In the recent times, chair-side/bed-side monitoring tests have gained importance over the routine laboratory tests as they are easier and faster to perform without requiring skilled personnel. Biosensors refer to such type of point-of-care devices that are developed to help in the early diagnosis, periodic monitoring, and treatment of disease. These devices utilize biological reactions for detecting and measuring a particular substance (analyte) of interest. Till date, blood has been the gold standard diagnostic fluid for various diseases. However, oral fluids such as saliva and gingival crevicular fluid offer advantages such as noninvasive collection of sample, smaller sample aliquots, easy storage and transportation, repeated sampling for monitoring over time, and greater sensitivity, making them an alternative clinical tool over serum and tissues for many biomedical diagnostic assays. This review highlights the use of oral fluid-based biosensors for diagnosis of caries, periodontitis, oral cancer, and various systemic diseases.

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Background: An adequate width of the attached gingiva helps in maintaining esthetics and proper plaque control. A thin gingiva may lead to recession after trauma or surgical and inflammatory injuries, thus sufficient thickness of the attached gingiva is desirable. Studies have shown considerable intra- and inter-examiner variation in both width and thickness of attached gingiva, which might be due to the presence of different gingival biotypes present in the adult population. By ascertaining gingival thickness, we can diagnose periodontal diseases and plan a proper treatment which is important for a good prognosis. Aims: The aim of the study is to evaluate the variations in the thickness of gingiva with respect to age, gender, and location in the dental arch. Materials and Methods: A total of 90 (45 males and 45 females) periodontally healthy subjects were divided into three different age groups. These individuals were examined for their gingival thickness in the maxillary and mandibular arches. Results: It was observed that the thickness of gingiva significantly decreased with age in both the arches and was significantly higher in females than males. The maxillary arch had thicker gingiva as compared to mandibular arch. Conclusion: In the present study, we concluded that the thickness of the gingiva varies with age, gender, and arch location.

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Background: Dental caries is one of the most common oral problems affecting children globally involving the people of all region and society. It can be seen in all age groups of children involving both deciduous and permanent teeth. Dental caries is a lifetime disease, and the highest priority risk group is between 6 and 12 years of age. Aims: The aim of the study was to evaluate the prevalence of dental caries in both primary and permanent dentition among the school-going children in Mahbubnagar district. Materials and Methods: A cross-sectional study was carried out in 2000 children in different areas of Mahbubnagar district in age group 6–12 years. The dental caries status was assessed by decayed, missing, and filled teeth (DMFT)/dmft index using the World Health Organization criteria 1997. Statistical Analysis: Collected data from each patient is subjected to statistical analysis to know the prevalence of dental caries. Results: Dental caries in both primary dentition and permanent dentition was 64.2% and 26.6%, respectively. The prevalence of dental caries in primary dentition was more in 7–8-year-old children and less in 11–12-year-old children (P > 0.05). Overall, mean dmft score of both males and females is 1.49 ± 1.56, the overall mean DMFT score of both males and females is 0.57 ± 1.23. Conclusion: The present study showed that the frequency of caries was found to be a higher in the Northern region of Mahbubnagar district. The dental caries was more in 7–8 years and less in 11–12 years children, whereas less in local villages of Mahbubnagar.

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The paradigm shift in our understanding of the dynamic, multifactorial nature of dental caries and the resultant change in caries preventive and treatment strategies necessitates that caries risk assessment (CRA) should be an integral part of any caries management protocol. This review discusses the rationale for CRA and the role various risk indicators play in the fluctuating demineralization-remineralization cycle of dental caries. It also provides an overview of different CRA methods and a risk-based clinical protocol for dental caries management in infants and children.

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The healing of hard and soft tissue in mediated by a wide range of intracellular and extracellular events that are regulated by signaling proteins. Platelets can play a crucial role in periodontal regeneration as they are the reservoirs of growth factors and cytokines which are the key factors for regeneration of bone and maturation of soft tissue. Platelet-rich plasma (PRP) is first generation platelet concentrate. However, the short duration of cytokine release and its poor mechanical properties have resulted in search of new material. Platelet-rich fibrin (PRF) is a natural fibrin-based biomaterial prepared from an anticoagulant-free blood harvest without any artificial biochemical modification (no bovine thrombin is required) that allows obtaining fibrin membranes enriched with platelets and growth factors. The slow polymerization during centrifugation, fibrin-based structure, ease of preparation, minimal expense makes PRF somewhat superior in some aspect to PRP.

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Vascular lesions are among the most common congenital and neonatal abnormalities. These anomalies can occur throughout the whole body, with 60%, however, being located in the head and neck region probably due to its intricate vascular anatomy of region. There is a significant confusion in the literature because of the use of confusing descriptive terminology for the same vascular entity and eponyms. Correct naming of lesion, appropriate classification, and clinical appearance of vascular lesions have a direct impact on understanding of etiologies of these complex lesions, diagnosis, and in treating patients. Thus, the aim of this article is to provide comprehensive knowledge about classifications and to have an insight of various important vascular lesions affecting head and neck region based on its pathogenesis, clinical presentation, and management.

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Cleft lip and palate is a common congenital malformation. Individuals born with this type of deformity, face number of challenges such as facial esthetics, hearing impairment, anatomical deformities to name a few. These patients require various treatments involving a multidisciplinary team such as prosthodontists, orthodontists, cosmetic dentists and surgeons. This report describes a case of orthodontic and prosthetic rehabitilation of an adult patient with unilateral cleft lip and palate.

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Aggressive periodontitis, is characterized by severe loss of attachment and destruction of alveolar bone around one or more permanent teeth during the period of pubescence. It is currently believed that a combination of bacteriologic and immunologic factors are of major importance in the etiology of this disease. The objective of this study was to point out the importance of early patient presentation, correct diagnosis, and proper prosthodontic management of the disease condition by the dentist. Our case was an 18-year-old male and his clinical and radiographic findings were typical for generalized juvenile periodontitis. Treatment consisted of thorough training in techniques of plaque control, scaling and root planing and administration of tetracycline 250 mg every six hours for three weeks. Preservation of facial countours and replacement of missing teeth with overdenture and fenestrated denture. There was significant improvement of these clinical parameters six months after treatment, and replacement of the missing teeth improved their appearance as expected. The psychotherapy offered gave the patients positive psychological effects that further restored their ability to socialize in their environment, which added to their positive experience of life. Longer follow-ups will add more knowledge about the treatment modalities for rehabilitation of aggressive periodontitis patients.

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Maxillary Antrolith is a rarely found calcified mass that occurs in the maxillary sinus formed by exogenous or endogenous origin. Stones arising in the antral cavities are uncommon, and their development is similar to that of a sialolith. We report a case of 55 yr. old male who came with h/o heaviness on right cheek region, nasal discharge and headache since 1 month. On evaluating the PNS radiograph shows the radiopacity in the right maxillary sinus. Caldwell-luc operation was done and the calcified masses (antroliths) along with antral polyps were removed. We report this case because of its rarity. The etiology, clinical and radiographic aspects and differential diagnosis of antrolith are also discussed.

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Background: The present study is conducted to evaluate and compare the clinical performance of conventional band and loop space maintainer and fiber reinforced composite resin (FRCR) space maintainers. Materials and Methods: A total of 45 extraction sites in the age group of 6–9 years having premature loss of primary molars or indicated for extraction were selected for the study. The patients were randomly divided into three groups as Group I, in which conventional band and loop space maintainer was given, Group II and Group III (FRCR), in which FRCR (everStick CandB) and impregnated glass fibers (Interlig) space maintainers were given, respectively. Patients were recalled at 3, 6, and 12-month interval for evaluation of all the three types of space maintainer. Results: Overall success rate of Group I was 86.7%, for Group II was 80%, and for Group III was 73.3% at the end of the study. Patient acceptability was significantly higher in Group II and Group III (FRCR) as compared to Group I (Conventional band and loop). In Group I, cement loss and fracture of loop, whereas in Group II and Group III, debonding at enamel composite was the most common failure followed by debonding at fiber composite and fiber fracture. FRCR space maintainers were found to be cost-effective as compared to Group I. More linear changes and angular changes were recorded in Group I as compared to Group II and Group III but difference was not significant (P > 0.05). Conclusion: Only single (buccal) surface application of FRCR space maintainers showed almost equal clinical efficacy compared to conventional band and loop space maintainer with significantly better patient acceptability, less cost, and time taken.

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Background: Impressions are an integral part of prosthodontics. Elastomeric impression materials are the impressions materials of choice in fixed prosthodontics for its better surface detail reproduction. Out of the elastomers available, vinyl polysiloxane represents the state of art impression material in prosthodontics, but even these materials cannot give an accurate reproduction of the tissues if there is separation of impression materials from the tray which may results in a distorted impression leading to poor final restorations made from such impressions. Hence, tray adhesives need to be applied to the tray to obtain an accurate and consistent impression. The purpose of the study was to evaluate the compatibility of three different impression materials to three different tray acrylic materials using tray adhesive, by determining the tensile bond strength. Materials and Methods: Two acrylic discs were utilized to make one impression sample of 3 mm thickness. The dimension of each acrylic disc was 2 mm in thickness and 2 cm in diameter. Specimens were made using a standard stainless steel die of the above-mentioned dimensions. A total of 135 specimens were prepared which included 15 samples in each category of nine groups. The samples were subjected to tensile bond strength testing using the universal testing machine and the values were recorded. All the values were subjected for statistical analysis. Results: Impregum (3M) specimens had demonstrated the highest tensile bond strength value (51.60N). Statistical analysis was done using Tukey's post hoc test and one-way ANOVA. Highly Statistical significant results were evident in Impregum (3M) and Indentium, as the P = 0.00. Conclusion: In this study Impregum (3M), specimens had highest tensile bond strength values compared to the other Groups followed by Indentium.

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Aim: The aim of the study was to assess the anterior and overall tooth size discrepancies in different malocclusions and evaluate its effect on gender in a sample of South Telangana (Khammam) population and to compare it with Bolton standards. Materials and Methods: The study sample consisted of 311 pretreatment study casts, which were selected from records of orthodontic patients, who were residents of Khammam, South Telangana. The sample was divided into three groups based on Angle Class I, II, and III malocclusions and further subdivided into male and female groups. The mesiodistal diameters of the teeth were measured using digital calipers, and the Bolton's analysis was carried out. Statistical Analysis Used: Intraclass correlation coefficient was assessed using Dahlberg's formula. ANOVA and post hoc least significant difference test were used. Results: The mean anterior and overall ratios were 79.17 ± 2.91 and 92.3 ± 1.88, respectively. A total of 64% and 45% of the study population had tooth size discrepancies in the anterior and overall ratios when assessed for >±1 standard deviation (SD). When the sample was assessed for discrepancies >±2 SD, it was observed that a total of 33.8% and 5.5% patients had anterior and overall tooth size discrepancies. Conclusions: With significant differences being observed between Bolton's and the present study values, the need for population standards gains importance for better results at the end of orthodontic treatment.

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Aim and Objectives: The aim of this study was to assess the knowledge and attitude of medical doctors towards the emergency management of dental trauma in the state of Himachal Pradesh. Materials and Methods: A cross-sectional survey in which, 500 medical doctors were randomly included in the study and the participation was voluntary. Data regarding the emergency management of avulsed tooth was collected using a self-administered questionnaire having questions which were close ended. Statistical analysis was carried out. Chi-square test was used to analyze the data gathered. Results: It was found that frequency of occurrence of soft tissue injuries of the face was 83%, laceration injuries was 79%, nasal bone fracture was 66%, intraoral soft tissue injuries of the lip was 67%, avulsion was 77%, and frequency of dental trauma of maxillary central incisor was 63%. Furthermore, the frequency of respondents having the knowledge about reimplantation was 46% and frequency of respondents having knowledge about the time of reimplantation was 60%. Frequency of respondents having knowledge about the preservation of tooth for reimplantation was 51%, whereas frequency of respondents having no knowledge about the preference of preservative medium was 47%. Frequency of respondents who have not seen traumatic injuries of primary teeth was 55% and the most frequently administered first aid was tetanus injection having 67%. Conclusion: The results from this study suggest that knowledge of the management of dental injuries among medical professionals/doctors was inadequate. However, appropriate training can significantly increase their knowledge.

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Introduction: Amalgam, the most commonly used restorative material, is composed of nearly 50% mercury and 69% silver. It cannot be disposed along with biomedical waste (BMW) because mercury-contaminated waste cannot be incinerated or autoclaved. Objectives: To assess the knowledge and observance of proper mercury hygiene and amalgam waste management among general dental practitioners (GDPs). Materials and Methods: A confidential questionnaire containing 14 questions regarding handling and disposal of amalgam was randomly distributed to 175 GDPs in Chandigarh, Panchkula, and Mohali. A response rate of 78% was obtained, and results were statistically analyzed. Results: Out of total dentists surveyed, 71% were found to be using amalgam as restorative material, 63% were doing <5 amalgam restorations per week. Only 6.5% of dentists placed rubber dam during removal and replacement of amalgam restorations. Fifty-five percent of dentists used high-volume evacuation. Filter was used only by 6% dentists. For 98%, dentists' evacuation drained into regular drain. Eighty-six percent of dentists never used amalgamator. Only 31% of dentists stored leftover amalgam scrap in radiographic fixer. Fifty-one percent of dentists disposed the bottle of leftover amalgam scrap along with BMW. One hundred percent of dentists disposed amalgam-contaminated gloves and cotton along with BMW. Only 17% of GDPs periodically monitored mercury vapors in their dental operatories. Conclusion: There exists a significant lack of knowledge regarding mercury hygiene and amalgam waste disposal among GDPs. Guidelines on mercury management need to be strongly implemented to prevent contamination of environment by mercury.

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Background: Oral submucous fibrosis (OSF) is a chronic debilitating disease and a potentially malignant disorder of the oral cavity. The pathogenesis of the disease is not well established. Trace elements such as copper and iron play an important role in the pathogenesis of OSF. Estimation of these elements in serum of the patients may be helpful in understanding the pathologic mechanism. Therefore, a study was carried out to analyze the level of serum copper and iron in the population of Central India. Materials and Methods: A case–control study was carried out on 35 patients with clinically diagnosed of OSF and 35 healthy controls. OSF patients were categorized by clinical staging. Serum copper and iron concentrations were measured by atomic absorption spectrophotometry. Results: Results of the study shows that the mean serum copper concentration was greater in study group (133.3 ± 19.2) compared to control group (113.9 ± 22.1) and the mean serum iron was lower in study group (116.0 ± 24.1) compared to control group (128.2 ± 23.4). The result obtained was statistically significant. The serum copper level increases as the clinical staging of OSF progresses, whereas serum iron level decreases as clinical staging progresses. Conclusion: There was an increase in copper level and decrease in iron level in study group compared to control group; this suggests that there is an increase in copper level with the advancement of clinical staging of OSF.

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Statement of the Problem: Sorption and solubility by soft liners is accompanied by volumetric changes, microbial infestation, distortion, hardening, color change, and reduced bond strength between the liner and denture base. Water sorption and solubility of soft liners are, therefore, of obvious importance because of their influence on the long-term stability of a soft liner. Aim: The purpose of this study was to evaluate and compare the water sorption and solubility of two chemically distinct soft liners (acrylic-based soft liner, Viscogel and silicone-based soft liner, Mollosil) at different storage intervals over 3-month period. Methods: Sixty disc-shaped specimens (30 mm × 1 mm) of each liner were fabricated, weighed, and divided into six groups of ten specimens each. The specimens were immersed in distilled water and in artificial saliva, and their weight data following immersion and subsequent drying were collected at 1 week, 1 month, and 3 months. The percentage sorption and solubility were calculated, and the data were submitted to one-way analysis of variance (ANOVA). The means were compared using Tukey's honest significant difference post hoc comparison. Results: One-way ANOVA revealed significant difference in the sorption and solubility between the two materials. Acrylic-based soft liner, Viscogel, demonstrated higher percentage absorption and solubility than its silicone-based counterpart, Mollosil, at all-time intervals in both distilled water and artificial saliva. Conclusion: On the basis of lower water sorption and solubility, silicone-based soft liner, Mollosil, may provide for better clinical success than acrylic-based soft liner, Viscogel.

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Background: The purpose of the study was to compare clinical efficacy of nonsurgical periodontal therapy with hand scaler, conventional ultrasonic scaler, and Vector^™ ultrasonic system in patients with generalized chronic periodontitis. Materials and Methods: Sixty patients with generalized chronic periodontitis fitting the inclusion and exclusion criteria were assigned to one of the three treatment groups (n = 20 in each group). Group I – hand scalers, Group II – conventional ultrasonic scalers, and Group III – Vector™ ultrasonic system. Before oral prophylaxis, clinical parameters (gingival index [GI], plaque index [PI], calculus index [CI], periodontal probing depth [PPD], clinical attachment loss [CAL], and hypersensitivity) were recorded. GI, PI, CI, and hypersensitivity were reevaluated at 1, 3, 6 and 12 weeks. PPD and CAL were reevaluated at 6 and 12 weeks. Results and Conclusion: The results showed that nonsurgical therapy with Vector^™ ultrasonic system is clinically comparable in all the parameters, to hand and conventional ultrasonic scalers, suggesting that it can be used as a gentle root debridement device for supportive periodontal therapy, as an alternative to other ultrasonic or sonic scalers.

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Background: Many systemic diseases have been implicated as risk factors in periodontal disease. Studies suggest that periodontal infection can adversely affect systemic health; by inference periodontal disease will also have an effect on blood values, but the data available is not conclusive. Aim: This clinical study was designed to evaluate the effect of treatment of plaque induced periodontitis on commonly assessed blood parameters. Materials and Method: 37 males and 31 females aged between 20 and 50 years in good general health but suffering from plaque induced chronic periodontitis were selected for the study. The selected patients were assessed for ESR, TLC, PMN count, lymphocyte count from DLC, HB, BT and their periodontal condition before the start of the study. SCRP was carried out and patients were reassessed for the same clinical and hematological parameters 21 days after the periodontal therapy (SCRP). Results: A highly significant reduction in the counts of PMNs and the values of ESI was seen after SCRP. Furthermore a significant reduction in TLC, lymphocytes count, and BT and a non significant decrease in Hb were also observed. Conclusion: SCRP done in patients of chronic periodontitis has a considerable affect on the assessed blood parameters.

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Objectives: To investigate the relationship between chronological age and the stages of maturation of cervical vertebrae maturation index (CVMI) and the middle phalanx of the middle finger (MP3) and to determine the correlation between CVMI and MP3. Materials and Methods: A cross-sectional study included 100 children (boys - 50, girls - 50) aged 8–14 years based on nonprobability quota sampling. The study included digital radiographs of the MP3 of the right hand and conventional lateral cephalograms. Chronological age was assessed by the date of birth, MP3 maturation by Rajagopal and Kansal's criteria, and CVMI development by Hassel and Farman's method. Statistical Analysis: Spearman's rank-order correlation coefficient was applied to measure the association between stages of MP3 and CVMI. Results: Progressive stages of MP3 and CVMI were seen as chronological age advanced. Girls showed an advanced trend than boys in both MP3 and CVMI stages. MP3 and CVMI stages showed a strong positive correlation (r + 0.836, P < 0.01). Conclusions: MP3 and CVMI both are equally good indicators of skeletal maturity. Assessment of skeletal maturity on lateral cephalogram (CVMI) is advantageous as it avoids the need for an additional radiograph.

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Background: Bonding of brackets to enamel has been a critical issue in orthodontic research since the significance of achieving a stable bond between the tooth and its bracket was obvious from the onset. This study aimed to determine the shear bond strength (SBS) of self-adhesive system, to compare SBS of conventional etchant, self-etching prime and self-adhesive system under dry condition, and to estimate the chair-side time saved for the application of the bonding agents.

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Aim: This study aims to evaluate the effect of saliva and blood contamination on the shear bond strength (SBS) of self- and total-etch adhesive systems on enamel and dentin. Materials and Methods: Sample of 100 extracted noncarious primary molars were taken as experimental groups, which were divided into two groups: self-etch group and total-etch group containing fifty teeth each. These groups were further divided into five subgroups - 10 teeth each. The specimens were then subjected to contamination with saliva or blood; before and after application of adhesive agent, whereas, in control group, there was no contamination done before and after adhesive application. Fresh saliva and blood were used. After the bonding procedure, resin composite was built up with diameter and height of 3 mm. After that, the specimens were tested for SBS in universal testing machine at a crosshead speed of 1 cm/min. The results were then statistically analyzed using one-way ANOVA. Results: The results of the study revealed that the SBS of self-etch adhesive system was better than the total-etch adhesive system and there was significant difference found among various subgroups of total-etch group, i.e., when adhesive application was done before, after and without saliva or blood contamination. There was no significant difference found within the subgroups of self-etch group when adhesive application was done before, after, and without saliva contamination. In case of blood contamination, significant difference was found in SBS in both self- and total-etch groups.

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Background: Traumatic dental injuries (TDIs) are widespread in the population and are a serious dental public health problem among children. Dental trauma may cause both functional and esthetic problems, with possible impacts on the patient's quality of life. Aim: The aim of the study is to assess the knowledge, attitude, and practice of elementary school teachers regarding dental trauma and its management. Materials and Methods: A questionnaire study consisting of 12 closed-ended questions were used to interview 150 elementary school teachers who participated in this study. The questions assessed the knowledge and attitude of teachers toward their student's dental trauma and its management. Statistical analysis was performed using Statistical Packages of Social Sciences (SPSS) version 17.0. Results: Among 150 teachers, 54% had dealt with trauma to their students, 91.3% school teachers said that they would save the avulsed tooth, 64% had heard about reimplantation of tooth, and 37% school teachers stated that they would not carry the tooth in any media reflecting their lack of knowledge regarding management of avulsed tooth. Conclusion: As many teachers have a low level of knowledge regarding dental trauma, there is a need for greater awareness to improve knowledge and attitude of teachers related to the emergency management of TDIs in children by organizing educative and motivational programs.

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Any occlusal force which goes beyond the adaptive capacity of our periodontium causes injury to periodontal structures, and the resultant trauma is called as trauma from occlusion (TFO), several schools of thoughts are there that whether TFO is an etiological factor or cofactor for the occurrence of periodontal diseases. Present review paper is an effort to clear the actual concept of TFO along with its historical background, etiological factors, relevant terminologies, signs and symptoms, and advanced diagnostic methods.

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Plaque control is the daily removal of dental plaque, oral biofilm and also prevention of their accumulation on the teeth and other parts of oral cavity. Dental plaque is the major etiology of maximum gingival and periodontal diseases. It is also related with various dental problems. Mechanical plaque control is a very effective method to get rid of plaque accumulation in oral cavity. In 3000 BC there was the first toothbrush invented by human beings. With time several modifications came in toothbrushes to make mechanical plaque control more effective in day to day oral hygiene practice. This article emphasizes on the advanced and emerging tools in mechanical plaque control methods in attaining an optimal level of oral hygiene standards and maintenance of oral health.

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The history of operative dentistry dates back to the era when Babylonians, Assyrians, and Egyptians (4500–4000 BC) were familiar with gold, and Etruscans and Phoenicians (2700 BC) were practising gold crowns. Since then, there have been numerous advances, developments, and researches which have proceeded continuously. These inventions have transformed the practice of operative dentistry into one which is more efficient and more comfortable for the patients as well as for the operating team. This article highlights the significant advancements in the field of operative dentistry which have occurred over a period of time and have helped us to serve our patients better.

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