Saline nasal irrigation (SNI) is a clinically established treatment that has been used to manage upper respiratory infections and allergies; there is also some indication that it may be effective in the setting of coronavirus disease-2019 (COVID-19). The possible advantages of SNI include the following benefits due to the well-known antiviral impact of sodium chloride (NaCl) and the mechanical cleansing effect arising from the irrigation method. First, there will most likely be a decrease in COVID-19 infection rates; second, illness severity will be lowered; and third, community transmission will be mitigated. Despite the need for more concentrated research into these aspects, public health organizations should emphasize alternate infection mitigation measures such as SNI in light of the ongoing COVID-19 problem, low global vaccine supply, and the rapid introduction of SARS-CoV-2 variants.

Aim: The aim of the study was to compare the ability of three endodontic sealers, Endofill (END), AH Plus (AHP), and Sealer Plus BC (SPB), to penetrate dentinal tubules. Materials and methods: Forty-five human teeth, single-rooted and previously instrumented mandibular premolars, were randomly divided into three experimental groups (n = 15): END (n = 15), AHP (n = 15), and SPB (n = 15). After obturation, dental sections were performed horizontally, at 2 and 5 mm from the root apex. The samples were analyzed by scanning electron microscopy associated with cathodoluminescence. Percentage penetration (PP%) and maximum penetration depth (MPD) of the sealers were evaluated by the Kruskal-Wallis and Mann-Whitney tests, for general and paired data, respectively. The Wilcoxon test was applied to analyze the differences between the 5 and 2 mm distances. A 5% significance level was adopted. Results: As for PP%, AHP and SPB were similar (p = 0.127) and presented higher values than END (AHP, p = 0.024 and SPB, p <0.001); with regard to MPD, AHP and SPB did not differ either (p = 0.450), but were higher than END (p <0.001); in both analyses, penetration was greater at 5 mm than at 2 mm (p <0.001). Conclusion: SPB showed satisfactory performance in penetrating dentinal tubules, being similar to AHP, and superior to END. Clinical significance: Greater penetration of sealer into the dentinal tubules may increase the chance of successful endodontic treatment.

Aim: To assess dentin–post bond strength and mode of failure through tensile strength testing of two endodontic post systems: CAD/CAM custom-milled fiber posts vs Splendor SAP. Materials and methods: Thirty extracted single-rooted mandibular premolars were sectioned 2 mm coronal to the cementoenamel junction. Root length was standardized at 15 mm, and the root canals were instrumented with #20 K-files followed by 30/0.03 and 30/0.05 ProDesign Logic rotary files, under irrigation with 2.5% NaOCl, and then submitted to final irrigation with 17% EDTA. Canals were filled with gutta-percha and AH PLUS sealer. After 24 hours, the teeth were prepared for post placement to a depth of 10 mm and randomly allocated into two experimental groups (n = 15): CAD/CAM (CC) and Splendor SAP (SS). All posts were cemented with RelyX U200 dual-cure self-adhesive resin cement. The roots were embedded in acrylic resin, and the specimens were stored for 7 days in moist heat (37°C). Tensile strength testing until failure was then performed in a universal testing machine using a crosshead speed of 0.5 mm/minute. The final failure load was tabulated for statistical analysis, and the G test was used to compare the failure modes observed under light microscopy (5× magnification). Results: There was no significant difference between groups regarding tensile bond strength to root dentin (p = 0.325). Conversely, failure mode differed significantly between groups (p = 0.037). Conclusion: The tensile bond strength observed for the CAD/CAM and Splendor SAP post systems was similar. Adhesive failure was predominant in both groups; however, the CAD/CAM custom-milled fiber posts failed predominantly at the dentin–resin cement interface, whereas Splendor SAP posts failed mostly at the post–resin cement interface. Clinical significance: A strong post–dentin bond is a key to the success of dental restorations and prosthetic rehabilitation. In teeth with severe coronal decay and wide canals, both of the tested systems would be able to achieve good cervical fit.

Aim: The aim of the study was to assess the symptoms associated with temporomandibular disorders (TMD) and bruxism among elderly population in Ranchi, India. Materials and methods: A cross-sectional study was done on 600 elderly subjects; data regarding the signs and symptoms associated with temporomandibular disorder and bruxism were recorded using both structured questionnaire and clinical examination. Spearman correlation analysis was done to find the association between TMD and bruxism. Results: Out of 600 subjects, 49% were males and 51% were females. The overall prevalence of TMD-related symptoms like temporomandibular joint (TMJ) pain, difficulty in jaw opening, TMJ sounds, and bruxism were 10.5, 11.2, 14, and 17% among elderly subjects. TMD symptoms and bruxism were relatively more commonly seen among females when compared to males. According to logistic regression (significantly correlated independent variables, i.e., TMD symptoms among analyzed variables), the dependent variable like bruxism had highest odds ratio, i.e., 8 for 60–70 years age-group and 15.1 for 70–80 year age-group. Conclusion: There was a lesser prevalence of symptoms related to TMD and bruxism among the study population, and bruxism had the highest odds ratio in TMD between the analyzed variables. Clinical significance: Human aging contributes too many oral problems, while resolving these, the felt needs of the population are sometimes ignored which adds up to the growing list of issues. Studies have shown inconclusive evidence regarding the prevalence of symptoms related to TMD and bruxism as these are known to trouble elderly populations.

Aim: To clinically evaluate the nature of precancerous and cancerous lesions associated with tobacco consumption habit and to correlate clinical profile with the histopathological findings of clinically suspected precancerous and cancerous lesions. Materials and methods: These included the examination of patients who visited the outpatient department (OPD) of the institute that includes 1,500 patients who had tobacco chewing habits were classified into the following two groups according to their characteristics. The study group comprised 270 patients, of which 170 gave consent for biopsy and 100 patients who not gave consent were counseled for tobacco cessation. Results: Among 270 patients, the highest number of patients, 146 (54.07%) patients, were found to be smokeless tobacco consumers followed by 65 (24.07%) patients who were smoked tobacco consumers while 59 (21.85%) patients were found to have both the habits. Wide variation was noted in duration and frequency of habit. Most prevalent site was the buccal mucosa affected in 138 (51.11%) patients who consumed both smoked as well as smokeless tobacco. And on clinical examination, 138 (51%) patients had leukoplakia followed by 54 (20%) patients with oral squamous cell carcinoma and 40 (15%) patients with oral submucous fibrosis (OSMF). Other patients were tobacco pouch keratosis 17 (6%), smoker's melanosis 8 (3%), smoker's palate 7 (3%), and erythroplakia 6 (2%). The patients who gave consent (170 patients) were evaluated histopathologically to correlate with clinical findings. Conclusion: Tobacco-related oral lesions are also high, which brings an alarming signal toward the development of cancer. Our contribution as healthcare providers can be made by conducting more oral health education programs and educating the general population about the adverse effects of tobacco. The appropriate clinical assessment and categorization of all these lesions aided us in motivating patients to undergo necessary treatments and also to discontinue their habits in order to prevent deterioration of their conditions. Clinical significance: Set up de-addiction centers in dental colleges and help tobacco users in discontinuing their habits. Interestingly, this study also served as a mirror for those patients who were unaware of the lesions they were giving abode to in their oral cavities.

Aim: To assess immediately loaded parallel conical connection (Nobel Biocare) implants with platform switch design in the maxillary esthetic zone for soft and hard tissue changes. Materials and methods: A total of 20 patients (n = 20) underwent prosthetic replacement of the missing maxillary anterior tooth, with an immediately loaded parallel conical connection implant (Noble Biocare, Sweden) having a platform switch design. The size of the implant was 3.75 mm in width and 13 mm in length for all patients and placement followed a standardized surgical protocol. Postoperatively, acrylic provisionalization was done within 48 hours followed by a definitive zirconia prosthesis in the 3rd month. Clinically and radiographically, the implants were evaluated for hard tissue (bone density, implant stability, crestal bone loss) and soft tissue changes (mucosal thickness—MT, sulcus probing depth—PD, bleeding on probing—BOP, width of keratinized gingiva—KG) at baseline till 36 months with follow-up intervals after loading. Results: All patients showed uneventful healing. The difference in implant stability and density scores was significant (p <0.05*) from baseline to 36 months indicating bone formation and osseointegration of the implant. Bleeding on probing was not observed, and probing depth remained within the acceptable range (≤5 mm) at all time intervals after loading. The marginal bone loss was minimal (≤0.2 mm annually) with the absence of implant mobility and without any peri-implant radiolucency. The thickness of the gingiva (3.47 ± 0.34 mm) and width of keratinized gingiva (2.46 ± 0.39 mm) remained within reasonable limits at the 36th month with acceptable esthetic appearance. Conclusion: In the present study, immediate loading of Nobel parallel conical connection implant in the maxillary anterior region provided adequate primary stability, minimal marginal bone loss, and increased bone density indicating earlier osseointegration. Decreased probing depth, absence of bleeding on probing, and adequate tissue collar at the neck showed better soft tissue emergence in the esthetic zone. The platform switch design demonstrated promising results and therefore can be used as an alternative to the conventional method. Clinical significance: The present study results suggest that parallel conical connection implants (Nobel Biocare) with TiUnite surface, built-in platform switch combined with conical connection interface, parallel walled body, tapered apex, and double threads from tip to platform are all designed to provide high primary stability and support immediate function protocol, hence can be used flexibly in different bone densities.

Aim: The aim of this in vitro study was to evaluate the effect of glass and nylon fiber reinforcement on surface topography of polymethyl methacrylate (PMMA) denture resin after polishing. Materials and methods: Stainless steel dies were used for preparation of specimens and were divided into three groups of 30 specimens each. Group A: Control group, Group B: PMMA reinforced with glass fibers, Group C: PMMA reinforced with nylon fibers. All specimens were finished and polished by a single operator to eliminate any inadvertent bias and ensure a constant pressure when polishing. The surface roughness of all the acrylic samples was measured with the help of profilometer (SURFCOM 130A). Results: Glass-reinforced PMMA showed higher mean surface roughness (0.16817 µm) as compared to unreinforced PMMA (0.10203 µm). Nylon-reinforced PMMA showed lower mean surface roughness (Ra) of 0.09177 µm as compared to unreinforced PMMM (0.10203 µm). Glass-reinforced PMMA showed a higher mean surface roughness (Ra) of 0.16817 µm as compared to nylon PMMA (0.09177 µm). Conclusion: Reinforcement with glass and nylon fibers affects the surface roughness of the PMMA resin, i.e., glass fibers increase the surface roughness of PMMA resin, whereas nylon fibers slightly decrease the surface roughness of PMMA resin. Hence, the use of nylon fiber may be justified to obtain a denture with increased fracture resistance, acceptable esthetic properties, and better denture hygiene and plaque accumulation. Clinical significance: Two important parameters are essential for ensuring the durability of a restorative material, which include surface roughness and color stability. Surface roughness may be the major cause of discomfort for the patient and it may be associated with complications by promoting the deposition of biofilm and microbial growth. The use of nylon fiber increases fracture resistance and provides acceptable esthetic properties and better denture hygiene and plaque accumulation.

Aim: The aim of the present study was to compare and evaluate the efficacy of two minimally invasive methods in the removal of infected carious dentin in primary molars. Materials and methods: Eighty primary molars with class I occlusal caries involving dentin were selected and allocated to either of the two groups using convenient sampling. Group A (n = 40) caries were excavated using BRIX 3000 and in Group B (n = 40) atraumatic restorative treatment (ART) caries were excavated using hand instruments only. In both groups, caries removal efficacy was evaluated clinically using caries detection dye (Sable and Sleek), and the patient's discomfort level was noted using the Wong-Baker faces pain rating scale (WBFPS). Results: The results indicated that BRIX 3000 was effective in the removal of caries from primary molars with a significant difference. While there was no statistically significant difference seen in pain perception on caries excavation using both the methods. Although, a mild discomfort was noted in Group B. Conclusion: Comparing the two minimally invasive techniques, the new chemomechanical solution (BRIX 3000) was an effective method for the removal of caries from primary molars. So, it can be considered an alternative to the conventional caries removal method in treating pediatric dental patients. Clinical significance: BRIX 3000 gel is effective in the removal of caries in children who are anxious and apprehensive as it is a noninvasive method of treatment in the pediatric age group.

Aim: To formulate, design, and chemically characterize a novel denture base resin (DBR) copolymer containing triazine-based antimicrobial comonomer and also to evaluate the double bond conversion (DC) in the copolymer with various concentrations of the comonomer by fourier transform infrared (FTIR) spectroscopy. Materials and methods: The study groups comprise a control group G0 in which the specimens (n = 10) were polymerized without the triazine comonomer and trial groups G10 and G20 where the polymerized specimens (n = 10 each) contained 10 and 20% triazine comonomer, respectively. FTIR was employed to ascertain and evaluate copolymerization (CP) and DC. The obtained DC values were subjected to statistical analysis. Results: A new denture base copolymer containing antimicrobial triazine comonomer was formed with ascertained copolymerization and higher DC than the control group. Twenty percent triazine comonomer in the copolymer exhibited the maximum DC. Conclusion: Incorporation of the antimicrobial comonomer copolymerized with DBR to form a novel denture base copolymer exhibiting high DC. Clinical significance: The novel denture base copolymer may prevent the microbial adhesion on the denture surface thereby preventing denture-induced stomatitis in the edentulous patients. Nonetheless, this novel copolymer may enhance the other necessary properties of the DBR and would ameliorate the living quality of the senile geriatric population with good in vivo serviceability.

Aim: The aim of the current in vitro research was to assess the effect of fluoride-containing mouthwashes on the strength and durability of three different synthetic absorbable suturing materials. Materials and methods: Three types of synthetic absorbable suture materials were employed in this research, and every group comprised 20 suture samples. These include group I: Polyglactin 910, group II: Polyglycolic acid, and group III: Poliglecaprone 25. This research utilized 4-0 gauge sutures. Each example was tied using a square surgeon's knot about elastic rubber tubing. The biology of the oral milieu was replicated in vitro through the use of artificial saliva. The medium that was subjected to test prior to inclusion were 0.2% chlorhexidine gluconate as well as 0.044% sodium fluoride. The tensile strength of the specimen suture materials was subjected to test at a particular time intervals: prior to immersion, the 1st day, the 7th day, as well as the 14th day after immersion. Tensile strength was evaluated using a Universal Ultra Test machine. Results: Post-immersion in 0.2% chlorhexidine gluconate mouthrinse, the mean tensile strength of polyglactin (PLG) 910 sutures was 24.48 ± 0.08 at pre-immersion and 4.36 ± 0.01 on the 14th day. The mean tensile strength of polyglycolic acid (PGA) sutures was 24.04 ± 0.26 at pre-immersion and 2.10 ± 0.02 on the 14th day. The mean tensile strength of Poliglecaprone 25 sutures was 23.82 ± 0.11 at pre-immersion and 1.34 ± 0.08 on the 14th day. Post-immersion in 0.044% sodium fluoride mouthrinse, the mean tensile strength of PLG 910 sutures was 24.18 ± 0.02 at pre-immersion and 5.12 ± 0.21 on the 14th day. The mean tensile strength of PGA sutures was 24.88 ± 0.34 at pre-immersion and 4.58 ± 0.10 on the 14th day. The mean tensile strength of Poliglecaprone 25 sutures was 24.48 ± 0.27 at pre-immersion and 5.08 ± 0.14 on the 14th day. A statistically noteworthy difference was noted amid the three types of sutures at dissimilar time points evaluated with p <0.001. Conclusion: The current research arrived at a conclusion that there is a significant difference between the mean tensile strength and purpose of the medium used for immersion as well as the tenure. Polyglactin suture material exhibited superior strength as compared to PGA and poliglecaprone suture substances following immersion in the investigational media. Clinical significance: Suture materials are employed in the closure of incised flaps, to aid healing by primary intention, along with control of bleeding. In oral as well as periodontal surgery, the right choice of sutures is very important for good healing. Suture choice for the mouth should be influenced by the requirements of the anticipated repair and the surgeon's fondness.

Background: Chronic inflammation and oxidative stress play a vital role in the pathogenesis of various diseases of the oral cavity including periodontal disease. Phytochemicals present in plants with antioxidant (AO) and anti-inflammatory properties could aid as a therapeutic adjunct in the management of these diseases. Aim: To assess the antioxidant and anti-inflammatory effects of aqueous and ethanolic extracts of Moringa oleifera Lam. (MOL) in an in vitro environment. Materials and methods: Aqueous and ethanolic extracts of M. oleifera Lam. were prepared by maceration. Antioxidant activity was assessed by FRAP, hydroxyl radical scavenging activity, and DPPH radical scavenging assay. Anti-inflammatory activity was assessed by Albumin Denaturation Assay. Experiments were repeated thrice, and mean and standard deviation were calculated. Results: Both the test substances exhibited significant antioxidant and anti-inflammatory activity, and aqueous extracts exhibited higher activity than ethanolic extract. Summary and conclusion: The anti-inflammatory and antioxidant activity of M. oleifera Lam. could be further explored for the management of periodontal disease as a local drug delivery system with the extract could be developed.

Aim: This study aims to detect the prevalence of oral manifestations in patients with psychiatric disorders on psychotropic medications. Materials and methods: A total of 46 patients above the age of 18 years who have been diagnosed with psychiatric illness and under psychotropic medications were included in this study. Thorough case history and oral findings were recorded. Patients with already existing systemic illness and other oral manifestations were excluded from this study. Results: Out of 46 patients, 34 patients presented with oral manifestations such as xerostomia, sialorrhea, geographic tongue, candidiasis, and burning mouth syndrome, secondary to the use of psychotropic medications. The oral manifestations were significantly higher in the patients under antipsychotics (80.0%), selective serotonin reuptake inhibitor (66.7%), antiepileptics (55.6%), antidepressants (44.4%), benzodiazepine (44.4%), and tricyclic antidepressants (13.7%). Conclusion: The commonly used psychotropic medications to treat patients with psychiatric illnesses such as selective serotonin reuptake inhibitor, tricyclic antidepressants, antidepressants, and benzodiazepines exhibited several oral manifestations. However, long-term use of these medications seems to cause oral changes. Clinical significance: Awareness among psychiatrists about oral changes associated with the use of psychotropic medication will assist them to make necessary modifications in the prescriptions. Dental practitioners will be able to recognize these changes early in the course of the condition and provide appropriate treatment.

Aim: To perform a 10-year scientometric analysis of the characteristics of the worldwide publication on the toxic effects of fluoride. Materials and methods: A bibliometric study of the worldwide scientific production on the toxic effects of fluoride during the years 2011–2020 was performed. All metadata from the Scopus database were evaluated. These were then exported to SciVal (Elsevier) for analysis of quantity, collaboration, and impact indicators. Results: We found that the “Biological Trace Element Research” was the most productive journal with 22 published manuscripts and that the most productive universities on the systemic toxic effects of fluoride on the body were Shanxi Agricultural University, Guizhou Medical University, and Huazhong University of Science and Technology with 31, 11, and 10 manuscripts, respectively. In addition, it was found that most of the world scientific production on the toxic effects of fluoride was published in Q1 level journals (top 25%). Conclusion: Finally, it was concluded that most of the total production on this topic was published in high-impact Q1 journals, with China being the leading country in terms of number and impact of publications. Finally, there was evidence of collaboration between the United States, China, and India, being the countries that led in co-authorship by country. Clinical significance: This research is of clinical importance as it allows the identification of the most productive institutions, authors, and countries in this field. In this way, strategic alliances can be established to enhance the development of research.

Aim: The aim of this study was to evaluate clinical features that might be related to success rates of autotransplantation of molars with complete root formation. Materials and methods: A group of 60 patients with completely formed third molars autotransplanted to a different molar socket was followed for a medium period of 5 years and 5 months. Extreme care was used in order to preserve the vitality of the periodontal ligament cells. The same technique was applied for all teeth despite different anatomies. Descriptive statistics was performed. The association of the various factors with failures was assessed by using the Fisher's exact test and a p-value of 0.05 was considered as significance threshold. Results: Autotransplantation was found to be a reliable method to replace extracted molar teeth with closed apices. The two major factors that positively influenced the outcomes were fixation with splint and a periodontal probing pocket depth less than 4 mm after the initial healing period. The technique resulted in a suitable well-conserved socket and donor tooth, after the extraction. Conclusion: An accurate case evaluation was critically important in order to identify the risks prior to surgery and to select the right patients for this procedure. Autotransplantation of third molar teeth is a feasible approach to replace compromised mature molars. Proper stabilization of the transplanted tooth is strategical for the success of this procedure. A conservative approach to unerupted wisdom teeth is also recommended. Clinical significance: Dental implants and fixed prostheses have been utilized to replace missing teeth, and orthodontic space closure can be sometimes an effective treatment option. Tooth autotransplantation can be a reliable and less invasive clinical alternative when an appropriate donor site is available.

Objective: To analyze the effects of various fluoride agents on metallic orthodontic materials. Design: PubMed, Google Scholar, and Embase were searched using keyword combinations such as fluoride mouthwash and orthodontic appliance and corrosion, fluoride and fixed appliance, and metal degradation. Results: Of 315 articles, 20 were selected for inclusion in the review. All types of fluoride agents, especially the acidulated form of fluoride, seemed to influence the corrosion of orthodontic metallic appliances. Conclusion: Since most of the studies reported suggest that fluoride ions are capable of causing corrosion of metallic orthodontic appliances, attention should be paid while prescribing fluoride agents for orthodontic patients. The degree of corrosion seems to be directly correlated with the acidity of the medium and the concentration of fluoride ions. Co-Cr brackets are resistant to corrosion by fluoride while stainless steel and Ti brackets are susceptible. Clinical significance: It allows making the right choice while choosing the orthodontic brackets in relation to their susceptibility to corrosion by fluoride ions.

Aim: This review aims to explore the importance of silk hydrogel and its potential in tissue engineering (TE). Background: Tissue engineering is a procedure that incorporates cells into the scaffold materials with suitable growth factors to regenerate injured tissue. For tissue formation in TE, the scaffold material plays a key role. Different forms of silk fibroin (SF), such as films, mats, hydrogels, and sponges, can be easily manufactured when SF is disintegrated into an aqueous solution. High precision procedures such as micropatterning and bioprinting of SF-based scaffolds have been used for enhanced fabrication. Review results: In this narrative review, SF physicochemical and mechanical properties have been presented. We have also discussed SF fabrication techniques like electrospinning, spin coating, freeze-drying, and physiochemical cross-linking. The application of SF-based scaffolds for skeletal, tissue, joint, muscle, epidermal, tissue repair, and tympanic membrane regeneration has also been addressed. Conclusion: SF has excellent mechanical properties, tunability, biodegradability, biocompatibility, and bioresorbability. Clinical significance: Silk hydrogels are an ideal scaffold matrix material that will significantly impact tissue engineering applications, given the rapid scientific advancements in this field.