Objectives: To compare the overall dental aesthetic index scores between rural and urban areas, males and females, and to correlate dental aesthetic index score with fluoride concentration in drinking water. Settings and Design: The study was cross sectional and conducted among 15 year old adolescents in the rural and urban areas of Nalgonda district, Andhra Pradesh, India (an endemic fluoride belt). Materials and Methods: Six out of 59 mandals in Nalgonda district were first selected by simple random sampling technique. Then 24 secondary schools were selected from these six selected mandals. All eligible grade X children from these sixteen rural and eight urban schools, having different fluoride concentrations in drinking water, selected by simple random sampling, were considered for the study. Dentofacial anomalies with criteria of dental aesthetic index were used for assessing malocclusion. The information on the dietary habits, orthodontic treatment history, parafunctional habits, continuous residence etc., was collected using a pre-designed questionnaire. The examination was carried out by three trained and calibrated dentists. The Dental Aesthetic Index (DAI) scores, in areas with below optimal, optimal and above optimal fluoride concentrations, between urban and rural areas were compared and analyzed using SPSS windows version 16. Results: The mean DAI scores, for the rural and urban population were 21.37 ± 5.845 (mean ± SD) and 22.26 ± 6.115, for males and females, it was 20.86 ± 5.100 and 22.70 ± 6.713 respectively. The mean DAI scores in areas with below optimal, optimal and above optimal fluoride concentration were 23.42 ± 7.205 (mean ± SD), 20.85 ± 4.658 and 19.93 ± 4.312 respectively. Conclusion: The prevalence and severity of malocclusion was more in urban than rural areas, more among females than males, and it decreased with increasing concentration of fluoride in drinking water.

Purpose: The aim of this study was to evaluate the microstrain exhibited by bone around immediately loaded, platform-switched, and non-platform-switched implants under vertical and angled loading using a finite element analysis (FEA) and also to evaluate whether platform-switched implants evoke a better response than non-platform-switched implants on a mechanical basis. Materials and Methods: Three-dimensional finite element study was undertaken to model and analyze an immediate loaded situation. FEA was chosen for this study since it is useful in determining the stress and strain around the dental implant. Bone responses to vertical and angulated loads on straight and angulated abutments (platform-switched and non-platform-switched abutments) were evaluated. Results: Non-platform-switched abutments tend to exhibit a lower tensile stress and compressive stress but higher microstrain value (conducive to higher chance of bone resorption) than platform-switched abutments. Ideal bone remodeling values of microstrain (50-3000 μϵ) were exhibited by platform-switched straight abutments under vertical load and angled load (with an abutment-implant diameter difference of 1 mm). Conclusion: In spite of the obvious advantages, the practice of immediate loading is limited due to apprehension associated with compromised bone response and a higher rate of bone loss around an immediately loaded implant. The mechanical basis for the concept of "platform switching" in immediately loaded situation is analyzed in this context. The results of this limited investigation indicated that the ideal values of microstrain (50-3000 microstrain) can be exhibited by platform switching of dental implants (with an abutment-implant diameter difference of 1 mm) and can be considered as a better alternative for prevention of crestal bone loss when compared to non-platform-switched implants.

Aims: The aim of this study is to verify the disinfection of diode laser, following chemo-mechanical procedures against Enterococcus fecalis. Materials and Methods: Crowns of 30 extracted premolar teeth were sectioned at the cemento- enamel junction. The canals were shaped using step-back technique to K-file #40. The teeth were randomly assigned to three groups and placed into nutrient broth containing bacterial suspension of Enterococcus fecalis. Group A received no laser radiation. Specimens of group B and C were treated with diode laser (Sirona) with energy set at 1.5 and 3 W, respectively. After laser irradiation, the teeth were placed in vials, which contained 2 mL of the nutrient broth. The vials were incubated at 37°C for 24 h. Grown colonies were identified by standard methods. Statistical Analysis Used: Statistical analysis used was the nonparametric Kruskal-Wallis test, with comparison using the Bonferroni methods of means. Results: Higher mean CFU/mL is recorded in Group A (without laser disinfection) followed by Group B (with 1.5 W laser disinfection) and Group C (with 3 W laser disinfection), respectively. The difference in CFU/mL between the three groups is found to be statistically significant ( P < 0.001). Conclusions: The results of this research show that the 980 nm diode laser can eliminate bacteria that has immigrated into dentin, thus being able to increase the success rate in endodontic therapy.

Aim : To measure the impact strength of denture base resins polymerized using short and long curing cycles by water bath, pressure cooker and microwave techniques. Materials and Methods: For impact strength testing, 60 samples were made. The sample dimensions were 60 mm × 12 mm × 3 mm, as standardized by the American Standards for Testing and Materials (ASTM). A digital caliper was used to locate the midpoint of sample. The impact strength was measured in IZOD type of impact tester using CEAST Impact tester. The pendulum struck the sample and it broke. The energy required to break the sample was measured in Joules. Data were analyzed using Student's " t" test. Results: There was statistically significant difference in the impact strength of denture base resins polymerized by long curing cycle and short curing cycle in each technique, with the long curing processing being the best. Conclusion: The polymerization technique plays an important role in the influence of impact strength in the denture base resin. This research demonstrates that the denture base resin polymerized by microwave processing technique possessed the highest impact strength.

Background: The aim of this study was to evaluate and compare the effectiveness of 0.5% tea, 2% neem, and 0.2% chlorhexidine mouthwashes on oral health. Materials and Methods: A randomized blinded controlled trial with 30 healthy human volunteers of age group 18-25 years was carried out. The subjects were randomly assigned to 3 groups i.e., group A - 0.2% chlorhexidine gluconate (bench mark control), Group B - 2% neem, and group C - 0.5% tea of 10 subjects per group. Plaque accumulation and gingival condition were recorded using plaque index and gingival index. Oral hygiene was assessed by simplified oral hygiene index (OHIS). Salivary pH was assessed by indikrom pH strips. Plaque, gingival, and simplified OHI scores as well as salivary pH were recorded at baseline, immediately after 1 ^st rinse, after 1 week, 2 ^nd week, and 3 ^rd week. The 3 ^rd week was skipped for group A. Results: Mean plaque and gingival scores were reduced over the 3 week trial period for experimental and control groups. Anti-plaque effectiveness was observed in all groups and the highest being in group C (P < 0.05). Neem and tea showed comparative effectiveness on gingiva better than chlorhexidine (P < 0.05). The salivary pH rise was sustained and significant in Group B and C compared to Group A. Oral hygiene improvement was better appreciated in Group B and Group C. Conclusion: The effectiveness of 0.5% tea was more compared to 2% neem and 0.2% chlorhexidine mouth rinse.

Aim: Present study evaluated the efficacy of natural derivative irrigants, Morinda citrifolia juice (MCJ), Aloe Vera and Propolis in comparison to 1% sodium hypochlorite with passive ultrasonic irrigation for removal of the intraradicular E. faecalis biofilms in extracted single rooted human permanent teeth. Materials and Methods: Biofilms of E. faecalis were grown on the prepared root canal walls of 60 standardized root halves which were longitudinally sectioned. These root halves were re-approximated and the samples were divided into five groups of twelve each. The groups were, Group A (1% NaOCl), Group B (MCJ), Group C (Aloe vera), Group D (Propolis) and Group E (Saline). These groups were treated with passive ultrasonic irrigation (PUI) along with the respective irrigants. The root halves were processed for scanning electron microscopy. Three images (X2.5), coronal, middle and apical, were taken for the twelve root halves in each of the five groups. The images were randomized and biofilm coverage assessed independently by three calibrated examiners, using a four-point scoring system. Results: 1% NaOCl with passive ultrasonic irrigation (PUI) was effective in completely removing E. faecalis biofilm and was superior to the natural irrigants like MCJ, Aloe vera and Propolis tested in this study. Conclusion: 1% NaOCl used along with passive ultrasonic irrigation was effective in completely removing E. faecalis biofilm when compared to natural irrigants (MCJ, Aloe Vera and Propolis).

Aim: The purpose of this study was to evaluate the effect of multiple root canal usage on the surface topography and fracture of Twisted File (TF) and ProTaper (PT) rotary Ni-Ti file systems, using scanning electron microscope (SEM). Materials and Methods: Ten sets of PT and TF instruments were used to prepare the mesial canals of mandibular first molars. TF 25, 0.06 taper and PT F1 instruments were analyzed by SEM when new and thereafter every three root canal usages. This sequence was repeated for both the TF and PT groups until 12 uses. Two images of the instrument were recorded, one of the instrument tip and the other 5 mm from the tip, both at ×100 magnification. The sequential use was continued till the instrument fractured and the number of root canal usages for the file to fracture was noted. All fracture surfaces were examined under the SEM. Results: Fresh TF instruments showed no surface wear when compared to PT instruments (P < 0.05). Spiral distortion scores remained the same for both the groups till the 6 ^th usage (P > 0.05), while at the 9 ^th usage TF showed a steep increase in the spiral distortion score when compared to PT (P < 0.05). PT instruments fractured at a mean root canal usage of 17.4, while TF instruments showed a mean root canal usage of 11.8. Fractographically, all the TF instruments failed due to torsion, while all the PT instruments failed because of cyclic fatigue. Conclusion: PT instruments showed more resistance to fracture than TF instruments.

Objective: To evaluate the precision of dimensional measurements of the mandible in two different positions on orthopantomogram (OPG) (one with mandibular plane parallel to the floor and the other with Frankfort horizontal plane parallel to the floor) and determine the dimensional reliability. Materials and Methods: Anatomical landmarks were used to denote points for measurements on mandible as well as OPG and respective measurements made. Magnification was hence calculated and compared with magnification factor (1.2) listed by the manufacturer. Results: Vertical measurements and anterior horizontal and oblique measurements showed minimal magnification. Posterior horizontal and oblique measurements showed increased magnification. The difference in measurements in the two positions and on comparison with the one given by the manufacturer was statistically significant for posterior horizontal measurements but not for posterior oblique. Horizontal measurements crossing the midline were highly magnified and the difference was statistically significant for the two positions and on comparison to the one given by manufacturer. Conclusion: Magnification factor given by the manufacturer is not uniform in all locations and varies with changes in positioning and hence should not be relied upon when accurate measurements are to be made.

Aims and Objectives: The purpose of this study was to assess the clinical and microbiological effects of a newly developed root-conditioning gel system containing tetracycline and a mixture of tetracycline and citric acid on non-surgical periodontal therapy. Materials and Methods: Four anterior teeth from four quadrants with a probing depth of 4-6 mm, in each of the 20 subjects with chronic periodontitis, were subjected to four different modalities of treatment. A total of 80 teeths were divided into four groups of 20 teeth each taken from separate quadrants, on the basis of one of the following four treatments: (1) Root planning alone in first quadrant (RP group); (2) tetracycline-containing gel in the second quadrant (TCG group); (3) root planning plus tetracycline-containing gel in third quadrant (RP + TCG group); (4) root planning plus a mixture of tetracycline and citric acid-containing gel in fourth quadrant (RP + TC-CAG group). Plaque index (PI), sulcular bleeding index, probing pocket depth, and clinical attachment level were measured for 0 day, 8 ^th week, and 12 ^th week, respectively. Subgingival plaque samples from each site were collected at the same visits and examined with dark field microscope for proportions of motile rods and spirochetes. Results: From 0 day to 12 ^th week, PI, sulcular bleeding index, probing pocket depth, and clinical attachment levels decreased significantly in all the groups. From 0 day to 12 ^th week, RP + TC-CAG group showed a significantly higher change in the PI score. From 0 day to 12 ^th week, RP group showed a significantly higher change in sulcular bleeding index score. A significant decrease in probing pocket depth and gain in clinical attachment level was noted at 12 ^th week in RP + TC-CAG group compared to the other groups. A significant decrease in the proportion of motile rods was found primarily in the RP + TC-CAG group. There was a decrease in the proportion of spirochetes in all the groups. Conclusion: The results indicated that the use of a mixture of tetracycline and citric acid-containing gel was effective in improving gingival health and in changing subgingival microflora.

Objective: The objective of this work was to assess the influence of storage time and pH cycling on water sorption by different composite resins. Materials and Methods: Nine resin brands were selected and divided into groups: G1-ROK (SDI), G2-ICE (SDI), G3-GLACIER (SDI), G4-Z350 (3M/ESPE), G5-Z250 (3M/ESPE), G6-TPH 3 (DENTSPLY), G7-ESTHET X (DENTSPLY), G8-SUPRAFILL (SSWHITE), and G9-MASTERFILL (BIODINΒMICS). Ninety specimens, ten per group, were obtained using an aluminum matrix. Specimens measured 10 mm diameter × 2 mm width. The groups were divided into subgroups according to the immersion solution: A - control (n = 05) stored in artificial saliva pH = 7.0 and B-test (n = 05) submitted to seven consecutive days of pH cycling (cariogenic challenger) that consisted of immersion in a pH° = 4.3 solution for 6 h followed by immersion in a pH¹ =7.0 solution for 18 h and stored in artificial saliva pH = 7.0 until the end of the experiment. The specimens were weighed on six occasions: T ⁰ (after fabrication), T ¹ (24 h), T ² (7 days), T ³ (15 days), T ⁴ (30 days), T ⁵ (60 days), and then analyzed. The water sorption was determined by the weight difference between the specimens at the time intervals. Results: The mean weight gain was exactly the same for both the subgroups within group G4. The highest means for the control subgroup were found in groups: G1, G5, G7, G8, and G9. For the pH cycling subgroup, the highest means were found in G2, G3, and G6; however, significant differences between the subgroups compared to the mean-weight gain were found for G1, G5, and G7. Conclusion: The water sorption of composite resins is dependent upon their storage time. The pH cycling created a significant impact on resins G1, G5, and G7. The sorption and solubility of composite resins vary according to their chemical composition.

Background: The aim of this study was to determine the association of dental caries and BMI-for-age in preschool children and whether BMI-for-age is similar or different between Severe Early Childhood Caries (S-ECC) and caries free children. Materials and Methods: Four hundred preschool children aged 30-70 months were entered into this study. The parameters examined in this study were weight, height, BMI-for-age and number of decayed, extracted and filled surfaces of deciduous teeth (defs). Based on dental caries, the subjects were also divided into S-ECC and caries-free groups. Then data was analyzed by t-test, one-way ANOVA, multiple regression and logistic regression tests. Results: The mean and SD of defs index was 8.37 ± 11.2. In the underweight, normal-weight, at risk of overweight and overweight groups, these values were 4.89 ± 10.8, 8.84 ± 11.8, 8.68 ± 10.6, and 10.39 ± 10.2, respectively. Multiple regression analysis revealed a statistically a significant direct association between BMI-for-age and defs index (P = 0.001) after adjusting for gender and age. The percentage of subjects who were caries free and S-ECC was 44.8% and 51.2%, respectively. Logistic regression analysis showed that there was statistically a significant inverse association between BMI-for-age scores and the frequency of caries-free (P = 0.001) and a significant direct association with S-ECC children (P = 0.001). Conclusions : The findings of this study demonstrated that there was an association between higher defs scores and severe early childhood caries with overweightness.

Background: Allium sativum, commonly known as garlic, exhibits antibacterial effects against a wide range of bacteria. Aim: The objective of this in vitro study was to assess the antibacterial effect of different concentrations of garlic extract against human dental plaque microbiota. Materials and Methods: Antibacterial activities of four different concentrations of garlic extract (5%, 10%, 20%, and 100%) were evaluated against Streptococcus mutans, Streptococcus sanguis, Streptococcus salivarius, Pseudomonas aeruginosa, and lactobacillus spp. using the disk diffusion method. Papers soaked in 0.2% concentration chlorhexidine gluconate and saline were used as positive and negative controls, respectively. The data were subjected to one-way ANOVA and the Tukey multiple comparisons test at a 5% significance level. Results: All bacterial strains were inhibited by all test materials. The inhibition zones of the different concentrations of garlic extract were not significantly different for S. mutans, S. sanguis, and S. salivarius. For P. aeruginosa and lactobacillus spp. the inhibition zones of 5%, 10% and 20% concentrations were not significantly different from one another, but they were significantly more than that of the 100% extract. Conclusion: The 5%, 10%, 20%, and 100% concentrations of garlic extract had similar effects, so further studies seem to be indicated on the usefulness of the 5% extract.

Aims: To analyze the density of the midpalatal suture by means of digital radiographs three months after retention to evaluate if this period of retention is really sufficient for bone repair. Materials and Methods: This prospective study consisted of 31 patients (11 girls and 20 boys) in the mixed or permanent dentition stage, treated using a tooth-tissue borne expanders (Haas). Occlusal digital radiographs were taken at three stages: prior to rapid maxillary expansion (Stage I); immediately after desired maxillary expansion (Stage II); and after three months of retention (Stage III). Radiographs were taken on a dental X-ray machine, set at 70 kVp and 7 mA with an exposure time of 0.04 s. A phosphor storage plate system, imaging plate size n. 2 (35 × 45 × 1.6 mm), was used. Three regions (A, B and C) measured 0.02 mm² were selected for optical density analysis. The difference between the measurements was evaluated with the paired t-test. Results: The optical density was reduced at Stages II and III compared with Stage I. Between-stage comparison showed statistically significant changes for all variables (P < 0.05), with the highest mean optical density at Stage I and the lowest at Stage II, in all groups. Actually, there was an increase in optical density between Stages II and III, but they are reduced compared with Stage I. Conclusion: The results strongly suggest that bone formation did not occur as expected, and that a longer retention period for bone repair may be necessary.

Aim: The aim of this study was to compare the cytotoxic effects of two indirect composite resins (Artglass and Solidex) on the viability of L-929 fibroblast cells at different incubation periods by storing them in artificial saliva (AS). Materials and Methods: Disk-shaped test samples were prepared according to manufacturers' instructions. Test materials were cured with light source (Dentacolor XS, Heraus Kulzer, Germany). The samples were divided into two groups. The first group's samples were transferred into a culture medium for 1 hour, 24 hours, 72 hours, 1 week and 2 weeks. The other group's samples were transferred into a culture medium for 1 hours, 24 hours, 72 hours, 1 week, and 2 weeks after being stored in AS for 48 hours. The eluates were obtained and pipetted for evaluation onto L-929 mouse fibroblast cultures incubated for 24 hours. Measurements were performed by MTT (3-(4,5)-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) assay. The degree of cytotoxicity for each sample was determined according to the reference values represented by the cells with a control group. Results: Statistical significance was determined by ANOVA. Both groups presented lower cell viability in comparison to the control group at all periods. Storing in artificial saliva reduced cytotoxicity significantly (P < 0.05). Stored Artglass and Solidex showed similar effects on cytotoxicity. Nonstored Solidex samples were found more cytotoxic than Artglass samples. The cell survival rate results of 24-hour incubation period were significantly lower than those of the other experimental periods (P < 0.05). Conclusion: Storing indirect composite resins in AS may reduce cytotoxic effects on the fibroblast cells. However, resin-based dental materials continue to release sufficient components to cause cytotoxic effects in vitro after 48 hours of storing in AS.

Objective: Tooth sensitivity is common after vital tooth bleaching. The aim of this study is to evaluate the effect of a desensitizing agent on shear bond strength of composite resin to bleached enamel; and determine whether a delay of one or two weeks in bonding procedure is sufficient subsequent to bleaching/desensitizer regimen. Materials and Methods: Buccal enamel surfaces of ninety-six human sound molars were prepared and divided into eight groups. The surfaces of specimens in Group 1 as negative control group were bonded by composite resin using the single bond adhesive. Specimens in Groups 2-4 were bleached with an at-home bleaching agent (Daywhite ACP). Relief ACP desensitizing gel alone was applied in Group 5. In Groups 6-8, specimens were bleached same as in Group 2 and relief ACP desensitizing gel was applied same as inGroup 5 subsequent to each bleaching session. Composite cylinders were bonded after 24 h, 7 days and 14 days in Groups 2-4, respectively, and also in Groups 6-8, respectively. The shear bond strengths of the cylinders were tested and data was analyzed using two-way ANOVA and Tukey test (α = 0.05). Results: The results showed that bleaching and bleaching/desensitizer regimens significantly reduced the bond strength of composite resin to enamel. However, desensitizer alone did not reduce bond strength. No statistically significant differences were found between bleaching and bleaching/desensitizer regarding bond strength. Conclusion: Bleaching or bleaching/desensitizer treatment significantly decreases bond strength of composite resin to enamel. In both regimens, adhesive bonding is recommended after two weeks.

Objective: To analyze the effect of different combinations of post and core materials on stress distribution in dentin of an endodontically treated tooth. Materials and Methods: This was an experimental stress analysis study. Models were made in photoelastic material, i.e., epoxy resin. Different combinations of post and core materials used were: Glass fiber post with composite core, stainless steel post with composite core, and cast metal post and core. Stresses generated were frozen, models were sliced and viewed under circular polariscope, and photographs were taken. Stress was calculated by counting the number of fringes. Results: For the combination of glass fiber post with composite core, the shear stresses calculated were 1.196, 1.196, and 2.898 MPa in the apical, mid-root, and cervical region, respectively. For the combination of stainless steel post with composite core, the apical, mid-root and cervical stresses were 1.534, 0.511, and 2.557 MPa, respectively. For cast metal post and core, the apical, mid-root, and cervical stresses were 0.852, 0.511, and 1.534 MPa, respectively. Conclusion: The cervical region of the teeth is subjected to the highest stresses irrespective of the material used. The stainless steel post with the composite core generated the highest stress concentration in different regions. A glass fiber post generated a uniform stress distribution. A cast metal post and core combination generated lesser stress than the other combinations. The vast difference in the elastic modulus of the restorative materials can lead to nonuniform stress distribution and concentration of stresses in different areas which can have deleterious effect on the survival of already compromised teeth and restoration. Such combinations should be avoided and the material which has an elastic modulus close to that of dentin should be preferred.

Introduction: Although digital cephalometric radiography is gaining popularity in orthodontic practice, the most important source of error in its tracing is uncertainty in landmark identification. Therefore, efforts to improve accuracy in landmark identification were directed primarily toward the improvement in image quality. One of the more useful techniques of this process involves digital image enhancement which can increase overall visual quality of image, but this does not necessarily mean a better identification of landmarks. The purpose of this study was to evaluate the effectiveness of digital image enhancements on reliability of landmark identification. Materials and Methods: Fifteen common landmarks including 10 skeletal and 5 soft tissues were selected on the cephalograms of 20 randomly selected patients, prepared in Natural Head Position (NHP). Two observers (orthodontists) identified landmarks on the 20 original photostimulable phosphor (PSP) digital cephalogram images and 20 enhanced digital images twice with an intervening time interval of at least 4 weeks. The x and y coordinates were further analyzed to evaluate the pattern of recording differences in horizontal and vertical directions. Reliability of landmarks identification was analyzed by paired t test. Results: There was a significant difference between original and enhanced digital images in terms of reliability of points Ar and N in vertical and horizontal dimensions, and enhanced images were significantly more reliable than original images. Identification of A point, Pogonion and Pronasal points, in vertical dimension of enhanced images was significantly more reliable than original ones. Reliability of Menton point identification in horizontal dimension was significantly more in enhanced images than original ones. Conclusion: Direct digital image enhancement by altering brightness and contrast can increase reliability of some landmark identification and this may lead to more accurate cephalometric analysis.

Objective: To evaluate the bond strength of a composite resin to the bovine enamel bleached with 35% hydrogen peroxide. It was used an etching-and-rinse adhesive system employed immediately, 7 and 14 days after the bleaching. Materials and Methods: Twenty bovine teeth were randomly distributed into 4 groups (n = 5), 3 experimental and 1 control. G1: Unbleached + restoration 14 days after storage in artificial saliva (control); G2: Bleached + restoration immediately after bleaching; G3: Bleached + restoration 7 days after bleaching; G4: Bleached + restoration 14 days after bleaching. Their buccal enamel surfaces were flattened, and a 25 mm² (5 × 5 mm) area from each one of these regions was outlined so as to standardize the experimental region. Universal hybrid composite resin Filtek™Z350 was inserted into four layers of 1 mm each and photo-activated. The bond strength was quantitatively evaluated by a microtensile test (1.0 mm/min) 24 h after the restorative procedures. The failure mode was assessed through scanning electron microscopy (SEM). Results: There was a significant reduction in the bond strength of the restored teeth immediately after the bleaching (G2). There were no significant differences in enamel bond strength between groups G1, G3, and G4. There was a predominance of adhesive and mixed (cohesive + adhesive) failure in all groups. Conclusion: The 7-day-period after the end of the bleaching with 35% hydrogen peroxide was enough to achieve the appropriate values of bond strength to the enamel.

Background: The aim of this study was to compare the efficacy of metabolic control and levels of interleukin 6 (IL-6) in gingival crevicular fluid after periodontal therapy in type 2 diabetes mellitus (DM) and nondiabetic (NDM) patients. Methods: This study was performed in 20 subjects (10 type 2 DM and 10 NDM patients with generalized chronic periodontal disease. Both groups were recorded for clinical parameters (plaque index (PI), gingival index (GI), probing depth (PD), gingival recession (GR) and clinical attachment level (CAL)), metabolic control (fasting glucose levels, glycated a-hemoglobin (HbA1c), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TR)), and IL-6 levels at baseline and 3 months after periodontal treatment. Results: DM and NDM patients revealed significant statistical reductions for clinical parameters (P < 0.05, RM ANOVA) after 3 months. DM group had improvements on HbA1c and had significant statistical increased of TRG (P < 0.05, RM ANOVA) after 3 months. No differences of LDL/HDL and IL-6 levels were found after 3 months in both groups. Conclusion: DM group presented a significant reduction of HbA1c levels after periodontal therapy. However, TRG levels increased after 3 months, which suggest more confirmatory studies to investigate if these results will be repeated in other studies.

Supernumerary teeth are those which are additional or in excess of the normal number. They can be either single or multiple, unilateral or bilateral and can be present anywhere in the dental arch with predilection for the premaxilla. Supernumerary teeth are mostly classified on position and form. Timing of surgical intervention of supernumerary teeth has been controversial with various authors having different opinions. Hence a new decision support system is put forward which can help in the treatment planning of supernumerary teeth.

An accurate diagnosis of the morphology of the root canal system is a prerequisite for successful root canal treatment. A major cause of endodontic treatment failure in missed (or) untreated root canals is that they still harbor infection. Careful radiographic interpretation and examination of pulp chamber floors are helpful in locating root canal entrances. These case reports present anatomical variations in upper and lower premolars.

Internal resorption has been described as a resorptive defect of internal aspect of tooth. It is caused by transformation of normal pulp tissue into granulomatous tissue with giant cells which resorb dentin. Though mostly idiopathic in origin, trauma, caries and restorative procedures have also been suggested to be contributing factors of internal resorption of pulp. Most of the internal resorption cases were found on isolated individual tooth. There are few case reports on multiple root resorptions. External root resorption have been frequently associated with systemic disorders like renal diseases hyperparathyroidism, rickets etc. A rare association of multiple internal resorption of permanent teeth (including lateral incisors, canines, premolars, sparing 2 ^nd and 3 ^rd . Permanent molars and missing 35,36, 42) with elevated levels of PTH and uric acid was evident in a 28 year old female patient who presented with fracture of crowns of permanent teeth. Though many cases related to dental manifestations of chronic renal disease and internal resorption of permanent teeth have been documented in literature, there is no evidence on association of hyperparathyroidism with multiple internal resorptions of teeth.

A case of a 10-year-old boy reported to us for delayed eruption of permanent teeth with classical features of orofacial digital syndrome (OFDS). The case of OFDS is being reported and the various clinico-radiological features of both type I and type II are compared. Chromosomal karyotyping of the case has also been performed.

This article describes a technique for repair of abutment tooth which fractured during removal of a provisional restoration before bisque trial. The technique uses plastic templates to fabricate new composite core foundation for the existing crowns. This technique helps the dentist to rebuild the core in a single appointment.

Idiopathic gingival fibromatosis (IGF) is a rare condition. It is genetically heterogeneous and is usually part of a syndrome or, rarely, an isolated disorder. This study presents a rare case of 13 year old boy who was diagnosed with isolated IGF. This diagnosis has been based on clinical examination and after ruling out family, drug, and medical histories. External bevel gingivectomy has been done to remove excess gingival tissues. Excised tissue has been examined histologically. The patient has been followed up for a period of two and half years. No recurrence has been observed.

Sexually transmitted diseases (STDs) are posing a growing public health problem on a global and national scale. Syphilis is one of the common STD. The dentist is most likely to come across associated oral manifestation of the disease. This is a case report of 60-year-old male patient who presented with multiple erythmatous lesions with shallow ulcerations and crusted appearance on the lip, mimicking few mucocutaneous lesions of oral cavity. He gave history of sexual exposure;further work up revealed it to be a case of secondary syphilis.

Context: Periodontal disease is caused by chronic infection inducing an inflammatory reaction leading to breakdown of tooth-supporting tissues. There are various risk factors for the disease, and smoking is one of them. Apoptosis plays a critical role in the regulation of inflammation and host immune response which helps in tissue homeostasis, and a disturbance in this is often associated with disease. The imbalance between the apoptosis and proliferation in the periodontal tissue results in periodontal disease. Neutrophils play an important role in the defense mechanism and are the most abundant immune cells in gingival inflammatory infiltrate in patients suffering from periodontal disease. Neutrophil disorders are associated with rapid destruction of periodontal tissues. Aim: To study the influence of smoking on apoptosis of neutrophils by quantifying them in the gingival connective tissue of smoking and nonsmoking subjects suffering from chronic periodontitis. Materials and Methods: Thirty gingival biopsies were harvested from 15 smoking and 15 nonsmoking subjects who suffered from chronic periodontitis. The apoptosis of neutrophils was assessed and quantified using p53 monoclonal mouse antihuman antibody. Statistical Analysis Used: Chi-square/Fisher'sexact test was used to find the significance of study parameters on a categorical scale between the two groups. Results: Neutrophil apoptosis was significantly more in the group of nonsmokers. There was no statistical difference between plaque and bleeding index, but there was a significant increase in clinical attachment loss among smokers. Conclusions: The study reveals that smoking plays a significant role in the inhibition of neutrophil apoptosis, thereby contributing to the destruction of periodontal tissues in periodontitis.

Context: Conventional casting techniques following the manufacturers' recommendations are time consuming. Accelerated casting techniques have been reported, but their accuracy with base metal alloys has not been adequately studied. Aim: We measured the vertical marginal gap of nickel-chromium copings made by conventional and accelerated casting techniques and determined the clinical acceptability of the cast copings in this study. Settings and Design: Experimental design, in vitro study, lab settings. Materials and Methods: Ten copings each were cast by conventional and accelerated casting techniques. All copings were identical, only their mold preparation schedules differed. Microscopic measurements were recorded at ×80 magnification on the perpendicular to the axial wall at four predetermined sites. The marginal gap values were evaluated by paired t test. Results: The mean marginal gap by conventional technique (34.02 μm) is approximately 10 μm lesser than that of accelerated casting technique (44.62 μm). As the P value is less than 0.0001, there is highly significant difference between the two techniques with regard to vertical marginal gap. Conclusion: The accelerated casting technique is time saving and the marginal gap measured was within the clinically acceptable limits and could be an alternative to time-consuming conventional techniques.

Aim: The aim of this study was to compare the microleakage in Class II box preparations with the gingival margin above and below the cemento-enamel junction (CEJ) restored with Silorane composite and methacrylate composite using two different layering techniques. Materials and Methods: Standardized box preparations (mesial box 1 mm above the CEJ and distal box 1 mm below the CEJ) were prepared in 60 upper premolars. The teeth were randomly divided into four groups containing 15 samples each; Group I: Restored with a Silorane composite using an oblique layering technique, Group II: Restored with Silorane composite using a vertical layering technique, Group III: Restored with methacrylate composite using the oblique layering technique, and Group IV: Restored with methacrylate composite using the vertical layering technique. The samples were stored in distilled water, followed by thermocycling and immersed in 2% methylene blue. The samples were sectioned and evaluated for microleakage at the gingival margin. Statistical Analysis: Kruskal-Wallis, Fischer exact test, Wilicoxon test, and Mann-Whitney U test. Results: Silorane composite had significantly lesser microleakage. No significant difference in microleakage was observed above and below the CEJ for Silorane-based composite. Conclusion: Silorane composite resin showed lesser microleakage compared to methacrylate composite resin. Clinical Significance: The Silorane-based composites improve the marginal adaptation due to their reduced shrinkage, thereby decreasing the residual stress at the adhesive-tooth interface.

A young male patient was shot from a revolver on his left temple from a close range, but surprisingly he survived. On imaging, a complete bullet was found occupying his left maxillary sinus and infratemporal fossa. The bullet, after hitting and breaking the neck of the mandible on the left side, ricocheted and entered the left maxillary sinus through its posterior wall. It was removed safely by a combination of sublabial antrotomy and endoscopic approach.

Goldenhar syndrome is a syndrome of complex structures developing from first and second branchial arches during blastogenesis. The etiology of this rare disease is not fully understood, as it has shown itself variable genetically and of unclear causes. The disorder is characterized by a wide spectrum of symptoms and physical features that may vary greatly in range and severity from case to case. Here we present a unique case of Goldenhar syndrome with absence of left condyle, hypoplasia of the zygomatic bone, no pneumatization of the mastoid process, underdeveloped mandible, bifid tongue and the skin tags in the preauricular area.