Aim: To evaluate the calcium ions (Ca²⁺) diffusion of calcium hydroxide-loaded poly(lactic-co-glycolic acid) biodegradable nanoparticles [Ca(OH)₂-loaded PLGA NPs] compared with conventional Ca(OH)₂ in a simulated external root resorption ex vivo model using inductively coupled plasma mass spectrometry (ICP-MS). Materials and methods: Thirty human mandibular premolars were prepared by sectioning the root segments to create roots measuring 10 mm from the anatomical apex. The root canals were instrumented and irrigated. The external root surface cavities were created. The specimens were randomly divided into the following three groups: Poly(lactic-co-glycolic acid) (PLGA; control group, n = 10), conventional calcium hydroxide [Ca(OH)₂] (Metapaste, n = 10), and Ca(OH)₂-loaded PLGA NPs [15% Ca(OH)₂, n = 10]. The intracanal materials were placed in the root canals, and the teeth were stored in phosphate-buffered saline at 37°C. The release of Ca²⁺ was measured at 7, 30, and 60 days using ICP-MS. Results: Both Ca(OH)₂-loaded PLGA NPs and Metapaste groups exhibited higher levels of Ca²⁺ release compared to the PLGA group at all time points. During the initial 7-day period, the Ca(OH)₂-loaded PLGA NPs exhibited a significantly greater release of Ca²⁺ compared to Metapaste. From day 7 to day 30, Metapaste displayed a significantly higher release of Ca²⁺ than the Ca(OH)₂-loaded PLGA NPs, but it experienced a subsequent decline in Ca²⁺ release after the 30-day period. After the 30-day mark, the Ca(OH)₂-loaded PLGA NPs once again exhibited a significantly higher release of Ca²⁺ compared to Metapaste. Conclusion: The Ca(OH)₂-loaded PLGA NPs exhibited sustained release of Ca²⁺ that exceeded conventional Ca(OH)₂, particularly during the first week, demonstrating a greater amount of Ca²⁺ release. Clinical significance: The utilization of Ca(OH)₂-loaded PLGA NPs as an intracanal medication for external inflammatory root resorption provided sustained release and had the potential to enhance the efficacy of inhibiting root resorption more effectively than conventional Ca(OH)₂.

Aim: The aim of this retrospective study is to investigate the effect of corticobasal implant penetration in the nasal and maxillary sinuses on sinus health and implant survival rate in cases of severely atrophid ridges. Materials and methods: This retrospective study was conducted on thirty patients with 172 implants who underwent corticobasal implant treatment between 2014 and 2018. Implants were divided into two groups according to the penetration depths (Group A, <4 mm; Group B, 4 mm). Inclusion criteria for the study included: (A) patients with severe maxillary ridge resorption with an immediately loaded corticobasal implant-supported prosthesis that showed implant protrusion inside the maxillary sinus on cone-beam computed tomography (CBCT); and (B) patients with a preoperative and postoperative follow-up CBCT scan using the same standard technique and machine. (C) Patients without any history of sinusitis before implant insertion patients who fulfilled the inclusion criteria were recalled for follow-up. The presence of sinus complications was clinically assessed according to the clinical practice guidelines for adult sinusitis of the American Academy of Otolaryngology—Head and Neck Surgery and Radiologically using CBCT. Moreover, patient satisfaction was evaluated using yes-or-no questions. The result was statistically analyzed using Fisher's Exact test. Results: Despite the differences in implant penetration depths, no clinical signs of sinusitis were evident in any patient. One patient presented with transient epistaxis after the surgery, and 2 patients with nine implants revealed nonsignificant thickening of the sinus membrane radiologically (p = 0.055). All implants showed optimum bone-implant contact with a 100% survival rate. A significant relationship was reported between the thickness of the membrane and the patient's gender, hypertension, and smoking habits. (p = 0.001*, p = 0.002*, and p = 0.034*, respectively). Conclusion: Penetration of corticobasal implants in the maxillary sinus did not compromise the health of the maxillary sinus or implant survival rate. Clinical significance: Limited posterior maxillary bony support and maxillary sinus pneumatization present challenges in implant dentistry and increase the possibility of implant protrusion inside the maxillary and nasal cavities. Hence, studying the effect of this protrusion on the maxillary sinuses’ health and implant survival is highly significant.

Aim: To formulate and characterize the chemical structure of a new dental composite with photodimerized cinnamyl methacrylate (PD-CMA) photo-crosslinking comonomer and to evaluate the monomer-to-polymer conversion (MPC) and glass transition temperature (T_g) of the new composite copolymers. Materials and methods: CMA was PD by ultraviolet C-type (UVC) irradiation. The research groups were a control group C0 without PD-CMA and two trial groups: E10 (10 wt. % PD-CMA substituted in the base comonomers (B) and diluent (D) mixture); E20 (20 wt.% PD-CMA completely replacing the diluent (D) monomer). Infrared (FTIR) and nuclear magnetic resonance (NMR) spectroscopies were employed for ascertaining copolymerization (CP). The surface features and composition of the copolymers were explained by field-emission scanning electron microscopy (FESEM) and energy dispersive X-ray (EDX) spectroscopy, respectively. The MPC and T_g of the copolymers were assessed using FTIR and differential scanning calorimetry, respectively. Statistical tests were used to compare the groups. Results: The configuration of the new copolymers P (BD-Co-CMA) and P(B-Co-CMA) was confirmed. The MPC% and T_g of the copolymers were better than the control. PD-CMA at 20 wt. % in the P (B-Co-CMA) copolymer exhibited the highest MPC% and T_g. Conclusion: The incorporation of PD-CMA in the composite resin resulted in new P (BD-Co-CMA) and P (B-Co-CMA) copolymers with improved MPC% and T_g. Clinical significance: The substitution with PD-CMA offset the shortcomings of the conventional BD comonomers concerning the mechanical properties and biocompatibility of the restorative composite resin. This might ameliorate the restorations in vivo longevity and serviceability.

Aim: The aim of this study was to assess the significance and role of physical parameters of saliva on periodontal health in children with Down syndrome (DS). Materials and methods: A comparative evaluation of physical parameters of saliva such as flow rate, viscosity, pH, quantity and buffering capacity, and buffer capacity was carried out using GC Saliva-Check Buffer kit and correlated with periodontal condition examined using community periodontal index of treatment needs (CPITN) in 40 DS subjects (group I) and 40 healthy controls (group II) aged 8–15 years. Results: Down syndrome subjects had a low resting salivary flow rate, moderately acidic saliva, very low quantity of stimulated saliva, and low buffering capacity. On correlating salivary parameters with the periodontal condition, DS subjects with CPITN code 1 had low resting salivary flow rate, normal viscosity, moderately acidic pH, very low quantity of stimulated saliva, and low buffering capacity. Down syndrome subjects with CPITN code 2 had low resting flow rate, increased viscosity, very low quantity of stimulated saliva, low buffering capacity, and moderately acidic pH. Healthy controls with CPITN code 0 had normal resting flow rate, viscosity of saliva, quantity of stimulated saliva, buffering capacity, and moderately acidic pH. Conclusion: Compared to healthy controls, DS subjects showed decreased values for resting flow rate, pH, quantity of stimulated saliva, and buffering capacity. A statistically significant correlation was observed between the physical parameters of saliva and periodontal condition in DS subjects (p < 0.05). Clinical significance: Periodontal diseases start at a very early age and periodontal health deteriorates at a faster rate in DS children for which saliva also plays its part. Prime importance should be given to frequent oral hygiene and preventive measures in DS children thus preventing accumulation of debris and plaque.

Aim: The current study's aim was to assess gingival crevicular blood as a noninvasive method to measure blood glucose levels. Materials and methods: The current study comprised a total of 50 patients who had been diagnosed with chronic periodontitis and age was ≥30 years old. The study's procedures were carried out after receiving informed consent. For finger capillary blood collection method, a sterile lancet was used to prick the finger and a drop of blood was taken, for gingival crevicular blood collection method, blood was taken from the gingival margin of the chosen site, and for venous blood collection method with the aid of a disposable syringe, a venous blood sample was taken from the patient's antecubital fossa for determining blood glucose levels. One-way analysis of variance (ANOVA) was used to examine the differences between the three methodologies’ significance, and Karl Pearson's correlation (r) was used to determine their correlation. Results: The maximum glucose level was found in venous blood (187.78 ± 18.23), followed by finger capillary blood (181.88 ± 21.67) and gingival crevicular blood (169.04 ± 11.24). And there was no significant difference between the different blood collection methods (p > 0.05). The positive significant correlation was found between gingival crevicular blood and finger capillary blood (r = 0.912, p < 0.001). Correlation with gingival crevicular blood and venous blood showed a positive correlation (r = 0.898, p < 0.001). Correlation between venous blood and finger capillary blood also showed a strong positive correlation (r = 0.988, p < 0.001). Conclusion: In conclusion, the findings of the current study suggest that blood drawn from the gingival crevicular during a clinical examination may be a great source for glucometric analysis. The gingival crevicular blood may show to be a promising technique for routine dental office screening for diabetes mellitus in periodontal patients, even if capillary/venous blood samples used for diabetes mellitus screening are the gold standard. Clinical significance: Oral health is crucial for the early detection of many systemic disorders. As a result, dentists are crucial in the screening for systemic disorders. One of the prevalent chronic disorders is diabetes. Any systemic disease that is detected early enough can avoid long-term problems.

Aim: To compare and evaluate the compressive and flexural strengths of two resin-based core build-up materials with an alkasite material. Materials and methods: ParaCore, Tetric N ceram Bulk-fill composite, and Cention N were used. A total of 90 specimens were prepared. Customized cylindrical split molds of dimension 6 ± 1 mm (height) × 4 ± 1 mm (diameter) were used to fabricate 15 samples of each core material for testing the compressive strength and rectangular split metal molds of dimensions 25 ± 1 mm (length) × 2 ± 1 mm (width) × 2 ± 1 mm (height) were used to fabricate 15 samples of each core material for testing the flexural strength. Then the samples were tested using a Universal testing machine (UTM). Results: The compressive and flexural strengths of Cention N were significantly less than ParaCore® but higher than Tetric® N-Ceram^TM Bulk-fill core build-up material. Conclusion: Within the limitations of this study, it was concluded that Cention N may be used as an alternative to other core build-up materials after further in-vitro and in-vivo studies. Clinical significance: Cention N had the added advantage that self-cure polymerization alone was sufficient to achieve good physical properties when compared to the other two resin-based core build-up materials.

Aim: To compare the load-bearing capacity of three and four-unit fixed partial denture (FPD) with two different designs of pontics reinforced with industrial glass fibers at two different positions of the FPD. Materials and methods: A total of 64 samples were made with Bis-acryl composite temporary material and reinforced with industrial glass fibers (E-glass). The specimens were divided into eight groups (groups I–VIII) depending on the number of units, type of pontic design and area of placement of fibers. A universal testing machine was used to evaluate and compare the load-bearing capacity of the specimens. The evaluated data were statistically analyzed using one-way ANOVA and Bonferroni post hoc tests (p ≤ 0.05). Results: Three-unit interim FPD and modified ridge lap pontic design showed greater load-bearing capacity after reinforcement with glass fibers than a four-unit interim FPD and hygienic pontic design, respectively. Fiber placement at the occlusal plus connector area as well as the cervical plus connector area had comparable results. Conclusion: Industrial glass fibers (E-glass) could be used as a cheaper alternative but clinical performance and their safety are yet to be evaluated. Clinical significance: Reinforcement with industrial-grade glass fibers can be a cheaper option for increasing the load-bearing capacity of interim partial dentures, but it needs to be studied in vivo through further studies.

Aim: The aim of this study is to compare the antiplaque and antigingivitis efficacy of 0.25% lemongrass oil mouthwash and 0.2% chlorhexidine mouthwash in patients undergoing fixed orthodontic treatment, who are suffering from gingivitis. Materials and methods: A total of 60 patients undergoing fixed orthodontic treatment with mild-to-moderate gingivitis were selected for the study. The patients were randomly divided into three groups of twenty each, that is, group I: 0.25% lemongrass oil mouthwash (n = 20); group II: 0.2% chlorhexidine mouthwash (n = 20); and group III: oral prophylaxis (n = 20). Baseline gingival index (GI) and plaque index (PI) were accessed followed by oral prophylaxis was done and the PI score was set to zero for all the patients. Patients were asked to swish their mouth with their respective mouthwashes and brushing (twice daily), that is, morning and before bedtime for 21 days. The PI and GI scores were recorded for all three groups on the 14th and the 21st days. The post hoc Bonferroni test was used for multiple comparisons of mean differences among variables after the application of the analysis of variance (ANOVA) test for comparison within the groups. Results: A lower PI and the GI were found in the lemongrass oil mouthwash group by the 14th and the 21st days, respectively, a statistically significant difference (p < 0.001) compared to the chlorhexidine mouthwash group. Conclusion: The findings of the current study suggested that 0.25% lemongrass oil mouthwash has the potential to be used as a natural or herbal alternative to chlorhexidine mouthwash. Clinical significance: It can be suggested that 0.25% lemongrass oil mouthwash may be a good herbal alternative to mouthwash containing 0.2% chlorhexidine gluconate.

Aims: A clinical study to compare the horizontal condylar guidance using protrusive interocclusal records, orthopantomography (OPG), and cone-beam computed tomography (CBCT) in edentulous patients. Subjects and methods: Thirty-six edentulous subjects were selected as per predetermined criteria. Horizontal condylar guidance was recorded using protrusive interocclusal records (PIR), OPG, and CBCT for each patient. The PIR were obtained using extraoral Gothic arch tracers to program the Hanau articulator. The horizontal condylar guidance angles (HCGAs) were digitally constructed using appropriate software along the posterior slope of articular eminence for all radiographs. The collected data were recorded, tabulated, and statistically analyzed. Results: The condylar guidance angle values were tested for significance to compare the different angles. The correlation of HCGA measurements on both sides between the three groups was analyzed. The PIR and OPG methods (p = 0.001), as well as the OPG and CBCT methods (p = 0.001), show substantial differences on both sides. On the contrary, the PIR and CBCT methods did not differ significantly (p = 0.11). Conclusion: Cone-beam computed tomography is as reliable and accurate as the clinical method. A significant correlation exists between the clinical method and CBCT. It can be used as a dependable adjunct to the clinical method of HCGA measurement. Clinical significance: Cone-beam computed tomography can overcome the shortcomings of the conventional clinical methods to determine the accurate horizontal condylar guidance angulation measurement. It is safer with minimum discomfort and wastage of time for the patients.

Aim: To evaluate the distribution of caries risk category of patients at a dental institution and determine adherence to providers’ recommendations. Materials and methods: A cross-sectional retrospective review of 1,235 patients records that included data collection on demographics, the sum of the number of decayed, missing due to caries, and filled teeth in the permanent teeth (DMFT), presence of frequent snacking, stimulated salivary flow rate, stimulated saliva pH, saliva buffering capacity, biofilm activity, caries risk category, anti-caries prescription accept/decline, and change in the caries risk category. Statistical analysis was carried out through Pearson's Chi-squared test and linear model ANOVA with a significance level of 0.05. Results: Pearson's Chi-squared test showed a statistically significant difference in frequency by risk category (p < 0.001) indicating that patients were skewed toward high and extreme caries risk. Linear model ANOVA showed that higher risk categories were associated with lower salivary flow rates (p = 0.010) and higher biofilm activity (p < 0.001). About, 1 out of 3 patients were reported to have frequent snacking (N = 391, 32%). Frequent snacking patients were more likely to present with higher caries risk assessment (p < 0.001), younger age (p < 0.001), and female (p < 0.001). Despite recommendations from the dental student provider, only 27% accepted the anti-cavity prescriptions while 61% declined the recommendation. Conclusion: Distribution of caries risk category is not evenly distributed, but rather skewed toward high and extreme caries risk levels. Despite the identified risks, there is low adherence to the recommendations provided by healthcare providers. The results underscore the necessity for targeted interventions and initiatives aimed at fostering behavioral changes to enhance oral health outcomes. Clinical significance: There is a high need for targeted interventions and initiatives that promote behavioral changes to enhance oral health outcomes.