Background: Communication plays a vital role in breaking down barriers between the patient and dental health professional, thereby strengthening treatment alliance. The proliferation of modes, speed of communication and reflexivity of knowledge have implications for health promotion. Aim: To evaluate the effect of social media-based oral health promotion programme in improving oral health among 18-20-year-old college students in Chennai city. Material and Methods: The interventional study consisted of college students between 18-20 years in Chennai city. A total of 140 participants with an allocation ratio of 1:1 were randomly assigned to the intervention and control group. Oral health education was provided to all the students using various oral health education aids. Status of participants for WhatsApp addiction, oral health Knowledge, Attitude and Practice (KAP) and oral health status (Simplified Oral Hygiene Index [OHI-S] and Modified Gingival Index [MGI]) were assessed. The intervention was given to the interventional group through WhatsApp using pictures, videos and text messages at first, second and third months. Follow up examinations were carried out for both the groups at the first, third and sixth month. Independent sample t-test to compare the mean values and Chi-Square to compare proportions between groups were used. Results: Statistically significant difference was seen in OHI-S [Mean- 2.52 (T0) to 0.77 (T3) P 0.001] and MGI [Mean- 1.58 (T0) to 0.58 (T3) P 0.001] scores among the intervention group. The percentage change in the KAP score from baseline to sixth month was comparatively higher among the intervention group. Conclusions: The intervention given through the WhatsApp application significantly improved the oral health status and KAP among its users.

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Introduction: The complications of soft drink consumption during orthodontic treatment includes degradation of enamel, reduction in the shear bond strength of orthodontic brackets, and also corrosion of orthodontic wires. The main objective of this review is to discuss the adverse effects of carbonated soft drink (CSD) consumption on patients undergoing fixed orthodontic treatment. Methods: A search of studies in MEDLINE (via PubMed), the Cochrane library, Web of science, IndMED, EMBASE, Google scholar and limited grey literature on the effects of consumption of CSDs was conducted. All pertinent abstracts were reviewed for inclusion. Full articles were retrieved for abstracts or titles that met the initial inclusion criteria or lacked sufficient detail for immediate exclusion. Results: Out of the 4484 results obtained from search, 16 articles were selected based on title and 6 articles were eliminated after reading the abstracts. 10 articles were selected for systematic review which included 6 invitro studies, 1 animal study, 1 observational study and 2 invivo studies. Of these, six studies evaluated the effects of carbonated drinks on the shear bond strength of brackets on enamel of which two evaluated the microhardness of enamel, two studies evaluated the mechanical and chemical properties of wires, one evaluated tooth movement and one study focussed on white spot lesions. The results from the selected articles showed that with the consumption of carbonated drinks, there was reduced shear bond strength of orthodontic brackets, altered enamel characteristics, alteration of mechanical and physical properties of orthodontic wires and decrease in rate of orthodontic tooth movement. Conclusion: Based on the available evidence, CSD consumption during orthodontic treatment definitely has an effect on orthodontic appliances, enamel and possibly on tooth movement.

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Aim: The present study aimed to determine the risk factors related to permanent maxillary incisors and soft tissue injuries along with providing information about the age distribution of trauma, overjet, lip competence and physical activity. Methods and Materials: The sample consisted of 2100 school children aged 8–14 years from 15 schools in the Nellore district. The sample was selected adopting a stratified random sampling method and screened applying WHO criteria for the oral examination. The screening was done in classrooms to obtain demographic data, including name, age, gender and children's experience to the maxillary incisor and soft tissue injuries. The injuries were categorized according to Andreasen classification. Overjet and lip competences were recorded, and physical activity was assessed using a questionnaire (PAQ-C). Results: Of the 2100 children, 228 (10.8%) had suffered traumatic injuries. Boys were 1.6 fold more prone to trauma than girls. Enamel fractures were a common type of trauma, and the commonly involved were maxillary central incisors. The relative risk for trauma is 1.215 times higher in increased overjet when compared to normal overjet. Incompetent lips showed 1.189 times greater risk of trauma. The high physical activity showed 1.692 times higher risk for trauma when compared to low physical activity. Conclusion: The prevalence of traumatic dental injuries among 8-14 year children was 10.8%. Boys were more commonly injured than girls. Increased overjet incompetent lips and high physical activities are risk factors for trauma. Enamel fracture was the most common type, and maxillary central incisors were the most common teeth having traumatic injuries.

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Ankylosing spondylitis (AS) is a chronic, multi-systemic inflammatory disorder. It rarely involves peripheral joints such as Temporomandibular joint (TMJ). Here, we present a case of a 44-year-old male, known case of AS for eight years who had TMJ-related complaints for two years. On examination, bony ankylosis of TMJ possibly due to pre-existing AS was made. A bilateral standard gap arthroplasty procedure was done. The challenges faced during the surgical procedure are discussed.

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Introduction: An ideal irrigant should exhibit good antimicrobial activity along with smear removal. Various plant extracts have been used for disinfection of the root canal system. The present study aims in evaluating the tissue response and systemic toxicity of ethanolic extract of Morinda citrifolia versus Morinda citrifolia fresh fruit juice in an animal model. Materials and Methods: A total 48 female adult wistar albino rats were randomly allocated into 4 groups as Group I- 3% sodium hypochlorite (n = 12), Group II- Saline (Control) (n = 12), Group III- ethanolic extract of Morinda citrifolia (n = 12), Group IV- Morinda citrifolia Fresh Fruit Juice (n = 12). A trough was made in the periapical bone, and the test sample was placed in the respective groups. The animals were euthanized for 7^th day, 14^th day and 30^th day and the tissue specimen was prepared for histopathological evaluation, and serum analysis was done for oxidative stress markers, liver and renal function tests. Results: Serum analysis exhibited significant elevation of Alkaline Phosphatase (ALP), Glutathione Peroxidase (GPX) and Glutathione Reductase (GR) and histopathology showed a higher inflammatory response at 7^th and 14^th days in group II and group III (p < 0.05), as compared to the other groups. At the 30^th day time interval, there was no statistically significant difference in serum analysis and inflammatory response, in all the four groups analysed (p > 0.05). Conclusion: Ethanolic extract of Morinda citrifolia was not biocompatible and more cytotoxic than a Morinda citrifolia fresh fruit juice. So, fresh fruit juice of Morinda citrifolia can be a preferred choice of natural root canal irrigant, with least possible cytotoxic effects as compared to the ethanolic extract.

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Context: Oral administration of midazolam is one of the most important protocols for producing adequate conscious sedation; however, it has an unpleasant taste and is poorly tolerated by pediatric patients. Aim: The aim of this study was to evaluate the sedative effect of diluted midazolam in different vehicles used to mask its unpleasant taste. Methods and Material: A total of 30 male mice (BALB-c) were randomly distributed in five groups. They were administered diluted midazolam in different vehicles (saline solution, paracetamol syrup, diclofenac suspension, multi-vitamin syrup, and boxed juice). All suspensions were administered orally (0.6 mg/Kg). The pH variation was evaluated with a digital pH meter, and the quality of sedation was evaluated in three tests: hole board test, grip strength test, and forced swimming test. Results: The paracetamol syrup vehicle was found to be the only vehicle which did not change its pH over time after dilution of midazolam. When evaluating the perforated platform, the greatest sedative effect was observed in the midazolam group with the paracetamol syrup (P > 0.05). Regarding grip strength, a difference was evident in all study groups at 45 minutes (P = 0.006); the midazolam group with the multi-vitamin syrup was less effective. Regarding the response time to forced swimming, the midazolam group with the paracetamol syrup presented the longest time at 15 and 30 minutes (5.39 ± 0.93 and 6.29 ± 0.83, respectively). Conclusion: The suspension of midazolam diluted in the paracetamol syrup is the most suitable for performing conscious sedation efficiently.

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Aims: To show the association between dental neglect and alexithymia among adult dental patients. Settings and Design: At times, certain individuals with dental neglect may experience trouble in communicating and/or understanding information, ability to identify, and describe their feelings termed as alexithymia. Hence, recognition of alexithymia in a dental setting is important, because it worsens the dentist–patient relationship, especially among patients who neglect their dental health. Materials and Methods: A cross-sectional survey was conducted among adult patients (≥20 years). Patients received a questionnaire assessing dental neglect [six-item Dental Neglect Scale (DNS)], alexithymia [20-item Toronto Alexithymia Scale (TAS-20)], and demographic profile. Statistical Analysis: Data were analyzed with standard statistical software (Statistical Package for the Social Sciences, version 22). P <0.05 was considered statistically significant. Results: A total sample of 1067 individuals comprising 553 (51.8%) females and 514 (48.2%) males with a mean age 35.33 ± 11.49 years participated in the study. Our findings showed that females had higher mean scores for both DNS and total TAS-20 and its factors. With increase in age and education, the mean scores of the DNS had significantly increased and mean scores of total TAS-20 and its factors had decreased with increase in age and education. Conclusion: The above study findings have supported the hypothesis that there is no association between dental neglect and alexithymia among adult dental patients.

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Background: Chemiluminescence is the production of light as a result of a chemical reaction. Oral potentially malignant disorders (OPMDs) include both precancerous lesions and conditions that carry an increased risk of cancer. There are different etiological and risk factors for OPMDs such as smoking, alcohol consumption, infections such as viral and fungal, sun exposure and certain other genetic factors. The most common etiological factor for OPMDs is tobacco usage. Chemiluminescence is a light-based detection system and is very useful for detecting OPMDs for early intervention. Because it is a non-invasive procedure, it can be used to evaluate dysplastic changes in various OPMDs at their initial stage for timely intervention. Vital staining has also been used as a chair-side marker for delineating normal and dysplastic oral mucosal tissues. Aim: To compare the efficacy of chemiluminescence with Lugol's iodine to that with toluidine blue in diagnosing dysplastic changes in tobacco associated oral lesions. Methodology: A total of 84 patients with clinically suspicious oral mucosal lesions and OPMDs with tobacco habit history were included and randomly assigned to either of the diagnostic study groups (Group A: chemiluminescence with Lugol's iodine or Group B: chemiluminescence with toluidine blue). All these patients were subjected to a histopathological examination (reference standard). Results: The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristics (ROC) were 91.7%, 66.7%, 84.6%, 80%, and 0.792 for chemiluminescence with Lugol's iodine group (P = 0.001) respectively whereas for chemiluminescence with toluidine blue, the sensitivity, specificity, PPV, NPV and ROC were 100%, 60%, 93.3%, 100% and 0.800 (P = 0.002), respectively. Conclusion: The combination of chemiluminescence with toluidine blue had a better diagnostic efficiency in detecting dysplasia in tobacco-associated oral lesions when compared to the group of chemiluminescence with Lugol's iodine.

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Background: Guided Endodontics is suggested as a reliable method for management of teeth with pulp canal obliteration (PCO). The guide used for this usually involves multiple teeth to gain stability but is bulky. It is therefore suboptimal to be used along with rubber dam. Aim: To describe the use of a minimized single-tooth guide template in three patients with radiographic evidence of PCO. Design: The template was designed and fabricated using the cone-beam computed tomography (CBCT) scan and a surface scan image of the involved teeth. In all three patients, the root canals were successfully negotiated within 15 minutes, with the template involving only the tooth in focus or with neighboring half of the teeth. The operator stabilized the template if required. Conclusions: This case series shows clinically that successful outcome can be obtained during guided endodontics with the use of a single-tooth template in previously traumatized anterior teeth with PCO.

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Introduction: Retrieval of separated instrument from a root canal may lead to increased dentin loss and prolonged treatment time. Aim: The aim of this study was to evaluate the retrieval time and increase in root canal volume after instrument retrieval with two retrieval techniques under dental operating microscope. Materials and Methods: Forty extracted human mandibular molars with 30°–40° mesiobuccal root canal curvature were selected based on cone-beam computed tomography (CBCT) and divided into two groups (n = 20 each). Group 1: Terauchi group (Terauchi ultrasonic tips) and Group 2: Satelec group (Satelec ET25 ultrasonic tip) based on the retrieval technique. Groups 1 and 2 were further divided into two subgroups (n = 10 each) based on the size of the separated instrument; Groups 1a and 2a with ProTaper Gold (PTG) F1 and Groups 1b and 2b with PTG F2. The time taken for retrieval was calculated and increase in root canal volume was evaluated using CBCT. Results were statistically analysed with paired t-test and post hoc analysis by Tukey's HSD test. Results: All separated instruments were successfully retrieved. The mean time for instrument retrieval was lower in Terauchi group than in the Satelec group (P > 0.05) but not significantly. The mean increase in total root canal volume post-retrieval as well as the mean volume corresponding to the coronal part of the separated instrument was significantly lower in Terauchi group than in Satelec group (P < 0.05). Conclusion: Terauchi ultrasonic instruments resulted in reduced instrument retrieval time with lower loss of root dentin.

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In the present era, the use of drugs is an important paradigm of health care. Reactions to drugs range from minor cutaneous reactions to potentially lethal conditions like Stevens–Johnson syndrome. A 13-year-old, male patient, known case of Stevens–Johnson Syndrome was referred from the pediatric ward for the management of oral mucosal lesions, post consumption of the antibiotic combination of sulfamethoxazole and trimethoprim. Failure of lesion regression led to the change in the treatment plan, speculating an allergic reaction to one of the components of the initial treatment medication (choline salicylate) as well. Identification and withdrawal of the offending medication and rendering supportive care along with treatment of the lesions with topical corticosteroids form the outline of management. This case report demonstrates the approach undertaken by the pediatric dentist to cure the oral mucosal lesions in symbiosis with pediatricians, ophthalmologists and nutritionists to cure this life-threatening condition.

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Aim: This study is proposed to assess the knowledge and practices among dental practitioners in the implementation of biomedical waste (BMW) management rules (2016) in Kumbakonam, Tamil Nadu; to assess the effective usage of the four colour-coded bins, those are used to handle the BMW; and to assess the service of the BMW collecting and disposing agents. Methodology: A questionnaire comprising of 12 closed-ended and 1 open-ended question regarding the dental practitioner's management of BMW in their daily clinical practice was developed. After validation, the questionnaire was sent as Google forms to 54 dental practitioners who are practicing at Kumbakonam, and responses were received from all. The collected data was entered in an Excel sheet, and then percentages were obtained for each response from the participants. Result: The most common challenges were, space-occupying BMW disposal bins as well as the lack of regular collection of BMW, this may be because the disposal agent's services cover a larger geographical area with lesser wastage collecting manpower. Though most of the study participants were well aware and practiced the management, still a small percentage of practitioners were lacking in this. The responses on storage and handling the BMW management reflect the knowledge gap in more than half of them. Conclusion: These challenges indicate the need for a well-established network of BMW collecting agencies and cost-effective, tailor-made colour-coded bins for suitable and continuous usage in dentistry.

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Introduction: The number of adult patients seeking orthodontics treatment has increased drastically. There is increased need for faster tooth movement and good esthetics. Piezocision is one of the methods used for accelerating the rate of tooth movement. Aims and Objectives: To assess the amount of root resorption after retraction of canine through piezocision site and compare it with that of recently extracted site using cone-beam computed tomography (CBCT) and assessment of dentin sialoprotein (DSP) levels in gingival crevicular fluid (GCF). Materials and Methods: A split mouth design was used in 15 patients who were undergoing first orthodontic treatment with premolar extractions. Randomly one of the sides was chosen as control (Group I) and the other side underwent piezocision procedure (Group II). 0.022 × 0.028'' MBT system was used with 0.017 × 0.025 SS wire for canine retraction using 150 grams of force. GCF samples were collected from mesio-buccal and disto-buccal of the canine with micropipette at baseline (T_O) and day 90(T₁) to detect the levels of DSP and the root resorption was measured using CBCT. Results: Statistically significant amount of root resorption was observed after retraction in both the groups. DSP levels were increased in both the groups, though little higher in Group II when compared to group I. Conclusion: DSP level was increased on the piezocision side but it was statistically insignificant which suggests the amount of root resorption on both the sides is similar.

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Background: Periodontitis is a multifactorial disease, and the causative periodontal pathogens have been detected in patient samples like plaque, gingival crevicular fluid (GCF), saliva, crevicular blood, gingival tissues, etc. Laser disinfection is an advanced treatment that has been shown to alter the bacterial flora and have greater efficacy in reducing the progression of the disease. Aim: This study is aimed to evaluate the immediate effects of a diode laser (970 ± 15 nm) on the microbial load in GCF, crevicular blood, and saliva samples of patients suffering from chronic periodontitis. Materials and Methods: A total of 45 subjects were recruited for the study. Each patient's mouth was divided equally into two halves, which were allotted randomly into two groups. In group I (test group), diode laser disinfection was performed, and in group II (control group), saline irrigation was performed. The GCF, saliva, and crevicular blood samples were collected before and immediately after disinfection for microbial analysis. Results: Clinical observations showed a reduction in microbial load in both groups, which were statistically significant in the test group. GCF and saliva samples showed greater reduction when compared with crevicular blood samples in both groups. Conclusion: This study concludes that the application of diode laser (970 ± 15 nm) has immediate reducing effects on the microbial load in GCF, crevicular blood, and saliva samples in patients with chronic periodontitis.

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Objective: To compare cephalometric parameters in parents of children with bilateral cleft lip and palate (BCLP) and parents of children without any craniofacial anomaly. Methods: A sample of 100 sets of parents were segregated into two groups of 50 parents each. The two groups included parents of children with BCLP and the parents of children with no craniofacial anomaly. Lateral cephalograms and postero-anterior (PA) cephalograms were examined for 100 parents of both the BCLP and control group, respectively. Tracings were scrutinized for 34 linear and angular parameters of dentocraniofacial skeleton. Data were analysed using unpaired Student's t-test. Result: Evaluated lateral cephalograms revealed 15 significant parameters in parents of children with BCLP including a significant increase in Ptm-S, maxillary length, SNA, articular angle and gonial angle. A significant decrease was noted in SN length, cranial base flexion, mandibular length, mandibular body length, total facial height, upper facial height, posterior facial height, Y-axis length and soft tissue total anterior facial height. Upon evaluation of PA cephalograms, four significant parameters were found in parents of children with BCLP. Cranial width, bizygomatic width, maxillary width and lateral interorbital width were significantly decreased in the parents of children with BCLP. Conclusion: Distinct dentocraniofacial morphological features have been found in parents of children with BCLP. Evaluation of these features might be the key to predicting the occurrence of clefts in their children and also planning for future linkage analysis studies amongst them.

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Background: For porcelain fused to metal restorations, computer-aided designing (CAD) / computer-aided manufacturing (CAM) systems claim to provide improved marginal fit than conventional casting systems. Aim: The present in-vitro study was conducted to compare the marginal fit of cobalt-chromium alloy copings fabricated with milled wax/lost wax, CAD/CAM milling/sintering and direct metal laser sintering (DMLS) techniques. Materials and Method: A metal die simulating a prepared tooth was fabricated and scanned using an optical scanner. A standardized coping design was used to manufacture 30 alloy copings divided into three groups of ten copings each i.e., milled wax/lost wax, milling/sintering and DMLS. A modified replica technique was used to measure the silicone film thickness at four pre-designated points on the margin under a digital stereo-microscope. Statistical Analysis: The mean values for marginal gap were compared using one-way Analysis of Variance (ANOVA) followed by Tukey-Kramer test for all pair-wise comparisons. Results: The mean marginal gap values obtained by using milled wax/lost wax technique, milling/sintering technique and DMLS technique were 88.44 μm, 61.135 μm and 55.39 μm, respectively. One-way ANOVA showed a significant difference for marginal fit between the lost wax group and the other two test groups (P < 0.05). Conclusion: The cobalt-chromium alloy copings fabricated using DMLS techniques displayed significantly better marginal fit than the milled wax/lost wax technique which may contribute to their improved clinical performance. DMLS technique produces restorations with an improved marginal fit and may be preferred by clinicians over milling and conventional casting techniques.

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Introduction: Marine algae possess a plethora of secondary active metabolites which has many biomedical applications. Anti-bacterial activity against oral cariogenic bacteria is reported in literature, however there is no comprehensive review available. Hence, this review is attempted to collate all the evidence available regarding the marine algal extracts and its constituents against oral cariogenic bacteria. Methods: Electronic search was conducted in the Google scholar, the Pubmed database and various clinical trial registries. Included studies were clinical, in-vitro studies assessing DMFT, DMFS, minimum inhibitory concentration or colony forming unit counts. Result: A total of 19 trials were obtained out of which only 7 were eligible for this review. Quality assessment was done by Higgins and Greens (2011) method. Results showed all the studies where they used crude algal extracts or its active constituents were showing anti-bacterial activity. Conclusion: Thus, this review showed that marine algal extracts and other constituents are having anti-microbial properties, making them potential anti-microbial agents for oral hygiene maintenance without adverse effects of currently available chemical based oral care products.

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Context: Newer glass ionomer cements with improved properties are constantly being developed. One such material is the novel Hybrid Glass-Ionomer cement (HGIC) with properties yet to be studied. Aims: The aim of this study was to compare the flexural strength, shear bond strength, wear resistance and fluoride release of Hybrid Glass Ionomer restorative with Conventional Glass Ionomer Cement (CGIC) and Resin modified Glass Ionomer Cement (RMGIC). Settings and Design: This was an in vitro study. Methods and Material: A total of 300 samples were tested in this study, with 100 samples per group and each group was further subdivided into 5 sub-groups with 20 samples each. Flexural and Shear bond strength values were determined by subjecting the specimens to a universal testing machine. For wear resistance, the specimens were assessed using a pin on the disc tribometer. For fluoride release, the test specimen suspended in 10 mL deionised water was tested at 24 h and 1 week. Statistical Analysis Used: One-way ANOVA. Results: RMGIC had the highest flexural and shear bond strength values followed by HGIC and CGIC. HGIC had the least wear rate followed by RMGIC and CGIC. At 24 h and 1 week, HGIC had the highest fluoride release among the study groups. Conclusions: HGIC exhibited the highest wear resistance and fluoride release among the cements studied. However, flexural and Shear bond strength values, of RMGIC, was comparatively higher.

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Aim: OrthoMTA and RetroMTA are newly developed mineral trioxide aggregates that were developed to achieve maximum benefits and clinical performance. This systematic review aimed at assessing and describing the constituents, properties and uses of OrthoMTA and RetroMTA. Methodology: Literature search was performed using the keywords, “OrthoMTA”, “RetroMTA”, “BioMTA”, “constituents” and “properties” in the databases, PubMed, Cochrane, Semantic scholar and Europe PubMed Central. Original articles in English describing the properties, constituents, uses/indications, history and recent advances on OrthoMTA and RetroMTA were considered for the study. Results: A total of 35 articles were selected for the systematic review based on keywords selected. Among the 35 articles, 5 articles described the composition and properties of OrthoMTA and RetroMTA, 7 articles depicted the usage of OrthoMTA and RetroMTA and the remaining articles discussed on the various properties of both OrthoMTA and RetroMTA. Conclusion: The present review confirmed that RetroMTA exhibits an excellent property, namely, short setting time, less tooth discoloration, high compressive strength, higher shear bond strength with time, higher push-out bond strength, low solubility, low cytotoxicity, biocompatibility, antibacterial property, and can be used in reparative processes in case of blood contamination. However, even OrthoMTA showed less microleakage, is biocompatible and possesses antibacterial properties.

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Introduction: Colour changes of the luting material can become clinically visible affecting the aesthetic appearance of thin ceramic veneers. Therefore, unfortunately, the long-term success of veneers is tied to the colour stability of the luting agent used to cement them. Aim: To compare the colour stability of different resin cements and its influence on the final shade of overlying ceramic using two different thicknesses of ceramic. Material and Methodology: Sixty disc-shaped specimens of high translucency (HT) A2 shade of two thicknesses (0.5 mm & 1 mm) were prepared from lithium disilicate glass-ceramic. The discs of each thickness were further divided into three groups randomly depending upon the resin cements used. Group A – light cure resin cement – Variolink N LC by Ivoclar Vivadent in clear shade, Group B – base paste of dual-cure resin cement – Variolink N by Ivoclar Vivadent in transparent shade and Group C dual-cure resin cement – Clearfil esthetic cement EX by Kuraray in clear shade were used to compare their colour stability. A spectrophotometer was used for the colour measurements of the specimens before and after accelerated ageing. The colour stability was determined by colour differences (ΔE) using the coordinates L*, a* and b* in the pre and post accelerated ageing. Results: On comparing the three resin cements, Group A showed the lowest ΔE, whereas the highest ΔE was observed in Group B. This finding was constant for discs of both thicknesses. Conclusion: Even though statistically significant results were observed between the groups, they were not visibly differentiable.

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Aim: To evaluate the effects of exposure parameters (tube current and voltage) to detect clear and unclear mandibular canals (MCs) using a complementary metal-oxide semiconductor (CMOS) or photo-stimulable phosphor plate (PSP) sensors. Methods: A total of 24 dry half-mandibles were divided into two groups with clear (n = 16) and unclear (n = 8) MCs. The retro-alveolar parallel technique was performed in the six-molar region of the mandibles using direct and indirect digital intra-oral sensors. Six combinations of tube voltage (kV) (60 kV, 66 kV, and 70 kV) and tube current (mA) (2 mA, 5 mA, and 8 mA) were applied, and 144 images of each group were obtained with each CMOS and PSP sensor. Images were processed using Image J software. To evaluate diagnostic accuracy, two square images of the first-molar region were obtained from each image, one with the MC inside and the other without the MC (a total of 576 images were observed). Three radiologists diagnosed the presence or absence of MCs. The diagnostic accuracy of each exposure parameter was compared with the area under the curve (Az) in receiver-operating characteristic analysis. Results: The Az values for clear MCs were higher than those for unclear MCs (P < 0.001). There were no significant differences when the tube current was modified. For unclear MCs, the Az increased when higher tube voltages were used, showing a significant difference using the PSP sensor (p = 0.004). There was no significant difference for clear MCs. Conclusions: Lower exposure parameters should be used for clear MCs, while higher tube voltage values should be used for unclear MCs.

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