Aims and Objectives: The aim of the study is to assess the efficacy of triphala in treating gingival diseases. Materials and Methods: A literature review was performed using Medline, PubMed, Wiley, ScienceDirect, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Grey literature using MeSH terms - Triphala, gingivitis, and dentistry. Of a total of 251 titles appeared from various sources, 243 articles were screened and 27 were related to the research question. This review was reported according to the preferred reporting items for systematic reviews and meta-analyses guidelines. Results: Seven trials were included and they were all compared with chlorhexidine. Among the seven trials, five found statistically significant differences favoring the effectiveness of triphala mouthwash. No meta-analysis was performed due to the clinical heterogeneity and differences in the reporting of data among the included studies. Conclusion: In the available literature, the multiple beneficial effects of triphala was found to be effective in treating gingival diseases as well as equally effective to the gold standard mouthwash chlorhexidine in improving gingival health.

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Dentists must know the impact of blood dyscrasias in the management of their patients. A good history taking in these patients is required to prevent any untoward incident in the operatory, and more so if any invasive treatment is planned. Most bleeding episodes are not worrisome and do not cause any emergency. However, there are cases where emergency management is required and must be provided immediately. Here, we discuss an extraordinary case of an 8-year-old male child who started to bleed after a minor trauma to lips and the blood clot restricted his mouth opening, to the point that there was complete mouth closure.

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Background: A new generation of smart alginates have been developed claiming to have good dimensional stability and deformation resistance. However, there is a lack of sufficient scientific evidence in this regard. Aim: This study aims to evaluate the dimensional stability of casts generated from first and second pour of two different types alginate purported to allow multiple pour and remain dimensionally stable after storage. Methodology: Forty impressions were made of a maxillary dentulous model (standard die), using two types of alginate (Hydrogum 5.0, Cavex Colour change). Two sets of casts were generated from 10 impressions of each type of alginate immediately. Ten impressions of each type of alginate were stored wrapped in damp paper towel and stored in zip-locked bags, and two sets of cast were generated after 24 h. Casts were scanned with a three dimensional model scanner and compared with standard die. Results: No significant difference was found between standard die and second poured casts of both alginates after immediate pouring. A significant difference was found between standard die and second poured casts of both alginates after 24 h. However, percentage dimensional change was within clinically acceptable limits. Conclusion: Clinically acceptable casts can be generated by the double pouring of new generation alginates. However, for better results casts should be poured immediately.

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Objective: Although oral health is a preventable disease, it affects a good portion of vulnerable populations, such as the elderly, children, low-income individuals, and certain racial and ethnic groups. Early childhood caries remains the most prevalent chronic childhood condition worldwide with 60%–90% of schoolchildren having dental cavities. We examined contributing and protecting factors that may have an impact on the oral health of the children in three rural communities in Ecuador. Materials and Methods: We conducted a minimally invasive clinical dental examination on 131 Ecuadorian children aged 6–12 years and used a modified caries management by risk assessment (CAMBRA) form to assess contributing and protecting factors for oral health. Data were analyzed using SPSS software (version 24). Results: Preliminary data show that about 80% of the mothers or primary caregivers had active decay in the past year and did not have a dental home. Almost half of the children had not seen a dentist within the last year, and some of them had never seen a dentist until the encounter with this study. The use of bottles or sippy cups with fluids other than water and frequent snacking was common in the communities. The results of the clinical examination indicated that the majority of the children had obvious dental decay, restorations, and dental plaque and a good proportion had also gingivitis. Conclusion/Implications: CAMBRA should become a standard tool of the comprehensive oral examination conducted by any health care professional and should be used as the basis for a preventive and treatment plan.

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Aims and Objectives: Direct pulp capping is a procedure which aims at protecting pulp vitality. When the dental pulp is exposed as a result of trauma, caries or by the dentist preparing for a deep restoration, then, it can be capped with a biocompatible material. It is expected that this procedure was allowed the pulp to heal normally and regenerate reparative dentine, thus preventing the need for more extensive and expensive root canal treatment (RCT). Materials and Methods: A total of 86 teeth of 85 patients diagnosed with reversible pulpitis were included in this study. After administration of local anesthesia, teeth were isolated with rubber dam. Mineral trioxide aggregate (MTA) was mixed according to manufacturers' instructions and 1–2 mm of MTA was placed over the pulpal exposure with a plastic filling instrument. All patients were scheduled for routine recall visits after 1, 3, and 6 months to monitor for pain on visual analog scale. All these readings were recorded on pro forma. The collected data were entered into SPSS version 19 and analyzed accordingly. Mean and standard deviation was calculated for quantitative variables like age. Frequency and percentage were calculated for qualitative variables such as the efficacy of MTA and gender. Stratification with respect to age and gender was done. Poststratification Chi-square test was applied. P ≤ 0.05 was considered statistically significant. Results: The average age of the patients was 37.59 ± 10.88 years. There were 30 (35.29%) male and 55 (64.71%) female. The effectiveness of MTA as a direct pulp capping material in cariously exposed mature permanent teeth was observed in 87.06% (74/85). Conclusion: Taking into consideration, the results of this study, it seems that when an exposure site is immediately sealed with MTA, the prognosis is promising. We found success rate of 87.06%. MTA can induce the formation of reparative dentine thus allow the pulp to heal normally and maintain pulp's vitality and regenerative potential so the need of RCT can be avoided.

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Aim: The aim of this study was to assess the knowledge, attitude, and awareness of the outpatients regarding dental implants. Objective: The objective of this study was to determine the reasons deterring a patient from choosing dental implants as a treatment modality inspite of its success rate and great clinical longevity. Materials and Methods: A self-administered questionnaire-based survey of 168 patients visiting the Clinic for replacement of teeth. The statistical analysis was done by the Chi-square test. Results: Females and volunteers of the age group of 15–30 years had the best oral hygiene. Lack of awareness followed by high cost was the main reason for not choosing dental implants. A significant number did not opt for implants because of its long waiting period. The dentist was the main source of knowledge, and most of the volunteers expected more information from the dentist. Conclusion: Based on the maintenance of oral hygiene, dental implants should be recommended to the age group of 15–30 years. Waiting period, high cost, and surgical procedures involved were all deterring factors for not choosing implant prosthesis. New developments should be made in the field of dental implants to eradicate these reasons. Electronic media should be used more effectively to improve awareness regarding dental implants.

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Introduction: Disability has often been described as a physiological deficit. Children with hearing impairment constitute one of the major population groups of physically challenged children. In India, the people are suffering from one or the other kind of disability which is equivalent to 2.1% of the country's population. Aims and Objectives: This study aims to assess the caries experience and oral hygiene status among the hearing and speech impaired children's. Materials and Methods: A cross-sectional survey was conducted among 100 participants aged 5–18 years attending a school for the sensory impaired children of Karad city, India. The participants were examined using Type III clinical examination. Oral hygiene status by oral hygiene index-simplified (OHI-S), Plaque index status and decayed, missing, and filled teeth/surface (DMFT/S) index were assessed. ANOVA, Chi-square test were used and P < 0.05 was considered statistically significant. Results: The largest component of DMFT/dmft was the decayed component, with a mean of 2.83 ± 0.94. P < 0.05 showing that this was statistically significant. The simplified calculus index and OHI-S index showed a significant difference between males and females of the study population (P < 0.05, S). Conclusion: There is an alarming situation for dental diseases among these hearing and speech impaired children. Hence, efforts should be made to encourage the parents and school teachers of these children to promote and improve their oral health.

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Objective: This cross-sectional survey is aimed to reveal oral health-related quality of life among the neglected elders, aged 60 years old and older, living in an elderly home. Materials and Methods: Survey was conducted at the elderly home of Tha-Bar-Wa Center, Thanlyin township, Yangon, Myanmar. Study participants (n = 146) were selected using systematic random sampling. Interview questionnaire and standard questionnaire of oral health impact profile (OHIP-14) were used to collect data and measured oral health-related quality of life. Dental status was assessed by visual inspection of one researcher throughout the survey. Descriptive statistics, t-test, or analysis of variance (ANOVA) was analyzed to demonstrate mean difference and multiple regression for statistically relationships. Results: Unacceptable level of oral health knowledge (72, 49.3%) and practice (83, 56.8%) were determined, regardless of the acceptable level of attitude (114, 78.1%). OHIP-14 scores range in 0–40, with mean standard deviation (SD) of 18.7 (9.7). Numbers of remaining teeth range in 0–32, with mean SD of 13.6 (8.6). OHIP-14 scores were significantly different between the age groups (60–64 and ≥70) (P = 0.006), living with partner or alone (P = 0.020), having >19 teeth to those being edentulous and those having ≤19 teeth (P < 0.001) and as of unacceptable or acceptable knowledge levels (P = 0.022). Significant negative relationship between number of remaining teeth and score of OHIP-14 was found when controlled for age in the year (β = −0.558, 95% CI = −0.828–−0.496, P < 0.001). Conclusion: Oral health-related quality of life in this group of neglected elders was averagely low and systematic oral health care is evidently in need.

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Background: Assessment of optical in comparison to traditional impressions is needed. The goal of this research is evaluating optical and traditional impressions regarding time, participant, and operators' preference. Materials and Methods: One optical and two traditional impressions were made in ten participants randomly. Optical scanner used is Omnicam of Cerec; traditional impression used closed mouth tray and other used one-step traditional tray. Time taking impression and occlusal relationship registration were evaluated. Participants and operators feeling about easiness of procedure were evaluated using visual analog scales. Paired t-test was applied detecting differences. Results: Mean time ± standard deviation was 336 ± 9.4 s using traditional closed mouth technique, 557 ± 8.2 for single step, and 397 ± 8.6 s for Omnicam. Timing of closed mouth technique was significantly lower than single-step and optical impression. Participant's assessment (very uncomfortable = 0 and comfortable = 100) measured 68 ± 9.7 for closed mouth, 79 ± 9.4 for optical, and 59 ± 9.7 for the single-step technique. There was statistical significance between differences except between closed mouth and single-step techniques; differences between them were not significant. Operators assessment (simple = 0 and very difficult = 100) was 21 ± 9.5 for closed mouth, 62 ± 9.2 for optical, and 46 ± 11.2 for single-step technique. There was statistical significance between the differences. Conclusions: Closed mouth took less time than optical and the single-step technique. Regarding comfort of participant, optical impression was the best. Operator's assessment favored optical impressions most as being the easiest.

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Aim and Objectives: The complex anatomy of the root canal system, the challenging oral environment, and a host of patient factors can present challenges to achieving the goals of endodontic treatment. There are no clear guidelines on when a general practitioner should refer to an endodontist, and standardized forms for assessing endodontic case difficulty are rarely used in dental practices. The aim of this study was thus to assess the level of endodontic difficulty at the Restorative Dentistry Clinic at the Lagos State University Teaching Hospital, Ikeja. Materials and Methods: The participating dentists assessed the cases presenting in the clinic by reviewing the patient's history, conducting a detailed oral examination, and a radiographic review. The level of endodontic difficulty was assessed using the American Association of Endodontic Case Difficulty Assessment Form and Guidelines. Data were analyzed using the Statistical Package for the Social Sciences for Windows Version 20 (IBM Corp., Armonk, New York, USA), and the Chi-square test was used to determine the level of association between the variables. A 95% confidence interval and a 5% level of significance were adopted. Results: A total of 200 respondents were seen. Majority were females (40; 60%), aged between 21 and 40 years (110; 55%), and had a tertiary level of education (75.5%); most of them had no underlying medical problem (93%), were cooperative and compliant (88%), and had no limitation in mouth opening (95%) and no jaw swelling (87.5%). Most respondents (190; 95%) had signs and symptoms consistent with recognized pulpal and periapical conditions, with minimum radiographic difficulty (192; 96%) and normal crown morphology (89.5%). Canal was visible and not reduced in size in 89% of the study participants. The highest difficulty values were obtained under the diagnostic and treatment criteria, where fifty (25%) teeth had moderate endodontic difficulty, while 11 (5.5%) had high difficulty. Conclusion: Majority of the root canal treatment (RCT) cases seen were of minimal difficulty and could be treated by general practitioners or resident doctors. About 5.5% of the study participants, however, required specialist care. Case selection is the process of discriminating cases according to their prognosis. Clinicians must thus be able to assess and make a practical decision about the complexity of RCT and decide whether it is within their capabilities.

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