Aim and Objectives: Oral surgical procedures can cause spread of infections in the clinics through visually imperceptible, splattered, and aerosolized blood. The aim of this study was to evaluate visually imperceptible blood contamination of clinical surfaces and personal protective equipment (PPE) in an oral surgery clinic using luminol. Materials and Methods: Following ethical approval, oral surgical procedures were performed under local anesthesia in a disinfected clinic, and PPE was used by the oral surgeon, dental assistant, and patients. After the procedure, clinical surfaces and PPE were evaluated for traces of visually imperceptible blood contamination using luminol. Data regarding blood contamination and the duration of the procedure were collected. Nonparametric tests, with 95% significance level (Epi Info, Stat Calc 7, CDC, Atlanta, USA), were used to identify statistical interactions between the duration of the procedure and the frequency of blood contamination. Results: Blood contamination was detected in flooring below surgical field (86.67%), instrument tray, operating light, dental chair, and suction unit (100%). Except head caps and shoe covers, blood contamination was detected in all the PPE used by the clinical personnel, and the eyewear and chest drapes used by patients. An increase in the surgical time beyond 40 min significantly increased the risk of blood contamination in the handcuffs of the clinical personnel (P < 0.01). Discussion and Conclusion: Visually imperceptible blood contamination of the clinical surfaces and PPE is associated with minor oral surgical procedures. This mandates the cleaning and disinfection of all clinical surfaces before and after minor oral surgical procedures and PPE for clinicians and patients during every procedure.

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AimsandObjectives: The aim of this work was to assess the advantages and disadvantages of magnetic resonance imaging (MRI) versus computed tomography (CT) in the initial evaluation of maxillofacial space infections by comparing various parameters of the imaging studies and comparing them on a three-point scale. Materials and Methods: We prospectively evaluated 15 patients with head and neck space infections. All patients underwent CT and MRI using similar slice thickness. We reviewed all imaging studies with special attention to location, extension, source of infection, extent of bone involvement, odontogenic or nonodontogenic, and presence of gas/calcium in the lesions. All the parameters were graded based on a three-point scale and were compared statistically by paired t-test. Results: According to the results we arrived at, MRI was superior to CT in regard to lesion conspicuity, extension, number of anatomic spaces involved, and source on infection. Although not significant, MRI detected a greater number of abscess collections. However, in the aspects of detection of intralesional gas and calcium and motion artifacts, CT was superior to MRI. However, these advantages of CT over MRI are not significantly better than those of MRI. Conclusion: MRI was considered superior to CT in the initial evaluation of head and neck space infections. Our study thus concludes that MRI may be used as the primary modality to evaluate patients with head and neck infections when clinically feasible.

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Aims and Objectives: Temporomandibular joint disorder (TMD) is an umbrella term for a number of conditions in the area of the joint, temple, and masticatory system. Many of those with TMD also suffer from headaches and anxiety. The aims and objectives of this study were to determine if there exists an association between the Diagnostic Criteria of TMD (DC/TMD) symptom questionnaire and report of headaches as well as stress. Materials and Methods: A cross-sectional study was implemented via the use of the DC/TMD symptom questionnaire and the perceived stress scale (PSS). This was distributed conveniently among dental students in a multi-dental school setting in Riyadh, Saudi Arabia, and was completed by 152 dental students. Odds ratios, Chi-square, and their corresponding 95% confidence intervals are reported. Statistical significance was set at P ≤ 0.05. Results: Those who ticked yes for pain on the TMD pain screener for pain with chewing hard or tough food, pain on mouth opening and lateral excursion, and pain with jaw habits as parafunction were at an odds risk from twice to thrice as likely to experience headaches. Similarly, those with poor coping skills on the PSS were more likely to have headaches (P = 0.002). Likewise, positive answers on the screener and symptom questionnaire were relevant with higher stress scores on the PSS. Conclusion: This study clarifies and reiterates the intertwined power of both stress and headaches; the former being a role player in TMD progression and the latter its product. TMD is unfortunately on the rise; it should not be brushed off as a nuisance. A multidisciplinary approach in diagnosis and treatment of both TMD and headaches by a team of orofacial pain specialist, neurologist, psychiatrist and/or psychologist, and physical therapists to untangle the deceiving presentation of both conditions would not only provide a more favorable prognosis but also improve cost and time expenditures.

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Aims and Objectives: Colored and deformed fluorotic teeth may affect the quality of life (QOL). The present study, therefore, evaluates the effect of dental fluorosis on the QOL of female high school and precollege students of Behbahan district in 2014. Materials and Methods: One hundred 15–18-year-old female students with dental fluorosis were selected from the high schools of Behbahan district by random cluster sampling technique. Dental fluorosis was measured clinically using Dean's index after analyzing the drinking water of the affected district. The effect of dental fluorosis on the QOL was then evaluated through a questionnaire. The data from Dean's index, condition-specific oral impact on daily performance (CS-OIDP) questionnaire, and the mean score of QOL questionnaire were analyzed in SPSS version 20 using Pearson's and Spearman's correlation analyses (α = 0.05). Results: The mean values of age and the QOL regarding appearance were 16.5 years and 61.5 ± 20.8 from 100, respectively. Spearman's correlation showed a positive correlation between CS-OIDP total score and the severity of fluorosis (P = 0.0001, r = 0.342). Spearman's correlation also showed a negative correlation between the QOL and the severity of fluorosis (P < 0.001, r = −0.496) so that by increasing the severity of fluorosis, the QOL was decreasing. Conclusions: Increasing the severity of fluorosis is associated with increasing the dissatisfaction and decreasing the QOL.

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Aims and Objective: The aim of the study is to determine the effect of chewing gum containing xylitol and sorbitol on mutans streptococci and Lactobacilli count in saliva, plaque, and gingival health and to compare the efficacy of chewing gums. Materials and Methods: The study was designed as a double-blinded randomized uncontrolled clinical trial with two parallel arms. A total of 80 students consented and completed the study. The test group (X) received corresponding pellets with xylitol and the control group (S) was given pellets containing sorbitol and maltitol three times daily for 30 days. Clinical scoring and saliva samples were collected at three different intervals, at baseline, 15^th, and 30^th day of the study. The outcome measure was plaque index score, gingival index score, salivary mutans streptococci, and Lactobacilli counts. Data collected were analyzed using Statistical Package for the Social Sciences (SPSS version 19.0). Results: There was no statistically significant difference between the mean of mutans streptococci count of test and control group at baseline and 15^th day, but there was statistically highly significant difference (P = 0.00) between the mean of mutans streptococci count in test and control group on the 30^th day. The mean of Lactobacilli count, plaque index, and gingival index score between test and control group showed no statistically significant difference at baseline, 15^th day, and 30^th day. Conclusion: The results suggest that only xylitol gum may interfere with the mutans streptococci composition and reduce it after continuous use of 30 days effectively as compared to sorbitol gum, but both the gums are equally effective on salivary Lactobacilli, plaque, and gingiva at different intervals.

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Aim and Objectives: The objective of the present study was to estimate the serum and salivary lactate dehydrogenase (LDH) levels in patients with oral submucous fibrosis (OSMF) and to study the association between serum and salivary LDH levels and mouth opening, frequency of habit, and duration of habit in patients with OSMF. Materials and Methods: Participants were divided into two groups: Group I – case group diagnosed with OSMF and Group II – the control group. Unstimulated whole saliva was collected from all the participants. The International Federation of Clinical Chemistry method was carried out with the help of LDH (P-L) kit (Crest Biosystems, Goa). Collection of blood sample was done under aseptic precautions and processed for LDH. The data were analyzed using SPSS software 2010 (version 19, IBM, Armonk, NY, USA). Descriptive statistics including mean, range, standard deviation, and percentage were used along with unpaired t-test and Pearson's correlation test. Results: All the participants were male and were in the age range of 18–60 years, with a mean age of 28.63 ± 10.39 years. The mean salivary LDH levels in patients with OSMF were 1057.30 ± 640.12 μg/dl and in the control group were 668.25 ± 498.45 μg/dl. The mean serum LDH level in patients with OSMF was 408.35 ± 158.35 μg/dl as compared to the control group was 313.05 ± 82.69 μg/dl. The Pearson's correlation coefficient between serum LDH and frequency of habit, duration of habit, and mouth opening was found to be 0.55, 0.53, and 0.69, respectively. The Pearson's correlation coefficient between salivary LDH and frequency of habit, duration of habit, and mouth opening was found to be 0.33, 0.04, and 0.13, respectively. The Pearson's correlation coefficient between salivary LDH and serum LDH was found to be −0.18. Conclusions: There was a significant increase in the serum and salivary LDH in OSMF patients as compared to controls; the salivary LDH did not seem to correlate with frequency of the habit, duration of the habit, or mouth opening of OSMF patients. However, serum LDH was found to correlate directly with frequency of the habit and mouth opening in OSMF patients. Hence, based on the results of the present study, it can be hypothesized that serum LDH is a better biological marker than salivary LDH in the evaluation of OSMF.

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Aim: The present study was aimed to compare the accuracy of Root ZX Mini and Propex II in the presence of 0.1% octinidine dohydrochloride (OCT), 2% chlorhexidine gluconate (CHX), and 5% sodium hypochlorite (NaOCl) heated and nonheated before and after preparation. Materials and Methods: Eighty extracted single-rooted teeth were selected for the study and decoronated. Teeth were mounted in an alginate model. Actual working length (AL) was measured using a stereomicroscope under ×4 magnification. Electronic working length measurements were recorded using Root ZX Mini and Propex II apex locators in the presence of 0.1% OCT, 2% CHX, and 5% NaOCl (nonheated and heated to 60°C) before and after preparation. Mean and standard deviation differences before and after preparation were calculated and statistically analyzed using analysis of variance and paired t-test. Results: The accuracy of Root ZX Mini before and after preparation within ±0.5 mm of AL was consistently high in the presence of irrigants than Propex II. 5% NaOCl (heated and nonheated) showed more variation than the other irrigants, in the working length determination in both the apex locators. Conclusion: Electronic length measurements were shorter with heated and nonheated 5% NaOCl and longer with 0.1% OCT and 2% CHX for both the electronic apex locators.

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Aims and Objectives: Peri-implant mucositis and peri-implantitis are one of the common biological complications affecting implant success. The present study aimed to evaluate various clinical parameters during implant maintenance phase. Materials and Methods: The study included patients undergoing implant maintenance phase for 1-year follow-up. The study consists of a total of forty individuals with age ranging from 35 to 65 years. They were further categorized into two subgroups on the basis of their history, i.e., Group 1: patients with no history of periodontitis before implant placement and Group 2: patients with a history of periodontitis before implant placement. Among the selected patients, a total of 98 implants were studied. All were individually evaluated for clinical parameters such as gingival index, pocket probing depth (PPD), and bleeding on probing (BOP). All the data obtained were tabulated and analyzed using statistical software SPSS version 18.0 for Windows (SPSS Inc., Chicago, USA). Quantitative analysis was done using t-test and Mann–Whitney U-test. Results: The mean age of the patients in Group 1 and Group 2 was 58.6 and 62.8 years, respectively, with not much gender difference. The mean plaque index for Group 1 was 0.17 ± 0.20, while for Group 2, it was 0.24 ± 0.14. The mean PPD and mean BOP for Group 1 came to be 2.60 ± 0.42 and 0.42 ± 0.15, respectively, whereas for Group 2, it was 4.08 ± 0.30 and 0.39 ± 0.48, respectively. Only PPD was found to be statistically significantly different between both the groups. Group 1 showed 2.0% peri-implantitis, whereas Group 2 showed 28% peri-implantitis. Conclusion: Due to increased prevalence of peri-implantitis cases with the increase in usage of implants, it becomes imperative to look up to the etiological factors and contributing factors so that the incidence of these can be minimized.

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Objective: The objective of this study is to recognize representative cranio-cervico-mandibular features of patients with Ehler–Danlos syndrome and associated temporomandibular disorders (TMDs), to assess a targeted and integrated treatment plan. Materials and Methods: After a diagnosis of disease, 38 individiuals with Ehler–Danlos syndrome and temporomandibular symptomatology referred were evaluated. Gnathological evaluation, according to the Diagnostic Criteria for TMDs, and radiographic imaging was performed. In addition, digital evaluation of occlusal and muscular balance, using surface electromyography of jaw muscles, was conducted. Statistical software for data analysis - STATA (StataCorp, College station, Texas, USA) - was used. Results: Most common temporomandibular dysfunctions were arthralgia, myalgia, disc displacement with reduction and subluxation. Headache and neck pain were the most frequent comorbidities. Somatization, depression, anxiety, and obsessive-compulsive behavior were the most recurrent psychological disorders. Electromyographic analysis showed out of normal range data. Conclusion: Early diagnosis and interception are requested to avoid injuries and repeated traumatism. Multidisciplinary treatments are available to approach all the aspects of the syndrome.

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Aims and Objectives: The introduction of ceramic brackets was a much-heralded development in the field of orthodontics. However, the increased frictional resistance with these brackets led to the development of ceramic brackets with metal slots, which claimed to combine the esthetics of ceramic brackets with the low frictional resistance of metal brackets. Hence, this study was undertaken to evaluate the rate of canine retraction and the amount of anchor loss while using ceramic brackets and ceramic brackets with metal slots and with conventional preadjusted edgewise appliance (PEA) metal brackets. Materials and Methods: The patient sample consists of 12 patients. Six patients received ceramic brackets on one canine and conventional PEA metal brackets on the opposite canine within the same arch. The other six patients received ceramic brackets with metal slot on one canine and conventional PEA metal brackets on the opposite canine within the same arch. Unpaired t-test was used to analyze the data using SPSS version 20 (3M Unitek, Bangalore, Karnataka, India). The rate of retraction was calculated for individual canine retraction after initial leveling and aligning. Anchor loss was also calculated using the pterygoid vertical to the mesiobuccal cusp of the upper first molar on the lateral cephalograms. Results: The result of this study showed that the difference in the rate of retraction between ceramic brackets with metal slot and conventional PEA metal brackets and ceramic bracket while clinically significant was not statistically significant. The difference in the amount of loss of anchorage of both the groups was not statistically significant. Conclusions: Incorporation of the metal slot in ceramic brackets has reduced frictional resistance for more efficient and desired tooth movement. Ceramic brackets with metal slot generate lower frictional forces than ceramic brackets but higher than conventional PEA metal brackets.

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Objective: Different fluoride varnishes are used for the prevention of dental caries. The aim of this study was to compare the antimicrobial effect of different fluoride varnishes, containing xylitol and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), on Streptococcus mutans. Materials and Methods: In this in vitro study, the antibacterial effects of four varnishes, namely Polimo and V-varnish (containing xylitol), MI varnish (containing CPP-ACP), and Preventa, were evaluated against S. mutans. The disc diffusion method was used for testing the bacterial sensitivity. The data were analyzed using the Kruskal–Wallis and Mann–Whitney U-tests. Results: According to the results, Polimo showed the highest antibacterial effects, compared to the other three varnishes (P ≤ 0.05). Growth inhibition zones were not observed in V-varnish and Preventa. The mean diameter of inhibition zone around the MI varnish was significantly higher, compared to those of the V varnish and Preventa (P ≤ 0.05). Conclusion: As the findings indicated, the fluoride varnish containing xylitol and CPP-ACP could be more effective iAQ1n the prevention of dental caries.

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Treating a live human being to their health has been considered as a noble profession since the ancient times. Doctors are duty bound by their professional ethics to provide the best treatment to their patients. Endodontics is the specialty branch of the dental science of saving natural teeth in the oral cavity. During endodontic procedures, a mishap can occur any time in a day-to-day practice and may be treated as negligence which in turn ends into some legal complications. To prevent and tackle such future medicolegal issues related to endodontic treatment, the knowledge of the legal aspect of such clinical situation is necessary.

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Aims and Objectives: Nicotine absorption through the mucous membrane is directly proportional to pH, so the snuff is buffered to pH of 8–9 by adding sodium carbonate. The objective of the present study is to assess the impact of various forms of sodium carbonate in snuff on mucosal conditions. Materials and Methods: The present cross-sectional study was conducted on 284 participants. Snuff users adding sodium carbonate were further splitted into two groups, that is, one group using sodium carbonate in premixed form, that is, (already mixed within pouches) and other group adding sodium carbonate separately (freshly mixed). The parametric one-way (ANOVA) of variance, stepwise regression analysis, and multiple logistic regression analysis have been done to narrate the relationship between variables of different forms of sodium carbonate in snuff and different oral conditions. Results: The statistics of our study reveals highly significant relationship between snuff users using sodium carbonate in freshly mixed (0.001**) form than that of premixed form (P = 0.030*). Conclusion: The present study narrates that there seems to be liaison between the use of sodium carbonate in snuff and oral mucosal lesions.

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Aims and Objectives: The reverse pull headgear has been widely used to intercept a developing skeletal Class III malocclusion with maxillary defi�ciency. Rapid maxillary expansion (RME) is recommended along with the reverse pull headgear because there is disruption of the circummaxillary and intermaxillary sutures. This, in turn, expedites the orthopedic effect of the reverse pull headgear. However, studies have shown that the circummaxillary sutures may not be fully disrupted by the use of RME alone. The protocol of alternate RME and constriction (Alt-RAMEC) has been found to produce much more beneficial effects. Hence, this retrospective study was conducted to compare and assess the results obtained in the two methods. Materials and Methods: This study comprised pre- and post-treatment lateral cephalograms of two groups of nine patients each (total 18 patients – 10 females and 8 males) having skeletal Class III malocclusion (ANB<0°) due to a retrognathic maxilla with or without associated mandibular prognathism treated at the Department of Orthodontics of a teaching institute in Kerala. The patients were treated with either Alt-RAMEC/protraction or RME/protraction. The statistical analysis of the data was done using statistical package SPSS Version 16 software (SPSS Inc., Chicago, IL, USA). Results: Skeletal, dental, and soft-tissue parameters in Group 2 (Alt-RAMEC group) showed very significant changes with the maxilla moving forward, mandible rotating backward and downward, and proclination of the maxillary incisors when compared to Group 1. Conclusions: It may be concluded from the results of our study that the Alt-RAMEC protocol and reverse pull headgear might be more effective than conventional RME and the reverse pull headgear to correct a retruded maxilla in a developing skeletal Class III patient.

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Aims and Objectives: The aim of this study was to evaluate the association between third molar agenesis and craniofacial morphology in a group of Iranian orthodontic patients. Materials and Methods: A total of 164 high-quality lateral cephalograms and panoramic radiographs were included in the study. Eighty-two radiographs with the absence of at least one-third molar were assigned to agenesis group and other 82 radiographic records were served as control group. Cephalometric analysis was performed, and the results were compared between the two groups using Independent Samples Student's t-test. Results: Significant differences were found in SNA, ANB, sum of posterior angles, and lower gonial angle between the study groups. All of them were smaller in the agenesis group. Conclusion: Third molar agenesis in this group of Iranian subjects is associated with deficient maxillary development and brachyfacial and hypodivergent skeletal pattern.

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Aim: The aim of this study is to compare the proliferative activity of exfoliated cells in bidi smoker's and nonsmoker's oral mucosa. Materials and Methods: The oral mucosal exfoliate smears were prepared from 40 individuals (20 nonsmokers and 20 smokers) with the age group ranging from 25 to 70 years, in and around Akola (Maharashtra). The Papanicolaou (PAP) stain and silver-stained nucleolar organizer region (AgNOR) were used to prepare cytogenic smear to evaluate the presence of cytological alterations, suggestive of inflammation, dysplasia, keratinization, and proliferative activity of epithelial cells. The present study involves PAP Class I and Class II smears. The obtained data were tabulated and statistically analyzed using statistical software IBM SPSS IBM Corp., Statistics for Windows, Version 20.0. Armonk, NY, USA: IBM Corp., and using t-test. Results: There was a significant difference in mean number of AgNORs/nucleus between nonsmokers (0.947 ± 0.2533) and smokers (3.021 ± 0.2256). There were 90% inflammatory changes observed in smokers whereas nonsmokers showed only 75% changes. PAP Class II changes, i.e., significant proliferative activity, were found between smokers and nonsmokers mucosa. Conclusion: A significant difference of AgNORs/nucleus was found between nonsmokers and smokers.

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