Attainment of ideal root canal treatment comprises various essential factors such as proper instrumentation, biomechanical preparation, obturation, and ultimately depending upon the case, post-endodontic restoration. Main objective of the treatment is to get absolute rid of microbial entity and prevent any future predilection of re-infection. In order to achieve that, proper seal is required to cut down any chance of proliferation of bacteria and future occurrence of any pathology. Although gutta-percha has been the standard obturating material used in root canal treatment, it does not reinforce endodontically treated roots owing to its inability to achieve an impervious seal along the dentinal walls of the root canal. Gutta-percha does not from a monoblock even with the use of a resin-based sealer such as AH Plus because the sealer does not bind to gutta-percha. As a result, a monoblock is formed (consisting of Resilon core material, Resin sealer, bonding agent/primer, and dentin). Another reason of Resilon being a better obturating material could be that the removal of smear layer by ethylenediaminetetraacetic acid (EDTA) after biomechanical preparation may have allowed the root canal filling material and root canal sealers to contact the canal wall and penetrate in the dentinal tubules, which may increase the strength of roots. New silicone-based sealers like Roekoseal automix and the most recent GuttaFlow have some affirmative results regarding solubility and biocompatibility, as compared to other sealers. Methacrylate resin-based sealers and mineral trioxide aggregate (MTA)-based sealers have opened a new horizon for sealers.

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Background: The study of anthropometric characteristics is of fundamental importance to solve problems related to identification. Craniometrical features are included among these characteristics, which are closely connected to forensic dentistry. Radiography is used in forensic for the identification of humans especially in cases where the body is decomposed, fragmented, or burned. Radiology can assist in giving accurate dimensions for which certain formulae can be applied to determine the gender. It has been reported that maxillary sinuses remain intact, although the skull and other bones may be badly disfigured in victims who are incinerated and therefore, that maxillary sinuses can be used for identification. Aim: This study has been carried out to check the accuracy and reliability of maxillary sinus in gender determination using morphometric parameters. Materials and Methods: Lateral cephalogram of 50 subjects (25 males and 25 females) were taken and morphometric parameters of maxillary sinus were analyzed using AutoCAD 2010 software (Autodesk, Inc.). Results: The mean area and perimeter of maxillary sinus in males was 1.7261 cm ² and 5.2885 cm whereas, the mean area and perimeter in females was 1.3424 cm ² and 4.3901 cm. In-group centroids if someone's discriminant function (DF) score is close to 0.838 then the subject are supposed to be male. Whereas, those having DF score closer to −0.838 are supposed to be females. DF analysis showed that, 76% of the original grouped cases were correctly classified. Hence, the overall sensitivity and specificity was found to be 80% and 72%. Conclusion: It can be concluded that morphometric analysis (area and perimeter) of maxillary sinus using AutoCAD 2010 software can assist in gender determination.

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Objective: An important characteristic of human dental enamel not yet studied in detail is its surface roughness in mesoscopic scale. This study evaluated quantitatively and qualitatively the surface topography of acid etched enamel with different etching times. Materials and Methods: Ninety-six human maxillary bicuspids were randomly distributed into three groups (n=32): T0 (control), pumiced; T15, 35% phosphoric acid etched enamel for 15 s; T30, 35% phosphoric acid etched enamel for 30 s. Roughness measurements Ra, Rz and root mean square (RMS) and 3D images of enamel's topography were obtained with atomic force microscopy (AFM), which is a powerful technique to obtain direct measurements on microscale features. Results and Conclusions: Roughness variables Ra, Rz and RMS presented statistically significant differences to all groups (P<0.000), with values increasing with etching time. This increase was greater from T0 to T15 than from T15 to T30. Enamel surface alterations T15 to T30 occur mainly due to increase in height and deepening of prisms central region.

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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.

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In the era of antibiotic resistance, a naturally occurring substance is needed to completely cure the infection without any toxic side-effects; a responsibility that "O ₃ or Ozone" seems to implement sincerely. Ozone gas has a high-oxidation potential and has the capacity to stimulate blood circulation and the immune response. It is a great supplement to conventional therapeutic dental modalities. Treatment may be achieved by increasing the resistance of the tooth against the microbial activity and reducing the extent of microbial activity. In addition to the recent materials and techniques, the therapeutic actions of ozone may provide beneficial results by reducing the demineralization of the tooth. Its bactericide, virucide and fungicide effects are based on its strong oxidation effect with the formation of free radicals as well as its direct destruction of almost all microorganisms. This potentially beneficial agent has been used in dentistry also. Ozone has a wide application in dentistry which includes treatment of carious lesions, root canal disinfection, wound healing impairments after surgical interventions, plaque control, disinfection of dentures, etc., The purpose of this article is to summarize the mechanism of action and different modalities of ozone therapy in the practice of dentistry.

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Increasing the consumption of fruits, vegetables, and whole grains is a practical strategy to optimize good health and to reduce the risk of various chronic diseases and cancer. There are approximately 5,000 individual phytochemicals which have been identified. These interfere with multiple important cellular pathways and play an important role in maintaining balance between health and disease. This article aims to provide awareness of various additive and synergistic effects of these natural occurring chemical substances (phytochemicals) found in various fruits and vegetables. Their mechanism of action in preventing various chronic diseases and cancer is also been highlighted in this article. Grouping plant foods by color provides simplification, but it is also important as a method to help consumer's make-wise food choices and promote health. We believe phytochemicals can be best acquired through whole-food consumption and not through the pills or an extracts.

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Objective: To assess the prevalence of malocclusion and deleterious oral habits among 12 and 15-year-old school children in Shimla city, India and to find, if any correlation exists between the two. Design: Correlational study design. Setting: Twelve schools in Shimla city, India. Materials and Methods: Prevalence of malocclusion and orthodontic treatment need was assessed using the Dental Aesthetic Index (DAI) among a sample of 961, 12 and 15-year-old school children in Shimla city, who received no orthodontic treatment before or during the study. Subjects were also assessed for deleterious oral habits. Statistical Analysis: Chi-square and Mann-Whitney U tests were used. Multivariate regression analysis was used to test the correlation of habits with mean DAI score and malocclusion traits. Results: Mean DAI score was 26.81±5.25. Nearly 53% of the study sample presented with malocclusion, ranging from 'definite' to 'handicapping' based on the DAI scores. The prevalence of various deleterious oral habits was 25.9%. About 29% of children with any oral habit developed malocclusion as compared to those without any habit (P value=0.023). Tongue thrusting, mouth breathing and thumb sucking habits had a significant impact on malocclusion. Conclusion: There was high prevalence of malocclusion (52.7%). Abnormal oral habits, particularly mouth breathing and tongue thrusting had a significant impact on malocclusion, resulting in higher frequency of crowding in anterior teeth, open bite, and spacing.

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Premature loss of primary molars can cause a number of undesirable consequences including loss of arch length, insufficient space for erupting premolars and mesial tipping of the permanent molars. Pulpectomy of primary molar teeth is considered as a reasonable treatment approach to ensure either normal shedding or a long-term survival in instances of retention. Despite being a more conservative treatment option than extraction, efficient pulpectomy of bizarre and tortuous root canals encased in roots programmed for physiologic resorption that show close proximity to developing permanent tooth buds presents a critical endodontic challenge. This article aims to provide an overview of this treatment approach, including partial and total pulpectomy, in primary molar teeth. In addition, the recommended guidelines that should be followed, and the current updates that have been developed, while commencing total pulpectomy in primary molars are discussed.

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Background: The aim of this study was to estimate the prevalence of gingivitis and investigate possible associations among gingivitis and socioeconomic, demographic variables and oral hygiene habits in a sample of adolescents in Greece. Materials and Methods: The study sample consisted of 812 adolescents, 384 boys and 428 girls aged 13-16 years. All participants were clinically examined and answered questions regarding socioeconomic, demographic variables and oral hygiene habits. Statistical analysis of the questionnaire items was carried out by using a multiple logistic regression analysis models. Results: Five hundred and ninety-one adolescents were diagnosed as having gingivitis giving a prevalence rate 72.8%. Male gender (P < 0.05), lower parental educational (P < 0.01) and income level (P = 0.001), no regular dental follow-up (P < 0.001), no daily tooth-brushing (P < 0.001), no dental floss use (P < 0.001), presence of dental plaque (P < 0.001), and smoking (P < 0.001) were the most important associated factors of gingivitis. Conclusion: The study showed that gingivitis was associated with male gender, lower educational and income parental level, inadequate oral hygiene, the presence of dental plaque and smoking while the prevalence of this condition in the study sample was 72.8%.

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Objectives: This study aimed to estimate the prevalence of dental anxiety and examine the socio-demographic associations of dental anxiety among a representative sample of UAE college populations. Materials and Methods: Four hundred and thirteen college students of Sharjah University in the UAE completed Modified Corah's Dental Anxiety Scale (MDAS) (47% males and 53% females). The survey also included questions in a yes/no format with which respondents rated attributions for their anxiety. Results: Prevalence of dental anxiety (MDAS score of 13 or more) was 36%, with overall severity represented by a mean score of 11.52 (SD: 4.88). Students who visited their dentist more than two years ago had significantly higher MDAS scores compared with those who visited their dentist less than two years ago (t-test, P=0.02). Compared with female students, a significantly higher proportion of males indicated that their last visit to the dentist was more than two years ago (17% vs. 30%, respectively, χ² -test, P=0.002). In addition, more than half of the students (55%) perceived a need for a checkup and 54% indicated that they visited the dentist because of problems with their teeth. Conclusions: The findings of this study indicate that although dental anxiety was not associated with gender and frequency of dental visits, feeling of lack of control and pain anticipation were strong predictors of anxiety. These results highlight the important role that dental healthcare providers could play in counseling anxious patients to reduce the impact of these factors on seeking dental care.

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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.

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Purpose: A key factor for the success or failure of a dental implant is the manner of stresses transferred to the surrounding bone. Parallel to this situation, cantilever extensions where it is not possible to place another implant, would cause greater stress and it should be avoided if possible. Manufacturers and clinicians try to develop new implant designs and superstructure materials to reduce the stresses around the implant and supporting bone tissue. This study analyzed the influence of superstructure materials and implant designs on stress distribution around dental implants supporting cantilever restoration under loading conditions. Materials and Methods: Three-dimensional finite element models of a 3-unit cantilever bridge were subjected to 150 N occlusal load to evaluate two different superstructure materials (conventional metal ceramic, fiber reinforced composite) and two different implant designs, cylinder type (Institut Straumann AG, Waldenburg, Switzerland) and cylinder type with micro threads around implant neck (Astra Tech AB, Mölndal, Sweden). To evaluate the distribution of stresses within the bone surrounding the implants, 3-dimensional finite element analysis was conducted using four mathematical models of unilateral 3-unit cantilever fixed partial dentures supported by two implants. Results: The stress distribution patterns and stress values were similar and stress concentrations were similar in both restoration materials. The highest stress concentrations were around the adjacent ITI implant, which supports the conventional metal porcelain restoration. Conclusions: Although, there was no significant difference in stress distribution between fiber reinforced composite (FRC) and conventional metal porcelain, stress values were lower in FRC restorations. The Astra-Tech micro-thread design reduced the stress that was distributed throughout the implant body, but it should be noted that the peak stress was still present on the implant neck.

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Background: Frenectomy is the complete excision of the frenum along with its attachment to the underlying bone. It can be done by conventional technique, electrosurgery or soft tissue lasers. Aim: To evaluate the effects of diode laser and scalpel technique on degree of post-operative pain and discomfort experienced by patients on the 1 ^st , 3 ^rd and the 7 ^th post-operative days after frenectomy. Materials and Methods: Ten patients who required frenectomy were randomly assigned to undergo treatment with diode laser or scalpel. The data were analyzed with paired t-test and intragroup comparison was determined by ANOVA. Results: Intergroup comparison of the mean VAS scores for discomfort and pain for both the groups showed significant difference. The VAS scores of pain and discomfort within scalpel group between 1 ^st and 3 ^rd day did not show any significant difference, however between 7 ^th day versus 3 ^rd and 1 ^st day difference was highly significant. The VAS scores of pain and discomfort within laser group between all the days showed significant difference. Conclusion: Taking into consideration the clinical outcome, the diode laser is a dependable alternative as it is an efficient and satisfactory option for procedures like frenectomy.

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Aim: The study was undertaken to compare the filling quality of a 30 gauge cannula (NaviTip™, Ultradent Inc., South Jordan, UT, USA) used on a pressure syringe with a lentulospiral in primary molars. Materials and Methods: Thirty mandibular first and second primary molars in 28 healthy children of both sexes in the age group of 4-8 years were included in the study. All pulpectomy procedures were performed by one investigator. Before obturation, the subjects were randomly selected for the two obturation techniques. Effectiveness of the two obturation techniques was assessed by three independent evaluators using postoperative radiographs taken immediately after each obturation. Filling quality was determined by analyzing presence or absence of voids, extent of fill and apical seal. Results: The results of the obturation quality of the tested techniques were collected and statistically analyzed using chi-square test. There was a significant difference for the presence of voids between the two groups. NaviTip group showed the best results for the number of voids (mesial χ² = 3.567, P = 0.0497) (distal χ² = 5.058, P = 0.0269). The lentulospiral group showed more number of optimal fillings. When results were compared in terms of apical seal, NaviTip showed better apical seal but statistically no difference (P >.05). Conclusion: Lentulospiral produced the best results in terms of length of obturation, while NaviTip syringe was efficient enough in controlling voids and produced the best results for apical seal.

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Objective: The objective of this study was to determine the barriers to regular dental attendance for check- up in a rural population in Shimla Himachal Pradesh. Materials and Methods: A cross-sectional questionnaire survey was conducted among 319 adults in the area of Thari Panchayat, Shogi, Shimla. The data was analyzed by SPSS version 13. Statistical tests used were chi square and multiple-variate analysis. Results: The response rate of the study was 96.8%. 46 (15.1%) visited a dentist within the previous one year. The most common reasons for the last dental visit were pain or a dental emergency (208, 68.5%). The most commonly reported reason for not seeking dental care was "no need to visit a dentist unless there is pain" by 190 (62.5%) in bivariate analysis as well as in multiple logistic regression analysis (Odds ratio: 1.95; CI: 1.71-2.22). Conclusion: Our findings suggest that only a small portion of population visited dentist in previous one year. They believe that visiting a dentist is necessary only for pain relief. Thus it is important to give them awareness programmes about the good oral health and motivating them to use the services available.

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Background : Saliva is the first biological fluid that is exposed to tobacco and is responsible for its changes especially the salivary flow rate (SFR) and salivary pH. Aims and Objectives : The aim of this study was to analyze and compare the long- term effects of tobacco on SFR and pH between tobacco chewers, smokers, and controls. Materials and Methods : A total of 60 Subjects were divided equally into tobacco smokers (group A), chewers (group B), and controls (group C). Saliva of each subject was collected under resting condition and SFR was expressed in mL/min for 10 min. Salivary pH was determined using the specific salivary pH strips. Results : The mean (±SD) SFR for group A; 4.34 (±0.3), group B; 3.07 (±0.26) and group C; 5.65 (±0.44) mL/min when compared and a significant relation was obtained. The mean (±SD) pH for group A; 6.8 (±0.1), group B; 6.7 (±0.1) and group C; 7.04 (±0.1) when compared and a non-significant relation was obtained though, lower salivary pH were observed in group A and B. Conclusion : Present study indicates that the SFR decreases appreciably among tobacco abusers especially more among smokeless form. A lower (acidic) salivary pH was observed in tobacco users as compared with control. These alterations in SFR and pH due to long-term effect of tobacco user can render oral mucosa vulnerable to various oral and dental diseases.

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Third molar teeth are subject to many dental complications because of their most posterior location, aberrant occlusal anatomy and abnormal eruption patterns. Owing to these anatomical limitations, their extraction remains the treatment of choice for many dental practitioners. Despite being a common dental procedure, minimum intervention and retaining every functional component of the dental arch are of prime importance in contemporary dental practice. As such, this review aims to discuss the application of this conservative approach on third molar teeth from an endodontic perspective. The internal and external root anatomy of maxillary and mandibular third molars and their relation to the surrounding vital structures are described. These anatomical landmarks are then correlated to the decision making for endodontic treatment strategies of third molars. In addition, the recommended guidelines that should be followed while commencing endodontic treatment in third molars are outlined.

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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.

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Oral myiasis is a relatively rare pathology in humans caused by invasion of body tissue or cavities of living animals or humans by larvae of certain dipteran flies. It is an uncommon clinical condition, being more frequent in underdeveloped countries, and in countries with tropical climate. Common pre-disposing factors are poor oral hygiene, halitosis, trauma, senility, suppurative oral lesions, and in patients with neuro-psychiatric deficits. The present article reports a case of oral myiasis involving the anterior palate in a physically and mentally disabled 24-year-old female patient.

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Objective: The aim of this study was to investigate oral glucose tolerance test (OGTT) in unstimulated whole saliva as a diagnostic specimen in clinical practice for detection of diabetes mellitus (DM). Materials and Methods: An interventional study was carried out in 30 apparently healthy individuals aged 24–59 years. Serum and saliva samples were obtained in fasting, 1 h and 2 h after glucose intake (75 g). Glucose concentration was determined by enzymatic colorimetric glucose oxidase-prostatic acid phosphatase assay. Statistical analysis of the repeated ANOVA (followed Bonferroni post-hoc test) and Pearson correlation coefficient were used. Results: The mean serum glucose concentration was significantly higher 1 h after glucose intake (152.32 ± 31.06) than both fasting state (106.38 ± 41.08; P < 0.001) and 2 h after glucose intake (125.21 ± 51.71; P < 0.001). Saliva glucose was also significantly higher 1 h after glucose intake (5.46 ± 2.41) than both fasting state (2.84 ± 1.46; P < 0.001) and 2 h after glucose intake (4.01 ± 1.91; P < 0.001). There were significant positive correlation between saliva and serum glucose concentration in fasting state (r = 0.502; P = 0.044), 1 h (r = 0.756; P = 0.0001), and 2 h (r = 0.543; P = 0.023) after oral glucose intake. Conclusion: It seems that unstimulated saliva can be used as an alternative to serum for diagnosis of DM in OGTT.

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Background: Dental caries is one of the most common dental disorders affecting from all over the globe. Dental caries affects 60%-90% of schoolchildren in most developed countries, and in several developing countries, the prevalence rates are increasing. Objective: To know oral health knowledge and practice among 9-12-year-old schoolchildren and its relation with dental caries. Methods: This is a questionnaire-based cross-sectional studies conducted from September 20, 2015, to January 27, 2016, selecting four male and four female primary schools. Two calibrated examiners examined the students under the normal light with mirror and probe. Results: A total of 276 (92%) were included in this cross-sectional study. There were 118 (43%) were males and 158 (57%) were females with mean age of 10.61 years and having mean Decayed, Missing, and Filled Tooth/decayed, missing, and filled tooth (DMFT/dmft) 1.47/1.78 in male and 1.69/5.34 in female. Three-quarters of the sample (75%) reported to cleaning their teeth at least once per day, and >95% reported using a toothbrush and toothpaste. The mean DMFT/dmft and D/d scores of female were significantly higher (P < 0.05) than that of the males. The mean dmft and all the components decreased with age, and there was a significant association (P < 0.01) between oral health knowledge and the caries status. Children with a higher DMFT/dmft score tended to have poor oral health knowledge compared to those with low DMFT/dmft scores. Conclusion: Poor oral health knowledge contributes major role in the prevalence of dental caries in both male and female. In female higher DMFT/dmft was observed in spite of having good oral health knowledge.

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Aim: The study was to determine the effect of maternal periodontal status on birth weight. Materials and Methods: This longitudinal study was conducted at the University of Benin Teaching Hospital, Benin City, Edo State. Recruited into the study were 300 pregnant women aged between 20 and 34 years who were randomly placed into two groups. Test group received oral prophylaxis upon enrolment and control group received prophylaxis after deliveries. The gestational age for enrolment was from 12 weeks to 36 weeks. The groups were balanced for other risk factors, while smoking and alcohol was assessed using the questionnaire. The participants were all primigravid women. Data were collected by means of interviewer-administered questionnaire, clinical dental examination and participants' hospital records. Results: Community Periodontal Index (CPI) assessment revealed that 44.4% recorded code 2; 22% had code 3; while 16.6% had code 4. The overall prevalence of low birth and normal weight in this study were 6.3% and 93.8% respectively. The prevalence of low birth weight (LBW) among the test and control group were 0.0% and 12.5% respectively. The highest prevalence of low birth weight delivery (27.3%) among the control group was among the participants with CPI score 4 which was statistically significant ( P<0.05). Conclusion: The study revealed that the control group had low birth weight deliveries, which was significantly associated with poor periodontal status. Therefore, there is the need for oral prophylaxis among pregnant women preferably before second trimester.

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Context: Color difference between maxillar and mandibular incisors is an anticipated subject, and it will help dentists during color matching. Aim: The aim of this study was to evaluate color differences of the maxillar and mandibular incisors and to find out relationships between gender and age. Materials and Methods: This study was conducted on 125 participants (51 males and 74 females) between 16-63 age groups and totally over maxillar and mandibular 480 healthy teeth by using spectrophotometer. Color differences between teeth were calculated by using ΔE formula. One way ANOVA statistical analysis determined statistically significant differences between maxiller-central and mandibular-canine teeth for ΔL and Δb parameters (P<0.05). Results: According to t-test result there were not a statistically significant color differences for women and men teeth (P<0.05). Scheffe statistical analysis results showed statistically significant differences between mandibular central and mandibular canine for ΔL parameters on 16-27, 28-39, and 52-63 age groups; for Δb parameters, there were statistically significant differences between 16-27 and 40-51 age groups (P<0.05). Conclusion: Women have more lighter teeth than men. Maxillar canines are more yellow and Maxillar centrals are more lighter than other incisors. 16-27, 28-39 age groups have more lighter teeth than 52-63 age groups and 16-27 age groups have more yellow teeth than 40-51 age groups.

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