Purpose: Hounsfield unit (HU) provides a quantitative evaluation of bone density. The assessment of bone density is essential for successful treatment plan. Although, multislice computed tomography (MSCT) is considered as gold standard in evaluating bone density, cone-beam computed tomography (CBCT) is frequently used in dentomaxillofacial imaging due to lower radiation dose, less complex device, and images with satisfactory resolution. Aims and Objectives: The aim of this study is to determine and compare the gray value and HU value of hypodense and hyperdense structures on CBCT and MSCT, respectively. The study also evaluated and compared the gray values in different field of views within CBCT. Materials and Methods: A total of 20 dry human mandibles were obtained. The gray values and HU values of hypodense structures (extraction socket, inferior alveolar canal, and mental foramen) and hyperdense structures (enamel, cancellous, and cortical bone) were evaluated and compared between CBCT and MSCT images, respectively. The obtained data were statistically analyzed. Statistical Analysis: One-way analyses of variance, ANOVA F-test. Results: The gray value for hypodense structures in large volume CBCT scans resembled the HU value. The study showed statistically significant difference (P < 0.001) in gray values for all the hyperdense structures in CBCT when compared to HU values of MSCT scans. Conclusion: The gray value for hypodense structures in large volume CBCT scan was more reliable and analogous to HU value in MSCT. The determination of grey values in CBCT may not be as accurate as HU value in CT for hyperdense structures.

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Tessier facial clefts are among the rarest facial clefts reported in literature and many contradicting issues have always been rising over the management and surgical approaches involved during the craniofacial cleft repair. Among the craniofacial clefts Tessier no. 4 is an extremely rare facial anomaly, and there are very few evidence which clearly describe the surgical approaches and techniques. Often these type of craniofacial clefts yield very poor surgical results, and they require multidisciplinary sequential corrective surgeries. This article presents a rare case of an 18-month-old baby with bilateral Tessier no. 4 clefts and its successful rehabilitation.

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Context, Aim, and Objectives: Diagnosis of temporomandibular joint (TMJ) disc displacement with reduction (DDR) is difficult. Literature combining different subjective parameters of TMJ function with an objective evaluation of TMJ function using joint vibration analysis (JVA) is limited. Hence, the study was planned to diagnose temporomandibular disorder accurately, to do a subjective and objective evaluation of TMJ function, and to assess the effectiveness of different types of splint therapy over the conventional anterior repositioning appliance (ARA) group. Design: Single-blind, randomized, comparative clinical trial conducted in thirty patients, 18–55 years of age, allocated to three groups, i.e., ARA conventional group, centric stabilization splint (CSS), and Soft splint (SS) groups. Subjects and Methods: Preoperative values of comfortable mouth opening (CMO) in mm, maximum mouth opening (MMO) in mm, TMJ clicking and tenderness (grading 0–3), visual analog scale pain score (0–10 cm), and total energy (TE) integral values of both TMJs using JVA were recorded. Postoperative values were taken at the time of delivery of splint at 1^st, 2^nd, 6^th, and 10^th week. Statistical Analysis and Results: Intergroup comparison – Kruskal–Wallis test showed no statistically significant difference in CMO, MMO, and TE values of right TMJs among three groups at any point. No significant difference was seen in TMJ clicking and tenderness among groups at any point of time except at 10 weeks and at 2 weeks, respectively, by Chi-square test. Intragroup comparison - Wilcoxon signed-rank test showed the significance of difference (P < 0.05*) in postoperative visits for CMO, MMO, pain score, and TE values. Clinical effect size, extent, consistency, and percentage of cases showing improvement were maximum for CSS group. Conclusions: The study concludes that the use of JVA for diagnosis along with history and clinical examination increases the accuracy of the diagnosis of DDR. ARA group was used as a conventional treatment option. Although statistically significant difference in pre- and post-treatment values was obtained in all the three groups, CSS group patients showed consistent clinically effective responses and more significant improvement in the subsequent follow-up visits than SS group. Hence, it is advisable to start therapy with CSS splint in TMJ DDR patients to get sooner and effective results without minimum side effects.

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Aim: To know the efficacy of Triphala extract and Chlorhexidine mouth rinse against plaque and gingival inflammation. Materials and Methods: A double blinded parallel arm randomised control trial was done among 60 participants aged 18-24 years. Participants were randomly allotted to three groups with 20 participants in each group of 0.6% triphala, 0.12% chlorhexidine and control group. Study was done in 2 phases of 21 days duration. During the experimental period, participants rinsed with the allocated mouth rinse 10ml twice daily for 30 seconds without any supervision. The plaque and gingival status were assessed using Silness and Loe and Loe and Silness at baseline and end of the phase. Statistical Analysis Used: The results were analysed using ANOVA(Analysis of Variance), Wilcoxon sign rank test and post hoc test with significant level at P value < 0.05. Results: Triphala and Chlorhexidine showed significant reduction in plaque and gingival scores as compared to Control group (P < 0.001). No significant difference was found between the plaque and gingival scores obtained with triphala extract and chlorhexidine mouth rinse. Conclusion: Triphala extract mouth rinse was effective in reducing plaque accumulation and gingival inflammation with reported no side effects.

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Treatment of edentulous sites with horizontal atrophy represents a clinical situation in which the positioning of endosseous implants might be complex or sometimes impossible without a staged regenerative approach. This case report presents management of horizontally deficient mandibular anterior ridge with a contemporary approach to treatment planning and application of platelet-rich fibrin membrane for ridge split technique and simultaneous implant placement. Implants in anterior mandibular area are considered to be most predictable, stable, with high success rate and patients' satisfaction with implant esthetics. In contrast to traditional ridge augmentation techniques, ridge splitting allows for immediate implant placement following surgery and eradicates the possible morbidity from a second surgical site.

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Purpose: The rationale of this in vivo study was to evaluate and compare different obturation techniques for the intracanal conveyance of Endoflas in the primary molars using conventional radiography. Materials and Methods: Thirty-eight children (4–9 years old) with total of 45 pulpally infected primary mandibular molars indicated for pulpectomy were categorized into three groups (i) endodontic pluggers, (ii) lentulospirals, and (iii) NaviTips, respectively, for obturation with Endoflas. The level of obturation and the presence of voids were evaluated radiographically, and the obtained data were statistically analyzed using Chi-square test. Results: The results showed no significant difference between the three techniques to deliver Endoflas. Motor-driven lentulospirals showed better results (64.4% optimal fillings) compared to the pluggers (62.2%), but NaviTips showed poor results (48.9%) for the level of obturation (P > 0.05). Voids were observed in all the techniques used. Pluggers and lentulospirals showed similar results with greater void-free canals, whereas NaviTip system showed more voids which was statistically not significant (P > 0.05). Conclusion: Motor-driven lentulospiral and pluggers were almost equally efficient to fill Endoflas to an optimal level, devoid of voids, and both were considered better compared to NaviTip system.

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Background and Objective: Over a century, an increased prevalence of gingival diseases associated with increasing plasma sex steroid hormone levels has been reported. These situations present unique challenges to the oral health-care professional. It is believed that hormonal fluctuations such as those associated with pregnancy, menstruation, and use of hormonal contraceptives lead to an increase in tooth mobility. However, this effect of female sex hormones on periodontal ligament and tooth-supporting alveolar bone has rarely been investigated. Hence, this study was conducted to understand the effect of hormonal changes during pregnancy on tooth mobility. Materials and Methods: Mobility of index teeth 16, 13, 21, 23, 24, 36, 33, 41, 43, and 44 was measured with periotest for fifty pregnant females at first trimester (12^th week), second trimester (24^th week), and third trimester (35^th week). Simplified oral hygiene index, plaque index, Gingival index (GI), and probing depth were also evaluated during the three trimesters of pregnancy for each subject participating in the study. Statistical Analysis: The results of the study were subjected to statistical analysis. Data analysis was done by applying Z-test for comparing difference between two sample means. Results: A small but statistically significant influence on the periotest value was seen during the three trimesters of pregnancy. GI scores significantly increased throughout pregnancy despite no significant change in plaque levels. Conclusion: Pregnancy had a significant influence on tooth mobility. Highest value of tooth mobility was seen in the last month of pregnancy. The maximum severity of gingivitis was also seen during the third trimester of pregnancy.

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Background: Identifying anxiety levels of parents accompanying their children can help the clinician in designing the behavior management strategies for the child. In addition, continued dental experience can improve the child's response, indicating desensitization to dental stress. Aims: To evaluate the influence of parental anxiety on children's behavior and understanding children's dental anxiety after sequential dental visits. Materials and Methods: A total of 175 children of age 6–12 years, 98 were boys and 77 were girls, were randomly selected from various schools of Navi Mumbai. Parental dental anxiety was assessed using the Corah's dental anxiety scale (DAS), and child anxiety level was measured using children fear survey schedule-dental subscale (CFSS-DS). Statistical Analysis Used: Pearson's correlation coefficient analysis, ANOVA, and Friedman test. Results: There is a significant positive correlation (P < 0.0001) between DAS scores and CFSS-DS scores at all three dental visits. The mean ± standard deviation, CFSS-DS scores at the first, second, and third dental visits are (34.07 ± 11.97), (31.04 ± 10.94), and (27.26 ± 9.39), respectively, showing the score is more during the first dental visit than the second and third visits. Conclusion: The dental anxiety levels in parents may influence the anxiety levels of children and also all children exhibited an improvement in the levels of dental anxiety from the first dental visit to the subsequent dental visits.

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Background: The endocrine and the immune system demonstrate a mutual relationship under pathophysiologic conditions. Thyroid hormone plays an important role in the regulation of normal growth and development. Although there is proven bidirectional influence of systemic diseases on periodontium, there are fewer studies on the effect of periodontal therapy on the hormone levels. This study aims to assess the effect of nonsurgical periodontal therapy (NSPT) on serum thyroid stimulating hormone (TSH) levels in hypothyroid patients with periodontal diseases. Materials and Methods: A total of 30 randomly chosen subjects of which 15 known hypothyroidism patients (13 females and 2 males) who were under medication for the same and 15 healthy individuals were enrolled into the study. Clinical parameters and serum TSH levels were recorded at baseline in both the groups, whereas TSH levels were recorded again at 3 months after NSPT in hypothyroid patients. Intergroup comparison was carried out by Tukey Kramer multiple comparisons test and the difference in variables was analyzed using one-way analysis of variance. Results: Mean values of TSH in hypothyroid patients 3.48 ± 1.41 μIU/ml showed significant reduction to 2.31 ± 1.24 μIU/ml (P ≤ 0.05) at 3 months follow up of NSPT. Clinical parameters improved significantly in both the groups after NSPT (P ≤ 0.05). Alveolar bone loss was greater in hypothyroid patients than the control group at baseline. Conclusion: NSPT plays a major role in improving periodontal conditions by reducing inflammatory markers and thereby influencing the thyroid hormone. Thus, immune system serves as an important link between thyroid dysfunction and periodontal diseases.

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Context: Despite efforts in restorative therapy, children who experience Early Childhood Caries (ECC) continue to be at a higher risk for new lesions in both the primary and the permanent dentition. Early interventions which disrupt the pathobiology of caries need identification of all the causative or risk factors. Aims and Objectives: This study dealt with the prevalence and associated risk factors of ECC among preschool children aged 3 to 5 years in Bengaluru city. Materials and Methods: Information regarding risk factors was obtained through a structured questionnaire among a random sample of 1152 children. Clinical examination was performed by a trained dental professional using the modified WHO oral health survey format. Statistical Analysis: Chi-square, one-way ANOVA, correlation, multiple linear regression analysis. Results: The prevalence of ECC among preschool children was 24.39% (P < 0.05), whereas the mean deft was 5.80 ± 8.90. The prevalence of ECC among males and females was 24.92% and 23.81%, respectively. 4.27% of children with ECC showed a history of prolonged breastfeeding beyond 2.5 years (P < 0.05). 50.18% of children had a history of using medications during bedtime/night. History of low birth weight was reported among 23.84% of ECC children. Only 13.52% of mothers claimed of getting a prenatal oral health care/counseling (P < 0.05). Conclusion: The prevalence of ECC was seen in almost a quarter of the population with a high deft. A significant relation was associated only with the feeding duration and lack of prenatal oral health counseling provided to parents.

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This study aims to report of two variants of gnathic osteosarcoma with highlights on the varied histopathological presentation of osteosarcomas (OS). OS present with diverse histological appearances. Despite significant advances in molecular pathogenesis and biomarkers, clinicopathologic correlation is still considered as the important criteria in diagnosis. Chondroblastic osteosarcoma in a 52-year-old female and fibroblastic osteosarcoma in a 35-year-old female. Osteosarcoma is a relatively rare disease of the oral and maxillofacial region. Regular screening and follow-up is highly recommended, as recurrence rates are higher. Thorough understanding of the histologic spectrum of osteosarcoma reduces the diagnostic difficulties in categorizing the OS and separating these neoplasms from benign bone diseases.

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Purpose: Anodized implants with moderately rough surface were introduced around 2000. Whether these implants enhanced biologic effect to improve the environment for better osseointegration was unclear. The purpose of this article was to review the literature available on anodized surface in terms of their clinical success rate and bone response in patients till now. Materials and Methods: A broad electronic search of MEDLINE and PubMed databases was performed. A focus was made on peer-reviewed dental journals. Only articles related to anodized implants were included. Both animal and human studies were included. Results: The initial search of articles resulted in 581 articles on anodized implants. The initial screening of titles and abstracts resulted in 112 full-text papers; 40 animal studies, 16 studies on cell adhesion and bacterial adhesion onto anodized surfaced implants, and 47 human studies were included. Nine studies, which do not fulfill the inclusion criteria, were excluded. Conclusions: The long-term studies on anodized surface implants do favor the surface, but in most of the studies, anodized surface is compared with that of machined surface, but not with other surfaces commercially available. Anodized surface in terms of clinical success rate in cases of compromised bone and immediately extracted sockets has shown favorable success.

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Background: The present study was conducted to evaluate the bond strength in the different root thirds (premolars and maxillary central incisors) of composite relined glass fiber posts compared to untreated glass fiber posts cemented with dual- or chemical-cure cements. Materials and Methods: Sixty human single-rooted premolars (flat canal) (n = 15) and 12 maxillary central incisors were used (round canal) (n = 3). The teeth were sectioned, and the roots received endodontic treatment. The standardized preparation of the canals was carried out, and the roots were randomly divided into four groups according to the cementation systems: G1: cemented posts (dual: Ambar/Allcem); G2: relined posts (dual: Ambar/Allcem); G3: cemented posts (chemical: Fusion Duralink/Cement Post); and G4: relined posts (chemical: Fusion Duralink/Cement Post). The roots were cut to give two slices of each third of the root canal per specimen. Push-out test was conducted at a speed of 0.5 mm/min. Data were analyzed by analysis of variance and Tukey's post hoc test (α = 0.05). Results: There was no statistically significant difference between groups for the premolars (flat canal) (P = 0.959). There was a significant difference in the central incisors between the middle and apical thirds in the cemented group when using the dual system (P = 0.04) and between the middle and apical thirds (P = 0.003) and cervical and apical thirds (P = 0.033) when using the chemical system. Conclusion: Due to the anatomy of the root canal, flat canal of the premolars does not require relining, but round canal of the maxillary central incisors demands it for more secure in the bond strength.

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Context: Endodontic materials have been assessed with regards to their potential for dental staining. Aims: To evaluate the coronal discoloration effect of Apexit Plus and Resino Seal in mandibular premolars using spectrophotometer. Settings and Design: The study design was original research. Materials and Methods: Forty human single-rooted mandibular first premolar teeth were selected for the study. They were divided into four groups of ten specimens each. Group 1 - Apexit Plus sealer, Group 2 - Resino Seal sealer, Group 3 - positive control (Blood), and Group 4 - negative control (distilled water). Teeth were resected 3 mm below at cementoenamel junction. In all samples, access cavities were prepared, instrumented, and irrigated. Sealers were mixed and placed into the pulp chamber through cervical access and control groups were filled with blood and distilled water. Coronal orifices were sealed using self-cure glass ionomer cement. Samples were analyzed using spectrophotometer to determine the discoloration in each group at 10, 17, and 24 days interval. Statistical Analysis Used: Statistical analysis used Wilcoxon signed-rank test. Results: All sealers used in the present study caused a progressive coronal discoloration over a time period of 17–24 days. There was statistically significant difference between resino seal sealer and apexit plus sealer , with resino seal showing greater coronal discoloration. Conclusion: Resino seal sealer has greater potential to cause discoloration of crown as compared to apexit plus sealer over a period of time.

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Background: Oral cancer is known to be governed by the antiapototic and loss of cell adhesion properties which dictate its progression. Aim: To study the immunexpression of E-cadherin and Bcl-2 in varying TNM stages and histopathological grades of OSCC. Materials and Methods: 11 cases of well differentiated, 10 cases of moderately differentiated and 11 cases of poorly differentiated OSCC were studied immunohistochemically using archival paraffin embedded tissue specimens. Statistical Analysis: Differences between the different variables were analyzed using ANOVA test, Kruskal–Wallis test and post hoc test followed by Bonferroni test. The resulting data was analyzed using SPSS software version 19. Results: The expression of Bcl-2 and E cadherin immunopositivity was associated positively with tumor grade, high T category and Histopathological grades. Conclusions: The results of this study points to the significance of cell proliferation and invasion as a major determinant of prognosis in OSCC.

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Aims: To assess the percentage of cell arrested in G2M phase by colchicine in the early detection and prognosis of oral cancer, by comparison of oral squamous cell with leukoplakia and oral submucous fibrosis (OSMF) using flow cytometry analysis. Materials and Methods: Biopsy samples 5 each of clinically diagnosed and histopathologically confirmed case of leukoplakia, OSMF, and squamous cell carcinoma (SCC) are included in the study. Results: Colchicines significantly inhibited the growth of oral SCC-9 cell line by arresting G2M phase of the cell cycle (94.90%). This cell cycle result indicated that doubling of DNA is a characteristic feature of cancer. Colchicines significantly inhibited the G2M phase of the cell cycle in leukoplakia (33.51%) as compared to control (23.60%). Colchicines marginally inhibited the G2M phase of the cell cycle in OSMF (31.83%) as compared to control (28.36%). Colchicines significantly inhibited the G2M phase of the cell cycle in SCC (63.05%) as compared to control (26.40%). Conclusion: DNA analysis by inhibition of G2M phase of cell cycle using colchicine facilitates early detection and also helps determine the prognosis of leukoplakia, OSMF, and oral cancer.

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