Context: The etiopathogenesis of temporomandibular joint (TMJ) disorders has been attributed to multiple factors and, while the importance of centric relation (CR) has been acknowledged in dental literature, the role of condylar position and CR-CO (CO-centric occlusion) discrepancy in TMJ dysfunction (TMD) has been a source of controversy. Aim: To establish the relationship between condyle position and TMD. Setting and Design: This was a case-control study to evaluate condylar displacement and interarch CR-CO discrepancy in symptomatic subjects (with TMD) and compare them with asymptomatic subjects. Materials and Methods: Forty subjects were screened for TMD based on Helkimo index and grouped into asymptomatic and symptomatic groups. CR was registered using the modified Roth power centric bite registration after neuromuscular deprogramming. Models thus mounted on an Advanced Dental Design (AD2) articulator were evaluated for interarch CR-CO discrepancy. The condylar position discrepancy was recorded on a device MCD (measured condylar deviation). Statistical Analysis: The Student's t test was used to test statistical significance. The paired t test and the unpaired t test were used for comparing results within and between the groups. Pearson correlation coefficient was used to find out the correlation between MCD measurements and dental three-dimensional (3D) model analysis measurements. The Chi-square test was used to evaluate the qualitative data. Results: The average vertical and horizontal condylar displacements were significantly greater in the symptomatic group than in the asymptomatic group. There were significant deviations at the level of the occlusion in both groups. Conclusion: Condyle position may play a significant role in the etiopathogenesis of TMJ disorders.

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Context: If tea can be shown to have an inhibitory effect on the growth of Streptococcus mutans there can be a basis for using it as an agent for reducing caries. Aims: The aim of the study was to determine the effect of aqueous and organic extracts of three types of tea (green, oolong, and black tea) on the growth of S. mutans. Settings and Design: In vitro study. Material and Methods: Qualitative and quantitative phytochemical analysis of the three types of tea was done. Organic extracts of methanol and ethanol and aqueous extracts (50% and 100%) of tea were prepared. Fifty microliters of these extracts were inoculated into wells prepared on Mueller-Hinton agar plates that had been previously smeared with S. mutans. The agar plates were incubated at 37΀C for 24 hours. A similar procedure was followed using 0.2% chlorhexidine, which served as the positive control. Statistical Analysis Used: Analysis of variance (ANOVA), post hoc Tukey test, Student's 't ' test (two-tailed, dependent), and Student's 't' test (two-tailed, independent) were used for analysis of the data. Results: All the phytochemicals were found to be higher in oolong tea. Both aqueous and organic extracts of oolong tea showed greatest zones of inhibition, followed by green tea and black tea. Aqueous extracts of oolong and green tea showed greater zone of inhibition than chlorhexidine. All the three types of tea inhibited growth of S. mutans. The greatest inhibition was observed with aqueous extract of oolong tea. Conclusions: Oolong tea extracts (aqueous and organic) showed a greater inhibitory effect on the growth of S. mutans than the other tea extracts .

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Context: Trauma has been an important public health problem worldwide. Facial injuries are among the most common types of trauma treated at emergency departments, associated or not with injuries in other anatomic sites. The patterns of facial fractures are usually affected by geography and socioeconomic conditions. Aim: To investigate the prevalence of facial fractures in Lages, state of Santa Catarina, southern Brazil, from September 2003 to August 2008. Settings and Design: Cross-sectional, retrospective, epidemiological study. Materials and Methods: Data on patients' gender, age, etiological agent, and facial region affected by fracture were collected from the charts of patients treated with facial fractures. Statistical Analysis Used: Qualitative variables were expressed as absolute and relative frequencies, and quantitative variables as means and standard deviation. The Chi-square test was used to evaluate the association between gender, traffic accidents and facial region affected. The association between etiological agents and facial region affected was assessed using the chi-square test and the adjusted residuals analysis. Results: 492 patients presented with oral and maxillofacial trauma, with 988 facial fractures; 80.9% of the patients were men, and the most frequent age group was 21-30 years (29.5%). The most frequent causes of fractures were: Traffic accidents in 27.9%, physical assault in 14.9%, and bicycle falls in 10.5%; several other causes scored below 10%. Conclusion: Regular publication of epidemiological data is extremely important for the implementation of prevention campaigns and for an increased awareness of the etiology of fractures affecting the face and other anatomic sites.

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Aim: To evaluate and compare the efficacy of two commercial and two household denture cleansers against Candida albicans adherent to acrylic denture base resin. Materials and Methods: Fifty specimens of acrylic denture base resin (10 × 10 × 2 mm) were fabricated and processed according to the manufacturer's instructions. Sterile acrylic resin specimens were inoculated by immersing in Sabouraud broth containing C albicans for 16 hours at 37°C in an incubator. Then the specimens were washed and immersed in denture cleansers (four groups) - Clinsodent^® (powder form), Fittydent^® (tablet form), vinegar (4% acetic acid), diluted vinegar (50% diluted with water), and water (control group) for 8 hours at room temperature. After 8 hours the acrylic resin specimens were washed, fixed with methanol, and stained with crystal violet. Candida cells adherent to the acrylic resin specimens were counted under microscope. The number of cells adherent to the test samples were compared with that adherent to the control. Statistical Analysis: The data were analyzed using the independent-samples 't ' tests, analysis of variance (ANOVA), and Tukey's HSD test. Results: All the denture cleansers were highly effective against C albicans. The effectiveness of commercial denture cleansers was significant better than that of household denture cleansers. Fittydent^® fared better than Clinsodent^® , but the difference between the two was not statistically significant (P=.765). Vinegar was more effective than diluted vinegar (P<.05). Conclusion: Within the limitations of this in vitro study, denture cleansers were found to be effective in reducing C albicans cells adhering to dentures. The commercial denture cleansers (Fittydent^® and Clinsodent^® ) were more effective than household denture cleansers (vinegar and diluted vinegar).

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Background: Cancer is a unique disease characterized by abnormal growth of cells which have the ability to invade the adjacent tissues and sometimes even distant organs. Oral cancer has multifactorial etiology and is significantly associated with risk factors of the individual's lifestyle, particularly, chronic use of tobacco, spicy food, alcohol and smoking. Many studies have indicated that genetic factors also have an influence on the etiology of cancer. Aim: To evaluate if any of the ABO blood groups are associated with an increased risk for oral cancer. Materials and Methods: The present study was conducted at Kidwai Memorial Institute of Oncology (KMIO), Bangalore, after obtaining permission from the Director of the institute. The study sample comprised 235 oral cancer patients and 812 controls. For statistical analysis, Chi-square test and odds ratio were used to assess the relationship between ABO blood groups and oral cancer. Probability level was fixed at ≤0.05. Results: It was found that people with blood group A had 1.46 times higher risk of developing oral cancer compared to people of other blood groups. Conclusion: By employing a simple blood grouping test during community field programs, people with blood group A in the age group of 40-59 years having tobacco chewing habits can be apprised that they are more at risk to develop oral cancer than people with other blood groups.

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Background and Objectives: Depressed chemotactic activity of polymorphoneutrophil (PMN) and monocyte (MN) appears to be one of the significant risk factors in the development of periodontal disease. Although bacteria are the primary etiologic factor in periodontal disease, the patient's host response is a determinant of disease susceptibility. Depressed chemotaxis of PMN and MN could lead to periodontal destruction by altering the host response i.e. impairment of the normal host response in neutralizing infection and alterations that result in destruction of the surrounding periodontal tissues. Materials and Methods: Thirty patients (10 healthy subjects, 10 chronic periodontitis, and 10 with aggressive periodontitis) participated in this study. Clinical parameters like plaque index, gingival index, probing pocket depth, and radiographic assessment were done. The peripheral blood PMNs and MNs were isolated from the patient and the chemotactic response was studied. Statistical analysis was performed using post-hoc Newman-Keul range test. Results: PMN and MN chemotaxis was found to be statistically significant (P<0.05) at baseline and three months after periodontal therapy in chronic and aggressive periodontitis group compared to healthy subjects. However on comparison between chronic and aggressive periodontitis group statistical significance was not found (P>0.05).Comparision between chronic periodontitis, aggressive periodontitis with healthy subjects, PMN and MN chemotaxis showed statistical significance (P<0.05) at baseline and three months after periodontal therapy, Whereas statistically there was no difference when chronic periodontitis was compared with aggressive periodontitis Interpretation and Conclusion: Depressed chemotaxis of PMN and MN results in increased periodontal destruction. In this study, depressed PMN and MN chemotaxis is seen in both aggressive periodontitis group and chronic periodontitis group and the response was altered although to a lesser degree after periodontal therapy in both groups indicating that effect of treatment does exist.

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Aim: To assess the effect of simulated mouth conditions reproduced with thermocycling on the tensile bond strength of two silicone based resilient denture liners with acrylic resin bases. Materials and Methods: Two silicone-based soft denture liners (Mollosil - Chairside autopolymerization and Molloplast B - Heat polymerization) were tested. For each liner, 30 specimens with a cross-sectional area of 10 Χ 10 mm and thickness 3 mm were processed between two acrylic blocks (Trevalon). Specimens were divided into a control group that was stored for 24 hours in water at 37°C and a test group that was thermocycled (2500 cycles) between baths of 5° and 55°C. Tensile bond strength (kg/cm ² ) was determined in a universal testing machine using crosshead speed of 5 mm/min. Statistical Analysis Used: The student t-test was used to determine the significance of the difference in bond strength between the two liners. Results: The mean tensile bond strength for control and thermocycled specimens of the two liners were: Mollosil (6.82 kg/cm ² and 8.41 kg/cm ² ) and Molloplast-B (16.30 kg/cm ² and 13.67 kg/cm ² ), respectively. Comparison of bond strength of control specimens with thermocycled specimens of the liners indicated a significant difference for both Mollosil (P=0.045) and Molloplast-B (P=0.027). Comparison between control specimens of both liners and thermocycled specimens of both liners indicated a highly significant difference (P<0.001). Conclusions: Heat polymerized resilient denture liner Molloplast-B had higher tensile bond strength than autopolymerizing liner Mollosil regardless of thermocycling. The bond strength of Mollosil increased after thermocycling while that of Molloplast-B decreased after thermocycling. Clinical Implications: Although heat-polymerized denture liners require more processing time than autopolymerizing liners, but they display much better adhesion properties to denture base resin and should thus be preferred when soft liner has to be used for a longer duration of time.

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Background: Tobacco use is reported to be rampant in urban slums in developing countries. Demographical variations in tobacco use between males living in urban slums vs those living in non-slum areas in India has not been reported, and this study was undertaken to address this issue. Materials and Methods: Secondary data analysis of National Family Health Survey-3 (NFHS-3) was undertaken to study demographical variations in tobacco use between urban slum dwellers and non-slum dwellers in eight Indian cities. Demographic determinants for use of smoking and chewing forms of tobacco in the two groups were analyzed. SPSS^® version 16.0 (SPSS Inc., IL, USA) was used for statistical analysis. Result: The study population comprised 6887 (41.8%) males from slum areas and 9588 (58.2%) from non-slum areas of eight urban cities. Cigarette/beedi smoking was the commonest form of tobacco use among the study population. Pan masala use was the least common form of smokeless tobacco use, next only to snuff. There was a high statistical significance observed within the various demographic parameter studied in both the slum and non-slum dwelling males in study population. However, on studying the differences between the two groups, it was observed that statistical significance of P≤.001 was observed with age (15-49), secondary education, religion, household structure and marital status. The difference between the two groups in the mean number of cigarettes/beedis smoked was not statistically significant (P=.598). Discussion and Conclusion: Male slum dwellers are a distinct urban population, whose health needs assessment requires a different approach than that for non-slum dwellers who often can afford the services that an urban Indian city can offer.

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Background: There has always been a constant search for the definition of idealistic and realistic orthodontic treatment goals for different ethnic groups around the world. This study was hence devised to study the mesio-distal angulations and labio-lingual inclinations of the clinical crowns in Dravidian population with pleasing profiles and non-orthodontic normal occlusion. Materials and Methods: Forty dental casts from a Dravidian sample (21.5 years) with Class I canine and molar relation; normal maxillo-mandibular relationship; well-aligned arches; with no dental anomaly, restorations or attrition; no history of previous orthodontic treatment, and exhibiting normal growth were studied. A custom-made tip-torque device was used to measure the crown angulations and inclinations. The arithmetic mean and standard deviations for each tooth type were compared with those of Andrew's Caucasian norms using Student's 't' test. Results: The study group exhibited statistically significant decrease in crown angulation (mesial tip) and increased labial crown torque in both upper and lower anteriors. The lower anteriors exhibited distal crown tip while the posteriors were significantly tipped more mesially. All the posteriors demonstrated increased lingual crown torque. Conclusion: Tip and torque modifications are suggested for the fine finishing and easy retention of occlusion in Dravidians while using straight wire appliance.

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Hallermann-Streiff syndrome-also called occulomandibulofacial syndrome, Francois syndrome, oculomandibulodyscephaly with hypotrichosis, Aubry syndrome I, and Ullrich-Fremery-Dohna syndrome-is a rare genetic disorder, which comprisesmultiple congenital abnormalities affecting chiefly the head and face. It is characterized by bird-like facies, dental abnormalities, hypotrichosis, atrophy of skin, congenital cataracts, bilateral microphthalmia, and proportionate nanism. An interesting case of Hallermann-Streiff syndrome in a 23-year-old female patient is reported here, with the emphasis on the orodental findings.

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Context: Variations in palatal bone thickness (PBT) at various locations have caused considerable problems when using these sites for anchorage purposes. Aims: To find the comparative thickness of the palatal bone at different locations and to validate its morphology for anchorage purposes using mini-implants (MI). Settings and Design: This investigation was undertaken to compare the mean PBT and level of significance of differences between male and female subjects and between two different age-groups. Materials and Methods: The computed tomography (CT) data for 60 patients (30 males and 30 females) in two different age-groups (group A: 15-24 years; group B: 25-35 years) were imported into CAD-based medical software, (MIMICS^® ; Materialise, Belgium) for multiplanar reconstruction. The measurements were made in two planes- transverse and sagittal-and at different positions in each of the planes. Statistical Analysis: The mean and standard deviations of the PBT at different points were calculated. The Student's t-test and Mann-Whitney U test were used for comparisons between the groups. Results: Significant variations were observed in the thickness of the palatal bone for both groups tested, with the anterior region at 4 mm behind the incisive papilla showing the maximum thickness. Conclusions: Despite the palatal bone being thickest in the mid-palatal suture (MPS) region, this is not the ideal site for anchorage purposes due to inadequate calcification and interposition of connective tissue, especially in young growing children. So, the alternate optimum position is the paramedian region, 3 mm lateral to the MPS and 4 mm from the incisive foramen (IF).

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Background: Dental caries being the commonest unmet public health problem indicates its need to urge the dentists to overcome this problem globally. Caries exhibit in different types and is found to be associated with co-aggregation property of microbial flora with other oral hygienic factors. In spite of the surgical removals, excavations and administration of antimicrobials for carious dentine, there seems to be repeated infection and chronic prevalence of caries. A complete understanding of microbial etiology and prevention of emerging drug-resistant strains will aid in the eradication of this chronic dentine problem condition from the oral cavity. Aim: This study is aimed to isolate the predominant bacterial pathogens associated with caries and to screen for the emergence of drug resistance among the isolated caries pathogens. Materials and Methods: Carious dentine specimens were collected from 75 endodontic patients and the samples were processed microbiologically to isolate the caries pathogens. Identification of the strains was done by standard biochemical characterization studies. Statistical analysis of the isolates was done by Pearson Chi-square test and Fisher's exact test. The predominant isolates were subjected to antimicrobial sensitivity test using Kirby Bauer's method. The results were recorded and analyzed for drug resistance. Results: Carious dentine samples yielded a high percentage of Lactobacillus sp., and Candida albicans from different type of caries. Among the study population, dentinal caries was the most predominant type affecting most males with other associated risk factors. Nearly 47.3% of the isolated Lactobacillus sp. and 55.5% of the yeast C. albicans were screened to show resistance against the antimicrobials used for the study. Conclusion: This study concludes by stating that Lactobacillus sp., and C. albicans are mostly involved in the caries etiology and show resistance to the commonest antimicrobial agent. This implicates the need for periodical antimicrobial susceptibility examination of the caries pathogens that will aid to prevent the emergence of resistance property among the dentinal pathogenic organisms.

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Background: Oral squamous cell carcinoma is the most common neoplasm and comprises of approximately 80% of the cancers occurring in the oral cavity. The role of the host response to this neoplasm has been recognized, and for many years the regional lymph node in tumor-bearing hosts has been considered as an anatomic barrier to the systematic dissemination of tumor cells. Morphological evaluation of the regional nodes has aided in understanding the immune response. Aim: The current study was carried out to observe the morphological changes occurring in the regional lymph nodes and to evaluate whether these features could be helpful in assessing the immunological status of the patient, and thereby, the prognosis of the patient. Materials and Methods: The study was based on lymph nodes from 63 patients with oral squamous cell carcinoma, who underwent radical neck dissection or modified neck dissection. In the lymph node, four morphological patterns were observed that included lymphocyte predominance, germinal center predominance, mixed pattern (sinus Histiocytosis), and an unstimulated pattern. The cases were then divided into four groups according to the predominant immunoreactivity pattern based on the World Health Organization (WHO) standardized system for reporting human lymph node morphology. Results: Revealed that risk of metastases to cervical lymph nodes in patients with lymphocyte predominance was less (28.6%) when compared to the high risk of metastases with germinal center predominance (68%), and these results were statistically significant (P < 0.05). Patients with a mixed pattern showed less risk of metastases (45.4%), while those with an unstimulated pattern had increased risk of metastases (66.6%), but the results were not statistically significant. It was also found that in the positive nodes, germinal center hyperplasia (50.2%) was the predominant pattern. Conclusion: The present study revealed that patients with lymphocyte predominance had less risk of metastases and patients with germinal center predominance had a high risk of metastases to the lymph node.

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Aim: Root canal irrigation plays an important role in the debridement and disinfection of the root canal system. "The purpose of this study was to evaluate the efficacy of Carisolv ^TM , 1% sodium hypochlorite (NaOCl) gel, and 1% NaOCl solution as root canal irrigants in deciduous anterior teeth." Materials and Methods: Thirty-six extracted deciduous anterior teeth were used. Root canals were flooded with NaOCl solution in Group A, NaOCl gel in Group B and Carisolv ^TM in Group C and incubated for 30 min. Scanning electron microscope photomicrographs of canal wall debris in the apical, middle and coronal thirds were scored. Results: The results showed that regardless of irrigation regime, canals were consistently cleaner in the coronal and middle thirds than in the apical thirds. NaOCl solution, NaOCl gel, and Carisolv ^TM had comparable activity at coronal third and middle third of root canals. At the apical third, NaOCl solution cleaned canals better than NaOCl gel and Carisolv ^TM . Carisolv ^TM cleaned debris better than NaOCl gel at the apical third. Conclusion: Carisolv ^TM can be used as an adjunct to root canal preparation.

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Context: Clinical and laboratory studies regarding performance of recently introduced luting cements: Adhesive resin cement and resin-modified glass ionomer cement (GIC), are limited. Aims: To compare the retention and marginal seating of Ni-Cr alloy restorations using newer luting cements: Resin-modified GIC and adhesive resin cement with those of the oldest cement, zinc phosphate. Materials and Methods: Thirty maxillary premolars of similar sizes were prepared to receive cast metal copings. Copings were placed on the prepared teeth and the marginal opening was examined using a Nikon Measuroscope. The specimens were randomly assigned to three groups. Group I castings were luted with zinc phosphate, Group II castings luted with resin-modified GIC, and Group III castings luted with adhesive resin cement. After cementation marginal seating was measured. Tensile loads required to dislodge the crowns were obtained using MTS machine. Statistical Analysis Used: Tukey's test, Analysis of Variance (ANOVA). Results: For zinc phosphate cement, mean marginal seating was 31 microns. Mean retentive strength was 287 Newtons. For resin-modified GIC, mean marginal seating was 29.6 microns. Mean retentive strength was 610 Newtons. For adhesive resin cement, mean marginal seating was 49 microns. Mean retentive strength was 613 Newtons. Conclusions: Marginal seating of adhesive resin cement was significantly greater than that of zinc phosphate and resin-modified GIC. Retentive strength of adhesive resin cement and resin-modified GIC was significantly greater than that of zinc phosphate There was no significant difference of retentive strength between adhesive resin cement and resin-modified GIC.

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Aim: To evaluate the use of proliferating cell nuclear antigen index in the different histopathological variants of ameloblastoma, such as the follicular, plexiform, and unicystic types, and in ameloblastic carcinoma by immunohistochemical staining. The proliferating cell nuclear antigen index values of the variants of ameloblastomas and ameloblastic carcinomas are compared in order to determine the biological behavior of these tumors. Materials and Methods: For the present study, archival tissues that had been diagnosed as ameloblastoma and ameloblastic carcinoma were collected from the department of oral pathology. Specimens were embedded in paraffin wax and were sectioned at a thickness of 5 μm and stained with hematoxylin-eosin for reconfirming the histologic pattern. It was also stained immunohistochemically for anti-proliferating cell nuclear antigen antibody. Results: Positive proliferating cell nuclear antigen expression is seen as a light brown, granular stain. The proliferating cell nuclear antigen values of ameloblastic carcinoma were almost five times the value of ameloblastoma. Analysis of variance test, Fischer's exact test/variance ratio test, and Student's t-test were performed and the probability values were determined. Summary and Conclusion: This study showed that ameloblastic carcinoma had the maximum proliferative capacity. Among the variants of ameloblastoma, the plexiform variety had the maximum proliferative capacity, followed by the follicular and unicystic varieties. Altogether, these data indicate that proliferating cell nuclear antigen is related to the biological behavior and proliferation of tumor cells in the variants of ameloblastoma and ameloblastic carcinoma.

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Objectives: The objective of the study was to determine the level of dental health care access and associated factors, at various public health facilities in the Union Territory (UT) of Chandigarh. Materials and Methods: A study was done using a multistage random sampling technique, to interview adult respondents at their homes and to interview the dentists in the public dental clinics and hospitals. Results: The mean composite access score was 59.2 (SD 18.9) in urban areas and 60.5 (SD 20.9) in rural areas (P=0.64) on a scale of 100. The mean score for the self-perceived condition of their oral health was 6.47 (95% CI 6.17 - 6.76). Thirty-four percent of the respondents did not contact a dentist despite having a problem in the last year, primarily because dental problems were not important for them (45%), they lacked time (22%), and took self-medication (16%). Overall 58% of the respondents suggested government clinics and 44% liked private dentists for treatment of dental cavities. The government setup was preferred because the facilities were cheaper and affordable. Conclusions: Dental health care access and only limited dental facilities were available in most of the dental clinics in Chandigarh. Self-reported dental problem was low, and people ignored their dental problems.

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Aim: The aim of this in vitro study was to evaluate the flexural bond strength of porcelain to combinations of used and new nickel-chromium alloy in various proportions. Materials and Methods: Used and new nickel-chromium bonding alloys were combined in various proportions (groups I to V; 10 samples per group) and their flexural bond strengths with porcelain were compared. A three-point loading system was used for the application of load. Load was applied at a constant speed of 0.5 mm/minute and the load required to fracture the porcelain was recorded for each specimen. Statistical Analysis Used: (a) Analysis of variance (ANOVA) and (b) Duncan's multiple range tests. Results: The best bond strength values were seen when 100% new alloy was used. According to the findings of this study, there was no adverse effects noted with up to 75% recast metal, but serious changes were found in the bond strength values when 100% old metal was used. Conclusions: The following conclusions were drawn from the study

1. Fresh nickel-chromium alloy shows the greatest porcelain adherence.
2. There is no significant change in bond strength of ceramic to alloy with up to 75% of used nickel-chromium alloy.
3. At least 25%- of new alloy should be added when recycled nickel-chromium alloy is being used for metal ceramic restorations.

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Objective: Intraoral corrosion of dental alloys has biological, functional, and esthetic consequences. Since it is well known that the salivary urea concentrations undergo changes with various diseases, the present study was undertaken to determine the effect of salivary urea concentrations on the corrosion behavior of commonly used dental casting alloys. Materials and Methods: Three casting alloys were subjected to polarization scans in synthetic saliva with three different urea concentrations. Results: Cyclic polarization clearly showed that urea levels above 20 mg/100 ml decreased corrosion current densities, increased the corrosion potentials and, at much higher urea levels, the breakdown potentials. Conclusion: The data indicate that elevated urea levels reduced the corrosion susceptibility of all alloys, possibly through adsorption of organics onto the metal surface. This study indicates that corrosion testing performed in sterile saline or synthetic saliva without organic components could be misleading.

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In India, tobacco use is incredibly linked to poverty and accounts for the high public health costs of treating tobacco-related diseases. Dental public health programs aid in detecting the tobacco-related periodontal diseases, oral cancers, etc., where the majority belongs to the submerged portion of iceberg, which otherwise leads to substantial morbidity and mortality. Moreover, public health dentists plays a key role in identifying both clinical and subclinical cases and aid in tobacco use cessation through various modes of health education and counseling. Therefore, the community-based measures are deemed to be the most cost-effective tool for tobacco cessation.

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A case of angiosarcoma of maxilla is presented. The occurrence of angiosarcoma in the oral cavity is a rare incidence and maxilla is one of the rarest sites to be involved. The purpose of this article is also to emphasize the fact that sometimes small, innocent-looking masses in the oral cavity might actually turn out to be a highly destructive malignant tumor. Hence, a complete radiographic and histopathologic examination is mandatory.

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Bisphosphonates constitute a group of drugs capable of modulating bone turnover and reduce its remodeling when an excessive resorption occurs. This is why they are indicated in a large group of bone diseases like postmenopausal osteoporosis or osteolysis associated with breast cancer or multiple myeloma. Over the last few years and due to their extensive use, many cases of complications associated with their use have been published. Among the most important possible adverse effects are the oral ones, with the appearance of ulcerations and, especially, osteonecrosis of the jaws associated with this therapy. In this paper, we have analyzed the general characteristics of these drugs and their mechanisms of action as well as the described adverse effects, especially oral and maxillofacial, have been made special reference, regarding the prevention of osteonecrosis of the jaws, heightened by cases described in the medical and odontological literature. The preventive protocol backs up the fundamental role of the odontologist in the effective prevention of this process before, during and after the treatment.

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Plasma cells are medium-sized round-to-oval cells with eccentrically placed nuclei, usually found in the red pulp of the spleen, tonsils, medulla of the lymph nodes, nasal mucosa, upper airway, lamina propria of the gastrointestinal tract, and sites of inflammation. Plasma cell granuloma is a rare reactive tumor-like proliferation composed chiefly of plasmacytic infiltrate. Here, we present a case of plasma cell granuloma of lip in a female patient.

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Knowledge regarding the morphological variations in roots and root canals aids in successful dental treatment. However, literature regarding dysmorphology of roots in primary dentition is sparse. The purpose of this article is to present a case of bilateral primary mandibular first molars with an unusual morphology of single root. Review of literature regarding variations in root number in primary dentition has been discussed in this article. The etiology for occurrence of such variations has also been briefly reviewed.

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Introduction: In patients with hopeless prognosis of the anterior teeth there is still a strong desire to save them for the sake of esthetics. If not grossly carious, broken down or discolored the extracted tooth after suitable modifications can be placed back in its original site by splinting it to the adjacent stable teeth. Materials and Methods: Fifteen patients (10 males, 5 females) in the age range of 40-65 years with pathologically migrated, unsalvageable teeth were treated by splinting the extracted teeth immediately with the stable adjacent teeth. After 12 weeks, all the patients were explained various treatment options available for replacement of the lost teeth. The patients were asked to fill out a simple closed ended questionnaire citing the various difficulties encountered during this transitional period, selection of further treatment modalities and the reasons for their choice. The feedback obtained was then analyzed statistically. Results: Hundred percent of patients were happy with the esthetics; however, 60% of them were dissatisfied with the function that it provided. The primary problem being apprehension of splint fracture and difficulty while incising and the data was found to be statistically significant (P=0.01**). All patients demanded a permanent treatment option following this with a fixed prosthesis. None of the patients were interested in the implant supported prosthesis due to cost, treatment time involved, and need for surgery. Conclusion: The concept of immediate pontic placement is surely a viable treatment option and promises an excellent transient esthetic solution for a lost tooth as well as enables good preparation of the extraction site for future prosthetic replacement.

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Surgical resection is an established and common method for treatment of maxillofacial tumors. Such intervening surgery in this region may involve the destruction of antral, nasal, or orbital contents and jaws. Normally, the end result is a defect which may affect speech, swallowing, mastication and facial appearance. Prosthodontic restoration of functions and facial form is an excellent method in the replacement of missing parts and restoration of contour. Pertinent research in materials, designs and methods have resulted in whole array of possible prosthess that can be provided to meet specific patient needs. This case report describes the fabrication of definitive obturator prosthesis made of flexible acrylic resin on a chrome cobalt base.

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The use of Qualitative Research (QR) methods are now getting common in various aspects of health and healthcare research and they can be used to interpret, explore, or obtain a deeper understanding of certain aspects of human beliefs, attitudes, or behavior through personal experiences and perspectives. The potential scope of QR in the field of dental public health is immense, but unfortunately, it has remained underutilized. However, there are a number of studies which have used this type of research to probe into some unanswered questions in the field of public health dentistry ranging from workforce issues to attitudes of patients. In recent health research, evidence gathered through QR methods provide understanding to the social, cultural, and economic factors affecting the health status and healthcare of an individual and the population as a whole. This study will provide an overview of what QR is and discuss its contributions to dental public health research.

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Objective: Even with beautifully done restorations, an unattractive gingival zenith position, can negatively affect the smile of a person. In this short communication we describe the treatment of a rotated maxillary right central incisor using a digital photographic approach instead of the conventional approach. Background: The conjecture literature on prosthodontic considerations and gingival zenith position in cases of rotated maxillary central incisors is sparse. The gingival zenith level (GZL) in an apical-coronal direction of lateral incisors, relative to the gingival tangential zenith line joining the adjacent central incisor and canine, is approximately 1 mm under healthy conditions. Materials and Methods: For our patient, the treatment plan was decided by CAD-CAM technique as Zirconia, jacket crown. Clinical procedures included enameloplasty on the left central and right lateral maxillary incisors. Reduction of the rotated and crooked incisor was performed in the normal manner; periodontal plastic surgery was also done. Results: The patient expressed satisfaction with the intermediary (preliminary) two-dimensional photographs that were provided by the CAD-CAM system. The technique distinguished among the different treatment modalities for aesthetics and to relieve the emotional problems which were faced by female patient. The gingival zenith level of the rotated incisor was also improved. Conclusion: Digital imaging provides an immediate treatment option for the patients. Software also provides an interim aid, for the clinician as well as technician, in the form of two-dimensional photographs. CAD-CAM is entirely a helping instrument against the conservative prosthetic options and gingival zenith position for a rotated central incisor. It helps in patient education and in motivation.

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Pulp calcifications are a frequent finding on bitewing and periapical radiographs in older age-groups but their occurrence in the entire dentition in young subjects is unusual. We report such an unusual occurrence of generalized pulp calcification in a 13-year-old Indian female. Radiographic examination of the dentition revealed pulp calcifications in all permanent teeth, located mostly in the pulp chamber but with some in the root canals. The patient's dental, medical, and family history was noncontributory. Biochemical analysis of the removed pulp calcification from one of the teeth during endodontic treatment showed large amounts of calcium, phosphorus, and carbonate. However, metabolic evaluation of patient through liver and kidney function tests and other blood investigations did not reveal any metabolic disorder. The patient was also evaluated for any systemic, syndromic, or genetic involvement but this was also noncontributory. Therefore, we propose that this unusual case of generalized pulp calcification is of idiopathic origin. In this work, histopathological and biochemical evaluations of the pulp calcification was done to try and understand the initiation and progress of calcifications in pulpal tissue.

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Irrespective of the cause, abnormalities in shape, size, and position of body organs are often perceived as looking wrong. This perception can subject the individual to significant peer ridicule and social ostracism. Rehabilitation of patients with auricular defects can either be done by reconstructive surgery or by prosthetic means. The article draws a comparison between the implant-supported prosthesis and reconstructive surgery, listing the benefits, limitations, indications and contraindications of both the techniques. As both the available techniques give excellent results in appropriately selected situations, the restorative team must present all the alternatives to the patient and choose judiciously the better of the two.

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Context: Mounting the maxillary and mandibular dentulous casts for Diagnostic purpose requires many steps (including making maxillary and mandibular impressions, face-bow transfer, and bite registration) or many appointments. A simple new technique of doing all of this together without compromising on the accuracy can save time over the conventional mounting procedure. Aim: To compare the accuracy of a new technique of a single-step diagnostic mounting procedure with that of the conventional diagnostic mounting procedure. Materials and Methods: Ten dentulous patients with the full complement of teeth and without any history of temporomandibular disorder and orthodontic treatment were selected for this study. A detachable metal triple tray to replace the fork part of the face bow fork that further could be attached to face bow was fabricated. Dual-arch impressions and face-bow transfer were made in these subjects using this modified triple tray. These mountings were compared with the ones done with the conventional mounting procedure. Five linear measurements (using stable reference points on the articulator and the cast) were made and the values obtained by both the methods were compared. Statistical Analysis: The Student's 't' test for statistical analysis was used in this study. Results: The measurement values obtained by the single-step method were almost similar to the ones obtained by the conventional method. The various mean measurements for the single step and conventional methods were 37.7 ± 6.8 and 38.5 ± 6.5 mm; 70.0 ± 4.4 and 70.1 ± 4.2 mm; 57.0 ± 4.9 and 57.3 ± 4.2 mm; 71.3 ± 4.5 and 71.0 ± 4.6 mm; and 58.7 ± 2.5 and 58.3 ± 2.3 mm; respectively. The differences between the values obtained by the conventional and single-step methods were not statistically significant. Conclusion: The single-step procedure of diagnostic mounting can be used as an alternative to the conventional method, without compromising the quality of mounting.

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Background: Periodontal infections, which serve as a reservoir of inflammatory mediators such prostaglandin E ₂ (PGE ₂ ), may pose a threat to the fetal-placental unit and cause preterm delivery. Aim: This study was conducted to estimate the PGE ₂ levels in gingival crevicular fluid (GCF) and to explore the association between GCF-PGE ₂ levels and preterm low birth weight (PLBW). Materials and Methods: Twenty-two pregnant patients were selected for the study. GCF samples were collected from these patients before delivery and again at 1 month after delivery. PGE ₂ level was estimated using a commercially available ELISA kit (Neogen™). Results: The mean GCF-PGE ₂ level was 5.8 ng/ml before parturition and 5.5 ng/ml after parturition, but the difference was not statistically significant. There was negative correlation between PGE ₂ levels and gestational age at birth. Conclusion: The study provides weak evidence that there is correlation between GCF-PGE ₂ levels and birth outcome. Further clinical trials with large samples are required to confirm the association between GCF-PGE ₂ levels and PLBW.

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