Aim: Dental caries is a biofilm-dependent disease resulting from the interaction between microorganisms, a susceptible host, and a cariogenic diet. The risk of developing caries lesions varies according to the individual characteristics and socioeconomic and cultural factors. The aim of this study was to evaluate the length of time of oral clearance of food from the occlusal surfaces of molars in preschool children. Materials and methods: Chocolate cookies or pieces of apple were distributed to 188 children aged 3 to 6 years, and the food retention was observed every 10 minutes for 1 hour. The degree of retention was ranked by scores: (0) total elimination, (1) partial retention, and (2) total retention. Results: Children 3 to 4 years of age took 30 minutes to eliminate the cookies from the surfaces of the teeth examined, while the children who were 5 to 6 years of age took 20 minutes. The lower molars needed more time to eliminate the cookies. All children eliminated apple in <10 minutes. Conclusion: The results suggest that in younger children, the food may remain in the oral cavity for a significant period of time. Clinical significance: As eating habits influence significantly the development of caries lesions, and cariogenic food directly changes the demineralization–remineralization process, the results of this study show the importance of counseling the families regarding the frequency, time, and type of food to be offered to preschoolers as a preventive measure to early childhood caries.

Aim: This study aims to assess the opinion of dental students and interns about the success rates of inferior alveolar nerve block (IANB). Materials and methods: A cross-sectional questionnairebased study was conducted among dental students and interns in the College of Dentistry, King Khalid University,Abha, Kingdom of Saudi Arabia. Before the conduct of the study, ethical approval was taken from the Scientific Research Committee, King Khalid University, Abha. A questionnaire containing two sections was formulated; the 1st section included questions of age, gender, and academic year, while the 2nd section included 10 questions related to IANB. Results: About 70% of the interns and 50.6% of dental students said that they always administered IANB while doing surgical and endodontic procedures in mandibular posterior teeth. When the respondents were asked about their awareness about alternative techniques (such as Gow–Gates technique and Vazirani–Akinosi) to classical IANB, the majority of interns (81.4%) and dental students (82%) were aware about these techniques although only theoretically, while 14.3% of interns and 11.2% of the dental students had practically used these alternative techniques. Conclusion: It was concluded that IANB was the most frequently used technique during various surgical and endodontic procedures. About 52.9% of the interns and 42.7% of dental students had rarely faced IANB failure in clinics. Both the students as well as interns were aware of other alternative techniques, such as Gow–Gates and Akinosi techniques of mandibular block anesthesia although they did not practice these techniques much in their day-to-day practice. Clinical significance: Effective IANB by interns and students for pain-free dentistry.

Aim: This study aims to investigate the effect of a calcium phosphate-based desensitizer paste on reduction of dentin hypersensitivity (DH). Materials and methods: This crossover study was designed as randomized, double-blinded, and placebo-controlled trial. Teethmate AP paste (TAP), containing tetracalcium phosphate (TTCP) and dicalcium phosphate anhydrous (DCPA) dispersed in a glycerol/polyethylene glycol paste, was compared with placebo (PLA), a calcium phosphate-free analog paste. A total of 45 patients with one hypersensitive cervical lesion in each of two contralateral quadrants were allocated to the trial when baseline sensitivity (pretreatment sensitivity score, PRE) on air-blast (AB) stimulation and probe scratching (PS) measured on a visual analog scale (VAS; 0–10) was ≥6. Patients were recalled after 1 day, 1 week, and 1, 3, and 6 months. One-way analysis of variance (ANOVA), Tukey’s post hoc test, and pairwise comparisons between TAP and PLA were conducted at all time points (α < 0.05). Results: Both treatments reduced DH significantly during the 6-month course. Immediately after treatment (posttreatment sensitivity score, POST), TAP sensitivity on AB was reduced to 63%, after 6 months to 39% of the PRE score, and PS to 60 and 54% respectively. Application of PLA reduced AB sensitivity at POST and 6 months to 79 and 60%, and on PS stimulation to 79 and 67% respectively. At all time points, TAP and PLA were significantly different (p < 0.05). Conclusion: Teethmate AP paste is a biocompatible and effective desensitizing agent when used for the treatment of moderately severe DH. Clinical significance: Calcium phosphate-based desensitizers are one of the most effective desensitizing agents and are expected to play an important role in the treatment of DH.

Aim: This study evaluated the influence of light emitting diode (LED) illumination bleaching technique on color stability of various computer-aided design–computer-aided manufacturing (CAD–CAM) of ceramic materials. Materials and methods: A total of 20 disk-shaped samples (width × length × thickness = 10 mm × 15 mm × 2 mm) were prepared from each of the ceramic materials for CAD–CAM including Lava™ Ultimate (LV), Vita Enamic® (En), IPS e.max® CAD (Me), inCoris® TZI (IC), and Prettau® zirconia (Pr). The samples from each type of ceramic were randomly divided into two groups based upon different bleaching techniques using 35% hydrogen peroxide with and without LED illumination. Colorimetric evaluation was determined using spectrophotometer for color differences. Results: The color difference (ΔE) upon bleaching, either without or with LED illumination [mean ± standard deviation (SD)], for each type of ceramic was 0.34 ± 0.21, 0.54 ± 0.41 for LV groups; 5.59 ± 1.35, 5.81 ± 1.45 for En groups, 4.60 ± 1.80, 6.92 ± 1.42 for Me groups, 3.43 ± 1.04, 4.14 ± 0.72 for IC groups, and 6.61 ± 0.80, 7.03 ± 0.64 for Pr groups respectively. The differences in color changes were indicated upon bleaching procedure in different degrees for the different ceramic materials. The analysis of variance (ANOVA) indicated significant differences of color change due to the effect of bleaching technique on the ceramic material (p < 0.05). Conclusion: Bleaching can affect the color stability of dental ceramics for CAD–CAM. Using 35% hydrogen peroxide bleaching agent with LED illumination caused more color alteration of dental ceramics than without LED illumination. Clinical significance: B leaching a ffects c olor o f c eramic materials. Clinicians should be careful in the protection of the existing restoration.

Objective: The aim was to evaluate and compare the adaptability of the three obturation materials: gutta-percha, GuttaFlow, and Soft-Core to the root canal walls. Materials and methods: Totally 30 mandibular premolar teeth were selected. The teeth were standardized and prepared with ProTaper rotary files. The teeth were randomly and equally divided into three groups—gutta-percha group: obturated with gutta-percha and AH Plus sealer using lateral compaction technique; Soft-Core group: obturated using Soft-Core system; and GuttaFlow: obturated with GuttaFlow. The roots of the teeth were sectioned at three levels (apical, middle, and coronal) and were observed under a stereomicroscope at 40× magnification. Area of voids (AVs), frequency of voids, and location of the voids were analyzed using image analysis software. Results: The lowest mean of AV was obtained by GuttaFlow 1.25% ± 1.93, followed by gutta-percha 1.33% ± 2.16, and Soft- Core 1.74% ± 2.23. Statistical analysis showed no significant difference among the three groups and the levels of the root. The frequency of voids in the coronal and the middle levels was more than the apical for all groups. The highest frequency of voids was detected in Soft-Core, followed by GuttaFlow and gutta-percha respectively. The voids were located in the interphase between sealer and obturation material as well as sealer and root canal walls in the gutta-percha and Soft-Core groups, whereas it was almost confined to the core for GuttaFlow group. Conclusion: GuttaFlow has a better adaptability to the walls compared with Soft-Core system and laterally compacted gutta-percha with AH Plus sealer. Clinical significance: GuttaFlow is an appropriate obturation material to enhance endodontic treatment.

Aim: One common complaint among the elderly is memory decline and tooth loss due to aging. Tooth loss affects masticatory function and reportedly may also contribute to the occurrence of memory disorders and depression. The aim of this study was to analyze the influence of complete denture use on memory capacity and depression level in elderly patients. Materials and methods: The study was conducted at Hasanuddin University Dental Hospital. The study was a clinical experiment with nonrandomized design with pre- and posttests. A purposive sampling technique was used with six fully edentulous patients willing to participate. Memory status was measured using the Mini-Mental State Examination (MMSE), and level of depression was evaluated using the geriatric depression scale (GDS). Memory status and level of depression measurements were performed before using complete dentures and 1 month after using complete dentures. The data were analyzed using statistical paired t-test. Results: At the 95% confidence level p < 0.05, the results showed a significant difference (increase) between initial MMSE average value (25.67) and the final MMSE average value (26.83). There was no significant change in the level of depression p > 0.05 between initial GDS (5.17) and final GDS (4.17). Conclusion: This study indicates that the use of complete dentures by fully edentulous patients may improve memory status, but does not seem to have a significant impact on depression level. Clinical significance: The relationship between tooth loss, depression, and memory is a complex relationship, where depression could be both a cause and an effect of memory dysfunction. Improvement of memory status using complete dentures will help to restore confidence level of elderly patients.

Aim: Oral health is one of the leading preventable problems around the globe. India is the second largest populous country, with the majority of the population living in rural areas. Rural population still uses traditional methods to maintain oral hygiene as opposed to urban population which has progressed to electronic toothbrushes. The aim of the present study was to identify the predisposing risk factors for oral health issues among early adolescents and develop a health risk communication tool that will aid in addressing the problem of oral hygiene in school-going children. Materials and methods: A cross-sectional study that included 920 school-going children of class 6 to 9th was conducted in the region of Balotra, Rajasthan, India. Single-stage cluster sampling technique was used in the study to select and collect data from children from 23 (15 government and 8 private) schools that were randomly selected. Analysis was done using Statistical Package for the Social Sciences (SPSS) version 15.0. Results: Overall, the prevalence of caries and dental fluorosis was found to be 47% and 61% respectively. The oral health problem of dental caries was seen to be less prevalent in girls (39.7%). Dental caries were found to be more in government schools (58.7%) and in rural areas (59.6%) as compared with urban areas (52.1%). It was also observed that prevalence of dental caries was more in permanent dentition (44%) as compared with primary dentition (14%). Factors found to be associated with caries were private schools, age of the children, and irregular brushing habits. Conclusion: Based on the prevalence of caries and fluorosis and other findings of the study, it can be concluded that children lack knowledge and awareness about oral hygiene. There is a need to enhance the oral health knowledge level of schoolgoing children. Implementation of a school health program would help change the status quo, and positively influence oral health and well-being of children. Clinical significance: Initiatives should be taken in the field of public health dentistry to address the problems of caries and dental fluorosis as they are quite prevalent in the area.

Aim: The treatment of odontogenic keratocyst (OKC) and unicystic ameloblastoma (UA) remains controversial. With modern innovations, trend is shifting toward minimally invasive surgical procedures. The aim of this study was to report the outcome of our conservative treatment protocol for OKC and UA, particularly highlighting the effectiveness of enucleation and peripheral ostectomy with chemical cauterization using Carnoy’s solution compared with aggressive techniques. Materials and methods: Eight patients with UA and 10 with keratocystic odontogenic tumor (KCOT) who reported to the KLE Vishwanath Katti Institute of Dental Sciences (KLE VKIDS), Belgaum, India, between 2008 and 2015 were included in the study. In addition to clinical and radiographic examination, incisional biopsy was done to confirm the diagnosis. All the patients were treated using enucleation with peripheral ostectomy and application of Carnoy’s solution for 5 minutes as a primary modality of choice postoperatively; patients with extensive lesion received an intermaxillary fixation for 5 to 6 weeks. Surgical obturator to obliterate the pathological defect was given in large defects. Results: The mean length of follow-up was 76 months since the last operation. In our experience, no recurrence has been encountered until May 2017. Conclusion: Our study suggests that conservative treatment with adequate postoperative follow-up yields clinically acceptable results with less morbidity. However, the patients must adhere to close follow-ups. Our algorithm for managing OKCs and UA of the jaws is also presented. This technique shows comparable results to other more aggressive techniques and can be used especially in large lesions that when treated with resection will interrupt continuity of the jaw. Clinical significance: For a long time, KCOT and UA were treated aggressively, i.e., through resection, but our study shows conservative treatment holds good. It also reduces the risks and complications associated with surgical resection.

Introduction: Candida is a normal microflora commonly found in subjects wearing denture compared with nonwearing denture. Altogether, removable partial denture (RPD) is manufactured by heat-cured and self-cured acrylic resins. Aim: The aim of this study is to observe the comparison of the colonies of Candida sp. in gargling-volume culture from subject wearers of heat-cured and self-cured acrylic resin RPDs. This study was conducted in the Microbiology Laboratory of Veterinarian Faculty, Syiah Kuala University (Unsyiah). Materials and methods: This is an analytical study with an experimental research design. Subjects were obtained by purposive sampling technique and were willing to fill in the informed consent. The gargling volume of six subjects wearing heat-cured and self-cured acrylic resin RPD was inoculated into the Sabouraud 4% dextrose agar (SDA) and incubated at 37°C for 24 to 48 hours. The colonies of Candida sp. were calculated with colony counter. Results: Only 4 of 6 samples (45% precision) had shown colonic growth of Candida sp. However, the t-test analysis shows that the colonies of Candida sp. displayed no significant difference between subjects wearing heat-cured and self-cured acrylic resins RPD (p > 0.05). Conclusion: It was concluded that there was no difference in the number of colonies of Candida sp. in the subject wearers of heat-cured acrylic resin compared with self-cured acrylic resin RPDs. Clinical significance: C linically, t he r esults o f t his s tudy showed differences in the number of colonies of Candida sp. In the subjects of RPD users of heat-cured acrylic resins, they contained fewer colonies of Candida sp. than the subjects of RPD self-cured acrylic resin users.

Introduction: Dental casting alloys made of high noble alloys, noble alloys, and predominantly base metal alloys have been used in the fabrication of fixed and removable prosthetic dental appliances. Nickel–chromium (NiCr) alloy has been widely used in the fabrication of fixed and removable partial denture frameworks owing to its superior physical properties and lower cost, but their resistance to tarnish and corrosion is debatable. Aim: The aim of this study is to evaluate and compare the corrosive behavior of four commercially available NiCr alloys with that of a high noble alloy. Materials and methods: Four commercially available NiCr alloys (study groups) and high noble alloy were used to study the corrosion by cyclic polarization test, and the parameters that were evaluated are corrosion potential (Ecorr), breakdown potential (Eb), repassivation potential (Ep), and corrosion current (Icorr). Results: When all the findings from the four parameters were evaluated, the values of the control group were significantly higher than the study groups, and among the four study groups, group III alloy was significantly more resistant to corrosion than the other alloy groups. Conclusion: Within the base metal alloy study groups, group III behaves to be more resistant to corrosion. Both nickel and chromium ions were released during the corrosion process, but the percentage of nickel ions was relatively higher than chromium ions. Clinical significance: With the advent of new dental alloys in the market, the biocompatibility of dental materials is of critical concern and the evaluation of corrosive behavior of new dental alloys is highly warranted. Keywords: Chromium, Corrosion, Cyclic polarization, Nickel, Noble alloy. How to cite this article: Begum R, Ariga P, Jain AR. Evaluation of Corrosive Behavior of Four Nickel–chromium Alloys in Artificial Saliva by Cyclic Polarization Test: An in vitro Study. World J Dent 2017;8(6):477-482.

Aim: The aim of this study was to assess the attitude and knowledge of general population towards orthodontic treatment in Kingdom of Saudi Arabia. Materials and methods: A cross-sectional questionnairebased study was conducted among the general population of Aseer, Kingdom of Saudi Arabia. A validated, self-administered 10-item questionnaire was formulated and sent to the study participants through social media. The responses were entered into Microsoft Excel sheet and statistically analyzed using Statistical Package for the Social Sciences (SPSS), version 17. Results: Majority (45.3%) of the respondents disagreed that people wearing orthodontic appliances do not look good, while 36.2% were neutral in answering the same. A bulk of respondents (81.2%) agreed that the orthodontic treatment is expensive, while only 7.4% of the respondents disagreed for the same. Majority (96%) of the respondents agreed that special oral hygiene aids, such as orthodontic brush, interdental brush, and mouthwash are required to be used during orthodontic treatment. Around 73% of the respondents agreed that orthodontic treatment takes a long time, while 20.6% were neutral in responding to the same. Conclusion: It was concluded that although most of the respondents were aware about the features of orthodontic treatment and also had a positive attitude about it, still not all had the same attitude. It is recommended that the orthodontists, general dentists, and public health dentists need to make collaborative efforts to overcome the barriers for uptake of orthodontic treatment by the people.

This case report describes the immediate dentin sealing (IDS) technique with self-etch dentin bonding agent (DBA) for indirect restorations. To avoid problems related to dentin exposure when preparing teeth for indirect restorations, the sealing of the dentin immediately after preparation and before impression has been recommended. The IDS technique with self-etch DBA prevents the patient from inconveniences associated with dentin demineralization by phosphoric acid in the traditional total-etch technique. The case report presented describes the indirect restoration of the right upper first molar using the IDS technique with a self-etch DBA covered with a low-viscosity composite resin. The lithium disilicate glass ceramic restoration was obtained with a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Selective enamel etching occurred before cementation with resin cement. A follow-up of 15 months revealed success of the treatment and lack of sensitivity. The incorporation of IDS with indirect restoring teeth adhesively may provide better marginal fit, reduce marginal infiltration, protect the dentin–pulp complex, reduce postoperative sensitivity, bring more comfort to the patient, and is long-lasting to the restored teeth. Clinical significance: The IDS technique with a self-etch DBA is an excellent clinical option to avoid some inconveniences of traditional protocols for indirect restorations.

Introduction: The abutment screw loosening has been a common clinical mishap affecting the success of the implant in the long run. With repeated insertion and removal of the implant abutment screw during fabrication of the restoration, frictional wear at the microscopic level in the screw threads had been reported. Aim: To assess the effectiveness of screw coating in minimizing abutment screw loosening in dental implants in literature. Results: A database search yielded a total of 14 articles out of which 8 were excluded based on the title and abstracts not relevant to the topic of our interest and 6 were included based on the core data. The six articles were reviewed, and four articles were consolidated to perform the meta-analysis. All the four studies showed a similar expression of outcome measure; the detorque values were expressed in Ncm. The χ2 = 144.71, df = 3, p < 0.00001, and I2 = 98%. Hence, a Random Effect model with 95% confidence interval was chosen for meta-analysis. The overall effect observed in the metaanalysis was Z = 0.36, p = 0.72, and no statistically significant differences were observed between the coated and noncoated screws with respect to detorque values. Conclusion: This meta-analysis inferred that there is no difference between the coated and noncoated screws with respect to screw loosening. Clinical significance: Noncoated screws are equally effective as coated screws with respect to abutment loosening in endosseous implants. Hence, the additional cost and technique sensitivity incurred with powdered screws may not drastically improve the rate of failure due to screw loosening.

Aim: The aim was focused on compiling a comprehensive overview of the extrinsic tooth bleaching and its mechanisms including in vitro and in vivo measurement methods and analyzing factors affecting the efficacy of the bleaching process on restorative materials and tooth structures. Background: The importance of tooth bleaching for patients has notably gained importance and been accompanied by a dramatic increase in the number of relevant products and procedures over the past two decades, with a concomitant rise in publications on this topic. Literatures have put forth that the mechanisms of tooth bleaching by peroxide agents occur by the diffusion of peroxide through the enamel to cause oxidation, and hence, lightening of colored species, particularly, within the dentinal regions. Results: An electronic search was conducted across Ovid Medline, complemented by a manual search across individual databases, such as Cochrane, Web of Science databases, and Google Scholar for the purpose of literature analysis on the mentioned topic. The studies were reviewed and compared. This article summarizes the current scientific and clinical opinions through a brief review with regards to the preferred way of bleaching and its impact on restorative materials. There are controversies in terms of performing tooth bleaching. Regarding extrinsic tooth bleaching, certain literature have pointed out that the in-office method is being followed by a high number of dental practitioners, whereas it should be practiced based on selection of the right cases. Conclusion: Based on previous findings, it is concluded that at-home bleaching technique appears to be the safest technique currently available, which is rapid, easy, and cheap. However, the correct selection of the cases is mandatory. The in-office method provides good outcomes, while it may be insufficient for correcting extreme discoloration. It should be considered that time and concentration are two crucial parameters that have a great influence on the successful bleaching process. These techniques are not entirely free from hazards, and therefore, using these agents under appropriate supervision and consultation with dental professionals is highly essential. Clinical significance: In-office tooth bleaching is a great method for providing rapid tooth bleaching, while it is not as safe as the home bleaching method. With the presented data over the past two decades, at-home bleaching has also become an accepted and integrated procedure. However, long-term health risks are also associated with professional at-home tooth bleaching using 10% carbamide peroxide (CP) gels, which is equivalent to 3.5% H2O2. Hence, it is recommended that the latter method should be mindfully approached when preferring long-term bleaching processes.

The aim of this study is to review the significance of parts and operating principle of compound light microscopy with emphasis on their troubleshooters. Light microscope has been an important diagnostic tool in scientific research over the years. The invention of the microscope by Anthony Leeuwenhoek has given rise to an interesting dimension in life sciences where great discoveries have been made to study various microorganisms and the structure of cells. Handling the microscope requires sound knowledge about its parts and their construction for effective functioning. There are innumerable faults regardless of the elegance of the microscope equipment or the experience level and skill of the user. Errors must be addressed carefully to detect the cause that may be due to poor specimen preparation or technical issues. The majority of photomicrography errors traced on the optical configuration of the microscope include improper illumination, use of the wrong filters, incorrect setting of the substage components and preservation, processing and mounting of tissue specimens, or microscopic optics. By capturing various photomicrographic images at different erronic modes of microscopic handling and artifactual appearances, the acceptable approach for the use of compound microscope has been emphasized with possible remedies to overcome them. Comprehension of the compound light microscopic components with causes and remedies of troubleshooters may lead to efficient handling of the instrument for investigative and diagnostic purposes. Clinical significance: Good knowledge of the right usage of microscope parts is pivotal in routine laboratory investigations for the diagnosis and prognosis of pathologies and scientific research.