Aim: The study aimed to determine the effect of consuming Ajwa dates on salivary flow rate (SFR), pH, and calcium ion level in caries and caries-free individuals. Materials and methods: The subjects selected in the study were 48 individuals who met the inclusion criteria and divided equally into two categories—caries and caries-free groups. Saliva was collected before, 5 minutes after, and 30 minutes after stimulation. SFR was measured by weighing the collected saliva were divided by time. Saliva pH was assessed using a pH meter, and salivary calcium ion levels were determined using the QuantiChrom Calcium Assay Kit. Data were analyzed using statistical analysis determined using the Statistical Package for the Social Sciences (SPSS) program and further analyzed by t-test. Results: The study showed that Ajwa dates significantly upregulated SFR (0.24–0.47 mL/minute), pH (5.77–5.98), and calcium concentrations (1.71–3.58 mg/dL) in caries groups. The increase was also observed in caries-free subjects. Changing in these saliva parameters was noticed in the first 5 minutes, while it returned to baseline after 30 minutes stimulation. Although the increase of pH and calcium between caries and caries-free individuals had no significant difference (p > 0.05), the alteration of SFR in noncaries subjects (0.4 mL/minute) was significantly higher than the caries ones (0.23 mL/minute) (p < 0.05). Conclusion: Ajwa dates increased the SFR, pH, and calcium ion levels after 5 minutes stimulation in both caries and caries-free individuals. However, this effect turned back to baseline values at the time of 30 minutes post stimulation. Clinical significance: Enhancing saliva production by natural foods is an appropriate method benefiting our oral environment. Consuming Ajwa dates induces saliva secretion as well as calcium that notably supports tooth remineralization. Thus, this fruit can become a potential dietary meal in preventing caries development.

Aim: The study aimed to fabricate and evaluate the impact strength and flexural strength of heat-cure polymethyl methacrylate (PMMA) denture base resin, reinforced with human hair and spider silk fibers. Materials and methods: Specimens were made by incorporating human hair fibers and spider silk fibers into the PMMA (by compression molding technique) in varying quantities. The impact strength and flexural strength were measured using standard equipment and compared with control specimens (without reinforcement). A scanning electron microscope (SEM) was used to study the fractured surface of the fiber-reinforced composites. Results: There was a significant increase in impact strength and flexural strength of the reinforced specimens up to a certain optimum level of fiber reinforcement compared to the control specimen. Conclusion: The human hair and spider silk fiber-reinforced PMMA showed a significant increase in mechanical properties. The present investigation proved that the reinforcement of biopolymers such as hair and spider silk could improve the mechanical properties of PMMA acrylic resin, which is widely used as a denture base material for the fabrication of record bases, special trays, etc. Clinical significance: Reinforcement of biopolymers such as hair and spider silk can be incorporated into PMMA acrylic resin to improve its mechanical properties.

Aim: To evaluate the efficacy of titanium dioxide (TiO₂) nanoparticles in combination with hydrogen peroxide (H₂O₂) and carbamide peroxide (CH₆N₂O₃). Materials and methods: A total of 40 freshly extracted maxillary central incisors were discolored by storing them in a freshly prepared coffee solution for 2 weeks and subjected to spectroscopic analysis. Baseline values L1, a1, and b1 of each sample were recorded. The teeth were then randomly divided into four groups (n = 10)—group I was treated with 35% H₂O₂; group II was treated with TiO₂ nanoparticles and 15% H₂O₂; group III was treated with 15% CH₆N₂O₃; and group IV was treated with TiO₂ nanoparticles and 15% CH₆N₂O₃. Immediately after treatment, the samples were analyzed spectroscopically, and the L2, a2, and b2 values of each sample were recorded. The samples were then stored in artificial saliva solution for 7 days and analyzed spectroscopically again, recording L3, a3, and b3 values of each sample. The difference was measured as ΔE*2-1 and ΔE*3-2 for each sample, and the data recorded was statistically analyzed. Results: Mean change in color difference (ΔE*2-1) was higher in group II (2.8200 ± 0.74294) than in group I (2.4300 ± 0.50594) and group IV (2.1360 ± 0.56400) than in group III (2.0910 ± 0.58711). Group II had the highest mean, followed by groups I, IV, and III, respectively. The mean change in color difference (ΔE*3-2) was higher in group II (7.3820 ± 1.31952) than in group I (5.7550 ± 1.18895) and group IV (4.3800 ± 1.56449) than in group III (4.1140 ± 1.00087). Group II had the highest mean, followed by groups I, IV, and III, respectively. The results obtained were statistically significant. Conclusion: The use of TiO₂ nanoparticles with lower concentrations of H₂O₂ and CH₆N₂O₃ has increased the efficiency and longevity of the traditional bleaching agent. Clinical significance: Around 35% of H₂O₂ is a commonly used bleaching agent, but according to some studies, higher concentrations of H₂O₂ cause sensitivity in patients. Decreasing the concentration of H₂O₂ helps decrease the postoperative sensitivity. The addition of nano-TiO_2, even with less concentration, gains high efficiency as a bleaching material.

Introduction: Denture disinfection is not taken seriously because patients are unaware of the effects of contaminated prostheses on systemic conditions. Among different methods of physical disinfection, ultraviolet (UV) light disinfection has a definite future because of the nondestructive nature of UV light on removable acrylic dentures. Aim: This study aims to “evaluate microbial contamination and compare the efficiency of UV disinfection of acrylic removable dentures with the conventional method of disinfection on contaminated dentures.” Materials and methods: In this study, 45 patients with complete and removable partial dentures were selected and subjected to three different disinfection methods. Group I—UV light-emitting diode (LED) disinfection (wavelength 254 nm) for approximately 300 seconds; group II—brushing with dentifrice; and group III—brushing with tap water for approximately 15–20 strokes. Pre- and postdisinfection microbial swab samples were collected, and the microbiological load in CFU/mL was determined for each sample. Specific microorganisms from the isolated colonies were also identified and analyzed. Results: According to the statistical analysis, there was a positive correlation between pre- and postdisinfection within the groups of disinfection (group I—UV light LED disinfection and group II—brushing with a dentifrice, but not within group III—brushing with tap water). Conclusion: A comparison of UV light disinfection with the other conventional disinfection methods shows a significant reduction in contamination, as measured by postdisinfection microbial colonies, and is comparable with brushing with dentifrices but not with brushing with tap water. Clinical significance: This study provides insights into the efficiency of UV light denture disinfection.

Aim: This study aimed to evaluate the effects of an antimicrobial primer containing selenium on the development of white spot lesions (WSLs) and shear bond strength after artificial caries induction. Materials and methods: A total of 90 maxillary premolars were divided into two groups, with 40 in each. Group I comprised specimens treated with Transbond XT primer (Etch + Transbond XT primer application + Transbond XT adhesive), while group II consisted of specimens treated with DenteShield™ primer (Etch + DenteShield™ primer + Transbond XT adhesive). The remaining 10 samples underwent only a cross-sectional microhardness test (at 10, 30, 50, 80, and 100 µm) to establish baseline data. After bonding, all samples were stored in artificial saliva for 24 hours. Out of the 40 samples in each group, 30 were subjected to microbial caries induction for 10, 30, and 60 days, respectively, by inoculating dental plaque containing Streptococcus mutans in a medium of brain heart infusion (BHI). These samples were then tested for shear bond strength and cross-sectional microhardness. Both groups were evaluated for their antimicrobial property by agar diffusion test and minimum inhibitory concentration (MIC). Data were recorded and statistically analyzed. Results: In group I, the microhardness decreased at depths of 10, 30, and 50 µm, with a mineral loss of 50, 36, and 13%, respectively. Comparatively, there was a reduced mineral loss of 18 and 11% for depths of 10 and 30 µm, respectively, in group II. Group II exhibited a shear bond strength of 12.9 ± 2.8 MPa, while group I showed 13.5 ± 1.9 MPa. The shear bond strength between the two groups showed no statistical significance. Group II demonstrated effective antimicrobial properties when evaluated with the agar diffusion method and MIC. Conclusion: Within the limitations of this study, it was concluded that DenteShield™ inhibited biofilm and reduced WSLs without compromising the shear bond strength. Clinical significance: The clinical significance of these findings lies in addressing the challenge of preventing WSLs in orthodontics. Therefore, DenteShield™ could serve as a viable alternative to conventional primers in orthodontic bonding procedures, due to its favorable impact on reducing WSLs while maintaining shear bond strength.

Aim: To evaluate the gingival crevicular fluid (GCF) sulfiredoxin (SRXN1) levels among patients with chronic periodontitis (CP) and healthy controls and to compare the two groups 1 month following nonsurgical periodontal therapy. Materials and methods: A total of 30 participants were allocated into two groups based on specific inclusion criteria—(1) group I, consisting of 15 individuals with periodontal health, and (2) group II, comprising 15 patients diagnosed with stage II grade B periodontitis. After a thorough clinical examination, GCF was obtained from both groups, and nonsurgical periodontal therapy was performed. After 1 month, a follow-up involved collecting GCF from both groups for subsequent analysis. SRXN1 levels in the collected samples were assessed using the enzyme-linked immunosorbent assay (ELISA) test. Results: Gingival crevicular fluid SRXN1 levels in the control group were 8.2946 ± 0.7081pg/mL, whereas, in periodontitis patients, it was 8.5323 ± 0.7016 pg/mL, which had no significant difference (p = 0.36). After nonsurgical periodontal therapy, a slight increase in GCF SRXN1 levels (8.8475 ± 0.8281 pg/mL) was observed compared to baseline among periodontitis patients was statistically insignificant (p = 0.18), whereas, in the control group, there was a reduction in GCF SRXN1 levels from a baseline to 1-month follow-up after nonsurgical periodontal therapy (p = 0.021). Conclusion: The present study's findings suggest that there is no notable difference in the levels of SRXN1 in GCF between individuals with CP and healthy controls. Moreover, no significant correlation was observed between GCF SRXN1 levels and clinical parameters. Clinical significance: The findings of this research underscore the potential utility of SRXN1 as a biomarker that facilitates the analysis of prognosis, clinical treatment response, and correlation in periodontal health and disease.

Aim: Oral squamous cell carcinoma (OSCC) is the most common oral malignancy, accounting for up to 80–90% of all oral malignancies. This occurs as a result of the multistep accumulation of heterogeneous genetic changes. β-catenin binds with E-cadherin to form a cell adhesion complex and acts as a tumor suppressor by restricting the Wnt/β-catenin signaling pathway. When β-catenin mutates or loses contact with E-cadherin, it translocates to the nucleus and upregulates transcription factors (TCFs). We analyzed and compared β-catenin expression in various phases of OSCC. Materials and methods: A retrospective study was conducted on 60 formalin-fixed paraffin-embedded tissue blocks (20 well-differentiated OSCC, 20 moderately differentiated OSCC, and 20 poorly differentiated OSCC). Diagnosis was made using hematoxylin and eosin, and oral mucosa was used as a control. Results: Statistically substantial downregulation of β-catenin was seen with increasing OSCC grades. As the disease progressed, β-catenin moved from the membrane to the cytoplasm. Nuclear positivity was found in poorly differentiated squamous cell cancer. Nuclear migration activates TCFs, which promote cell proliferation. Conclusion: The study revealed a good prognostic role of both β-catenin in OSCC. Clinical significance: The marker can be used for prognostic as well as therapeutic purposes.

Aim: This case–control study aimed to evaluate the levels of mutans streptococci in primary caries in children and permanent caries in adolescents, with levels of mutans streptococci in caries-free children and adolescents in correlation with the decayed, missing, and filled permanent teeth (DMFT) scores. The oral health behavior of these groups was also studied. Materials and methods: The sample size comprised 60 subjects—15 children having caries in primary dentition and 15 caries-free children in the age range of 2–5 years, 15 adolescents having caries in permanent dentition, and 15 caries-free adolescents in the age range of 12–15 years. The oral health behavior and dietary practices were recorded according to the World Health Organization (WHO) oral health questionnaire. The decayed, missing, and filled primary teeth (dmft)/DMFT index was calculated using WHO caries diagnostic criteria. Plaque samples were collected aseptically from the tooth sites, pooled, and inoculated on mitis salivarius agar (MSA). The total mutans streptococci count (CFU/mL) was then determined. The data were analyzed using paired t-tests and analysis of variance (ANOVA). Results: Mutans streptococci in the caries group in children were 1.35 ± 1.99 CFU/mL. This was significantly higher (p < 0.01) compared to mutans streptococci in the caries group in adolescents, which was 0.8 ± 0.14 CFU/mL. The study shows high levels of mutans streptococci in the primary caries group with a high DMFT score correlating with increased sugar consumption and, to a lesser extent, with tooth brushing. Conclusion: In the present study, it is observed that mutans streptococci are more predominant in caries of children than in the caries of adolescents. Clinical significance: Caries research has focused largely on mutans streptococci as the main etiological pathogen of dental caries, but its impact on different stages of dentition has not been fully understood. Caries susceptibility associated with mutans streptococci is significantly high in the primary dentition stage. Therefore, the acquisition/transmission of mutans streptococci to prevent caries should be targeted in childhood.

Aim: The aim of the study is to evaluate the marginal adaptation of polyether ether ketone (PEEK), cobalt-chromium (CoCr) metal, and indirect composites in class II mesio-occluso-distal (MOD) inlay cavity preparations. Materials and methods: A total of 30 freshly extracted maxillary premolars are collected and randomly divided into three groups of 10 samples each (N = 10). Group I comprises Metal inlays (CoCr), group II comprises PEEK inlays, and group III comprises Indirect composite inlays. Class II MOD inlay cavities are prepared with no. 271 and 169L burs. Cavity preparations for all the groups are standardized using a Williams-calibrated probe. The PEEK and metal inlay cavity preparations are scanned and milled with the help of a computer-aided design/computer-aided manufacturing (CAD/CAM) machine. Composite inlays are prepared using an indirect lab technique. Inlay restorations are luted with resin-modified glass ionomer luting cement, and the specimens are subjected to thermocycling for 24 hours. Each specimen is cut horizontally at the level of the gingival seat. The cut specimens are observed under a scanning electron microscope to investigate the gaps formed at the restoration/cement interface and the cement/tooth interface. Results: Marginal adaptation of metal inlays is less compared to PEEK inlays and indirect composite inlays. However, the marginal gaps of all three inlays are within the clinically acceptable range. Conclusion: Marginal adaptation of PEEK inlays luted with resin-modified glass ionomer cement (RMGIC) on class II MOD preparations on maxillary premolars has shown significant values compared to the CoCr metal inlays and indirect composite inlays. The marginal gap of metal inlays, PEEK inlays, and indirect composite inlays was <100 μm, which is clinically acceptable. Clinical significance: Polyether ether ketone is a thermoplastic organic polymer that is biocompatible and possesses properties similar to bone. It is milled by CAD/CAM processes and does not exhibit any casting shrinkage, unlike conventional metal inlays. Additionally, it does not demonstrate polymerization shrinkage, as seen with indirect composite inlays.

Aim: The aim of the study is to evaluate the prevalence of dental caries among the representative subjects of the state of Tamil Nadu, India. Materials and methods: A total of 1,205 samples for dental caries was collected using “WHO Oral Health Assessment Form—1997” among the index age-group of 5, 12, 15, 35–44, and 65–74 years in Tamil Nadu, India, using a multistage random sampling technique. The state of Tamil Nadu was divided into four zones. Two districts were selected from an individual zone. Finally, the samples were collected from urban to rural areas in eight districts of Tamil Nadu from the male and female participants. The statistical test used was Chi-squared test using Statistical Package for the Social Sciences (SPSS) Software Version 20. Results: The collective prevalence of dental caries among the representative subjects of the state of Tamil Nadu state is 64.8%. The prevalence of dental caries among males were 66.07% and females were 63.53% in Tamil Nadu. The prevalence of dental caries among 5-, 12-, 15-, 35–44-, and 65–74-years age-group in Tamil Nadu were 52.7, 62.66, 64.32, 72.2, and 72.2%, respectively. The prevalence of dental caries in urban and rural areas were 56.59 and 73.39%, respectively. The prevalence of dental caries among the four zones of Tamil Nadu, that is, north zone (77.29%), west zone (55.08%), delta zone (65%), and south zone (62.3%). Conclusion: This study confirms dental caries as a widespread public health concern in the state of Tamil Nadu, India with the high prevalence rate spread over the rural areas and the north zone of the state. Clinical significance: This study provides insights regarding the dental caries prevalence status of the state of Tamil Nadu, India for formulating further longitudinal studies.

Aims and background: The aim of this study is to explore the impact of search engines and social media (SM) use on health information seeking among dental patients, and to assess the impact of health information from search engines and SM on dental health behavior. Materials and methods: A cross-sectional study was carried out by distributing self-administered prevalidated questionnaires to 354 patients reporting to a tertiary dental care hospital in Kochi, Kerala. Study participants in the age-group of 18–60 were included in the study after obtaining informed consent. There were 27 questions included in the questionnaire. Among them, 10 questions assessed the general trend of SM/search engine usage among dental patients seeking oral health information (OHI), while 17 questions assessed the attitude and application towards the information obtained about oral health through SM and search engines. Data was recorded and statistically analyzed using IBM Statistical Package for the Social Sciences Statistics (SPSS) (version 27). Results: The survey involved 354 participants, primarily aged 18–35 (68.6%), with a majority being female graduates (56.5%). Smartphones (91.24%) were their main internet access tool, and SM, especially Facebook, WhatsApp, and Instagram, played a central role in OHI dissemination. Participants valued accessibility (47.18%) but expressed concerns about online information reliability (44.07%). Most participants found online OHI positively impacting their behavior (65%) and believed that dentists should engage in professional interactions via SM (73.2%). Most of them reported having good oral health (48.9%) and regular dental visits (65.8%). Conclusion: The results indicate a growing reliance on digital platforms, particularly SM, for accessing OHI. While participants appreciate the convenience and cost-effectiveness of online information, concerns regarding its reliability persist. Clinical significance: The study underscores the significant role SM plays in shaping health-seeking behaviors and the importance of healthcare professionals utilizing these platforms for professional interaction with patients. Additionally, it assesses the role of SM and search engine usage in influencing oral health decisions and behaviors, thereby contributing to the development of more effective patient education and intervention strategies in dental care settings.

Aim: The aim of the present study is to comparatively evaluate the clinical and microbiological efficacy of Arimedadi oil and 0.2% chlorhexidine (CHX) gluconate mouthwash as an adjuvant to scaling in chronic gingivitis. Materials and methods: A total of 45 subjects were randomly divided into three groups, that is, group I (scaling alone), group II [scaling + adjunctive use of 0.2% CHX antiseptic drug delivery system (ADS) mouthwash], and group III (scaling + adjunctive use of Arimedadi oil) over a period of 21 days. Plaque index (PI) and gingival index (GI) were measured at baseline, 14th day, and 21st day, and the number of aerobic colony-forming units (CFU) was evaluated at baseline and 21st day. Results: There was a statistically significant reduction of GI (p-value of 0.00), PI (p-value of 0.00), and number of CFU (p-value of 0.04) in groups II and III over a period of 21 days. However, on intergroup comparison, the reduction of PI was greater in group II on the 14th day (p-value of 0.042), whereas group III was as effective as group II in the reduction of PI, GI, and number of CFU on the 21st day (p-value of 0.00). Conclusion: Arimedadi oil is as effective as CHX in preventing plaque formation and gingival inflammation, as well as reducing the number of aerobic CFUs. Clinical significance: The preventive and therapeutic advantages of polyherbal products such as Arimedadi oil are a reliable and potentially secure substitute for CHX mouthwash.

Aims: This study aims to internally audit an oral and maxillofacial pathology laboratory from January 2021 to December 2022. Materials and methods: The information related to oral pathology laboratory activities documented in the Dental Information Archival Software (DIAS) of Saveetha Dental College was utilized for this study. Data on biopsies, cytology, income, and expenditure were analyzed using Statistical Package for the Social Sciences (SPSS) software version 23 (IBM, Armonk, United States of America). The mean and standard deviation were calculated for all the key components across all the quarterly data. Results: Incisional biopsies decreased by 9%, while excisional biopsies increased by 26.5%. Cytology receipt decreased by 15%, and frozen section biopsies increased by 10%. Total biopsies increased by 7.3%, maintaining consistent turnaround times (TATs). Revenue increased by ₹29,012.5, and expenditure decreased by ₹23,191. Conclusion: The introduction of the DIAS into oral pathology laboratory activities reduced TAT for incisional and excisional biopsies. We could consistently improve our biopsy cases, increase revenue, and decrease expenditure. Clinical significance: Protocols favoring excisional biopsies over incisional ones may explain decreased incisional biopsies. Clear protocols for biopsy selection are essential for diagnostic accuracy. Internal auditing ensured compliance and optimized resource utilization in our oral pathology laboratory. Integrating internal auditing into laboratory practices is crucial for maintaining high standards of patient care and confidence in healthcare services.

Aim: Systematic analysis of in vivo studies for clinical evaluation of marginal fit of milled and layered ceramic fixed partial dentures (FPDs) was considered for review. Materials and methods: Electronic databases were searched on clinical marginal fit of milled and layered ceramic crowns and FPDs—PubMed, Ovid Medline, Elsevier ScienceDirect, Wiley Online Library, Cochrane Library, Lilacs, and Google Scholar from January 1990 to December 2021, and a total of 660 articles were obtained, among which six of them were included in this study. In addition, a hand search was performed through standard dental journals using the keywords milled and layered ceramics and marginal adaptation and fracture resistance. All included studies evaluated the clinical marginal and internal adaptation of ceramic crowns fabricated with computer-aided design/computer-aided manufacturing (CAD/CAM) milling and conventional casting. Results: Six studies were included in the systematic review, all of which were clinical trials. Among them, five articles showed that milled and layered ceramics had similar marginal fit, good success rates, and a satisfactory clinical outcome, while in one article, layered ceramics showed significantly better marginal and internal adaptation. Conclusion: Marginal fit is an important criterion that determines the quality and survival rate of the prosthesis. On reviewing the marginal fit of the milled and layered ceramic, it was found that they showed similar internal and external marginal adaptation, along with good short-term survival rates, making them suitable for clinical practice. Clinical significance: The quality of any fixed dental prosthesis depends upon the marginal fit and comfort of the prosthesis. The milled and layered ceramics showed similar marginal adaptation. Hence, both restorations can be recommended for fixed partial denture.

Aim: The aim of this systematic review was to compare the clinical effectiveness of 1% sodium hypochlorite (NaOCl) solution with other commonly used irrigants during pulpectomy. Materials and methods: An extensive search was conducted in PubMed, Cochrane, LILACS, Google Scholar, and ScienceDirect until December 2022 in order to identify randomized controlled trials and clinical trials that evaluated the use of 1% NaOCl irrigation in primary molars. Only those trials that met the inclusion criteria were selected for the review. Two independent reviewers were involved in the process of selecting studies, extracting data, and evaluating bias using the Cochrane Collaboration tool and the risk of bias assessment tool 2.0 (RoB 2) to determine the level of bias in the included studies. Results: The systematic review analyzed four articles that met the inclusion criteria, comparing 1% NaOCl irrigation with other commonly used irrigation solutions. The evaluated factors include clinical success, radiographic success over a 1-year period, quality of obturation, and reduction in bacterial count. In clinical success evaluations, 1% NaOCl demonstrated no failures after 12 months of follow-up. Radiographs revealed minimal root resorption in the 1% NaOCl group, indicating its effectiveness. In the obturation quality test, the 1% NaOCl group had more voids. In bacterial count reduction comparisons, 1% NaOCl was equally effective as other irrigants compared. Conclusion: Based on the studies evaluated and the limitations of this review, it is possible to conclude that irrigation with 1% NaOCl is as effective as other irrigation solutions evaluated in the included studies. Clinical significance: The usage of 1% NaOCl irrigation may reduce tissue irritation. This presents a safer alternative by potentially improving patient comfort and treatment efficacy in pediatric dentistry.