This study explores the downregulation of Dual Specificity Phosphatase-1 (DUSP-1) expression in oral cancer progression during the pandemic and post-pandemic situations.

Aim: To compare the surface microhardness, compressive strength, and antimicrobial activity of white Portland nanoparticle and microparticle Peruvian cement, mineral trioxide aggregate (MTA), and neomineral trioxide aggregate (NeoMTA) at 24 hours and 28 days. Materials and methods: Twenty specimens were prepared for each group of cement microparticulated powder (PCm), nanoparticulated cement (PCn), MTA, and NeoMTA to be evaluated at two different times, 24 hours and 28 days for the surface microhardness test and compressive strength. For the antimicrobial activity tests, another 20 specimens were prepared for each group of cement where they were subdivided into two subgroups according to the different periods at 24 hours and 48 hours. For the surface microhardness and compressive strength, the specimens, and the cement groups were mixed according to the manufacturer's instructions and transferred to a cylindrical polyethylene mold of 6-mm diameter and 4-mm height. The compressive strength test was conducted using a universal testing machine. Moreover, the agar diffusion technique was to evaluate the antibacterial and antifungal activity of the American Type Culture Collection (ATCC) Enterococcus faecalis and Candida albicans. Finally, the data were statistically analyzed. Results: The highest microhardness values for the 24-hour subgroup were recorded for NeoMTA cement (16.99 ± 2.02), followed by MTA, PCn, and PCm, respectively. As for the 28-day subgroup, PCn cement (41.64 ± 3.20) presented the highest microhardness, followed by NeoMTA, PCm, and MTA, respectively, with statistically significant differences among them. The compressive strength of both subgroups 24 hours and 28 days exhibited the highest mean for PCn (41.3 ± 4.29, 65.74 ± 3.06), followed by PCm, NeoMTA, and the lowest value for MTA cement. Finally, for the antimicrobial activity, the highest mean for the 24-hours and 48-hours subgroup was recorded for NeoMTA cement (17.6 ± 1.26, 17.8 ± 1.44), followed by PCn, PCm, and the lowest value for MTA, with significant differences between them. Clinical significance: It is highly recommended, Portland cement (PC) as a viable substitute since it has very similar components and properties, but at a lower cost. Conclusion: Regardless of the evaluation time, PCn produced higher surface microhardness and compressive strength; however, NeoMTA showed higher antimicrobial activity.

Aim: The aim of this prospective study is to evaluate the treatment outcomes and patient satisfaction following the use of fixed immediately loaded corticobasal implant-supported prostheses. Materials and methods: One hundred and seventy-four corticobasal implants (basal cortical screw, BCS implant design) were inserted in 20 consecutive patients with compromised ridge support. Implant survival and success were assessed using the James–Misch implant health quality scale and the Albrektsson criteria for implant success. The peri-implant health was evaluated at 1 week and 3, 6, 9, 12, and 18 months postoperatively. Moreover, the radiographic and prosthetic parameters and patient satisfaction were assessed. Results: The implants showed optimum implant health and a 100% survival rate with none (0%) of the implants failing, mobile, lost, or fractured. Using Wilcoxon signed-rank test, significant decreases in both the modified gingival indexes and the probable pocket depth (PPD) and slight significant increases in the plaque index (PI) at 3, 9, 12, and 18 months and a nonsignificant increase at 6-month follow-up were reported with a range of 0–1. The calculus index (CI) was zero at all follow-up visits. Radiographic evaluations revealed increases in the bone-to-implant contact. Evaluation of the prostheses showed some treatable complications, and all the patients were satisfied. Conclusion: The use of corticobasal implant-supported prosthesis meets the patient's demand for an immediate, fixed treatment modality, with high survival and success rates, optimum peri-implant soft tissue health, and high reported satisfaction. Clinical significance: Corticobasal implants can improve the patient's esthetic, phonetic, mastication, and quality of life with the advantage of eliminating the need of bone grafting procedures.

Aim: This study aimed to evaluate the spatial location of the second mesiobuccal canal (MB2) of maxillary molars (MMs), using cone-beam computed tomography (CBCT), in a Brazilian subpopulation. Materials and methods: The CBCT examination of 250 patients performed on the Eagle 3D device was analyzed, totaling 787 MMs. Using the Radiant Dicom Viewer software, measurements were made of the distances, in millimeters (mm), between the first mesiobuccal canal (MB1), MB2, and palatal (P) canal inputs, from the axial sections. The Image J software evaluated the angle formed by the lines. The data obtained were analyzed statistically by Fisher's exact and Chi-square tests with a significance of 5%. Results: The prevalence of MB2 canals observed was 76.44 and 41.73% in the first and second molars (1MMs and 2MMs), respectively (p < 0.05). The average of the distances and angles performed, for the location of the MB2 canals of the analyzed teeth, were MB1-P = 5.83 mm, MB1-MB2 = 2.31 mm, and MB2 for the intersection of the connecting distance from MB2-T = 0.90 mm. The average angle formed between the MB1-P and MB1-MB2 distances was 25.89° and 19.68° for the 1MMs and 2MMs, respectively. It was also observed that 91.4 and 75.4% of the maxillary 1MMs and 2MMs, respectively, presented the MB2 canals mesially located at the line connecting the MB1-P canals (p < 0.0001). Conclusion: The MB2 canals were located mesially to the MB1 canal with an average distance of 2 mm between the canals. Clinical significance: The anatomical knowledge of the spatial location of the MB2 canal in different ethnicities is important for the planning and execution of endodontic treatment.

Aim: The aim of the present study is to evaluate the probiotic effect of Lactobacillus acidophilus and Lactobacillus rhamnosus on clinical isolates of Mutans Streptococci (MS) and antibiotic susceptibility of these strains to commonly used antibiotics in dentistry. Materials and methods: Plaque samples from permanent first molars were collected and transferred aseptically onto Mitis–Salivarius agar and incubated at 37°C for 24 hours in the presence of 5–10% CO₂. Mutans streptococci colonies were identified biochemically using Hi-Strep identification kit. The inhibitory activity of the clinical strains of MS on Lactobacilli was investigated using agar-overlay interference technique. Positive inhibition was appreciated as a clear zone around the Lactobacilli. Disk diffusion assay was done as described by CLSI M100-S25 for antibiotic susceptibility. The zone of growth inhibition caused by Lactobacilli and antibiotics on MS clinical strains was measured directly using a vernier caliper. Statistical analysis was done using independent t-test. Results: Mutans streptococci exhibited positive inhibition with both the probiotic strains and L. acidophilus showed more zones of inhibition than L. rhamnosus. Antibiotic susceptibility of clinical strains of MS showed sensitivity to penicillin and vancomycin, however, tetracycline and erythromycin showed very few resistant strains. The highest zone of inhibition was shown by cephalothin followed by penicillin, tetracycline, ciprofloxacin, erythromycin, and vancomycin. Conclusion: L. rhamnosus and L. acidophilus have strong inhibitory effects on clinical strains of MS. Lactobacillus acidophilus showed a higher zone of inhibition. All the clinical strains of MS were sensitive to penicillin and vancomycin. The highest zone of inhibition was shown by cephalothin. Clinical significance: Dental caries remains silent epidemic and increasing antibiotic resistance is another major challenge that threatens the world. Newer methods such as whole-bacteria replacement therapy using probiotics for decreasing harmful oral pathogens and reducing the intake of antibiotics must be explored. More researches to promote use of probiotics should be initiated due to its possible preventive and health maintenance benefits providing an end to new cavities and antibiotic resistance.

Aim: This study was conducted to comparatively assess the retention and vertical marginal fit of cobalt–chromium copings fabricated by the conventional casting technique, 3D-printed resin pattern, and with direct metal laser sintering (DMLS) technique. Materials and methods: Out of the total 60 test samples, 20 copings were obtained from inlay-casting wax and 20 from casting of 3D-printed resin patterns. In total, 20 copings were obtained from the laser sintering technique. All 60 test samples were then cemented serially on the prepared maxillary-extracted premolars and were evaluated for vertical marginal gap in 8 pre-established reference areas. Retention was evaluated using a universal testing machine. Results: Results obtained for both marginal gap and retention were statistically analyzed, and the values fall within the clinically acceptable range. The DMLS technique proved precedence over the other two techniques used, as it exhibited maximum retention and marginal accuracy, which is an area of prime concern. Conclusion: The results from this study encourage further research with different pattern-forming materials and techniques and the need to identify the factors that facilitate better marginal fit and retention of cast restorations. Clinical significance: This study has myriad of applications in clinical dentistry mainly in decision-making for casting procedure to provide better retention and marginal accuracy for fabrication of Co–Cr crowns. It also aims to aid the clinician to minimize errors by using different techniques for fabrication of wax pattern as well as the coping, keeping abreast with the recent technology to evaluate the accuracy of 3D-printed resin pattern over conventional wax pattern.

Aim: To evaluate the role of the addition of different concentrations of sodium chloride salt to conventional intracanal irrigants to vary their osmotic values and thereby compare their antibacterial efficacy. Materials and methods: In an active attachment biofilm model, Enterococcus faecalis (ATCC 29212) biofilms were grown. Sodium chloride salts were added to 100 mL of distilled water to make 6M (hyperosmotic), 0.5M, and 0.25M (hypoosmotic) sodium chloride solutions, respectively. The experimental groups were divided into three groups: Group I: 5.25% sodium hypochlorite, group II: 2% chlorhexidine, and group III: 2% povidone iodine, and four subgroups within these three groups, such as subgroup A (without salt solution), subgroup B (with 6M of hyperosmotic salt solution), subgroup C (with 0.5M of hypoosmotic salt solution), and subgroup D (with 0.25M of hypoosmotic salt solution), respectively. Biofilms were treated with all the subgroups for a contact time of 15 min. A crystal violet assay was done to estimate the bacterial cell biomass. Results: The results revealed that subgroups IIIB, IB, and IID, ID had a statistical reduction in bacterial biomass at p < 0.05. There were no significant differences between subgroups IC, IIC, and IIIC and subgroups IA, IIA, and IIIA. Conclusion: The antibacterial efficacy of all three irrigants was significantly affected by varying the osmolarities. Clinical significance: The results prove that the hyperosmotic and hypoosmotic salt solutions, along with irrigants, have enhanced antibacterial efficacy on E. faecalis biofilm due to its ability to vary the turgor pressure of cell wall, as well as the inherent properties of the irrigants such as hypochlorous acid formation, ionic interaction, and free radical interactions.

Aim: The goal of this study was to determine the frequency of early primary tooth loss among school children in and around Melmaruvathur, Tamil Nadu, India. Materials and methods: A cross-sectional study involving all the children aged between 5 and 9 years in and around Melmaruvathur, Tamil Nadu, India, from January 2022 to July 2022 was conducted. A total of 20 government schools were approached for participation in the study, study population consisted of 800 government school children (358 boys and 442 girls). All clinical assessments were done in the natural light by an experienced examiner. Age and missing teeth were among the data gathered. Results: The findings revealed that 20.8% of the sample had lost their primary teeth before the age of 6 (p > 0.05), although no gender differences were seen, males (12.6%) were more commonly affected than females (8.2%). The mandibular arch (61.8%) was more commonly affected than the maxillary arch (38.2%). In accordance with the frequency of early loss of teeth relative to tooth type, the molars (98.2%) were the most commonly prematurely lost teeth followed by the incisors (1.5%) and the cuspids (0.3%). The left lower primary first molars (42.3%) were the most often missing teeth, and the frequency was highest in 8-year-old children (38.9%). Conclusion: It was shown that lower primary molars were the most often missing teeth in the current investigation, and that early loss was highly prevalent. Clinical significance: Early loss of primary teeth leads to lots of malocclusion problems mainly arch length discrepancies are seen. Early detection and management of the space problems associated with the early loss of primary teeth would help in reducing malocclusion problems.

Aim: This study aimed to compare modified ridge splitting (RS) and distraction osteogenesis (DO) for horizontal ridge expansion clinically (bone width, pain, and soft tissue healing) and radiographically (bone width). Material and methods: This randomized clinical trial was conducted on fourteen patients who had a partial edentulous narrow mandibular posterior alveolar ridge (not less than 4-mm width and 12-mm height). All patients were divided randomly into two equal groups: Group I was treated with a modified bone-splitting technique, and group II was treated with DO technique by the fabricated device as AlveoWider®, and without any graft material for both groups. All patients were followed up clinically to evaluate the increase of bone width at preoperative measurement (T0) and 6 months postoperative (T6), and radiographically by cone-beam computed tomography (CBCT) at T0, 3 months postoperative (T3), and T6. Descriptive and bivariate statistics were computed using the SPSS version (SPSS, IBM Inc., Chicago, IL, USA), and p ≤ 0.05 was considered an indicator of statistical significance. Results: All patients were female. Patients’ ages ranged from 18 to 45 years, with a mean age of 32.07 ± 5.87 years. Radiographically, there is no significant statistical difference in comparing between two groups for the creation of a horizontal alveolar bone; however, there was a highly significant statistical difference (p < 0.001) in each group between different interval periods (T0, T3, and T6) with mean start 5.27 ± 0.53, and 5.19 ± 0.72 at T0 reaching to 7.60 ± 0.89 and 7.09 ± 0.96 at T3, and slightly decreases to 7.52 ± 0.79 and 7.02 ± 0.79 in T6 with radiographic evaluation, and it represented clinically in each group with mean 3.57 ± 0.313 and 4.0 ± 0.58 at T0 increase to 6.55 ± 0.395 and 6.52 ± 0.45 at T6 for both groups, respectively. There is a statistically significant difference in soft tissue healing with the average mean of 4.57 ± 0.24 and 3.57 ± 0.509 and pain with an average mean of 1.66 ± 0.22 and 4.74 ± 0.55 with p = 0.001 and p < 0.001 when comparing between both groups, respectively, that is, p = 0.001 is considered to be statistically significant. Conclusion: Both techniques seem to be useful as augmentation techniques for dental implant placement in a narrow alveolar ridge. Techniques are sensitive and need good experience. The modified splitting technique has fewer complications, less pain, and better soft tissue healing when compared with the DO technique. Clinical significance: Both techniques are alternative methods for the treatment of the atrophic alveolar ridge with uneventful healing except for minor complications that do not interfere with dental implant placement.

Aim: The aim of this study was to assess and compare the pain during infiltration by a modified two-stage local anesthetic infiltration technique under topical anesthesia (TA). Materials and methods: In this cross-over double-blind study, 30 volunteers participated, where two groups were given single-stage infiltration and the other two had two-stage infiltrations. Depending upon the infiltration technique (one- or two-stage) and the use of TA, the patients were randomly divided into four groups. Local anesthesia (LA) was administered by infiltration into the mucobuccal fold of the maxillary central incisor, and the pain perceived during the infiltration in each group was recorded. The volunteers were recalled after 24 hours to assess the tenderness at the injection site. The volunteers were recalled 2 weeks after infiltration for the subsequent groups to assess the pain for this cross-over study. Results: A statistically significant difference was observed in the pain perceived when TA was used and when the infiltration was done in two stages. Regarding the pain at the site of injection after 24 hours, no significant difference was observed among the volunteers. Conclusion: Topical anesthesia was effective in reducing the pain of injection when compared to placebo. The pain of injection is further reduced with a two-stage infiltration technique after TA application. Clinical significance: Topical anesthesia can be used routinely before infiltration, and LA infiltration injections are less painful if administered in two stages.

Aim: To evaluate voids and sealing ability using a disposable syringe, endodontic pressure syringe, and Skinni syringe with NaviTip in primary molars with cone-beam computed tomography (CBCT). Materials and methods: The 15 extracted primary mandibular molars with at least one root ≥8 mm length and an equal number of mesiobuccal canals were divided into three groups, i.e., obturation using a disposable syringe, an endodontic pressure syringe, and a Skinni syringe with NaviTip, respectively. The evaluation of the apical seal was determined as the measurement between the apical end of the filling material and the radiographic apex. The quality of the filling was determined by the size, number, type, and location of voids present. Statistical analysis was done using the Chi-square test and post-hoc test. Results: The endodontic pressure syringe score was the highest and statistically significant in obtaining apical seal (p = 0.013). Disposable syringe shows highest size of voids (p = 0.01) in which type I-voids (p = 0.04) and type S-voids (p = 0.07) were statistically significant. The location of voids was maximum at the middle third of the root (p = 0.016). Conclusion: The endodontic pressure syringe provided the best root canal obturation of primary molars, whereas the disposable syringe was least effective with the maximum number and size of voids. Clinical significance: Comparing the voids and sealing abilities of different obturating techniques with CBCT would help the pediatric practitioners for better outcome of obturation in primary teeth.

Aim: The purpose of this study was to evaluate the effect of zirconia surface treatment with CO₂ and Nd:YAG laser on shear bond strength (SBS) between the zirconia framework and porcelain veneering. Materials and methods: In this in vitro study, zirconia blocks were converted to 50 cubes and were divided randomly into 5 groups. After sintering (S), porcelain was applied in the control group. The surface treatment of the second to fifth groups included CO₂ laser + (S), (S + CO₂), Nd:YAG laser + (S), and (S + Nd), respectively. The SBS test was done, and data were analyzed by SPSS16 software. One sample was randomly chosen from each group and the type of failure was examined under scanning electron microscope (SEM). To compare the pairs of means, the least significant difference test was used and the determined significance level was 5% (p < 0.05). Results: The SBS of S + Nd group was significantly higher than the other ones, except for S + CO₂ group. The least amount of SBS belonged to CO₂ + S and the highest to S + Nd group. There were no significant differences between the other groups. Conclusion: The bond strength of veneering porcelain to zirconia can be altered by surface treatments. It can also be affected by the type and sequence of laser and sintering application. The effect of Nd:YAG laser on the surface of zirconia, in order to create roughness to increase SBS, is better than that of CO₂ laser. Clinical significance: Surface treatment of zirconia by certain types of lasers reduces the chipping of the ceramic veneer and increases the success rate of all-ceramic restorations.

Aim: The aim of this study was to determine the current level of knowledge and understanding about dental trauma and its management in children among dental practitioners. Materials and methods: The study was conducted after obtaining the ethical clearance from the Institutional Review Board (IRB). A structured questionnaire was prepared, which comprised 20 questions and was validated by dental trauma experts. The questionnaire, which covers all aspects of traumatic dental injuries (TDIs) in both primary and permanent dentition, was distributed online to 850 dental practitioners. The questionnaire was open from January 2022 to April 2022, with a 3-month time frame to complete it. The responses were collected and statistical analysis was done using SPSS software. Results: The mean age of the participants were 22–30 years. Furthermore, 515 participants were females and 263 were males. In this survey among 784 responses, 449 dentists were trained in dental trauma and 618 participants had personal experience in managing dental trauma. All other questions about knowledge and awareness of dental trauma management received fewer correct answers. Conclusion: According to the present study, dental practitioners have only mild-to-moderate knowledge and awareness about dental trauma. From the latest the International Association for Dental Traumatology guidelines, dentists need to consistently update their knowledge through dental trauma conferences, workshops, trainings, and symposiums. Clinical significance: This study informs us about the existing level of dental knowledge about dental trauma, which is significantly low. This will considerably boost dental practitioners’ interest in TDIs. As a result, practitioners’ expertise will grow, allowing them to better care for their patients.

Background: Fine-needle aspiration cytology (FNAC) of the salivary gland is crucial in the identification of salivary gland lesions, but the variation in morphological pattern and the overlap of morphological traits can result in erroneous interpretation and affect treatment, making FNAC of the salivary gland problematic. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was created to address these problems. Objectives: To ascertain whether the FNAC method using MSRSGC was reliable in predicting the risk of malignancy (ROM) in each category of salivary gland lesions. Materials and methods: The databases PubMed-MEDLINE, Web of Science, Cochrane, Scopus, and Google Scholar were all searched using pertinent keywords, reference searches, and citation searches. A fixed effect model was used to determine the pooled proportion with a 95% confidence interval (CI). All statistical analyses were performed using Meta Disc and R version 4.0.2 (R Foundation for Statistical Computing). Results: After reviewing the submissions’ abstracts and titles, 58 documents that satisfied the necessary inclusion and exclusion criteria were ultimately selected. A total of 19,652 samples from 19,408 individuals was analyzed, out of which 9,958 samples were available for histopathological follow-up. The pooled ROM for category I was 10%, category II was 5%, category III was 28%, category IV A was 2%, Category IV B was 34%, category V was 91%, and category VI was 99%. Conclusion: Milan System for Reporting Salivary Gland Cytopathology is useful for risk stratification and quality control, confirming its validity and diagnostic utility. Widespread use of MSRSGC would improve the accuracy of salivary gland cytology and lead to better patient care and improved treatment strategies. The results of this study are in consonance with reported values as per MSRSGC except for category V. Clinical significance: The MSRSGC which was first reported in 2018 is a very useful tool for proper stratification of ROM in salivary gland FNAC. This study allowed us to validate the ROM values in different categories as reported in MSRSGC.

Objective: Dentin hypersensitivity (DH) is characterized by a short, sharp pain in response to a thermal or tactile stimulus. The application of desensitizing agents such as GLUMA and laser is a non-invasive and safe approach to decrease sensitivity. The evidence for the efficacy of GLUMA desensitizer compared to laser desensitization in patients with DH was evaluated for 6 months. Design: In March 2022, an electronic search of PubMed, Scopus, and Web of Science databases was conducted. Articles published in English that compared GLUMA and laser in the treatment of DH with a follow-up of 6 months or more were included. Randomized, non-randomized controlled trials, and clinical trials were included. Risk of bias assessment tools developed by the Cochrane collaboration ROB 2 and ROBINS-I were used to assess the quality of studies. The GRADE assessment method was used to assess the certainty of evidence. Results: About 36 studies were identified in the search results. After applying the predefined eligibility criteria, eight studies with 205 participants and 894 sites were included in this review. Of the eight studies, four were judged to be at high risk of bias, three had some concerns, and one had a serious risk of bias. The certainty of the evidence was graded as low. Conclusion: Based on limited evidence, GLUMA and laser appear to be equally effective in providing relief from DH. GLUMA showed an immediate effect and provided pain relief. Over the course of a week, laser showed long-term stable results. GLUMA is effective in providing immediate relief.

Aim: The aim of this systematic review is to compare the bonding performance of indirect restoration with the reinforced immediate dentin sealing (IDS) method as opposed to the conventional IDS method. Materials and methods: A literature search was conducted in PubMed, Cochrane, and EBSCOHost up to January 31st 2022, accompanied by a hand search in Google Scholar. Inclusion criteria involved studies comparing conventional IDS and reinforced IDS protocol and evaluating various parameters influencing the bonding performance, such as type of indirect restoration, etching protocol, cavity design, tooth surface preparation, method of oral cavity simulation, and processing after luting. The quality of six included studies was appraised using CRIS guidelines. Results: A total of 29 publications was identified, and 6 of them fulfilled the inclusion criteria. All of the included studies were in vitro studies. The predetermined data were independently extracted and evaluated by four reviewers. It was observed that most of the studies showed an improvement in bond strength with reinforced IDS when compared with conventional IDS. Also, etch-and-rinse and 2-step self-etch adhesive protocols have shown better bonding performance than universal adhesive systems. Conclusion: Reinforced IDS has similar or better bond strength to that of conventional IDS strategies. The need for prospective studies is highlighted. The future clinical studies for immediate dentin sealing ought to be reported in a uniform and methodological way. Clinical significance: Application of an additional layer of low-viscosity resin composite provides a thicker adhesive layer, prevents re-exposure of dentin during the final restoration, and allows a smoother preparation in lesser clinical chair time and eliminates any possible undercuts. Thus, reinforced IDS has shown to result in better preservation of the dentinal seal than IDS technique.