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   2018| September-October  | Volume 8 | Issue 5  
    Online since October 8, 2018

 
 
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REVIEW ARTICLES
Nickel–Titanium rotary instruments: Development of the single-file systems
Maryam Kuzekanani
September-October 2018, 8(5):386-390
DOI:10.4103/jispcd.JISPCD_225_18  PMID:30430063
Over the past two decades, the nickel–titanium (NiTi) rotary instruments have highly improved the quality of the cleaning and shaping of the root canals. The superelasticity and shape memory of these instruments reduce the possibility of the canal transportation along with saving the time for both the patients and the clinicians. Several commercial types of these instruments, produced by different manufacturers, have currently become available by modifying the characteristics of the wonder NiTi alloy and also the cross-sectional shapes, cutting edges, tapering and numbers and distances of the flutes of the instruments. Up to this date, five generations for NiTi rotary instruments have been described according to the time of introduction, properties, and method of application. The aim of this article is to review the evolution of these five generations of NiTi rotary instruments since their inception.
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ORIGINAL ARTICLES
Factors affecting access to oral health care among adults in Abha city, Saudi Arabia
Mohammed Abdullah Almutlaqah, Mohammad Abdul Baseer, Navin Anand Ingle, Mansour K Assery, Majdah A Al Khadhari
September-October 2018, 8(5):431-438
DOI:10.4103/jispcd.JISPCD_205_18  PMID:30430071
Aims and Objectives: To investigate the self-reported access problems to dental care among adults in Abha city, KSA. Materials and Methods: A cross-sectional descriptive survey was carried out among adults in Abha city, Saudi Arabia. A structured, close-ended, self-administered questionnaire elicited the access and utilization of dental care among a sample of adults. Data were collected and analyzed using SPSS version 21.0 statistical software. The descriptive statistics and logistic regression analysis were performed to predict the variables associated with access and utilization of dental care. Results: A total of 499 adults (male = 270, female = 229) participated in the study. More than half (289, 57.9%) of the participants utilized dental services and emergency services (283, 56.7%) were the most common reason to visit dentist. For most of the participants (281, 57.1%), the last dental visit was less than 1 year. Majority (409, 82%) of the participants self-funded for their treatment in private dental clinics (382, 76.6%). More than half (258, 51.7%) of the participants received restorative treatment during their last visit to dentist. Cost (39.1%) and lack of time (28.7%) were the main barriers to accessing dental care. Education and income were all involved in predicting nonutilization of dental services among the study participants. Conclusion: Access to and utilization of dental care are the multidimensional concepts influenced by many factors. Cost and lack of time were the predominant barriers to utilization of dental services. Access to dental care is a multidimensional issue with education and income, were considered as the significant predictors of nonutilization of dental services. Similarly, income and transportation problems significantly predicted the use of private dental services. Marital status, transportation problem, health problems, and difficulty in movement were all concerned with multiple barriers to accessing dental services among the study participants.
  13 3,100 354
Efficacy of a self-designed mobile application to improve child dental health knowledge among parents
Alaa Ahmad Alqarni, Haifa Musa Alfaifi, Najla Ahmed Aseeri, Thuraya Gadah, Rafi Ahmed Togoo
September-October 2018, 8(5):424-430
DOI:10.4103/jispcd.JISPCD_195_18  PMID:30430070
Objectives: The objective of the study is to develop a mobile-based application and assess its efficacy in improving child dental health knowledge of parents. Subjects and Methods: A mobile-based application (Your child's smile) was developed and made available on application-store and play store. This application provided all essential information to parents on child dental health prepartum and from infancy to adolescence. To assess improvement in parent's knowledge two similar pretested questionnaires were incorporated within the application, one to be filled at initial registration and other after the parents had utilized the application. Responses were entered into MS excel sheet and analyzed using IBM SPSS statistics version 20.0. Results: Within the 15 days' research period, the application was downloaded by 230 parents out of whom 110 answered only the 1st and 120 both questionnaires. Out of the 120 who responded to both majority showed highly significant (P < 0.01) or significant (P < 0.05) improvement in their knowledge on tooth development, importance of deciduous teeth, importance of regular dental check-up, pit and fissure sealants, bedtime bottle use, and consequence of early loss of deciduous teeth. Confidence in child dental health knowledge was also evident in other areas with more parents opting for agreeing, strongly agree, or disagree options. A majority 75% of parents favored the use of mobile applications as an effective child dental health knowledge tool. Conclusion: Within the limitations of the study, we can conclude that mobile based applications are an effective tool for providing child oral health knowledge to parents and significant improvement in knowledge is evident after parents utilized the mobile-based application.
  9 3,577 353
Bite force evaluation in complete denture wearer with different denture base materials: A randomized controlled clinical trial
Mostafa I Fayad, Hussam Hakem T. Alruwaili, Muhammad Sartaj Khan, Muhammad Nadeem Baig
September-October 2018, 8(5):416-419
DOI:10.4103/jispcd.JISPCD_2_18  PMID:30430068
Aim: The aim of this study is to evaluate the maximum bite force (MBF) with different denture base materials in completely edentulous patients. Materials and Methods: MBF was evaluated in randomly selected 100 completely edentulous patients. Patients were selected from the Outpatient Clinic, College of Dentistry, Aljouf University, Saudi Arabia. The patients were randomly divided into two equal groups: Group I (control group): Patient received a conventional heat-cured acrylic complete denture (Vertex™ Regular, Vertex-Dental B.V., The Netherlands) and Group II (experimental group): Patient received a thermoplastic complete denture (Vertex™ ThermoSens, Vertex-Dental B.V., The Netherlands). MBF measurements were taken at the time of new denture placement and after 6 months of denture use. Statistics were analyzed using independent t-test to compare the MBF measurements between both groups. Results: At the time of denture placement, there was no significant difference in bite force measurements between both groups. Bite force is increasing considerably after 6 months of denture use, and it was higher than MBF recorded at the time of new prosthesis placement in the same group. The MBF values were considerably higher in patients with a thermoplastic denture than patients with conventional acrylic denture with statistically significant difference after 6 months of denture use. Conclusion: After 6 months of denture use, patients with a thermoplastic denture have a higher biting force than patients with a conventional acrylic denture. Therefore, it could be considered a treatment plan option according to the ridge nature and quality to solve the problem of diminished bite force in old age patients.
  8 3,527 312
Evaluation of the prevalence of oral mucosal lesions in a population of eastern coast of South India
M Krishna Priya, P Srinivas, T Devaki
September-October 2018, 8(5):396-401
DOI:10.4103/jispcd.JISPCD_207_17  PMID:30430065
Objective/Aim: The aim of this study is to measure the association between oral mucosal lesions (OMLs) and habit of tobacco and alcohol in the population of Guntur city, Andhra Pradesh, South India. Material and Method: A cross-sectional study was conducted on 300 participants in Guntur city with the habit of tobacco and alcohol consumption in various forms who were selected by stratified cluster random sampling technique. Guntur city was divided into four zones, that is, North, East, South, and West; and two administrative wards were randomly selected from each zone as clusters. Information was obtained by interviewing the participant regarding various tobacco-related habits followed by standardized clinical examination in the field. Clinical data were collected using a modified 1980 WHO Pro forma where the basis for diagnosis was established as per the criteria provided by the epidemiology guide for the diagnosis of oral mucosal diseases (WHO). Statistical tests such as Pearson Chi-square were exercised to test the significance, using SPSS version 19.0 with 0.05 as cutoff level of significance. Results: Overall oral soft-tissue lesions were found in 42.4% of the study participants including nicotinic stomatitis, tobacco pouch keratosis, smokers melanosis, mild keratosis of the palate, and chewer's mucosa. In this study, nicotinic stomatitis was found to be the most common soft-tissue lesion among men, while leukoplakia was found to be the most common premalignant lesion with the prevalence being 5.7%. While oral submucous fibrosis was found to be the most common premalignant condition among women. It was found that 13.2% of illiterates (53) were having leukoplakia. In the present study, the lower labial mucosa and buccal mucosa were found to be the most common sites of occurrence of leukoplakia and oral submucous fibrosis. Conclusion: This study gives information on the association of OML in smokers, chewers, alcoholics, and those with mixed habits. This study highlighted six habit-related OML which included potentially malignant disorders such as leukoplakia and oral submucous fibrosis. Future case–control or cohort studies for individual lesions and with larger sample size are necessary to evaluate the risk for OML including potentially malignant conditions and oral cancer resulting from smoking and chewing habits.
  6 4,000 644
Comparison of cheiloscopy and rugoscopy in Karnataka, Kerala, and Manipuri population
Sangameshwar Manikya, V Sureka, MD Prasanna, Krantikiran Ealla, Sridhar Reddy, Padala Swetha Bindu
September-October 2018, 8(5):439-445
DOI:10.4103/jispcd.JISPCD_223_18  PMID:30430072
Aims and Objectives: The aim of the study was to evaluate and compare lip prints and palatal rugae pattern in Kerala, Karnataka, and Manipuri population. Materials and Methods: The study involved 180 individuals (60 each from Karnataka, Kerala, and Manipuri population). Lipstick was used to record lip prints, which were visualized by magnifying lens. Palatal rugae were recorded on maxillary casts of all subjects and analyzed following Kapali S et al.' s classification. Statistical Package for the Social Sciences version 20 for Windows software was used for analysis. Results: Among the study population, most frequent lip print pattern was Type 3 and least was Type 1'. When patterns were compared between groups, Type 3 was the most common in Manipuri and Kerala and Type 3 in Karnataka groups. In the entire population, males showed Type 3 and females showed Type 1. On analysis of overall rugae wavy, forward and divergence patterns were predominant. On comparison of gender, males demonstrated greater number of wavy and perpendicular rugae, and females had curved, straight, forward, and backward. Conclusion: Both cheiloscopy and rugoscopy have the prospective to recognize an individual. Cheiloscopy is more reliable than rugoscopy in making out the group and gender of an individual.
  3 2,857 225
Biomechanical behavior of an implant system using polyether ether ketone bar: Finite element analysis
Otávio Augusto Luitz Jaros, Geraldo Alberto Pinheiro De Carvalho, Aline Batista Gonçalves Franco, Simone Kreve, Paulo Augusto Batista Lopes, Sergio Cândido Dias
September-October 2018, 8(5):446-450
DOI:10.4103/jispcd.JISPCD_183_18  PMID:30430073
Aim and Objectives: This study assessed, through finite element analysis, the biomechanical behavior of an implant system using the All-on-Four® technique with nickel–chromium (M1) and polyether ether ketone (PEEK) bars (M2). Materials and Methods: Implants and components were represented in three-dimensional (3D) geometric models and submitted to three types of load: axial, oblique, and load on all teeth. The 3D models were exported to a computer-aided design-like software such as Solidworks 2016 (Dassault Systemes, Solidworks Corps, USA) for editing and Nonuniform Rational Basis Splines parametrization. Results: Data were analyzed according to system's areas of action: peri-implant bone, implant, intermediates, intermediates' screws, prostheses' screws, and bars. Largest peak stress was shown in M2. Conclusion: PEEK is a promising material for use in dentistry; however, further studies are necessary to evaluate its performance.
  3 3,142 316
A comparative immunohistochemical study of presence and distribution pattern of stromal myofibroblast in oral dysplasia and in different grades of oral squamous cell carcinoma
Kalpajyoti Bhattacharjee, HC Girish, Sanjay Murgod, Alshame M. J. Alshame, K Shyamala, Vaidhehi N Nayak
September-October 2018, 8(5):451-456
DOI:10.4103/jispcd.JISPCD_236_18  PMID:30430074
Aims and Objectives: Squamous cell carcinoma (SCC) is a common oral malignancy with a poor survival rate. Early tumorigenesis is marked by transdifferentiation of fibroblasts to myofibroblasts (MFs), which is supported by growth factors and cytokines expressed by tumor cells. The expression of alpha-smooth muscle actin (αSMA) marker correlates with the activation of MFs. This study was undertaken to compare the frequency and distribution of αSMA immunoexpression in oral epithelial dysplasia (OED) and OSCC. Materials and Methods: This study was conducted on samples collected from patients with oral epithelial dysplasia and oral SCC who visited Rajarajeswari Dental College and Hospital, Bengaluru. Tissue sections were subjected to Immunohistochemistry using αSMA marker, and cells were counted. The obtained data was subjected to Kruskal–Wallis test and Mann–Whitney U-test. Results: On performing Kruskal–Wallis test and Mann–Whitney U-test between the three groups (normal oral mucosa, OED, and OSCC) statistically significant result was found in the frequency between OED and OSCC and between normal tissue and OSCC. On comparing the distribution pattern, statistically significant result was found between OED and OSCC and between normal tissue and OSCC. Conclusion: The expression of MFs increases as the disease progresses from high-grade epithelial dysplasia to invasive OSCC. Poorly differentiated SCC showed more attendance of positive MFs in the stroma than other grades of OSCC. The rise in the number of αSMA-positive MFs and change in distribution pattern in OSCC can be associated with tumor invasive characteristics. Thus, the proliferation of MFs may be used as a stromal marker of premalignancy and malignancy.
  3 2,398 253
CASE REPORT
Four-year follow-up of increased vertical dimension of occlusion using resin composites
Cendrella Assaf, Jean Claude Fahd, Joseph Sabbagh
September-October 2018, 8(5):469-474
DOI:10.4103/jispcd.JISPCD_233_18  PMID:30430077
The objectives of this case report were to treat a severe loss of the vertical dimension of occlusion with indirect composite and to evaluate the durability of the restorations. A 55-year-old male complains from severe wear of teeth, leading to a change in normal occlusal plane. Two major treatment modalities were proposed to this patient; a conventional invasive crown placement with root canal treatments or a minimally invasive approach relying on adhesion. The latter was adopted and used to treat this patient. This paper describes a step-by-step approach of the different treatment phases starting with teeth preparation, then provisional prostheses, and ending with the placement of indirect anterior veneers and posterior onlays, all made with laboratory resin composite. Satisfactory clinical results were observed over the 4-year follow-up, with minimum failures limited to one partial fracture of inlay treated with direct adhesive repair.
  2 5,393 552
ORIGINAL ARTICLES
Effect of recasting on physical properties of base metal alloys: An in vitro study
Jittin James, Jose Julian, J Rahul, Gibi Babu Philip, Jinsa P Devassy, PB Reba
September-October 2018, 8(5):457-462
DOI:10.4103/jispcd.JISPCD_237_18  PMID:30430075
Aims and Objectives: This study aims to establish the outcome of recasting on tensile strength, modulus of elasticity, and hardness of Nickel–chromium alloys. Materials and Methods: Fifty wax patterns were fabricated, using the lost wax technique, the measurements of which were standardized. They were categorized into five groups of ten each. Group I included samples casted with new alloy alone. Group II samples consisted of 75% new alloy and 25% once casted alloy. Group III was casted with 50% of each. Group IV with 25% new metal and 75% previous alloy and samples of Group V samples were casted with once casted alloy alone. Modulus of elasticity and tensile strength were measured by universal testing machine, whereas hardness using microhardness tester. The values were statistically analysed. IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. IBM Corp, Armonk, NY, USA. for Windows software was used for analysis. Results: We found a slight variation in mean tensile strength and modulus of elasticity, which was statistically insignificant variation among the groups. However, there was a significant difference in mean hardness between Groups III, IV, and V. Conclusion: It is prudent to use pure alloy alone for casting. However, in view of environment and economical factors, addition of <50% reused alloy to pure alloy is satisfactory clinically.
  2 2,741 248
Comparison of light-emitting diode-curing unit and halogen-based light-curing unit for the polymerization of orthodontic resins: An in vitro study
Guneet Guram, Junaid Ahmed Shaik
September-October 2018, 8(5):409-415
DOI:10.4103/jispcd.JISPCD_302_17  PMID:30430067
Aims and Objectives: Conventionally, composites are cured using halogen-based light-curing units (LCUs). However, recently, light-emitting diode (LED) LCUs have been introduced commercially, claiming many advantages, yet producing comparable bond strength even when cured with single LED LCUs. This present study was undertaken to compare the shear bond strength of orthodontic brackets bonded to teeth with conventional halogen LCU (3M ESPE Elipar 2500) and LED LCU (3M ESPE Elipar FreeLight 2) and to determine the site of bond failure. Materials and Methods: Fifty extracted human bicuspid teeth were randomly divided into two groups of 25 each. All the teeth were etched and primed. Then, orthodontic brackets were bonded onto the teeth with the light-cured adhesive (Transbond XT, 3M Unitek), and the adhesive was cured with halogen LCU and LED LCU for Group I and Group II, respectively. The brackets were then subjected to shear stress using a Hounsfield universal testing machine at a crosshead speed of 1 mm/min. The force was recorded in Kgf and converted to MPa. The residual adhesive was scored based on the modified adhesive remnant index (ARI) using an optical stereomicroscope. The data were analyzed using the Student's t-test and the Mann–Whitney test at a significance level of 0.05. Results: The results have shown that there is no significant difference between the shear bond strengths and the ARI scores of both the groups. Conclusion: From this study, it can be concluded that (1) LED LCUs containing even only a single LED can cure the composite as well as a halogen-based LCU; (2) there is no statistically significant difference in the shear bond strengths of the two groups; and (3) the ARI scores show no significant difference.
  2 3,046 267
REVIEW ARTICLES
The relationship between salivary total antioxidant capacity and dental caries in children: A meta-analysis with assessment of moderators
Sharat Chandra Pani
September-October 2018, 8(5):381-385
DOI:10.4103/jispcd.JISPCD_203_18  PMID:30430062
Objective: There has been variation reported in literature examining the relationship between dental caries and total antioxidant capacity (TAC) of saliva in children. This study aimed to systematically review the literature and conduct a meta-analysis of the association between dental caries and TAC in children. Methodology: A systematic review of literature was done using the PubMed, Medline, and EBSCO libraries. Of the total of 68 records found, 11 studies were qualitatively assessed in the final analysis. These studies yielded a total of 13 comparisons to be included in the meta-analysis. The type of dentition of the child and the test used to measure TAC were assigned as moderators. A meta-analysis was done of the mean TAC levels, while a meta-regression was formulated using the moderators. All analyses were performed using OpenMetaAnalyst™ meta-analysis software (Brown University, RI, USA). Results: The meta-analysis showed significant increase in TAC in children with dental caries when compared to their caries-free counterparts (P < 0.001). The meta-analysis showed high levels of heterogeneity (I2 = 99.48). The meta-regression revealed that, while the type of dentition was a significant moderating factor (P = 0.002), the method used to assess the TAC was not (P = 0.053). Conclusion: There is a significant increase in TAC in children with dental caries when compared to their caries-free counterparts.
  2 3,597 547
ORIGINAL ARTICLES
Histopathological evaluation of dental pulp of primary teeth pulpotomized with formocresol with/without a capping agent: A randomized clinical trial
Fatemeh Kadkhodaei Oliadarani, Rosa Haghgoo, Fatemeh Mashhadiabbas, Mehrdad Kahvand
September-October 2018, 8(5):420-423
DOI:10.4103/jispcd.JISPCD_30_18  PMID:30430069
Objectives: This study aimed to assess the reaction of dental pulp of pulpotomized teeth with/without applying a capping agent. This study was performed as randomized clinical trial. Materials and Methods: This split-mouth clinical trial was conducted on eight pairs of primary canine teeth scheduled for extraction as part of orthodontic treatment. The teeth were randomly assigned to the intervention and control groups. In the intervention group, canine teeth were restored with amalgam after pulpotomy with formocresol. In the control group, zinc oxide eugenol paste was applied as the capping agent after pulpotomy with formocresol, and the teeth were then restored with amalgam. After 1 month, the teeth were extracted in both groups and stained with hematoxylin and eosin for histological analysis. Pulp reaction was assessed in terms of pathological parameters. Data were analyzed using the Mann–Whitney U-test and Fisher's exact test. The statistical analysis software was SPSS 16. Results: No significant difference was found between the two groups in terms of inflammation, vitality, internal resorption, bleeding, presence of osteoclasts and dentinoclasts, and internal regeneration. Dentinal bridge did not form in any group. Conclusion: According to the results of this study, formocresol pulpotomy of primary teeth can be completed without the application of a capping agent.
  1 2,385 207
Effect of hyaluronic acid added to suture material and its relationship with bacterial colonization: An in vitro study
Varma Rama Sudhir, Thomas Biju, Amitha Ramesh, Suleiman Ergieg, Salim Abou Fanas, Vijay Desai, Afrah Aldhanhani Mohammed, Malaz Abdulaziz Ahmed
September-October 2018, 8(5):391-395
DOI:10.4103/jispcd.JISPCD_222_18  PMID:30430064
Aims and Objectives: The aims of this study were to evaluate the presence of Staphylococcus aureus and Escherichia coli, in polyglycolic acid (PGA) 4-0 and silk sutures, with or without hyaluronic acid (HA) treatment. Materials and Methods: This in vitro study measured S. aureus and E. coli growth on PGA and silk sutures, through incubation in agar media for 24 h. The suture length was 10 cm and divided into three parts: A (8 h), B (16 h), and C (24 h), which were observed every 8 h, followed by suspension on a microscopic slide. This was repeated thrice. The number of S. aureus and E. coli cells was recorded and compared between the suture types. Results: The mean S. aureus colony forming units (CFUs) differed at each time point between non-HA and HA-PGA sutures (P = 0.0016), with a greater number of CFUs on non-HA-PGA. The mean S. aureus CFUs were significantly higher on non-HA silk than on HA-silk sutures (P = 0.008). There was a significant increase in E. coli CFUs on non-HA silk than on HA-silk sutures (P = 0.008). E. coli CFUs were higher on non-HA-PGA than on HA-PGA sutures (P = 0.006). We performed repeated measures two-way ANOVA (SPSS version 13.0) for comparison between group factors and time points and Posthoc analysis using independent samples t-test. Conclusions: HA reduced wicking in both PGA and silk sutures.
  1 3,996 358
A preliminary investigation into the dietary and oral practices associated with fractured teeth and prostheses in a Trinidadian population
Shivaughn Maria Marchan, William Adam Joseph Smith
September-October 2018, 8(5):402-408
DOI:10.4103/jispcd.JISPCD_107_18  PMID:30430066
Objectives: This preliminary study seeks to determine the relationship between fractured teeth, restorations, prostheses, and specific dietary practices. Methodology: Anonymous questionnaires were randomly distributed to a convenience sample of Trinidadian adults at various locations around the country, after gaining consent. Data were analyzed using the software; Statistical Package for the Social Sciences for significant associations between various types of food and broken teeth or prosthesis using odds ratios. Results: Three hundred questionnaires were completed. Seventy-five percent of the patients preferred crunchy or hard foods and 51% of the respondents liked crushing bones, mostly chicken bones. It was observed that respondents with a dietary preference for fried whole chana, split chana, crab, and sugarcane were significantly associated with broken dentures. Respondents eating whole chana also had a significant association with broken teeth and broken dentures. Associations were found between some dietary preferences, ethnicities, and age groups. Conclusions: Significant associations between age, ethnicity, sex, and certain dietary practices and habits were found. There also appears to be a significant relationship between patients with fractured teeth, restorations, and prostheses with certain dietary preferences.
  - 2,167 167
Knowledge, attitude, and practice toward impression technique and materials for recording impression in implant placement among dental practitioners in Patna city, Bihar
Ujjal Chatterjee, Ashish Srivastava, Abhinav Singh, Ankur Aggarwal, Chetan Jagdish, Akshat Sharma
September-October 2018, 8(5):463-468
DOI:10.4103/jispcd.JISPCD_325_18  PMID:30430076
Objectives: The present study is conducted to explore the knowledge, attitude, and practice towards impression technique and materials for recording impression in implant placement among general dental practitioners. Materials and Methods: The present study is a cross-sectional questionnaire study. The study was conducted among general dental practitioners in Patna city in November–December 2017. Patna city was divided into five directions, which are north, south, east, west, and central. From each direction, 20 clinics were selected randomly, and dental practitioners from there clinics were interviewed. A closed-ended questionnaire consists of 19 items was prepared, the questionnaire was divided into four parts. Results: Majority of study participants (58 [34%]) were above the age of 40 years. 96 (56%) of study participants were male. Most of the study participants (89 [50%]) were having MDS degree. Knowledge, attitude, and behavior scores among study participants. About 43% of study participants have good knowledge scores regarding impression technique and material in implant placement while 50% of study participants had fair attitude score. About 58% of study participants had fair practice score. There was statistically significant correlation (P ≤ 0.05*) between knowledge and attitude of study participants. Conclusion: It was concluded that there was good knowledge, fair attitude, and practice among the dental professionals regarding the impression technique and materials for recording impression in implant placement. There was statistically significant correlation between knowledge and attitude of study participants. There was statistically significant correlation between some demographic variables and knowledge, attitude, and practice of study participants.
  - 2,532 224
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