Aim and Objective: The present study was conducted in patients with bruxism to evaluate the effect of botulinum toxin type A (BTX-A) (Botox, Allergan, Inc., Irvine, CA, USA) in the treatment of myofascial pain and the occlusal force characteristics of masticatory muscles. Materials and Methods: Twenty-four diagnosed with bruxism were randomly divided into three groups (n = 8) and treated by bilateral intramuscular injection of BTX-A and placebo-treated with saline placebo injections and control group where no injections were given. The clinical parameters such as pain at rest and during chewing were assessed and occlusal force analysis system to measure the distribution of occlusal force in bruxism patients. All the three groups were assessed at baseline time and at 1 week, 3 months, and 6 months follow-up appointments. Descriptive analysis showed that improvements in parameters such as pain at rest; pain during chewing clinical outcome variables were higher in the botox treated group than in the placebo-treated subjects. Results: The pain at rest and at chewing decreased in the BTX-A group while remaining constant in the placebo group and control group. There was a significant change in maximum occlusal force in the BTX-A group compared with the other two groups (P < 0.05, post hoc Bonferroni test, no exact P value), and there was no significant difference between the placebo and control groups (post hoc Bonferroni test, no exact P value). Conclusion: Results from the present study supported the efficacy of BTX-A to reduce myofascial pain symptoms in bruxers, and effective in reducing the occlusal force.

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Background: To evaluate the effectiveness of subgingival irrigation with 10% povidone-iodine as an adjunct to scaling and root planing (SRP) and to assess the effectiveness of 10% povidone-iodine in reducing periodontal pathogens mainly Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa). Methodology: Sixty patients with chronic periodontitis of mild to moderate type with periodontal pocket depths (PDs) of 4–6 mm were recruited. At baseline, plaque index, gingival index, and bleeding index were assessed. The PD and clinical attachment level were assessed using the Florida probe^®. Pooled subgingival plaque samples were collected. Each participant was allocated into 2 arches, maxillary arch received SRP alone and mandibular arch received SRP with 10% of povidone-iodine irrigation at baseline. After 3 months, same clinical parameters were assessed and plaque samples were collected from both arches. The collected plaque samples were evaluated using polymerase chain reaction. Data were analyzed using SPSS software, version 10 and through independent-samples t-test, paired-samples t-test, and repeated measures ANOVA. Results: At 3 months posttreatment, subgingival irrigation with povidone-iodine together with SRP showed a statistically significant reduction in all the clinical parameters and in levels of Pg and Aa. Conclusion: In the present study, 10% povidone-iodine irrigation as an adjunct to SRP favored the nonsurgical periodontal therapy, due to its broad-spectrum antimicrobial activity. Hence, it could be considered as an adjunctive treatment approach in the treatment of chronic periodontitis.

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Ankyloglossia or “tongue-tie” is a rare congenital anomaly characterized by an abnormally short, thick, fibrosed lingual frenulum which may cause restriction in function of tongue including limitation in tongue movement. The lingual frenulum may be fibrous or muscular, and the tie may be complete or partial. Most often, ankyloglossia is seen as an isolated condition in an otherwise normal individual. This article reports the surgical management of a 20-year-old patient having ankyloglossia associated with restricted movement of tongue and difficulty in speech. The treatment involved is surgical removal of the lingual frenum followed by tongue training exercise and speech therapy to functionally rehabilitate the tongue. Six months postoperatively, the patient showed uneventful healing and was satisfied with the procedure.

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Mandibular retrognathism is one of the important contributing anatomical factors to the obstructive sleep apnea (OSA). Such patients suffer from number of apneic or hypopneic events during sleep such as snoring, daytime sleepiness, fatigue, inability to concentrate, and irritability. Distraction osteogenesis is a less invasive surgical technique in the management of OSA by correcting the reduced airway space. Apart from correcting functional disturbances due to OSA, it also corrects the facial profile resulting in the substantial improvement in cosmetic appearance. We report a case of a 3-year-old boy who was struggling with severe retrognathic chin and OSA causing hypopneic episodes and snoring. He was successfully treated by bilateral mandibular distraction which resulted in significant improvement of respiratory distress and feeding as well as evidential advancement of the mandible was achieved.

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Background: As the search for reliable clinical indicators for management of human immunodeficiency virus/AIDS continues, mucocutaneous manifestations of HIV are considered among key clinical indicators for prediction of underlying degree of immunosuppression, systemic opportunistic infections, and disease progression. Objectives: (1) To study the prevalence of mucocutaneous manifestations in HIV-seropositive patients attending the ART center of our hospital (2) To correlate mucocutaneous manifestations with CD4 cell counts. Materials and Methods: A total of 200 HIV-seropositive patients of adult age group visiting our hospital were included in the study. Information on demographics such as age, sex, transmission route, socioeconomic status, educational status, CD4 counts, and mucocutaneous findings was collected through interview administered survey and case records followed by oral and cutaneous examination. Results: Mean CD4 cell count of asymptomatic HIV/AIDS patients was 580.96 cells/mm³. In comparison with the CD4 cell count of asymptomatic HIV-positive patients, (mean 580.96 cells/mm³) CD4 cell count of HIV-positive patients with various mucocutaneous manifestations (mean 409.65 cells/mm³) was correlated using student t-test and was statistically significant (P = 0.017). Conclusion: This study revealed maximum mucocutaneous lesions in the CD4 count range of 200–500. Nail changes accounted for the most common cutaneous manifestation with 53%, and pigmentation accounted for the most common oral manifestation with 39%. Mucocutaneous manifestations can arouse one to suspect the diagnosis of HIV infection in an otherwise healthy unwary patient. They can serve as a dependable marker of HIV disease.

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Background: Detection and evaluation of dental caries is of epidemiological importance. Its early detection is important to commence appropriate treatment planning. Cavitated, noncavitated, and initial lesions of dental caries can be detected by various indices. Objectives: The objective of the study was to assess the caries experience in schoolchildren using decayed-missing-filled teeth (DMFT)/decayed-extracted-filled teeth (deft), International Caries Detection and Assessment System-II (ICDAS-II), and Caries Assessment Spectrum and Treatment (CAST) systems. Materials and Methods: An epidemiological survey was carried out among 1550 schoolchildren (37,644 teeth) between the age ranges of 4 and 14 years. American Dental Association type III examination was performed using plane mouth mirrors and community periodontal index probes using DMFT/deft, ICDAS II, and CAST indices. Results: Out of 37,644 teeth examined, 2,718 teeth had shown caries. Caries experience with DMFT/deft index was 5.54%. Highest score of DMFT was observed in deciduous dentition period (59.02%). Overall prevalence of dental caries with ICDAS and CAST system was 6.7% and 6.95%, respectively. The highest percentage of noncavitated lesions (ICDAS - 2.26% and CAST - 3.9%) and greater prevalence of caries among deciduous teeth (ICDAS - 53.2% and CAST - 58.7%) was observed with both ICDAS and CAST systems. Conclusion: A high prevalence of noncavitated lesions and less number of sealants and restorations indicates the lack of awareness for prevention and treatment of oral diseases, which suggests a strong need for preventive and operative treatments.

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Aim: To prospectively evaluate soft and hard tissue responses to orthodontic treatment of bimaxillary protrusion (BMP) in Dravidian population using McLaughlin, Bennett, and Trevisi (MBT) mechanics of the preadjusted edgewise appliance. Methods: Thirty-one adult (18–30 years) Class I BMP patients were treated using the above mechanics after extraction of four first premolars. Forty-five pre- and post-treatment variables on lateral cephalograms were compared using paired t-test and Pearson's correlation coefficient. Results: All linear and angular parameters pertaining to hard and soft tissues showed significant changes, indicating retraction of incisors, upper and lower lips; increase in nasolabial angle; and decrease in circumoral convexity, interlabial gap, and lip thickness. Various correlations established were (1) upper lip to upper incisor retraction 1:2.01, (2) lower lip to upper incisor retraction 1:1.5, (3) lower lip to lower incisor retraction 1:1, and (4) upper incisor retraction to nasolabial angle 1:2.02. Conclusions: Orthodontic therapy using MBT mechanics is very useful in achieving favorable hard and soft tissue changes, following four first premolar extractions in BMP. The various correlations established between incisor retraction and soft tissue parameters could prove useful to the discerning clinician.

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Background: The distinguishing feature of cancer cells is their ability to proliferate indefinitely, which is in contrast to the restricted cell multiplication potential for somatic cells. A better understanding of this contrasting behavior was provided in the early 1990s with the discovery of a relationship between telomeres, telomerase, aging, and cancer. Telomeres (tandem repeat DNA sequence TTAGGG) are protective caps at the ends of human chromosomes. Normal human cells experience telomere shortening with each successive cell division. However, in tumor cells, an overexpression of telomerase confers limitless replicative potential to tumor cells by continuous elongation of telomeres. The objective of this review was to systematically assess the data available on telomerase expression in oral cancer, with special reference to its role in diagnosis, prognosis, and treatment. Materials and Methods: A systematic review of studies that investigated the telomerase expression in oral squamous cell carcinoma (OSCC) was registered with PROSPERO. Subsequent to registration, a predetermined search strategy in accordance with PRISMA guidelines was formulated, and a literature search was conducted using online databases along with hand searching. Results: Eighty-nine articles from PubMed, 83 from Scopus, 5 from BioMed Central, 43 from Google Scholar, and 2 from hand search were identified. A total of 21 articles were shortlisted that met strict inclusion and exclusion criteria and quality assessment. Each study was evaluated for the markers under study, type of sample used, study design/methodology, and statistical analysis. The studies were then grouped into three subheads depending on their implications in the diagnosis, prognosis, and treatment of OSCC. Conclusion: This review explains the basic biology and the clinical implications of telomerase-based diagnosis and prognosis, the prospects for its use in anticancer therapy, in the context of oral cancer.

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Context (Background): Lips prints are unique and are a tool for personal identification. Aims: Indian population can be divided into different ethno-racial groups. In this study, we aimed at finding the most and the least prevalent lip print patterns in these groups and also to observe any similarities or differences that may exist in these groups in terms of lip print patterns. Settings and Design: Lip prints in 755 individuals categorized into different ethno-racial groups were studied. Materials and Methods: Brown- and pink-colored lipsticks, cellophane tape, and magnifying lens were used to record and study the lip prints. Results: Among all the three ethno-racial groups, Type I was the most prevalent lip print pattern observed. The least prevalent lip print pattern in all the three groups was Type IV. Inference/Conclusion: Lip prints hold potential as supplementary tools for identification where they can be recorded with ease. The observation and classification of lip print patterns in different ethno-racial groups not only provide some useful data but also open a new window to a field that can contribute extensively to criminal investigation and identification.

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Purpose: The study aims to assess the quality of life (QOL) of oral cancer survivors, 1–5 years after the treatment. Materials and Methods: The data of fifty patients concerning their QOL were gained from the Outpatient Department of K.L.E's Dr. Prabhakar Kore Hospital and Medical Research Institute, Belagavi, and Karnataka Cancer Therapy and Research Institute, Navanagar, Hubli, Karnataka, India. All the patients suffered from oral cancer (stage T2–T4) and underwent surgery with reconstruction followed by chemotherapy or radiotherapy or both. The patients completed the standard European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) C-30 (version 3.0) and QLQ Head and Neck Cancer Specific (QLQ H and N-35) (version 1.0). Scoring was done according to the EORTC scoring manual. Results: The mean age at the time of diagnosis was 45.0 (±9.0). The study population had a mean global health status (GHS) for overall QOL of 55.5 ± 13.4.The mean functional scale (FS) was 87.5 (±9.6).The mean QLQ C-30 symptom scale (SS) was 16.3 (±11.9) and the mean QLQ H and N-35 SS (H and NSS) was 26.9 ± 11.5. Location, gender, age, and time after the treatment showed very less discrepancy in the group comparisons of GHS, FS, SS, and H and NSS whereas comparison based on T-stage showed significant difference in scores. Conclusion: Oral cancer has a significant impact on the QOL of the patients. Assessment of QOL should receive adequate attention in treatment planning and rehabilitation. This would definitely help in delivery of better symptom directed therapies and improve the QOL of the patients.

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Background and Aim: Biofilms in dental unit waterlines (DUWLs), suction hoses, and fittings are a potentially significant source of cross-contamination posing significant health risk as these may come into contact with patients during treatment. The purpose of this in vitro study was to identify the spectrum of bacterial flora colonizing the DUWLs and to detect pathogenic microorganisms present in such an environmental niche. Materials and Methods: Thirty DUWL samples were collected from in use dental units selected randomly from various clinical departments. Samples were collected from the following devices; 3-in-1 syringe waterline, section of waterline tubing supplying the 3-in-1 syringe, and the air rotor water. The samples were subjected to bacteriological analysis, and all bacterial isolates were tested for their ability to form biofilms. Results: A descriptive analysis of the results obtained was carried out, and it was observed that 7 out of 30 (23.3%) samples collected from DUWL were supplying water of unsatisfactory quality with species of low-pathogenicity bacteria isolated present in significant numbers; four of ten (40%) water supply lines contained bacterial biofilms; and the species with greatest capability to form biofilms were Enterobacter species (spp.). In addition, the results were also subjected to Chi-square test which revealed no statistical difference between the species and the location of collection of samples. Conclusion: Within the limitations of this study, it is concluded that DUWLs are not totally free of contamination. Microbial biofilms are a significant source of cross-contamination and cross-infection in the dental clinic environment.

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Background and Objectives: The pathogenesis of inflammatory periodontal diseases essentially involves degradation of extracellular matrix molecules, and collagen breakdown and matrix metalloproteinases (MMPs) are proteinases primarily involved in this process. It is known that doxycycline downregulates MMP activity. Curcumin has anti-inflammatory effect and also downregulates MMP activity. Thus, a study was conducted to evaluate the anti-inflammatory effect of curcumin by its inhibition of MMP-9 activity and compare the same with doxcycline, which has known anticollagenase activity. Subjects and Methods: Gingival tissue samples were obtained from thirty patients diagnosed with chronic periodontitis. The tissue extracts were treated with Curcumin and doxycycline and inhibition of MMP-9 analyzed by gelatinzymography. Gels obtained were stained with Coomassie Brilliant Blue, and enzymatic activities detected as bands of gelatinlysis against blue background. Relative MMP-9 levels were measured by scanning the clear zones and analyzing the percentage inhibition. Results: Results showed that MMP-9 activity was significantly decreased by both the drugs. Curcumin showed 61.01% reduction in the MMP-9 activity at 1500 μg/ml concentration and doxycycline showed 59.58% reduction in the MMP-9 activity at 300 μg/ml concentration. Conclusion: The current study showed that curcumin has inhibitory effect on polymorphonuclear leukocyte-type MMP-9 involved in matrix degradation in periodontitis. Since Curcumin has a potent anti-inflammatory effect, it may have therapeutic potential as a host modulation agent in periodontal diseases.

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Aims and Objectives: This study aimed to evaluate the effects of at-home and in-office bleaching on the shear bond strength (SBS) of metal, ceramic, and composite orthodontic brackets and to compare their SBSs. Subjects and Methods: A total of 96 human lower premolar teeth were used for this study. Six teeth were used for scanning electron microscopic study while the remaining ninety were divided into three equal groups. Each group was further subdivided into three subgroups with ten samples each. Three protocols were used. In the at-home bleaching group (n = 30), opalescence non-PF (potassium nitrate and fluoride) bleaching agent (10% carbamide peroxide) was applied onto the teeth daily for 14 days and left for 8 h each day. Teeth in the in-office group (n = 30) were treated twice in consecutive days with Opalescence boost PF (40% hydrogen peroxide). After bleaching, the specimens were stored in distilled water for 1 day before bonding. SBS testing was performed on all teeth using Instron universal testing machine. Results: Analysis of variance indicated a significant difference (P < 0.005) among the groups. Maximum SBS was shown by ceramic brackets in control group (Ib) and minimum was shown by composite brackets of in-office bleached group (IIIc). Conclusions: The results showed that at-home bleaching did not affect the SBS significantly whereas in-office bleaching reduced SBS of metal, ceramic, and composite brackets significantly. It is preferable to use metal or ceramic brackets than composite brackets for bonding 24 h after bleaching.

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Aims and Objectives: To evaluate the presence and thickness of submucosal fibrosis in oral submucous fibrosis (OSMF) patients ultrasonographically and to correlate these findings with the clinical stage and histological grade of OSMF. Materials and Methods: Forty participants (twenty cases and twenty controls) were included in the study. The patients diagnosed clinically as having OSMF and consented for biopsy were included in the cases, and completely healthy individuals with no habit history or oral lesions were included in the control group after matching the body mass index. After clinically staging, the patients' transcutaneous ultrasonography (USG) was performed and after that punch biopsy was taken and the specimen was graded histopathologically. Results: The data were statistically analyzed using Mann–Whitney test and Spearman's rank correlation. The cases showed increased submucosal thickness as compared to the controls. The USG measurements statistically correlated with the clinical stage and histopathological grade of OSMF. Conclusion: USG proves to be a valuable adjunctive modality in diagnosing, staging and also evaluating the prognosis of OSMF.

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Background: Root coverage (RC) procedures such as lateral positioned flap (LPF) have been used since long time but with limited success and specific indications. Aim: This prospective clinical study was designed to evaluate clinically the effect of modified LPF (mLPF) with platelet-rich fibrin (PRF) graft for the treatment of denuded root surfaces. Materials and Methods: Fifteen isolated Miller's Class I and II gingival recession of single-rooted teeth were selected for the study. Scaling and root planing was done, and oral hygiene instructions were given to the patients. Plaque index, gingival index, and recession parameters (probing depth, gingival recession height, clinical attachment level [CAL], and width of keratinized tissue [WKT]) were assessed at baseline. Following this, mLPF with PRF was done at the recession sites, and parameters were assessed at 3 and 6 months. Statistical Analysis: To analyze the posttreatment effect, paired t-test was performed at relevant degrees of freedom and 95% confidence level. Results: The mean percentage of RC attained was 72.2% at 3 months and 73.5% at 6 months. The WKT shows a mean gain of 2.93 mm at 3 months and 3 mm at 6 months. Conclusion: mLPF with PRF produced statistically significant reduction in recession depth and gain in both CAL and WKT by the end of 6 months.

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Aims: To investigate the perceptions of subjects regarding nonsurgical periodontal treatment over a period of 1 year. Settings and Design: This is a secondary analysis of a randomized clinical trial, in a longitudinal observational design. Methods: Nineteen subjects (47.24 ± 6.47 years) with moderate to severe periodontitis completed a questionnaire at two different times after a nonsurgical periodontal treatment: 30 (T1) and 390 days (T2). The questionnaire with 40 items was divided into three domains: 1-perception of changes in clinical signs of periodontal disease, 2-psychological aspects of the subject regarding their oral health status, and 3-satisfaction with the treatment. Statistical analysis: Each response on the Likert scale initially showed scores ranging from 1 to 5 points. The results for each question were dichotomized into 1 or 0, respectively, showing if the subject was favorable or unfavorable to treatment. A descriptive data analysis was performed, assessing the agreement of the results in T1 and T2 (Kappa). Results: The results generally showed a favorable perception related to the treatment and continued satisfaction over time. The exceptions were in regards to gingival recession, persistent bleeding and bad breath, and difficulty in performing the mechanical control imposed by the professional. Conclusion: It was concluded that the therapy used was satisfactory to the subjects and that a favorable perception was maintained after 1 year of follow-up.

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Aim of Study: The aim is to evaluate existence of sexual dimorphism by variation in right and left permanent maxillary molars using buccolingual width (BLW) and mesio-distal width (MDW) measured intraorally and on study casts among Sri Ganganagar population. Materials and Methods: Fifty patients (25 males and 25 females) with 17–25 years of age were selected. Impressions of maxillary arch were taken and the BLW and MDW were measured using digital Vernier calipers on study casts and intraorally. Results: Highly significant correlation was found between MDW and BLW of both the maxillary permanent first molars for both genders (P < 0.05) intraorally. The MDW and BLW on study cast of both sides in both gender were more on left side in males while on right side in females. Conclusion: Left maxillary permanent first molar showed minimum mean difference of measurements on study cast and introrally than right, thus better predictor for gender dimorphism in forensics.

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Introduction: Accredited social health activists (ASHAs) are the grassroot level health activists in the community who are involved in health education and community mobilization toward utilizing the health services. Materials and Methods: A descriptive cross-sectional study was carried out to assess the oral health knowledge among ASHAs working in Guntur district of Andhra Pradesh, India. Five Primary Health Centers were randomly selected, and the total sample was 275. Categorical data were analyzed using Chi-square test. P ≤ 0.05 was considered to be statistically significant. Results: The mean age was 32 ± 5.11 years and mean education was 9 ± 1.329 years of schooling. ASHAs were categorized into two groups based on their education levels, i.e., Group I whose education qualification is <10^th class and Group II whose education qualification is above 10^th class to observe any difference in knowledge based on their education. Overall knowledge among ASHAs was poor and also it was observed that both the groups were having poor knowledge regarding dental caries, calculus, dental plaque, oral cancer, and change of tooth brush. About 69.5% of the ASHAs were approached by public with dental problems, but only a few, i.e., 15.8% have referred the patients to the nearby dentist. Conclusion: As we know that most of the dental diseases are preventable, there is a dire need that ASHAs should be thoroughly educated in the aspects of oral health and diseases during their training period. This not only helps in creating awareness among them but also serves the ultimate purpose of improving the oral health of rural population.

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Background: Diabetes mellitus (DM) is associated with complications and orodental disease. Whether screening for DM during orodental health visits is a potential option is yet to be established in Nigeria. This study aims at assessing the prevalence of hyperglycemia in orodental disease as a clinical scenario to capitalize for opportunistic screening. Materials and Methods: This study was undertaken in Catholic Hospital Abbi for Ndokwa communities and dental clinic of Eku Baptist Government Hospital, all in Nigeria. However, 474 individuals (433 community-based and 41 dental clinic-based) including 10 orodental cases were screened for hyperglycemia and waist-hip circumference indices. Blood lipid profiles were also performed. Based on fasting blood glucose levels, participants were grouped into non-diabetic (n = 172), prediabetic (n = 168), and diabetic (n = 78). A World Health Organization questionnaire on oral health was used to collect information on orodental disease risk factors. Data were analyzed with IBM SPSS 22 statistical package. Results: In the community-based cohort, the prevalence of hyperglycemia was 56.8%, including 38.8% prediabetes and 18.0% undiagnosed DM (UDM). In the dental-based group, 63.4% were hyperglycemic including 53.7% prediabetes and 9.7% UDM. There was significant difference (P < 0.05) in the ages of the participants in relation to glycemic status, with 17–29 years having the highest prevalence of UDM. However, 42.5% of the community-based clients had indication(s) of orodental disease. Conclusion: This is probably the first study to highlight higher prevalence of hyperglycemia from screening at a dental setting compared to general clinic. Opportunistic screening of DM in dental settings may be an option to consider during clients' orodental health visits.

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Objective: Maxillofacial prosthesis are supported by implants, require a retentive matrix to retain the suprastructure. The retentive matrix is made up of acrylic resin to which the silicone prostheses are anchored by micro-mechanical bond. The delamination of silicone away from the retentive matrix is a persisting problem in implant-supported maxillofacial prosthesis. Aim: This study aimed to evaluate the effect of laser etching on the shear bond strength (BS) between acrylic resin and maxillofacial silicone, after 24 h of fabrication and after 200 h of accelerated aging. Materials and Methods: The samples were prepared according to ISO/TR 11405:1994 in maxillofacial silicone and polymethyl methacrylate resin. The untreated samples were Group A (control), Group B (silicon carbide [SiC] paper abrasion 80 grit size), and Group C (erbium-doped yttrium aluminum garnet laser etching). Then, the samples were coated with primer and bonded to maxillofacial silicone. The samples were subjected to shear BS test in an universal testing machine after 24 h of fabrication and after 200 h of accelerated aging. Results: The results were statistically analyzed using one-way ANOVA and Tukey's HSD post hoc test. The shear BS test after 24 h of fabrication showed better BS in SiC paper abrasion. The shear BS test after 200 h of accelerated aging showed better BS in laser etching compared to SiC abrasion. Conclusion: Laser etching produced better shear BS compared to conventional SiC paper abrasion after 200 h of accelerated aging process.

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