Nanotechnology is the field of science dealing with the manipulation of the matter at the nanoscale level. The science of nanotechnology has emerged as a promising concept in all fields of medicine including dentistry and its scope is increasing everyday. It has also gained relevance in the field of orthodontics owing to its wide range of applications ranging from nanocoatings in archwires and brackets, orthodontic bonding, antimicrobial properties, atomic force microscopy to some future applications such as shape memory polymers, mandibular growth stimulation with gene therapy, acceleration of orthodontic movement, and use as biomechanical sensors. The enormous range of application of nanotechnology in orthodontics demands an intensive research into its current and future usages. This article aims to review and discuss the various applications and its potential usage in orthodontics.

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Aim: The aim of this study was to determine the impact and challenges of emergency remote teaching faced by the dental faculty during the first and the second wave of COVID-19 in India. Materials and Methods: A cross-sectional descriptive questionnaire study was carried out consisting of two surveys. Data for the first questionnaire was recruited from 135 faculty members engaged in online teaching and comprised details about sociodemographic, designation, teaching experience, online teaching practices, perceptions, and challenges faced by the faculty members during online teaching during the first wave of COVID-19 pandemic in India. Categorical variables were reported as counts and percentages. Group comparisons were made with the Chi-square test. The same participants were given the second questionnaire to access their efficacy in overcoming the challenges faced by them during the second wave. Results: 54.8% of the participants were female. 46.7% of respondents were Professors by designation. Variation was evident for the personal, technical, financial barriers and challenges caused by students' attitude with designation as a variable. 67.4% of the participants devoted extra time to prepare their lectures. 62.2% of the faculty faced network issues. 53.3% of the faculty reported increased expenditure on data. Maximum challenges were seen in the category based on students' attitude which deteriorated the quality of the lectures. 74.1% of the teachers agreed that online teaching was better for theoretical learning. There was not much difference observed in the response regarding personal barriers among faculty members with gender as a variable in the first wave, but notable differences were seen for technical barriers, especially lack of formal training. During second-wave study, Internet connectivity still remained a barrier. Conclusion: Challenges faced by the faculty members regarding online learning decreased in the second wave as compared to the first wave, but network connectivity and students' attitude remained an issue. Scope of theoretical online teaching was perceived to be better as compared to practical teaching.

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Background: The association between preganancy and poor oral health and its effects on preterm low birth infants are well documented in scientific literature. A pilot study was conducted with 160 pregnant women in the year 2016 showed that oral hygiene awareness among pregnant women was least among those who did not complete basic school education. This was the motive to conduct the present survey. Aims and Objectives: The Aim of this survey is to determine the knowledge and awareness on oral hygiene practices and to evaluate the role of education status on awareness of poor oral health and pregnancy outcomes among 500 pregnant women in Chennai city, Tamil Nadu, using self-tested questionnaire. Materials and Methods: A Descriptive cross sectional study was conducted among 500 pregnant women attending maternity clinics in Chennai using Self administered questionnaire. Results: Among 500 participants majority of them 72% of school educated never visited dentist. Only 6.2% of Undergraduate women was referred by gynecologist for dental check up during pregnancy. 31.3% of school educated felt that first trimester was safe to undergo dental treatment with p=0.000. Conclusion: This survey showed that level of education played a significant role in awareness about oral hygiene among pregnant women.

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Background: C-reactive protein (CRP) is a nonglycosylated pentameric polypeptide comprising 206 amino acid residues. CRP causes activation of the classical complement pathway by binding to various autologous and extrinsic ligands exposed on membranes of injured, necrotic, or cells undergoing apoptosis. There is evolving evidence which strongly suggests that CRP is an inflammatory marker and is significantly elevated in patients diagnosed with tumors such as hepatocellular, pulmonary, and breast carcinomas. In addition, serum CRP level has been shown to be associated with size of tumor (T), clinic-pathological characteristics, and metastasis to lymph nodes. Aim: The aim of this study was to compare serum CRP levels in potentially malignant disorders and oral malignancies. Materials and Methods: This cross-sectional prospective study was designed to study serum CRP levels in patients with oral potentially malignant disorders (leukoplakia and oral submucous fibrosis), patients with oral squamous cell carcinoma, and normal controls. Study participants were divided into four groups: (1) Group I comprising 40 patients with leukoplakia, (2) Group II comprising 40 patients with oral submucous fibrosis, (3) Group III comprising 40 patients with oral squamous cell carcinoma, and (4) Group IV comprising 40 controls. Five milliliters of venous blood was collected after venipuncture from the antecubital vein followed by centrifugation, and serum was separated. This separated serum was analyzed for CRP levels using SPINREACT kit and semi-automated biochemical analyzer (Kyoto, Japan). All obtained data were entered into Microsoft Excel Worksheet 2007, and tabulations were performed using SPSS 16 (Statistical Package for the Social Sciences) software (IBM Corporation, Chicago, IL, USA). P < 0.05 was considered statistically significant. Results: Mean ± standard deviation values derived were 5.5 ± 4.8 mg/dl (Group I), 6.1 ± 4.9 mg/dl (Group II), 10.5 ± 2.4 mg/dl (Group III), and 2.1 ± 1.6 mg/dl (Group IV), respectively. On applying one-way analysis of variance for comparison of three groups, P < 0.003 was obtained. The results implied that an extremely significant statistical correlation existed between all studied groups when serum CRP levels were compared. Conclusion: Serum CRP levels are prognostic markers in oral potentially malignant disorders and oral malignancies.

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The aesthetic rehabilitation of a young toddler who are suffering from multiple tooth loss due to early childhood caries or extensive dental trauma is one of the challenging tasks for the Paediatric dentist in his/her day to day practise. Due to the loss of primary anterior teeth at an early age, loss of esthetic, masticatory efficiency, and mispronunciation of labiodentals sounds and development of abnormal oral habits are developed. Parent's desire plays one of the most major roles for an anterior esthetic appliance for their wards. This case report discusses and elaborates in detail one of the type of fixed anterior esthetic appliance and the considerations to be made while making treatment plan for when and why to place them.

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Purpose: To evaluate the efficacy of tramadol as a local anesthetic effect. Materials and Methods: Fifty patients were evaluated. Group A given tramadol and Group B given lignocaine. Parameters such as pain on injection, onset of action, duration of effect, and side effects if any were recorded. Results: None of the patients showed any allergic response to the respective drug administered. The onset of anesthesia (objective) for tramadol and lignocaine was, respectively, 165.0 ± 39.80 s and 159.60 ± 35.09 s, not statistically significant (P = 0.613). Mean duration of anesthesia for them was 47.50 ± 7.51 min for tramadol and 45.70 ± 7.10 min for lignocaine, also statistically nonsignificant (P = 0.388). Regarding intraoperative pain, mean was 0.41 ± 1.013 of tramadol and of lignocaine was 0.31 ± 0.451, P = 0.654 also being statistically nonsignificant. Two patients receiving tramadol had nausea and 1 had pain. Those receiving lignocaine, only 1 patient had pain (P = 0.214). Conclusion: Tramadol has an almost similar local anesthetic efficacy with that of lignocaine.

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Aim: To investigate anatomical and morphological variability of permanent mandibular first premolar teeth in the population of Manipur state of Indian subcontinent. Materials and Methods: Four hundred and eighty teeth from a pool of Manipuri population were studied for anatomical and morphological variability using staining and clearing technique. All samples were evaluated for the number of roots, root canals, root canal configuration, presence of lateral canals, intercanal communications, and apical deltas. Results: Single root with one canal was present in 81.25% (390/480) and single root with two canals in 18.75% (90/480) of samples. Root canal configuration according to Vertucci's classification was as follows: Type I (43.7%) followed by Type V (25%), Type VI (12.5%), and Type II, III, and VII (6.25%). Intercanal communications in the apical third were 12.5% (60/480) and 6.25% (30/480) in the middle third of the root. Occurrence of lateral canals in the apical third was 18.75% (90/480). Apical delta was found in 37.75% (180/480) of samples. Conclusion: The results of this study highlight the variability patterns of mandibular first premolar tooth existent in the population of the state of Manipur. Single-rooted teeth are most common with predominantly Vertucci's Type I root canal configuration and significant presence of lateral canals and apical ramifications. Clinical Significance: Sound knowledge of anatomy of the root canal and possible variations can contribute to a successful treatment outcome.

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Background: Maxillofacial trauma is one of the growing concerns in the field of health sector around the world. Fractures of the maxillofacial region often lead to considerable morbidity of esthetics and function. Aim: This study aims to establish the incidence and pattern of facial bone fractures as well as to present their etiology, frequency, and distribution among the cases reporting in the major trauma center of eastern Uttar Pradesh. Materials and Methods: The total number of patients included in this study was 575. The data were obtained from previous documented records. Proportions and relations of data are compared with the help of the Chi-square test. P < 0.05 suggests results are significant. Results: Of 575 patients, 376 patients had isolated fractures and 199 patients had mixed fractures. The mandible is the most commonly affected bone. The most commonly involved anatomical site was parasymphysis of the mandible (25.6% [202/790]), followed by zygomatic complex 14.9% (118/790). The mean age of patients was 28.92 years with a male predilection. The mean age for males and females was 29.44 years and 24.29 years, respectively. The most common age group involved in maxillofacial injury was 21–30. The correlation of anatomical sites of maxillofacial fractures according to age group was inferred to be statistically insignificant as P > 0.05. The most common mode of injury was inferred to be road traffic accidents (85.7% [493/575]). The correlation between anatomical site and mode of injuries was found to be statistically significant (P < 0.05). Conclusion: This study concludes that road traffic accident is the most common mode of injury and the most common bone involved is the mandible, with parasymphysis being the most affected anatomical site. The current study also demonstrates a significant correlation between the anatomical site of injury and the mode of injury.

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Background: Maxillofacial injuries are a serious public health problem and are often associated with severe morbidity, disfigurement, and psychological problems. The life of the patient often takes a turn for the worst and he/she has to face many difficulties moving forward. Analysing and determining the quality of life of such cases will give us a better understanding and insight and will further improve the care and treatment of the patients. Aims: Analyse and evaluate the psychosocial impact of maxillofacial fractures on individuals who were healthy pre-trauma. Material and Methods: The participants are the 30 patients with facial trauma reported to the Department of Oral and maxillofacial surgery of the School of Dental Sciences and Krishna hospital, Karad, who will be required to undergo surgical treatment (i.e., Open reduction and internal fixation for facial fractures) and are willing to participate in this study. All 30 patients were given a questionnaire form modified from the pre-existing Acute Stress Disorder Scale, Oral Health Impact Profile questionnaire and Posttraumatic Diagnostic Scale, which includes questions regarding speech, sense of taste, pain, uncomfortable eating, orientation, tension, unsatisfactory diet, interrupted meals, difficulty to relax, embarrassment, irritability, occupational dysfunction, etc. during their 15 days follow up appointment post-surgery. This obtained data was then analysed and was subjected to appropriate statistical analysis. Result: In a study sample of 30 patients, 8% were found with intense psychosocial issues due to trauma, 14% had a moderate, and 18% had mild issues that affected the quality of their life post-trauma. Conclusion: The study shows a great need for psychological screening and evaluation of patients with maxillofacial injury/fractures due to trauma to improve the patient's physical and psychological recovery.

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Aim and Objective: The aim of our study was to evaluate hemorrhage immediately after extraction and postextraction in patients on oral anticoagulant therapy for the past 5 years. Materials and Methods: A total of 100 patients, equally divided into study group and control group of 50 patients each, who were on anticoagulant therapy for the past 5 years were included in the study and were assessed for general medical status, drug dosage, indication for anticoagulant therapy, and duration of treatment before being included in the study. Before undertaking any procedure, the international normalized ratio (INR) for each of the patient under study was requested and the study was only performed if INR was within the therapeutic range of 2.0–4.0 for each patient. Any patients with INR outside the therapeutic range, patients with liver disease, patients on other drugs that affect the hemostasis (long-term use of nonsteroidal anti-inflammatory drug, chemotherapeutic and immunosuppressant drugs), and patients who refused to sign the consent for the study were excluded from the study. Results: None of the patients, in study group, had any immediate postoperative bleeding during the 30 min that they were observed after the extractions, and no patient in study group had any bleeding during the first 24 h. One patient from the study group (50-year-old female, INR 3.2) had intermittent oozing on the 3^rd day postoperatively, after extractions of lower right 2^nd molar. Conclusion: We conclude that hemorrhagic episodes postextraction in patients on anti-coagulant therapy is manageable following atraumatic extraction, hemostatic agents and sutures. Its also concluded that patients on anticoagulant are at high risk of thromboembolic events than postextraction hemorrhage so anticoagulant therapy should be continued without any alteration.

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Oral health-care services provided by the dentist have to follow certain standards to avoid any kind of negligence during treatment. Patient safety is an important aspect of quality in health care system. In the present time, all dentists need to be cautious about the general perception and the high cost involved in the treatment and to avoid any serious injury to the patient. The best way to prevent being involved in a litigation is to follow a good clinical practice patterns. This article emphasizes on common clinical mishap and dental patient incidents in a clinical practice.

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Provisional implants (PIs) can offer a total contribution to a patient's esthetic comfort and chew during the integration of standard implants. Although temporary implants are not intended for osseointegration and have to withdraw at there or 4 months, most of them begin to move during this process, and most of them had extracted before standard implants integration. Resin fixed prosthesis attached to temporary implant abutments gives the patient stability, gives esthetics, and gives protection to traditional implants, compared to removable prostheses, which more quickly leads to the loosening and loss of these temporary implants. Temporary implants could be used with cemented or screwed resin prosthesis or with titanium framework, depending on the patient's bite, bruxism, or clenching. All PIs are made in one piece, titanium grade 5, with V threads and a Bioetched surface (rough surface) to increase the insertion torque and bone to implant contact in soft and hard bone. Temporary upper fixed denture, relined with resin, is the easiest solution for protecting and reducing the risk of failure of some of the standard implants. The possible solution in such cases is the use of temporary implants as support for the fixed structure, acting as protection of traditional implants and bone grafts. Our clinical case was made with six temporary implants TR^® 2.7 mm diameter by 13 mm length, grinding extracted teeth using smart dentin grinder, and fixed temporary denture for 3 months. At 4 months, a complete zirconium denture was screwed in standard implants.

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Backround: Periodontal diseases are classified into different categories based on the clinical symptoms and related to these there can be changes in the cytokine levels in the connective tissue and elaboration of these in the gingival crevicular fluid. (GCF). Aims and objectives: The aim of this study was to evaluate the levels of IL-11 and IL-17 in the gingival crevicular fluid of patients with Aggressive Periodontitis and Chronic Periodontitis and co-relate them with the clinical parameters. Materials and Methods: GCF was collected from the deepest sites of the periodontitis patients and ELIS A was used to determine the levels of IL-11 and IL-17 levels. Results: GCF of patients in each category was assayed and the levels of IL-11 and IL-17 were co-related with clinical symptoms. Conclusion: Study showed strong co-relation of Aggressive and Chronic Periodontitis with IL-11 and IL-17.

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