall lowest levels of knowledge, while 3rd-year students had higher knowledge levels of all smoking cessation methods. Conclusion: The present study highlights the need for further educational programs among medical students. Including specific modules on tobacco in the medical curriculum can have a potential impact. In particular, efforts should be made to increase awareness of smoking cessation methods for actionable. Clinical significance: Increasing awareness about tobacco and its detrimental effects among medical students, clinicians, and healthcare workers can significantly improve tobacco control at a national scale.

Aim: The aim of the study was to analyze the bone regenerative potential of a recombinant parathormone derivative in experimentally induced critical-size calvarial defects in Wistar albino rats. Materials and methods: Critical-size cranial defects were created in 30 Wistar albino rats which were randomly divided into five groups. Group I was the sham control, in groups II, III, and IV defect was filled with 10, 20, and 40 μg concentrations of recombinant parathyroid hormone (PTH) respectively, in group V, the defect was filled with β-tricalcium phosphate (TCP) + hydroxyapatite (HA). The bone regeneration was assessed at 30 and 60 days, postoperatively by histopathology, histomorphometry, and radiographs. At the end of the experiment, a toxicity analysis was also done. Results: Histological evaluation showed trabecular bone formation in the groups that received parathormone derivative. Histomorphometry showed lesser inflammatory changes, better bone width, improved thickness of bone trabeculae, better bone quality, increased osteocyte count, and a higher percentage of new bone formation in group IV. The radiographs also showed improved bone regeneration in group IV. The serum biochemical parameters such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and creatine kinase (CK) showed significant alterations (p < 0.01) in all the treatment groups when compared to the control group. Conclusion: The results suggest that the local administration of recombinant parathormone derivative encouraged bone healing in critical-size calvarial defects in rats. The 40 μg concentration is found to be the most effective dosage with no associated organ toxicity. Clinical significance: Complete alveolar bone regeneration is still an elusive goal in periodontal therapy. Local application of recombinant parathormone derivative might have a promising role in periodontal regeneration.

Aim and background: Third molar extractions are performed quite frequently in a clinical setup. However, complications associated with surgery of impacted mandibular third molars reporting pseudoaneurysm formation are extremely rare. In the present case report, we discuss a case of an aneurysm associated with a wisdom tooth in the lower left region of the jaw in a middle-aged patient. Case description: A 30-year-old male reported a chief complaint of pain in the lower left region of the jaw. On oral examination, a partially erupted third molar was seen associated with bleeding on probing. A computed tomography angiography (CTA) of the neck was done, which revealed left facial artery saccular aneurysmal dilatation. An emergency embolization was planned. Under general anesthesia, in the first half, the department of vascular intervention (DVI) radiology team performed the carotid angioplasty with embolization which was followed by the maxillofacial team, who performed a surgical extraction of the partially erupted third molar in the left quadrant. He was then shifted to the general ward and discharged the next day in an overall stable condition. Conclusion: Even though traumatic aneurysms are uncommon in the facial region; it is essential to include this lesion in the differential diagnosis of soft tissue lesions in order to prevent severe bleeding complications. Clinical significance: Oral surgeons must promote the spread of awareness regarding routine dental visits for early diagnosis.

Background and aim: The aim of this article is to report a rare case of odontogenic myxoma (OM) with concurrent fragile X syndrome (FXS). OM has a high rate of recurrence, which makes its management very significant. Case description: A 10-year-old male patient reported to the dental outpatient department (OPD) with a chief complaint of swelling on his right lower side of the face for 3 months. His medical history revealed “FXS” and epilepsy. The swelling was evident extra-orally, and on intraoral examination, it extended into the buccal vestibule on the right side from 44 to 47 regions. Radiographic examination revealed a well-defined radiolucency measuring 2 × 2 cm. On histopathological examination, a final diagnosis of OM was established. Excision of the lesion was performed under general anesthesia, and no recurrence has been noted yet. Conclusion: This is the first report in the literature on OM occurring in an FXS patient treated with enucleation and peripheral ostectomy. The existence of OM, FXS, and epilepsy is a challenging aspect to manage. Clinical significance: Oral surgical procedures in patients with FXS can be performed with a good prognosis. The presence of comorbidities and locoregional challenges should be addressed for optimum management outcomes.

Aim: The objective of this article is to review the evolution and advancement of biomaterials in the dental sector, especially the development of biomaterials for dental implants, while also focusing on their biocompatibility properties and assessment procedures. Background: Biomaterials are rapidly developing new classes of materials, particularly in the fields of medicine and materials engineering. Dentistry exerts special demands on the materials used to repair damaged hard tissues, like teeth and bones, as well as damaged soft tissues. In terms of their physical, chemical, and biological activities, a variety of materials are being used with potential benefits and drawbacks. Review results: The dental care sector is benefiting from the growth of biomaterials with specialized properties. Titanium (Ti) and its alloys, zirconia (Zr), and a few biopolymers are the most commonly utilized biomaterials. These materials are suitable for usage due to their anticorrosion, mechanical strength, biocompatibility, and nontoxicity properties. In allergic people, these materials can cause inflammation, bone loss, and pain, despite their widespread use. Conclusion: These biomaterials have received considerable attention given their numerous potential uses in the medical field and their advantages in the long-term safety of implants. It is very important to choose a material that meets the requirements for biocompatibility and has a low risk and a high benefit-to-risk ratio. Clinical significance: As the world recognizes the superior functional features of one material over another, the dentistry industry is transitioning to the idea of material advantage. In light of this, there has to be additional investigation into the materials’ individual performance in reducing allergic reactions in people with consistent success.