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1 The VAT Technique" Teaching Oral Prophylaxis , Ajay Kakar
Teaching a patient oral prophylaxis may seem like an innocuous exercise but it is a most critical aspect in clinical dentistry. It is hardly given the importance it deserves. The purpose of this issue is to highlight its importance and present an effective technique for the same.
2 The Association of Trace Elements and Vitamins with Lichen Planus: Review Article , Maryam Baghizadeh Fini
Lichen planus is a continual mucocutaneous inflammatory disorder of multifactor nature with numerous clinical symptoms. Nu-merous researchers attribute a key role in disease development to disruptions in the immune system. Appropriate doses of micronu-trients are essential for the immune system to perform effectively. Micronutrient deficiency suppresses immunity by influencing the innate immune system, responses to T-cell mediated and adaptive antibody, resulting in disruption of the balanced host response. Since these trace elements and vitamins have an important role in the immune system and oral lichen planus has a significant rela-tionship with the disturbances in the immune system, the importance of these elements should be considered for each patient. Just several articles examined the hematological anomalies and nutritional imbalances in OLP patients. In this study, all required informa-tion about trace elements and vitamins in OLP patients is obtained.
3 Coronavirus-A Review Article , Maharshi Malakar
A strain of coronavirus. The new virus has been named SARS-CoV-2 and the disease it causes, Covid-19. The WHO has declared the outbreak a Public Health Emergency of International Concern. The disease was first identified in 2019 in Wuhan, China and has since spread globally, resulting in the 2019-20 coronavirus pandemic. Common symptoms include fever, cough, and shortness of breath. Muscle pain, sputum production and sore throat are less common. While the majority of cases result in mild symptoms, some progress to severe pneumonia and multi-organ failure. At present it is now a great concern
4 Treating Infant Population Fracture Mandible by Prof. Katpar’s Innovative Splint technique: Reported from Pakistan , Shahjahan Katpar, Maria Shabbir, Muhtada Ahmed, Jawad Safdar, Shoaib Ayub and Muneer Zardari
Introduction: Mandibular fractures occur relatively less frequent in infantile population as compared to adults, due to elasticity of bone, protected anatomical structures and infrequent exposures to road traffic accidents etc. The treatment procedures involved for such cases is different from those of adults, due to concerns regarding growth, developing Dentition and early healing.Case Report: Here we discuss case of 8 months old female infant patient presented with fracture of anterior mandible following fall from stairs. The fractured jaw was reduced at theatre without any impression taking and cast formation procedure for acrylic splint and we avoiding using resorbable bone plates. Instead, we used Compound impression material cake piece which is a muco-com-pressive, thermoplastic material, used as a substitute for an acrylic splint. This was secured with silk suture and rubber tube pieces, replacing circum-mandibular stainless steel wire with silk following manual closed reduction of fracture, under general anesthesia.Results: The clinical application of this technique results in timely and adequate reduction of fracture in pediatric population which was confirmed on post-operative radiographs and clinical follow-up visits of patient and their family reviews.Conclusion: The article provides an innovative, pioneer, non-invasive surgical procedure to treat infantile mandibular fracture cases by “Prof. Katpar’s DUHS splinting technique” within early days of trauma, avoiding costly resorbable bone plates, acrylic splints and early reduction
5 Promotion of Oral Health Care in Infants - A Preventive Strategy to Reduce the Burden of Early Childhood Caries , Subhathira Rajasekaran, Sham S Bhat, Vidya Bhat, Sundeep Hegde K, Neha Thilak and Minu Mumtaz
Infant oral health care is the foundation on which a life time of preventive education and dental care can be built in order to help acquire optimal oral health in a child. The purpose of an infant oral health program is to improve access to oral health care and to provide counseling and anticipatory guidance in oral hygiene for children aged 6 months to 5 years. The first step of infant oral health care is the preventive oral health behavior of parents since they would influence their children’s behavior in adapting to the preven-tive oral health practices as they grow along. Early dental interventions present an opportunity to educate parents about the medical, dental and cost benefits of preventive care which is effective in reducing early childhood caries. A comprehensive infant oral care program includes risk assessments at regularly scheduled dental visits, preventive treatments such as fluoride varnishes or sealants, parental education on the correct methods to clean the baby's mouth and establishment of dental home and use of anticipatory guid-ance. The present article highlights the important guidelines of infant oral health care
6 Delivery Systems of Local Anesthetics in Dentistry: An Update , Neha Thilak, Sundeep Hegde K, Sham S Bhat, Vidya Bhat, Subhathira Rajasekaran and Minu Mumtaz OV
Effective delivery of local anesthesia is one of the most important aspects of dentistry. Obtaining adequate pain control will re-sult in minimum discomfort of the patient during dental procedures, at the same time it helps the dentist to render the treatment effectively. Even though the modern dental syringes which is the most common method of local anesthesia administration were introduced many years ago, different modifications in delivering local anesthetics have evolved over time. These innovations have lead to decreased pain during administration of local anesthesia and also reduced side effects. This article discusses about different advancements in the delivery systems of local anesthesia.
7 Protocols during COVID-19 Outbreak- A Maxillofacial Surgeon’s Perspective , Sundaram Rajaram, Gauthami Sundar and Rajaram RS
The lightening pace of spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has made the whole world come to a standstill. The rising numbers of the people affected with this viral infection, despite adhering to the proper preventive measure guidelines has evoked a global sensation. The abundance of Corona virus (SARS-CoV2), the causative virus, in the nasal and salivary secretions in the infected has got serious and obvious relationship to the dental professionals. It becomes the moral responsibility of the Maxillofacial Surgeon to identify such patients who are infected, and avoidance of the spread of the infection. Thus, participating in the efforts to curb the spread of overwhelming infection and safeguarding the unaffected public who seek dental attention. This article aims to highlight the protocols to be followed in treating patients in an outbreak of COVID-19 virus from the Oral and Maxil-lofacial Surgeon’s point of view. Clinical Relevance: The 62-year-old ENT specialist Liang Wudong died on Saturday morning, 25th January 2020 as reported by the Chinese Global Times website. Liang’s death highlighted the pressure faced by medical staff in the state as social media was flooded with posts showing exhausted workers struggling to cope [1].Oral and Maxillofacial Surgeons need to be aware and prepared for tackling any impending infectious disease challenge as might be the case in the current outbreak of SARS-Cov2 transmission and its associated Coronavirus disease (COVID-19) that can be life-threatening to susceptible patients
8 Mouth Breathing-Its Consequences, Diagnosis, Treatment , Sukhdeep Singh, Neha Awasthi and Taru Gupta
The mouth breather is a patient with multiple conditions and therefore requires comprehensive and multidisciplinary clinical look to early detect this syndrome, minimizing its deleterious effects. A pediatric dentist may be one of the first healthcare profes-sionals to come in contact with a patient who exhibits mouth breathing and thus it is important to have a sound knowledge to per-form correct diagnosis and effective treatment. A review of current data on the skeletofacial, dental and gingival changes that occur in mouth breathing individuals is given, with the intention of raising the awareness of dental professionals towards the special needs of these patients
9 Ameloblastoma: Case Report , Isaque Toledo Zimmermann and Milena Bortolotto Felippe Silva
Ameloblastomas are rare odontogenic tumors of the jaws, more frequently found in mandible. Etiology, clinical and histological behavior, and various modality of treatment have been extensively discussed. Conservative treatment sometimes associated with additional procedures has been used as a good option for many treatments of this tumor. The present article has for objective describe a case of ameloblastoma of jaw treated by conservative methods where jaw fracture occurred as a complication of this initial therapeutics
10 Gingival Depigmentation , Ibrahim Mohamed Mahgoub Eldowi
Background 24 years old male complaining from gingival hyperpigmentation. Gingival hyperpigmentation is a common aesthetic concern in patients with a gummy smile Aim of the Case Study Using a diode laser with 980nm wavelength with fiber tip size 300 μm can give very good aesthetic results. Why diode laser for this case? After examination, this hyperpigmentation was due to higher secretion of Melanin pigments beyond the normal level and because of his gummy smile, it was very obvious when he speak or smile. Diode 980 nm wavelength is highly absorbed by pigments, like melanin.
11 Surgical Treatment of Impacted Tooth Associated with a Big Odontoma: Piezosurgery Approach , Cardarelli Angelo, Michele Grechi and Arun K Garg
The aim of this study is to describe a clinical case about a young patient, 13 years old, that he has a big odontoma in the right site of the mandible associated with an impacted tooth. So, it was described a piezo surgery approach in order to obtain a conservative approach.
12 Prosthetic Rehabilitation of Siebert’s Class II Case and Pier Abutments - Case Report , Swati Pustake, Kanchan Bagul, Sachin Chaware, and Preetha Negi
Replacement of teeth with periodontally compromised abutment is a challenge. A tough choice of aesthetics over function is often made by the operator for the satisfaction of the patient. The modified concepts of fixed partial dentures allow one to choose longevity of the prosthesis by not compromising on the aesthetic factors. Ridge defect often leads to a convenient treatment option of removable partial dentures which will not be preferred by the patient. Andrews bridge a fixed removable type of prosthesis is perfect solution for this situation. In long span multiple missing cases Nonrigid connectors have been recommended to reduce the forces as they provide a stress-breaking effect. In this case report, there are two opportunities that allow us to incorporate the modified fixed partial denture technique. Andrews bridge in the lower anterior segment to mask the ridge loss and the posterior long span FPD with a tenon mortise attachment. These two attachments used in this case not only prolongs the life of already compromised anterior teeth but also allows the posterior abutment to remain healthy throughout in long span fixed partial dentures
13 Psychological Effects of Orthognathic Surgery , Shalini Parihar and Sudhanshu
Orthognathic surgery refers to a group of corrective bone operations that involve movement of the jawbones completely or in parts.Orthognathic surgery is indicated when there are severe dentofacial deformities that cannot be managed by orthodontic treatment alone, especially in adulthood, when the natural growth forces have ceased. Dentofacial deformities are described as deformities that affect primarily the jaws and dentition
14 Hyaluronic Acid: Intraoral Application , Albert- López MJ, Pallarés-Serrano Al and Javier A Bardají
Hyaluronic acid (HA) is a polysaccharide present in the connective tissue of many organisms. It has high molecular weight, is biocompatible and is found in various body fluids such as: synovial fluid, serum, saliva, gingival crevicular fluid (GCF), etc. This component has numerous physiological and structural characteristics such as volume maintenance and improvement of tissue resistance, cellular and extracellular interactions, interactions with growth factors, regulation of osmotic pressure, tissue lubrication, bactericidal, fungistatic effects, anti-edematous and osteoconductive. The results that have been obtained show that it is a natural component that can provide numerous advantages. For all these reasons, hyaluronic acid (HA) is used in different fields of medicine is studied and recently, it was also introduced in the dental field for aesthetic purposes in perioral areas. Although it is not so well documented, it has been observed that it is intraoral application can bring many benefits. The aim of this systematic review aimed to collect the applications at the intraoral level that hyaluronic acid (HA) can have in different dental procedures.
15 Primitive Neuroectodermal Tumor of Maxilla - A Rare Case Report in Adult , Mahesh KP and Karthikeya Patil
Primitive neuroectodermal tumor (PNET) includes a wide array of lesions with varying central and peripheral nervous system having differentiating potential. It is their insidious clinical symptoms, varying locations and rarity, the accurate diagnosis of peripheral PNETs poses a challenge for clinicians. PNETs has diagnostically characteristic immunophenotypical and genetic features that distinguish them from other small round cell tumors. We recently got to treat a patient with maxillary swelling on the left side of the face, its clinical course, histopathology with immunohistochemistry correlation of this rare entity PNET is discussed.
16 Corona Virus Disease - 2019 (COVID-19) - Planning for Emergency Dental Practice and Dental Education , Fazal Ghani
The substantial knowledge of virology related to the epidemiologic characteristics, clinical spectrum, and treatment has made it possible for the dental healthcare personnel, to continue working safely by implementing efficient strategies to prevent, control and stop the spread of COVID-19. Despite this, the current COVID-19 outbreak necessitates we must be constantly aware of infectious threats that may challenge our infection control regimen in the dental settings, our preparedness for the provision of dental health care services and dental teaching and education. The infection prevention and control strategies to be adopted must have an evidence base and should follow the recommendations from the local and international centers for disease control and infection prevention and control according to the epidemic situation. The current epidemic outbreak emphasizes the need for improving the infection prevention and control strategies in the dental settings, adoption of alternative learning strategies for students and the need for further research on the ways for responding to such future contagious diseases
17 Die and Die Materials - An Overview , Sunny Sharma, Lucky Jindal, Abhishek Kumar, Kumar Gaurav, Rudhra Munshi, Anukriti
Dentists are often faced with sectioning and soldering implant supported superstructures and long span tooth supported fixed partial dentures. These steps increase chair time, procedural cost and decrease clinical efficiency. One way to decrease the number of clinical steps is by improving the accuracy of working cast/die system. A cast die system captures the necessary information so that it can be transported to the laboratory
18 An Overview on Gingival Depigmentation Procedures : Case Series and Follow up , Tanusha Sharma, Charu Agrawal and Mishal Shah
The gingival complex plays an important role in the overall esthetics of a smile . Melanin, which is a brown pigment, is the most common natural pigment that contributes to endogenous pigmentation of the gingiva. For depigmentation of gingiva many treatment modalities have been reported like Scraping, Bur Abrasion, Partial Thickness Flap, Cryotherapy, Electrosurgery and Laser. The present article describes five cases of gingival melanin hyperpigmentation - Scraping, Bur Abrasion, Partial Thickness Flap, Electrocautery and Laser Technique. The purpose of the article is to discuss and compare the different techniques employed for depigmentation.
19 Prevalence of Odontogenic-Related Maxillary Sinus Pathologies in an United States Dental School Population , Yueh Ju Hsiao, Shang Lun (Allen) Liu, Jie Yang, Randolph R Resnik and Jon B Suzuki
Objectives: Odontogenic-related maxillary sinus pathologies are identified in cone beam computerized tomography taken for maxillary sinus augmentation and dental implant therapies. The purpose of this study is to determine the prevalence of odontogenicrelated maxillary sinus pathologies among a dental school population. Materials and Methods: Eight hundred and twenty-one patients were retrospectively evaluated for odontogenic-related maxillary sinus pathologies using cone beam computed tomography (CBCT). Age, gender, ethnicity, and dentition status were evaluated to determine potential relationships of the presence of odontogenic-related sinus pathologies. Results: Among 534 CBCT scans, 331 scans presented without sinus pathology bilaterally and 203 scans presented with sinus pathologies in one or both sinuses. 79 scans presented with odontogenic-related maxillary sinus pathologies. The most frequent observations were mucosal thickening. The tooth most frequently associated with pathologic findings were first molars followed by second molars. The findings were higher in males than females (p = 0.006). Age and ethnicity was not a significant factor (p = 0.10, p = 0.05). Dentition status showed root canals (34.65%) were the most commonly associated with pathology. Conclusion: The prevalence of odontogenic-related maxillary sinus pathology was found in 36% of sinuses. Identification and management of odontogenic pathologies are essential to minimize complications. CBCT is highly recommended as a diagnostic tool prior to lateral wall maxillary sinus augmentation surgery and implant placement. Management of odontogenic-related maxillary sinus pathologies need to be tailored to individual patients and involves varying combinations of medical and dental management
20 Coping with the Corona Crisis-Mental Status and Beyond , Aditya Jayan and Gaurav
“Life” as Atharva Veda describes is not merely a sequence of events from birth to death, but also a culmination of various emotions, feelings and frames of mind where it ushers from the cuddling arms of the parents to the burning arms to the funeral pyre! “Lockdown” on the other hand if interpreted aptly is not an act of being imprisoned but a longer period of discipline and an act towards the Nation. Its a test of mindset wherein we are getting to serve our nation without actually doing anything being back at home! Its a persistence of the mindset that we will not go back to normal, normal never was! Our pre-corona existence was not normal other than we normalized greed, inequality, exhaustion, depletion, extraction, disconnection, confusion, rage, hoarding, hate and luck.
21 Maximum Mouth Opening among Saudi Arabian Adults , Fahad Alshammari, Njoud AlSaheel, Najd Alhamzah, Ra’ed Salma and Ahmed Alshammari
Background: The mouth opening range is one of the major characteristics features that different one person from the other. Literature has shown that the maximal mouth opening range varies among different people, ages and regions. On average, a person should be able to fit 3 fingers in an opened mouth. However, differences exist. Aim: To set a reference measurement for maximal mouth opening in Saudi Arabian adult population. Methods: The study was conducted on patients attending dental clinics in Riyadh, Kingdom of Saudi Arabia. The maximum mouth opening (MMO) was recorded for adult patients using a ruler. The patients were requested to open their mouth at maximum level and the length between the maxillary central incisor edge and the mandibular central incisor edge in the same side of the mouth was measured. Correlation of the mouth opening with age was determined using a Spearman correlation matrix. Besides, Kruskal Wallis and Mann Whitney tests were used for comparing the continuous variables. Conclusion: The conclusion obtained from the findings is that the males mean maximal mouth opening of an adult was significantly higher than females in Saudi. A negative correlation suggesting that mouth opening decreases with age. Results: The maximal mouth opening mean ± SD of the participants was 50.1 ± 6.3 mm. Mean ± SD maximal mouth opening for males (52.5 ± 6.3 mm) was statistically significantly higher than females (47.8 ± 5.3 mm) (p < 0.05). Spearman’s test between maximal mouth opening and age showed a negative correlation of p > 0.05. No statistically significant difference was found between the mean ± SD maximal mouth opening and age groups (p > 0.05).
22 Digital Age Estimation Using Orthopatomograms in Indian Population: A Comparative Study , Ramakant Gupta, Swati Gupta and Manju Gupta
Introduction: Orthopantomographs are non- destructive tool for age estimation by indirectly measuring the rate of secondary dentine deposition. Cameriere.,et al. introduced one such Europeanpopulation based method and modified by researchers for Indian population; but their applicability is yet to be assessed. Aim and Objective: To assess the applicability of Cameriere’s method and its modification by Jeevan.,et al. Bebshet.,et al. for mandibular canines and Sexena, Jeevan.,et al,Juneja.,et al. for maxillary canines in an Indian population in Faridabad district of Haryana by evaluating the pulp/tooth ratio in canines on right side using digital orthopantomographs. Materials and Methods: Digital orthopantomographs of 60 patients (30 males, 30 females, 16- 72 years) were selected by simple random sampling. Pulp and tooth areas were measured and their ratio was computed using computer software. Age was calculated using the Cameriere’s method and its modification by Jeevan.,et al,Bebshet.,et al,Sexena, Juneja.,et al.Mean absolute error (MAE) for each method was calculated for each method. Conclusion: Jeevan’s formula revealed least MAE and slightly more percentage of cases with errors < ± 10 years i.e. acceptable’’ age estimates than others, therefore, itis more applicable for Indian population. Results: The present study showed no recognisable difference in dental age assessed by all the methods. Overestimation of age with MAE <± 10 years was found in Indian population using all the methodsConclusion: Jeevan’s formula revealed least MAE and slightly more percentage of cases with errors < ± 10 years i.e. acceptable’’ age estimates than others, therefore, itis more applicable for Indian population.
23 COVID-19 Impact on Dentists in Bosnia and Herzegovina: Qualitative Study , Zerina Hadzic
The COVID-19 pandemic has caused economic and health consequences in many countries around the world. Some occupations, including dentists, were highlighted as the most endangered due to aerosols and the possibility of spreading the COVID-19 virus during the incubation period. It is well-known that aerosol generated in dental procedures with a large number of droplets, provoking that the standard protective measures in daily clinical work may not be effective enough to prevent the spread of COVID-19, especially when patients are in the incubation period or unaware that they are infected. The aim of the study is to check the attitude and possible fear and concern related to the COVID-19 pandemic among dentists in Bosnia and Herzegovina who are employed in the public and private health sector.
24 Non-Surgical Management of Unusually Large Chronic Recurrent Periapical Abscess and an Insight on Periapical Radiolucencies , Swati Gupta, Ramakant Gupta and Manju Gupta
Recurrent inflammatory periapical lesions are commonly encountered oral pathologies. The usual cause of these periapical lesions is endodontic in nature and can be easily treated by endodontic treatment. They exhibit wide biologic behaviors and their presentation as recurrent pus discharging ulcers can lead to patient’s apprehension and even be cause for clinician’s anxiety. This is because many non-endodontic causes may also lead to periapical lesions. A thorough knowledge about them therefore, is crucial for clinicians not only to properly diagnose and manage such cases, but is also important to safeguard themselves from patient’s evil intentions of making easy money by claiming refund. The present case is one such example where unusually large chronic recurrent periapical abscess was managed with non- surgical endodontic treatment. With this case report, authors intend to discuss the different periapical radiolucencies and explain scientific guidelines for their adequate diagnosis and management.
25 Sorption and Solubility of Nanofilled Composite Resins in Mouthwashes with Different pH , Shaqran Hamid Alabbadi, Meshal Abdullah Bagari, Ibrahim Mohamed Hamouda and Khalid Talal Abdullah Aboalshamat
Objectives: The aim of this study was test the effect of mouthwashes with different pH on sorption and solubility of nano-filled composite resin restorative materials. Materials and Methods: 56 cylindrical specimens were prepared from 2 types of nanofilled composite resins, 28 specimens from each material. Specimens of each type of composite were randomly divided into four groups (n = 7). 7 specimens were used as a control group immersed in distilled water. The other 3 groups were stored in the following mouth washes (Avohex, Listerine and Parodontax) for seven days. Specimens were dried in desiccator to a constant weight before immersion. The immersion media were changed daily for 7 days, waived in air and weighted to calculate the amount of sorption. Specimens were dried again and reweighted to calculate the amount of solubility. Sorption and solubility tests were made using electronic balance. Results: Both composite resins showed varying degrees of water sorption and solubility in all storage media. SDI ice composite resin showed higher water sorption in Listerine and lower in Avohex mouth washes. SDI Ice nanohybrid composite resin showed higher solubility in Avohex mouth wash and lower solubility in distilled water. Charisma nanohybrid composite resin showed higher water sorption in Avohex mouth wash and lower in distilled water. Listerine and Parodontax mouthwashes showed intermediate comparable values. Charisma nanohybrid composite resin showed higher solubility in distilled water and lower in Listerine mouthwash. Listerine and Parodontax mouth washes had intermediate effects of sorption and solubility on both types of composite resins. Conclusion: All tested nanofilled composite resins showed varying degrees of water sorption and solubility in all storage media. SDI ice composite resin showed higher water sorption in Listerine and higher solubility in Avohex mouthwashes. It exhibited lower sorption in Avohex mouth wash and lower solubility in distilled water. Charisma nanohybrid composite resin composite resin showed higher water sorption in Avohex and higher solubility in distilled water. It demonstrated lower sorption in distilled water and lower solubility in Avohex mouth wash.
26 Vitamin D: Another Protection Barrier for the Dentist in Times of SARS-CoV-2 , Diego Fernando López, Valentina Rios Borrás and David Alejandro Rivera
The knowledge about vitamin D role in human physiology is highly relevant in Dentistry, particularly considering the current world health emergency (pandemia) of the disease known as COVID-19, caused by the virus SARS-CoV-2. The deficiency of some nutrients including vitamins and hormone precursors is a factor predisposing to disease and susceptibility to infections of the respiratory tract. Additionally, in orthodontics, vitamin D is able to increase dental movement and in Implant Dentistry improves osseointegration. The aim of the present review is to provide information regarding COVID-19 and vitamin D role in the immune system and respiratory system, useful for the dental staff to help patients and themselves to take preventive actions to mitigate the consequences of COVID-19 pandemia in near future
27 Dentistry x Covid-19 = Uncertainty? , Meenakshi Ray
In October 2015, 218 villagers were asked to submit blood samples in Jinning county, China. The villages were adjacent to caves, which were home to a variety of Coronavirus-carrying bats. The blood samples were tested to find that nearly 3% carried antibodies against SARS-like coronavirus. Bat-to-human transmission of the coronaviruses was then brought to light for the first time ever.
28 A Conceptual Evolved Model of Dental Practice - The Ideologies of an Inter-disciplinary Team (IDT) , Monu Survashe and Anita Merani
The present study explores the ideologies of an interdisciplinary team for better patient centered healthcare outcomes. The principles studied in the literature review were used to formulate a conceptual design of IDT. A conceptual design was then planned for cessation of tobacco smoking among diabetic patients by the dentist and the physician who specializes as a certified health coach, to reduce the burden of the underlying systemic issues along with the dental treatment.
29 Changing Scenario of Dentistry with COVID-19-An Overview , Ashima Trivedi and Ashwani Kumar Trivedi
Corona virus disease 2019 which proved to be a global pandemic has a noticeable impact on the field of dentistry. This is an overview of the changing scenario of dentistry with Covid-19 and the possible protocols which the Dental health care professional (DHCP) needs to follow for protection and safety in future. It covers all the changes and guidelines for dentists to continue with the dental practise. Also, the impact of novel corona virus has lead to a fear in public and professionals which may be noticed as a markable decline in dental treatments.
30 Relationship between Inflammation-Related Markers in Peri-Implant Crevicular Fluid and Clinical Parameters in Partially Edentulous Saudi Arabian Diabetic Subjects , Shaden Aljabr, Mansoor Assery, Sami Shafik, Naghshbandi Jafar, Nasser Al-Daghri, Osama Amer and Khalid Al-Hezaimi
Introduction: A high prevalence of diabetes mellitus and dental caries in Saudi Arabian population is overwhelmingly reported. The aim of the study was to assess the following: 1) clinical findings of PD, BOP, and amount of keratinized tissue present around dental implant and 2) PICF levels of IL-1α, IL-1β, IL-6, and IL-8 in diabetic and non-diabetic partially edentulous Saudi Arabian subjects. Materials and Methods: Total of 32 partially edentulous subjects, 16 diabetic and 16 non-diabetic, were included in the study. PICF samples were taken from peri-implant sulcus using paper point and PCR essays for IL-1α, IL-1β, IL-6, and IL-8 was performed. Clinical parameters of peri-implant PD, BOP and amount of keratinized tissue were recorded. Conclusion: PD, BOP and PICF IL-6 levels were found to be significantly higher in Saudi Arabian diabetic subjects compared to Saudi non-diabetic subjects. Also, a positive relation found between deep PD and four inflammatory markers which are IL-1α, IL-1β, IL-6 and IL-8. Results: Diabetic subjects had more significant BOP than non-diabetic counterparts (p-<0.001). No significant difference was found between diabetic and non-diabetic patients in the amount of keratinized tissue (P < 0.765). A significant high level of IL-6 in diabetic subjects when compared to healthy subjects (P < 0.033). No significant difference between diabetic and non-diabetic subjects in the serum level of IL-1α (P < 0.121), IL-1β (P < 0.171) and IL-8 (P < 0.223). A positive correlation between increased serum level of IL-1α, IL-1β, IL-6 and IL-8 with increased PD was determined.
31 3D Printing: Towards the Future of Oral and Maxillofacial Surgery , Marwa G Noureldin and Noha Y Dessoky
This descriptive review focuses on the advanced revolution of the 3D printing technology in the field of oral and maxillofacial surgery (OMFS). This technology is now trending and growing popular throughout the different aspects of the specialty to include oral and maxillofacial diagnosis, treatment planning, surgical interventions and novel tissue engineering. Moreover, it has an interesting prospect in education and training of dental students.
32 Dentistry in the Post COVID-19 World- Are We Prepared? , Vrushali Abhyankar, Gabriela Fernandes, Vinay Jain and Paul Luepke
Background: Covid-19 pandemic has affected dental profession tremendously and has placed dentists and dental professionals in the very high exposure risk jobs. Practicing dentistry requires the provider to be in close proximity of the patients and their oral cavity. Many dental procedures tend to generate aerosols owing to the use of an air rotor or highspeed handpiece. The impact of Covid-19 on dentistry, like all other professions is ever evolving and newer guidelines are published almost every day. The authors also examine the ethical, psychological and financial implications of this pandemic to the dental professionals as well as patients. The important role of organized dentistry is highlighted in facilitating change to adapt to the new norm and implement the safer practice guidelines. Conclusion: The authors conclude that significant changes need to be undertaken to protect patients, dental professionals, auxiliary personnel.
33 Low-Level-Laser-Therapy after Third Molar Removal in a Patient Affected by Osteogenesis Imperfecta , Chiara Moreschi and Stefano Bianchi
LLLT is used in oral surgery to reduce the discomfort of the patients after surgical procedures, such as pain, swelling and trismus. We showed in our case report the use of LLLT as for the reduction of post-operative discomfort as to prevent osteonecrosis of the jaws, since our patient was affected with osteogenesis imperfecta. The patient did not have any complications after surgery and after a one year follow-up she did not show any radiological or clinical sign of osteonecrosis of the jaws
34 Utility of Sodium Tetradecyl Sulphate for the Management of Oral Venous Malformation , Krishna Kishor, Shiv Kishor, Heera, Hiralal Ash, Kumar Arunesh and Sudarsan Sen
Venous malformation are one of the most common lesions of oral cavity. The lesion may be congenital malformation in neonates or arteriovenous malformation in adults. Various surgical and medical managements are possible for vascular lesions which includes surgical excision, laser therapy, cryotherapy, selective embolization, intralesional sclerosing agents, beta blocker and steroid therapy. In this current study we assessed the efficacy of intra lesioned injection of sclerosing agent i.e. 3% sodium tetra decyl sulphate in oral lesions of venous malformation. Sclerotherapy with 3% sodium tetra decyl sulphate is an effective agent in treating benign oral lesion of vascular malformation and provides alternatives to surgical method.
35 Synergistic Effects of Cordycepin and Genistein on Preosteoblast MC3T3-E1 Cells with Endoplasmic Reticulum Stress , Jiaxuan Lu, Xin Luo and Xiting Li
Endoplasmic reticulum (ER) stress activation disturbs bone homeostasis and plays an important role in osteolytic bone diseases development. Cordycepin (3'-deoxyadenosine), a natural structural analog of adenosine, possess multiple pharmacological activities and exerts osteoprotective effect. Genistein can be used as protectors or synergists of adenosine drugs. The aim of the present study was to investigate whether the combination of cordycepin (Cor) and genistein (Gen) regulates proliferation, migration and differentiation of preosteoblast MC3T3-E1 cells in a tunicamycin (TM)-induced acute ER stress model. Cell viability were assessed using cell counting kit-8 (CCK-8) assay and osteoblast migration were evaluated by transwell chamber assay. The differentiation was assessed by alkaline phosphatase (ALP) staining assay. qRT-PCR assay was performed to confirm the establishment of ER stress model and to measure the mRNA level of key molecules involved in osteogenic differentiation. Exposure to the combination of 10μM cordycepin and 10μM genistein had no cytotoxicity in MC3T3-E1 cells, but increased the number of proliferative cells after pretreatment with 2 μg/ml TM. Analogously, ER stress-induced suppression on MC3T3-E1 cells migration was restored to control levels by the administration of cordycepin and genistein combination. Cordycepin and genistein combination significantly up-regulated ALP activity of MC3T3-E1 cells in TM-induced ER stress model. The qRT-PCR data demonstrated that the combined treatment effectively accelerated osteogenic differentiation by enhancing the mRNA level of differentiation markers including collagen type I, ALP, BSP and OPN. These results reveal that the co-administration of cordycepin and genistein exerts synergistic osteoprotective effects and has the potential to serve as a host risk reduction strategy for osteolytic bone diseases associated with ER stress activation.
36 Studying the Correlation between CBCT Linear Measurement and Actual Measurement during Surgery in Implant Candidates , Mehrdad Panjnoush, Yadollah Shayesteh, Elham Romoozi and Maryam Johari
Background: One of the main uses of CBCT is the design of implant therapies, and linear calculations in these therapies are important in quantifying bone (height and width). However, previous researches have all been conducted on dry skulls and no research has been performed in patients' clinical conditions. Aim of the Study: The aim of this research was to determine the correlation between CBCT linear measurements and actual measurements during surgery in patients undergoing implant surgery. Materials and Methods: In diagnostic research, 54 patients were selected for implant treatment in the premolars and the distance of the mental foramen to the apex of the ridge was measured using a caliper during surgery. The same calculations were repeated in CBCT images with Romex is software by two observers at two 2-week intervals. The difference in bone height calculations in CBCT images and actual measurements during surgery were analyzed by repeated values and ANOVA. Results: The difference in absolute value of bone height in CBCT images (second observer) and its actual values was 0.811 ± 0.54, 0.894 ± 0.67 between the first observer and its actual values,0.871 ± 0.63 between the first observer in the next 2 weeks later and the actual values,0.804 ± 0.57 between second observer in 2 weeks later and its actual values. The mean difference of bone height observations by 2 observers in 2 weeks from its actual values was equal to 0.0 ± 828.89 mm. No significant differences were observed between the absolute magnitude values of bone height measurements in CBCT images and their actual values at the time of surgery after exposure. Conclusion: Given the limited bone height difference in CBCT images from its actual values, this imaging modality appears to be a useful and accurate tool for estimating bone height in implant surgery in clinical settings.
37 Intraoperative Anatomical Surface Marking and Cone Beam Computerized Tomography for Assessment of the Hamulus in Palatoplasty by Younger Cleft Surgeons , Bergonzani M, Uy V, Zeinalddin M and Lotha B
Understanding the surface anatomy markers for the hamulus in palate surgery is often a useful pointer to the position of the hook of hamulus during cleft palate surgery. This innovative idea is of particular use in Veau 1 and 2 where only medial incisions are used. Younger cleft surgeons feel more comfortable when they are able to clearly see palate structures during careful dissection. Using the intraoperative method of marking out the position of the hamulus makes the whole process of identifying the hook of hamulus a lot simpler. Drawing a vertical line from the mid tuberosity which intersects a horizontal from the level of the posterior spine, the hamulus which lies a few mm below and medial to the intersection, can easily be found. We divide each region into clockwise zones 1, 2, 3, 4 and found the position to be consistent in zone 4, slightly medial and below the intersection of the two lines. This finding was also noted on cone beam CT images of adult and pediatric palates.
38 Efficacy of Garlic in Conjunction with Pentoxifylline in the Management of Oral Submucous Fibrosis - A Cross-Sectional Pilot Study , Leelakshi, Vathsala Naik and Gaurav
Introduction and Objectives: Oral submucous fibrosis (OSMF) is a chronic, progressive, and irreversible disease of the oral mucosa. Though numerous modalities have been tried but all are palliative and have no curative value. Pentoxifylline possessing vasorelaxive and antifibrotic properties believed to potentiate the anti-inflammatory, anti-oxidant and immune modulating properties of garlic. So, the present a cross-sectional pilot studywas undertaken to evaluate the efficacy of Garlic in conjunction with pentoxifylline in the management of OSMF. Methods: The study consisted of 10 OSMF patients. Pentoxifylline (400 mg) was administered thrice daily along with garlic pearls, 2 pearls; thrice daily. Drugs were administered systemically after food for a duration of 2 months. Patients were evaluated every 15 days for the assessment of clinical parameters, i.e. Burning sensation, reduction in mouth opening, tongue protrusion and cheek flexibility. Pre and post treatment study parameters were measured and compared. The improvement was assessed at the end of the study. Results: All the patients were males with the mean age of 26.04 years. Patients exhibited a mean reduction of 95.68% in burning sensation and an increment of 5.37 mm in mouth opening. The cheek flexibility and tongue protrusion also showed significant improvements in the study groups. All the patients showed significant (p > 0.001) improvement in SOD levels following treatment. Conclusion: Overall assessment of the all clinico-biochemical parameters showed a significant improvement. Thus, choice of such therapy is beneficial, affordable, easily available and most importantly a non-invasive treatment modality for OSMF
39 Mandibular Fractures and their Radiographic Diagnosis , Latika Bachani Chopra, Ashok Lingappa, Monika Singh and Anshul
When a patient who has sustained facial trauma is brought to our clinic, the question of bony involvement arises in our mind. The accurate diagnosis of fractures depends upon a thorough clinical examination followed by appropriate radiographic diagnosis. Hence, it would be wise to say that clinical and radiographic examination go hand in hand for the diagnosis of fractures.
40 Future of Dentistry due to COVID-19 , Yesh Sharma
As we all know since a few months, we are facing the same dilemma or fear of COVID-19. The whole world is suffering from this viral infection, and according to the WHO, this virus hold a large number of family of other viruses too. Every sector whether medical, dental, sports, business or industries all are affected by this COVID-19. Still the count of getting infected is increasing day by day, many people lost their lives at early stage of their life or at late stage of their life.
41 Role of Xp-Endo Finisher Agitation File with the Use of EDTA and Chitosan, on Smear Layer Removal by SEM and the Use of Flame Atomic Absorption Spectrometry to Quantify the Concentration of Calcium Ions: An In Vitro Study , Marwan (Mohammad Shafik) Ashour Seyaj, Salsabyl Mohamed Ibrahim and Shaimaa Ismail Gawdat
The aim of this study was to evaluate the effectiveness of the XP-endo Finisher file on smear layer removal in straight root canals after biomechanical instrumentation in comparison to two different chelating solutions (EDTA and Chitosan) by scanning electron microscope and to quantify the concentration of calcium ions on surface of root dentin by using atomic absorption spectrophotometry with flame (AASF).
42 Legal Validity of Criminal Identification from the Comparative Analysis of Bitemarks , Joana Mancellos, Maria Inês Guimarães and Joaquim Gonçalves
Human bitemarks are normally associated with violent crimes, and when recorded, they can be the basis for the constitution of forensic evidence in a legal context. The recording and the comparative analysis of these marks, allied with data on the suspects, enable the elaboration of forensic reports that lead to the exclusion or non- exclusion of suspects, and they also contribute to the unfolding of a criminal proceeding in which the court is responsible for issuing a sentence to a defendant. The legal validity of the comparative analysis of bitemarks in human identification is a widely discussed topic in the scientific community. The numerous publications on this subject reveal different opinions regarding its contribution in crime situations and whether or not it is legally valid. The objective of this literature review is to determine the legal significance of bitemarks in the identification of criminals, considering the methods used to study bitemarks and the reliability of their results.
43 CBCT Localization of Impacted Maxillary Canines - Case Study , Al-Kiyumi H, Shetty K, Al-Senaidi A, Zeinalddin M and Viswapurna PS
Impacted maxillary canines are commonly encountered in orthodontics. The permanent maxillary canine is the second most frequent impacted tooth after the third molar. Cone Beam Computed Tomography (CBCT) is as an effective method to localize and evaluate the exact position of the maxillary impacted canines. In this case report, Initial conventional radiographs were taken. CBCT was performed to localize the actual position of the impacted
44 Saliva: In Relation to COVID19 , Manal Abdalla Eltahir
COVID19, as it designated by WHO, infection outbreak is constitute a real disaster worldwide, from December 2019 to April 2020, the number of affected individuals is more than the million victims. This short review aimed to gather information in the form of answering important questions in the context of Saliva in relation to COVID19 Which is caused by SARS-CoV2, as an emergent infection with limited information about. These questions are: is saliva just an environment facilitates the viral transmission?, How the saliva gets infected with corona virus? what is the actual role of the ACE2 receptors express in the oral cavity in the context of the pathogenesis of COVID-19 disease? What is the life span of the virus in saliva? and What is the role of antiviral components of saliva in combating of the coronavirus?
45 Extra Corporeal Fixation of Cranial Bone Fracture , Sundaram Rajaram, Manjunath NM, J Joseph Arnold and Gauthami Sundar
Fracture of the frontal bone, although form a low percentage of Maxillofacial cases, carries significant risk for the patient, regardless of the type of injury. Usual methods of stabilizing fragments in cranial bone fracture include the use of threads, wires, plates, titanium clamps. This article presents and discusses a case of cranial bone fracture and subsequent management of the same. The uniqueness of this article lies in the new approach to facilitate the fixation of the fractured bone fragments extra corporeally. Thus, this article aims in describing a technique that is safe and simple for the operator and patient. The fixation was very rigid and aesthetic results were attained.
46 Clinical and Radiological Retrospective Multicenter Analysis on 864 Implants with more than 10 Years Follow-up , Giuliano Garlini, Salvatore D’amato, Valeria Chierichetti, Luca Levrini, Clelia Di Serio and Marco Redemagni
The use of dental implants is a widely accepted treatment modality for fully and partially edentulous patients. The beginning of the year 2000 brought the development of moderately rough implant surfaces and macro-designs that are nowadays considered to represent the gold standard for implant treatment. The purpose of this retrospective cohort study was to present long-term data more than 10 years, on survival rate, marginal bone level changes and peri-implant soft tissue healthy status of 709 patients with 864 dental implants in fully and partially edentulous cases.
47 Educational Needs of Dental Laser as Perceived by Dental Graduates: A Survey of Knowledge and Skill Requirements , Faisal Hameed, Irfan Al, Waheed Gul Shaikh, Laraib Mazhar, Nabeel Hafeez, Muhammad Aqeel Aslam and Faizan Abdul Hussain Lakhdir
To assess the educational level and knowledge of the use of laser in Dentistry among the undergraduate and postgraduate students, fresh dental Surgeons and the consultants of different colleges in Karachi.Descriptive, Cross-sectional study was carried out at different dental colleges of Karachi using a self-administered pretested questionnaire from January 2018 to December 2018. The questionnaire consists of 2 parts. First part is about dental laser education and the second one is about the knowledge of dental laser applications. The second part is sub-sectioned to 6 sections. Each section consists of several items related to the uses of laser in 5 different dental specialties in addition to a section in laser protection. The analysis was performed by scoring 2 for a correct response, 0 for don’t know response and -2 for an incorrect response. Students’ knowledge scores will be calculated and transferred to a scale ranged between 2 and -2. Score of > 1 considered as sufficient knowledge, while score of <1 will be considered as insufficient knowledge.
48 A Case of Sinonasal Lymphoepithelial Carcinoma Presenting as a Palatal Swelling , Nikolaos Kolomvos, Dionysios Kyrmizakis, Evangelia Piperi and Evanthia Chrysomali 
Lymphoepithelial carcinoma is a rare type of undifferentiated carcinoma, characterized by atypical epithelial cells surrounded by a reactive lymphoplasmacytic infiltrate. We report a case of sinonasal lymphoepithelial carcinoma arising in the left maxillary sinus in an 80-year-old Caucasian male patient. The lesion had invaded the adjacent lateral wall of the nasal cavity appearing on the palate as a painful swelling. There was no evidence of tumor involvement from the nasopharynx and larynx assessment and no swollen cervical lymph nodes were noticed on the head and neck imaging examination. An incisional biopsy from the oral cavity, as well as an endoscopic biopsy of the neighboring nasal mass were performed. The histopathological and immunohistochemical analysis of both specimens showed identical features and a common diagnosis of sinonasal lymphoepithelial carcinoma was rendered. In conclusion, oral swellings located on the palate may be associated with maxillary sinus malignancies. Thus, the clinician should include in the differential diagnosis not only primary oral carcinomas, but also malignant neoplasms arising from neighboring anatomic sites.
49 Role of Human Papilloma Virus (HPV) in Potentially Malignant and Malignant Lesions of Head and Neck , Paramita Ingle, Basavaraj Bhagawati and Meenal Jethlia
The sixth most common cancer diagnosed worldwide are head and neck cancer (HNC). In 2008, 633,000 new cases were diagnosed out of which 355,000 cases resulted in mortality. Early detection of precancerous lesions remains a challenge to clinicians. In 1983, evidence of Human Papilloma Virus (HPV) infection was identified in a subset of oropharyngeal carcinomas (OPC). Thus, confirming HPV as a causative agent in HNC. HPV is now recognized as an important risk factor for the development of oropharyngeal cancers, and results of previous studies have demonstrated epidemiological and molecular evidence of the presence of the HPV genome in pre-malignant oral lesions in SCC tissues, especially of the subtypes of HPV-16 and -18. There is close to no evidence linking HPV to carcinoma. However, this review focuses on the role of HPV in oral oncology and to comment on the HPV DNA reported frequencies potentially malignant oral lesions
50 Clinical Comparison of Treatments for Dentine Sensitivity from Non-carious Cervical Lesions , Karen Pintado-Palomino, Bruna Neves de Freitas, Larisse Eduardo Adami, Mariana Montanhini de Lima, Takami Hirono Hotta, Wilson Matsumoto, Cesar Bataglion and Camila Tirapelli
This study compared the effectiveness of in-office and at home treatments for cervical dentine sensitivity (CDS) from non-carious cervical lesions.Sixty participants with CDS were selected and randomly allocated into six groups of treatment: LA: gallium aluminium arsenide laser and LP: laser-placebo (4 in-office sessions); RMGI: resin-modified glass-ionomer and ARC: adhesive resin cement (in-office single session); DD: stannous fluoride desensitizing dentifrice and RD: regular dentifrice (30 days at home-use). CDS was assessed with the visual analogue scale at pre-treatment, immediately after treatment and at 1, 2 weeks, 1 and 2 months after the end of treatment. Data were compared using the Kruskal-Wallis and Friedman tests (p < 0.05).
51 Effects of Sugar Crystals on Cerebrum , Subham Kumari
Aim behind writing this article is to give powerful impact on the peoples mentality. Sugar is the generic name conferred to sweet tasting, a soluble carbohydrate.
52 Treatments for Paresthesias after Orthognathic Surgery: Literature Review , José Victor Marconato, Luis Eduardo Genaro and Paloma Fernandes
Orthognathic surgery is a procedure of choice for the treatment of skeletal deformities; however, it is common to observe a change in sensitivity called paresthesia, in cases where the nerves are injured. For the patient's sensitivity to return, it is necessary to perform treatments such as the use of low-power laser, acupuncture and drug treatment. This work sought to identify these treatments and describe them, in order to guide the clinical management of dental surgeons.
53 Comparing the Anxiety Level between Myofascial Pain Dysfunction Syndrome Patients and Others , Sara Pourshahidi, Hooman Ebrahimi and Zahra Pourabdollah
Myofascial pain dysfunction syndrome (MPDS) is the most common temporomandibular disorder and a psychophysiologic disease that primarily involves the muscles of mastication and can cause pain, mouth opening limitation, mandibular deviation during mouth opening and closing and tenderness of one or more masticatory muscles or tendons. Among various ideas about the etiologic factors of MPDS, two main reasons are occlusal disorders and mental health problem. More researches recently, focus on mental health problem as the main and initial factor of MPDS. Anxiety is one of the most fundamental psychological problem that exists in almost all societies, it increases muscle’s tonisity and thus leads to pain. Considering the high prevalence of anxiety in patients suffering from this syndrome, this study is to investigate anxiety intensity in these patients and compare that with two control groups. The first control group were 30 patients who referred to dental school because of any problems except MPDS, and the second one included 30 Shiraz citizens. All three groups were informed about the procedure of the study and then completed Spielberger Anxiety Intensity Questionnaire, that had been validated before. Then a psychologist checked and graded the questionnaires. Using spss v.15 we analyzed the data with ANCOVA and Chi-Square tests. This study demonstrated that the MPDS patients had more anxiety than the common people of the society. The significant point in our study was the comparison of anxiety level in MPDS patients with the other patients that referred to dental school with a reason other than MPDS which revealed no significant statistically difference. According to this result, we can say that the high anxiety level in MPDS patients may be not related to the disease and can be due to the situation they share with others who refer to dental school, so the anxiety may be the result of their disease and not the cause.
54 To Investigate the Influence of Conventional and Non-Conventional Drill on Implant Stability During Bone Bed Preparation- A Systematic Review , Rachel Quadros
There are multiple surgical techniques proposed for implant bone bed preparation to enhance the stability of implants. However, there is no adequate amount of scientific evidence to support the association between the surgical techniques and implant stability.This systematic review aims to investigate the influence of laser/piezoelectric or conventional drill on its surgical outcome during bone bed preparationThe studies included were from January 2007 to December 2017 An electronic search was done of PubMed, Google Scholar, Institutional Library and manual search of various journals. The inclusion criteria composed of all randomized control trials and observational studies evaluating the implant stability after bone bed preparation conventionally or using a piezo electric system or laser. All studies selected were in ENGLISH language only and included in vitro and in vivo studies conducted in animals.
55 Properties Affecting the Fracture Resistance of All Acrylic Resin in All-on-4® Technique - An In Vitro Study , N Chandra Sekhar, Paladugu Lakshmi Sandhya, Kollipara Soujanya, Kothuri Naga Ravalika and Jagadeesh Konchada
All-on-4® concept has seen much success mainly due to its immediate loading quality. A temporary fixed hybrid usually made of all acrylic resin is given for 6 months which is later replaced by a definitive prosthesis. This temporary prosthesis is supported by only four implants and strength of the complete unit depends on the strength of denture base which plays a major role in final outcome. This study is designed to evaluate different commercially available all acrylic resin denture materials with better flexural strength, impact strength and water sorption properties.Investigation of the impact strength, flexural strength and water sorption of three denture base materials, namely, Trevalon HI, Brecrystal and Ivocap plus. A total of 90 samples were prepared from these materials. Universal testing machine and Izod impact tester was used for flexural strength and impact strength and for evaluating water sorption, the specimens were stored in a desiccator at 37ºC for 23 hours and the samples are weighed using a balance
56 Contracted Endodontic Cavity in a Severely Calcified Anterior Tooth Using Guided Endodontics Technique: Case Report , Alessandra Rosa de Sá, José Flávio Gabrich Giovannini, Henrique Trindade de Magalhães, Victor Couto Figueiredo, Tiago Braga and Rodrigo Rodrigues Amaral
Pulp canal obliteration (PCO) is characterized by the deposition of calcified tissue within the root canal space, which may partially or totally involve the canal. The endodontic treatment of calcified teeth is considered a challenging task depending on the severity of pulp obliteration. Recently, guided endodontics has become an alternative approach for those cases. This case report describes the use of guided endodontic access for the maxillary left lateral incisor of a 73-year-old male patient that required restorative treatment. The tooth had an extensive coronary fracture and demanded endodontic treatment for prosthetic purposes. Periapical radiography showed that pulp obliteration was severe at the cervical and middle thirds of the root. A cone beam computed tomography (CBCT) was requested in order to assess the level of obliteration. A three-dimensional (3D) template was planned with the CBCT's images along with intraoral scanning. A prototyped guide for guided endodontic access was performed, and the dental procedures were concluded safely. Guided endodontic access was paramount to overcome the pulp obliteration and ensured the endodontic treatment, and prosthetic rehabilitation could be performed.
57 Role of Sesame Oil Pulling in the Management of Oral Submucous Fibrosis: A Pilot Study , Shriya Khaira, Priyanka Verma and Sunita Gupta
Oral Submucous Fibrosis is a progressive, premalignant condition for which multiple treatment modalities have been tried with partial success rate. Oil pulling is a newer treatment modality which involves swishing of oil in the mouth. Sesame oil has been used as it possesses antioxidative properties which prevent free radical injury to oral tissues.To find a holistic, cost effective and permanent treatment approach with no side effects: Twenty clinically and histopathologically diagnosed subjects of oral sub mucous fibrosis were treated by oil pulling procedure for 6 months. All subjects were instructed to perform oil pulling with sesame oil for 15-20 minutes every morning. The parameters recorded on day 0 and at the end of 6 months were mouth opening, tongue protrusion, VAS scale, cheek flexibility and gingival index. Intra group comparison were made using wilcoxon signed rank test.
58 Emerging Trends in Healthcare-A Path to the Future , Gokul Venkateshwar, Ekta Keswani and Sumeet Shinde
The last few months has compelled us look at healthcare through the prism of the Covid 19 pandemic, the path of trajectory of the contagion points to the surge of the pandemic leading to a huge public health crisis. Despite the lockdowns imposed by several Governments across the world, the pandemic shows no signs of abating, with the daily fluctuating graph being a point of vexatious debate. The adamant virus has managed to leave its footprints everywhere leading to an enormous challenge being thrown on our healthcare system, traditionally entrenched in combating diseases prevalent in our society. Though in recent years in the last decade or so the virus crisis has manifested as SARS, H1N1, Swine flu, the current zenith of Covid 19 has surpassed the viruses prevalence hitherto known to the world in a short span of time. The pandemic has ravaged societies across the countries and created economic and social imbalances affecting all strata of the society in developed and developing nations as well. This pandemic is no longer confined to the boundaries of any nation, its prevalence today is across continents, threatening to upend humanity. Today we stand at the edge of a precipice, staring at a crisis at a time when our civilization is trying to achieve its pinnacle. The impact of health on our socio economic structure, is undeniable and we no longer can push it under a carpet and ignore it anymore.
59 Role of HPV in Oral Cancer , Smitha T
Oral cancer is one of the major health issues in India. The traditional risk factors or oral cancer include pan chewing, tobacco and alcohol use. However, Human papillomavirus (HPV) 16 is now being implicated causing oral cancer. Until recent times, the research on oral cancer has focused on factors like genetics, evolving lifestyle and environmental factors such as pollution. The possible etiological role of HPV16 and 18 in oral oncogenesis needs to be addressed. Additionally, there are many aspects of HPV in causation of oral cancer that still needs to be understood and addressed. The following chapter focuses on types and role of HPV, its pathogenesis within the oral cavity, and prognosis in case of HPV-positive cancer cases. The chapter also includes an update on the diagnostic tests, with highlight on various specific biomarkers, and the treatments developed to contain the HPV-positive cancer cases. Current research areas and future perspectives have been covered in this chapter which can be taken up to advance the research on HPVpositive oral cancer.
60 Occupational Hazards in Dentistry , Abhirami
Dental care has been revolutionized due to information explosion and technical advances, as a result of these advances quality care can be provided to the population but while doing so, dentist and their teams exposed to a number of hazards peculiar to this profession leading to various ailments specific to the profession that develop and intensify with years.
61 Changing Trends in Dental Practice during the Pandemic , Rishi Bhimani
COVID-19 pandemic has crippled and incapacitated the entire world in the past 6 months. With its array of symptoms and degree of severity, most countries-imposed lockdown time and again to prevent the spread of infection.
62 Infra Orbital Ethmoid (Haller) Cells: A Cone Beam Computed Tomographic Study in a Population of Iran , Maryam Johari, Elham Romoozi, Hemmat Gholinia Ahangar and Ehsan Moudi
The aim of this study was to evaluate the frequency of Haller cells in a population of Iran using Cone beam computed tomography (CBCT) to further identify it as a predisposing factor for sinusitis.
63 Role of Dentists in the National Emergency COVID , Ojas Kumar Singh, Subham Kumari, Puja Kumari, Mausmi Singh, Shweta Singh and Anirban Roy
In this article my aim is to, summarize the effective collection of the host factors co-operated and indicating zonal pathways activated during human novel coronavirus infection, and its whole biomolecular relation, get evoking on Human CoV-infection with inducing stress response, autophagy, apoptosis, and innate immunity
64 Advanced Diagnostic Aids in Detection of Potentially Premalignant Oral Epithelial Lesions - A Review   , Jayanta Saikia, Balaji Pachipulusu, Poornima Govindaraju and Bhagyashree M Nair  
Oral cancer is one of the most mutilating disease afflicting mankind. Precancerous lesions, conditions and early stage oral cancer cannot be adequately identified by visual inspection alone and may be easily overlooked and neglected. Differentiation between early stage cancer, precancerous lesions and benign lesions is often difficult because of the similar appearance of the lesions. Surgical biopsy is a gold standard for diagnosis, but this needs professional services, which are impractical at times. Alternative screening methods which are non-invasive, easily performed and highly accurate are the norms for any test to accept as an alternative for histopathology  
65 Clinical Outcomes of Neutral Zone Techniques Employment in Maxillofacial Prostheses , Masmoudi Karim, Chabbi K, Adouani A, Ayadi M and Jamila J
Prosthetic rehabilitation for patients undergoing substantial maxillary surgery is challenging. Certainly, implantology is the best option for improving prosthesis’s support, retention, and stability. Nevertheless, the neutral zone technique can also be considered an equally effective approach patients complaining about unstable maxillofacial reconstructions, particularly when implant therapy is not feasible.
66 Are we Fortified for Prevention and Control of Epidemic Outbreaks like COVID 19 in Schools of India: A Cross-sectional Knowledge Awareness and Perception Survey on Education and Training Professionals in India (KAPEI-1) , Ramakant Gupta, Swati Gupta and Manju Gupta
Schools teachers, being the intellectual resource, can aid in controlling epidemics like COVID 19. To serve the purpose school teachers themselves need to be aware of such emergencies.
67 Validation of the Distance between Upper Canine Gingival Margin Zenith to Ipsilateral Lower Canine Gingival Margin Zenith as Method for Determination of the Occlusal Vertical Dimension , Cristian Abad-Coronel and Rubén Arindia
The vertical dimension of occlusion (VDO) is one of the most important parameters to consider for diagnosis and treatment planning in a prosthetic rehabilitation. Various methods to determine it have been proposed throughout the scientific literature, without establishing a universally accepted method. Various factors, such as the differences in the biotype and phenotypic characteristics of the patients in certain populations, could generate variations in the measurements obtained.
68 Effect of Platelet Rich Plasma on Alveolar Osteitis and Bone Healing Following Surgical Extraction of Teeth , Ismail Ahmed, Syed Ghazanfar Hassan, Parveen Memon, Emaan Fatima Qureshi, Muhammad Maarij Hassaan Qureshi, Salman Shams and Mahwish Memon
To determine the efficacy of platelet rich plasma on bone healing of alveolar socket and alveolar osteitis prevention following surgical extraction of teeth compared to normal healing.
69 The Quintessence of Keratinized Gingiva in the Periodontal and Peri Implant Realm: Conventional Knacks Revisited. Case Reports , Sumit Munjal, Seema Munjal and D S Mehta
Gingiva, with its unique texture and coral pink color, is the most delicate tissue in the oral cavity and the first essential component of the periodontium. Keratinized Gingiva is presumed desirable because it influences the outcome of all the periodontal treatments. The connective tissue grafts were used in varying situations in the present report, the goal being to re-evaluate the predictability of traditional skills of augmentation in the peri-implant and periodontal domain. It’s high time the traditional knowledge and today’s innovative biomaterials forge a definite science wherein a regeneration of ravaged soft tissues is irrefutable.
70 Different Approach to Transverse Palatal Expansion: MARPE (Miniscrew Assisted Rapid Expander) Over RME (Rapid Maxillary Expander) , Aisha Ali Riyamy, Thuraiya Al Rashdi, Karthik Shetty, Mohammad Zeinalddin and P S Viswapurna
Maxillary deficiency is among the huge culprits in orthodontic patients seeking treatment. Multiple treatment modalities are there to tackle this problem. The most common treatment approaches are rapid maxillary expansion (RME) and miniscrew/surgical assisted rapid palatal expansion (MARPE/SARPE). In this article we reviewed two different approaches of treatment, side effects of RME and also the non-surgical mini screw assisted expansion in both older and younger patients. The stability of expansion, skeletal and dentoalveolar effects in both treatment approaches were reviewed.
71 Combating COVID-19: A Dentist Perspective , Pranjali V Bawankar, Abhay P Kolte and Rajashri A Kolte
The current scenario in the world is awfully perilous and insecure because of the world pandemic of COVID- 19.Healthcare workers (HCW) are frontline warriors for prevention and treatment of Coronavirus affected patients. Face-to-face communication and consistent exposure to body fluids such as blood and saliva predispose dental care workers at serious risk for 2019-nCoV infection. As demonstrated by the recent coronavirus outbreak, information is not enough. During dental practice, blood and saliva can be scattered and aerosol production is common. Accordingly, dental practice can be an impending risk for dental staff, and there is a high risk of cross-infection. This article deals with all information collected to date on the virus, in accordance with the guidelines of international health care institutions and provides a comprehensive protocol for managing possible exposure to patients or those suspected of having coronavirus.
72 Attachments in Cast Partial Denture: A Case Report , Swapnita Vaity, Omkar Shetty, Gaurang Mistry and Manali Mehta
Retention of prosthesis is one of the key factors in the success of the prosthesis. Apart from retention, one of the major concerns in removable partial dentures has been stress transfer on the remaining tissue; particularly in distal extension cases. The use of attachment gained momentum in around late 1950s after considerable efforts by Steiger and Boilet. The need for extra retention and improved esthetics, lead to the development of intra-coronal and extra-coronal attachments. Attachment is a mechanical device for fixation, retention, and stabilization of prosthesis. The criteria that help in the selection of the attachments are location, function, retention, space and cost factors. The article presents a case report on attachment in cast partial denture.
73 Transfloral Acupuncture - A New Combination of Ear Acupuncture and Floral Essences to Improve the Energy of Patients , Andreas Wirz-Ridolfi
In any patient the extension of the actual electromagnetic field is decisive for his state of health as well as for the effectiveness of any therapeutic measure. With the innovative method of Transfloral Acupuncture it is possible to improve the energetic level of patients considerably within seconds. Most foci (which are obstacles for diagnosis and treatment) are dental foci. Teeth, even if they don't yet need treatment by a dentist, can present a focus causing a considerable loss of energy for the patient. This loss of energy reduces his capability to react to treatment as well as his immune system. According to the research of Prof. Frank Bahr and Dr. Heike-Dorit Schmid every tooth is in resonance to a flower essence, (Bach, Californian flower essences or Australian Bush flowers). By means of the Vascular Autonomous Signal (VAS) and the Bahr detector (a combination of a 3-Volt hammer and a black and white hammer) all teeth are controlled and the corresponding flower essence is chosen. A drop of the floral essence is given orally and another drop is placed on the ear lobe of the patient at the place of the tooth found to be a focus. Now a permanent needle is inserted through the floral essence into the ear lobe
74 Knowledge and Attitude of Parents towards Avulsed Permanent Tooth of their Children and its Emergency Management at RAK College of Dental Sciences Clinic , Sally Kamal El Din Mohamed, Dana Abdullah, Suzan Omar, Huda Abutayyem, Tamer El-Marsafawy and Rania Hamed Ghanem
Traumatic injuries to dentoalveolar tissues are considered the most serious oral health problem amongst children and adolescents Epidemiological studies revealed that children from 8 to 12 years often suffer a dental injury. It may vary from minor tooth fracture to extensive dentoalveolar damage that involves the supporting structures and avulsion. Avulsion is defined as total dislodgment of the tooth from its socket. It represents about 16% of all traumatic dentoalveolar injuries (TDI). Central incisor is the most affected tooth due to their labial projection which make them more susceptible to facial trauma.
75 Endodontic Management of Trauma-induced External Root Resorption Following Orthodontic Treatment by Placement of Biodentine: A Case Report , Reza Sayyad Soufdoost, Ali Jamali Ghomi, Hossein Labbaf and Homeira Ansari Lari
External root resorption is considered as a frequent complication of orthodontic tooth movement, particularly, in a tooth with the history of trauma and resorption. Advances in dental material science not only have increased demand from the patients for saving their teeth, also have enabled clinicians to treat the complicated cases. Previously most of the teeth with severe external root resorption were scheduled to extraction due to poor prognosis of conventional endodontic treatment. This case report presents successful nonsurgical endodontic management of a trauma-induced perforating external root resorption with Biodentine which had been progressing rapidly after applying orthodontic forces. 24 months follow-up revealed arrest of root resorption, and advanced healing of the lesion
76 Intraosseous Odontoma Erupted: Diagnosis and Treatment , Estefanía Raquel Fernández, González María M, Barrios Evelin E and Krupp Sebastián
Odontoma is the most frequent benign odontogenic tumor in the oral cavity, especially in the anterior sector of the maxilla, with a greater predominance in men in a 1.5: 1 ratio, diagnosed between the first and second decades of life. It is a pathology where the dental tissues are normal, but its structure is disorganized. Regarding the etiology, it is related to trauma, morpho differentiation, genetic disorders and Malassez remains. They are of limited growth, asymptomatic and are responsible for the bone retention of permanent teeth. The therapeutic treatment of choice is surgical excision and they generally do not recur. The following report presents a 28-year-old male patient who attended the Dental Clinic Service of the Faculty of Dentistry of the National University of the Northeast for cosmetic reasons and upper lip discomfort when speaking. The clinical, radiographic and histopathological study confirmed the presence of a complex odontoma erupted above the dental piece 5.4 still present in the oral cavity. It was successfully removed without postoperative complications. This clinical case is of great diagnostic interest compared to other pathologies with similar characteristics. The success of the treatment was the result of a correct clinical, radiographic and histopathological diagnosis
77 Porcelain Laminate Veneers-Current State of the Art in Aesthetic Dentistry , Ajit Jankar, Suresh Kamble, Sachin Chaware, Shruti Botwe, Suraj Sonawane and Madhavi Galale
Porcelain laminate veneers have been proved to be durable and an aesthetic treatment modality in dental clinics. Dental porcelain has become the most widely used material for the construction of crowns in dentistry because of its excellent esthetic properties and its ability to duplicate the appearance of natural tooth structure. It is a conservative and non-invasive technique treating aesthetic and functional problems in the anterior teeth. Nowadays, innumerable variety of dental ceramics are available for fabricating laminate veneers. It is imperative for clinicians to know and understand the composition and properties of these materials to choose the appropriate option according to clinical situations
78 Rehabilitation of Patient with Immediate Cast Partial Denture Using Patient’s Natural Maxillary Anterior Teeth , Priyanka Tiwari, Rajesh Sethuraman and JR Patel
In dental practice immediate denture is commonly used before extracting all the remaining teeth. There are many advantages of using this denture such as esthetics, speech, occlusion, maintaining the facial height, muscle tone and tongue size. Maxillary anterior teeth as patient’s natural teeth are used due to improving the self-esteem, esthetics, smile and confidence of a patient. Also as natural teeth retain their hue and strength for sufficient period of time. Removable partial denture can be used but Cast partial denture is a better option as it provides better fit and hygiene and it is an alternative to the patient who are not willing to get fixed prosthesis done or in whom FDP is not indicated. Hence Immediate cast partial denture is the choice of treatment in such cases. In this case patient’s natural maxillary teeth is used to form immediate cast partial denture, together with replacement of missing teeth in maxillary and mandibular arches.
79 Suitable Materials for Indirect Posterior Partial Restorations , Sarra Nasri, Yosra Gassara, Dalenda Hadyaoui, Zohra Nouira, Belhassan Harzallah and Mounir Cherif
Indirect posterior partial restorations may offer a viable and cost-effective treatment option for the restoration of extensively decayed teeth. An increasing variety of restoration materials are available on the market nowadays, which makes the material choice a difficult decision. In this article, the most important criteria of selection are presented to guide the dentist in the selection of the restoration material.
80 Telescopic Overdenture for Partially Edentulous Patients: A Case Report , Surbhi Jain
M.M. Devan stated, “It is more important to preserve what already exists than to replace what is missing" has always set a gold standard and has never been disapproved. In clinical situations with remaining partial dentition, various treatment options are available to the prosthodontists out of which overdentures have always been considered as a superior treatment modality. Preventive prosthodontics has always been advantageous in maintaining the propioreception and preventing residual ridge resorption, which forms the basis of preventive prosthodontics. This clinical report describes the prosthodontic rehabilitation of a patient with a mandibular telescopic overdenture for added advantages like better retention, stability, support and psychological benefits of the patient
81 Pharmacological Management of Orthodontic Pain: A Systematic Review and Meta-Analysis , Basel Mofti, Moataz ElShehaby, Mona A Montasser and David Bearn
The objective of this systematic review and meta-analysis was to assess the effectiveness of various pharmacological interventions on pain experienced by patients undergoing orthodontic therapy
82 Sport Activities, Oral and Dental Health. A Mutual Relationship , Panagiotis Ntovas, Nikolaos Loumprinis, Panagiotis Maniatakos, Vakou Dimitra and Christos Rahiotis
To review the relationship between sport activities, oral and dental health.A literature search was carried out through the Medline database (PubMed) and the Cochrane Controlled Clinical Trials Register. A subject-specific search strategy was conducted since the August of 2018 using the following keywords: sport drinks, energy drinks, sports oral health, mouthguard, oral anabolic Steroid, oral trauma, dental trauma, Barodontalgia, Odontecrexis, Sport Maxillofacial Injuries, Athletic injuries and Sports Medicine
83 Comparative Evaluation of 3 Caries Risk Assessment Tools for Children with Early Childhood Caries , Nessa Mary John and Latha Anandakrishna
Caries risk assessment is the determination of the likelihood of the incidence of new carious lesions. Individualized risk assessment of an infant or toddler will help both the health care provider and parent/caregiver to identify the factors associated with early childhood caries, so that a preventive plan can be developed.To compare three different caries risk assessment tools, Caries-risk Assessment Tool (CAT), Caries Management by Risk Assessment (CAMBRA) and Cariogram® for children with/without Early Childhood Caries (ECC).
84 A Comparative Evaluation of Cement Application Methods on Marginal Discrepancies and Retention of Cement Retained Implant Restorations: An In Vitro Study , Swati Jain, Preeti Satheesh and Malathi Dayalan
The purpose of this study was to evaluate the retention values and marginal adaptation of implant- supported metal crowns using four different cementation techniques.Eighty implant abutment complex (IAC) and metal crowns with defect free and smooth marginal surface were used in the study. Each IAC was composed of a 5.5 mm high titanium abutment screwed onto a 10mm long stainless steel implant analog with 25 Ncm torque according to manufacturer’s instructions. The specimens were divided into four groups (groups A-D, twenty specimens per group) according to the cementation technique employed. In Group A, cement was evenly placed over the entire interior marginal surface (IMS) of the crown. In Group B, cement was evenly placed only on the occlusal surface of the crown. In Group C, cement was evenly applied on all the axial walls of interior surface of crown excluding occlusal surface In Group D resin abutment replica technique was used. Zinc phosphate cement (DPI, Harvard) was used for all cementation procedures according to manufacturer’s instructions. All specimens were subjected to 1000 thermal cycles between 5˚C and 55˚C with a dwell time of 10 seconds in a thermocycling device.
85 The Foundational Basis of Aesthetic Cleft Lip Surgery for Cleft Surgery Trainees: A Retrospective, Observational Study of Early Post-Operative Results in Bilateral Cleft Lip Surgery Using Some Anthropometric Nuances , Lotha B and Zeinalddin M
The bilateral cleft lip deformity is often a challenging surgery for younger cleft trainees because of the associated nasal deformities. Done with care, using Mulliken’s five principles of symmetry, muscle continuity, philtral size and shape, median tubercle formation using labial elements, and alar cartilage positioning, one is able to achieve satisfactory results over time. These pillars remain the constant for younger cleft trainees. Anthropometric measurements form the basis of functional aesthetic bilateral cleft lip repair. Success of bilateral cleft lip surgery involves correct anthropometric measurements and the five principles
86 Challenges and Implications for Dental Professionals during Novel Corona Virus Disease (COVID-19) , Tanusha Sharma
The outbreak of novel coronavirus disease (COVID-19) has influenced every aspect of human life. Medical professionals, especially dentist are at a very high risk of getting infected. Because of close contact with infected patients dental professionals can easily be infected. Due to the characteristics of the hospital settings, the positioning of clinician and patient the risk of cross infection is high. For dental clinics and hospitals which are under the containment zone affected with COVID-19, major infection control protocols are highly recommended. This article focuses on the challenges and implications for a dental professionals during novel Corona virus disease (COVID-19). Dental practitioners need to be aware and prepared for tackling corona disease.
87 Corona Virus (COVID-19) Impact on Patient Environment in Dental Practice , Ossama A AlKhatib, Samar MF Saati, Muhanad O AlKhatib, Delia O Alkhatib and Alaa A Albasher
The environmental circumstances create further risk factors that affect severity and duration of oral and periodontal diseases; Corona Virus (COVID-19) makes trouble changing of immune defenses which result in damage the tissue cells at several vital areas of the human body, and may convert the mechanism and symptoms of patient diseases. Till now Corona viral pandemic has been changing the patient social lifestyle and affected dental clinical practice, and becomes more critical for infection control against all infectious diseases that should be managed before starting treatment of bacterial periodontal disease and other dental problems. Many new requirements become in need to extend our educational understanding about how these infectious viral or bacterial diseases will contaminate people and are transferring from person to person, especially in dental clinic during practice on patient, and how much to drew attention for additional protective procedures to the patient who still has been looking for a new different managements. So that our concepts should be changed to correspond to all new patient required demands after corona virus pandemic
88 Binder’s Syndrome: The Need of an Ortho-Surgical Approach , Priti Shukla, Amit Nagar and Rachit Thakral
Despite the frequent presence of all characteristic orofacial features and profound dental malocclusions there is very little to be found in the literature of maxillofacial surgeons to diagnose a case of Binder syndrome or also known as maxillo-nasal dysplasia or maxillo-nasal dysostosis. Nordenram., et al. recommended to delay any definitive orthodontic treatment in individuals with this syndrome up to the time when growth has ceased. For severe cases they also advise for grafting in the nasal area along with Le-Fort I and II osteotomy. Thus, in such cases the orthodontic treatment should go hand in hand with the surgical team hence opting for an ortho-surgical approach. The aim of the orthodontist in the post-surgical phase should be improvement of facial beauty, relieve crowding of the arches and their co-ordination and to obtain a Class I molar relationship.
89 Frontal Sinus as Tool in Identification , Anushri Tiwari
Identification of the dead is important in mass disasters, road traffic accidents, criminal investigations as well as accidents involving fire. The most common identification techniques are: fingerprinting, dental comparison, and DNA profiling. This review aims at delving into the use of frontal sinus as an aid in the identification process.
90 Irrigants: A Game Changer in Root Canal Treatment , Yesh Sharma
One of the principal goals of root canal treatment is the cleaning of entire root canal system through removal of pulpal debris, smear layer and smear plugs. Instrumentation alone is not sufficient to remove pulpal debris and smear layer thoroughly. Irrigation of root canal system in between instrumentation is mandatory to completely debride and clean the root canal.
91 Skeletal Anchorage System [Miniplates] - An Orthodontic Perspective - A Review , Amit Bhardwaj, Ashish Kumar Sharma, Kratika Mishra and Rahul Jeswani
In the orthodontic world paradigms have started to shift since the invention of mini-plates in the anchorage armamentarium. Miniplates as bone-borne anchor unit have enabled us with management of wider discrepancies than those with tooth-borne anchor unit by conventional biomechanics. Miniplate enables clinicians for having good control over tooth movement and anchorage control in three dimension that is sagittal, vertical and transverse plane. This present literature review will explain about how the skeletal anchorage system is versatile with usage of miniplates for the correction of malocclusion, emphasising on orthodontic and orthopedic movements within three dimensions. Management of impacted teeth and adult orthodontics along with periodontal conditions is also explained in this review.
92 Skeletal Anchorage System [Miniplates] - An Orthodontic Perspective - A Review , Amit Bhardwaj, Ashish Kumar Sharma, Kratika Mishra and Rahul Jeswani
In the orthodontic world paradigms have started to shift since the invention of mini-plates in the anchorage armamentarium. Miniplates as bone-borne anchor unit have enabled us with management of wider discrepancies than those with tooth-borne anchor unit by conventional biomechanics. Miniplate enables clinicians for having good control over tooth movement and anchorage control in three dimension that is sagittal, vertical and transverse plane. This present literature review will explain about how the skeletal anchorage system is versatile with usage of miniplates for the correction of malocclusion, emphasising on orthodontic and orthopedic movements within three dimensions. Management of impacted teeth and adult orthodontics along with periodontal conditions is also explained in this review.
93 Candida Species Around Dental Implants in Saudi Arabian Diabetic Patients , Rehab M Alhossaini, Mansour K Assery, Sami Shafik and Khalid Al-Hezaimi
Reports confirm high prevalence of diabetes mellitus and dental caries associated with early tooth loss often replaced by dental implants in the Saudi Arabian society. This study aims to (1) assess clinical periodontal parameters of probing depth (PD), bleeding on probing (BOP) and amount of keratinized tissues (KT) around dental implants and (2) identify and type the fungal colonization present in the peri-implant crevicular fluid (PICF) in diabetic and non-diabetic Saudi nationals.
94 Correlation between Periodontal Disease and Oral Health Related Quality of Life , Sadia Rashid, Sana Zafar, Ayma Syed, Danish Javed, Nadia Junaid, Muhammad Umair Dastgir Bhatti and Muhammad Rizwan
The objective of the study was to assess the correlation between periodontal disease and oral health related quality of life amongst study sample. It was a case control study including 632 individuals screened by calibrated examiners at Department of Oral Diagnosis, Dental Hospital, Sialkot, Pakistan. Oral examination was carried out by two calibrated examiners to measure the periodontal disease i.e. (CAL more than 2 mm, BOP more than 6 sites and PPD more than 4 mm). Three hundred and sixteen (316) were participants with periodontal disease (case group) and 316 were participants without periodontal disease (control group). A back translated Urdu version of the standardized validated oral health impact profile (OHIP-14) questionnaire was used to quantifying the impact on quality of life in both groups. Approximately 63.0% participants in case group had trouble in pronouncing words due to periodontal disease and only 9.0% in control group reported this issue. 83% participants had painful itching in mouth in the case group and 13% in control group. Majority (81.5%) of the participants in case group were uncomfortable in eating food and 72.9% felt tense due to periodontal disease. 69.7% participants in case group were found irritable with other people as compared to only 5% in control group.
95 Dentistry and Artificial Intelligence , Rashmi J Kurup, Amandeep Sodhi and Sangeetha R
Artificial intelligence (AI) is a technology which is quickly advancing and has captivated the minds of researchers across the globe. The adoption of artificial intelligence (AI) in healthcare is developing while profoundly changing the face of healthcare delivery. AI is being employed in a horde of settings including hospitals, clinical laboratories and research facilities. From data processing and finding relevant information to using neural networks for diagnosis and to the introduction of augmented reality and virtual reality in dental education, its inception has witnessed some of the exceptional achievements in dentistry. The key applications involve diagnosis and treatment recommendations, patient engagement and adherence, and administrative activities. Thus, this circumstance demands every dentist to get acquainted with this technology as the future of dentistry is adjoining the execution of its applications. The need for proper documentation of the patient’s information, quick and dependable treatment protocols through robotics in the field of surgery has encouraged the utilization of these software technologies in assisting the dentist to diagnose and treat the patients productively. However, this technological advancement is still in the phases of outset and this article is an endeavor to highlight the role of artificial intelligence in dentistry.
96 Conscious Sedation in Pediatric Dentistry: One Step forward , Siji Elizabeth, Bhawna G Saraf, Neha Sheoran, Pramodh Thomas John, Disha Kapil and Megha Chawla
Early childhood are usually associated with dental pain and anxiety among pediatric patients that is often carried into adulthood. Dental treatment of these patients are often challenging and also require adequate cooperation. Such patients can be managed using pharmacological methods. A thorough knowledge of the basic agents used for sedation is necessary. This article thus has reviewed on basic pharmacological agents used in the procedural sedation in children briefing its pharmacological properties.
97 Rounding Up the Usual Suspects in Orthognathic Surgery: Improving the Learning Curve for Clinical Fellowship Trainees by Following Some Nuances to Prevent Technical Errors and Maladjustments during Surgery First Orthognathic Surgery , Lotha B, Fattal A and Zeinalddin M
Surgery first orthognathic surgery is one of the most fascinating advances in orthognathic surgery and involves a teamwork between craniofacial orthodontists and craniofacial plastic surgeons. One of the most rewarding aspects is the shortened treatment time as well as dramatic and immediate facial profile improvement before the follow up orthodontic treatment. However, the surgery is fraught with challenges for younger surgeons if finer technical steps are not followed accurately. The 3 D simulation is best done with craniofacial orthodontists who can help plan the post op orthodontic movements after the surgery. As a result of observing certain nuances, the procedure can be performed comfortably and symmetry achieved by a well-executed plan by the orthodontistsurgeon team to the immense benefit of the patients with facial asymmetry.
98 Oral Squamous Papilloma: A Case Report , Gautami Kaimal, Shivaprasad, S Savita and Benita Maria Regi
Oral squamous papilloma is a benign proliferation of the stratified squamous epithelium, which results in a papillary or verrucous exophytic mass induced by human papilloma virus (HPV). Most of the oral mucosal lesions are often asymptomatic and have less progression. Tongue, soft palate, and uvula are common sites for occurrence. Surgical excision of the lesion was done and was sent for histopathological analyses that confirmed the diagnosis
99 Four Year Follow Up of Immediate Provizionalization of Osseointegrated Dental Implant in Patient with Rheumatoid Polyarthritis , Rym Masmoudi, Hela Jegham, Hend Ouertani and Mohamed Bassem Khattech
Successful osseointegration and long term maintenance of endoosseous dental implant are influenced by implant to bone interface requiring continual bone remodeling. Many factors can influence bone remodeling and lead to osseointegration failure. Rheumatoid polyarthritis (RA) is a systemic autoimmune disease characterized by bone damage. Anti-rheumatic drugs such as Methotrexate and Glycocorticoid have deleterious effects on bone metabolism and turnover.
100 Graphical Trends and Machine Learning Forecast of COVID19 Around the Globe , Keshav Kumar, PG Naveen Kumar, Dharmendra Kumar, Mausam Kumar, Vaishali and Kunal Krishn
An epidemic disease is contagious and have the capability of spreading into entire nation if timely adequate measures are not taken to curb the epidemic. Coronavirus outbreak from Wuhan in South China is engulfing approximately entire world within nearly four month of time span. Till date nearly 10 lakh people are infected and around 50 thousand died due to this disease around the world. In this article we are going to represent the graphical trends of infected cases around the WHO six zone, calculation of Basic Reproduction Number, Using Machine Learning tried to find out the near future scenario
101 Professional Perception on Criminal Identification through Bitemarks in Portugal , Joana Mancellos, Maria Inês Guimarães and Joaquim Gonçalves
This study is aimed at examining the judgment of Portuguese criminal justice professionals on the importance of bitemarks for human identification in a crime context. It describes the results of a survey published in the Google Forms platform, in which 65 individuals took part. We were able to conclude that, in general, the respondents agree that bitemarks are important for human identification and should be used frequently in legal settings. The results obtained in this study suggest that those who’ve worked in crimes involving bitemarks attach more importance to the forensic analysis of these injuries than those who don’t have experience in these cases.
102 Interceptive Orthodontics in an Adult Patient: A Case Report , Trudee Hoyte, Anne Kowlessar, Visha Ramroop and David Bearn
This report describes a case of a 44year old Indo-Trinidadian woman who presented with impacted canines. On examination the patient was found to have retained upper right and left primary canines. A panoramic x-ray was taken which showed fully developed permanent canines and primary canines whose roots showed no sign of resorption. The patient also presented with dental anxiety and hence was an irregular attender. The presenting complaint was attempted eruption of upper left permanent canine and thus the patient requested removal of the upper primary canines and she would accept the resulting alignment. The upper left primary canine was removed, and the root was found to be intact with no resorption of the primary canine was evident. The permanent canine after 3 months showed some active eruption into the arch, although at review after 4 years it remained not fully erupted. Interceptive extraction of primary canines in an adult may allow spontaneous/active eruption of impacted permanent canines.
103 A Comparative Evaluation of the Effectiveness of Saline, Chlorhexidine and Ozone Irrigating Solutions on Microorganisms in the Root Canal - An In Vivo Study , Alan Winston David, Sarvepalli Venkata Satish, Sudhir Dole, Suresh Kumar Kovvuru and Basavana Gowda
To evaluate the effectiveness of normal saline, 2% Chlorhexidine solution and Ozone oil on microorganisms in the root canal.This study was carried out on 45 patients, out of which 60 anterior fractured teeth were selected which are asymptomatic, non-vital and necrotic in nature. Teeth were randomly divided into three groups of 20 each depending upon the type of irrigants used i.e. Saline, Chlorhexidine and Ozone. After access opening, two microbial samples were taken from each tooth: a) Pre- irrigation i.e. sample after pulp extirpation and before irrigation, b) Post-irrigation i.e. sample after irrigation, which were stored in sterile containers and immediately transferred to microbiological laboratory for incubation aerobically at 37°C for 24 hours. Then, the samples were streaked on blood agar culture media and incubated for 48 hours. After 48 hours, the colony forming units were counted using a colony counter. Statistical analysis was carried out using Kruskal-Wallis test, Wilcoxson signed rank test and MannWhitney test
104 Impact of Digital Photography and Conventional Method on the Accuracy of Shade Matching in the Esthetic Zone (In Vivo Study) , Rawan Ferroukhi, Omaima S El Dein El-Mahallawi and Ahmed Naguib M Hussien
Accuracy of shade matching using conventional shade guides is a concern because color perception is highly subjective. Also, entirely relying on the digital method for shade selection can result in a deviation of color interpretation which may have an impact on the device’s repeatability and accuracy.To evaluate digital photography’s accuracy in improving shade matching compared to conventional methods (visual shade guide and spectrophotometer).
105 Causes of Permanant Teeth Extraction in Relation to Age: A Study from Qassim Region, KSA , Bashayer Mohmmad AlMutiry and Manal Abdalla Eltahir
This Cross sectional study was conducted in Qassim University female dental clinics, with the objectives to determine the causes of tooth extraction in relation to age group, as well as the commonest tooth for the extraction, according to the exclusion criteria 181 female subjects were included in the study, the results was, the highest age group found in 30- 39 (34.8%) The major cause for teeth extractions, is Caries (73%) in young age group followed by periodontal diseases (16%,) as the patients getting elder, while prosthodontics (10.5%) is the least reason for extractions. The most common tooth for extraction is the left first lower molars (8.3%) due to caries. As a causative agent
106 Linear IgA Disease - A Rare Sub Epithelial Disorder: A Current Appraisal , Shamimul Hasan
Linear IgA disease is a non hereditary, autoimmune sub epidermal bullous disease, characterized by the presence of linear deposition of IgA auto antibodies along the basement membrane zone. The disease has a bimodal occurrence, manifesting in both children and adults. The cause is usually obscure in childhood, although, adult onset cases are primarily due to drugs (vancomycin), malignancies and infections. Skin and several mucous membrane involvement usually occur, and oral lesions are rarely seen in the disease. Dapsone forms the mainstay of treatment along with corticosteroids.
107 Clinical and Microbiological Evaluation of Caries Removal Using Brix 3000 Gel, Polymer Bur and Laser Technique in Primary Molars: An In Vivo Study , Jaya AR, Kalyani M Choudhar and Vinaychandra R
Newer techniques of Brix 3000 gel, Polymer bur and laser irradiation of dentinal caries removal are minimally invasive methods and should be more frequently employed in Pediatric Dentistry. To evaluate three different techniques of caries excavation in primary teeth in terms of efficacy, efficiency, fear and anxiety experienced during the procedure.Sample of 30 children aged 5 to 9 years were equally divided into 3 groups –Brix 3000 Gel group (Group 1), Polymer bur group (Group 2), Laser group (Group 3).Microbiological investigation was used to determine efficacy. Time was recorded to determine efficiency and Wong-Baker Faces Pain Scale (WBFPS) was used to assess the pain experienced.
108 Dental Management of a Child with Neuroblastoma Undergoing Chemotherapy - A Case Report , Niranjana CN, Sahana Mahesh, Neha Gupta, Sreedevi Jayakrishnan and Megha Sanganeria
Neuroblastoma is a extremely rare developmental neoplasm arising from the embryonic sympathoadrenal lineage of the neural crest which affects young children whose prognosis becomes poor and poor as the age advances. Neuroblastoma arise as tumor from the tissues of the sympathetic nervous system, typically in the adrenal medulla or paraspinal ganglia, and thus can present as mass lesions in the neck, chest, abdomen, or pelvis. The clinical presentation is highly variable, ranging from a mass that causes no symptoms to a primary tumor that causes critical illness possibly resulting from local invasion, widely disseminated disease, or both. There is no standard dental treatment protocol for the management of neuroblastoma due to its poor survival rate and rarity. However, any dental treatment may follow a preventive and restorative protocol. Surgical procedures should be performed under supervision as it may trigger metastasis and further complications. This paper is a case report on a 4-year-old child who is suffering from stage 4 neuroblastoma- a malignant round cell tumor, which has a survival rate of 20%.
109 Natural Antimicrobial Agents for the Prevention of Dental Caries: A Review , AKM Shafiul Kadir, Md Mahfuzur Rahman, Farhana Faruque, Tilottoma Mohona and Jannatun Naim Nipun
Among various oral and dental problems, dental caries is one of the most common problems. There are certain factors which initiate dental caries formation. Oral microorganisms are one of them specifically Streptococcus mutans. Streptococcus mutans is an encapsulated gram- positive coccus which is and produces acid responsible for tooth decay. There are various treatment and prevention methods which are tested on dental caries but medicinal plants are found to be beneficial from ancient times. The current review focuses on different medicinal plants which can be used for the prevention of dental caries caused by Streptococcus mutans.
110 Exploring the Role of Platelet Derived Concentrates in Accelerated Orthodontics - A Narrative Review , Gayatri Ganesh and Thulika Tripathi
One of the major goals in the field of clinical research is the hastening of the regenerative process by waning the duration of the wound healing. Platelets play a crucial role in these procedures, as they act as reservoirs of cytokines and growth factors. Orthodontic tooth movement largely involves bone remodeling comprising of alternate cycles of bone resorption and deposition. The past decades have witnessed various attempts to accelerate the rate of this movement by various techniques leading to a decrease in the treatment time, a highly desired outcome by the patient as well as the orthodontist. The following review attempts to summarize existing literature concerning the application of platelet derived concentrates in dentistry and their potential role in orthodontics. The most commonly used platelet derived concentrates i.e. Platelet Rich Plasma (PRP), Plasma rich in growth factors (PRGF) and the Platelet rich Fibrin (PRF) have been described and compared to aid in future opportunities of clinical research.
111 Tele-Dentistry-Best Option during Covid-19 Crisis , Bharat Joshi
Covid-19 crisis has done lot of damage both psychologically and mentally. It becomes difficult to visit any dentist or medical faculty because of exposure risk and death chances. But dental problems are independent of any natural calamity or pandemic.
112 Comparative Evaluation of the Antibacterial Activity of Cinnamon zylanicum (True Cinnamon) and Azadirachta indica (Neem) Herbal Extracts Versus Calcium Hydroxide Intracanal Medication against Enterococcus faecalis in Single Rooted Premolars Teeth: A Randomized In Vitro Study , Hisham (El-sayed Abo Elenein) El-sayed, Hany Samy Sadek and Marwa Mahmoud Bedier
This Comparative Randomized in-vitro study was conducted to compare the antibacterial effect of two different herbal extracts: Cinnamon zylanicum (True Cinnamon) and Azadiracta Indica (Neem) versus Calcium Hydroxide (Ca (OH)2 ) as an intracanal medication against Enterococcus Faecalis (E. faecalis) in single-rooted premolars teeth.
113 COVID19: Growing Rage and New Appearing Challenges for Upcoming Dentistry , Mayank Singhal, Manoj Goyal and Pratibha Kaushik
The corona virus (COVID-19) has summoned health care professionals and it has evoked different types of reactions all around the world. Although routine general dental procedures have been suspended in countries influenced by COVID-19 disease, the requirement for assembled high priority care given by health care professionals with personal protective equipment takes precedence. With all the ignition of details available online, it becomes hard to bracket authentic guidance, this article is primarily based on the facts associated with precautions and preventions measures to be taken by dental health care professionals.
114 A Literature-Based Discussion of Root Canal Treatment of Teeth with Developmental Anomalies , Mohammed A Alobaid
To review the literature pertaining to root canal management in different types of tooth abnormalities.An electronic search was conducted through databases PubMed and Google Scholar for different dental anomalies. Also, classical textbooks on dental anatomy, endodontics, and oral biology were searched. The search terms were: dental anomalies, root canal treatment in tooth anomaly, classification of tooth anomalies, gemination, fusion, dilacerations, and other different types of anomalies.
115 Machine Learning in Multidimensional Biomarker Design: A Milestone in Precision Medicine - A Systematic Review , Raajasiri Iyengar and Gaurav
With the emerging era of precision medicine and high-throughput sequencing technologies, huge amount of ‘omics’ data has been gathered. Data interpretation remains a challenge due to the large and evolving magnitude of the dataset [3]. Precision medicine not only includes targeted therapeutics, but also necessitates ‘precision diagnostics’. Rational design of multidimensional biomarkers is the keystone of precision diagnostics, wherein multiple biomarkers are cumulatively assessed using computational techniques to yield specific patterns [1]. Patterns thus obtained are analyzed with Machine learning algorithms to arrive at a diagnosis that is both reliable and accurate
116 Factors Affecting Patient Satisfaction in Fixed Orthodontic Patients. A Questionnaire Study , Monika Mahajan
The objective of present study was to assess factors contributing to patient satisfaction after orthodontic treatment as patient satisfaction is important for ensuring patients adherence in orthodontic treatment. This study also aims at exploring any difference gender wise in perception of the satisfaction with orthodontic treatment through a questionnaire.A total of 45 patients who had completed their fixed orthodontic treatment in the Department of Orthodontics, were selected. The number of female patients were 30 and male patients were 15 with the age of the patients from 12 to 28 years. At the end of the fixed orthodontic treatment i.e. after debonding a questionnaire to assess patients satisfaction with orthodontic care was given to the patient. The questionnaire had 65 questions which were placed under 7 subgroups. The patient had to answer as yes or no to the questions.
117 Crestal Maxillary Sinus Lift with Rotating Instruments and Different Grafting Materials: Results at 4 Years Follow Up , Giuliano Garlini, Michele Perelli, Alessandro Fasano, Lorenzo Daniele and Marco Redemagni
The maxillary sinus lift with lateral approach has always been one of the most complex procedures in terms of post-operative morbidity. For this reason efforts have been made to introduce less invasive methods. The use of osteotomes has been considered a good alternative. The main problem is linked to the perception of the patient, who considers this method particularly annoying to bear because of the percussion. To overcome this, methods with a crestal approach with rotating instruments are increasingly being disseminated.
118 A Rare Genetic Disorder in Modern Ages - Goldenhar Syndrome , Shalini Subramanyam and Peeyush Shivhare
Goldenhar syndrome (GS) also known as oculoauriculovertebral dysplasia is a relatively common developmental disorder characterized by craniofacial anomalies in association with ocular, auricular, vertebral, cardiac, renal, central nervous system and maxillofacial defects. This condition was first described in 1952 by the Swiss ophthalmologist, Maurice Goldenhar. The incidence of this condition varies from 1 in 3,500 to 1 in 5,600 live births. Goldenhar syndrome needs to a multidisciplinary approach regarding craniofacial and cardiologic associations. We are presenting a case of 19 yr old male who was diagnosed with Goldenhar syndrome
119 Prosthetic Management of a Patient with Anhidrotic Ectodermal Dysplasia: Clinical Case Report , Nidal Elmoutawakkil, Khadija Kaoun and Samira Bellemkhannate
The anhidrotic ectodermal dysplasia gathers a set of diversified pathologies characterized by the triad anhidrosis, hypotrichosis, anodontia (hypodontia); the management of young patients with this condition often requires a multidisciplinary approach within the scope of prevention, pediatric and prosthodontic dentistry.The following case describes the clinical steps of a prosthodontic rehabilitation of a 9 years-old patient affected by anhidrotic ectodermal dysplasia, complete dentures were made using a 3D conceived and printed Fox plan. Conclusion: The prosthetic rehabilitation of these young patients will not only restore all the manducatory functions but also their psychomotor apparatus affected by the aesthetic repercussions of the ectodermal dysplasia.
120 PRF from the Perspective of a Daily Practitioner: Where are the Limits? , Andreas Van Orten and Hakan Bilhan
Platelet-rich fibrin (PRF) is being used in dentistry as an over physiological concentrate of autologous growth factors capable of stimulating tissue regeneration and being increasingly more popular in private practice. Since about 20 years platelet concentrates are being used in oral and maxillofacial surgery. With various modifications, mainly concerning the presence or absence of leukocytes and their concentration, as well as the presence and consistency of the fibrin matrix, the scope of application has continuously expanded.
121 Overview of Various Angled Abutments Commercially Available: A Review , Kothuri Naga Ravalika, Rahat Aisha Yasmeen, N Chandra Sekhar, Kollipara Soujanya and Valliammai Rajendran
The utilization of implant‑supported crowns and bridges has become a well‑established and preferred approach in treating com‑ pletely and partially edentulous states. An ideal implant position is requisite for obtaining good esthetic results and correct emer‑ gence of screw access hole. Commonly, due to insufficient bone volume, implant will be placed in available bone which leads to unfa‑ vorably placed implants. Once placed, such implants are restored by giving a cement‑retained prosthesis to avoid labial/buccal screw access holes witch are esthetically unpleasing. In such a scenario, a graftless solution would be using an angulated screw channel technology which tilts the prosthetic screw access hole emergence in a desirable direction that is more esthetic and acceptable. Angu‑ lated abutment system is unique and exclusive and are designed through computer‑aided design and computer‑aided manufacturing technologies. This system rectifies angulation issues with millimetric precision with full freedom of movement. This review article presents an overview of various types of angulated abutments commercially available. It highlights the features and angulation provi‑ sion of various commercially available angulated abutments.
122 Class II Malocclusion Management of an Adult Patient Using PowerScope® 2 Class II Corrector - A Clinical Case Report , Ravindranath MJ1  and Little Mahendra
The role of functional jaw orthopedics plays a vital role in treating the skeletal malocclusion, timely planned and well-executed treatment results in attain an excellent functional occlusion and craniofacial harmony. This article presents a case report of an adult patient diagnosed with Angles Class II malocclusion with an increased overjet of 9 mm and overbite of 5 mm with incompetent lip relationship. Whereas the skeletal base was an Orthognathic maxilla and Retrognathic mandible. The patient was treated in two phases where the first phase consists of a leveling and alignment of the teeth and the second phase with PowerScope 2 Class II corrector device for mandibular advancement to achieve the skeletal discrepancy. The overall treatment duration took 18 months. The success in orthodontic treatment depends on patient compliance particularly in correcting skeletal malocclusions. There is always a constant search for a simple appliance in the treatment of these type of malocclusions. PowerScope 2 Class II corrector is a promising appliance that is relatively simple to install and easy to maintain by patients this directly helps the orthodontist in maintaining patient compliance to achieve the predicted treatment outcome.
123 Accidental Dislodgement of Separated Instrument in the Maxillary Sinus: A Unusual Case , Avisha Agrawal, Pratima Shenoi, Rajesh Kubde, Snehal Sonarkar, Gautam Badole, Vandana Kokane, Ankita Ramteke and Purabi Edbor
Root canal therapy consists of a cascade of scientifically-based technical procedures. Failure to follow the standard protocols and lack of knowledge can lead to a number of iatrogenic accidents which are collectively called “endodontic mishaps”. One of the most frequently encountered endodontic mishap is a separation of the endodontic instrument. Heroic attempts to remove separated instrument may lead to dislodgment of instrument in the periapical area. At times such instrument get dislodged in the maxillary sinus when treating upper maxillary molars and canines. Separated instrument in maxillary sinus, irrespective of their origin or nature, act as foreign body and Such objects should normally be removed at the earliest in order to minimize the likelihood of maxillary sinus complications. Studies have shown that some of the objects can cause chronic sinusitis because of the invasion of the sinus by highly virulent bacteria, while some remains asymptomatic. It is an uncommon finding to observe, an asymptomatic dental endodontic instrument in a position so close to the maxillary sinus without any oro-antral fistula formation and/or sinusitis attacks. This paper presents the case of a separated endodontic instrument which was pushed inadvertently in the maxillary sinus of a 41-year-old female patient
124 The Perceived Oral Health Status, Practices, Knowledge and Periodontal Status of Pregnant Women in a Maternity Hospital in Trinidad , Reisha Rafeek, Visha Ramsaroop, Ramaa Balkaran, Anne Kowlessar, Arlana Bissoon, Christine Royer and Risa Yuk Low
The aim of this study is to report the oral health status, practices, knowledge and periodontal status of pregnant women in a maternity hospital in Trinidad.A convenience sample of pregnant women who attended a maternity hospital was recruited. Data were collected using a self-administered questionnaire which included frequency and reason for dental attendance, perceived oral health status and oral health knowledge and practices. Oral health examinations took place at the University of the West Indies (UWI), School of Dentistry including the Basic Periodontal Examination (BPE). Data were analyzed using SPSS version 24.0 in which descriptive analysis and Chi-square tests were performed.
125 Cephalometric Evaluation of Main Airway Dimensions in Subjects with Different Growth Patterns and their Relation to Patients’ Ages and Genders , Rabaa Mahmoud Aboubakr, Nabeela Hassan Almalki, Sohir Shehata Kamel, Salah Awad Alanazi, Saleh Hassan Alqhtani4, Abdullah Ali Almulhim4 and Osama Mesfer Alkhathami
Airway shape and dimensions has been attracted attention during the past few decades, this is can be attributed to the relationship between upper airway configuration and sleep-disordered breathing as well as its relation to craniofacial morphology in general.This study was conducted to 1. Compare the pharyngeal dimensions of subjects with different vertical growth patterns. 2. Assess the impact of modifying variables like age, and gender on airway dimensions.Data collection was based on both cephalometric radiographs and patients’ files analysis. Radiographs were grouped according to patients’ ages, genders, and vertical growth pattern. Lateral cephalometric radiographs were taken using a standardized technique. SN-MP angle used to divide the sample into hypodivergent, noromodivergent, hyperdivergent growth patterns with values of < 26°, 26-38°, and >38° respectively as proposed by Isaacson., et al. The upper and lower pharyngeal airways width measured by using McNamara’s airway analysis.
126 Robots and Archwire Bending, a Better Solution? Literature Review , Assim Anas Assim Alsalam, Rashid Mohammad Iqbal and Huda Abutayyem
Orthodontic appliance is the basis of the orthodontic treatment and making it more accurate and efficient would improve the general orthodontic treatment and change the standards of oral health.The point of this research was to differentiate between the conventional wire bending in fixed orthodontic appliances and the automated robot made wire. Additionally, to see if robot wire bending is dominating and has favored results over ordinary wire bending.
127 Apical Surgery: New Concepts , Younes Kalakhy
Apical surgery is a technique developed for the surgical treatment of apical lesions of pulpal origin, some authors speak of surgical endodontics or endodontic surgery. The surgical protocol consists of the surgical approach of the periapical region, tissue debridement and removal of granulation or cystic tissue and then proceed to the resection of the root apex and finish by filling the apex with a material ensuring apical hermeticity, we speak of retrograde filling. His technique has seen a lot of improvement especially with a new generation of materials such as MTA (Mineral trioxide aggregate) and bioceramics as well as the advent of piezosurgery and the operating microscope In this paper , we will focus on the definition, indications, contraindications as well as the principle and the surgical protocol.
128 Inflammatory Dentigerous Cyst in Mandible in a 10 Year Old Male Child - A Case Report and Review of Literature , Madhu Verma and Jyoti Mittal
Dentigerous cyst is the most commonly found among odontogenic cysts. Regarding its origin, it may be developmental or inflammatory. The inflammatory dentigerous cyst occurs only in mixed dentition patient and too with less frequency. The cyst is mostly seen as a unilocular radiolucency that encloses permanent teeth buds which can be displaced at times. Treatment of inflammatory dentigerous cyst in children is aimed to save as many developing permanent teeth as possible. This article presents a case of uncomplicated behavior of a huge mandibular dentigerous cyst in a 10-year-old boy after marsuplisation. Long-term follow-up examination showed complete bony healing and spontaneous eruption of permanent teeth even if they were badly dislocated.
129 A Cephalometric Study of FH-SN Angle in Different Sagittal Skeletal Patterns among Patients Seeking Orthodontic Treatment , Rajan Singh, Avinash Chaudhary, Basanta K Shrestha, Deependra Prasad Sarraf and Pankaj Shah
Frankfort horizontal (FH) plane and Sella-Nasion (SN) plane are commonly used reference planes in orthodontic cephalometry. Any variation in this angulation from its accepted 7 degree can affect the cephalometric diagnosis. The objective of the study was to determine an average FH-SN angle among patients seeking orthodontic treatment.One hundred lateral cephalograms were obtained from the records of patients who came for orthodontic treatment in Orthodontics and Dentofacial Orthopaedic Unit. Cephalometric tracing was done on acetate tracing paper of 0.004 inch thick using 3H pencil of 0.5 mm. Mean and standard deviation of FH-SN angle of the samples was calculated. One way analysis of variance and independent-samples t-test were used for assessing the relationship between dependent and independent variables at P-value of 0.05.
130 OMFS Residency and Silver-Linings Amidst the Darkness of a Pandemic , Jiean Joseph Heifetz-Li, Ross Miller, Allen F Fielding and Samer Abdelsamie
The COVID-19 pandemic has profoundly altered the inherent ways we conduct ourselves and interact. The way that human beings work and play has changed across the globe. The virus has ravaged economies and healthcare systems, leaving no aspect of patient care untouched. As oral and maxillofacial surgeons and residents, our unique position in the hospital setting puts us at the interface of dentistry and medicine, and as a result, we have witnessed this virus’ devastating effects firsthand. While maintaining a positive outlook during this trying time is difficult, we have learned that there are silver linings in the darkness of a pandemic
131 Resin-Modified Glass Ionomer Varnish Versus Acidulated Phosphorus Fluoride Gel in Prevention of White Spot Lesions During Comprehensive Orthodontic Treatment (Split Mouth Randomized Clinical Trial) (A Comparative Study) , Mohamed Zidan, Fouad Aly ElSharaby and Eman Mohie El-Din El-Sayed
Although fluoride varnish has been investigated and recommended by many studies for the prevention of white spot lesion, its effective use over the course of 3 months from a single application is not considered enough especially when it is compared to newly proposed material. These materials such as resin-modified glass ionomer have not been studied enough throughout literature to evaluate their real effect
132 Current Diagnostic Methods in the Detection of Oral Cancer- An Update , Sunitha HM, Amandeep Sodhi and Vathsala Naik
Oral cancer is the 6th most common cancer in the world with significant morbidity and mortality which is frequently associated with local lymph node metastasis. As the prevalence of the disease is increasing and the survival rate has remained low for decades, it is essential to diagnose the disease at an early stage. Early diagnosis of the disease significantly increases the probability of the cure of oral squamous cell carcinoma with minimal impairment and deformity of the associated structures. Various methods in the diagnosis of Oral cancer are visualization methods, vital staining which includes - Toluidine Blue, Lugol’s iodine, Methylene blue, laboratory based diagnostics- Biopsy, salivary biomarkers, Light based diagnostic tools, salivary biomarkers, advanced imaging modalities. This article reviews the conventional and latest diagnostic methods which aids in not only early detection but also in accurate treatment planning of oral cancer
133 Hospital Dentistry: Dentist's Performance in the Pediatric Sector , Alexandre Ramos Braga
Hospital Dentistry is a dental specialty that aims to perform oral care and procedures in the hospital environment. Child hospitalization is considered a traumatic experience that leads the child to different feelings, such as anguish, anxiety and fear. The child will have to deal with different and noisy environments, lights, constant routine procedures, exposing him to great stress. The dentist's role in this context becomes very important, being part of the multidisciplinary team. The dentist, in the condition of examining children in a hospital environment, verifies the real need and the best opportunity to intervene in the oral cavity in order to maintain their healthy clinical condition as a whole. General health may be at risk if oral health is compromised, which can interfere with the recovery process. Treatment should include all dental specialties, considering a patient's clinical condition. The patient can be submitted to emergency procedures in the case of trauma and preventive procedures when the systemic condition worsens or is not affected by hospital infection
134 Fixed Functional Appliances in Orthodontics- A Literature Review , Sachin Katole, Prafull Parchake and Sheetal Jankare
Class II malocclusion is one of the frequently discussed malocclusion in Orthodontic literature. However, its correction becomes crucial part of treatment planning depending upon the etiology of malocclusion, age of the patient and also patient cooperation. Fixed functional appliances has been widely used in orthodontic practice for correction of Class II malocclusion. In spite of wide popularity, fixed functional appliances has its own advantages and disadvantages. Current literature review provides detailed information about fixed functional appliances and its use in orthodontics.
135 Zinc Oxide Eugenol as an Obturation Material in Primary Dentition , J John Shibin, Prathima GS and Suganya M
Maintaining the deciduous teeth in a functional state until its shedding time is the main aim of Pediatric Dentistry. Primary tooth is the best and natural space maintainer which helps to maintain the arch integrity, arch length and guides the permanent tooth eruption. If the deciduous teeth are damaged irreversibly it can be managed by root canal therapy which was first advocated in 1932 in order to serve its function till exfoliation. One of the key factors for the success of pulp therapy is selecting a suitable obturation material. Even though various obturation materials are existing in practice, Zinc Oxide Eugenol (ZOE) remains as the Gold standard material. This review article presents an overview of Zinc Oxide Eugenol as an obturating material.
136 Covid 19 - A New Normal for Dentistry during Pandemic , Aparajita Singh, Shubham Gupta, Ruchi Gopal and Pratik Surana
The corona virus disease also known as COVID-19, is a viral infection that first reported in Wuhan, China in last month of 2019, which rapidly involve the most of countries in world. Covid-19 infection transmitted through droplet, when a person is in close contact with Covid-19 positive person. Since dental professionals has an unique operatory environment which involve close examination of oral cavity and aerosol generation during the clinical procedures, the risk of Covid-19 transmission from an infected patient is very high. Present article provides the insight of Covid-19 infection and precautions and considerations to the practice dentistry in this pandemic.
137 Comparative Evaluation of the Changes in Surface Topography and Crystallization of Gutta Percha Cones by Four Chemical Solutions: An SEM Study , Arun Kurian Varghese, SV Satish, Krishna Rao Kilaru, Ashwini M Patil and Basvana Gowda
The aim of the study was to observe the surface topography and crystallization of GP cones by aloe vera, glutaraldehyde, sodium hypochlorite and propolis - using a Scanning electron microscope (SEM).Seventy GP points of size 80 and 2% taper were divided into five groups depending on the type of chemical agents used for disinfection.
138 Effectiveness of Clobetasol Propionate in the Treatment of Oral Lichen Planus - A Systematic Review , Meena Jethlia, Paramita Ingle and Sujata Manwate
Lichen planus is an inflammatory disease affecting skin and oral mucosa with a typical Wickham’s white striae and keratotic cap. Clobetasol propionate is a corticosteroid used for minimizing pain and discomfort associated with the disease.Search strategy was framed and relevant articles were identified through titles, abstract and full text read in PubMed and Google scholar published between 1st January 2000 and 31st October 2019. Other language articles were translated as required. Only randomized controlled trial, clinical studies using Clobetasol propionate in any form and dosage and assessing its effectiveness in oral lichen planus were included. Case reports and series, reviews, editorials, conference proceeding were excluded.
139 Healing of Periapical Lesions with Conventional Root Canal Treatment: A Case Report , Nayantara Sud
Infected pulp tissue is the major cause of periapical lesions, a majority of which are granulomas, radicular cysts or abscess. These lesions can only be diagnosed histologically. Root canal treatment or non surgical endodontic treatment is the treatment of choice in these cases without surgical intervention. Healing after the non surgical treatment takes place in about one year. In non surgical treatment emphasis is laid on thorough debridement, disinfection of the root canal system and obturation of canals. There are higher rate of healing in the anterior segment as compared to the posterior segment. The periapical index (PAI) is widely used measure to know the status of the periapical tissues. Thus, conventional endodontic therapy in combination with calcium hydroxide as an intracanal medicament contributed effectively in healing of periapical lesions in these cases.
140 Ability of Sodium Hypochlorite to Clean Dentinal Tubules by Manual or Sonic Activation at Varying Temperature: A Confocal Laser Scanning Microscopic Study , Avisha Agrawal
To compare Ability of Sodium Hypochlorite to clean dentinal tubules by manual or sonic activation at varying temperature: A Confocal Laser Scanning Microscopic Study.The primary aim of endodontic treatment is to eliminate the microorganism within the root canal system and prevent recontamination. According to Weine, untreated and unfilled lateral canals can retain enough irritants in a protected sanctuary high enough to cause endodontic treatment failure. To achieve the complete cleaning and disinfection, sodium hypochlorite is used as a potent irrigating solution. Studies have been reported that preheating sodium hypochlorite enhances its tissue solubility and disinfection properties. Cavitation and acoustic streaming of the irrigant contribute to the biological chemical activity for maximum effectiveness Many studies have been reported that has studied the effectiveness of sonic instrument on the cleanliness of the canal with sodium hypochlorite. A literature search did not identify any studies evaluating the penetration depth of preheated sodium hypochlorite using sonic instrument by confocal laser electron microscopy
141 Odontogenic Keratocyst Mimicking Odontogenic Dentigerous Cyst. A Laborious Diagnostic and Therapeutic Challenge , Mahamadou Konate, Mounia El Bouhairi and Ihsane Benyahya
Odontogenic keratocyst (OKC) is a developmental cyst of jaw which arises from odontogenic epithelium. OKCs has been considered to be cystic neoplasms and called keratocystic odontogenic tumors in WHO classification in 2005. Although reclassified as cysts by WHO at 2017, OKCs are characterized by clinically aggressive behavior and high risk of recurrence. Clinical and radiological features are not specific and can mimic other lesions of jaw as dentigerous cyst. This tumor is also a developmental cyst but is less aggressive and not recurring. The management differs depending on the nature of the cyst. This paper presents OKC case mimicking dentigerous cyst, also the histopathological characteristics specific to odontogenic keratocyst as well as the adapted management.
142 Slow Dentistry in Post Coronavirus 19 Era: Clinical Practice, Education and Well-being , Nurcan Buduneli, Fusun Ozer, Saynur Vardar-Sengul, Zeynep Burcin Gonen, Figen Cizmeci Senel, Aylin Baysan6 and Sema S Hakki
This review aims to critically evaluate the guidelines with respect to slow dentistry in clinical practice, education and well-being for staff and students in the post COVID-19 era.According to the data released on 14 October, cases of COVID-19 have been spotted in 215 different countries, with 38,688,225 total cases, 1,095,492 deaths and 29,035,243 recoveries. Since presence of asymptomatic infected cases is an unfortunate reality with COVID-19 and creating aerosols is a common occurrence in dentistry, the risk of cross-infection is high for patients and healthcare providers during dental procedures.
143 Why Need Periodontal Dressing (What All Options Available) , Shubhankar Kumar Singh and Deepak Chopra
Periodontal pack is a surgical dressing used to cover surgical site to prevent from any infections. Periodontal dressings, also known as periodontal packs, provide similar benefits when applied after periodontal surgical procedures. Still there are many controversies whether to pack or not pack. We have available pack in Eugenol, Non Eugenol, light cure and others. In this article we see why we need perio pack and all options available.
144 Treatment of the Anterior Crossbite in Mixed Dentition: Case Reports , Mohanad Alsaadi
Anterior crossbite is a malocclusion which may resulted in many complications which can be avoided by early diagnosis and intervention with fixed or removable appliances. This study aimed to presenting different results of treating anterior crossbite during mixed dentition in different age of three attended children by using removable acrylic appliance with bite plan and to summarize the advantages and disadvantages of the other non- selected methods in this study. Clinical examination of children aged 8-10 who attended with chief complaint of crowding and esthetically displeasure showed one or two permanent maxillary incisors position behind the permanent lower incisors in each case. After clinical and radiographical examination, removable acrylic appliances with bite plans were selected to treat the three cases. Treatment periods were 6-8 weeks according to the cases severity. The selected appliance had been discussed in comparison with the non-selected methods. The first step to treat the anterior crossbite is to know the indications of each treatment methods in order to apply the suitable one for each case
145 Peri-implantitis Seeded by Permanent Cement - A Case Report from Karachi, Pakistan , Munis Mukhtar, Zehra Tariq and Maaz Asaad
Peri-implantitis is a chronic complication affecting the soft and hard tissues surrounding the dental implant. The prevalence of peri-implantitis ranges from 21% on implant-level, and 34% on patient-level. Several treatment methods have been proposed that are aimed at arresting the disease and potentially regenerating bone defects related to it. Here, we report the case of a patient presented with cement induced peri-implantitis of moderate severity with thin, mobile soft tissue and a probing depth of 6mm two years post-implant placement. A radiographic assessment revealed bone resorption of about 40% of the length of the implant. Mechanical and Chemical debridement, followed by hard and soft tissue grafting, was employed as a treatment modality for the successful resolution of peri-implantitis.
146 Prevalence of Dental and Oral Diseases in People Living with HIV, A Systematic Review , Sheehama J, Mwadinohamba I and Lukolo L
This systemic review, of the prevalence of dental and oral manifestations in people living with HIV, was conducted from articles based on studies in various countries that aimed to establish the characteristics and prevalence of individual oral manifestations.The electronic retrieval systems and databases that were searched for relevant articles were PubMed and Google Scholar. A total of 41,237 articles were found on these sites, of which only 5 were included in the review. The five articles were selected based on the criteria of: articles published in English; studies carried out between January 2005 to November 2019 (recent data of less than 15 years); articles discussing only the prevalence of dental and oral diseases in people living with HIV. Exclusion criteria included articles that were more than 15 years old, that were focused on newly infected patients and articles that included other systemic diseases –such as Diabetes Mellitus- that could adversely affect oral health.
147 An Update of Oral Therapies Used for Children and Adolescent of Autism Spectrum Disorder (ASD) and Recommended Prosthodontic Guidelines , Sachin Chaware, Surekha Dubey Godbole and Vrushali Thakare
Autism spectrum disorder (ASD) is the most prevalent Neurodevelopmental condition of unknown etiology. The integration of sensory difficulties with ASD affects the day to day routine activities and shows much dependence on parents or caretakers of ASD children and adolescents. The most significant oral sensory challenge is the imperfect development of speech followed by atypical feeding behavior. Currently, speech therapy is the central therapy used for speech errors, followed by Oral placement therapy, Nonspeech oral motor therapy, and audio digital therapies. However, all oral therapies have advantages and limitations, due amount of time required and nature of the disorder. The present review evaluated the current status of oral therapies and recommended prosthodontic based guidelines based upon the oral sensory-motor pattern associated with ASD subjects.
148 A Recommendation of PHTALOX® Mouthwash for Preventing Infection and Progression of COVID-19 , Paulo Sérgio da Silva Santos, Bernardo da Fonseca Orcina, Lucas Marques da Costa Alves, Rodrigo Cardoso de Oliveira, Mariana Schutzer Ragghianti Zangrando and Fabiano Vieira Vilhena
The mouth has a significant role when it comes to the transmission process of SARS - CoV-2. This happens due to the spread of small droplets which makes the oral and oropharynx mucosa easy targets for the virus
149 Crestal Sinus Lift Using Osseodensification Burs: Clinical Cases , Cardarelli Angelo and Arun K Garg
The purpose of this work is to present an alternative technique to normal sinus lift in the upper jaw with minimal invasive approach in order to reduce biological costs using the osseodensification mode. Infact following this technique is possible at the same time place the implant with high primary stability and increase the vertical bone height with and without bone graft. Compared to the traditional technique like lateral sinus lift or crestal approach with manual osteotomes, this procedure is less invasive and more predictable and precise
150 Inflammatory Pathology of the Oral Cavity: Relevance in Oral Oncogenesis , Teresa Sequeira, Gonçalo Sousa, Eurico Monteiro and Augusta Silveira
Oral cancer is considered to be a growing public health problem and within head and neck cancer pathology, it is the most common. It is the 6th most common cancer in the world, corresponding to approximately 3% of all cancers. Despite the dedication and investment in this pathology, the advances in diagnosis strategies and the development of early intervention programs and treatments, aimed to be more targeted, more effective and less aggressive, the global survival rate after 5 years has remained worldwide at approximately 50% over the last three decades. The evaluation of Quality of Life stands out in this context as a key indicator, along with survival. We aim to review oral cancer etiology and discuss inflammation role in oral oncogenesis, considering its potential to modulate and amplify the impact of known risk factors. Additionally, we point out inflammation as predictive of poor prognosis in patients with oral cancer or at risk of developing it. Articles were collected from the PubMed, Bon, Elsevier, Science Direct databases, considering mainly the last 5 years of publication (2015 to 2020). The indexing terms used were “oral oncology and risk factors”, “oral oncology and epidemiology” and “inflammation and oncogenesis”. The role of the immune system and inflammation in the initiation, promotion and progression of oncologic pathology of the oral cavity has deserved maximum attention from the scientific community. It is clear that the presence of pro-inflammatory factors associated with immunosuppression are closely related to oral oncogenesis and poor prognosis. The chronic inflammation can contribute to modulate and amplify risk factors actions.
151 Ceramic Implantology: Boon or Bane in Implant Dentistry? , Arpit Sikri, SV Singh, Jyotsana Sikri and Ruben Lobo
Implants have been a gold standard treatment protocol for prosthetic rehabilitation in dental practices. Titanium and its alloys have ruled dental implantology since its initiation, harking back to the 1960s. As far as the clinical practice is concerned, many patients worry about the materials being exposed to their oral cavity and the effect this can have on their general wellbeing
152 Comparative Evaluation of Apical Transportation and Centering Ability of 4 NITI Rotary Systems with Different Metallurgy in Severely Curved Root Canals , Ehab Abdel Hamid
The aim of the present study was to compare apical transportation and centering ability of one curve (OC) system with other heat treated NiTi rotary systems; Protaper next (PTN), Hyflex EDM (HFEDM) and 2shape (TS), using CBCT scanning.Forty mesiobuccal canals of mandibular molars with an angle of curvature ranging from (25°- 40°) were divided equally according to file system used in canal preparation into 4 groups of 10 samples each: PTN group; HFEDM group, TS group and OC group. Samples were scanned using CBCT scanner before and after preparation to evaluate root canal transportation and centering ratio at 2, 3, 4 and 5 mm from the apex. The significance level was set at P ≤ 0.05.
153 Assessment of Alcohol and Other Habits Among Young Adults Attending Diagnostic Camp in Budhanilkantha Municipality Area, Kathmandu Nepal - A Descriptive Study , Roy S, Ranjan P, Dhakal S, Pramod Kumar Yadav, Yadav K and Bansal A
An observational study was conducted in Budhanilkantha area, Kathmandu to determine the status of oral hygiene of individuals during diagnostic camp.A total 360 subjects between 18-50 years of age range were selected for the study. It consisted of demographic detail that includes age, gender, residence, religion and other deleterious habits. Data samples were analyzed by descriptive statistics like mean and percentage with the use of using spss software version 16
154 Black Stains in Children and its Correlation to Dental Caries , Ibrahim H El-Kalla and Hanaa Mahmoud Shalan
This study assessed the prevalence of black stain on teeth of Egyptian school-children and determine the possible correlation with dental caries.Six primary schools were included. About 1615 children of 4 - 12 years were clinically examined for the presence of black stain (BS) and recorded according to Koch criteria. DMFT and dft were assessed in children using WHO criteria. Data were statistically analyzed using student t test and spearman correlation test.
155 Distribution of Gingival Biotypes of Anterior Teeth in Egyptian Adults with Skeletal Class II and Skeletal Class III Jaw Relations and Different Vertical Facial Patterns: A Cross-Sectional Study , Ahmed Magdy Sabrah, Amany Hassan Abd El Ghany and Fady Fahim
Studying the distribution of gingival biotypes and evaluation of width of keratinized gingiva of anterior teeth in Egyptian adults with skeletal class II and skeletal class III jaw relations and different vertical facial patterns.This cross-sectional study included 182 Egyptian orthodontic patients with skeletal class II and skeletal class III pattern (74 males, 108 females) who applied for orthodontic treatment in faculty of Dentistry, Cairo University starting from November 2018 October 2019. They were included in the study based on Wits appraisal measured on lateral cephalometric radiograph taken as a routine record before orthodontic treatment. They were further divided into six subgroups based on vertical facial pattern according to facial axis angle. Gingival biotypes for the anterior teeth have been classified either thick biotype or thin biotype using probe transparency method. Width of keratinized gingiva has been measured for each anterior tooth using digital caliper.
156 Treatment of Endodontic-Periodontal Lesions - Three Clinical Cases , Valbona Disha, Nilena Nasi Eriksen and Erda Qorri
Endodontic-Periodontal lesions are clinical findings that presents both diagnostic and therapeutic dilemmas. Knowing the etiology is very important in determining the proper treatment protocol and the long term success.The purpose of this report is to present three clinical cases with endodontic-periodontal lesions treated only with endodontic treatment.The study presents three clinical cases with periodontal bifurcation lesions. Treatment included metapex placed in the root canals for 1 week, followed by canal sealing with guta-percha and cement. The patients were followed up 12 months to 3 years.
157 Breaking Bad News - A Neglected Aspect in Dentistry: A Brief Review , Dr. Nevica Baruah and Dr. Anisha Yaji
An effective communication between the doctor and patient is heart and art of medicine. Though the art of diagnosing is taught in medical and dental schools the art of effective communication still needs to be worked on. With dentist being a primary contact point for diagnosing oral cancer cases, the diagnosis can alter the life of patient as well as their families. Unfortunately the dental practitioners are least exposed to situations where in they have to communicate the bad news to the patient. This review aims at shedding light on different aspects of breaking bad news to the patients in a dental set up
158 Halitosis: Causes and its Management , Umma Zainab
Halitosis or oral malodor or bad breath is a prevalent condition which presents itself commonly in routine dental practice. It is a common problem that affects all ages and also has a psychosocial impact on the patients causing many of them distress, anxiety and embarrassment. The condition can be physiological or pathological with a number of underlying factors, with many a time multiple factors contributing to the issue. This article reflects on the multifactorial etiology of the condition and its management briefly
159 Menopause and its Effects on Oral Cavity , Mahnoor Ejaz Chaudry, Rizwana Muhammad Hanif, Maham Liaqat, Urooj Aftab and Sabeen Masood
The purpose of the study was to evaluate and analyse the effects of menopause on the oral cavity.A description based cross-sectional online survey.It was carried from august, 2020 to September, 2020.A total of 104 patients have participated in this study. Patients were asked their age and when did they reach menopause. It was further divided to evaluate the knowledge, awareness, practices, and behaviour pattern associated with oral hygiene and symptoms of menopause.
160 Oral Mucositis, a Side Effect of Hematological Malignancies Treatment , Boris Aurer
Oral mucositis is painful inflammation of oral mucosa and one of the most common side effects of chemotherapy, radiotherapy and hematopoietic stem cells transplantation. As the damaged mucosa is very painful, it causes problems in oral intake of food and beverages. Oral mucositis significantly impairs patients’ quality of life and may affect the outcome of hematological malignancy treatment. This paper presents a review of published data on the pathogenesis, clinical picture, complications, and therapy and prevention of oral mucositis in patients treated for hematological malignancies. The most significant factor for the development of oral mucositis is the type and intensity of antineoplastic therapy and use of agents that damage oral mucosa. Best prophylaxis is implementation of professional oral hygiene measures and motivation of patients to maintain good individual oral hygiene and avoid harmful habits which damage oral mucosa, such as alcohol and smoking, at least during antineoplastic therapy
161 Assessment of Stress Distribution Using Equator Attachment Design in Mandibular Implant-retained Overdentures in Comparison with Ball and Socket Attachment Design: 3D Finite Element Analysis , Mahmoud Samir, Hamdi Abo Alfotouh and Mostafa Helmy
To accomplish a comparative study between two types of attachment Equator and Ball/Socket in mandibular implant supported overdenture by using finite element analysis and assessment of stress distribution on the bone, implant. overdenture, mucosa and attachment.Three-dimensional models simulated a clinical situation where an edentulous mandible was restored by two different treatment options using implant overdentures. The overdentures were supported by two implants placed at the approximate canine region using Ball/Socket and Equator attachments. The load was applied of value of 50,100,200 N with angle of vertical 90° then the oblique load with angel 45°
162 Alternative Medicine in Dentistry: A Holistic Approach - A Review , Sunbul Tabrez, Neelkant Patil, Shobhit Kaswan and Lalita Chandna
Alternative medicine is a group of diverse medical and health care systems, practices and products that are not considered part of conventional medicine. It includes the use of dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy and spiritual healing. They have lesser side effects and are also cost effective as compared to traditional medicine. The World Health Organization (WHO) has identified 150 systems of alternative medicine, out of which the most practiced ones are Ayurveda, Homeopathy, Naturopathy, Unani, Magneto therapy, Aroma therapy, Yoga, Massage therapy, etc. The alternative medical systems involve Western culture (Homeopathy and Naturopathy) and Non-Western culture (Ayurveda and Chinese medicine). We know that stress is a major causative factor for various psychosomatic disorders and oral diseases which can be prevented by holistic approaches. Many oral mucosal lesions like aphthous stomatitis, lichen planus, OSMF, leukoplakia, radiation mucositis have yielded great results for healing by the use of plant extracts. Even though the treatments are usually of longer durations, are unconventional and often lack errors in reasoning, but have yielded positive effects on various individuals. This paper emphasizes on the use of alternative medicine in dentistry
163 Using A Mouthwash Containing Propolis, Clove Oil and Chlorhexidine to Improve the Caries Risk of High-risk Patients: Randomized Clinical Trial , Moataz Gamal Konsouh, Mohammad Adel Ezzat Khairy and Maha Abdelsalam Elbaz
This study was conducted to determine the effect of using mouthwash of propolis, clove oil and chlorhexidine versus chlorhexidine mouthwash on the risk assessment of patients with high caries risk.In the control group; significant decrease in the caries risk percentage resulted after 6 months (48.8 ± 7.3) for the once daily application frequency. The same resulted for twice daily application frequency, significant decrease after 6 months (45.8 ± 5.6). In the test group, significant decrease after 6 Months (49.7 ± 6.7) for the once daily application frequency. The same resulted for twice daily, significant decrease after 6 months (46.3 ± 6.0).A total of 64 patients were assigned in this study. Patients were randomly divided into two groups according to type of mouthwash (A) where group A1 patients used Chlorhexidine mouthwash as control group while group A2 patients used Chlorhexidine with propolis and clove oil mouthwash as test group with 32 patients in each group. Each group was further divided into two groups according to application frequency (T) where T1 represents patients using the mouthwash once daily for one week every month for 6 months and T2 where patients used the mouthwash twice daily for one week every month for 6 months. Cariogram assessment was performed for each patient at baseline, 3 months and 6 months to obtain the caries risk percentage for each patient at the different time intervals.
164 Bone Necrosis After Pulp Treatment of Temporary Molar with Calcium Hydroxide: In Vivo Confirmation , Cristina Cardoso-Silva, Maria Llanes and Elena Barbería
Calcium hydroxide has been used for a variety of purposes in dentistry including pulpotomy of temporary molars. Several studies examining inflammatory response to its use generally demonstrated a mild inflammatory reaction. However, it may cause adverse reactions damaging bone and soft tissues either by direct contact after poor implementation or after ion diffusion. The severity and extent of the lesion depends on the quantity and concentration used, as well as on the time of contact. The following report describes a case of bone necrosis after a pulpotomy with calcium hydroxide in a temporary molar. Pathological analysis confirmed de diagnosis
165 Dental Calculus – Mere Ash Heap or Still A Mystery: A Review of Literature on Etiologic Significance of Dental Calculus , Swati Gupta, Ramakant Gupta and Manju Gupta
Chronic inflammatory periodontal diseases i.e., gingivitis and periodontitis are one of the most common afflictions faced by the human beings. They are considered to be infectious in nature having polymicrobial etiology. Dental plaque, which is a pool of these disease causing microorganisms has been the focus of researchers for the long time, and is considered to be the primary etiologic agent in disease etiopathogenesis. However, dental calculus which is a mineralized product of this plaque remains ignored and is considered merely as an ash heap of minor significance in etiopathogenesis of disease. Even though, there literature evidences of presence of intact and viable bacteria within the non- mineralized channels and islands in supragingival calculus from various studies. However, viability of bacteria in dental calculus and their role in disease pathogenesis still remained obscure. Therefore, this review intends to collate all the available literature and present the studies related to etiologic significance of dental calculus and investigation of the viability of bacteria in dental calculus along with their identification at one place and provide a way forward towards better understanding on etiopathogenesis and treatment of periodontal diseases
166 Comparison of Postoperative Pain after Root Canal Instrumentation Using M-Pro and ProTaper Next in Molars with Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial , Mohammed Essam Othman, Randa Mohammed Elboghdadi2 and Shaimaa Ismail Gawdat
The aim of the present study was to clinically compare the postoperative pain after root canal preparation using M-pro rotary system and ProTaper Next rotary system in molars with symptomatic irreversible pulpitis.A total of 50 patients with symptomatic irreversible pulpitis were included in the study. After clinical and radiographic examination, patients were assigned randomly into two groups (n = 25). In (Group A), root canals were instrumented with M-Pro rotary files. In (Group B), root canals were instrumented with ProTaper Next rotary files. All teeth were treated in a single visit. Pain was recorded by the Numerical Rating Scale preoperatively and at 6, 12, 24, 48, and 72 hours postoperatively. Placebo tablets were given to the patients to be taken in the case of mild pain and an analgesic was prescribed in case of an emergency. All demographic data, pain scores and number of analgesics tablets taken were collected from the patients. Data were analyzed using Chi-square test and Mann-Whitney U test
167 A Comparative Study of Biocompatibility and Marginal Adaptability of MTA, Biodentine, and Glass Ionomer Cement as Root -End Filling Materials (Comparative In-Vitro Study) , Mohammed Awadd Ali, Maged M Negm and Heba AEl-Asfouri
The aim of the present study was to compare the in vitro biological behavior and marginal adaptability of MTA, Biodentine and glass-ionomer cement as retrograde filling materials.The biocompatibility test was made on fibroblast cells regarding cell viability. The cells were exposed to the extracts of the materials of 1, 5 and 7 days to measure cell viability using MTT assay. Regarding marginal adaptability twenty-four singlerooted teeth were resected 3 mm from the apex. Root-end cavities were then prepared using a fissure bur and filled with one of the following materials Glass ionomer cement (GIC), Mineral trioxide aggregate (MTA) and a bioactive cement Biodentine. The roots were then sectioned longitudinally. Scanning electron microscope (SEM) was used to determine area of gaps and adaptation of the root-end filling materials with the dentin
168 Monomorphic Adenoma: A Diagnosis or a Misnomer? A Review of Literature on Terminologies, Features and Differential Diagnosis of Basal Cell Adenoma , Swati Gupta, Ramakant Gupta and Manju Gupta
Basal cell adenoma, previously was termed by few authors as Monomorphic adenoma. The term “Monomorphic adenoma” was originally proposed for any benign epithelial salivary gland tumour other than benign mixed tumors. Monomorphic adenoma included tumours such as Warthins tumour, basal cell adenoma and canalicular adenoma. However, in the new 2005 WHO classification of salivary gland tumours the term “monomorphic adenoma” is not included and basal cell adenoma is considered as a separate entity. This paper intends to discuss the controversies regarding the terminology and classification of monomorphic adenoma along with diagnosis and differentiation of basal cell adenoma from other tumours
169 The Efficacy of Medical Consultation to Improve Oral Health Outcomes in Patients with Sickle Cell Disease , Gail Cherry-Peppers, Andrea D Jackson, Cheryl Fryer, Candice Mitchell, Xinbin Gu, Dana C Jackson, Robert Gamble, Albert Cheek, Gillian Robinson- Warner, Meirong Liu, Romella Rodgers, Floydstyne Williams, Courtney Ford, Gretchen Peppers, Lee Goodloe, John Atere, Thomas Savage and Phillip Woods
Sickle Cell Disease is a complex genetic disorder resulting from the presence of a mutated form of hemo-globin. Morbidity, frequency of crisis, degree of anemia, and organ systems involved vary considerably per patient. Dental health professionals and other specialists commonly request comprehensive medical consultations prior to performing complex periodontal, endodontic, and surgical procedures. It is of great benefit to have a very detailed medical consultation and history of treatment in order to have successful dental outcomes and minimize post-treatment dental complications. This review is to raise awareness about the impact of oral diseases in patients with sickle cell disease and to emphasize the importance of full medical disclosure and a well-documented medical status report which can guide treatment planning and greatly improve the course of dental treatment.
170 Evaluation of the Effect of Enlargement of the Apical One Third by Protaper Universal Rotary Files System on Elimination of Enterococcus faecalis and Surface Irregularities in Single Canaled Premolars (A Comparative In-Vitro Study) , Mohammed Yasien Taher Alagha, Maged Mohamed Negm and Shaimaa Ismail Gawdat
The aim of the study was to evaluate the effect of enlargement of the apical one third of root canals; by using F4 in comparison to F3 Protaper files; on the amount of Enterococcus Faecalis and surface irregularities in the apical third.24 freshly extracted human single canalled premolars were obtained. The root lengths were standardized to 15 ± 1 mm. The root canals were instrumented up to #20 K-file till the apical constriction for standardization. Following root canal preparation and sterilization, all root canals were completely filled with 30µ E. faecalis suspension and incubated at 37°C for one week with refreshment every 48 hours. All teeth were sampled after bacterial injection and before instrumentation for examination of bacterial presence inside the canals. For the apical one third assessment, Scanning Electron Microscope "SEM" was used to examine the surface irregularities.The results concerning bacterial reduction revealed that Group II (F4), showed a significantly higher E. faecalis reduction than Group I (F3) (P = 0.025). However, none of the preparation sizes rendered a bacterial free root canal system. Topographic surface analysis revealed that group II (F4) had significantly lower surface irregularities in comparison to group I (F3) (P = 0.036).
171 5MO as Alternative to MTA in Endodontic Treatments , Helen Rushdi Ayoubi
Five mineral oxides (5MO) is a new dental material, its color is white, developed as alternative to mineral trioxide aggregate (MTA) which generally used to treat endodontic accidents and complications. It was developed by Doctor Maisour Ala Rachi in Syria at Faculty of Dentistry, Damascus University, where this material came as the result of a research, according to which Dr. Maisour Ala Rachi attained a doctorate degree PhD in (2007), this research was supervised by Professor Doctor Mohammad Salem Rekab, where Dr. Maisour Ala Rachi made a comparison between MTA and local gray portland cement (GPC) (Syrian Company, Tar-tous, Syria), and he found that the two materials have similar prop-erties through histological, radiographical, and clinical criteria.
172 The Authentic Inbred Sheath - “The Immunoglobulin" , Santhi Gorle, Srikanth Adusumilli, Rukmini Jyothirmayee Jakati, Rani Ponnaganti, Sahithi Valluripalli and Sanjeev V Jakati
Humans have developed a highly specialized defense mechanism system due to continuous stimulation by foreign material from the environment. Immunoglobulins are unique structures in the body which is synthesized by plasma cells and, to some extent, by lymphocytes. They have a significant role in recognizing and protecting the body against foreign material, either present freely in the body fluids or attached to cell surfaces. Besides the plasma, immunoglobulins may be identified in other body fluids or tissues such as urine, spinal fluid, milk, saliva, tears, lymph nodes, and spleen.
173 Substance P (SP) Increases the Adhesion of Oral Squamous Cell Carcinoma (OSCC) To Human Umbilical Vein Endothelial Cells (HUVEC) Through Upregulating Adhesion Molecules; Implication for Metastasis , Moustafa Elhousiny, Kate Miller, Anura Ariyawadana and Alan Nimmo
Interaction of cancer cells with endothelial cells plays an important role in metastasis. Our study hypothesised that SP might play a role in the early onset adhesion of OSCC to HUVEC cells lines via upregulating the adhesion molecule expression.
174 Cosmetic Dentistry with Ceramic Veneers Revisited , Maninder Hundal
An ideal aesthetic treatment plan should be minimally invasive, preserving as much of the natural tooth structure as possible. The ceramic veneers have achieved great success since their introduction nearly three decades ago as they fulfil the above criteria very well. Continuous evolution of materials, laboratory techniques and clinical procedures have made the ceramic laminate veneers a re-liable modern technique. Veneers are mainly fabricated from conventional low fusing feldspathic porcelain. Two popular methods for fabrication of porcelain veneers are the platinum foil technique and the refractory die technique.
175 Analysis of Malocclusion and its Characteristics in the Referred Free State Orthodontic Patients , Mandla Dominic Nyakale
Planning and provision of orthodontic services may require some baseline epidemiological data with regards to the distribution of malocclusion and its severity within a given population.
176 Radicular Cyst with Associated Extramedullary Hematopoiesis: A Previously Undescribed Phenomenon. Literature Review and Report of a Case , Toferer Astrid, Truschnegg Astrid, Beham-Schmid Christine and Beham Alfred
The aim of this paper is to present the first case of a radicular cyst, with associated extramedullary hematopoiesis in a 57- year- old male patient. Prompted by this unique finding, we reviewed the existing literature systematically to identify extramed.A review of the evidence was conducted using PubMed/MEDLINE and Google Scholar. The following key words were applied: “extramedullary hematopoiesis” OR “extramedullary haematopoiesis” AND “maxillofacial”, OR “jaw”, OR “sinonasal tract”, OR “paranasal sinus”, OR “sinus”.
177 Assessment of Mandibular and Dental Arch Profiles in Subjects with Mandibular Third Molar Impaction , Asha V, Kim Upadhyay and Sow Bhagya Lakshmi
To determine the normal size of the mandible and the difference of the dental arch length and the total teeth size space that is important for prevention of mandibular third molar impaction.
178 Influence of Periapical Pathosis Upon Postoperative Pain Following Primary Root Canal Treatment in a Single Session Approach , Mostafa I Negm
This clinical study examined the influence of periapical pathosis of pulpal origin upon postoperative pain following root canal treatment in a single session approach in comparison to those with irreversible pulpal diseases and healthy periodontium
179 Prevalence of Tobacco Among Business Process Outsourcing (BPO) of North India: KAP Study , Saundarya P, Taufique Answer, Henna Mir, Sushila Sah, Supriya Naren and Sayani Roy
Business Process Outsourcing (BPO) industry has been rapidly expanding in India over the last 10 years. While em-ployment in the business process outsourcing (BPO) sector has meant that young adults are reaching their career milestones and financial goals much earlier than before, surveys show that Business Process Outsourcing (BPO) employees face steady challenges at work that can be chronically stressful. the present study aims to highlight the ill effect of tobacco and its uses by BPO workers.
180 Intimate Partner Violence Prevention: Moral, Legal and Healthcare Algorithms , Joana Braamcamp de Mancellos
“Gender inequality” and “gender-based violence” are paradigms that one hope would be extinct by the 21st Century, two cultural concepts that our society tries to disguise as dated, but that still exist in the form of intimate partner violence in developed countries. In this literature review, intimate partner violence is described as a serious public health issue with high occurrence rates across the world, which requires an urgent implementation of protection and prevention measures.The extensive study of contents resulting from a search with the terms “intimate partner violence”, “domestic violence”, “preven-tion”, “violence against women”, “abuse”, “IPV” and “crime” allowed to gather information on preventive measures and integrate updated statistics of the World Health Organization (WHO) and of the Portuguese Association for Victim Support (APAV).The measures of protection and prevention of this type of crimes demand a change of moral and legal behaviours around the globe, as well as the implementation of algorithms of functional performance that can be applied by health professionals at patient-directed services. In this literature review, we will present the “RESPECT”, “AVDR” and “HELP” algorithms.
181 Leave no Tooth Behind - A Retreatment Case Report , Reaba Rebecca Thomas, Aby John, Shashi Rashmi Acharya and Archit Kedia
In a dental practice, it is becoming increasingly common to have endodontic cases which are seen to fail. The spike in the number of endodontic treatments carried out has consequently led to the increase in the number of failures seen and complications in their management. Endodontic retreatment is favored over dental extraction due to the desire to preserve the tooth and prevent adverse consequences in terms of functional and psychological effects that the loss of a tooth would have on a patient. This article showcases a clinical case that required endodontic retreatment to combat any complications that could arise and lead ultimately to the extrac-tion of the tooth. Considering that the tooth in question has a special importance with a physiognomic role, we resorted to its end-odontic retreatment and we have covered it with a porcelain fused to metal crown.
182 Current Situation of Oral Diseases Among Police Officers and Soldiers of Nam Dinh Provincial Public Security Department in Vietnam, in 2019-2020: Examination, Diagnosis and Intervention with Some Biomedical Techniques , Nguyen Huu Ban, Dao Anh Son, Vu Manh Tuan and Nguyen Thi Thuy Hanh
Describe the current state of oral disease and evaluate results of examination, diagnosis and some interventions with biomedical techniques among police officers and soldiers of Nam Dinh provincial public security department in Viet Nam, in 2019-2020.Description of cross section and vertical track intervention was performed with 843 officers and soldiers of Nam Dinh provincial public security department. The purpose of 3 regions was selected and each region was randomly selected 2 units. In each unit was selected, all police officers and soldiers of each unit were sampled. Information was collected by questionnaires, through direct questioning and clinical examination. Some biomedical techniques such as techniques of imaging diagnostics, techniques of oral imaging, digital photography, application of information technology, artificial intelligence to support examination, diagnosis and some oral disease interventions.
183 Estimation of Serum Copper Levels in Oral Submucous Fibrosis Patients: A Quantitative Study , Bhavna Tyagi, Deepak Bhargava, Ritika Sharma, Vidyadevi Chandarvarkar1 and Pradeep Sundersan
Oral submucous fibrosis (OSMF) is documented as a potentially malignant disorder with a 7.6% malignant transformation rate. Various trace elements such as, copper, zinc, and iron are getting much attention in the early recognition of cancer and poten-tially malignant disorders including OSMF.To evaluate the levels of copper in the OSMF patients’ blood serum and compare with healthy individuals.
184 Evaluation of P53 in the Expression of Odontogenic Keratocysts , M Bousserouit and S Chbicheb
The odontogenic keratocyst also called epidermoid cyst, was first described by Philipsen in 1956; it develops at the expense of remnants of the odontogenic epithelium included in the maxillae. It is characterized by a large keratinization of its squamous border, aggressive growth and a strong propensity for recidivism. After the root cyst and the follicular cyst, the odontogenic keratocyst is the most common cyst of the maxillae.The odontogenic keratocyst has been a widely studied patholo-gy with a continually changing nomenclature of a "primordial cyst" to "odontogenic keratocyst". The aggressive nature of this unique jaw pathology has kept it in the limelight since its discovery with documented cases of cortical erosion, soft tissue involvement and extension in the skull base, orbit and infratemporal fossa. It's been a topic of debate for a long time, if the cysts could be as aggressive as this pathological entity.
185 Updated Protocols in Immediate Post Extraction Implants , Valeria Azzolini, Pier Paolo Scaperrotta, Angelo Li Pizzi and Jose María Aguado Gil
NowadaysImmediate Implants represent a widely spread and predictable treatment option; but, different protocols have been proposed along the years and it is still debated which of them could lead to better results.The objective of our study is to analyze the updated guidelines to follow when placing immediate implants and to discuss the esthetic and functional results obtained. We will investigate the surgical and the prosthetic protocols individually and combined each other taking into account the follow up period and the survival rate.
186 Mini-implants for Gummy Smile Management: A Case Report , Meriam Nasfi, Hiba Gmati, Mounira Rtibi, Abdelatif Boughzela and Anissa Zinelabidine
In this case report, treatment of skeletal Class I malocclusion with a convex profile showing a gummy smile with incisive diastema was described.Intrusion of the upper incisors using mini-screw implants as an orthodontic anchorage was our treatment of choice. The patient’s smile was also improved using periodontal procedures.An adequate overbite and overjet, as well as a satisfactory maxillary gingival exposure in the smile were obtained at the end of the treatment.The aim of this paper was to highlight the importance of mini-implants for incisors intrusion and gummy smile correction in the anterior area. In order to intrude and procline the retroclined extruded incisors, both upper anterior mini-implants (1.2 x 8.0 mm) and elastic chains were utilized. Mini-implants can successfully be used as orthodontic anchorage for anterior teeth intrusion.
187 A Journey from 3D to 4D in Orthodontics – A Review Article , Mamta Phogat and Tulika Tripathi
Orthodontic records are one of the main milestones in orthodontic therapy. Records are essential not only for diagnosis and treat-ment planning but also for follow-up of the case, communicating with colleagues, and evalu¬ating the treatment outcomes. Various 3D techniques such as such as Computerized Tomography (CT), Cone Beam Computerized Tomography (CBCT), Micro Computerized Tomography (MCT), 3D laser scanning, structured light technique, stereophotogrammetry or 3D surface imaging systems (3dMD), 3D facial morphometry (3DFM), Tuned Aperture Computed Tomography (TACT), and Magnetic Resonance Imaging (MRI) has cre-ated the potential for comprehensive facial evaluation. Recently, with the emergence of 4D a new dimension (motion) has been added to the imaging filed which has enabled capturing of dynamic facial movements. However, more elaborative and interdisciplinary research work needs to be done to explore the scope of 4D techniques. Therefore, the aim of this study is to review advances in 3D and 4d imaging with in the field of orthodontics.
188 Effect of Intracanal Cryotherapy on Postoperative Pain in Molar Teeth with Symptomatic Irreversible Pulpitis and Apical Periodontitis: A Randomized Clinical Trial , Magy Essam Elaskary, Abeer Marzouk and Alaa ELBaz
The aim of the present study was to evaluate the effect of cryotherapy using cold saline irrigation as a final irrigant on postop-erative pain in molar teeth with symptomatic irreversible pulpitis and apical periodontitis.A total of 30 patients with symptomatic irreversible pulpitis and apical periodontitis in their mandibular first molars, were included in the study. After completion of biomechanical preparation using Mpro Rotary system in a single visit and irrigation with 2.5% sodium hypochlorite for cleaning and shaping. Patients were randomly assigned into two groups (n = 15). In( group A), final irrigation was done using 15 ml cold saline (2.5°C) for 6 mins at three successive times. The solution was stored in refrigerator until use and then its temperature was checked using digital thermometer. In( group B), final irrigation was done using 15 ml room temperature saline for 6 mins. In both groups irrigation procedures were done using 27-gauge side-vented needle fit to a 5ml dispos-able plastic syringe placed 2-3 mm away from apex without binding. Pain was recorded postoperatively after 6, 12, 24, 48 and 72 hours by Numerical Rating Scale (NRS). Patients were given an analgesic (Ibuprofen 200 mg) in case of severe pain. All demographic data. NRS scores and number of analgesics taken were collected from the patients and statistically analyzed by chi-square test and Mann-whitney U test.
189 Adenoid Cystic Carcinoma of Salivary Glands – A Duplet of Cases , Shalini Subramanyam, Peeyush Shivhare and Amit Ashok Basannavar
Adenoid cystic carcinoma is regarded as a rare malignant neoplasm of the salivary gland. The clinical as well as pathological features of this neoplasm include slow growth, perineural invasion and the potential for local recurrence. The total incidence rate is about 2 – 4% of head and neck tumors. It involves palate most commonly among the minor salivary glands, and parotid and subman-dibular salivary glands among the majors. Here, we describe two cases of adenoid cystic carcinoma involving the parotid salivary gland and the palate regions.
190 Life After Covid-19 Changes in Normal Functioning of Dental Colleges , Joshi Bharat
Covid-19 has almost transformed the life of all the dentists. While private practioners are facing the problem of normal pa-tient OPD in their respective clinics, Dental colleges are facing lot of challenges like normal educational pattern. Now there is a need for separate screening of normal patient because of fear of Cov-id-19 Dental education is suffering because the complete strength of students is missing. They have a fear of contacting the infection from suspected patient.
191 Double and Triple Images in the Panoramic Technique: An Experimental Approach , Ameni Chebbi, Manel Gharbi, Imen Chaabani, Olfa Zaghdene and Touhami Ben Alaya
Panoramic radiograph is a simple technique that is generally used in all dental specialties. In addition to the formation of real images, ghost images may also form into the panoramic radiograph, and prevent an appropriate diagnosis. The objective of this experimental study was to show the patterns leading to the formation of panoramic radiograph ghost images caused by metal objects placed in different regions of the skull model and to present some clinical illustrations showing the formation of multiple images of a single object. These phenomena may lead to difficulties in radiographic interpretation if they are not properly understood.
192 Effect of Using Anterior Bite Plane in the Treatment of Growing Orthodontic Patients with Deep Overbite Malocclusion: A Systematic Review , Dina Essrar, Mona Salah Fayed, Amr Mohamed Ali Abouelezz, Fady Hussein Fahim, Mohamed Abd El-Ghafour, Mohamed El Koussy and Mostafa El Dawlatly
Correction of deep bite is one of the primary objectives of orthodontic treatment. Different treatment modalities could be used including anterior bite plane (ABP). The aim of this study was to evaluate the effect of ABP on treatment of deep overbite in growing patients.
193 Fracture Resistance of Endodontically Treated Mandibular Premolars Obturated with Different Sealers an In-Vitro Study , Salma Abdo
This study was design to compare the in vitro effects of different root canal sealers on the fracture resistance of endodonti‑cally treated teeth.
194 Dental Fluorosis: The Impact on Young Adults’ Lives and Treatment Options , Seghir Arwa
Dental fluorosis is a cosmetic condition characterized by hypo mineralization of tooth enamel caused by ingestion of excessive fluo-ride during enamel formation. It generally appears as various degrees of tooth discoloration during growth. The severity of dental fluorosis depends on the dose administrated or ingested, age and the duration of the exposure. The most common form of fluorosis is characterized by small opaque white spots scattered over the tooth covering less than 25% of the surface. The severe form however is characterized by brown stains giving teeth a corroded-looking appearance where the discoloration is widespread. The purpose of this article is to study the impact of dental fluorosis on the psychological development of young individuals in addition to possible treatment plans
195 Oral Health Status and Knowledge, Attitudes and Practices of Students Attending Public Secondary Schools, in Georgetown , Zoe Perreira, Maritza O Perez2 and Carlos Bruzon
Oral health is essential to general health and wellbeing. Fostering good oral health behaviour is fundamental to the prevention of oral diseases. Adopting healthy practices at an early age can lead to improved dental health that is more sustainable in the future. In Guyana, very little information is available on the oral health status of adolescence.
196 The Efficacy of Lugol’s Iodine Solution in Detecting Dysplasia and Carcinoma in Situ Around Oral Cancerous and Precancerous Lesion and its Impact on the Marginal Clearance: A Comparative Study , Abhishek Kumar Singh, Krishna Kishor, Dayashankara Rao JK, Rahul Kashyap, Pradeep Das and Heera
Despite good prospect of early diagnosis small developing lesions often go unrecognised. 60% of le-sions are well advanced by the time of discovery. The aim of the study was to evaluate the efficacy of Lugol’s Iodine in detecting the presence of Dysplasia or Carcinoma in situ at the margins of oral cancerous and precancerous lesions. And to evaluate the difference in resected margins between Lugol’s stained and unstained lesions.
197 Localization of Basicranium Midline by Submentovertex Projection for the Evaluation of Condylar Asymmetry Using Craniostat Ear Rods and Foramen Spinosum as Reference , Shikha Khare, Karthikeya Patil and Mahima VG
Craniofacial asymmetry is rarely appreciable and is often unnoticed, but it is often a cause of major diagnostic difficulties in orthodontics. Currently, no clear universally accepted method exists for the evaluation of craniofacial asymmetries therefore differ-ent methods are utilised to determine midline and evaluate asymmetry. This study was conducted to compare the reliability and va-lidity of two different methods for cranial midline localization through cephalometric analysis of mandibular condylar asymmetries.
198 Coronoidectomy in Management of Post Traumatic Zygomatico-Coronoid Ankylosis - A Case Report , Himanshu Soni, Manoj Bhaskar, Joseph Lijo, Arjun Shenoy and Yash
Zygomatico-coronoid ankylosis refers to fibrous or bony fusion between zygomatic arch and coronoid process of mandible which results from inadequate or delayed treatment caused by fractures of upper and lower facial fractures due to RTA, personal violence, sports injury and gunshots injury. ZCA is unprecedented kind of extra-articular ankylosis. We report a case of posttraumatic facial injury in 40year old male with untreated left midface fracture resulting in trismus at initial presentation. Radiographic evaluation shows mass of heterotrophic bone formation due to untreated left midface and lower face fracture resulting in bony fusion between zygomatic arch and coronoid process. Coronoidectomy was accomplished with an intraoral approach under general anesthesia fol-lowed by aggressive physiotherapy. Immediate and late postoperatively it produced good functional and esthetic outcome
199 Soft tissue Cephalometric norms for Orthognathic Surgery in Nepalese Adults , Joshi Sandhya, Baliga Mohan and Philip Pramod
Normative cephalometric data based on one population group does not represent all other groups. Therefore, accu-rate and comprehensive set of soft tissue cephalometric reference parameters are required for particular population seeking surgical procedures. The purpose of this study was to establish normative values of soft tissue profiles in Nepalese adults, to compare the data obtained with those of caucasian adults using Cephalometric for orthognathic surgery (COGS) analysis (Legan - Burstone); also to identify possible sex differences between Nepalese young men and women.
200 A Comparison between the Antibacterial Activity of Propolis and Ginseng Extracts on Porphyromonas gingivalis and Prevotella intermedia Isolated from Patients with Chronic Periodontitis , Heba A Shawky and Walid A Lotfy
The antimicrobial activity of ginseng extract was investigated in-vitro against 24 clinical isolates of Porphyromonas gingivalis and Prevotella intermedia. To our knowledge, there is a lack of researches on the evaluation of the antimicrobial effectiveness of ginseng extract on periodontopathic bacteria. We also compared the in-vitro antibacterial action of ginseng extract to that of propolis extract by agar diffusion method. The MIC values of ginseng extract against Porphyromonas gingivalis and Prevotella intermediawere 512 and 1024μg/ml, respectively. While the MIC obtained for propolis extract were 256 and 512μg/ml against Porphyromonas gingivalisand Prevotella intermedia,respectively. Moreover, the statistical analysis for the effect of ginseng and propolis extracts on Porphy-romonas gingivalis and Prevotella intermedia using student paired t-test revealed a significant difference between the two groups (p< 0.001). However, the anti-Porphyromonas gingivalis and anti-Prevotella intermedia mean activities of ginseng extract were lower than that of propolis extract by 1.32 and 0.17 AU, respectively. The results of the current study support the usage of ginseng extract as an adjuvant to periodontal therapy after proper in-vivo studies are performed.
201 Efficacy of PARASORB Cone® for Prevention of Local Bleeding after Oral Surgery in Patients Treated Chronically with Anticoagulants (Dihydroxycoumarin Derivatives) , Damian Dudek, Arkadiusz Badziński, Jacek Karpe, Oliwia Warmusz and Edyta Reichman-Warmusz
Anticoagulant therapy with dihydroxycoumarin derivatives is often related to local bleeding in oral surgery. Accord-ingly, the purpose of this study was to determine whether PARASORB Cone® formulation enables oral surgery without discontinua-tion ofanticoagulant therapy.35 patients with various cardiacdisorders underwent 66 tooth and rootextractions without discontinu-ation ofanticoagulant treatment. The control group was composed of 30 patients with cardiac disorders in whom anticoagulant therapy was discontinued before tooth extractions. PARASORB® Cone Formulation was used topically with single sutures and com-pression. Sutures were removed after 7 days following tooth extraction. The visual assessment of bleeding and wound healing was performed on Days 2, 3 and 7 of follow-up
202 Ectodermal Dysplasia: Report of a Case in Trinidad , Trudee Hoyte, Anne Kowlessar, Kevin Henry, Adilah Mahabir, Tichard Manwah and Anil Ali
Ectodermal dysplasia (ED) is a rare heterogenous group of inherited disorders involving ectodermal structures like the skin, nails, hair, teeth and eccrine glands. The most common syndromes are the hypohydrotic ED and hidrotic ED. This is a case of a 3 year old Afro-Trinidadian female, who presented extra orally with sparse fine scalp hair and eyebrows, soft and dry skin, eczema, a saddle nose, thick everted and protuberant lips. Intra oral findings included hypodontia, dry mucous membranes and conically shaped teeth. The patient was first seen by a paediatric dentist with a presenting complaint of missing teeth and was referred to a dermatologist and an orthodontist.
203 Ameloblastoma of the Anterior Mandible - A Case Report , Anitha Krishnan Pandarathodiyil, Narendra Prakash Rai and Sukumaran Anil
Ameloblastoma is a neoplasm originating from the odontogenic epithelium. The tumor is considered benign despite its locally invasive nature. The pathogenesis of ameloblastoma involves the origin of the tumor from one of the following sources: remnants of dental lamina or remnants of the Hertwig’s epithelial root sheath, basal cells of the oral mucosa, developing enamel organ, and epithelial lining of an odontogenic cyst. It can exhibit different clinico-radiographic presentations such as conventional, unicystic and peripheral. Ameloblastomas occur most predominantly in the posterior mandible, in the molar-ascending ramus area, and are quite uncommon in the anterior jaws. Third to seventh decade is the usual age range for the occurrence of ameloblastomas with no gender predilection. A case of ameloblastoma which occurred in the anterior mandible of a 24-year-old female patient is presented. The clinico-pathological features, diagnostic criteria, and management of the case are discussed. The case is important because of its unusual presentation in the anterior region of the mandible and the diagnostic challenge it posed during the initial investigation.
204 Biocompatibility of Dental Implant: Revised , Nagy Abdulsamee, Ahmed Elkhadem and Passant Nagi
A dental implant is a good example of the integrated framework of science and technology in multiple disciplines, including surface chemistry and physics, biomechanics, from macro-scale to nano-scale manufacturing technologies and surface engineering, among different dental materials and their effective applications. There are important features for dental implant systems, like all other dental materials and products, since the surface of dental implants is directly in contact with vital hard/soft tissue and is sub-ject to both chemical and mechanical bio-environments. Such appliances should include, at the very least, biological compatibility, mechanical compatibility and morphological compatibility with the important tissues surrounding it. Most of the dentists know well biological compatibility but overlook mechanical compatibility, and morphological compatibility. Therefore, this review throws a deliberate sight on these points.
205 Pyogenic Granuloma - A Simple Treatment Approach with Sclerotherapy , Shalini Subramanyam and Peeyush Shivhare
Pyogenic granuloma (PG) is a benign exophytic vascular tumor, which is actually a reactive inflammatory mass of blood vessels with few fibroblasts within the mucosa or skin, was first reported by Hullihen in 1844. Variety of treatment options such as surgical excision, laser treatment, electrodessication, chemical cautery, cryosurgery, intral-esional steroid injection etc. are available, but many a times, recurrence has also been reported.Sclerotherapy is defined as the “targeted elimination of small vessels, varicose veins and vascular anomalies by the injection of a “sclerosant”. It offers an alternative to conventional methods like surgery, lasers, radio frequency ablation and electrodesiccation procedure with success and less chance of recurrences.Herein, we present a case of 22 years old female with a clinical diagnosis of PG, treated with intralesional 0.2 ml of 3% sodium tetradecyl sulfate (STS). The lesion healed completely at the patient’s 3rd visit and recurrence was not reported till the patient was followed up for one year.
206 Evaluation of Setting Time and Solubility of Bio-ceramic Sealer Before and After Mixing with Prednisolone Powder: A Comparative In Vitro Study , Amany Ibrahiem Ahmed Mohamed, Hebatallah Mohammed El Far Fatma Mohamed Saeed and Nehal Lotfy Abou Raya
The aim of this study was to evaluate, setting time and solubility of Sure-Seal Root Bio-Ceramic sealer before and after mixing with Prednisolone powder.Setting time test: sixteen Plaster of Paris molds (eight molds for each group) were soaked in distilled water for 24 hours then filled with the non-modified and modified sealer after addition of previously ground prednisolone powder to sealer and obtaining a homogenous mix. Setting time was calculated by using the Gilmore needle till the time that the needle probe fail to make indentation on the sealer’s surface. Solubility test: Fourteen split Teflon molds (Seven molds for each group) were filled with non-modified and modified sealer as we mentioned before. Molds were placed between two pieces of wet cloth and two-glass slabs then kept in an incubator. Solubility was calculated as a percentage of mass loss at 24 hours, 7, 14, 28 days to determine the effect of time on the material solubility
207 Effect of M-pro Versus ProTaper Next Rotary Instrumentation Systems on Apically Extruded Debris in Single Canals (A Comparative In Vitro Study) , Nourhan Ezzat Mohammed Morgan1, Alaa AL Din Diab and Hany Samy Sadek
The purpose of this study aimed to evaluate the amount of apically extruded debris after canal preparation using M-Pro (CM) and ProTaper Next rotary system files.Forty extracted human, single-rooted mandibular premolars were divided into two groups (n=20) in each group. The root canal instrumented by G1 ProTaper Next (Dentsply Maillefer, Baillagues, Switzerland) and G2 M-Pro (CM) (Guangdong, shanghai, China) according to the manufactures' instructions. Distal water was used as the irrigant. The apically extruded debris was collected in preweighted glass vials. The vials were stored in an incubator for 5 days. The vials were weighed to obtain the final dry weight of the extruded debris. The amount of apically extruded debris was calculated from the difference between the weights of the glass vials with dried debris and prewighted of the empty glass vial. The data were statistically analyses
208 Hereditary Benign Migratory Glossitis in a Young Child: A Case Report , Akhilesh Sharma, Shweta Chaubey and Priya Subramaniam
To present a rare case of hereditary benign migratory glossitis.The clinical presentation of the lesion may mimic other mucosal conditions, allergic reactions, deficiency states. A four year old child presented with pain in teeth and well circumscribed irregular areas of denudation on dorsal surface of tongue. Thorough history revealed similar asymptomatic condition in tongue of father and sibling of child. Other oral con-ditions were ruled out and diagnosed as hereditary benign migratory glossitis.
209 Estimation of Salivary Immunoglobulin A and Total Salivary Protein in Patients with Recurrent Aphthous Ulcer , Reshma Ramachandran and Anuradha Pai
Recurrent aphthous ulceration is amongst the not uncommon ulcerative, inflammatory, oral mucosal conditions whose precise etiopathogenesis remain obscure. Several local and systemic factors have been postulated as the possible predisposing agents for RAS. The presence of immune factors at the site locally, have been seen to play a pivotal role in fortification in counteraction to oral diseases.
210 Botox A Injection Compared with Modified Lip Repositioning Surgery in the Treatment of Adult Patients with Gummy Smile Due to Hypermobile Upper Lip , Zainab Abdel-Rhman Mohammed, Mohammed Abd Al-Alim Bushnak, Manal Yahia Foda and Dalia El Boghdady
Smile esthetics is one of the most important factors affecting facial attractiveness, Gummy smile is recognized by the American Academy of Periodontology (AAP) as a deformity in smile and mucogingival condition that affects the area around the teeth. Which may be related to gingival, skeletal, dental, muscular cause or combinations among the possible causes. The most im-portant esthetic goal in orthodontics is to achieve a balanced smile which can be best described as an appropriate positioning of teeth and gingival scaffold within the dynamic display zone.
211 The Upper and Lower Pharyngeal Airway Widths in Different Sagittal and Vertical Craniofacial Patterns Among a Sample of Sudanese Adults , Alaa M Abdalla and Amal H Abuaffan
This study is aimed at producing norms for the Pharyngeal airway space in subjects with skeletal Class 1 and normal vertical relation and at the unveiling of constrictions related to skeletal morphology.The study sample consisted of 106 healthy untreated subjects (male=35 and female=71), ages ranging from 17 to 25 years old. The subjects were grouped according to ANB angle and their vertical relation. The cephalometric films were traced manually and analyzed using Mc Namara analysis of Upper and Lower pharyngeal airway spaces (UPA and LPA). Norms were obtained and the sizes of UPA and LPA compared in different sagittal and vertical relations.
212 Human Immune Response to COVID-19 Infection and Potential Role of Chloroquine Family of Drugs: A Review , Sunita Singh, Chandrashekharaiah PS, Vishal Paul, Santosh Kodgire, Shivbachan Kushwaha, Debanjan Sanyal and Santanu Dasgupta
In December 2019, COVID-19 disease outbreak started from Wuhan, China. World is still, witnessing a massive morbidity and mortality due to the pandemic caused by novel coronavirus severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). This newly discovered virus enters inside and infect the body cells through the angiotensin-converting enzyme 2 (ACE2) receptor. The S1 protein of SARS-CoV-2 binds to the ACE2 receptor which results in endocytosis and transfer of virus into endosomes of body cells. Entry of SARS-CoV-2 results in activation of the innate immune responses first followed by the adaptive immune responses. The effective host immune responses are crucial to control and prevent the viral infections. However, the excessive production of pro-inflammatory cytokines and decrease in the number of T-lymphocytes are the major reasons associated with severity of COVID-19. Therefore, anti-inflammatory drugs such as Chloroquine (CQ) and hydroxychloroquine (HCQ) may play a crucial role to control and prevent the progression of disease by immunomodulation. The treatment responses of COVID-19 patients to these drugs have been found positive in some cases and clinical studies are underway for evaluating these drugs for the same. Moreover, regulatory bodies such as Food and Drug Administration (FDA) and European Medicines Agency (EMA) have recommended usage these drugs in emer-gency and chronic situation to treat critically ill COVID-19 patients under doctor’s supervision. The national task force (NTF) set up by Indian Council of Medical Research, has recommended high risk individuals to take HCQ for prophylaxis. This review summarizes human immune response and various aspects of CQ and HCQ with special reference to COVID-19.
213 Helicobacter pylori Treatment , Abdulaziz Radhi S ALjohni, Bassam A Aljohny, Sultan Saud Alahmad, Abdulaziz M Hakami, Omar Alfaroq and NA Al-Tayyar
H. pylori the Helicobacter genus, is found in over 80% of cases of gastric cancer in developed and emerging nations. H. pylori is gram-negative and is responsible for gastroduodenal diseases as the recognized major human bacterial pathogen. It will remain in the stomach for life until acquired and colonized. Acute and chronic gastritis, peptic ulcer disease, gastric adenocarcinoma and lymphoid tissue tumor combined with mucosa are found in a limited population of carriers (MALTA). In certain instances, H. The pylori infection is absolutely asymptomatic or has signs that are nearly imperceptible. H. pylori are different depending on the form of media, blunted/rounded ends in gastric biopsy specimens, but in fresh culture on agar medium they are rod-like and spiral shape when coccoid is on prolonged culture.Infection therapy depends on a mixture of antimicrobial agents and antisecretory agents, and the bactericidal activity of anti-microbial agents includes an elevation of gastric pH by antisecretory agents. Alternatively, although the mechanism of action is not yet apparent, to enhance eradication of H, phytomedicines and probiotics have been used H. pylori. The effect of antimicrobials and antisecretory agents is not only based on their pharmacological action, but also on their pharmacokinetic properties. Several anti-microbial agents have been used for H, including amoxicillin, clarithromycin, levofloxacin, metronidazole, tetracycline, rifabutin and compounds containing bismuth H. pylori
214 Resins for CAD/CAM Dentures , K Chandrasekharan Nair, Pradeep C Dathan and T Mohankumar
Dentures fabricated by computer aided designing and manufac-turing (CAD/CAM) process has a history of nearly three decades. Introduction of CAD/CAM marks a great departure from the con-ventional processing.
215 Efficacy of Endodontic Irrigation Activation Systems on Enterococcus Faecalis Colonizing the Dentinal Tubules Using Confocal Laser Scanning Microscope: An In-Virto Study , Ameena Khaled Bagunaid, Saied M Abdelazziz, Somaia Abdulatif3and Fatma Abo Naeem
To assess the efficacy of two irrigation activation system with the Syringe needle irrigation on the percentage of viable Entero-coccus faecalis colonizing the dentinal tubules of single-rooted teeth.Fifty-one single-rooted human teeth were selected, instrumented using Fanta AF Blue S4 and Hyflex EDM up to size 40, autoclaved, and then inoculated with E. faecalis. The samples were randomly assigned into three main groups (n = 15), all were used to the method of irrigant activation. Group, I (EDDY tips), Group, II (XP-endo Finisher), Group, III (Syringe needle irrigation), and six teeth were used as a positive control. irrigation was done with 5.25% of NaOCl in all the samples. The teeth were split longitudinally with Isomet saw and examined with Confocal Laser Scanning Microscope (CLSM) to visualize the percentage of dead bacteria at dif-ferent depths in the dentinal tubules at different canal locations.
216 What do Nigerian Dentists Know About Nanodentistry? , Enabulele JE, Sede MA and Udoye CI
The potentials of nanotechnology in the field of dentistry are enormous. This study evaluated the level of awareness and knowledge of a population of Nigerian dentists about nanodentistry.This was a descriptive cross-sectional study of a population of Nigerian dentists. The study assessed the level of awareness regarding 6 different areas of dentistry where nanotechnology has been utilized and also assessed the knowledge of nanodentistry among the respondents.
217 Osteonecrosis of Jaw as an Oral Manifestation of COVID-19: A Case Report , Gaurav Gupta, DK Gupta, Priyanka Gupta and Neelja Gupta
Various oral manifestations have been reported in patients with COVID-19. However, there is still a question about whether these lesions are due to coronavirus infection or secondary manifestations resulting from the patient’s systemic condition. Oral conditions in a patient diagnosed with COVID-19. COVID-19 has emerged as a challenge to the clinicians worldwide. Since the outbreak in De-cember 2019, COVID-19 has affected > 08,00,00,000 worldwide till December 2020. The most common symptoms are pyrexia and dry cough and in few cases breathing difficulties, dyssomnia and altered taste sensation. Present understanding among researchers shows that coronavirus enters human cells via the receptor angiotensin-converting enzyme 2 (ACE2). The prevalence of clinical manifestations is still unidentified, the range of COVID-19 manifestations on the oral cavity has been seen in various forms. The cur-rent case series aims to report a rare finding of bone and soft tissue defect in maxilla as a possible sequelae of C0VID-19 infection.
218 A Novel Reconstruction of a Large Mandibular Cystic Defect by Bone Graft Substitute , Radhika Shashank Tayshetye, Nitin Bhola, Anendd Jadhav and Chirag Patil
Odontogenic cysts are the most common lesions in the oral and maxillofacial region. The commonly chosen treatment approach for it is enucleation and extraction of the involved tooth, if required. To decrease infections and for spontaneous bone regeneration, various bone grafts are increasingly investigated for filling the defect. Autogenous bone graft being the gold standard has its various shortcomings which lead to the search for allogenous, xenografts and alloplasts. Surgical grade calcium sulfate is considered a con-venient, safe and readily available bone graft substitute with consistently successful results. This uniqueness of Calcium Sulphate has increased its purpose in the void filling. The purpose of this paper is to present a case of a large Dentigerous Cyst (D.C.) which was successfully managed by antibiotic impregnated Calcium Sulphate as a Bone Graft Substitutes in post cystectomy defect and exhibit its spontaneous bone regeneration radiographically
219 Prospective Study on Anatomical Variation of Paranasal Sinus and Nasal Cavity in CT Scans and Literature Review , Shilpa Prabhu, Amal Faisal Al Abdulla and Magdy Ramadan Abdulmaaboud
To estimate anatomic variation of paranasal sinus in Bahrain population and to compare their prevalence in different studies.It is a prospective study of 100 ct scans of paranasal sinus with no significant sinus pathology. We deter-mined prevalence of variations of paranasal sinuses and compared it with other studies.Our study showed similar results in anatomic variation to that found in the literature with some differences in parameters like most common type of keros classification and type of uncinated process.
220 Evaluation of Oral Health Knowledge Among Type II Diabetes Mellitus Patients and the Effect of Phase I Periodontal Therapy on Glycemic Status of the Individuals , Sheela Kumar Gujjari, Rishika Battula, Kunchok Dolma and Sindhu Gujjari
Periodontal disease and diabetes share a bidirectional relationship and inflammation plays a pivotal role in both. Dia-betes causes various complications and periodontal disease has been established as the 6th complication. Integration of qualitative research into intervention studies is becoming popular as the qualitative research can be used to understand the people’s belief, experiences, attitudes, behaviours and interactions thereby enhancing the understanding of the research query. Thus, this study involved a mixed research which helped to assess the knowledge, attitude and practice among diabetics and used an intervention to assess the glycemic control which not only treated the patients but helped in motivating and educating them on the importance of oral hygiene and glycemic control.
221 Evaluation of Regenerative Periodontal Therapy in Intrabony Defects with Single Flap Approach Using Bovine Xenograft in Smokers and Non-smokers , Dalli Bharath Simha Reddy, Rupasree Gundala, Kankipati Amrutha, Nemakal Sumana, Ch Susmitha SS and Sravani Bontu
Periodontal disease is the most prevalent disease across the world. It is an inflammatory disease involving progres-sive and episodic loss of the periodontal attachment apparatus with tissue destruction consequentially arising out of host response against bacterial antigens as well as irritants leads to loss of alveolar bone and supporting the teeth. Chronic periodontitis causes various types of bony defects, among them intra-bony defect is most common. There are two primary treatment modalities for treat-ing periodontitis and associated changes, including non-surgical and surgical periodontal therapy.
222 Clinical Evaluation of Efficacy of 1.2% Atorvastatin Loaded in PRF with Collagen as a Barrier Membrane in Alveolar Ridge Preservation after Mandibular Molar Extraction , Kankipati Amrutha, Rupasree Gundala, YSHS Chakravarthy Reddy, Dalli Bharath Simha Reddy, Putta Sri Krishna Chaitanya and Patcha Harika
Extraction of teeth accounts for loss in height and width of the tooth dependent alveolar process, which results in a significant structural and dimensional changes leading to the atrophy of the residual ridge. Most of the resorption occurs during the first 3 months of healing, although dimensional changes can be observed up to 1 year after tooth extraction. Therefore, regenerative or other surgical intervention appear to arrest the bone resorptive process, to restore the alveolar process thus preserving the natu-ral contours and preparing the anatomical surroundings for the suggested prosthesis.To evaluate and compare the efficacy of 1.2% Atorvastatin loaded in PRF with collagen as a barrier membrane in alveolar ridge preservation versus controls after mandibular molar extraction, by measuring the following clinical parameters like relative coronal level of gingiva, mucogingival junction, crest of socket, socket depth, socket width at the most coronal level and to evaluate bone density changes radiographically by QDSR (Quantitative Digital Subtraction Radiography) technique in 1.2% Atorvas-tatin group and controls.
223 Attitude and Awareness about Radiation Protection among Dental Surgeons in Jaipur City: A Questionnaire Based Study , Kanica Sharma, Neelkant Patil, Shobhit Kaswan, Lalita Chandna, Sunbul Tabrez and Dinesh Kumar
Dental radiology represents the most frequent diagnostic radiological investigation performed in almost every age groups.The aim of this study was to determine the level of awareness regarding radiation protection among the dental practitioners in Jaipur city.This questionnaire study was carried out among 100 dental surgeons in Jaipur city. A multiple-choice re-sponse type of questionnaire was designed with close - ended questions with a maximum choice of 3 responses.This questionnaire study highlights important parameters that must be taken into consideration to reduce radiation exposure and also show the level of awareness and concern of dental practitioners of Jaipur regarding hazards and protection.
224 Evaluation of the Effect of Final Rinse with Chitosan Nanoparticles and EDTA on the Push-out Bond Strength of Resin-based and Bioceramic-based Root Canal Sealers (A Comparative In Vitro Study) , Anan Medhat Mohamed, Angie Galal Ghoneim and Nehal Nabil Roshdy
This study was conducted to evaluate the effect of chitosan nanoparticles (CNPs), CNPs/EDTA (1:1) and EDTA as final irrigants on the push-out bond strength of different root canal sealers.Thirty extracted human, single-rooted mandibular premolars were decoronated and prepared using ProTaper Next rotary system with 2.5% sodium hypochlorite (NaOCl) irrigation. The specimens were randomly distributed into three groups ac-cording to the final irrigation protocol; Group 1: 0.2% CNPs, Group 2: 0.2% CNPs/17% EDTA (1:1), and Group 3: 17% EDTA. A stan-dardized volume of 5 ml of each chelating solution was used for 3 min. Each group was further divided into two subgroups based on the root canal sealer used for obturation; AH Plus resin sealer and Sure-Seal Root bioceramic sealer. For assessment of the push-out bond strength, roots were sectioned horizontally to obtain 2 mm-thick discs from the coronal, middle and apical thirds, then discs were subjected to a compressive load via the universal testing machine followed by assessment of the failure pattern using stereo-microscope.
225 MALDI (Matrix Assisted Laser Desorption Ionisation): Imaging Modality for Tumour Diagnosis , Akshara Lenin, Prajakta Suresh Kundekar, Kumar Sougata, K yeswanth Sunny and Gaurav
MALDI or Matrix Assisted Laser Desorption Ionisation has emerged as a powerful, versatile imaging modality that has since its advent created ripples in the scientific community. The major reason for its success is the ability of this system to criti-cally analyze, study the macromolecules and detect their presence in thousands of samples simultaneously. Moreover, because of its soft ionization techniques, it is now possible to study the biomolecules which would have previously decomposed due to inappropri-ate ionization skills. It is also the first of its kind to bring the world of mass spectrometry and the world of histology under the same banner creating a modality that is currently transforming the way we have understood the world of bioinformatics. Now it is possible to study a broad spectrum of analytes in unprecedented detail most of which until a few years ago had been completely unknown to the scientific communities.
226 The Advantages of Saliva Sampling Method for Diagnosis of COVID 19 , Amera K Alkaisi and Salma B Abdo
Several tests for many persons have to be conducted in order to control the pandemic and prevent the possibility of transmission of (Covid -19) to health care workers and other patients. The main aim of this study was to detect the importance of saliva sample for early diagnosis of Corona virus 2019 (COVID-19). Saliva sample considered as an alternative for diagnosis of COVID-19 as salivary gland found to express surface receptor angiotensin converting enzyme II, (ACE2) a receptor that plays a key role within the entry of SARS Corona Virus-2 (SARS-CoV-2) into the cell. The sample can be self-collected from the entrance of the oral cavity easily, in a way the risk of virus transmission to healthcare personnel can be minimized avoiding the use of protective equipment. There are several ways for collection of saliva, such as spitting out, directly from salivary duct gland and collection with sponge- like device. The analysis of Saliva can be used to detect oral cancer, dental caries, periodontal diseases, diabetes, breast cancer, and lung cancer. The saliva polymerase chain reaction (PCR) test demonstrated high sensitivity comparable performance to the current standard naso-pharyngeal and throat swabs. In addition, saliva could be used for monitoring viral clearance, as it contains the highest live COVID-19 viruses and viral load during the first week.
227 Surgical Reintervention in the Chin in a Patient with a Silicone Chin Implant - A Case Report , João Luiz Carlini, Kendy Lipski and Silmara Regina Teodorovitz Roeder
The use of biomaterials may be an option for the treatment mainly of chin deficiencies. One of the most used materials is silicone prostheses. However, some problems with this material were observed, mainly the bone resorption by compression of the muscu-lature, generating intense resorption, as detected in this described clinical case, where fracture of the jaw could occur. Prosthesis removal, chin osteotomy and reconstruction with an allogeneic graft were performed.
228 Activating Sleeping Brain Cells- A Paradigm Shift in Dentistry , Aishwarya P R Kumar, Ameena Kamal and Gaurav
Neural stem cells (NSC) produce neurons and surrounding glial cells in the brain. The neurons and the glial cells can be regenerated with the further understanding of the mechanism of neural crest cells. Molecules that form a complex called STRIPAK (Striatin Interacting Phosphatase and Kinase) like Mob4 (Monopolar spindle-one binder family member 4), Cka (Connector of kinase to AP1) and PP2A (Protein Phosphatase 2A/Microtubular star, Mts) that promote reactivation in NSCs.
229 Challenging Issues in Development and Integration of Modern Kinematics with Components and Images Obtained from Different Sources in Biomechanical Applications , Yevsey Gutman, Nadejda Krasnorutskaya and Gary Gutman
In spite of the existing and successful development of CAD/CAM methods for mechanical applications, the ability to model the motion of biomechanical systems still presents many challenges. The reason for those challenges is in complexity of the nature of components to be used for the projects, specifically based on the origin of the parts: where are they coming from. Depending on the biomechanical application it could be as many as three different sources for the parts to be included in to the “assembled” system. They are: (1) “standard” parts which can be designed using the conventional CAD system, (2) parts which can be obtained only through the process of surface scanning; and (3) components which are the product of CT scanning with volumetric property. An Advanced method is discussed here which can deal in case of biomechanical systems to address the weaknesses of the Standard Ap-proach in use for purely mechanical systems.
230 A Comparative Evaluation of the Efficacy of Herbal Mouthrinse (P. granatum and S. persica) with Chlorhexidine Mouthrinse on Inhibition of Plaque and Gingivitis , Anamika and Amrinder Singh Tuli
In the past 40 years, Chlorhexidine has been extensively studied and used for plaque control in dentistry. It is a bisbigu-anide and is considered as a gold standard antiplaque agent due to its prolonged substantivity. It has a limited use period due to its known side effects such as extrinsic stains and alterations in taste sensation. On the other hand, mouthwashes made from the herbal and plant sources containing natural occurring active ingredients provide a gentle, harmless and a trustworthy option. P. granatum and S. persica are such plant products that are known to have antiplaque effects. Moreover, their use also overcomes the side effects caused by the chlorhexidine.
231 A New Microscope to Tiny Tumours - A Systematic Review , Kumar Sougata, Prerana G and and Gaurav
The authenticity and expertise of various imaging systems have been usually restricted as most of these imaging systems cannot visualize minute tumours. This is the reason certain cancers such as ovarian cancers and breast cancers are only diagnosed in their terminal stages. Moreover, despite landmark advances in varied areas of diagnostic imaging the detection and screening for most of these tumours remain poor. As the world is constantly being woven in the cocoon of technology it thereby be-comes imperative to develop and come up with better diagnostic modalities than the ones available to us. Also, with the global cancer burden constantly on the rise, various new imaging modalities come up as new waves in the field of radiology.Aim of the Study: To assess the significance of imaging systems in the diagnosis of small-sized tumours.
232 Role of Corticobasal Implants in the Rehabilitation of Dentoalveolar Trauma , Ashish Chakranarayan and Priya Jeyaraj
Management of dentoalveolar trauma often poses a unique challenge in terms of a need to replace both dental and bony hard tissues. In cases with loss of bone along with tooth the crestal implant-based management is often delayed due to insuf-ficient bone. Corticobasal implants offers a comprehensive management for such conditions. Three cases of dentoalveolar trauma were managed and rehabilitated successfully at our centre using cor-ticobasal implants. No adjunctive bone reconstructive or regenerative procedure, such as bone grafting or distraction were carried out to facilitate implant placement.
233 Salivary Proteomics and Transcriptomics: An Evidence-based Systematic Review , Shivangi Pandey, Kuntalika Sarkar, Kumar Sougata and Gaurav
Proteins are considered to be the building blocks of our bodies and they are known to harbor a vast array of informa-tion, the spectrum of which ranges from the knowledge of physical or pathological conditions to provide us with a pool of biomarkers. Saliva at the same time forms an indispensable part of the oral cavity and with recent researches, it is known to be a huge source of these proteins. As biochemical and molecular technologies are developing each day the gradual intersection of the above two men-tioned sources (saliva and proteins) becomes an inevitable pool of knowledge which if carefully studied could throw open future doors of non-invasive diagnostic procedures encompassing multitudes of systemic and metabolic diseases. In this literature review, we have tried and explained the two important biomarkers present in saliva namely proteomes and transcriptomes, and how these are eventually co-related and could serve us to understand the bigger picture of quick and efficient diagnosis.
234 Artificial Intelligence in the Field of Oral Medicine - A Systematic Review , Kumar Sougata, Ayushi Bhargava and Gaurav
With the entire world weaving the cocoon of Robotics and Artificial Intelligence (AI) it’s hard to exempt the field of dentistry from the effects of this powerful tool. From venturing into cases involving vital structures to now being associated with the effects of ever going technology dentistry has evolved leaps and bounds. From minimizing harm to the patient to predicting the dental schedule of a teenager, algorithms and softwares are built to do it all
235 “Trail” in Cancers - Time to Curb the Crab: A Meta-Analysis Research , Ayushi Bhargava and Gaurav
TRAIL (tumor necrosis factor related apoptosis inducing ligand) is the one of the recently developed method for curing cancer. The method demonstrates modified lipid nanoparticles which attaches to TRAIL and E selectin all of which coats the WBCs. The designed nature of modified leukocytes is cytotoxic and shows homology to TNF leading to targeted death of cancerous cells without harming normal healthy cells of one’s body. These modified leukocytes designed using body’s own defenses track down and induces apoptosis of absconding cancer cells. This approach shows large potential for patients with metastatic cancer as TRAIL coated leukocytes occur innate. Since current therapies have lot of disadvantages with it, which allows TRAIL therapy to be investi-gated at a large scale
236 COVID-19, An Eye Opening Pandemic - A Mini Review , Peeyush Shivhare, Shalini Subramanyam and Prapulla Sridhara Murthy
Corona virus disease (Covid-19) is an infectious disease of newly discovered Corona virus variant towards the end of the year 2019. It quickly infected thousands and millions of people all over world, spreading widely like a wildfire. By the end of January 2020, World Health organization declared the outbreak as global health emergency and later in March 2020, they announced COVID-19 as a global Pandemic. The uniqueness of Covid -19 was how little was known about the disease. Hence, it was a battle for many research-ers, scientists, doctors, dentists, governments and the masses to understand the ongoing Pandemic situation. Although predomi-nantly COVID-19 affects lungs, it did have manifestations on other parts of the human body. Here in this mini literature review, we tried to shed some light on basic aspects of COVID-19 along with oral manifestations, pathophysiology from the dental aspect along with recent advances in Vaccine and the ongoing clinical trials. We encourage active participation of Dentists in promoting the aware-ness and preventing the spread of covid -19 by understanding and equipping themselves with recent updates on this very disease.
237 Metagenomics: Rejuvenating Oral Medicine: Concepts Recultured- A Meta-Analysis Research , Shivangi Pandey, Shailaja Kushwaha, Pallab Roy and Gaurav
Metagenomics is the study of genetic material which has been directly taken from environmental samples. It is also known as environmental genomics, ecogenomics or community genomics. The initial molecular work in this field was done by Nor-man R. Pace and colleagues, they used PCR to explore the diversity of ribosomal RNA sequences. The knowledge that was gathered from these explorative studies led Pace to propose the idea of cloning DNA directly from environmental samples in the early 1985. Metagenomics as said can be a powerful tool to view the microbial world and its hidden diversity of microscopic life. Metagenom-ics offers immense potential to understand the entire world of living creatures around us. Since DNA sequencing shows a fall, when compared to metagenomics, which now allows microbial ecology to be investigated at a much larger scale and detail than before.
238 Geometric Analysis of Mesio-buccal Root Canals of Mandibular Molars Prepared by (M-pro), FlexMaster and RaCe File systems: An In Vitro Study , Mahmoud Bahaa Eldin Mohammad Gouda, Reem Ahmed Lutfy and Shaimaa Ismail Gawdat
The aim of this study was to evaluate and compare 3 file systems; M-Pro, FlexMaster and RaCe in preparing moderately severe curved mesiobuccal canals of human mandibular molars regarding: transportation of the canal, the centering ability and change of radius of canal curvature, using cone-beam computed tomography (CBCT) scanning. A total of fifty-one mesiobuccal root canals of extracted human mandibular first and second molars with the angle of curvature ranging 20-35 ͦ (according to Schneider) were collected and divided into three equal groups. After access cavi-ties preparation and working length determination, distal roots with the respective part of the crowns of all samples were sectioned at the furcation level and discarded. Samples were mounted in acrylic resin molds and then CBCT scanning was done pre and post instrumentation using the same scanning parameters. Root canal preparation was done according to the manufacturers' instructions of each NiTi system. The pre and post-images were superimposed using a fusion module of OnDemand 3D App software to measure the dentin thickness at root canal levels (2, 3, 5 and 8 mm from the tooth apex). Canal transportation and centering ability were re-corded according to formula introduced by Gambill., et al. while the change in the radius of canal curvature was recorded following Estrela., et al. Data was tabulated and statistically analyzed.
239 Pattern of Mandibular Third Molar Impaction in North-Central Nigeria: Panoramic Radiographic Assessment , Seidu Adebayo Bello and Nathan Ukuoghene Ikimi
The third molar is the most common tooth in the mouth that fails to erupt partially or completely into its functional position and this could be because of an impediment on the eruption path. Management of impacted third molar is usually by a surgical procedure extraction and successful treatment is enhanced with the aid of a radiograph which is either the periapical x-ray or the panoramic radiograph. This study reports on a large population of patients, using the panoramic radiograph to evaluate and compare with the periapical radiograph the various pattern of the impacted mandibular third molar presented in north central Nigeria.A retrospective examination of digital panoramic radiographs obtained from patients who had surgical extractions of impacted mandibular molars between March 2016 to April 2020. The data obtained were analysed using the Statistical Packages for the Social Sciences (SPSS) version 20. Chi-square test was done to determine statistical significance which was set as P < 0.05.There were 366 (55.8%) male and 289 (44.1%) females, with an age range of 16 to 70years and a mean age of 34 ± 12.5 years. Impaction was found on one side of the mandible in 30.3% and on both sides of the mandible in 69.5% of the patients and the most common type of impaction according to Winter’s classification was mesioangular impaction and found more common among males in this study at 43.4%.Our results here gave better clarity with the use of the panoramic radiographs and therefore strongly recommends the orthopan-tomogram (OPG) before any mandibular 3rd molar extraction is done.
240 Labial Type Dens in Dente: A Rare Case Report , Manisha D Yadav, Bhakti Patil Soman and Deepa Das
Dens Invaginatus, also known as dens in dente a rare developmental anomaly affecting human dentition. It arises as a result of invagination into the surface of tooth crown or root before calcification has occurred. Most commonly affected teeth are permanent maxillary lateral incisors and is usually seen on the palatal aspect. In the present case report it was, rare to be seen on the labial as-pect of maxillary central incisor. This anomaly may increase the risk of pulp disease and can potentially complicate treatment due to its aberrant anatomy thus, posing a diagnostic challenge. Radiography plays a vital role in diagnosing such developmental anomaly. Compared to conventional radiograph Cone Beam Computed Tomography (CBCT) plays an invaluable role in the diagnosis of the ex-tent dens invaginatus and in appropriate treatment planning. This case report highlights the role of CBCT in the diagnosis of various types of dens in dente.
241 Unusual Clinical Presentation of Oral Leukoplakia: Case Report and Review of Literature , Lavanya Pasalkar, Shrutika Sonawane, Vikram Khare, Pallavi Channe
Oral cancer is the most commonly seen malignancy in Indian males and leukoplakia is the commonest of all precancerous lesions which can transfer into oral carcinoma. The estimated global prevalence of oral leukoplakia is 2.60% with 0.13 to 34% malignant transformation rate. It has been proved that clinical type, grade of dysplasia and age are associated risk factors with malignant transformation. A 38 yrs male patient found to have a tiny solitary well defined white plaque like lesion on buccal mu-cosa hardly 2 mm x 3 mm which was unnoticed by the patient till then. Surface of the lesion was raised, rough and wrinkled. It was non-scrapable. Patient had tobacco and gutka chewing habit with cigarette smoking since 5 years. Though the size of lesion was too small considering all the factors provisional diagnosis of homogeneous leukoplakia was given. An immediate excisional biopsy was performed. Histopathological examination revealed oral leukoplakia with moderate dysplasia. Dysplastic changes could have been a major risk factor for malignant transformation. Early diagnosis and excision of lesion ensured good prognosis.
242 Acceptance and Attitudes toward Covid-19 Vaccines among Health Practitioners in Tricity (Chandigarh, Panchkula and Mohali) a Cross-Sectional Study , Preety Gupta, Rajesh Kumar Gupta, Shivani Gupta and Sumit Garg
Coronavirus (SARS-CoV-2) made the headlines after its initial breakout in Wuhan, China in December 2019. Virus by genome, lethal naturally, strongly contagious by character succeeded in making a brand new chapter in everyone’s life during a very short span making it a deadly disease. Its widespread has raised many concerns for global health particularly healthcare providers. Vaccines are effective interventions which will reduce the high burden of diseases globally. However, public health authorities face problem of hesitancy of individuals for vaccine. With the supply of COVID-19 vaccines, little information is offered on the general public acceptability and attitudes towards the COVID-19 vaccines. This study is aimed to analyze the acceptability of COVID-19 vac-cines and its predictors additionally to the attitudes towards these vaccines among public in tricity.
243 Can we Predict Molar-Incisor-Hypomineralisation from Hypomineralised Primary Dentition?: A Systematic Review and a Meta-Analysis , Wafa Hammami and Soumaya Touzi
Molar-incisor-hypomineralisation (MIH) is a widespread lesion in the world. It usually occurs in the last stage of mi-neralisation of second primary molars; for this reason, a predictive relationship was assessed by several authors.The aim of this systematic review and meta-analysis was to investigate whether the occurrence of hypomineralised de-ciduous molars can predict molar-incisor-hypomineralisation lesions in children’s permanent teeth.A broad search in MedLine, Cochrane Library, Scopus, Web of Science, Ebscohost, Google scholar, Science direct and OpenGrey databases were conducted using all terms related to the subject. Manual search on grey literature was also per-formed. Relevant papers published in English since 2010 were identified after a review of their titles, abstracts and full text reading
244 Autogenous Demineralized Dentin Matrix Graft for Socket Preservation , Mahadeepa Kar, Ashish Gupta, N Srinath, Umashankar DN, Mahesh Kumar and Ankita Dahiya
The study aims to evaluate the efficacy of autogenous tooth as bone graft material in the extraction socket and also to assess the potential use of the material as an alternative for autologous bone and other graft materials.30 patients requiring extraction of bilateral mandibular third molars were included. It was a split-mouth technique; one side was taken up as the control group and the other side as the study group. Postoperative pain and bone healing were assessed at 3 and 6 months follow-ups post-operatively.The intensity of pain was higher in 24 hours as compared to 7 days in the study and control group but it was statistically not significant (p > 0.05). The intensity of swelling was higher in 24 hours as compared to 7 days in the study group which was sta-tistically significant (p < 0.05). In the study group, it was 127.97 and 120.5 was in the control group. The study group was higher as compared to the control group and it was statistically significant (p < 0.05)
245 The Use of Bite Raisers in Orthodontic Treatment - A Review of Literature , Gurkeerat Singh, Harshita Gupta, Anu Rathi, Deepali Bisht, Varun Goyal, Raj Kumar Singh and Sonali Dhawan
Patients undergoing orthodontic treatment often require temporary bite raisers primarily for disocclusion of the dentition and unob-structed tooth movement. Depending upon the type of malocclusion and the desired treatment result, a variety of bite raisers can be fabricated. They improve dental and facial balance as well as gives relief from temporomandibular joint disorders (TMD) symptoms. This article reviews the different bite raisers currently used in day-to-day practice along with their biomechanics involved and in deciding their position, duration, thickness and material used
246 Evaluation and Compare Effectiveness and Durability of ICON Resin Infiltration and Acidulated Phosphorus Fluoride in Treatment of Post-Orthodontic White Spot Lesions , Mohamed Said Ibrahim, HalaMunir2, Fady Hussein and Dalia El Boghdady
Randomized clinical trial was conducted to evaluate of the effectiveness and durability of Icon resin infiltration compared to acidulated phosphorus fluoride in management of white spot lesions. Eighteen patients with an age range of 12 - 25 years which included both males and females were enrolled in this study. The scoring criteria according to the lightness scale were graded from 0 to 100. Patient satisfaction score was recorded using a visual analogue scale from 0 to 100 according to patient's own evaluation for each quadrant before, after intervention and after 3 months follow up. A significant improvement of WSL esthetics was found im-mediately after Icon resin application by 18.2% and 18.8% in both upper and lower arches respectively. However, after three months follow up it was significantly reduced to 15% in the upper and 17.2% in the lower arches. A slight improvement in esthetics of white spot lesions was found immediately after APF application by 7.2% in both upper and lower arches while, after three months follow up period it significantly improved from 7.2% to 10% Patient satisfaction scores revealed that before application, there was dissatisfac-tion among the patients of the perception of their teeth. However, greater satisfaction scores were found immediately after Icon resin and APF application and after 3 months follow up. This results suggest that Both Icon resin and acidulated phosphorus fluoride gel improved esthetics of white spot lesions