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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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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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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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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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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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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Aims and Objectives: Curing units in dental offices across Punjab are analyzed for a practical purpose. Materials and Methods: One thousand light-curing units regularly used by the dentists in dental offices across the state of Punjab were examined for their output intensity. Various factors include as follows: type, power of light-curing unit, material molecule formation on tip (YES/NO), diameter of guide tip, and frequency of bulb replacement. A radiometer, a magnifying glass, and a Vernier caliper were used. Data were collected and analyzed. Results: About 75.80% of dentists use light-emitting diode (LED) lights, while 24.20% utilize halogen lamps to cure dental composites. 36.60% of light-curing units of the state had light intensity below 300 mW/cm², out of which 61.60% were quartz–tungsten–halogen (QTH) and 28.60% LED light-curing units. 17.40% of light-curing units recorded light intensity between 301 and 400 mW/cm². 46% of light-curing units registered an output intensity of >400 mW/cm². 79.60% of light units showed material particle buildup on light-curing tips. 62.40% of dentists never replaced the bulbs of their light-curing units. Two-third of dental the practitioners avoided infection control barriers on the tips of curing units. Conclusions: There is a deficit of knowledge among dental practitioners in Punjab regarding care of light-curing units. Dental light-curing units should be regularly checked and infection control remedies should be opted.

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Background: Dental caries is the predominant cause of tooth loss in children and young adults. Mutans streptococci are the principal etiological agents of dental caries, of which Streptococcus mutans (SM) and Streptococcus sobrinus are most important in terms of human caries. Genetic factors also contribute to dental caries of which dermatoglyphics is one. Aim: The aim of the study was to explore the unique relationship between genetic component (dermatoglyphics) and dental components (dental caries, salivary pH, SM level) and to identify children at particular risk of dental decay. Settings and Design: One hundred children, 6–12 years of age, were selected and divided into two groups: Group 1 (children with dental caries, subject group) and Group 2 (children without dental caries, control group). Methods: Dermatoglyphic patterns were recorded using a digital scanner (CanoScan LiDE), and dental caries status was recorded with “decayed-extracted-filled teeth” index for primary teeth and “decayed-missing-filled teeth” index for permanent teeth. Salivary pH was determined using pH meter strips. SM level was estimated by microbial culture of collected saliva samples. Statistical Analysis: Mann–Whitney test, Wilcoxon test, and Z-test were applied. Results and Conclusion: (1) Subject group had a decreased frequency of loops, whereas control group had increased frequency of loop pattern on palmer digits (P < 0.001). (2) Subject group had a low salivary pH toward normal and control group had high salivary pH values toward normal (P < 0.001). (3) Subject group had high SM level as compared to control group (P < 0.001). Therefore, there exists a relationship between genetic component (dermatoglyphics) and dental component (dental caries, salivary pH, and SM level).

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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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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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Introduction: The modern society considers facial attractiveness as an important physical attribute. The great variance in soft tissue drape of the human face complicates accurate assessment of the soft tissue profile, and it is a known fact that facial features of different ethnic groups differ significantly. This study was undertaken to establish norms for Himachali ethnic population. Materials and Methods: The sample comprised lateral cephalograms taken in natural head position of 100 normal individuals (50 males, 50 females). The cephalograms were analyzed by Arnett soft tissue cephalometric analysis for orthodontic diagnosis and treatment planning. Student's t-test was used to compare the means of the two groups. Results: Statistically significant differences were found between Himachali males and females in certain key parameters. Males have thicker soft tissue structures and a more acute nasolabial angle than females. Males have longer faces and females have greater interlabial gap and maxillary incisor exposure. Males have more deep-set facial structures than females. Conclusions: Statistically significant differences were found between Himachali males and females in certain key parameters. Differences were also noted between other ethnic groups and Himachali faces.

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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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Buccal exostoses are broad-based, non-malignant surface growth occurring on the outer or facial surface of the maxilla and/or mandible, found usually in the premolar and molar region. Etiology is still not established, but it has been suggested that the bony overgrowth can be because of abnormally increased masticatory forces to the teeth. Compensatory response to periodontal disease has been proposed to explain some cases of exostoses; they tend to appear in early adolescence and may very slowly increase in size with time. They are painless, self-limiting and may increase patient concern about poor esthetics, inability to perform oral hygiene procedures, and compromised periodontal health by causing food lodgment. The following article presents a very rare case of bilateral buccal-sided maxillary and mandibular exostoses in the anterior region which was an accidental finding in a chronic generalized periodontitis patient.

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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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Context: Oral health is essential for elderly person's general health and well-being. The most common oral problem in elderly is tooth loss which results due to periodontal diseases and caries. Prosthetic status is very important as it is related to dietary intake and maintaining nutritional status. Hence, to promote the oral health of the elderly, we need to know their prosthetic status and need. Aims: The aim of this study is to find the prosthetic status and need of 65–74 years old elderly residing in old age homes of Delhi, India. Settings and Design: A cross-sectional study was conducted among a total of 464 residents of 20 old age homes of Delhi, India. Material and Methods: Residents with age group of 64–75 were included in the study. The prosthetic status with treatment need was recorded using the World Health Organization Oral Health Assessment Form (1997). Statistical Analysis Used: Chi-square test and t-test were used to find significance of variables. P < 0.05 was considered significant. Results: Full removable dentures were worn by 7.30% of participants with predominance in upper arch, and one bridge was seen in 9.10% of participants with predominance in lower arch. Full removable denture was required in 25.20% of participants. Most of participants required multiunit prosthesis in both upper as well as lower arch (42.20% and 36.20%, respectively). Conclusion: The present study underlines a considerable need for dental treatment in elderly as the prosthetic status of participants was poor, and prosthetic needs were high.

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Background: Calcium hydroxide (Ca(OH)₂) is the most commonly used intracanal material; it needs to be removed in entirety before obturation. Several techniques have been used for the same including use of various hand and rotary files. Aim: This study was carried out to compare the efficacy of Hand K files and single and multiple rotary file system in removal of Ca(OH)₂. Methodology: Distobuccal root of 45 maxillary molars were selected on the basis of specified inclusion and exclusion criteria. They were divided into three groups - Group 1 (H and K file), Group 2 (HERO Shaper), and Group 3 (One Shape). Biomechanical preparation (BMP) was carried out as per the manufacturer's instructions; 2.5% sodium hypochlorite was used as the irrigant and 17% ethylenediaminetetraacetic acid as the penultimate irrigant. Ca(OH)₂powder was mixed with normal saline to obtain a paste; canals were filled with this paste using a Lentulo spiral and were sealed. After 7 days, Ca(OH)₂was removed, using the same file system as that used for BMP. Samples were sectioned longitudinally and evaluated under a stereomicroscope. Statistical Analysis: Statistical analysis of the obtained data was carried out using one-way analysis of variance test. Results: HERO Shaper displayed better removal of Ca(OH)₂than One Shape and Hand K file. Moreover, removal was better in the middle third of canal than apical third. Conclusion: Multiple rotary file system (HERO Shaper) is more effective in removal of Ca(OH)₂than the single file system (One Shape)

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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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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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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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Aims: This study aims to compare the incidence of interappointment flare-up during endodontic treatment in diabetics and nondiabetics patients using calcium hydroxide and chlorhexidine gel as intracanal medicament. Materials and Methods: A total of 60 patients requiring root canal treatment were chosen. 30 known diabetic patients with fasting blood sugar (FBS) = 100–120 mg/dl were in Group 1 while others non-diabetic patients with FBS ≤ 100 mg/dl were placed in Group 2. After initiation of endodontic procedures and biomechanical preparation, 15 patients were chosen randomly to place calcium hydroxide paste or chlorhexidine gel, as intracanal medicament in both groups. The pain was recorded on day 1, 2, 3, 7, and 14 posttreatment using verbal rating scale. Result: A total of 10 of 60 patients developed interappointment flare-up, of which 5 (16.6%) were diabetics, and 2 (6%) were nondiabetic patients. The results comparing the interappointment flare-ups between the groups were statistically nonsignificant (P - 0.2179). Conclusions: Although the incidence of interappointment flare-up in diabetic patients is approximately twice than that seen in nondiabetic patients, these results are nonsignificant. This indicates that interappointment flare-ups in diabetic patients with good glycemic control are essentially similar to healthy individual with no metabolic diseases.

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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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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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