1 Laser Welding in Orthodontics: A Review Study , Smarika Jain1, Pavan Kumar Vibhute2, Chetan Patil3, Vinay Umale4, Rohit Kulshrestha5*, Kshama Chandurkar6
Since its initial development, the laser has been hailed as a potentially useful welding tool for a variety of applications. The scope for technical and commercial laser welding applications has increased greatly since the development of multi-kilowatt CO2 lasers around 1970. The laser’s capability of generating a power density greater than 106 watts/cm2 is a primary factor in establishing its potential for welding. Numerous experiments have shown that the high-quality precision weld joints are permitted by lasers which are rivaled only by electron beam. By reviewing recent work in the field, this article will present the state of the art of laser welding. This paper attempts to give an insight into the laser welding and its principle and types of lasers used for orthodontic purposes, types of dental alloys used by the orthodontist, and effect of various laser parameters. The literature review has made this apparent that laser assisted orthodontic welding will continue to grow and will become an unparalleled technology for orthodontic arena. The laser thus offers an easily maneuvered, chemically clean, high-intensity, atmospheric welding process producing deep-penetration welds (aspect ratio greater than 1:1) with narrow Heat Affected Zone (HAZ) and subsequent low distortion.
2 The Oral Mucosa: Subtypes of Epidermolysis Bullosa , Michel Goldberg1*
The oral cavity, which consists of the lips, vestibule, gums, hard and soft palates, tongue, tonsil, uvula and salivary glands, is covered by a superficial pluristratified epithelium. The oral mucosa includes masticatory, lining, or specialized layers. The basement membrane separates the epithelium from the mucosa. Subtypes of have been identified: Epidermolysis Bullosa Aquisita (EBA), Epidermolysis Bullosa Simplex (EBS), junctional, and dystrophic. Blisters are characterised in this genetic pathology as epidermolysis bullosa simplex (suprabasal), and Epidermolysis Bullosa Junctionalis (EBJ) (located in the different layers of the basement membrane). This form have distinct character by separation within epithelial keratinocytes, or between the epithelial cells and the basement membrane (Herlitz form, involving both the skin and the lamina propria, blistering occurring at sites of friction). Dystrophic Epidermolysis Bullosa (DEB) involves discontinuities in the underlying connective tissue. There is no efficient therapy for EB, resulting from genetic mutations. Treatment helps to control symptoms but not treat these disorders.
3 COVID-19 and Dentistry-A Perspective​ , Mithra N Hegde1* Shazeena Qaiser2, Nidarsh Hegde3
The novel Coronavirus (nCoV-19) pandemic that originated in Wuhan, China, has become a major public health challenge all around the world. Due to the inherent transmission characteristics of the virus, i.e., through droplet infection or airborne, dental professionals are at a higher risk of exposure. This review gives a preliminary insight into the disease spread and highlights the crucial elements to be considered in terms of recommendations, guidelines, preventive measures, patient management protocol, current medications, and pipeline drugs.
4 Revisiting the Concept of Diagonal Pre-cure Splitting of Horizontal Increments in Direct Composite Restorations , Khamis A Hassan1* Salwa E Khier2
The unavoidable, inherent property of polymerization shrinkage in composite resins generates stresses in direct composite restorations which are detrimental to composite material, prepared tooth structure and interfacial bond. Several restorative techniques have been advocated to minimize these stresses and increase the restoration success rate. One such technique is the split-increment technique which is based on the concept of diagonal pre-cure splitting of horizontal increments for the relief of shrinkage stresses by creating contraction joints in each composite increment prior to light curing. This mini review aims to revisit this concept for enhancing its understanding and providing more concise guidelines for its application in moderate-to-large cavities in the cervical, occlusal, and proximal areas.
5 Dentistry at the Crossroad-Profession and Entrepreneurship , Mahyunah Masud1*, Anisah Lokman1, Mohamed Ibrahim Abu Hassan1
Profession is a paid occupation involving prolonged and specialized preparation and training at the level of higher education. Dentist is a profession that focused on serving the oral health needs of patients and society, with the financial gain derived from the service they provided. Entrepreneurship in dentistry is undertaking both innovations and business acumen to transform them into economic goods. Today, increasing number of dentists practice in the field of health care, competing for patients, treat patients with the intention of earning a significant profit for their services. Being your own boss, setting your own hours, making a decent living and helping people in need are the major allure for entrepreneurship among dental professionals [1]. Since the future of health care after this pandemic episode of COVID-19 is hard to gauge, entrepeneurship in health related field especially in dentistry needs new direction. Serious new patient management approach to accommodate standing operative procedures would be the future of the profession and entrepreneurship.
6 Histological Effect of Smoking on Gingiva of Patients with Type II Diabetes Mellitus and Chronic Periodontitis: A Randomized Controlled Trial​ , Esha Yadav1*, Rudrakshi Chickanna2, Prabhuji MLV3
Aim: To assess the histological findings on gingiva of smokers and non-smokers who are type II diabetics diagnosed with chronic periodontitis. Materials and methods: Between the age Group of 30-60 years, patients diagnosed with chronic periodontitis were classified into two Groups. The Group I included ten smoker diabetic patients suffering from chronic periodontitis while Group II included ten non-smoker and diabetic patients with the history of chronic periodontitis. Results: Diabetic patient’s demonstrated sub epithelial connective tissue lysis, breakdown of collagen fiber bundles. While smokers showed increased epithelial dysplasia and were statistically significant. Conclusion: Smoking and type II diabetes were significantly associated with Periodontitis. It is suggested that smoking cessation and control of diabetes should be instigated as a vital component of periodontal therapy.
7 Lavender Aromatherapy in the Management of Dental Anxiety , Joanna Chiyon Kumar1, K Padmanabhan Akhil2*
Overview: Anxiety in the dental office is a common challenge for the clinicians. Dentophobia is a common cause for reduced motivation and infrequent dental visits for patients with oral diseases. Several techniques to reduce dental anxiety have been in practice since years. This review aims to summarize the potential use of Lavender as an aromatherapeutic agent for dental anxiety management. Methodology: Articles pertaining to the key words “Lavender”, “Lavender Aromatherapy”, “Dental anxiety management” and “Complementary and Alternative medicine (CAM)” were searched in MEDLINE database of references and abstracts on life sciences and biomedical topics. The findings from the studies were consolidated and inferences were summarized into a review. Results: Although less in practice, our literature search found that lavender aromatherapy was an effective adjunct to manage current or state anxiety and should be considered as an “on the spot” therapeutic agent in managing dental anxiety. Conclusion: Within the confines of the review, it could be concluded that lavender aromatherapy is an effective method of managing dental anxiety. Compared to the conventional methods described in the literature, aromatherapy offers the benefit of increased patient compliance and reduced rates of complications associated with such procedures. However further research focussed on the effectiveness of this method should be done for establishing this therapy as an optimal therapy to manage dental anxiety.
8 Wound Healing and Dental Therapies: Repair and Regeneration , Michel Goldberg1*
In reaction to a wound, inflammation is associated with the healing process leading to repair or regeneration. Extracellular components (ECM) are classified into fiber-forming structural molecules (collagens I, III, V), nonfiber-forming structural molecules (including proteoglycans and glycosaminoglycans) and ‘‘matricellular proteins’’ (osteopontin, SPARC, CCN2, tenascin-C and Fibulin-5) that have no structural functions but modify cell-matrix interactions. Wound healing implies a sequence of phases: bleeding and formation of a clot, inflammation proceeding proliferation of epidermal cells, changes in the dermal matrix, capillary ingrowth, wound contraction and remodelling. Cellular (neutrophils, monocytes / macrophages, mast cells and stem cells) and molecular components of the wounded tissue are involved in these processes. Macrophages contribute to the removal of apoptotic bodies. Inflammation includes different forms of cell death (apoptosis, necrosis, nemosis, and autophagy). Mediators of repair and inflammation encompass growth factors (TGF-β, TGF-α, FGF, PDGF, EGF, KGF, IGF-1, NGF, VEGF, and the serine-protease thrombin), Resident cells proliferate and migrate, closing the wound. The successive events are reflecting hormonal regulations, effects of metalloproteinases and MMPs inhibitors. Angiogenesis and the formation of granulation tissue are contributing to the end of the healing process characterized by high density of fibroblasts, granulocytes, and loosely organized collagen bundles. Either the reparative process is returning to a normal situation (wound healing), with or without the formation of a scar, or dental tissue regeneration paves the way for the future of endodontic and periodontal therapies.
9 Multiple Supplemental and Impacted Teeth (Polydent): A Non-Syndromic Case Report , Louis ZG Touyz1*, Daphna Vermes2
Many cases of supernumerary teeth are found in congenital syndromes. Most prevalent dental modifications found, are the number of teeth in genetic conditions affecting ectodermal structures including Cleidocranial Dysostosis (CCD), hypohydrotic ectodermal dysplasia, focal dermal hypoplasia, craniofacial dysostosis, and aperts syndrome. The patient’s main complaint was of toothache. Clinically there were no macroscopically detectable abnormalities, and he was unaware of any dental problems. His physical and facial appearance showed no deviations from normal, and he chewed, swallowed and spoke without impediment. A complement of permanent human teeth is usually 32, within four quadrants of the mouth; from the center point there are two incisors, one canine, two pre-molars and three molars. Total 4 × 8 =32 teeth and humans rarely develop more. Presented here is a case with multiple extra supplemental teeth eight in number in his permanent dentition, most of which six were identified radiographically and impacted. This case presented no other identifiable abnormalities in the mouth. The patient’s pain derived from one supplemental upper premolar, which was removed. Exodontia other teeth not in function was advised, the patient acknowledged this but failed to return. This unique presentation with supplemental teeth and impactions was deemed to be non-syndromic.
10 Antiseptic, Aseptic and Sterilizing Practices in General Dentistry-In the Age of COVID-19: An Appraisal , Louis ZG Touyz1*
This appraisal recalls past best antiseptic practices, discusses and underlines the necessity, importance and practice of optimal contemporary infection-control, for dentists in the COVID-19 pandemic.
11 Biodentine: A Unique Bio-Active Endodontic Material with Versatile Uses , I Anand Sherwood1*, James L Gutmann2, Geeth Deepika1, Vanitha Sadashivam1, Evangelin J1, Divya Meena1, Nivedha V1, Ramyadharshini T1, Joyson Joe Asir1, Subashri V1, CT Valliappan1, Pavula S1
Biodentine is bioactive endodontic cement. This case series report contains some common clinical indications where Biodentine been used successfully and some off-label usage of this material, which has enabled successful clinical outcomes. Cases present in the report are from the year 2016 to the present date.
12 The Influence of Terms of Pulp Extirpation during Tooth Auto Transplantation on Resorption and Ankylosis in Adults , Kristina Badalyan1, Alena Zedgenidze1*
Objectives: According to the studies, the best time for endodontic treatment after accidental replan-tation is no more than two weeks. Unlike cases of tooth trauma, in autotransplantation, all the manipulations flow under relatively sterile conditions and the likelihood of pulp infection is minimal. We decided to check out the resorption rate in case of different terms of pulp extirpation and whether revascularization is possible with a favorable healing course. Material and Methods: In this study we performed the autologous transplantation of closed-apex third molars in 52 adult patients, divided in 3 groups. In the 1st group (8 cases) the pulp extirpation was done before the surgery, in the 2nd group it was performed in 2 weeks after the surgery (33 cases). In the 3rd group there was no treatment at all (11 cases). Results: Results were evaluated after 3, 6, 12, 24 months by clinical and radio-graphic examination. The survival rate and the pulp condition of the transplanted teeth was observed. The dynamic periotestometry examination was performed in order to track the resorptive processes. For statistical data processing we used the Mann-Whitney test. Conclusions. No dependence of the development of inflammatory and replacement resorption on the time of pulp extirpation was evaluated. During this observation period direct confirmation of revascularization has not been obtained. Despite possible pulp necrosis inside the transplanted tooth, the risk of inflammatory resorption is minimal in the absence of infection. Periotestometry data showed that process of replacement resorption stopped after 6 months in most cases.
13 Tooth Supported Overdenture for Partially Edentulous Denture Using Magnetic Attachment -A Case Report , Walid Al-Jallad1*
The only reliable method of preserving the remaining bone structure is by maintaining the functional health of the teeth. The dentist’s role can range from simple treatment to full-mouth rehabilitation and partially edentulous patients have many treatment options ranging from FPD, RPD to dental implants. Furthermore, the use of copings and precision attachments on the remaining teeth enhances the retention of the denture. Studies have also demonstrated that precision-attachment partials dentures last longer, wear less, needless adjustments, look better, work better, less destructive, protect abutment teeth, and are easier to clean. Magnets increase retention of partial or complete dentures and overdentures regardless of the path of insertion. Magnets are easy to use alone or together with any type of retainer. This clinical report describes a novel method of fabricating a tooth-supported Removable Partial Denture in lower arch retained with magnetic attachment, to enhance retention and stability of the prosthesis and overcome the drawback of extracoronal attachment which could affect the aesthetics
14 Vertical Facial Midline Variations in Ethnic Groups , Ashwini Bhangale1, Ajay Kakar2, Maria Csillag3*
This study was carried out to evaluate the incidence and pattern of facial midlines across three ethnic grtoupsd of populations. The ethnic groups being studied are Caucasian, African and Oriental. The Smylist philosophy has introduced the concept of different kinds of vertical facial midlines. Based on this concept the distribution and incidence of straight, curved and sloped midlines, as propounded by Smylist, was assessed. This study can be considered as an extension or follow up of a study done on an Indian population to assess the incidence of facial midlines which was published in 2019. There were 50 subjects included in each of the ethnic groups to make a total of 150 subjects. A photo documentation was used for each of the subjects. The pictures were standardized in the straight face Cheese A picture as defined in the Smylist concept. An attempt was made to keep an equal number of male and female subjects. All the pictures were loaded on the Smylist software and the facial analysis was carried out to generate and identify the type of midline present. The results showed that the incidence of the straight midline was the lowest in all the three ethnic groups. The curved and the sloped midline make up the bulk of the cases. The curved was the highest in the Caucasian group and the sloped was the largest percentage in the African and oriental groups. It can be safely concluded that the incidence of vertical straight midline is ostensibly less and should not be deliberated as a foundation for functional and aesthetic rehabilitation. This is consistently observed in all kinds of ethnic groups and follows the pattern of the Indian study. It can also be concluded that the curved and sloped incidences vary considerably in different ethnic groups.
15 Dental Implant Considerations in Patients with Periodontal Disease , Radhamoni MadhavanPillai Baiju1*, Biju Thomas2
Dental implants have transformed the prosthetic replacement of teeth. Plaque biofilm is the primary etiologic agent for periodontitis and peri-implantitis. Dental plaque biofilm induced inflammation and associated tissue destruction endanger the success and survival of dental implants more than the way it affects natural teeth. Existing periodontitis / history of periodontal disease is considered as a risk factor for peri-implantitis. Meticulous plaque control should be established and comprehensive periodontal therapy executed to obtain periodontal disease stability before dental implant provision. Maintenance of implant is more difficult than maintenance of teeth. Hence extracting teeth for the sake of replacement with implants is not always a good alternative. The general considerations for successful implant placement and maintenance in periodontitis patients are discussed.
16 The Relationship between Self-Rated Proficiency in Orthodontics and Tested Orthodontic Knowledge of Dentists Using Facebook in the United Kingdom , MJ Rowland-Warmann1*, Parmjit Singh2
Introduction: There has been a rise in orthodontic treatments being undertaken by dentists in the United Kingdom (UK). Levels of orthodontic education vary, and this may impact upon self-rated proficiency and tested knowledge of orthodontics. Purpose: The study aimed to assess the relationship between self-rated proficiency in orthodontics and tested orthodontic knowledge of dentists in a UK Facebook group, and determine if this was related to the level of orthodontic education. Materials and Methods: A two-part online survey was sent to dentists who were members of a closed Facebook group (The Dentist UK). Part one asked demographic and attitudinal questions including practice environment, level of orthodontic education and self-rated ability in diagnosis and treatment (proficiency). Part two consisted of questions to test orthodontic knowledge. Eligible participants were placed into one of four groups based on level of education: General Dental Practitioners (GDPs) with single day course completion (group 1), multiple day course completion (group 2), postgraduate course completion (group 3) and specialist level training (group 4). Results: A total of 102 participants completed the study, of which 38.2% (n=39) did not undertake orthodontic treatments. The remaining participants (n=63; 61.8%) were assigned group 1 (n=32; 50.8%), group 2 (n=8; 12.7%), group 3 (n=13; 20.6%) and group 4 (n=10; 15.9%). Group 1 rated themselves least proficient (mean=3.27), followed by group 2 (mean=3.71), group 3 (mean=3.9) and then group 4 (mean=4.47). Knowledge test scores were lowest for group 1 (37.8%), then group 2 (60%), group 3 (56.2%) and group 4 (73.5%). Self-rated proficiency significantly predicted accuracy on the knowledge test. The level of education positively correlated with the knowledge test scores. Conclusions: Test scores for orthodontic knowledge generally increased with increasing levels of self-rated orthodontic proficiency. Those with lower levels of orthodontic education generally performed less well in the orthodontic knowledge test.
17 The Next Level Implant Biomaterial: Silicon Nitride , Arpit Sikri1*, Jyotsana Sikri2
Dental caries and periodontal disease form the two most important factors for tooth loss. Rehabilitation of the lost dentition involves either fixed or removable prosthesis. Above all, dental implants have also proven to be the 1st choice of treatment in terms of prosthetic rehabilitation. According to glossary of Prosthodontic Terms (9th Edition), dental implant is defined as a prosthetic device made of alloplastic material(s) implanted into the oral tissues beneath the mucosal and/or periosteal layer and on or within the bone to provide retention and support for a fixed or removable dental prosthesis; a substance that is placed into and/or on the jaw bone to support a fixed or removable dental prosthesis. In addition to this, dental implant is that portion of an implant which provides support for the dental implant abutment(s) through adaptation on (eposteal), within (endosteal), or through (transosteal) the bone.
18 Evaluation of Redox Potential of Herbal Toothpastes: An in-vitro Study , Chaithra Lakshmi V1*, Nishmitha Hegde2, Nidarsh D Hegde3, Suchetha Kumari4, Mithra N Hegde5, Nireeksha Shetty6
Aim: To evaluate the reducing potential of herbal toothpastes in comparison with a non-herbal toothpaste. Methodology: In-vitro analysis was conducted among seven herbal toothpaste groups (numbered from 1-7) and one non-herbal toothpaste (group 8). The toothpastes were diluted with distilled water, filtered, and the clear solution was taken as a test sample. Evaluation of reducing potential was done by Dinitrophenylhydrazine (DNPH) method. The results were obtained using the ANOVA test. Result: Group 3 (Dabur dant rakshak) of the herbal tooth pastes showed the highest reducing potential with a mean value of 4.46 followed by group 5 (Patanjali Dantkanti), group 2 (Dabur red gel), group 1 (Dabur Red toothpaste), group 6 (Colgate Swarna Vedshakti), group 4 (Dabur babool ayurvedic), group 7 (Dabur meswak) and the least mean value was observed in non- herbal group 8 (Colgate Strong teeth). Clinical Significance: The imbalance between antioxidants and free radicals leads to pathologies in the oral cavity such as dental caries, periodontitis, oral mucosal lesions including some pre-cancerous and cancerous lesions. The medicated toothpastes containing herbal products with increasing redox potential and decreasing free radical activities would be beneficial in enhancing oral health.
19 Dental Shade Matching: Recent Technologies and Future Smart Applications , Rania Moussa1*
Shade matching in dental practice has been a great challenge for years. Shade matching has been carried out visually which proved unreliable and subjective. Alternatively, digital devices as spectrophotometer, colorimeter and digital photography were introduced which proved reliable but increased cost and time. The combination of patients requesting more esthetic restorations with dentists not willing to invest in expensive solutions, motivated researchers to investigate in new technologies for cost effective shade matching. Dental companies have offered smart apps with proposed techniques to benefit from high resolution built-in cameras of smart phones to facilitate shade matching. These smartphone-based colorimeter apps offered a low-cost, portable shade matching alternative, and allowed storing and sharing of the results. Accuracy and reliability of smart apps in dental shade matching are still questionable and requires development and optimization. It is recommended that researchers and software companies identify professionals’ needs and to design appropriate technologies, that would improve and accelerate performance in color selection for both clinicians and dental technicians.
20 Surgical Reintervention in the Chin in a Patient with a Silicone Chin Implant - A Case Report , João Luiz Carlini1*, Kendy Lipski2, Silmara Regina Teodorovitz Roeder3
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 musculature, 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.
21 The Clinical Effect of Diode Laser in the Treatment of the Periodontal Pockets in Comparison with the Use of Photodynamic Therapy , Mohamed AA Quriba1*, Tarek Harash2, Naieven Helmy3
Periodontal diseases a group of microbial infections that’s found in gingiva and supporting tissues of the teeth. The effect of microorganisms in the periodontitis could be confirmed. Purpose: The current study was conducted to evaluate the effects of diode laser versus Photodynamic Therapy (PDT) in periodontitis treatment as non-surgical method of treatment. Materials and Methods: Thirty patients’ males and females suffering from gingival pockets with age range from 20 to 65 years old from faculty of oral and dental medicine out clinics and selected randomly and divided in 2 groups each group contains fifteen patients. Group A received scaling and root planning in addition to 980 nm diode laser while Group B group received scaling and root planning in addition to PDT. Results: showed statistically significance improvement in group A (F=114.697, P=0.000) and in group B (F=126.308, P=0.000). Also, there was statistically significant difference between the two groups (F=5.904, P=0.000) with most difference in Pocket Depth only (F=21.122, P=0.000) with statistically significant differences in post treatment value (F= 2.333, P=0.000) and follow up at one (F=0.700, P=0.019) and six months (F=1.100, P=0.000). Conclusion: Both PDT and Diode therapy have significant effect in pocket depth, bacterial count and bleeding examination in periodontitis treatment, but PDT have Superior effect when pocket depth is the target.
22 Antibiotics Prescription Impact on Late Dental Implants Survival , Rawaa Younus Al-Rawee1*, Sajid Khazaal Ameen2
ims from this study is evaluating effect of antibiotics administration on dental implants failure in healthy patients underwent simple to moderate dental implant surgeries whether delayed or immediate (post-extraction) implantation. Complete assessment of the valuable or risky effects of oral antibiotics use with dental implant placement versus no antibiotic administration. One hundred twenty (120) consecutive medically fit patients necessitate oral rehabilitation by dental implants in different tooth loss area. These patients were arbitrarily distributed to 3 diverse categories: No Antibiotic Prescription (NOAB) Preoperative and Postoperative Antibiotic use (PPAB) consisting of amoxicillin 1.5 g 1 hour before surgery and 500 mg three times per day; for 7 days following surgery Postoperative Antibiotic Coverage (POAB) consisting of and 500 mg three times per day; started after surgery and continued for 1 week after surgery. Significant correlation are shown in this study analysis for three years follow-up periods with Wilcoxon Signed Ranks Test. Follow-up maintained in 6th month, 1st year, 2nd year and final check-up well done clinically and radiographically to exclude any failure of implant caused by peri-implantitis. Out of the twenty failed implant in both surgical procedure which observed in the 3rd month at stage of gingival former; no extra failure are recorded. Author thought that antibiotics can have role to prevent proceeding complications extends to failure more over patients instruction to keep good oral hygiene can play role beside.
23 Effect of Smoking and Periodontal Diseases on Salivary Glycoconjugates and Oxidative Stress Markers-A Comparative Study , Bhagyalekshmi M1*, Seba Abraham2
Background and Objectives: The most important feature in periodontal disease is degradation of extracellular matrix, resulting in elevated levels of various salivary biomarkers in periodontal diseases. Smoking results in oxidative stress as a result of imbalance between Reactive Oxygen Species (ROS) and antioxidants. The present study was intendent to assess and compare the levels of salivary glycoconjugates, oxidative stress markers and transforming growth factor β1 (TGF- β1) levels in periodontally healthy and chronic periodontitis subjects with and without smoking habits. Methods: A total of 100 subjects of age between 20 to 60 years were selected and equally divided among the four groups. The four groups were group 1 (periodontally healthy non-smokers), group 2 (periodontally healthy smokers), group 3 (chronic periodontitis non-smokers) and group 4 (chronic periodontitis smokers). Saliva samples were collected from all the four groups. The biochemical parameters assessed include Free Sialic Acid, Protein Bound Sialic Acid, L-Fucose, Total proteins, Total hexose, Superoxide Dismutase, Malondialdehyde and Transforming Growth Factor-Beta1 (TGF-β1). Results: The analysis of variance showed that there exists a statistically significant differences in the mean value of salivary total proteins (p<0.05), total hexose (p<0.01), Superoxide Dismutase (p<0.01), Malondialdehyde (p<0.05), Transforming Growth Factor β1 (p <0.01) among the four groups. Conclusions: The present study highlights the need for incorporating smoking cessation programs in routine periodontal therapy. The alterations in the levels of glycoconjugates are observed in other pathological conditions like rheumatoid arthritis, cirrhosis, cancer, cardiovascular diseases. These potent biomarkers mapped way for screening other inflammatory conditions too.  
24 The Professional Experiences and Development of Dental Technology Students to Work Based Learning a Five-Year Study , Michael G Reeson1*
Background: Work based learning is a fundamental aspect of all healthcare professionals training, as it enables students to develop the knowledge and skills required in their professional practise. Research into work-based learning provides evidence to argue that both obstacles and benefits exist. However, there appears to be no studies that discuss the quality of a work-based placement or the type of work placement students undertake. Objectives: This study investigates the professional experiences and development of dental technology students to work-based learning placements as part of their three-year full-time course in dental technology. Methods: Students in year two of the course undertook hospital departmental and commercial dental laboratory work based placements over one academic year; each work placement consisted of eight-week blocks with five placement providers. Using a qualitative approach, data sources included work placement diaries and participant feedback. Results: Six major domains were identified that accurately characterized the participants’ beliefs, thoughts and practices. The results indicate the majority of students recognized the benefits of work-based placements in developing relevant skills, knowledge and experience whilst gaining first-hand experience of life in a real working environment. Conclusion: It is suggested future dental technology curricula should provide opportunities to develop comprehensive and effective work based learning for students. This needs to be systematically developed within the dental technology curriculum if it is to achieve its desired goal.
25 Dosimetry Comparison of CBCT versus Digital 2D Orthodontic Imaging in a Pediatric Orthodontic Patient , AB Albin1, AD Goren2,5*, RD Faber1, NK Anderson4, LT Dauer3, B Quinn3, D Miodownik3, K Kelly3, I Branets2, DC Colosi5, M Mahdian5
The purpose of the study was to evaluate the amount of radiation potentially absorbed by a pediatric patient during whole-head (13×15 cm) CBCT imaging compared with digital panoramic and lateral cephalometric imaging using the same machine. For each of the three imaging modalities, twenty-one nanoDot Optically Stimulated Luminescent Dosimeters (OSLDs) were placed in a pediatric anthropomorphic 10-year old phantom in order to record absorbed radiation doses at different radiosensitive locations. All imaging was performed using the manufacturer’s recommended exposure settings. Ten more runs were performed with an OSLD placed only at the thyroid. A Monte Carlo Analysis was performed to extrapolate the absorbed doses for the remaining twenty organ locations. Equivalent doses for the head and neck organs and overall effective doses was determined using the International Commission on Radiological Protection’s tissue weighting factor guidelines. For each of the organs tested, there was a statistically significant differences in radiation doses across the three imaging modalities. The highest radiation doses were observed in CBCT imaging for all organs. The average effective dose was higher in CBCT than in lateral ceph and panoramic imaging combined. The results of the study suggest that in order to reduce pediatric patient radiation exposure during routine orthodontic records, conventional 2D imaging with digital panoramic and lateral cephalometric modalities should be used preferentially over CBCT imaging.
26 Treatment of Intrabony Defects by Decortication with CeraboneTM and DFDBA - A Randomised Controlled Trial , Irfana S Babrawala1, Rudrakshi C2*, Prabhuji MLV3, Shobith S Mampuzha4, Divya Khanna1, Deepthi Dharmaraj Sali1
Objective: Decalcified Freeze Dried Bone Allograft (DFDBA) and xenografts have shown good results in the management of intrabony defects. Decortication of the bone has shown favourable results in guided bone regeneration procedures. The goal of the present study was to check the efficacy of decortication with decalcified freeze dried bone allograft (DFDBA) and Cerabone™ bone grafts and to compare the response between the bone grafts placed using Radiovisiography (RVG) and Cone Beam Computed Tomography (CBCT) in intrabony defects. Methodology: In this split mouth study, ten patients presenting with bilaterally intrabony defects were selected and decortication was done in all the defects. They were randomly allocated as Group I which received DFDBA and Group II received Cerabone™. Clinical parameters included Pocket Probing Depth (PPD), Relative Attachment Level (RAL), Plaque Index (I), Periodontal Disease Index (PDI) and Gingival Bleeding Index (GBI). Radiographically Intrabony Defect Depth (IBD) and defect resolution were measured at baseline, 3 months, 6 months and 9 months with RVG. CBCT was used at baseline and 9 months. Results: Both the groups demonstrated statistically significant PPD reduction, attachment gain and radiographic bone fill. The differences between the groups were statistically significant and more favourable in Group II. Conclusion: Decortication plus Cerabone™ significantly improved the clinical and radiographic parameters of intrabony defects at 9 months after treatment when compared to decortication plus DFDBA.
27 Oral Mucormycosis: A New Threat to COVID Patients? A Guide to Oral Health , Sahana Sadasivam1*, Geeta IB2
The World Health Organization declared the outbreak of corona virus as a public health emergency of international concern on 30th January 2020. It has been over a year and a half since this outbreak and has led to heavy casualties across the globe. New mutant strains of the virus have said to emerge over the past year leading to the demise of people from various age groups. The most common symptoms of symptomatic covid positive patients include fever, dry cough, tiredness and less common symptoms include aches and pains, sore throat, diarrhoea, headache, loss of taste and smell. Some of the serious complications include difficulty in breathing/shortness of breath, chest pain or pressure. A new recently emerged complication of COVID-19 is a rare fungal infection also called the black fungus caused by a group of fungi called mucormycetes. These group of fungi commonly appear throughout the environment, particularly in association with decaying organic matter and in the soil. Contact with these fungal spores is very common as it is spread out in the environment but usually do not pose a greater harm or risk. The frequency of the black fungus in COVID patients is increasing due to immunodeficiency states like diabetes, malignancies, hematopoietic disorders, poor oral hygiene and immunosuppressive drugs. Oral health is essential to general health and greatly influences the quality of life. Early detection and proper care can prevent this disease from becoming fatal. Maintaining oral health is of utmost importance in preventing fungal infections becoming debilitating. This article a guide to oral health with key points to prevent any opportunistic organism giving its way in compromising general health.
28 Accuracy of CBCT Linear Measurements in Orthogonal versus Corrected Coronal Planes , Remy Golding1*, Laurence J Walsh2, Paul Monsour3
Objectives: To assess the accuracy of measurements between a simulated tooth root and Inferior Dental Canal (IDC) in medium field-of-view Cone Beam Computed Tomography (CBCT) scans, comparing orthogonal plane measurements with views ‘corrected’ perpendicular to the IDC. Study Design: Sixteen CBCT scans were acquired, including equally 0.2 mm and 0.4 mm resolutions and two machines. Distances between root and IDC of 1-3 mm (horizontal and vertical) and 0.5 mm (horizontal) were measured with Radiant DICOM viewer. Retest reliability was assessed for 80 sites. Results: High retest reliability was demonstrated (limits of agreement -0.33 mm [(-0.42) – (-0.25)] to 0.28 mm [0.19 – 0.36]). Uncorrected maximum over-estimation was 0.74 mm, and median was -0.02 mm (SD 0.21). Corrected maximum over-estimation was 0.64 mm, and median was -0.04 mm (SD 0.19). The difference in medians was found to be statistically significant (p = 0.006, d = 0.26). Uncorrected measurements were larger than corrected by greater than 0.5 mm in seven instances (maximum difference of 0.77 mm), and smaller by greater than 0.5 mm in two instances (maximum difference of 0.64 mm). Conclusions: Idealised CBCT measurements can achieve sub-millimetre accuracy. Corrected view measurements may reduce the risk of distance over-estimation. Further prospective research using patient data is warranted.
29 Knowledge, Perceived Competency and Problems in Using Basic Periodontal Examination (BPE) as a Screening Tool for Periodontal Patients by New Clinical Dental Students , Mahyunah Masud1*
Background: Recognition of disease is an essential component in periodontal disease management. It requires effective Basic Periodontal Examination (BPE), to guide the need for treatment. This study aimed to assess the year 3 clinical students’ knowledge, usage, perceived competency, and problems in conducting BPE. It also assessed the effectiveness of the teaching and learning (T and L) of BPE. Method: The cross-sectional, self-administered questionnaire survey was conducted among the year 3 students in two dental institutions. Lectures and hands-on training given to the students were followed by five months of clinical exposure on BPE to screen new patients. The thirteen questions provided to the students were divided into demographic data, number of BPE conducted, time taken, perception on knowledge on BPE, usage, competency and problems that they might have faced while conducting BPE. Results: A total of eighty-five year 3 students participated in this study with 422 BPE performance recorded. The average time taken was 5 to 15 minutes per patient. On perceived knowledge and clinical performance, 58% presented with moderate to high score on the understanding, indication, codes, instruments used and skill on BPE. Most perceived BPE as a useful guide for treatment needs but the main problems were uncooperative patients and too many sites to probe. Conclusion: Although new clinical students perceived BPE was useful and 50% felt that they were competent, only 20% of them had high knowledge and skill. Effective T and L with appropriate exposure to BPE were needed to improve during the next two years of study before graduation.
30 Comparison of Crestal Bone Levels of Prevail Implants with Platform-Switched: Following One Year   , Pablo Correa E1*, Camilo Lopez2
Purpose: To evaluate the changes in the bone crest around the implants with abutments with platform-switched in a retrospective clinical investigation derived from a previous study. Materials and Methods: Twenty-six healthy patients mean age of 51,6 ± 11,4 with one or more missing teeth were consecutively treated with Prevail implants, with and without platform-switched, conical, and with complete treatment. A total of 68 implants were placed test group with a prevailing implant with platform-switched (34 implants) and control group with the prevailing implant without platform-switched (34 implants). The final restorations were delivered 4 to 11 months after the insertion of the implant. Digital standardized periapical radiographs using customized film holders were obtained at the time of implant insertion and 12 months after. Marginal levels of peri-implant bone were measured on the mesial and distal surfaces of each implant using digital imaging software. Results: All the osseo integrated implants were clinically stable at the 12-month follow-up. The cumulative survival rate was 100%. The average bone loss was 1,34 ± 1,02 mm on mesial and 1,57 ± 0,99 mm on distal for the control group and 0,56 ± 0.85 mm on mesial and 0,82 ± 0,92 mm on distal for the test group. There are no significant differences related to sex, implant site, and bone density. Conclusion: The results of this study suggest that using implants with platform-switched may be effective in conserved the crestal bone level, reducing bone loss, and preserving the aesthetics of peri-implant tissues.
31 Pediatric Dentistry: Challenges during COVID-19 Pandemic , Sanhati Biswas1, Puloma Bagchi1, Nilotpol Kashyap2*
In the present scenario when the whole world is fighting against the deadly COVID-19 virus, oral health of children is of great concern for the pediatric dentists. Children are now unwillingly locked inside their home and as a result they are in continuous habit of frequent food intake which is giving rise to various oral health issues. Various researches have also suggested children may play role as asymptomatic carrier of the infection and may lead to further spread of infection, but mortality rate is very negligible. So it is important to provide preventive measures for children for better oral health with minimal intervention and by remote information and education of caregivers and by using teledentistry. Moreover it is of utmost importance to follow the protective protocols while treating the child patients in the dental clinic to prevent cross-infection. This review is aimed at providing information regarding management of pediatric dental patients in midst of ongoing pandemic by following necessary protocols and preventive measures to prevent spread of COVID-19.
32 Coralline Hydroxyapatite Bone Graft in Non-Contained Defects: Case Report , Peter Vickers1, Gordon Slater2*, Luke Mathen3
Substitute bone grafts are gaining popularity in orthopaedics and faciomaxillary surgery. There are numerous products that are available to clinicians currently on the market. Here, we present a case report of a large non-contained mandibular defect that was successfully treated with a Coralline Hydroxyapatite (CHA). This paper will discuss the need for CHA in dental bone defect repair, and it’s effectiveness in the specific case study.
33 Role of Conservative Management in Treating Ameloblastoma of Jaw Bones: A Review of Literature , Prasanthi Gurram1*, Pooja Narayanan2*, Saravanan Chandran3, Lakshmi Rathan AC1
Objective: The objective of this review article is to identify the role of conservative management and conditions which could produce positive outcomes in a recurrent tumor like Ameloblastoma of the jaw bones. Method: Data was collected from the search engine PUBMED, MEDLINE, etc. Most of the articles collected have been published between the years 2010-2020. Result: 56 articles were selected overall and 49 have been selected after considering the exclusion criteria. The exclusion criteria include any non-original articles, articles that include other types of Odontogenic tumors, evidence containing animal studies etc. The articles selected range from review papers, short reports, retrospective reviews and/ or studies to systematic reviews and research papers.  Conclusion: The current review paper suggests that Conservative techniques like Enucleation/ Marsupialization along with adjuvant procedures like Chemical cauterization and Dredging techniques have shown promising results in certain kinds of Unicystic and minimally invasive Solid / Multicystic Ameloblastoma.
34 The Effect of Delmopinol Mouthwash on Aphthous Stomatitis , Torgny Sjödin, Rolf Movert, Mikael Åström
Objective: The purpose of this article was to perform a reanalysis of the adverse recordings from Phase III studies of Decapinol Mouthwash (containing 2 mg/mL of the active ingredient delmopinol HCl) on patients with gingivitis with respect to occurrence of aphthous stomatitis. Materials and Methods:  The adverse events recordings from 8 randomized double-blind clinical studies on patients with gingivitis were statistically evaluated with respect to presence of aphthous stomatitis. The patients were treated for 2-6 months with mouthwashes containing delmopinol HCl 0.2%, delmopinol HCl 0.1%, chlorhexidine digluconate 0.2% or placebo. The number of visits in each study was three. Each time the patients visited the dentist for efficacy determinations, also data like adverse events were recorded. The number of patients with aphthous stomatitis at the different visits was calculated. Meta-analysis using the Fisher’s exact test was performed to evaluate how the effect was related to the different treatments. Results: After 4-6 weeks, the patients rinsing with delmopinol HCl 0.2% was the only group showing a significantly better effect than the placebo group. After 2-3 months, all groups rinsing with the delmopinol or chlorhexidine solutions showed statistically significantly better efficacy data than the placebo group. There was no statistically significant difference between the different treatments with active ingredient. After 5-6 months no statistically significant effect over placebo was observed for any of the treatments. Conclusion: The ability of delmopinol to reduce the incidence of aphthous stomatitis was found to be superior to placebo and at least as good as chlorhexidine. Further clinical studies designed for patients with Recurrent Aphthous Stomatitis (RAS) should be performed to determine the effectiveness of delmopinol.
35 Hypochlorite Accident through Perforation: A Sequence of Iatrogenic Accidents , Noor I Othman
The most generally utilized root channel water system arrangement is sodium hypochlorite (NaOCl). It is utilized at convergence of 0.5% – 5.25% and is powerful against most endodontic microorganisms for example Enterococcus, Actinomyces and yeast. At 0.5% – 1%, NaOCl breaks down just necrotic tissue however at a higher focus, it disintegrates both necrotic and fundamental tissue. It has little impact on inorganic tissue. Though NaOCl is disliked in light of the fact that it has a horrendous taste, harmfulness and spills can demolish a patient’s clothing because of its dying impact. It enjoys the benefit of decreasing the acidic impact on the periradicular tissues while keeping up with the truly necessary antibacterial property. Inaccurate assurance of endodontic working length, iatrogenic broadening of the apical foramen, parallel hole, or wedging of the flooding needle are the normal variables of the subject. Obviously, safety measures should be embraced to forestall such accidents. The patient’s clothing ought to be safeguarded successfully against the irrigant, as well as the patient’s and administrator’s eyes. The flooding needle should be fixed to the needle and should not be wedged into the root channel. From this case, clearly the area of the hole is a vital data. During water system a low and consistent tension should be utilized and all abundance irrigant leaves the root waterway coronally through the entrance hole with the assistance of a fast attractions. Root holes might prompt tooth extraction. It is a generally expected confusion of endodontic treatment or post readiness. Fruitful administration relies essentially upon quick fixing of the hole subsequently anticipation of contamination. A few variables decide the accomplishment of these objectives, generally significant of which are: season of event, size and area of the hole.
36 A Case of Pleomorphic Adenoma at Superficial Lobe of Left Parotid Gland , MC Prasant1, Pavan Tenglikar2, Ziyauddin2*, Rohit Kumar Singh2, Shiv Pratap Singh2, Shreya Chouksey3
Pleomorphic adenomas are the most commonly occuring benign salivary gland tumors, mainly affecting the superficial lobe of the parotid gland and among the minor salivary glands the most common sites are palate, lips and cheek. Rarely involves floor of mouth, tongue, throat, nasal cavity, etc.  It is also known as bening mixed tumour on the basis of its epithelial and connective tissue origin. Here we report an interesting case aiming to throw light on Pleomorphic adenoma of left side parotid gland. Wide local excision was suggested treatment of choice under general anesthesia.
37 Dental Implant Placement by Using Metal Reinforced Acrylic Stent - An Innovative Technique , MC Prasant1, Ziyauddin2*, Rohit Kumar Singh2, Tushanshu Soni2, Shiv Pratap Singh2, Shreya Chouksey3
Since the Branemark method, implant surgery has progressed significantly as well as its delayed impact on the edentulous jaw. 2 A surgical guide, also known as a stent, is essential for implant placement at correct location and angulation. Transferring productive and prosthetic arrangement details to the surgical stage is evaluative.
38 Comparative Evaluation of Lycopene and Therapeutic Ultrasound by Using Diagnostic Ultrasonography in the Management of Oral Submucous Fibrosis (OSMF): A Clinical Trial , Roopam Saini1, Upasana Sethi Ahuja2, Nidhi Puri3*, Akshay Rathore4, Seema Ahuja5, Smiti Rekha Das1
  Introduction: Oral Submucous Fibrosis is considered to be multifactorial with several treatment modalities available but only to provide symptomatic relief. The use of non-invasive biological techniques with minimal or no side effects is highly recommended in view of its premalignant nature. Methodology: A total of 40 patients (20 in each group) who were clinically and histopathologically diagnosed as OSMF were included in the study. The patients were subjected to diagnostic ultrasonography to evaluate the masseter muscle and submucosal thickness. All the patients were then randomly divided into 2 equal groups where group I was given Lycopene therapy (8 mg twice a day for 3 months) and Group II was given therapeutic ultrasound in continuous mode at a frequency of 3 MHz and intensity of 1-1.25 W/cm2 for 15 minutes on each side of cheek (for consecutive 15 days). After that it was administered thrice in a week for next 15 days and then twice a week for next 1 month. All the patients were followed up at 7th day, 15th day, at 1 month and 3 months to evaluate all the parameters. After 3 months, post treatment Diagnostic USG was done to evaluate treatment outcome. Results: There was a statistically significant difference observed among both the groups. There was significant reduction in burning sensation on VAS, (p < 0.005), increase in mouth opening and cheek flexibility (p < 0.005) in Therapeutic ultrasound group as compared to Lycopene group on 1 month and 3 months follow up visits. Conclusion: Therapeutic ultrasound showed more improvement in improving signs and symptoms of OSMF as compared to Lycopene therapy.
39 Suture Thread Incisional Biopsy of Oral Tissue , Hamad Albagiah1, Lujain Al Sahman2*
Objective: To report a suture thread incisional biopsy technique performed on a 32-year-old patient with oral white lesion that resulted in a successful sample for histopathology. Case report: A 32-year-old male reported to the outpatient dental clinic with the chief complaint of the appearance of painless white patches under his tongue. The patient had discovered the patches 3 months prior to his visit. Complete oral examination showed a 2 cm × 2 cm, non-scrapable white lesion on the floor of the mouth. An incisional biopsy was        performed to confirm the provisional diagnosis of oral leukoplakia. Following a special technique, a suture needle and thread was inserted at a 90-degree angle along the tissue surface, followed by pulling the grasped tissue with the thread and cutting it with a size 15 scalpel blade. Hemostasis was achieved with single interrupted sutures. Macroscopic examination revealed a tiny wedge of oral mucosa with whitish surface and yellowish base measured 0.4 cm × 0.3 cm × 0.2 cm. Microscopic examination revealed a wedge of oral mucosa surfaced by stratified squamous epithelium. The final diagnosis was revealed to be mild dysplasia with hyperkeratosis. Conclusion: The sample taken was found clear for the histopathological examination. The suture thread incisional biopsy technique was found to have many advantages over conventional incisional biopsy techniques. However, the procedure needs highly skilled clinicians to perform it. Further research is needed to better document more incisional biopsy cases using this technique.
40 Pediatric Restorative Option for Congenitally Missing Anterior Teeth: A Carolina Bridge Case Series , Puranik Chaitanya P1*, Yinger Sheaffer2, Ólafsson Vilhelm G3
Congenital absence of permanent maxillary lateral incisors can have a negative impact on adolescent patients from a functional and psychological standpoint. Historically used treatment options for hypodontia are invasive, warranting preparation of the abutment teeth and/or comprehensive orthodontic treatment. Dental implants are a preferred modality without the need for abutment preparation; however, are contraindicated until the completion of skeletal growth. This case-series presents two case-reports of adolescent patients with congenitally missing permanent maxillary lateral incisors restored using a novel resin-bonded bridge (Carolina Bridge). The Carolina Bridge is a conservative, esthetic, cost-effective, reversible, long-term, interim treatment option to replace missing teeth until implant-supported restorations are indicated. The basics of the Carolina Bridge including indications, contraindications, case selection criteria and clinical fabrication steps are presented in detail to help clinicians with treatment planning and execution.
41 Human Oral Dirofilariasis: A Case Report and Comprehensive Literature Review , Sreenandini AR1, Santosh A Nandimath2*, Rajkumar GC3
Many case reports indicate that human oral dirofilariasis is rare and has presented the case as a diagnostic challenge to dentists and oral surgeons due to similarity in clinical presentation with tumors. However, an in-depth review of the literature resulted in finding more than 80 cases of oral dirofilariasis reported throughout the world. There is a lack of awareness among dentists and oral surgeons about the rapidly spreading zoonotic infection. This paper presents a case report of a 25-year-old male patient diagnosed with dirofilariasis in his right buccal subcutaneous nodule. Besides the case report, the paper also presents the parasitic infection process, factors contributing to the spread of the infection, common clinical symptoms, diagnostic methods, treatment options and ways to control the infection. The paper brings about various knowledge gaps that need in-depth study. The primary objective of this work is to spread awareness among dentists and oral surgeons about the rapidly spreading zoonosis and highlight the need for a coordinated effort to control the infection.
42 Post-Endodontic Pain after Root Canal Treatment of Symptomatic Teeth with Mtwo and Safe Sider Multiple File Systems: A Randomized Clinical Trial , Eshagh Ali Saberi1*, Narges Farhad-Mollashahi1, Arezoo Hooshmandi2, Arezoo Pirhaji3
Background: Considering the increasing popularity of rotary files among dental clinicians and the emergence of several types of rotary systems, clinical trials are necessary to compare these systems from various aspects. Objectives:  This study compared post-endodontic pain following the use of Mtwo and Safe Sider multiple file system. Methods: A total of 150 maxillary and mandibular molars with symptomatic irreversible pulpitis were selected. Their root canals were randomly instrumented with hand files, Mtwo and Safe Sider instruments. The severity of postoperative pain was assessed using a Visual Analog Scale (VAS) at 6, 12, 24, 48 and 72 hours. The data were analyzed using repeated measures ANOVA. P<0.05 was considered statistically significant. Results: The mean postoperative pain score significantly decreased in all three groups over time. The mean pain score at 12 and 24 hours post-treatment was significantly higher in the Safe Sider group compared to the other two groups. At 6, 48 and 72 hours, no significant difference was noted in the severity of pain among the three groups. Conclusions: Postoperative pain is significantly higher at 12 and 24 hours following endodontic treatment with Safe Sider compared to the conventional hand instruments and Mtwo system.
43 Eruption Status of First Permanent Molar and Prevalence of Dental Caries among School Going North Indian Children: An Epidemiological Study , Shalini Garg1, Abhishek Dhindsa2*, Pragati Poddar3, Rakesh Sharma4, Sumit Singla5
Background: Dental caries is one of the most widespread oral disease affecting children and adults globally irrespective of age and gender. The prevalence of dental caries is of the immense concern and is the primary subject of many epidemiological researches being executed throughout the world. Aim: The present study aimed to assess the eruption status of first permanent molar and evaluate the prevalence of dental caries in children between 5-8 years of age Materials and Methods: A cross sectional study was carried out in 1008 children in five different schools of district Barara, Ambala, Haryana. The aim was to determine the caries free proportions, caries experience and collection of baseline data regarding the status of permanent first molars between the age groups of 5-8 years. Dental caries was assessed using dmft index using World Health Organization criteria 1997. Results: The prevalence of dental caries was more in boys of 7-8 years age group as compared to girls in the same age group (p-value 0.052). 89% of children had first permanent molar erupted between 7-8 years of age while only 27% of children of 5-6 years age group had first permanent molar erupted.
44 Perspectives of Parents regarding the Appropriateness of Physical Restraint Alone or in Conjunction with Sedative Techniques for Managing Challenging Pediatric Dental Behaviour , John E Nathan1*
Purpose: A retrospective look at parents’ responses to having witnessed their children of varying levels of apprehension undergo sedative treatment visits across a 35 year period. Sedation visits with outcomes ranging from optimal or adequate, to inadequate and over-dosage, were assessed by both parents and their clinician. Methods: After witnessing their child’s visits, parents were asked if they would choose sedation for future visits under circumstances where outcomes cited need for persistent application of restraints vs more favorable outcomes. Post-treatment surveys of over 4,360 parents were conducted at the time of discharge after observing their children’s responses to oral sedation visits in a private practice setting. Variable dosing of Chloral hydrate-Hydroxyzine with and without Meperidine, and Midazolam with and without Meperidine were compared. Results: Not surprisingly, for parents where sedation was rated inadequate, 95% indicated they would likely opt for alternative modalities rather than subject their children to measures which ultimately necessitated persistent applications of restraint. Under circumstances where outcomes enabled treatment objectives to be accomplished without any form of restraint, parents correspondingly indicated they would have no reservation in accepting a pharmacological modality for future visits. Where transient application of physical restraint was needed to overcome minimally, moderately, or severely interfering behaviors, reactions were mixed among parents while clearly leaning in the direction of finding sedation desirable. Parents observing less than adequate success of sedation indicated they would consent to using sedation procedures for future visits only if it meant avoiding use of general anesthesia. Conclusion: Perceptions of parents where persistent application of restraints were needed found their use neither acceptable, appropriate nor desirable. There appears to be a trend in this direction amongst clinicians of today but in lieu of current practices which make little or no use of sedative modalities, this appears by no means universal.
45 Alveolar Ridge Augmentation with Implant Placement in the Anterior Maxilla: A Case Report , Pragyan Mohanty1, Kunchok Dolma J1, Anil Kumar Gujjari2, Sai Krishna D4, Sheela Kumar Gujjari4*, Kritika Banerjee5
Loss of teeth in the anterior region in a young patient can be very traumatic. Not only are they concerned about the function, but also about the aesthetics. The rehabilitation of missing teeth poses the challenge of deficiency of both hard and soft tissues. This case report highlights the rehabilitation of the teeth in the aesthetic zone of a patient who had lost teeth due to a road traffic accident. An inter-disciplinary approach was used to treat this patient. Alveolar ridge was augmented prior to implant placement. The ridge deficiency was successfully augmented with autogenous bone graft, which laid a strong foundation for the osseointegration for implant placement and the patient was satisfied with the functional and aesthetic outcome, which was measured using the Pink Esthetic score and White Esthetic Score.    
46 Knowledge, Attitude and Practice of Tobacco Cessation Counselling among Dental Professionals in Maharashtra- An Opportunity for Health Promotion , Aarti Prabhu1, Kunal Oswal2*, Kumar Gaurav Chhabra3, Ashwini Avasare4, Ashok Dhoble5
Background: Patients can have a better prognosis and quality of life if tobacco-related lesions in the oral cavity are detected early. These oral symptoms can be identified and isolated with the aid of a dental check-up. Tobacco use habits can be intervened in and tobacco cessation counselling can be provided by trained oral health specialists. Hence the aim of the present study was to assess knowledge, attitude, and behaviour of dental professionals towards tobacco cessation counselling for tobacco users in Maharashtra, India. Methodology: A self- administered questionnaire-based survey was sent to members of Indian Dental Association (IDA) through email. The results were analysed using statistical programme SPSS 25.0 software. Results: 78% of the participants had not undergone tobacco counselling training. 83% of participants had not been trained to give psychological support to patients who were attempting to quit smoking. Nicotine Replacement Therapy was mentioned by 86% of those polled. To a large extent, 54% of participants think it is their obligation to give cigarette cessation counselling. Only 33% of participants felt confidence in their abilities to provide appropriate smoke cessation advice. Only 38% of participants were hopeful about their patients’ abilities to quit smoking. 38% of participants inquire about their patients’ tobacco usage, and 18% provide extensive tobacco cessation counselling. Conclusion: Tobacco intervention by dentists is an excellent strategy to lower the cost of tobacco-related curative and palliative care. As a result, more dentists should provide their patients tobacco cessation counselling. Dental health practitioners should receive comprehensive training in these treatments so that they can deliver appropriate services to tobacco users.
47 Gingival and Periodontal Diseases Seen in Children and Adolescents: A Review of Literature , Nillotpol Kashyap,1*, Shreya Rani2, Nishi Singh3, Soni Patel2
Gingival and periodontal ontal disease are seen in children at various stages of their growth period. Although gingival diseases are fairly common in children it is the opposite for periodontal diseases. Periodontal diseases are fairly uncommon in children and can be seen only if the children are suffering from some syndromes or genetical anomalies like Chediak Higashi syndrome, leucocytic adhesion defect etc. Gingival diseases can occur due to improper maintenance of oral health or during puberty in girls. Gingival diseases may have other causes like viral, bacterial, drug induced etc. This review article is an attempt to exlain the causes of gingival and periodontal diseases and their proper management in the dental clinic.
48 Full Mouth Implant Rehabilitation Using Fixed Detachable Bio-HPP Frameworks in the Presence of One-piece Implants: A Clinical Report , Kenda I Hanno1*, Ahmed M Abdelhamid2, Mohamed Moataz Khamis2
Background: The purpose of this case report is to describe a case of full arch rehabilitation in the maxilla and mandible using fixed detachable BioHPP frameworks veneered with prefabricated veneers in the presence of one-piece implants. Methods and findings: A 63-year-old male patient presented with a maxillary acrylic resin fixed restoration supported on six implants and a mandibular implant retained overdenture on two one-piece implants. Five implants were placed in the mandible in addition to the existing two one-piece implants using CAD/CAM surgical guides. Steps for prosthetic construction of the final full arch BioHPP restorations were completed. The mandibular BioHPP framework was relieved during construction to accommodate the one-piece implants. Cement was applied to fill the space in the framework above the one-piece implants. Conclusion: Full arch screw-retained restorations can be fabricated in the presence of one-piece implants without sectioning of the abutment part to avoid patient discomfort and heat generation. The low modulus of elasticity of BioHPP along with prefabricated PMMA veneers provided a major advantage over other materials by dampening the occlusal forces and reducing debonding rates.
49 Analysis of Clinical Outcomes in Connective Tissue Donor Site Healing With Two Different Suturing Protocols: A Prospective Case Control Study , Saravanan Sampoornam Pape Reddy1*, Prashanth Thankappan2, Satisha Tirumala Suryaprakash3, Shreehari Ambika Krishnan4, Balakrishnan Jayan5
Background: Connective tissue harvesting from the hard palate has been practiced since decades and remains the ‘gold standard’ for soft tissue grafts. Very little has been researched on healing patterns of the palatal donor site and the incidence of post-operative complications of donor site. Aim: The aim of the study was to evaluate the influence of two different suturing methods on the healing outcomes of donor site after Connective Tissue Graft (CTG) harvsting. Material and Methods: Thirty patients who had undergone CTG harvest for various procedures were analyzed for the assessment of clinical healing outcomes of palatal donor site. A similar technique for the harvest of CTG in both groups was used using Liu’s class Ia incision. The method of closure of the donor site in these patients was divided into two groups; Group A – combination of criss-cross and horizontal mattress sutures and Group B – simple interrupted sutures. The parameters assessed preoperatively were palatal tissue thickness, intraoperative superficial palatal flap thickness and postoperatively the incidence of post-operative complications and donor site healing was assessed using Wachtel’s index (2003) at 7 days, 14 days and 1 month postoperatively. Results: The incidence of complications was more in Group B in comparison to Group A. The healing outcomes differed significantly between Group A and B at 7 days, 14 days and 1 month postoperatively; however, there was no statistically and clinically significant difference at 03 months post operatively. Conclusion: The combination of criss-cross with horizontal mattress suture for closure of palatal donor site after harvesting with Liu’s Class Ia incision was found to yield superior patient comfort and lesser post-operative complications during the early healing period.
50 An Injury Profile of Maxillofacial Trauma in Yaoundé: An Observational Study in Cameroon, Nokam Abena Marie Elvire1,2,5*, Nseme Etouckey Eric2,3 Lowé Micheèle1,2, Mefouigui Laurienne2, Mindja Eko David2,4,5, Bengondo Messanga Charles1,2,6
Introduction: Maxillofacial Trauma (MFT) is an important condition because of its frequency, facial involvement and severity of injury. The aim of the study was to determine the lesion profile of patients suffering from maxillofacial trauma in three hospitals in Yaoundé. Methodology: This was a descriptivestudy that took place over a period of 7 months during 2022; it included all maxillofacial trauma patients received in three hospitals in the city of Yaoundé. The sampling was consecutive and exhaustive. The data collected from the files of the patients recruited over five years from January 1, 2015 to December 31, 2020 were recorded in a pre-designed data processing form which was divided into socio-demographic data, clinical aspects and circumstances of occurrence of MFT. The information collected was entered and analyzed using SPSS version 25.0 software. Results: Out of 491 patient records collected, 293 patients were included, i.e., a prevalence of 59.67% of exploitable documents. The male gender predominated with 75.1% of cases, with a gender ratio of 3.01. The age group 30 to 40 years was the most represented with a mean age of 34.4 years and extreme values of 5 and 83 years. Secondary education was found in 60% of cases and 73.7% of patientswere workers. Maxillofacial trauma was caused by Road Traffic Accidents (RTA) in 71% of cases. Osteoarticular tissues were affected in 79.5% of cases with unifocal fractures (50.9%) and mandibular fractures (54.4%). The dental-alveolar injuries (25.3%) were of the type of dental expulsion (51.3%) and partial dislocation (40.5%). Mucosal trauma was associated in 56.3% of cases, with wounds in 47.9%. Conclusion: Maxillofacial trauma primarily affects male workers in their third decade. They mainly result from RTA with polymorphous clinical incidences. The lesions may be osteoarticular or not associated with alveolar-dental or mucosal trauma.
51 Sealant Penetration into Occlusal Fissures: An In-Vitro Optical Coherence Tomography Study, Noor Hanisah Rahim1, Nurul Izyani Johari1, Maria Angela Gonzalez2, Prema Sukumaran3*
ckground: Penetrating Keratoplasty with cataract extraction and Intraocular Lens (IOL) implantation (Triple procedure) is very challenging procedure because in cases of Opaque cornea, status of anterior segment is difficult to predict that can lead to intraoperative surprises. If not managed properly, these can severely affect visual outcome. To avoid this, we performed Ultrasound Biomicroscopy (UBM) preoperatively for detailed analysis of anterior segment structures and associated pathologies and later compared it with intraoperative findings to judge predictive accuracy of UBM in guiding surgical strategies, decision making and modifications intraoperatively. Methods and findings: 20 eyes of 20 patients with different grades of corneal opacities like simple corneal opacities (6 eyes) or adherent leucoma (7 eyes) or anterior staphyloma (7 eyes) that underwent Triple procedure (Penetrating Keratoplasty+ cataract extraction+ IOL implantation) were evaluated preoperatively by UBM and the findings were compared intraoperatively to find predictive accuracy of UBM. Extent and depth of corneal lesions, corneal thickness, anterior chamber depth, type, position and extent of synechiae, pupillary membrane and status of lens and capsule were assessed. Scan was performed to visualize any posterior segment pathology and to find Axial Length (AL). Keratometry readings of other eye were taken to calculate IOL power for implantation. Preoperative UBM findings when co-related intraoperatively was found to be accurate in 71.42%- 100% parameters and accordingly these cases underwent penetrating Keratoplasty with other modifications like Iridectomy, Membranectomy, Synechiolysis, iris reconstruction, Trabeculectomy, cataract extraction and IOL implantation. Conclusion: In cataract coexisting with corneal pathologies, UBM is Best and reliable guide in predicting and preplanning of surgical strategies f
52 The Tubercule Carabeli in a Moroccan Population, A Chafii1, A Mouhibi2*, A Sayeh3, A Andoh4
Aim: The aim of our study was to determine the prevalence, degree of expression and the symmetry of the Tubercle of Carabelli “TC” in a sample of Dentistry students to highlight this sensitive area to dental caries. Materials and methods: We conducted a descriptive transversal survey of students in the 4th year of the academic year 2015/2016 at the Faculty of Dental Medicine of Casablanca. The study is made on plaster models, by measuring the mesiodistal diameter of the TC with an electronic caliper. Results: Several results were obtained: 64.29% of the study population have the CT, while it is absent in 35.71% of cases, 37.50% With a tubercle of Carabelli little developed, 26.71% With a well-developed Carabelli tubercle, 61.11% of cases exhibit TC bilaterally and 38.89% Of cases present the TC unilaterally. The results are consistent with those obtained in other surveys conducted in other countries. Conclusion: The lack of standardization of the study’s methodology makes it difficult to compare the results of various studies, hence the need for similar studies on larger samples. Clinical Significance: It has some importance in the dental, forensic, anthropological and dental industries. In orthodontics, the cause of premature caries and periodontal diseases, also in extractions, the molar extraction instruments have no housing for this cusp and can therefore lead to his fracture.
53 A Comparative Evaluation of Medical Grade Calcium Sulphate Hemihydrate With and Without Platelet Rich Fibrin as a Bone Regenerative Material in the Treatment of Intraosseous Periodontal Defects- A Clinical and CBCT (Cone Beam Computed Tomography) Assessment, Anuradha Maurya1*, KT Chandrashekar1, Rohit Mishra1, Elashri Chatterjee1, Anushree Choudhary1, Anurag Maurya1
The periodontal regeneration is one of the main objective in periodontal management and can be achieved by use of barrier membrane, bone grafts and growth factors. Calcium sulphate, an alloplast material and platelet rich fibrin was used in this clinical trial. Aims: To compare medical grade calcium sulphate hemihydrate with and without platelet rich fibrin as a bone regenerative material in the treatment of intraosseous periodontal defects by clinical and CBCT assessment. Materials and Methods: 30 defect sites were included in the study and were randomly allocated to either Group A, Group B or Group C. Group A was the control group, Group B included the placement of medical grade calcium sulphate hemihydrate whereas Group C included the placement of medical grade calcium sulphate hemihydrate with platelet rich fibrin in periodontal intrabony defects. Statistical analysis of plaque index, gingival index, probing pocket depth, clinical attachment loss and defect fill by CBCT was performed. Statistical analysis used: Kruskal Walis test and Chi‑square test for categorical variables were used for analysis. The critical levels of significance of the results were considered at 0.05 levels, i.e., P < 0.05 was considered statistically significant. Results: Statistically more significant difference in probing pocket depth, clinical attachment loss and defect fill was observed in Group C (MGCSH+PRF) in comparison to Group B (Medical Grade Calcium Sulphate Hemihydrate) which showed better results than Group A. Conclusion: MGCSH with PRF produced more favourable results than MGCSH alone.
54 Malpractice Payments and Adverse Actions against Dentists in Texas-A Fifteen-Year Trend Analysis, Jasmine Kaur1, Viyan S Kadhium2*, Priyanka Belgal3, Riddhi Chheda4, Cheske Allora5, Peggy Timothé6, Sheetal R Asher7, Romesh P Nalliah8
Objective: Health practitioners are potentially subject to malpractice claims against them and previous research has indicated that legal proceedings against dentists are becoming a larger proportion of all malpractice payments against healthcare professionals in the United States. The objective of this study is to describe trends in the number of malpractice payments and adverse actions made against dentists in the state of Texas over a fifteen-year period from 2006 to 2020. Methods: Data regarding the adverse actions and malpractice payments against dentists was retrieved from the National Practice Data Bank for the years 2006-2020. The data set included adverse actions such as loss of clinical licensure, loss of clinical privileges or panel memberships, drug enforcement administration license and Department of Health and Human Services-Office of the Inspector General exclusion (i.e., exclusion from federally funded health programs). We exported all data into data visualization tools which we used to study and report trends. The University of Michigan Medical School Committee on Human Studies determined our study was not regulated and exempt (HUM00116742). Results: The number of adverse actions against dentists in Texas rose from 2006 (75 actions) to 2015 (164 actions) followed by a downward trend until 2020 (70 actions). The number of malpractice payments against dentists had an inverse relationship with adverse actions between 2006 – 2014 and again 2017 – 2020. However, during 2014 – 2016 there was a concurrent increase in malpractice payments and adverse actions. Loss of clinical licensure was the most common (91.23%) adverse action, followed by Drug Enforcement Administration (DEA) action (3.77%), Health and human services – exclusions by the Office of the Inspector General (HHS OIG) exclusion (1.68%) with the least common being cancellation of clinical privileges/panel memberships (1.33%). Conclusion: The number of malpractice payments against dentists followed a loosely inverse relationship with adverse actions.
55 Association of Serum IgG Antibody to P. gingivalis and Early Chronic Kidney Disease in Diabetics and Non-Diabetics with Periodontitis, Minusha Grace S1, Sheela Kumar Gujjari2*, Manjunath S Shetty3, Sumana MN4
Background: Diabetes and Periodontitis share a bidirectional relationship. Hyperglycaemia and duration of diabetes can cause the micro-organisms to thrive in the periodontium leading to the activation of the innate i mmune system and cause low grade infla mmation leading to systemic diseases such as Chronic Kidney Disease (CKD). The co mmonly used markers of CKD are Serum Creatinine and Albumin. Antibodies like IgG have been found to be elevated with decreased Kidney Function which is also elevated in infla mmatory conditions like Diabetes and Periodontitis. As there are no studies done to detect the progression of diabetes and periodontitis to early chronic kidney disease stages by using IgG antibody titre against P. gingivalis as a biomarker. The present study evaluated the same. Methods: Patients were divided into the following group two Groups of 40 each; Group 1 Periodontitis without diabetes) and Group 2 (Periodontitis with Diabetes). Periodontal parameters were recorded. Serum Creatinine, urine albumin and estimated Glomerular Filtration Rate (eGFR) were calculated in both the groups. Serum IgG antibody titre against P. gingivalis was detected using ELISA. Results: IgG antibody titre against P. gingivalis was detected in both groups with no statistical significance (p-value 0.166). eGFR were significantly (p-value-0.007) lower in diabetics with Periodontitis compared with non-diabetics with periodontitis. A significant (p-value-0.002) association was found when IgG antibody against P. gingivalis compared with eGFR in both the groups. Serum Creatinine and urine albumin were significantly higher [p value- 0.001 and p-value- 0.040] in diabetics with Periodontitis compared to non-Diabetics with Periodontitis. Conclusion: IgG antibody titre against P. gingivalis was similar in both the groups with no significant difference but it was associated with decreased eGFR which revealed that IgG antibody titre against P. gingivalis may be used to detect the progression of diabetes to Early chronic kidney Disease Stages. Hence more studies are required to establish it as a potential marker in diabetic patients with periodontitis.
56 Oral Health Status among Children between the Ages of 12 and 15 Attending Government and Private School Systems in Bareilly City , Nandita Gautam1*, Anushtha Kushwaha1, Ankita Chandak2, Yesha Yadav3, Shaurya Upadhyay4
Background: Statistics on the oral health status of children from various socioeconomic backgrounds are available through assessments of children’s oral health status in public and private schools. The current study’s objective is to evaluate and compare the levels of oral hygiene, gingival health and caries experience among students attending government and private schools in Bareilly City. Subjects and Methods: The study participants were selected using a stratified random sample technique combined with cluster sampling. The oral hygiene state, gingival status and caries experience of 12 and 15-year-old students from three public and private schools were evaluated and compared. Three qualified and calibrated investigators used a mouth mirror and explorer while doing the test outside in the daytime. Results: The research observes 604 kids in all, 331 from the government and 273 from private homes. Kids attend government schools had a mean Oral Hygiene Index that was Simplified (OHIS) that was greater (2.9 [1.1]) than kids attending private schools (0.6 [0.4]). Children attending government schools had higher mean gingival scores and mean decaying, missing and filled tooth than those attending private schools. Students at government schools were far more likely to have poor oral hygiene, mild to severe gingivitis and caries encounter. Conclusion: Compared to children attending government schools, students who attend private schools had a considerably lower rate of oral illnesses. Therefore, in any statewide school oral health programs that are proposed, children from government schools should be given preference over those from private schools.
57 Things Go Better With Cola? Not For Teeth, Prof/Dr Louis Zalman Glick Touyz1*
Pop-drinks are promoted aggressively for consumption and profits. Most are mixtures of phosphoric acid with (CO2) gas, sugars and flavorings. Sugar-free drinks remain acid even when flavored by synthetic sweeteners. Most have acidities (pH below 5.5) which decalcify teeth, after ingestion. Pop-drinks cause erosion decalcification without bacterial action. Caries starts as decalcification with consequent cavitation by bacterial invasion. Saliva neutralizes dietary acids within 30 minutes. Repeated sips of colas keep mouth and oral biofilm acidity low and long enough to start decalcification. Evidence of decalcification from pop-drinks are exiguous; this appraisal cites research that implicates pop-drinks, specifically colas and guarana, in causing decalcification and by extrapolation, also consequent dental erosion and tooth decay.
58 Current Understanding and Treatment Strategies of Peri-Implant Diseases - An Overview, Navjot Kaur1, Tarun Nanda2*, Baljeet Singh3, Sonia Nanda4
As the general practitioners and specialists all over are placing dental implants with increased confidence and expertise, so are the diseases and complications associated with them have gained momentum. Peri-implant diseases consisting primarily of peri-implant mucositis and peri-implantitis consists of soft tissue and hard tissue inflammation resulting in increased clinical parameters such as pocket depth, clinical attachment loss, implant mobility along with radiological findings of bone loss around the implant body and prosthesis. To manage these infections, various treatment strategies have propped up in dentistry that one can mix and match the different options according to the situation and do the needful. In this article, there is description of peri-implant diseases, signs and symptoms that are associated with them and the therapeutical options that can be applied to treat them. The goal of this article is to make the diagnosis and therapy easy and narratable with the help of flowcharts, so that the reader whether an academician or a clinician can understand the cause, effect of peri-implant diseases and can correct them for the benefit of the patients.
59 New Possibilities on the Application of Violet Light in Dentistry Combining Aesthetics and Microbiological Control: Report of Two Clinical Cases, Vitor Hugo Panhóca1*, Thaila Quatrini Corrêa1, Vanderlei Salvador Bagnato1,2
Dental bleaching performed in a dental office is considered among the bleaching techniques one of the most safety avoiding damages to the mucous membranes and to the gastrointestinal tract of the patient. The application of violet light appears as an innovative reality in dental bleaching with effective results. The aim of this study was to show the new possibilities of violet LED light (405 nm, 165 mW/cm2) with liquid peroxide solution used during the dental bleaching in two clinical cases. Dental bleaching was done using a violet LED light source and simultaneous irrigation used hydrogen peroxide liquid on the dental arches with the aim of also promoting oral decontamination in the patient. Based on the results, it was possible to show that violet light has real applicability in tooth whitening and potential to be used in oral decontamination. In addition, the violet light accelerates the whitening process allowing excellent results and minimizing the aggressiveness of this procedure to the patients. Thus, violet light is a new tool for tooth whitening with the advantage of combining the control and prevention of diseases initiated by microorganisms in the oral cavity.
60 Electronic Health Records in Dental Education: A Scoping Review and Quantitative Analysis of Publications , Pedro Diniz Rebouças1,2, Lorena Walesca Macedo-Rodrigues2, Maria Tayara Marques de Freitas2, Paula Ventura da Silveira3, Iriana Carla Junqueira Zanin4*
The use of Electronic Health Records (EHRs) by dentists is already a reality in several countries, including Brazil, both in private practices and in higher education institutions, also providing data for oral health surveillance and epidemiology. The purpose of this scoping review was to search the literature for publications on the importance, applicability, efficacy and ease of the use of electronic medical records in dental education. Following the terms of the PRISMA-ScR, this review sought publications on the use of EHRs in dentistry schools. The databases used in the search were Pubmed, BVS, Web of Science, Scopus and ProQuest, without language limitations and publication period, using the terms ‘Dental School’, ‘Dental Education’ and ‘Electronic Health Records’. Initially, the search resulted in 548 articles. After reading the abstract, full text and removing duplicates, 63 were included. Then, it was divided in three groups according to main thematic: EHRs implementation (n = 25); Data obtained from Dental Schools EHRs used for publications (n = 26); EHRs system efficacy and challenges (n = 12). The use of electronic medical records in the teaching of dentistry collaborates positively with the development of students during graduation. We believe that this alternative of searching and collecting information will be increasingly used in epidemiological studies, due to its practicality and objectivity.
61 Tooth Root Formation , Michel Goldberg1*
The formation of the tooth crown implies dentin and pulp construction (including mantle dentin, odontoblasts, Höhl cells, and vascular, axons and pulp cells). The root formation involves acellular and cellular cementum, peripheral and central dentins. Vascular cells and nerves are located in the central part of the root, whereas the superficial layer (Hopewell-Smith and Tomes granular layers) are located at the periphery. In the central part of the pulp, fibroblasts and immunocompetent cells are identified as T-lymphocytes, B-lymphocytes, dendritic cells, NK cells. In human deciduous teeth, HLA-DR+, CD68+, and factor XIIIa are present, whereas T and B-lymphocytes form clusters. The Hertwig’s Epithelial Enamel Epithelium (HERS’s) is formed by two layers. The HERS’s cells dissociate, and cells, taking origin from the dental follicular sac and from the papilla, migrates. The OEE becomes periodontal ligament cells whereas the IEE becomes cementoblasts. The interconversion of epithelial cells into mesenchymal cells seems to be a crucial event in tooth root formation. Tooth eruption is associated to root lengthening. The temporary tooth is gradually destroyed (root cementoclasts), whereas the permanent coronal part of the tooth erupts and acquire it final shape and position.
62 Can the Age Affect the Regenerations Carried Out With Dental Graft? , Elio Minetti1*, Filiberto Mastrangelo2, Andrea Palermo3
Introduction: The tooth extraction is followed by marked osseous changes of the residual alveolar ridge including severe bone alterations both in height and width. For this reason has been developed the Alveolar Ridge Preservation (ARP). It is important for the dental surgeon to know how the alveolar crest changes when a ARP is performed. The metabolism affects bone repair reaction. To prevent alveolar ridge dimensional changes, since numerous graft materials have been suggested. In the last years, a growing interest in teeth material, due to his bone similarity, has been observed as a valuable alternative to synthetic biomaterials. Aim: We want to assess if the age affects the regenerations ARP using dental graft. Material and Methods: In this study 115 histologies from different patients (59 Male and 56 female) were analyzed splitting in six different age range: 20-30, 30-40, 40-50, 50-60, 60-70, over 70. The statistical analysis was effectuated using a P-value analyzing the differences between each age each other and cumulative. Results: The statistical differences are not relevant even if the sample’s number is limited only in two groups the differences are slightly above the significant value. The differences between the average value is not significative P
63 Progression of Periodontal Disease in Individuals with Cleft Lip, Alveolus and Palate: 8-Year Longitudinal Study , Bruno Nicoliello Moreira1, Bárbara Fortunato Prohmann2, Nicole Rosa de Freitas3, Luisa Belluco Guerrini3, Gisele da Silva Dalben4, Ana Lúcia Pompéia Fraga de Almeida5* 
Objective: To compare the progression of periodontal disease of sextants in individuals with cleft lip, alveolus and palate. Materials and Methods: This longitudinal, cross-section study was performed following the STROBE Statement. The sample included the study was conducted on 30 individuals, of both genders, aged 22 to 53 years, with cleft lip, alveolus and palate. The following clinical parameters were evaluated: measurement of probing depth of the sulcus or Periodontal pocket (PD), Clinical Attachment Level (CAL), Gingival Index (GI), plaque index (PI), buccal Gingival Recession (GR) in six sites of all teeth, except for the third molars. Analysis of the variation of clinical parameters of each tooth over the study period in relation to its sextant was performed by the Kruskal-Wallis and Dunn test. The variation of clinical parameters during the study period and the age of individuals were correlated using the Spearman correlation test. All tests considered a significance level of 5%. Results: The following means were found: PD 2.4 mm, CAL 2.6 mm, GI 0.9, PI 1.0 and BR 0.3 mm. There was increase in the mean PD and CAL (p
64 Effect of Virtual Reality Distraction on Pain Perception, Anxiety and Hemodynamic Changes during Therapeutic Extraction of Bilateral Maxillary First Premolars Split-Mouth Technique , Raghu Kumaravelu1*, Ranjitha R2, Sathyanarayanan R3, Venugopalan V4, Sailesh Kumer4, Raja Sethupathy Cheeman4
Aim: The aim of the study is to assess the effect of virtual reality distraction on pain and anxiety during therapeutic extraction of bilateral maxillary first premolars. Design: Non Randomized prospective split mouth technique requiring therapeutic extraction of bilateral maxillary first premolars. Setting: All patients reporting to the department of OMFS Indira Gandhi dental college and hospital Pondicherry requiring therapeutic extraction of bilateral maxillary first premolars. Participants: Covering 56 patients requiring therapeutic extraction of bilateral maxillary first premolars who meets the inclusive and exclusive criteria. Main Outcome Measures: Anxiety is measured using Likert scale, vitals using sphygmomanometer and pulse oximeter. Results: Parameters analysed using T-test, there is subsequent reduction of Systolic blood pressure, respiratory rate and pulse rate using virtual reality distraction when compared to without virtual reality distraction except for diastolic blood pressure. Conclusion: By distracting the attention of the patient, pain and anxiety levels of the patients can be reduced and producers can be done smoothly according to our study results.
65 The Future Perspective of Hyaluronic Acid Gel in the Management of Aggressive Periodontitis , Pooja Bharadwaj1*
Over these past few years, there are certain recently developed therapeutic approaches in the field of Periodontology, whose main motive is to achieve the comfort level by the patient. These therapeutic approaches are either used as an adjunct to conventional treatment approaches or as a substitute for the conventional treatment approaches. However over these few years one of the material on which various researches have been carried out is the hyaluronic acid upon which when investigations carried out indicated to be used in regenerative surgery as a membrane as mainly because of its bacteriostatic effects (particularly Aggregatibacter actinomycetemcomitans, Prevotella oris and Staphylococcus aureus) on wound contamination. Thus taking the bacteriostatic property of hyaluronic acid into consideration this editorial review highlights that how hyaluronic acid gel in future can be used as a useful adjunct in the management of aggressive periodontitis cases. The main etiological factor for the causation of gingivitis and periodontitis is the plaque and now a recent concept has come into existence and that is the host response [1,2]. Though plaque is the most common causative factor in the progression of gingivitis to periodontitis, there are certain other factors as well which can either modify the response of host to the cause periodontitis, or to solely act as a causative factor for the progression to periodontitis. Some of these factors can be systemic factors such as diabetes, environmental factors such as smoking, and genetic factors [3]. Talking about the genetic factors so one of the type of periodontitis in which a positive genetic history is a sole causative factor is the aggressive periodontitis which in fact is also a reliable diagnostic indicator that a person is suffering from aggressive periodontitis. In aggressive periodontitis because of the insufficiency of deposits in contrast to disease severity, earlier it was difficult to believe that any role of microbe can be present for this disease severity but later on it was proved through various correlation studies that a strong microbe i.e. Aggregatibacter actinomycetemcomitans is strongly correlated with aggressive periodontitis.
66 An Observational Study: Use of Systemic Antibiotics for Endodontic Infections Treatment, Constantin Mădălina1, Oana Andreea Diaconu1*, Lelia Mihaela Gheorghiță1, Marilena Bătăiosu2, Lucian Dragomir3, Andreea Gabriela Nicola4, Cristian Niky Cumpătă5, Constantin Dăguci4, Adina Turcu4, Mihaela Jana Tuculina1*
Aim: The purpose of this study was to determine the knowledge and habits of Romanian dentists about prescribing systemic antibiotics via oral for endodontic infection treatment. Materials and Methods: In this study we asked Romanian dentists trough social media platforms and using Google Forms App to answer a 11 questions survey about systemic use of antibiotics (via oral) for endodontic infections. 116 dentists filled the questionnaire and the responses were considered valid. The collected data were processed statistically with the Microsoft Excel program (San 27 Francisco, USA). Results: 116 Romanian dentists responded to this questionnaire. 53% of them prescribed oral antibiotics for 5 days, 43% for 7 days and only 3% for 3 days. In non-allergic patients the majority prescribed as a first choice antibiotic amoxicillin in association with Clavulanic acid – 54% and only 30% prescribed simple amoxicillin. The most prescribed antibiotic for patients with penicillin allergy was clindamycin (61,3 %). In cases of symptomatic irreversible pulpitis 15,5 % prescribed antibiotic. For cases of pulp necrosis with asymptomatic apical periodontitis and the presence of a sinus tract 21,7% prescribed antibiotic. Regarding the prophylactic use of antibiotics 46% of the respondents prescribed it following outdated guide lines (1 g administered 1 hour before the procedure or 1g before and 1g after the procedure), or recommended it in cases where was no need for use of antibiotics (11,7% prescribed antibiotics for patients under treatment with oral bisphosphonates). Conclusion: The knowledge and habits of Romanian dentists about the use of antibiotics as a supportive treatment in endodontic infections must be updated and improved because many prescribe it in a wrong way or in unnecessary cases.
67 Bioceramic Sealants: A Review, Magda Niculescu1, Oana Andreea Diaconu1*, Lelia Mihaela Gheorghiță1, Marilena Bătăiosu2, Lucian Dragomir3, Andreea Gabriela Nicola4, Cristian Niky Cumpătă5, Constantin Dăguci4, Adina Turcu4, Mihaela Jana Tuculina1*
Bioceramic sealants are considered an advantageous technology in modern endodontics. The aim of this article is to highlight the characteristics of bioceramic sealants and to compare them with other root system sealing materials. An extensive search of the endodontic literature was conducted to identify publications related to bioceramic sealants. The results of laboratory and clinical studies on the biological and physical properties of bioceramic-based sealants, as well as comparative studies with other sealants, were evaluated. Several studies evaluated different properties of bioceramic-based sealants, including physical properties, biocompatibility, sealability, adhesion, solubility and antibacterial efficacy. Bioceramic-based sealants were found to be biocompatible and comparable to other commercial sealants. Clinical outcomes associated with the use of bioceramic-based root canal sealants are not established in the literature. In modern dentistry, the endodontic field is improving with new materials and methods. In 2007, the American Endodontic Association adopted the term regenerative endodontics [1]. It promotes the idea of bioactive materials, these are materials that are durable in contact with tissues and have the ability to produce changes at the interface with them, producing their regeneration. In other words, the focus has been on materials that promote tissue regeneration rather than tissue healing [2].
68 Evaluation of the Effectiveness of Collagen Membrane in the Management of Oro-Antral Fistula/Communication - A Clinical Study , Anuj Agarwal1, Akshi Choudhary2*
Background: The opening adjoining maxillary sinus with the oral cavity is termed as Oroantral Communication (OAC) which when left untreated leads to oroantral fistula or maxillary sinusitis. Surgical closure within 48 hours is recommended for OAC to circumvent complications like sinus infections. The current study is designed to evaluate collagen membranes for the treatment of OACs which was reported as a safe and easy procedure. Method: The study was conducted with the patients who needed the management for Oroantral Fistula/Oroantral Communication (OAF/OAC) which developed following the posterior maxillary tooth removal. To cover OAF/OAC with a collagen membrane, Bio-Gide (GTR/GBR Collagen Membrane) was inserted in the socket. The particular membranes were then attached using sutures to the adjoining gingiva, and medication like Amoxicillin 500 mg, Metronidazole, nasal decongestant drops and steam inhalation were prescribed for one week to each patient. After day 7, sutures were removed. Patients were checked following the first, third, six weeks and third month. Data were statistically analyzed and an Independent T-test was performed. Results: All the patients accepted Bio-Gide (GTR/GBR Collagen Membrane) perfectly, soft tissue was recovered completely without any problem. Soft tissue was completely epithelialized in the defective area for all the samples. No relapse was reported in any of the patients following a 3- month follow-up. Conclusion: Bio-Gide (GTR/GBR Collagen Membrane) technique is simple and effective for treating OACs with a diameter of 5 mm or less and with negligible complication.
69 Locating Cephalometric Landmarks with Multi-Phase Deep Learning , Soh Nishimoto1*, Kenichiro Kawai1 , Toshihiro Fujiwara1 , Hisako Ishise1 , Masao Kakibuchi1
Cephalometric analysis has long been one of the most helpful approaches in evaluating cranio-maxillo-facial skeletal profile. To perform this, locating anatomical landmarks on an X-ray image is a crucial step, demanding time and expertise. An automated cephalogram analyzer, if developed, will be a great help for practitioners. Artificial intelligence, including machine learning is emerging these days. Deep learning is one of the most developing techniques in data science field. The authors attempted to enhance the accuracy of an automated landmark predicting system utilizing multi-phase deep learning and voting. To guarantee objectivity, an open-to-the-public dataset, cephalometric images accompanied with coordinate values of 19 landmarks, were used. A regressional system was developed, consisted with convolutional neural networks of three phases. First phase network was to determine approximate position of each landmark, inputting whole area of compressed original images. Five secondary networks were to narrow down the area, based on the first phase prediction. Third phase networks were trained by small areas around respective landmarks, with original resolution. Third phase prediction with voting was done inputting 81 shifted areas. Successful detection rates improved as the phase advances. Voting in third phase improved successful detection rate. In comparison with previously reported benchmarks, using the same dataset, proposed system marked better results. Within the physical limitation of memory and computation, multi-phase deep learning may be a solution to deal with large images.
70 Epidemiological Study of Periodontal Changes in Children with Malocclusions from Oltenia Region, Romania , Mahmoud Katta1, Stelian-Mihai-Sever Petrescu2, Felicia Ileana Mărășescu2, Mihaela Jana Țuculină3*, Liliana Eugenia Cuțui4, Ruxandra Voinea-Georgescu5, Horia Mocanu5, Cristian Niky Cumpătă5, Andreea Gabriela Nicola6, Ionela Teodora Dascălu2
Objective: The aim of this study was to determine the prevalence of periodontal changes in children with malocclusions from Olt and Gorj Counties, Romania. Materials and Method: In this research direction, we took into account: gender (male and female), the place of origin (rural and urban), the classes of maloccusions (according to Angle’s classification) and the existence or not of fixed orthodontic appliances. The study included a number of 4508 children, aged between 6 and 14 years. The data were collected from December 2019 to February 2020, based on the project „Educație pentru sănătate orală. Cercetări privind anomaliile dento-maxilare și leziunile odonto-parodontale la școlarii din Oltenia”, in which several institutions were involved. In order to perform complex statistical tests (Z-test for proportions, Chi-squared test), commands from the XLSTAT module were used. The study was interrupted before it was completed due to the COVID-19 pandemic outbreak. Results: We noted that there is a highly significant difference (p
71 Machine Learning-Based Noise Reduction for Craniofacial Bone Segmentation in CT Images, Soh Nishimoto1*, Takuya Saito1, Hisako Ishise1, Toshihiro Fujiwara1, Kenichiro Kawai1, Maso Kakibuchi1
Objective: When high X-ray absorption rate materials such as metal prosthetics are in the field of CT scan, noise called metal artifacts might appear. In reconstructing a three-dimensional bone model from X-ray CT images, the metal artifacts remain. Often, the image of the scanning bed also remains. A machine learning-based system to reduce noises in the craniofacial CT images was constructed. Methods: DICOM images of CT archives of patients with head and neck tumors were used. The metal artifacts and beds were removed from the threshold segmented images to obtain the target bony images. U-nets, respectively with the function loss of mean squared error, Dice and Jaccard, were trained by the datasets consisting of 5671 DICOM images and corresponding target images. DICOM images of 2000 validation datasets were given to the trained models and predicted images were obtained. Results: The use of mean squared errors presented superiority to Dice or Jaccard loss. The mean prediction error pixels were 14.43, 778.57, and 757.60 respectively per 512 x 512 pixeled image. Conclusion: Automatic CT image noise reduction system was constructed. Dedicated to the delineation of craniofacial bones, the presented study showed high prediction accuracy. The “correctness” of the predictions made by this system may not be guaranteed, but the results were generally satisfactory.
72 There was a Time When Board Certification in Pediatric Dentistry Meant Something, John E Nathan1*
As one reflects on their time on this planet, it’s become apparent that change is inevitable and conceptualization of what was once thought definitive carries new meaning and interpretation. In the political world, while we continually witness diversion and disagreement amongst our elected representatives, we nevertheless once held them in high respect for their competence, commitment to serve and intellect. Today, general discontent and distrust let alone blatant hatred, prevail predicated upon human bias and disrespect for fundamental beliefs in what is fair, ethical, the rule of law and in the best interest of all. In the field of pediatric dentistry, pursuit of excellence existed by virtue of what constituted board certification; it exemplified the demonstration of what constituted the highest level of knowledge, skill and commitment to enhanced learning. Those achieving Diplomate status, having submitted to the most arduous of testing were recognized as the “best of the best “in the field. Society however evolves and finds need to update and re-examine its values and priorities. In earlier days, the fact that few pursued this level of recognition, (approximately 15%) for reasons related to excessive cost and willingness to undergo such rigorous scrutiny, contributed to the prestige of achieving board certification. These numbers were for the most part consistent across all specialty disciplines. The standards for what constituted expectations for board certification remained at this level until the arrival of the millennium. Emphasis appears to have largely shifted from setting Diplomate status from the pursuit of excellence to one of moderate decree. Defining a level for which a high percentage of its membership could qualify for having achieved a desirable level of proficiency became the mission of the post-millennial Board.