Objective: The objective of this study was to determine the sealing ability of different root canal cement: resin AH Plus^®, calcium hydroxide Sealapex^®, and eugenol zinc oxide Pulp Canal Sealer^® by measuring the apical penetration of a dye. Methods: One hundred straight single-canal teeth were biomechanically prepared to 0.5 mm of the apical foramen. The teeth were divided into four groups, three experimental groups, with thirty teeth in each group, and a control group, with ten teeth. The following sealants were selected: AH Plus^®, Sealapex^®, and Pulp Canal Sealer^®. The root canal was not sealed in the control group. Lateral condensation was performed on the experimental groups using gutta-percha. The teeth were immersed in Indian ink to determine leakage. Results: In the experimental groups, ink penetration was observed in about 50% of the teeth. The lowest mean penetration was observed in the AH Plus^® group (30.9 (±42.9)), and the highest was observed in Pulp Canal Sealer^® (94.35 [±79.9]), (P < 0.001). Sealapex^® (42.7 [±56.3]) had lower ink penetration than Pulp Canal Sealer^® (P < 0.005). No statistically significant difference was observed in dye penetration between AH Plus^® and Sealapex^® (P = 0.2931). Conclusion: Low dye periapical penetration was observed using AH Plus and the calcium hydroxide cement (Sealapex^®), while higher penetration was observed in Pulp Canal Sealer^®.

Background: Dental education shapes the attitudes and professional behavior of dentists when treating pediatric patients. We evaluated the extent to which general dental practitioners (GDPs) in private and public hospitals were willing to treat pediatric patients as well as their attitude to preventive dentistry. Materials and Methods: A web-based questionnaire comprising 18 questions was E-mailed to 600 GDPs across Turkey. Descriptive statistics and the Pearson Chi-squared test were used for statistical analysis. Results: The response rate was 63.6% (n = 382). Of the 382 GDPs, 40 were unwilling to treat pediatric patients, whereas 74 stated that they treated such patients rarely. The GDPs were most unwilling to treat pediatric patients under 4 years of age (35.1%). The most frequent reason cited for unwillingness to treat was the uncooperative behavior of pediatric patients (77.2%). Of the GDPs, 51.6% and 56.8% preferred topical fluoride and fissure sealant, respectively, as preventive measures. Conclusions: GDPs are unwilling to treat pediatric patients due to their lack of cooperation. To overcome this, theoretical and practical training in pediatric dentistry behavior management techniques should be promoted.

Objective: The objective was to examine the association of having poor oral health-care access and low socioeconomic status on poor oral health outcomes such as gingivitis/periodontitis and severe periodontitis in United States (US) adults. Methods: A cross-sectional analysis of 4745 US adults 30 years and older from the National Health and Nutrition Examination Survey (NHANES) 2015–2016 was done. Poor oral health outcomes were determined by the response of the respondents to the questionnaire. Logistic and regression analyses were used to determine the association of having poor oral health-care access and low socioeconomic status on poor oral health outcomes. To take into account the complex survey sampling methods, all the analyses were weighted. Results: This research study found an increased association between limited dental health-care access and poor oral health outcomes such as gingivitis/periodontitis and severe periodontitis among US adults aged 30 years and older. The low socioeconomic status and severe periodontitis results of the unadjusted model of the regression analysis suggest that people who belong to the low socioeconomic group were less likely to have severe periodontitis than people who belong to the high socioeconomic group. In all the other regression models, low socioeconomic status did not have a significant association with poor oral health outcomes such as gingivitis/periodontitis and severe periodontitis. Conclusion: On analyzing the NHANES 2015–2016 data, an increased association between limited dental health-care access and poor oral health outcomes such as gingivitis/periodontitis and severe periodontitis was found in US adults aged 30 years and older. A decreased association was found for low socioeconomic status and severe periodontitis from the unadjusted model of the regression analysis. More research is needed to solve the issue of having poor oral health outcomes such as gingivitis and periodontitis due to not having enough access to dental health care among low-income US adults.

Introduction: An occlusal plane analyzer has long been used to assist an operator in the development of an initial mandibular occlusal plane in diagnostic contour casts and later as an integral part of both the contours of the definitive restorations as guide for the actual tooth preparation. Broadrick and Yurkstas metal occlusal template were devices frequently used to determine the proper occlusal plane. Aim: The aim of this study was to determine which of the two methods. Broadrick flag occlusal plane analyzer or Yurkstas metal occlusal template is more conservative during occlusal plane adjustment. Materials and Methods: Eight diagnostic casts mounted on Hanau semi-adjustable articulator were selected from the casts of patients of undergraduate 6^th-year dental students, King Abdulaziz University. Diagnostic maxillary cast was mounted according to arbitrary ear-bow and the mandibular casts were mounted according to centric relation records. First, Broadrick occlusal plane analyzer was secured to the upper member of the articulator. The anterior and posterior survey points were drawn. From the intersection point, the anteroposterior curve was drawn on the buccal surfaces of the canine, premolar, and molar. The distance from these lines to the cusp tip was measured through mesiobuccal, midbuccal, and distobuccal areas. Yurkstas metallic occlusal plane was used in the second method. The articulating paper horseshoe was placed between the occlusal table of the stone teeth and the metallic template, and the articulator was closed and taped several times, a die marking indicating the first over-erupted teeth. Then the highlighted area was reduced to 1 mm. The procedure was repeated until a uniform touch of the template over the mandibular teeth was maintained. Finally, the amount of reduction was collected. Conclusion: Producing curve of Spee is more conservative while using Yurkstas metallic occlusal plane.

Background: Since yore, “xylene” has always been the nonpareil clearing medium known to be employed in tissue processing and staining. However, the toxic effects of “xylene” range from mild irritation to its severe form as a carcinogenic agent. As there is an increasing need for replacement of this perilous agent, this study aims to determine the efficacy of “pure groundnut oil” (GO) and “pure coconut oil” (CO) which are indigenous to us, as an option in contrast to “xylene” as a clearing agent. Materials and Methods: An aggregate of 45 delicate tissue samples were handled at the same time in “xylene” (15) “pure GO” (15), and “pure CO” (15) as clearing specialists. The “xylene-” treated samples (X), “pure CO-” treated samples, and “pure GO-” treated samples were inspected for cellular architecture and quality of staining and comparison has been made between the three groups. Results: All the three groups showed similar results, and there was no difference identified when checked for cellular architecture and staining quality. Conclusion: The results suggest that both “pure CO” and “pure GO” has been shown to be an efficient replacement for “xylene” as a clearing medium, without jeopardizing on its histological features.

Introduction: Forensic odontology plays a pivotal part in victim recognition. Stable landmarks enable identification of the deceased when the remains are mutilated par recognition. In our study, we propose to employ intermolar width as an aid in gender determination.Aim: The aim of this study was to determine and correlate the intermolar width with either gender. Materials and Methods: The intermolar widths of 100 patients were determined. Impressions were made and the dental casts were evaluated using a Digital Vernier Caliper for intermolar width. Results: In our study, mean was calculated for intermolar arch width in maxillary arch for males and females. Student's t-test was employed to evaluate the means of the intermolar width in maxillary and mandibular arches for males and females. The mean was statistically significant with P< 0.05. Male and female maxillary arch intermolar width was 45.74 ± 2.09 and 47.44 ± 1.82, respectively, with t value of 5.98. Conclusion: From the results, we conclude that maxillary intermolar arch width can be employed as a tool in gender identification of individuals.

Aim: The aim of this in vitro study is to assess and to comparatively evaluate the marginal sealing ability and the compressive strength between type VII GIC, type IX GIC and IRM. Materials and Methodology: Class I cavities were made on a total of 30 extracted and preserved premolars and restored with type VII GIC, type IX GIC and IRM (3 groups of 10 samples each). Samples were thermocycled, stained with 2% gentian violet dye, sectioned bucco-lingually and scored for microleakage under Stereo-Zoom microscope and results were statistically evaluated. 30 Cylindrical shaped moulds were taken and restored with Type VII GIC, Type IX GIC and IRM.(3 groups of 10 specimens each) . The specimens were tested for compressive strength by mounting them on Universal testing machine. Results: The comparison of the performance between the three groups showed a statistically significant difference. P< 0.05 were considered to be significant values. Conclusion: In this study, Type IX GIC showed the least microleakage and high compressive strength when compared to the other two restorative cements. This in-vitro study needs a proper clinical investigation to be applied as a clinical long-term study to overcome the lack of exact oral environmental reflections.

Aims: The aim of this study was to assess the oral dryness in postmenopausal women and to correlate the salivary flow rate determined by modified Schirmer's test (MST) with the clinical oral dryness score (CODS) obtained from Challacombe Scale. Subjects and Methods: Forty postmenopausal women were questioned regarding their oral dryness status. Patients complaining of xerostomia formed the case group and rest formed the control group. CODS was assessed based on the ten features of oral dryness. Unstimulated whole salivary flow rate was assessed by MST. Statistical Analysis Used: All data were analyzed using inferential statistics such as Chi-square, Fisher's exact test, and Spearman correlation, and the analysis was carried out with SPSS 17. Results: There was statistically significant difference between case and control group with regard to CODS (P = 0.001) and modified Schirmer's (P = 0.004). A low-negative correlation was observed between modified Schirmer's score and CODS (r = -0.17). Conclusion: Since CODS correlated with modified Schirmer's score, it indicates that CODS can be utilized for semiquantitative assessment of oral dryness.

Aim: The aim of this study was to evaluate the soft-tissue parameter that is depth and angle of mentolabial sulcus and to correlate this parameter with type of malocclusion present in an ethnic Tamilian population. Objective: The objective of the study was to evaluate the depth and angle of the mentolabial sulcus, to determine the type of malocclusion, and to correlate the soft-tissue parameter and malocclusion. Materials and Methods: This study was conducted in 260 university students (65 males and 95 females) between April and September 2018. Photographs of all the students were taken using a digital camera. Mentolabial sulcus depth and angles were measured from the lateral photographs using an angle instrument along with the molar and canine relation. The type of mentolabial sulcus was also taken into account. The data were analyzed using the SPSS software version 22. The comparison of sulcus between males and females was performed using two-sample t-test at 95% confidence interval. Results: The mean mentolabial sulcus angle in the Tamilian population was 117.18° ± 9.24° (males: 118.19° ± 12.28° and females: 116.19° ± 12.28°). There was no statistically significant difference of sulcus angle between males and females (P = 0.078). The sulcus was classified as deep, average, and shallow in males and females. In total students, the average was more predominant followed by deep and shallow. Conclusion: The mean mentolabial sulcus angle in the Tamilian population was 117.18° ± 9.24°, in males was 118.19° ± 12.28°, and in females was 116.19° ± 12.28°. The sulcus was classified as deep, average, and shallow. There was no statistically significant difference of sulcus angle between males and females. The average type of sulcus was more predominant in the Tamilian population.

Introduction: Chronic heart disease in children imposes a great burden in most developing countries, especially among those with congenital heart disease where early surgical intervention is difficult because of limited medical facilities. Most of our patients survive on long-time oral medications, some of which are sweetened. Therefore, there is a heightened risk of dental caries. This study sought to determine if there were more caries in children with chronic heart disease than those without heart disease.Materials and Methods: This study was cross-sectional, and oral examinations were done using mouth mirror. A convenient sampling method was adopted. Children were recruited over an 8-month period (May–December 2017). Results: This study compared 130 children with varied forms of cardiac defect with 130 children who had no chronic morbidity or any cardiac lesion. Their ages ranged from 1 to 14 years, with a mean of 5.85 +/- 3.30. The prevalence of dental caries was generally low in this report; dental caries was identified in 20.8% of all the children. Among those with cardiac defect, 30 (25.2%) had dental caries. Furthermore, caries was observed more frequently among cardiac patients on chronic medication when compared with the control, and this observation was statistically significant (X² = 18.846, df = 1,P= 0.00). The mean decayed, missing, and filled teeth (dmft, 2.03 +/- 0.85) and (DMFT, 1.22 +/- 0.44) for primary and permanent dentition were higher among those with cardiac defect; those without cardiac lesion had a mean dmft of 1.31 +/- 0.48 and DMFT of 1.00 +/- 0.00. Conclusion: Dental caries was low in this study though most cases were reported among patients with cardiac disease.

Mercury (Hg) has been well known as one of the most toxic nonradioactive materials. Anthropogenic mercury is now a major worldwide concern and is an international priority toxic pollutant. Mercury vapour release from amalgam is the most important form of mercury that determines human exposure. Autopsy studies have shown higher levels of mercury in the tissues of human with amalgam fillings as opposed to those who were not similarly exposed. study objective is to sensitize the dentist and dental staff about mercury toxicity and strategies for proper handling of amalgam in order to reduce the health hazards caused by mercury for both dentist, patient and environment. Data search included PubMed, PubMed Central, Cochrane and Google Scholar until January 2019, out of 59 publications, 43 full text articles were deemed important were analysis. Discussion focus on an integrated toxicological based on release, uptake. toxicology and management protocol to understand interrelationship of these substantial contents. Added insight of Indian scenario in this review educate dental fraternity of correspondence between consumerism and bionomic loop, where safety consensuses are questionable. Growing advances in technology and raising aesthetic demands have led way aesthetic dentistry. Hence promoting the use of cost-effective and clinically effectual mercury free alternatives for dental restoration is inevitable in years to come.

Vitamin D is a fat-soluble vitamin with pleiotropic effects on different organ systems of the body. Major portion of the vitamin is synthesized in the epidermis under the influence of sunlight. Conventionally, Vitamin D had been solely associated with the metabolism and health of skeletal tissues. Osteomalacia/osteoporosis in adults and rickets in children were the only symptoms previously attributed to Vitamin D deficiency. The potential role of adequate Vitamin D for the proper functioning of diverse tissues throughout the body is now well recognized. The prevalence of Vitamin D deficiency or insufficiency is rampant and affects people of all ages. Vitamin D is essential for the maintenance of periodontal health. Adequate levels of the vitamin have a “perio-protective” effect and can decrease susceptibility to periodontal diseases. This “sunshine effect” of the vitamin on the periodontium can be mainly attributed to its immune-modulatory action. This review addresses the basics of Vitamin D metabolism and underlines the role of Vitamin D on periodontal health, disease, and therapy.

The relationship between dental morphological traits and ancestry has received the utmost amount of attention from dental anthropologists and forensic odontologists. Caucasoid, Mongoloids, and Negroid are the chief racial groups of the world. The dentition of each race has been reported to be unique to its race and has been employed to determine ancestry. Unfortunately, over the years, the concept of race has been fading away due to hybridization between races worldwide. Hence, one cannot solely rely on dental morphological traits to assign a race to an unknown. Nevertheless, even though dental morphological traits have been blended among the three races, there are still those traits that are dominant in one or the other ethnic group.

Apexification is a procedure for closure of the open apex in an immature necrotic tooth. Apexification with calcium hydroxide is considered as the gold standard. However, this technique is associated with certain difficulties such as very long treatment period, possibility of tooth fracture, and incomplete calcification of the bridge. Single-visit mineral trioxide aggregate (MTA) apexification has become popular over the calcium hydroxide technique. In this article, three case reports of 3 months to 1-year follow-up are presented, which were treated by the single visit apexification procedure which includes recent artificial barrier methods with MTA as the apical plug and the rest of the canal was obturated with thermoplastisized gutta-percha.

Clinically missing or unerupted permanent teeth manifest in early childhood itself, yet they may be misdiagnosed or left untreated due to the lack of knowledge or experience, which might have a major impact on facial esthetics and psychological aspect of the individual. Physical obstruction is the primary local cause for delayed tooth eruption. These obstacles can be due to the presence of supernumerary teeth, mucosal barrier, scar tissue, and tumors. The procurement of conventional radiographs is restricted with the advent of cone-beam computed tomography which is considered as a best tool in an localizing impacted tooth in the field of dentistry. The present case report depicts a 2-year follow-up of a horizontally impacted maxillary permanent central incisor associated with odontoma that was surgically reimplanted successfully.