Aim: The aim of this study was to measure the effect of different attachments: telescopic crown, double Akers’ (DA)clasp, distal clasp (DC)-retained removable partial dentures (RPDs), and cantilever bridge on the intrusive movement of the abutment teeth. Materials and methods: A model imitating mandibular ridge of Kennedy Class I was fabricated with first and second premolar as abutments. A telescopic crown, DA, DC-retained RPDs, and cantilever bridge were fabricated. Each partial denture was placed at a time on the model; 50 N force was applied on each partial denture using ZWICK universal testing machine. The intrusion of the abutments was recorded using SOLARTON device. Data were collected and tabulated. Results: The mean values of the intrusive movement in telescopic separated (TS) RPD, telescopic joined (TJ) RPD, DA RPD, DC RPD, and cantilever bridge in tooth 35 were 147, 75, 57, 334, and 307 μm respectively, and in tooth 45 were 136,81, 65, 435, and 335 μm respectively. Conclusion: It can be concluded from the retrieved data that DA clasp-retained RPD caused less intrusion of the abutments than telescopic crown-retained RPD, followed by the DC than cantilever bridge. Clinical significance: The DA clasp is most favorable in the utilization in mandibular Kennedy Class I situation followed by telescopic crowns.

Aim: To evaluate the microshear bond strength and adhesive interface using scanning electron microscopy (SEM) of selfetching adhesive systems on normal and artificially hypermineralized dentin substrates. Materials and methods: A total of 65 (n = 65) bovine incisors were divided into two groups according to dentin type: Normal (n = 28) and artificially hypermineralized (n = 29). Composite resin cylinders were placed on these surfaces and cured (3M™ ESPE™ Filtek™ Z350 XT). Each group was divided into four subgroups (n = 7) according to the self-etching adhesive systems used (Clearfil SE Bond, AdheSE®, Adper™ Easy One, and OptiBond™ All-In-One™), and microshear bond tests were performed. In addition, one specimen from each group was prepared for an evaluation of the adhesive interface under a microscope (×2000 magnification). The differences between the groups were determined using two-way analysis of variance (ANOVA) and Tukey’s test (p < 0.05). Results: For normal dentin, the microshear bond strength values in MPa were as follows: Clearfil = 15.65; AdheSE = 14.71; Easy One = 21.92; and OptiBond = 28.43. For hypermineralized dentin, the values were as follows: Clearfil = 20.96; AdheSE =17.23; a nd O ptiBond = 2 3.29. T here were n o s ignificant differences between any of the adhesives used (p > 0.05). When adhesion, dentin, and interaction were treated as factors and analyzed, a significant difference was found only in the case of the adhesive (p = 0.0002). Conclusion: Self-etching adhesive systems with higher degrees of acidity do not necessarily exhibit greater microshear bond strength in hypermineralized teeth. Clinical significance: It is important to obtain bond strength values to analyze the possible clinical performance of the adhesive systems. Furthermore, information on their interactions with different types of dentin substrates proved complementary and useful in the study performed herein.

Aim: To assess the anticariogenicity of microwave-assisted 0.5% extract of Stevia rebaudiana leaves in high caries risk patients. Materials and methods: Forty-six patients with high risk for caries were selected. They were randomly assigned to two groups; group I was allocated for chlorhexidine (CHX) mouthwash (0.12% Perio-Aid) and group II for S. rebaudiana (0.5% extract of Stevia bio) mouthwash. Salivary pH, buffer, and microbial count were assessed before the patients were asked to use the mouthwashes. Patients were prescribed the mouthwash/ extract twice a day for 7 days. On the 8th day, postrinse salivary pH, buffer analysis and Streptococcus mutans and Lactobacilli count were done. Results: Significant difference in pre- and postrinse values of pH and buffer was found in both groups. However, no difference was noted between groups. Both groups decreased the bacterial count to <105 colony-forming units (CFUs) in all the patients. Conclusion: Stevia rebaudiana extract in 0.5% concentration improved the pH and buffering capacity of the saliva in a high caries risk patient. It also reduced cariogenic organisms in saliva. Clinical significance: Stevia rebaudiana extract in 0.5% concentration can be used as a mouthwash for moderate-to-high caries risk patients. However, long-term clinical studies are required to prove its substantivity like that of CHX.

Aim: The aim of this study is to investigate the effect of mobile phone waves and Wi-Fi on electrolytes and oxidative stress indices of saliva. Materials and methods: A case group of 20 Wi-Fi and mobile phone users and a control group of 20 deaf people were selected. Saliva samples were obtained from both of these groups. Study variables, including the electrolytes and oxidative stress indices of saliva, were measured. The independent two-sample t-test was used to analyze the data. The statistical significance was defined at p < 0.05. Results: The mean sodium and malondialdehyde (MDA) levels in the case group were higher than in the control group. The results also showed that there was no significant difference between sodium and potassium levels (p = 0.163 and p = 0.892, respectively) and the oxidative stress of total antioxidant (TAO) and MDA (p = 0.138 and p = 0.115, respectively) in either of the two groups. However, there was a significant difference in salivary nitric oxide (NO) levels (p = 0.04) between the case and control groups. Conclusion: Electromagnetic waves affected the saliva composition to an extent that it caused a significant decrease in the NO levels of the case group. Clinical significance: Nitric oxide acts as an active radical in nonspecific defense mechanisms in the oral cavity. So, reduction of NO with mobile phone and Wi-Fi waves can cause disruption in the human defense system. These results illustrate the necessity of reducing contact with these waves.

Introduction: Children with dental problems are 12 times more likely to have restricted activity days.1 More than 50 million school hours are lost annually because of oral health problems, which affect children’s performance at school and success in later life. In a metropolitan city like Mumbai, no systematic assessment on the oral health problems is available, especially among children belonging to low socioeconomic class studying in municipal schools. Hence, the current study was planned among the children studying in V to VII standards in suburban municipal school and predominantly from a low socioeconomic area, located in the field practice area of a teaching medical college. Materials and methods: The present cross-sectional study was conducted among 299 schoolchildren aged 9 to 13 years using a pretested semi-structured questionnaire and clinical oral examination to assess their oral health morbidities, healthseeking behavior, and need for dental interventions. Results: About 78.3% children were found with dental caries and 61.2% children were suffering from bleeding and inflamed gums; 19.4% children required extraction and 41.5% required extraction and restoration. However, dental services were availed by only 13.6% of the children. Conclusion: Sustained advocacy and regular dental outreach programs are needed among parents, teachers, and schoolchildren for early diagnosis and management of oral morbidities. Clinical significance: Oral health and people’s behavior are largely determined by the socioeconomic milieu and the conditions in which they live. Therefore, treatment for all common oral health problems is not feasible due to limited resources. As rightly said, prevention is better than cure, and oral health awareness education of the public and schoolchildren at large can make a huge difference.

Background: The prevalence of periodontitis is significantly higher among people with poorly controlled diabetes mellitus (DM). The current study aimed to correlate the possible relation of stress in patients with chronic periodontitis as well as DM. Materials and methods: A total of 60 individuals were recruited in the age range of 35 to 50 years. Patients were divided into three groups which include 20 each: group I: chronic periodontitis with diabetic mellitus; group II: chronic periodontitis without DM; and group III: systemically and periodontally healthy individuals. Psychological assessment and biochemical analysis were carried out in all the patients. Results: Mean clinical attachment level (CAL) in group I was 6.21 mm, group II was 5.40 mm, and group III was 0.00 mm (healthy periodontium). Group I recorded highest mean cortisol levels of 22.55, which was significantly higher as compared with group III, which presented a mean cortisol level of 12.72. Mean cortisol level in group II was 15.70, which was marginally higher than in group II. Individual cortisol levels were relatively constant in group II (minimum 14 and maximum 18). Group III presented a skewed individual cortisol levels (minimum 8.78 and maximum 17.31), whereas group I presented a significantly high individual cortisol levels (minimum 16 and maximum 25.5). Group III presented least mean prostate symptom score (PSS) of 6.75, group II 18.55, and group III 24.90. Conclusion: There seems to be a strong correlation between periodontal destruction, DM stress, and serum cortisol levels. Clinical significance: Psychosocial stress influences the course and progression of periodontitis and should be addressed before and during treatment.

Aim: The aim of the study is to find out the radiographic correlation between cervical vertebrae maturation (CVM) and chronological age. Materials and methods: A total of 67 patients, 35 boys and 32 girls, who required orthodontic and orthopedic treatment were selected for the study after considering inclusion and exclusion criteria. Cervical vertebrae as seen in lateral cephalogram were assessed using the criteria as proposed by Lambarki modified by Hassel and Farman. Results: Statistical analysis using analysis of variance (ANOVA) test (Fisher’s F-test) showed that for males, F = 13.539 and p = 0.000 and for females, F = 22.159 and p = 0.000. This indicates that the correlation is very highly significant in both sexes. Conclusion: The chronological age could be predicted reliably assessing the CVM index. The skeletal maturity is achieved faster in females compared with males. Clinical significance: This method finds its application where growth modification treatment is indicated. The results have great value in forensic odontology.

Aim: The present study was carried out with the objective of comparing the compressive strength and setting time of four experimental nanohybrid mineral trioxide aggregates (MTAs) and angelus MTA.Materials and methods: In this research, four experimental formulations of nanohybrid MTA (groups are with the base of Portland cement, containing nanoparticles of zirconia, aluminum oxide, titanium, nanosilica, and gypsum and bismuth trioxide) and angelus MTA were compared. Powder and water were mixed with the ratio determined by a factory for angelus MTA and were mixed at a ratio of 3:1 in experimental samples until the consistency of putty was reached. These were then placed in stainless steel cylinder generators, with a diameter of 4 mm and a height of 6 mm, for testing compressive strength, and in generators with a diameter of 10 mm and height of 2 mm to test setting time. The samples prepared were tested after 24 hours and a month using a strength-testing machine. A 135 G needle was used to test the initial setting time in the prepared samples, and a 456.5 G needle was used to test the final setting time. In the end, data were analyzed using Statistical Package for the Social Sciences (SPSS) software. Results: Experimental nanohybrid MTA P significantly showed the minimum setting time and experimental nanohybrid MTA Q showed the maximum setting time in 30 days (p < 0.05). Angelus MTA had greater compressive strength than the experimental materials in 24 hours. Conclusion: Experimental MTAs showed less setting time compared with the angelus MTA. Addition of nanoparticles in the Q group significantly affected the compressive strength of MTA. Compressive strength significantly increased over time in all groups.Clinical significance: Considering that experimental MTAs showed less setting time compared with the commercial type, experimental MTAs can be deployed in clinical usage.

Introduction: Hydrogen peroxide (H2O2) is an effective bleaching agent of tooth whitening, but its use causes changes in the chemical composition of the elements that configure tooth enamel. The purpose of this study is to determine whether there are changes in the composition of the elements that configure the tooth enamel after bleaching using 35% H2O2. Materials and methods: This study was performed in vitro, which is an experimental research laboratory with controlled time series design. The samples used in this study were six permanent incisors postextraction and are divided into treatment and control groups. The control group was soaked in saline and treatment groups applied with H2O2 35%, with time series of 1, 1.5, 2, 2.5, and 3 hours. The elemental composition of enamel was observed using energy-dispersive X-ray spectroscopy analysis; results can be obtained both qualitatively and quantitatively. This study was analyzed using non-parametric test (Kruskal–Wallis test) to determine changes in enamel composition after bleaching, whether there is a change in enamel composition or not. Results: The results of this study showed a p-value of 0.406 (p < 0.05; significant). The result shows a change in the composition of dental enamel after bleaching using 35% H2O2. Conclusion: Application of 35% H2O2 as the bleaching agent does not have a significant influence on changes in the composition of the elements contained in the enamel.

Aim: The aim of this study was to evaluate the degree of monomer conversion of bulk fill composites at different depths. Materials and methods: The bulk fill products tested were SDR™, SonicFill™ System, Venus® Bulk Fill, and Tetric Evo- Ceram® Bulk Fill. In addition, this study tested conventional composites that have been indicated for use in association with bulk fill composites (Venus® and Tetric EvoCeram®), as well as the Ceram X™ conventional composite. To analyze the degree of conversion (DC), specimens (n = 10) consisting of four individual portions through the depths of cure (1, 2, 3, and 4 mm) were created. These samples were ground, pressed with potassium bromine, and analyzed using Fourier-transform infrared (FT-IR) spectroscopy. Two-way analysis of variance (ANOVA) and Bonferroni post hoc methods were applied to the results (p < 0.05). Results: Venus® Bulk Fill exhibited the best results at all of the depths tested. None of the bulk fill composites considered herein exhibited any significant differences between the depths. Conventional composites were found to have significantly lower DCs at greater depths. Conclusion: The results show that when depth of cure is being considered, bulk fill composites may be used at thicknesses of up to 4 mm. Clinical significance: Bulk fill composites are indicated to be inserted in increments of up to 4 mm. In this sense, it is fundamental to determine DC in these depths to ensure obtaining adequate mechanical properties.

Aim: The aim of this study is to evaluate the stability and antibacterial effect of various concentrations of triple antibiotic paste (TAP) against Enterococcus faecalis with antibiotic susceptibility testing. Materials and methods: The stability and antibacterial effect of TAP was tested with antibiotic susceptibility test against E. faecalis by using Agar disk diffusion method over a period of 1, 3, 7, 14, and 21 days. The samples were divided into three groups: group I (1% TAP), group II (2% TAP), group III (3% TAP), and group IV (chlorhexidine as control). The zones of inhibition were measured after 24 hours and were recorded in millimeters and the same procedure was repeated again after 3, 7, 14, and 21 days. Results: Higher concentration of 3% TAP showed superior antibacterial effect against E. faecalis compared with 1% TAP, 2% TAP, and control group (chlorhexidine). The antibacterial efficacy increased more rapidly after 21 days when compared with 24 hours, 3 days, and 7 days. Conclusion: Under specified limitations of this in vitro study, higher concentration of TAP can be used as an effective intracanal medicament against E. faecalis. It is clearly experimented that longer duration of application of intracanal medicament increases its antibacterial effect against E. faecalis. Clinical significance: Triple antibiotic paste can be prepared, stabilized, and used for a period of 21 days.

Aim: The aim of the study was to analyze the stress distribution and displacement of palatally impacted maxillary canine and its adjacent teeth (lateral incisor and first premolar) when orthodontic extrusion forces were applied on the impacted canine. Materials and methods: A three-dimensional finite element model of a maxilla containing a palatally impacted canine was constructed. Forces of 50, 70, and 100 gm were loaded on the impacted tooth. Results: There was a steady increase in the initial rate of displacement and the von Mises stress of the periodontal ligament (PDL) in the three teeth when the magnitude of the force that was applied onto the canine increased. The initial rate of displacement was more in the first premolar tooth as compared with lateral incisor and the impacted teeth. Conclusion: The rate of displacement in relation to the first premolar was more as compared with the lateral incisor, indicating that the first premolars had the maximum anchor loss. The use of minimal forces is ideal to extrude the impacted canines, as observed from the study that the PDL stress increases with increase in the magnitude of force. Clinical significance: The use of finite element analysis (FEA) can help us to understand how biological tissues (tooth, PDL, alveolar bone, etc.) would respond to the orthodontic forces that are being applied on them. Individual virtual models customized to the patient’s clinical situation can be obtained and tested for various orthodontic force applications.

Aim: The aim of this article was to present a detailed case report of semidirect composite restoration in tooth #36 and its anatomical and esthetic reestablishments. Semidirect restorative technique is an alternative with many advantages for both clinicians and patients. It can improve esthetics with minimal dental tissue removal, reduce polymerization contraction, improve marginal sealing, reduce infiltration and postoperative sensitivity, and enhance the restoration longevity. Moreover, it is a low-cost technique and carried out in a single session. A female patient reported with sensitivity and discomfort in tooth #36 region; clinical evaluation showed marginal infiltration and restoration loss, and thus, semidirect restoration technique was recommended. The impression was carried out using precision alginate, and a semirigid addition silicone model was obtained. Semidirect restoration was performed using a model outside the mouth. Semidirect restoration is a viable alternative improving dental esthetics with conservative treatment, reducing polymerization shrinkage, improving marginal sealing, reducing infiltration and postoperative sensitivity, and enhancing restoration quality. Clinical significance: Semidirect restoration is a low-cost technique with advantages, such as polymerization control, esthetic refinement, and facilitating of occlusal and contact point adjustments.

Aim: The aim of the study is to try growth modification in late pubertal growth. Introduction: In the given case report, clinician tried tandem appliance for correcting skeletal class III malocclusion in a patient on the verge of growth completion. Case report: A 12-year-old female patient with maxillary deficiency was treated with growth modulation therapy for maxillary advancement. Residual growth potential was fully utilized and facial harmony was established for future. Conclusion: Class III malocclusion in adolescents is challenging to treat. Incidence of class III malocclusion is <5% among Indian population, and lack of awareness creates difficulties in its treatment options. If a growing patient reports on time with the complaint of sunken face appearance or cross-bite, the clinician may treat the patient very well with relevant treatment options. Because of lack of awareness, the patient with Class III malocclusion reported after completion of growth. This situation reduces available treatment modalities. Clinical significance: We are reporting a case of a female patient with class III malocclusion at the end of growth completion. Treatment modalities tried at the end of growth were found to be effective. Chin cap was given to the patient to prevent relapse from any possible remaining growth of mandible.

Aim: The purpose of this article is to reiterate the importance of transmylohyoid orotracheal intubation in panfacial fractures that require maxillomandibular fixation (MMF) followed by assessment of occlusion and the need to avoid tracheostomy. Maxillofacial injuries are very common following road traffic accidents. Many times, injured patients present with panfacial fractures and need intraoperative MMF to attain dental occlusion, setting unique anesthetic challenges. A choice often has to be made between orotracheal and nasotracheal when surgical access to the nasal or oral cavity is necessary. A 28-year-old obese male patient was scheduled for the management of panfacial fracture sustained in a motorcycle accident. Transmylohyoid orotracheal intubation was performed due to the need for MMF. Transmylohyoid orotracheal intubation is a simple, secure, and effective procedure for operative airway control in major panfacial traumas. Clinical significance: Transmylohyoid orotracheal intubation should be chosen over tracheostomy in panfacial fractures that manifest as MMF.

Introduction: Periodontitis results in defects of the bone, of which the horizontal defects are the most common. Treatment options for horizontal defects are minimal with unpredictable results. Background: Polymethyl methacrylate (PMMA) bone cement has been effectively used in orthopedic surgeries. The material has excellent interface integrity with bone and hence would develop an efficient micromechanical bond to both bone and tooth. This material can be used to reconstruct the lost alveolar bone, especially in areas with horizontal bone defects where regeneration is difficult to achieve. Results: The PMMA bone cement has certain properties that make it a not very apt replacement of the dynamic alveolar bone. However, modification of the cement through addition and replacement of appropriate materials would make it an effectual foundation for the teeth deprived of their alveolar bone. Conclusion: Bone cement, with appropriate modifications, might prove a novel substitute for the lost alveolar bone structure. Clinical significance: Horizontal bone defects that form the majority of periodontal bone defects require a definitive treatment modality to allow for retention of the affected teeth. Modified bone cement could prove to be the much required miracle agent in the treatment of horizontal bone defects.