Background: Plaque control is the daily removal of dental plaque, oral biofilms, and also prevention of their accumulation on the other parts of the oral cavity. Dental plaque is the major etiology of maximum gingival and periodontal diseases. This study is an effort to find if chewable brushing is better than manual. Objective: The objective was to evaluate and compare the efficacy of manual toothbrush and chewable toothbrush on fifty patients, in the age group of 8–12 years over a period of 28 days. Materials and Methods: This study used a randomized, double-blinding, single-center, two-treatment, parallel group, design subjects with mild to moderate plaque and gingivitis were evaluated for baseline whole mouth gingival margin and approximal plaque. Clinical assessments were performed using the Quigley-Hein Plaque Index (TQHI) and Simplified Oral Hygiene Index. Subjects received either manual or chewable toothbrush. Data were entered on to the Microsoft Excel and statically analyzed using (SPSS version 21.0 IBM, Chicago III, IL, USA). Data were evaluated by t-test with a P < 0.005 considered to be statistically significant. Results: Fifty subjects participated in the study; 25 in the manual toothbrush and 25 in the chewable toothbrush group. Both brushes demonstrated significant reductions in plaque and gingivitis over the 28 days study period (P < 0.001). The chewable toothbrush was significantly more effective than the manual toothbrush. No adverse events were observed with either brush. Conclusion: The plaque and gingivitis reduction for the chewable toothbrush were significantly greater than for the Manual toothbrush.

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Introduction: Extracted teeth are utilized in dentistry as particulate autologous dentin for immediate grafting of the extraction site after mechanical cleaning and chemical disinfection. The objective of this study was to determine the effectiveness of 0.5M sodium hydroxide in 20% ethanol (Dentin Cleanser™) in eliminating three different types of pathogenic bacteria in comparison to ethylenediaminetetraacetic acid (EDTA) or citric acid. Seven naive extracted teeth were mechanically cleaned, dried, and sectioned to separate the crown from the roots. Each tooth was separately crushed using the Smart Dentin Grinder^® device. The sterile particles of crown or root were subdivided into three equal-size groups where each was then contaminated and incubated in an oven at 37°C under low pressure and oxygen flow over 48 h for Escherichia coli (Group A) and Enterococcus faecalis (Group B) and over 72 h for Porphyromonas gingivalis (Group C), respectively. On each agar Petri dish, four paper discs, each loaded with one of the following solutions: Dentin Cleanser (sodium hydroxide plus ethanol), 10% EDTA, phosphate-buffered saline (PBS), or 10% citric acid, were placed in the safe distance for not interfering with disinfectant agent activity. All pathogenic bacteria were highly sensitive to Dentin Cleanser and EDTA disinfectant activity while citric acid or PBS exhibited low or no sensitivity. No difference in sensitivity was found between crown and root particulate or particle size. Our findings show that Dentin Cleanser is most effective in eliminating those pathogenic bacteria without demineralizing the particulate. Context: The experiment was done in the University Laboratory. Aims: The objective of this study was to determine the effectiveness of 0.5M sodium hydroxide in 20% ethanol (Dentin Cleanser™) in eliminating three different types of pathogenic bacteria in comparison to EDTA or citric acid, before tooth graft will be used as a biomaterial. Settings and Design: The study protocol was approved by the Catholic University of Murcia Ethics Committee (UCAM; registration number 6781; July 21, 2017). Seven human teeth were extracted from a 60-year-old patient due to advanced periodontal disease (two central upper incisors, one upper canine, one upper premolar, two lower molars, and one lower canine). The patient received no financial compensation for participating in this study. Materials and Methods: Seven naïve extracted teeth were mechanically cleaned, dried, and sectioned to separate the crown from the roots. Each tooth was separately crushed using the Smart Dentin Grinder^® device (KometaBio Inc., Cresskill, NJ, USA). The particles were sieved to obtain particles ranging from 400 to 600 um and 800–1200 um in size, all sterilized using an autoclave. The sterile particles of crown or root were subdivided into three equal-size groups where each was then contaminated and incubated in an oven at 37°C under low pressure and oxygen flow over 48 h for E. coli (Group A) and E. faecalis (Group B) and over 72 h for P. gingivalis (Group C), respectively. Then, each subgroup was immersed in 15 agar Petri dishes and again each was inoculated with the same bacteria allowing full growth of bacteria. On each agar Petri dish, four paper discs, each loaded with one of the following solutions: Dentin Cleanser (sodium hydroxide plus ethanol), 10% EDTA, PBS, or 10% citric acid, were placed in the safe distance for not interfering with disinfectant agent activity. Statistical Analysis Used: Statistical analysis was performed using PASW Statistics v. 18.0.0 software (SPSS). One-way analysis of variance was applied for the comparison of the means for halos, assuming a level of significance of 95% (P < 0.05). Kolmogorov–Smirnov and Shapiro–Wilk tests were applied for normality. Results: The results of the present study show that the 0.5M sodium hydroxide with 20% ethanol also termed as Dentin Cleanser presented the widest diameter halo of free bacterial growth, most effective against P. gingivalis (15.76 ± 0.28), less effective against E. faecalis (13.21 ± 0.72) and E. coli (12.14 ± 0.12). Similarly, EDTA was effective in eliminating the same strains of bacteria, while citric acid was not effective according to the Duraffourd halo inhibition scale. PBS had no effect in inhibiting bacterial growth. Both the Dentin Cleanser and EDTA were significantly effective in inhibiting bacterial growth in comparison to PBS and citric acid. No significant differences were observed between the dentin particulate and the dentin–enamel mix particulate or human bone marrow related to the level of sensitivity measured for each of the disinfectants tested. Conclusions: The use of the Dentin Cleanser (sodium hydroxide plus ethanol) or EDTA 10% appears to be an effective disinfectant method of tooth particulate prior to use of such particulate as autologous grafting material. Although E. coli, P. gingivalis, and E. faecalis were found to be sensitive to the presence of these disinfectants, additional bacterial types should be further investigated.

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Background: Odontogenic lesions can bring about diagnostic challenges due to overlapping histology among pathologists. Thus, there are few tumor markers that provide accurate diagnosis. Syndecan-1 (CD-138) and podoplanin (PDPN) are proteoglycans that have been described as substantial diagnostic and prognostic markers in various odontogenic lesions. Aim: This study aims to evaluate and compare the immunohistochemical expression of syndecan-1 (CD-138) and podoplanin in keratocystic odontogenic tumor, orthokeratinized odontogenic cyst (OOC), and dentigerous cyst (DC). Materials and Methods: The formalin-fixed paraffin-embedded tissue blocks of KCOT, OOC, and DCs were retrieved form the archives of department. Three sections each of 3 μm thickness were made using a rotary microtome and they were stained with syndecan-1 (CD-138) and podoplanin (PDPN) using immunohistochemical methods and standard hematoxylin and eosin stain. Results: Immunohistochemical expression of syndecan-1in KCOT was found to be weakly to moderately positive in 6 cases with 2 cases exhibiting positive expression. In OOC, 3 cases displayed negative expression-1 whereas 7 cases were weakly to moderately positive. Immunohistochemical expression of podoplanin in KCOT was observed to be weakly to moderately positive in 4 cases with 5 cases exhibiting strongly positive expression. In OOC, 3 cases displayed negative immunohistochemical expression for podoplanin and 4 cases were strongly positive. Immunoreactivity for podoplanin in DC was negative in 3 cases whereas 5 cases were weakly to moderately positive. Conclusion: The absence of significant correlation between expression of syndecan-1 and podoplanin reinforces the exact role of these proteins in the differentiation of odontogenic lesions which need to be elucidated further.

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Introduction: It is crucial to take care of stability between various implant parts for the general success rate of the reconstruction. Component fit, saliva contamination, machining accuracy, and screw preload influence the steadiness of implant–abutment connection. Loosening of abutment screws has been a well-known technical problem. Aim: The aim of this study was to gauge repeated tightening and loosening torque on two commercially available implant/abutment connection designs. Study Design: This was an in vitro study. Methodology: A total of 32 implant analogs samples using a metal die with, metal ring of 20mm x 20mm x 20mm in size and a hole in the center were prepared. For both the groups, the implant analog was axially threaded within bases. They were clasped at an edge parallel to the standard minimal bone position. A 35 N/cm torque was enforced, each implant and abutment connection in both the groups using toque ratchet. After 20 min, screws were loosened and detorque measurement was recorded up to ten times. Scanning electron microscope micrographs of selected screws also are presented. SPSS (21.0 version) was used for analyzing data. Results: The mean residual torque for Group 1 was − 51.45 and Group 2 was − 43.29. The RTq (%) was found to be significantly less (0.028*) among Group 2: conical connection as compared to Group 1: butt joint connection. Conclusion: The loosening torque was significantly less in conical connection as compared to butt joint connection.

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Context: Postoperative pain(POP) as a consequence of root canal preparation, is a major side effect, of endodontic treatment. It can be prevented by the use of cryotherapy. This randomized control trial was carried out, to test the latter's efficacy, so that it can be recommended, as a preventive measure for POP, during endodontic treatment. Aims: To evaluate the effect of cryotherapy on post-operative pain (POP) during endodontic treatment. Setting and design: Randomized controlled trial was conducted on 40 patients based on inclusion and exclusion criteria [Table 1] in mandibular premolars, diagnosed with symptomatic irreversible pulpitis and normal periapical tissues. Methods & Material: 40 patients were randomly distributed into two groups, Experimental and Control. In the experimental group, 10ml cold saline solution, at -, while in the control group, 10ml of saline solution at room temperature, was used as the final irrigant. Patients were asked to fill a questionnaire, pre-operatively and post-operatively at 6, 24, 48 and 72 hours. Statistical analysis: The obtained data was subjected to statistical analysis using SPSS version ' .0' software. Results: Incidence and intensity of POP, was found to be lower in patients treated with cold saline. Conclusion: Use of cold saline solution as final irrigant, during endodontic treatment, reduces the incidence and intensity of post endodontic pain.

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Background: Being healthcare professionals, the dentists should be aware of the basic and practical aspects of basic life support (BLS) and cardiopulmonary resuscitation (CPR). This study helps assess the knowledge and awareness of dental professionals toward it. Aim: The aim of the study is to assess the level of knowledge, awareness, and attitude toward “BLS” among dental students, interns, and dental practitioners. Materials and Methods: This survey-based study enrolled 70 students from 3^rd-year BDS, 70 students from final-year BDS, 80 interns, and 45 dental academicians/practitioners of the dental college. A semi-structured, validated, peer-reviewed questionnaire was used with three sections – demographic data, qualification, and experience; knowledge of participants regarding BLS (26 multiple-choice questions); and awareness and attitude toward BLS (7 close-ended questions). Results: Surprisingly, none of the 265 participants had complete knowledge of BLS and CPR. They lacked in basic knowledge of this important lifesaving protocol. The students and interns also were unaware of basic and applied knowledge of BLS, which shows the necessity of its inclusion in BDS curriculum. Conclusion: The understanding of lack of knowledge and awareness about BLS and CPR is alarming. Its inclusion in curriculum, training, and periodic re-training of dental undergraduates, interns, postgraduates, academicians, and practitioners is necessary.

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Background: Among the postoperative complications following periodontal surgery, the risk of infection stands out the most since infection of the surgical site can lead to poor surgical outcomes in terms of wound healing. Aim: This study aims to evaluate antibiotic-prescribing practices for various periodontal surgeries in vicinity of Nagpur city. Materials and Methods: An anonymous survey was distributed to periodontists through Google forms. The survey questioned prescribing practices for various periodontal surgeries, the demographic data and place of practice of the clinician, rationale for prescribing or not prescribing antibiotics, and acceptability of guidelines. The survey consisted of 12 questions, 7 of which were questioned to the practitioners “In an otherwise healthy patient, would you prescribe antibiotics for a X procedure” where X included various periodontal surgeries. Response choices were limited to “In most cases yes, in most cases no and I do not perform this procedure.” Results were analyzed using statistical software. Results: A total of 50 periodontists responded out of 98 who were contacted to participate in the survey with a response rate of 51%. Nearly 58% of practitioners had a predominant work setting of a dental college and 42% have a predominant work setting of private practice. Practitioners were significantly more likely to prescribe antibiotics all the periodontal surgical procedures. The most common rationale for prescribing antibiotics was to decrease the chances of developing an infection, whereas the most common rationale for not prescribing antibiotics was a healthy patient and based on current and previous literature. Nearly 66% of practitioners reported that they would follow the guidelines for antibiotic prescription if they were developed by American Academy of Periodontology (AAP). Bivariate analysis revealed that there is no significant role of other characteristics on the response of an individual. Even multivariate analysis does not reveal significance of baseline characteristics although it revealed that respondents working in a dental college are 2.15 times more likely to follow AAP guidelines as compared to private practitioners. Females are 1.64 times more likely to follow AAP guidelines as compared to males and respondents practicing inside Nagpur are 1.35 times more likely to follow AAP guidelines as compared to those practicing outside city. Conclusion: Practitioners are more likely to prescribe antibiotics in the majority of the periodontal surgical procedures despite the standard indications for prescription. This misuse can lead to numerous complications in treatment and development of antibiotic resistance. Based on these results, specific guidelines for the use of antibiotics suggesting a particular antibiotic to be used in a particular periodontal surgery and its duration is the need of the hour to prevent the overuse of antibiotics.

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Context: Melanin pigmentation of the gingiva is a physiological process that occurs in all ethnicities. Many treatment modalities are available to treat gingival hyperpigmentation. These are based on the principle of complete removal of the epithelial layer along with a part of subepithelial connective tissue which is then permitted to heal by secondary intention. Aim: This study aims to compare the treatment outcome of laser and its effectiveness in the management of gingival hyperpigmentation over scalpel. Design: A split-mouth study. Methods: Twenty young patients, between the ages of 18–35 with no systemic comorbidities with concerns regarding of dark-colored gums were selected for the study. A split-mouth study involving treatment of melanin pigmentation using scalpel abrasion on one side (left side upper and lower jaws) and Diode laser (980 nm) on other side (right side upper and lower jaws) was carried out. Observations regarding time taken, amount of bleeding during procedure, postoperative pain, healing of wound, and recurrence were made. Statistical Analysis: Data were analyzed using SPSS version 21.0 for Microsoft Windows. Results: Pain and healing were comparable in both the groups, though intraoperative time consumed and bleeding was significantly lower for laser group. Recurrence also was significantly lower on the laser group. Conclusion: Diode lasers can give better results in the management of gingival pigmentation compared to conventional scalpel abrasion technique.

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Background: There is a high prevalence of work-related musculoskeletal disorders in dentists. The most commonly affected areas are the neck, low back, wrist, and hand. The symptoms of the musculoskeletal disorder occur during the educational and training course in dental students. Aim: The aim of this study was to assess neck pain and the scapular stability in graduate dental students. Study Design: This was an observational, cross-sectional study. Study Setting: This study was conducted at a dental college attached to a tertiary care hospital. Methods: The site of pain over the neck region (in subjects with pain) was assessed using body diagrams. Assessment of intensity of pain (if present) was done using Numerical Rating Scale, scapular posture using the pectoralis minor (PM) length test and resting scapular upward rotation using Baseline Bubble Inclinometer, dynamic scapular positioning using Lateral Scapular Slide Test, and muscle strength of scapular stabilizers using Lafayette Manual Muscle Tester. The outcome measures were compared between 1^st-year undergraduate dental students (Group A) and dental interns (Group B). Results: Sixty-three female dental students (Group A, n = 32; Group B, n = 31) were included. There was a significant difference in the PM length test of left side (P = 0.02) and intensity of pain (right side P = 0.008, left side P = 0.003) in Groups A and B. The site of pain was over the lateral aspect of the neck and the character of pain was aching. We found no significant difference in other outcome measures. Conclusion: Dental students suffer from neck pain. Static scapular posture was affected, whereas the dynamic scapular stability was not affected.

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Aim: The objective of the study was to compare the effect of different irrigation regimes on push out bond strength of calcium silicate cements – Biodentine and mineral trioxide aggregate (MTA). Materials and Methods: Forty-eight human teeth with single root canals were divided into three groups according to irrigation regimes. Each canal was irrigated with 5 ml of each irrigant during and after biomechanical preparation as follows: 3% sodium hypochlorite (NaOCl) and 17% ethylenediaminetetraacetic acid; 3% NaOCl during and Q mix 2 in 1 after instrumentation and distil water as the control group. Canals were filled with biodentine and MTA accordingly. A horizontal middle root section of 1.5-mm thickness was taken, and analysis was done under the universal testing machine. Statistical Analysis Used: The statistical analysis was done by the one-way analysis of variance and post hoc Tukey test. The comparative analysis was done by using the independent t-test. Results: The push-out bond strength of 3% NaOCl + Q mix 2 in 1 was highest. The least was of the control group. Conclusion: The irrigation regimes have a differential effect on root canal sealers.

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Background: Ceramic veneers is one of the conservative esthetic treatment modality in dentistry. Success of veneer is very much dependent on the design preparation. Materials and Methods: Thirty selected teeth were categorized within three groups of 10 each with varying design preparations. After mounting the specimens, the incisal reduction was done, and porcelain laminate veneers were fabricated. Then cementation of the veneers was done with resin-cement, and fracture load was applied and recorded. Results: Multiple comparisons were done using post-hoc Tukey's test and modality of failure of veneers among the different designs were done using Chi-square test with the level of significance fixed at 0.05. Conclusion: Ceramic veneers preparation design including1 mm incisal reduction along with 1 mm of palatal-chamfer height revealed greater fracture toughness in contrast to incisal-reduction 1 mm along with butt-joint preparation design.

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Objectives: The objectives of this study were as follows: (1) to provide an overview of the feasibility, utility, merits, and demerits of virtual microscopy (VM) in pathological diagnostics and (2) to evaluate its advantages in dental and medical teaching over conventional microscopes. Materials and Methods: A literature survey was carried out in August 2020 in electronic databases such as PubMed using keywords such as virtual microscopy and whole slide imaging. The searches revealed 956 articles out of which 36 were selected after reading the full-text articles. Results: The review of 36 articles revealed that VM or whole-slide imaging (WSI) allows access to entire scanned sections of tissue that can be viewed on a computer in exactly the same way as conventional glass slides with a microscope and can be explored at several magnifications. VM offers many advantages like ease of accessibility through the Internet anytime or in any place, and moreover, the virtual slide does not get damaged or fade away like glass slide. Since it increases learning and comprehension, virtual microscopes have been used extensively in dental and medical education. Conclusions: VM opens a new world in tissue-based diagnosis through digitization of slides. The experiences of telepathology applications have already proved that it is a promising technology which has been adopted by histopathologists and cytologists across the world and contributing immensely to telepathology consultation in underserved areas. It is a feasible, valid, and approved technology for pathological diagnosis.

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Advancements in digital technology have transformed our daily lives, bringing everything within reach of our fingertips. In the last few decades, technologies have developed, trying to simulate the functioning of the human brain. The extensive search to simulate the human brain has led to the development of artificial intelligence (AI). AI deals with the computational understanding and ability of computers to mimic the human brain and perform tasks. With emerging technologies, AI has begun to establish the field of health care. The field of medicine and dentistry has encouraged the use of these technologies from data acquisition to even performing virtual surgeries. This paper highlights the role of AI in various fields of dentistry.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also currently known as CoV disease 2019 (COVID-19), has created a global health upheaval. The saliva of an infected person serves as a source for the transmission of CoV. The angiotensin-converting enzyme-2 receptors serve as the host receptor cells for CoV which is expressed in high numbers in salivary glands, oral mucosa, and gingiva. The salivary gland is a potential reservoir for COVID-19 even in asymptomatic but infected carriers. This knowledge could be used to employ salivary sampling as a noninvasive diagnostic method. IgA, IgM antibodies detected in self-collected saliva show more stability than RNA and may aid in the identification of asymptomatic patients. Saliva shows high sensitivity and specificity in the diagnosis of COVID-19 with >90% concordance reported between the saliva and nasopharyngeal swabs. Standardization with respect to sample collection, storage, and transport media can help in validation of diagnostic application of salivary-based testing.

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