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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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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Hemisection denotes the removal of compromised root and the associated crown portion with the loss of periodontal attachment and is performed to maintain the original tooth structure and attain the fixed prosthesis. The success rate of such procedure is high. The present case report demonstrates the successful management of hemisection of 46 with occlusal rehabilitation. It was a conservative approach aiming to retain as much original tooth structure as possible against the option of extraction of the natural tooth.

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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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Aims: The present study was conducted with the aim to explore the authenticity and evidentiary value of imprints of the lips for any peculiar pattern regarding specific gender so that it could be used as a reliable tool in the identification of an individual at the crime scene. Materials and Methods: This study comprised 500 (248 females and 252 males) randomly selected dental students with age ranging from 18 to 30 years. Lip prints were recorded with the help of a cellophane tape strip and analyzed according to Suzuki and Tsuchihashi classification. Results: The most predominant pattern in the entire study population was found to be Type I in females and Type III in males with highly significant statistical values. It was also demonstrated that no two lip prints were found to match each other which proves that every individual has unique lip prints. This uniqueness can further help in personal identification. Conclusion: Cheiloscopy or lip print analysis can be used to identify an individual and place him/her at the crime scene. It is an important antemortem tool which may aid in justice to the victim.

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Introduction: The dental health care providers and their community service in any nation play a pivotal role in bridging the gap between the oral health care and social service system. Understanding that there is a shortage and disparity in the oral health services provided, a greater emphasis on its awareness and education is the present need; thus, the aim of the study is to assess the attitude toward community service among dental students. Methodology: A cross-sectional questionnaire-based study was conducted among undergraduate dental students who were present on the day of study, and their attitude toward community service was assessed using a standardized Community Service Attitude Scale which consists of eight domains. Data were analyzed using descriptive statistics, Chi-square test, and ANOVA. The level of significance was set at P < 0.05. Results: The total participants included were 171. The levels of attitude toward community service among the study participants based on year (P = 0.0492), gender (P = 0.00482), and voluntary activity (P = 0.042) were found to be statistically significant. Conclusion: The attitude toward community service is influenced by gender and year of study. Hence, any practical training program with regard to service learning in their undergraduate curriculum would highly contribute to influence their attitude toward community service.

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Background: Interproximal reduction was introduced as an alternative to tooth extraction in patients with mild-to-moderate crowding, the beneficial outcomes of interdental reduction have been well documented, but nevertheless, possible detrimental effects on enamel have also been an issue of debate. Interproximal reduction generates the formation of grooves and valleys creating plaque retentive areas, predisposing teeth to caries, and periodontal disease. Various proximal stripping techniques, it is postulated, produce varying grades of roughness of the enamel surface; it is in this area that the research in this paper was focused. Aim: The aim is to evaluate enamel surface roughness after various interproximal reduction and polishing methods. Materials and Methods: 16-blade tungsten carbide bur, diamond disc, diamond-coated metal strip, fine Sof-Lex disc, and fine diamond bur were used for interproximal reduction and polishing on extracted human premolars. The specimens were then evaluated under scanning electron microscope (SEM) and surface plots of images were made using Image J software. Statistical Analysis: The data obtained were subjected to ANOVA and posthoc multiple tests. Results: Under the SEM, all interproximal reduction protocols resulted in roughened and grooved enamel surfaces. The use of diamond-coated metal strip followed by polishing with fine Sof-Lex disc created surfaces that were reasonably smooth. Conclusions: The enamel surfaces after reduction with diamond-coated metal strip and polishing by fine Sof-Lex disc (group F) were the smoothest.

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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: Periodontal disease has been labeled as the “sixth” complication of diabetes. The two diseases have a bidirectional adverse relationship to each other. Diabetes can aggravate periodontitis, and periodontitis can negatively affect the glycemic control of diabetics. Oral hygiene awareness and treatment of periodontal diseases play an important part not only in prevention of many complications due to diabetes but also decrease the morbidity due to these manifestations. Aim: The goal of this cross-sectional study was to determine the actual awareness of diabetic patients about their oral health and the oral hygiene measures being practiced by them. Another aim was to evaluate their knowledge regarding the impact of oral health on glycemic control. It was also assessed whether there was any significant difference in the oral health awareness levels with their nondiabetic counterparts. Materials and Methods: One hundred diabetic and one hundred nondiabetic respondents filled up a validated questionnaire which comprised questions on personal data, oral hygiene knowledge, attitude, oral hygiene practices, and their knowledge regarding the correlation of oral health to adverse glycemic control and vice versa. Data were compiled and subjected to statistical analysis. Results: The results indicate no statistically significant differences in the variables assessed in both the groups, indicating that no further knowledge had been imparted to the diabetics after they were detected with the disease. Seventy-three percent of nondiabetics and 76% of diabetics were unaware of the relationship between oral health and diabetes. Conclusion: The study concludes that both diabetics and nondiabetics lack awareness of the relationships between diabetes and oral health. To provide better oral health care, more knowledge needs to be made available to the diabetic patients and the medical community.

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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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Restoration of primary incisors, which have been severely damaged by extensive caries or trauma, is a difficult task for the pediatric dentist. Primary teeth dictate the physical appearance, and their structural affects leads to loss of esthetics compromised mastication, poor phonetics, development of aberrant habits, neuromuscular imbalance, and difficulty in social and psychological adjustment of the child. Case description: This case report discusses the restoration of severely decayed primary maxillary incisors using composite resin restoration reinforced with glass impregnated post in anterior teeth in a 4-year-old male patient. The use of intracanal posts in endodontically treated teeth improves the retention of a eventual restoration. The use of impregnated fiberglass post together with flowable composite offers an alternative where all components are bonded together to form a firmly attached restoration. This technique of glass impregnated composite resin post and core has shown promising results and has presented pediatric dentists with an additional treatment option.

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The case report describes smile designing of a 22-year-old male patient who was surgically operated for unilateral cleft lip (left side) with Andrew's Bridge system. It is composed of two components: Fixed component (retainers on abutments joined by bar) and removable component. The patient exhibited maxillary anterior defect (Siebert's Class-III anterior ridge defect), teeth transposition, increased mesiodistal edentulous space, bilaterally missing lateral incisor. When there is a limitation of bone grafting/surgical augmentation, alternative treatment modalities such as removable partial dentures, fixed partial dentures with gingival porcelain and/or fixed-removable partial dentures known as Andrew's bridge are indicated.

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Background: A study on prevalence, complications, and possible etiological factors of supernumerary teeth in 6–12-year-old schoolchildren of Rohtak, India. Aim: This study aimed to study the prevalence of supernumerary teeth in Rohtak district, Haryana, India and elucidate the possible etiological factors for their origin and the type of malocclusion caused by their presence. Materials and Methods: Two thousand and sixty school-going nonsyndromic children of 6–12-year age were examined for the presence of supernumerary teeth and referred to the Department of Pedodontics and Preventive Dentistry. Detailed history, clinical and radiographic examinations were done. Chi-squared test was used for statistical analysis. Results: Ninety-four supernumerary teeth were found in 81 children. All supernumerary teeth were found in maxilla. Most of these teeth were erupted, conical, and in the midline. Labial displacement of adjacent teeth was most commonly seen. Birth order of these children was mostly 2^nd or 3^rd, and majority of them belonged to the Jat community and were born at home by normal delivery. Conclusions: The present study emphasizes the necessity for early detection and appropriate management of supernumerary teeth. We suggest the development of further approaches including family studies to estimate the importance of genetic and possible environmental factors to attain a more precise knowledge of the etiology of hyperdontia.

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Introduction: The inclination of occlusal plane (OP) is determined by paralleling the OP to ala-tragus line. Inspite of its wide acceptability, the exact location of tragal point on ala-tragus line is unclear. In addition, morphologic features vary among various ethnic groups. Therefore, it is important to evaluate the exact reference point on tragus among Ludhiana population. Aim: The aim of this study is to determine the posterior reference point of the ala-tragus line that forms the most parallel line with the natural OP among Ludhiana population. Methodology: Digital lateral cephalograms were taken in 100 dentulous Angle's Class I subjects of 18–30 age group. Stainless steel balls were attached to ala of the nose (A) and three points that corresponded to superior (S), middle (M), and inferior (I) points on the tragus of ear. The angle formed by each line (SA, MA, and IA planes) with Frankfort horizontal (FH) plane and OP were measured on all tracings of cephalograms. Results: The mean angular value of IFH (angle between IA-FH planes) was the closest to the Cant of OP, and the mean angular value of IOP (angle between IA plane and OP plane) was the least compared to angles MOP (angle between MA-OP planes) and SOP (angle between SA-OP planes). Conclusion: The inferior point marked on tragus is the most appropriate point for marking ala-tragus line among Angle's Class I subjects of Ludhiana.

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Objectives: The study aimed to check the age- and gender-wise prevalence of oral habits in the children of 7–16-year-old Indian children. Materials and Methods: A cross-sectional survey involving 1029 (661 males and 368 females) children of age 7–16 years was done to record the presence or absence of the oral habits with the aid of the anamnestic questionnaire. The recorded oral habits were tongue thrusting, thumb or digit sucking, mouth breathing, bruxism, lip biting or lip sucking, and nail biting. The collected data were subjected to Pearson's Chi-square statistical analysis to know the overall difference in the prevalence rate of different oral habits and to evaluate the gender- and age-wise difference in the prevalence of oral habits. Results: Oral habits were present in 594 participants (57.73%). The highest prevalence rate was registered for tongue thrusting habit (28.8%), which was followed by nail biting (201/19.5%) and thumb sucking (128/12.4%), mouth breathing (109/10.6%), lip biting (85/8.3%), and bruxism (29/2.8%). The male participants showed a greater prevalence rate for the oral habits than the female participants (58.55% vs. 56.25%). There was a significant difference in the age-wise prevalence of oral habits with older children showing greater prevalence of oral habits than the younger ones. Conclusion: The prevalence of oral habits in the current group of children is high. It warrants the need for the community-based educational preventive and interceptive programs to spread the awareness regarding the deleterious effects of these oral habits.

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