Aim: This study aims to evaluate the efficacy of calcium phosphate-poly(lactide-co-glycolide) composite graft in the regeneration of intrabony defects in chronic periodontitis patients over a period of 12 months. Materials and methods: A total of 11 systemically healthy chronic periodontitis patients with 22 graftable sites were treated with calcium phosphate cement (CPC) bone graft (control group) and CPC-poly(lactic-co-glycolic acid)(PLGA) composite (test group) after flap reflection and debridement. Clinical parameters such as probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at baseline and 3, 6, 9, and 12 months. Bone probing depth (BPD) and radiographic parameters such as defect depth (DD), changes in alveolar crest level (ALR), defect depth reduction (DDR), and percentage in defect depth reduction (PDDR) were calculated at baseline, and 6 and 12 months. The data were recorded and statistically analyzed. Results: On intragroup comparison, there was a significant improvement in all the parameters over a period of 1 year (clinically and radiographically). However, there was no statistically significant difference between the two groups in any of the parameters though there was a slightly higher bone fill noted in the test group. Conclusion: Even though the CPC-PLGA composite bone graft showed a slight improvement in clinical and radiographic parameters as compared to the CPC graft, it was not statistically significant. Clinical significance: A major drawback of Calcium Phosphate cements as bone grafts is their poor degradability. The PLGA microspheres degrade to expose macropores and interconnected pores in the graft substrate which in turn would promote the ingrowth of osteoblasts. Also, this composite graft is mouldable, and resorbable and has been shown to snugly fit into the defects making them a suitable scaffold material.

Aim: This study aimed to compare the clinical outcomes of a conventional Erich's arch bar vs a modified screw-retained arch bar in maxillomandibular fixation of mandibular fracture. Materials and methods: This parallel-arm randomized control trial included patients from the outpatient clinic with single favorable mandibular fractures that are indicated for closed reduction. They were subjected to maxillomandibular fixation using conventional Erich's arch bars in the control group and modified screw-retained arch bars in the study group. The outcome measures included operating time, glove perforations, postoperative pain, oral hygiene, fixation stability, occlusion, and mucosal coverage. Results: A total of 20 patients (12 males and 8 females) with a 1:1 allocation ratio were included. There was a significant statistical difference regarding operation time and number of glove perforations in favor of group B as p < 0.001, p = 0.007, respectively. There was a significant statistical difference regarding pain after 1 day (p < 0.001), 1 week (p < 0.001) in favor of group B, and at 4 weeks (p = 0.015), and 6 weeks (p = 0.002) in favor of group A. Regarding oral hygiene at 1 week (p = 0.021) and at 6 weeks (p < 0.001), there was a significant statistical difference in favor of group B. Regarding mucosal coverage at 6 weeks, there was a significant statistical difference in favor of group A (p = 0.005). Conclusion: The modified screw-retained arch bar can be considered an alternative to conventional arch bar as it provided less application time and better operator safety. It also showed better patient satisfaction regarding pain and oral hygiene. Clinical significance: Maxillomandibular fixation with the conventional technique was modified to screw-retained arch bar which is less time-consuming and provides better patient and operator satisfaction.

Aim: The aim of the current study was to evaluate the dimensional accuracy of three various interocclusal recording materials. Materials and methods: A total of 90 disc-shaped samples were prepared using polyether paste, wax, and polyvinyl siloxane material with the support of stainless steel die. For the purposes of this investigation, three frequently utilized interocclusal recording materials were chosen, and 30 samples from each material were prepared. Group I: Bite registration using polyether paste; Group II: Bite registration using wax; Group III: Bite registration using polyvinyl siloxane material. No samples were exposed to direct sunlight during storage and were kept at room temperature. Using a 10x universal measuring microscope, each sample disc was examined for the presence of horizontal and vertical lines inscripted in the die. For each of the samples, readings were taken at different time periods of 24, 48, and 72 hours. Results: After 24 hours, the less dimensional changes were found in polyether paste group (0.11 ± 0.07) followed by polyvinyl siloxane material group (0.19 ± 0.04) and wax group (0.25 ± 0.12). After 48 hours, the less dimensional changes were found in polyether paste group (0.34 ± 0.02) followed by polyvinyl siloxane material group (0.42 ± 0.01) and wax group (0.94 ± 0.12). After 72 hours, the least dimensional changes were found in polyether paste group (0.46 ± 0.14) followed by polyvinyl siloxane material group (0.92 ± 0.03) and wax group (1.14 ± 0.09). Conclusion: The present study concluded that both the material and time factors had an impact on dimensional stability. The most dimensionally stable group was the polyether paste group, which was followed by the polyvinyl siloxane and wax material groups. Clinical significance: Interocclusal recording material records the occlusal connection between real or artificial teeth for occlusal rehabilitation planning and for creating removable and fixed dentures. The creation of a clinically acceptable prosthesis is dependent upon the accuracy of the patient's diagnostic or working casts and the interocclusal record.

Aim: The purpose of the present study was to evaluate the impact of various chemical solvents on bond strength of orthodontic brackets. Materials and methods: One hundred healthy human premolars with undamaged buccal surfaces that were extracted for orthodontic purposes were gathered. Using 37% orthophosphoric acid, primer, and Transbond XT adhesive, ceramic 0.018” × 0.022” slot orthodontic brackets were adhered to the tooth surface. Following thermocycling, all samples were divided into four groups, with 25 samples in each group: group I: control; group II: application of ethanol; group III: application of acetone; and group IV: application of dimethyl sulfoxide (DMSO). Following the debonding tests, a double-ocular stereomicroscope was used to inspect the tooth surfaces. Additionally, adhesive remnant index (ARI) values were evaluated at 40× magnification. Data were recorded and statistically analyzed. Results: The bond strength was lesser in acetone applied group (16.18 ± 3.64) followed by DMSO applied group (22.08 ± 2.86), ethanol applied group (24.36 ± 4.02), and control group (27.14 ± 3.68). There was a highly significant difference found between the chemical solvents group. The ARI score 3 was present in control (12%), ethanol (8%), and DMSO (4%), and it was absent in acetone applied group. The ARI score 0 was more in acetone applied group (24%). Conclusion: The present study concluded that the reduced debonding force was found with the application of acetone solvent followed by DMSO, ethanol, and control groups. Applying acetone can be a substitute technique to help with ceramic bracket debonding. Clinical significance: Orthodontic bracket debonding cannot occur without shear bond strength (SBS). The need for an ideal debonding technique for ceramic brackets without negative consequences arises from the risk of enamel damage that frequently follows the process. Acetone treatment prior to ceramic bracket debonding could be an alternate clinical technique to preventing enamel damage and facilitating debonding.

Aim: To assess the potential for systemic toxicity when silver nanoparticle-coated mini-implants were implanted in Wistar albino rats conducted as a comparative study in the animal model by assessing the blood biochemistry, liver and kidney function, and histology of the implanted site. Materials and methods: The surface of the mini-implant was coated with a green-mediated silver nanoparticle. Uncoated mini-implants were placed in two groups of eight Wistar albino rats, and silver nanoparticle-coated mini-implants were placed in another eight rats. The bone's general conditions, blood biochemistry assessing for ALT, AST, GPT, GOT, and histological sections using H and E stain and Masson's Trichrome stain were examined at 7, 14, and 28-day intervals. Results: The creatinine, urea, ALP, and ALT showed no signs of systemic toxicity during the 28-day follow-up period in the Wistar rats both in the test and control groups. The histological evaluation, which was conducted using HE and MTS stain, revealed osteogenesis and adequate healing of the insertion site in the group where coated mini-implant was placed. The bone sample revealed no abnormalities in the control group with uncoated mini-implants. Conclusion: Green synthesized silver nanoparticle-coated mini-implant does not cause systemic toxicity as indicated by no abnormalities in the levels of creatinine, urea, ALT, ALP, GPT, and GOT. The bone histology indicates that the coated mini-implants placed in animal bone healed with adequate osteogenesis. Clinical significance: Silver nanoparticles have potential for antimicrobial activity. Mini-implants placed as temporary anchorage devices in orthodontics often fail due to inflammation and plaque. Silver nanoparticle-coated mini-implants would reduce the risk of mini-implant failure as it would have antimicrobial potential and eliminate this cause for failure of mini-implants.

Aim: To compare the removal torque loss (RTL) percentage of screw-retained, cement-retained, and combined screw- and cement-retained implant-supported crowns after cyclic loading and measure the impact of cyclic loading on removal torque. Materials and methods: Thirty-two dental implants (4.0 × 10 mm) in resin blocks and abutments were divided into four groups (n = 8) based on restoration design: combined screw- and cement-retained group (SC), two cement-retained groups: cemented with adhesive resin cement (AR) (Panavia V5) or provisional cement (PR) (RelyX Temp NE), and screw-retained one-piece titanium group (TI). Removal torques were measured in Newton-centimeter (Ncm) before and after 500,000-cycle cyclic loading with forces ranging from 20 to 200 N at 15 Hz. The RTL percentage in each group was calculated. The paired t-test was used to detect the difference between pre-loading (RT1) and post-loading removal torque (RT2) in each group and 1-way ANOVA was used to detect the difference of RTL percentage between groups. Results: The post-loading removal torques in all groups were significantly lower than their pre-loading removal torques (p < 0.001). The 1-way ANOVA test found no significant difference in the RTL% between the study groups. The PR group exhibited the lower RTL% (30.74 ± 7.3%), followed by the TI (30.78 ± 5.6%), AR (32.12 ± 2.5%), and SC (35.71 ± 5.1%) groups. Conclusion: Combined screw- and cement-retained restorations exhibited similar RTL compared with other restoration designs, and cyclic loading significantly affected the removal torque. Clinical significance: Combined screw- and cement-retained restorations can be utilized in single-tooth situations, offering a comparable impact on screw joint stability while providing benefit of retrievability. Cyclic loading significantly influences joint stability, periodic checkup for screw loosening is recommended.

Aim: This study was aimed at evaluating the effect of acetyl-11-keto-β-boswellic acid (AKBA) on dental pulp stem cells (DPSCs) viability and proliferation to be used as a potential root canal medicament. Materials and methods: Dental pulp stem cells were isolated from human third molars. The phenotypic characterization of DPSCs was verified by flow cytometry analysis. The viability assay was performed using the methyl-thiazoltetrazolium (MTT) assay. Cells were treated with different concentration of triple antibiotic paste (TAP) and calcium hydroxide Ca(OH₂) (5, 2.5, 1, 0.5, and 0.25 mg/mL), AKBA (10, 5, 1, 0.1, and 0.01 µM). All experiments were done in separate triplicate experiments. Results: Dental pulp stem cells were characterized by flow cytometry. Cells treated with Ca(OH)₂ (1, 2.5, and 5 mg/mL) showed significantly reduced viability compared with the control cells (p < 0.05). Dental pulp stem cells treated with 1, 2.5, and 5 mg/mL TAP resulted in a significant decrease in viability (p < 0.05). Cells treated with AKBA in concentrations (1, 0.1, and 0.01 µM) demonstrated higher viability than the control group (p < 0.05), while AKBA in concentrations (5 and 10 µM) showed equal or decreased viability than the control group. (p > 0.05). Regarding cell density assay, AKBA showed significant increase in cell density after 5 and 7 days compared with cells medicated with TAP and Ca(OH)₂ while TAP revealed marked reduction in cell density in all the tested intervals. Conclusion: Acetyl-11-keto-β-boswellic acid in lower concentrations (0.01, 0.1, and 1 µM) demonstrated superior cell viability than TAP and Ca(OH)₂, and it may possess the potential to be an intracanal medicament in regenerative endodontics. Clinical significance: Studying the effect of different potential root canal medicaments and their capability to induce DPSCs proliferation might be of value. The influence of AKBA on the viability and proliferation of DPSCs tested in this study sheds light on its use as a potential intracanal medication especially in regenerative endodontics.

Aim: This study aims to assess the antimicrobial efficacy and impact on color stability of Thymus (T.) vulgaris solution compared to conventional disinfectants on maxillofacial silicones. Materials and methods: Various solutions were evaluated, including T. vulgaris solutions at 5 and 10%, saline (control), chlorhexidine (4%), and soap water. The substrates were MDX4-4210 silicone elastomers, and the microorganisms tested were Candida (C.) albicans and Staphylococcus (S.) aureus. The viability of microorganisms was determined through an 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) reduction assay, and color stability was measured using a spectrophotometer with X-Rite Europe software. Statistical analysis was performed using the Kruskal–Wallis test, Mann–Whitney U post hoc test, and Wilcoxon Signed Rank test. Results: Soap water demonstrated superior disinfectant action against both microorganisms, while T. vulgaris solutions at 5 and 10% exhibited comparable antimicrobial efficacy. Chlorhexidine and 10% T. vulgaris solution showed minimal color changes in the silicone material. In contrast, soap water and the 5% T. vulgaris solution resulted in clinically unacceptable color alterations. Conclusion: This study underscores the potential of T. vulgaris as an herbal disinfectant for combating microbial biofilms on maxillofacial silicones, particularly at concentrations of 5 and 10%. The importance of maintaining color stability is emphasized, with Chlorhexidine and the 10% T. vulgaris solution demonstrating effective preservation of esthetics. These findings suggest the viability of considering T. vulgaris as an alternative disinfectant in clinical settings for maxillofacial silicone prostheses. Clinical significance: Maxillofacial silicones are vital in restoring aesthetic features for individuals with facial trauma, congenital deformities, or post-surgical interventions. Yet, biofilm-related infections jeopardize their durability and visual integrity. Clinically, T. vulgaris signifies a potential advance in prosthodontic care, offering valuable insights for improving antimicrobial performance and aesthetic durability in maxillofacial prostheses.

Aim: Oral hygiene is one of the most significant lifestyle-related determinants of well-being. Health sciences undergraduate students are not only future healthcare providers but also educators of society in maintaining the overall general health. The aim of the study was to assess the practice, perception, and attitude of healthcare students in RAS Al-Khaimah toward toothbrush selection, maintenance, and replacement. Materials and methods: A prospective cross-sectional study was conducted among medicine, dentistry, pharmacy, and nursing undergraduate students. The data on demography, practice, perception, and attitude was collected using a self-administered structured questionnaire. It was evaluated using the Chi-square test and Spearman's rho test. Results: Out of 318 participating students of both genders, medicine (26.4%), dentistry (25.7%), pharmacy (35.8%), and nursing (12.0%) students showed satisfactory practice (51.8%) and perception (77.3%) of toothbrush selection, maintenance, and replacement. A significant difference (p = 0.000) in attitude was observed across the different disciplines. Conclusion: The study group demonstrated a satisfactory level of understanding regarding the selection, maintenance and replacement of toothbrush to ensure oral care and hygiene. Educating the health sciences students during their undergraduate studies with more general health topics such as oral hygiene is of utmost need, and community engagements, interdisciplinary learning approaches and curriculum updates can help to achieve this. Clinical significance: This study draws the attention for the inclusion of health-related topics in the curriculum that may impact on community health and education.

Aim: To perform a bibliometric analysis of the scientific production related to the use of probiotics in oral health. Materials and methods: A retrospective, descriptive, observational study with a scientometric approach was conducted. Metadata from scientific articles were retrieved from the Web of Science (WoS) Core Collection and analyzed using Medical Subject Headings (MeSH) and Emtree terms. The search strategy included the terms related to probiotics and oral health, and articles published between 2013 and 2022 were analyzed. Different scientometric indicators were used to analyze the production, impact, and network collaboration. Results: A total of 485 articles were retrieved from 241 sources, with an average annual growth rate of 10.72%. The manuscripts received an average citation per doc of 15.2. Authors collaborated on an average of 5.76 coauthors per paper. The number of articles published increased progressively from 2013 to 2022. The year 2022 had the highest number of articles published (90), while in 2013 only 36 articles were published. There was a progressive decrease in the average number of citations per article, from 32.44 in 2013 to 2.41 in 2022. Conclusion: The production of articles on probiotics in dentistry has grown steadily, with an annual growth rate of 10.72%. The most productive countries were the United States, Italy, and China. The importance of international scientific collaborations and the need for more research in this field is emphasized. Clinical significance: The findings of this study may help researchers identify areas that require further study and lead to more rapid and efficient advances in the use of probiotics to improve oral health. Its clinical importance lies in its value and ability to inform and guide future research to advance this field of science.

Aim: To determine dental arch relationships of Saudi children born with nonsyndromic complete unilateral cleft lip and palate (UCLP). Material and methods: This is a retrospective cohort study that comprised dental study models of 74 UCLP Saudi children aged 8–10 years who were recruited from 14 referral cleft centers. All participants had their cleft lip and palate repaired with no history of alveolar bone graft or any orthodontic treatment. Dental arch relationships of UCLP patients were assessed using the Great Ormond Street, London, and Oslo (GOSLON) Yardstick—a clinical tool that categorizes dental relationships of UCLP children into five discrete grades from I to V. The reliability of the rating was assessed with weighted kappa (κ) statistics. Results: Three children (4.1%) had excellent surgical outcomes (grade I), 18 children (24.3%) filled into grade II (good outcome), 22 subjects (29.7%) had grade III (fair outcome), 27 children (36.5%) had grade IV (poor outcome), and 4 subjects (5.4%) were ranked as having very poor outcomes (grade V). The mean GOSLON score was 3.39. Intrarater and interrater agreements were high indicating good reproducibility. Conclusion: Based on the dental arch relationships, the treatment outcome of UCLP Saudi children was unsatisfactory, with a mean GOSLON score of 3.39. Delayed palate repair and the use of presurgical orthopedics may be considered in the future for cleft deformity management. Clinical significance: To address the effect of particular cleft surgical protocol on dental arch relationships of UCLP patients.

Aim: Lesbian, gay, bisexual, transgender, and queer (LGBTQ), female sex workers (FSW), and heterogenders are those unconventional groups of the society who are identified with major unacceptance. Thus, the present study is conducted to assess and compare the oral health status, substance abuse pattern and nicotine dependence using Fagerstrom nicotine dependence scale (FNDP) among the LGBTQ, FSW, and heterogender in a defined location of Gautam Buddha Nagar, district in West U.P. Materials and methods: The present exploratory research included three study groups, the LGBTQ, FSW, and heterogenders (HG) residing in the same habitat. Purposive snowball sampling was conducted for the accessibility of the unapproachable population in the defined geographical location at Gautam Budha Nagar, district in West Uttar Pradesh. The data collection of a total of 177 participants was done using a pre-validated, pretested proforma consisting of three different parts including WHO oral health assessment form for adults, 2013, questionnaire regarding pattern of substance abuse and FNDS. Data were recorded and statistically analyzed using SPSS. Results: Prevalence of oral health disorders including dental caries, periodontal disease as well as oral mucosal lesions were more commonly found among the LGBTQ participants followed by FSW and the differences were found to be statistically significant. In context of altered habits, 100% of the participants in the present study were reported with smokeless tobacco habits whereas majority of the FSW were reported with a habit of smoking tobacco. Conclusion: In addition to belonging to ethnic and sexual minority, and having minimal or low education status, and low socioeconomic status, the present study groups are reported to have suboptimal access to quality healthcare and are further reported with high level of substance abuse as well as nicotine dependence. Clinical significance: The present study is an attempt to provide base line data for further research and provide data to the policy makers so as to increase the healthcare access to the present groups.

Aims and background: To assess the procedural errors committed by undergraduate students at RAK College of Dental Sciences, during root canal treatments and the factors associated with these errors. Materials and methods: In this cross-sectional study, 180 self-administered questionnaires were distributed, each comprising 26 questions, among 4th and 5th-year students. Participants were requested to report their endodontic mishaps based on feedback from their supervisors. The questionnaire assessed the frequency and types of procedural errors, considering patient, operator, and tooth-related factors. Data were collected tabulated and analyzed using the Chi-square test. Results: A total of 124 root canal-treated teeth exhibiting iatrogenic errors done by students were assessed. Out of which, 53% were performed by 5th-year students, and 69% were conducted by female operators. About 62% of errors occurred in the upper teeth and 68% in the posterior teeth. The most prevalent errors during the rubber dam isolation step were soft tissue trauma (21%) and isolation leakage (20%), significantly associated with limited mouth opening, excessive salivation, and tooth malalignment (p < 0.05). Apical blockage (15%) emerged as the most frequent error during instrumentation phase, showing a significant association with canal dimension and curvature (p < 0.05). For access cavity and obturation phases, under-extended cavity (9%), and under-extended filling (11%) were the most reported errors, respectively. Conclusion: Tooth isolation emerges as a particularly challenging aspect for dental students, particularly when dealing with patients exhibiting limited mouth opening and excessive salivation. Clinical significance: Clinical instructors should caution the undergraduates about the heightened risk of endodontic procedural errors when dealing with patients exhibiting limited mouth opening, excessive salivation, tooth misalignment, and narrow canals. Addressing these challenges is crucial for enhancing the proficiency of undergraduate students in performing successful root canal treatments.

Aim: This split-mouth randomized trial (RCT) aimed to assess the effect of diode laser on the clinical parameters in patients with periodontitis, compare the results with scaling and root planing (SRP) alone, and assess the implications of diode laser (DL) on plaque bacteria. Materials and methods: Seventeen periodontitis patients were randomly assigned into two equal groups based on the therapy delivered. Group I (control site) received just SRP at baseline, while group II (test site) received both SRP and DL irradiation. For both groups, the clinical periodontal parameters probing pocket depth (PPD), and clinical attachment level (CAL) were measured at baseline, 30 days, and 90 days. Microbiological amount was also measured at baseline, 30, and 90 days after periodontal treatment. The amounts of Aggregatibacter actinomycetemcomitans (A.a), Prevotella intermedia (Pr. intermedia), and Porphyromonas gingivalis (P. gingivalis) were determined using real-time PCR probing with specific bacterial primers. Results: In both groups, PPD and CAL showed statistically significant reductions at different time intervals (p < 0.05). No significant difference were observed in CAL values after 1 and 3 months in both test and control groups (p > 0.05). The mean values of the concentration of A.a, Pr. intermedia and P. gingivalis were lower in the case group as compared to the control group and the difference was statistically significant after 1 month (*p = 0.001). Clinical significance: According to this study, non-invasive laser treatment has the potential to improve clinical outcomes by lowering the quantity of A.a, Pr. intermedia and P. gingivalis. Conclusion: In both groups, a considerable decrease in the periodontal pathogens A.a, Pr. intermedia and P. gingivalis were discovered; however, the intergroup comparison was insignificant in relation to PD and CAL. The adjunctive treatment with diode laser showed better efficacy in ensuring a better periodontal treatment than SRP alone.

Aims: The purpose of this systematic review was to evaluate the cost-effectiveness and acceptance of children and their parents of the Hall technique (HT) for dental rehabilitation in pediatric dentistry. Background: The approach of the HT is that of minimally invasive treatment of the dental element and is used exclusively on primary molars. Various studies in the literature point to HT as a restorative option well accepted by children and parents and quite predictable, with low retreatment rates and good cost-effectiveness for the management of primary molars with carious lesions. However, no systematic review in the literature has approached randomized clinical trials on these topics to produce a high level of evidence and help establish clinical HT protocols. Review results: Eight articles were selected for the systematic review. The HT was more cost-effective than procedures using other restorative materials. Regarding acceptance, in terms of esthetics, high percentages of satisfaction were reported for parents and children, with a divergence between studies in the comparison of esthetic preference with atraumatic restorative treatment. However, when considering crown cementation pain, comfort, anxiety, preference, and satisfaction, the HT was generally better evaluated when compared to other restorative materials. Conclusion: The HT is an excellent restorative option when considering cost-effectiveness and acceptance and is recommended for use in daily clinical practice. Clinical significance: Results indicate that HT is superior to other restorative materials regarding its acceptance by children and parents in terms of pain, comfort, anxiety, and crown preference and satisfaction. There were also high percentages of satisfaction with esthetics. Hall technique may initially appear expensive for dentists, but its effectiveness over time and the lesser need for consultations and reinventions ensure better cost-benefit than other restorative materials.