Effective and efficient infection control in the orthodontic office is essential for the safety of patients. A comprehensive infection control strategy must be implemented by the orthodontist without compromising on cost-effectiveness and time factor, that safeguards not only his own health but also of the auxiliary staff and even the community. It is also important to follow manufacturer's instructions for dental instruments and devices regarding sterilization to avoid damage to these items.

Dental biofilms are complex and multispecies ecosystems, and its formation requires coordinated chemical signaling between different micro-organisms present in the oral cavity. During the initial stages of its formation, planktonic bacterial cells directly attach to surfaces of the oral cavity or indirectly bind to other bacterial cells. This binding occurs through co-aggregation, which is critical for the temporary retention of bacteria on dental surfaces as well as bacterial colonization. It is during this colonization that the micro-organisms are able to interact with each other. In general, interspecies interactions involve communication, typically via quorum sensing, and metabolic cooperation or competition. Interactions among species within a biofilm can be antagonistic, such as competition over nutrients and growth inhibition, or synergistic. In this review, we discuss these important interactions among oral bacteria within the dental biofilm communities and novel therapies that could inhibit pathogenic micro-organisms and disrupt biofilm.

Health-care workers have an occupational risk of infection with hepatitis B virus (HBV) and hepatitis C virus (HCV). Since dental healthcare professionals have numerous patients and are exposed to blood, they are likely to have the maximum risk. HBC and HCV are transmitted by skin prick with infected, contaminated needles and syringes or through accidental inoculation of minute quantities of blood during surgical and dental procedures. HBV can be prevented by strict adherence to standard microbiological practices and techniques, and routine use of appropriate barrier precautions to prevent skin and mucous membrane exposure when handling blood and other body fluids of all patients in healthcare settings and pre-exposure vaccines. Despite many publications about programs and strategies to prevent transmission, HBV and HCV infections remain a major public health issue. Oral clinical manifestations can be observed, such as bleeding disorders, jaundice, fetor hepaticus, and xerostomia. The most frequent extrahepatic manifestations mostly affect the oral region in the form of lichen planus, xerostomia, Sjögren's syndrome, and sialadenitis. The present paper highlights some of the important oral manifestations related to hepatitis B and C infection and various post-exposure protocols that can be undertaken to minimize the risk of infection.

Fluoride is considered the corner stone of the preventive dentistry. Fluoride has both beneficial and detrimental effects on human health. In terms of dental health, the prevalence of dental caries is inversely related to the concentration of fluoride in drinking water; while there is a dose-response relationship between the concentration of fluoride in drinking water and the prevalence of dental fluorosis. Fluoride has a statistically significant association with a wide range of adverse effects like increased risk of bone fractures, decreased thyroid function, and lowered intelligent quotient, arthritic-like condition, early puberty and possibly, osteosarcoma. The aim of the present review is to discuss the current status of fluorides in dentistry in view of its benefits and adverse effects.

Objective: Surgical removal of impacted third molar is one of the common surgical procedures carried out in Oral and Maxillofacial Surgery set up. This study aimed at clinically assessing the three different surgical techniques (lingual split, using chisel and mallet, buccal approach techniques, using rotary instruments used in the removal of impacted mandibular third molars. Materials and Methods: The present clinical study comprised of 150 impacted mandibular wisdom teeth. Patients were divided in three groups and bone covering the third molar was removed by the Lingual split technique using chisel and mallet, Buccal approach technique using chisel and mallet, and Buccal approach technique using rotary instruments. Results: Surgical time was significantly increased in bur technique. Trismus was significantly increased in lingual split technique and bur technique from buccal approach technique using chisel and mallet. Post-operative nerve injury was significantly higher in lingual split technique. Dry socket was more in patients of bur technique. Conclusion: In this study we found that lingual split technique using chisel and mallet is found to be better among all three techniques used followed by buccal approach using chisel and mallet and the buccal approach technique using rotary instruments.

Objective: Homeopathic preparations are popular and well accepted by parents and children. These preparations are easily available and are prescribed for acute and chronic conditions. However, their sugar content may affect oral health. Aims and Objectives: This preliminary study assessed salivary pH following administration of homeopathic medicines commonly prescribed for children. Materials and Methods: Forty-five normal and healthy children were divided into 3 groups of 15 children each: Group 1 was given a placebo, group 2 was given chamomilla (2x), and group 3 was given arsenicum (2x). Each child was given 2 pellets to be placed below the tongue and allowed to dissolve completely. Unstimulated saliva samples were collected at baseline, and following 5, 15, 30, and 60 minutes of administration. The saliva samples were suitably transferred to the laboratory for recording of pH using a digital pH meter. The titratable acidity of both homeopathic medicines was assessed. Data was subjected to statistical analysis. Results: Mean salivary pH at 15 minutes was 5.40 in group 1, 5.16 in group 2 and 5.42 in group 3, which was significant. (P=0.000) At 30 and 60 minutes, pH in groups 2 and 3 remained lower than that of group 1. The titratable acidity of chamomilla and arsenicum was found to be 0.14 mmol and 0.018 mmol, respectively. Conclusion: There was a significant reduction in salivary pH at 5, 15, and 30 minutes in groups 1 and 2. In all groups, salivary pH did not return to baseline values even after one hour of administering the homeopathic pellets.

Statement of Problem: Anatomic and histologic make up of interdental region is crucial in maintaining the integrity and health of interdental papilla during surgical and restorative procedures. The effect of vertical and horizontal distance between the teeth on the incidence of interproximal papilla has been widely explored and is considered as a contentious issue. Though several non-surgical methods have been developed to assess bone level, the accuracy and reliability of these methods were questioned. Purpose and Aim: To compare the reliability of the non-invasive method using radiographs with invasive method to measure the length of papilla from the tip of papilla to crest of interdental bone. Materials and Methods: In the present study, non-invasive method using radiograph was compared to invasive method to measure length of papilla from the tip of papilla to crest of interdental bone. Radiographic length, bone probing length, and actual papilla length was measured in 20 chronic periodontitis patients, and the results were statistically analyzed. Results and Conclusion: A statistically significant correlation was observed in invasive versus non-invasive method of assessment of distance between the tip of papilla to the crest of interdental bone, indicating the importance of standardization of radiographic aids.

Objectives: To determine the oral hygiene status and practices among rural dwellers in Delta and Edo States of Nigeria. Materials and Methods: One-hundred and fifty-four participants (45 males and 109 females) between the ages of 5 and 88 years with mean age of 33.44΁2.34 years selected among individuals attending Children Evangelism Ministry Free Medical Outreach in five rural communities in both Delta and Edo State of Nigeria were studied. Data were collected through clinical examinations and the use of interviewer-administered questionnaires. Results: Of the 154 participants studied, 22.1% participants had one or more carious teeth, 11.7% participants had at least one missing tooth and 0.6% participants had fillings. Toothache (33.1%) and gingival bleeding (27.3%) were reported oral health problems among the participants. One third (33.8%) of the participants had poor oral hygiene status. Oral hygiene status was significantly associated with age, gender, and educational status, but there was no significant variation among the various communities. Majority of the participants cleaned their teeth with toothbrush and toothpaste-133 (86.4%), indulged in once-daily tooth cleaning-115 (74.7%), and have never visited the dentist-145 (94.2%). There existed significant association between daily tooth cleaning frequency, age, gender, location and level of education. Conclusion: The oral hygiene and oral health practices among rural dwellers were suboptimal. There is need to develop and implement community-oriented oral health promotion programs targeting oral health practices to control preventable oral diseases among rural dweller.

Purpose: To describe a protocol for the immediate placement of implant into the infected alveolar socket. Materials and Methods: In this study, a total number of 40 implants were placed immediately into the extraction sockets. Each case had a different periapical condition (acute, endodontic and periodontal infection). Great care had been taken in debridement of the socket, extraction of tooth/teeth and guided bone regeneration along with the use of pre-operative and post-operative anti-microbial agent. Results: All except three implants were osseo-integrated within 6 months to 1 year. The complications were due to the extraction procedure and bone regeneration process. Conclusion: Predisposing factors for failures are incomplete debridement of the socket, poor oral hygiene, incomplete closure of the wound, and systemic factors like hormones. From this study, we may conclude that immediate implants are a viable treatment option for patients with periapical infections.

Objective: To determine the prevalence and reasons for chewing stick use among adult Muslim's inhabitants of Banyo in the Adamawa region of Cameroon. Materials and Methods: This questionnaire-based cross-sectional study aimed at determining the prevalence and reasons for chewing stick use among Muslims was conducted between November 2010 and April 2011. Results: Of the 220 participants in this study, 187 (85.0%) of them reported chewing stick use for teeth cleaning, and this was higher among males than females. Chewing stick use increased with ageing and varied among participants of different professions. Chewing stick users accented that the chewing stick use has a relationship with religion, and believed that chewing stick has a positive effect in the mouth than the non-users. Chewing stick users were less likely to have visited the dentist and experienced mouth odor but more likely to report oral health problems than non-users. The majority of the participants used chewing stick alone while a few used chewing stick with salt, charcoal and toothpaste The reasons for chewing stick use were religious advice, treatment of oral diseases, imitation of others and pleasure. Conclusion: Chewing stick use was common among participants with religious advice being the most dominant reason for the usage. Chewing stick users were less likely to visit the dentist, experience mouth odor but are more likely to report oral health problem than the non-users. This study information will serve as a useful guide in community oral health interventional development programme among Muslims.

Objective: To determine the pattern of self-medication among dental, midwifery and nursing students and to evaluate the factors associated with self-medication. Materials and Methods: A questionnaire-based cross-sectional of dental, nursing and midwifery students undergoing clinical training in University of Benin Teaching Hospital, Nigeria was conducted in 2010. The elicited data include demography, use of drug without doctor's prescription, type of drug used (pain relievers, antibiotics, anti-malarial, cough medication and nutritional supplement), reasons for self-medication, factors that influenced the choice of drug and source of drug. Results: A total of 76.8% of the respondents indulged in self-medication practices. Of which, 33.0% used the medication inappropriately. The type of self-medication use was, pain relievers (60.5%), antibiotics (43.2%), anti-malarial (40.5%), cough medication (16.7%) and nutritional supplement (16.0%). Previous experience with the illness and perceived minor nature of the illness were the predominant reasons for the self-medication practices among the respondents. The major factors that influenced their choice of medication were previous experience with similar symptoms (39.7%), advice of non-doctor health professional (33.5%). Pharmacy shop was the main source of the self-medicated drugs. Conclusion: Self-medication was a common practice among this studied group of health workers. The level of inappropriate drug use denotes self-medication as an unhealthy option, and it therefore, should be discouraged.

Objective: The aim of the present study was to investigate the prevalence of periodontal diseases among individuals with type I and type II diabetes in north India and evaluate the association of this condition with behavioral and clinical variables. Materials and Methods: A cross-sectional study was carried out on a calculated sample of 300 individuals with diabetes. Periodontitis was defined as clinical attachment loss (CAL) >3 mm in two or more non-adjacent teeth or those that exhibited CAL >5 mm in 30.0% of teeth. All subjects were over 30 years of age and underwent a periodontal examination. Behavioral characteristics as well as medical history and dental history were obtained with a structured interview. Discrete (categorical) groups were compared by Chi-square (χ²) test. A two-tailed (α=2) P<0.05 was considered statistically significant. GraphPad Prism (version 5.0) was used for the analysis. Results: A total of 6.7% exhibited a healthy periodontium; 68.0% exhibited gingivitis; and 25.3% exhibited periodontitis. The univariate analysis revealed that periodontitis was statistically more prevalent among men (P=0.001); among participants with type II diabetes (P=0.009); those with more than five years of diabetes (P=0.065); those with tobacco smoking habits (P<0.001); and those who had not visited the dentist in the previous year (P<0.001). Conclusion: Multiple determinants are associated with the prevalence of periodontitis among patients with diabetes.

Objective: Esthetic and functional rehabilitation of severely mutilated fractured central incisors teeth using homogenous biological fragment bonding. Materials and Methods: Freshly extracted maxillary central incisors were treated endodontically and post spaces were prepared. Intra-radicular biological post core were fabricated from the sectioned roots of extracted canines. Cementation of biological post core in prepared space was done after clinical and radiological confirmation. Subsequent esthetic rehabilitation was done using adaptation of biological crown which was prepared from morphologically similar extracted maxillary central incisor. Results: The association between biological crowns and post core offers excellent esthetic, functional, and psychosocial results, which justifies the use of this technique to achieve the morphofunctional recovery of extensively damaged teeth. Conclusion: The biological restorations are an alternative technique for reconstruction of extensively damaged teeth that provides highly functional and esthetic outcomes.

Psoriasis is a chronic, genetically linked, scaly, and inflammatory disease of the skin. Oral manifestations of psoriasis are rare and are often difficult to diagnose. A 35-year-old female presented with gum bleeding, chronic irritation, intolerance to salt and spicy food, and frequent occurrence of painful mouth ulcers with a fissured tongue. Examination of the oral cavity showed desquamations on the buccal mucosa with pedunculated and exophytic growths and also slight gingival enlargements in the anterior segment. The exophytic growths along with gingival enlargement were excised and sent for histopathological examination, which revealed them to be psoriasis. Oral psoriasis is a rare entity and might be confused with other oral mucous membrane dermatoses; hence, it should be considered under differential diagnosis of oral mucous membrane disorders and confirmed histopathologically.

The purpose of this study was to analyze the effect of orthodontic movement on non-vital teeth, illustrated with a clinical case. A review of the literature shows it is controversial as to whether or not orthodontic forces can be initiated and sustained without the resorptive process occurring. Induced resorption during tooth movement depends on multiple factors, which require the close attention of the dentist to ensure an accurate diagnosis and correct mechanotherapy with respect to the periodontium. The orthodontic treatment described here was performed on a woman 36 years of age with endodontically treated teeth. This case demonstrated that the biomechanics follow biological principles and thus prevent deleterious effects on the components of the periodontium and the bone and maintains the integrity of the root length.

Esthetic and functional rehabilitation is the primary goal of the treatment of crown-root-fractured tooth. A 14-year-old male patient that fractured her maxillary left canine with biologic width violation is presented. Transurgical exposures of the fracture remnant were performed to possibility the rubber dam isolation followed by crown re-attachment using bonding system and a resin composite. Clinical and radiographic examination 5 months after trauma showed good esthetics, pulp normality, and periodontal health.

Calcifying epithelial odontogenic tumor or Pindborg tumor is a rare benign odontogenic tumor that was first described by a Danish pathologist Jens Jorgen Pindborg in 1955. It is thought to arise from the epithelial element of the enamel origin and is histologically characterized by the presence of polygonal epithelial cells, amyloid globules, and Liesegang ring calcifications. A few cases have been shown to demonstrate clear cells (Langerhans cells) in the tumor. Non-calcifying epithelial odontogenic tumor (NCEOT) s very rare and only four cases have been documented in the English Language Literature to date. All these cases were present intraosseously (central). We present the first case of an extraosseous (peripheral) NCEOT with clear cells (Langerhans cells) and briefly discuss as well as review the histogenesis along with the differences in its clinicopathological and prognostic profile with respect to other variants.

A seventeen year old male presented with a 5 month history of left sided purulent rhinorrhoea and left facial pain. Occlusal view X-ray of maxilla showed the presence of an ectopic canine in the leftt anterosuperior aspect of the maxillary sinus entrapped in soft tissue. Surgical removal of the tooth and the diseased antral tissue was undertaken via a Caldwell-Luc procedure with resolution of symptoms.