Fluoride has been described as an essential element needed for normal development and growth of animals and extremely useful for human beings. Fluoride is abundant in the environment and the main source of fluoride to humans is drinking water. It has been proved to be beneficial in recommended doses, and at the same time its toxicity at higher levels has also been well established. Fluoride gets accumulated in hard tissues of the body and has been know to play an important role in mineralization of bone and teeth. At high levels it has been known to cause dental and skeletal fluorosis. There are suggested effects of very high levels of fluoride on various body organs and genetic material. The purpose of this paper is to review the various aspects of fluoride and its importance in human life.

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Background and Objectives: Lichen planus is a relatively common chronic inflammatory disease of oral mucosa and skin. Cortisol, also called as "stress hormone", has been used as an indicator in various stress evaluation studies. Salivary cortisol measurement is an indicator of free cortisol or biologically active cortisol in human serum and provides noninvasive and easy technique. Recent studies have been conflicting, and hence, in the present study, evaluation of salivary cortisol levels and psychosocial factors in oral lichen planus (OLP) patients was done. Materials and Methods: A total of 30 patients with clinically and histopathologically proven cases of OLP, along with the age and sex-matched healthy controls were included in the study. Samples of stimulated saliva were collected, centrifuged and analyzed for the level of cortisol with cortisol enzyme linked immunosorbent assay. Psychosocial factors of study and control groups were measured by depression anxiety and stress scale. Student's t-test was used to compare the psychological factors and salivary cortisol levels between patients with the OLP and the control group. Results: Irrespective of sex, significantly higher depression (83.4 ± 15.4%), anxiety (80.5 ± 11.3%), and stress (94.2 ± 6.2%) scores were observed in OLP patients compared to controls. Increased cortisol levels were observed among 17 (56.6%) OLP patients in the study group. A positive correlation was found between psychological factors and salivary cortisol levels in the OLP patients. The values of Pearson's correlation coefficient "r", between depression, anxiety, and stress with salivary cortisol was: +0.42,S; +0.27,NS; and +0.65,HS, respectively among the study group.

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Objective: This study was done to establish the craniofacial anthropometric norms of the young adult (18- 25 years) Malaysian Indian. Materials and Methods: The study group consisted of convenient samples of 100 healthy volunteers, with equal number of female and male subjects who had no history of mixed racial-parentage. Twenty-two linear measurements were taken twice from 28 landmarks over six craniofacial regions. The methodology and evaluation of indices of the craniofacial region was adapted from Hajnis et al. Results: The minimum measurements are always contributed by the female Indian except for the nose height (n-sn), (left) eye fissure length (ex-en), upper vermillion height (ls-sto), and lower vermillion height (sto-li). There is a gender difference in all the measurements except the (left) eye fissure height (independent t-test; P < 0.05). The Malaysian Indians exhibit some North American White Caucasian (NAWC) features in all regions. The cephalic index indicates a brachycephalic or relatively short wide head with a tendency towards mesocephaly. From the low nasal index, the Malaysian Indian female have a nose that is narrow or leptorrhin similar to the NAWCs. The lower value of the upper lip height to mouth width index in the Indian female indicates a relatively shorter upper lip height compared to the mouth width, also similar to the NAWC. Conclusion: This study establishes the craniofacial anthropometric norms of the Malaysian Indian over 22 parameters. Male in general has a significantly higher measurement than female. The Malaysian Indians do exhibit some NAWC features.

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Background: The diagnosis of dental caries is fundamental to the practice of dentistry. Despite the fact that dental caries has declined considerably, it is still a problem of great importance. The reduction in caries prevalence has not occurred uniformly for all the surfaces. The greatest reduction was observed at lesions located on smooth surfaces, so that occlusal caries are most common in children. Aim: The purpose of this study is to determine the clinical efficacy of DIAGNOdent in detecting occlusal caries. Materials and Methods: A total number of 50 teeth were subjected for visual, radiographic, and DIAGNOdent examinations. All the three methods were compared to histology which is a gold standard. Results: The result obtained showed that DIAGNOdent is superior to visual and radiographic methods in diagnosing occlusal caries.

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Background: The radiopacity degree of posts is not enough for adequate visualization during radiographic analyses. Glass fiber post with stainless steel reinforcement has been fabricated in an attempt to overcome this limitation. Aim: This study was designed to determine the influence of this metal reinforcement on the post mechanical properties. Materials and Methods: This study evaluated flexural modulus (E), flexural strength (σ), and stiffness (S) of five different fiber post systems (n = 5): RfX (Reforpost Glass Fiber RX; Ângelus, Londrina, PR, Brazil); RG (Reforpost Glass Fiber, Ângelus); RC (Reforpost Carbon Fiber, Ângelus); FP (Fibrekor Post; Jeneric Pentron Inc., Wallingford, CT, USA); and CP (C-Post; Bisco Dental Products, Schaumburg, IL, USA), testing the hypothesis that the insertion of a metal reinforcement (RfX) jeopardizes the mechanical properties of a glass fiber post. Posts were loaded in three-point bending using a testing machine with a crosshead speed of 0.5 mm/min. Results : The results were statistically analyzed using one-way ANOVA and Tukey's multiple range tests (a = 0.05). Mean and standard deviation values of E (GPa), s (MPa), and S (N/mm) were as follows: RfX: 10.8 ± 1.6, 598.0 ± 52.0, 132.0 ± 21.9; RG: 10.6 ± 1.0, 562.0 ± 24.9, 137.8 ± 5.5; RC: 15.9 ± 2.4, 680.5 ± 34.8, 190.9 ± 12.9; FP: 10.9 ± 1.4, 586.8 ± 21.9, 122.4 ± 17.3; CP: 6.3 ± 1.7, 678.1 ± 54.2, 246.0 ± 41.7. Carbon fiber posts showed the highest mean s values (P < 0.05). In addition, RC showed the highest mean E value and CP showed the highest mean S value (P < 0.05). Conclusion : The hypothesis was rejected since the metal reinforcement in the glass fiber post (RfX) does not decrease the mechanical property values. Posts reinforced with carbon fibers have a higher flexural strength than glass fiber posts, although all posts showed similar mechanical property values with dentin.

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Chlorhexidine is a widely used antiseptic and disinfectant in medical and nonmedical environments. Compared to its ubiquitous use, allergic contact dermatitis from chlorhexidine has rarely been reported and so its sensitization rate seems to be low. The prevalence of contact urticaria and anaphylaxis due to chlorhexidine remains to be unknown. This case report presents a case of urticaria due to oral use of chlorhexidine. The adverse reaction was confirmed by skin prick test.

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Aim : To compare the push-out strength of bovine- and human-root dentin and, thus, evaluate the suitability of bovine-root dentin to substitute human-root dentin for bond strength testing. Materials and Methods : Ten single-rooted human-teeth and ten bovine incisors were prepared using a #3 bur of a fiber post system (12 mm long). The posts were duplicated with resin cement (Duolink). The root canals were treated with All Bond 2 adhesive system and the resin posts were cemented using Duolink. The specimens were cut perpendicular to their long axis, yielding disc-specimens with 1.5 mm thickness, which were submitted to a push-out test (1 mm/min). Ten bond strength values per group (n = 10) were used for statistical analysis (Student t test, a =.05). Results : Statistically significant differences were found for the bond strength values between bovine- (4.1 ± 1.3 MPa) and human-root dentin (8.6 ± 5.7 MPa) (P =.0001). Conclusion : The push-out strengths of bovine- and human-root dentin were statistically different.

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Objectives: The purpose of this study was to compare root canal preparation in curved canals in molar teeth with the rotary NiTi Mtwo and ProTaper systems in terms of canal shape and smear layer. Materials and Methods: Mesiobuccal canals of 60 molar teeth with angles of curvature between 25 and 35 degrees were prepared with a torque controlled low speed engine; 30 canals for each system. Each individual instrument was used to prepare four root canals and the time required for preparation was recorded. Standardized radiographs were taken before and following instrumentation and used to determine changes in canal curvature. Results: There was no significant difference in preparation time between the two systems. No instruments separated during use. The Mtwo system gave a statistically smaller change in canal curvature and thus was better for maintaining the original shape of the root canal, with less transportation (P less than 0.05). The greatest difference was seen for maxillary molar teeth. When prepared root canals were examined by SEM there was no difference between the two systems at the coronal, middle or apical thirds. Conclusion: Overall, the results of this study suggest that Mtwo instruments are preferable for situations where canals are curved, particularly for maxillary molars.

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Lichen planus (LP) is a mucocutaneous disease with well-established clinical and microscopic features. The oral mucosa and skin may present clinical and microscopic alterations similar to those observed in LP, called lichenoid reactions (LRs), which are triggered by systemic or topical etiological agents. The difficulties faced to establish the differential diagnosis between the two pathologies were investigated in the literature. It was observed that the etiology of LP is still under discussion, with a tendency to self-immunity, while the etiology of LRs is related to the contact with specific agents, such as metallic restorative materials, resins, and drugs, allowing the establishment of a cause-effect relationship. In this case, the disease is caused by the antigen fixation in the epithelial cells, which are destructed by the immune system. Based on these data, protocols are suggested for this differentiation. The important role played by the integration between the clinician and the oral pathologist in the diagnostic process is highlighted. The treatment of LP comprises mainly the utilization of corticosteroids and the LR is treated by removal of the causal factor. Differentiation between the two diseases allows an effective and correct therapeutic approach.

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Objectives : This study was undertaken to detect the gene polymorphism of detoxification enzymes and estimate the antioxidant enzyme status in patients with oral cancer, oral leukoplakia and oral submucous fibrosis (OSF). Materials and Methods : The GSTM1 and GSTT1 gene polymorphism was evaluated using polymerase chain reaction; the antioxidant enzyme was estimated using biochemical methods. Statistical analyses were performed using student t-test and odds-ratio to estimate relative risk (RR). Results : The RR at 95% confidence interval (CI) for GSTM1 and GSTT1 was statistically significant for all groups. The mean values of glutathione were significantly raised in all groups. The mean values of ceruloplasmin and malonaldehyde was statistically significant among cancer and OSF patients but was insignificant in smokers and cases with leukoplakia. Conclusion : Several genes perform the same function which implies the need to test for several genetic polymorphisms to identify individuals at high risk. The level of antioxidant enzymes correlate with the degree of oxidative damage. The need for further studies is emphasised.

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Background : Microwave postpolymerization has been suggested as a method to improve the flexural strength of an autopolymerizing denture reline resin. However, the effect of microwave postpolymerization on the residual monomer content and its influence on flexural strength have not been investigated. Objectives : This study analyzed the effect of microwave postpolymerization on the residual monomer content and its influence on the flexural strength of an autopolymerizing reline resin (Denture Liner). Materials and Methods : A total of 70 specimens (64 Χ 10 Χ 3.3 mm) were polymerized according to the manufacturer's instructions and divided into 7 groups (n = 10). Control group specimens were not subjectedto any further processing. Before testing, the specimens were subjected to postpolymerization in a microwave oven using different power (550 and 650 W) and time (3, 4, and 5 min) settings. Two specimens of each group were then manually ground into fine powder and samples extracted from the specimens using reflux method. The samples were then subjected to gas chromatography for residual monomer determination in area%. Eight specimens were subjected to a three-point bending device with a span of 50 mm and crosshead speed of 5 mm/min, and the flexural strength was determined in MPa. Data analyses included Student's t-test and one-way analysis of variance. Results : For the Denture Liner reline resin, the residual monomer content decreased and the flexural strength increased significantly with the application of microwave irradiation using different time/power combinations. The specimens with the lowest residual monomer content were the similar specimens which presented with the highest flexural strength. Conclusion : Microwave postpolymerization irradiation can be an effective method for increasing the flexural strength of denture liner (at 650 W for 5 min) by reducing the residual monomer content by further polymerization at free radical sites.

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Background: Tobacco consumption is a major health menace owing to its widespread use particularly among adolescents. Owing to the presence of impressionable, curious minds, adolescents are highly prone to a number of influences within and outside home, leading them to experiment with tobacco. The addictive nature of tobacco is potent enough to turn these experimental users to addicts. Objectives: To identify the prominent factors leading to initiation of tobacco use among adolescents of Moradabad. Materials and Methods: Two-stage sampling was used to identify 590 adolescents (study population) from four senior secondary schools in Moradabad. The response towards tobacco, and its use, was assessed through structured questionnaires. Responses of all study population and association between dependent and explanatory variables were assessed using c² test (Chi-square test) using SPSS package (version 12). Results: The study results show that 17.3% of the adolescents have experimented with tobacco. Curiosity and peer pressure were the main reasons behind trying tobacco. Parental tobacco status, especially place of use (at home or outside), had a significant influence on adolescents experimenting tobacco . Conclusion: Tobacco use by parents is likely to influence adolescents, as they perceive tobacco use as a positive and acceptable behavior, and develop favorable personal beliefs and subjective norms towards tobacco use.

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To reinforce awareness among dentists about their role in person identification and the importance of maintaining dental records of all their patients. The article reviews basic procedures of dental identification and some cases where dental identification played a key role in eventual identification of the person. Forensic odontology is an integral part of forensic sciences. Forensic dental identifications, especially in times of mass disasters, depend mainly on the availability of ante mortem dental records. It is the social responsibility of each and every dentist to maintain dental records of their patients for the noble cause of identification in the event of mass disaster.

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Background: Posts and cores are often required for restoration of pulpless teeth and to provide retention and resistance for a complete crown, but conventional posts may increase the root fracture. Objective: This study was performed to compare the root fracture resistance of extracted teeth treated with different fibers reinforced with composite posts and treated teeth with conventional post and core systems. Materials and Methods: Root canal therapy was performed for 50 mandibular first premolars. The coronal portion of each tooth was amputated, and five post and core systems (cast, polyethylene woven, glass, carbon, and quartz fiber posts) were compared. Acrylic resin blocks were used for mounting, using a layer of elastomeric impression material covering the roots. The load was applied axially and measured with a universal testing machine. Results and Conclusion: Significantly, cast posts and cores had a higher failure threshold including teeth fracture; whereas, fiber posts failure was due to core fracture, with or without fractures in coronal portion of posts. Difference in FRC posts did not provide any significant difference in the load failure and the mode of fracture.

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Background and Objectives: A number of bacteria have now become antibiotic-resistant. This increases the importance of ayurvedic drugs. We report, here, the activity of different extracts (petroleum ether, chloroform, methanol and water) of Quercus infectoria galls against dental pathogens - Streptococcus mutans, Streptococcus salivarius, Staphylococcus aureus, Lactobacillus acidophilus (designated) and Streptococcus sanguis (isolated). Materials and Methods: The cup-plate method was used in anti-bacterial activity of the extracts at concentration of 200 mg/ml against dental pathogens. Minimum inhibitory concentration (MIC) values of most effective extracts against the most susceptible bacteria were determined using a two-fold serial micro dilution method. Results: Methanolic extract showed maximum anti-bacterial activity against all the bacteria. The most susceptible bacteria were S. sanguis followed by S. aureus, S. mutans, S. salivarius and L. acidophilus. The MIC values showed that methanolic extract was more effective than water extract. Conclusion: The plant has the potential to generate herbal metabolites. The crude extracts demonstrating anti-dental caries activity could result in the discovery of new chemical classes of antibiotics. These chemical classes of antibiotics could serve as selective agents for the maintenance of human health and provide bio-chemical tools for the study of infectious diseases.

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Background and Objectives : The objective in localization is selection of a suitable technique which has minimal radiation dose, cost and maximum details. Panoramic radiograph, being a screening radiograph, can satisfy the above needs. Taking this into consideration, the present study was done to evaluate the reliability of panoramic radiograph in localization of impacted permanent maxillary canines by applying the criteria suggested by Chaushu et al. and by comparing it with Clark's rule. Materials and Methods : The study comprised of 114 subjects in the age group of 13-30 years of both the genders with 150 impacted canines visiting Department of Oral Medicine and Radiology during the study period. The study subjects were examined for clinically missing canine, and then confirmed with intra-oral peri-apical radiograph (IOPAR). Panoramic radiographs (for application of Chaushu et al. criteria) and IOPAR's (for application of Clark's rule) of the subjects were made and interpreted for parameters pertaining to the impacted canines. The data obtained was tabulated and subjected to statistical analysis using the statistical package for social sciences (SPSS) software. Results : Determination of the bucco-palatal position from panoramic radiographs, by applying Chaushu, et al. criteria, showed that localization in bucco-palatal position was possible for 96 of the 102 impacted canines placed in the middle and coronal zones. The remaining six impacted canines, three each in the middle and coronal zones, could not be localized as they showed overlapping in their range. By excluding them, the overall agreement worked out to be 94.11%. Localization was not possible for 48 impacted canines that lied in the apical zone. Conclusion : A single panoramic radiograph can serve as a reliable indicator for determining the bucco-palatal position of the impacted canines when they lie in the middle and coronal zones. When they lie in the apical zone it is recommended to explore their presence with other conventional or advanced imaging modalities.

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Objectives: The aim of this in vitro study was to evaluate the antimicrobial action of BioPure MTAD (Dentsply Tulsa Dental, Johnson City, TN), Tetraclean, Cloreximid (a mixture of Chlorhexidine (CHX) digluconate and Cetrimide), and 5.25% NaOCl (Ogna Laboratori Farmaceutici, Milano, Italy) against selected endodontic pathogens (Enterococcus faecalis, Porphyromonas gingivalis, and Prevotella intermedia). Materials and Methods: The agar plate diffusion procedure was used to observe the antimibrobial activity of irrigants. Results: Statistical analysis revealed significant effects of the different irrigants on the bacteria colonies. Treatment with 5.25% NaOCl induced a larger zone of microbial inhibition in Prevotella intermedia and Porphyromonas gingivalis (Tukey HSD post-test, P = 0.0001) when compare to MTAD, Tetraclean and CHX. Anyway, MTAD and Tetraclean were more effective to inhibit bacterial growth compared to CHX (P < 0.0001, Tukey HSD post-test). Furthermore, post hoc analysis revealed that MTAD and Tetraclean induced the largest zone of microbial inhibition of Enterococcus faecalis cultured under both aerobic and anaerobic conditions, when compared with 2% CHX and NaOCl (P < 0.0001, Tukey HSD post-test). The control group showed no microbial inhibition. Conclusion: 5.25% NaOCl showed a high antimicrobial activity against anaerobic bacteria. MTAD and Tetraclean showed a high action against both, strictly anaerobic and facultative anaerobic bacteria. Chlorexidine + Cetrimide (Cloreximid) showed the lowest antibacterial activity against both, facultative and strictly anaerobic bacteria tested.

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Objective : The aim of the study was to assess the severity of the disease in oral submucous fibrosis (OSF), correlate the clinical, functional staging with histopathological staging, and analyze collagen distribution in different stages of OSF using the picrosirius red stain under polarizing microscopy. Materials and Methods : The study included randomly incorporated 50 subjects, of whom 40 were patients with OSF, and 10 were in the control group. Clinical, functional staging in OSF cases was done depending upon definite criteria. A histopathological study was conducted using the hematoxylin and eosin stain and picrosirius red stain. Collagen fibers were analyzed for thickness and polarizing colors. Furthermore, clinical, functional, and histopathological stages were compared. Statistical Analysis : Descriptive data which included mean, SD, and percentages were calculated for each group. Categorical data were analyzed by the chi-square test. Multiple group comparisons were made by one-way ANOVA followed by Student's t-test for pairwise comparisons. For all tests, a P-value of 0.05 or less was considered for statistical significance. Results : As the severity of the disease increased, clinically, there was definite progression in subjective and objective symptoms. Polarized microscopic, examination revealed, there was a gradual decrease in the green-greenish yellow color of the fibers and a shift to orange red-red color with increase in severity of the disease. Thereby, it appeared that the tight packing of collagen fibers in OSF progressively increased as the disease progressed from early to advanced stages. We observed that the comparison of functional staging with histopathological staging was a more reliable indicator of the severity of the disease. Conclusion : In the present study, we observed that mouth opening was restricted with advancing stages of OSF. The investigation also points to the importance of assessing the cases of OSF, especially with regard to functional and histological staging in planning the treatment.

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Objective : This study was done to examine caries prevalence and corresponding treatment needs in school children of rural areas of Udaipur, Rajasthan. Materials and Methods : A total of 750 children of rural areas in the age group of 6-10 years were examined, using WHO index, to record the prevalence of dental caries and treatment needs. The results were subjected to statistical analysis using chi square test. Results : Dental caries was found in 63.20% children, and 85.07% children needed dental treatment. The highest need was of one surface filling (85.73%) followed by sealant (51.20%). Conclusion : Dental caries showed to be a significant health issue in the rural population requiring immediate attention.

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Aims and Objectives: To compare the autofluorescence spectra of oral submucous fibrosis (OSF) with normal mucosa, the autofluorescence spectra of OSF before and after treatment with intralesional dexamethasone and hyaluronidase, the clinical improvement following treatment with the changes in autofluorescence spectra and to prove that autofluorescence spectroscopy is a good method for diagnosis and assessment of treatment effectiveness in OSF. Materials and Methods: The study was conducted at the Department of Oral Medicine and Radiology, Tamilnadu Government Dental College and Hospital, Chennai and Division of Medical Physics and Lasers, Department of Physics, Anna University, Chennai in 20 patients seeking medical management for symptomatic OSF and 20 patients who had dental caries only without any oral mucosal diseases and oral habits were used as normal controls. Their ages ranged from 20 to 40 years, including both male and female. In vivo fluorescence emission spectra were obtained using a handheld optical fiber probe attached to a Fluoromax-2 spectrofluorometer. Results: The fluorescence spectrum of OSF had an intense fluorescence emission at 385 nm with a secondary emission peak at 440 nm compared with that of the normal oral mucosa. The average fluorescence spectrum of the post treated OSF mucosa had a lesser intensity around 385 nm and a higher intensity around 440 nm than that of the pre treated OSF mucosa, thereby mimicking the normal oral mucosa. All the three clinical parameters (maximal mouth opening, tongue protrusion and the severity of burning sensation) showed a high statistical significance, with P < 0.001, as in the case of classification of pre treated OSF mucosa from the post treated OSF mucosa using the autofluorescence technique. Conclusion: The change in the fluorescence emission spectrum for both normal and OSF mucosa before and after treatment can be explained by analyzing the changes in the fluorescence intensity of the endogenous fluorophores.

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Background and Objectives : Low-level laser therapy (LLLT) has been extensively applied to improve wound healing due to some biostimulatory properties presented by laser arrays apparently able to accelerate the cicatricial repair of soft tissue injuries. However, many controversial results have been reported in the literature, probably as a result of the wide sort of different protocols of photobiomodulation employed in those experiments. The goal of this study was to investigate the effect of a low-dose protocol of LLT on the intensity of the inflammatory response and the pattern of collagen fibers' deposition during second-intention wound healing in rodents. Materials and Methods : Standard-sized wounds were carried out in the back of 24 male rats. Half of them underwent LLLT treatment (16 J/cm ² ) at 660 nm delivered for 7 days. Eight and 14 days after the wounds were performed, the repairing area was removed and stained in HE and Masson's trichrome, and the inflammatory response, epithelization, and collagen fiber depositions were evaluated. Results : We found that LLLT was able to slightly reduce the intensity of the inflammatory reaction as well as to enhance substantially the epithelization process at both 8 ^th and 14 ^th days. In addition, it also appeared to stimulate the deposition of collagen fibers at the final stages of wound healing. Conclusions : The LLLT protocol tested in this study resulted in some improvements in second-intention wound healing in rodents.

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Rhinosporidiosis is a benign chronic granulomatous infection caused by Rhinosporidium seeberi. Rhinosporidiosis is endemic in south Asia, notably in southern India and Sri Lanka. Majority of the cases have been reported to occur in upper respiratory sites, notably anterior nares, nasal cavity, nasopharynx, larynx and soft palate. Only two rare cases of involvement of parotid duct, have been reported in literature. Hence, this case will probably be the third to be reported.

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Background: Coverage of gingival recession defects has been considered as a subject of interest for dental practitioners. Aim: The present study was aimed to compare the clinical outcomes of root coverage (RC) procedures, using coronally advanced flap (CAF) in combination with acellular dermal matrix (ADM) with or without enamel matrix derivatives (EMD). Materials and Methods: A total of 36 Miller class I or II recession defects in 15 eligible patients were selected. The defects were randomly allocated to test (CAF+ADM+EMD) and control (CAF+ADM) groups. Recession depth (RD), recession width (RW), width of keratinized tissue (WKT), clinical attachment level (CAL), and the position of mucogingival junction (MGJ) were measured at baseline, two and six months after treatment. Statistical Analysis: Data were analyzed using repeated measures ANOVA and paired sample t-test with the patients as statistical unit. Results: At two-month follow-up, the mean RC for CAF+ADM+EMD and CAF+ADM was 82.75 ± 22 and 88.89 ± 22 percent, respectively. However, these values did not change significantly after six months. Both treatments led to significant RC (P < 0.001), whereas no significant differences were observed in WKT, CAL, and MGJ between the study groups. Conclusion: The application of EMD does not improve the clinical efficacy of ADM in combination with CAF in RC procedures.

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Objectives : The objective of the present study was to evaluate in vitro film thickness of two endodontic sealers containing epoxy-resin and zinc-oxide-eugenol, respectively in the apical region of the root canal system. Materials and Methods : A total of 20 palatine roots of the first maxillary molars were submitted to instrumentation up to a #40 file by the step-back technique and irrigated with 2 ml of NaOCl after each change of file. The roots were divided at random into two groups of 10 elements; one group was sealed with the Sealer 26^® cement and the other one with the EndoFill^® cement using the classical technique. The roots were abraded in the apical region until exposure of the filling and cut crosswise at 3 mm to obtain samples. The samples were analyzed by optic microscopy with 40X magnification. The images obtained were recorded using the Adobe Premiere 5.1^® software and submitted to morphometric analysis using an integration grid that permitted the quantification of the area filled with the sealer or gutta-percha, and eventual empty spaces. Results : Statistical analysis of the data (Kruskal-Wallis test, P < 0.05) revealed no significant differences between the epoxy-resin-based cement Sealer 26^® (47.85%) and the zinc- oxide- eugenol-based cement EndoFill^® (54.16%). Conclusion : We conclude that the two sealers tested showed a similar behavior regarding the cement film thickness in the apical region.

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Ionizing radiation has been known to induce malignant transformation in human beings. Radiation-induced sarcomas are a late sequel of radiation therapy. Most sarcomas have been reported to occur after exposure to a radiation dose of 55 Gray (Gy) and above, with a dose ranging from 16 to 112 Gys. Spindle cell sarcomas, arising after radiotherapy given to treat the carcinoma of head and neck region is a very uncommon sequel. This is a rare case report of spindle cell sarcoma of left maxilla, in a 24-year-old male, occurring as a late complication of radiotherapy with Cobalt-60 given for the treatment of retinoblastoma of the left eye 21 years back.

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Making impressions in microstomia patients is often cumbersome. A modification of standard impression procedure is often necessary while treating such patients. This article describes the fabrication of a custom sectional impression tray with interlocking type of a handle for definitive impression procedures in a microstomia patient.

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Aims : To evaluate the antimicrobial activity of 10% and 37% carbamide peroxide during dental bleaching in three different modes. Materials and Methods : This five-week double-blind randomized controlled trial included 32 volunteers assigned to four groups (n = 8). Each group received bleaching agents or placebo as an in-office and at-home treatment. The dental bleaching techniques were: In-office bleaching (37% carbamide peroxide: CP37); at-home bleaching (10% carbamide peroxide: CP10) and the association of both (CP37 and CP10). Saliva samples were collected right before (baseline), right after, 12 hours after, and seven days after the treatment. Counts of total microorganisms, Streptococci, and Mutans streptococci were carried out. Friedman test (α = 0.05) was used to compare the microorganism counts. Results : The number of the all oral microorganisms remained stable during all experiment. Conclusions : No bleaching agent (CP37, CP10 or the combination of both) was able to reduce the oral microorganisms tested.

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Dental anomalies have been known to occur in humans due to a variety of genetic and environmental factors. Combinations of dental anomalies are known to be associated with specific syndromes. A few cases of multiple dental anomalies have been reported in patients with no generalized abnormalities. This case report describes an unusual occurrence of a combination of dental anomalies in an apparently normal healthy 12-year-old female patient. The dental anomalies in this patient were multiple dens invaginatus, generalized enamel hypoplasia, generalized microdontia, root resorption and multiple periapical lesions, shovel shaped incisors, cup shaped premolars, taurodontism, hypodontia and supernumerary teeth.

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Aim: To evaluate the influence of quartz tungsten halogen and plasma arc curing (PAC) lights on Knoop hardness and change in polymerization temperature of resin composite. Materials and Methods: Filtek Z250 and Esthet X composites were used in the shade A3. The temperature increase was registered with Type-k thermocouple connected to a digital thermometer (Iopetherm 46). A self-cured polymerized acrylic resin base was built in order to guide the thermocouple and to support the dentin disk of 1.0 mm thickness obtained from bovine tooth. On the acrylic resin base, elastomer mold of 2.0 mm was adapted. The temperature increase was measured after composite light curing. After 24 h, the specimens were submitted to Knoop hardness test (HMV-2000, Shimadzu, Tokyo, Japan). Data were submitted to ANOVA and Tukey's test (a = 0.05). Results: For both composites, there were no significant differences (P > 0.05) in the top surface hardness; however, PAC promoted statistically lower (P < 0.05) Knoop hardness number values in the bottom. The mean temperature increase showed no significant statistical differences (P > 0.05). Conclusion: The standardized radiant exposure showed no influence on the temperature increase of the composite, however, showed significant effect on hardness values.

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Aggressive periodontitis (AgP) comprises a group of rare, often severe, rapidly progressive forms of periodontitis mostly characterized by an early age of clinical manifestation and a distinctive tendency for cases to aggregate in families. Abnormal dental morphology and position have been associated with severe periodontal diseases. The purpose of this paper is to report a case of multiple dental anomalies associated with AgP. This paper reports a case of unusual association of multiple dental anomalies to AgP. Clinical findings and history led to the diagnosis of localized AgP, and radiologically. It was associated with multiple dental anomalies, especially supernumerary roots. Thus, the present case represents a very interesting demonstration of AgP association with supernumerary roots and the nature of this association merits further investigations.

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Inflammation of oral mucosa induced by anti neoplastic drugs is an important, dose limiting and costly side effect of cancer therapy. Here is presented an exacerbated case of oral mucositis associated with renal failure in a patient who underwent bone marrow transplantation. The clinical aspects and an integrated rehabilitation program are discussed below.

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