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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.